Background: Persons with Down syndrome (DS) experience an increased risk of pneumonia. We determined the incidence and outcomes of pneumonia and relationship to underlying comorbidities in persons with and without DS in the United States.
Methods: This retrospective matched cohort study used de-identified administrative claims data from Optum. Persons with DS were matched 1:4 to persons without DS on age, sex, and race/ethnicity. Pneumonia episodes were analyzed for incidence, rate ratios and 95 % confidence intervals, clinical outcomes, and comorbidities.
Results: During 1-year follow-up among 33796 persons with and 135184 without DS, the incidence of all-cause pneumonia (pneumonia) was substantially higher among people with DS than those without DS (12427 vs. 2531 episodes/100000 person-years; 4.7-5.7 fold increase). Persons with DS and pneumonia were more likely to be hospitalized (39.4 % vs. 13.9 %) or admitted to the ICU (16.8 % vs. 4.8 %). Mortality was higher 1 year after first pneumonia (5.7 % vs. 2.4 %; P < 0.0001). Results were similar for episodes of pneumococcal pneumonia. Specific comorbidities were associated with pneumonia, particularly heart disease in children and neurologic disease in adults, which only partially mediated the effect of DS on pneumonia.
Conclusions: Among persons with DS, incidence of pneumonia and associated hospitalizations were increased; mortality among those with pneumonia was comparable at 30 days, but higher at 1 year. DS should be considered an independent risk condition for pneumonia.
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http://dx.doi.org/10.1016/j.vaccine.2023.05.063 | DOI Listing |
Am J Emerg Med
January 2025
Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain; Emergency Department, Hospital Clínico Universitario, Gerencia Regional de Salud de Castilla y León, Valladolid, Spain.
Background: The study of the inclusion of new variables in already existing early warning scores is a growing field. The aim of this work was to determine how capnometry measurements, in the form of end-tidal CO2 (ETCO2) and the perfusion index (PI), could improve the National Early Warning Score (NEWS2).
Methods: A secondary, prospective, multicenter, cohort study was undertaken in adult patients with unselected acute diseases who needed continuous monitoring in the emergency department (ED), involving two tertiary hospitals in Spain from October 1, 2022, to June 30, 2023.
J Nurs Adm
December 2024
Authors Affiliations: Clinical Nurse Specialist (Dr. Lindell) and Clinical Nurse Specialist (Dr. Larsen), Department of Nursing, Mayo Clinic, Rochester, Minnesota.
Person-centered coaching provided by clinical nurse specialists (CNSs) is an effective, acceptable, and feasible evidence-based intervention. Psychosocial distress experienced by older adults and their families during transitions of care can contribute to adverse events. CNS coaching demonstrated increased self-reported preparedness for healthcare transitions and knowledge-of-care options.
View Article and Find Full Text PDFJ Nurs Adm
December 2024
Author Affiliations: Senior Operations Leader, Analytics and Nurse Scientist (Dr Kim), Kaiser Permanente National Patient Care Services, Oakland; Assistant Clinical Professor (Dr Kim), Community Health Systems, University of California, San Francisco School of Nursing, San Francisco; Professor Emeritus (Dr Latham), California State University, Fullerton, School of Nursing, Fullerton; Education Program Coordinator (Dr Krom), Assistant Professor of Medicine (Dr Krom), Cedars-Sinai Marina Del Ray Hospital, Marina Del Ray; Director (Dr Failla), Nursing Workforce Transitions, Caster Nursing Institute, Sharp HealthCare, San Diego; Regional Director and Nurse Scientist (Dr Kawar), Nursing Research and EBP Program, Kaiser Permanente Southern California and Hawaii Patient Care Services, Pasadena.
Disseminating research or evidence-based practice is not straightforward. As more clinical nurses, executive nurse leaders, nurse scientists, and faculty contribute to new knowledge, there is an increasing need to support the processes to publish and disseminate manuscripts to advance healthcare. Nurse administrators and leaders are key influencers and supporters to bolster expertise and resources to publish.
View Article and Find Full Text PDFPain
February 2025
Department of Anesthesiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.
Chronic pain is a pervasive and debilitating condition with increasing implications for public health, affecting millions of individuals worldwide. Despite its high prevalence, the underlying neural mechanisms and pathophysiology remain only partly understood. Since its introduction 35 years ago, brain diffusion magnetic resonance imaging (MRI) has emerged as a powerful tool to investigate changes in white matter microstructure and connectivity associated with chronic pain.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
January 2025
Institute of Medical Microbiology, Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, Aachen 52074, Germany.
Postnatal establishment of enteric metabolic, host-microbial and immune homeostasis is the result of precisely timed and tightly regulated developmental and adaptive processes. Here, we show that infection with the invasive enteropathogen Typhimurium results in accelerated maturation of the neonatal epithelium with premature appearance of antimicrobial, metabolic, developmental, and regenerative features of the adult tissue. Using conditional Myd88-deficient mice, we identify the critical contribution of immune cell-derived mediators.
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