<  |
Related Articles |
Effect of antibiotic guidelines on outcomes of hospitalized patients with nursing home-acquired pneumonia.
J Am Geriatr Soc. 2009 Jun;57(6):1030-5
Authors: El Solh AA, Akinnusi ME, Alfarah Z, Patel A
OBJECTIVES: To compare the 2003 community-acquired pneumonia (CAP) guideline and the 2005 healthcare-associated pneumonia (HCAP) guideline on time to clinical stability, length of hospital stay, and mortality in nursing home patients hospitalized for pneumonia. DESIGN: Retrospective study. SETTING: Three tertiary-care hospitals. PARTICIPANTS: Three hundred thirty-four nursing home patients. MEASUREMENTS: Patients were classified according to the antibiotic regimens they received based on the 2003 CAP guideline or the 2005 HCAP guideline. Time to clinical stability, time to switch therapy, and mortality were evaluated in an intention-to-treat analysis. A multivariate survival model using propensity analysis was used to adjust for heterogeneity between the two groups. RESULTS: Of the 334 patients, 258 (77%) were treated according to the 2003 HCAP guideline. Time to clinical stability did not differ between those treated according to the 2003 CAP or the 2005 HCAP guidelines. Only the Pneumonia Severity Index (P=.006) and multilobar involvement (P=.005) were significantly associated with delay in achieving clinical stability. Adjusted in-hospital and 30-day mortality were comparable in both cohorts (odds ratio (OR)=0.87, 95% confidence interval (CI)=0.49-1.34, and OR=0.79, 95% CI=0.42-1.31, respectively), although time to switch therapy and length of stay were longer for those treated according to the 2005 HCAP guideline. CONCLUSION: In hospitalized nursing home patients with pneumonia, treatment with an antibiotic regimen according to the 2003 CAP guideline achieved comparable time to clinical stability and in-hospital and 30-day mortality with a regimen based on the 2005 HCAP guideline.
PMID: 19460091 [PubMed - in process]
]]>
Veröffentlicht in Guidelines | Keine Kommentare »
Montag, 08. Juni 2009
<  |
Related Articles |
ESPEN Guidelines on Parenteral Nutrition: Home Parenteral Nutrition (HPN) in adult patients.
Clin Nutr. 2009 May 20;
Authors: Staun M, Pironi L, Bozzetti F, Baxter J, Forbes A, Joly F, Jeppesen P, Moreno J, Hébuterne X, Pertkiewicz M, Mühlebach S, Shenkin A, Van Gossum A
Home parenteral nutrition (HPN) was introduced as a treatment modality in the early 1970s primarily for the treatment of chronic intestinal failure in patients with benign disease. The relatively low morbidity and mortality associated with HPN has encouraged its widespread use in western countries. Thus there is huge clinical experience, but there are still few controlled clinical studies of treatment effects and management of complications. The purpose of these guidelines is to highlight areas of good practice and promote the use of standardized treatment protocols between centers. The guidelines may serve as a framework for development of policies and procedures.
PMID: 19464089 [PubMed - as supplied by publisher]
]]>
Veröffentlicht in Guidelines | Keine Kommentare »
Montag, 08. Juni 2009
< ![CDATA[
|
Related Articles |
Adherence to the French Programme National Nutrition Santé Guideline Score is associated with better nutrient intake and nutritional status.
J Am Diet Assoc. 2009 Jun;109(6):1031-41
Authors: Estaquio C, Kesse-Guyot E, Deschamps V, Bertrais S, Dauchet L, Galan P, Hercberg S, Castetbon K
BACKGROUND: The Nutrition and Health Program (Programme National Nutrition Santé), which has been carried out in France since 2001, includes diet and physical activity recommendations that are being widely disseminated to the general population. OBJECTIVES: To develop a score based on adherence to these recommendations and retrospectively estimated its association with demographic and behavior factors, nutrient intake, and serum biomarkers. The Programme National Nutrition Santé Guideline Score (PNNS-GS) includes 13 components. Scoring and cut-off values were determined using information provided by national guidelines. At least one point was attributed when the behavior reported was in accordance with the recommendation. DESIGN/SUBJECTS: Adults participating in the SU.VI.MAX study with a minimum of three 24-hour dietary records were included in our analysis (n=5,500). STATISTICAL ANALYSIS: Data were analyzed by sex, and sex-specific quartiles of scores were estimated. Multiple logistic regression models adjusted for social and demographic variables were used to estimate the odds ratios for having a relatively high score (quartile 4 vs others). Multivariate linear regression models were used to examine associations of nutrient intake or biomarkers with PNNS-GS quartiles. When applicable, we included a linear contrast to test for trend. RESULTS: The authors found statistical associations between the top PNNS-GS quartile and older age, higher occupational categories, nonsmoking status, and normal body mass (P < or = 0.05). Higher PNNS-GS was also associated with lower intake of energy, cholesterol, and added simple sugars, and higher intake of various protective micronutrients. In addition, higher levels of serum beta-carotene and vitamin C were positively associated with increasing quartiles of PNNS-GS. CONCLUSIONS: This score is a useful tool for monitoring compliance with the French recommendations.
PMID: 19465185 [PubMed - in process]
]]>
Veröffentlicht in Guidelines | Keine Kommentare »
