scholarly journals Statin prescription in patients with chronic obstructive pulmonary disease and risk of exacerbations: a retrospective cohort study in the Clinical Practice Research Datalink

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e050757
Author(s):  
Margaret C Smith ◽  
Helen Frances Ashdown ◽  
James Peter Sheppard ◽  
Christopher C Butler ◽  
Clare Bankhead
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Practice Research ◽  
Chronic Obstructive ◽  
Clinical Practice Research Datalink ◽  
Severe Exacerbation ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease

ObjectiveObservational studies have suggested a beneficial effect of taking statins on frequency of chronic obstructive pulmonary disease (COPD) exacerbations. However, clinical trials of statins in people with COPD did not confirm those results. This study aimed to investigate this association using a methodological approach, which reduces the biases associated with some previous observational study designs.DesignRetrospective cohort study comparing new-users of statins with non-users.SettingGeneral practices in England contributing to the Clinical Practice Research Datalink in 2007–2017, with linkage to data on Hospital Episode Statistics inpatient episodes.Participants48 124 people with COPD, aged over 40 years, who had not been prescribed statin in the previous year.ExposureParticipants became new-users of statins at their first prescription for a statin during follow-up. They were then assumed to remain statin users. Statin users were compared with non-users.OutcomesPrimary outcomes were COPD exacerbation, or severe exacerbation requiring hospitalisation. Secondary outcomes were death from any cause (for comparison with other studies) and urinary tract infection (negative-control). Maximum follow-up was 3 years. Adjusted HR were calculated using time-dependent Cox regression. The Andersen-Gill model was used for recurrent exacerbations. Covariates included demographic variables, variables related to COPD severity, cardiovascular comorbidities as time-dependent variables, and other comorbidities at baseline.Results7266 participants became new-users of statins over an average 2.5 years of follow-up. In total, 30 961 people developed an exacerbation, 8110 severe exacerbation, 3650 urinary tract infection and 5355 died. Adjusted HR (95% CI) in statin users compared with non-users were first exacerbation 1.01 (0.96–1.06), severe exacerbation 0.92 (0.84–0.99), number of exacerbations 1.00 (0.97–1.04), urinary tract infection 1.10 (0.98–1.23) and death 0.63 (0.57–0.70).ConclusionsIn this study of health records from a Primary Care database, statin use in people with COPD was not associated with a lower risk of COPD exacerbation.

scholarly journals Urinary tract infection is associated with hypokalemia: a case control study

2020 ◽  
Author(s):  
Ai-Ling Shen ◽  
Hsiu-Li Lin ◽  
Hsiu-Chen Lin ◽  
Yuan-Fu Tseng ◽  
Chien-Yeh Hsu ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Beta Blockers ◽  
Clinical Problem ◽  
Control Group ◽  
Chronic Obstructive ◽  
Chi Square ◽  
Obstructive Pulmonary Disease ◽  
Control Study

Abstract BackgroundHypokalemia is a common clinical problem. The association between urinary tract infection (UTI) and hypokalemia is not clear. Hypokalemia is common in patients with UTI in clinical observation. The aim of the study is to determine if UTI is associated with hypokalemia.Methods Patients hospitalized with UTI and the control group were retrieved from the Longitudinal Health Insurance Database 2005. The control group was patients hospitalized with other reasons and were matched for the confoundings of UTI and hypokalemia. We analyze the risk of hypokalemia using logistic regression and calculate the odds ratio (OR) and 95% confidence interval (CI) of OR.ResultsWe analyzed 44952 UTI patients and 44952 matched control patients. The percentage (10.3%, n=4625) of hypokalemia was higher in UTI patients than that (5.2%, n=2342) in control patients (chi-square, p < 0.001). UTI was associated with hypokalemia (p < 0.001) and the OR was 2.04 (95% CI 1.94 - 2.16). Cerebrovascular accident, chronic obstructive pulmonary disease, diabetes, hypertension, congestive heart failure, and medications including diuretics, beta-blockers, insulin, and laxatives were also associated with hypokalemia. Recurrent UTI was associated with hypokalemia in patients with UTI.ConclusionsHypokalemia is linked to urinary tract infection and potassium should be tested in UTI patients. The association of hypokalemia and UTI is independent of patients’ comorbidities and medications.

Long-term follow-up of premature infants with urinary tract infection

2021 ◽  
Author(s):  
Lotem Goldberg ◽  
Yael Borovitz ◽  
Nir Sokolover ◽  
Asaf Lebel ◽  
Miriam Davidovits
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Premature Infants ◽  
Long Term Follow Up

Urinary Tract Infection

1979 ◽  
Vol 1 (5) ◽  
pp. 133-136
Author(s):  
Richard H. Rapkin
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Culture ◽  
Underlying Disease ◽  
Chief Complaint ◽  
Voiding Cystourethrogram ◽  
Intravenous Pyelogram ◽  
Rapid Generation

The identification of urinary tract infection (UTI) is important in order to reduce its morbidity, to prevent its sequelae, and to identify underlying disease. This article will discuss methods of diagnosis and management of UTI, screening for UTI, and the importance of further evaluation and follow-up of children with UTIs. Much of what we know about UTI is controversial and rapid generation of new knowledge may make current recommendations passé. CASE V.M., a 4-year-old girl, was brought to the physician's office with the chief complaint of frequency of urination. Nine months before she had been seen because of frequency and dysuria and two consecutive midstream urine cultures grew &gt;100,000 colonies/ml of a Gramneative rod. Sulfisoxazole was begun and a urine culture was sterile 48 hours after therapy was begun. The dysuria and frequency disappeared; therapy was continued for ten days and a urine culture four days later was sterile. One week later a voiding cystourethrogram (VCU) and an intravenous pyelogram (IVP) were performed and were interpreted as normal. Repeat urine cultures at one, two, three, and six months after the episode were sterile. Two days before the child was seen, she had become irritable and wet the bed during sleep (she had been successfully trained at 27 months of age), and she began to void frequently during the next 24 hours.

scholarly journals Infeções do Trato Urinário numa Coorte de Transplantados Renais

2014 ◽  
Vol 27 (3) ◽  
pp. 364 ◽  
Author(s):  
Ana Bispo ◽  
Milene Fernandes ◽  
Cristina Toscano ◽  
Teresa Marques ◽  
Domingos Machado ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Hospital Admissions ◽  
Female Gender ◽  
Tract Infections

<strong>Introduction:</strong> Urinary tract infection is the most common infectious complication following renal transplantation and its frequency is insufficiently studied in Portugal. The aim of this study was to characterize the incidence of urinary tract infections and recurrent urinary tract infections in renal transplant recipients.<br /><strong>Material and Methods:</strong> This was a retrospective cohort observational study, obtained from clinical files of all patients who received a renal transplant at the Hospital of Santa Cruz, from January 2004 to December 2005, with a mean follow-up period of five years or until date of graft loss, death or loss of follow-up. After a descriptive analysis of the population, we used bivariate tests to identify risk factors for urinary tract infections.<br /><strong>Results:</strong> A total of 127 patients were included, with a 593 patients.year follow-up. We detected 53 patients (41.7%) presenting with at least one episode of urinary tract infection; 21 patients (16.5%) had recurrent urinary tract infection. Female gender was the only risk factor associated with the occurrence of urinary tract infections (p &lt; 0.001, OR = 7.08, RR = 2.95) and recurrent urinary tract infections (p &lt; 0.001, OR = 4.66, RR = 2.83). Escherichia coli (51.6%), Klebsiella pneumoniae (15.5%) and Enterobacter spp (9.9%) were the<br />most frequently identified pathogens. Patients did not reveal an increased mortality or allograft loss. However, urinary tract infections were the most important cause of hospital admissions.<br /><strong>Discussion:</strong> Female gender was the only risk factor for urinary tract infections in this population. Escherichia coli was the most frequent agent isolated.<br /><strong>Conclusion:</strong> Despite preventive measures, urinary tract infections remain an important cause of morbidity and hospital admissions.<br /><strong>Keywords:</strong> Urinary Tract Infections; Postoperative Complications; Risk Factors; Kidney Transplantation; Portugal.

scholarly journals A prospective, follow up study to assess guidelines compliance in uncomplicated urinary tract infection

2020 ◽  
Vol 9 (8) ◽  
pp. 4292
Author(s):  
Manisha Bisht ◽  
PreetinderSingh Manshahia ◽  
Ankur Mittal ◽  
Mohit Bhatia ◽  
ShailendraS Handu
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Uncomplicated Urinary Tract Infection ◽  
Follow Up Study

scholarly journals A Study of Abdomenal Pain in Children

2008 ◽  
Vol 47 (172) ◽  
Author(s):  
Kashyap Narsingh Shakya ◽  
UMS Dangol ◽  
SB Khadka
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Operative Management ◽  
Infantile Colic ◽  
Medical College ◽  
Pain Abdomen ◽  
Cause Of Pain ◽  
Secondary Causes

Pain abdomen is a common pediatric complaint that brings patient to the hospital in Nepal.Knowledge about its etiology and frequency helps in its evaluation and management. The presentstudy was undertaken to find out the causes and their frequency of pain abdomen in Nepalichildren. Children with pain abdomen presenting at the emergency room and pediatric outpatientdepartment of Kathmandu Medical College, Kathmandu from January, 2006 to December 2007 wereclinically evaluated and investigated to find out the causes and frequency of their pain abdomen. Theoutcomes were tabulated and analyzed for interpretation. Of 444 patients attended, 356 completedinvestigations and came for follow up. Cause of pain abdomen was apparent in 117 (32.9%) only.91.5% were medical causes, comprising predominantly of diarrheal diseases (28.3%), infantile colic(9.4%), urinary tract infection (7.7%) and acid peptic disease (6.8%). 8.5% causes were related tosurgical conditions, which needed operative management. Secondary or extra-abdominal causeswere found in 20 cases (17.1%). Pneumonia (2), functional (5), vulvovaginitis (2) and infantile colic(11) were predominant causes. Our study showed that the causes of pain abdomen in children werepredominantly medical. Gastroenteritis was the most frequent cause. Secondary causes, includingfunctional and emotional causes were infrequent. Small percentage needing surgical managementformed a diagnostic challenge.Key words: abdomen, children, gastroenteritis, pain

Prediction of renal cortical defect and scar using neutrophil-to-lymphocyte ratio in children with febrile urinary tract infection

2017 ◽  
Vol 56 (03) ◽  
pp. 109-114 ◽  
Author(s):  
Jeong Won Lee ◽  
Joon Soo Park ◽  
Kyeong Bae Park ◽  
Gyeong Hee Yoo ◽  
Seung Soo Kim ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Neutrophil To Lymphocyte Ratio ◽  
Febrile Urinary Tract Infection ◽  
Lymphocyte Ratio ◽  
Cortical Defect ◽  
Febrile Uti ◽  
Dmsa Scan

SummaryAim: This study is aimed to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) for cortical defect on initial and follow-up Tc-99m dimercaptosuccinic acid (DMSA) scan in children with the first febrile urinary tract infection (UTI). Methods: We retrospectively enrolled 179 children with the first febrile UTI who underwent DMSA scan and laboratory tests. In patients with abnormal DMSA scan findings, follow-up DMSA scan was performed at least 6 months after the initial scan. All DMSA scans were classified as negative and positive cortical defects. Multiple logistic regression analyses were performed to identify the risk factors for cortical defect on initial and follow-up DMSA scan. Results: Cortical defects on initial DMSA scan were noted in 133 patients. Vesicoureteral reflux (VUR), white blood cell count, absolute neutrophil count, NLR, and serum C-reactive protein level were independent predictive factors for positive cortical defect on initial DMSA scan (p < 0.050). On follow-up DMSA scan, 24 of the 133 patients showed persistent cortical defects, and only VUR was significantly associated with persistent cortical defect (p = 0.002). In 84 patients who showed cortical defect on initial scan and absence of VUR, only NLR was significantly associated with persistent cortical defect on follow-up scan (p = 0.025). Conclusion: NLR was significantly associated with persistent cortical defect on follow-up DMSA scan in patients without VUR, as well as positive cortical defect on initial scan.

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