A prospective cohort study of healthcare visits and rehospitalizations after hospital discharge in community-acquired pneumonia

Background and objective: We aimed to identify the frequency of, reasons for and risk factors associated with additional healthcare visits and rehospitalizations (healthcare interactions) by patients with community-acquired pneumonia (CAP) within 30 days of hospital discharge. Methods: Observational analysis of a prospective cohort of adults hospitalized with CAP at a tertiary hospital (2007-2009). Additional healthcare interactions were defined as the visits to a primary care centre or emergency department and hospital readmissions within 30 days of discharge. Results: Of the 934 hospitalized patients with CAP, 282 (34.1%) had additional healthcare interactions within 30 days of hospital discharge: 149 (52.8%) needed an additional visit to their primary care centre and 177 (62.8%) attended the emergency department. Seventy-two (25.5%) patients were readmitted to hospital. The main reasons for additional healthcare interactions were worsening of signs or symptoms of CAP and new or worsening comorbid conditions independent of pneumonia, mainly cardiovascular and pulmonary diseases. The only independent factor associated with visits to primary care centre or emergency department was alcohol abuse (odds ratio [OR] = 1.65; 95% confidence interval [CI]: 1.03-2.64). Prior hospitalization (≤ 90 days) (OR = 2.47; 95% CI: 1.11-5.52) and comorbidities (OR = 3.99; 95% CI: 1.12-14.23) were independently associated with rehospitalization. Conclusions: Additional healthcare visits and rehospitalizations within 30 days of hospital discharge are common in patients with CAP. This is mainly due to a worsening of signs or symptoms of CAP and/or comorbid conditions. These findings may have implications for discharge planning and follow-up of patients with CAP.

A prospective cohort study of healthcare visits and rehospitalizations after hospital discharge in community-acquired pneumonia

Background and objective: We aimed to identify the frequency of, reasons for and risk factors associated with additional healthcare visits and rehospitalizations (healthcare interactions) by patients with community-acquired pneumonia (CAP) within 30 days of hospital discharge. Methods: Observational analysis of a prospective cohort of adults hospitalized with CAP at a tertiary hospital (2007-2009). Additional healthcare interactions were defined as the visits to a primary care centre or emergency department and hospital readmissions within 30 days of discharge. Results: Of the 934 hospitalized patients with CAP, 282 (34.1%) had additional healthcare interactions within 30 days of hospital discharge: 149 (52.8%) needed an additional visit to their primary care centre and 177 (62.8%) attended the emergency department. Seventy-two (25.5%) patients were readmitted to hospital. The main reasons for additional healthcare interactions were worsening of signs or symptoms of CAP and new or worsening comorbid conditions independent of pneumonia, mainly cardiovascular and pulmonary diseases. The only independent factor associated with visits to primary care centre or emergency department was alcohol abuse (odds ratio [OR] = 1.65; 95% confidence interval [CI]: 1.03-2.64). Prior hospitalization (≤ 90 days) (OR = 2.47; 95% CI: 1.11-5.52) and comorbidities (OR = 3.99; 95% CI: 1.12-14.23) were independently associated with rehospitalization. Conclusions: Additional healthcare visits and rehospitalizations within 30 days of hospital discharge are common in patients with CAP. This is mainly due to a worsening of signs or symptoms of CAP and/or comorbid conditions. These findings may have implications for discharge planning and follow-up of patients with CAP.

A prospective cohort study of healthcare visits and rehospitalizations after hospital discharge in community-acquired pneumonia

Background and objective: We aimed to identify the frequency of, reasons for and risk factors associated with additional healthcare visits and rehospitalizations (healthcare interactions) by patients with community-acquired pneumonia (CAP) within 30 days of hospital discharge. Methods: Observational analysis of a prospective cohort of adults hospitalized with CAP at a tertiary hospital (2007-2009). Additional healthcare interactions were defined as the visits to a primary care centre or emergency department and hospital readmissions within 30 days of discharge. Results: Of the 934 hospitalized patients with CAP, 282 (34.1%) had additional healthcare interactions within 30 days of hospital discharge: 149 (52.8%) needed an additional visit to their primary care centre and 177 (62.8%) attended the emergency department. Seventy-two (25.5%) patients were readmitted to hospital. The main reasons for additional healthcare interactions were worsening of signs or symptoms of CAP and new or worsening comorbid conditions independent of pneumonia, mainly cardiovascular and pulmonary diseases. The only independent factor associated with visits to primary care centre or emergency department was alcohol abuse (odds ratio [OR] = 1.65; 95% confidence interval [CI]: 1.03-2.64). Prior hospitalization (≤ 90 days) (OR = 2.47; 95% CI: 1.11-5.52) and comorbidities (OR = 3.99; 95% CI: 1.12-14.23) were independently associated with rehospitalization. Conclusions: Additional healthcare visits and rehospitalizations within 30 days of hospital discharge are common in patients with CAP. This is mainly due to a worsening of signs or symptoms of CAP and/or comorbid conditions. These findings may have implications for discharge planning and follow-up of patients with CAP.

Duration of anticoagulation after venous thromboembolism in real world clinical practice.

INTRODUCTION: Venous thromboembolism (VTE) carries a considerable risk of recurrence and anticoagulants should be administered for a minimum of three months. Since little is known about real life management of VTE, we aimed to describe current practice in the secondary prevention of VTE. MATERIALS AND METHODS: Using the database of an international, prospective registry on patients treated for VTE, RIETE, information was collected on risk factors for VTE and bleeding, anticoagulant treatment, and clinical outcomes during follow up. Multivariate analysis using logistic regression was performed to identify predictors of treatment duration. RESULTS: Of 6944 patients with a first episode of VTE 41.1% had unprovoked VTE, 31.8% had transient risk factors, 27.1% had cancer. After the exclusion of patients who died during the first year of observation, the rate of patients treated for >12 months was 55.1%, 41.9%, and 43.2%, respectively (p<0.001). Pulmonary embolism at presentation, recurrence while on treatment, chronic heart failure and age >65 years were independently associated with treatment for >12 months. Body weight <75 kg, anemia, cancer, and the presence of transient risk factors were associated with treatment for 12 months or less. Major bleeding occurred more frequently than recurrent VTE in patients with VTE secondary to transient risk factors and cancer; fatal bleeding was more frequent than fatal recurrent PE in all subgroups. CONCLUSIONS: We observed heterogeneous duration of anticoagulant treatment for the secondary prevention of VTE. A substantial proportion of patients, in particular those with VTE secondary to transient risk factors, may be exposed to a possibly unnecessary risk of bleeding.

El plan de lengua y cohesión social en Catañunya: primeros datos de una investigación = Language and Social Cohesion Plan in Catalonia: Initial research data

Los programas de inmersión lingüística han constituido y constituyen dentro del Sistema Educativo catalánla principal forma para que el alumnado de lengua familiar no-catalana aprenda una nueva lengua, el catalán,sin que, en su proceso de aprendizaje, vea mermado ni el desarrollo de su propia lengua ni su rendimientoacadémico. El éxito de la inmersión lingüística en las décadas anteriores ha sido frecuentemente utilizado comouno de los argumentos orientativos para justificar la política lingüística que se sigue en la escolarización de lainfancia extranjera. Sin embargo, los resultados obtenidos por investigaciones recientes parece que no avalanempíricamente dicho argumento. Este artículo analiza dichos resultados y expone, a partir del Plan para laLengua y Cohesión Social puesto en marcha por el Departamento de Educación de la Generalitat de Cataluña,cuáles son los retos que se presentan a su Sistema Educativo dentro del nuevo marco que supone el aumento de ladiversidad cultural y lingüística en la actual sociedad catalana

Application of differential scanning calorimetry in hair samples as a possible tool in Forensic Science

The Differential Scanning Calorimetry (DSC) was used to study the thermal behavior of hair samples and to verify the possibility of identifying an individual based on DSC curves from a data bank. Hair samples of students and officials from Instituto de Química de Araraquara, UNESP were obtained to build up a data bank. Thus to sought an individual, under incognito participant of this data bank, was identified using DSC curves.

The role of consistency in empirical science

Any inconsistent theory whose underlying logic is classical encompasses all the sentences of its own language. As it denies everything it asserts, it is useless for explaining or predicting anything. Nevertheless, paraconsistent logic has shown that it is possible to live with contradictions and still avoid the collapse of the theory. The main point of this paper is to show that even if it is formally possible to isolate the contradictions and to live with them, this cohabitation is neither desired by working scientists not desirable for the progress of science. Several cases from the recent history of physics and cosmology are analyzed.

Regeneration of five commercially-valuable tree species after experimental logging in an Amazonian forest

This study investigated the regeneration variation of five commercially valuable tree species in relation to different intensities of felling in fourteen 4-ha plots in an area under experimental forest management. This experiment was carried out in a typical Amazonian tropical forest sample on "terra-firme," in Manaus (AM). Plots were logged 7 and 8 years (1987 and 1988), or 3 years (1993) before the study. All trees with height greater than 2 m, and diameter at breast height (DBH) smaller than 10 cm were measured. Only Aniba hostmanniana, Ocotea aciphylla, Licaria pachycarpa, Eschweilera coriacea and Goupia glabra were sufficiently common for individual analyses. These species have high timber values in the local market. Eight years after logging, the species responded differently to logging intensities. The numbers of individuals of Goupia glabra and Aniba hostmanniana were positively related to the intensity of logging, while Ocotea aciphylla, Licaria pachycarpa, and Eschweilera coriacea showed no statistically significant response. In the most recently (1993) logged areas, Goupia glabra and Aniba hostmanniana had higher numbers of individuals than the control plots.

Cardiorespiratory responses during and after water exercise in pregnant and non-pregnant women

PURPOSE: to compare the blood pressure and oxygen consumption (VO2) responses between pregnant and non-pregnant women, during cycle ergometer exercise on land and in water. METHODS: ten pregnant (27 to 29 weeks of gestation) and ten non-pregnant women were enrolled. Two cardiopulmonary tests were performed on a cycle ergometer (water and land) at the heart rate corresponding to VO2, over a period of 30 minutes each. Exercise measurements consisted of recording blood pressure every five minutes, and heart rate and VO2 every 20 seconds. Two-way ANOVA was used and α=0.05 (SPSS 17.0). RESULTS: there was no difference in cardiovascular responses between pregnant and non-pregnant women during the exercise. The Pregnant Group demonstrated significant differences in systolic (131.6±8.2; 142.6±11.3 mmHg), diastolic (64.8±5.9; 74.5±5.3 mmHg), and mean blood pressure (87.0±4.1; 97.2±5.7 mmHg), during water and land exercise, respectively. The Non-pregnant women Group also had a significantly lower systolic (130.5±8.4; 135.9±8.7 mmHg), diastolic (67.4±5.7; 69.0±10.1 mmHg), and mean blood pressure (88.4±4.8; 91.3±7.8 mmHg) during water exercise compared to the land one. There were no significant differences in VO2 values between water and land exercises or between pregnant and non-pregnant women. After the first five-minute recovery period, both blood pressure and VO2 were similar to pre-exercise values. CONCLUSIONS: for pregnant women with 27 to 29 weeks of gestation, water exercise at the heart rate corresponding to VO2 is physiologically appropriate. These women also present a lower blood pressure response to exercise in water than on land.

Storytelling as a branding tool in social media

Tutkimuksen tavoitteena on kuvailla tarinankerrontaa brändin rakennuksen välineenä, ja selvittää mitkä ovat tarinankerronnan erityispiirteet sosiaalisessa mediassa. Aikaisempien teorioiden ja julkaisujen avulla kootaan viitekehys joka osoittaa käsitteiden vaikutukset toisiinsa. Tutkimus osoittaa tarinankerronnan vaikuttavan vahvistavasti kaikkiin brändipääoman ulottuvuuksiin, lähinnä tunteita herättävien ja muistettavuutta lisäävien ominaisuuksiensa ansiosta. Empiirisessä osiossa selvitetään laadullisen sisällönanalyysin keinoin kuinka yleistä brändien tarinankerronta tällä hetkellä on, ja kuvaillaan millaisia tarinoita yritykset kertovat. Aineisto koostuu sadan suosituimman brändin Facebookissa jakamista videomuotoisista tarinoista. Tutkimus osoitti, että brändien tarinankerronta sosiaalisessa mediassa on toistaiseksi melko vähäistä. Tarinat voidaan luokitella kirjallisuudesta tuttujen tarinatyyppien mukaisesti. Suurin osa brändien esittämistä tarinoista pyrkii synnyttämään yleisössä ihailun ja nostalgian tunteita, mutta useat tarinat myös sisältävät humoristisia piirteitä.

Low dose of dichloroacetate infusion reduces blood lactate after submaximal exercise in horses

The acute administration of an indirect activator of the enzyme pyruvate dehydrogenase (PDH) in human athletes causes a reduction in blood lactate level during and after exercise. A single IV dose (2.5m.kg-1) of dichloroacetate (DCA) was administered before a submaximal incremental exercise test (IET) with five velocity steps, from 5.0 m.s-1 for 1 min to 6.0, 6.5, 7.0 and 7.5m.s-1 every 30s in four untrained mares. The blood collections were done in the period after exercise, at times 1, 3, 5, 10, 15 and 20 min. Blood lactate and glucose (mM) were determined electro-enzymatically utilizing a YSI 2300 automated analyzer. There was a 15.3% decrease in mean total blood lactate determined from the values obtained at all assessment times in both trials after the exercise. There was a decrease in blood lactate 1, 3, 5, 10, 15 and 20 min after exercise for the mares that received prior DCA treatment, with respective mean values of 6.31±0.90 vs 5.81±0.50, 6.45±1.19 vs 5.58±1.06, 6.07±1.56 vs 5.26±1.12, 4.88±1.61 vs 3.95±1.00, 3.66±1.41 vs 2.86±0.75 and 2.75±0.51 vs 2.04±0.30. There was no difference in glucose concentrations. By means of linear regression analysis, V140, V160, V180 and V200 were determined (velocity at which the rate heart is 140, 160, 180, and 200 beats/minute, respectively). The velocities related to heart rate did not differ, indicating that there was no ergogenic effect, but prior administration of a relatively low dose of DCA in mares reduced lactatemia after an IET.

Parasites of the freshwater fish trade in Brazil: science metric study

This paper presents a science metric study of parasites of fish farming in Brazil, including a significant review of the literature. The methodology used was based on researching articles in three different databases, carried out ​on May 2012: ISI (Institute for Scientific Information), SciELO (Scientific Electronic Library Online), and Google Academic. The number of articles on fish parasites is mounting (currently over 110), having much increased since 1995. However, the quantity is still low compared with the amount of papers on parasites of fish from natural environments. In Brazil, the farmed fish that have been studied the most are pacu, tilapia and tambaqui. Monogeneans represent the most prevalent group, followed by protozoa and crustaceans. The regions most researched were the southeast and south, making up 84% of the total literature. The main issue addressed in articles was pathology, followed by treatment and record. In conclusion, the treatment of parasitic diseases of farmed fish in Brazil is still incipient, highlighting the importance and usefulness of management practices to prevent the occurrence of health problems.