The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Marc T Zubrow - One of the best experts on this subject based on the ideXlab platform.
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Bandemia with normal white blood cell counts associated with infection
The American Journal of Medicine, 2012Co-Authors: Marci Drees, Narrani Kanapathippillai, Marc T ZubrowAbstract:Abstract Objective Measuring immature white blood cell forms ("bands") has been considered clinically unnecessary. We performed this study to determine whether elevated band counts, with normal total white blood cells on admission, were associated with infection or in-hospital death. Methods We performed a retrospective cohort study including all patients admitted to the Christiana Care Health System 2-hospital, 1100-bed community-based academic health system in 2009 with normal white blood cells (3800-10,800 per mm 3 ) on admission who had manual differentials performed. We defined our band groups as normal (≤10% bands and other immature cells), moderate (11%-19%), or high (≥20%). Via chart review, we ascertained vital signs and culture results for all patients with elevated bands and 407 randomly sampled patients with normal bands. Cultures likely to be contaminants were excluded. We used multivariable logistic regression to determine whether Bandemia was predictive of significant positive cultures or death. Results Of 2342 patients, 167 (7.1%) had high bands and 205 (8.6%) had moderate bands. The mean white blood cell count was 7.5 cells/mm 3 , with no difference among groups. Bandemia was associated with increased odds of having any significant positive culture (adjusted odds ratio [OR], 2.0, 95% confidence interval [CI], 1.3-3.1 for moderate bands; adjusted OR, 2.8, 95% CI, 1.7-4.3 for high bands) and having positive blood cultures (adjusted OR, 3.8, 95% CI, 2.0-7.2 for moderate bands; adjusted OR, 6.2, 95% CI, 3.2-11.8 for high bands). Patients with moderate or high bands also had increased odds of in-hospital death (adjusted OR, 3.2, 95% CI, 1.7-6.1; adjusted OR, 4.7, 95% CI, 2.4-9.0, respectively). Conclusions Even with normal total white blood cells, patients with moderate and high Bandemia on admission had significantly increased odds of having positive cultures, including blood cultures, and of in-hospital mortality.
Marci Drees - One of the best experts on this subject based on the ideXlab platform.
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Bandemia with normal white blood cell counts associated with infection
The American Journal of Medicine, 2012Co-Authors: Marci Drees, Narrani Kanapathippillai, Marc T ZubrowAbstract:Abstract Objective Measuring immature white blood cell forms ("bands") has been considered clinically unnecessary. We performed this study to determine whether elevated band counts, with normal total white blood cells on admission, were associated with infection or in-hospital death. Methods We performed a retrospective cohort study including all patients admitted to the Christiana Care Health System 2-hospital, 1100-bed community-based academic health system in 2009 with normal white blood cells (3800-10,800 per mm 3 ) on admission who had manual differentials performed. We defined our band groups as normal (≤10% bands and other immature cells), moderate (11%-19%), or high (≥20%). Via chart review, we ascertained vital signs and culture results for all patients with elevated bands and 407 randomly sampled patients with normal bands. Cultures likely to be contaminants were excluded. We used multivariable logistic regression to determine whether Bandemia was predictive of significant positive cultures or death. Results Of 2342 patients, 167 (7.1%) had high bands and 205 (8.6%) had moderate bands. The mean white blood cell count was 7.5 cells/mm 3 , with no difference among groups. Bandemia was associated with increased odds of having any significant positive culture (adjusted odds ratio [OR], 2.0, 95% confidence interval [CI], 1.3-3.1 for moderate bands; adjusted OR, 2.8, 95% CI, 1.7-4.3 for high bands) and having positive blood cultures (adjusted OR, 3.8, 95% CI, 2.0-7.2 for moderate bands; adjusted OR, 6.2, 95% CI, 3.2-11.8 for high bands). Patients with moderate or high bands also had increased odds of in-hospital death (adjusted OR, 3.2, 95% CI, 1.7-6.1; adjusted OR, 4.7, 95% CI, 2.4-9.0, respectively). Conclusions Even with normal total white blood cells, patients with moderate and high Bandemia on admission had significantly increased odds of having positive cultures, including blood cultures, and of in-hospital mortality.
Narrani Kanapathippillai - One of the best experts on this subject based on the ideXlab platform.
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Bandemia with normal white blood cell counts associated with infection
The American Journal of Medicine, 2012Co-Authors: Marci Drees, Narrani Kanapathippillai, Marc T ZubrowAbstract:Abstract Objective Measuring immature white blood cell forms ("bands") has been considered clinically unnecessary. We performed this study to determine whether elevated band counts, with normal total white blood cells on admission, were associated with infection or in-hospital death. Methods We performed a retrospective cohort study including all patients admitted to the Christiana Care Health System 2-hospital, 1100-bed community-based academic health system in 2009 with normal white blood cells (3800-10,800 per mm 3 ) on admission who had manual differentials performed. We defined our band groups as normal (≤10% bands and other immature cells), moderate (11%-19%), or high (≥20%). Via chart review, we ascertained vital signs and culture results for all patients with elevated bands and 407 randomly sampled patients with normal bands. Cultures likely to be contaminants were excluded. We used multivariable logistic regression to determine whether Bandemia was predictive of significant positive cultures or death. Results Of 2342 patients, 167 (7.1%) had high bands and 205 (8.6%) had moderate bands. The mean white blood cell count was 7.5 cells/mm 3 , with no difference among groups. Bandemia was associated with increased odds of having any significant positive culture (adjusted odds ratio [OR], 2.0, 95% confidence interval [CI], 1.3-3.1 for moderate bands; adjusted OR, 2.8, 95% CI, 1.7-4.3 for high bands) and having positive blood cultures (adjusted OR, 3.8, 95% CI, 2.0-7.2 for moderate bands; adjusted OR, 6.2, 95% CI, 3.2-11.8 for high bands). Patients with moderate or high bands also had increased odds of in-hospital death (adjusted OR, 3.2, 95% CI, 1.7-6.1; adjusted OR, 4.7, 95% CI, 2.4-9.0, respectively). Conclusions Even with normal total white blood cells, patients with moderate and high Bandemia on admission had significantly increased odds of having positive cultures, including blood cultures, and of in-hospital mortality.
Eileen Shi - One of the best experts on this subject based on the ideXlab platform.
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clinical outcomes of emergency department patients with Bandemia
2017Co-Authors: Eileen ShiAbstract:Author(s): Shi, Eileen | Abstract: Background: While an elevated white blood cell count (WBC) is a widely utilized measure for evidence of infection and an important criterion for evaluation of systemic inflammatory response syndrome (SIRS), its component band count occupies a more contested position within clinical emergency medicine. Recent studies indicate that Bandemia is highly predictive of a serious infection, suggesting that clinicians who do not appreciate the value of band counts may delay diagnosis or overlook severe infections. Objectives: Whereas previous studies focused on determining the quantitative value of the band count (i.e. determining sensitivity, threshold for Bandemia, etc.), this study directs attention to patient-centered outcomes, hypothesizing that the degree of Bandemia predisposes patients to subsequent negative clinical outcomes associated with underappreciated severe infections. Methods: This retrospective study of electronic medical records includes patients who initially presented to the Emergency Department (ED) with Bandemia and were subsequently discharged from the ED. These patients were screened for repeat ED visits within 7 days and death within 30 days. Results: In patients with severe Bandemia who were discharged from the ED, there was a 20.9% revisit rate at 7 days and a 4.9% mortality rate at 30 days, placing severely bandemic patients at 5 times significantly greater mortality compared to non-bandemic patients (p=0.032). Conclusion: Our review of patient outcomes suggests that the degree of Bandemia, especially in the setting of concurrent tachycardia or fever, is associated with greater likelihood of negative clinical outcomes.
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clinical outcomes of ed patients with Bandemia
American Journal of Emergency Medicine, 2015Co-Authors: Eileen Shi, Gary M Vilke, Christopher J Coyne, Leslie C Oyama, Edward M CastilloAbstract:Abstract Background Although an elevated white blood cell count is a widely utilized measure for evidence of infection and an important criterion for evaluation of systemic inflammatory response syndrome, its component band count occupies a more contested position within clinical emergency medicine. Recent studies indicate that Bandemia is highly predictive of a serious infection, suggesting that clinicians who do not appreciate the value of band counts may delay diagnosis or overlook severe infections. Objectives Whereas previous studies focused on determining the quantitative value of the band count (ie, determining sensitivity, threshold for Bandemia, etc.), this study directs attention to patient-centered outcomes, hypothesizing that the degree of Bandemia predisposes patients to subsequent negative clinical outcomes associated with underappreciated severe infections. Methods This retrospective study of electronic medical records includes patients who initially presented to the emergency department (ED) with Bandemia and were subsequently discharged from the ED. These patients were screened for repeat ED visits within 7 days and death within 30 days. Results In patients with severe Bandemia who were discharged from the ED, there was a 20.9% revisit rate at 7 days and a 4.9% mortality rate at 30 days, placing severely bandemic patients at 5 times significantly greater mortality compared to nonbandemic patients ( P = .032). Conclusion Our review of patient outcomes suggests that the degree of Bandemia, especially in the setting of concurrent tachycardia or fever, is associated with greater likelihood of negative clinical outcomes.
Giroux Henry - One of the best experts on this subject based on the ideXlab platform.
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La pandemia de Covid-19 está exponiendo la plaga del Neoliberalismo
2020Co-Authors: Giroux HenryAbstract:The current coronavirus pandemic is more than a medical crisis, it is also a political and ideological crisis. It is a crisis deeply rooted in years of neglect by neoliberal governments that denied the importance of public health and the public good while defunding the institutions that made them possible. We still have the opportunity to reimagine a world in which the future does not mimic the predatory neoliberal present. This should be a world that brings together the struggles for justice, emancipation and social equality. More urgent than ever is the need to struggle for a world that imagines and acts on the utopian promises of a just and democratic socialist society. In the face of the COVID-19 pandemic, matters of criticism, understanding and resistance are elevated into a matter of life or death. Resistance is a dire necessity.A atual pandemia de coronavírus é mais do que uma crise médica, é também uma crise política e ideológica. Uma crise fortemente enraizada em anos de negligência por governos neoliberais que negaram a importância da saúde pública e do bem comum, subfinanciando as instituições que o tornaram possível. Temos a oportunidade de voltar a imaginar um mundo em que o futuro não imite esse presente neoliberal predatório. Deve ser um mundo que une as lutas por justiça, emancipação e igualdade social. É mais urgente do que nunca lutar por um mundo que imagine e atue nas promessas utópicas de uma sociedade socialista democrata. Apesar da pandemia do COVID-19, questões de crítica, compreensão e resistência surgem para uma questão de vida ou morte. A resistência é uma necessidade urgente.La pandemia actual de coronavirus es más que una crisis médica, es también una crisis política e ideológica.Una crisis que está fuertemente arraigada en años de negligencia de los gobiernos neoliberales que negaron la importancia de la salud pública y del bien común desfinanciando a las instituciones que los hicieron posible. Tenemos la oportunidad de reimaginar un mundo en el cual el futuro no imite a este presente neoliberal depredador. Debe ser un mundo que una las luchas por la justicia, la emancipación y la igualdad social. Es más urgente que nunca luchar por un mundo que imagine y actúe sobre las promesas utópicas de una sociedad socialista democrática. A pesar de la pandemia de COVID-19, las cuestiones de crítica, entendimiento y resistencia se elevan a una cuestión de vida o muerte. La resistencia es una necesidad urgente
