“Background: Antibiotics are widely used in acute exacerba

“Background: Antibiotics are widely used in acute exacerbations of COPD (AE-COPD), but their additional benefit to a therapeutic regimen that already includes steroids is uncertain. We evaluated the association between antibiotic therapy and outcomes among a large cohort of patients

treated with steroids who were hospitalized with AE-COPD and compared the effectiveness of three commonly used antibiotic regimens.\n\nMethod: We conducted a retrospective cohort study of patients aged >= 40 years hospitalized for AE-COPD from January 1, 2006, PP2 supplier through December 1, 2007, at 410 acute care hospitals throughout the United States.\n\nResults: Of the 53,900 patients who met the inclusion criteria, 85% were treated with antibiotics in the first 2 hospital days; 50% were treated with a quinolone, 22% with macrolides plus cephalosporin, and 9% with macrofide monotherapy. Compared with patients not treated with antibiotics, those who received antibiotics had lower mortality (1% vs 1.8%, P < .0001). In multivariable analysis, receipt of antibiotics was associated with a 40% reduction in WH-4-023 the risk of in-hospital mortality (RR, 0.60; 95% CI, 0.50-0.73) and a 13% reduction in the risk of 30-day readmission for COPD (RR, 0.87; 95% CI, 0.79-0.96). The risk

of late ventilation and readmission for Clostridium difficile colitis was not significantly different between the two groups. We found little difference in the outcomes associated with three common antibiotic treatment choices.\n\nConclusions: Our results Selleckchem HSP990 suggest that the addition of antibiotics

to a regimen that includes steroids may have a beneficial effect on short-term outcomes for patients hospitalized with AE-COPD. CHEST 2013; 143(1):82-90″
“Background This study examined potential associations between parental safety beliefs and children’s chore assignments or risk of agricultural injury.\n\nMethods Analyses were based on nested case-control data collected by the 1999 and 2001 Regional Rural Injury Study-H (RRIS-II) surveillance efforts. Cases (n = 425, reporting injuries) and controls (n = 1,886, no injuries; selected using incidence density sampling) were persons younger than 20 years of age from Midwestern agricultural households. A causal model served as the basis for multivariate data analysis.\n\nResults Decreased risks of injury (odds ratio [OR] and 95% confidence intervals [Cl]) were observed for working-aged children with “moderate,” compared to “very strict” parental monitoring (0.60; 0.40-0.90), and with parents believing in the importance of physical (0.80; 0.60-0.95) and cognitive readiness (0.70, 0.50-0.90, all children; 0.30, 0.20-0.50, females) when assigning new tasks. Parents’ safety beliefs were not associated with chore assignments.

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