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Iskalni niz: "ključne besede" (mortality) .

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Growth response of different tree species (oaks, beech and pine) from SE Europe to precipitation over time
Saša Orlović, Stefan Stjepanović, Bratislav Matović, Tom Levanič, Dejan Stojanović

Povzetek: Changing climatic conditions can have various consequences for forest ecosystems, from increasing frequencies of forest fires, ice and windstorm events to pathogen outbreaks and mass mortalities. The Standardized Precipitation Index (SPI) was chosen for the evaluation of drought impact on the radial growth of trees after extensive preliminary testing of various calculated monthly climate parameters from the CARPATCLIM database. SPI was calculated for periods between 3 and 36 months for different sites (lowland and mountainous parts of Serbia, Southeast Europe), from which Quercus robur, Q. cerris, Fagus sylvatica and Pinus sylvestris samples were acquired. Bootstrapped Pearson%s correlations between SPI monthly indices and radial growth of tree species were calculated. We found that 12-month SPI for summer months may be a good predictor of positive and negative growth of different species at different sites. The strongest positive correlations for five of six tree-ring width chronologies were between 12-month June and 14-month September SPI, which implies that high growth rates can be expected when the autumn of the previous year, and winter, spring and summer of the current year, are well supplied with precipitation, and vice versa (low precipitation in given period/low growth rates).
Ključne besede: standardized precipitation index, SPI, climate change, tree mortality, Quercus sp., Fagus sylvatica, Pinus sylvestris
DiRROS - Objavljeno: 18.04.2018; Ogledov: 1777; Prenosov: 781
.pdf Celotno besedilo (2,91 MB)

Low growth resilience to drought is related to future mortality risk in trees
Lucía De Soto, Maxime Cailleret, Frank Sterck, Steven Jansen, Koen Kramer, Elisabeth M.R. Robert, Tuomas Aakala, Mariano M. Amoroso, Christof Bigler, Jesus Julio Camarero, Katarina Čufar, Tom Levanič, 2020

Povzetek: Severe droughts have the potential to reduce forest productivity and trigger tree mortality. Most trees face several drought events during their life and therefore resilience to dry conditions might be crucial to long-term survival. We assess how growth resilience to severe droughts, including its components resistance and recovery, is related to the ability to survive future droughts by using a tree-ring database of surviving and now-dead trees from 118 sites (22 species, >3,500 trees). We find that, across the variety of regions and species sampled, trees that died during water shortages were less resilient to previous non-lethal droughts, relative to coexisting surviving trees of the same species. In angiosperms, drought-related mortality risk is associated with lower resistance (low capacity to reduce impact of the initial drought), while it is related to reduced recovery (low capacity to attain pre-drought growth rates) in gymnosperms. The different resilience strategies in these two taxonomic groups open new avenues to improve our understanding and prediction of drought-induced mortality. Resilience to drought is crucial for tree survival under climate change. Here, DeSoto et al. show that trees that died during drought were less resilient to previous dry events compared to surviving conspecifics, but the resilience strategies differ between angiosperms and gymnosperms.
Ključne besede: trees, mortality, gymnosperms, angiosperms, drought, resilience, resistance, recovery
DiRROS - Objavljeno: 20.02.2020; Ogledov: 563; Prenosov: 334
URL Celotno besedilo (0,00 KB)

Expenditures on oncology drugs and cancer mortality-to-incidence ratio in Central and Eastern Europe
Eduard Vrdoljak, Gyorgy Bodoky, Jacek Jassem, Razvan A. Popescu, Robert Pirker, Tanja Čufer, Semir Beslija, Alexsandru Eniu, Vladimir Todorović, Katerina Kopečková, 2019

Povzetek: Background. There is a steady decline in cancer mortality in Western Europe (WE), but this trend is not so obvious in Central and Eastern Europe (CEE). One of the largest discrepancies between WE and CEE is the level of investment in cancer care. The objective of our analysis was to examine the correlation between mortality-to-incidence (M/I) ratio and expenditures on oncology drugs in CEE and WE. Materials and Methods. This cross-sectional analysis was done on publicly available data. Data on expenditures for oncology drugs were obtained from QuintilesIMS, and data on M/I ratio from Globocan. The main outcome was mortality-to-incidence ratio, and the primary analysis was performed by Spearman's rank correlation. Results. There is a large discrepancy in expenditure on oncology drugs per cancer case between WE and CEE, and within CEE. Average expenditure on oncology drugs per capita as well as per new cancer case was 2.5 times higher in WE than in CEE. Availability of oncology drugs was highest in Germany (100%), relatively similar in WE (average of 91%), but in CEE it ranged from 37% to 86%, with an average of 70%. Annual expenditures on all oncology drugs per new cancer case was significantly negatively correlated with the M/I ratio (Spearman's p = -0.90, p < .001). Conclusion. There is a financial threshold for oncology drugs per cancer case needed to increase survival. Based on significantly lower expenditures for oncology drugs in CEE in comparison with WE, more investment for drugs as well as better, more organized,value-oriented consumption is needed. Implications for Practice. Cancer is not treated equally successfully in Western Europe (WE) and in Central and Eastern Europe (CEE). This study showed that success in treatment of cancer is associated with the amount of money invested in oncology drugs. CEE countries spend on average 2.5 times less than WE countries for oncology drugs per new cancer case. These findings should be used by healthcare providers and oncologists struggling for more resources and better, more organized, evidence-based allocation of these resources as well as better oncology outcomes.
Ključne besede: neoplasms -- mortality -- epidemiology, incidence, pharmaceutical preparations -- economics, cancer, oncology, Central Europe, Eastern Europe, drug expenditures
DiRROS - Objavljeno: 26.10.2020; Ogledov: 226; Prenosov: 39

Decontamination strategies and bloodstream infections with antibiotic-resistant microorganisms in ventilated patients : a randomized clinical trial
Bastiaan H. Wittekamp, Nienke L. Plantinga, Ben S. Cooper, Joaquin Lopez-Contreras, Pere Coll, Jordi Mancebo, Matt P. Wise, Matt P. G. Morgan, Pieter Depuydt, Jerina Boelens, Viktorija Tomič, Franc Šifrer, 2018

Povzetek: Importance: The effects of chlorhexidine (CHX) mouthwash, selective oropharyngeal decontamination (SOD), and selective digestive tract decontamination (SDD) on patient outcomes in ICUs with moderate to high levels of antibiotic resistance are unknown. Objective: To determine associations between CHX 2%, SOD, and SDD and the occurrence of ICU-acquired bloodstream infections with multidrug-resistant gram-negative bacteria (MDRGNB) and 28-day mortality in ICUs with moderate to high levels of antibiotic resistance. Design, setting, and participants: Randomized trial conducted from December 1, 2013, to May 31, 2017, in 13 European ICUs where at least 5% of bloodstream infections are caused by extended-spectrum [beta]-lactamase-producing Enterobacteriaceae. Patients with anticipated mechanical ventilation of more than 24 hours were eligible. The final date of follow-up was September 20, 2017. Interventions: Standard care was daily CHX 2% body washings and a hand hygiene improvement program. Following a baseline period from 6 to 14 months, each ICU was assigned in random order to 3 separate 6-month intervention periods with either CHX 2% mouthwash, SOD (mouthpaste with colistin, tobramycin, and nystatin), or SDD (the same mouthpaste and gastrointestinal suspension with the same antibiotics), all applied 4 times daily. Main outcomes and measures: The occurrence of ICU-acquired bloodstream infection with MDRGNB (primary outcome) and 28-day mortality (secondary outcome) during each intervention period compared with the baseline period. Results: A total of 8665 patients (median age, 64.1 years; 5561 men [64.2%]) were included in the study (2251, 2108, 2224, and 2082 in the baseline, CHX, SOD, and SDD periods, respectively). ICU-acquired bloodstream infection with MDRGNB occurred among 144 patients (154 episodes) in 2.1%, 1.8%, 1.5%, and 1.2% of included patients during the baseline, CHX, SOD, and SDD periods, respectively. Absolute risk reductions were 0.3% (95% CI, -0.6% to 1.1%), 0.6% (95% CI, -0.2% to 1.4%), and 0.8% (95% CI, 0.1% to 1.6%) for CHX, SOD, and SDD, respectively, compared with baseline. Adjusted hazard ratios were 1.13 (95% CI, 0.68-1.88), 0.89 (95% CI, 0.55-1.45), and 0.70 (95% CI, 0.43-1.14) during the CHX, SOD, and SDD periods, respectively, vs baseline. Crude mortality risks on day 28 were 31.9%, 32.9%, 32.4%, and 34.1% during the baseline, CHX, SOD, and SDD periods, respectively. Adjusted odds ratios for 28-day mortality were 1.07 (95% CI, 0.86-1.32), 1.05 (95% CI, 0.85-1.29), and 1.03 (95% CI, 0.80-1.32) for CHX, SOD, and SDD, respectively, vs baseline. Conclusions and relevance: Among patients receiving mechanical ventilation in ICUs with moderate to high antibiotic resistance prevalence, use of CHX mouthwash, SOD, or SDD was not associated with reductions in ICU-acquired bloodstream infections caused by MDRGNB compared with standard care.
Ključne besede: anti-infective agents -- therapeutic use, bacteremia -- prevention and control, chlorhexidine -- therapeutic use, cross infection -- prevention and control, disinfection -- methods, bacterial drug resistance, gastrointestinal tract -- microbiology, Gram-negative bacterial infections -- prevention and control, hospital mortality, intensive care units, mouthwashes -- therapeutic use, oropharynx -- microbiology, artificial respiration, multicenter study, randomized controlled trial
DiRROS - Objavljeno: 09.11.2020; Ogledov: 196; Prenosov: 60

The clinical relevance of oliguria in the critically ill patient : analysis of a large observational database
Jean Louis Vincent, Andrew Ferguson, Peter Pickkers, Stephan M. Jakob, Ulrich Jaschinski, Ghaleb A. Almekhlafi, Marc Leone, Majid Mokhtari, Luis E. Fontes, Philippe R. Bauer, Yasser Sakr, 2020

Povzetek: Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output < 0.5 ml/kg/h) in acutely ill patients and its association with the need for renal replacement therapy (RRT) and outcome. Methods: International observational study. All adult (> 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient-oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged-oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent-oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19%1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97%1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.
Ključne besede: critical care, critical illness, urine, oliguria, kidney, renal insufficiency, kidney diseases, acute kidney failure, mortality, urine output, renal replacement therapy
DiRROS - Objavljeno: 18.11.2020; Ogledov: 192; Prenosov: 166
URL Celotno besedilo (0,00 KB)

Comparison of European ICU patients in 2012 (ICON) versus 2002 (SOAP)
Jean Louis Vincent, Jean-Yves Lefrant, Katarzyna Kotfis, Rahul Nanchal, Ignacio Martin-Loeches, Xavier Wittebole, Samir G. Sakka, Peter Pickkers, Rui P. Moreno, Yasser Sakr, 2018

Povzetek: Purpose: To evaluate differences in the characteristics and outcomes of intensive care unit (ICU) patients over time. Methods: We reviewed all epidemiological data, including comorbidities, types and severity of organ failure, interventions, lengths of stay and outcome, for patients from the Sepsis Occurrence in Acutely ill Patients (SOAP) study, an observational study conducted in European intensive care units in 2002, and the Intensive Care Over Nations (ICON) audit, a survey of intensive care unit patients conducted in 2012. Results: We compared the 3147 patients from the SOAP study with the 4852 patients from the ICON audit admitted to intensive care units in the same countries as those in the SOAP study. The ICON patients were older (62.5 +/- 17.0 vs. 60.6 +/- 17.4 years) and had higher severity scores than the SOAP patients. The proportion of patients with sepsis at any time during the intensive care unit stay was slightly higher in the ICON study (31.9 vs. 29.6%, p = 0.03). In multilevel analysis, the adjusted odds of ICU mortality were significantly lower for ICON patients than for SOAP patients, particularly in patients with sepsis [OR 0.45 (0.35-0.59), p < 0.001]. Conclusions: Over the 10-year period between 2002 and 2012, the proportion of patients with sepsis admitted to European ICUs remained relatively stable, but the severity of disease increased. In multilevel analysis, the odds of ICU mortality were lower in our 2012 cohort compared to our 2002 cohort, particularly in patients with sepsis.
Ključne besede: intensive care units -- analysis -- epidemiology -- mortality, sepsis, severity of disease
DiRROS - Objavljeno: 30.11.2020; Ogledov: 300; Prenosov: 131
URL Celotno besedilo (0,00 KB)

Reconstruction of brown bear population dynamics in Slovenia in the period 1998-2019 : ǂa ǂnew approach combining genetics and long-term mortality data
Klemen Jerina, Andrés Ordiz, 2021

Povzetek: Reliable data and methods for assessing changes in wildlife population size over time are necessary for management and conservation. For most species, assessing abundance is an expensive and labor-intensive task that is not affordable on a frequent basis. We present a novel approach to reconstructing brown bear population dynamics in Slovenia in the period 1998-2019, based on the combination of two CMR non-invasive genetic estimates (in 2007 and 2015) and long-term mortality records, to show how the latter can help the study of population dynamics in combination with point-in-time estimates. The spring (i.e. including newborn cubs) population size estimate was 383 (CI: 336-432) bears in 1998 and 971 (CI: 825-1161) bears in 2019. In this period, the average annual population growth rate was 4.5 %. The predicted population size differed by just 7 % from the non-invasive genetic size estimate after eight years, suggesting that the method is reliable. It can predict the evolution of the population size under different management scenarios and provide information on key parameters, e.g. background mortality and the sex- and age-structure of the population. Our approach can be used for several other wildlife species, but it requires reliable mortality data over time.
Ključne besede: genetic estimates of population size, mortality records, population monitoring, population size, predictive modelling, brown bear
DiRROS - Objavljeno: 28.03.2021; Ogledov: 117; Prenosov: 62
.pdf Celotno besedilo (1005,41 KB)

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