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Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen in hospital-acquired infections. MRSA-colonized inpatients who may benefit from undergoing decolonization have not been identified.
To identify risk factors for MRSA infection among patients who are colonized with MRSA at hospital admission.
A case-control study.
A 146-bed Veterans Affairs hospital.
Case patients were those patients admitted from January 2003 to August 2011 who were found to be colonized with MRSA on admission and then developed MRSA infection. Control subjects were those patients admitted during the same period who were found to be colonized with MRSA on admission but who did not develop MRSA infection.
A retrospective review.
A total of 75 case patients and 150 control subjects were identified. A stay in the intensive care unit (ICU) was the significant risk factor in univariate analysis (P<.001). Prior history of MRSA (P = .03), transfer from a nursing home (P = .002), experiencing respiratory failure (P<.001), and receipt of transfusion (P = .001) remained significant variables in multivariate analysis. Prior history of MRSA colonization or infection (P = .02), difficulty swallowing (P = .04), presence of an open wound (P = .002), and placement of a central line (P = .02) were identified as risk factors for developing MRSA infection for patients in the ICU. Duration of hospitalization, readmission rate, and mortality rate were significantly higher in case patients than in control subjects (P< .001, .001, and <.001, respectively).
MRSA-colonized patients admitted to the ICU or admitted from nursing homes have a high risk of developing MRSA infection. These patients may benefit from undergoing decolonization.
Low cholesterol may act as a peripheral marker for parasuicide.
To examine the relationship between total serum cholesterol and psychological parameters in parasuicide.
Total serum cholesterol and self-rated scores for impulsivity, depression and suicidal intent were measured in 100 consecutive patients following parasuicide, pair-matched with normal and psychiatric control groups.
Backward, stepwise multiple regression analysis revealed a significantly lower mean cholesterol in the parasuicide population (P<0.01). Across all groups there was an independent significant (P<0.01) negative correlation between cholesterol and self-reported scores of impulsivity. No correlation existed between cholesterol and scores for depression or suicidal intent.
The data confirm previous reports of low cholesterol in parasuicide. This is the first reported investigation of the construct of impulsivity in relation to cholesterol. We hypothesise that the reported increased mortality in populations with low cholesterol may derive from increased suicide and accident rates consequent on increased tendencies to impulsivity in these populations.
The principal aim of this study was to assess the validity and usefulness of the Ways of Coping (Revised) questionnaire (Folkman & Lazarus, 1985) with a British sample of parents of children with Down's syndrome. Factor analysis yielded five subscales which were compared with those reported elsewhere. Other properties of the instrument were investigated. It was concluded that the instrument was potentially valuable to those investigating coping in families with special problems.
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