Comparing clinical outcomes in HIV-infected and uninfected older men hospitalized with community-acquired pneumonia.

OBJECTIVES: Outcomes of community-acquired pneumonia (CAP) among HIV-infected older adults are unclear. METHODS: Associations between HIV infection and three CAP outcomes (30-day mortality, readmission within 30 days post-discharge, and hospital length of stay [LOS]) were examined in the Veterans Aging Cohort Study (VACS) of male Veterans, age ≥ 50 years, hospitalized for CAP from 10/1/2002 through 08/31/2010. Associations between the VACS Index and CAP outcomes were assessed in multivariable models. RESULTS: Among 117 557 Veterans (36 922 HIV-infected and 80 635 uninfected), 1203 met our eligibility criteria. The 30-day mortality rate was 5.3%, the mean LOS was 7.3 days, and 13.2% were readmitted within 30 days of discharge. In unadjusted analyses, there were no significant differences between HIV-infected and uninfected participants regarding the three CAP outcomes (P > 0.2). A higher VACS Index was associated with increased 30-day mortality, readmission, and LOS in both HIV-infected and uninfected groups. Generic organ system components of the VACS Index were associated with adverse CAP outcomes; HIV-specific components were not. Among HIV-infected participants, those not on antiretroviral therapy (ART) had a higher 30-day mortality (HR 2.94 [95% CI 1.51, 5.72]; P = 0.002) and a longer LOS (slope 2.69 days [95% CI 0.65, 4.73]; P = 0.008), after accounting for VACS Index. Readmission was not associated with ART use (OR 1.12 [95% CI 0.62, 2.00] P = 0.714). CONCLUSION: Among HIV-infected and uninfected older adults hospitalized for CAP, organ system components of the VACS Index were associated with adverse CAP outcomes. Among HIV-infected individuals, ART was associated with decreased 30-day mortality and LOS.

A comparison of thromboelastogram and template bleeding time in the evaluation of platelet function after aspirin ingestion.

STUDY OBJECTIVE: To compare template bleeding time (TBT) with thromboelastography (TEG) in human subjects after aspirin ingestion. DESIGN: Healthy volunteers were given a single 650 mg dose of aspirin or a dose of 650 mg of aspirin on three successive days. TBT and TEG studies were performed prior to aspirin ingestion and 4, 24, 72, and 168 hours after ingestion. SETTING: Inpatient operating room support area at the UCLA Center for Health Sciences. VOLUNTEERS: Residents and nurses who were in good general health, had not taken aspirin for 2 weeks, had normal platelet counts, and had no evidence of bleeding or coagulation disorders. INTERVENTION: TBT and TEG studies were performed prior to and after the ingestion of aspirin. MEASUREMENTS AND MAIN RESULTS: TBT studies were significantly prolonged at 4, 24, and 72 hours compared with controls. Maximum bleeding time prolongation occurred 24 hours after aspirin ingestion. Bleeding time returned to control values by the end of 168 hours (1 week). No TEG parameter was significantly changed by aspirin ingestion. CONCLUSION: TEG results may not identify patients who have an increased bleeding time as a result of aspirin ingestion.

The relationship of hair zinc concentrations to height, weight, age, and sex in the normal population.

Hair samples from forty-nine normal individuals (both children and adults) were assessed for concentrations of zinc. Pearson correlation coefficients were computed between zinc values and the variables: height, weight, and age (see Table 3). In children (under 240 months), all these relationships were linear, positive, and statistically significant. A linear regression equation using all these variables was found to account for 47.7% of the variance in hair zinc concentrations. In adults (over 240 months), the correlation coefficients between hair zinc and height, weight, and age were not found to be significant, with the exception of the negative correlation between hair zinc and weight (r = -0.464; P less than 0.047). Nevertheless, a multivariate linear regression equation accounted for about 24.6% of the variability of hair zinc values. In both children and adults, tests for sex differences in means and standard deviations using both raw score and residual values failed to reveal any significant differences. Similarly, no significant sex differences were observed between corresponding correlation coefficients. Results indicate that future studies utilizing hair must systematically or mathematically control for individual variation in zinc concentrations due to differences in age, weight, and height.