7 research outputs found
History of the Paulists and their activities in Križevci
No full textU izlaganju ću prikazati povijest, djelovanje i kulturnu važnost pavlina. Prvi je dio posvećen općoj povijesti Pavlinskoga reda. Usmjerit ću se na prve promicatelje reda (pustinjaci) kao i na njihovo organiziranje do osnutka, a onda i priznanje od Crkve i rimskoga pape. Iz burne pavlinske povijesti izdvojit ću tek njihov progon od Osmanlija te borbu protiv protestantizma i crkvenih reforama Josipa II. Pri završetku ovoga dijela izlaganja usredotočit ću se i na obnovu Pavlinskoga reda nakon njegova ukinuća 1786. godine.
U sljedećemu dijelu izlaganja prikazat ću svakodnevni život pavlina. U tome ću se dijelu baviti zadatcima, regulama i ciljevima Pavlinskoga reda. Posebnu ću pozornost pritom posvetiti osnovnoj djelatnosti, zatim načinu života u samostanima te doprinosu pavlina u gospodarstvu, kulturi, obrani i politici onih zemalja u kojima su djelovali.
Dio izlaganja posvetit ću dolasku i povijesti pavlina u Hrvatskoj. Njihovu povijest u hrvatskim krajevima pratit ću od 1244. godine, dakle od osnutka prvoga pavlinskoga samostana u Dubici, pa sve do danas. Dakako spomenut ću i ostale pavlinske samostane u Hrvatskoj, a napose njihovo osnivanje i sudbinu u vrijeme osmanlijskoga prodiranja. Isto ću tako pozornost usmjeriti i na širenje i jačanje Pavlinskoga reda tijekom 17. i 18. stoljeća pa sve do njegova ukinuća dekretom cara Josipa II. Također ću opisati pokušaje i tijek obnove Pavlinskoga reda u Hrvatskoj. Naime život i djelovanje pavlina vezano je uz njihove samostane. Neki od samostana, primjerice Kamensko (Karlovac), zatim Sv. Petar u Šumi (Istra), onda Svetice (Ozalj) te samostan u Posedarju, djeluju i danas. Podsjećam da od samostana koji više nisu u funkciji, ili pak više nisu pavlinski, ponajprije treba istaknuti samostane u Lepoglavi, Dubici i Remetama.
Važno je naglasiti da su pavlini bili prisutni u crkvenim, kulturnim i društvenim djelatnostima. U izlaganju ću spomenuti one pavlinske redovnike koji su, primjerice, kao kipari, slikari, pisci, povjesničari, profesori i biskupi svojim djelovanjem ostavili najdublji trag.
Izlaganje ću završiti kratkim prikazom povijesti pavlinskoga reda u Križevcima. Usmjerit ću se na njihov dolazak u Križevce te na njihovo osnivanje samostana, a potom i gimnazije. Pritom ću istaknuti one koji su među njima bili najcjenjeniji, pri čemu ću navesti i područje njihova rada.The writer presents the history, activities and cultural in“uence of the Paulists with general information on their order from first hermits and their grouping to the establishing of the order and papal and church recognition. From their turbulent history a special report is given concerning their pursuit led by the Osmanlis, fight against Protestantism and church reforms started by Joseph II nd. The order was abolished in 1786 but was re-established later. The author also vividly de-scribes everyday life of Paulist monks and states
their daily chores, regulations and goals, stressing their contribution to economy, culture, defense and politics in the countries they lived. The third part of the paper speaks about the Paulists in Croatia from their first monastery in Dubica dating from 1244 till today.
The life and work of the Paulists is closely linked to their monasteries of which some are in function even today: Kamensko in Karlovac, Sv. Petar u Šumi/St Peter in the Woods in Istria, Svetice in Ozalj, Posedarje. Monasteries that do not function any longer are in Lepoglava, Dubica and Remete. The order was active in all fields of human interest: cultural, religious, social, so some Paulist members who left trace as sculptors, painters, writers, historiographers, teachers and bishopsare mentioned. The last part of the paper speaks of the order in Križevci - their arrival, founding of the monastery, high school they opened and run, and the most prominent order members in Križevci
The role of centre and country factors on process and outcome indicators in critically ill patients with hospital-acquired bloodstream infections
No full textPurpose: The primary objective of this study was to evaluate the associations between centre/country-based factors and two important process and outcome indicators in patients with hospital-acquired bloodstream infections (HABSI). Methods: We used data on HABSI from the prospective EUROBACT-2 study to evaluate the associations between centre/country factors on a process or an outcome indicator: adequacy of antimicrobial therapy within the first 24 h or 28-day mortality, respectively. Mixed logistical models with clustering by centre identified factors associated with both indicators. Results: Two thousand two hundred nine patients from two hundred one intensive care units (ICUs) were included in forty-seven countries. Overall, 51% (n = 1128) of patients received an adequate antimicrobial therapy and the 28-day mortality was 38% (n = 839). The availability of therapeutic drug monitoring (TDM) for aminoglycosides everyday [odds ratio (OR) 1.48, 95% confidence interval (CI) 1.03-2.14] or within a few hours (OR 1.79, 95% CI 1.34-2.38), surveillance cultures for multidrug-resistant organism carriage performed weekly (OR 1.45, 95% CI 1.09-1.93), and increasing Human Development Index (HDI) values were associated with adequate antimicrobial therapy. The presence of intermediate care beds (OR 0.63, 95% CI 0.47-0.84), TDM for aminoglycoside available everyday (OR 0.66, 95% CI 0.44-1.00) or within a few hours (OR 0.51, 95% CI 0.37-0.70), 24/7 consultation of clinical pharmacists (OR 0.67, 95% CI 0.47-0.95), percentage of vancomycin-resistant enterococci (VRE) between 10% and 25% in the ICU (OR 1.67, 95% CI 1.00-2.80), and decreasing HDI values were associated with 28-day mortality. Conclusion: Centre/country factors should be targeted for future interventions to improve management strategies and outcome of HABSI in ICU patients
Effect of adequacy of empirical antibiotic therapy for hospital-acquired bloodstream infections on ICU patient prognosis: a causal inference approach using data from the Eurobact2 study
No full textObjectives: Hospital-acquired bloodstream infections (HA-BSI) in the intensive care unit (ICU) are common life-threatening events. We wanted to investigate the association between early adequate antibiotic therapy and 28-day mortality in ICU patients surviving for at least 1 day after the onset of HA-BSI. Methods: We used individual data from a prospective, observational, multicenter, intercontinental cohort study (Eurobact2). We included patients followed for ≥1 day for whom time-to-appropriate treatment was available. We used an adjusted frailty-Cox proportional hazard model to assess the effect of time-to-treatment-adequacy on 28-day mortality. Infection- and patient-related variables identified as confounders by the Directed Acyclic Graph were used for adjustment. Adequate therapy within 24 hours was used for primary analysis. Secondary analyses were performed for adequate therapy within 48 and 72 hours and for identified patient subgroups. Results: Among the 2,418 patients included in 330 centers worldwide, 28-day mortality was 32.8% (n=402/1226) in patients who were adequately treated within 24 hours after HA-BSI onset and 40% (n=477/1192) in inadequately treated patients (p<0.01). Adequacy within 24 hours was more common in young, immunosuppressed patients, and with HA-BSI due to Gram-negative pathogens. Antimicrobial adequacy was significantly associated with 28-day survival (aHR 0.83, 95% CI 0.72-0.96, p=0.01). The estimated population attributable fraction (PAF) of 28-day mortality of inadequate therapy was 9.15% (95% CI 1.9%-16.2%). Conclusions: In patients with HA-BSI admitted in ICU, the PAF of 28-day mortality of inadequate therapy within 24 hours was 9.15%. This estimate should be used when hypothesizing the possible benefit of any intervention aiming at reducing the time-to-appropriate antimicrobial therapy in HA-BSI
Presentation, management, and outcomes of older compared to younger adults with hospital-acquired bloodstream infections in the intensive care unit: a multicenter cohort study
No full textPurpose: Older adults admitted to the intensive care unit (ICU) usually have fair baseline functional capacity, yet their age and frailty may compromise their management. We compared the characteristics and management of older (≥ 75 years) versus younger adults hospitalized in ICU with hospital-acquired bloodstream infection (HA-BSI). Methods: Nested cohort study within the EUROBACT-2 database, a multinational prospective cohort study including adults (≥ 18 years) hospitalized in the ICU during 2019-2021. We compared older versus younger adults in terms of infection characteristics (clinical signs and symptoms, source, and microbiological data), management (imaging, source control, antimicrobial therapy), and outcomes (28-day mortality and hospital discharge). Results: Among 2111 individuals hospitalized in 219 ICUs with HA-BSI, 563 (27%) were ≥ 75 years old. Compared to younger patients, these individuals had higher comorbidity score and lower functional capacity; presented more often with a pulmonary, urinary, or unknown HA-BSI source; and had lower heart rate, blood pressure and temperature at presentation. Pathogens and resistance rates were similar in both groups. Differences in management included mainly lower rates of effective source control achievement among aged individuals. Older adults also had significantly higher day-28 mortality (50% versus 34%, p < 0.001), and lower rates of discharge from hospital (12% versus 20%, p < 0.001) by this time. Conclusions: Older adults with HA-BSI hospitalized in ICU have different baseline characteristics and source of infection compared to younger patients. Management of older adults differs mainly by lower probability to achieve source control. This should be targeted to improve outcomes among older ICU patients
Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study
No full textPurpose: In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods: We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results: 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions: HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes
Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study
No full textPurpose
In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials.
Methods
We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021.
Results
2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28.
Conclusions
HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes
