Invasive Aspergillosis in Patients with Chronic Obstructive Pulmonary Diseases
Bibliographic record
Abstract
OBJECTIVES: To determine the outcomes, and clinical and therapeutic factors associated with the development of invasive pulmonary aspergillosis (IPA) in patients with obstructive pulmonary diseases. DESIGN: A case control study examining patients who developed IPA while hospitalized, and controls who were matched by year of hospitalization and type of obstructive lung disease. SETTING: A tertiary care university-affiliated respiratory hospital. PATIENTS: Twelve patients were identified who had developed nosocomial IPA. Each case was compared with four control patients: two with and two without Aspergillus colonization. RESULTS: Patients and control patients had similar demographic characteristics, comorbid illnesses and severity of underlying pulmonary disease. All cases required admission to the intensive care unit and eight patients (67%) died, whereas only 17% of control patients required admission to the intensive care unit and 7% died. The patients with IPA received significantly higher daily doses of corticosteroids (median 106 mg of prednisone or equivalent for 18 days) and more broad-spectrum antibiotics (median three antibiotics for 13 days) in hospital before the development of aspergillosis compared with the control patients (median 44 mg for 14 days, and 1.5 antibiotics for nine days, respectively). Among the control patients, those with Aspergillus colonization were more likely to have received corticosteroid therapy and broad-spectrum antibiotics during and in the month preceding the index hospitalization, although the hospital course was not different. CONCLUSIONS: IPA, although rare in patients with chronic obstructive lung diseases, was associated with high doses of corticosteroids and multiple broad-spectrum antibiotics. More judicious use of antibiotics and avoidance of prolonged high-dose corticosteroids may help prevent occurrences of IPA with its attendant serious morbidity and high mortality.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".