Diabetes mellitus is an independent risk factor for ICU-acquired bloodstream infections.

OBJECTIVE: To investigate the role of diabetes as risk factor for ICU-acquired bloodstream infections (BSI). DESIGN: Prospective observational study. SETTING: A general eight-bed ICU of a tertiary hospital. PATIENTS: Three hundred and forty-three consecutive patients (63 diabetic and 280 nondiabetic) admitted in the ICU. METHODS: BSI episodes in the ICU were recorded and classified as primary, secondary, catheter-related and mixed according to strict criteria. In all patients, blood glucose was strictly controlled with a continuous insulin infusion within a range of 80-120 mg/dl. RESULTS: One-hundred and eighteen patients (34.4%) developed at least one BSI episode. Diabetic patients had an increased probability of developing at least one BSI episode compared with nondiabetic patients (hazard ratio = 1.66, 95% confidence interval 1.04-2.64, P = 0.034) in a Cox proportional hazards regression model adjusting for age, gender, admission category and APACHE II score at admission in the ICU and comorbidities. CONCLUSIONS: Despite strict glycemic control, diabetic patients have a 1.7-fold probability of developing an ICU-acquired BSI compared to nondiabetic subjects.

Mortality among pilots and cabin crew in Greece, 1960-1997.

BACKGROUND: Specific health hazards, among them radiation of cosmic origin, have caused some concern among aircrew in civil aviation in recent years. Several cohort studies in Northern countries have investigated mortality and cancer incidence among aircrew. Our goal was to study the pattern of mortality among Greek commercial airline cockpit and cabin crew. METHODS: We performed a retrospective cohort study including 843 Olympic Airways cockpit crew and 1835 cabin attendants. Standardized mortality ratios (SMR) were calculated based on death rates of the Greek population. Duration of employment as a proxy for occupational exposure was used to stratify the cohort. RESULTS: For cockpit crew, the overall SMR was 0.7 (n = 65, 95% CI: 0.5-0.9). The SMR for all cancers was also significantly decreased (n = 17; SMR = 0.6; 95% CI: 0.3-0.9). Most of this reduction was due to a large deficit in lung cancer deaths (SMR = 0.1; 95% CI: 0.0-0.5). Slight but non-significant increases were noted for brain and liver cancer. The SMR for cardiovascular death was close to unity. Among female cabin attendants the SMR for all causes was 0.8 (95% CI: 0.4-1.3). The SMR for all cancers was 0.8 (95% CI: 0.3-1.7). Mortality from breast cancer was not increased. Among male cabin crew, SMR for all causes was 0.5 (95% CI: 0.3-0.9). Analyses according to duration of employment showed no pattern. CONCLUSIONS: In this first-ever occupational cohort study in Greece, Greek aircrew had a low overall and cancer mortality. Due to the small number of events, the strength of our study is limited. The Greek data will be included in a pooled analysis of European studies.