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.Nosocomial infections and mortality in hospitalized patients in the United States.
Nosocomial infections are associated with an increase in morbidity and mortality, not only for hospitalized patients but also for surgical patients outside the hospital setting. In order to estimate the risk of mortality associated with nosocomial infections, a retrospective cohort study of hospitalized patients was performed in four different hospitals with long-stay surgery wards. The incidence of nosocomial infections according to the Centers for Disease Control (CDC) definitions was 8.8%. The mortality rate of patients with nosocomial infections was 41.7%, while that of patients without infection was 22.5%. Nosocomial infections were more prevalent in patients who had: ventilator dependency, prior to the infection, a history of alcohol abuse, transfer from another hospital, or a diagnosis of renal failure. In addition, we found that multiple nosocomial infections had a higher risk for mortality than single infection. The most common infections were pneumonia, sepsis, and urinary tract infections. Patients with nosocomial infections were more likely to die in these four hospitals than noninfected patients. Nosocomial infections were present in approximately 9% of all hospitalized patients and were associated with a higher mortality. Although a large number of patients without nosocomial infections died during the study period, it is suggested that these mortality rates were the lower limit of normal mortality in a hospital with appropriate preventive measures in place. Patients who are at greater risk of nosocomial infections should be identified early. Hospital discharge and transfer procedures may be safer than staying in the hospital. Improved methods are needed to monitor and control nosocomial infections.Cross-cultural adaptation of the Hearing Handicap Inventory for Adults (HHIA) into Brazilian Portuguese.
The Hearing Handicap Inventory for Adults (HHIA) is used as a measure of the self-perceived impact of hearing impairment on quality of life. The purpose of this study was to evaluate the cross-cultural adaptation of the Brazilian Portuguese version of the HHIA (HHIA-Br) for use in the Brazilian Portuguese population. The original HHIA in English and the Brazilian Portuguese version were sent for a forward-backward translation process. Seventeen professionals translated the scale into Brazilian Portuguese. Cultural and linguistic equivalence was assessed by 10 experts. Additionally, the scale was administered to 60 elderly people who were the target group of the instruments. The scale was analyzed according to the method of functional equivalence (F2) and content validity. The Brazilian

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