Fungal infections in the ICUMarya D Zilberberg
Department of Health Policy and Management, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003, USA
Infect Dis Clin North Am 23:625-42. 2009
..Given the rapidly changing literature in this broad area, it is imperative that physicians caring for immunosuppressed patients and for the critically ill remain abreast of this evolving field...
Clostridium difficile infections among hospitalized children, United States, 1997-2006Marya D Zilberberg
University of Massachusetts, Amherst, Massachusetts, USA
Emerg Infect Dis 16:604-9. 2010
..27), which in turn was second only to incidence for children 1-4 years of age (44.87). Pediatric CDI-related hospitalizations are increasing. A better understanding of the epidemiology and outcomes of CDI is urgently needed...
- Implementing quality improvements in the intensive care unit: ventilator bundle as an example
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
Crit Care Med 37:305-9. 2009
..The Institute for Healthcare Improvement has led the charge with its ventilator bundle aimed at VAP prevention. We set out to review the literature on the effectiveness of the bundle to prevent VAP...
Increase in Clostridium difficile-related hospitalizations among infants in the United States, 2000-2005Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
Pediatr Infect Dis J 27:1111-3. 2008
..Because incidence of hospitalizations with other infectious enteritides has remained essentially stable, this growth in CDAD cannot be explained by a gastroenteritis reporting bias...
- Prolonged acute mechanical ventilation: implications for hospital benchmarking
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Goshen, MA 01032, USA
Chest 135:1157-62. 2009
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- Understanding cost-effectiveness in the ICU
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01032, USA
Semin Respir Crit Care Med 31:13-8. 2010
..This article provides a primer for understanding the methods and applications of cost-effectiveness and cost-utility analyses in the ICU...
- Epidemiology of healthcare-associated pneumonia (HCAP)
Marya D Zilberberg
Department of Health Policy and Management, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts 01032, USA
Semin Respir Crit Care Med 30:10-5. 2009
..More precise instruments are needed to heighten clinicians' index of suspicion for treating probable resistant pathogens with appropriate empirical antibiotic choices...
- Epidemiology and outcomes of clostridium difficile-associated disease among patients on prolonged acute mechanical ventilation
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Goshen, MA 01032, USA
Chest 136:752-8. 2009
..We examined the rates and outcomes of CDAD among adult PAMV patients...
- Clostridium difficile-associated disease and mortality among the elderly critically ill
Marya D Zilberberg
School of Public Health and Health Sciences MDZ, University of Massachusetts, Amherst, MA, USA
Crit Care Med 37:2583-9. 2009
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- Growth and geographic variation in hospitalizations with resistant infections, United States, 2000-2005
Marya D Zilberberg
EviMed Research Group, LLC, Goshen, Massachussetts 01032, USA
Emerg Infect Dis 14:1756-8. 2008
..Regional variations noted in the aggregate and by individual infection may help clarify modifiable risk factors driving these infections...
- Secular trends in candidemia-related hospitalization in the United States, 2000-2005
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, USA
Infect Control Hosp Epidemiol 29:978-80. 2008
..56 cases; and the incidence per 1,000 hospitalizations rose by 49%, from 0.28 to 0.42 cases. The proportion of all candidemia-related hospitalizations in which candidemia was the principal diagnosis remained stable at approximately 14%...
- Imipenem resistance of Pseudomonas in pneumonia: a systematic literature review
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
BMC Pulm Med 10:45. 2010
..NPs in particular are likely to be caused by Pseudomonas aeruginosa (PA), ~20% of which in observational studies are resistant to imipenem. We sought to identify the burden of PA imipenem resistance in pneumonia...
- Hospitalizations with healthcare-associated complicated skin and skin structure infections: impact of inappropriate empiric therapy on outcomes
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
J Hosp Med 5:535-40. 2010
..We studied the association of inappropriate empiric therapy with outcomes in patients with HCA complicated skin and skin structure infections (cSSSI)...
- Epidemiology, clinical and economic outcomes of admission hyponatremia among hospitalized patients
Marya D Zilberberg
EviMed Research Group, Goshen, MA, USA
Curr Med Res Opin 24:1601-8. 2008
..Hyponatremia, the most frequent electrolyte derangement identified among hospitalized patients, is associated with worsened outcomes in patients with pneumonia, heart failure and other disorders...
- Cost-effectiveness model of empiric doripenem compared with imipenem-cilastatin in ventilator-associated pneumonia
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
Surg Infect (Larchmt) 11:409-17. 2010
..We developed a model to quantify outcome differences between strategies of empiric treatment of VAP with DOR vs. IMI...
- Increase in adult Clostridium difficile-related hospitalizations and case-fatality rate, United States, 2000-2005
Marya D Zilberberg
University of Massachusetts, Amherst, Massachusetts 01032, USA
Emerg Infect Dis 14:929-31. 2008
..The incidence of adult CDAD hospitalizations doubled from 5.5 cases per 10,000 population in 2000 to 11.2 in 2005, and the CDAD-related age-adjusted case-fatality rate rose from 1.2% in 2000 to 2.2% in 2004...
- Inappropriate empiric antifungal therapy for candidemia in the ICU and hospital resource utilization: a retrospective cohort study
Marya D Zilberberg
EviMed Research Group, LLC, PO Box 303, Goshen, MA 01032, USA
BMC Infect Dis 10:150. 2010
..Inappropriate antifungal therapy (IAT) is known to increase a patient's risk for death. We hypothesized that in an ICU cohort it would also adversely affect resource utilization...
- Epidemiology and outcomes of hospitalizations with complicated skin and skin-structure infections: implications of healthcare-associated infection risk factors
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
Infect Control Hosp Epidemiol 30:1203-10. 2009
..Because prompt appropriate treatment is associated with better outcomes, we studied the epidemiology of healthcare-associated complicated skin and skin-structure infections (cSSSIs)...
- Cost-effectiveness of micafungin as an alternative to fluconazole empiric treatment of suspected ICU-acquired candidemia among patients with sepsis: a model simulation
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Arnold House, Amherst, MA 01003, USA
Crit Care 13:R94. 2009
..400 mg daily fluconazole (FLU) for suspected intensive care unit-acquired candidemia (ICU-AC) among septic patients...
- Hyponatremia and hospital outcomes among patients with pneumonia: a retrospective cohort study
Marya D Zilberberg
Evi Med Research Group, LLC, Goshen, Massachusetts, USA
BMC Pulm Med 8:16. 2008
..Hyponatremia, occurring in >1/4 of patients with CAP, is associated with greater disease severity and worsened outcomes...
- Antimicrobial therapy escalation and hospital mortality among patients with health-care-associated pneumonia: a single-center experience
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003 9304, USA
Chest 134:963-8. 2008
..Initial inappropriate treatment has been shown to increase hospital mortality. It is not known whether escalation in response to culture results mitigates this risk...
- Preventing clostridium difficile infection in the intensive care unit
Marya D Zilberberg
EviMed Research Group, LLC, Goshen, MA 01032, USA
Crit Care Clin 29:11-8. 2013
....
- Descriptive epidemiology of hereditary angioedema hospitalizations in the United States, 2004-2007
Marya D Zilberberg
University of Massachusetts, Amherst, USA
Allergy Asthma Proc 32:248-54. 2011
..HAE hospitalization volume is substantial. Because diagnostic uncertainty is likely, HAE and its related resource use may be underestimated. HAE prevention strategies need to be examined in the context of these outcomes...
- Secular trends of hospitalization with vancomycin-resistant enterococcus infection in the United States, 2000-2006
Andrew M Ramsey
School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
Infect Control Hosp Epidemiol 30:184-6. 2009
..Because infection due to vancomycin-resistant organisms is associated with poor outcomes, the epidemiology of this trend needs further exploration...
- Anemia, transfusions and hospital outcomes among critically ill patients on prolonged acute mechanical ventilation: a retrospective cohort study
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, North Pleasant Street, Amherst, Massachusetts 01003, USA
Crit Care 12:R60. 2008
..We hypothesized that transfusions among patients receiving PAMV are common and associated with worsened clinical and economic outcomes...
- Prolonged acute mechanical ventilation, hospital resource utilization, and mortality in the United States
Marya D Zilberberg
University of Massachusetts, School of Public Health and Health Sciences, Amherst, MA, USA
Crit Care Med 36:724-30. 2008
..We compared the prevalence, characteristics, and outcomes of MV < 96 hrs (MV < 96) and prolonged acute MV (PAMV) of > or = 96 hrs' duration in a representative sample of U.S. hospital discharges...
- Descriptive epidemiology of hereditary angioedema emergency department visits in the United States, 2006-2007
Marya D Zilberberg
Department of of Biostastics and Epidemiology, University of Massachusetts, Amherst, USA
Allergy Asthma Proc 32:390-4. 2011
..Although likely representing a fraction of the entire HAE population, prevention and acute treatment strategies aimed at those at risk for frequent exacerbations and disproportionate resource use need to be examined...
- Using electronic health information to risk-stratify rates of Clostridium difficile infection in US hospitals
Marya D Zilberberg
Division of Healthcare Quality Promotion, University of Massachusetts and EviMed Research Group, Amherst, Massachusetts 30333, USA
Infect Control Hosp Epidemiol 32:649-55. 2011
..We applied definitions for hospital-onset (HO) and community-onset (CO) CDI to electronic data from 85 hospitals between January 2007 and June 2008 to identify factors associated with higher HO CDI rates...
- Red blood cell transfusions and the risk of acute respiratory distress syndrome among the critically ill: a cohort study
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, P, O, Box 303, Goshen, MA 01032, USA
Crit Care 11:R63. 2007
..Uncertainty remains regarding the strength of this relationship...
- Prolonged acute mechanical ventilation and hospital bed utilization in 2020 in the United States: implications for budgets, plant and personnel planning
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
BMC Health Serv Res 8:242. 2008
..Their numbers are projected to double by year 2020. To aid in planning for this growth, we projected their annualized days and costs of hospital use and SNF discharges in year 2020 in the US...
- Development and validation of a bedside risk score for MRSA among patients hospitalized with complicated skin and skin structure infections
Marya D Zilberberg
EviMed Research Group, LLC, Goshen, MA, USA
BMC Infect Dis 12:154. 2012
..We sought to develop a simple bedside decision rule to tailor empiric coverage more accurately...
- Accuracy of previous estimates for adult prolonged acute mechanical ventilation volume in 2020: update using 2000-2008 data
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
Crit Care Med 40:18-20. 2012
..With 2006-2008 data becoming available, we explored the precision of our previous formulas and estimates...
- Effect of a restrictive transfusion strategy on transfusion-attributable severe acute complications and costs in the US ICUs: a model simulation
Marya D Zilberberg
University of Massachusetts, 715 North Pleasant Street, Amherst, MA 01003, USA
BMC Health Serv Res 7:138. 2007
..We estimated the potential annual reduction in transfusion-attributable severe acute complications (TSACs) and costs across the US ICUs with the adoption of restrictive strategy...
- Growth in adult prolonged acute mechanical ventilation: implications for healthcare delivery
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
Crit Care Med 36:1451-5. 2008
..Because of this disproportionate resource utilization and the shifting U.S. demographics, we projected the expected volume of adult PAMV cases through year 2020...
- Economics at the end of life: hospital and ICU perspectives
Marya D Zilberberg
EviMed Research Group, LLC, Goshen, MA 01032, USA
Semin Respir Crit Care Med 33:362-9. 2012
..Frank discussions with patients and family about their desires in the context of the prognosis, as well as symptom support, can yield both economic savings and better quality of life...
- Economic aspects of preventing health care-associated infections in the intensive care unit
Marya D Zilberberg
Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
Crit Care Clin 28:89-97, vi-vii. 2012
..We use ventilator-associated pneumonia as the case study to illustrate the pitfalls and challenges of arriving at the optimal HAI preventive strategies in the ICU...
- Healthcare-associated pneumonia: the state of evidence to date
Marya D Zilberberg
University of Massachusetts, Amherst, MA, USA
Curr Opin Pulm Med 17:142-7. 2011
..Controversies persist as to whether HCAP is a useful designation for diagnosis, treatment and outcome prediction...
- Ventilator-associated pneumonia: the clinical pulmonary infection score as a surrogate for diagnostics and outcome
Marya D Zilberberg
School of Public Health and Health Sciences, University of Massachusetts, Amherst, DC, USA
Clin Infect Dis 51:S131-5. 2010
..At present, the CPIS has a limited role both clinically and as a research tool...
- Ventilator-associated pneumonia as a model for approaching cost-effectiveness and infection prevention in the ICU
Marya D Zilberberg
University of Massachusetts, Amherst, Massachusetts, USA
Curr Opin Infect Dis 24:385-9. 2011
..Furthermore, in the era of resource constraints, cost-effectiveness of various strategies is critical to consider...
- The burden of hospitalizations and emergency department visits with hereditary angioedema and angioedema in the United States, 2007
Marya D Zilberberg
Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
Allergy Asthma Proc 31:511-9. 2010
..Clinical validation of current case definition would be useful, because administrative data may present an attractive source for investigating these populations...
