scholarly journals Antibiotic susceptibility trend before and after long-term use of selective digestive decontamination: a 16 year ecological study

2019 ◽  
Vol 74 (8) ◽  
pp. 2289-2294 ◽  
Author(s):  
Yanire Lloréns-Villar ◽  
Fernando Tusell ◽  
Andrés Canut ◽  
Helena Barrasa ◽  
Esther Corral ◽  
...  
Keyword(s):  
Interrupted Time Series ◽  
National Registry ◽  
Selective Digestive Decontamination ◽  
University Hospital ◽  
High Concentration ◽  
Susceptibility Data ◽  
Before And After ◽  
The Difference ◽  
The University ◽  
Susceptibility Rate

Abstract Objectives The aim of this study was to compare antimicrobial susceptibility rates in a Spanish ICU before and after the introduction of selective digestive decontamination (SDD) and also to compare these with susceptibility data from other Spanish ICUs without SDD. Methods We performed a retrospective study in the ICU of the University Hospital of Alava, where SDD was implemented in 2002. The SDD protocol consisted of a 2% mixture of gentamicin, colistin and amphotericin B applied on the buccal mucosa and a suspension of the same drugs in the gastrointestinal tract; additionally, for the first 3 days, systemic ceftriaxone was administered. From 1998 to 2013 we analysed the susceptibility rates for 48 antimicrobial/organism combinations. Interrupted time series using a linear dynamic model with SDD as an intervention was used. Data from other ICUs were obtained from the ENVIN-HELICS national registry. Results Only amoxicillin/clavulanic acid against Escherichia coli and Proteus mirabilis, and a high concentration of gentamicin against Enterococcus faecalis, resulted in a significant decrease in the susceptibility rate after the implementation of SDD, with a drop of 20%, 27% and 32%, respectively. Compared with other Spanish ICUs without SDD, the susceptibility rate was higher in the ICU of our hospital in most cases. When it was lower, differences were <10%, except for a high concentration of streptomycin against Enterococcus faecium, for which the difference was 19%. Conclusions No relevant changes in the overall susceptibility rate after the implementation of SDD were detected. Susceptibility rates were not lower than those in the Spanish ICUs without SDD.

Tem analysis of multiple-energy arsenic implanted and Rta'd silicon

1987 ◽  
Vol 45 ◽  
pp. 246-247
Author(s):  
R.A. Herring
Keyword(s):  
Device Fabrication ◽  
High Concentration ◽  
Tem Analysis ◽  
Defect Clusters ◽  
High Fluences ◽  
Small Defect ◽  
Before And After ◽  
The Matrix ◽  
The Difference ◽  
Factor Type

Rapid thermal annealing (RTA) of ion-implanted Si is important for device fabrication. The defect structures of 2.5, 4.0, and 6.0 MeV As-implanted silicon irradiated to fluences of 2E14, 4E14, and 6E14, respectively, have been analyzed by electron diffraction both before and after RTA at 1100°C for 10 seconds. At such high fluences and energies the implanted As ions change the Si from crystalline to amorphous. Three distinct amorphous regions emerge due to the three implantation energies used (Fig. 1). The amorphous regions are separated from each other by crystalline Si (marked L1, L2, and L3 in Fig. 1) which contains a high concentration of small defect clusters. The small defect clusters were similar to what had been determined earlier as being amorphous zones since their contrast was principally of the structure-factor type that arises due to the difference in extinction distance between the matrix and damage regions.

Teaching the History of Technical Communication: A Lesson with Franklin and Hoover

2003 ◽  
Vol 33 (1) ◽  
pp. 65-81 ◽  
Author(s):  
Jeff Todd
Keyword(s):  
Technical Communication ◽  
English Language ◽  
Industrial Revolution ◽  
Technical Writing ◽  
Benjamin Franklin ◽  
Teaching History ◽  
Before And After ◽  
History Of ◽  
The Difference ◽  
The University

The first part of this article shows that research in the history of technical communication has increased in quantity and sophistication over the last 20 years. Scholarship that describes how to teach with that information, however, has not followed, even though teaching the history of the field is a need recognized by several scholars. The article provides and defends four guidelines as a foundation to study ways to incorporate history into classroom lessons: 1) maintain a continued research interest in teaching history; 2) limit to technical rather than scientific discourse; 3) focus on English-language texts; and 4) focus on American texts, authors, and practices. The second part of the essay works within the guidelines to show a lesson that contrasts technical texts by Benjamin Franklin and Herbert Hoover. The lesson can help students see the difference in technical writing before and after the Industrial Revolution, a difference that mirrors their own transition from the university to the workforce.

scholarly journals Causes of Vitamin K Deficiency in Patients on Haemodialysis

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2513
Author(s):  
Signe Wikstrøm ◽  
Katrine Aagaard Lentz ◽  
Ditte Hansen ◽  
Lars Melholt Rasmussen ◽  
Jette Jakobsen ◽  
...  
Keyword(s):  
Vitamin K ◽  
Absorption Capacity ◽  
Protein Supplementation ◽  
Matrix Gla Protein ◽  
Vitamin K1 ◽  
High Concentration ◽  
Vitamin K Deficiency ◽  
Before And After ◽  
K Deficiency ◽  
The Difference

Background: A low vitamin K status is common in patients on haemodialysis, and this is considered one of the reasons for the accelerated atherosclerosis in these patients. The vitamin is essential in activation of the protein Matrix Gla Protein (MGP), and the inactive form, dp-ucMGP, is used to measure vitamin K status. The purpose of this study was to investigate possible underlying causes of low vitamin K status, which could potentially be low intake, washout during dialysis or inhibited absorption capacity. Moreover, the aim was to investigate whether the biomarker dp-ucMGP is affected in these patients. Method: Vitamin K intake was assessed by a Food Frequency Questionnaire (FFQ) and absorption capacity by means of D-xylose testing. dp-ucMGP was measured in plasma before and after dialysis, and phylloquinine (vitamin K1) and dp-ucMGP were measured in the dialysate. Changes in dp-ucMGP were measured after 14 days of protein supplementation. Results: All patients had plasma dp-ucMGP above 750 pmol/L, and a low intake of vitamin K. The absorption capacity was normal. The difference in dp-ucMGP before and after dialysis was −1022 pmol/L (p < 0.001). Vitamin K1 was not present in the dialysate but dp-ucMGP was at a high concentration. The change in dp-ucMGP before and after protein supplementation was −165 pmol/L (p = 0.06). Conclusion: All patients had vitamin K deficiency. The reason for the low vitamin K status is not due to removal of vitamin K during dialysis or decreased absorption but is plausibly due to a low intake of vitamin K in food. dp-ucMGP is washed out during dialysis, but not affected by protein intake to a clinically relevant degree.

scholarly journals Longitudinal Study of Viral and Bacterial Contamination of Hospital Pediatricians’ Mobile Phones

2020 ◽  
Vol 8 (12) ◽  
pp. 2011
Author(s):  
Aymeric Cantais ◽  
Florence Grattard ◽  
Julie Gagnaire ◽  
Olivier Mory ◽  
Aurélie Plat ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Mobile Phones ◽  
Healthcare Workers ◽  
Winter Season ◽  
University Hospital ◽  
Infectious Agents ◽  
Study Results ◽  
Before And After ◽  
The University

Mobile phones (MPs) of healthcare workers (HCWs) may represent an important source of transmission of infectious agents. This longitudinal study documents the contamination of these tools. Ten MPs handled by senior pediatricians were sampled once a week during 23 weeks in three pediatric wards of the University Hospital of Saint-Etienne, France. Cultures were performed for bacteria and multiplex PCR assays for a panel of respiratory and enteric viruses. A questionnaire on hygiene habits regarding phoning and care was filled-in by pediatricians before and after the study. From a total of 230 samples, 145 (63%) were contaminated by at least one pathogen. The MPs from emergency departments were the most impacted. Viruses were detected in 179 samples; bacteria were isolated in 59 samples. Contamination increased during the winter epidemic peak. A cross-contamination by Paracoccus yeei between hands and MPs of different HCWs was demonstrated. The communication of the study results influenced the hygiene behaviors. This study highlights the contamination of MPs by pathogens that are resistant in the environment, and its sustainability along the winter season. The role of MPs as vectors of nosocomial infection needs to be better investigated.

scholarly journals Susceptibility of Urinary Tract Bacteria to Fosfomycin

2009 ◽  
Vol 53 (10) ◽  
pp. 4508-4510 ◽  
Author(s):  
Sofia Maraki ◽  
George Samonis ◽  
Petros I. Rafailidis ◽  
Evridiki K. Vouloumanou ◽  
Emmanuel Mavromanolakis ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Vitro Activity ◽  
University Hospital ◽  
In Vitro Activity ◽  
Gram Negative ◽  
Susceptibility Data ◽  
The University ◽  
Urinary Isolates

ABSTRACT We evaluated the in vitro activity of fosfomycin against urinary isolates in a region in Greece that exhibits considerable antimicrobial resistance by evaluating retrospectively relevant susceptibility data retrieved from the microbiological library of the University Hospital of Heraklion, Crete, Greece. We examined 578 urinary isolates. In total, 516 (89.2%) were susceptible to fosfomycin; 415 isolates were gram negative, and 101 isolates were gram positive. Fosfomycin appears to exhibit good levels of in vitro activity against the examined urinary isolates.

scholarly journals Are We over Dissecting the Cord in Orchidopexy?

2020 ◽  
Vol 5 (3) ◽  
pp. p16
Author(s):  
Hashem Mohammad Al-Momani, M.D. ◽  
Ahmad Aliwisat ◽  
Ibrahim Abdel Qader Khrais, M.D. ◽  
Osama Sarhan, M.D. ◽  
Ibraheem Suleiman Obaidat, M.D. ◽  
...  
Keyword(s):  
Spermatic Cord ◽  
Undescended Testis ◽  
Subcutaneous Fat ◽  
University Hospital ◽  
Increased Risk ◽  
Before And After ◽  
Incorrect Measurement ◽  
The Difference ◽  
Dissection Techniques ◽  
Cord Length

Background: Orchidopexy is a procedure of securing the testis inside the scrotum in patients with cryptorchidism. In the literature, various dissection techniques have been described to lengthen the spermatic cord to ensure a tension-free fixation of the testis to the lowest point of the scrotum.Objectives: The aim of this study is to determine if incorrect measurement of the spermatic cord’s length during open inguinal orchidopexy had led surgeons to over dissect the cord in a way that may pose an increased risk of testes, vas deferens and spermatic vessels.Materials and Methods: We prospectively studied the results of 40 orchidopexies performed in 40 patients with peeping or canalicular undescended testis , which was done at the Jordan university hospital in Amman from April 2018 to March 2019 , We compared the position of the testis before and after tunneling inside the inguinal canal. The difference in length is measured and analyzed.Conclusion: Failure to account for the subcutaneous fat layer thickness during orchidopexy increases the likelihood of over dissecting the spermatic cord which increases the risk of vas and vessels injury In this study we found that there is a difference between the cord length outside and inside the canal with excess length after passing the cord inside the canal ranges from 1-3 cm . This means that we do not need to dissect the cord to make the testis reaches the scrotum from outside. This decreases the risk of harming the cord and its contents.

scholarly journals Impact of Communicative and Informative Strategies on Influenza Vaccination Adherence and Absenteeism from Work of Health Care Professionals Working at the University Hospital of Palermo, Italy: A Quasi-Experimental Field Trial on Twelve Influenza Seasons

Vaccines ◽  
2019 ◽  
Vol 8 (1) ◽  
pp. 5 ◽  
Author(s):  
Claudio Costantino ◽  
Alessandra Casuccio ◽  
Francesca Caracci ◽  
Stefania Bono ◽  
Giuseppe Calamusa ◽  
...  
Keyword(s):  
Health Care ◽  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
Health Care Professionals ◽  
High Risk Group ◽  
University Hospital ◽  
Hospital Units ◽  
Before And After ◽  
Quasi Experimental ◽  
The University

Every year, about 20% of health care workers (HCWs) acquire influenza, continuing to work and encouraging virus spreading. Influenza vaccination coverage rates and absenteeism from work among HCWs of the University Hospital (UH) of Palermo were analyzed before and after the implementation of several initiatives in order to increase HCWs’ awareness about influenza vaccination. Vaccines administration within hospital units, dedicated web pages on social media and on the UH of Palermo institutional web site, and mandatory compilation of a dissent form for those HCWs who refused vaccination were carried out during the last four influenza seasons. After the introduction of these strategies, influenza vaccination coverage went up from 5.2% (2014/2015 season) to 37.2% (2018/2019 season) (p < 0.001), and mean age of vaccinated HCWs significantly decreased from 48.1 years (95% CI: 45.7–50.5) to 35.9 years (95% CI: 35.0–36.8). A reduction of working days lost due to acute sickness among HCWs of the UH of Palermo was observed. Fear of adverse reactions and not considering themselves as a high-risk group for contracting influenza were the main reasons reported by HCWs that refused vaccination. Strategies undertaken at the UH of Palermo allowed a significant increase in vaccination adherence and a significant reduction of absenteeism from work.

scholarly journals 224. Effect of Easing Overnight Restrictions on Antimicrobial Starts

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S113-S113
Author(s):  
Michael E Yarrington ◽  
Rebekah Wrenn ◽  
Justin Spivey ◽  
Christopher Shoff ◽  
Steven S Spires ◽  
...  
Keyword(s):  
Phase Shift ◽  
Interrupted Time Series ◽  
Antibiotic Use ◽  
Early Morning ◽  
University Hospital ◽  
Hospital Data ◽  
Process Change ◽  
Research Support ◽  
Before And After ◽  
The Hours

Abstract Background Some institutions allow administration of restricted antibiotics overnight until evaluation the following day (i.e. first dose free) to adapt to limitations in personnel resources. Whether this method results in higher number of overnight requests compared to strict 24/7 preauthorization has not been fully described. Methods In October 2019, Duke University Hospital (DUH) changed from strict preauthorization to allow initiation of two restricted agents (meropenem and micafungin) between the hours of 11pm to 7am. We performed an interrupted time series (ITS) analysis to evaluate the phase shift and change in trend in the number of new meropenem and micafungin orders per week before (Jan 2019-Oct 2019) and after (Oct 2019- Mar 2020) the process change. First antimicrobial orders for meropenem and micafungin were counted for unique patient encounters. We fit a Gaussian distribution function to the number of orders per hour of day to estimate the percent of orders initiated overnight (11p-7a) and during day/evening hours (7a-11p) before and after the process change. Results Hospital data included 1728 new meropenem and micafungin orders over a 61-week period (~28 per week). The total number of meropenem and micafungin orders was constant between Jan 2019 and October 2019 (+0.07 orders/week, 95% CI -0.13 to 0.27, Figure 1) and the phase shift during the first week of October was non-significant (-4.38 orders, 95% CI -12.34 to 3.58). The number of orders increased after October 2019 (+0.70 orders/week, 95% CI 0.13 to 1.25), however a sensitivity analysis removing the largest outlier eliminates significance. The percent of total orders between 11am to 7pm increased from 13.3% to 17.2% after the intervention (Figure 2). Overall antibiotic use remained similar through the study period. Figure 1. Estimated Approvals per Week Figure 2. Approvals by Hour of Day Conclusion There was no significant immediate change in overnight prescribing of meropenem and micafungin, however a trend towards increased number of orders appeared after removing overnight restriction requirements. Instead of “stealth dosing”, where providers wait to enter restricted antibiotic orders until evening hours, we observed a small increase in starts in early morning hours (1am-6am). Preauthorization approaches must adapt to personnel resources and quality of life for antimicrobial stewards. Disclosures Michael J. Smith, MD, MSC.E, Kentucky Medicaid (Grant/Research Support)Merck (Grant/Research Support) Rebekah W. Moehring, MD, MPH, Agency for Healthcare Quality and Research (Grant/Research Support)Centers for Disease Control and Prevention (Grant/Research Support)

scholarly journals Bayesian approach to comparing the left ventricular volume in myocardial infarction and in normal cases

2021 ◽  
Author(s):  
A.T. Hernowo
Keyword(s):  
Myocardial Infarction ◽  
Bayesian Approach ◽  
Left Ventricular Volume ◽  
Ventricular Volume ◽  
Left Ventricular ◽  
University Hospital ◽  
Years Of Experience ◽  
Post Contrast ◽  
The Difference ◽  
The University

AbstractIntroductionPost-contrast delayed-enhancement MRI helps to show the extent of myocardial infarction (MI), as well as allowing the morphometric analysis of the heart structure, e.g., left ventricular volume (LVV). Here the author deployed Bayesian implementation of statistical inference to determine the difference between the LVV in MI cases and in normal controls.MethodsSixty-seven MI patients and thirty-three controls from the EMIDEC dataset challenge were used. These were acquired at the University Hospital of Dijon (France). A cardiologist with 10 years of experience in cardiology and MRI and a biophysicist with 20 years of experience of cardiovascular MRI supervised the acquisition and annotated the images. ITK-Snap was used to extract the LVV and Bayesian inference were used to investigate the data.ResultsPatients with MI were younger than the controls (58.3 ± 11.5 vs. 66.5 ± 12.9 years; BF10 = 17.9). With age taken into consideration, the patients showed larger LVV relative to the controls (128.1 ± 46.3 vs. 83.4 ± 24.4 cm3; post-hoc BF10 = 12663.8).SummaryUsing Bayesian approach, we can conclude decisively that there is volumetric difference or remodeling in individuals with MI.

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