Abstract
Background
Approximately 25% of inpatients have urinary catheters at some point during their hospital stay; over half are deemed inappropriate. This is significant as catheter-associated ...urinary tract infections (CAUTI) increase morbidity, mortality and length of hospitalisation. Lack of medical documentation and clinician awareness of catheters have been identified as risk factors for inappropriate catheterisation. The aim of this audit was to assess inpatient urinary catheter use among medical inpatients to determine if the indication and insertion procedure were clearly documented.
Methods
The audit was conducted over one day and included all medical inpatients aged 18 years and above. Emergency Department and High Dependency patients were excluded. Data was collected using standardised data collection sheets and involved a review of medical/nursing notes. Data was benchmarked against Health Service Executive guidelines.
Results
27 of 132 medical inpatients (20%) had a urinary catheter in situ on the day of audit. 37% (n = 10) had long-term urinary catheters in situ prior to admission and are not considered further. Of the remaining 63% (n = 17), 9 were female (53%), 8 were male (47%), and the average age was 75 years. Indication was documented in nursing notes for 76% and in medical notes for 53%. Indications included monitoring urinary output (29%), urinary retention (24%), sepsis (18%), comfort (6%) and haematuria (6%). Catheter insertion procedure was documented in nursing notes for 59% and in medical notes for 12%.
Conclusion
One fifth of medical inpatients had urinary catheters on the day of audit. 63% of these patients did not have a catheter prior to admission. Overall medical documentation of catheter indication and insertion procedure is poor. Better documentation would likely improve clinician awareness of their patient’s catheters and prompt earlier review of appropriateness. Education sessions, insertion proforma stickers and catheter review reminder systems are suggested to improve documentation.
Objective: Molecular methods offer a more rapid alternative for the detection of H. pylori resistance to antibiotics than traditional culture-based methods. The aim of the study was to evaluate the ...RIDAGENE H. pylori real-time PCR assay compared to culture-based methods for the detection of H. pylori and clarithromycin resistance using gastric biopsies. Patients and Methods: Following ethical approval and informed consent, adults were recruited prospectively from Tallaght University Hospital and Letterkenny University Hospital, Ireland, regardless of H. pylori treatment history. During routine gastroscopy, subjects had 1 antrum and 1 corpus biopsy taken for H. pylori culture and DNA extraction. Clarithromycin susceptibility testing on cultures was performed by ETEST (Biomerieux, UK). The RIDAGENE H. pylori assay (R-Biopharm AG, Germany) was used for detection of H. pylori DNA and clarithromycin resistance-associated point mutations. Results: In all, samples from 191 culture-positive patients (mean age 48.4 ± 15.3 years; 45.0% (N=86) female) were analysed. The RIDAGENE assay detected H. pylori in 100% of biopsy samples from which H. pylori was cultured. The clarithromycin resistance rate by culture was significantly higher than by real-time PCR (49.2% (N=94/191) and 38.7% (N=74/191, respectively; p=0.04; χ2 test). Results agreed between both methods in 84.3% (N=161/191) of cases. The sensitivity and specificity of the RIDAGENE assay compared to culture for the detection of clarithromycin resistance were 74.0% (95% CI: 64.0-82.4%) and 94.7% (95% CI: 88.1-98.3%), respectively. The positive predictive value was 93.4% (95% CI: 85.7-97.1%) and the negative predictive value was 78.3% (95% CI: 71.9-83.5%). Conclusions: The RIDAGENE assay detected H. pylori in all culture-positive samples. However, the low sensitivity compared to culture for clarithromycin susceptibility testing in our cohort may limit its use to cases where culture-based methods are unsuccessful. Further studies are required to fully characterise H. pylori clarithromycin resistance mechanisms in our study population.
The present study documents the wood-boring trace fossil Asthenopodichnium from the Palaeocene sediments of the Barmer Hill Formation (BHF) in the Barmer Basin, Western Rajasthan, India. The ...Asthenopodichnium trace fossils are loosely to tightly packed, pouch-like burrows or almond-shaped structures identified as Asthenopodichnium lignorum, whereas lozenge and J-shaped structures are designated as Asthenopodichnium lithuanicum. The A. lignorum trace markers are considered to be the feeding and dwelling burrows produced by wood-rotting fungi, whereas A. lithuanicum are interpreted as feeding and dwelling burrows produced by Mayfly nymphs and larvae. The sedimentological and palaeontological studies of trace fossil-bearing horizons of BHF suggest freshwater fluvial sedimentary environment with humid to sub-humid climate.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Pre-treatment with 5-aminosalicylic acid (5-ASA) significantly reduced sperm-shape abnormalities in endosulfan-treated rats. The number of abnormal sperm in the epididymis was markedly increased by ...endosulfan treatment but pre-treatment with 5-ASA kept these values close to normal. Treatment with 5-ASA at a dose of 25
mg/kg bw was more effective in reducing sperm-shape abnormality and sperm count than at a dose of 50
mg/kg bw. Endosulfan significantly increased the level of lactate dehydrogenase (LDH) in rats but a marked decrease was observed upon pre-treatment with 25
mg/kg bw 5-ASA. Changes in plasma testosterone levels were not significantly correlated with 5-ASA pre-treatment but histopathological analysis of seminiferous tubules and Leydig cells showed significant protection from endosulfan-induced tissue damage such as necrosis. The population of Sertoli cells increased and the lumen of the seminiferous tubules contained a greater number of spermatids. There was a corresponding increase in the number of Leydig cells. A curative study with 5-ASA showed a similar protection from endosulfan-induced toxicity and cellular damage, but the extent of protection was significantly lower.
Innovative scaffold designs that modulate the local inflammatory microenvironment through favorable macrophage polarization and suppressing oxidative stress are needed for successful clinical ...translation of regenerative cell therapies and graft integration. We herein report derivation of a hydrazone-crosslinked gallol functionalized hyaluronic acid (HA-GA)-based hydrogel that displayed outstanding viscoelastic properties and immunomodulatory characteristics. Grafting of 6% gallol (GA) to a HA-backbone formed an interpenetrative network by promoting an additional crosslink between the gallol groups in addition to hydrazone crosslinking. This significantly enhanced the mechanical stability and displayed shear-thinning/self-healing characteristics, facilitated tissue adhesive properties to porcine tissue and also displayed radical scavenging properties, protecting encapsulated fibroblasts from peroxide challenge. The THP-1 human macrophage cell line or primary bone-marrow-derived murine macrophages cultured within HA-GA gels displayed selective polarization to a predominantly anti-inflammatory phenotype by upregulating IL4ra, IL-10, TGF-β, and TGF-βR1 expression when compared with HA-HA gels. Conversely, culturing of pro-inflammatory activated primary murine macrophages in HA-GA gels resulted in a significant reduction of pro-inflammatory TNF-α, IL-1β, SOCS3 and IL-6 marker expression, and upregulated expression of anti-inflammatory cytokines including TGF-β. Finally, when the gels were implanted subcutaneously into healthy mice, we observed infiltration of pro-inflammatory myeloid cells in HA-HA gels, while immunosuppressive phenotypes were observed within the HA-GA gels. Taken together these data suggest that HA-GA gels are an ideal injectable scaffold for viable immunotherapeutic interventions.
Host immune response against the implanted scaffolds that are designed to deliver stem cells or therapeutic proteins in vivo significantly limits the functional outcome. For this reason, we have designed immunomodulatory injectable scaffolds that can favorably polarize the recruited macrophages and impart antioxidant properties to suppress oxidative stress. Specifically, we have tailored a hyaluronic acid-based extracellular matrix mimetic injectable scaffold that is grafted with immunomodulatory gallol moiety. Gallol functionalization of hydrogel not only enhanced the mechanical properties of the scaffold by forming an interpenetrating network but also induced antioxidant properties, tissue adhesive properties, and polarized primary murine macrophages to immunosuppressive phenotype. We believe such immunoresponsive implants will pave the way for developing the next-generation of biomaterials for regenerative medicine applications.
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Background: Chronic infection has a known effect on the cytokine levels of the body which adversely affects erythropoiesis. Aim: The aim of this study is to compare hematological parameters among ...participants with and without chronic periodontitis which also is a known infectious inflammatory disease of the gums. Materials and Methods: Forty patients with severe chronic periodontitis (Group A) and forty periodontally healthy participants (Group B) in the age group of 30-55 years presenting to the Outpatient Department of the Faculty of Dental Sciences, Banaras Hindu University, were recruited in the study and were assessed for various hematological and periodontal parameters. SPSS 17.0 version was used. Student's t-test (unpaired) was used. P < 0.05 was considered statistically significant. Results: Group A showed lower hemoglobin (Hb, 13.47 ± 1.05, P = 0.019), erythrocyte count (4.63 ± 0.40, P = 0.002), and mean corpuscular Hb concentration (32.58 ± 0.90, P = 0.003) values compared to Group B (13.95 ± 0.70, 4.90 ± 0.33, and 33.18 ± 0.81, respectively). Conclusion: Within the limitations of the study, it can be safely deduced that a positive relationship exists between the hematological parameters and severity of chronic periodontal disease, suggesting that long-standing chronic periodontitis may lead to the development of signs of anemia.
Aims To determine the completeness of polyp resection (i.e. achieving an R0 margin) and its relation with Endoscopists, histopathologist, size, location and technique of polypectomy in an NSS cohort. ...The definition of R0 margin is complete macroscopic resection with a negative microscopic margin at polypectomy. Method NCCS (National Colon Cancer Screening) colonoscopies are offered to bowel cancer screening patients after a positive faecal immunochemical test (FIT) test in a Joint Advisory Group (JAG) accredited Gastrointestinal Endoscopy centre. We histologically evaluated the polyp margins for complete resection, which was defined as the absence of adenomatous or hyperplastic tissue in the resected polyp margins in a cohort of faecal immunochemical test positive patients. Results A total of 186 consecutive NCCS colonoscopies out of a total of 542 performed between 2013 and 2017 were included in this study. Of the polyps excised 152(27%) had a R0 margin histologically, and 30(5%) had involvement of the margin. Surprisingly in 373(67%) of polyps pathologists were unable to assess the margin. Conclusion Achieving an R0 margin should be a key performance indicator for endoscopists performing polypectomy. At the same time more studies on polyp margins are recommended.
Despite substantial progress being made relating to 2D-nanofiller-based composite nanolaminates, the fabrication of composite nanolaminates with enhanced ductility and toughness is still challenging. ...In this study, layered structure graphene oxide (GO)/gelatin powder (GP) composites nanolaminates with enhanced ductility and toughness have been achieved by a simple vacuum filtration of aqueous dispersion of GO/GP composite solution containing 5 wt% of GO. The composite film containing 5 wt% GO shows outstanding improvement of 200% in the stress at break value, with simultaneous enhancement of 52% of the strain at break value compared to GP film. A significant improvement in toughness from 2.2 MJ m −3 to 9.5 MJ m −3 is observed in the composite film containing 5 wt% GO. These significant enhancements of the mechanical properties of the composite film are obtained via the formation of an intercalated nanolaminate structure, H-bonding interactions, and the tailoring of the crystal structure of GP in the composite film, as proved via field-emission scanning electron microscopy, Fourier-transform infrared spectroscopy, and wide-angle X-ray diffraction studies. The growing of fibroblast cells on the composite films signifies that they are not cytotoxic. These GO/GP composites with significant mechanical properties and biocompatibility are very promising for various biomedical applications.
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