Wanted: a national standard for early hearing detection and intervention outcomes data

The Joint Committee on Infant Hearing (JCIH, 2000) has presented principles and guidelines for universal newborn hearing screening and early hearing detection and intervention (EHDI). The guidelines describe the need for a national data set for early hearing detection and intervention. The guidelines fail to provide the specific constructs for such a data set. To the authors' knowledge, no nationally proposed uniform data structure exists to capture EHDI services' outcome metrics. This article presents a proposed newborn hearing screening and EHDI data model. This model was developed to record EHDI outcomes data from Military Health System birthing centers. The data are to be collected for tracking implementation of Healthy People 2010 goals related to newborn hearing screening and EHDI programs within the Military Health System. In this article, the authors use the T. Helfer, A. Shields, and K. Gates (2000) methods to model a uniform structure for collection of newborn hearing screening and EHDI data. They also discuss expansion of the data model for application to public health reporting of EHDI outcomes in the civilian sector to include integration of Census Bureau demographic data and geographic information system data to further enhance the research value of these EHDI outcomes data. They offer the data model with the intention of supporting national research efforts for studying the efficacy of EHDI programs and to help establish a national evidence-based practice database for such programs.     

Persistence of the same strain of Legionella pneumophila in the water system of an Italian hospital for 15 years.

In 2004, an outbreak of legionnaires disease occurred in a hospital in northern Italy with a water system that had been disinfected multiple times since 1990 and equipped with a continuous disinfecting system. Molecular typing linked the outbreak to contamination of the hospital water system and demonstrated the persistence of a predominant strain of Legionella pneumophila for 15 years.     

Use of cultivation-dependent and -independent techniques to assess contamination of central venous catheters: a pilot study

Background  

Catheters are the most common cause of nosocomial infections and are associated with increased risk of mortality, length of hospital stay and cost. Prevention of infections and fast and correct diagnosis is highly important.     

Combined Procedures with Laparoscopic Cholecystectomy

With advancement in laparoscopic surgery a number of surgical procedures can be performed combined with laparoscopic cholecystectomy in a single surgery. We evaluate the safety & efficacy of such surgeries. A retrospective review of all patients who had undergone combined procedures with laparoscopic cholecystectomy during January 2005 to June 2009 was performed. 3144 laparoscopic cholecystectomies were performed in the period from January 2005 to June 2009. Of these, 401 cases were combined with another procedure. The mean operative time was 80 min (range 50–270 min). The mean hospital stay was 3.2 days (range 1–5 days). The mean no. of days injectable analgesics was required was 2 days (range 1 day–4 days). Combined procedures provide patients with all the benefits of minimal invasive surgery and also give the benefit of single time anaesthesia without adding to post operative morbidity & hospital stay.     

Open liver resection for colorectal metastases: better short- and long-term outcomes in patients potentially suitable for laparoscopic liver resection

Background:

There is no prospective randomized data comparing laparoscopic to open hepatectomy. This study compared short- and long-term outcomes in patients undergoing hepatectomy for colorectal metastases (CRM), who were suitable for either laparoscopic or open surgery.

Methods:

Data were prospectively collected from consecutive patients undergoing hepatic resection of CRM at a single centre (1987–2007). Patients who were suitable for laparoscopic resection (Group 1) were compared with patients whose tumour characteristics would best be considered for open resection (Group 2).

Results:

Out of 1152 hepatectomies, 266 (23.1%) were deemed suitable for a laparoscopic approach. The median (IQR) number of metastases was greater in Group 2 [2(1–20) vs. 1(1–10), P < 0.001], as was the mean (SD) tumour size [5.3(3.6) cm vs. 3.3(1.2) cm, P < 0.001]. The median (IQR) operation time [210 (70) min vs. 240 (90) min, P < 0.001] and blood loss [270 (265) ml vs. 355 (320) ml, P < 0.001] were less in Group 1. There was no difference in length of stay, morbidity or mortality. Patients in Group 2 had a higher R1 resection rate (14.9%) compared with Group 1 (4.5%, P < 0.001) and lower 5-year survival (37.8% vs. 44.2%, P= 0.005).

Discussion:

Current criteria for laparoscopic hepatectomy selects patients who have more straight-forward surgery, with less risk of an involved resection margin and better long-term survival, compared with patients unsuited to a laparoscopic approach. Clearly defined criteria for laparoscopic hepatectomy are essential to allow meaningful analysis of outcomes and the results of unrandomized series of laparoscopic hepatectomies must be interpreted with caution.     

Chemistry and pharmacology of neglected helminthic diseases

Neglected helminthic diseases cause many social, economic and health care challenges in developing countries. The high number of patients suffering from these parasitic infections and the lack of sufficient treatment options represent severe problems. Research on new drugs and therapies to meet this urgent requirement has to be intensified. This review focuses on infections caused by four helminthic parasites, which have been declared as neglected diseases by the World Health Organization: namely drancunculiasis, lymphatic filariasis, onchoceriasis, and schistosomiasis. They show a considerable overlap in their world-wide prevalence and treatment strategies. Nevertheless, treatment is not without complications. The most efficient lymphatic filariasis drug, diethylcarbamazine, causes severe adverse effects in onchocerciasis patients and completely fails in the treatment of drancunculiasis. In this review, we discuss these incongruities at the molecular and cellular level. Furthermore, established or investigational drug combination regimens are highlighted. In the past years, progress has been made in the area of schistosomiasis and onchocerciasis. The molecular biology of underlying mechanisms, signalling pathways and related targets affected by drug therapy are discussed in detail. Finally, successful treatment strategies and remaining future challenges are summarized.