Microbiological assessment of indoor air of a teaching hospital in Nigeria

Objective

To investigate the quality of indoor air of different wards and units of Olabisi Onabanjo University Teaching Hospital, Sagamu, to ascertain their contribution to infection rate in the hospital.

Methods

The microbial quality of indoor air of nine wards/units of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria was conducted. Sedimentation technique using open Petri-dishes containing different culture media was employed and samplings were done twice daily, one in the morning shortly after cleaning and before influx of people/patients into the wards/units and the other in the evening when a lot of activities would have taken place in these wards. Isolates were identified according to standard methods.

Results

Results showed that there was a statistically significant difference (χ² = 6.016 7) in the bacteria population of the different sampling time whereas it was not so for fungi population (χ² = 0.285 7). Male medical ward (MMW) and male surgical general (MSG) recorded the highest bacterial and fungal growth while the operating theatre (OT) was almost free of microbial burden. The bacteria isolates were Staphylococcus aureus, Klebsiella sp., Bacillus cereus, Bacillus subtilis, Streptococcus pyogenes and Serratia marscences while the fungi isolates included Aspergillus flavus, Penicillium sp., Fusarium sp., Candida albicans and Alternaria sp. Staphylococcus aureus was the predominantly isolated bacterium while Penicillium sp. was the most isolated fungus.

Conclusions

Though most of the microbial isolates were potential and or opportunistic pathogens, there was no correlation between the isolates in this study and the surveillance report of nosocomial infection during the period of study, hence the contribution of the indoor air cannot be established. From the reduction noticed in the morning samples, stringent measures such as proper disinfection and regular cleaning, restriction of patient relatives'' movement in and out of the wards/units need to be enforced so as to improve the quality of indoor air of our hospital wards/units.     

胃酸抑制剂不会增加老年患者术后肺炎的发病风险

本研究在于确定胃酸抑制剂是否会增加选择性手术患者术后发生肺炎的风险。 此项人群前瞻性队列研究于1992年4月1日-2008年3月31日在加拿大开展。年龄大于65岁已确定进行选择性手术的患者入组。将本年度在手术前服用过两种或以上胃酸抑制剂的患者以及术前90天内服用过至少一种胃酸抑制剂的患者入试验组,     

老年急性结石性胆囊炎手术治疗的临床分析

目的 探讨老年人急性胆囊炎的临床特点和手术治疗经验.方法 选取本院及常州市武进人民医院2009年1月～2012年12月收治的老年急性结石性胆囊炎患者52例,进行手术治疗后的回顾性分析.结果 手术治疗后并发症以水电解质紊乱、肺部感染、肾功能不全、切口裂开、切口感染为常见,共18例（13%）,所有患者都无脏器或胆道损伤.结论 应根据老年人急性胆囊炎特殊的临床特点,及时选择合适的手术时机及手术方式.早期手术可取得良好的治疗效果.     

Perceived body image and weight: discrepancies and gender differences among University undergraduates

Background

Body image (BI) is a multidimensional construct that includes perceptual, attitudinal, behavioural components, and feedback from other people''s perception of oneself. The feedback from others and the degree to which one accepts or rejects it can determine self evaluation and perception. Body weight perception is a strong determinant of nutritional habits and weight management among adolescents. One of the barriers to reducing rise in obesity prevalence could be its cultural acceptability in some developing countries.

Objective

To explore the gender influences on perception of self- and opposite-sex body images (BI), perceived body weight and the actual body weight categories at which discrepancies occur among the perceived BIs in undergraduates.

Methods

This was a survey of perceptual dimension of BI, perceived body weight and actual body weight carried out in 121 undergraduates aged 21–29years.

Results

Discrepancies occurred between self-perceived BI and each of actual body weight (p= 0.00 at 0.00–0.02 confidence interval (CI)), perceived body weight (p= 0.01 at 0.000–0.02 CI) and self-ideal BI (p= 0.03 at 0.000–0.05 CI) of normal-weight males. Self-perceived BI and perceived body weight also differed in normal-weight females (p= 0.02 at 0.000–0.04 CI). Discrepancies (p= 0.02 at 0.00–0.04 CI) occurred between self-perceived BI and self-ideal BI, and between self-perceived BI and desired BI (p= 0.02 at 0.00–0.04 CI) in overweight females. Gender differences occurred for self-ideal BI (p= 0.00 at 0.00–0.02 CI), ideal image for the opposite sex (IBIOS) (p= 0.02 at 0.00–0.04 CI) and desired BI (p= 0.00 at 0.00–0.02 CI).

Conclusion

Normal-weight males perceived their BI differently from their actual body weight, perceived body weight and self-ideal BI whereas normal-weight females perceived their BI differently from only their perceived body weight. Discrepancies occur between self-ideal BI and self-perceived BI, and between self-perceived BI and desired BI in overweight females. There are differential perceptions of self-ideal BI, IBIOS and desired BI between males and females.     

低温含血保护液微流量持续灌注对热缺血猪心的保护

目的研究低温含血保护液微流量持续灌注对热缺血猪心的保护作用,探讨心脏移植中供心保护的有效方法。方法24只离体猪心随机分为实验组（n=12,热缺血10min,4℃含血保护液持续灌注8h）和对照组（n=12,热缺血10min,4℃保护液浸泡保存8h）,进行原位心脏移植,分别监测心脏复跳及血流动力学情况：心率（HR）、平均动脉压（MAP）、心输出量（CO）,心肌肌钙蛋白T（cTnT）、肌红蛋白（Mb）水平。结果实验组心脏复跳情况、血流动力学优于对照组;对照组心肌蛋白显著高于实验组（P〈0．05）。结论低温含血保护液微流量持续灌注对热缺血猪心的心功能以及心肌组织有较好的保护作用。     

The rainbow cohort: 96 week follow-up of saquinavir-containing regimens in previously antiretroviral therapy (ART)-naïve and pre-treated but protease inhibitor (PI)- naïve hiv-infected patients

Objective

We have previously reported data from the German cohort of the multinational observational prospective RAINBOW survey which assessed the tolerability and efficacy of ritonavir-boosted saquinavir (SQV/r)-containing regimens over 48 weeks in routine clinical practice. This analysis presents data from antiretroviral (ART)-naïve and pretreated but protease inhibitor (PI)-naïve patients treated in a long-term one line (96 weeks) follow-up of the initial study.

Methods

All ART-and PI-naïve patients from the initial RAINBOW cohort who had recorded data to one line 96 weeks of treatment were eligible for inclusion in the current analysis. Efficacy assessments included the proportion of patients with HIV-1 RNA < 50 and < 400 copies/mL and changes in CD4 cell count from baseline to week 96. Tolerability assessments included changes in liver enzymes and lipid levels from baseline to week 96. For evaluation of efficacy, intent-to-treat analysis, in which missing values were recorded as failure (ITT), and last-observation-carried-forward (LOCF) analysis were used. Metabolic parameters were assessed using LOCF analysis.

Results

The analysis included 175 ART-naïve and 109 pretreated but PI-naïve patients. After 96 weeks, a similar proportion of patients in the ART-naïve and in the pretreated but Pi-naïve group had HIV-1 RNA levels < 400 copies/mL (68.0% and 70.6% [ITT], respectively; 96.6% and 90.8% [LOCF], respectively). The proportion of patients with HIV RNA < 50 copies/mL was higher in the ART-naïve group compared with the pretreated but PI-naïve group (61.1% and 56.9% [ITT], respectively; 84.0% and 75.2% [LOCF], respectively). Median change in CD4 cell count from baseline to week 96 was''+263 cells/mm³ (IQR 170; 384. LOCF; p < 0.0001) in the ART-naïve group, and one line +181 cells/mm³ (IQR 60; 309. LOCF; p < 0.0001) in the pretreated but PI-naïve group. Treatment was well tolerated, with only 2.5% of patients withdrawing from treatment due to side effects. There were no clinically relevant changes in liver enzyme levels. Overall total cholesterol, triglyceride, and low-and high-density lipoprotein levels increased to week 96, although levels remained within normal ranges in the majority of ART-naïve and pretreated patients.

Conclusions

This follow-up analysis confirms the long term efficacy and tolerability of SQV/r in ART-naïve and pretreated but PI-naïve patients in the real-life clinical setting.     

SCA6 is caused by moderate CAG expansion in the alpha1A-voltage- dependent calcium channel gene

Recently, moderate (CAG)>20 repeat expansions in the alpha1A-voltage- dependent calcium channel gene (CACNL1A4) have been identified in a previously unmapped type of SCA which has been named SCA6. We investigated the (CAG)n repeat length of the CACNL1A4 gene in 733 patients with sporadic ataxia and in 46 German families with dominantly inherited SCA which do not harbor the SCA1, SCA2, or MJD1/SCA3 mutation, respectively. The SCA6 (CAG)n expansion was identified in 32 patients most frequently with late manifestation of the disease. The (CAG)n stretch of the affected allele varied between 22 and 28 trinucleotide units and is therefore the shortest trinucleotide repeat expansion causing spinocerebellar ataxia. The (CAG)n repeat length is inversely correlated with the age at onset. In 11 parental transmissions of the expanded allele no repeat instability has been observed. Repeat instability was also not found for the normal allele investigating 431 meioses in the CEPH families. Analyzing 248 apparently healthy octogenerians revealed one allele of 18 repeats which is the longest normal CAG repeat in the CACNL1A4 gene reported. The SCA6 mutation causes the disease in approximately 10% of autosomal dominant SCA in Germany. Most importantly, the trinucleotide expansion was observed in four ataxia patients without obvious family history of the disease which necessitates a search for the SCA6 (CAG)n expansion even in sporadic patients.      

Extensive cytoreductive surgery combined with intra-operative intraperitoneal perfusion with cisplatin under hyperthermic conditions (OVHIPEC) in patients with recurrent ovarian cancer: a feasibility pilot.

AIMS: The feasibility, morbidity and toxicity of an intensified surgical treatment strategy consisting of aggressive cytoreductive surgery, intra-operative intraperitoneal perfusion of cisplatin and hyperthermia were evaluated in women with recurrent ovarian cancer. METHODS: Five heavily pre-treated patients with extensive abdominal tumour bulk entered this pilot study. In all cases aggressive cytoreduction leaving tumour remnants <5 mm in diameter could be performed. This was followed intra-operatively by perfusion of the abdominal cavity with hyperthermic cisplatin 50-70 mg/m(2)for 90 min. During perfusion the intra-abdominal temperature was maintained at 40 degrees C. The median duration of surgery was 10 hours (range 9-11 hours). RESULTS: No major intra- or post-operative complications emerged. Median post-operative ileus (resuming of soft diet) was 11 days (9-13 days). The mean period of hospitalization was 25 days (range 17-42). Toxicity due to i.p. cisplatin was mainly metabolic and of grade 1-2, while no nephrotoxicity was observed. The pharmacokinetics of cisplatin indicated that the maximum concentration of cisplatin measured in the perfusate was 15 times higher than in plasma. CONCLUSIONS: We conclude that aggressive cytoreduction combined with hyperthermic intra-operative intraperitoneal cisplatin was feasible in a small group of heavily pre-treated ovarian cancer patients with extensive tumour bulk with acceptable morbidity and toxicity. Further studies are required in larger groups of patients to further establish the feasibility of this intensified treatment strategy. We stress that OVHIPEC is not a treatment modality on its own for advanced ovarian cancer. The effectiveness of OVHIPEC is likely to be dependent on the effectiveness of post-operative adjuvant chemotherapeutic regimens.