Prevention of hypoxia and hyperoxia during endotracheal suctioning

A new suction catheter, designed to deliver alternately oxygen or suction, prevented episodes of hypoxia and hyperoxia in a group of infants during endotracheal suctioning. Twenty infants received both conventional endotracheal suctioning and suctioning by the new catheter. The infants had a maximal change from a presuctioning transcutaneous oxygen (PtcO2) of 12 +/- 8 torr and required 3.1 +/- 2 min to regain their presuctioning oxygenation level compared to a maximal change of 21 +/- 10 torr (p less than .05) and a stabilization time of 5.3 +/- 2.6 min (p less than .05) in the conventionally treated group. Three study infants experienced an abnormal PtcO2 (either less than 40 or greater than 90 torr), while 13 control infants suffered these abnormalities (p less than .01). The use of this new suction device effectively reduced the exposure of this group of infants to episodes of aberrant oxygen states and allowed for a shorter recovery time.     

British Society for Medical Mycology proposed standards of care for patients with invasive fungal infections

Outcomes for invasive fungal infections have greatly improved in the past decade, and several new antifungal drugs have been or will be licensed in the next few years. Early accurate diagnosis and appropriate treatment have major impact on survival. In a 1995 survey of laboratory practice in the UK for mycology, major disparities were seen, with many laboratories not undertaking even simple diagnostic procedures. Delays in processing and inadequate procedures for handling samples, incomplete or delayed reporting of results, or a combination of these, compromise the care of patients. In randomised trials of antifungal chemotherapy, optimum treatments and good alternatives for others have been defined for some infections. High-quality care requires a multidisciplinary approach to diagnosis and management. In this review, we propose microbiology, histopathology, radiology, and clinical auditing standards, with the evidence base for each reviewed. The standards are absolutes, and, therefore, provide a straightforward basis for improving services to patients if they are all implemented.     

Reliability and Validity of a Korean Version of the Leicester Cough Questionnaire

Purpose

There are no specific tools for measurement of the severity of chronic cough in Korea. We developed a Korean version of the Leicester Cough Questionnaire (LCQ) and tested its scaling and clinical properties.

Methods

The LCQ was adapted for Korean conditions following a forward-backward translation procedure. All patients referred to chronic cough clinics at 5 university hospitals between May 2011 and October 2013 completed 2 questionnaires, the LCQ and the Short-Form 36 (SF-36), upon presentation and completed the LCQ and the Global Rating of Change (GRC) upon follow-up visits after 2 or 4 weeks. Concurrent validation, internal consistency, repeatability, and responsiveness were determined.

Results

For the concurrent validation, the correlation coefficients (n=202 patients) between the LCQ and SF-36 varied between 0.42 and 0.58. The internal consistency of the LCQ (n=207) was high for each of the domains with a Cronbach''s alpha coefficient of 0.82-0.94. The repeatability of the LCQ in patients with no change in cough (n=23) was high, with intra-class correlation coefficients of 0.66-0.81. Patients who reported an improvement in cough (n=30) on follow-up visits demonstrated significant improvement in each of the domains of the LCQ.

Conclusions

The Korean version of the LCQ is a valid and reliable questionnaire for measurement of the severity of cough in patients with chronic cough.