Impact of Protective Footwear on Floor and Air Contamination of Intensive Care Units

Background

Use of protective footwear before entering the intensive care units is enforced with the assumption that it lowers the incidence of bacterial floor colonization. The present study was carried out to find the efficacy of protective footwear on bacterial floor colonization.

Methods

The study was carried out in the intensive care unit of a tertiary care hospital. The study was divided into two phases of two weeks each, phase I with and phase II without use of protective footwear. Samples were taken at six different sites namely footwear exchange area; visitors /staff route; partitioned patient cubicle; central monitoring area; open patient cubicle and scrub up areas. Floor samples were taken at 0600, 1100, 1700 and 2200 hours and air samples at 0600 and 1700 hours. Bacteria were identified and colony forming units (cfu) measured from floor and colony forming units/metre³ (cfu/m3) from air sample cultures.

Result

A total of 9521 bacterial colony forming units were isolated from 192 samples in phase I from the floor samples and 9971cfu from 192 samples in phase II. From 96 air samples in each phase, a mean of 262 cfu/m³ in phase I and 220cfu/m³ in phase II were isolated. The difference between the two phases was statistically not significant (p value > 0.05 for both).

Conclusion

Floor and air colony counts showed no significant difference in the two phases with and without protective footwear. Protective footwear had no significant impact on bacterial contamination of floors.Key Words: Floor contamination, Intensive care unit, Protective footwear, Floor samples, Bacterial floor colonization     

腹主动脉瘤术后血小板变化的临床意义

目的探讨腹主动脉瘤腔内修复术后血小板变化的特点及其临床意义.方法121例腹主动脉瘤切除术中81例行主髂动脉单臂腔内修复术(endovascular     

The prevalence of BRCA1 mutations among young women with triple-negative breast cancer

Background

Molecular screening for BRCA1 and BRCA2 mutations is now an established component of risk evaluation and management of familial breast cancer. Features of hereditary breast cancer include an early age-of-onset and over-representation of the 'triple-negative' phenotype (negative for estrogen-receptor, progesterone-receptor and HER2). The decision to offer genetic testing to a breast cancer patient is usually based on her family history, but in the absence of a family history of cancer, some women may qualify for testing based on the age-of-onset and/or the pathologic features of the breast cancer.

Methods

We studied 54 women who were diagnosed with high-grade, triple-negative invasive breast cancer at or before age 40. These women were selected for study because they had little or no family history of breast or ovarian cancer and they did not qualify for genetic testing using conventional family history criteria. BRCA1 screening was performed using a combination of fluorescent multiplexed-PCR analysis, BRCA1 exon-13 6 kb duplication screening, the protein truncation test (PTT) and fluorescent multiplexed denaturing gradient gel electrophoresis (DGGE). All coding exons of BRCA1 were screened. The two large exons of BRCA2 were also screened using PTT. All mutations were confirmed with direct sequencing.

Results

Five deleterious BRCA1 mutations and one deleterious BRCA2 mutation were identified in the 54 patients with early-onset, triple-negative breast cancer (11%).

Conclusion

Women with early-onset triple-negative breast cancer are candidates for genetic testing for BRCA1, even in the absence of a family history of breast or ovarian cancer.     

人乳头瘤病毒与结直肠癌的关系

随着分子生物学技术的进步,有关人乳头瘤病毒（ｈｕｍａｎｐａｐｉｌｌｏｍａｖｉｒｕｓ,ＨＰＶ）与肿瘤关系的研究也得到了迅速的深入和发展．越来越多的证据表明,ＨＰＶ与人类许多严重疾病,特别是癌症等有着密切关系．已经肯定ＨＰＶ在宫颈癌［１］、肛周癌［２］、ＡＩＤＳ病［３］、口腔癌［４］等疾病发生、发展过程中起着重要的作用．在消化道肿瘤中,ＨＰＶ与食管癌的关系,呈现一定的区域性特点：即在食管癌高发区如中国、南非等,ＨＰＶ是食管癌的高危因素;而在食管癌低发区如西欧、北美等,ＨＰＶ与癌相关性较差［５］．近年…     

Quality of End-of-Life Care in Gastrointestinal Cancers: A 13-Year Population-Based Retrospective Analysis in Ontario,Canada

Population-based quality indicators of either aggressive or supportive care at end of life (EOL), especially when specific to a cancer type, help to inform quality improvement efforts. This is a population-based, retrospective cohort study of gastrointestinal (GI) cancer decedents in Ontario from 1 January 2006–31 December 2018, using administrative data. Quality indices included hospitalizations, emergency department (ED) use, intensive care unit admissions, receipt of chemotherapy, physician house call, and palliative home care in the last 14–30 days of life. Previously defined aggregate measures of both aggressive and supportive care at end of life were also used. In our population of 69,983 patients who died of a GI malignancy during the study period, the odds of experiencing aggressive care at EOL remained stable, while the odds of experiencing supportive care at EOL increased. Most of our population received palliative care in the last year of life (n = 65,076, 93.0%) and a palliative care home care service in the last 30 days of life (n = 45,327, 70.0%). A significant number of patients also experienced death in an acute care hospital bed (n = 28,721, 41.0%) or had a new hospitalisation in the last 30 days of life (n = 33,283, 51.4%). The majority of patients received palliative care in the last year of life, and a majority received a palliative care home service within the last 30 days of life. The odds of receiving supportive care at EOL have increased over time. Differences in care exist according to income, age, and rurality.