Detection and quantification of lupus anticoagulants in plasma from heparin treated patients, using addition of polybrene

BACKGROUND: Lupus anticoagulants prolong clotting times in phospholipid-dependent coagulation tests. Lupus Ratio assays are integrated tests for lupus anticoagulants that may be based on APTT, RVVT or dPT clotting times. If a patient is being treated with unfractionated heparin, however, the heparin prolong clotting times and the diagnosis of lupus anticoagulant is invalidated. Commercial assays may have heparin neutralising agents added to their reagents. However, the type and efficacy of the heparin neutralisation is often not documented. We wanted to test the influence and efficacy of heparin neutralisers in the Lupus Ratio assay. METHODS: Several heparin neutralisers were tested, and polybrene was chosen for further testing. Unfractionated heparin and/or polybrene were added to normal plasma and to plasma from patients with or without lupus anticoagulant and clotting times compared before and after the additions. Lupus anticoagulant-positive patients were given 5000 IU i.v. of unfractionated heparin and plasma was collected just before and five minutes after the injection. Lupus Ratios were calculated after polybrene was added to the postinjection samples. RESULTS: The Lupus Ratio became slightly lower when polybrene was added to plasma without heparin. Plasma heparinised in vitro and plasma from patients that had received heparin, both had Lupus Ratios nearly identical to the Lupus Ratios calculated before any additions. CONCLUSION: By addition of polybrene to a final concentration of 7.9 μg/ml in test plasma, Lupus Ratio may be determined in lupus anticoagulant-negative as well as positive plasmas irrespective of the presence of heparin 0.0 – 1.3 U/ml

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Représentations de la vieillesse dans la littérature . Un conte, une nouvelle et un roman du XIXᵉ siècle

Résumé L'objectif principal de notre mémoire a été de chercher des descriptions littéraires de la vieillesse, et d'étudier la vieillesse comme thème littéraire, principalement dans la littérature française. Notre but est de faire voir qu' « Un c ur simple » de Gustave Flaubert (1877), « Monsieur Parent » (1885) de Guy de Maupassant et Le Père Goriot d'Honoré de Balzac (1835) qualifient comme récits de vieillesse. Les images de la vieillesse et la conception générale de ce qu'est une vie humaine, sont différentes d'une culture à une autre et aussi d'un moment historique à un autre. La conception du statut de la personne âgée et des différentes phases qui constituent la vieillesse, comme quand on commence à vieillir, peut différer culturellement et historiquement. Le point de départ de notre analyse est l' uvre qui a inspiré le thème de notre mémoire, est le conte « Un c ur simple » de Flaubert. Notre but est de faire voir que la vieillesse est un des thèmes principaux du conte. Nous cherchons des analogies et des différences entre les uvres choisies. Le roman de Balzac est aussi une uvre connue qui thématise la vieillesse. La vieillesse est aussi un thème recourant chez Maupassant. Nous voulons montrer que c'est le cas dans sa nouvelle « Monsieur Parent »

Sammenligning av engelskkunnskaper hos to grupper 6. – 7. klassinger undervist etter henholdsvis L97 og K06

I denne artikkelen sammenlignes muntlige og skriftlige engelskferdigheter hos en gruppe 6.-7.klassinger i 2001, i hovedsak undervist etter L97, og en gruppe 6.klassinger i 2009, i hovedsak undervist etter Kunnskapsløftet 2006 (K06). Siden elevene undervist etter K06 i sum har hatt flere år og flere undervisningstimer i engelsk, forventet vi at de skulle gjøre det bedre enn elevene undervist etter L97. Dataene våre signaliserer at dette ikke er tilfelle. Elevene ble testet individuelt, og deres språkforståelse og produksjon ble kartlagt. Gruppen undervist etter K06 viste svakere resultat på grammatisk kompetanse og metakunnskap om språket enn gruppen undervist etter L97, mens de var noe bedre til å snakke fritt. Resultatene blir diskutert på bakgrunn av de aktuelle læreplanene, elevenes kognitive utvikling, lærerkompetanse, nasjonal og internasjonal forskning på språklæring