Knowledge and attitude towards the gradual reduction of salt in bread – an online survey

Aim: Assess knowledge and attitude towards the gradual reduction of salt in bread and the potential impact on eating habits of children (6-18 years) and their families, as part as a Health Impact Assessment pilot study.N/

Definition of key drivers for project success regarding the General Data Protection Regulation

In the context of the General Data Protection Regulation (GDPR), organisational governance must consider data privacy concerns and regulations. This will avoid illegal situations, the related fines, damage to organisational reputation or, even, temporary/definitive limitation on processing activities. An innovative conceptual model is proposed to deliver the necessary change that addresses GDPR concerns based on the enablers concept. Moreover, project success is (re)examined to include stakeholders perceptions, in addition to organisational effectiveness, which is defined by the respect for legal requirements and by demonstration of compliance with the Regulation at an acceptable cost, i.e. the typical internal deliverables.info:eu-repo/semantics/acceptedVersio

Differences in compliance with Surviving Sepsis Campaign recommendations according to hospital entrance time: day versus night

Introduction Higher compliance with Surviving Sepsis Campaign (SSC) recommendations has been associated with lower mortality. The authors evaluate differences in compliance with SSC 6-hour bundle according to hospital entrance time (day versus night) and its impact on hospital mortality. Methods Prospective cohort study of all patients with community-acquired severe sepsis admitted to the intensive care unit of a large university tertiary care hospital, over 3.5 years with a follow-up until hospital discharge. Time to compliance with each recommendation of the SSC 6-hour bundle was calculated according to hospital entrance period: day (08:30 to 20:30) versus night (20:30 to 08:30). For the same periods, clinical staff composition and the number of patients attending the emergency department (ED) was also recorded. Results In this period 300 consecutive patients were included. Compliance rate was (night vs. day): serum lactate measurement 57% vs. 49% (P = 0.171), blood cultures drawn 59% vs. 37% (P 8 mmHg 45% vs. 29% (P = 0.021), and central venous oxygen saturation (SvcO2) >70%, 7% vs. 2% (P = 0.082); fluids were administered in all patients with hypotension in both periods and vasopressors were administered in patients with hypotension not responsive to fluids in 100% vs. 99%. Time to get specific actions done was also different (night vs. day): serum lactate measurement (4.5 vs. 7 h, P = 0.018), blood cultures drawn (4 vs. 8 h, P < 0.001), antibiotic administration (5 vs. 8 h, P < 0.001), central venous pressure (8 vs. 11 h, P = 0.01), and SvcO2 monitoring (2.5 vs. 11 h, P = 0.222). The composition of the nursing team was the same around the clock; the medical team was reduced at night with a higher proportion of less differentiated doctors. The number of patients attending the Emergency Department was lower overnight. Hospital mortality rate was 34% in patients entering in the night period vs. 40% in those entering during the day (P = 0.281). Conclusion Compliance with SSC recommendations was higher at night. A possible explanation might be the increased nurse to patient ratio in that period. Adjustment of the clinical team composition to the patients' demand is needed to increase compliance and improve prognosis

Cloning of a peroxidase enzyme involved in the biosynthesis of pharmaceutically active terpenoid indole alkaloids in Catharanthus roseus (L.) G. Don

info:eu-repo/semantics/publishedVersio

Cloning of a peroxidase enzyme involved in the biosynthesis of pharmaceutically active terpenoid indole alkaloids in Catharanthus roseus (L.) G. Don

info:eu-repo/semantics/publishedVersio

Classification of healthcare-associated infection: a systematic review 10 years after the first proposal

BACKGROUND: Ten years after the first proposal, a consensus definition of healthcare-associated infection (HCAI) has not been reached, preventing the development of specific treatment recommendations. A systematic review of all definitions of HCAI used in clinical studies is made. METHODS: The search strategy focused on an HCAI definition. MEDLINE, SCOPUS and ISI Web of Knowledge were searched for articles published from earliest achievable data until November 2012. Abstracts from scientific meetings were searched for relevant abstracts along with a manual search of references from reports, earlier reviews and retrieved studies. RESULTS: The search retrieved 49,405 references: 15,311 were duplicates and 33,828 were excluded based on title and abstract. Of the remaining 266, 43 met the inclusion criteria. The definition more frequently used was the initial proposed in 2002--in infection present at hospital admission or within 48 hours of admission in patients that fulfilled any of the following criteria: received intravenous therapy at home, wound care or specialized nursing care in the previous 30 days; attended a hospital or hemodialysis clinic or received intravenous chemotherapy in the previous 30 days; were hospitalized in an acute care hospital for ≥2 days in the previous 90 days, resided in a nursing home or long-term care facility. Additional criteria founded in other studies were: immunosuppression, active or metastatic cancer, previous radiation therapy, transfer from another care facility, elderly or physically disabled persons who need healthcare, previous submission to invasive procedures, surgery performed in the last 180 days, family member with a multi-drug resistant microorganism and recent treatment with antibiotics. CONCLUSIONS: Based on the evidence gathered we conclude that the definition initially proposed is widely accepted. In a future revision, recent invasive procedures, hospitalization in the last year or previous antibiotic treatment should be considered for inclusion in the definition. The role of immunosuppression in the definition of HCAI still requires ongoing discussion.This research was supported by an ASSUCIP (Associação de Apoio à Unidade de Cuidados Intensivos Polivalente - ICU, Hospital de Santo António, Porto, Portugal) grant. Dr. Cardoso is partially funded by a PhD research grant from the Teaching and Research Department (Departamento de Formação, Ensino e Investigação) of Oporto Hospital Centre. The funding organization had no role in the design or conduct of the study; the collection, analysis or interpretation of the data; or the preparation, review or approval of the manuscript, nor in the decision to submit the manuscript for publication

Defeitos da β-Oxidação Mitocondrial: Um Caso Fatal de Deficiência em 3-Hidroxi-Acil-CoA Desidrogenase de Cadeia Longa. (LCHAD)

Descreve-se um caso fatal de deficiência em 3-hidroxi-acil-CoA desidrogenase de cadeia longa (LCHAD) diagnosticado numa criança de 8 meses de idade, segunda filha de um casal jovem, saudável e consanguíneo. Os primeiros sintomas manifestaram-se aos 6,5 meses de idade ao entrar em coma hipoglicémico não cetótico do qual recupera após infusão i.v. de glucose. Detectou-se hepatomegália e posteriormente cardiomegália. A presença de acidúria 3-hidroxi-dicarboxílica foi confirmada após teste de jejum prolongado de 13th e o estudo enzimático efectuado em cultura de fibroblastos de biópsia de pele confirmou o déficit em LCHAD