Clinical and Laboratory Characteristics of Hyperprolactinemia in Children and Adolescents: National Survey

Conclusion: We present the largest cohort of children and adolescents with hyperprolactinemia in the literature to date. Hyperprolactinemia is more common in females and cabergoline is highly effective and practical to use in adolescents, due to its biweekly dosing. Indications for surgery in pediatric cases need to be revised

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

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

The Relationship between the Sydney Classification and the First-Line Treatment Efficacy in Helicobacter-Associated Gastritis

Objective: Helicobacter pyloriis responsible for a wide spectrum of diseases. Due to ease of use and access, the standard triple therapy is being used as first-line eradication in many areas. Intestinal metaplasia (IM) is a precancerous lesion that requires eradication therapy. Our aim is to investigate the effect of IM on the standard triple therapy success in H. pylori-positive patients. Subjects and Methods: The patients who were referred to Duzce University Hospital and Avrasya Hospital Gastroenterohepatology clinic between January 2014 and December 2016 and diagnosed with H. pylori-positive gastritis and underwent first-line eradication were evaluated retrospectively. Biopsy specimens were evaluated according to the updated Sydney system. All patients diagnosed with H. pylori started treatment with pantoprazole 40 mg b.i.d., amoxicillin 1 g b.i.d. and clarithromycin 500 mg b.i.d. for 14 days. Results: The mean age of 181 patients included in the study was 55.5 +/- 7.8. The success rate of H. pylori eradication was found to be low in severe chronic inflammation (p = 0.001). The success rate was found to be high among patients with no neutrophil activity (p = 0.009). As the intensity of IM increased, density of H. pylori was found to be decreased (p = 0.019). There was no correlation between glandular atrophy, IM, and H. pylori eradication success rate (p = 0.390 and p = 0.812). Conclusion: The severity of chronic inflammation is the most effective Sydney criteria for success of eradication, while the presence on IM does not have any effect.WOS:0005981443000072-s2.0-85097968133PubMed: 3234440

Retrospective Evaluation of Corneal Foreign Bodies with Anterior Segment Optical Coherence Tomography

Objectives: To assess the anterior segment optical coherence tomography (AS-OCT) findings of various types of corneal foreign bodies. Materials and Methods: The medical records of patients with corneal foreign body were retrospectively analyzed. Patients who underwent anterior segment photography and Spectralis AS-OCT (Heidelberg Engineering GmbH, Germany) imaging were included. Results: The AS-OCT findings of 22 eyes of 20 patients with corneal foreign body were reviewed. The mean age was 34.9 +/- 14.98 years (range, 15-71) with a female/male ratio of 4/16. The mean best corrected visual acuity at presentation was 0 +/- 0 LogMAR (range, 0-0). There were 18 metallic, 3 organic (chestnut burr), and 1 chemical clay foreign bodies. The metal materials demonstrated hyperreflectivity with a mirror effect. Chemical clay, which is an opaque material, had a hyperreflective appearance. Chestnut burr is an organic foreign body with a feather-like pattern and was not detected with AS-OCT. Conclusion: AS-OCT is a valuable non-invasive tool to define the characteristics of foreign bodies, as well as decide the proper treatment method and monitor patients with corneal foreign bodies

Physicochemical and Antimicrobial Properties of Oleoresin Capsicum Nanoemulsions Formulated with Lecithin and Sucrose Monopalmitate

Oleoresin capsicum (OC) is an extract of chili pepper containing the active agent capsaicin. In this study, OC-loaded nanoemulsions were prepared by microfluidization and stabilized with sucrose monopalmitate (SMP) and lecithin. The difference in size and distribution of droplets determined the nanoemulsion behavior mainly due to the interaction of emulsifiers between oil and aqueous phase. The hydrophilic interaction between SMP and aqueous phase and the hydrophobic interaction between lecithin and oil phase were monitored with NMR relaxometry. OC nanoemulsion fabricated with SMP showed the best transparency with smallest droplet size (around 34nm) and stable with glycerol after 28days at ambient storage. Lecithin containing nanoemulsions showed improved bioactivity as showing antioxidant (0.82mg DPPH/L) and antimicrobial (3.40 log for Escherichia coli and 4.37 log for Staphylococcus aureus) activity. Finally, results have important implications to determine the appropriate formulation conditions for OC with food-grade surfactants to be used in pharmaceuticals and food industry

Capsaicin emulsions: Formulation and characterization

Oleoresin capsicum, the oil extract of chili pepper, is mainly composed of capsaicin. Capsaicin is a hydrophobic volatile compound exhibiting antimicrobial activity against various microorganisms. Capsaicin in the form of an emulsion-based carrier system could be a good alternative to enhance bioavailability and simultaneously to increase the shelf-life of food. In this study, capsaicin emulsions were formulated using three different surfactants (Tween 80, commercial soy lecithin, and sucrose monopalmitate/SMP). Effects of aqueous phase composition, pH, and heating the pre-homogenized dispersion were investigated. For characterization, NMR relaxometry, color, turbidity, and antioxidant activity experiments were conducted. Antimicrobial efficacies of the emulsions were also evaluated against Escherichia coli andStaphylococcus aureus. Mean particle sizes of emulsions with surfactants Tween 80, lecithin, and SMP were found to be 68.30, 582.63, and 50.10nm, respectively. Lecithin-containing emulsions showed the highest antimicrobial activity against S. aureus with 4.60log reduction, whereas the same effect was observed in Tween 80-containing emulsions against E. coli with 3.86 log reduction. Emulsions prepared with SMP showed the highest antioxidant activity with 0.482mg DPPH/L emulsion. The formulated emulsions have the potential to be used in food industry as antimicrobial food grade solutions