150 research outputs found
Urinary ATP as an indicator of infection and inflammation of the urinary tract in patients with lower urinary tract symptoms
BACKGROUND:
Adenosine-5'-triphosphate (ATP) is a neurotransmitter and inflammatory cytokine implicated in the pathophysiology of lower urinary tract disease. ATP additionally reflects microbial biomass thus has potential as a surrogate marker of urinary tract infection (UTI). The optimum clinical sampling method for ATP urinalysis has not been established. We tested the potential of urinary ATP in the assessment of lower urinary tract symptoms, infection and inflammation, and validated sampling methods for clinical practice.
METHODS:
A prospective, blinded, cross-sectional observational study of adult patients presenting with lower urinary tract symptoms (LUTS) and asymptomatic controls, was conducted between October 2009 and October 2012. Urinary ATP was assayed by a luciferin-luciferase method, pyuria counted by microscopy of fresh unspun urine and symptoms assessed using validated questionnaires. The sample collection, storage and processing methods were also validated.
RESULTS:
75 controls and 340 patients with LUTS were grouped as without pyuria (n = 100), pyuria 1-9 wbc ?l(-1) (n = 120) and pyuria ?10 wbc ?l(-1) (n = 120). Urinary ATP was higher in association with female gender, voiding symptoms, pyuria greater than 10 wbc ?l(-1) and negative MSU culture. ROC curve analysis showed no evidence of diagnostic test potential. The urinary ATP signal decayed with storage at 23°C but was prevented by immediate freezing at ??-20°C, without boric acid preservative and without the need to centrifuge urine prior to freezing.
CONCLUSIONS:
Urinary ATP may have a role as a research tool but is unconvincing as a surrogate, clinical diagnostic marker
Secular Trends in Nosocomial Bloodstream Infections: Antibiotic-Resistant Bacteria Increase the Total Burden of Infection
In this international study, we demonstrate that increasing rates of nosocomial bloodstream infections caused by antibiotic-resistant bacteria do not replace infections caused by antibiotic-susceptible bacteria, but occur in addition to these infections, thereby increasing the total burden of diseas
Governing policy evaluation? Towards a new typology
As policy evaluation matures, thoughts are turning to its governance. However, few scholars have combined insights from the evaluation and governance literatures to shed new light on this matter. In order to address this important gap, this article develops a new typology of ways to comprehend and perhaps ultimately govern ex-post policy evaluation activities. The article then explores its validity in the context of climate policy evaluation activities, a vibrant policy area in which the demand for and practices of evaluation have grown fast, particularly in Europe. The analysis reveals that the typology usefully guides new thinking, but also highlights important gaps in our empirical knowledge of the various modes of governing policy evaluation. The article identifies a need for a new research agenda that simultaneously develops a fuller understanding of these evaluation practices and the options for governing them
Surveillance of Antimicrobial Use and Antimicrobial Resistance in German Intensive Care Units (SARI): A Summary of the Data from 2001 through 2004
Center size and glycemic control:An international study with 504 centers from seven countries
Impacto da implantação de um guia terapêutico para o tratamento de pneumonia nosocomial adquirida na unidade de terapia intensiva em hospital universitário
Evaluation systems in a crowded policy space: Implications for local school governance
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