International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

What is the role of genetics in occupational asthma?

Abstract not available, the article is an editoria

Genetics and the occupational environment.

PURPOSE OF REVIEW: This article will focus on the role of risk factors including genetic factors in the development of sensitization and occupational asthma. RECENT FINDINGS: We will review the recent literature published on the genetics of occupational asthma, especially on genes coding for class II human leukocyte antigen and on respiratory antioxidant mechanisms. We will also discuss published work on non-occupational asthma and on allergic rhinitis because this information may contribute to a better understanding of the mechanisms involved in occupational asthma and serve to confirm data obtained on the disease. To date, although some progress has been made in the field of occupational asthma genetics, most studies were based on small sample sizes, findings were not replicated, and gene-environment interactions have not yet been established. SUMMARY: Occupational asthma is a widespread and frequent condition and has relevant long-term adverse health and economic consequences. The search for risk factors including genetic factors in the development of the disease and an understanding of the mechanisms of interaction between genes and environment are important because the identification of individuals who are susceptible to occupational asthma together with an effective control of exposure to respiratory sensitizers in the workplace may be helpful in preventing the disease

Inhaled glucocorticoids in chronic obstructive pulmonary disease

--

The role of genetic factors in occupational asthma.

This article explores the influence of genetic factors on the development of sensitisation and occupational asthma (OA). First, several types of studies aimed at examining the role of genes, as well as the role of gene-environment interactions in asthma, including the available data for OA specifically, were reviewed. Genetic approaches include linkage and allele-sharing analysis and segregation analysis. Secondly, deoxyribonucleic acid banking for epidemiological studies was focused upon, highlighting the factors to be considered in choosing the appropriate specimens for genotyping. OA, like asthma, is a multifactorial condition and, to date, no ideal genetic study has been described to examine complex gene-environment interactions. Most studies in OA have examined human leukocyte antigen-associated polymorphisms with some nonreproducible results. The search for genes in occupational asthma is still in progress, and much of the information obtained has been based on small sample sizes, using different strategies for the recruitment of subjects. The best methodological approach still needs to be determined and the results of genetic identification need to be confirmed in different samples

Malattie Respiratorie professionali

--

Occupational asthma.

-

Induced sputum studies in COPD

--

Women and asthma, in Respiratory diseases in women, a cura di S. Buist, C.E. Mapp

--

Pathophysiology

--