Perceptions and practices related to clinical alarms

Background: Clinical alarms represent the top hazard listed in the �Top Ten Health Technology Hazards� report. Frequent false alarms can disrupt patient care and reduce trust in alarms. Aim: The aim of the present study was to investigate the perceptions and practices of critical and noncritical care nurses regarding clinical alarms. Methodology: This was a descriptive analytical study conducted from October 2016 to February 2017 at three hospitals on 197 nurses at Neyshabur University of Medical Sciences in Neyshabur, Northeastern Iran. Participants were selected through stratified random sampling. The perceptions were measured through the 2011 Health care Technology Foundation Clinical Alarms Survey. Results: More than half of the nurses believed that frequent false alarms reduced trust in alarms, leading nurses to inappropriately disable alarms. The nurses ranked frequent false alarms as the most important issue in response to alarms. More than 60 of the nurses indicated that they needed more training on the use of bedside and central monitors. Conclusion: The result of this study suggested that frequent false alarms, as the most important issue related to alarms, should be taken into account by hospital administrators and researchers to decrease alarm fatigue and improve alarm system safety. More specialized clinical policies and procedures for alarm management should also be considered. © 2019 Wiley Periodicals, Inc

Association between serum cytokine concentrations and the presence of hypertriglyceridemia

Objective Hypertriglyceridemia is an established risk factor for coronary-heart-disease. Inflammatory cytokines are known to be important mediators of atherogenesis; however, the relationship between the concentrations of specific inflammatory cytokines and the presence of hypertriglyceridemia has not been well established. The purpose of this study was to investigate the relationship between the serum levels of several pro- and anti-inflammatory cytokines and the presence of hypertriglyceridemia. Design and methods Four hundred and eighty-four subjects with/without established hypertriglyceridemia were recruited. Anthropometric parameters and biochemical analysis (including a full fasting lipid profile) were determined. The serum levels of several cytokines and growth factors including IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, MCP-1, IFN-γ, EGF, and VEGF were measured followed by univariate and multivariate analyses. Results Individuals with hypertriglyceridemia had a significantly higher body mass index, total-cholesterol and triglyceride, compared to the group without hypertriglyceridemia. Serum levels of MCP-1, TNF-α and IL-8 were significantly higher in subjects with hypertriglyceridemia e.g., IL-8 from 7.8 ng/L (95% CI: 4.6�18.9) versus 5.7 ng/L (95% CI: 3.6�11.9), P < 0.05. The multivariate analysis showed that the increased serum concentration of TNF-α was independently associated with high-density lipoprotein cholesterol (HDL-C), while the serum levels of IL-8 and MCP-1 were associated with hypertriglyceridemia. Conclusion Subjects with serum triglycerides of � 2.25 mmol/L had an altered cytokine-profile, particularly with respect to serum IL-8, MCP-1 and TNF-α, which might partially account for its adverse clinical-consequences. Further-investigations in a large multi-center setting are warranted to unravel the potential functional-importance of these cytokines in individuals with hypertriglyceridemia. © 2016 The Canadian Society of Clinical Chemist

Erratum: Impact of the C1431T Polymorphism of the Peroxisome Proliferator Activated Receptor-Gamma (PPAR-γ) Gene on Fasted Serum Lipid Levels in Patients with Coronary Artery Disease

<b><i>Background/Aims:</i></b> The C1431T polymorphism of peroxisome proliferator activated receptor-γ (PPAR-γ) gene is related to diabetes and metabolic-syndrome. However, studies have been inconclusive about its association with coronary artery disease (CAD) and there have been no studies analyzing the association of this polymorphism with fasted-serum-lipid levels in Iranian-individuals with CAD. We investigated the association of PPAR-γ C1431T-polymorphism with CAD and dyslipidaemia in 787 individuals. <b><i>Methods:</i></b> Anthropometric-parameters and biochemical-measurements were evaluated, followed by genotyping. The association of the genetic-polymorphisms with CAD and lipid-profile was determined by univariate/multivariate-analyses. <b><i>Results:</i></b> Patients with CT or CT+TT genotype were at an increased-risk of CAD relative to CC-carriers (adjusted odds ratio: 2.03; 95% confidence interval, 1.01-4.09; p = 0.046). However, in the larger population, CT genotype was present at a higher frequency in the group with a positive angiogram. Furthermore, CT+TT genotypes were associated with an altered fasted-lipid-profile in the initial population sample of patients with a positive angiogram, compared to the group with a negative-angiogram. The angiogram-positive patients carrying the T allele had a significantly higher triglyceride, serum C-reactive protein and fasting-blood-glucose. <b><i>Conclusion:</i></b> We have found the PPAR-γ C1431T polymorphism was significantly associated with fasted serum lipid profile in individuals with angiographically defined CAD. Since accumulating data support the role of PPAR-γ polymorphisms in CAD, further studies are required to investigate the association of this polymorphism with coronary artery disease