10 research outputs found
The Global Alliance for Infections in Surgery : defining a model for antimicrobial stewardship-results from an international cross-sectional survey
Background: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p <0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). Conclusion: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.Peer reviewe
4-(4-Fluorobenzoyl)-1-[2-(4-iodo-2,5-dimethoxyphenyl)ethyl]piperidine and its derivatives: synthesis and affinity at 5-HT2A, 5-HT2B and 5-HT2c serotonin receptors
Simplified analogues of Ritanserin and their affinity at 5-HT2A, 5-HT2B and 5-HT2C serotonin receptors
Binders alternative to Portland cement and waste management for sustainable constructionâpart 1
This review presents âa state of the artâ report on sustainability in construction materials. The authors propose different solutions to make the concrete industry more environmentally friendly in order to reduce greenhouse gases emissions and consumption of non-renewable resources. Part 1âthe present paperâfocuses on the use of binders alternative to Portland cement, including sulfoaluminate cements, alkali-activated materials, and geopolymers. Part 2 will be dedicated to traditional Portland-free binders and waste management and recycling in mortar and concrete production
Binders alternative to Portland cement and waste management for sustainable constructionâpart 1
Binders alternative to Portland cement and waste management for sustainable construction â Part 2
The paper represents the âstate of the artâ on sustainability in construction materials. In Part 1 of the paper, issues related to production, microstructures, chemical nature, engineering properties, and durability of mixtures based on binders alternative to Portland cement were presented. This second part of the paper concerns the use of traditional and innovative Portland-free lime-based mortars in the conservation of cultural heritage, and the recycling and management of wastes to reduce consumption of natural resources in the production of construction materials. The latter is one of the main concerns in terms of sustainability since nowadays more than 75% of wastes are disposed of in landfills
Binders alternative to Portland cement and waste management for sustainable construction â Part 2
The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey
Background: Antimicrobial Stewardship Programs (ASPs) have been promoted
to optimize antimicrobial usage and patient outcomes, and to reduce the
emergence of antimicrobial-resistant organisms. However, the best
strategies for an ASP are not definitively established and are likely to
vary based on local culture, policy, and routine clinical practice, and
probably limited resources in middle-income countries. The aim of this
study is to evaluate structures and resources of antimicrobial
stewardship teams (ASTs) in surgical departments from different regions
of the world.
Methods: A cross-sectional web-based survey was conducted in 2016 on 173
physicians who participated in the AGORA (Antimicrobials: A Global
Alliance for Optimizing their Rational Use in Intra-Abdominal
Infections) project and on 658 international experts in the fields of
ASPs, infection control, and infections in surgery.
Results: The response rate was 19.4%. One hundred fifty-six (98.7%)
participants stated their hospital had a multidisciplinary AST. The
median number of physicians working inside the team was five
[interquartile range 4-6]. An infectious disease specialist, a
microbiologist and an infection control specialist were, respectively,
present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component
in 59.0% of cases and was significantly more likely to be present in
university hospitals (89.5%, p < 0.05) compared to community teaching
(83.3%) and community hospitals (66.7%). Protocols for pre-operative
prophylaxis and for antimicrobial treatment of surgical infections were
respectively implemented in 96.2 and 82.3% of the hospitals. The
majority of the surgical departments implemented both persuasive and
restrictive interventions (72.8%). The most common types of
interventions in surgical departments were dissemination of educational
materials (62.5%), expert approval (61.0%), audit and feedback
(55.1%), educational outreach (53.7%), and compulsory order forms
(51.5%).
Conclusion: The survey showed a heterogeneous organization of ASPs
worldwide, demonstrating the necessity of a multidisciplinary and
collaborative approach in the battle against antimicrobial resistance in
surgical infections, and the importance of educational efforts towards
this goal