The local clinical validation of a new lithium heparin tube with a barrier: BD Vacutainer® Barricor LH Plasma tube

Introduction: Although serum-providing blood tubes with a barrier are still widely used due to their significant advantages, the use of blood tubes with a barrier to provide plasma is becoming widespread. We compared 22 analytes in a BD Vacutainer® Barricor LH Plasma tube for local clinical validation of this new lithium heparin tube with a barrier. Materials and methods: Samples from 44 volunteers were collected in different tubes (Becton Dickinson and Company): Z tube without additive (reference), clot-activator tube with gel (SST), lithium heparin tube without gel (LiH), and lithium heparin tube with barrier (Barricor). Analyte concentrations in different tubes were compared with the reference tube. All tubes were also evaluated according to additional testing (different centrifugation durations, blood-sampling techniques and individual differences). Results: Aspartate aminotransferase (AST), glucose (Glc), potassium (K), lactate dehydrogenase (LD), sodium (Na), and total protein (TP) had a significant bias in Barricor (9.19%, - 3.24%, - 4.88%, 21.60%, - 0.40%, 5.03%, respectively) relative to the reference tube. There was no statistical difference between different centrifugation durations and individual differences for AST, K and LD in LiH and/or Barricor (P > 0.05). There was a significant bias for LD between LiH and Barricor in terms of blood-sampling techniques (21.2% and 12.4%, respectively). Conclusions: Recently, the use of plasma has become prominent due to some of its advantages. In this study, plasma AST, K, LD, Glc and TP levels in Barricor were clinically different in comparison to serum. The results of additional tests showed that higher levels of LD in Barricor did not result from haemolysis, and they might be related to other factors including number of platelets, cellular fragility, or functional environment

Retrospective evaluation of patients hospitalized due to bronchial asthma during 1991-1995 at Dr. Sami Ulus Center for Pediatrics

Introduction: Asthma is a heterogeneous disease characterized by chronic airway inflammation. Bronchial asthma ‎is the most common chronic disease of childhood and is among the causes of frequent hospitalization in children. ‎This study aims to describe the demographic and clinical characteristics of the patients hospitalized due to ‎‎"bronchial asthma" within five years. Methods: The hospital records of patients aged 0-15 years admitted with the diagnosis of bronchial asthma to the Dr. Sami Ulus Center for Pediatrics between 1991-1995 were examined. The sociodemographic characteristics, ‎skin, and laboratory values of the patients and the medications they received were examined. ‎Results: Of the total 135 patients, 58.5% (n = 79) were males. The age distribution of the inpatients was mostly in ‎the age group of 3-5 years (57.8%, n = 78). The mean annual hospitalization rate was 0.53%. Patients ‎hospitalized for five days composed the largest group (39.3%, n = 53). Most of the hospitalized patients (74.1%; n = ‎‎100) were coming from urban settings. The most common pathologic condition on chest X-ray were increased ‎aeration + infiltration (52%, n = 70). Sinusitis was accompanied to 78.5% of the hospitalizations. There was ‎‎50.4% (n = 68) leukocytosis in the hemograms. Most sensitive skin tests were mixed grass pollen and house dust. ‎The primary medication used in prophylactic treatments was Ketotifen. Salbutamol was the most common ‎medication used in the emergency department, theophylline and antibiotics for the bedside, and salbutamol syrup ‎was the most prescribed medication for the discharged patients.‎ Conclusion: The greater proportion of male gender and 3-5 year-olds in the study group indicated that these risk ‎factors were consistent with the previous literature. The similarity of annual admission rates within the years indicates ‎that there is no change in asthma frequency in the population served over time. Even though the number of cases ‎requiring antibiotics in bronchial asthma is high (similar to sinusitis), we believe that the use of antibiotics should be ‎lowered.

Assessment of the signs of anxiety and depression in relatives giving care to cancer patients hospitalized in the palliative care service

Introduction: Previously, palliative care was an approach brought forward in terminal patients when treatment options were exhausted. However, today, the opinion that palliative care should be initiated in addition to other treatment modalities starting from the moment of diagnosing a life-threatening disease has become prominent. The symptoms of depression and anxiety are common in patients with chronic diseases such as cancer. Moving on from the fact that these findings also manifest in the relatives of patients, this study aims to identify the symptoms of depression and anxiety and to assess these symptoms in the relatives of patients hospitalized in the extensive palliative care center.Methods: Designed as a descriptive cross-sectional study, this survey included a single group without control and was performed by conducting face-to-face interviews after obtaining consent from patient relatives. The questionnaire prepared consisted of the Beck anxiety scale (BAS), Beck depression scale (BDS), the hospital anxiety and depression scale (HADS) together with sociodemographic variables. The study included 102 volunteers and was carried out over a three-month period. Sociodemographic data of the patients were summarized using descriptive statistics. Subgroup analyses were performed using appropriate parametric and non-parametric tests.Results: The study enrolled 102 participants providing care to a relative in the palliative care service. Among these, 61 (59.8%) were women, and 41 (40.2%) were men. The risk for depression was identified as 43.1% (n=44) according to the BAS, and as 91.2% (n=93) according to the HADS. The anxiety rate was 66.7% (n=68) according to the BAS. Among these, 36.7% (n=25) demonstrated mild anxiety, 30.8% (n=21) demonstrated moderate anxiety and 32.3% (n=22) demonstrated severe anxiety. According to HADS, the risk for anxiety was 72.5% (n=74). Conclusion: The fact that the presence of depression and anxiety was significant in the caregivers of patients in the palliative care service warrants careful follow-up and necessary support of both the patients and their caregivers for mood disorders

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically