scholarly journals Impact of changes in the WHO’s 2019 update of DDDs on the measurement of adult hospital antibacterial consumption in Catalonia (Spain), 2008–18

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Santiago Grau ◽  
Sergi Hernández ◽  
Enric Limón ◽  
Esther Calbo ◽  
Juan P Horcajada ◽  
...  
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
Temporal Trends ◽  
Accurate Assessment ◽  
Antimicrobial Consumption ◽  
National Program ◽  
Bed Days ◽  
Student’S T ◽  
Linear Regressions ◽  
Adult Hospital ◽  
Student’S T Test

Abstract Objectives In 2019 the WHO fully adopted new DDD values. The objective of this study is to analyse their impact on the measurement of consumption of antibacterials in hospitals participating in the Catalan Infection Control and Antimicrobial Stewardship National Program (VINCat-PROA) in Catalonia (Spain) between 2008 and 2018. Methods The anatomical therapeutic chemical/DDD system was used to monitor adult hospital antibacterial consumption expressed in DDD/100 bed-days. Consumption from 2008 to 2018 was calculated using both pre- and post-update DDD values. Differences were calculated as the percentage variation in DDD/100 bed-days and analysed with Student’s t-test. Simple linear regressions were performed to evaluate the trends in adult antimicrobial consumption over the study period. Results The overall consumption according to post-update DDD values decreased by 12.2% (P < 0.001) compared with the pre-update DDD values. Penicillins (−19.6.%; P < 0.001) and carbapenems (−19.0%; P = 0.023) showed the greatest reduction, followed by cephalosporins (−7.7%; P = 0.021) and quinolone antibacterials (−7.7%; P = 0.017). ICU services showed the greatest overall reduction (−13.1%; P < 0.001). From 2008 to 2018 there was a statistically significant decrease in consumption of penicillins and quinolone antibacterials and a statistically significant increase in cephalosporin and carbapenem consumption with both pre- and post-update DDD values. There were no variations in the ranking of consumption between the pre- and post-update DDD values. Conclusions The WHO’s updates of DDDs have had a significant impact on the measurement of antibacterial consumption. In our region, they have corrected an overestimation of penicillin and carbapenem consumption amounting to 19%. It is essential to bear these findings in mind for an accurate assessment of temporal trends and benchmarking.

scholarly journals Trends of Adult Antimicrobial Hospital Consumption in Catalonia (Spain) from 2008 to 2018

2020 ◽  
Vol 41 (S1) ◽  
pp. s500-s501
Author(s):  
Santiago Grau ◽  
Sergi Hernández ◽  
Ariadna Padullés ◽  
Montserrat Gimenez ◽  
Lucía Boix-Palop ◽  
...  
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
Pearson Correlation ◽  
Acute Care Hospital ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Antimicrobial Consumption ◽  
Surgical Units ◽  
Amoxicillin Clavulanate ◽  
Bed Days ◽  
Hospital Consumption

Background: Antimicrobial resistance is a disturbing problem in the health system. A relationship between the use of certain antimicrobials and a resistance increase has been proposed. Since this phenomenon is not usually attributed to specific uses of antimicrobials but preferably to its evolution over the years, the analysis of the antimicrobial consumption over time can justify the epidemiological situation of a given region in terms of resistance and possible increases and decreases for specific microorganisms. The objective of this study was to analyze the evolution of the use of antimicrobials in Catalonia during 2008–2018 through the VINCat program (Infection Control and Antimicrobial Stewardship Catalonian Program). Methods: The number of hospitals participating in the VINCat increased from 46 in 2008 to 63 in 2018 (ie, 68.8% and 85.7% of all adult acute-care hospital beds in Catalonia, respectively). Hospitalization days recorded at the participating hospitals increased from 2,991,053 in 2008 to 3,714,938 in 2018. The Anatomical Therapeutic Chemical Classification (ATC) defined daily dose (DDD) index was used for monitoring antimicrobial consumption. Simple linear regressions were performed, the linear relationship was checked by ANOVA tests, and the Pearson correlation (Pc) coefficients were obtained. Values of P ≤ .05 were considered statistically significant. Results: From 2008 to 2018, there was a statistically significant increase of global antibacterial consumption (65.50 vs 71.73 DDD per 100 bed days; P = .001) and antimycotic consumption (3.09 vs 3.45 DDD per 100 bed days, P = .012) due to an increase of consumption in the surgical units. At the same time, there was a decrease in the consumption of antimycotics in the medical units (4.35 vs 3.90 DDD per 100 bed days; P =.029). Cephalosporins and carbapenem consumption increased both globally (10.88 vs 13.86 DDD per 100 bed days; P < .001) and in medical and surgical units (3.26 vs 5.38 DDD per 100 bed days; P < .001). This increase was mainly associated with ceftriaxone (3.45 vs 5.46 DDD per 100 bed days; P < .001) and meropenem (1.12 vs 3.08 DDD per 100 bed days; P < .001). There was a global decrease in the consumption of penicillins (26.10 vs 24.24 DDD per 100 bed days; P = .012) and quinolones (11.63 vs 9.61 DDD per 100 bed days; P = .004). This trend was observed also in ICUs and medical units but not in surgical units, for which only quinolones showed a significant decrease. Decreases in the use of amoxicillin/clavulanate acid (17.80 vs 14.24 DDD per 100 bed days; P < .001) and ciprofloxacin (5.68 vs 4.01 DDD per 100 bed days; P < .001) were observed. Conclusions: The increase in the use of antimicrobials in Catalonia is concerning. This increase is attributable to the use of these drugs in surgical units. Antibiotic stewardship measures should be aimed primarily at these units. The increasing use of carbapenems should be analyzed.Funding: NoneDisclosures: Juan Pablo Horcajada reports consulting fees from MSD, Pfizer, and Menarini as well as speaker honoraria from MSD, Pfizer, and Zambon.

Serosal and cutaneous recordings of gastric myoelectrical activity in patients with gastroparesis

1994 ◽  
Vol 266 (1) ◽  
pp. G90-G98 ◽  
Author(s):  
J. D. Chen ◽  
B. D. Schirmer ◽  
R. W. McCallum
Keyword(s):  
Electrical Stimulation ◽  
Slow Wave ◽  
Test Meal ◽  
Frequency Change ◽  
Fasting State ◽  
Gastric Myoelectrical Activity ◽  
Myoelectrical Activity ◽  
Gastric Slow Wave ◽  
Student’S T ◽  
Student’S T Test

The aims of this study were to 1) investigate gastric myoelectrical activity in patients with gastroparesis, 2) validate the cutaneous electrogastrogram (EGG) in tracking the frequency change of the gastric slow wave, and 3) investigate the effect of electrical stimulation on gastric myoelectrical activity. Gastric myoelectrical activity was recorded in 12 patients with documented gastroparesis using serosal electrodes for > 200 min in each subject. All recordings were made at least 4 days after surgery. Each session consisted of a 30-min recording in the fasting state and a 30-min recording after a test meal. The test meal (liquid or mixed) was selected according to patient's tolerance. Electrical stimulation was performed in three subjects via the serosal electrodes at a frequency of 3 cycles/min. Gastric myoelectrical activity was recorded using serosal electrodes in each session. The serosal recording showed slow waves of 2.5 to 4.0 cycles/min in all 12 subjects. Absence of spikes was noted in 11 of the 12 subjects. The simultaneous serosal and cutaneous recording of gastric myoelectrical activity showed that the frequency of the EGG was exactly the same as that of the serosal recording. Liquid meals resulted in a significant decrease in slow-wave frequency (Student's t test, P = 0.006), and the EGG accurately reflected this change. Electrical stimulation had no effect on the frequency of the gastric slow wave and did not induce spikes.(ABSTRACT TRUNCATED AT 250 WORDS)

The Effect of Changes in Dialysate Volume on Glucose and Urea Equilibration

1994 ◽  
Vol 14 (3) ◽  
pp. 236-239 ◽  
Author(s):  
Edward C. Kohaut ◽  
F. Bryson Waldo ◽  
Mark R. Benfield
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Prospective Study ◽  
Body Surface ◽  
Patient Population ◽  
Different Ages ◽  
Student’S T ◽  
A Prospective Study ◽  
Dialysate Volume ◽  
Student’S T Test

Objectives To determine the effect of changing dialysate volume on urea and glucoseequilibration curves and to determine, if dialysate volume is prescribed on the basis of body surface area, whether equilibration curves will be consistent in patients of different sizes and ages. Design A prospective study wherein children with acute or chronic renal failure had peritoneal equilibration studies done with dwell volumes of 30 mL/kg, 40 mL/kg, and 1200 mL/m2. Patient Population Twenty-two children: 7 under 3 years of age; 8 between 3 and 10 years of age; 7 older than 10 years of age. Statistics Student's t-test. Results Urea and glucose equilibrated rapidly at dwell volumes of 30 mL/kg, slower at dwell volumes of 40 mL/kg, and slowest at dwell volumes of 1200 mL/m2. Equilibration curves were similar in children of different ages when dialysate volumes of 1200 mL/m2 were infused. Conclusion Dialysate volumes of 1200 mL/m2 should be used when equilibration studies are being done to compare individuals of different ages and sizes.

scholarly journals Development and Validation of 2-Azaspiro [4,5] Decan-3-One (Impurity A) in Gabapentin Determination Method Using qNMR Spectroscopy

Molecules ◽  
2021 ◽  
Vol 26 (6) ◽  
pp. 1656
Author(s):  
Nataliya E. Kuz’mina ◽  
Sergey V. Moiseev ◽  
Mikhail D. Khorolskiy ◽  
Anna I. Lutceva
Keyword(s):  
Test Procedure ◽  
Active Pharmaceutical Ingredient ◽  
Test Methods ◽  
Intermediate Precision ◽  
Coefficients Of Variation ◽  
Validation Parameters ◽  
Limit Of Quantitation ◽  
Student’S T ◽  
Development And Validation ◽  
Student’S T Test

The authors developed a 1H qNMR test procedure for identification and quantification of impurity A present in gabapentin active pharmaceutical ingredient (API) and gabapentin products. The validation studies helped to determine the limit of quantitation and assess linearity, accuracy, repeatability, intermediate precision, specificity, and robustness of the procedure. Spike-and-recovery assays were used to calculate standard deviations, coefficients of variation, confidence intervals, bias, Fisher’s F test, and Student’s t-test for assay results. The obtained statistical values satisfy the acceptance criteria for the validation parameters. The authors compared the results of impurity A quantification in gabapentin APIs and capsules by using the 1H qNMR and HPLC test methods.

scholarly journals Antimicrobial Consumption among 66 Acute Care Hospitals in Catalonia: Impact of the COVID-19 Pandemic

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 943
Author(s):  
Santiago Grau ◽  
Sergi Hernández ◽  
Daniel Echeverría-Esnal ◽  
Alexander Almendral ◽  
Ricard Ferrer ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Acute Care ◽  
Antimicrobial Consumption ◽  
Trend Pattern ◽  
Defined Daily Doses ◽  
Bed Days ◽  
Antifungal Consumption ◽  
Antibacterial And Antifungal ◽  
Antifungal Use ◽  
The Impact

Background: Antimicrobials have been widely used during the COVID-19 pandemic. This study aimed to analyze the impact of the COVID-19 pandemic on the antimicrobial consumption of 66 hospitals in Catalonia. Methods: Adult antibacterial and antimycotic consumption was calculated as defined daily doses (DDD)/100 bed-days and DDD/100 discharges. Firstly, overall and ICU consumption in 2019 and 2020 were compared. Secondly, observed ICU 2020 consumptions were compared with non-COVID-19 2020 estimated consumptions (based on the trend from 2008–2019). Results: Overall, antibacterial consumption increased by 2.31% and 4.15% DDD/100 bed-days and DDD/100 discharges, respectively. Azithromycin (105.4% and 109.08% DDD/100 bed-days and DDD/100 discharges, respectively) and ceftriaxone (25.72% and 27.97% DDD/100 bed-days and DDD/100 discharges, respectively) mainly accounted for this finding. Likewise, antifungal consumption increased by 10.25% DDD/100 bed-days and 12.22% DDD/100 discharges, mainly due to echinocandins or amphotericin B. ICU antibacterial and antimycotic consumption decreased by 1.28% and 4.35% DDD/100 bed-days, respectively. On the contrary, antibacterial and antifungal use, expressed in DDD/100 discharges, increased by 23.42% and 19.58%. Azithromycin (275.09%), ceftriaxone (55.11%), cefepime (106.35%), vancomycin (29.81%), linezolid (31.28%), amphotericin B (87.98%), and voriconazole (96.17%) use changed the most. Observed consumption of amphotericin B, azithromycin, caspofungin, ceftriaxone, vancomycin, and voriconazole were higher than estimated values. Conclusions: The consumption indicators for most antimicrobials deviated from the expected trend pattern. A worrisome increase in antibacterial and antifungal consumption was observed in ICUs in Catalonia.

scholarly journals Potential intravenous drug incompatibilities in a pediatric unit

2016 ◽  
Vol 14 (2) ◽  
pp. 185-189 ◽  
Author(s):  
Karla Dalliane Batista Leal ◽  
Ramon Weyler Duarte Leopoldino ◽  
Rand Randall Martins ◽  
Lourena Mafra Veríssimo
Keyword(s):  
Risk Factors ◽  
University Hospital ◽  
Intravenous Drug ◽  
Penicillin G ◽  
Cross Sectional ◽  
Relative Risks ◽  
Related Risk ◽  
Student’S T ◽  
Level Of Significance ◽  
Student’S T Test

ABSTRACT Objective To investigate potential intravenous drug incompatibilities and related risk factors in a pediatric unit. Methods A cross-sectional analytical study conducted in the pediatric unit of a university hospital in Brazil. Data on prescriptions given to children aged 0-15 years from June to October 2014 were collected. Prescriptions that did not include intravenous drugs and prescriptions with incomplete dosage regimen or written in poor handwriting were excluded. Associations between variables and the risk of potential incompatibility were investigated using the Student’s t test and ANOVA; the level of significance was set at 5% (p<0.05). Relative risks were calculated for each drug involved in potential incompatibility with 95% confidence interval. Results A total of 222 children participated in the study; 132 (59.5%) children were male and 118 (53.2%) were aged between 0 and 2 years. The mean length of stay was 7.7±2.3 days. Dipyrone, penicillin G and ceftriaxona were the most commonly prescribed drugs. At least one potential incompatibility was detected in about 85% of children (1.2 incompatibility/patient ratio). Most incompatibilities detected fell into the non-tested (93.4%), precipitation (5.5%), turbidity (0.7%) or chemical decomposition (0.4%) categories. The number of drugs and prescription of diazepam, phenytoin, phenobarbital or metronidazole were risk factors for potential incompatibility. Conclusion Most pediatric prescriptions involved potential incompatibilities, with higher prevalence of non-tested incompatibilities. The number of drugs and prescription of diazepam, phenobarbital, phenytoin or metronidazole were risk factors for potential incompatibilities.

scholarly journals Indicators of Targeted Physical Fitness in Judo and Jujutsu—Preliminary Results of Research

2021 ◽  
Vol 18 (8) ◽  
pp. 4347
Author(s):  
Wojciech J. Cynarski ◽  
Jan Słopecki ◽  
Bartosz Dziadek ◽  
Peter Böschen ◽  
Paweł Piepiora
Keyword(s):  
Reaction Time ◽  
Visual Stimulation ◽  
Intrinsic Value ◽  
Reaction Times ◽  
Arithmetic Means ◽  
Simple Reaction ◽  
Martial Art ◽  
Student’S T ◽  
Pearson Correlations ◽  
Student’S T Test

(1) Study aim: This is a comparative study for judo and jujutsu practitioners. It has an intrinsic value. The aim of this study was to showcase a comparison of practitioners of judo and a similar martial art jujutsu with regard to manual abilities. The study applied the measurement of simple reaction time in response to a visual stimulus and handgrip measurement. (2) Materials and Methods: The group comprising N = 69 black belts from Poland and Germany (including 30 from judo and 39 from jujutsu) applied two trials: “grasping of Ditrich rod” and dynamometric handgrip measurement. The analysis of the results involved the calculations of arithmetic means, standard deviations, and Pearson correlations. Analysis of the differences (Mann–Whitney U test) and Student’s t-test were also applied to establish statistical differences. (3) Results: In the test involving handgrip measurement, the subjects from Poland (both those practicing judo and jujutsu) gained better results compared to their German counterparts. In the test involving grasping of Ditrich rod, a positive correlation was demonstrated in the group of German judokas between the age and reaction time of the subjects (rxy = 0.66, p < 0.05), as well as in the group of jujutsu subjects between body weight and the reaction time (rxy = 0.49, p < 0.05). A significant and strong correlation between handgrip and weight was also established for the group of German judokas (rxy = 0.75, p < 0.05). In Polish competitors, the correlations were only established between the age and handgrip measurements (rxy = 0.49, p < 0.05). (4) Conclusions: Simple reaction times in response to visual stimulation were shorter in the subjects practicing the martial art jujutsu. However, the statement regarding the advantage of the judokas in terms of handgrip force was not confirmed by the results.

scholarly journals ASSOCIATION BETWEEN SERUM URIC ACID AND METABOLIC SYNDROME

2018 ◽  
Vol 11 (10) ◽  
pp. 400 ◽  
Author(s):  
Thaslima Nandhini Js ◽  
Savitha Basker G ◽  
Vishnupriya V
Keyword(s):  
Metabolic Syndrome ◽  
Uric Acid ◽  
Venous Blood ◽  
Fasting Blood Glucose ◽  
Control Group ◽  
Serum Triglycerides ◽  
Significant Difference ◽  
Disease Condition ◽  
Student’S T ◽  
Student’S T Test

Objective: Metabolic syndrome is a cluster of disease condition characterized by truncal obesity, hypertriglyceridemia, elevated blood pressure, and insulin resistance. An excessive circulating uric acid (UA) level even within normal range is always comorbid with metabolic syndrome and its components. The aim of the current study was to investigate the association between metabolic syndrome and serum UA level.Methods: A total of 60 subjects were divided into two groups of healthy (30 individuals) and metabolic syndrome patients (30 individuals) from dental outpatient department of Saveetha Dental College and Hospitals. 5 ml of fasting venous blood was collected in the plain collection tubes and centrifuged, and then serum was separated. Then, the serum was used to analyze the fasting blood glucose, serum triglycerides (TGLs), and serum UA by GOD-POD, enzymatic colorimetric, and uricase method, respectively. A statistical analysis was performed using Student’s t-test. p<0.05 was considered to be statistically significant.Result: Mean body mass index (BMI), fasting blood sugar (FBS), TGL, and UA level of control group were 23.36±1.81, 84.45±13.1, 110.9±22.6, and 3.48±1.21 respectively. Mean BMI, FBS, TGL, and UA level of study group were 35.24±3.04, 122.85±23.3, 212.1±39.6 and 9.08±2.63 respectively. There is a significant difference between these two groups with p<0.0001.Conclusion: This study showed that those individuals with metabolic syndrome have higher UA level that indicates hyperuricemia which is a significant predictor of metabolic syndrome.

scholarly journals Distances between mandibular posterior teeth and the WALA ridge in Peruvians with normal occlusion

2017 ◽  
Vol 22 (6) ◽  
pp. 56-60 ◽  
Author(s):  
Carla Y. Kong-Zárate ◽  
Marcos J. Carruitero ◽  
Will A. Andrews
Keyword(s):  
Age Groups ◽  
Test Results ◽  
Posterior Teeth ◽  
Normal Occlusion ◽  
Tooth Type ◽  
The Mean ◽  
Student’S T ◽  
Mandibular Posterior Teeth ◽  
Digital Caliper ◽  
Student’S T Test

ABSTRACT Objective: The purposes of this investigation were to determine the horizontal distances between the mandibular posterior teeth and the WALA ridge in a sample of Peruvians with normal occlusion and to compare them by tooth type, sex, arch side, and age groups. Methods: 65 dental casts of subjects with normal occlusion were collected. Posterior teeth, except for third molars, were evaluated. The horizontal distances between the occluso-gingival midpoints of the buccal surfaces (FA points) of each tooth and the WALA ridge were measured using a modified digital caliper. The values between each different tooth type within the sample were compared using the ANOVA and Scheffe tests, while comparisons by sex, arch side and age groups, using the Student’s t-test. Results: The mean distances in the sample was 0.96 mm for first premolars, 1.45 mm for second premolars, 2.12 mm for first molars and 2.55 mm for second molars. Statistically significant differences between each of the four tooth types were found. There were no significant differences found between sex, arch side and age groups. Conclusion: The horizontal distances between the mandibular posterior teeth and the WALA ridge increased progressively from the first premolars to the second molars in Peruvians with normal occlusion. The WALA ridge was a good landmark to evaluate the positions of posterior teeth in Peruvians with normal occlusion.

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