scholarly journals Anti-microbial effect of filtered 222nm excimer lamps in a hospital waiting area

2021 ◽  
Author(s):  
Jacob Thyrsted ◽  
Søren Helbo Skaarup ◽  
Andreas Fløe Hvass ◽  
Sara Moeslund Joensen ◽  
Stine Y. Nielsen ◽  
...  
Keyword(s):  
Real World ◽  
Pathogenic Bacteria ◽  
Bacterial Species ◽  
Bacterial Load ◽  
Real Life ◽  
University Hospital ◽  
Waiting Room ◽  
Excimer Lamps ◽  
Real Life Setting ◽  
Waiting Area

SummaryBackgroundHospital aquired infections is a considerable challenge for vulnerable patients. Ultraviolet light based on the excitation of mercury emit light at 254nm and has well established antimicrobial effects but the use hereof in populated areas is hindered by the carcinogenic properties of 254nm. This is in contrast to the recently developed excimer lamps based on krypton chloride (KrCl). These lamps emit light with a peak intensity at a wavelength of 222nm and have recently been demonstrated to have broad bactericidal and viricidal effects including efficient inactivation of SARS-CoV2. It is, however, unclear how efficiently 222nm lamps perform in a real-life setting such as a hospital waiting area. In this study we aimed to assess the antimicrobial efficacy of filtered 222nm excimer lamps in a real-world setting at an out-patient pulmonology clinic.MethodsFiltered KrCl 222nm excimer lamps (UV222 lamps) were installed in a densely populated waiting room at the out-patient waiting area at Department of Respiratory Diseases and Allergy at Aarhus University Hospital, Aarhus, Denmark. Furniture sufaces were sampled and analyzed for bacterial load in a single arm interventional longitudinal study with and without exposure to filtered 222nm UVC-light. Furthermore, bacterial species were identified using MALDI-ToF mass-spectrometry.FindingsThe exposure to filtered 222nm UVC-light significantly reduced the number of colony-forming-units, and patches with high desity of bacteria. Pathogenic bacteria such as Staphylococcus Aureus and Staphylococcus Epidermidis were detected only in the non-exposed areas suggesting that these species are highly sensitive to inactivation by 222nm UVC-light.ConclusionFiltered 222nm UVC-light is highly anti-microbial in a real-world clinical setting reducing bacterial load and eradicating clinically relevant bacteria species. Filtered 222nm UVC-light has the potential to become an important part of current and future anti-microbial prevention in the clinic.

scholarly journals Applications of Wearable Technology in a Real-Life Setting in People with Knee Osteoarthritis: A Systematic Scoping Review

2021 ◽  
Vol 10 (23) ◽  
pp. 5645
Author(s):  
Tomasz Cudejko ◽  
Kate Button ◽  
Jake Willott ◽  
Mohammad Al-Amri
Keyword(s):  
Knee Osteoarthritis ◽  
Real World ◽  
Real Life ◽  
Wearable Technology ◽  
Physical Activity Assessment ◽  
Activity Assessment ◽  
Real World Setting ◽  
Real Life Setting ◽  
Clinical Potential ◽  
Provision Of Care

With the growing number of people affected by osteoarthritis, wearable technology may enable the provision of care outside a traditional clinical setting and thus transform how healthcare is delivered for this patient group. Here, we mapped the available empirical evidence on the utilization of wearable technology in a real-world setting in people with knee osteoarthritis. From an analysis of 68 studies, we found that the use of accelerometers for physical activity assessment is the most prevalent mode of use of wearable technology in this population. We identify low technical complexity and cost, ability to connect with a healthcare professional, and consistency in the analysis of the data as the most critical facilitators for the feasibility of using wearable technology in a real-world setting. To fully realize the clinical potential of wearable technology for people with knee osteoarthritis, this review highlights the need for more research employing wearables for information sharing and treatment, increased inter-study consistency through standardization and improved reporting, and increased representation of vulnerable populations.

scholarly journals Underlying causes of under-utilization of cardiac resynchronization therapy in real-world heart failure settings

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E Choha ◽  
J Henrysson ◽  
E Thunstrom ◽  
M Fu ◽  
C Basic
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Cardiac Resynchronization Therapy ◽  
Real World ◽  
Angiotensin Receptor Blockers ◽  
Real Life ◽  
University Hospital ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Underlying Causes

Abstract Background Despite well-established effectiveness of cardiac resynchronization therapy (CRT) in patients with heart failure (HF), it remained significantly under-utilized. The underlying causes are still not well described. Aim To investigate how many patients with HF were eligible for CRT and determine underlying causes why CRT was abstained for these patients in real life settings. Methods Retrospective review of medical data was carried out in all patients hospitalized for newly diagnosed HF from January 1, 2016 to December 31, 2019. Patients were identified from the local university hospital register with three afiliations by use of international classification of disease (ICD)-10 codes I50.0-I50.9. Medical journals, including electrocardiograms and echocardiograms, were reviewed. The indication for CRT was evaluated three months after mineralocorticoid receptor antagonists (MRA) were initiated as addition to angiotensin converting enzyme inhibitor /angiotensin-receptor blockers and beta-blocker treatment according to European guidelines for heart failure from 2016. Follow-up was minimum one year and up to two years after HF diagnosis. Results In 3456 patients with HF, 642 (18.6%) were patients hospitalized for new onset of HF with ejection fraction (EF) <40%. Out of those, 104 (16.2%) patients were excluded because of incomplete medical record as a result of referral to primary care. Finally, 538 were included in this study. Overall, 163 patients (30.3%) met CRT criteria with 22.5%, 2.6%, 1.9% complying with recommendation IA, IIA, IIB respectively, and 3.9% had more than 50% right ventricular pacing. Only 52 (9.7%) of patients received CRT with mean age 69.3±11.5 years, and 69.2% men and EF 31.9% ± 7.6. In all these patients with HF eligible for CRT, no difference was found in baseline data including hypertension, ischemic heart disease, atrial fibrillation, valvular heart disease, diabetes mellitus, stroke, cancer and renal failure nor medical treatment between those received CRT and those without CRT. Among underlying causes of under-utilization of CRT, 24.3% were due to multiple concomitant comorbidities, 4.5% due to patient's own wish, 12.5% due to other reasons such as socioeconomic problems and 58.6% with unknown reasons. Mortality rates were 20.7% in patients without treatment with CRT compared with 7.7% in those who received CRT (p=0.037). Conclusion In this real world HF cohort, 1/3 patients were eligible for CRT treatment. However only 1/3 received CRT and 58.6% had no contraindication but did not receive CRT, which emphasize urgent need for structured implementation methods for device treatment in patients with HF. FUNDunding Acknowledgement Type of funding sources: None.

Bacterial Contamination of Hospital Physicians' Stethoscopes

1999 ◽  
Vol 20 (9) ◽  
pp. 626-628 ◽  
Author(s):  
Louis Bernard ◽  
Anne Kereveur ◽  
Dominique Durand ◽  
Jeanne Gonot ◽  
Fred Goldstein ◽  
...  
Keyword(s):  
General Hospital ◽  
Nosocomial Infections ◽  
Pathogenic Bacteria ◽  
Bacterial Contamination ◽  
Bacterial Species ◽  
Bacterial Load ◽  
Clinical Use ◽  
Bacterial Survival ◽  
Liquid Soap ◽  
Kinetics Of

AbstractBecause stethoscopes might be potential vectors of nosocomial infections, this study, conducted in a 450-bed general hospital, was devised to evaluate the bacterial contamination of stethoscopes; bacterial survival on stethoscope membranes; the kinetics of the bacterial load on stethoscope membranes during clinical use; and the efficacy of 70% alcohol or liquid soap for membrane disinfection. Among the 355 stethoscopes tested, 234 carried ≥2 different bacterial species; 31 carried potentially pathogenic bacteria. Although some bacteria deposited onto membranes could survive 6 to 18 hours, none survived after disinfection.

scholarly journals Wastewater Collection and Transportation through Drainage Network- a Potential Threat to Biodiversity & Local Eco-system in Zanzibar Stone-town & Surroundings

2018 ◽  
pp. 1-13
Author(s):  
Z. M. Abubakar ◽  
A. R. Rabia ◽  
A. M. Ussi ◽  
M. A. Bakar ◽  
R. A. Ali
Keyword(s):  
Waste Water ◽  
Urban Areas ◽  
Pathogenic Bacteria ◽  
Bacterial Species ◽  
Bacterial Load ◽  
Waste Water Treatment ◽  
Potential Threat ◽  
Cross Sectional ◽  
Health Crisis ◽  
High Turbidity

Waste water effluents voided in the coastal areas of Zanzibar are highly polluted posing a public health crisis. This cross-sectional study, carried out in September 2017, investigated bacterial load and physicochemical characteristics of the effluents discharged into coastal marine waters of the Zanzibar stone town and peri-urban areas. Ten drains, seven of which were impervious and three pervious, were sampled twice per day in mornings and afternoons. Each drain was sampled at three sites; the out-pour site close to the sea and two sites upstream 100 meters apart. Physicochemical parameters including Dissolved Oxygen (DO), pH and turbidity were determined immediately after arrival in the laboratory. Colony forming units/ ml were also determined.  Bacterial counts were higher in impervious drains, in out-pour sites and in the afternoons. Conversely counts were lower in the out-pour sites compared to upstream sites in the pervious drains. DO was significantly higher in the pervious compared to impervious drains (p = 0.004). Turbidity was high in the mornings, but one drain had significantly high turbidity (p=0.0009). In all drains pH was high in the afternoon than mornings. Thirteen bacterial species, mostly gram-negative Enterobacteriaceae were isolated. Vibrio cholerae was isolated from 5 drains. Ground water close to pervious drains had coliforms beyond WHO guidelines. Waste water drains in Zanzibar urban and peri-urban areas are vastly contaminated with organic matter and pathogenic bacteria leading to high turbidity and oxygen depletion. It is recommended to increase awareness to the public and introduce waste water treatment strategies both physically and chemically.

scholarly journals Efficacy of a bacterial fluorescence imaging device in an outpatient wound care clinic: a pilot study

2019 ◽  
Vol 28 (7) ◽  
pp. 438-443 ◽  
Author(s):  
Ciaran M. Hurley ◽  
Pat McClusky ◽  
Ryan M. Sugrue ◽  
James A. Clover ◽  
Jason E. Kelly
Keyword(s):  
Real Time ◽  
Fluorescence Imaging ◽  
Predictive Value ◽  
Pathogenic Bacteria ◽  
Wound Care ◽  
Bacterial Species ◽  
University Hospital ◽  
Fluorescent Light ◽  
Care Clinic ◽  
Imaging Device

Objective: Subsurface bacterial burden can be missed during standard wound examination protocols. The real-time bacterial fluorescence imaging device, MolecuLight i:X, visualises the presence of potentially harmful levels of bacteria through endogenous autofluorescence, without the need for contrast agents or contact with the patient. The intended use of the imaging device is to assist with the management of patients with wounds by enabling real-time visualisation of potentially harmful bacteria. The aim of this study was to establish the accuracy of the wound imaging device at detecting pathogenic bacteria in wounds. Methods: A single-centre, prospective observational study was conducted in Cork University Hospital in an outpatient plastic surgery wound care clinic. Patients had their wounds photographed under white and autofluorescent light with the imaging device. Auto-fluorescent images were compared with the microbiological swab results. Results: A total of 33 patients and 43 swabs were included, of which 95.3% (n=41) were positive for bacteria growth. Staphylococcus aureus was the most common bacterial species identified. The imaging device had a sensitivity of 100% and specificity of 78% at identifying pathological bacteria presence in wounds on fluorescent light imaging. The positive predictive value (PPV) was 95.4%. The negative predictive value (NPV) was 100%. It demonstrated a sensitivity and specificity of 100% at detecting the presence of Pseudomonas spp. Conclusion: The imaging device used could be a safe, effective, accurate and easy-to-use autofluorescent device to improve the assessment of wounds in the outpatient clinic setting. In conjunction with best clinical practice, the device can be used to guide clinicians use of antibiotics and specialised dressings.

scholarly journals The use of real-world effectiveness measurements in clinical settings at Helsinki University Hospital: a systematic literature review

2020 ◽  
Vol 9 (5) ◽  
pp. 321-326
Author(s):  
Kati Koskinen ◽  
Maija Hytönen ◽  
Pirjo Räsänen
Keyword(s):  
Quality Of Life ◽  
Real World ◽  
Real Life ◽  
University Hospital ◽  
Health Related Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
Quality Of Life Instruments

Aim: Patient reported outcomes collected alongside clinical trials do not reflect real-world effectiveness (RWE). This review assessed the use of RWE measurements in routine clinical treatment and the instruments applied to collect that data. Materials & methods: The RWE articles published from HUS (Helsinki University Hospital) were extracted from several databases. Results: Out of 170 eligible articles, generic health-related quality of life instruments were used in 87 (51.2%) and disease-specific health-related quality of life instruments in 58 (34.1%) articles as a primary measurement. Most of the articles pertained to surgery, gynecology and pediatric surgery. Conclusion: The number of articles assessing RWE is very limited compared with all the articles published from HUS. Thus, we still have limited information about the effectiveness of the treatment in real life.

scholarly journals Impact of haze events on airborne bacterial consortia–a case study

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
S. M. N. K. Thilakarathne ◽  
A. Ekanayake ◽  
P. S. Madamarandawala ◽  
W. B. C. P. Weerarathne ◽  
C. A. Thotawatthage ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Pathogenic Bacteria ◽  
Negative Impact ◽  
Anthropogenic Activities ◽  
Bacterial Species ◽  
Bacterial Load ◽  
Common Species ◽  
Burkholderia Multivorans ◽  
Bacterial Consortia ◽  
Haze Event

AbstractTransboundary haze events received a noticeable attention recently, due to their frequent occurrences. They are mainly, consequences of anthropogenic activities. Sri Lanka experienced a haze event parallel to India in November 2019, the first air pollution event in Sri Lanka linked to a haze event in India. Due to the limited availability of information on haze-related microorganisms, we conducted this study in Kandy, Sri Lanka, aiming to explore the airborne bacterial consortia during a haze event. The natural sedimentation method was used for air sampling. Bacterial identification and the total bacterial load were determined using Sanger sequencing and qPCR. Notably, the total bacterial load was elevated by ~ 40% with the haze and decreased with decreasing haze intensity. The highest bacterial load was reported during the day time of the most intense hazy day (1.89 × 106 cells/µl) compared to non-hazy days (lowest; 1.12 × 105 cells/µl). Twelve bacterial species were identified and the most abundant phylum was Proteobacteria. The most common species observed during haze was Acinetobacter modestus. The percentage of culturable bacterial species was also high during the haze event (75% during day time of the most intense hazy day compared to 25% on the control). Two human pathogenic bacteria Burkholderia multivorans and Chryseobacterium gleum were found only during the haze event. Therefore, haze events could be hazardous to humans by means of the presence and fluctuating amounts of pathogenic bacteria. Thus, these findings are important in developing policies and guidelines to monitor and minimize the negative impact of haze events.

scholarly journals Study on Air Bacteria at Different Altitudinal Locations in Tezpur to Tawang Axis

2020 ◽  
Vol 5 (2) ◽  
pp. 93-102
Author(s):  
Soumya Chatterjee ◽  
Sibnarayan Datta ◽  
Leeza Banu ◽  
Mohan G. Vairale ◽  
Sonika Sharma
Keyword(s):  
16S Rrna ◽  
Human Health ◽  
Pathogenic Bacteria ◽  
Bacterial Species ◽  
Bacterial Load ◽  
Well Being ◽  
Molecular Techniques ◽  
Rrna Gene ◽  
Public Health Perspective ◽  
Pathogenic Potential

Microflora plays an important role in modulating environmental quality. Among microflora, bacteria are omnipresent in the environment. Pathogenic bacteria, present in air, are known to affect significantly the health and well-being of human, animal or plant populations. Air bacteria monitoring is thus essential for surveillance of pathogenic microorganisms from public health perspective besides its significant implications in detection and mitigation of biothreat related issues. Despite the geo-politically strategic importance of northeast India, there is scarcity of data on human health and disease surveillance. Considering these facts, we, for the first time studied the bacterial diversity of air at six important sites adjacent to the international border in the northeast region of India, having an altitude range of 73 m (Tezpur) to 4170 m (Sela Pass) above sea level. Standard microbiological techniques, such as Tryptone Soya Agar, Mannitol salt and McConkey agar strips and plates were used for air bacterial load assessment and culture for subsequent analysis using biochemical and molecular techniques. Following RFLP study, twenty six different bacterial colonies were isolated. Subsequently, bacteria identification was carried out by examining the substrate utilisation patterns, sequencing 16S rRNA gene and phylogenetic analysis. Results of the study reveal that the isolates mostly belong to two genera Bacillus and Staphylococcus (eleven in each genus), along with Micrococcus, Pseduomonas and Acinetobacter. Based on significant match of our sequences with that of medically important bacterial 16S rRNA sequences available at 16SpathDB 2.0 and review of available literature, we found that a number of these bacterial species have the pathogenic potential. In this manuscript we report our results and discuss the importance of air bacterial surveillance from the perspective of human health, hygiene and biothreat mitigation.

scholarly journals Guselkumab Treatment Outcomes and Persistence in a Nationwide Real-world Cohort of Patients with Plaque Psoriasis

2021 ◽  
Author(s):  
Tarja Mälkönen ◽  
Pauliina Nuutinen ◽  
Taru Hallinen ◽  
Erkki Soini ◽  
Riikka Nissinen ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Real World ◽  
Plaque Psoriasis ◽  
Treatment Duration ◽  
Real Life ◽  
Severity Index ◽  
Biologic Therapies ◽  
Treatment Persistence ◽  
Real Life Setting

Guselkumab treatment outcomes and persistence were assessed in a real-world cohort of Finnish patients with difficult-to-treat plaque psoriasis over a median follow-up of 1 year. Data on 181 patients who initiated guselkumab at the 15 study centres were collected retrospectively from the patient charts. Prior exposure to biologic therapies was common with 56% and 35% having used at least 1 and 2 biologics, respectively. Median guselkumab treatment duration was 11 months with 21 patients (12%) discontinuing treatment during follow-up. Of 85 patients with a follow-up duration of at least 1 year, 73 (86%) were still on guselkumab at 1 year. Significant improvements during follow-up were seen in the absolute Psoriasis Area and Severity Index (PASI) scores with 32 patients (80%) having absolute PASI ≤ 2 after a 9–14-month treatment. Guselkumab treatment was effective and treatment persistence was high in the nationwide Finnish real-life setting.

scholarly journals Pomalidomide and Dexamethasone Are Effective in Relapsed or Refractory Multiple Myeloma in a Real-Life Setting: A Multicenter Retrospective Study in Taiwan

2021 ◽  
Vol 11 ◽  
Author(s):  
Yu-Chin Hung ◽  
Jyh-Pyng Gau ◽  
Shang-Yi Huang ◽  
Bor-Sheng Ko ◽  
Chieh-Lin Jerry Teng
Keyword(s):  
Multiple Myeloma ◽  
Real World ◽  
Real Life ◽  
Progression Free Survival ◽  
High Dose ◽  
Free Survival ◽  
Refractory Multiple Myeloma ◽  
High Dose Dexamethasone ◽  
Real Life Setting ◽  
Multicenter Registry

BackgroundThe therapeutic options of relapsed or refractory multiple myeloma (RRMM) remain a challenge. The MM-003 trial demonstrated that RRMM patients treated with pomalidomide and dexamethasone (Pom/Dex) have better progression-free survival (PFS) than those treated with high-dose dexamethasone alone. However, the real-world effectiveness of Pom/Dex in these patients in Taiwan remains unclear.MethodsThis multicenter, registry-based study retrospectively reviewed the medical records of 49 consecutive patients undergoing Pom/Dex treatment for RRMM. We investigated the overall response rate (ORR) and PFS in these patients. The patients were stratified into two groups: those who received two (n=33) and those who received more than two (n=16) prior lines of treatment according to the numbers of regimens before Pom/Dex therapy. The differences in ORR and PFS between these two groups were further analyzed. We also analyzed factors attributed to disease progression.ResultsThe ORR was 47.7%, and the median PFS was 4.0 months (range, 0.1−21.1). Patients who received two prior lines of treatment had a higher ORR than those who received more than two prior lines of treatment (55.2% vs. 33.3%; p=0.045). The median PFS of these groups was 4.8 and 3.9 months, respectively (p=0.805). Primary lenalidomide refractoriness reduced the risk of myeloma progression following Pom/Dex treatment (hazard ratio, 0.14; p=0.001).ConclusionsThe median PFS following Pom/Dex treatment in Taiwanese RRMM patients in a real-world setting was similar to that reported by the MM-003 trial. Primary lenalidomide refractoriness should not be an obstacle for Pom/Dex treatment in RRMM.

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