Unveiling the hidden threat of carbapenemase-producing Enterobacteriaceae in hospital water environments: A single-center study.

This retrospective study examined the presence of carbapenemase-producing Enterobacteriaceae in hospital water environments. Results showed that carbapenemase-producing Enterobacteriaceae was detected in 41.5% of the samples within 1 m of a water source (showers or sinks), with 20.6% of the positive samples associated with shower water sources.

Reproducibility of mRNA-Based Testing of ESR1, PGR, ERBB2, and MKI67 Expression in Invasive Breast Cancer-A Europe-Wide External Quality Assessment.

Estrogen receptor (ER), progesterone receptor (PgR), Ki-67, and HER2 immunohistochemistry (IHC) together with HER2 in situ hybridization (ISH) are utilized to classify invasive breast cancer (IBC) into predictive molecular subtypes. As IHC evaluation may be hampered by analytical errors, gene expression assays could offer a reliable alternative. In this first Europe-wide external quality assessment (EQA) study, we investigated performance of mRNA-based Xpert® Breast Cancer STRAT4 (CE-IVD) in five European laboratories. The cohort comprised ten pre-therapy IBC core biopsies diagnosed in the coordinating center (CC). STRAT4 binary (positive or negative) mRNA results of each marker (ESR1, PGR, ERBB2, MKI67) were compared with the gold standard IHC/ISH performed by the CC. Sensitivity, specificity, and accuracy of ESR1 and ERBB2 mRNA were 100% for all samples. In contrast, PGR expression was falsely negative for one case by two sites and MKI67 falsely negative for two cases (respectively by four and one sites). These cases had STRAT4 expression values close to assay cut-offs and immunohistochemically presented heterogeneous low positive PgR and heterogeneous Ki-67. Our EQA shows that STRAT4 mRNA assay may be a reproducible method to evaluate ER, PgR, HER2, and Ki-67 status. However, cases with expression values close to assay cut-offs should be carefully reviewed.

Effectiveness of Mind-Body Intervention for Inflammatory Conditions: Results from a 26-Week Randomized, Non-Blinded, Parallel-Group Trial.

Biopsychosocial intervention has been suggested as a complementary treatment strategy for patients with chronic conditions. We compared the effect of a mind-body intervention (MBI), relative to treatment-as-usual (TAU) on WHO-5 Well-being Index during an intensive period of 12 weeks and follow-up at week 26 among patients with either psoriasis (PsO) or rheumatoid arthritis (RA). The MBI was based on the 'Relaxation Response Resiliency Program' and the 'Open and Calm Program', as well as 'Mindfulness Based Stress Reduction' (MBSR). The trial was randomized, management-as-usual, and controlled. Statistical analyses were based on the intention-to-treat population using repeated measures and mixed effects models (NCT03888261). We screened 39 potential participants, 35 of which (PsO, n = 20; RA, n = 15) met the eligibility criteria and were randomized: 17 in the MBI group and 18 in the TAU group. Attrition from the intervention program was 19%, with 65% of MBI patients and 71% of TAU patients completing the outcome assessments. After 12 weeks, a statistically significant difference in WHO-5 was observed between the groups (p = 0.019). However, according to the protocol, during the entire trial period, the average (least squares mean values) WHO-5 score was higher although not statistically significant in the MBI group (65.3) compared with the TAU group (59.1), corresponding to a between-group difference over 26 weeks of 6.15 (95% CI: -0.26 to 12.56; p = 0.060). All things considered, adding biopsychosocial intervention to clinical practice to patients with conditions, such as PsO and RA, could potentially improve health-related quality of life.

[GETTING READY FOR THE FIRST MINUTE OF LIFE - THE DEVELOPMENT AND ORGANIZATION OF NEONATAL RESUSCITATION IN ISRAEL].

INTRODUCTION: The recognition of the newborn as a separate patient with special unique needs and rights began relatively late compared to other medical disciplines. This process occurred concomitantly with the development of modern neonatology in the country and the establishment of special care nurseries. The process included organization of skilled teams, standardization of treatment methods, introduction of standardized language and practices, and teamwork optimization. The importance of providing support to a newborn in distress after birth - in the first minute, and as needed for the first hour of his life, coined as "The Golden Hour", is highlighted in the training sessions in the program. These principles are conveyed today in multiple simulation-based training courses of multidisciplinary teams taking place in most Israeli hospitals, based on the recommendations of the leading organizations in the field and following the consensus statements outlined by the International Liaison Committee for Resuscitation (ILCOR). This article describes the processes that enabled present achievements, and the goals for further future improvements in the outcomes of newborn resuscitation in Israel.

Parents to chronically ill adolescents have ambivalent views on confidential youth consultations - a mixed methods study.

BACKGROUND: Confidential youth consultations aiming at enhancing adolescent autonomy are a cornerstone of transitional care. At the same time, parental support is essential. These conflicting considerations result in a clinical dilemma. OBJECTIVE: The aim of this study was to examine the attitudes of parents to chronically ill adolescents regarding confidential youth consultations and to explore the underlying reasons. METHODS: A sequential explanatory mixed methods design consisting of a cross-sectional questionnaire survey (n = 117) and three focus group interviews among parents (n = 12) to chronically ill adolescents (12-19 years) was used. Quantitative data were analyzed descriptively. Qualitative data were analyzed using King's template method. RESULTS: The parents preferred independent youth consultations starting around the age of 14-15 years. Around 60% of the parents had one or more concerns regarding independent youth consultations. Although 64% of the parents supported conditional or full confidentiality during adolescence, 95% wanted information even though their child did not consent. In the qualitative analysis, the parents described caring for a child with chronic disease as a term of life perceiving themselves as an "octopus" with numerous roles related to daily care and treatment and at the same time with thoughts and worries regarding the future. We found four themes: 'a life with chronic disease', 'responsibility', 'protection' and 'apprenticeship'. The parents' attitudes were influenced by their roles and their perception of the adolescent's competences as well as their experience with the healthcare system. CONCLUSIONS: Our findings suggest that parents need transitional care too.

[Psychological vulnerability of teams working with displaced Syrians in Lebanon]. / Vulnérabilité psychique des équipes, expérience libanaise auprès des déplacés syriens.

In the context of the humanitarian crisis of Syrian refugees in Lebanon, a team of young Lebanese social workers attempted to identify the most economically vulnerable people. These professionals have themselves sometimes been exposed to social and economic difficulties, having in their own past experienced war and deprivation. They were confronted with experiences of war, poverty, inter-community conflicts, the recollection of their own family trauma or guilt. Support in the form of psychological care was provided to them.

Body image altered by psoriasis. A study based on individual interviews and a model for body image.

BACKGROUND: Visible psoriasis skin symptoms have a severe psychological impact on quality of life. To improve clinical approaches, methods of assessing these aspects are needed. OBJECTIVES: To investigate the influence of psoriasis on patients' body image based on the Body Image Model (BIM). METHODS: In-depth semi-structured interviews were conducted. Transcriptions of the interviews were subsequently analyzed using concepts from the BIM. RESULTS: Eight patients with severe to moderate psoriasis (PASI ≥10) were interviewed. Five thematic issues linked to the negative impact of psoriasis on patient body image were identified: body coverage, sexual inhibitions, the influence of social support, reduced exercise activity and a negative self-image. Furthermore, information obtained through the Dermatology Life Quality Index (DLQI) questionnaires did not entirely reflect statements from patients made during interviews. CONCLUSION: An altered body image has a psychosocial impact on patients with visible psoriasis that may result in increased body coverage, sexual inhibitions and reduced exercise activity. This further affects self-image negatively and influences how people with psoriasis handle the risk of metabolic syndrome. Assessment of patient body image using components of the BIM increases the possibility of identifying important psychosocial aspects of psoriasis and the related risk of metabolic syndrome and is thus a valuable support for the DLQI questionnaires.

Multiplexed immunohistochemical detection of tumor markers in breast cancer tissue using laser ablation inductively coupled plasma mass spectrometry.

We optimized multiplexed immunohistochemistry (IHC) on breast cancer tissue. Up to 20 tumor markers are routinely evaluated for one patient, and thus, a common analysis results in a series of time consuming staining procedures. As an alternative, we used lanthanides for labeling of primary antibodies, which are applied in IHC. Laser ablation (LA) ICPMS was elaborated as a detection tool for multiplexed IHC of tissue sections. In this study, we optimized sample preparation steps and LA ICPMS parameters to achieve a sufficient signal-to-background ratio. The results prove the high selectivity of applied antibodies, which was sustained after labeling. Up to three tumor markers (Her 2, CK 7, and MUC 1) were detected simultaneously in a single multiplex analysis of a 5 µm thin breast cancer tissue at a laser spot size of 200 µm. Furthermore, the LA ICPMS results indicate a significantly higher expression level of MUC 1 compared to Her 2 and CK 7, which was not obvious from the conventionally stained tissue sections.