Asunto(s)
Intoxicación por Monóxido de Carbono/complicaciones , Disfunción Ventricular Izquierda/etiología , Disfunción Ventricular Derecha/etiología , Intoxicación por Monóxido de Carbono/terapia , Cardiotónicos/uso terapéutico , Ecocardiografía , Humanos , Oxigenoterapia Hiperbárica/métodos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Disfunción Ventricular Izquierda/diagnóstico por imagen , Disfunción Ventricular Izquierda/terapia , Disfunción Ventricular Derecha/diagnóstico por imagen , Disfunción Ventricular Derecha/terapiaRESUMEN
We examined the results of surveillance of extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae, which are pathogens known to cause nosocomial outbreaks, at a comprehensive cancer center in Japan over a 5-year period. We found that the admission prevalence and the incidence of ESBL-producing E coli increased during the study period, in contrast with ESBL-producing K pneumoniae, in which the parameters remained low throughout the study period.
Asunto(s)
Infecciones por Escherichia coli/microbiología , Escherichia coli/efectos de los fármacos , Instituciones de Salud , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/efectos de los fármacos , beta-Lactamasas/metabolismo , Infección Hospitalaria/microbiología , Farmacorresistencia Bacteriana , Escherichia coli/enzimología , Escherichia coli/genética , Escherichia coli/metabolismo , Infecciones por Escherichia coli/epidemiología , Regulación Bacteriana de la Expresión Génica/fisiología , Regulación Enzimológica de la Expresión Génica/fisiología , Humanos , Control de Infecciones/métodos , Japón , Infecciones por Klebsiella/epidemiología , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/metabolismo , Estudios Retrospectivos , beta-Lactamasas/genéticaRESUMEN
Extrapulmonary tuberculosis (TB) can be infectious when diagnostic or therapeutic procedures are performed on infected lesions. We retrospectively describe infection control and evaluate isolation failure rates during the manipulation of active extrapulmonary TB lesions at a comprehensive cancer center over a 5-year period. Among patients with a high suspicion of cancer, extrapulmonary TB was not suspected, and airborne precautions often were not used when manipulating infected lesions.
Asunto(s)
Infección Hospitalaria/prevención & control , Transmisión de Enfermedad Infecciosa/prevención & control , Control de Infecciones/métodos , Neoplasias/complicaciones , Tuberculosis/prevención & control , Adulto , Anciano , Infección Hospitalaria/transmisión , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/diagnóstico , Neoplasias/tratamiento farmacológico , Estudios Retrospectivos , Centros de Atención Terciaria , Tuberculosis/transmisiónRESUMEN
BACKGROUND: Lipid emulsions have been suggested to reduce immune responses, particularly in severely stressed patients. The authors investigated the influence of the slow intravenous infusion of a soybean oil-based lipid emulsion on some immune parameters in patients who had undergone an esophagectomy for esophageal cancer. METHODS: Thirty-two patients who had undergone an esophagectomy were randomly divided into a lipid emulsion (LPD)-treated group and a control group. All patients received parenteral feeding with a glucose-based solution. Patients in the LPD group received 100 mL of a 20% soybean oil emulsion for 7 days after the esophagectomy in addition to the glucose-based feeding. A slow infusion rate (0.09-0.12 g/kg/h) was adopted to take account of the intrinsic degradation of infused lipids. Immune responses were measured based on lymphocyte proliferation and serum concentrations of monocyte chemoattractant protein-1 (MCP-1), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). The authors also measured levels of rapid turnover proteins (ie, transferrin, prealbumin, and retinol-binding protein). RESULTS: Phytohemagglutinin- and concanavalin A-stimulated lymphocyte proliferation significantly decreased after the esophagectomy, but no significant difference was seen between the LPD and control groups. No significant difference in changes in plasma concentrations of MCP-1, IL-6 and TNF-α occurred between the 2 groups either. Plasma concentrations of rapid turnover proteins did not differ between the groups. CONCLUSIONS: These results indicate that the lipid emulsion did not affect the immune parameters measured in patients who had undergone an esophagectomy when administered at a slow rate.