Effects of isolation rooms on the prevalence of hospital acquired pneumonia in a respiratory ICU.

BACKGROUND: The incidence of hospital acquired pneumonia (HAP) varies according to the type of intensive care units (ICUs). AIM: The aims of this study were to determine the frequency of hospital acquired pneumonia (HAP) and the effect of isolation rooms on the frequency of pneumonia in the ICU. MATERIALS AND METHODS: The present investigation was carried out between January 2004 and July 2008. The ICU, which was 4-bed ward-type between January 2004 and February 2006 (1st period), was reconfigured as isolated rooms with only 2 beds each after March 2006 (2nd period). 153 and 379 patients were followed up in the ICU in the 1st and 2nd periods, respectively. Blood, sputum, and deep tracheal aspiration cultures were used for the isolation of the causative agents. RESULTS: No significant difference was detected between the general characteristics of patients. HAP developed in 101 patients (19%). The prevalence of HAP was 22.9% in the 1st period and 17.4% in the 2nd period. During the 1st and 2nd periods, the HAP infection densities were 22.2 and 16.1/1000 patient-days and the ventilator-associated pneumonia densities were 48.1 and 37.6/1000 ventilator-days, respectively. Eighty-six percent of HAP was ventilator-associated pneumonia (VAP). CONCLUSIONS: Isolation rooms in the ICU may be an effective strategy to control and decrease the rate of pneumonia in the ICU in addition to other preventive strategies.

Decommissioning a phosphoric acid production plant: a radiological protection case study.

During a preliminary survey at the area of an abandoned fertilizer plant, increased levels of radioactivity were measured at places, buildings, constructions and materials. The extent of the contamination was determined and the affected areas were characterized as controlled areas. After the quantitative and qualitative determination of the contaminated materials, the decontamination was planned and performed step by step: the contaminated materials were categorized according to their physical characteristics (scrap metals, plastic pipes, scales and residues, building materials, etc) and according to their level of radioactivity. Depending on the material type, different decontamination and disposal options were proposed; the most appropriate technique was chosen taking into account apart from technical issues, the legal framework, radiation protection issues, the opinion of the local authorities involved as well as the owner's wish. After taking away the biggest amount of the contaminated materials, an iterative process consisting of surveys and decontamination actions was performed in order to remove the residual traces of contamination from the area. During the final survey, no residual surface contamination was detected; some sparsely distributed low level contaminated materials deeply immersed into the soil were found and removed.

Tuberculosis in Turkey: high altitude and other socio-economic risk factors.

BACKGROUND: In Turkey, there are insufficient data regarding the relation between altitude and the incidence of tuberculosis (TB). OBJECTIVES: This study aimed to investigate the effect of high altitude and socio-economic conditions on the incidence of TB in Turkey. METHODS: The mean incidence of TB in 56 Turkish cities was measured as n/100,000 population between 1999 and 2005. The mean altitude of each city was recorded in metres. RESULTS: The incidence of TB was lower in cities located at high altitude (P=0.000) and higher in cities with a high population density (P=0.000). Multivariate analysis showed that the incidence of TB in low altitude cities was 3.28-fold higher than in high altitude cities (P=0.000). In cities with a population density >80 people/km(2), the incidence of TB was 4.18-fold higher than in cities with a lower population density (P=0.000) Other factors found to affect the incidence of TB were having a social insurance card and a low annual income. CONCLUSIONS: There was a strong negative correlation between altitude and the incidence of TB, and population density was significantly associated with the incidence of TB. Possession of a social insurance card and fertility rate were also risk factors for TB. The authors believe that altitude has a stronger influence on the incidence of TB than the other factors. The effect of altitude on TB may reveal new data, but further studies need to be undertaken to assess the effects of potential factors on the incidence of TB.