Parents' perceptions of patient safety in paediatric hospital care-A mixed-methods systematic review.

AIM(S): To identify and summarize evidence on paediatric patient safety in a hospital setting from parents' point of view. DESIGN: A mixed-methods systematic review. PROSPERO ID: ID number CRD42023453626. DATA SOURCES: PubMed, Scopus, ScienceDirect, the Cochrane Library and the Wiley database were searched in July 2023. REVIEW METHODS: Two researchers independently applied eligibility criteria, selected studies and conducted a quality appraisal. Data-based convergent synthesis and thematic content analysis were employed. RESULTS: Twelve studies were included: eight qualitative research studies, two cross-sectional studies, one non-randomized experimental study and one mixed-methods study. The results were grouped into two themes-parental perceptions of inclusion in paediatric patient safety and parental perceptions of exclusion from paediatric patient safety-and comprised seven main subthemes: comfort in communication, parental engagement, communication difficulties, withdrawal from activity, uncertainty about available information and threats to patient safety. CONCLUSIONS: Parents are willing to be engaged in care but require support from healthcare professionals, as they are often anxious about the condition of their children and actions they believe might be helpful. They need to be treated as valuable partners and be engaged in communication and decision processes. IMPACT: The development and implementation of interventions involving parents in ensuring the safety of hospitalized paediatric patients should be of the utmost priority to healthcare organizations, as the common theme throughout the included studies was the need for improved communication with and recognition of parents as allies. REPORTING METHOD: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was followed. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Antimicrobial susceptibility among clinical Nocardia species identified by multilocus sequence analysis.

Antimicrobial susceptibility patterns of 112 clinical isolates, 28 type strains, and 9 reference strains of Nocardia were determined using the Sensititre Rapmyco microdilution panel (Thermo Fisher, Inc.). Isolates were identified by highly discriminatory multilocus sequence analysis and were chosen to represent the diversity of species recovered from clinical specimens in Ontario, Canada. Susceptibility to the most commonly used drug, trimethoprim-sulfamethoxazole, was observed in 97% of isolates. Linezolid and amikacin were also highly effective; 100% and 99% of all isolates demonstrated a susceptible phenotype. For the remaining antimicrobials, resistance was species specific with isolates of Nocardia otitidiscaviarum, N. brasiliensis, N. abscessus complex, N. nova complex, N. transvalensis complex, N. farcinica, and N. cyriacigeorgica displaying the traditional characteristic drug pattern types. In addition, the antimicrobial susceptibility profiles of a variety of rarely encountered species isolated from clinical specimens are reported for the first time and were categorized into four additional drug pattern types. Finally, MICs for the control strains N. nova ATCC BAA-2227, N. asteroides ATCC 19247(T), and N. farcinica ATCC 23826 were robustly determined to demonstrate method reproducibility and suitability of the commercial Sensititre Rapmyco panel for antimicrobial susceptibility testing of Nocardia spp. isolated from clinical specimens. The reported values will facilitate quality control and standardization among laboratories.

[Postinfarction cardiac remodeling--clinical consequences]. / Pozawalowa przebudowa serca--konsekwencje kliniczne.

Despite the considerable progress in the setting of invasive and pharmacological treatment still in about 20-30% patients with myocardial infarction in long-term observation an unfavourable post-infarction remodeling along with development of LV dilatation is to be seen. The heart forms the structural and functional unity, thus morphological changes due to cardiac post-infarction remodeling process are accompanied by systolic and diastolic myocardial dysfunction, which in consequence may lead to appearance of heart failure. In recent years our knowledge regarding causative factors of post-infarction cardiac remodeling has been remarkably widening and in the light of accumulating data indicating the possibility of LV remodeling regression, elaboration of the new specific-orientated methods of counteracting its uneventful consequenses is a matter of time.

Serum levels of interleukin-6, interleukin-10 and C-reactive protein in relation to left ventricular function in patients with myocardial infarction treated with primary angioplasty.

BACKGROUND: Inflammatory factors are involved in the cardiac remodelling process after myocardial infarction (MI). Pronounced and sustained activation of proinflammatory factors is believed to enhance the damage to the myocardium and leads to its dysfunction and heart failure. Anti-inflammatory factors, especially interleukin-10 (IL-10), exert a protective action by reducing excessive inflammatory reactions. AIM: To asses the relationship between serum levels of IL-6, IL-10, CRP and echocardiographic indices of myocardial function in patients with ST-elevated myocardial infarction (STEMI) treated with primary angioplasty. Prognostic value of IL-6, IL-10 and CRP levels in predicting systolic and diastolic dysfunction 6 months after MI was also assessed. METHODS: We studied 75 patients aged 36-82 (28 women and 47 men) presenting with STEMI treated with primary angioplasty. Blood samples for assesment of IL-6, IL-10 and CRP levels were on days 3 and 7 (3d, 7d) of MI and after 6-month follow-up (6m). Echocardiographic examination was performed on day 7 and 6 months after MI during which the parameters of LV systolic (LVEF, WMSI) and diastolic function (E/A, DT, IVRT, Ep, E/Ep) were evaluated. Twenty four healthy persons served as controls. RESULTS: Interleukin-6 and CRP levels in consecutive measurements correlated significantly inversely with LVEF (7d) and LVEF (6m). The IL-10 (7d) and IL-10 (6m) level correlated positively with LVEF (6m) (r=0.39, p=0.02; r=0.27, p=0.04). The IL-6 and CRP levels in consecutive measurements correlated significantly positively with E/A and E/Ep and inversely with IVRT, DT and Ep. The IL-10 (3d) level correlated inversely with DT (6m) (r=-0.25, p=0.04), while IL-10 (7d) level correlated positively with DT (6m) (r=0.36, p=0.004). Increased level of IL-6 (3d) and CRP (3d) was an independent prognostic factor of LV systolic (OR=1.27, p=0.02; OR=1.14, p=0.05) and diastolic dysfunction (OR=1.14, p=0.03; OR=1.05, p=0.01) 6 months after MI. CONCLUSIONS: 1. A significant, correlations between increased IL-6, CRP level and impaired LV systolic and diastolic function indicate the possible involvement of these factors in postinfarction cardiac damage. 2. Increased level of IL-6 and CRP in the acute phase of MI is an independent predictor of LV systolic and diastolic dysfunction 6 months after MI. 3. Increased serum level of IL-10 in the acute phase of MI reflects the extension of post-infarction myocardial lesion. 4. Maintenance of increased level of IL-10 for days/months after MI seems to be prognostically beneficial.

[Multiple percutaneous coronary stent implantation due to myocardial bridging--a case report]. / Wielokrotny zabieg stentowania mostka miesniowego--opis przypadku.

We present a case of a woman who had acute coronary syndrome caused by myocardial bridge. She was treated with percutaneous coronary intervention and stent implantation. Two months after the procedure the patient had myocardial infarction because of subacute thrombosis and during the second intervention another stent was implanted. After a few months another acute coronary syndrome occurred because of restenosis and balloon angioplasty with stent implantation was performed. Despite this the artery occluded and sufficient collateral circulation was developed. Current opinions concerning percutaneous coronary interventions of myocardial bridges are presented.

Serum levels of interleukin-6, interleukin-10 and C-reactive protein in patients with myocardial infarction treated with primary angioplasty during a 6-month follow-up.

INTRODUCTION: Recent studies indicate that inflammatory and immune factors are involved in the post-infarction cardiac remodeling. OBJECTIVES: We evaluated serum levels of interleukin-6 (IL-6), interleukin-10 (IL-10) and C-reactive protein (CRP) in patients with acute coronary syndrome with ST-segment elevation myocardial infarction (STEMI) in the acute phase of the disease and 6 months later. Moreover we sought to determine the effect of selected clinical parameters on the levels of the inflammatory factors. PATIENTS AND METHODS: The study involved 75 patients with STEMI, aged 36-82 years, treated with primary angioplasty. Blood samples for determination of IL-6, IL-10 and CRP levels were taken on the 3rd and 7th day of hospitalization and after 6 months. RESULTS: In the acute phase of myocardial infarction (MI) the levels of IL-6, IL-10 and CRP, as well as the IL-6/IL-10 and CRP/IL-10 indexes were higher than in the control group. Six months later the CRP level decreased significantly, and the levels of IL-6 and IL-10 and the studied indices normalized. In the acute phase of MI there were positive correlations between the studied factors. The independent predictors of IL-6, IL-10 and CRP levels were body mass index (BMI), troponin I, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and the baseline levels of inflammatory markers. CONCLUSIONS: In the acute phase of MI, inflammatory activation is enhanced with predominant proinflammatory response. In the course of the healing process within 6 months inflammation is suppressed and the balance between pro- and anti-inflammatory activation is restored. The size of MI, BMI, lipid levels and the baseline levels of inflammatory markers influence the levels of inflammatory factors.

[Pulse pressure as a prognostic indicator of organ damage in patients with essential hypertension]. / Cisnienie tetna jako wskaznik prognostyczny powiklan narzadowych u chorych na pierwotne nadcisnienie tetnicze.

Pulse pressure (PP), defined as systolic blood pressure minus diastolic blood pressure, plays an important role as a risk factor for cardiovascular events. Pulse pressure is pulsatile component of blood pressure. A widened pulse pressure reflects increased stiffness of the large arteries. The aim of the study was to evaluate the association between pulse pressure and organ damage in essential hypertension. We examined 60 subjects, 34 women aged 59 +/- 13 years and 26 men aged 48 +/- 17 years with primary hypertension. In every subject we performed 24-hour automatic blood pressure measurement and echocardiography, abdominal ultrasonography, funduscopy, chest x-ray. We measured sodium potassium, creatinine level in serum and in urine, creatinine clearance and microalbuminuria. Pulse pressure is proportional to the stage of hypertension. A dimension of the aorta parallels with measures of blood pressure. The strong correlation between pulse pressure and damage in funduscopy can indicate, that complication in fundus of the eye are dependent more than the level of a pressure. The significantly higher sodium level in serum and the positive correlation between natremia, natriuresis and pulse pressure proves the role of natrium in pathophysiology of hypertension.