Home transfusion: three decades of practice at a tertiary care hospital.

BACKGROUND: Hospital at Home (HH) provides specialized care at the patients' homes. Keeping patients in familial surroundings can result in better outcomes reducing readmission to hospital, mortality, and costs of care. Home transfusion (HT) can be a key element in HH management but is scarcely deployed due to concerns about safety and cost. We have reviewed our HT practice to assess its feasibility and safety. STUDY DESIGN AND METHODS: We prospectively reviewed data collected from 1985 to 2015, focusing specially on feasibility and procedural safety, looking for adverse events of transfusion. We also assessed the situation in similar hospitals in Spain with a survey about their practice. RESULTS: A total of 613 patients received 2260 blood components in 2126 transfusion episodes. A total of 93% patients received fewer than 10 transfusions. Most patients were treated for blood diseases (32%) or cancers (20%). The rate of adverse effects was 2.68% and decreased significantly with time. Fever was the most common adverse reaction. Patients who received transfusion of more than one blood product in a day were at higher risk of adverse events. No errors or near-miss events were detected, and no patient had to be readmitted to hospital for this cause. The survey on HT practices in similar hospitals showed great variation in practice. CONCLUSION: HT is feasible, sustainable, and safe, when performed on selected patients by dedicated HH units with well-trained staff, under specific protocols.

Effectiveness and safety of ertapenem used in hospital-at-home units: data from Spanish Outpatient Parenteral Antimicrobial Therapy Registry.

AIM: To evaluate the effectiveness and safety of ertapenem in patients hospitalized at home. PATIENTS & METHODS: Retrospective analysis of data from Spanish Outpatient Parenteral Antimicrobial Therapy (OPAT) registry. RESULTS: Data from 1428 patients (median age 70 years; 5.4% institutionalized) and 1547 infectious processes (24% self-administration) were analyzed. Clinical cure or improvement was achieved in 93.8% of cases. Rate of related readmissions was 4.2%, of clinically important complications -3.9%, and of adverse drug reactions -3.2%. High comorbidity burden, contagion in nursing home and certain types of infection were associated with worse prognosis. Self-administration was effective and safe, except in case of nursing home-acquired infections. CONCLUSION: Ertapenem OPAT was effective and safe. Caregivers in nursing homes should be better trained in OPAT-related procedures.

Predominance of G9P[4] Rotavirus from Children with Acute Gastroenteritis in Northwestern Mexico.

In Mexico, group A rotavirus (RVA) infections remain the most common cause of severe dehydrating diarrhea in children. This study was conducted to examine the circulating RVA strains in the northwest region of Mexico. RVA strains collected from stool samples of children were genotyped, and their partial sequences were analyzed. RT-PCR of the VP4 and VP7 genes showed the partial G9P[4] genotype in all the samples. Sequencing and phylogenetic analysis of the partial VP7 gene amplicons of 10 strains showed that they clustered in the RVA G9 lineage III, and 7 of them showed 100% identity with the reference strain LB1562, which was collected in the USA 2 years earlier. The amino acid sequences of the VP7 and VP4 antigenic regions were highly conserved between the analyzed RVA strains. Active surveillance is important for monitoring the emergence of RVA strains and their impact on cases of gastroenteritis.

Tomato (Solanum lycopersicum).

Agrobacterium-mediated transformation is the most common method for the incorporation of foreign genes into the genome of tomato as well as many other species in the Solanaceae family. This chapter describes a protocol for the genetic transformation of tomato cultivar Micro-Tom using cotyledons as explants. Detailed procedures are also included for determining gene-copy number using a duplex qPCR TaqMan assay, and the histochemical analysis of GUS expression.

Prevalence and intensity of soil-transmitted helminthiasis, prevalence of malaria and nutritional status of school going children in honduras.

BACKGROUND: Many small studies have been done in Honduras estimating soil-transmitted helminthiasis (STH) prevalence but a country-wide study was last done in 2005. The country has the highest burden of malaria among all Central American countries. The present study was done to estimate country-wide STH prevalence and intensity, malaria prevalence and nutritional status in school going children. METHODS AND FINDINGS: A cross-sectional study was conducted following PAHO/WHO guidelines to select a sample of school going children of 3rd to 5th grades, representative of ecological regions in the country. A survey questionnaire was filled; anthropometric measurements, stool sample for STH and blood sample for malaria were taken. Kato-Katz method was used for STH prevalence and intensity and rapid diagnostic tests, microscopy, and polymerase chain reaction (PCR) were used for malaria parasite detection. A total of 2554 students were studied of which 43.5% had one or more STH. Trichuriasis was the most prevalent (34%) followed by ascariasis (22.3%) and hookworm (0.9%). Ecological regions II (59.7%) and VI (55.6%) in the north had the highest STH prevalence rates while IV had the lowest (10.6%). Prevalence of one or more high intensity STH was low (1.6%). Plasmodium vivax was detected by PCR in only 5 students (0.2%), all of which belonged to the same municipality; no P. falciparum infection was detected. The majority of children (83%) had normal body mass index for their respective age but a significant proportion were overweight (10.42%) and obese (4.35%). CONCLUSIONS: Biannual deworming campaigns would be necessary in ecological regions II and VI, where STH prevalence is >50%. High prevalence of obesity in school going children is a worrying trend and portends of future increase in obesity related diseases. Malaria prevalence, both symptomatic and asymptomatic, was low and provides evidence for Honduras to embark on elimination of the disease.

Respiratory illness in late preterm infants during the first six months of life.

UNLABELLED: Late preterm infants are physiologically immature and at risk for respiratory complications. The study's objective was to determine the incidence of respiratory illnesses in a group of preterm infants (33-35 weeks) during the first six months of life. METHODS: Parents were contacted by phone in the six months period after participating in an educational program and a short survey was performed. RESULTS: None of the infants required admission to the intensive care unit in the newborn period. According to parents, 71% of the babies had a common cold, 9% bronchiolitis, and 3% pneumonia. Fifty four percent of the babies visited the emergency room due to respiratory illnesses and (12%) required admission. CONCLUSION: Late preterm infants present respiratory illnesses during the first months of life which result in medical expenditures, emergency room visits, and hospital admissions. Educational interventions about preventive measures are needed to decrease the morbidity associated to these illnesses.