The effect of chlorhexidine on Acinetobacter baumannii in intensive care units.

Background and Objectives: Measures to prevent the emergence of hospital-acquired infections (HAIs) include a daily bath with chlorhexidine gluconate (CHG). The aim of this study was to determine the effect of patients bathing daily with CHG on the bacterial colonization on patient surfaces, environmental surrounding areas, and attending healthcare workers (HCWs). Materials and Methods: Patients were randomized by a 1:1 in two groups. Patients in group 1 were bathed daily with CHG; patients in group 2 were bathed with a placebo. Microbiological sampling of patients, environment, and HCWs were carried out on days 0, 3, and 10. The clonal relatedness of selected isolates collected was determined through pulsed-field gel electrophoresis. Clinical and demographic data were obtained from medical files. Results: Thirty-three patients were included (18 in group 1 and 15 in group 2). The more common species was Acinetobacter baumannii (n=144), followed by Klebsiella pneumoniae (n=81). A. baumannii was isolated more frequently on environmental surfaces in group 2 than group 1 (day 0 vs. day 3 vs. day 10; p = 0.0388). Twelve clones of A. baumannii were detected, with predominant clone A detected in patients and environmental surfaces. No pathogens were detected in HCWs. Conclusion: Our data support that CHG bathing decreases A. baumannii surviving on the environmental surfaces of critically ill patients.

Healthcare personnel infected with novel influenza A H1N1 virus in university hospitals in Buenos Aires, Argentina.

Data on the clinical presentation, risk factors, and outcomes for healthcare personnel (HCP) infected with influenza A H1N1 virus (H1N1) are limited. From June to July 2009, a prospective study was conducted among HCP with influenza-like illness (ILI) at university hospitals in Buenos Aires. A reverse transcription polymerase chain reaction (RT-PCR) was used to diagnose H1N1. A logistic regression model was developed to identify factors associated with H1N1. Among 1519 HCP, 96 (6.3%) were diagnosed with an ILI. Of these, 85 (88.5%) were swabbed for H1N1 detection, with 43 positive cases (2.8%). Seasonal influenza immunization was recorded in 76%. Comparison of H1N1-positive vs. H1N1-negative cases showed that H1N1-positive cases more frequently had asthenia (72% vs. 48%, p = 0.03) and cough (79% vs. 43%, p = 0.008) and less frequently had diarrhoea (9% vs. 29%, p = 0.03) and prior prophylaxis with oseltamivir (5% vs. 31%, p = 0.002). The logistic regression model showed that presence of cough (odds ratio (OR) 6.93, 95% confidence interval (CI) 2.24, 21.4) was associated with an increased risk of H1N1. Prior prophylaxis with oseltamivir (OR 0.08, 95% CI 0.01, 0.43) was associated with a lower probability of H1N1 infection. A high proportion of HCP with an ILI were infected with H1N1. Complication rates were relatively low. Prior prophylaxis with oseltamivir was associated with a lower risk of developing H1N1.

Effectiveness of a mouthwash containing Triclosan and Gantrez in the reduction of biofilm and gingivitis: a clinical pilot study.

AIM: The aim of this pilot study was to evaluate the effectiveness of a mouthwash containing Triclosan and Gantrez in the reduction of bacterial biofilm and gingivitis. METHODS AND MATERIALS: Thirty patients were assigned to control and experimental groups. The visible plaque index and the marginal bleeding index were determined at the baseline, and at the second and third months, at which time a percentage of bacterial plaque and bleeding was obtained for each patient. All patients were given unlabeled toothpaste without Triclosan and Gantrez and soft-bristle toothbrushes. Additionally, the experimental group patients used unlabeled mouthwash with Triclosan and Gantrez. The participants were instructed to rinse for 60 seconds after brushing, twice a day. RESULTS: At the baseline, the control and experimental group's bacterial plaque and marginal bleeding indices were close to each other (46.61% and 50.75% respectively; 7.62% and 9.59% respectively). At the third month, the experimental group presented bacterial plaque and marginal bleeding indices of 6.56% and 0.43% respectively, while the control presented 11.37% and 2.41% respectively. There were no significant differences between the two groups (p>0.05), with a discrete tendency to better results in the experimental group for both variables. However, there were significant differences among the experimental periods (p<0.05), except between the second and third months of observation. CONCLUSION: The mouthwash did not bring forth an additional advantage when combined with brushing. Additional studies where the observation period may be prolonged and the number of subjects increased are recommended. CLINICAL SIGNIFICANCE: It is important to understand the role chemical control of supragingival plaque can play as an aid in the treatment of periodontal diseases. Since bacterial biofilm is the primary etiological factor in gingivitis and periodontitis, it is essential to know how to control it in order to provide a more complete therapeutic strategy for patient care.

Análisis de un programa de atención nutricional respecto a la seguridad alimentaria y nutricional de la comunidad Sikuani del municipio de Puerto Gaitán, Meta: Un reporte de caso comunitario / Analysis of the nutritional care program regarding the food and nutritional security of the Sikuani community: case report

Fundamentos: La seguridad alimentaria y nutricional supone que las personas tienen una disponibilidad de alimentos que garanticen su aprovechamiento biológico suficiente para satisfacer las necesidades energéticas y nutricionales. Las intervenciones mediadas a través de programas comunitarios para promover una alimentación adecuada y contribuir a la mejoría de la situación nutricional en poblaciones étnicas, conlleva a interrogantes respecto a la pertinencia. El objetivo del presente estudio fue analizar las limitaciones del programa para garantizar la disponibilidad de alimentos, acceso, consumo y aprovechamiento biológico de la población Sikuani. Métodos: Se realizó una reflexión crítica de un caso comunitario de un programa en el marco de la seguridad alimentaria, desde la observación y experiencia. El análisis parte de organizar una serie de preguntas para reportar la experiencia en el programa considerando la definición de seguridad alimentaria y nutricional y la perspectiva de factores que influyen en propender o no una adecuada alimentación y nutrición en la comunidad Sikuani. Resultados: se rescataron cambios positivos como el empoderamiento de cuidadores respecto a protección y cuidados que requieren los niños y en la mejoría del estado de desnutrición, evidenciados a través de la toma de medidas antropométricas y la observación. Se identificaron situaciones de cambios comportamentales que alteraron no solo el estado nutricional de la población beneficiaria y su familia, sino también su sistema alimentario tradicional. Conclusiones: se considera que el programa es pertinente como parte de una estrategia de prevención de la desnutrición, ya que considera el mejoramiento del estado nutricional, el fortalecimiento familiar y el entorno protector mediante acciones pedagógicas que respondan a las características del contexto cultural. (AU)

Background: Food and nutritional security assumes that people have food availability that guarantees its sufficient biological use to satisfy energy and nutritional needs. Interventions mediated through community programs to promote adequate nutrition and contribute to the improvement of the nutritional situation in ethnic populations raise questions regarding relevance. The objective of this study was to analyze the limitations of the program to guarantee the availability of food, access, consumption and biological use of the Sikuani population. Methods: A critical reflection was carried out on a community case of a program within the framework of food security, from observation and experience. The analysis starts from organizing a series of questions to report the experience in the program, considering the definition of food and nutritional security and the perspective of factors that influence whether or not to promote adequate food and nutrition in the Sikuani community. Results: Positive changes were recovered such as the empowerment of caregivers regarding the protection and care that children require and the improvement in the state of malnutrition, evidenced through the taking of anthropometric measurements and observation. Situations of behavioral changes were identified that altered not only the nutritional status of the beneficiary population and their family, but also their traditional food system. Conclusions: The program is considered relevant as part of a malnutrition prevention strategy, since it considers the improvement of nutritional status, family strengthening and the protective environment through pedagogical actions that respond to the characteristics of the cultural context. (AU)

Percepción de la calidad de vida en pacientes con cáncer de próstata avanzado: un estudio cualitativo descriptivo / Perception of the Quality of Life of Patients with Advanced Prostate Cancer: A Descriptive Qualitative Study

Objetivo Describir las percepciones de calidad de vida en una muestra de pacientes con cáncer de próstata avanzado de un hospital universitario. Métodos Desde un enfoque cualitativo descriptivo, se realizaron entrevistas semiestructuradas y líneas de tiempo para explorar la percepción de calidad de vida de siete pacientes con cáncer de próstata desde su diagnóstico. Por medio de un análisis temático de corte inductivo-deductivo, se identificaron las dimensiones de la calidad de vida que se perciben con mayores cambios a partir de la enfermedad y su tratamiento. Resultados Entre las dimensiones que se encuentran más frecuentemente afectadas están las funciones urinaria, sexual y hormonal. Así mismo, los participantes describen afectaciones relacionadas con los síntomas generales del cáncer y su tratamiento, el estado de ánimo y las limitaciones en la atención por el sistema de salud. Por otra parte, los participantes reportan que su calidad de vida se ve fortalecida gracias a nuevos hábitos y prácticas personales, así como la consolidación del apoyo social, en el que incluyen a la pareja, la familia y la relación con su médico tratante. Conclusiones El fortalecimiento de la relación médico-paciente basada en el trato cordial, disposición afectiva y empatía al momento de la valoración médica, y la consolidación de una adecuada red de apoyo social como mecanismo de afrontamiento ante el proceso de enfermedad se establecen como las principales estrategias para incrementar la percepción de calidad de vida relacionada con la salud de los pacientes con cáncer de próstata avanzado.

Purpose To describe the preception of the quality of life of a sample of patients with advanced prostate cancer from a university hospital. Methods Based on a descriptive qualitative approach, semi-structured interviews were held and timelines were developed to explore the perception of quality of life of seven patients with prostate cancer since their diagnosis. Through an inductive-deductive thematic analysis, the dimensions of quality of life that have had more changes due to the disease and its treatment were identified. Results Among the quality of life dimensions that are most frequently affected are urinary, sexual and hormonal functions. Likewise, the participants describe affectations related to the general symptoms of cancer and its treatment, changes in mood, and limitations in the care provided by the health system. However, participants report that their quality of life is strengthened by new habits and personal practices, as well as with the consolidation of social support, in which they include their partners, their families, and their relationship with their treating physician. Conclusions The strengthening of the doctor-patient relationship based on cordial treatment, affective disposition and empathy at the time of the medical evaluation, and the establishment of an adequate social support network as a coping mechanism in the face of the disease process are consolidated as the main strategies to increase the perception of the health-related quality of life of patients with advanced prostate cancer.