Mcintoshwestermann5788

We observed a significantly lower incidence of ELUCR in the PICC group (0.2 versus 7.7 events per 100 catheter-days; P less then 0.001). When the incidence of ELUCR was analyzed according to the duration of indwelling catheterisation for each type of catheter (divided into one-week intervals), differences between both groups were also significant (P-values≤0.001 for the first three weeks of treatment). During the second week of IV treatment, only one patient in the PICC group (2.1%) developed an ELUCR compared to 19 (38.8%) in the control group (P less then 0.001). CONCLUSIONS A PICC placed and maintained by a dedicated nursing team is an excellent alternative to peripheral venous catheters or CVCs for administrating antimicrobial therapy for both short and long periods of treatment. INTRODUCTION The objective was to compare incidence rates of pertussis in children under the age of one in Castelló, before and after the introduction of vaccination of pregnant women in January 2015. METHODS The incidence of the post-vaccine period (2015-2018) was compared with the pre-vaccine period (2011-2014) in all ages, in children from 3 to 11 months and under 3 months. The relative risks and their 95% confidence intervals (95% CI) were calculated. RESULTS The overall rate of pertussis in all ages was higher in the post-vaccine period than in the pre-vaccine period (0.23 vs. 0.15 per 1.000 person-years), but decreased in those under 3 months. The relative risks were 1.56 (95% CI 1.34-1.82) in all ages; 1.73 (95% CI 0.87-3.57) for children aged 3 to 11 months, and 0.35 (95% CI 0.16-0.69) for children under 3 months. A similar pattern was observed for hospitalised children. CONCLUSIONS The incidence rate in children under 3 months was reduced by 65% in the period after the intervention, and the hospitalisation risk rate by 71%, suggesting that the measure has been effective and specific for this age group. INTRODUCTION Burns patients with psychiatric comorbidities may be at increased risk of harm from drug interactions. We aimed to identify the most common classes of drug involved, the potential clinical effects and any clinical evidence for their occurrence. METHODS The International Burn Injury Database was used to identify all admission episodes for patients with a psychiatric comorbidity over a 5-year period at an adult regional burns unit. For this group, all drugs administered were categorised as either a new or continuing medication. Following this, an established online tool was used to screen for potential interactions between drugs. Where one was identified, a retrospective notes review was used to investigate whether it had occurred clinically. RESULTS Ninety-one admission episodes were identified and records were available for 60 of these. In total, 145 incidences of severe potential interactions were identified (89 between a new drug and a continuing drug and 56 between two new drugs). The most frequently involved continuing drugs with the potential for interaction were neurotransmitter reuptake-inhibiting antidepressants and mirtazapine, while the most common new drugs identified were ondansetron, fentanyl and tramadol. The most frequently identified potential consequence of interactions were serotonin syndrome, arrhythmias and hypokalaemia. Clinically, there was minimal evidence for any interaction. CONCLUSION We have found many potential severe interactions in this patient group and psychotropic drugs were more commonly implicated than other drug classes. However, there was little evidence of the clinical manifestations of interaction. Serious drug interactions in burns patients are likely rare, but clinicians should be aware of the most likely drugs involved and the possible sequelae. PURPOSE To evaluate the effectiveness of the robotic-assisted exercise with virtual gaming on total active range of motion (ROM) of the digits, hand grip strength (HGS), and hand function in children with hand burns. METHODS Thirty-three children with burn caused by thermal injury (flame or scald) with the involvement of the wrist and hand, total body surface area (TBSA) less then 30%, and age between 6-12 years, were included in this study. The patients were randomly allocated to one of the two groups; control group (n = 16; received 60-min of the traditional hand rehabilitation program, three times per week for two successive months) and experimental group (n = 17; engaged in an additional 20 min of interactive robot-enhanced hand rehabilitation besides the traditional rehabilitation). Outcomes measured were the total active ROM of the digits, HGS, and hand function at three occasions during the study at the baseline, post-treatment, and 3 months follow-up. RESULTS In the experimental group, results regarding total active (ROM) of the digits, HGS, and hand function were statistically significant in comparison to the control group either after treatment (P less then .05, P = .04, and P = .005) respectively or at the follow-up (P less then .05, P = .023, and P = .012) respectively favoring the experimental group. CONCLUSION The robot-enhanced exercise with virtual gaming can increase total active ROM of the fingers' digits, improve HGS, and hand function in children with hand burns. INTRODUCTION The estimated incidence of non-accidental burns varies between 1-25% in children. Distinguishing non-accidental burns from accidental burns can be very complicated but is of utmost importance for prevention of future injuries. Several studies concerning non-accidental burns have been published, however a clear overview is lacking. AIM To conduct a systematic review of the existing literature to identify the incidence and characteristics of burns due to intentional causes and neglect. METHODS The protocol of this systematic review was prospectively registered in an international database (PROSPERO, National Institute for Health Research, York, United Kingdom). We searched literature in electronic databases published from 1948 until July 2018 written in English, Dutch, German and French. Two researchers screened, selected and graded the included articles, using standard methodology. C59 in vivo We included primary studies of confirmed non-accidental burns in children. We excluded literature reviews, case-reports and unpublished data.