The impact of antimicrobial stewardship ward rounds on antimicrobial use and predictors of advice, uptake, and outcomes.

Objectives: To identify the impact of introducing antimicrobial stewardship (AMS) ward rounds.

Methods: We used an interrupted time-series approach to investigate the impact of implementing AMS ward rounds with in-person feedback from a multi-disciplinary team in Hospital-1, also comparing to Hospital-2 in the same city where AMS ward rounds were not yet implemented. Regression models were used to identify predictors of advice given, whether advice was followed, and associations between advice uptake and length of stay.

Continuous Positive Airway Pressure but Not GLP1-mediated Weight Loss Improves Early Cardiovascular Disease in Obstructive Sleep Apnea: A Randomized Proof-of-Concept Study.

Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular (CV) morbidity and mortality, but the benefit of continuous positive airway pressure (CPAP) is uncertain. However, most randomized controlled trials have focused on the role of CPAP in secondary prevention, although there is growing evidence of a potential benefit on early CV disease. Weight loss in combination with CPAP may be superior but is difficult to achieve and maintain with conventional measures alone.

Combined autologous blood patch-immediate patient rollover does not reduce the pneumothorax or chest drain rate following CT-guided lung biopsy compared to immediate patient rollover alone.

Puprose: The purpose of this study was to evaluate a combined autologous blood-patch (ABP)-immediate patient rollover (IPR) technique compared with the IPR technique alone on the incidence of pneumothorax and chest drainage following CT-guided lung biopsy.

Methods: In this interventional cohort study of both prospectively and retrospectively acquired data, 652 patients underwent CT-guided lung biopsy. Patient demographics, lesion characteristics and technical biopsy variables including the combined ABP-IPR versus IPR alone were evaluated as predictors of pneumothorax and chest drain rates using regression analysis.

Short notice cancellations - an insight into Irish surgical waiting lists.

Background: The reasons underlying prolonged waiting lists for surgery in Ireland are multifactorial. Patient-related factors including non-attendances contribute in part to the current waiting times.

Aims: To determine the rate of short notice cancellation for day case surgery in a model 2 HSE hospital over a 1-month period and to implement an intervention to try and reduce the rate of cancellation.

An unusual case of multiple self-inflicted punctures to the precordium.

Sewing needles, albeit a rare case of penetrating cardiac injury, are potentially life-threatening. We report a case of successful intra-cardiac needle removal from a 32 year old who inserted multiple needles into the chest and abdomen.

Seroepidemiology and phylogenetic characterisation of measles virus in Ireland, 2004-2013.

Background: Ireland is classified as an area of high measles incidence. A World Health Organisation-European Region strategic plan exists for measles elimination by 2015.

Objectives: To retrospectively investigate measles outbreaks using all patient samples (sera and oral fluid) received for measles laboratory diagnosis and characterise the genetic diversity of circulating measles genotypes in Ireland.

Use of a geographic information system to map cases of measles in real-time during an outbreak in Dublin, Ireland, 2011.

In 2011, there was a large measles outbreak in Dublin. Nationally 285 cases were notified to the end of December 2011, and 250 (88%) were located in the Dublin region. After the first case was notified in week 6, numbers gradually increased, with 25 notified in June and a peak of 53 cases in August.

Fate of the two-component lantibiotic lacticin 3147 in the gastrointestinal tract.

The component peptides of lacticin 3147 were degraded by alpha-chymotrypsin in vitro with a resultant loss of antimicrobial activity. Activity was also lost in ileum digesta. Following oral ingestion, neither of the lacticin 3147 peptides was detected in the gastric, jejunum, or ileum digesta of pigs, and no lacticin 3147 activity was found in the feces.

Cirrus cloud mimics in the laboratory: an infrared spectroscopy study of thin films of mixed ice of water with organic acids and ammonia.

The structures of formic and acetic acids deposited on a thin gold substrate held in vacuum at low temperatures and their related water-ice promoted chemistry have been investigated. The condensed water/guest films were taken to act as cirrus cloud "mimics." Such laboratory representations provide a necessary prelude to understanding how low temperature surfaces can affect chemical composition changes in the upper atmosphere.

A lacticin 3147 enriched food ingredient reduces Streptococcus mutans isolated from the human oral cavity in saliva.

Aims: To isolate and characterise Streptococcus mutans from Irish saliva samples and to assess their sensitivity to a food-grade preparation of the lantibiotic, lacticin 3147, produced by Lactococcus lactis DPC3147.

Methods And Results: Saliva samples collected from children with varying oral health status were screened on Mitis Salivarius agar for the presence of pathogenic streptococci. Following selective plating, 16S rDNA sequencing and Pulsed Field Gel Electrophoresis (PFGE), 15 distinct strains of Strep.

The perception of ward-based nurses seconded into an Outreach Service.

A group of ward nurses were seconded into an Outreach Service for a 2-week period. Following this, the group took part in an evaluation of the placement using a focus group methodology. The aim of this project was to explore the perceptions of a ward-based nurse recruited into the Outreach Service so that they could function effectively and efficiently in that role.

Coronectomy (intentional partial odontectomy of lower third molars).

Objective: This study evaluates the rate of infection of retained lower third molar roots after coronectomy in teeth judged to be in intimate relation to the inferior alveolar nerve.

Study Design: This was a retrospective study of 52 patients who were operated on over a 10-year period.

Results: Only 3 of 52 patients had to have roots removed because of pain or infection.

Implementing a critical care course for ward nurses.

This article describes the setting up and evaluation of a course for ward-based nurses, which is designed to improve their skills in caring for highly dependent patients. The authors suggest such courses can increase nurses' confidence and competence and, as well as enhancing care, can improve communication with senior staff about issues of concern.

Granulomatous peritonitis in hydatid disease.

We report a rare case of persisting granulomatous inflammation within the peritoneal cavity due to previous leakage from a liver hydatid cyst, with the granulomata bearing hooklets originating from protosolices of Echinococcus granulosus. The patient was treated with a full three-month course of albendazole. We believe this represents a rare case of 'pseudotuberculous peritonitis'.

Why nurses choose not to undertake clinical supervision--the findings from one ICU.

A two-year action research study explored the implementation of clinical supervision in an intensive care unit (ICU). This paper focuses on one aspect of that study--the lack of uptake of clinical supervision. The themes that emerged from interview data focused on: resources, the purpose of clinical supervision, having good enough support elsewhere and personal issues.