Reducing the risk of non-sterility of aseptic handling in hospital pharmacies, part C: applying risk assessment and risk control in practice.

Objectives: To describe the application of the model described in part A and part B of this series of articles for risk assessment (RA) and risk control (RC) of non-sterility during aseptic handling. The model was applied in nine hospital pharmacies.

Methods: The starting point was an audit of each hospital pharmacy.

Reducing the risk of non-sterility of aseptic handling in hospital pharmacies, part A: risk assessment.

Objectives: To determine prospectively the sources of risk of non-sterility during aseptic handling and to quantify the risks of each of these sources.

Methods: A risk assessment (RA) of non-sterility according to Failure Mode and Effect Analysis was executed by a multidisciplinary team of (hospital) pharmacists and technicians, a consultant experienced in aseptic processing and an independent facilitator. The team determined the sources of risk of non-sterility, a 5 point scale for severity, occurrence and detection, and risk acceptance levels.

Reducing the risk of non-sterility of aseptic handling in hospital pharmacies, part B: risk control.

Objectives: To determine prospectively the risk reducing measures of non-sterility during aseptic handling and to develop a method for prioritising these measures.

Methods: In the first part of this series of articles, we identified all sources of risk which could contaminate a product during aseptic handling, and calculated the remaining risks of non-sterility using a risk assessment (RA) model. We concluded that additional research of some risk sources was needed before risk control (RC) could be executed on all risk sources.

Insulin induces airway smooth muscle contraction.

Background And Purpose: Recently, the use of inhaled insulin formulations for the treatment of type I and type II diabetes has been approved in Europe and in the United States. For regular use, it is critical that airway function remains unimpaired in response to insulin exposure.

Experimental Approach: We investigated the effects of insulin on airway smooth muscle (ASM) contraction and contractile prostaglandin (PG) production, using guinea-pig open-ring tracheal smooth muscle preparations.

Outcome predictors of pneumonia in elderly patients: importance of functional assessment.

Objectives: To evaluate the outcome of elderly patients with community-acquired pneumonia (CAP) seen at an acute-care hospital, analyzing the importance of CAP severity, functional status, comorbidity, and frailty.

Design: Prospective observational study.

Setting: Emergency department and geriatric medical day hospital of a university teaching hospital.

Herpes zoster as an immune reconstitution disease after initiation of combination antiretroviral therapy in patients with human immunodeficiency virus type-1 infection.

Background: Initiation of combination antiretroviral therapy may be followed by inflammatory reactions. We studied the epidemiology of herpes zoster infection among patients with human immunodeficiency virus (HIV) infection who were treated with combination antiretroviral therapy.

Subjects And Methods: Of 316 patients who initiated combination antiretroviral therapy, 24 (8%) were treated for herpes zoster within 17 weeks of starting therapy.

Proton magnetic resonance spectroscopy pattern of progressive multifocal leukoencephalopathy in AIDS.

The objective was to determine whether the use of intermediate echo times (135 ms) in proton magnetic resonance spectroscopy (1H-MRS) detects a homogenous pattern in progressive multifocal leukoencephalopathy (PML) in HIV-1 infected people, and to confirm the results of previous studies. Six patients infected with HIV-1, with PML established by biopsy, and six healthy age and sex matched volunteers were evaluated to define their spectroscopic pattern. 1H-MRS spectra performed at 1.

Pseudomonas aeruginosa bronchopulmonary infection in patients with AIDS, with emphasis on relapsing infection.

The aim of this study was to delineate the clinical and therapeutic characteristics of Pseudomonas aeruginosa bronchopulmonary infection in acquired immunodeficiency syndrome (AIDS) patients. Eighteen AIDS patients had 39 episodes of P. aeruginosa bronchopulmonary infection.

[Cerebral toxoplasmosis in patients with human immunodeficiency virus (HIV) infection. Clinico-radiological and therapeutic aspects in 63 patients].

We have retrospectively reviewed 63 cases of encephalic toxoplasmosis (ET) in HIV-infected patients in order to determine clinical and radiological characteristics, the diagnostic value of serologic determinations, and the response to antioxoplasmic therapy. ET was the AIDS-defining condition in 44% of the patients. Eighty of the patients had a CD4 cell count < 100/microliters when ET was diagnosed.

[Eosinophilic pustular folliculitis in acquired immunodeficiency syndrome. Report of 6 cases].

Eosinophilic pustulous foliculitis (EPF) is a rare dermatosis which has been reported in association with the human immunodeficiency virus infection. Six patients infected with HIV are reported with advanced disease in whom the diagnosis of EPF was made. All patients has a highly pruritic follicular papular rash.