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3 results

  • Closed-Hub Systems with Protected Connections and the Reduction of Risk of Catheter-Related Bloodstream Infection in Pediatric Patients Receiving Intravenous Prostanoid Therapy for Pulmonary Hypertension

  • D. Dunbar Ivy, Michelle Calderbank, Brandie D. Wagner, Susan Dolan, Ann-Christine Nyquist, Michael Wade, William M. Nickels, Aimee K. Doran
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 30 / Issue 9 / September 2009
    Published online by Cambridge University Press:
    02 January 2015, pp. 823-829
    Print publication:
    September 2009
  • Background.

    Intravenous prostanoids (epoprostenol and treprostinil) are effective therapies for pulmonary arterial hypertension but carry a risk of catheter-related bloodstream infection (CR-BSI). Prevention of CR-BSI during long-term use of indwelling central venous catheters is important.

    Objective.

    To evaluate whether using a closed-hub system and waterproofing catheter hub connections reduces the rate of CR-BSI per 1,000 catheter-days.

    Design.

    Single-center open observational study (January 2003-December 2008).

    Patients.

    Pediatric patients with pulmonary arterial hypertension who received intravenous prostanoids.

    Methods.

    In July 2007, CR-BSI preventive measures were implemented, including the use of a closed-hub system and the waterproofing of catheter hub connections during showering. Rates of CR-BSI before and after implementing preventive measures were compared with respect to medication administered and type of bacterial infection.

    Results.

    Fifty patients received intravenous prostanoid therapy for a total of 41,840 catheter-days. The rate of CR-BSI during the study period was 0.51 infections per 1,000 catheter-days for epoprostenol and 1.38 infections per 1,000 catheter-days for treprostinil, which differed significantly (P < .01 ). CR-BSIs caused by gram-negative pathogens occurred more frequently with treprostinil than with epoprostenol (0.91 infections per 1,000 catheter-days vs 0.08 infections per 1,000 catheter-days; P <.01). Patients treated with treprostinil after the implemented changes had a significant decrease in CR-BSI rate (1.95 infections per 1,000 catheter-days vs 0.19 infections per 1,000 catheter-days; P <.01).

    Conclusion.

    The closed-hub system and the maintenance of dry catheter hub connections significantly reduced the incidence of CR-BSI (particularly infections caused by gram-negative pathogens) in patients receiving intravenous treprostinil.

  • Women, nationalism and the Philippine revolution

  • Christine Doran
  • Journal:
    Nations and Nationalism / Volume 5 / Issue 2 / April 1999
    Published online by Cambridge University Press:
    01 April 1999, pp. 237-258
    Print publication:
    April 1999

  • Filipino women participated actively in the Philippine Revolution (1896–1902), performing a wide range of tasks essential to sustaining the revolutionary challenge against Spanish and American imperialism. Though largely omitted from mainstream histories of the nationalist revolution, women's involvement has been recorded in several marginalised texts. However, these texts have invariably used a limiting format based on presenting biographies of outstanding women. This article suggests an alternative approach, by situating the history of revolutionary Filipino women within a comparative framework. The article outlines key ideas of feminist writers who have analysed women's participation in nationalist struggles from an international perspective. Drawing on these ideas, some new approaches to women in the Philippine Revolution are suggested.