Self-testing of oral anticoagulation is a new possibility related to the development of portable capillary whole blood prothrombin time monitors. The aim of this study was to evaluate one of this monitors, Coaguchek®, with respect to its comparability with our routine prothrombin time determination system, as well as with the reference manual technique and two thromboplastins of high sensitivity, Manchester Reagent and one manufactured in our center, Thromboplastin Bilbao, in a group of patients on oral anticoagulant treatment. Although a correlation of r = 0.9271 was found between international normalized ratio (INR) values of Coaguchek and our routine method, Neoplastine/STA analyzer, the difference of the INR scatter increased with the magnitude of measurement, being lowest for INR between the portable monitor and Manchester Reagent and Thromboplastin Bilbao, with a similar coefficient of correlation, r = 0.8948 and r = 0.8905, respectively. A test was performed showing a 65.6% agreement with the INR values of the STA analyzer, 66.4% with Manchester Reagent and 73.4% with Thromboplastin Bilbao. On the basis of this correspondence with laboratory prothrombin time results Coaguchek may be considered as a possible option for monitoring anticoagulated patients even though patients should be given instructions and advice as regards the management and interpretation of the results.
The purpose of this study was to assess the effectiveness of silver-embedded surfaces (BactiBlock®) to prevent surface colonization by multi-resistant bacteria (MRB) and to reduce the incidence of MRB colonization and infection in patients admitted to an intensive care unit (ICU). A 6-month prospective observational study in a 24-bed mixed ICU divided into two identical subunits (12 beds each) was designed. Seven solid mobile screens were placed in one of the subunits while in the other cloth screens remained. Solid screens were constructed with high-density polyethylene embedded in Bactiblock®. To evaluate the effectiveness of screens coated with Bactiblock®, number of MRB isolates on screens were compared for 6 months. Likewise, numbers of new patients and ICU-stays with MRB colonization in the two subunits were compared. One hundred forty screen samples were collected in 10-point prevalent days. MRB were detected on 28 (20.0%) samples. Over the 70 samples taken on cloth folding screens, MRB were detected in 25 (35.7%), while only 3 (4.3%) of the 70 samples taken on Bactiblock® screens were positive for MRB (p < 0.001). The unit with Bactiblock® screens presented fewer number of ICU stays with MRB colonization (27.8% vs 47.1%; p < 0.001). No significant differences were found in the global incidence of MRB nosocomial infection. The presence of Bactiblock® embedded in solid folding screens avoided MRB surface colonization and reduced MRB transmission to patients admitted to critical care units, proving to be an useful tool in the control of MRB.
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