Safety and Effectiveness of Cytomegalovirus Specific Antigen Induced Interferon-Gamma ELISPOT/ELISA: A Systematic Review / 대한임상미생물학회지

Background@#This study evaluated the safety and effectiveness of the cytomegalovirus (CMV) Specific Antigen Induced Interferon-Gamma ELISPOT (enzyme-linked immunosorbent spot)/ELISA (enzyme-linked immunosorbent assay) procedure in predicting the risk of CMV infection/disease in immunocompromised patients through a systematic literature review. @*Methods@#The searched electronic databases included MEDLINE, EMBASE and the Cochrane Library. A total of 884 non-duplicate citations were retrieved and a total of 25 studies (15 cohort studies, 10 cross-sectional studies) were included in this review. Study subjects were selected among patients with solid organ, hematopoietic stem cell transplantation, or those who were on hemodialysis. Data extraction and literature quality assessment were carried out independently by two researchers. @*Results@#Most of the studies were conducted on patients with solid organ transplants. As it is conducted outside the body, CMV Specific Antigen Induced Interferon-Gamma ELISPOT/ELISA assay was safe. Regarding its effectiveness, most studies on risk analysis based on prognosisrelated outcomes reported that the inactive group showed a significantly higher hazard ratio or odds ratio than the active group. Results of Kaplan-Meier survival analysis also showed that the inactive group had a significantly higher incidence of CMV event (CMV infection, CMV disease, other events) than the active group. However, various thresholds for CMV cell immune response were reported, as was a broad range of predictive diagnostic accuracies. @*Conclusion@#CMV Specific Antigen Induced Interferon-Gamma ELISPOT/ELISA assay has potential to stratify the risk of CMV infection/disease among solid organ transplant patients and to determine a policy for a prophylaxis/preemptive. However, additional literature evidence is needed to establish thresholds for CMV cell immune response and standardized tests.

Safety and Effectiveness of Cytomegalovirus Specific Antigen Induced Interferon-Gamma ELISPOT/ELISA: A Systematic Review / 대한임상미생물학회지

Background@#This study evaluated the safety and effectiveness of the cytomegalovirus (CMV) Specific Antigen Induced Interferon-Gamma ELISPOT (enzyme-linked immunosorbent spot)/ELISA (enzyme-linked immunosorbent assay) procedure in predicting the risk of CMV infection/disease in immunocompromised patients through a systematic literature review. @*Methods@#The searched electronic databases included MEDLINE, EMBASE and the Cochrane Library. A total of 884 non-duplicate citations were retrieved and a total of 25 studies (15 cohort studies, 10 cross-sectional studies) were included in this review. Study subjects were selected among patients with solid organ, hematopoietic stem cell transplantation, or those who were on hemodialysis. Data extraction and literature quality assessment were carried out independently by two researchers. @*Results@#Most of the studies were conducted on patients with solid organ transplants. As it is conducted outside the body, CMV Specific Antigen Induced Interferon-Gamma ELISPOT/ELISA assay was safe. Regarding its effectiveness, most studies on risk analysis based on prognosisrelated outcomes reported that the inactive group showed a significantly higher hazard ratio or odds ratio than the active group. Results of Kaplan-Meier survival analysis also showed that the inactive group had a significantly higher incidence of CMV event (CMV infection, CMV disease, other events) than the active group. However, various thresholds for CMV cell immune response were reported, as was a broad range of predictive diagnostic accuracies. @*Conclusion@#CMV Specific Antigen Induced Interferon-Gamma ELISPOT/ELISA assay has potential to stratify the risk of CMV infection/disease among solid organ transplant patients and to determine a policy for a prophylaxis/preemptive. However, additional literature evidence is needed to establish thresholds for CMV cell immune response and standardized tests.

Practical Communication Strategies to Improve the Surgical Outcomes in a Pediatric Cardiac Intensive Care Unit / 간호행정학회지

PURPOSE: The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). METHODS: Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS. RESULTS: The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (chi2=7.23, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (chi2=6.66, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (chi2=20.31, p<.001). CONCLUSION: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.

Effectiveness of Deep Breathing Exercise for Postoperative Pulmonary Complications Prevention: A Systematic Review / 기본간호학회지

PURPOSE: This study was done to evaluate effectiveness of deep breathing exercise as a postoperative intervention to prevent pulmonary complications. METHODS: A search of databases from 1990 to 2012 was done including MEDLINE, EMBASE, CINAHL, Cochrane Library and eight Korean databases. Ten studies met eligibility criteria. Researchers trained in systematic review, independently assessed the methodological quality of selected studies using the Cochrane's risk of bias tool. Data were analyzed using RevMan 5.2 program. RESULTS: Among ten RCTs in four studies, deep breathing exercise was compared with an instrument using interventions such as incentive spirometry, in the other four studies deep breathing exercise was compared with non-intervention, and in last two studies bundles of interventions including coughing and early ambulation were assessed. A significant difference was found between deep breathing exercise group and non-intervention group. The odds ratio (OR) of occurrence of pulmonary complications for deep breathing exercise versus non-intervention was 0.30. However, there was no significant difference between deep breathing exercise group and incentive spirometry group (OR=1.22). CONCLUSION: Deep breathing exercise is vital to improving cost-effectiveness and efficiency of patient care in preventing postoperative pulmonary complications. For evidence-based nursing, standardized guidelines for deep breathing in postoperative care should be further studied.

Role Transition of Senior Year Nursing Students: Analysis of Predictors for Role Transition / 간호행정학회지

PURPOSE: The purpose of this study was to identify the perception of role transition from a student nurse to a registered nurse among senior year nursing students and to examine factors affecting their role transition. METHODS: A descriptive survey with convenience sampling was conducted in four nursing colleges in Seoul, South Korea. Data were collected using a self-administrated questionnaire. Four instruments including role transition, self-esteem, interpersonal relationships and anxiety during clinical practicum were used and the students'demographics were also collected. A multiple logistic regression was used to identify predictors for the role transition. RESULTS: A total of 233 nursing students were surveyed and final analysis was conducted utilizing 226 participants. Mean point of perceived role transition (5 point scale) was 3.34+/-0.44. In a multiple regression model, high self-esteem, good interpersonal relationships, low anxiety during clinical practicum, and high satisfaction in college life were significant predictors of a smooth transition (Adj. R2=.32, F=22.28, p<.001). CONCLUSION: The findings suggest that role transition from a student nurse to a registered nurse is facilitated through the establishment of programs to improve self-esteem and interpersonal relationships and to reduce anxiety during clinical practicum.