ABSTRACT
A bundle is a small, straightforward set of scientifically grounded elements (generally three to five) that, when implemented together, result in better outcomes than when implemented individually. Bundles have found their greatest application in the prevention of Healthcare-Associated Infections (HAIs). The bundles examined concern the prevention of VAP for patients undergoing mechanical ventilation, the prevention of BSI CVC, the prevention of surgical side infection (SSI), the prevention of catheter-associated urinary tract infections, the prevention of infection by Clostridium difficile and the treatment of sepsis. Studies show a reduction in mortality rates, infection rates and in the length of hospital stay. Some studies have low statistical significance due to the small number of patients examined, and future studies will be needed to confirm these results.
Subject(s)
Clinical Protocols , Disease Management , Professional Practice/standards , Bacteremia/epidemiology , Bacteremia/etiology , Bacteremia/prevention & control , Catheterization, Central Venous/adverse effects , Clostridium Infections/epidemiology , Clostridium Infections/prevention & control , Cross Infection/epidemiology , Cross Infection/prevention & control , Guideline Adherence , Humans , Italy/epidemiology , Pneumonia, Bacterial/epidemiology , Pneumonia, Bacterial/etiology , Pneumonia, Bacterial/prevention & control , Practice Guidelines as Topic , Respiration, Artificial/adverse effects , Surgical Wound Infection/epidemiology , Surgical Wound Infection/prevention & control , Systemic Inflammatory Response Syndrome/epidemiology , Systemic Inflammatory Response Syndrome/prevention & control , Urinary Catheterization/adverse effects , Urinary Tract Infections/epidemiology , Urinary Tract Infections/etiology , Urinary Tract Infections/prevention & controlABSTRACT
It is generally held that there are genetic factors for dizygotic (DZ) twinning, but the pattern of inheritance is far from clear. We report on a rare pedigree with three sets of spontaneous DZ female twin births in three successive generations. To our knowledge no similar pedigrees have been reported in literature. Zygosity determination in three pairs of twins was performed with ABO, MN and Rh blood groups from erythrocytes and with STR analysis from samples of saliva. In our pedigree, the direct transmission of the DZ twinning through the maternal line seems show an autosomal dominant pattern of inheritance. We believe that the inheritance of DZ twinning appears to be recessive in most case and autosomal dominant only in rare instances. It is plausible with the hypothesis that the expression of the dizygotic twinning trait in a mother shows a genetic heterogeneity.
