The occurrence of prediabetes among patients in a PrimaryCare setting in Trinidad

OBJECTICE: To determine the occurrence of pre-diabetes inpatients in a primary care setting in Trinidad and to identifythe risk factors associated with its development. DESIGN AND METHODS: Using a prospective cross-sectionalstudy, 44 patients who met the eligibility criteria where randomlyselected to enter the study. After a 12 hour fast, HbA1c, fastingplasma glucose, HDL and LDL cholesterol were measured, aswell as BMI and waist circumference. RESULTS: Of the 44 sampled participants, 77.3 % (n=34) werefemales and 22.7% (n=10) were males. 23 of the sampledfemales were over the normal weight for their height, and ofthe 8 pre-diabetic females, 75% had a waist circumference of>102cm, signifying abdominal obesity.A higher mean value was obtained for the lipid profile (excludingthe HLDL values) and HbA1c in the pre-diabetic population. CONCLUSION: The proportion of patients with prediabetes was25%. (95% CI 14.6-39.4) BMI, Triglycerides and LDL werefound to have a significant association with pre-diabetes(p=0.014, p=0.004 respectively). There needs to be a higherindex of suspicion for concomitant cardiovascular disease inpre-diabetics. Future interventions for monitoring this high riskgroup should include assessment of cardiometabolic risk factors.

[Muco-cutaneous colonization and nosocomial infections caused by methicillin-resistant Staphylococcus aureus and Acinetobacter baumanii in intensive care patients]. / Colonisation cutaneo-muqueuse et infections nosocomiales à Staphylococcus aureus meticilline résistant et à Acinetobacter baumanii chez des malades en réanimation médicale.

This study was designed to assess the frequency and risk factors for colonization with MRSA and A. baumanii in the intensive care unit, and to analyse the relationship between colonization and infection with MRSA or A. baumanii. During a 24-day survey period, colonization was studied weekly with nasal, throat and digit skin swabs; nosocomial infections were routinely monitored according to CDC recommendations. Clinical data and invasive procedures were registered during a one-year non-epidemic period; 103 ICU patients hospitalized for more than 7 days were prospectively included. We investigated acquired colonization and nosocomial infection with SAMR or A. baumanii for 87 patients not colonized by SAMR or A. baumanii on admission. The colonization acquisition rate was 56% for MRSA and 27% for A. baumanii. Infection incidence (cases per 1,000 patient-days) was 6.46 for MRSA and 1.61 for A. baumanii. On univariate analysis, acquired MRSA colonization was associated with longer ICU stays, longer mechanical ventilation and longer central venous catheterization. Multivariate analysis only showed an association with longer ICU stay. Acquired A. baumanii colonization was associated with SAPSII, longer mechanical ventilation, and longer central venous catheterization in univariate analysis. Multivariate analysis only showed an association with SAPSII and longer mechanical ventilation. In this study, SAMR or A. baumanii infections were not associated with colonization or clinical setting or invasive procedures.

[Assessment of three filters for respiratory function tests]. / Evaluation de trois filtres destinés aux explorations fonctionnelles respiratoires.

Several filters specific for respiratory function tests have been on the market for several years. Recommended by the manufacturers to avoid contaminating the equipment and thus improve patient safety, these filters require a considerable financial investment. We studied the passage of diluted blood into artificial saliva in a patient model simulating inspiration tests and rapid forced expiration to assess the retention capacity of three filters used for respiratory function tests: Multi SPIRO MI-90016 (MultiSPIRO), PF 30S (Pall Biomedical) and Spirobac (Dar. S.p.A). The mean percentage of passage was 1.48% through the MI-90016 filter, 57.15% through the PF 30 S filter and 70.45% through the Spirobac filter. These findings provide further elements for choosing filters for respiratory function tests. Indeed, despite the manufacturers' commercial arguments, the technical documents provided do not give necessary information on the filtering capacity of the filters on the market. We have observed that two out of the three filters tested do no meet the standards expected by clinicians.