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• Daily chlorhexidine gluconate (CHG) bathing can reduce patient's infection risk. • Patient refusal of CHG bathing is noted to be a major barrier to compliance. • Iterative Plan-Do-Study-Act cycles were implemented to target patient refusals. • After 6 months, patient refusal of CHG bathing and CLABSI rates decreased. Daily chlorhexidine gluconate (CHG) bathing is a well-supported intervention to reduce patient's risk of central line associated bloodstream infection (CLABSI); however, compliance with this practice is suboptimal. One major barrier is patient refusals of CHG bathing. The purpose of this project was to implement tailored interventions to mitigate this barrier. The specific aims were to reduce patient refusals, increase compliance with CHG bathing, and evaluate CLABSI rates and nursing staff's knowledge of CHG bathing. Iterative Plan-Do-Study-Act (PDSA) cycles were implemented over the course of 6 months. Run charts were used to identify signals of improvement. Interventions included printed educational flyers for staff and patients, educational sessions, an electronic learning module, and a "badge buddy." We saw a reduction in the median percentage of patient refusals documented, from 23% to 8% after the PDSA cycles. Documentation compliance with CHG bathing increased only slightly from 46% to 47%. CLABSI rates decreased 6% from 0.69 to 0.65. Using interventions tailored to the clinical setting can impact patient outcomes. Other health care systems should consider implementing PDSA cycles to improve evidence-based practices. Using PDSA cycles can result in a reduction in patient refusal documentation, and may slightly improve CHG bathing compliance and CLABSI rates. [ABSTRACT FROM AUTHOR]

Highlights: [•] First non-substrate analogue inhibitor of the trypanosome GPI pathway. [•] Active against recombinant enzyme and cell-free system. [•] Low molecular weight and good ligand efficiency. [ABSTRACT FROM AUTHOR]

Abstract: Quinols have been developed as a class of potential anti-cancer compounds. They are thought to act as double Michael acceptors, forming two covalent bonds to their target protein(s). Quinols have also been shown to have activity against the parasite Trypanosoma brucei, the causative organism of human African trypanosomiasis, but they demonstrated little selectivity over mammalian MRC5 cells in a counter-screen. In this paper, we report screening of further examples of quinols against T. brucei. We were able to derive an SAR, but the compounds demonstrated little selectivity over MRC5 cells. In an approach to increase selectivity, we attached melamine and benzamidine motifs to the quinols, because these moieties are known to be selectively concentrated in the parasite by transporter proteins. In general these transporter motif-containing analogues showed increased selectivity; however they also showed reduced levels of potency against T. brucei. [Copyright &y& Elsevier]

Abstract: We report the extension of the copper(II) tetrafluoroborate catalysed opening of epoxides with alcohols to include a wider variety of alcohols, a range of solvents and a method to purify the products from the reaction. [Copyright &y& Elsevier]

Abstract: Study Objective: To compare surgical and immediate postoperative results of robot-assisted laparoscopic myomectomy vs myomectomy via laparotomy in patients with 3 myomas or fewer. Design: Case-control (Canadian Task Force classification II-2). Setting: University hospital. Patients: Seventy-five women who had undergone robotic-assisted laparoscopic myomectomy were compared with patients who had undergone myomectomy via laparotomy. Interventions: Medical records were reviewed for surgical and postoperative variables. Both groups had 3 myomas or fewer confirmed at preoperative magnetic resonance imaging or final pathology report. Measurements and Main Results: No significant differences were observed between patients insofar as preoperative demographic data. There was a significant increase in mean duration of surgery for robotic-assisted myomectomy. There was a significant decrease in blood loss, change in hematocrit concentration on postoperative day 1, length of stay, number of days to regular diet, and febrile morbidity in robotic-assisted myomectomies. There were no significant differences in operative or postoperative complications. Conclusion: Although robotic-assisted myomectomy took substantially longer, most of the other variables improved in comparison with similar procedures performed via laparotomy. [Copyright &y& Elsevier]

Type 2 diabetes is highly prevalent in North America and is associated with increased risk of cardiovascular disease (CVD). Evidence supports a role for soy protein in the reduction of serum lipids related to CVD risk; however, few studies have focused on adults with type 2 diabetes who are not on lipid-lowering medications and/or do not have diabetic complications. The purpose of this study was to determine the effect of soy protein isolate (SPI) consumption on serum lipids in adults with diet-controlled type 2 diabetes. Using a double-blind, randomized, crossover, placebo-controlled intervention study design, adults with diet-controlled type 2 diabetes (n = 29) consumed SRI 180 mg/d aglycone isoflavones) or milk protein isolate (MPI) for 57 d each separated by a 28-d washout period. Twenty-four-hour urine samples were collected on d 54-56 of each treatment for analysis of isoflavones and blood was collected on d 1 and 57 of each treatment and analyzed for serum lipids and apolipoproteins. SPI consumption increased urinary isoflavones compared with MPI. SPI consumption reduced serum LDL cholesterol (P = 0.04), LDL cholesterol:HDL cholesterol (P = 0.02), and apolipoprotein B:apolipoprotein A-I (P = 0.05) compared with MPI. SPI did not affect serum total cholesterol, HDL cholesterol, triacylglycerol, apolipoprotein B, or apolipoprotein A-I. These data demonstrate that consumption of soy protein can modulate some serum lipids in a direction beneficial for CVD risk in adults with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Abstract: Study objective: To compare surgical and postoperative results after laparoscopic supracervical hysterectomy between the first 2 cases and last 2 cases performed by each senior resident. Design: Retrospective, case-control study (Canadian Task Force classification II-B). Setting: University hospital. Patients: Two hundred six women underwent laparoscopic supracervical hysterectomy. Interventions: Charts were reviewed to determine length of surgery, operative and postoperative complications, and other surgical values. A comparison was made between the first 2 and last 2 cases of 25 chief residents. Measurements and main results: There was no statistically significant difference between the first 2 and last 2 patients of each resident in terms of age, indication for surgery, uterine mass, ethnicity, body mass index, or parity. There was a significant decrease in the mean time of the first 2 cases versus the last 2 cases: 201.4 minutes versus 137.2 minutes (p <.001). There was no significant difference in blood loss, change in hematocrit, length of hospital stay, and surgical or postoperative complications. Conclusions: Laparoscopic supracervical hysterectomy is a technically challenging procedure that nevertheless can be learned quickly with rapid improvement in operative time and without undue risk to the patient. Since initially presenting these data in 2003, the senior residents are now getting twice the amount of exposure to this surgery. In addition, these data now include residents who were exposed to this type of surgery as junior residents. Although residents are beginning to have increased experience in performing laparoscopic supracervical hysterectomy before their chief year, there is still a significant difference in operative time from the initial 2 procedures to the last 2 procedures completed by a chief resident. [Copyright &y& Elsevier]

Transcription factors play important roles in regulating cell growth and differentiation. In this study, treatment of the MTC cell line, TT, with phorbol 12-myristate 13-acetate (PMA) was shown to reduce neurite outgrowth which may be associated with de-differentiation and loss of the transformed phenotype. Northern blotting revealed that PMA transiently induced early growth response gene 1 (Egr-1) expression and decreased RET expression. Transient transfection analyses using 5′-deletion constructs of the basal RET promoter, demonstrated the requirement of a region between −70 and −33 bp for PMA-inducible expression. Gel shift and supershift studies demonstrated that PMA induced Egr-1 formed part of a complex capable of binding to the RET minimal promoter. Overexpression of Egr-1 displaced both sephacryl and phosphocellulose protein 1 (Sp1) and Sp3 from a GC-box element previously found to be important for RET basal expression. Furthermore, use of a raf-1 inducible TT cell line, that has been previously shown to downregulate RET expression, revealed that this downregulation may be linked to the induction of Egr-1. Our data suggest that regulation of RET expression during development and in medullary thyroid carcinoma may be determined, at least in part, by this complex of Sp and Egr-1 proteins. [Copyright &y& Elsevier]