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Pseudomonas aeruginosa (PA) is a common cause of healthcare-associated infection (PA-HAI) in the intensive care unit (ICU). To describe the epidemiology of PA-HAI in ICUs in Ontario, Canada, and to identify episodes of sink-to-patient PA transmission. This was a prospective cohort study of patients in six ICUs from 2018 to 2019, with retrieval of PA clinical isolates, and PA-screening of antimicrobial-resistant organism surveillance rectal swabs, and of sink drain, air, and faucet samples. All PA isolates underwent whole-genome sequencing. PA-HAI was defined using US National Healthcare Safety Network criteria. ICU-acquired PA was defined as PA isolated from specimens obtained ≥48 h after ICU admission in those with prior negative rectal swabs. Sink-to-patient PA transmission was defined as ICU-acquired PA with close genomic relationship to isolate(s) previously recovered from sinks in a room/bedspace occupied 3–14 days prior to collection date of the relevant patient specimen. Over ten months, 72 PA-HAIs occurred among 60/4263 admissions. The rate of PA-HAI was 2.40 per 1000 patient-ICU-days; higher in patients who were PA-colonized on admission. PA-HAI was associated with longer stay (median: 26 vs 3 days uninfected; P < 0.001) and contributed to death in 22/60 cases (36.7%). Fifty-eight admissions with ICU-acquired PA were identified, contributing 35/72 (48.6%) PA-HAIs. Four patients with five PA-HAIs (6.9%) had closely related isolates previously recovered from their room/bedspace sinks. Nearly half of PA causing HAI appeared to be acquired in ICUs, and 7% of PA-HAIs were associated with sink-to-patient transmission. Sinks may be an under-recognized reservoir for HAIs. [ABSTRACT FROM AUTHOR]

A class of one-compartment models for pressure controlled mechanical ventilation is studied. The resistive pressure term in the general model is of the form: R1Q + R2Q&z.sfnc;Q&z.sfnc; where Q denotes the flow in and out of the compartment. This Rohrer-type model (R1 ≠ 0 and R2 ≠ 0) is compared against the special cases:

Introduction/Background This purpose of this study was to investigate the difference in dysphagia of stroke patients based on side of lesion. Material and method 164 stroke patients referred to our department from August to November 2017. 134 patients underwent bedside swallowing assessment; BSA. Out of 110 (right lesion (R): 46, left lesion (L): 64) unilateral supratentorial stroke patients,patients (R: 18, L: 26) with dysphagia were recruited. Median age was 79 years. The mean time from hospital admission to BSA was 4 days. 44. BSA used Repetitive saliva swallowing test, Modified water swallowing test, and 30 ml water swallowing test. Dysphagia severity was evaluated by Dysphagia Severity Scale; DSS. The following data was collected through the database: Stroke Impairment Assessment Set; SIAS (Items of Affected-side Motor Function), National Institutes of Health Stroke Scale; NIHSS, Functional Independence Measure; FIM. Statistical analyses were considered significant with P < 0.05. Results The average of initial SIAS score was R12/L9, and final was R14/L11. The average of initial NIHSS score was R12/L15, and final was R11/L14. The average of initial FIM score was R22/L24, and final was R58/L50. Approximately 5, 28, 28, 39, and 0% of patients with R, and 11, 31, 31, 23, and 4% of patients with L had pre-treatment DSS of 1 (Saliva aspiration), 2 (Food aspiration), 3 (Water aspiration),4 (Occasional aspiration), 5 (oral problems), respectively. Post-treatment, 17, 22, 11, 17, 0, 11, and 22% of patients with R, and 4,23,8,15,4,15,and 31% with L had DSS of 1, 2, 3, 4, 5, 6 (Minimum problem), 7 (Normal). Approximately 61% patients with R and 69% patients with L relied on oral intake post-treatment. Conclusion There were not significant differences in dysphagia severity between patients with R and L. Future studies are necessary with large sample size to examine the difference for distribution of dysphagia severity scale. [ABSTRACT FROM AUTHOR]