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  • American journal of infection control. 06/2014; 42(6):690-1.
  • International Journal of Antimicrobial Agents. 01/2014;
  • Infection Control and Hospital Epidemiology 11/2013; 34(11):1235-1237.
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    ABSTRACT: Background. In 2009, the World Health Organization (WHO) recommended "My Five Moments for Hand Hygiene" (5MHH) to optimize hand hygiene (HH). Uptake of these recommendations by healthcare workers (HCWs) remains uncertain. Methods. We prospectively observed HCW compliance to 5MHH. After observations, eligible HCWs who consented to interviews completed surveys on factors associated with HH compliance based on constructs from the transtheoretical model of behavioral change (TTM) and the theory of planned behavior (TPB). Survey results were compared with observed HCW behaviors. Results. There were 968 observations among 123 HCWs, of whom 110 (89.4%) were female and 63 (51.3%) were nurses. The mean HH compliance for all 5MHH was 23.2% (95% confidence interval [CI], 18.1%-28.3%) by direct observation versus 82.4% (95% CI, 79.9%-84.9%) by self report. The HCW 5MHH compliance was associated with critical care unit encounters ([Formula: see text]), medicine unit encounters ([Formula: see text], [Formula: see text]), immunocompromised patient encounters ([Formula: see text]), and HCW prioritized patient advocacy ([Formula: see text]). Self-reported TTM stages of action or maintenance ([Formula: see text]) and the total TPB behavior score correlated with observed 5MHH ([Formula: see text], [Formula: see text]) and with self-reported 5MHH compliance ([Formula: see text], [Formula: see text]). Conclusion. Observed HCW compliance to 5MHH was associated with the type of hospital unit, type of provider-patient encounter, and theory-based behavioral measures of 5MHH commitment.
    Infection Control and Hospital Epidemiology 11/2013; 34(11):1137-1145.
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    ABSTRACT: Studies about continuous electrocardiographic (ECG) monitoring in detection of paroxysmal atrial fibrillation (PAF) in Asian patients with acute ischemic stroke are very limited. We looked for the prevalence and associated factors of atrial fibrillation (AF) and PAF in Thai patients with acute ischemic stroke. In all, 204 patients with acute ischemic stroke were prospectively included. Snapshot 12-lead ECG and continuous ECG monitoring for at least the first 24 hours were performed. Multivariate analyses were performed to find out the associated factors of AF and PAF. AF was diagnosed in 31 patients (15%) and PAF in 15 patients (7%). Twelve and 3 patients with PAF were diagnosed by continuous ECG monitoring and snapshot 12-lead ECG, respectively. Mean duration of continuous ECG monitoring and mean time to detect PAF were 55 and 23 hours, respectively. Multivariate analysis revealed that age of 70 years or older (odds ratio [OR] 3.52, 95% confidence interval [CI] 1.68-7.35, P = .001) and heart diseases (OR 4.26, 95% CI 1.14-15.95, P = .031) were associated with AF and PAF. AF/PAF was one of the common causes of ischemic stroke in Thai patients. Most PAF was detected by continuous ECG monitoring. Snapshot 12-lead ECG and continuous ECG monitoring should be recommended in all patients with acute ischemic stroke.
    Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association 11/2013;
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    ABSTRACT: The infrapatellar fat pad is one of the structures that obscures exposure in minimally invasive total knee arthroplasty (MIS TKA). Most MIS TKA surgeons (and many surgeons who use other approaches as well) excise the fat pad for better exposure of the knee. There is still controversy about the result of fat pad excision on patella baja, pain, and function. In the setting of a randomized controlled trial, we sought to determine whether infrapatellar fat pad excision during MIS TKA causes (1) patellar tendon shortening (as measured by patella baja); (2) increased anterior knee pain; (3) decreases in the Knee Society Score or functional subscore; or (4) more patella-related complications. We randomized 90 patients undergoing MIS TKA at one institution into two groups. In one group, 45 patients underwent MIS TKA with complete infrapatellar fat pad excision and in the other group, 45 patients received MIS TKA without infrapatellar fat pad excision. The patella was selectively resurfaced in these patients; there was no difference between the groups in terms of the percentage of patients whose patellae were resurfaced. We measured patellar tendon shortening, knee flexion, anterior knee pain, Knee Society Score (KSS), functional subscore, and patellar complications at preoperative and postoperative periods of 6 weeks, 3 months, 6 months, and 1 year; complete followup data were available on 86% of patients (77 of 90) who were enrolled. At the final followup, no significant differences were observed in patellar tendon shortening, KSS, functional subscore, or knee flexion in either group. However, patients with their infrapatellar fat pad excised experienced more anterior knee pain (8.3% versus 0%; p = 0.03; 95% confidence interval, -0.007 to 0.174) at the end of the study. No patellar complications were found in either group. Infrapatellar fat pad excision in MIS TKA resulted in an increasing small percentage of patients with anterior knee pain after surgery. Surgeons should keep the fat pad if excellent exposure can be achieved but resect it if needed to improve exposure during TKA. Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
    Clinical Orthopaedics and Related Research 10/2013;
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    ABSTRACT: There are few records for total ankle replacement (TAR) in Asia. We aimed to report the cumulative intermediate-term outcomes in terms of clinical scores, survivorship and failure rates for patients managed with TAR in Asia. We conducted a systematic search for relevant articles published in English and other languages between January 1990 and February 2012. The study published before 1990 and used outdated prosthesis designs implanted before the early 1980s was excluded. Eligible studies were evaluated using the Coleman Methodology Score and data collection was independently performed by three reviewers. Seven studies qualified for analysis, describing 321 implants (112 HINTEGRA(®), 104 TNK, 35 STAR, 13 ND-Bioceram, 57 un-reported implants). Overall studies showed the improvement of clinical scores following TAR. Pooled data for the survivorship analysis ranged from 100% at 3.2 years to 77% at 14.1 years. Pooled mean failure rate was 4.9±3.2% over a mean follow-up of 5.2±1.7 years. TAR prostheses currently used in Asia achieved satisfactory intermediate-term outcomes in terms of clinical scores, survivorship and failure rates.
    Foot and Ankle Surgery 09/2013; 19(3):148-54.
  • Infection Control and Hospital Epidemiology 08/2013; 34(8):861-3.
  • Clinical Infectious Diseases 07/2013;
  • Article: Erratum.
    Infection Control and Hospital Epidemiology 07/2013; 34(7):767.
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