1.Effects of infection control rounds on the the quality of infection management in ICU ward
Xue-Hua CUI ; Ling WANG ; Jin-Hua HUNG ; Xu-Hui KONG
Chinese Journal of Modern Nursing 2013;19(29):3660-3662
Objective To understanding the implementation of ICU infection control measures and the effect of ICU infection control measures on hospital infection control,in order to take effective control measures to reduce the occurrence of hospital infection.Methods The infection control personnel inspected the implementation of ICU infection control measures 2 times per week.The results of clinical rounds were discussed and analyzed,the rectifcation measures were formulated,and the rectification results feedback.Results The rates of correct and compliance on hand hygiene were respectively 79.2%,51.6% after rounds,and were higher than 58.5%,30.3% before rounds,and the differences were statistically significant (x2 =10.65,50.24,respectively; P < 0.05).The incidence rates of ventilator associated pneumonia (VAP),arteriovenous catheter-related bloodstream infection (CRBSI) and urethral catheter-related urinary tract infection (CAUTI)were respectively17.1%,2.4%,1.1% after rounds,and were lower than 30.2%,4.8%,2.5% before rounds,and the differences were statistically significant (x2 =4.08,0.42,4.06,respectively; P < 0.05).The qualified rates of infection control indicators including enviroumental health management,sterile technical operation,disposable sterile items management and medical waste management were respectively 94.3%,96.2%,95.2%,91.4% after rounds,and was significantly higher than 80.9%,72.3%,79.1%,68.6%before rounds,and the differences were statistically significant (x2 =7.42,20.71,10.88,15.74,respectively; P < 0.05).The rectification rate of infection control measures problems was 95.4% in 2012,and was significantly higher than 77.8% in 2011.Conclusions Infection control rounds can improve subjective initiative and the bidirectional interaction in infection monitoring personnel,ICU physicians and nurses,improve the execution rate of prevention and control measures,and improve the quality of infection control.
2.Metformin and statins reduce hepatocellular carcinoma risk in chronic hepatitis C patients with failed antiviral therapy
Pei-Chien TSAI ; Chung-Feng HUANG ; Ming-Lun YEH ; Meng-Hsuan HSIEH ; Hsing-Tao KUO ; Chao-Hung HUNG ; Kuo-Chih TSENG ; Hsueh-Chou LAI ; Cheng-Yuan PENG ; Jing-Houng WANG ; Jyh-Jou CHEN ; Pei-Lun LEE ; Rong-Nan CHIEN ; Chi-Chieh YANG ; Gin-Ho LO ; Jia-Horng KAO ; Chun-Jen LIU ; Chen-Hua LIU ; Sheng-Lei YAN ; Chun-Yen LIN ; Wei-Wen SU ; Cheng-Hsin CHU ; Chih-Jen CHEN ; Shui-Yi TUNG ; Chi‐Ming TAI ; Chih-Wen LIN ; Ching-Chu LO ; Pin-Nan CHENG ; Yen-Cheng CHIU ; Chia-Chi WANG ; Jin-Shiung CHENG ; Wei-Lun TSAI ; Han-Chieh LIN ; Yi-Hsiang HUANG ; Chi-Yi CHEN ; Jee-Fu HUANG ; Chia-Yen DAI ; Wan-Long CHUNG ; Ming-Jong BAIR ; Ming-Lung YU ;
Clinical and Molecular Hepatology 2024;30(3):468-486
Background/Aims:
Chronic hepatitis C (CHC) patients who failed antiviral therapy are at increased risk for hepatocellular carcinoma (HCC). This study assessed the potential role of metformin and statins, medications for diabetes mellitus (DM) and hyperlipidemia (HLP), in reducing HCC risk among these patients.
Methods:
We included CHC patients from the T-COACH study who failed antiviral therapy. We tracked the onset of HCC 1.5 years post-therapy by linking to Taiwan’s cancer registry data from 2003 to 2019. We accounted for death and liver transplantation as competing risks and employed Gray’s cumulative incidence and Cox subdistribution hazards models to analyze HCC development.
Results:
Out of 2,779 patients, 480 (17.3%) developed HCC post-therapy. DM patients not using metformin had a 51% increased risk of HCC compared to non-DM patients, while HLP patients on statins had a 50% reduced risk compared to those without HLP. The 5-year HCC incidence was significantly higher for metformin non-users (16.5%) versus non-DM patients (11.3%; adjusted sub-distribution hazard ratio [aSHR]=1.51; P=0.007) and metformin users (3.1%; aSHR=1.59; P=0.022). Statin use in HLP patients correlated with a lower HCC risk (3.8%) compared to non-HLP patients (12.5%; aSHR=0.50; P<0.001). Notably, the increased HCC risk associated with non-use of metformin was primarily seen in non-cirrhotic patients, whereas statins decreased HCC risk in both cirrhotic and non-cirrhotic patients.
Conclusions
Metformin and statins may have a chemopreventive effect against HCC in CHC patients who failed antiviral therapy. These results support the need for personalized preventive strategies in managing HCC risk.