University Hospital In Southern Research Articles

Effects of Alcohol Consumption on Oxidative Stress in a Sample of Patients Recruited in a Dietary Center in a Southern University Hospital: A Retrospective Study.

Background and objectives: The aim of this retrospective study was to evaluate the effects of alcohol consumption on oxidative stress. Materials and Methods: The study was conducted by analyzing the increase in lipid peroxidation, the reduction of antioxidant defenses and the alteration of the oxidation/antioxidant balance after the administration of ethanol in 25% aqueous solution (v/v) at a concentration of 0.76 g/kg of body weight daily in two doses for 3 days. The changes in oxidative stress indices were investigated by standard methods previously described. Results: Ethanol administration has determined a significant increase in plasma levels of lipid hydroperoxide (LOOH), malonilaldehyde (MDA) and oxidized glutathione (GSSH), and a decrease in total antioxidant capacity (TAC), reduced glutathione (GSH) and GSH/GSSH ratio. Conclusions: In the proposed experimental condition, the excessive and repeated consumption of ethanol causes oxidative damage, as shown by the increase in lipid peroxidation, the reduction of antioxidant defenses and the alteration of the oxidation/antioxidant balance, which, at least in part, are responsible for the harmful effects of excess ethanol.

Non-communicable diseases in Southern Tunisia: morbidity, mortality profile and chronological trends

Abstract Introduction Non-communicable diseases (NCDs) represent a major public health problem worldwide. Giving their impact on the morbidity and mortality burden, understanding their chronological trends over time is a priority for epidemiological surveillance. We aimed to determine the epidemiological specificities of NCDs and to study their chronological trends over the period 2010-2015. Methods We retrospectively collected data of hospitalized patients from the regional registry of morbidity and mortality in the Southern University Hospital of Tunisia during the period 2010-2015. Results We included 18081 patients with NCDs aged ≥ 25 years, with an annual number of 3013 cases/year. The median age of patients was 60 years(Interquartile range IQR = [43-80 years)]). There were 10288 males(57%), with a sex ratio (male/female)of 1.3. The distribution of NCDs was characterized by the predominance of cardiovascular disease(CVD)(10346 cases, 57.2%), then cancers(3034 cases; 16.8%),diabetes(2489 cases; 13.8%) and chronic respiratory tract diseases(2212 cases; 12.2%). Chronological trends analysis of NCDs showed that they remained globally stable between 2010 and 2015. The same result was applied to the group of cancers, chronic respiratory diseases and diabetes mellitus. However, there was a sharp rise for CVD between 2010 and 2015(ρ = 0.84; p = 0.036). The proportion of CVD increased significantly among men(ρ = 0.87; p = 0.019) and elderly(ρ = 0.88; p = 0.019). During the study period, 234 deaths were due to NCDs, with hospital mortality and lethality rates of 5.2/1000 hospitalizations and 1.29%, respectively. CVD were the main cause of deaths(60%). The hospital mortality rate of NCDs increased significantly from 2010 to 2015(ρ = 0.85; p = 0.031), notably for CVDs(ρ = 0.94; p = 0.005). Conclusions Chronological trends analysis revealed a significant rise in the morbidity and mortality burden ofCVDs during the period 2010-2015. It is imperative, therefore, to strengthen health care for these patients. Key messages Non-communicable diseases. Morbidity and mortality.

Clinical characteristics, mortality, and prognostic factors for bullous pemphigoid in a Thai population.

Bullous pemphigoid is an uncommon, autoimmune, blistering disease. Clinical features, associated conditions, and outcomes differ according to country. We aimed to determine the mortality rate and clinical characteristics of Thai patients and to evaluate the risk factors associated with survival.A retrospective analysis was conducted on 119 patients, over a ten-year period, at Songklanagarind Hospital, the largest tertiary university hospital in Southern Thailand.The median age of onset was 82 years [interquartile range 72, 90], and 60 (50.4%) patients were men. The underlying diseases were hypertension (53.8%), neurological disease (42.8%), and diabetes mellitus (31.9%). Fifty-eight patients (48.7%) experienced pruritus, and 61.3% of patients had mild cutaneous lesions (less than 10% of the body surface area) on the day of diagnosis. Nine percent of patients presented with mucosal involvement. Complete blood counts showed anemia (32.8%), neutrophilia (30.3%), and eosinophilia (42.9%). The 1-, 3- and 5-year overall mortality rates were 28.1% [95% confidence interval (CI), 7.8–36.6], 55.7% (95% CI, 44.4–64.7) and 71.9% (95% CI 59.9–80.2), respectively. On multivariate analysis, high neutrophil/lymphocyte ratio [odds ratio (OR) 5.55, P < .001] and anemia (OR 2.93, P = .025) were found to be independently associated with mortality rate, whereas disease remission (OR 0.25, P = .003) was demonstrated to be a good prognostic factor.This is the first study to analyze the mortality rate of Bullous pemphigoid in Thailand. Mortality was associated with high neutrophil/lymphocyte ratio and anemia.

Definition of a novel vaccination pathway in PLWHA: experience of a Southern University Hospital

Abstract Background At the end of 2018 across the globe there are ∼37.9 million people with HIV/AIDS also thanks to the use of HAART which led to an increase in life expectancy. The Italy Immunization Plan 2017-19 recommend vaccines to these patients but a protocol still isn't present. Moreover, despite the availability of effective vaccines, coverage remained very low for many reasons including problems with privacy. The objectives of this study were a) the appliance of a shared clinical pathway between the “Immunization Center of Hospital Hygiene Operating Unit” and the “HIV/AIDS Disease Prevention, Diagnosis and Treatment Center of Infectious Diseases Operating Unit” b) the increase in vaccination coverage and the evaluation of side effects. Methods A prospective study was conducted from Oct 2019 to Feb 2020 at the G. Martino University Hospital of Messina. In particular, of the 138 patients followed by the Infectious Diseases OU, after evaluation of their immune status, 62% were enrolled in this study. Following the acquisition of informed consent, we collected socio-anagraphical data and we started the free administration of vaccines by providing an hoc calendar in the Immunization Center. Statistical analysis was performed with R software. Results The sample was represented by 86 patients (74% males and 26% females, 21% foreigners and 79% Italian, mean age=40±13.6 SD). We didn't observe drop out and no differences were observed for local/systemic AEs generally reported. We obtained an increase of vaccination coverage with a total of 74 doses administered for flu (+164%) and 240 for other vaccines (+172%). In particular, we immunized a total of 74% of patients for HPV (2% in 2018), 42% for HAV (28% in 2018), 37% for HBV (28% in 2018), 58% for pneumococcal (21% in 2018), 54% for meningococcal ACWY and B (0% in 2018). Conclusions The undertook clinical pathway showed the relevance of specific management of these patients and the need to increase the vaccination offer. Key messages The immunization in people living with HIV is priority to reduce the risk of infectious disease. It’s important to implement a shared clinical pathway to increase vaccination rates of these patients. The application of the protocol had an high impact in patients' adhesion to vaccination also thanks to the chance of accessing to the service in a comfortable setting and suitable to protect privacy.

Quality of Life in Diabetic Patients in the Primary Care Unit

Objective: This study aimed to evaluate the level of quality of life and related factors in type 2 diabetic patients who were followed up at the Primary Care Unit of a university hospital in southern Thailand.Material and Methods: A cross-sectional study was conducted in type 2 diabetes patients who were continuously followed up at the primary care unit. Quality of life was the primary outcome assessed by the World Health Organization Quality of Life Brief-Thai questionnaire and related factors were analyzed using the multivariate generalized linear model.Results: This study included 158 patients who fit our eligibility criteria. The median age was 66 years old and median duration of diabetes was 10 years. Most had comorbidities and a quarter had diabetic complications. The results show 64.6% of the study sample had a good level of quality of life and no one had a bad level of quality of life. The results of multivariate generalized linear model show that no factors were associated with overall quality of life. Obesity was statistically significantly associated with a lower quality of life in the physical health dimension [odd ratio (OR)=0.35 (0.14, 0.89), p-value=0.027] and diabetic complications were associated with a lower quality of life in the psychological dimension [OR=0.27 (0.08, 0.85), p-value=0.025].Conclusion: Most diabetic patients had a good quality of life. There were no factors associated with overall quality of life, but obesity and diabetic complications were statistically significantly associated with some dimensions of quality of life. Healthcare providers should assess aspects of quality of life in patients with chronic diseases.

Non-communicable diseases in Southern Tunisia: morbidity, mortality profile and chronological trends

Non-communicable diseases (NCDs) represent a major public health problem worldwide. Giving their impact on the morbidity and mortality burden, understanding their chronological trends over time is a priority for epidemiological surveillance. We aimed to determine the epidemiological specificities of NCDs and to study their chronological trends over the period&#160;2010-2015. We retrospectively collected data of hospitalized&#160;patients from the regional registry of morbidity and mortality in the Southern University Hospital of Tunisia during the period 2010-2015. We included 18,081 patients with NCDs aged ≥ 25 years. The distribution of NCDs was characterized by the predominance of cardiovascular disease (CVD) (10,346 cases, 57.2%). Chronological trends analysis of NCDs showed that NCDs remained globally stable between 2010 and 2015. The same result applied to the group of cancers, chronic respiratory diseases and diabetes mellitus. However, CVD increased significantly between 2010 and 2015 (ρ = 0.84; p = 0.036). The proportion of CVD increased significantly among men (ρ = 0.87; p = 0.019) and elderly (ρ = 0.88; p = 0.019). The hospital mortality rate of NCDs increased significantly (ρ = 0.85; p = 0.031), notably for CVDs (ρ = 0.94; p = 0.005). Chronological trends analysis revealed a significant rise in the morbidity and mortality burden of CVDs during the period 2010-2015. It is imperative, therefore, to strengthen health care for these&#160;patients and to introduce the concept of integrated NCDs prevention as an essential component of the health system.

Effects of aerators, filters and chlorination on contamination of water samples: a nine years study in a Southern University Hospital.

The aim of our study was to evaluate the microbiological contamination by Pseudomonas aeruginosa in the water system of the University Hospital "G. Martino" in Messina over a period of nine years, in order to a) clarify possible relationship between the presence of aerators and contamination, b) to highlight the presence of a yearly variation and c) to verify the statistical difference between microbiological contamination of taps with and without filters. We carried out our study between January 2010 and December 2018 through the collection of water samples that were analysed for total bacteria count and Pseudomonas aeruginosa. The differences between the results recorded over the nine-year study period were evaluated using variance analysis. P values of <0.05 were considered statistically significant. Software R was used for statistical assessment. We analysed a total of 6168 samples with a positive rate of 9.31% and a decreasing trend over the years to a value of 2.44% (p<0.001), due to the elimination of the aerators of taps without filters and also to the introduction of filters in taps of high-risk wards and surgical rooms. We found statistical difference between taps with or without filter (p<0.001) and a higher positive rate during the summer season compared to the other months. These results reveal a high level of contamination of taps by opportunistic bacteria with severe implications especially for high-risk settings and therefore, the need to improve the management of these devices.

Need for structured healthcare organization and support for return to work after stroke in Sweden: Experiences of stroke survivors.

To explore stroke survivors' experiences of healthcare-related facilitators and barriers concerning return to work after stroke. A qualitative study. Outpatient stroke rehabilitation unit at a University Hospital in southern Sweden. A convenient sample of 20 persons admitted to Skåne University Hospital for acute stroke care (median age 52 years), in employment of at least 10 h per week at stroke onset and having been referred to stroke rehabilitation within 180 days. The interviews were performed by focus groups, and the data were analysed by content analysis. Facilitating factors were a tailored rehabilitation content with relevant treatments, adequate timing and a structured stepwise return-to-work process. A lack of sufficient early healthcare information, rehabilitation planning and coordination were perceived as barriers. An early rehabilitation plan, a contact person, and improved communication between rehabilitation actors were requested, as well as help with work transport, home care, children and psychosocial support for families. Tailored rehabilitation content and a structured stepwise return-to-work process facilitated return to work. Insufficient structure within the healthcare system and lack of support in daily life were perceived barriers to return to work, and need to be improved. These aspects should be considered in the return-to-work process after stroke.

Time trend prevalence of artificial nutrition counselling in a university hospital.

The negative effects of malnutrition on the prognosis of hospitalized patients are well documented; however, less known is the awareness and knowledge of health care professionals about this complication. The aim of this study was to evaluate the trend of the requests for nutritional consultation in years and the prescription of artificial nutrition (AN), for adult patients at a university hospital in southern Italy in the years 2004, 2008, 2012, and 2016 to assess the progress of medical teams concerning awareness of hospital malnutrition. This was a retrospective study that evaluated the time trend of nutritional consultation requests and related prescription of AN, for adult patients at a university hospital in southern Italy in the years 2004, 2008, 2012, and 2016. Of 112 233 inpatients, 2505 received a nutritional consultation with the prescription of AN. The number of patients on AN increased from 507 of 33 240 (1.52%) in 2004 to 730 of 29 195 (2.5%) in 2008 (P < 0.001), remaining almost stable in 2012 and 2016. The request for AN was quite equally distributed between surgical (51.5%) and medical wards (48.5%), with a prevalence among patients with oncologic diseases (806 patients [65.6%]). As for nononcologic diseases, 20.4% involved the gastrointestinal tract and 6.3% the nervous system. Throughout the 12 y of observation, parenteral nutrition was the main prescribed support (59.8%) followed by oral nutritional supplements (26.1%) and enteral nutrition (9.3%). Mean nutritional intervention duration was 11 d (±10.8 d). The request of AN for hospitalized patients increased over time, probably owing to improved medical consciousness of the potential risks for malnutrition and the availability of a specialized clinical nutrition team.

Seasonality of birth affects paediatric coeliac disease.

This study investigated the seasonality of birth in children diagnosed with coeliac disease (CD) at a tertiary University hospital in Southern Israel. This was a population-based retrospective time series analysis study from January 1988 to December 2014. There were 308 903 live births at Soroka University Medical Centre during the study period and 699 were diagnosed with CD. We combined three databases covering births, CD diagnoses and weather indices. The daily proportion of births that resulted in CD for the different four seasons and high seasons were compared to the weather indices on the day of birth using negative binomial regression. Statistically significant associations were found between the season of birth and the rate of CD, with autumn births being associated with a higher risk for the development of CD than births during the summer, with an incidence ratio of 1.22. The association was further increased when the defined summer and autumn high seasons were used, with an incidence ratio of 1.40. No association was found between CD and the mean temperature and global radiation. Coeliac disease was associated with birth during the autumn and the autumn high season posed an even more significant risk factor.

Characteristics and Outcomes of Intensive Care Unit Survivors: Experience of a Multidisciplinary Outpatient Clinic in a Teaching Hospital

OBJECTIVES:To describe the experience of an outpatient clinic with the multidisciplinary evaluation of intensive care unit survivors and to analyze their social, psychological, and physical characteristics in a low-income population and a developing country.METHODS:Retrospective cohort study. Adult survivors from a general intensive care unit were evaluated three months after discharge in a post-intensive care unit outpatient multidisciplinary clinic over a period of 6 years (2008-2014) in a University Hospital in southern Brazil.RESULTS:A total of 688 out of 1945 intensive care unit survivors received care at the clinic. Of these, 45.2% had psychological disorders (particularly depression), 49.0% had respiratory impairments (abnormal spirometry), and 24.6% had moderate to intense dyspnea during daily life activities. Patients experienced weight loss during hospitalization (mean=11.7%) but good recovery after discharge (mean gain=9.1%), and 94.6% were receiving nutrition orally. One-third of patients showed a reduction of peripheral muscular strength, and 5.7% had moderate to severe tetraparesis or tetraplegia. There was a significant impairment in quality of life (SF-36), particularly in the physical and emotional aspects and in functional capacity. The economic impacts on the affected families, which were mostly low-income families, were considerable. Most patients did not have full access to rehabilitation services, even though half of the families were receiving financial support from the government.CONCLUSIONS:A significant number of intensive care unit survivors evaluated 3 months after discharge had psychological, respiratory, motor, and socioeconomic problems; these findings highlight that strategies aimed to assist critically ill patients should be extended to the post-hospitalization period and that this problem is particularly important in low-income populations.

Successful changes in management accounting systems: A healthcare case study

This paper explores how a change in the management accounting systems (MAS) of healthcare organisations was implemented in a manner acceptable to those involved. The study employed a longitudinal case study of a university hospital in southern Italy, and was informed by Broadbent and Laughlin's Middle Range Theory (MRT). The findings revealed that the change in the MAS was successful due to the involvement of professionals in the ongoing process of change. This involvement reduced their natural tendency to resist, and increased the commitment of the various groups of professionals to the new business culture.

Mechanical ventilation in patients in the intensive care unit of a general university hospital in southern Brazil: an epidemiological study

OBJECTIVES:To determine the characteristics, the frequency and the mortality rates of patients needing mechanical ventilation and to identify the risk factors associated with mortality in the intensive care unit (ICU) of a general university hospital in southern Brazil.METHOD:Prospective cohort study in patients admitted to the ICU who needed mechanical ventilation for at least 24 hours between March 2004 and April 2007.RESULTS:A total of 1,115 patients admitted to the ICU needed mechanical ventilation. The mortality rate was 51%. The mean age (± standard deviation) was 57±18 years, and the mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 22.6±8.3. The variables independently associated with mortality were (i) conditions present at the beginning of mechanical ventilation, age (hazard ratio: 1.01; p<0.001); the APACHE II score (hazard ratio: 1.01; p<0.005); acute lung injury/acute respiratory distress syndrome (hazard ratio: 1.38; p=0.009), sepsis (hazard ratio: 1.33; p=0.003), chronic obstructive pulmonary disease (hazard ratio: 0.58; p=0.042), and pneumonia (hazard ratio: 0.78; p=0.013) as causes of mechanical ventilation; and renal (hazard ratio: 1.29; p=0.011) and neurological (hazard ratio: 1.25; p=0.024) failure, and (ii) conditions occurring during the course of mechanical ventilation, acute lung injuri/acute respiratory distress syndrome (hazard ratio: 1.31; p<0.010); sepsis (hazard ratio: 1.53; p<0.001); and renal (hazard ratio: 1.75; p<0.001), cardiovascular (hazard ratio: 1.32; p≤0.009), and hepatic (hazard ratio: 1.67; p≤0.001) failure.CONCLUSIONS:This large cohort study provides a comprehensive profile of mechanical ventilation patients in South America. The mortality rate of patients who required mechanical ventilation was higher, which may have been related to the severity of illness of the patients admitted to our ICU. Risk factors for hospital mortality included conditions present at the start of mechanical ventilation conditions that occurred during mechanical support.

Epidemiology of candidemia in neonatal intensive care units: a persistent public health problem.

Candidemia has become an increasingly important problem in infants hospitalized in the Neonatal Intensive Care Units (NICUs). Candida species are the third most common agents of late-onset infections in critically ill neonates and they are associated with high morbidity and mortality rates. In this study we evaluated the epidemiology of Candida bloodstream infections in the NICU of an Italian university hospital during a 15-year period. Our specific aims were to analyze the change in species distribution and the vitro susceptibility of these yeasts to fluconazole (FCZ) and amphotericin B (AmB). A retrospective study of candidemia in the NICU of a university hospital in southern Italy, covering the years 2000-2014 was carried out. The isolates were identified using the VITEK2 yeast identification system and antifungal susceptibility was determined using the E-test method. Among the 57 patients with confirmed candidemia, 60% were males (n = 34 cases) and 82% (n = 47) had a gestational age of 24-32 weeks. Twenty-seven neonates (47%) had a very low birth weight (<1500 g), 20 (35%) an extremely low birth weight (<1000 g), and 10 (18%) a low birth weight (<2500 g). The most important potential risk factors were the placement of a central venous catheter, total parenteral nutrition, and endotracheal intubation (100%, each). Candida albicans was the most frequent yeast (47%), followed by Candida parapsilosis (44%). The proportion of Candida non-albicans increased slightly, from 46% in 2000-2004 to 71% in 2010-2014 (χ2 test for trend, p = 0.030). All isolates were susceptible to FCZ and AmB. The detection in this epidemiologic study of an increase in Candida non-albicans highlights the importance of correct species-level identification in the rapid diagnosis for an efficient treatment of candidemia. Knowledge of the local epidemiological trends in Candida species isolated in blood cultures will facilitate therapeutic decision-making.

Characteristics of requests for psychiatric consultation-liaison in elderly hospitalized in a university hospital in southern of Brazil

The consultation-liaison (C-L) psychiatry represents a healthcare modality that gives upon the request of other healthcare professionals providing comprehensive care to all aspects involved in being sick and hospitalized. The aim of this study was to characterize the C-L psychiatry calls in elderly hospitalized at Hospital Sao Lucas da PUCRS (HSL-PUCRS) in the years 2012 and 2013. It is observational, descriptive, retrospective and cross sectional. The study population consisted of all the elderly (60 or older) admitted to the HSL-PUCRS treated in psychiatric C-L regimen. Data were collected from the consultation registration protocols filled by residents of that hospital upon the request of care. During the study period, 167 patients that were referred to C-L psychiatry team were enrolled. Most attended by the Sistema Unico de Saude (SUS), female, married and uneducated. Depressive, psychotic and anxiety symptoms were the main reasons for referral to consultation (68.9%). The most prevalent psychiatric diagnosis was mood disorder (51.3%). Pharmacotherapy was the conduct used by C-L consultant in 81.4% of the elderly and antidepressants and antipsychotics were the most appropriate medications. From the characterization of the profile of the elderly attended by the consultation in general hospitals is expected to contribute to the medical practices of various specialties involved in the hospital, as well as provide subsidies for the improvement of C-L psychiatry.

"Tobacco dependence treatment makes no sense because"…: rebuttal of commonly-heard arguments against providing tobacco dependence treatment in the hospital setting.

BackgroundThe provision of tobacco dependence treatment in health care settings, particularly in countries lacking a history of strong tobacco control policy implementation, is limited by continued misconceptions on the part of health professionals and decision-makers regarding its worth and efficacy. In this paper, we rebut 9 arguments against the provision of tobacco dependence treatment that we have encountered in our experiences implementing and maintaining a dedicated smoking cessation service at a large university hospital in southern Germany.DiscussionBroadly, the arguments relate to the nature of addiction, the efficacy and safety of stop-smoking medication and behavioural support, and the benefits and challenges of quitting. They include: (a) If smokers really want to quit, they will be able to do it alone (without help); (b) You can’t forbid patients from doing what they want; (c) Patients will be upset if you talk to them about their smoking; (d) Stop-smoking medication has side effects that are more dangerous than smoking; (e) You have to be well trained to help smokers to quit (otherwise you can do more harm than good); (f) If you smoke yourself, you lack credibility; (g) If you have cancer, it is too late to quit; (h) Nicotine withdrawal is dangerous for heavy smokers; and (i) Smokers die earlier, thus reducing costs to the health system.SummaryIt is hoped that the counter-arguments presented here arm tobacco control advocates and practitioners working in health care settings, particularly in countries which have not prioritised tobacco control, to respond appropriately and convincingly to those opposed to the provision of tobacco dependence treatment.

Mind the gap between recommendation and implementation—principles and lessons in the aftermath of incident investigations: a semi-quantitative and qualitative study of factors leading to the successful implementation of recommendations

ObjectivesUsing the findings of incident investigations to improve patient safety management is well-established and mandatory under Swedish law. This study seeks to identify the mechanisms behind successful implementation of the...

Cuidado de enfermagem à criança que tem doença oncológica avançada: ser-com no cotidiano assistencial

phenomenological investigation that aims to comprehend the meaning of taking care of children who has an advance oncologic disease that illness no longer responds to healing treatments for nursing staff. Interviews with 15 nursing professionals were developed in a southern university hospital in Brazil. The statements, analyzed through heideggerian method, revealed that caring means to be attached to the child for treatment time, supporting the family and, sometimes, put oneself in the mother’s place for also being a mother. It unveiled being-nursing-staff-professional shows itself on being-with the child and family members. It indicated a human being relational nature. It concludes that pediatric oncologic care transcends technical and routine techniques, and it demands competences to provide na specific care for the family and child’s singularities and needs.

1642 Describing the use of Off-Label and not Approved Medications in a Neonatal Intensive Care Unit in South Brazil

Background and AimsIt is known that unlicensed medicines (unapproved) or used other way than directed in the label (off-label use) are widely prescribed in children. In the NICU, the severity...

Air sampling methods to evaluate microbial contamination in operating theatres: results of a comparative study in an orthopaedics department

To evaluate the level of microbial contamination of air in operating theatres using active [i.e. surface air system (SAS)] and passive [i.e. index of microbial air contamination (IMA) and nitrocellulose membranes positioned near the wound] sampling systems. Sampling was performed between January 2010 and January 2011 in the operating theatre of the orthopaedics department in a university hospital in Southern Italy. During surgery, the mean bacterial loads recorded were 2232.9 colony-forming units (cfu)/m(2)/h with the IMA method, 123.2 cfu/m(3) with the SAS method and 2768.2 cfu/m(2)/h with the nitrocellulose membranes. Correlation was found between the results of the three methods. Staphylococcus aureus was detected in 12 of 60 operations (20%) with the membranes, five (8.3%) operations with the SAS method, and three operations (5%) with the IMA method. Use of nitrocellulose membranes placed near a wound is a valid method for measuring the microbial contamination of air. This method was more sensitive than the IMA method and was not subject to any calibration bias, unlike active air monitoring systems.