Ventilation systems needed to avoid fungal spores

The importance of safe indoor ventilation for people with respiratory conditions has been highlighted by research showing high levels of Aspergillus fumigatus fungal spores in hospital rooms with outdoor facing windows.

A research team that included Professor Andrew Jones, Consultant Physician in Respiratory Medicine and Head of Department at the Manchester Adult Cystic Fibrosis Centre (MACFC), undertook environmental air sampling over 14 months to test both outside and inside levels of fungal growth at the Centre between November 2014 and January 2016.

Their findings, published in Frontiers in Cellular and Infection Microbiology, showed that airborne counts of fungal spores peaked from May to October, driven by increased temperatures and lower wind speeds.

They also found that rooms with external windows had elevated fungal counts compared to those not directly connected to the outdoors, and that no fungus spores were detected in rooms with positive pressure ventilation (with the exception of four samples).

“For vulnerable patients, ventilation with systems which use filters and laminar air flow may be a useful way to keep the air free of fungi,” said Professor Malcolm Richardson, Professor of Medical Mycology at The University of Manchester and Consultant Clinical Scientist in Mycology, at the Manchester University NHS Foundation Trust Mycology Reference Centre, commenting on the findings.

However, he stressed that further work is “required to find causative proof of climate and weather affecting fungus levels,” and also to determine “the exact clinical implications of these findings for cystic fibrosis patients who are predisposed to Aspergillus related diseases.”

Discharge summary abbreviations cause confusion

Medical abbreviations used by specialists in hospital discharge summaries are often confusing to the GPs who receive them and also ambiguous for hospital colleagues and junior doctors, an Australian study has found.

A retrospective audit of 802 discharge summaries at a Queensland regional health service found that they contained an average of 17 abbreviations, and almost one in five GPs were unable to interpret at least one of them.

Almost all (94%) of GPs said that ambiguous abbreviations had a negative impact on patient care and 60% said they spent too much time of clarifying them. Abbreviations could also have multiple possible meanings in different contexts and led to confusion for 15% of junior doctors working in other departments of the same hospital, the study found.

While most had no problems with abbreviations such as Hb and IHD, the abbreviations that had widest range of misinterpretations or ‘don’t know’ responses included NAD, DEM, PE, LC, TGA, TCH and BAE.

The study authors said hospitals should adopt a standardised list of acceptable abbreviations for medical documentation, which is made available to both hospital medical staff and GPs.

They also noted that abbreviations were very location specific, with marked differences between those used by Melbourne and Sydney hospitals.

The findings are published in the Internal Medicine Journal.

SCLC insights clear path to personalised medicine

New insights on small cell lung cancer (SCLC) development could lead to personalised treatments and reduced mortality, Australian researchers say.

A study of SCLC progression in mice showed MYC overexpression gave mutant neuroendocrine, club and alveolar type II cells a proliferative advantage, inducing adenoma or carcinoma in situ that didn’t continue to invasive disease.

Combined with Trp53 and Rb1 deletion, however, the mutations exclusively led to SCLC formation in all cell types — with each cell of origin influencing disease latency, metastatic potential and the SCLC phenotype’s transcriptional profile.

The findings suggest SCLC “is a series of diseases rather than being a single form of cancer” that only derives from neuroendocrine cells, a statement from the Hudson Institute of Medical Research read.

Understanding the drivers of SCLC will allow researchers to develop new, targeted therapies that improve survival outcomes, study coauthor and Hudson Institute STAT Cancer Biology Research Group Head Dr Daniel Gough said in the statement.

The full study is available in Oncogene.