Effectiveness of post-exposure prophylaxis during varicella outbreaks among primary and middle school students in Shanghai: An analysis of three-year surveillance data

ObjectivesTo evaluate the effectiveness of post-exposure prophylaxis conducted during varicella outbreaks among students in Shanghai.MethodsSurveillance data were collected from September 1, 2013 to December 31, 2016 involving 3524 susceptible students in 109 primary and middle school classes where emergency vaccinations (EVs) had been administered. Students were divided into two groups according to their prior vaccination (PV) varicella vaccine status. A secondary attack rate was used to compare EV and non-EV groups using a chi-squared test. Stratification analyses were performed, adjusting for the EV administration date, the vaccination coverage rate, and the number of cases prior to the EV.ResultsThe effectiveness rate was 92.2% (95% confidence interval (CI): 37.1–99.0%) when EV was applied within 3 days following the outbreak onset date, and 95.2% (95% CI: 79.9–98.8%) when vaccination coverage was ≥80% among students with PV. When students with PV received an EV for varicella within 3 days, the effectiveness rate was 100%.ConclusionsEV showed high protective effectiveness for varicella during outbreaks, especially if administered within 3 days of an outbreak and in conjunction with a high coverage rate.     

济宁市2011—2015年狂犬病暴露人群流行病学特征分析

目的了解山东省济宁市狂犬病暴露人群暴露流行病学特征及暴露后处置情况,为狂犬病防控提供科学参考依据。方法收集2011—2015年济宁市狂犬病暴露登记资料进行统计分析。结果 2011—2015年共接诊狂犬病暴露病例221 272例,性别比为1.49:1,0~14岁儿童最多,占32.71%;各月均有暴露者发生,7—8月为高峰,占22.51%;致伤动物以犬类为最多,占83.92%;暴露者到狂犬病处置门诊处理为主,占79.22%,全程接种人用狂犬病疫苗的145 092例,占Ⅱ、Ⅲ级暴露的72.16%,注射过狂犬病被动免疫制剂的12 783例,占Ⅲ级暴露的18.6%。结论济宁市群众对狂犬病防控知识缺乏,狂犬病暴露规范处置率较低,应加强狂犬病监测和健康教育,提高狂犬病防治知识。     

Antibiotic prophylaxis for dentoalveolar surgery: is it indicated?

Usually dentists in Australia give patients oral antibiotics after dentoalveolar surgery as a prophylaxis against wound infection. When this practice is compared to the principle of antibiotic prophylaxis in major surgery it is found to be at variance in a number of ways. In major surgery, the risk of infection should be high, and the consequences of infection severe or catastrophic, before antibiotic prophylaxis is ordered. If it is provided then a high dose of an appropriate spectrum antibiotic must be present in the blood prior to the first incision. Other factors which need to be considered are the degree of tissue trauma, the extent of host compromise, other medical comorbidities and length of hospitalization. Standardized protocols of administration have been determined and evaluated for most major surgical procedures. Dentoalveolar surgery is undoubtedly a skilled and technically challenging procedure. However, in contrast to major surgical procedures, it has a less than five per cent infection rate and rarely has severe adverse consequences. Dentoalveolar surgery should be of short duration with minimal tissue damage and performed in the dental chair under local anaesthesia. Controlled studies for both mandibular third molar surgery and placement of dental implants show little or no evidence of benefit from antibiotic prophylaxis and there is an adverse risk from the antibiotic. This review concludes that there is no case for antibiotic prophylaxis for most dentoalveolar surgery in fit patients. In the few cases where it can be considered, a single high pre-operative dose should be given.     

不同氟化物对人工羟基磷灰石摄氟量的影响

目的：探讨复合氟化物制剂（Co-F)及其组成成分中的氟化锌对牙齿无机质的影响。方法：将羟基磷灰石浸入各种氟化物溶液中，经过1、10d作用后，测定羟基磷灰石摄取氟量。应用与Co-F溶液相同氟浓度的氟化钠溶液作为对照。结果：发现浸入氟化锌溶液的羟基磷灰石摄取氟量最高。X线衍射分析有磷酸锌及氟化钙生成。浸入对照组氟化钠溶液的羟基磷灰石摄取氟量明显低于浸入Co-F溶液的羟基磷灰石摄取氟量。浸入Co-F溶液的羟基磷灰石1d及10d期间摄取氟量与浸入氟化锌溶液的羟基磷灰石摄取氟量相比较，没有显著性差异。结论：在羟基磷灰石摄取氟方面，复合氟化物制剂中氟化锌组分有重要的作用。     

Effect of monthly prophylaxis on caries and gingivitis in schoolchildren

ABSTRACT The effect of professional prophylaxis given each month to individual children was investigated. A total of 225 schoolchildren, 10–12 years of age, participated during the experimental year. Each prophylactic session required about 15 min, and included tooth-brushing instructions, professional tooth cleansings and fluoride rinses. Significantly fewer new interproximal carious lesions were obtained in the experimental group compared with the control group. No differences were observed for occlusal, buccal or lingual surfaces. The frequency of gingivitis was significantly reduced during the year of trial in the experimental group. The efficacy of the preventive treatment was most noticeable in children with high caries experience. For clinical practice monthly prophylaxes could be recommended to the most susceptible individuals.     

A clinical investigation of dental evacuation systems in reducing aerosols

BackgroundThe route of transmission of severe acute respiratory syndrome coronavirus 2 has challenged dentistry to improve the safety for patients and the dental team during various treatment procedures. The purpose of this study was to evaluate and compare the effectiveness of dental evacuation systems in reducing aerosols during oral prophylactic procedures in a large clinical setting.MethodsThis was a single-center, controlled clinical trial using a split-mouth design. A total of 93 student participants were recruited according to the inclusion and exclusion criteria. Aerosol samples were collected on blood agar plates that were placed around the clinic at 4 treatment periods: baseline, high-volume evacuation (HVE), combination (HVE and intraoral suction device), and posttreatment. Student operators were randomized to perform oral prophylaxis using ultrasonic scalers on 1 side of the mouth, using only HVE suction for the HVE treatment period and then with the addition of an intraoral suction device for the combination treatment period. Agar plates were collected after each period and incubated at 37 °C for 48 hours. Colony-forming unit (CFU) counts were determined using an automatic colony counter.ResultsThe use of a combination of devices resulted in significant reductions in CFUs compared with the use of the intraoral suction device alone (P < .001). The highest amounts of CFUs were found in the operating zone and on patients during both HVE and combination treatment periods.ConclusionsWithin limitations of this study, the authors found significant reductions in the amount of microbial aerosols when both HVE and an intraoral suction device were used.Practical ImplicationsThe combination of HVE and intraoral suction devices significantly decreases microbial aerosols during oral prophylaxis procedures.     

A national audit of antibiotic prophylaxis in elective laparoscopic cholecystectomy

Introduction

Laparoscopic surgeons in Great Britain and Ireland were surveyed to assess their use of antibiotic prophylaxis in elective laparoscopic cholecystectomy. This followed a Cochrane review that found no evidence to support the use of antibiotic prophylaxis in routine cases.

Methods

Data were collected on routine use of antibiotics in elective laparoscopic cholecystectomy, and how that was influenced by factors such as bile spillage, patient co-morbidities and surgeons’ experience. An online questionnaire was sent to 450 laparoscopic surgeons in December 2011.

Results

Data were received from 111 surgeons (87 consultants) representing over 7,000 cases per year. In routine cases without bile spillage, 64% of respondents gave no antibiotics and 36% gave a single dose. In cases with bile spillage, 11% gave no antibiotics. However, 80% gave one dose and 7% gave three doses. Co-amoxiclav was used by 75% of surgeons. Surgeons are more likely to give antibiotics when patients have risk factors for infective endocarditis.

Conclusions

This study suggests over 20,000 doses of antibiotics and over £100,000 could be saved annually if surgeons modified their practice to follow current guidelines.     

体外循环及抗生素对瓣膜置换术患者咽部菌群及手术切口细菌定植的影响

为了解体外循环（ＣＰＢ）及抗生素对瓣膜置换术患者咽部菌群及手术切口细菌定植的影响。ＣＰＢ前及后５天进行了咽部和手术切口采样细菌培养。术后咽部细菌明显减少（Ｐ＜００１），咽部菌群构成中草绿色链球菌、奈瑟氏菌增加，四联球菌减少（Ｐ＜００１）。术后６例患者出现手术切口细菌定植，这种细菌定植与监护室观察及呼吸机使用时间有关。认为：在可能情况下缩短监护室观察及呼吸机使用时间对防止ＣＰＢ术后瓣膜置换术患者发生医院内感染是有益的