Autosensitisation (Autoeczematisation) reactions in a case of diaper dermatitis candidiasis

Diaper dermatitis is the most common cutaneous diagnosis in infants. Most cases are associated with the yeast colonisation of Candida or diaper dermatitis candidiasis (DDC). It is an irritating and inflammatory acute dermatitis in the perineal and perianal areas resulting from the occlusion and irritation caused by diapers. Autoeczematization to a distant focus of dermatophyte infection very rarely presents as DDC. We present a 1-month-old boy with lesion on diaper area (gluteal area, perineum, groin and genitalia) and with clusters of pustules and vesicles on a large erythematous base over the dorsal area of both hands.     

护理干预对预防新生儿红臀的效果观察

目的通过护理干预和采取不同的用药方法,减少新生儿红臀的发生率。方法采用随机抽样方法分好对照组和实验组,对照组新生儿臀部护理使用婴儿扑粉和一次性尿布。实验组除新生儿常规护理外,联合使用鞣酸软膏加纯棉尿布。结果实验组新生儿红臀发病率2.70%明显低于对照组红臀发生率24.32%,两者之间有显著性差别（χ2=36.80,P〈0.005）。结论说明保持皮肤干燥是治疗的有效措施,油膏制剂取代传统的扑粉对预防新生儿红臀的发生有值得推广的价值。     

Secondary Haemophilus influenzae type b in day-care facilities. Risk factors and prevention

The risk factors for acquisition of secondary day-care-associated Haemophilus influenzae type b disease were evaluated in a cohort of children in Seattle-King County, Washington; Atlanta; and the state of Oklahoma. During the study period, 129 primary cases were identified in children less than 5 years old who attended day-care facilities. In ten instances (8%), a secondary case occurred between one and 60 days after a primary case in the same classroom. Risk of secondary disease in classroom contacts was strongly age related: 2.4% in children 0 to 11 months old, 1.2% in children 12 to 23 months old, and 0.0% in children 24 to 59 months old. Controlling for age, children attending day-care more hours per week were more likely to transmit or acquire secondary disease. Risk of secondary disease for children in other classrooms at a center where a case had occurred was not significantly greater than risk of primary disease. Administration of rifampin to classroom contacts of a child with invasive H influenzae was effective in preventing secondary cases (95% confidence interval for rifampin efficacy, 47% to 100%). For children 0 to 23 months old not treated with rifampin, risk of secondary disease was 2.7% (95% confidence interval, 1.1% to 4.3%), a risk approaching that reported in household contacts.     

Hand Hygiene among Anesthesiologists and Microorganisms Contamination in Anesthesia Environments: A Single-Center Observational Study

ObjectiveTo investigate the baseline levels of microorganisms' growth on the hands of anesthesiologists and in the anesthesia environment at a cancer hospital.MethodsThis study performed in nine operating rooms and among 25 anesthesiologists at a cancer hospital. Sampling of the hands of anesthesiologists and the anesthesia environment was performed at a ready-to-use operating room before patient contact began and after decontamination.ResultsMicroorganisms' growth results showed that 20% (5/25) of anesthesiologists' hands carried microorganisms (> 10 CFU/cm²) before patient contact began. Female anesthesiologists performed hand hygiene better than did their male counterparts, with fewer CFUs (P = 0.0069) and fewer species (P = 0.0202). Our study also found that 55.6% (5/9) of ready-to-use operating rooms carried microorganisms (> 5 CFU/cm²). Microorganisms regrowth began quickly (1 hour) after disinfection, and increased gradually over time, reaching the threshold at 4 hours after disinfection. Staphylococcus aureus was isolated from the hands of 20% (5/25) of anesthesiologists and 33.3% (3/9) of operating rooms.ConclusionOur study indicates that male anesthesiologists need to pay more attention to the standard operating procedures and effect evaluation of hand hygiene, daily cleaning rate of the operating room may be insufficient, and we would suggest that there should be a repeat cleaning every four hours.     

广东高州市2005年医疗机构消毒质量监测分析

目的评价辖区内医疗机构消毒灭菌质量，督促各医疗单位提高消毒灭菌效果，防止医源性感染的发生。方法对辖区内的医疗单位已消毒或灭菌的用品进行抽样检测，将检测结果进行统计学分析。结果这次采集使用中消毒液、无菌器械、物体表面、手术室空气和医务人员手共3556份，检测达卫生标准2955份，符合率为83、10％，不同样品检测达卫生标准百分率依次为97．37％、95．56％、86．25％、75．41％和62、49％。结论高州市医疗机构消毒灭菌质量用卫生指标评价，卫生站的符合卫生标准率低于医院，手术室空气和医务人员手的监测合格率低于使用中消毒液和无菌器械。     

Intestinal parasites in metropolitan Toronto day-care centres.

In 1981, 900 children (aged 3 months to 10 years) and 146 staff attending 22 day-care centres in metropolitan Toronto chosen at random provided a stool specimen in a survey for intestinal parasites. Of the children, 4% to 36% were infected in 20 of 22 centres. Overall, 19% of the children and 14% of the staff had intestinal parasites: 8.6% and 4.0% respectively had Dientamoeba fragilis, and 7.8% and 2.0% respectively had Giardia lamblia. The highest prevalence of dientamebiasis was in the 7- to 10-year-olds, whereas giardiasis was detected most frequently in the 6-year-olds. Infection with intestinal parasites was not correlated with age, sex, duration in the day-care centre, dog ownership, travel history, gastrointestinal symptoms or the proportion of children in the day-care centre who were born in less developed countries. Immigrant children and children of parents born in industrialized countries (including Canada) were more likely to be infected than were children born in Canada of parents from the developing world. Dientamebiasis was associated with cat ownership. Thus, intestinal protozoa--in particular, D. fragilis and G. lamblia--are endemic in Toronto day-care centres.     

Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: a randomised study

In a multicentre study of sepsis after total hip or knee replacement the operations performed by each surgeon were allocated at random between control and ultraclean-air operating rooms. Records were obtained from over 8000 such operations. In the patients whose prostheses were inserted in an operating room ventilated by an ultraclean-air system the incidence of joint sepsis confirmed at reoperation within the next one to four years was about half that of patients who had had the operation in a conventionally ventilated room at the same hospital. When whole-body exhaust-ventilated suits had been worn by the operating team in a theatre ventilated by an ultraclean-air system the incidence of sepsis was about a quarter of that found after operations performed with conventional ventilation. When all groups in the trial were considered together the analysis showed deep sepsis after 63 out of 4133 operations in the control group (1.5%) and after 23 out of 3922 operations in the ultraclean-air groups (0.6%) (ratio 2.6, 95% confidence limits 1.6-4.2; p less than 0.001). The design of the study did not include a strictly controlled test of the effect of prophylactic antibiotics, but their use was associated with a lower incidence of sepsis than in patients who had received no antibiotic prophylaxis at their operations (0.6% (34/5831) v 2.3% (52/2221); ratio 4.0).     

日常化妆品中微生物的检测分析

目的了解衡阳市日用化妆品的微生物污染现状。方法采用随机抽样的方法在衡阳各宾馆、招待所和某高校采集150份化妆品,按照2007版《化妆品卫生规范》微生物检验方法操作进行检验。结果150份化妆品使用前微生物合格率为96％,其中菌落总数合格率99．3％,粪大肠菌群合格率99．3％,铜绿假单胞菌合格率98％,金黄色葡萄球菌、霉菌和酵母菌合格率均为100％。高校中化妆品使用30d后和使用60d后,微生物污染检测样品合格率分别为94％和82％。结论化妆品中菌落总数超标率问题依然存在,且化妆品微生物污染存在一次污染和二次污染。     

我区某医院消毒及细菌污染调查分析

目的 探讨医院细菌污染情况,为减少医源性感染提供依据。方法空气中细菌污染采用平板暴露法,医护人员手、消毒剂等采用连续划线分离培养法。结果空气污染率为63．26％,医护人员手污染率为46.15％,消毒液的污染率为10．53％。结论 医院污染较严重,医源性感染问题亟待解决。     

Occupational risk of human parvovirus B19 infection for school and day-care personnel during an outbreak of erythema infectiosum

Human parvovirus B19, the cause of erythema infectiosum, has recently been associated with adverse fetal outcomes. During a large outbreak of erythema infectiosum in Connecticut, a survey was conducted on 571 (90%) of 634 school and day-care personnel to determine the risk of acquiring B19 infection. Serologic evidence of B19 infection was determined by using an enzyme-linked immunosorbent assay. Of the school and day-care personnel, 58% had evidence of previous B19 infection. The minimal rate of B19 infection in susceptible personnel during the outbreak was 19%. The risk was increased for teachers and day-care providers who had contact with younger children and with greater numbers of ill children. These results suggest that B19 infection is an occupational risk for school and day-care personnel.     

某医疗单位消毒质量监测报告

目的为进一步控制医院感染的发生,对某基层医疗单位的消毒质量进行了监测。方法对某基层医疗单位消毒质量的监测按消毒技术规范介绍的方法进行。结果空气监测合格率67.2%;物体表面监测合格率87.2%;医护人员手监测合格率70.6%;使用中的消毒液细菌污染监测合格率100.0%;紫外线灯监测合格率50.0%;高压灭菌效果监测合格率50.0%。结论加强消毒管理,提高消毒工作质量。     

微型游离腓动脉穿支皮瓣修复手足小创面27例效果观察

目的：探讨微型游离腓动脉穿支皮瓣修复手足小创面的临床价值。方法选取2009年3月至2013年12月于本院采用微型游离腓动脉穿支皮瓣进行修复治疗的27例手足小创面患者为研究对象,观察所有患者治疗后的皮瓣成活率、臃肿率、手足功能优良率及皮瓣部位感觉功能评估结果。结果患者的皮瓣成活率达到100.00%,手足功能优良率达到100.00%,皮瓣部位感觉功能持续改善,无一例皮瓣臃肿发生。结论微型游离腓动脉穿支皮瓣修复手足小创面的临床价值较高,患者治疗后的手足功能恢复更佳。     

2009年金乡县托幼机构消毒效果调查

目的了解金乡县托幼机构卫生状况,为卫生行政管理提供科学依据。方法参照中华人民共和国卫生部《消毒技术规范》2002年版和GB15892-1995《医院消毒卫生标准》进行检验和评价。结果95家幼儿园空气细菌总数合格率为24.24%,毛巾合格率63.76%,幼儿和教师手合格率47.72%,物体表面合格率54.84%,其中公立幼儿园(共28家)空气细菌总数合格率47.42%,毛巾合格率78.57%,幼儿和教师手合格率72.90%,物体表面合格率75.89%。私立幼儿园(共67家)空气细菌总数合格率10.78%,毛巾合格率54.58%,幼儿和教师手合格率17.78%,物体表面合格率42.93%。结论公立幼儿园和私立幼儿园对消毒工作的认识和重视程度不够。     

Mechanisms of glove tears and sharp injuries among surgical personnel

OBJECTIVE.--The development of strategies to prevent exposure to blood for operating room personnel has been hampered by a lack of knowledge about the specific mechanisms of exposure. The purpose of this study was to classify the mechanisms of glove tears and sharp injuries in the operating room. DESIGN.--During a 3-month period, a nurse interviewed operating room personnel immediately after a glove tear or sharp injury had occurred. SETTING.--Yale-New Haven (Conn) Hospital is a tertiary care teaching hospital. RESULTS.--There were 249 glove tears and 70 sharp injuries. Visible skin contact with the patient's blood occurred in 156 glove tears (63%). The mechanism causing the tear could be identified in only 81 (33%). For 230 glove tears (92%), personnel were wearing single gloves. Of 70 sharp injuries, 47 (67%) were caused by needles and usually occurred during suturing. The following three mechanisms accounted for 40 sharp injuries (57%): (1) hands injured while stationary and holding an instrument, 11 (16%)-a position of risk not previously identified; (2) hands injured while retracting tissue, 12 (17%); and (3) injuries caused by sharp instruments not being used, 17 (24%). Instrument passage caused only four sharp injuries (6%). CONCLUSIONS.--The majority of glove tears have an unknown mechanism, and alteration in the manufacture or number of gloves worn may be helpful in reducing cutaneous blood exposures. The identification of specific mechanisms of sharp injuries should lead to effective strategies to prevent exposure to the human immunodeficiency virus and other blood-borne pathogens in the operating room.     

A comparison of kinematic recording instruments

Kinematics, the study of motion, is employed in numerous biomechanics and human performance investigations. The types of instrumentation used in these studies vary at fundamental technical levels, making it difficult to relate results from studies carried out at different laboratories using different instrumentation. A project was designed to compare two commonly used types of kinematic recording techniques, i.e., the 6 df electromagnetic tracker system and the video motion analysis system. A four-level testing and comparison method was conducted involving static and dynamic inanimate objects, as well as human subjects under static and dynamic conditions. It was demonstrated that for rigid body inanimate objects the two systems produce nearly identical values under stationary conditions and are comparable under moving conditions. The systems show only trivial discrepancies in static human body measurements, and perform in qualitatively similar ways on human motion.     

Characterization of hospital waste in Lahore, Pakistan

Background It is a common practice in developing countries that medical/infectious waste openly dumped with municipal solid waste.This paper presented a generation and characterization study of hospital waste.Determination of the waste composition is a basic step for selecting the most efficient treatment method of hospital waste.Methods Stratified random sampling was used to collect the samples of general as well as medical wastes for seven days.Medical waste was sorted into 10 categories whereas general waste was classified into 11 categories.Incineration was observed thoroughly for observing flaws in the incineration process.Data was analyzed by using SPSS software version 16.0.Results The studied hospital produced an average 297 kilograms of medical waste daily and it comprises plastics （71.0％）,glass （13.9％）,papers etc.（3.8％）,cotton/dressings （5.7％）,masks/gloves/sheets （0.3％） diapers （0.4％）,wasted machines used in operation theaters （2.0％） and blades （0.1％）.Laboratories,cancer ward,nursery ward,OPD and emergency ward are the largest infectious waste producing departments in the hospital.The hospital produced an average 3 511 kilograms of general waste daily in which organics constitute （44.3％）,diapers etc.（42.8％）,demolition materials （3.7％）,plastic waste mixing medical plastic waste （2.5％）,miscellaneous （2.14％）,cloth/clothes （1.6％）,cardboard （1.3％）,papers （0.8％）,cotton dressings （0.28％）,glass （0.27％） and iron materials （0.18％）.Other alarming facts are：medical waste is recycled in study area,after incineration of hospital waste,ash simply dumped in the premises of the hospital without any liner system.Conclusions The studied hospital produces 10％ of infectious waste and 90％ of general waste.The largest components of the infectious waste are plastic and glass.Organics and diapers are major components of the general waste coming from different sites of the hospital.Lack of training,inadequate knowledge regarding to the composition of the infectious waste and risks associated with the waste are the major issues which must be addressed and resolved.     

局部氧疗治疗新生儿尿布性皮炎的疗效观察

目的:观察局部氧疗治疗新生儿尿布性皮炎的疗效。方法:将98例患尿布性皮炎新生儿随机分为观察组49例和对照组49例,两组患儿的常规治疗护理、健康教育方法相同,对照组根据红臀程度局部涂思密达、金霉素软膏;观察组患儿在此基础上,局部吹氧3次/d,10～15 min/次,比较两组患儿治愈率及愈合时间。结果:观察组疗效明显优于对照组,观察组患儿创面愈合时间为(2.75±0.62)d,治愈率77.55%,对照组创面愈合时间为(5.34±1.08)d,治愈率为51.02%,两组比较差异有统计学意义(P<0.05)。结论:对新生儿尿布性皮炎常规治疗前使用局部氧疗,疗效显著,可明显缩短愈合时间,减轻患儿痛苦,缩短住院时间;且此方法简便﹑经济、安全,无不良反应,治疗效果满意,值得临床推广应用。     

Viral hepatitis associated with day-care centers.

From September 1976 through March 1978, we investigated 11 outbreaks of non-B viral hepatitis associated with Louisiana day-care centers. The outbreaks included 168 cases, most of which were erroneously considered "sporadic" cases of non-B viral hepatitis prior to the investigations. Thirteen percent of all non-B viral hepatitis cases reported in the New Orleans metropolitan area during 1977 were associated with one of the outbreaks. Most of the cases in each outbreak and 85% overall were in older, usually adult, contacts of children attending the day-care centers. Within the household, parents appeared to be at greatest risk, particularly those who had 1- to 2-year-old children in the day-care center. Day-care center outbreaks of non-B hepatitis are easily overlooked and may be more widespread than is currently appreciated.     

玉溪市中心城区民营医院消毒灭菌质量监测分析

目的了解玉溪市中心城区民营医院消毒灭菌质量状况。方法采用现场采样和实验室检测方法监测玉溪市中心城区20家民营医院消毒灭菌质量。结果经连续3年监测消毒与灭菌总合格率为93.29%;2007～2009年的合格率依次为81.27%、95.72%和98.87%。使用中消毒液、物体表面、压力蒸汽灭菌器和灭菌物品合格率为100%,手术室空气合格率为93.47%,紫外线灯管辐照度合格率为87.95%,医护人员手合格率为79.35%。结论建议改善手术室空气消毒设备,完善洗手设施,加强培训,规范洗手,加强自主监测,提高医院消毒灭菌质量,保障医疗安全。     

The occupational risk of cytomegalovirus infection among day-care providers.

We prospectively studied day-care providers at six day-care centers in south-eastern Iowa to determine their occupational risk for primary cytomegalovirus infection and to define epidemiologic risk factors. Ninety-six (38%) of 252 day-care providers were seropositive for cytomegalovirus by latex agglutination at entry into the study. Among 82 seronegative providers available for follow-up, seven seroconversions occurred at only two of the six participating centers, yielding an annualized seroconversion rate of 7.9%. Median time to seroconversion among these providers was 13 months. Using Kaplan-Meier estimates of risk, we determined that the overall risk of seroconversion among providers at various centers ranged from 0% to 22% by 12 months and from 0% to 40% by 16 months. Risk of cytomegalovirus acquisition by providers was independent of race, age, education, the presence of a child at home, or caring for children younger than 2 or 3 years in the day-care center. However, the risk of seroconversion among day-care providers appeared to parallel rates of cytomegalovirus excretion and acquisition among children at each center.