Acinetobacter are important emerging nosocomial pathogens. In this paper thirteen Acinetobacter baumanii from intensive care patients were isolated. These were initially typed using the API-20 NE biotyping system and antibiogram analysis. Results obtained using these methods failed to convincingly characterise the organisms. In this report a method to characterise these Acinetobacter baumanii isolates is described, which utilises a modified polymerase chain reaction (PCR), capable of generating genomic fingerprints, known as DNA amplification fingerprinting (DAF). Purified chromosomal DNA of cultured clinical isolates of Acinetobacter baumanii were subjected to DAF using the M13 universal sequencing primer. Polymorphic DNA bands produced, were visualised after agarose gel electrophoresis and ethidium bromide staining. Results demonstrated that six of the thirteen clinical isolates represented one group and a second group of two isolates displayed identical fingerprint patterns. The remaining four organisms were all unique. This genotype based method is rapid, simple, reproducible and may have potential as a means of specifically typing Acinetobacter spp. allowing the route(s) of nosocomial transmission to be identified and to assess the efficiency of instituted infection control measures.

Acinetobacter↗

PubMedDate not supplied

The provision of secondary cardiac prevention measures in a hospital cardiac clinic population and the relationship to psychological variables.

BACKGROUND: Implementing preventive measures in patients with established heart disease is one of the most effective health promotion activities, but there is little research on the relationship between cognition and secondary preventive behaviour. AIM: To determine the provision of secondary cardiac prevention measures among patients with established heart disease attending a cardiac outpatient clinic. METHODS: The study was conducted in an outpatient department over a 14-week period in 1999. Management of risk markers was noted from the medical records and lifestyle and psychological variables were self-reported. RESULTS: Of 294 patients with heart disease, 41% were available for study. Fourteen per cent were current smokers, one-quarter of males and one-third of females had a body mass index (BMI) greater that 30. Almost 90% attend their GP bimonthly, 67% had a normal systolic and 88.3% a normal diastolic pressure, 34% had normal cholesterol levels and 75% were on aspirin. Lifestyle variables were significantly affected by patient cardiac knowledge, sense of control over their heart disease and perceptions of their illness. CONCLUSIONS: These results highlight the potential health gain available to patients with established heart disease. The results also suggest that psychological factors may play a role in patients' health behaviours.

Coronary Disease↗

PubMedDate not supplied

Primary abdominal wall clear cell carcinoma arising in a Caesarean section scar endometriosis.

BACKGROUND: Endometriosis occurring in a surgical scar is well recognized and occurs mainly in patients with a history of hysterectomy or Caesarean section. Scar endometriosis, as well as endometriosis at other sites, can undergo malignant change. Endometrioid carcinoma is the most common malignant tumour arising in endometriosis. However, clear cell carcinoma can also occur but is unusual. AIM: To discuss the diagnosis and management of such a case. METHODS: We report a case of primary clear cell carcinoma in endometriosis of a Caesarean section scar and review the literature. RESULTS: The patient presented with a large right lower quadrant abdominal wall mass within a Caesarean section scar. Histological examination revealed a clear cell carcinoma. The patient had a prior history of pelvic endometriosis. According to the Irish National Cancer Registry, this is the first reported case of a primary abdominal wall clear cell carcinoma developing within a Caesarean section scar in Ireland. CONCLUSION: Any lesion occurring in a Caesarean section scar with a history of previous endometriosis cannot be underestimated and warrants careful clinical follow-up and histological evaluation as appropriate.

Adenocarcinoma, Clear Cell↗

PubMedDate not supplied

Testing a participatory strategy to change hygiene behaviour: face washing in central Tanzania.

A participatory strategy to increase face washing was designed and tested in central Tanzania. Changing children's face-washing behaviour is postulated to be important in preventing the transmission of eye disease, particularly blinding trachoma. The strategy used non-formal adult education techniques at neighbourhood level meetings to build a community consensus to keep children's faces clean for the prevention of eye disease. Men, women, schoolchildren, traditional healers and village social groups participated in the intervention. The strategy was evaluated by observing changes in numbers of clean faces of a sample of preschool children in the village. Clean faces increased from 9% to 33% over the course of a year. Factors which were related to sustained change in children's clean faces included distance to water, age of the child, and presence of a corrugated metal roof. Owning cattle was associated with lack of sustainable change in this population.

Baths↗

PubMedDate not supplied

Evaluation of barriers to surgical compliance in the treatment of trichiasis.

PURPOSE: Eyelid repair surgery can prevent the effects of trichiasis leading to visual loss. Cost, transportation difficulties, and familial responsibilities have been identified as major barriers to surgical compliance. We evaluated whether offering trichiasis surgery in the village was effective in increasing the rate of surgical acceptance and in decreasing perceived barriers to surgery. METHODS: In 1989, 205 women with trichiasis were identified in Central Tanzania and were offered free surgery along with free transport. As of 1991, only 18% of these women had undergone the surgery. We followed-up these women 7 years later after village level surgery was introduced. RESULTS: Since 1991, an additional 12% of the women had undergone eyelid surgery. 44% were conducted in the village. Surgical cases since 1991 reported shorter travel times to the place of surgery, similar post-surgical problems, and fewer days in the hospital. While providing benefits to the patient, increased village eye services did not increase the rate of surgical acceptance. The women who declined surgery did not know surgery in the village was available and the perceived cost and transportation difficulties continued to be barriers. 50% of the non-acceptors stated that there was nothing that would enable them to accept surgical intervention despite the fact that 3/4 of them reported eye symptoms that interfered with their daily activities. CONCLUSIONS: The cost efficacy of village level eye services needs to be evaluated and the awareness of these services increased.

Cost-Benefit Analysis↗

PubMedDate not supplied

The mutational meltdown in asexual populations.

Loss of fitness due to the accumulation of deleterious mutations appears to be inevitable in small, obligately asexual populations, as these are incapable of reconstituting highly fit genotypes by recombination or back mutation. The cumulative buildup of such mutations is expected to lead to an eventual reduction in population size, and this facilitates the chance accumulation of future mutations. This synergistic interaction between population size reduction and mutation accumulation leads to an extinction process known as the mutational meltdown, and provides a powerful explanation for the rarity of obligate asexuality. We give an overview of the theory of the mutational meltdown, showing how the process depends on the demographic properties of a population, the properties of mutations, and the relationship between fitness and number of mutations incurred.

Biological Evolution↗

PubMedDate not supplied

Congenital heart disease: assessment and case-finding by community health nurses.

Explore the source record for details and available documents.

Community Health Nursing↗

PubMedDate not supplied

Continuing education: bronchopulmonary dysplasia: management after discharge.

Nowhere is the pediatric home health care nurse's knowledge, guidance, and support more crucial than in helping with home management of babies with bronchopulmonary dysplasia, a syndrome of infancy that closely resembles chronic lung disease in adults.

Bronchopulmonary Dysplasia↗