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Biomedical subjects

R H George

Publications and source records attributed to R H George.

At least 19 recordsLinked to original sources
PubMed1991

Staff training: a key factor in reducing intravascular catheter sepsis.

A children's hospital nutritional care team prospectively monitored the frequency of sepsis in central venous catheters used for administering parenteral nutrition. During an initial study period of 12 months, 26/58 (45%) of catheters were removed because of proved sepsis. The possible causes of this alarmingly high rate were examined, with catheter care techniques on the wards coming under particular scrutiny. As a result protocols were modified and an intensive staff training programme implemented throughout the hospital, led by the nutritional care sister. Subsequently, the catheter sepsis rate was significantly reduced with only 9/107 (8%) of consecutive catheters becoming infected. These findings emphasise the key role that education of staff plays in controlling central venous catheter sepsis and the importance and cost effectiveness of special nursing staff in implementing such measures.

Asepsis↗
PubMed1990

Dietary management of D-lactic acidosis in short bowel syndrome.

Manipulation of carbohydrate intake was used to treat severe, recurrent D-lactic acidosis in a patient with short bowel syndrome. Dietary carbohydrate composition was determined after assessment of D-lactic acid production from various carbohydrate substrates by faecal flora in vitro. This approach may be preferable to repeated courses of antibiotics.

Acidosis, Lactic↗
PubMed1988

The prevention and control of mycobacterial infections in hospitals.

Infections resulting from contamination of medical equipment and medications with opportunistic mycobacteria are reviewed and the mode of spread discussed. The prevention of Mycobacterium tuberculosis in patients and staff, by the implementation of occupational health schemes, infection control policies and disinfection policies is also reviewed. The problems relating to immunocompromised patients are also discussed.

Cross Infection↗
PubMed1988

Evaluation of use of Signal system of blood culture in paediatrics.

A new method of blood culture, the Signal system (Oxoid), was assessed in paediatric practice. Isolation rates of pathogens, frequency of contamination (false positive results), and time taken to detect positive cultures were analysed. Four hundred and seventy nine organisms were isolated from 457 of 3000 cultures collected, of which 283 organisms were considered to be clinically important. The overall rate of positive cultures was 15.2%, and clinically important organisms were isolated from 9.1%, giving an overall contamination rate of 6.1%. The rate of contamination with Gram positive bacilli was 1.1% and coagulase negative staphylococci 4.2%. Over 51.6% of all isolates were detected within 24 hours, 81% within 48 hours, and 86% within three days: 91.1% of clinically important organisms were isolated within three days. Unimportant organisms tended to give a delayed signal, although this sometimes occurred with Candida spp, Klebsiella spp, Pseudomonas spp and a small number of other such organisms. Four hundred and forty nine of the 457 positive cultures gave a visible signal. Six of seven isolates of Haemophilus influenzae failed to give a signal, as did two coagulase negative staphylococci. The Signal system is a convenient and cost effective method of blood culture.

Adolescent↗
PubMed1987

Oral candida: is dummy carriage the culprit?

Oral candida in subjects who sucked dummies was almost double that of controls. Although the carriage of Candida albicans on silicone dummies was significantly reduced compared with latex dummies, oral colonisation was unaffected, suggesting that dummy carriage is not the cause of the observed increase.

Candidiasis, Oral↗
PubMed1986

An outbreak of tuberculosis in a children's hospital.

A 3-year-old girl was admitted to a children's hospital; subsequently her mother was found to have pulmonary tuberculosis with smear-positive sputum. Of over 400 patients, their families and staff at risk in the hospital, 30 inpatients, three outpatients, two sibling visitors and one staff member became infected. A retrospective cohort study of exposed inpatients identified exposure duration, exposure proximity and primary diagnosis as independent predictors of infection risk. Children with neoplastic disease who were being treated with cytotoxic and immunosuppressive therapy with clotting factors were at a greater risk of developing clinical disease including disseminated infection. Altogether three generations of infected children and adults were diagnosed amongst community and hospital contacts in this extended outbreak. These findings support current recommendations for the follow-up of highly susceptible casual contacts of cases of pulmonary tuberculosis with smear-positive sputa.

Adult↗
PubMed1986

Candida albicans arthritis in an infant.

Candida albicans arthritis, preceded by peritonitis and septicaemia arose in an infant following cardiac surgery. Details of the case are described. Diagnosis and management of this condition are discussed.

Amphotericin B↗
PubMed1986

Ten years' experience of Haemophilus influenzae infection at Birmingham Children's Hospital.

A survey of serious infections due to Haemophilus influenzae, in the years 1973-1984, was made at the Birmingham Children's Hospital. Eight-three cases were recorded, comprising 42 of meningitis, 18 of septicaemia, 16 of epiglottitis and seven of septic arthritis or osteomyelitis. The mortality rate for meningitis and septicaemia was 5%, but no child with epiglottitis or septic arthritis died. The data are compared with those of American studies. The incidence of severe haemophilus infection in the inner city area of Birmingham was estimated to be at least 1 in 950 children during the period of the study.

Arthritis, Infectious↗
PubMed1986

Improving survival in bacterial endocarditis.

Twenty six cases of bacterial endocarditis in infancy and childhood were treated with a mortality of less than 8%. Twenty two had recognised congenital heart disease and four had previously normal hearts. Thirteen out of the 24 cases with positive blood cultures had staphylococcal infection. Appropriate antibiotics were identified by measurement of the minimum bactericidal concentration as an indicator of antibiotic sensitivity. The bactericidal activity of the patient's serum during treatment was monitored by back titration against the causative organism to assess the optimal antibiotic combination and dosage. Treatment was continued for six weeks in most cases, comprising intravenous treatment for at least the first three weeks, but then being substituted with oral treatment in some. Twenty one cases were successfully treated medically. Five developed complications requiring surgery, two of whom died.

Administration, Oral↗