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Biomedical subjects

W M Valenti

Publications and source records attributed to W M Valenti.

At least 19 recordsLinked to original sources
PubMed1986

Infection control and the pregnant health care worker.

Health care workers may be exposed to a variety of infectious agents in the workplace. The pregnant health care worker presents additional concerns because of the potential risk of infection to the developing fetus. Health care workers often misunderstand the basic elements of infection transmission. The result of this misinformation is that personnel are most often concerned about the agents that are least transmissible. To develop an infection control program that is rational and workable, the infection control practitioner must have a thorough understanding of the mechanisms of disease transmission. With this foundation, an infection control program for the pregnant health care worker will rarely involve transfer to alternative assignments or work restriction based on pregnancy alone. The approach outlined in this article stresses a more generic approach to infection control by isolating the disease and not the employee.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Systemic antibiotic use in nursing homes. A quality assessment.

In this evaluation of the prevalence and quality of systemic antibiotic use in nursing homes, 42 skilled nursing facilities (SNFs) and their 11 attached intermediate care facilities (ICFs) were surveyed. A random sample of 2238 patients (51%) from the total of 4378 beds was selected and of these, 7.7% of the total (8.6% of the SNF and 4.5% of the ICF) patients were on systemic antibiotics on the day of the survey. The most common suspected sites of infection were urinary tract (58.4%), lower respiratory tract (19.1%), and skin or subcutaneous tissue (4.6%). Criteria for appropriateness of initiating systemic antibiotics, for adequacy of initial diagnostic workup, and for appropriate specific antibiotics were developed by the authors, with input from a group of medical directors of nursing homes, based on Centers for Disease Control and Federal Drug Administration guidelines. Evidence to start an antibiotic was judged adequate in 62.4% of cases. Workups were considered inadequate in a high proportion of cases. For example, urinalysis was ordered in only 23.8% and urine culture in 57.4% of suspected urinary tract infections; chest x-ray was ordered in 24.2% and sputum culture in 3.0% of suspected lower respiratory infections. Recommendations are made as to minimum adequate workup for suspected infections and appropriate evidence to justify start of a systemic antibiotic, recognizing the limitations in diagnostic modalities in the nursing home setting and the special problems of their resident populations.

Aged↗
PubMed1985

Update on AIDS.

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Acquired Immunodeficiency Syndrome↗
PubMed1985

Prevention and control of tuberculosis.

Programs for tuberculosis prevention in health care workers can be complex and often raise questions and controversies among employee health and infection control practitioners alike. Although tuberculosis is declining in incidence in the US, preventive programs for health care workers will continue to be a part of employee health programs. As with other aspects of infection control, the practitioner must develop and modify the program to reflect the state of the art and current thinking in tuberculosis prevention and control.

BCG Vaccine↗
PubMed1985

AIDS update Part 2.

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Acquired Immunodeficiency Syndrome↗
PubMed1980

Clostridium perfringens wound infection associated with elastic bandages.

Clostridium perfringens wound infections were associated with the use of nonsterile elastic outer bandages in diabetic patients who had undergone lower extremity amputation for vascular insufficiency. In each case a second surgical procedure was required. Elastic bandages similar to those used in these procedures were found to contain C perfringens and other clostridial species. This report illustrates the need for maintenance of a sterile, nonpermeable inner barrier to prevent transudation of bacteria into the wound and the potential benefit of using sterile elastic outer bandages after amputation for vascular insufficiency.

Aged↗
PubMed1978

Factors predisposing to oropharyngeal colonization with gram-negative bacilli in the aged.

To assess the factors responsible for oropharyngeal colonization with gram-negative bacilli among elderly persons in institutions, we performed a cross-sectional survey of 407 volunteers, 65 years of age and older, who had not received antimicrobials in the previous four weeks. Colonization increased with level of care: from 9 per cent in independent residents of apartments to 60 per cent in patients on an acute hospital ward (P less than 0.0001). Klebsiella species was found in 41 per cent of those with colonization, Escherichia coli in 24 per cent and enterobacter species in 14 per cent. There was no association between numbers of normal flora and numbers of gram-negative bacilli. Associated with colonization were bladder incontinence, deteriorating or terminal clinical status, inability to walk or perform activities of daily living and incapacitation due to neoplastic, respiratory and cardiac disease (P less than 0.05). Multivariate analysis indicated that respiratory disease and being bedridden contributed most to colonization.

Activities of Daily Living↗