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At least 883 records · Page 49Linked to original sources
PubMed2005

Average annual risk of tuberculous infection in India.

Estimates of the prevalence of tuberculous infection among children 1-9 years of age were available for four defined zones of India from a recently concluded tuberculin survey. These were pooled together and the average annual risk of infection in the country was computed as 1.5%. It was higher in urban areas, at 2.2%, than in rural areas, at 1.3%. The results call for further intensification of tuberculosis control activities, especially in urban areas, greater involvement of private practitioners and information, education and communication (IEC) for high-risk groups, to reduce the diagnostic and treatment delay thereby reducing the transmission of infection in all settings.

Child↗
PubMed2003

[Rickettsiosis: state of the art at the turn of the 21st century].

Information about changes in the modern taxonomy of intracellular bacteria conditionally united within the nomination of "Rickettsioses" is presented in the paper. Due to a total hobby related with keeping home animals (pets), cats and dogs, apart from the cattle, joined the natural ecological cycles of rickettsioses stimulation. The morbidity of rickettsioses of the acaroid group has been persistently growing; like in case with other pathologies (Lyme's disease) involving the acaroid transfer factor, its obvious "urbanization" is pronounced. Absolute and relative morbidity indices in respect to rickettsioses, which are epidemiologically important for Russia, are presented. The modern knowledge database concerning the rickettsioses makes it possible to control the epidemic process for this infection category. It is noteworthy, that Prowazek's rickettsiosis of its both forms (i.e. the epidemic and relapsing ones), which does not have an independent cycle of circulation of its stimulator in wild nature, and unlike the acaroid group rickettsioses, turned into a socially controllable infection. It will be totally eliminated, during 10-15 years, both in Russia and the CIS countries. The practitioners are well supplied with a variety of drugs of tetracycline and fluorine-quinol groups, which makes it possible to arrest the infection process in patients rapidly and effectively and to prevent the lethal cases. A low incidence rate of rickettsioses, including Q fever, within the general infection morbidity, and taking into consideration the availability of methods for effective therapy and prevention, makes one consider a comprehensive vaccination against the discussed group of infections to be irrational. Obviously, such vaccination must be still applied in respect to a limited number of persons from among high-risk groups and for two or three varieties of rickettsioses only (i.e. Prowazek's rickettsioses, Rocky Mountain spotted fever and Q fever). Live vaccines, obtained on the basis of attenuated and recombined strains (which have a full-scale set of specific antigens), are recommended.

Animals↗
PubMed1999

[Lipoprotein profile of patients infected with HIV in Côte d'Ivoire].

Aids is a cachexysing disease which is striking Africa. Côte d'Ivoire with its 12% seroprevalence is paying a heavy tribute to this pandemia. The course of the disease is characterized by the occurrence of immunological and biochemical disorders. The aim of this study is to offer African practitioners, clinicians and biologists some biochimical parameters that would help them to follow up people infected with HIV. The authors determined the lipoprotein profile in 204 people (112 Aids patients, 61 HIV infected asymptomatics and 31 controls seronegative to HIV), of both sexes aged 17 to 70 years old. The results show a relatively high level of triglyceridemia, a decreased level of total cholesterol, apoproteins A1 and B and a hypergammaglobulinemia with concomitant and significant increase in the level of orosomucoide as a stigmate of inflammation. These data could help practitioners who lack CD4/CD8 count and viral load monitoring in the follow up of their AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Minimizing the impact of drug-resistant Streptococcus pneumoniae (DRSP). A strategy from the DRSP Working Group.

Emergence of drug-resistant Streptococcus pneumoniae (DRSP) presents a challenge to the medical and public health communities since the magnitude of the problem is not known, the clinical impact of DRSP infections is not well described, national vaccination rates are low, and antimicrobial drugs are often used excessively and inappropriately. To address the problem of DRSP, a working group by Centers for Disease Control and Prevention was formed in June 1994 consisting of public health practitioners, health care providers, and clinical laboratorians representing state and federal agencies and various professional organizations. Through periodic open meetings, the working group has developed a strategy for surveillance, investigation, prevention, and control of infections due to DRSP. The strategy focuses on (1) implementing an electronic laboratory-based surveillance (ELBS) system for reporting invasive DRSP infections and providing clinically relevant feedback to clinicians, (2) identifying risk factors and outcomes of DRSP infection, (3) increasing pneumococcal vaccination, and (4) promoting judicious antimicrobial drug use. Data received through ELBS will be used to make timely estimates of the community-specific prevalence of drug-resistant pneumococci. National, regional, and local trends will be made available to health care providers and clinicians to promote optimal antimicrobial drug use and increased vaccination in targeted areas. Once in operation, the ELBS network will be adaptable to other diseases, improving the comprehensiveness and timeliness of public health surveillance. The intended outcome of the strategy is to reduce complications of DRSP infection, such as long-term sequelae of infection, health care expenditures, morbidity, and mortality.

Anti-Bacterial Agents↗
PubMed1992

Survey of the treatment of Chlamydia trachomatis infection of the female genital tract.

A questionnaire was sent to every tenth (n = 302) general practitioner in Norway. The physicians were to indicate their choice of antibiotic regimen for the treatment of genital chlamydial infections in women. Sixty-nine percent of the practitioners responded. The choice of treatment varied widely between the respondents. Forty-two different regimens were used for chlamydial cervicitis, 34 for cervicitis in pregnancy and 63 for probable pelvic infection. Of the prescribed treatments for these three diagnoses 14%, 5% and 46%, respectively, were compatible with the advice of the World Health Organization or the Centers for Disease Control. For the three previously mentioned diagnoses 49%, 79% and 43%, respectively, of the practioners would prescribe an antibiotic in either smaller doses, fewer daily doses or shorter duration than recommended. There is an urgent need to improve and standardize Norwegian general practitioners' treatment of chlamydial infection in women.

Anti-Bacterial Agents↗
PubMed2002

Is roxithromycin better than amoxicillin in the treatment of acute lower respiratory tract infections in primary care? A double-blind randomized controlled trial.

OBJECTIVE: To assess the efficacy of roxithromycin relative to amoxicillin. STUDY DESIGN: We conducted a double-blind randomized controlled trial of oral 500 mg amoxicillin 3 times per day vs oral 300 mg roxithromycin once a day for 10 days. POPULATION: We included 196 adults who had presented to a general practitioner with lower respiratory tract infection (LRTI) and, in the physician's opinion, needed antibiotic treatment. OUTCOMES MEASURED: We measured clinical response after 10 and 28 days, defined in 4 ways: (1) decrease in LRTI symptoms; (2) complete absence of symptoms; (3) decrease in signs; and (4) complete absence of signs. Self-reported response included the decrease in symptoms and the time until resumption of impaired or abandoned daily activities on days 1 through 10, 21, and 27. RESULTS: Clinical cure rates after the completion of antibiotic treatment (10 days) were not significantly different for the 2 groups. After 28 days, the roxithromycin group showed no increase in cure rate as evidenced by the decrease in symptoms, indicating a significantly lower cure rate. However, this difference did not alter physicians' overall conclusion after complete follow-up that 90% of patients, regardless of age, had been effectively treated with either amoxicillin or roxithromycin. CONCLUSIONS: The surplus value of roxithromycin was not confirmed. Amoxicillin remains a reliable first-choice antibiotic in the treatment of LRTI in general practice.

Adult↗
PubMed1992

Is mouthrinsing before dental procedures worthwhile?

Without adequate protection, dental practitioners risk infection from microorganisms from patients' mouths. The authors discuss the role of pre-procedural mouthrinses in the infection control process.

Anti-Infective Agents, Local↗
PubMed1989

The prevention of cross-infection. Progress in the West Midlands.

A questionnaire was sent to a group of general dental practitioners in the West Midlands, one year after they had participated in a previous survey and a year following publication of the British Dental Association's 'Guide to blood-borne viruses and the control of cross-infection in dentistry'. Results show that awareness of the need to safeguard patients and staff from the risks of cross-infection continues to grow and that procedures undertaken to reduce the possibility of cross-infection continue to be improved.

Attitude to Health↗
PubMed2004

Genital Chlamydia trachomatis infection in Australia: epidemiology and clinical implications.

Over the last decade, notification rates for genital Chlamydia trachomatis infection in Australia have been rising progressively. While chlamydia is common and possibly increasing in the general population, heterosexual adolescents, indigenous Australians in remote settings, and homosexually active men are at particular risk of infection. Few studies are available on the extent of morbidity from chlamydia-associated diseases. Australia urgently needs a national strategy to control chlamydia, with widespread, selective screening as a key component. As general practitioners have an important role to play, we proffer guidelines for selective testing in primary care.

Australia↗
PubMedDate not supplied

Hazards of gloves in dentistry.

Concerns about AIDS, hepatitis and infection control have increased the use of gloves in medical and dental practice. Though generally assumed to be protective, gloves pose many hazards to the practitioner and patient. This is especially significant in dentistry where a large assortment of materials and manipulative techniques are used as part of treatment. Gloves, with relatively large porosities, are poor barriers to viruses. They can promote bacterial growth, skin lesions, toxic and allergic reactions in patient and staff. Gloves are costly, time consuming to use, reduce sensitivity and dexterity. Gloves do not protect the wearer from penetrating injuries, the leading source of HIV and HBV infections in health care workers. The use of gloves is helpful only in those cases where their advantages outweigh liabilities. Governmental regulations, requiring universal glove-wear compliance, may not be in the best public or professional interest.

Dental Care↗
PubMed2002

A survey of the use of matrix bands and their decontamination in general dental practice.

AIMS: The aims of this study were to determine the pattern of use and re-use of matrix bands in general practice in Scotland, to demonstrate which type of matrix band is most commonly used and to examine infection control measures of relevance to the safe use and re-use of matrix bands. MATERIALS AND METHODS SUBJECTS: 621 of Scotland's 1,849 general dental practitioners were randomly selected. DATA COLLECTION: A 19-item self-reported questionnaire was mailed in June 1999 with a follow-up mailing sent in August 1999. ANALYSIS: Data analysis involved descriptive statistics and cross-tabulation. Where appropriate, differences between categories were tested for significance by a Chi-square test. RESULTS: A total of 479 questionnaires were returned, representing a response rate of 77%. Reported compliance with routine glove wearing was high (91%). Most dentists (92%) provided training on instrument cleaning and sterilisation for their dental nurses. Ultrasonic baths were used by 59% of practitioners; the remainder soaked or manually scrubbed instruments to remove debris before autoclaving. The Siqveland matrix was the matrix of choice for 96% of respondents. 7% provided a new matrix band for each patient. Most (64%) changed bands only when they were bent or damaged; 29% changed them daily or weekly. Deterrents to use of a new band for each patient were cost (39%) and time (52%). A total of 54% of respondents considered matrix band replacement unnecessary between patients. CONCLUSIONS: The Siqveland matrix band is the most popular among the study group of dental practitioners. Re-use of matrix bands is common. Guidelines for the safe re-use of matrix bands are required.

Attitude of Health Personnel↗
PubMed1987

Hepatitis B in general practice: epidemiology, clinical and serological features, and control.

In an outbreak of hepatitis B virus infection in a south Wales village 31 cases were identified over 16 months. Spread of the infection was by sharing needles and by sexual contact. Twenty seven patients were known to have symptoms, of whom nine had an anicteric illness. Generally the illness was mild with no deaths, and there was only one chronic carrier. Two patients were only transiently positive for hepatitis B surface antigen. The outbreak was controlled by vigorous contact tracing and counselling. Despite an enormous increase in workload for the general practitioner and problems including disposal of contaminated needles, outbreaks of hepatitis B virus infection may adequately be treated in the community.

Carrier State↗
PubMed2002

Understanding variation for clinical governance: an illustration using the diagnosis and treatment of sore throat.

BACKGROUND: The aim of clinical governance is to improve clinical care. An understanding of the information contained in variation is central to any improvement effort. We must distinguish between variation intrinsic to a process (common cause variation) and variation caused by extrinsic factors (special cause variation). The control chart is a method of distinguishing between these two kinds of variation: it is used in industry to effect improvement and may be useful in primary care. AIM: To illustrate the use of control charts to distinguish between common cause and special cause variation and to guide appropriate action. DESIGN OF STUDY: Analysis of diagnostic and treatment decisions for sore throat. SETTING: Single practice in the West Midlands. METHODS: We identified each general practitioner's (GP's) consultations for sore throat over a two-year period. We grouped these into two diagnostic categories (tonsillitis and non-tonsillar throat infection) and two treatment categories (antibiotics and no antibiotics). These data were illustrated graphically as XY control charts. RESULTS: In this practice, a special cause affects one GP's diagnosis--he is less likely to use the term 'tonsillitis'. A special cause also affects his treatment decisions--he is more likely to prescribe antibiotics. Diagnostic and treatment differences between the remaining GPs are consistent with common cause variation. CONCLUSION: In this practice, action to improve the quality of diagnosis and treatment of sore throat shouldfocus on investigating why one practitioner's diagnosis and treatment differs from that of his colleagues. Control chart analysis is valuable because it enables users to obtain practical guidance for action.

Decision Making↗
PubMedDate not supplied

Study of KAP of the private medical practitioners about national disease control programmes.

This study was carried out among the Private Allopathic Medical Practitioners (PMPs) at Khardah Municipal area (West Bengal) to find out their perception & practice about management protocol of diseases like acute respiratory infections and diarrhoel diseases in children, malaria and tuberculosis. Data was collected by interviewing the PMPs with pre-designed open-ended questionnaire. It was supplemented by analysing sample prescriptions of the same diseases. The study revealed that PMPs knowledge and practice were not at par with national guidelines. The need for periodic sensitization of PMPs regarding national disease control programme was emphasized.

Child↗
PubMed2003

Travel epidemiology: the Saudi perspective.

The Kingdom of Saudi Arabia occupies four-fifths of the Arabian Peninsula, with a land area of 2 million square kilometres. Saudi Arabia holds a unique position in the Islamic world, as the custodian of the two holiest places of Islam, in Mecca and Medina. Annually, some 2 million Muslims from over 140 countries embark on Hajj. This extraordinary en masse migration is a unique forum for the study of travel epidemiology since the Hajj carries various health risks, both communicable and non-communicable, often on a colossal scale. Non-communicable hazards of the Hajj include stampede and motor vehicle trauma, fire-related burn injuries and accidental hand injury during animal slaughter. Communicable hazards in the form of outbreaks of multiple infectious diseases have been reported repeatedly, during and following the Hajj. Meningococcal meningitis, gastroenteritis, hepatitis A, B and C, and various zoonotic diseases comprise some of the possible infectious hazards at the Hajj. Many of these infectious and non-infectious hazards can be avoided or averted by adopting appropriate prophylactic measures. Physicians and health personnel must be aware of these risks to appropriately educate, immunize and prepare these travellers facing the unique epidemiological challenges of Hajj in an effort to minimize untoward effects. Travel epidemiology related to the Hajj is a new and exciting area, which offers valuable insights to the travel specialist. The sheer scale of numbers affords a rare view of migration medicine in action. As data is continually gathered and both national and international policy making is tailored to vital insights gained through travel epidemiology, the Hajj will be continually safeguarded. Practitioners will gain from findings of travel related epidemiological changes in evolution at the Hajj: the impact of vaccinating policies, infection control policies and public health are afforded a real-world laboratory setting at each annual Hajj, allowing us to learn from this unique phenomenon of migration medicine.

Animals↗
PubMed1992

Urinary IgG antibody against mixed heat-killed coliform antigen and lipopolysaccharide core antigen.

AIMS: To determine whether antibody to lipopolysaccharide-core (LPS-core) antigen is an important component of the antibody, detected by mixed heat-killed coliform antigen, in urine from patients with suspected urinary tract infection. METHODS: LPS-core antigen and mixed heat-killed coliform antigen were used in an enzyme linked immunosorbent assay (ELISA) to measure IgG antibody in midstream urine samples. Seventy two samples from students attending their general practitioner with symptoms suggestive of urinary tract infection, six samples from which a Gram positive organism was isolated, and 16 asymptomatic controls were tested. Plates coated with LPS-core antigen were also used to absorb out the antibody detected by the mixed heat-killed coliform antigen. RESULTS: Antibody to either antigen was associated with a positive culture, but neither was a useful predictor of a positive culture. There was a significant correlation between the results of the two assays (r = 0.7633; p less than 0.001), and absorption with LPS-core antigen did reduce the level of antibody to the mixed heat-killed coliform antigen. Antibody to both preparations was found in patients with Gram positive urinary tract infection. CONCLUSION: Antibody to LPS-core antigen forms a substantial part of the antibody detected by mixed heat-killed coliform ELISA. The antibodies detected by these assays are probably the result of non-specific leakage of antibody into the urine, rather than a specific immune response.

Antibodies, Bacterial↗
PubMed1993

Controversies in cross-infection control.

The following article is intended to question certain procedures designed to prevent cross-infection. It is the first of a series of occasional articles describing new techniques, research, and new products, which it is hoped, may enable dental practitioners to update their knowledge of this rapidly changing subject.

Cross Infection↗