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Preventive Measures (preventive + measure)
Kinds of Preventive Measures Selected AbstractsEmergence of Salmonella paratyphi A as a Major Cause of Enteric Fever: Need for Early Detection, Preventive Measures, and Effective VaccinesJOURNAL OF TRAVEL MEDICINE, Issue 5 2008Monthida Fangtham MD First page of article [source] The prevention of deep venous thrombosis in physically restrained patients with schizophreniaINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 8 2010M. De Hert Summary Background:, Physical restraint and seclusion are associated with several risks. Antipsychotic drug use increases this risk. Objective:, To evaluate whether the risk of thromboembolism in physical restraint and seclusion of patients with psychosis, treated with antipsychotic medication, was considered by taking preventive measures. Method:, Anonymous data on all consecutively admitted patients with schizophrenia, treated with antipsychotic medication, between 2002 and 2009, were analysed. Diagnostic information and data about seclusion procedures and medication were collected. Preventive measures of thromboembolism in patients in physical restraint were assessed by reviewing case notes and the medication prescribed at the time of seclusion. Results:, Seclusion of patients with psychosis is common. Out of 679 identified patients, 170 had been secluded (472 events). Physical restraint use was not a rare event (N seclusions with restraint use 296, 62.7%). Pharmacological preventive measures (use of heparine dugs) were taken frequently to prevent deep vein thrombosis (DVT) by physical restraint or isolation. Sixty-five (38.2%) out of 170 secluded patients, including a majority of patients who had been under physical restraint, had been administered anticoagulants at the time of seclusion. No cases of DVT occurred. Conclusions:, Preventive measures were routinely administered in clinical practice and were effective in the prevention of DVT. For a clinical setting, it is important to establish a clear and detailed management plan on seclusion and fixation taken into account in all possible risks of physical restraint. [source] Burns to persons suffering from diabetes: a systemic preventive approachJOURNAL OF NURSING AND HEALTHCARE OF CHRONIC ILLNE SS: AN INTERNATIONAL INTERDISCIPLINARY JOURNAL, Issue 2 2009MScN (edu), Ma'en Zaid Abu-Qamar Dnurs Aims. To report the findings of an investigation of patients with diabetes and burns, with emphasis on implications for practice: primary and secondary preventions. Background. Diabetes and burns are complex conditions with multi-system involvements, which worsen outcomes for patients, and their management. This research investigated outcomes for patients and diabetes management. Methods. Data on outcomes were obtained from records of patients hospitalised for foot burns in an Australian hospital from 1999,2004. A questionnaire survey design was employed to obtain information on how clinicians in burns units manage diabetes. SPSS was used to analyse data obtained from both resources. Comments written in the questionnaire were analysed using relational analysis. Results. Of the 64 patients, 12 were with diabetes and 52 were without diabetes. Those with diabetes were more likely to sustain contact foot burns (58·3% Diabetes Mellitus vs. 13·5% non Diabetes Mellitus ,2 = 11·487, p = 0·002). The duration of hospitalisation was statistically significantly longer among patients with diabetes compared with those without diabetes (U = 169, p = 0·014); although the two groups were not statistically significant different in terms of severity of burns and received treatment. Of the 29 clinical leaders, 21 (72%) indicated that they regularly provided care to patients with diabetes. Most respondents (n = 15; 58%) reported that new plans need to be initiated to accommodate the combined insult of diabetes and burns. Diabetes centres were located in all participating sites; but not always involved in the process of care. Conclusion. The co-existence of diabetes and burns worsens outcomes for patients, and complicates management plans. Optimal management can be achieved via a multidisciplinary approach starting with glycaemic control, and continued to aggressive management of diabetes and burns. Relevance to clinical practice. Preventive measures should start with tight glycaemic control, identification and avoidance of sources of trauma, early detection and treatment, and continue to aggressive inpatient management of patients with both diabetes and a burn injury. [source] Risk factors of scabies in psychiatric and long-term care hospitals: A nationwide mail-in survey in JapanTHE JOURNAL OF DERMATOLOGY, Issue 9 2009Kuniko MAKIGAMI Abstract Despite the commonness of scabies in Japanese institutional settings, the nationwide prevalence of scabies has not been elucidated. This study was conducted to assess the prevalence of scabies and control measures in Japanese hospitals. A questionnaire on scabies epidemiology (e.g. number of patients and onsets of outbreak) and preventive measures were sent to psychiatric hospitals and long-term care hospitals nationwide (n = 1795) in January 2005. Seven hundred and forty-one hospitals responded (41.3%). Three hundred and thirty-three (44.9%) respondent hospitals had one or more scabies cases in 2004. Among 159 hospitals that had experienced scabies outbreak, only 32 of them reported cases of crusted scabies. Multivariate regression analysis showed that hospitals had a greater number of beds, and that acute- and long-term care wards were more likely to experience scabies onsets. Hospitals that compiled their infection control manuals on scabies, treated suspicious patients with scabicides without confirmed diagnosis, and performed skin checkup of inpatients were more likely to experience scabies cases. Infection control personnel should be aware that unrecognized crusted scabies can cause outbreaks. Higher patient turnover is a risk factor for scabies introduction into a hospital. Preventive measures against scabies, such as patient screening at admission and treating all suspicious patients without confirmed diagnosis, were not effective to avoid scabies introduction. [source] Ultrafiltration and Dry Weight,What Are the Cardiovascular Effects?ARTIFICIAL ORGANS, Issue 3 2003Article first published online: 2 APR 200, Bernd G. Stegmayr Abstract: Long-term prognosis in dialysis is poor compared to that in healthy control persons. A worsening of the prognosis is noted especially for patients who at initiation of dialysis have congestive heart failure, ischemic heart disease, or left ventricular dysfunction or hypertrophy. This is the main reason that cardiovascular causes are the most common for morbidity in these patients. The weight obtained when normal urine output is present is the dry weight. With reduced ability to excrete the volume by the kidneys in end-stage renal disease (ESRD), the body will retain water and the patient will gain weight. This extra weight is due to volume overload. While volume overload may induce a rise in blood pressure, if the heart is in acceptable condition, a fast removal of fluid by ultrafiltration (UF) during dialysis may instead cause hypotension. Ultrafiltration failure in peritoneal dialysis (PD) patients may lead to successive water retention and overhydration with subsequent cardiac failure, while volume overload may occur over a few days in hemodialysis (HD) patients. Anemia or even too-high hematocrit may impair cardiac function further and worsen conditions caused by wrong dry weight. Thus, during long-term and sustained volume overload, left ventricular (LV) hypertrophy will occur in an eccentric manner. A sustained overload then may lead to cell death and LV dilatation and, eventually, systolic dysfunction. Once a severe left ventricular dilatation has developed, the blood pressure may decrease during volume overload. A worsened prognosis is seen if malnutrition and low albumin levels are present. Volume overload necessitates ultrafiltration to achieve dry weight. Thereby, volume contraction contributes to exaggerated stimulation of or response to activation of the RAS and alpha-adrenergic sympathetic systems. If ultrafiltration goes beyond these compensatory mechanisms, hypotension will occur and increase the risk for hypoperfusion of vital organs. Such episodes may cause cardiac morbidity, aspiration pneumonia, vascular access closure, or neurological complications (seizures, cerebral infarction), besides a more rapid lowering of residual renal function. Preventive measures are, first, finding the right dry weight; second, minimizing interdialytic weight gain; third, optimizing the target for hemoglobin (110,120 g/l); fourth, lowering dialysate calcium (1.25 mmol/l); and fifth, eventually using higher dialysate potassium if long dialyses are performed. [source] Prevention of occupational skin disease: a workplace intervention study in geriatric nursesBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2009M. Dulon Summary Background, Health care workers have an increased risk of occupational dermatosis. Objectives To determine whether a skin care programme reduces skin disease on the hands of geriatric nurses and increases protective behaviour and the provision of skin care products at the workplace. The intervention was based on a 2-h skin care training session and an occupational advisory service. Methods, The study design was a randomized intervention study with a control group. Three hundred and eighty-eight geriatric nurses were included in the intervention group exposed to a skin care programme (IG; n = 146) and in the control group (CG; n = 242). Both groups completed questionnaires on exposure and underwent clinical examinations of their hands at the beginning and after a 12-month period. Preventive measures initiated by the employer at the workplace were documented at baseline and at 3 months after the intervention. Results, At baseline, no difference between the IG and the CG was found with respect to skin changes or work-related behaviour. At follow-up, the frequency of skin disease was significantly reduced in the IG, from 26% at baseline to 17% at follow-up, whereas the frequency remained almost unchanged in the CG. Effects on behaviour in the IG included significant increases in the use of moisturizers and hand disinfection instead of hand washing. The provision of cotton gloves and barrier cream products increased at intervention workplaces. Conclusions, Effective implementation of an occupational skin care programme for geriatric nurses should include both the training of the nurses and an occupational advisory service for management. [source] Update on risk factors and future perspectives for preterm infantsACTA OPHTHALMOLOGICA, Issue 2009A HELLSTRöM Purpose To give an update on risk factors for retinopathy of prematurity with special focus on postnatal growth and growth factors Methods The relationship between birth weight, serum levels of IGF-I as well as postnatal longitudinal growth and ROP will be presented. Preventive measures will be discussed. Results Birth weight data on 451 infants demonstrated initially a significant difference in BW between different ROP stages but when taking gestational age and sex into account the significance was eliminated. Recently, a new diagnostic tool based on weekly neonatal measurements of body weight and serum insulin-like growth factor 1 (IGF-I) levels, was shown to be predictive for ROP development. The algorithm "Weight IGF-I Neonatal ROP" (WINROPÔ) predicted early (mean 10 weeks) all infants who later developed proliferative ROP requiring treatment. The WINROP algorithm was then taken one step further using only serial weight measurements (n=700), excluding blood sampling for measuring IGF-I. With this approach WINROP predicted all infants who later developed proliferative ROP requiring treatment (100% sensitivity) and correctly identified 75% of those who did not develop proliferative ROP, and thus would not need any ophthalmologic screening. We have also shown a close relationship between postnatal growth, severe ROP and poor brain development. Conclusion For decades, neonatal intensive care has focused on survival of the most immature babies. Time has come to find methods to ameliorate the nutrition for the children born very preterm. It is known that IGF-I is essential for growth and development of the immature vasculature of the eye. Intervention with substitution of IGF-I to the very preterm babies to raise IGF-I up to normal intrauterine levels might be beneficial. Commercial interest [source] Dental trauma incidence and mouthguard use in elite athletes in TurkeyDENTAL TRAUMATOLOGY, Issue 2 2005e Diljin Keçeci Abstract,,, Contact sports may lead to dental trauma, which often can be reduced with appropriate preventive measures. While numerous studies exist on this topic for several countries throughout the world, there is a lack of comprehensive descriptive studies in Turkey. The purpose of this study was to investigate the incidence and type of dental injuries associated with three different sports among Turkish elite athletes, who do not contact (volleyball), contact directly (taekwondo) or indirectly (handball) with competition rivals. Additionally, awareness and use of mouthguards were also compared. Thus, during the 2003 and 2004 Turkish National Championships in three sports, 50 taekwondo, 62 handball and 50 volleyball male athletes were interviewed by questionnaire. Results showed that taekwondo and handball athletes experienced significantly more dental trauma than volleyball athletes (P < 0.05). Twelve of the taekwondo (24%), 16 of the handball (26%) and four of the volleyball athletes (8%) experienced at least one type of dental injury. Awareness of mouthguards as a preventive measure against dental trauma was significantly higher among taekwondo and handball athletes (P < 0.05), although a very small percentage in either of these sports actually wore a mouthguard (10 and 0%, respectively). Trauma incidence between direct contact with rival competitors and indirect contact with rival competitors was not significantly different. The incidence of dental trauma in contact sports shows that the awareness and use of mouthguards must be intensified. Mouthguard use should be made compulsory, especially in those sports with high risk for dental trauma. [source] Injecting 1000 Centistoke Liquid Silicone With Ease and PrecisionDERMATOLOGIC SURGERY, Issue 3 2003Anthony V. Benedetto DO, FACP BACKGROUND Since the Food and Drug Administration approved the use of the 1000 centistoke liquid silicone, Silikon 1000, for intraocular injection, the off-label use of this injectable silicone oil as a permanent soft-tissue filler for facial rejuvenation has increased in the United States. Injecting liquid silicone by the microdroplet technique is the most important preventive measure that one can use to avoid the adverse sequelae of silicone migration and granuloma formation, especially when injecting silicone to improve small facial defects resulting from acne scars, surgical procedures, or photoaging. OBJECTIVE To introduce an easy method for injecting a viscous silicone oil by the microdroplet technique, using an inexpensive syringe and needle that currently is available from distributors of medical supplies in the United States. METHOD We suggest the use of a Becton Dickinson 3/10 cc insulin U-100 syringe to inject Silikon 1000. This syringe contains up to 0.3 mL of fluid, and its barrel is clearly marked with an easy-to-read scale of large cross-hatches. Each cross-hatch marking represents either a unit value of 0.01 mL or a half-unit value of 0.005 mL of fluid, which is the approximate volume preferred when injecting liquid silicone into facial defects. Because not enough negative pressure can be generated in this needle and syringe to draw up the viscous silicone oil, we describe a convenient and easy method for filling this 3/10 cc diabetic syringe with Silikon 1000. RESULTS We have found that by using the Becton Dickinson 3/10 cc insulin U-100 syringe, our technique of injecting minute amounts of Silikon 1000 is facilitated because each widely spaced cross-hatch on the side of the syringe barrel is easy to read and measures exact amounts of the silicone oil. These lines of the scale on the syringe barrel are so large and clearly marked that it is virtually impossible to overinject the most minute amount of silicone. CONCLUSION Sequential microdroplets of 0.01 cc or less of Silikon 1000 can be measured and injected with the greatest ease and precision so that inadvertent overdosing and complications can be avoided. [source] The clinical relevance of infancy: A progress reportINFANT MENTAL HEALTH JOURNAL, Issue 3 2008Daniel Stern In the past few decades, findings from infant observations have played a key role in the following selected areas: (a) The emphasis now is on interpersonal and intersubjective processes rather than on intrapsychic processes. This is a paradigm shift towards a two-person psychology. (b) The elaboration of the attachment domain has reoriented our views of development and treatment. (c) The success of extended home-visiting programs as a preventive measure for parents and infants at risk has brought an agonizing reappraisal of what makes prevention (and therapy) work. (d) By default, the baby's world is nonverbal. This has led to a productive reexploration of unconsciousness, especially the domain of implicit knowledge. For the future, the following are some of the areas of great promise: (a) Attachment, love and "holding" must be disentangled. (b) We must study how and when the mirror neuron system gets micro- and macroregulated. One is not always open to empathic reception. (c) The articulation between the nonverbal (implicit) with the verbal (explicit) needs far more study. (d) The nonspecific factors of psychotherapy seem to be the most important in bringing about change and prevention. We need a greater systematic study of the nonspecific. (e) The triad and quartet, and so on need further exploration. (f) There are many more, but the beauty of research is that you can't know where it will go next. [source] Efficacy of in-feed probiotics against Aeromonas bestiarum and Ichthyophthirius multifiliis skin infections in rainbow trout (Oncorhynchus mykiss, Walbaum)JOURNAL OF APPLIED MICROBIOLOGY, Issue 3 2008N. Pieters Abstract Aims:, The aim of this study was to assess the efficacy of in-feed probiotics as a preventive measure against skin infections caused by Aeromonas bestiarum and Ichthyophthirius multifiliis (Ich) in rainbow trout. Methods and Results:, Fin rot was induced in fish by intradermal injection with 0·1 ml volumes containing 105 cells per ml A. bestiarum at the base of the dorsal fin. Ich infections resulted from immersion in Ich-contaminated water. Each probiotic was administered orally [108 cells per g feed for GC2 (Aeromonas sobria) and 1010 cells per g feed for BA211 (Brochothrix thermosphacta)] for 14 days. Results showed that, after challenge with A. bestiarum, probiotics GC2 and BA211 led to 76% and 88% survival, respectively, in contrast to 22% survival for controls. Fish fed with probiotic GC2 had 100% survival after challenge with Ich compared with 2% for probiotic BA211 and 0% for controls. Analysis of innate immune responses revealed that probiotic GC2 promoted higher phagocytic activity, whereas probiotic BA211 led to enhanced respiratory burst activity. Conclusion:, Of the two probiotics examined, GC2 was more effective in protecting against both fin rot and Ich. Each probiotic appeared to stimulate different pathways within the innate immune system. Significance and Impact of the Study:, This is the first demonstration that probiotics can protect fish against surface infections. Furthermore, this is the first time a probiotic has been shown to protect against a eucaryotic pathogen, namely I. multifiliis. [source] Helicobacter pylori as a class I carcinogen: Physiopathology and management strategiesJOURNAL OF CELLULAR BIOCHEMISTRY, Issue 2 2007Paraskevi Vogiatzi Abstract The gram-negative bacterium Helicobacter pylori is known as a persistent colonizer of the human stomach, and probably less known is that it is also involved in extraintestinal diseases. Public awareness of its contribution in the development of gastric cancer is less than 15 years old. The efficacy of the current therapies based on antibiotics against H. pylori has been limited by difficulties such as antibiotic resistance and recurrence. As a consequence, the development of promising vaccines was prompted as the best preventive measure. Unfortunately, so far vaccines failed the transition from animal models to human trials. This keynote presentation is to provide a bird's eye view of H. pylori -related gastric diseases, including gastric cancer, with a synthesis of the molecular mechanisms involved, and an exhaustive presentation and discussion of the current therapeutic guidelines and future strategies for prevention or therapy. J. Cell. Biochem. 102: 264,273, 2007. © 2007 Wiley-Liss, Inc. [source] The History of Toxoplasma gondii,The First 100 YearsTHE JOURNAL OF EUKARYOTIC MICROBIOLOGY, Issue 6 2008JITENDER P. DUBEY ABSTRACT. In this paper the history of Toxoplasma gondii and toxoplasmosis is reviewed. This protozoan parasite was first discovered in 1908 and named a year later. Its medical importance remained unknown until 1939 when T. gondii was identified in tissues of a congenitally infected infant, and veterinary importance became known when it was found to cause abortion storms in sheep in 1957. The discovery of a T. gondii specific antibody test, Sabin,Feldman dye test in 1948 led to the recognition that T. gondii is a common parasite of warm-blooded hosts with a worldwide distribution. Its life cycle was not discovered until 1970 when it was found that felids are its definitive host and an environmentally resistant stage (oocyst) is excreted in feces of infected cats. The recent discovery of its common infection in certain marine wildlife (sea otters) indicates contamination of our seas with T. gondii oocysts washed from land. Hygeine remains the best preventive measure because currently there is no vaccine to prevent toxoplasmosis in humans. [source] Active Immunization to Prevent De Novo Hepatitis B Virus Infection in Pediatric Live Donor Liver RecipientsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2007C.-C. Lin This study aims to evaluate the efficacy of HBV vaccination as an alternative preventive measure against de novo HBV infection in pediatric living donor liver transplantation (LDLT). Sixty recipients were enrolled in this study. Thirty received grafts from anti-HBc(+) donors, and another 30 received grafts from anti-HBc(,) donors. HBV vaccine was given pretransplant to every candidate. Posttransplant, lamivudine was routinely given to recipients receiving anti-HBc(+) grafts for about 2 years. Forty-seven (78%) recipients achieved high levels of anti-HBs titer (>1000 IU/L). Two (3.3%) recipients developed de novo HBV infection where one received an anti-HBc(,) graft and another received an anti-HBc(+) graft. Both recipients were in the lower anti-HBs titer group (<1000 IU/L). The incidence of de novo HBV infection was significantly higher in the lower titer group (15.4% vs. 0%, p = 0.04). The median follow-up period was 51 months in recipients with anti-HBc(,) grafts and 57 months in those with anti-HBc(+) grafts. Active immunization is an effective method to prevent de novo HBV infection. It can result in high levels of anti-HBs titer (>1000 IU/L) which may prevent de novo HBV infection in pediatric patients with efficient primary vaccination undergoing LDLT. [source] The impact of changing dental needs on cost savings from fluoridationAUSTRALIAN DENTAL JOURNAL, Issue 1 2010AC Campain Abstract Background:, Although community water fluoridation has been one of the cornerstone strategies for the prevention and control of dental caries, questions are still raised regarding its cost-effectiveness. This study assessed the impact of changing dental needs on the cost savings from community water fluoridation in Australia. Methods:, Net costs were estimated as Costs(programme) minus Costs(averted caries). Averted costs were estimated as the product of caries increment in non-fluoridated community, effectiveness of fluoridation and the cost of a carious surface. Modelling considered four age-cohorts: 6,20, 21,45, 46,65 and 66+ years and three time points 1970s, 1980s, and 1990s. Cost of a carious surface was estimated by conventional and complex methods. Real discount rates (4, 7 (base) and 10%) were utilized. Results:, With base-case assumptions, the average annual cost savings/person, using Australian dollars at the 2005 level, ranged from $56.41 (1970s) to $17.75 (1990s) (conventional method) and from $249.45 (1970s) to $69.86 (1990s) (complex method). Under worst-case assumptions fluoridation remained cost-effective with cost savings ranging from $24.15 (1970s) to $3.87 (1990s) (conventional method) and $107.85 (1970s) and $24.53 (1990s) (complex method). For 66+ years cohort (1990s) fluoridation did not show a cost saving, but costs/person were marginal. Conclusions:, Community water fluoridation remains a cost-effective preventive measure in Australia. [source] Effects of the PAF receptor antagonist UK74505 on local and remote reperfusion injuries following ischaemia of the superior mesenteric artery in the ratBRITISH JOURNAL OF PHARMACOLOGY, Issue 8 2000D G Souza The effects of the long lasting and potent PAF receptor antagonist UK74505 were assessed on the local and remote injuries following ischaemia and reperfusion (I/R) of the superior mesenteric artery (SMA) in rats. In a severe model of ischaemia (120 min) and reperfusion (120) injury, in addition to the local and remote increases in vascular permeability and neutrophil accumulation, there was significant tissue haemorrhage, blood neutropenia, systemic hypotension and elevated local and systemic TNF-, levels. Post-ischaemic treatment with the selectin blocker fucoidin (10 mg kg,1) prevented neutrophil accumulation in tissue and, in consequence, all the local and systemic injuries following severe I/R. Treatment with an optimal dose of UK74505 (1 mg kg,1) also reversed local and remote neutrophil accumulation, increases in vascular permeability and intestinal haemorrhage. UK74505 partially inhibited blood neutropenia and reperfusion-induced hypotension. Interestingly, both fucoidin and UK74505 prevented the local, but not systemic, increases of TNF-, levels following severe I/R injury, demonstrating an important role of migrating cells for the local production of TNF-,. However, the results do not support a role for PAF as an intermediate molecule in the production of systemic TNF-,. The beneficial effects of UK74505 and other PAF receptor antagonists in models of I/R injury in animals and the safety of UK74505 use in man warrant further investigations of the use of this drug as preventive measure for I/R injury in humans. British Journal of Pharmacology (2000) 131, 1800,1808; doi:10.1038/sj.bjp.0703756 [source] Appropriateness of breast-conserving treatment of breast carcinoma in women with germline mutations in BRCA1 or BRCA2CANCER, Issue 1 2005A clinic-based series Abstract BACKGROUND Although BRCA1 and BRCA2 were identified in 1994 and 1995, respectively, to the authors' knowledge the optimal management of women with BRCA -associated breast carcinoma remains incompletely defined. The current study evaluates the appropriateness of breast-conserving therapy (BCT) in women with BRCA mutations. METHODS Between May 1992 and October 2003, 87 female participants in genetic testing protocols were identified who 1) were found to have deleterious germline BRCA mutations and 2) reported a history of invasive breast carcinoma that was treated with wide local excision and radiation therapy. Clinical records were reviewed and follow-up was updated. RESULTS The 87 subjects underwent BCT for 95 invasive breast tumors (8 women received BCT for metachronous bilateral tumors). In all 95 treated breasts, the 5-year and 10-year probabilities of metachronous ipsilateral breast carcinoma (MIBC) were 11.2% and 13.6%, respectively. Among the 87 subjects, the 5-year and 10-year probabilities of metachronous contralateral breast carcinoma (CBC) after treatment of the index tumor were 11.9% and 37.6%. No clinical factors were identified that were associated with either MIBC or CBC, including the use of tamoxifen or chemotherapy. CONCLUSIONS Women with BRCA -associated breast carcinoma who undergo BCT appear to have risks of MIBC that are similar to those reported for young women without known mutations. The indications for unilateral mastectomy in this group of women should be the same as those for women with nonhereditary carcinoma. However, significant risks of CBC and possibly late MIBC may prompt the serious consideration of bilateral mastectomy as a preventive measure. Cancer 2005. © 2004 American Cancer Society. [source] A school-based fluoride mouth rinsing programme in Sarawak: a 3-year field studyCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 4 2010Catherine Jean-Ai Chen Chen CJ-A, Ling KS, Esa R, Chia JC, Eddy A, Yaw SL. A school-based fluoride mouth rinsing programme in Sarawak: a 3-year field study. Community Dent Oral Epidemiol 2010; 38: 310,314. © 2010 John Wiley & Sons A/S Abstract,,, Background:, This study was undertaken to assess the impact of fluoride mouth rinsing on caries experience in a cohort of schoolchildren 3 years after implementation. Methods:, 270 children aged 8,9 years from four schools in Sarawak were selected at baseline. Baseline data was collected to ensure that the selected schools did not differ significantly. Children from two schools rinsed with 0.2% sodium fluoride under supervision, while those from the other schools did not. Results:, After 3 years, 242 schoolchildren remained in the study. At the end of the study, the mean DMFT for the test group was 2.3 (95% CI, 1.93,2.67) while the mean DMFT for the control group was 4.01 (95% CI, 3.39,4.63). The mean DMFS for the test group was 3.40 (95% CI, 2.68,4.12) while the mean DMFS for the control group was 6.67 (95% CI, 5.47,7.87). After 3 years, 24.2% of those in the test group remained caries free compared to 11.5% in the control group. The risk of developing caries decreased 0.52 times among the children from the ,test' group exposed to the fluoride mouth rinsing programme as compared to the unexposed ,control' group (RR = 0.48, 95% CI, 0.26,0.85). Discussion and conclusion:, The findings show that a school-based weekly 0.2% sodium fluoride mouth rinsing programme is an effective caries preventive measure and should be implemented in fluoride-deficient areas as a means of reducing the prevalence of dental caries in these communities. [source] Shoe contact dermatitis from dimethyl fumarate: clinical manifestations, patch test results, chemical analysis, and source of exposureCONTACT DERMATITIS, Issue 5 2009Ana Giménez-Arnau Background: The methyl ester form of fumaric acid named dimethyl fumarate (DMF) is an effective mould-growth inhibitor. Its irritating and sensitizing properties were demonstrated in animal models. Recently, DMF has been identified as responsible for furniture contact dermatitis in Europe. Objective: To describe the clinical manifestations, patch test results, shoe chemical analysis, and source of exposure to DMF-induced shoe contact dermatitis. Patients, Materials, and Methods: Patients with suspected shoe contact dermatitis were studied in compliance with the Declaration of Helsinki. Patch test results obtained with their own shoe and the European baseline series, acrylates and fumaric acid esters (FAE), were recorded according to international guidelines. The content of DMF in shoes was analysed with gas chromatography and mass spectrometry. Results: Acute, immediate irritant contact dermatitis and non-immunological contact urticaria were observed in eight adults and two children, respectively. All the adult patients studied developed a delayed sensitization demonstrated by a positive patch testing to DMF , 0.1% in pet. Cross-reactivity with other FAEs and acrylates was observed. At least 12 different shoe brands were investigated. The chemical analysis from the available shoes showed the presence of DMF. Conclusion: DMF in shoes was responsible for severe contact dermatitis. Global preventive measures for avoiding contact with DMF are necessary. [source] FS13.2 Intervention on work-related skin problems among gut cleanersCONTACT DERMATITIS, Issue 3 2004Mari-Ann Flyvholm Work-related skin problems are frequent in the food processing industry. A randomised intervention study with a one-year follow up was carried out among gut cleaners in order to prevent work-related skin problems due to wet work. The effects of the intervention were primarily measured by telephone interviews using questionnaires based on a standardized questionnaire for work-related skin diseases and exposure (NOSQ-2002).* The intervention activities included an evidence-based prevention program and an evidence-based method for implementation. Six of the 18 participating departments were randomly assigned to the intervention group and the remaining 12 departments to the comparison group. A total of 644 employees responded in the baseline interview and 622 in the follow-up interview carried out a year later. The participation rates were 87,5% and 71,6% respectively. Among the 495 participants answering in both interviews the frequency of eczema on hands or forearms within the past 3 months was reduced significantly by more than 25% in the intervention departments. A minor increase was observed in the comparison departments. This study has shown that even in jobs without the possibility to reduce high exposure to wet work work-related skin problems can be reduced by proper preventive measures. *) Susitaival P, Flyvholm M-A, Meding B, Kanerva L, Lindberg M, Svensson Å, Ólafsson JH. Contact Dermatitis 2003;49:70,76. [source] FS13.5 Occupational contact dermatitis: printer worker's viewpointsCONTACT DERMATITIS, Issue 3 2004Terry Brown Introduction:, Occupational contact dermatitis (OCD) is very common in the printing industry due to contact with chemicals, paper, and wet work. It can be avoided by adequate protective measures, but the effectiveness of intervention depends heavily on the employer's and employee's awareness of this health risk. Objectives:, The study aimed to collect information on the knowledge, attitudes and beliefs of print workers about the risk of OCD and methods of prevention. Methods:, A series of focus groups were held with print workers, health and safety officers and managers to discuss their awareness of dermal risk factors, risk behaviour at work, attitudes to health and safety and options on possible preventive measures. A number of companies were also visited to observe, overtly and covertly, the normal work practices. Results:, OCD was not perceived to be either a major problem or a health and safety priority. There was general agreement about the processes and work practices that could cause skin problems. However, work practices varied considerably and did not always reflect this awareness. There was general concern about the type and availability of personal protective equipment, especially gloves and after-work skin cream. The provision of an occupational health service was generally felt to be inadequate, and no company had a policy in place that specifically addressed skin care. Conclusions:, These findings highlight the urgency to intensify health and safety education on skin care within the printing industry. Recommendations were developed for the evaluation of a series of risk reduction strategies. [source] Dental trauma incidence and mouthguard use in elite athletes in TurkeyDENTAL TRAUMATOLOGY, Issue 2 2005e Diljin Keçeci Abstract,,, Contact sports may lead to dental trauma, which often can be reduced with appropriate preventive measures. While numerous studies exist on this topic for several countries throughout the world, there is a lack of comprehensive descriptive studies in Turkey. The purpose of this study was to investigate the incidence and type of dental injuries associated with three different sports among Turkish elite athletes, who do not contact (volleyball), contact directly (taekwondo) or indirectly (handball) with competition rivals. Additionally, awareness and use of mouthguards were also compared. Thus, during the 2003 and 2004 Turkish National Championships in three sports, 50 taekwondo, 62 handball and 50 volleyball male athletes were interviewed by questionnaire. Results showed that taekwondo and handball athletes experienced significantly more dental trauma than volleyball athletes (P < 0.05). Twelve of the taekwondo (24%), 16 of the handball (26%) and four of the volleyball athletes (8%) experienced at least one type of dental injury. Awareness of mouthguards as a preventive measure against dental trauma was significantly higher among taekwondo and handball athletes (P < 0.05), although a very small percentage in either of these sports actually wore a mouthguard (10 and 0%, respectively). Trauma incidence between direct contact with rival competitors and indirect contact with rival competitors was not significantly different. The incidence of dental trauma in contact sports shows that the awareness and use of mouthguards must be intensified. Mouthguard use should be made compulsory, especially in those sports with high risk for dental trauma. [source] Complications of Nail Surgery: A Review of the LiteratureDERMATOLOGIC SURGERY, Issue 3 2001Meena Moossavi MD Background. The realm of nail unit surgery encompasses the dermatologist as well as the hand surgeon. Nail surgery complications may include allergy to anesthetic, infection, hematoma, nail deformity, and persistent pain and swelling. Objective. To review the pertinent literature regarding nail unit surgery complications. Methods. A Medline literature search was performed for relevant publications. Results. Nail unit surgery complications appear to be relatively infrequent. The majority of postoperative nail deformity complications result from nail matrix damage. Conclusion. Complications may be reduced to a minimum by preventive measures, such as careful patient selection, sterile technique, and gentle treatment of the nail matrix. [source] Latex allergy: diagnosis and managementDERMATOLOGIC THERAPY, Issue 4 2004James S. Taylor ABSTRACT:, Latex allergy is an IgE-mediated immediate hypersensitivity response to natural rubber latex (NRL) protein with a variety of clinical signs ranging from contact urticaria, angioedema, asthma, and anaphylaxis. Major allergens include dipped latex products such as gloves and balloons. In highest risk for NRL allergy are patients with spina bifida, but health care workers and others who wear latex gloves are also at risk. NRL allergic patients may also react to fruits/foods, especially banana, kiwi, and avocado. Diagnosis is made by a positive latex RAST and/or skin prick test or challenge test to NRL. Allergen avoidance and substitution and the use of latex-safe devices including synthetic gloves (vinyl, synthetic polyisoprene, neoprene, nitrile, block polymers, or polyurethane) are essential for the affected patient. Accommodation in the workplace may include the use of powder-free, low-allergen NRL gloves or synthetic gloves. These preventive measures have significantly reduced the prevalence of reported reactions to NRL. Hyposensitization is not yet feasible. [source] Should we beware of the Precautionary Principle?ECONOMIC POLICY, Issue 33 2001Christian Gollier How should society deal with risks when there is scientific uncertainty about the size of these risks? There has been much recent discussion of the Precautionary Principle, which states that lack of full scientific knowledge should not be used as a reason to postpone cost,effective preventive measures. We show in this paper that the Precautionary Principle contradicts one important intuition about the right way to act in the face of risk, namely the principle of ,looking before you leap'. When we expect to learn more about the future, the effectiveness of our preventive measures will be greater if we learn before we act. However, a number of other ways of taking uncertainty into account are consistent with a reasonable interpretation of the Precautionary Principle. First, postponing preventive measures may increase our vulnerability to damage, which induces a precautionary motive for risk,prevention, similar to the precautionary savings motive. Secondly, stronger preventive actions often yield more flexibility for the future, so that acting early has an option value. Thirdly, when better information comes from a process of learning,by,doing, the risk associated with early events is amplified by the information they yield about the future. This plays a role analogous to that of an increase in risk aversion, making us more cautious. Fourthly, because imperfect knowledge of the risk makes it difficult to insure, the social cost of risk should include a risk premium. Finally, uncertainty about the economic environment enjoyed by future generations should be taken into account. This raises the benefit of acting early to prevent long,term risks. If the Precautionary Principle sometimes gives good and sometimes gives bad advice, there is no escape from the need to undertake a careful cost,benefit analysis. We show that standard cost,benefit analysis can be refined to take account of scientific uncertainty, in ways that balance the Precautionary Principle against the benefits of waiting to learn before we act. Furthermore, it is important that they be used to do so, for instinct is an unreliable guide in such circumstances. Abandoning cost,benefit analysis in favour of simple maxims can result in some seriously misleading conclusions. [source] Environmental burden of disease: HRQoL and statistical perspectivesENVIRONMETRICS, Issue 5 2004Pranab Kumar Sen Abstract Environmental toxicity and pollution mingled with substandard sanitation and public health practice can lead to serious health problems. Some of these toxics can be identified and subjected to preventive measures but together with some other major factors they form the environmental burden of disease, more seriously in developing countries. As a result, in health related quality of life risk assessments, especially relating to cancer of various types, as well as chronic and intestinal diseases, we need to incorporate toxicology as well as environmental epidemiology. Statistical perspectives in this challenging task are appraised with special attention to the arsenite contamination of the groundwater problem. Copyright © 2004 John Wiley & Sons, Ltd. [source] Prevalence of alcohol use disorders and associated factors: a population-based study using AUDIT in southern BrazilADDICTION, Issue 6 2003Raúl A. Mendoza-Sassi ABSTRACT Aims To assess the prevalence of potential alcohol use disorders and associated factors using the Alcohol Use Disorders Identification Test (AUDIT). Design Cross-sectional study. Setting A town in southern Brazil. Participants A representative sample of 1260 people aged 15 and over. Measurements Demographic, socioeconomic, smoking habit and mental health data were collected. Logistic regression was used in the multivariate analysis, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Findings Overall prevalence of alcohol use disorder was 7.9%, with 14.5% prevalence among men and 2.4% among women. The risk of alcohol misuse increased across social class (P linear trend = 0.03) and compared with the highest classes (A and B), groups C through E had ORs of 1.48, 1.51 and 2.36, respectively. Males had an OR of 6.89 (CI 3.61,13.16) compared with women. A linear trend was found (P = 0.001) between smoking categories, and smokers (OR 3.27; CI 1.91,5.58) and ex-smokers (OR 1.30; CI 0.56,2.98) were at higher risk than non-smokers. Those with minor psychiatric disorders had a 2.48 OR (CI 1.35,4.56) of presenting a positive test. Conclusions The AUDIT detected a high prevalence of potential alcohol use disorders in the population sampled. Those identified are potential targets for preventive measures implemented through health policies. [source] Breast Cancer Knowledge and Preventive Behaviors An Urban Emergency Department-based SurveyACADEMIC EMERGENCY MEDICINE, Issue 12 2000Kevin M. Takakuwa MA Abstract. Objective: To assess general knowledge and preventive behaviors regarding breast cancer among women who present to an urban emergency department. Methods: During a six-month study period, a convenience sampling of women aged 21 years and older who were in treatment and waiting areas was surveyed. The anonymous written survey asked about demographic variables, knowledge, and preventive behaviors regarding breast cancer. Knowledge was assessed with questions about the recommended frequency of breast self-examination and the recommended age for first mammography. Performance was assessed by questions about breast self-exam and mammography. Subgroup analysis was done by age (above and below 40 years old), race, income (above and below the median), insurance type, history of breast lump, and family history (FH) of breast cancer. Results: Four hundred women completed surveys. Two hundred twelve (53%) correctly knew the answers to the two knowledge questions. Knowledge was greater in women with private insurance. Knowledge of the frequency of breast self-exam was significantly greater among whites and Native Americans than among African Americans, Asians, or Hispanics. Stated performance of preventive behaviors was 72% (288) for breast self-exam and for mammography. Preventive behaviors were significantly more likely to be performed by higher-income and privately-insured women. Breast self-exam was more likely to be done in older women, those with a history of a breast lump, and those with a FH of breast cancer. Conclusions: Women with lower income and without private insurance were less likely to be knowledgeable and practice preventive measures for detecting breast disease. [source] Systemverhalten und Prozessoptimierung beim ErddruckschildGEOMECHANICS AND TUNNELLING, Issue 3 2008Ulrich Maidl Dr.-Ing. Eine konsequente Analyse der Prozessdaten kann die Sicherheit, aber auch die Effektivität des Ressourceneinsatzes beim hoch technisierten Schildvortrieb erheblich steigern. Präventive Maßnahmen zur Prozessoptimierung können durch die zeitnahe Analyse des Systemverhaltens während des Bauablaufs rechtzeitig eingeleitet werden. Eine Analyse des Systemverhaltens wird durch die Aufspaltung des Bauablaufs in Teilprozesse und die Definition der Schlüsselprozesse möglich. Im folgenden Artikel wird am Beispiel des Erddruckschilds aufgezeigt, wie beim heutigen Stand der Technik Prozesse realitätsnah simuliert und während der Ausführung unter Einsatz der vorhandenen Mess- und Datenerfassungstechnik analysiert werden können. System Behaviour and Process Optimization at EPB Shield A consistent analysis of the process parameters in highly mechanised shield tunnelling, not only increases the safety, but it also improves the efficiency of the resources in action. The real time analysis of the system's behaviour allows to timely carry out preventive measures during the construction process with the aim of optimizing the construction process. The analysis of the system's behaviour is possible by splitting the construction sequence in a series of partial processes and by defining the key processes. The present paper represents an EPB shield study case, which shows how the present state of the art allows simulating processes realistically during construction, by applying existing monitoring and data registration technology. [source] Comprehensive studies of cognitive impairment of the elderly with type 2 diabetesGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 3 2006Takashi Sakurai Type 2 diabetes mellitus is associated with cognitive dysfunction and increases the risk of dementia for the elderly. The aim of the study presented here was to provide a brief review of how disturbance of glucose and metabolic homeostasis may be implicated in the cognitive decline of patients with type 2 diabetes. Several risk factors such as nutrition, cerebrovascular disorders and the neurotoxic effects of hyperglycemia may combine for the formation of mechanisms of cognitive decline in the diabetic elderly. It should be noted that cognitive deficits of diabetes are accompanied by neuroradiological changes in the brain, so that cognitive dysfunction both with and without brain structural changes may overlap during cognitive decline of the diabetic elderly. Recently, we conducted two studies to explore, by means of brain imaging, hierarchical relationships among clinical profiles of diabetes, cognitive function, white matter hyperintensity and brain atrophy. The results suggested that subcortical brain atrophy and hyperintensity constitute predictors of the rate of progression of cognitive dysfunction in the diabetic elderly, while cortical atrophy is associated with high diastolic blood pressure and lower HbA1c. These hypotheses may explain in part the underlying mechanisms of cognitive impairment in the diabetic elderly. Prospective intervention studies are needed, however, to clarify the mechanism of cognitive dysfunction of the diabetic elderly and what the targets are for preventive measures. [source] | |||||||||||||||||||||||||||||||||||||||||||