Cases Of Local Infection Research Articles

Arterial catheter outcomes in intensive care: An analysis of 1117 patients

BackgroundAccess to arterial circulation through arterial catheters (ACs) is crucial for monitoring and decision-making in intensive care units (ICU) but carries the risk of complications including bloodstream infection (BSI). MethodsWe conducted a secondary analysis of data from four randomised controlled trials in Australian ICUs, investigating the efficacy of different AC interventions. De-identified data were combined into a single dataset, and per-patient outcomes analysed. The primary outcome was AC-BSI, defined as laboratory-confirmed bloodstream infection (LCBI) type 1 or 2, with a concurrent local infection. All-cause AC failure was defined as any unplanned removal. AC infection and failure were reported as rates per 1000 catheter days and hours. ResultsData from 1117 adult patients were analysed. Mean age was 58.8 years (±16.6); and 41% (n = 462) were male. Median AC dwell time was 110 h (IQR 28.3–168.0). There was one case (<0.1%; 0.18/1000 catheter days [95% CI 0.03–1.29]) of AC-BSI, and 14 cases of LCBI (1%; 13 LCBI-1 and 1 LCBI-2; 2.54/1000 catheter days [95% CI 1.51–4.30]). LCBI were most commonly Enterococcus faecalis; Escherichia coli and Klebsiella pneumoniae. There were four cases of local infection (<1%; 0.73/1000 catheter days [95% CI 0.27–1.94]). Overall AC failure rate was 13% (n = 146) or 26.53/1000 catheter days (95% CI 22.56–31.20). ConclusionThis study identified a relatively low incidence of complications. This is likely reflective of poor monitoring of ACs in intensive care. Better surveillance and a rigorous prospective evaluation of AC outcomes is required to understand the true risk ACs pose to critically ill patients.

C-Reactive Protein, Procalcitonin, and a Novel Pathogenesis and Therapeutic Target of Thrombocytopenia in Sepsis.

Objective The aim of the study is to analyze the clinical characteristics, pathogen distribution, and drug sensitivity information of adult sepsis, and to provide reference for empirical clinical use; to explore the relationship between C-reactive protein (CRP) and calcitonin (PCT) The clinical value in the diagnosis of adult sepsis. Methods We collected 455 cases of hospitalized patients with positive blood culture, including 352 cases with sepsis and 103 cases without sepsis; 1609 cases of hospitalized patients with suspected infection and negative blood culture, including 287 cases of sepsis, and 518 cases of non-infectious systemic inflammatory response syndrome (SIRS) and 804 cases of local infection. Age, gender, route of admission, admission status, CRP, PCT, and white blood cell (WBC) levels were collected from the patients. The differences between the factors were statistically analyzed, and the receiver operating characteristic curve (ROC curve) was plotted to obtain the optimal cut-off values of CRP and PCT and their area under the curve (AUC), and to compare the CRP, PCT and PCT, and the CRP + PCT tandem to diagnose sepsis sensitivity and specificity. Results (1) 387 pathogenic strains were isolated from blood cultures of patients with sepsis, 71.06% Gram-negative, 26.87% Gram-positive and 2.07% fungi. (2) Among Gram-positive bacteria, Staphylococcus aureus was 87.5% resistant to penicillin and sensitive to vancomycin, milantropine, and teicoplanin; among Gram-negative bacteria, Escherichia coli was resistant to piracillin The resistance rate was 73.1%, fully susceptible to viraemia (100%) and resistant to imipenem, amikacin, and lacillin/tazole. (3) Among patients with positive blood cultures, CRP and PCT levels were higher in patients with sepsis than in those without sepsis. Pairwise comparison of ROC curves showed that the diagnostic value of PCT was greater than that of CRP (P=0.016). Conclusion CRP and PCT have a good reference value for diagnosis of sepsis patients and determination of the degree of infection in septic patients, especially PCT is more valuable for diagnosis of sepsis.

The autochthonous cases of acute opisthorchiasis in the Moscow region

Acute stages of parasitic diseases are rare diagnosed and therefore, clinicians have limited knowledge of their clinical features. We describe five autochtnonous acute cases of opisthorchiasis in Moscow region acquired from eating raw ides (L. idus). The most frequent clinical symptoms were febrile, eosinophilic syndrome with cholestasis. The patients were positive for IgG antibodies to Opisthorchis felineus. Eggs of O. felineus were found in one patient. As egg production O. felineus starts 1 month after exposure and opisthorchiasis cases in Moscow region have low numbers of worms, the sensitivity of microscopy is low. Therefore we consider opisthorchiasis in all patients of unexplained acute fever, pain in upper right abdominal quadrant, and eosinophilia with cholestasis, when patients confirm the ingestion of raw fish. We recommend one day of praziquantel 25 mg/kg TID to patients infected with O. felineus. In previous publications describing the autochtnonous cases of opisthorchiasis in Moscow region the authors supposed that cases of local infection will be found again in Moscow region and this is just a matter of time. The cases reported here confirm that this infection is endemic in Moscow region. The local people living close to rivers especially those who eat raw fish are at risk of infection O. felineus. There is a clear need to undertake special studies pertaining to the ways of promoting people living in Moscow region become aware of opisthorchiasis and to be motivated in preventive measures and treatment.

Analysis of dynamic contact network of patients with COVID-19 in Shaanxi Province of China

The spread of COVID-19 is closely related to the structure of human social networks. Based on 237 cases, by using epidemiological retrospective statistics, data visualization, and social network analysis methods, this paper summarized characteristics of patients with COVID-19 in Shaanxi, China, and analyzed these patients’ dynamic contact network structure. The study found that there are many clustered infections through strong ties, about one-third of cases are caused by relatives' infection. In early stages of the epidemic, imported cases were the most, and in the later stages, local infection cases were the most. The infected people were mostly middle-aged men. Symptoms of imported cases occurred on average of 3 days after they arrived, and medical measures were taken 5 days later on average. All cases showed symptoms in less than 2 days on average and were then taken to medical treatment. The contact network can be divided into multiple disconnected components. The largest component has 12 patients. The average degree centrality in the network is 0.987, average betweenness degree is 0, average closeness degree is 0.452, and average PageRank index is 0.0042. The number of contacts of patients is unevenly distributed in the network.

A review of malaria elimination in Minhang District, Shanghai

Objective To analyze the malaria epidemic situation and prevention and control process, and we summarize and assess the malaria elimination work in Minhang District, Shanghai, so as to provide the evidence for maintaining the eradication of malaria. Methods The data of control work, reports, documents, work plans, strategies and measures of malaria in Minhang District from 1950 to 2019 were collected and analyzed, to indicate its epidemiological characteristics and preventive procedure by descriptive epidemiological methods. And we summarized and evaluated the process of eliminating malaria in Minhang District. Results Malaria used to be the most dangerous infectious disease in Minhang District. Two outbreaks occurred in 1954 and 1961 respectively, with the highest annual incidence of 7 824.98/100 000, with P. vivax as the dominant vector and Anopheles sinensis as the only vector. Through comprehensive prevention and control, the incidence of malaria gradually decreased to 10 per 100 000 in 1980, and the standard of basically eliminating malaria was met in 1985. In 2010, Minhang District launched the Action Plan for Eliminating Malaria, and implemented comprehensive technical measures focusing on eliminating the source of infection and blocking transmission. By 2015, there had been no local infection cases for five consecutive years, meeting the assessment standards for eliminating malaria. The malaria eradication maintenance phase began after 2016. According to the characteristics of malaria epidemic in different periods, Minhang District adopted targeted prevention and control measures, which experienced different stages of malaria epidemic, control, monitoring, elimination and post-elimination maintenance. After 2013, all the cases were imported from abroad, and the majority of them were middle-aged and young migrating population. There were no obvious characteristics of the infected species and onset time of the cases. The focus of prevention and control is to timely detect and deal with malaria cases to prevent further transmission. Conclusion Maintaining surveillance networks and surveillance capabilities, and preventing the risk of retransmission of imported cases has become a new challenge after malaria eradication has been entered the maintenance phase. 摘要：目的 分析上海市闵行区不同时期疟疾流行状况和防治历程, 总结闵行区消除疟疾工作, 为维持消除疟疾 状态提供依据。 方法 收集闵行区1950—2019年疟疾防治疫情相关报表、工作计划总结、防治文件和策略等资料, 采 用描述流行病学方法分析闵行区疟疾流行特征与防治措施, 总结评估闵行区消除疟疾历程。 结果 疟疾曾是闵行区 危害最大的传染病, 1954年和1961年先后发生过2次暴发流行, 年发病率最髙达7 824.98/10万, 以间日疟为主, 中华按 蚊为唯一传播媒介。经过综合防治, 1980年疟疾发病率逐步降低至10/10万, 1985年达到了基本消灭疟疾的标准;2010 年启动闵行区消除疟疾行动计划 , 实施以清除传染源、阻断传播为重点的综合技术措施 , 至2015年连续5年无本地感 染病例, 达到了消除疟疾考核标准;2016年后进人消除疟疾维持阶段。闵行区根据不同时期疟疾流行特点采取了针对 性防控措施, 经历疟疾流行、控制、监测、消除和消除后维持的不同阶段。2013年后病例均为境外输人性病例, 以中青 年流动人口为主, 感染虫种和病例发病时间无明显特征, 防控重点是及时发现和处置疟疾病例, 防止引起续发传播。 结论 达到消除疟疾标准后, 维持疟疾监测网络和监测能力, 防止输人性病例再传播风险成为面临的新挑战。

ЭПИДЕМИОЛОГИЧЕСКАЯ СИТУАЦИЯ ПО ДИРОФИЛЯРИОЗУ НА ТЕРРИТОРИИ ОМСКОЙ ОБЛАСТИ

The objects of the study were the maps of the epidemiological survey of persons (26 people) infected with dirofilariae for the period 2013-2020 and living in the Omsk region, as well as dirofilaria helminths removed from the invaded residents (26 helminths). The type of helminths was determined by morphological characteristics, as well as by molecular biological methods. Dirofilaria DNA was detected by PCR with species-specific primers. Determination of the sequences of the obtained amplicons was determined by direct sequencing. The level of sequence homology was determined using GenBank. The material was statistically processed using Microsoft Excel 2010. Dirofilariasis is registered in people of all age groups, however, 73.1% of all cases are in people over 40 years old. Among the infected, women predominated, there were almost 2 times more of them than males. The affected people lived either within the city of Omsk and the adjacent recreational zone, or in the southern districts of the region. In 61.5% of cases, the helminth was localized in the organ of vision. According to the results of parasitological studies, in 80.8% of cases of all removed helminths, immature females were identified, in 19.2% - males. All remote helminths are morphologically assigned to the species D. repens. The species of six dirofilariae was confirmed by PCR with species primers and sequencing of amplification products, which showed almost 100% homology with the European sequences of D. repens published in GenBank. On the territory of the Omsk region, from one to four cases of local infection with dirofilariae are recorded annually. Omsk region can be classified as an area with a low risk of infection with dirofilariae, studies are needed to clarify the prevalence of pathogens of dirofilariasis in the northern regions of the region, as well as in general in Western Siberia to assess the risk of infection of the population, especially taking into account climatic changes. Key words: dirofilariosis, parasitic diseases, nematodes transmitted by mosquitoes

Soft Tissue Contouring at the Time of Osseointegrated Implant Reconstruction for Lower Extremity Amputation.

Patients with lower extremity amputations using a classic socket prosthesis face many challenges related to the socket-limb interface. The adaptation of osseointegration has allowed for the attachment of a prosthesis directly to bone, eliminating this interface and providing mechanical benefits. Contrary to the socket prosthesis, the osseointegrated prosthesis requires reducing and minimizing the soft tissue envelope. Studies have shown that patients who have undergone placement of these implants have high rates of reoperation for soft tissue redundancy. The purpose of our study was to evaluate complication rates and need for revisional surgery using our technique of soft tissue closure around the prosthesis at the time of implant placement. An institutional review board-approved, retrospective chart review was performed on all patients who underwent implantation of an osseointegrated prosthesis for lower extremity amputation with concomitant plastic surgery closure at our institution during a 2-year period from June 2017 to June 2019. Patient demographics, health status descriptors, operative data, length of admission, and rates of postoperative complications were gathered from the electronic medical record and coded into a HIPAA-compliant database. Specific outcomes tracked included minor and major infection, osteomyelitis, implant failure, hematoma, seroma, delayed wound healing, and rates of reoperation and readmission. There were a total of 14 patients who underwent osseointegrated implant placement with concomitant plastic surgical coverage of the prosthesis during the study period. The average patient age was 50 years (range, 26-70 years), and average body mass index was 32.2 kg/m (range, 19.7-44.8 kg/m). Average follow-up time was 28 weeks (range, 10-73 weeks). There were 2 cases of local infection resolved with a course of oral antibiotics. There were no instances of infection requiring procedural intervention or hospital admission, nor any cases of osteomyelitis. Two patients required outpatient surgery for exchange of implant abutment, one required revision of a prosthesis for hardware loosening, and one required targeted muscle reinnervation of a sciatic nerve neuroma. There were no patients who required revisional surgery for soft tissue redundancy and no cases of delayed wound healing. Adequate planning of incisions and soft tissue contouring is important in the care of osseointegrated patients. Plastic surgery involvement can decrease soft tissue complications and lead to improved patient outcomes.

1722. Histoplasmosis Acquired in Alberta, Canada, 2011–2018

BackgroundHistoplasmosis is a serious fungal infection caused by the geographically restricted, dimorphic fungus Histoplasma capsulatum. In Canada, the geographic range of H. capsulatum is classically thought to be restricted to southern parts of Ontario and Quebec. Over the past decade, histoplasmosis has occasionally been diagnosed in patients in Alberta without travel to areas of known geographic risk (Figure 1). We studied the epidemiology and geographic distribution of histoplasmosis in Alberta to assess evidence for locally-acquired infections.MethodsWe retrospectively reviewed all laboratory-confirmed (culture, antigen and/or immunodiffusion positive) cases of histoplasmosis diagnosed from January 1, 2011 to June 30, 2018. Data collected by public health and clinical charts were reviewed for clinical presentation, exposure and travel histories, and geographic distribution of cases. Cases of histoplasmosis in patients who had not left Alberta or associated with a local point source were classified as definite local acquisition; cases in patients with remote travel but with local exposures and appropriate timing of disease onset were deemed “probable” cases of local infection. University of Alberta’s Research Ethics Board approved this study.ResultsWe identified 45 laboratory-confirmed cases of histoplasmosis, including 17 cases that were locally acquired. Among these, there were 12 cases of definite local acquisition, including 8 patients from 3 point-source outbreaks—all involving exposure to bats and/or their droppings in chimneys or attics of private dwellings or churches—and 4 sporadic cases in patients who had never traveled. Of the other 5 cases probably acquired in Alberta, patients had previously traveled (n = 4) or travel history was incomplete (n = 1) but local exposures preceding infection were considered compelling. The mean incidence rate of locally acquired infection was 0.062/100,000 population with incidence increasing since 2014. Table 1 shows features of locally acquired cases.ConclusionThis study, for the first time, establishes Alberta as a region of geographic risk for histoplasmosis. The diagnosis should be considered in patients with compatible symptoms and exposure history, even in the absence of travel. Disclosures All authors: No reported disclosures.

Application of three fingers to pinching needle method in infusion port

Objective To explore the advantages of the three-finger method of pinching the needle infusion port. Methods A total of forty three patients who underwent intracranial vein infusion port implantation between January 2018 and June 2018 were enrolled. The self-control method was divided into the test group and the control group, and both groups of patients used a safe butterfly wing non-destructive needle. The control group used the traditional needle insertion method from July 1st to July 31st. The experimental group used the three-finger needle-to-needle method from August 1st to August 31st to compare the two groups of patients in one-time injection. Different results in terms of local skin bleeding and patient satisfaction. Results The one-time injection rate and non-bleed rate of the control group were both 25.6%(11/43) and the satisfaction rate was 20.9%(9/43). There was one case of pedicle turnover, one case of clipping syndrome, and one case of local infection; no other complications. The one-time injection rate and non-bleed rate of the test group were both 90.7%(39/43) and the satisfaction rate was 90.7%(39/43); there was one case of clipping syndrome; no other complications. The difference of one-time injection rate, local non-bleed rate and satisfaction rate between the two groups was statistically significant (χ2=37.45, 37.45,42.43, both P<0.05). Conclusions The three-finger method of pinching the needle can improve the one-time injection rate of the nurse, improve the patient's satisfaction and reduce the complications. This aspect deserves to be promoted in the clinic. Key words: Three-finger pinch; Needle; Port

Epidemiological characteristics of malaria prevalence in Danyang City from 2004 to 2015

To analyze the epidemiological characteristics of malaria prevalence in Danyang City from 2004 to 2015, so as to provide the evidence for formulating the strategy of prevention and control of malaria. The data of malaria serum tests, the reported malaria cases from the Internet Reporting System, and the epidemiological case survey from 2004 to 2015 as well as the mosquito monitoring data from 2008 to 2015 were collected and analyzed. From 2004 to 2015, 58 malaria cases were reported in Danyang City, with an average annual incidence rate of 0.6/105. Among the cases reported, vivax malaria accounted for 65.52% (38/58), falciparum malaria accounted for 5.17% (3/58), oval malaria accounted for 1.72% (1/58), and unclassified subtype accounted for 27.59% (16/58). The local infection cases accounted for 31.03% (18/ 58), and the imported cases accounted for 68.97% (40/58). There were no local infections since 2011. Anopheles sinensis, the only malaria vector in Danyang City, was still prevalent, but its density was low. Imported malaria poses a serious threat to the malaria elimination achievements in Danyang City, and the surveillance and disposal of imported malaria need to be strengthened.

Epidemiological characteristics of malaria in Yizheng City from 2000 to 2016

To explore the epidemiological characteristics of malaria in Yizheng City, so as to provide a reference for formulating the control strategy in the future. The data of malaria case reports and prevention and control work in Yizheng City were collected and retrospectively analyzed. Totally 55 malaria cases were found in Yizheng City from 2000 to 2016 with an average incidence of 0.56/105. The malaria cases were local cases from 2000 to 2010 and since 2011 they were all imported cases. The endemic situation of malarial in Yizheng City is stable and no local infection cases occur in this place for six consecutive years. The imported cases should be paid more attention to in the future control work.

Clinical efficacy of botulinum toxin in salivary duct stenosis: A preliminary study of six cases.

Salivary duct stenosis is the second most common cause of obstructive pathology after lithiases, and it primarily affects the parotid gland. Salivary duct stenosis is treated with drug therapy and/or sialendoscopy. If unsuccessful, surgical removal of the gland is indicated, but it is associated with a high risk of facial morbidity. The aim of this study is to evaluate the clinical efficacy of an alternate treatment, botulinum toxin, in salivary duct stenosis. In a preliminary retrospective study from January 2011 to December 2014, six patients with parotid duct stenosis received 50IU of botulinum toxin in three injections in the parotid gland. The frequency of relapses and the intensity of pain and swelling were recorded before and after treatment. The onset of action and duration of efficacy were also assessed. Four of six patients showed a decrease in the frequency of swelling episodes and greater pain relief during the first year of treatment, but to a lesser extent after 2years. The mean duration of efficacy was 3.5months with an interval between two injections of 5.7months. Only one parotidectomy had to be performed. No major side effects were observed, with only one case of local infection at the injection site. Botulinum toxin appears to be a viable alternative in treating salivary duct stenosis before resorting to surgical gland removal.

Analysis of assessment results of malaria elimination in counties (districts) of Huai'an City

Objective To analyze the results of the assessment of malaria elimination in 8 counties (districts) in Huai'an City, Jiangsu Province, so as to provide evidences for consolidating the achievement of malaria elimination. Methods The data from the network reports of malaria epidemic situation, blood examinations of febrile patients, epidemiological questionnaires of malaria cases, investigation and disposal of epidemic focuses were collected and analyzed in Huai'an City from 2010 to 2016. The results of the assessment on the clinicians'ability of malaria diagnosis and treatment as well as the inspectors'skill of Plasmodium microscopic examinations were analyzed. In the natural village where the last local case of malaria was reported, no less than 200 blood filter papers were made for gene detection of Plasmodium. Results From 2010 to 2016, 308 malaria cases were reported in Huai'an City. Totally 323 002 patients received blood detection of malaria, among which 272 ones were positive and the positive rate was 0.08%. The majority of the malaria cases were imported, except 19 and 3 local infection cases in 2010 and 2011, respectively. Except Qinghe District, a total of 1 420 blood filter papers from the other 7 counties (districts) were detected genetically, and the results were all negative. Six of the eight counties (districts) gained an average score of 20 points on the Plasmodium microscopic examination, and Jinhu County and Huai'an District got a minimum average score of 19.6 points. In capacity assessment of malaria diagnosis and treatment, Hongze District gained the highest average score of 20 points, and Huai'an District got the lowest average score of 18.8 points. The malaria elimination assessment scores of the eight counties (districts) were all above 97 points. All the 8 counties (districts) in Huai'an City passed the malaria elimination assessment at county (district) level until 2016. Conclusions All the 8 counties (districts) in Huai'an City have passed the malaria elimination assessment with high scores. After the malaria elimination, the monitoring still should continue to consolidate the achievement.

Time characteristics of imported malaria cases in Yunnan Province

Objective To investigate the time distribution characteristics and the epidemic trends of imported malaria cases in Yunnan Province. Methods The malaria case records and epidemiological history data of Yunnan Province were collected, and the local infection cases were excluded. The data were statistical analyzed. Results The imported malaria cases had a significantly seasonal periodicity (Q = 26.574, P < 0.05) and epidemic trends (Q = 35.487, P < 0.05). The imported peak was in May, while February was the lowest month of imported cases, and the difference was significant (Z = -2.619, P < 0.05). The simple seasonal prediction model was the best model (R2 = 0.677, BIC = 4.867) for forecast while the residual sequence was white noise (Q = 14.226, P > 0.05). By using the model to predict the cases in January, February and March of 2016, the number (95% CI) were 29 (7-50), 22 (0-44) and 31 (8-54), and the actual number of imported malaria cases were 29, 24 and 38 cases respectively and all cases were included in the 95% CI. Conclusion The imported malaria cases in Yunnan Province had a significantly seasonal periodicity and epidemic trends, and the established model has good prediction on the recent cases.

Post Traumatic Reconstruction of the Pediatric Heel and Achilles Tendon: A Review of Pedicle Flap Options in 31 Motorcycle Spoke Trauma Patients.

Severe motorcycle spoke injuries of the heel lead to Achilles tendon defects, calcaneal tubercle exposure or loss, and overlying soft tissue defects, which are challenging to treat. Given the special physiological and developmental characteristics of children, severe spoke injuries of the heel in children are especially troublesome.We report details of 31 cases of severe motorcycle spoke injuries of the heel in children. The reconstruction timing depended on the time since injury, systematic conditions, and concurrent injuries. Eighteen cases were reconstructed at the time of emergency surgery, and 13 cases underwent delayed reconstruction. Appropriate flap transfer and Achilles tendon repair were conducted based on the defect size of the Achilles tendon, the main location of the soft tissue defect, and the distal residues of the Achilles tendon.Of the 31 cases, 16 cases were reconstructed with sliding gastrocnemius musculocutaneous flaps, 7 cases had saphenous neurocutaneous flaps, 4 cases had posterior tibial perforator flaps, 3 cases had sural neurocutaneous flaps, and 1 case was repaired with a peroneal artery perforator flap. All flaps healed uneventfully except for 3 cases of flap partial necrosis and 1 case of local infection of the Achilles tendon. During 6 months to 4 years of follow-up, dorsiflexion of the ankle was obviously limited at first but gradually recovered and enabled normal walking. However, due to the possibilities of calcaneal defects, epiphyseal injuries, and Achilles tendon problems, long-term follow-up is indicated.

Schistosomiasis surveillance after interruption of schistosomiasis transmission in Xiuzhou District, Jiaxing City

To analyze the endemic situation of schistosomiasis after its interruption of transmission in Xiuzhou District, Jiaxing City, Zhejiang Province, so as to provide the references for future surveillance work. The data of schistosomiasis and Oncomelania hupensis snails in Xiuzhou District were collected and analyzed statistically. From 1994 to 2015, totally 975 village-times were investigated for O. hupensis snails, and the accumulated area of 4 385.31 hm2 was surveyed. Twenty former snail sites were reoccurring, with an area of 32.61 hm2. An area of 57.71 hm2 was supplied with snail eradication measures. Totally 11 941 snails were dissected and no schistosome infected snails were found. The serum and stool tests were performed to 221 794 and 3 731 residents respectively, and no local infection cases but four imported cases were found. The endemic situation of schistosomiasis in Xiuzhou District is stable after the transmission was interrupted. However, there are imported schistosomiasis cases, and therefore, the prevention of imported infection source is the focus of surveillance work.

Surgical Treatment of Displaced Supracondylar Pediatric Humerus Fractures: Comparison of Two Pinning Techniques

The aim of this study is to report the results of the treatment of displaced supracondylar humerus fractures comparing two different techniques, crossed and lateral pins. We retrospectively reviewed 35 children hospitalized between May 2005 and December 2012. Patients were treated with two different pin configurations, crossed (Group 1) and lateral (Group 2). After surgery, clinical and radiographic evaluation was performed. Postoperatively, the clinical assessment showed recovery of joint function of the elbow. Radiographically, Group 1 showed a difference in the Baumann angle between the value of the injured limb and the normal angle of 5.3° ± 2.12°; in Group 2 the difference was 4.9° ± 2.82°. Complications: group 1, two cases of short paresthesia, one case of slight varus, mild asymmetry, and deficit to extension of the humerus and group 2, two cases of local infection and one of a slight hyperextension were reported. Both groups achieved a satisfying outcome with similar results in joint function recovery and complications.

Monitoring situation of eliminating malaria in Shaoguan City from 2001 to 2014

To analyze the malaria monitoring situation in Shaoguan City from 2001 to 2014, and evaluate the efficacy of the malaria control and prevention work, so as to provide the evidence for formulating the effective eliminating malaria measures. The microscopic examination monitoring points of "four-fever" patients were established in medical institutions at all levels in Shaoguan City from 2001 to 2014, and the fever patients were examined by microscopy and the active case monitoring was performed. By using the epidemiology method, the malaria incidence and classification of cases were described and analyzed statistically. From 2001 to 2014, 91 381 "four-fever" patients were monitored and 22 malaria patients were found with the average positive rate of 0.02%. Among the 22 malaria patients, 20 were imported (90.91%) and 2 were local cases (9.09%). The local patients were infected with Plasmodium vivax, and among the imported patients, 16 patients were infected with P. vivax, 2 infected with P. falciparum and 2 infected with P. ovale. No local infection cases were found since 2006. All the patients were timely treated and no second generation cases were found. From 2011 to 2014, 2 611 person-times were actively investigated in 7 counties (city) and no malaria patients were found. In Shaoguan City, there are remarkable achievements in the malaria prevention and control work. However, there are still imported cases in recent years, and therefore, the monitoring system should be perfected and the effective monitoring should be strengthened.

Effects of magnesium sulfate wet compress nursing on prognosis of child′s scrotum hematoma after indirect inguinal hernia

Objective To investigate effects of magnesium sulfate wet compress nursing on prognosis of child′s scrotum hematoma after indirect inguinal hernia. Methods A total of 54 pediatric children were collected for inguinal hernia operation by convenient sampling method, and random number table method were used to averagely divide patients into control group (received routine nursing) and observation group (given conventional care and magnesium sulfate local wet dressing care). The child′s length of hematoma vanishing and incidence of complications were compared between two groups. Results In the observation group, the length of hematoma vanishing was 4-10 d, the average time (5.8±1.45)d, while the length of hematoma vanishing was 6-14 d, the average (7.8±2.11)d in the control group (P<0.05). There was no incidence of ulcer, local infection and other complications in the observation group whereas 3 cases of ulcer and 1 cases of local infection in the control group (P<0.05). Conclusions Magnesium sulfate wet compress nursing can shorten the length of child′s scrotum hematoma vanishing after indirect inguinal hernia surgery and reduce the incidence of complications. Key words: Pediatric Department; Indirect inguinal hernia; Scrotum hematoma; Magnesium sulfate wet compress

Percutaneous dilatational tracheostomy following total artificial heart implantation.

Coagulation disorders and an immune-altered state are common among total artificial heart patients. In this context, we sought to evaluate the safety of percutaneous dilatational tracheostomy in cases of prolonged need for mechanical ventilatory support. We retrospectively analysed the charts of 11 total artificial heart patients who received percutaneous dilatational tracheostomy. We focused on early and late complications. We observed no major complications and no procedure-related deaths. Early minor complications included venous oozing (45.4%) and one case of local infection. Late complications, including subglottic stenosis, stomal infection or infections of the lower respiratory tract, were not observed. In conclusion, percutaneous dilatational tracheostomy in total artificial heart patients is safe. Considering the well-known benefits of early tracheotomy over prolonged translaryngeal intubation, we advocate early timing of therapy in cases of prolonged mechanical ventilation.