Fistula Campaigns-Are They of Any Benefit?

Objective Evaluation of the problems encountered during a voluntarily fistula campaign in a regional hospital of Niger (Africa) Materials and Methods Women underwent basic gynecological examination, methylene blue testing, and/or direct cystoscopy as necessary According to their clinical condition, women were informed and surgical options offered as appropriate Operations were performed under spinal or epidural anesthesia Immediate postoperative outcomes were followed during the stay of the surgical team in the country Results A total of 62 women were examined and 11 had causes of incontinence other than obstetric fistula In 9 8% of the women, severe local infection precluding any surgical intervention was evident In 58 8% of patients, the trigonal region and/or urethra were irreversibly damaged A proportion of patients (9 8%) with large lesions and intact urethra that were offered vaginal layered closure refused the intervention Of the women that were operated on (21 6%), six underwent vaginal layered closure with Martius fat flap and five women underwent a combined abdomino vaginal approach Conclusion It is extremely difficult to meet the needs of this global problem with short term programs and volunteers Directing these efforts to specialist fistula centers and creating reliable scientific evidence should be the main goal [Taiwan J Obstet Gynecol 2010,49(3) 291-296

International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

Experimental investigation of transverse loading on composite panels coated with different gelcoat colors subjected to UV radiation and hygrothermal aging

This study focuses on the effects of hygrothermal and UV radiation aging on the reinforced epoxy composites coated with gelcoat. The aim of this study is to investigate the influence of gelcoat colors on the tensile properties, impact behavior and thermodynamic properties of the composite panels after the aging process has been performed. Two different gelcoat colors were chosen as black and yellow. Unidirectional E-glass fiber fabrics with an areal density 300 g m(-2) as reinforcement and epoxy matrix were used. Vacuum-assisted resin infusion molding (VARIM) method was used to manufacture composite panels. The tensile test specimens were prepared according to ASTM standards. Tensile strength of both fiber and transverse directions, the impact perforation threshold, and stroge modulus of the aged samples decreased compared to unaged (virgin) samples. However, the drop in mentioned properties for coated materials is less than for uncoated materials, especially in yellow coated materials. The temperature of hygrothermal conditions significantly affected the perforation threshold. Moreover, the tensile strength in transverse direction in yellow samples decreased approximately 13%, while it decreased 23% in the black coated samples. Impact perforation threshold of unaged (virgin), uncoated, coated with yellow gelcoat and coated with black gelcoat is obtained to be 75, 57, 65 and 61 J, respectively

Factors that affect interictal cardiovascular autonomic dysfunction in temporal lobe epilepsy: Role of hippocampal sclerosis

The aim of this study was to evaluate possible factors affecting interictal cardiovascular autonomic function in temporal lobe epilepsy with complex partial seizures, paying special attention to hippocampal sclerosis. The study was carried out with 88 patients with epilepsy (22 with left hippocampal sclerosis, 22 with right hippocampal sclerosis, and 44 Without hippocampal sclerosis) and 44 healthy subjects. All subjects underwent three tests of cardiac autonomic function: heart rate variation during resting activity, heart rate variation in response to deep breathing and blood pressure response to rising quickly from the supine position. Hippocampal sclerosis and disease duration were found to have significantly important effects on parasympathetic autonomic function, whereas seizure control and type of antiepileptic drug had significant effects on sympathetic autonomic function. This study shows that in addition to factors related to the chronic nature of epilepsy and antiepileptic drug use, hippocampal sclerosis may cause autonomic dysfunction during the interictal period in persons with temporal lobe epilepsy. (C) 2009 Elsevier Inc. All rights reserved