Infection control consequences – early Staphylococcal Scalded Skin Syndrome or Kawasaki Syndrome?

Childhood exanthemata are caused by a broad spectrum of common pathogens. Many exanthemata initially present very similarly, even though caused by different organisms, ranging from virus to bacteria and their respective toxins. In the majority of cases the diagnosis is only of academic value, since therapy does hardly differ. However, in some cases accurate and prompt diagnosis is paramount, since therapy and appropriate hygiene measures prevent morbidity and mortality. We present a case with two differential diagnoses, Staphylococcal Scalded Skin Syndrome and Kawasaki Syndrome, which demonstrates the importance of considering relatively rare conditions as the cause of a childhood exanthema and discuss differences in therapeutic and infection control management. From an infection control point of view, Staphylococcal Scalded Skin Syndrome is, in contrast to Kawasaki Syndrome, highly transmittable to other paediatric patients via the hands of the staff. Therefore maintaining correct hand hygiene as well as other infection control measures are of importance until the final diagnosis is established

An investigation of the relationship between alcohol use and satisfaction with life among college students

The purpose of the investigation was to determine the relationship between alcohol use and satisfaction with life among college students. Six null hypotheses were developed to address the purpose of the study. Null hypothesis one states,no significant relationship exists between satisfaction with life and frequency of alcohol use. In the five other hypotheses the relationship was interacted by class standing,ethnicity, gender,living arrangement,and social fraternity or sorority membership.The population selected for the investigation was students attending theUniversity ofTennessee-Knoxville and enrolled in selective courses during the spring 2000 semester. A sample of convenience was selected from students enrolled in Health And Safety Sciences classes during the spring 2000 semester. Nine sections,consisting of 216 students participated in the study.Data were collected by administering a paper-and-pencil survey to students enrolled in general elective health classes during the Spring 2000 semester. Participantswere given a packet of materials consisting of the demographic and drug use survey questionnaire,the Satisfaction with Life Scale(Diener and Pavot,1985)instrument,and an envelope. The packets were completed in one sitting, during a regularly scheduled health class. Due to the lack of need for identifying each participant and the sensitivity of the drug use questions,total anonymity was required. Participants were informed of subjects\u27 rights, and that participation was voluntary and could withdraw from the study at any time.Each survey was visually inspected and data were entered into a Microsoft Excel Spreadsheet. The Statistical Package For Social Sciences(SPSS)was used for data analysis. A Spearman\u27s rho correlation was used to determine the overall,general relationship between alcohol use and satisfaction with life. Analysis of variance was used to evaluate differences in mean satisfaction with life scores between the levels of alcohol use. Analysis of variance was used to evaluate the relationship of alcohol use and satisfaction with life by class standing,ethnic origin, gender,living arrangement,and social fraternity or social sorority membership.The Spearman\u27s rho correlation indicated a nonsignificant,indirect correlation of-.109(p=.111)for the overall,general relationship between alcohol use and satisfaction with life was reported. The analysis of variance did not find significant differences[F(3,212)=1.13,p=.345] in mean satisfaction with life scores for the four levels of use.The main effect,the relationship of alcohol use and satisfaction with life was interacted by class standing,ethnicity, gender,living arrangement,and social fraternity or sorority membership. The analysis of variance did not find significant differences for any of the interactions. It was concluded that no evidence was found of a definitive nature to associate alcohol use with satisfaction with life. Based on the findings of this study,alcohol use does not influence or affect satisfaction with life

Public Health Rep

LITTLE IS KNOWN ABOUT BLOOD PRESSURE LEVELS and the extent of high blood pressure in Hispanic children and adolescents, especially in groups other than Mexican Americans. The authors of this study investigated the levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the extent of high blood pressure among Mexican-American, Cuban-American, and mainland Puerto Rican children and adolescents who participated in the Hispanic Health and Nutrition Examination Survey (HHANES). Very few children and adolescents in these three Hispanic groups had high normal or high blood pressure. Puerto Rican children had significantly lower DBP than Mexican-American (2.4 mmHg) and Cuban-American (1.8 mmHg) children. Their SBP was also lower (1.7 mmHg) than that of Cuban-American children. These findings should be interpreted cautiously, however, since a significant observer effect was also found in this study. Correlates of blood pressure in children in all three Hispanic groups were consistent with those found in studies of other ethnic groups. Age, body mass index, and pulse rate were significant predictors of both SBP and DBP (P less than 0.05). Gender was an important predictor of SBP but not DBP. Socioeconomic and cultural factors were not significant predictors of blood pressure in these Hispanic groups.8898765PMCnul

DNA characterization of Lyme disease spirochetes.

Lyme disease spirochetes (LDS) have phenotypic characteristics of both treponemes and borreliae. To ascertain whether one or more species of LDS exist, as well as their taxonomic status, we determined the DNA base (G + C) content for three strains of LDS, the DNA relatedness of ten strains isolated in the United States or Europe, and the DNA relatedness of LDS to other spirochetes. The G + C content of the three LDS strains was 28.1-29.0 mol%, most similar to those of Borellia hermsii (30.6 mol %) and Treponema hyodysenteriae (25.6 mol %) among the other spirochetes tested. DNA hybridization studies of nine LDS strains to a reference strain isolated from human blood revealed divergence (unpaired bases) within related nucleotide sequences of only 0.0-1.0 percent, indicating the strains were one species. Similarly, relatedness values of seven strains to the reference strain were high: 58-98 percent (mean, 71 percent) in 50 degrees C reactions and 50-93 percent (mean, 69 percent) in 65 degrees C reactions. Labeled DNA from B. hermsii was 30-40 percent related to three Lyme disease spirochete strains in 50 degrees C reactions and 8-10 percent related in 65 degrees C reactions. In contrast, DNA from the reference LDS strain showed relatedness of only 1 percent to DNAs of two leptospires and only 16 percent to DNA from T. hyodysenteriae. We conclude that LDS are a single species, genetically unlike treponemes or leptospires, which belong in the genus Borrelia

Survey of Obstetrician-Gynecologists in the United States About Toxoplasmosis

Background: Although the incidence of toxoplasmosis is low in the United States, up to 6000 congenital cases occur annually. In September 1998, the Centers for Disease Control and Prevention held a conference about toxoplasmosis; participants recommended a survey of the toxoplasmosis-related knowledge and practices of obstetrician-gynecologists and the development of professional educational materials for them. Methods: In the fall of 1999, surveys were mailed to a 2% random sample of American College of Obstetricians and Gynecologists (ACOG) members and to a demographically representative group of ACOGmembers known as the Collaborative Ambulatory Research Network (CARN). Responses were not significantly different for the random and CARN groups for most questions (p value shown when different). Results: Among 768 US practicing ACOG members surveyed, 364 (47%) responded. Seven per cent (CARN 10%, random 5%) had diagnosed one or more case(s) of acute toxoplasmosis in the past year. Respondents were well-informed about how to prevent toxoplasmosis. However, only 12% (CARN 11%, random 12%) indicated that a positive Toxoplasma IgM test might be a false–positive result, and only 11% (CARN 14%, random 9%) were aware that the Food and Drug Administration sent an advisory to all ACOG members in 1997 stating that some Toxoplasma IgM test kits have high false–positive rates. Most of those surveyed (CARN 70%, random 59%; X(2) p < 0.05) were opposed to universal screening of pregnant women. Conclusions: Many US obstetrician-gynecologists will encounter acute toxoplasmosis during their careers, but they are frequently uncertain about interpretation of the laboratory tests for the disease. Most would not recommend universal screening of pregnant women

Promising Practices in Preconception Care for Women at Risk for Poor Health and Pregnancy Outcomes

Objectives: Two programs targeting urban African-American women are presented as promising models for preconception care, which includes interconception care. Methods: The Grady Memorial Hospital Interpregnancy Care (IPC) Program in Atlanta, Georgia, and the Magnolia Project in Jacksonville, Florida, are described. The IPC program aims to investigate whether IPC can improve the health status, pregnancy planning and child spacing of women at risk of recurrent very low birthweight (VLBW). The Magnolia Project aims to reduce key risks in women of childbearing age, such as lack of family planning and repeat sexually transmitted diseases (STDs), through its case management activities. Results: Seven out of 21 women in the IPC were identified as having a previously unrecognized or poorly managed chronic disease. 21/21 women developed a reproductive plan for themselves, and none of the 21 women became pregnant within nine months following the birth of their VLBW baby. The Magnolia Project had a success rate of greater than 70% in resolving the key risks (lack of family planning, repeat STDs) among case management participants. The black to white infant mortality (IM) ratio was better for the babies born to women managed in the Magnolia Project compared to the same ration for the United States. Conclusions: Preconception care targeted to African-American women at risk for poor birth outcomes appears to be effective when specific risk factors are identified and interventions are appropriate. Outreach to women at risk and case management can be effective in optimizing the woman's health and subsequent reproductive health outcomes