An appreciation of A.E. Malloch, MB, MD (1844-1919): a forgotten surgical pioneer.
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Dr. Archibald Edward Malloch was a surgeon whose life and work were greatly influenced by Joseph Lister and his revolutionary system of antiseptic surgery. This paper describes how a young Canadian medical man came to introduce Lister's system to North America in 1869 and studies his career in the light of Lister's surgical epoch. (+info)
Expectations and perceptions of Greek patients regarding the quality of dental health care.
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OBJECTIVE: The aim of this study was to investigate the perceptions and expectations of patients regarding the quality of dental health care they received and the criteria they used to select a dentist. DESIGN: Descriptive study. METHODS: Two questionnaires referring to the expectations and the perceptions of dental health care were handed to patients. Likert-type scales were used to evaluate the characteristics examined. These characteristics have been classified in four quality dimensions: 'assurance', 'empathy', 'reliability' and 'responsiveness'. STUDY PARTICIPANTS AND SETTING: Two hundred consecutive patients who visited the Dental Clinic of the School of Dentistry, University of Athens, Greece, in 1998-1999. RESULTS: The patients' top priority was adherence to the rules of antisepsis and sterilization. Women of the middle and lower socio-economic groups were more demanding than men of the same groups, while men of the upper socio-economic group appeared to be more demanding than women (P = 0.02). Their perceptions of the dental service provided reflected their satisfaction regarding the adherence to the rules of antisepsis and sterilization, but also showed their moderate satisfaction regarding most of the other characteristics and their dissatisfaction regarding information on oral health and hygiene. CONCLUSION: Expectations and demands regarding empathy (approach to the patient) and assurance were placed at the top of the patients' priorities. A highly significant quality gap was observed between the desires of the patients and their perceptions (P< 0.01) and the largest gap was noted concerning information they received about oral health diseases. The largest quality gap was also observed in characteristics regarding responsiveness. (+info)
Wound infection in colonic surgery.
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Three hundred forty-one consecutive cases of colonic surgery performed by the Proctology service of our hospital have been reviewed. There was a total of 7 wound infections, constituting an incidence of 2.1%. The infection rate in clean contaminated cases was 0.8% and in contaminated cases, 4.7%. The mortality rate was 2.3%. Parenteral antibiotics were used in less than 50% of the operations. Our impression is that attention to one modality of wound infection prevention with disregard for the others will produce little. However, close attention to all the modalities by which we can hope to reduce wound infection appears to produce strikingly beneficial results. (+info)
Bacteriology of air-conditioning ducts with special reference to operating rooms.
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The number of bacteria in air, before filtration with five different easily available filters in the low positive-pressure type of airconditioning system of the Winnipeg General Hospital, was between 3 and 4/cu. ft., and after filtration between 1 and 2/cu. ft. with all types of filters. Cl. welchii contributed about 1% and Staph. pyogenes about 0.1% of this total. Sampling the exhaust air from an operating room during an operation showed that the bacterial count fluctuated with the degree of activity in the room and was from two to 10 times as high as in the air delivered to the room.Atlhough every reasonable attempt should be made to diminish the bacterial count of air in hospitals, if much energy and money is to be spent it would probably be wiser to investigate sources of hospital infection other than the type of air-conditioning system described in this report. (+info)
Enumeration of air-borne bacteria in hospital.
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An investigation of the "normal" bacterial content of the air of a large general hospital is described. In many different places within five different areas 70 to 200 settle-plate or slit-sampler bacterial counts were carried out. Average counts were most often of the same order as or lower than other published results and were proportional to human activity. The use of the logarithms of the counts showed no advantage, and conventional statistics should be applied with caution in evaluating such studies. Slitsampler and settle-plate counts of all bacteria showed no correlation, whereas those of Staph. aureus were correlated. There is a lack of parallelism between hospital infection and air bacteria counted by current methods, which are, therefore, not suitable for routine use. (+info)
ASEPSIS IN THE OPERATING THEATRE.
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In the investigation of several blood stream infections following open-heart surgery, sutures and other material that had been exposed and handled in the sterile field were examined bacteriologically. One hundred and seventy-five open-heart operations were carried out during the study period and a high percentage of the specimens cultured yielded viable staphylococci and diphtheroids. Glove powder, textile fibres, and skin squames were found in the dust that collected in the room during the operations and staphylococci were frequently recovered from this source, and from the floor. Although the air supply to the theatre appeared to be of good quality, it is suggested that air currents within the room had caused dissemination of this foreign material and had probably contributed to wound infections. (+info)
BETA-PROPIOLACTONE DECONTAMINATION OF SIMIAN VIRUS-40 AS DETERMINED BY A RAPID FLUORESCENT-ANTIBODY ASSAY.
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beta-Propiolactone vapor treatment of vaccine production facilities has been shown to be approximately 90% effective in the elimination of large quantities of Simian virus-40 (SV(40)). The use of a rapid fluorescent-antibody assay for the detection of SV(40) was also studied. (+info)
Preparing the wound bed 2003: focus on infection and inflammation.
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Wound bed preparation is the promotion of wound closure through diagnosis of the cause, attention to patient-centered concerns, and correction of systemic and local factors that may delay healing. To enhance the evidence base that may be lacking, a review of relevant literature was conducted and combined with input from the International Wound Bed Preparation Advisory Board and the Canadian Chronic Wound Advisory Board to create an updated examination of practices. A template based on expert opinion of the clinical actions corresponding to each step in the paradigm of preparing the wound bed is presented and the effects of local factors (tissue debridement, infection or inflammation, moisture balance, and edge effect [TIME]) are discussed. This review differentiates increased bacterial burden/infection in the superficial and deep wound bed compartments from inflammation and provides a topical approach to treatment. Inflammatory conditions causing leg ulcers, including pyoderma gangrenosum and vasculitis are reviewed. The topical combination of silver with absorptive dressings has led to new therapeutic options for increased bacterial burden in the surface wound compartment. A compilation of the available systematic reviews for the treatment of infection has been included as a background for the expert opinion. (+info)