RESUMO
CONTEXT: Hospital-acquired infections (HAIs) are a global problem. One of the common causes of HAI is through the health-care workers, mainly because of failure to comply with the recommended infection control guidelines. AIMS: The aim of our study was to educate and train the nurses regarding infection control practices and assess the impact of training and assess whether this training actually made any change in the incidence of catheter-associated urinary tract infection (CAUTI) and intravenous (IV) line-related infections. MATERIALS AND METHODS: Baseline knowledge, attitude, and practices study of willingly participating 105 nurses regarding infection control was done. The incidence of CAUTI and IV line-related infection was calculated in the areas of their postings. They were trained via an educational module regarding infection control practices. We again assessed the incidence of CAUTI and IV line-related infections in the same areas 2 months after training. Data analysis was done using SPSS version 20.0. Student's t-test was used to analyze the difference in the prevalence of CAUTI and IV line-associated HAIs pre intervention and post intervention. RESULTS: There was reduction in the incidence of IV line-related infection, though it was not significant (P 0.15) and no change in the incidence of CAUTI after intervention. CONCLUSION: Single educational module though improved nurses' knowledge and attitude regarding infection control but failed to result in significant improvement in practices and incidence of HAIs.
RESUMO
Recent literature stresses various factors that influence outcome in neonates with esophageal atresia (EA), including associated congenital anomalies, ventilator dependency, and gap length. Although the existing modalities can fairly accurately assess the first two factors, a comparable modality for assessing the interpouch gap in a natural unstretched position preoperatively is lacking. A technique of direct sagittal computed tomography (CT) scanning of the chest, initially employed by Tam et al. in 1987, was found to provide fairly accurate information on the level of origin of the fistula and the interpouch distance, with pouches in natural, unstretched positions, in two neonates with EA and distal tracheoesophageal fistula (TEF). However, no further studies were reported using this technique. We studied 10 neonates with EA and distal TEF, the most common variant, using this technique. The addition of axial cuts was done in the event of a short upper pouch or suboptimally-clear anatomical details in sagittal chest CT films. The preoperative information in our study subjects was found to corroborate well with operative findings except in the one patient with laryngotracheoesophageal cleft (LTEC). Prior information of a left bronchoesophageal fistula in two of the neonates with dextrocardia greatly helped us in saving operative time and difficulties and postoperative hassles. The chest CT scan proved to be a noninvasive and quick means for investigating neonates with the most common variant of EA. CT scanning could be extended for routine preoperative evaluation of neonates with EA to prepare for intraoperative problems, besides helping prognostication.
Assuntos
Atresia Esofágica/diagnóstico por imagem , Recém-Nascido , Radiografia Torácica/métodos , Tomografia Computadorizada por Raios X/métodos , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/cirurgia , Dextrocardia/diagnóstico por imagem , Atresia Esofágica/cirurgia , Fístula Esofágica/diagnóstico por imagem , Fístula Esofágica/cirurgia , Esôfago/anormalidades , Esôfago/diagnóstico por imagem , Esôfago/cirurgia , Humanos , Complicações Intraoperatórias/prevenção & controle , Laringe/anormalidades , Laringe/diagnóstico por imagem , Cuidados Pré-Operatórios , Intensificação de Imagem Radiográfica/métodos , Toracotomia/métodos , Traqueia/anormalidades , Traqueia/diagnóstico por imagem , Fístula Traqueoesofágica/diagnóstico por imagem , Fístula Traqueoesofágica/cirurgiaRESUMO
A patient with aortic regurgitation, stenosis, and calcification of the septum is reported. Results of echocardiography revealed asymmetrical septal hypertrophy without other features of idiopathic hypertrophic subaortic stenosis. There was no subaortic obstruction evident on cardiac catheterization and angiography. This case serves to emphasize that calcification of the interventricular septum is another possible cause of asymmetrical septal hypertrophy.
RESUMO
This report describes a patient who received a traumatic injury of the neck 28 years prior to admission to this institution. He had required multiple hospitalizations, along with medications for congestive heart failure. After ligation of a large arteriovenous fistula and replacement of a 3 cm segment of the left common carotid artery with an 8 mm double-velour graft, the patient was greatly improved.