Healthcare workers' hand hygiene knowledge and compliance evaluation, in a Greek university hospital.

OBJECTIVE: Healthcare associated infections affect both patients and employees, in terms of morbidity, mortality, and financial costs. Routine hand hygiene is the most important factor against this pestilence. Hand hygiene knowledge and compliance of healthcare workers are considered poor worldwide. Herein, we aimed to measure knowledge and compliance with hand hygiene of the healthcare workers at a university hospital. MATERIALS AND METHODS: The "WHO hand hygiene knowledge questionnaire for healthcare workers" was translated in the Greek language, and was validated linguistically, culturally, and psychometrically. Reliability, content, construct, and convergent validity were measured. A survey on hand hygiene knowledge, and compliance, based on this questionnaire, was conducted on 439 employees. RESULTS: The translated questionnaire presented good reliability, with Guttman's Lambda-6 evaluation (0.7). Content Validity Ratio was 84.6%. Confirmatory and exploratory factor analysis showed moderate construct validity. Convergent validity showed low correlation between the questionnaire items. Regarding the answers received, it was found that only 55.3% of the respondents received formal training on hand hygiene during the last three years prior to the study. Furthermore, 74.0% of them used alcohol-based solutions routinely. Only 54.3% of the participants presented an acceptable level of hand hygiene knowledge. CONCLUSIONS: The translation and validation of the WHO questionnaire resulted in an acceptable, reliable, and valid instrument. The survey showed that hand hygiene is rather a matter of habit, than of knowledge, and that there is great need of more organized training.

The association between obesity and the risk for development of eating disorders - A large-scale epidemiological study.

OBJECTIVE: Eating disorders and obesity are serious, multifactorial diseases with increasing prevalence worldwide, often manifesting during childhood and adolescence. The aim of this study was to investigate the risk for developing eating disorders in children and adolescents of Primary and Secondary Education, with normal or excessive body weight. MATERIALS AND METHODS: A representative sample (N=3504) of students from schools of Western Greece, 50.2% boys, aged 10-16 years old, participated in the present cross-sectional epidemiological study. The students' dietary habits were assessed through multiple-choice questions and the risk for the development of eating disorders was evaluated using the Eating Attitudes Scale (EAT-13) validated questionnaire. Anthropometric measurements were obtained and the BMI, BMI% and BMI z-score were calculated. RESULTS: Nearly 20% of the participants, particularly those with overweight or obesity, were at increased risk for developing eating disorders (25% of normal weight-, 28.2% of overweight- and 33% of participants with obesity). Boys were more likely to develop eating disorders than girls, but not statistically significantly. A positive correlation of: (1) the overall EAT-13 score, (2) food pre-occupation score and (3) dieting score, with BMI z-score and obesity was found, as opposed to a negative correlation of Important Others score with BMI z-score and obesity. CONCLUSIONS: Increased awareness regarding the risk for developing eating disorders or disordered eating in children and adolescents with overweight and obesity is recommended to avoid underdiagnosis of this condition. Prompt identification of children at risk contributes to the implementation of targeted and effective prevention and treatment interventions.

Battling bacterial infection with hexamethylene diisocyanate cross-linked and Cefaclor-loaded collagen scaffolds.

Implant infections remain a major healthcare problem due to the prolonged hospitalisation period required to disrupt and treat bacterial biofilm formation, and the need for additional surgery to remove/replace the infected implant, which if not removed in a timely manner may lead to sepsis. Although localised drug administration, via an implanted scaffold, has shown promise in a clinical setting, the ideal scaffold cross-linking (to initially withstand the aggressive infection environment) and drug (to be effective against infection) have yet to be identified. In this work, in the first instance, the biochemical, biophysical, and biological properties of collagen sponges as a function of various concentrations (0.625%, 1.0%, 2.5%, 5.0%, and 10.0%) of hexamethylene diisocyanate were assessed. Data presented illustrate that hexamethylene diisocyanate at 0.625% concentration was able to effectively stabilise collagen scaffolds, as judged by the reduction in free amines, adequate resistance to collagenase digestion, reduction in swelling, increase in denaturation temperature, suitable mechanical properties, and appropriate cytocompatibility. Subsequently, collagen scaffolds stabilised with 0.625% hexamethylene diisocyanate were loaded with variable concentrations (0, 10, 100, and 500 µg ml-1) of Cefaclor and Ranalexin. Both drugs exhibited similar loading efficiency, release profile, and cytocompatibility. However, only collagen scaffolds loaded with 100 µg ml-1 Cefaclor exhibited adequate antibacterial properties against both 106 and 108 colony-forming units per ml of both Escherichia coli and Staphylococcus epidermidis.

In Vitro Enzymatic Degradation of Tissue Grafts and Collagen Biomaterials by Matrix Metalloproteinases: Improving the Collagenase Assay.

Matrix metalloproteinase-1 and -8 are active during the wound healing and remodelling processes, degrading native extracellular matrix and implantable devices. However, traditional in vitro assays utilize primarily matrix metalloproteinase-1 to mimic the in vivo degradation microenvironment. Herein, we assessed the influence of various concentrations of matrix metalloproteinase- 1 and 8 (50, 100, and 200 U/mL) as a function of pH (5.5 and 7.4) and time (3, 6, 9, 12, and 24 h) on the degradation profile of three tissue grafts (chemically cross-linked Permacol, nonchemically cross-linked Permacol and nonchemically cross-linked Strattice) and a collagen biomaterial (nonchemically cross-linked collagen sponge). Chemically cross-linked and nonchemically cross-linked Permacol samples exhibited the highest resistance to enzymatic degradation, while nonchemically cross-linked collagen sponges exhibited the least resistance to enzymatic degradation. Qualitative and quantitative degradation analysis of all samples revealed a similar degradation profile over time, independently of the matrix metalloproteinase used and its respective concentration and pH. These data indicate that matrix metalloproteinase-1 and matrix metalloproteinase-8 exhibit similar degradation profile in vitro, suggesting that matrix metalloproteinase-8 should be used for collagenase assay.

The human neurosecretory neurones under perinatal hypoxia: a quantitative immunohistochemical study of the supraoptic nucleus in autopsy material.

In the rat, experimental manipulations that cause activation of the magnocellular neurosecretory neurones result in the synthesis, in addition to vasopressin (AVP) and oxytocin (OXY), of other neurotransmitters or peptides, including tyrosine hydroxylase (TH), the first and rate limiting enzyme for catecholamine biosynthesis. In the human neonate, our previous study showed that TH was selectively increased in AVP neurones of subjects that died from prolonged perinatal hypoxia. The purpose of the present study was to quantitatively investigate the expression of TH, AVP, OXY and neurophysin in magnocellular neurones of the human neonate in relation to the severity/duration of perinatal hypoxia, as estimated by neuropathological criteria. Autopsy was performed after obtaining parental written consent for diagnostic and research purposes. The intensity of the immunohistochemical reactions and the cellular/nuclear size were measured in the dorsolateral supraoptic nucleus using a computerised image analysis system. We showed that prolonged perinatal hypoxia resulted in the activation of the magnocellular neuroendocrine neurones of the human neonate, as indicated by their increased neuronal and nuclear size. OXY neurones appeared larger than the AVP ones at birth, possibly indicating an active role of foetal OXY during labour or even earlier. The gradual increase in the duration of the insult resulted in the reduction of intracellular AVP content, in parallel with a dramatic increase in the expression of TH, indicating a functional interaction of these peptides under neuronal activation. Ιsolated evidence in our series, obtained from an infant of a diabetic mother, raises the probability that in the case of hyperglycaemia the above pathogenetic mechanisms are diversified.