Pseudohyperphosphatemia associated with high-dose liposomal and lipid complex amphotericin B when tested with Synchron LX 20 (Beckman/Coulter) phosphorous assay.

Although case reports of hyperphosphatemia have been previously described in patients receiving liposomal amphotericin B, this has not been reported in patients receiving the lipid complex formulation. We report a case of hyperphosphatemia that persisted despite switching from liposomal to lipid complex amphotericin B in a child with invasive zygomycosis. This case suggests that in the context of acute renal dysfunction, hyperphosphatemia may also be observed with lipid complex amphotericin B. This case highlights the importance of differentiating between pseudohyperphosphatemia and hyperphosphatemia to prevent complications.

Practices and attitudes of surgeons toward the prevention of surgical site infections: a provincial survey in Alberta, Canada.

We surveyed 589 surgeons in Alberta, Canada, about the prevention of surgical site infections and compared their practices to the recommendations of evidence-based guidelines. Of the 247 (42%) who responded, most (156 [63%]) were not in compliance with guideline recommendations for preoperative bathing, hair removal, antimicrobial prophylaxis, or intraoperative skin preparation (although 91 [37%] state they are following guidelines).

The assessment and management of tinea capitis in children.

Tinea capitis is an infection of the scalp and hair shaft caused by dermatophyte fungi. It is seen in all age groups, and the incidence seems to be on the rise in North America. Clinical diagnosis of tinea capitis can be challenging, as symptoms can vary from minimal pruritus with no hair loss, to severe tenderness, purulence, and permanent scarring in inflammatory kerion lesions. The diagnosis of tinea capitis must be confirmed in the laboratory by using fungal stains or obtaining cultures, since treatment may be prolonged with potential side effects. Systemic therapy is needed because topical antifungals cannot effectively penetrate the hair shaft to eradicate the infection. Oral griseofulvin remains the standard treatment agent, but terbinafine and itraconazole are also effective alternatives (although currently without Food and Drug Administration approval).

A survey of Alberta physicians' use of and attitudes toward face masks and face shields in the operating room setting.

BACKGROUND: There is little evidence that surgical mask use by physicians in the operating room (OR) reduces surgical site infections (SSIs), but masks do protect the wearer from potentially infectious splashes. Face shields offer even more protection because they cover the eyes, but they may be perceived as offering less protection to the patient than do masks. The objectives of this study were to ascertain if there were predictors to determine which OR physicians are continuing to use masks and what their reasons are for doing so, and which OR physicians would accept face shields and their reasons for doing so. METHODS: We surveyed the province of Alberta's surgeons, general practice (GP) surgeons, anesthesiologists, and GP anesthetists to determine how many physicians in the OR wear surgical masks, their reasons for wearing surgical masks (ethical, legal, protection of the patient, protection of the wearer), and if they believe that face shields offer more protection to the patient or to the wearer. We also sought to examine which demographic factors affected their responses. The data were examined with chi(2) analysis to assess the relationships of age and practitioner type, and for various outcome variables. A significance level of P < .05 was accepted as statistically significant. RESULTS: The sex of the physician did not affect his/her responses. Older physicians believe that the OR team has an ethical and legal responsibility to wear surgical masks; masks are worn to prevent the spread of disease, not because it is tradition to do so; masks protect the wearer more than do face shields; and wearing face shields alone will subject the patient to higher rates of SSIs. Surgeons are more likely than are anesthesiologists to wear surgical masks in the OR and wear a surgical mask and a face shield if the patient has risk factors for a blood borne infection. CONCLUSIONS: According to our survey, age and profession were the most important variables that affected the potential use of surgical masks and face shields. Younger OR physicians likely would be amenable to using face shields in addition to masks in the OR to protect themselves from exposure to blood or bodily fluids.