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Biomedical subjects

R G Mathias

Publications and source records attributed to R G Mathias.

At least 37 records · Page 2Linked to original sources
PubMed1990

Adoption of guidelines for Universal Precautions and Body Substance Isolation in Canadian acute-care hospitals.

The impact of recently recommended hospital infection control guidelines on Canadian acute-care hospitals is unknown. A confidential cross-sectional mailed survey of all acute-care Canadian hospitals was conducted to determine rates of receipt and adoption of published guidelines for Universal Precautions (UP) or Body Substance Isolation (BSI), rationale for adoption and knowledge of costs and benefits. Five hundred and seventy-nine of 943 sites (61%) responded (exceeding 80% in urban centers); 94% among hospitals with at least 300 beds and 57% among those under 300 beds. Seventy-four percent of responders claimed adoption of UP (65%) or BSI (9%), staff protection being their primary motivation. Adoption of either UP or BSI was associated with size (p less than .001), increasing progressively from 45% in the smallest group (less than 25 beds) to 84% in the largest (greater than or equal to 500 beds). Many hospitals introduced modifications and some substituted names other than UP or BSI in adopting a new strategy. In practice, UP and BSI now mean different things in different hospitals, and the distinction between them has become blurred. Furthermore, only 5% claiming adoption of a new strategy adopted all of the fundamental policies expected under UP or BSI. Receipt of guidelines was also correlated with size: one-third of hospitals under 200 beds had not received key publications defining UP and BSI. Only 19% claiming adoption of a new strategy indicated knowledge of cost implications. These results suggest a need for closer collaboration among hospitals and government agencies in developing uniform infection control policies, and for systematic evaluation of the cost and effectiveness of new strategies.

Body Fluids↗
PubMed1990

Epidemiology and pathogenicity of Blastocystis hominis.

A prospective study was performed on a large outpatient population to evaluate the epidemiology and pathogenicity of Blastocystis hominis. Patients with stool specimens positive for B. hominis and negative for other bacterial and parasitic pathogens were sent a questionnaire and were requested to submit a follow-up specimen for ova-and-parasite examination. B. hominis was identified in 530 of 16,545 specimens (3.2%). There was a spectrum of clinical-pathological presentations in the 143 patients evaluated. An asymptomatic carrier state was seen in 19 patients. Fifteen patients had an illness consistent with acute self-limited B. hominis gastroenteritis, and 21 patients had chronic gastroenteritis associated with B. hominis. In the epidemiological evaluation of 130 patients, the most common symptoms were watery diarrhea, abdominal pain, and gas. We did not find a statistically significant association between the number of organisms present and the disease state. In summary, our results are consistent with a role for B. hominis in acute and chronic gastroenteritis; however, further detailed studies are necessary to determine whether that role is one of association or causation.

Adolescent↗
PubMed1989

Clinical and microbiological evaluation of four culture methods for the diagnosis of peritonitis in patients on continuous ambulatory peritoneal dialysis.

A prospective study was performed to evaluate four culture methods for the diagnosis of bacterial peritonitis in patients on continuous ambulatory peritoneal dialysis. Peritonitis was present in 44 of 85 patient admissions (52%). The overall sensitivity of the culture methods in detecting peritonitis was 66%. The sensitivities of the individual methods were as follows: bag culture method, 61%; blood culture broth method, 51%; filter method, 54%; and plate method, 39%. Our broad definition of peritonitis resulted in lower sensitivities. A combination of the bag and blood culture broth methods detected all positive cultures.

Bacteria↗
PubMed1989

The role of secondary vaccine failures in measles outbreaks.

An outbreak of measles in 1985-86 in a community where measles vaccine trials had been carried out from 1974-76 allowed the assessment of the role of secondary vaccine failures in previously immunized children. A total of 188 children from the vaccine trial were followed. Of these, 175 seroconverted initially while 13 (6 per cent) required re-immunization (primary failure). A total of 13 cases of measles, eight of which were laboratory and/or physician-confirmed, were reported in this cohort. Of these, nine cases occurred in the 175 subjects who had hemagglutination inhibition test (HI) and neutralizing antibody responses following the initial immunization. These nine cases represent secondary vaccine failures. An additional four cases occurred in the 13 subjects with primary vaccine failure. We conclude that secondary vaccine failures occur and that while primary failures account for most cases, secondary vaccine failures contribute to the occurrence of measles cases in an epidemic. A booster dose of measles vaccine may be necessary to reduce susceptibility to a sufficiently low level to allow the goal of measles elimination to be achieved.

Adolescent↗
PubMed1986

Prevalence of hepatitis B in anaesthesia personnel.

Hepatitis B virus (HBV) infection, an occupational risk to anaesthetists, varies widely in incidence throughout the world. This study was undertaken to define the prevalence of previous HBV infection in anaesthesia personnel in the teaching hospitals of metropolitan Vancouver. Participants donated a blood sample and completed a questionnaire. Overall participation rate was 90.4 per cent. No participants were HBV carriers. Ten of 83 anaesthetists (12 per cent) had antibodies to HBV while all anaesthesia residents were seronegative. Anaesthetists with HBV antibodies tended to be either older or foreign born. Standard precautions taken by anaesthetists such as use of preoperative questioning of a patient's hepatitis status or the use of gloves when handling body fluids of a suspected or proven HBV carrier could not be shown to affect this seropositivity rate. This study, consistent with others, suggests that anaesthetists are at risk for acquiring HBV infection from occupational exposure. This risk appears to be somewhat less than that for surgeons, dentists, and staff of dialysis and urban emergency units.

Anesthesiology↗
PubMed1985

Booster immunisation for diphtheria and tetanus: no evidence of need in adults.

Recommendations to give adults diphtheria and tetanus toxoid every ten years have been based on serological surveys that have shown lower antibody levels in older populations. The purpose of an immunisation programme, however, is to prevent disease and not merely to produce antibodies. In Canada, although an immunisation programme against diphtheria has been in operation for nearly sixty years, age-specific morbidity and mortality rates for diphtheria do not show an increase with age. Similarly, age-specific death rates from tetanus do not show any increase. From Canadian surveillance data, there is no evidence to suggest that people are leaving the immune pool and entering the susceptible pool. Immunisation programmes do not need to include routine administration of booster doses of diphtheria and tetanus toxoids to adults since the benefits of the procedure do not justify the risks or costs. Continuing case-surveillance will bring to light any increase in incidence of disease justifying a need for an adult programme.

Adult↗
PubMed1984

Reactogenicity of fluid compared with adsorbed diphtheria-pertussis-tetanus vaccine.

Shortly after the introduction of adsorbed diphtheria-pertussis-tetanus (DPT) vaccine in British Columbia the frequency of reports of reactions to the vaccine increased. As the reasons for the increase were not clear a study was carried out in five health units to compare the reactions to adsorbed DPT vaccine manufactured by Wyeth Ltd. and Connaught Laboratories Ltd. and fluid DPT vaccines manufactured by Connaught, all the vaccines being injected in the anterolateral thigh. From the responses on 1619 questionnaires that the parents of vaccinated children had completed it was found that the relative risk of a reaction was higher with the fluid than with the adsorbed Connaught vaccine (1.7 for redness and 1.8 for swelling on the day of vaccination but 1.0 for drowsiness and 1.3 for persistent crying). The size and duration of local redness and swelling were also greater with the fluid than with the adsorbed Connaught vaccines. The results with the Wyeth and Connaught vaccine were very similar. Only 10% of the parents said that there had been no reaction; 9% said that the reaction was severe, and 6% said that it was completely unacceptable. The overall frequency of local reactions was 86.1%.

Adsorption↗
PubMed1984

Comparative trial of treatment with Prioderm lotion and Kwellada shampoo in children with head lice.

The safety and efficacy of treatment with a new pediculicide lotion, Prioderm (0.5% malathion in isopropanol), were compared with those of treatment with Kwellada (1% lindane) shampoo in a randomized trial of children with head lice. The children's scalps were examined for live lice immediately, 7 days and 4 to 6 weeks following treatment. To determine the in-vitro ovicidal effect of treatment, samples of hair with nits were removed before and immediately following treatment; the subsequent rates of hatching were compared. No live lice were present immediately following either treatment. At 7 days after treatment 2 of the 29 children treated with Prioderm lotion and 4 of the 33 children treated with Kwellada shampoo were infested with live lice, whereas at 4 to 6 weeks after treatment 5 and 3 children respectively were infested. The initial effectiveness of treatment was 93% in the children treated with Prioderm lotion and 88% in those treated with Kwellada shampoo; however, a large difference in efficacy could have been missed owing to the small number of children in the study. Both preparations demonstrated in-vitro ovicidal activity, but neither totally abolished post-treatment hatching. No side effects were reported from either preparation. Because ovicidal activity was incomplete two treatments with the same pediculicides should be given about 7 days apart.

Child↗