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W Ebner

Publications and source records attributed to W Ebner.

29 records · Page 2Linked to original sources
PubMed2000

Can household dishwashers be used to disinfect medical equipment?

In hospitals, medical instruments are usually cleaned and disinfected in a washer/disinfector. However, it is not efficient for small hospitals or general practitioners to purchase such machines as they would not be working to capacity. We investigated the possibility of cleaning and disinfecting medical equipment in a conventional household dishwasher modified to achieve a temperature of 71 degrees C. For this purpose we contaminated screws with different test soils containing either bacterial (100 screws) or viral (106 screws) suspensions. Test organisms were re-isolated from 2% of the screws after bacterial contamination and 4.7% of those with viral contamination. In both cases we found dishwasher-processing to be a suitable means of disinfecting medical instruments.

Bacterial Infections↗
PubMed2000

Can quality circles improve hospital-acquired infection control?

It is a fundamental principle of continuous quality improvement (CQI) that processes should be the objects of quality improvement. The objective of this study was to improve process quality concerning the prevention of hospital-acquired infections in surgical departments and intensive care units by a continuous quality improvement (CQI) approach based mainly on quality circles. This approach was evaluated in a prospective controlled intervention study in medium-size acute care hospitals (four intervention and four control hospitals). During two intervention periods (each 10 months) four external physicians with training in hospital epidemiology and infection control introduced and supervised quality circles in the intervention hospitals. Process quality was assessed by interviewing senior staff members before the first and after the second intervention period using standardized questionnaires. The gold standard process quality was defined on the basis of the CDC/HICPAC-guidelines for the prevention of hospital-acquired infections. Most of the evaluated aspects of process quality belonged to the HICPAC-categories IA and IB respectively, the CDC category I. Fifty quality circle sessions were performed in the four intervention hospitals of which 28 were dealing directly with key subjects in infection control. In the intervention hospitals, 19.8% of evaluated aspects of process quality which concerned the prevention of hospital-acquired infections were improved compared to only 6.9% in the control hospitals (P<0.05). Sixty-six point seven percent of positive changes in process quality were initiated by the results of the quality circles. Our study demonstrates that a CQI approach based on infection control quality circles can lead to a substantial improvement of process quality regarding the prevention of hospital-acquired infections.

Cross Infection↗
PubMed1999

Nosocomial infections in a neurosurgery intensive care unit.

In order to identify overall and site-specific nosocomial infection (NI) rates in patients receiving neurosurgical intensive care therapy, a prospective study was started in February 1997 in the eight-bed neurosurgical ICU of the University Hospital of Freiburg, Germany. Case records were reviewed twice a week, all microbiology reports were reviewed and ward staff was consulted. NI were defined according to the CDC-criteria and were categorised into specific infection sites. Within 20 months, 545 patients with a total of 5,117 patient days were investigated (mean length of stay: 9.4 days). 113 NI were identified in 90 patients (72 pts. with one, 13 with two and 5 with three infections, respectively). A moderate to high overall incidence (20.7/100 pts.) and a moderate incidence density (22.1/1,000 patient days) of NI in the neurosurgical ICU could be documented; these figures are well within the range of published data. Site specific incidence rates and incidence densities were: 1 bloodstream infection per 100 patients (0.9 central line-associated BSIs per 1,000 central line-days), 9 pneumonias per 100 patients (15.1 ventilator-associated pneumonias per 1,000 ventilator-days), 7.3 urinary tract infections per 100 patients (8.5 urinary catheter-associated UTIs per 1,000 urinary catheter-days). Additionally, 1.1 cases of meningitis, 0.7 brain abscesses/ventriculitis, and 1.7 other infections (surgical site infection, bronchitis, catheter related local infection, diarrhoea) were documented per 100 patients, respectively. 14.6% of isolated pathogens were E. coli, 10.2% enterococci, 9.6% S. aureus, 6.4% CNS, 6.4% Klebsiella spp., 5% Enterobacter spp. and 5% Pseudomonas spp. In 11 cases of NI no pathogen could be isolated.

Adolescent↗
PubMed1983

[Whipple's disease--a case study].

Whipple's disease is rare. The majority of patients are men. Before the advent of antibiotics the disease was almost invariably fatal. Now fewer deaths are recorded. We report about a typical case with the additional signs of sacro-iliitis, so that at first the false diagnosis of ankylosing spondylitis was made.

Diagnosis, Differential↗
PubMed1983

[Therapy of spondylitis ankylopoetica with levamisole. Behavior of clinical and immunological parameters].

The therapeutical effect of levamisole in ankylosing spondylitis as well as the effect of this therapy on the immunologic parameters were to be examined. Since the sample consisted of 10 patients only, statistically relevant results were not to be expected. Only male patients with positive HLA-B 27 have been examined. The therapeutical effect after treatment of 3 months has been observed as good to very good. The immunologic parameters reacted in a mode which had formerly been described as immunomodulating.

Adult↗
PubMed1983

Meclofenamate sodium in the treatment of ankylosing spondylitis. Report of a European double-blind controlled multicenter study.

98 patients with reversible, definite, active ankylosing spondylitis were selected for this study. 49 patients were treated with N-(2,6-dichloro-m-tolyl)anthranilic acid, sodium salt (meclofenamate sodium, Meclomen) and 49 patients with indometacin. Following a single-blind baseline period on placebo, patients received either 200 mg meclofenamate sodium per day or 100 mg indometacin per day for one week, in the second week the doses were increased to 250 mg meclofenamate sodium and 125 mg indometacin and from the third through the eight week 300 mg meclofenamate sodium and 150 mg indometacin were given. The results of this double-blind study showed that similar improvement in mobility of the vertebral column and spondylitic pain could be achieved with meclofenamate sodium and indometacin in patients with ankylosing spondylitis. Although both treatments were well tolerated fewer meclofenamate sodium patients reported adverse reactions than did those who had received indometacin. It is concluded that meclofenamate sodium offers an effective and safe alternative to indometacin in the treatment of patients with ankylosing spondylitis.

Adolescent↗
PubMedDate not supplied

[Contact thermography in assessing inflammatory joint diseases].

Cutaneous hyperthermia represents a symptom of inflammatory joint diseases and "activated" arthroses. Arthritis and arthrosis may be differentiated by the different distribution and extent of hyperthermia. In an equal number of different joint diseases the symptoms and signs and the course of the diseases were investigated with the aid of contact thermography. The results indicate different exact localisations of temperature changes in the affected joints which together with the clinical findings may make it possible to establish differential diagnostic definitions between arthrosis and rheumatoid arthritis. In the authors' opinion contact thermography is, however, not suited for observations of the course of the diseases.

Arthritis↗
PubMedDate not supplied

[Anemia in chronic polyarthritis].

In 216 patients, the correlation of anemia and activity of rheumatoid arthritis was studied. In 27% a concomitant anemia was found. These findings are congruent with those of other authors. There is a significant correlation between activity of rheumatoid disease and evolution of anemia as well as changes of serum iron level. With reference to the literature possible pathogenetic mechanisms of this type of anemia are reviewed. Therapeutic possibilities are briefly discussed.

Adolescent↗
PubMedDate not supplied

Concepts of diffusion theory and a graphic approach to the description of the epidemic flow of contagious disease.

Concepts used to analyze sociological, geographic, and economic processes were adapted to an examination of the diffusion of contagious disease. The example used in applying these concepts was an epidemic of variola minor which continued for 12 months in an area of 1,006 square kilometers centered on the city of Bragança Paulista, Sao Paulo State (Brazil). A graphic procedure is proposed that depicts aspects of the epidemic flow of person-to-person transmission. Spatial, temporal, and sociological characteristics of the epidemic flow are disclosed in sequential diagrams. They represent geographic areas as well as schools and agglomerates of households affected by the epidemic at a given time, the mode of diffusion, and the source of the infection. The procedure yielded indirect evidence of the role of school pupils as introducers of variola minor into households and school classes. All subdivisions of the city, six of the seven rural districts, and four of the five elementary schools were affected through hierarchical (between-areas) diffusion. Subsequently, there was neighborhood (within-area) diffusion, and this resulted in new interactions between areas.

Brazil↗