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Biomedical subjects

W al-Wali

Publications and source records attributed to W al-Wali.

12 recordsLinked to original sources
PubMed2001

The prevention of tetanus in England and Wales.

Today, tetanus is a rare disease in England and Wales although in less developed and less affluent areas of the World it is still a major cause of morbidity and mortality, particularly in neonates and women following childbirth. An estimated 400,000 deaths worldwide occur annually from neonatal tetanus and in 1989 the World Health Organization adopted the goal of eliminating neonatal tetanus as a public health problem by 1995-2000. This goal has not yet been achieved worldwide; however in England and Wales tetanus in neonates and young women has been extremely rare for the last 50 years. We can attribute the success in eliminating tetanus in the UK to the adoption of highly effective preventative measures as we know that the causative organism is still ubiquitous in the environment. This article outlines how we have achieved the elimination of tetanus in the UK through the development and introduction of appropriately targeted immunisation, combined with an appreciation of the importance of adequate wound toilet measures. The discovery of tetanus toxoid and its applicability for vaccination has been of great benefit and the new challenges which we face relate to the introduction of new multi-component vaccines and how we might better protect the elderly. In other parts of the world, for the cost of a few pence, one dose of tetanus toxoid can still mean the difference between life and death.

Communicable Disease Control↗
PubMed2000

Outbreak of meningococcal disease in Rotherham illustrates the value of coordination, communication, and collaboration in management.

On New Year's Eve 1998, two teenagers from the same school in Rotherham died of serogroup C meningococcal septicaemia. A third linked case occurred three days later. Over eight days starting on New Year's Eve, a further five cases of meningococcal disease arose across Rotherham district, four of whom were severely ill with serogroup C meningococcal septicaemia. Intense media interest, high levels of public concern, and anxieties caused by several 'false alarm' cases added to the challenge faced by a small health district. This article describes the epidemiology of the incident and policy decisions made, but focuses on the operational aspects of outbreak management (coordination, communication, and collaboration), an area often neglected in outbreak reports.

Adolescent↗
PubMed1993

Bacteriological evaluation of a down-draught necropsy table ventilation system.

AIMS: To evaluate the microbiological efficacy of a down-draught necropsy table ventilation system (which surrounds the cadaver with a "curtain" of air under continuous extraction) during post mortem procedures. METHODS: Air sampling was carried out both in the presence and absence of staff and cadaver and during a full post mortem procedure, with functioning and non-functioning table air extraction. The penetration of the air "curtain" was also examined during the use of an oscillating bone saw by means of a tracer organism, Bacillus subtilis var niger, painted on to the skull. RESULTS: There was little difference between bacterial counts obtained in the presence of staff only, staff plus cadaver, or during a post mortem examination. With all counts obtained, however, there was a two to three-fold reduction when the ventilation was in operation compared with when the extract duct was occluded. Using the tracer organism, a two to three log reduction in counts was shown when the "curtain" was in operation during the use of the oscillating bone saw. CONCLUSIONS: These results suggest that the system provides potential protection for post mortem room staff against airborne infections.

Air Conditioning↗
PubMed1992

Differing prognostic significance of reinfection and relapse in CAPD peritonitis.

All episodes of recurrent infection in a CAPD unit over a 26-month period have been analysed to discover whether relapse and reinfection have different prognostic importance. Relapse and reinfection were distinguished by detailed microbiological investigation. Prognosis was expressed in terms of outcome of treatment and the fate of the Tenckhoff catheter. Twenty-nine patients suffered recurrent infections (i.e. more than one infection during a 12-month period). Nine (6 male, 3 female, age range 42-73 years) had relapses, and 20 (16 male, 4 female, age range 42-74 years) reinfections. The characteristics of the two groups of patients were indistinguishable. Relapse was of graver prognostic consequence: patients who relapsed were significantly less likely to respond to antibiotic treatment (78% versus 20%) and have to have their catheters removed (78% versus 10%) than those with reinfections. Thus it is important to differentiate relapse from reinfection in CAPD peritonitis. In addition to being helpful for the management of individual patients, this is essential if results of therapeutic trials are to be interpreted correctly.

Adult↗
PubMed1991

Comparative trial of norfloxacin and macrocrystalline nitrofurantoin (Macrodantin) in the prophylaxis of recurrent urinary tract infection in women.

Eighty-eight women with a history of recurrent urinary tract infection (at least four attacks in the preceding 12 months) were randomized to take either norfloxacin 200 mg at night (45 patients) or macrocrystalline nitrofurantoin 100 mg at night (43 patients) for 12 months. A decrease in the number of symptomatic attacks while taking this prophylaxis was observed in 94 per cent of the patients and this improvement was maintained during the 6 months following the end of prophylaxis in 69 per cent. The mean interval between symptomatic episodes while taking prophylaxis was 7.2-fold and 6.9-fold greater, respectively, than in the 12 months before starting prophylaxis. There were only nine breakthrough infections during 74 patient-years of prophylaxis, four in patients taking norfloxacin (two enterococci, one Staphylococcus epidermidis, one Escherichia coli), and five in those taking macrocrystalline nitrofurantoin (four E. coli, one Klebsiella pneumoniae). Adverse events caused four patients taking norfloxacin (8 per cent) and seven taking macrocrystalline nitrofurantoin (14 per cent) to stop prophylaxis. Norfloxacin had a marked suppressive effect on the coliform part of the faecal flora, with no emergence of resistance. Thus, norfloxacin appears to be an excellent alternative agent to macrocrystalline nitrofurantoin for the prevention of recurrent urinary infections.

Adolescent↗
PubMed1990

Detective work in continuous ambulatory peritoneal dialysis.

We report five cases of continuous ambulatory peritoneal dialysis in which the mechanisms and sources of infection were established. We show how diligent enquiry and environmental investigation can explain the pathogenesis of infection and help in prevention by motivation of the patient.

Aeromonas↗
PubMedDate not supplied

Which glove, when?

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Choice Behavior↗