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OBJECTIVE: To determine the bactericidal effect on surfaces of ceiling- and wall-mounted UV C (UVC) light (wavelength, 254 nm) in isolation units, compared with standard hospital environmental cleaning and chemical disinfection during final disinfection after patients are treated for infections. DESIGN: Microbial samples were obtained from surfaces in isolation units (patient room, anteroom, and bathroom) before and after irradiation with UVC, chloramine disinfection, and standard hospital environmental cleaning. Samples were tested using standard contact plates. SETTING: Four identical, negative air-pressure isolation units (patient room, anteroom, and bathroom) with a defined number of ceiling- and wall-mounted UVC light units. The UVC distribution was monitored in one isolation unit after irradiation for approximately 40 minutes, corresponding to doses ranging from 160 J/m2 in a shadowed area to 19,230 J/m2 at the mostly highly exposed site (which is high enough to inactivate most bacterial organisms, including spores). RESULTS: UVC disinfection significantly reduced the number of bacteria on surfaces directly or indirectly exposed to UVC to a very low number, as did 5% chloramine disinfection alone (P<.001 for both). Completely shadowed areas in the isolation unit (eg, the bed rail, lockers, and mattresses) still required disinfection by chemicals. CONCLUSION: Disinfection with UVC light may significantly reduce environmental bacterial contamination and thereby protect the next patient housed in an isolation room. UVC disinfection may not be used alone but is a good addition to chemical disinfection.

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Dietary studies and whole-body measurements were used to estimate the intake of radiocesium and the radiation dose received by different groups of people in Norway after the Chernobyl accident. Freshwater fish, milk, and reindeer meat were the major sources for radiocesium intake. Dietary advice, together with agricultural decontamination measures, resulted in a considerable reduction in the exposure level of the population. A majority (40-80%) of the specially selected groups (farmers-hunters and Sami reindeer herdsman) changed its diet significantly after the accident. Without dietary changes, specifically a reduction in the consumption of freshwater fish and reindeer meat, the Sami group would have had a 400-700% higher radiocesium intake, and the farmers-hunters' intake would have been up to 50% higher than what they actually had experienced.

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Calprotectin (L1) is a major granulocyte and monocyte protein which is released during activation of these cells. The plasma level of L1 is thought to reflect disease activity in rheumatoid arthritis (RA). In our cross sectional study of 70 patients with RA, L1 had significant correlations with erythrocyte sedimentation rate (r = 0.50), C-reactive protein (r = 0.58), orosomucoid (r = 0.62), platelet count (r = 0.42), leukocyte count (r = 0.33) and IgM rheumatoid factor (r = 0.32); and with the following clinical variables: number of swollen joints (r = 0.24), grip strength (r = -0.22), PIP joint circumferences (r = 0.33) and a combined global assessment score (r = 0.24). L1 was higher in seropositive (median 14,861 micrograms/l) than seronegative patients (median 10,487 micrograms/l) (p less than 0.03).

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60 patients and their referring general practitioners were asked to evaluate the benefit of examination by a rheumatologist in an out-patient clinic. A large percentage of the patients (73%) and of the GPs (89%) were satisfied with the outcome of the examination, even though only 29% of the patients and 37% of the GPs thought that the advice given by the specialist had helped. A majority (60%) of the patients would have liked to have received more information from the specialist, about the diagnosis, and 49% patients claimed that they had not been given any advice on treatment. The results of this study will lead to a change in how we inform patients about diagnosis and treatment in our out-patient clinic.

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Ninety-seven mildly obese females (BMI = 27.4 kg/m2) were in a randomized, double-blind, placebo-controlled trial treated for 52 weeks. The treatment consisted of a hypocaloric diet providing 5000 kJ/day (1200 kcal) and a dietary fibre supplement of 7 g/day for 11 weeks, (part I), followed by a diet providing 6720 kJ/day (1600 kcal) and a dietary fibre supplement of 6 g/day for 16 weeks (part II). Finally placebo was withdrawn and all still adhering subjects were given a dietary fibre supplement of 6 g/day and an ad libitum diet for the rest of the period (part III). Initial body weights were comparable, 76.9 +/- 0.8 kg in the fibre group versus 77.7 +/- 1.3 kg in the placebo group. During part I the weight reduction in the fibre group of 4.9 kg was significantly higher compared to that of 3.3 kg in the placebo group (P = 0.05). Accumulated weight reduction during part II was still significantly higher in the fibre group, 3.8 kg, compared to 2.8 kg in the placebo group (P less than 0.05). Total weight loss in the fibre group after 52 weeks was 6.7 kg. Probability of adherence to the treatment regimen was significantly higher in the fibre group from week 13 and onwards (P less than 0.01). Initial blood pressures were comparable. A significant reduction of systolic blood pressure occurred in both groups. A significant reduction of diastolic blood pressure occurred in the fibre group only, from 85.4 +/- 1.2 mmHg to 81.7 +/- 1.1 mmHg (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

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A 14-year-old boy developed an acute Guillain-Barré syndrome (GBS) 14 days after receiving the second prophylactic dose of human diploid cell rabies vaccine. The symmetrical sensorimotor polyneuropathy included bilateral facial weakness. GBS after vaccination with human diploid cell rabies vaccine must be extremely rare, and has not hitherto been reported.

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Twenty-eight patients with chronic urinary tract infections were treated with 400 mg pivmecillinam orally three times daily for 10 to 15 days. The diagnosis was confirmed by a history of cystitis or cystopyelitis four to six times annually, microscopy of urine sediment, and growth of pathogens in urine specimens obtained by suprapubic bladder puncture. Three days, three and six weeks after completion of therapy the success rates were 24/28, 20/28 and 19/28 respectively. Pivmecillinam was well tolerated. Two patients developed nausea and vomiting. Other side-effects were not observed. Pivmecillinam is a useful drug in the treatment of chronic urinary tract infections.

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A general social desirability factor emerged at the second-order level when a set of individual social desirability scale values were correlated between subjects (i.e., across items) and factor analysed. However, no such general factor emerged at the second-order level when the individual judgments were correlated between items (i.e., across subjects).

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