RESUMEN
OBJECTIVE: To identify seroprevalence of varicella and the relationship with their histories of experiences of varicella diseases and to provide appropriate immunization against varicella, mumps, measles, rubella and hepatitis B to medical students. MATERIAL AND METHOD: All of the medical students were eligible for participation after informed consents. Immunization history against varicella, mumps, measles, rubella (MMR) and hepatitis B were obtained from a questionnaire. A blood sample was obtained from each student for IgG antibody against VZV by ELISA. Medical students with an uncertain history or no documentation of hepatitis B vaccination were tested for HBsAg and anti-HBcIgG by ELISA. RESULTS: There were 383 medical students enrolled. The mean age at enrollment was 21.6 years (median 21.4 years; range 18-25.8 years). Of 383 medical students, 372 (97.2%) had documents of receiving MMR immunizations. The blood samples were obtained from 374 of 383 (97.6%) medical students to identify the immunity against varicella zoster virus (VZV) and the seroprevalence rate was 92%. Using VZVIgG antibody detection as a standard test, history of experience of varicella disease provided positive predictive value of 99.3% (148/149). Of 383 medical students, 277 (72.3%) were tested for hepatitis B markers and 243 (87.7%) students showed negative results. The prevalence of HBsAg carriers was 0.01% (4/383). CONCLUSION: Suboptimal immunities against vaccine preventable diseases could be demonstrated in the medical students including varicella and hepatitis B. New recommendations of immunizations against varicella, MMR and hepatitis B viruses for a particular group of the population were provided.
Asunto(s)
Varicela/inmunología , Hepatitis B/inmunología , Estudiantes de Medicina , Distribución de Chi-Cuadrado , Varicela/epidemiología , Ensayo de Inmunoadsorción Enzimática , Femenino , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Humanos , Inmunoglobulina G/sangre , Masculino , Sarampión/prevención & control , Vacuna contra el Sarampión-Parotiditis-Rubéola/administración & dosificación , Paperas/prevención & control , Valor Predictivo de las Pruebas , Rubéola (Sarampión Alemán)/prevención & control , Estudios Seroepidemiológicos , Encuestas y Cuestionarios , Tailandia/epidemiología , Adulto JovenRESUMEN
Congenital cystic adenomatoid malformation (CCAM) is a rare congenital cystic abnormality of the lung. Most of cases are usually diagnosed and managed in the newborn period even though some are asymptomatic and present in childhood or adult. The authors report a 7-year-old girl who presented with chronic cough, hemoptysis and clubbing of fingers. Physical examination revealed decreased breath sound and dullness on percussion at right upper chest. A chest radiograph showed a large thin-walled cyst with air fluid and a small thin-walled cyst occupied the whole right upper lobe. Computed tomography (CT) of the chest showed two large thin-walled cavities with air fluid level in the right upper lobe with few small cavities nearby. She was given antibiotics and cardiovascular and thoracic surgeon was consulted. The patient underwent right upper lobectomy. Microscopic examination was compatible with CCAM type 1. The post operative course was uneventful and the recovery was complete. She continued to be healthy at a follow-up visit about 8 months postoperatively but chest radiograph showed soft tissue density at right upper lung field. Chest CT findings were compatible with recurrent CCAM. A follow-up chest radiograph at 13 months postoperatively showed significant reduction in size of the lesion.
Asunto(s)
Malformación Adenomatoide Quística Congénita del Pulmón/diagnóstico por imagen , Malformación Adenomatoide Quística Congénita del Pulmón/cirugía , Absceso Pulmonar/cirugía , Niño , Tos/etiología , Malformación Adenomatoide Quística Congénita del Pulmón/complicaciones , Femenino , Estudios de Seguimiento , Humanos , Absceso Pulmonar/diagnóstico por imagen , Absceso Pulmonar/etiología , Neumonectomía , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
OBJECTIVE: To demonstrate the incidence of catheter-related blood stream infection (CRBSI) of patients in the pediatric intensive care unit (PICU) after implementing the new guideline to prevent CRBSI. METHODS: All patients who were admitted to PICU at Phramongkutklao Hospital between January and December 2006 and had central venous catheter (CVC) inserted from the operation room before admission or CVC placed in the PICU were included in a cohort study with longitudinal assessment of an overall catheter care policy targeted at the reduction of vascular access infection. The guideline included five key components (hand hygiene, maximal barrier precautions, povidine skin antiseptic, optimal catheter site selection, daily review of line necessity with prompt removal of unnecessary lines) called "central line bundle". All nursing staffs in the PICU were asked to attend an educational meeting in order to review the scientific data on vascular access insertion, device use and care. Data regarding age, underlying disease, location of insertion, duration, and complication were recorded. RESULTS: A total of 61 patients were recruited. Average duration of catheterization was 8.7 days. Complications were found in 8 cases (13.1%). Hematoma was the most common complication (6.6%) followed by infection (3.3%). Rate of CRBSI was reduced from 2.6 per 1000 catheter days to 2.4 per 1000 catheter days after implementing the new practice guideline. CONCLUSION: Rate of CRBSI was reduced after implementing the new "central line bundle" guideline to prevent CRBSI.