[EurSafety Health-Net: MRSA Eradication in Nursing Homes and Home Care - A Practice Report]. / EurSafety Health-Net: MRSA-Sanierung in der Pflege (MSP) - ein Praxisbericht.

In 2009 the project EurSafety Health-Net, funded by Interreg IVa, was initiated in order to create a cross-border quality alliance to enhance patient safety in the field of infectious diseases. Within this framework, several studies and projects addressing key topics of infection control were carried out. We describe the two-year project "MRSA decolonisation in care settings (MSP)", which aimed at evaluating a simple and economic way of decolonisation of non-hospitalised MRSA carriers in 2 districts in Lower Saxony. In the course of the project 181 decolonisations of MRSA carriers were performed by nursing homes and nursing services for outpatients in cooperation with the local public health authorities of the districts Ammerland and Grafschaft Bentheim. Of 181 cases 134 were eligible for statistical analysis. The project provided protocols for 2 different starting situations: 1) Continuing and completing a decolonisation treatment subsequent to a hospital stay by nursing services for outpatients or in a nursing home. 2) Starting a decolonisation treatment in a nursing home or by nursing services for outpatients. The carriers were provided with the required materials either by the hospitals (situation 1) or by the local public health authorities (situation 2) free of charge. The decolonisation treatment and the testing were offered only to carriers free of properties deemed as decolonisation obstacles and was applied without involvement of the general practitioner. Short- and long-term success of the 5 day decolonisation treatment was tested afterwards by two swabs (14 days and 6 months after the end of the treatment). The results of the 6-month control swabs showed that 45% of the carriers were successfully decolonised in the long term. All parties involved regarded the procedure of the MSP project as effective with respect to the target. Thus, even after the project was finished, both districts continued applying the MSP protocol.

Improved quantitative PCR protocols for adenovirus and CMV with an internal inhibition control system and automated nucleic acid isolation.

With the establishment of routine virus load (DNAemia) screening for Human adenovirus (HAdV) and Cytomegalovirus (CMV) in post-transplant care quality standards for quantitative PCR-assays are increasing. Established real-time PCR assays were improved with a fully automated DNA-extraction and with a competitive internal control DNA packaged into a lambda phage which serves as an extraction and amplification control in each sample. HAdV and CMV DNA were detected and quantified simultaneously in various types of diagnostic samples like blood, feces or respiratory tract materials. Inhibition was observed in 0.33-0.66% of over 14,000 diagnostic samples, an infrequent but nevertheless not negligible event, which is observed mainly in stool samples. CMV viral load in broncho-alveolar lavage fluid (BALF) ranged between positive but below the quantitation limit of 1,000 copies/ml up to 1.8 × 10(7) copies/ml with a median of 6.0 × 10(3) copies/ml. Forty-one (4.7%) BALF samples had a viral load above 5.0 × 10(5) copies/ml, which was proposed as a threshold for the diagnosis of pneumonia. HAdV viral loads ranged between positive but below the quantitation limit of 1,000 copies/ml to a very high concentration of 1.3 × 10(11) copies/ml in stool and BALF samples. A HAdV-DNAemia of >10(4) copies/ml was found only in patients with stool viral load of above 10(5) copies/ml. These data support the hypothesis that quantitation in diagnostic materials other than blood may give valuable diagnostic information and that further evaluation of this approach is reasonable.

[Blow-out fractures in childhood]. / Blow-out Frakturen im Kindesalter.

Both of large groups, lateral and central facial skull fractures, are further divided into isolated fractures of particular localisation (zygomatic arc, orbital floor fractures etc.) and compound fractures of varying degrees. 33 patients aged 5 to 14 years with fractures of the orbital floor (blow-out fractures) were followed up for 3 months to 9 years. Advances in the primary surgery have contributed to an improvement in the treatment of defects. The present investigation confirms the view that blow-out fractures with diplopia and prolaps in childhood require early surgical treatment.

[Monitoring hearing during ototoxic cisplatin therapy]. / Zur Uberwachung des Gehörs während der ototoxischen Cisplatin-Therapie.

In the 1983-1988 period, the audition of 17 children was studied prior to and during antineoplastic chemotherapy with cumulative total cisplatin doses from 270 to 1530 mg/m2. The hearing tests were conducted by means of an objective method which doses not depend on patients' cooperation: the recording of fast auditory evoked potentials. Tone threshold audiograms were additionally obtained from cooperative children. Of the 17 patients, 14 showed a dose-dependent symmetric hearing loss which in part was severe and related in particular to the high-frequency domain. Three patients exhibited no hearing impairment even though the total cisplatin dose applied ranged from 630 to 810 mg/m2. To conclude, while allowing for reports in the literature, recommendations are given on how hearing impairment can be minimised in view of the priority of the antineoplastic action of cisplatin.

[Influence of orotic acid upon post-excitatory facilitation released by stimulation of the tooth pulp]. / Der Einfluss von Orotsäure auf die durch Zahnpulpareizung ausgelöste postexzitatorische Fazilitation

The influence of orotic acid on post-excitatory facilitation of evoked potentials released by electric stimulation of the tooth pulp in the sensomotor cortex was studied. 15-360 min following application of 100 mg/kg orotic acid, increase in amplitude of potentials released by stimulation of the tooth pulp, reinforcement of the post-excitatory facilitation observable 5 msec after stimulation occurred.