Contamination of a dental unit water line system by legionella pneumophila in the mashhad school of dentistry in 2009.

BACKGROUND: Dental unit waterline system is considered potential source for contamination with Legionella species. The aim of this study was to determine if contamination of a dental unit water line system by Legionella pneumophila serogroup1 in the Mashhad School of Dentistry occurred in 2009. METHODS: A total of 52 dental units were selected from all clinical departments of the Mashhad School of Dentistry. Samples of water were collected from outlets of water/air spray, high-speed dental hand pieces and water cup fillers. Samples were tested via the ELISA method. RESULTS: At the beginning of the work day, a total of 36.1 percent of dental units were contaminated by Legionella pneumophila serogroup 1. CONCLUSION: Infection control of the dental unit water line system regarding legionella in the Mashhad School of Dentistry is a challenge and engineering controls should be used in contaminated clinics.

Colorectal polyps: a frequently-missed cause of rectal bleeding in Egyptian children.

OBJECTIVES: Colorectal polyps are important causes of rectal bleeding but they have been infrequently reported in Egyptian children. The prevalence and characteristics of colorectal polyps in a consecutive cohort of Egyptian children with rectal bleeding are presented. METHODS: A total of 174 children aged 2-12 years [mean (SD) 6.4 (3.7)] with fresh rectal bleeding were enrolled prospectively. Rectal examination, laboratory investigations and fibre-optic colonoscopy were performed in all patients. RESULTS: The source of bleeding was diagnosed as colorectal polyps in 100 patients (57.4%) and was owing to other causes in 74. The interval between onset of symptoms and presentation ranged from 2 to 48 months [mean (SD) 18.3 (16)]. In patients with other causes, rectal bleeding was attributed to intestinal amoebiasis (42), diarrhoea/dysentery (18), severe constipation (2) and intestinal schistosomiasis (2). Polyps were solitary in 56 children (56%) and ranged from 2 to 5 in 34 (34%) and >5 in 10 (10%). Polyps were confined to the rectum in 68 children, were rectosigmoid in 20, in the descending colon in 8, and splenic flexure in 4. Polyps were juvenile in 84 children (84%), inflammatory in 10 (10%) and hyperplastic, schistosomal or adenomatous in 2 each (6%). Colonoscopic polypectomy was successful and arrested the bleeding in all cases. CONCLUSION: In Egyptian children, colorectal polyps are relatively common and an easily treatable cause of fresh rectal bleeding. They should be high on the list of differential diagnoses.

Teaching effectiveness and learning outcomes of baccalaureate nursing students in a critical care practicum: a lebanese experience.

This process-product replicated study examines the relationship between the clinical teacher behavior effectiveness of critical care instructors and baccalaureate nursing students' learning outcomes in a critical care practicum. Teacher behaviors that were found to be significantly associated with student learning outcomes included flexibility, giving opportunity to observe, quality of answering questions, quality of discourse, feedback specificity, and concern for the learner's progress and problems.

Pathological assessment of the response of locally advanced breast cancer to neoadjuvant chemotherapy and its implications for surgical management.

The effectiveness of breast-conserving surgery for patients with locally advanced breast cancer (LABC) after neoadjuvant chemotherapy (NACT) is still a controversial issue, and variable incidences of locoregional failures have been reported. The present study was conducted to pathologically assess the response of LABC to NACT, and also to evaluate the efficacy of preoperative clinical examination and mammography in detecting these pathological changes. A total of 38 patients with LABC received NACT in the form of three cycles of fluorouracil/adriamycin/cyclophosphamide and were then subjected to a mastectomy. The residual tumors in the mastectomy specimens were measured, mapped, and compared to the pretreatment and preoperative clinical and mammographic findings for evaluation. An objective response to NACT was observed in 70.4% of the patients; however, only 26.7% of them were suitable candidates for conservative surgery. The rest of the responders showed an increased incidence of multifocality and in situ lesions localized within the original tumor-bearing area. Both clinical examinations and mammography were inadequate for the selection of candidates for breast conservation. Tumor regression by NACT is probably induced by a process of tumor segmentation. It is also associated with an increased incidence of multifocality and in situ lesions.

Bilharzial role in staging bladder carcinoma histopathological-transurethral sonography and computerized tomography.

Bilharzial bladder tumour of 28 patients staged pre-operatively by transurethral ultrasound and computerized tomography (CT). The accuracy varied from 66.6% to 77.7% in different stages as compared with pathological stage. The bilharzial reaction could be play a role in this accuracy and the histopathological study is the accurate way to express the depth of infiltration of the tumour in the bladder wall as well as the depth of vascular invasion which may be greater than the primary tumour itself.

The relation of HLA-DR antigen, lymphocytes and natural killer cells in human bilharzial bladder carcinoma.

The HLA-DR antigen type was studied in fifty-four patients with bilharzial bladder carcinoma and in ten patients but with non malignant bilharzial bladder lesions as controls. The monoclonal antibodies were used to identify the pattern of the distribution of lymphocytes subset and the natural killer cells. These immunohistochemical studies through some light on the relation between the different immunocompetent cells in the bladder tissue and suggested their functional role particularly in bilharziasis and in the tumour surveillance.

Comparison of three immunodiagnostic tests in detection of trichinosis in naturally infected rats.

The Counter current immunoelectrophoresis (CEP), the Enzyme linked immunosorbent assay (ELISA) and the Indirect immunofluorescent (IF) were evaluated in detection of antibodies in naturally infected rats. The test subjects included ten infected rats as indicated by digestion method of muscle biopsy and 13 rats free from trichinosis. Of the immunodiagnostic tests evaluated, the CEP gave the highest diagnostic accuracy. The ELISA was the least accurate. The high sensitivity and specificity of the CEP for detection of anti-trichinellal antibodies suggest that it could be developed as a serodiagnostic test for trichinosis.

The pattern of bilharzial infection with hepatitis B virus associated with delta agent.

Delta hepatitis is a relatively common in Egypt especially in patients with chronic liver disease. Delta virus infection is associated with a high frequency of hepatic decompensation and it seems to impose additional burden on liver function. It does not seem to be more prevalent in particular type of cirrhosis but the CAH pathology was found to be mostly associated with virus infection. HBV replication seems to be inhibited by the presence of delta virus as evidenced by the low frequency of HBe Ag in serum and HBs Ag in liver among patients with HDV infection.

The use of three immunologic tests in detection of antibodies against Trichinella spiralis.

Human sera (330 from patients with manifestations suggestive trichinosis) were examined for antibodies. The immunologic tests used were counter current immunoelectrophoresis (CEP), enzyme linked immunosorbent assay (ELISA) and immunoflourescence (IF). Seropositive reactions were demonstrated in 2.7%, 5.4% and 2.4% of the sera by the 3 tests respectively. However, 2.4% of the sera were seropositive by the three tests. It seems that the use of two of these tests is valuable in diagnosis when muscle biopsy is unproductive.