Evidence for airborne infectious disease transmission in public ground transport--a literature review.

While guidelines on contact tracing (CT) after exposure to certain infectious pathogens during air travel exist, no guidance documents are available on CT in response to potential exposure on public ground transport. We reviewed scientific and non-scientific literature on transmission of airborne pathogens in public ground transport and on factors potentially influencing transmission. We identified 32 relevant publications (15 scientific and 17 non-scientific). Most of the selected studies dealt with transmission of tuberculosis. However, the relation between travel duration, proximity to the index case and environmental factors, such as ventilation, on disease transmission in public ground transport is poorly understood. Considering the difficulty and probably limited effectiveness of CT in ground transport, our results suggest that only exceptional circumstances would justify CT. This contrasts with the high level of attention CT in air travel seems to receive in international regulations and recommendations. We question whether the indication for CT should be revisited after a risk­benefit assessment that takes into account exposure in both ground and air transport.

Facemasks and intensified hand hygiene in a German household trial during the 2009/2010 influenza A(H1N1) pandemic: adherence and tolerability in children and adults.

Non-pharmaceutical interventions (NPI) such as facemasks and intensified hand hygiene may be effective in preventing influenza infections in households. It may be equally important that household members, especially children, can learn to use, maintain and tolerate these measures. We monitored adherence and tolerability of these NPI within a cluster-randomized trial in households with influenza index patients. We recruited 147 participants in 41 households, 39 (95%) out of 41 index patients were children (aged <14 years). In households assigned to wear facemasks, their use peaked on day 4 after symptom onset of the index patient at 73% and at 65% for children and adults, respectively. Mean daily frequency of hand disinfection in households assigned to intensified hand hygiene measures peaked at 7·7 (day 6) for children and at 10·1 (day 5) for adults. The majority of participants reported no problems with mask wearing. Data suggest that usage of NPI can be taught and that measures are well tolerated by adults and even sick children alike.

[Comparative study of expert assessment of applications for inpatient care according to SGB XI with reference to hospital patients]. / Vergleichende Studie zum Begutachtungsverfahren von Anträgen auf stationäre Pflege nach SGB XI bei Krankenhauspatienten.

The applications for care in a nursing home, proposed by patients in hospitals, should be judged promptly. Judgements based on specifications compiled by the hospital social service are compared to the results of direct examination of the patient in hospital; 96% agreement regarding need for care, 91% agreement regarding necessity of care in a nursing home. We found in 35% a variation in care rank between both methods. In 52% of cases there was no need for a further examination; the care rank was estimated as definite.

[Results of surgical therapy of acute pancreatitis]. / Ergebnisse der operativen Therapie der akuten Pankreatitis.

Operative treatment of acute pancreatitis was carried out in 143 patients. The disease was caused by bilestones in 68%, by alcohol in 23%, idiopathic in 8%, and by different reasons (postoperative, helminthic disease) in 1% of the patients. The severity of the disease was classified into the grades I to III according to Kümmerle. The lowest rate of complications and lowest mortality rates were observed in operations performed within the first hours or after two weeks after the beginning of the disease. The alcoholic pancreatitis showed the lowest mortality rate (16%), despite of 81% of these patients suffering from the severe grades II and III. This may result from the decision in favour of early second look operations in these patients.