RESUMO
BACKGROUND: After a community investigation had implicated hospital admission as a shared feature of a cluster of acute Plasmodium falciparum malaria (AFM) cases in Riyadh, Saudi Arabia, we began an in-hospital investigation to determine the method of transmission. METHODS: We investigated all AFM patients admitted to one paediatric hospital for any reason from December, 1991, to April, 1992. We classified AFM as locally acquired (LAFM) if during the month before AFM onset the patient had not visited a malarious area, and as hospital acquired (HAFM) if the LAFM patient had been admitted to hospital during that month. We compared exposures of HAFM cases with those of other patients sampled from the same wards. We observed nursing practices and investigated by anonymous questionnaire how nurses administered parenteral drugs. FINDINGS: Of 21 LAFM cases, 20 (95%) had a previous hospital admission (exposure admission) compared with 15 (25%) of 61 other patients (p < 0.001; chi 2 test). During the exposure admission, all HAFM patients had occupied the same room as, or a room adjacent to, an AFM patient; 14 (23%) of 60 other patients occupied the same room or rooms adjacent to an AFM patient (p < 0.001, chi 2). 90% of HAFM patients received infusions through a heparin lock during the exposure admission, compared with 49% of 120 general patients (p < 0.001, chi 2). 10% of nurses admitted to using one syringe for more than one heparin lock and 50% filled syringes with enough heparin for three to ten heparin locks. INTERPRETATION: P falciparum was transmitted between patients when single syringes were used on heparin locks of sequential patients. This practice would easily transmit other blood-borne agents.
Assuntos
Cateteres de Demora/efeitos adversos , Infecção Hospitalar/transmissão , Heparina/administração & dosagem , Malária Falciparum/transmissão , Pré-Escolar , Feminino , Humanos , Lactente , Infusões Parenterais/enfermagem , Masculino , Arábia Saudita , SeringasRESUMO
This paper reports a 13 year old Yemenian boy with cutaneous leishmaniasis (CL.). The histopathological picture of the CL lesions showed marked dysplasia indicating premalignancy. The possibility that CL as one of the predisposing factors for skin malignancy was discussed.
Assuntos
Leishmaniose Cutânea/complicações , Lesões Pré-Cancerosas/etiologia , Neoplasias Cutâneas/etiologia , Adolescente , Humanos , Masculino , Pele/patologiaRESUMO
A total of 294 specimens were collected and identified as three species of the genus Phlebotomus and four species of the genus Sergentomyia. Of interest was the demonstration of promastigotes in the foregut of two females P. papatasi.
Assuntos
Leishmania/isolamento & purificação , Leishmaniose/transmissão , Phlebotomus , Psychodidae , Animais , Feminino , Insetos Vetores/parasitologia , Masculino , Phlebotomus/parasitologia , Arábia SauditaRESUMO
While cutaneous leishmaniasis (CL) is a protozoal parasite of the skin, basal cell carcinoma (BCC) is a malignant tumour of the skin. In this paper, we report the identification of cutaneous leishmaniasis and basal cell carcinoma in one patient, in the same site and same lesion. This raised the possibility that CL is a predisposing factor for BCC.
