A national survey of disinfection techniques for flexible nasendoscopes in UK ENT out-patient departments

2000 ◽  
Vol 114 (3) ◽  
pp. 202-204 ◽  
Author(s):  
G. K. Banfield ◽  
A. E. Hinton
Keyword(s):  
Human Immunodeficiency Virus ◽  
High Risk ◽  
Financial Resources ◽  
National Guidelines ◽  
Immunodeficiency Virus ◽  
Risk Patients ◽  
Chemical Disinfectant ◽  
Spread Of Infection ◽  
Patient Use ◽  
Disposable Plastic

Flexible fibre-optic nasendoscopes have become a ubiquitous ENT out-patient tool for the inspection of the nasopharynx, larynx and hypopharynx. Disinfection of the instrument between patient use is important to prevent potential spread of infection but the methods used vary considerably. We designed a questionnaire which was piloted and then sent to 115 UK ENT out-patient departments to establish current UK practice. Most units (67 per cent) use a chemical soak system but the type of chemical disinfectant, the method of delivery and the duration of soak varied considerably. A few hospitals use a disposable plastic sheath system and others simply wipe the instrument with an alcohol swab in between patient use. The protocols for disinfection after high risk patients e.g. human immunodeficiency virus (HIV), hepatitis B varied from hospital to hospital.The results demonstrate a lack of standard practice that is wasteful of financial resources and may expose patients to unnecessary risk. There is a need for an authoritative ENT body to publish national guidelines as may be found in other specialities and other countries.

scholarly journals A Randomized Controlled Trial of Isoniazid to Prevent Mycobacterium tuberculosis Infection in Kenyan Human Immunodeficiency Virus–Exposed Uninfected Infants

2020 ◽  
Author(s):  
Sylvia M LaCourse ◽  
Barbra A Richardson ◽  
John Kinuthia ◽  
A J Warr ◽  
Elizabeth Maleche-Obimbo ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Mycobacterium Tuberculosis ◽  
High Risk ◽  
Adverse Events ◽  
Controlled Trial ◽  
Preventive Therapy ◽  
Infection Prevalence ◽  
Mycobacterium Tuberculosis Infection ◽  
Immunodeficiency Virus ◽  
Exposed Uninfected

Abstract Background Human immunodeficiency virus (HIV)–exposed uninfected (HEU) infants in endemic settings are at high risk of tuberculosis (TB). For infants, progression from primary Mycobacterium tuberculosis (Mtb) infection to TB disease can be rapid. We assessed whether isoniazid (INH) prevents primary Mtb infection. Methods We conducted a randomized nonblinded controlled trial enrolling HEU infants 6 weeks of age without known TB exposure in Kenya. Participants were randomized (1:1) to 12 months of daily INH (10 mg/kg) vs no INH. Primary endpoint was Mtb infection at end of 12 months, assessed by interferon-γ release assay (QuantiFERON-TB Gold Plus) and/or tuberculin skin test (TST, added 6 months after first participant exit). Results Between 15 August 2016 and 6 June 2018, 416 infants were screened, with 300 (72%) randomized to INH or no INH (150 per arm); 2 were excluded due to HIV infection. Among 298 randomized HEU infants, 12-month retention was 96.3% (287/298), and 88.9% (265/298) had primary outcome data. Mtb infection prevalence at 12-month follow-up was 10.6% (28/265); 7.6% (10/132) in the INH arm and 13.5% (18/133) in the no INH arm (7.0 vs 13.4 per 100 person-years; hazard ratio, 0.53 [95% confidence interval {CI}, .24–1.14]; P = .11]), and driven primarily by TST positivity (8.6% [8/93] in INH and 18.1% [17/94] in no INH; relative risk, 0.48 [95% CI, .22–1.05]; P = .07). Frequency of severe adverse events was similar between arms (INH, 14.0% [21/150] vs no INH, 10.7% [16/150]; P = .38), with no INH-related adverse events. Conclusions Further studies evaluating TB preventive therapy to prevent or delay primary Mtb infection in HEU and other high-risk infants are warranted. Clinical Trials Registration NCT02613169.

Situational and Sociodemographic Characteristics of Children Infected With Human Immunodeficiency Virus From Pediatric Sexual Abuse

PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 39-44
Author(s):  
George A. Gellert ◽  
Michael J. Durfee ◽  
Carol D. Berkowitz ◽  
Kathleen V. Higgins ◽  
Vincent C. Tubiolo
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Sexual Abuse ◽  
High Risk ◽  
Hiv Infection ◽  
Sociodemographic Characteristics ◽  
Antibody Testing ◽  
Immunodeficiency Virus ◽  
Hiv Antibody Testing ◽  
Hiv Seropositive

This study assessed the situational and sociodemographic characteristics of children infected with human immunodeficiency virus (HIV) from pediatric sexual abuse. A letter of inquiry was sent to 2147 professionals across health and social service disciplines involved with child abuse assessment, treatment, and prevention. Respondents working in programs where HIV antibody testing of abuse victims occurs and who had identified HIV infection in one or more abused children were sent a survey to assess the demographics of victims, the family/living situation where abuse occurred, alternative risks for HIV infection, bases for diagnosis of sexual abuse and for HIV antibody testing, and profiles of the perpetrator and type of abuse. Of 5622 estimated HIV antibody tests conducted during 113 198 sex abuse assessments, 28 children were infected with HIV and lacked any alternative transmission route to that of sexual abuse. A total of 41 HIV-infected children with a history of sexual abuse were identified. Thirteen cases had alternative risk factors and were excluded from analysis. Sixty-four percent of the 28 victims with sexual abuse as the sole risk factor were female and 71% were African-American. The mean age was 9 years. Coinfection with another sexually transmitted disease (STD) occurred in 9 (33%) cases. Sexual abuse was diagnosed on the basis of a victim disclosure in 21 (75%) cases. The basis for HIV antibody testing was physical findings suggestive of HIV infection in 9 (32%) cases, HIV-seropositive or high-risk perpetrator in 6 (21%) and 2 (7%) cases, respectively, and the presence of another STD in the victim in 4 (14%) cases. Perpetrators were a child's parent in 10 (42%) cases and another relative in 6 (25%) cases. Perpetrators had behavioral risk factors for or signs/symptoms of HIV infection in 14 (58%) cases. The serostatus of perpetrators was known at time of abuse assessment in 16 (67%) cases and all were seropositive. Duration and form of abusive acts were variable, with 3 victims reporting a single episode and 13 (68%) reporting 6 or more episodes. Penile vaginal and/or rectal penetration was reported in only 50% of cases. It is concluded that sexual abuse must be considered as a potential, although infrequent, mode of transmission of HIV infection in children. Children who have been abused should be evaluated selectively for HIV infection particularly if the perpetrator is known to be HIV seropositive or engages in HIV high-risk behavior, if abuse occurred in a geographic area of high disease prevalence, and if the child has symptoms of HIV infection or another STD. Children who are found to be HIV infected and lack risk factors such as prior transfusion or maternal (perinatal) infection should be assessed for pediatric sexual abuse.

scholarly journals Lack of evidence of prolonged human immunodeficiency virus infection before antibody seroconversion

Blood ◽  
1988 ◽  
Vol 71 (6) ◽  
pp. 1752-1754
Author(s):  
JE Groopman ◽  
T Caiazzo ◽  
MA Thomas ◽  
RA Ferriani ◽  
S Saltzman ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
High Risk ◽  
Screening Tests ◽  
Homosexual Men ◽  
Immunodeficiency Virus ◽  
Aids Related Complex ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Very High ◽  
Considerable Concern

Recently, considerable concern has been raised regarding the possibility that antibody-based screening tests for the human immunodeficiency virus (HIV) may fail to detect certain high-risk individuals for prolonged periods of time. It has been proposed that testing for HIV-related antigen may be a necessary procedure to detect such individuals. To address this issue, we longitudinally studied two groups of homosexual men: direct sexual partners of acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC) patients and individuals who ultimately sero-converted. There was no evidence of prolonged infection with HIV in the absence of detectable antibody in these two groups. It appears at this time that, even among subjects at very high risk for HIV infection, currently available antibody-based assays are sufficient to identify infected individuals.

Screening for drugs of abuse: effect of heat-treating urine for safe handling of samples

1990 ◽  
Vol 36 (6) ◽  
pp. 908-910 ◽  
Author(s):  
K Wolff ◽  
M A Shanab ◽  
M J Sanderson ◽  
A W Hay
Keyword(s):  
Heat Treatment ◽  
Human Immunodeficiency Virus ◽  
Drugs Of Abuse ◽  
Heat Treating ◽  
Immunodeficiency Virus ◽  
Aids Virus ◽  
Risk Patients ◽  
Higher Temperature ◽  
Abused Drugs ◽  
The Stability

Abstract Heating urine samples from high-risk patients for 1 h at 56 degrees C is no longer believed to completely inactivate human immunodeficiency virus (HIV; AIDS virus). To protect staff who are handling infectious samples such as those from drug-addiction units, heating at a higher temperature may be necessary. We report the stability to heat treatment (at 60, 70, and 100 degrees C) at pH 5.1 and 7.6 of some commonly abused drugs, namely, methadone, pethidine, amphetamine, the cocaine metabolite, benzoylecgonine, and the dextropropoxyphene metabolite nordextropropoxyphene. Heat-treating urine at 60 degrees C for 1.5 h or 70 degrees C for 1 h did not significantly affect the measured concentrations of these drugs. However, heat treatment at 100 degrees C for 1 h reduced the recovery of all the drugs. Benzoylecgonine and amphetamine were most susceptible to the different forms of heat treatment.

scholarly journals Silent infections with human immunodeficiency virus type 1 are highly unlikely in multitransfused seronegative hemophiliacs [see comments]

Blood ◽  
1990 ◽  
Vol 76 (10) ◽  
pp. 1924-1926 ◽  
Author(s):  
J Gibbons ◽  
JM Cory ◽  
IK Hewlett ◽  
JS Epstein ◽  
ME Eyster
Keyword(s):  
Human Immunodeficiency Virus ◽  
High Risk ◽  
Human Immunodeficiency Virus Type ◽  
Virus Type ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Immunodeficiency Virus ◽  
Contaminated Blood ◽  
Hiv 1

Abstract We used the polymerase chain reaction (PCR) to determine the frequency of silent human immunodeficiency virus type 1 (HIV-1) infections in seronegative high-risk individuals with hemophilia who had been exposed to contaminated blood products more than 3 years previously. In a cross- sectional study of a cohort of 57 prospectively followed seronegative hemophiliacs who received multiple transfusions before 1986, HIV-1 proviral DNA was found transiently in only one patient. These data suggest that the rate of HIV infection among high-risk antibody negative individuals with hemophilia is very low to absent, in the range of 0% to 2%. These findings should provide considerable reassurance to seronegative persons with hemophilia and their sexual partners.

scholarly journals Defining “High-risk Sexual Behavior” in the Context of Substance Use

2019 ◽  
Vol 1 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Nishtha Chawla ◽  
Siddharth Sarkar
Keyword(s):  
Human Immunodeficiency Virus ◽  
Substance Use ◽  
Sexual Behavior ◽  
High Risk ◽  
Risky Sex ◽  
Current Evidence ◽  
High Risk Sexual Behavior ◽  
Immunodeficiency Virus ◽  
Definition Of ◽  
Risk Sexual Behavior

Introduction: Sexual behavior is a behavior exhibited by individuals to gratify one of their basic needs, that is the sexual need. Often the way in which sexual behavior is practiced may lead to negative consequences. However, the definition of a sexual behavior as risky varies with regards to culture, gender, age, and the threshold. Objectives: This review aims to study different definitions of high-risk sexual behavior available in literature, the differences in the prevalence of various risks associated with risky sex in substance-using population as compared to general population, and eventually formulating a tentative definition of “high-risk sexual behavior” in the context of substance use. Current evidence and results of literature search as we have entered into the epidemic of human immunodeficiency virus globally, it is important clinically as well as from the public health perspective to define high-risk sexual behavior discretely helping the researchers quantify the burden and the clinicians focus on the population at risk. High-risk sexual behavior has often been discussed and studied in various studies till date. However, literature lacks a discrete definition of high-risk sexual behavior. Risky sex (or high-risk sexual behavior) has been variably defined in different studies. Majority of the definitions in the studies focus on sexually transmitted infection, especially human immunodeficiency virus. A few studies talk about unintended pregnancies or abortions. Conclusion: The association between high-risk sexual behavior and substance use has been well established. Further research is warranted to obtain a definition which has greater precision and clinical utility, and which can be integrated in preventive and promotive pursuits.

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