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Issue 208 - 7 Dec 2011

Articles - Anaphylaxis

1. Recognition, assessment and management of anaphylaxis
By Linton, Elizabeth & Watson, David. Nursing Standard, 7/21/2010, Vol. 24 Issue 46: p35-39
This article describes the physiological changes that take place during anaphylaxis, explores the ABCDE (airway, breathing, circulation, disability, exposure) approach to patient assessment and discusses the pharmacological interventions required to treat anaphylaxis effectively. [ABSTRACT FROM AUTHOR].

2. Challenging adverse reactions in children with food allergies
By Waring, Gillian & Levy, David. Paediatric Nursing, Jul 2010, Vol. 22 Issue 6: p16-22
The Department of Health (2006) has highlighted that food allergy is increasing in prevalence. In response, Tameside General Hospital in Greater Manchester has developed a dedicated children's allergy service. By using skin tests, followed by oral consumption of a particular food, the clinic is able to establish allergies and prevent future adverse reactions. This article summarises the findings of an audit of food challenges that were undertaken at the clinic. [ABSTRACT FROM AUTHOR].

3. Anaphylactic Shock with Multiorgan Failure in a Cyclist after Intravenous Administration of Actovegin
By Maillo, Luis. Annals of Internal Medicine, 3/4/2008, Vol. 148 Issue 5:p407
A letter to the editor is presented in response to the article about the case of anaphylaxis with use of Actovergin..

4. Anaphylactic Shock
By Amerecho, Ruth. Internet Journal of Health, 2005, Vol. 4 Issue 2:p6
The body can tolerate allergies of mild nature and the person affected may live with it and prevent the allergy by avoiding exposure to the substance producing this allergic reaction. If the individual is exposed to foreign materials like drugs then most likely that he would be subjected to such reaction if he is vulnerable That may happen at his home, doctor clinic and in hospital There are many records of severe allergic reaction to the following classes of substances and items: Food, insect bite and drugs. All are incriminated in liberating histamine. Drugs, which are notorious to produce serious reactions, are: morphine, pethidine, thiopentone, dextran, haemacel Antibiotics, penicillin Immunizing agents, horse sera, latex and the list is expanding. The immediate management includes activation of the emergency services either in society or in hospital to administer life saving measures and follow up according to the following major lines 1. Severe reaction (Anaphylactic shock): Treatment should be immediate, ask for help from emergency services and usually in hospital setting the cardio-pulmonary resuscitation (CPR) team would be informed. Meanwhile put the patient in supine position, loosen his collar and tight belt, etc. If breathing is noisy this is called stridor, the patient will need oxygen. If swelling of the mouth and larynx happen (laryngeal oedema), the patient may need artificial airway which is usually performed by the emergency team (endotracheal intubation) which needs special instruments. So till then the patient should be given oxygen by mask. 2. Cardiovascular collapse calls for immediate resuscitation (CPR). Guarantee the open vein, judicious use of intravenous fluids, which is usually administered by the CPR team. 3. Adrenaline, 0.5 ml 1:1000 intravenously also can be injected in remote areas (outreach of the medical facilities) by a special pen [ABSTRACT FROM AUTHOR].

5. Acute transfusion reactions in the pediatric intensive care unit
By Gauvin, France et al. Transfusion, Nov 2006, Vol. 46 Issue 11: p1899-1908
Acute transfusion reactions (ATRs) are probably underdiagnosed in critically ill children because associated symptoms can frequently be attributed to the patient’s underlying disease. This study was undertaken to determine the incidence, type, imputability, and severity of ATRs observed in a tertiary care pediatric intensive care unit (PICU).
STUDY DESIGN AND METHODS: All transfusions of labile blood product administered to consecutive patients admitted to our PICU, between February 2002 and February 2004, were prospectively recorded. For each transfusion, the bedside nurse recorded the patient’s status before, during, and up to 4 hours after the transfusion, as well as the presence of any new sign or symptom suggesting an ATR. Three independent experts retrospectively reviewed all transfusion event reports and hospital charts. The presence, type, imputability, and severity of ATRs were adjudicated by consensus of two of three experts (Delphi method), with predefined criteria.
RESULTS: A total of 2509 transfusions were administered to 305 patients during the study. Forty transfusion events (1.6%) were confirmed to be ATRs by expert consensus: 24 febrile nonhemolytic, 6 minor allergic, 4 isolated hypotension, 3 bacterial contamination, 1 major allergic (anaphylactic shock), 1 TRALI, and 1 hemolytic reaction. Imputability of ATRs was probable or possible in 35 cases (88%). ATRs led to an immediate vital threat in 15 percent of cases.
CONCLUSION: Improved surveillance of transfusions given to PICU patients and better knowledge of these reactions by health care professionals should improve the safety of transfusions in the PICU. [ABSTRACT FROM AUTHOR].

6. Inhibitory Effects of Selaginella tamariscina on Immediate Allergic Reactions
By Yue Dai et al. American Journal of Chinese Medicine, 2005, Vol. 33 Issue 6: p957-966
The anti-allergic effects of a 70% ethanol extract from Selaginella tamariscina herb (EST) were evaluated in this study. EST given at the doses of 500 and 1000 mg/kg can inhibit mouse systemic anaphylactic shock induced by compound 48/80 in a dose-dependent manner. It can also dose-dependently block rat homologous passive cutaneous anaphylaxis and skin reactions caused by exogenous histamine and serotonin with a significant difference observed at the dose of 1000 mg/kg. In addition, EST can reduce histamine release from rat peritoneal mast cells triggered by compound 48/80 and an antigen in vitro. When incubated with rat mast cells, the extract (200 µg/ml) can significantly elevate the intracellular cAMP levels. The finding suggests that EST inhibits mast cell-dependent, immediate allergic reactions. Its effects appear to be mediated by reducing the release of vasoactive amines such as histamine from mast cells via stabilizing the cell membrane and weakening the inflammatory action of these amines. Based on these results, Selaginella tamariscina and one of its active components flavonoids may be useful as potential remedies for allergic rhinitis and other allergy-related diseases. [ABSTRACT FROM AUTHOR].

Articles - Food Poisoning

7. The overlooked hazards of holiday eating
Harvard Women's Health Watch, Dec 2011, Vol. 19 Issue 4: p2-3
The article presents information on avoiding food-poisoning during holidays and celebrations. The tips provided by U.S. Food and Drug Administration (FDA) include avoidance of cross-contamination, watching the temperature and not leaving the poultry outside for more than two hours. Some foods and beverages get contaminated by bacteria more easily and should be taken special care of like turkey whose proper cooking and storage are critical..

8. Foodborne outbreaks: managing the risks
By Younes, Maged; Fleck, Fiona. Bulletin of the World Health Organization, Aug 2011, Vol. 89 Issue 8: p554-555
The article presents an interview with Maged Younes, the director of the department of food safety at the World Health Organization. When asked what has been learned about communicating the risk of health threats following an Escherichia coli outbreak in Germany, Younes says that it will take time to assess lessons learned from the event. He comments on communicating about risks that people face from food poisoning. Younes believes that protecting public health should always be a priority..

9. A Review of Gastrointestinal Outbreaks in Schools: Effective Infection Control Interventions
By Lee, Marilyn B. Journal of School Health, Dec 2010, Vol. 80 Issue 12: p588-598
The purpose of this study was to review documented outbreaks of gastrointestinal illness in schools, published in the last 10 years, to identify etiology, mode of transmission, the number of children affected, morbidity and mortality patterns, and interventions for control and prevention. Searches of electronic databases, public health publications, and federal, state, and provincial public health Web sites were completed. Of the 121 outbreaks that met the inclusion criteria, 51% were bacterial, 40% viral, 7% were from Cryptosporidium, and 2% from multiple organisms. Transmission routes recorded in 101 reports included foodborne (45%), person-to-person (16%), waterborne (12%), and animal contact (11%). Actions to control outbreaks included alerting medical and public health authorities or the community to the outbreak (13%), treating cases (12%), enhancing hand washing (11%), and increased vigilance during food preparation (8%). Recommendations to prevent future outbreaks were compared with previously published studies that demonstrated effectiveness. The risk of foodborne illness was reduced when food handlers practiced effective hand washing technique and received food safety training and certification. Student training programs on hand hygiene, enhanced cleaning and disinfection of the school, and hepatitis A vaccination were found effective. Children should be supervised on farm visits, hand washing strictly enforced, and food eaten in an area separated from the animals. Staff and students should have a positive, continuous communication with public health authorities including educational sessions and immediate reporting of possible outbreaks. [ABSTRACT FROM AUTHOR].

Journals - Table of Contents

10. From Journal of Infection Prevention, November 2011, Volume 12, Issue 6
10A. Strategy, technology and tweeting
10B. The use of social media in the dissemination of information from scientific meetings
10C. Using infection prevention data for improvement: the infection prevention control team as a clinical support micro-system
10D. A UK district general hospital cleaning study: a comparison of the performance of ultramicrofibre technology with or without addition of a novel copper-based biocide with standard hypochlorite-based cleaning
10E. Community nurses’ wound audit – a proxy measure for surgical site infections?
10F. Effectiveness and feasibility of using a physical barrier device in reducing rates of microbial contamination of sphygmomanometer cuffs
10G. Hand hygiene knowledge and attitudes: comparisons between student nurses
10H. Assessing the efficacy of photocatalytic oxidation on bacterial contamination in a clinical setting – a randomised controlled trial
10I. Pneumococcal immunisation for the over 65s wins a reprieve

News - National

11. Southern Cross calls for subsidies
By Anne Gibson 5:30 AM Wednesday Dec 7, 2011 Share4  Email
Expand Southern Cross executives and board members. Photo / Sarah IveyHealthcare insurer Southern Cross is calling for Government subsidies for the sector because a rapidly ageing population is threatening the system. Ian McPherson, group chief executive, told almost 500 society members in Auckland yesterday that state handouts might be needed to avoid a crisis

12. New Zealand's midwife rules to change
NZ Herald - Tuesday Dec 6, 2011
The Health Ministry is set to change the way independent midwives report to district health boards, an expert medical witness has told a coroner's inquest in Wanganui. Coroner Garry Evans has been hearing evidence into the death of a boy who died soon after he was born seven years ago at Wanganui Hospital. The vice-president of the Royal New Zealand College of Obstetricians and Gynaecologists, Dr Digby Ngan Kee, told the inquest that access agreements meant independent midwives were not legally accountable to DHBs even after a critical incident

13. Executive Drug Addicts
OPINION: What is your favourite performance enhancing drug?
Whether you work at home or in a sky-high office block in the city, chances are your answer was caffeine. Caffeine is the world's most popular psychoactive drug and has similar pharmacological effects on the body as many illegal substances we associate with doing harm.

News - International

14. Social networking - or social and not working?
OPINION: For many employers, their first instinct is to ban the use of social media at work. No more Facebook. No more Twitter. And, seemingly, no more engagement, as younger employees become disgruntled at the prohibition of a tool that's all-pervasive in their personal lives. Earlier this week, Optus released a study on the future of the workplace. They commissioned an independent research company - Stancombe - to survey and interview more than 300 IT and HR executives around Australia.

15. Optus ‘Future of Work’ Report reveals mobile and collaborative technologies will mobilise Australia’s workforce
- Study shows the future of work is mobile, flexible and collaborative by 2014 - 2016
- IT and HR engagement critical to realise this vision
The future of work in Australia by 2014 – 2016 is flexible, collaborative and mobile according to the Optus Business ‘Future of Work’ report released today. The study found Australian businesses expect rapid growth of smartphones, tablets and mobile applications in the workplace in the next three to five years, which will mobilise their workforce and increase flexibility and productivity. The report, which surveyed IT and HR decision makers from over 320 medium to large organisations*, also shows greater use of collaboration tools, fast uptake of social media and a growing demand by workers to use personal devices at work. This is putting pressure on IT and HR departments to work closer together to enable a secure and productive flexible working environment. “Our report found that the widespread adoption of mobile technologies, increased use of internal collaboration tools, and greater employee access to social media is changing how we work and creating more workplace flexibility and productivity. Gen-X (30 – 50 year olds) in particular are driving the demand for mobile tools that enable flexible working, while younger Gen-Y workers (up to 29 years old) are driving demand for internal collaboration tools. More organisations will also allow staff to use personal devices such as tablets to access their corporate network, reinforcing the need for new policies to ensure security requirements are met,” said Rob Parcell, Managing Director at Optus Business.
Here is a link to the full report
Preparing for the new normal: mobile working

16. Smartphone users starting to feel the pain
Optus - Australia, 4 Dec, 2011
USERS of smartphones and tablet computers are starting to get high-tech blues, as increasing numbers of the tech savvy are coming down with ailments from "text neck" to "text thumb injury".
Health experts in Britain have warned that the strain injuries stemming from long periods spent staring at small screens and tapping at tiny keys can be debilitating. And the injuries are becoming more common as high-tech gadgets grow ever more popular. More and more Britons use their smartphones -- in effect tiny PCs that fit in a jacket pocket -- for accessing the internet rather than making phone calls.

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