Clinical and epidemiological aspects of human parvovirus B19 infection in an urban area in Brazil (Niterói city area, State of Rio de Janeiro, Brazil)

This study was designed to analyse the clinical and epidemiological data from human parvovirus B19 cases in a six-year study of rash diseases conduct in an urban area in Brazil (Niterói city area, State of Rio de Janeiro). A total of 673 patients with acute rash diseases were seen at two primary health care units and at a general hospital. A clotted blood sample was collected from all subjects at the time of consultation. Forty-nine per cent (330 cases) of the patients were negative for dengue, rubella and measles IgM or for low avidity IgG to HHV-6. Of these 330, 105 (31.8%) were identified as IgM positive to parvovirus B19 by using an antibody capture EIA. During the study period, three distinct peaks of parvovirus infection were detected, suggesting that the disease appears to cycle in approximately 4-5 years. B19 infection was characterized by variable combinations of fever, flu-like symptoms, arthropathy, and gastrointestinal symptoms. Frequency of fever and arthropathy was substantially higher in adults, 75% [chi2 (1 D.F.) = 11.39, p = 0.0007] and 62.5% [chi2 (1 D.F.) = 29.89, p = 0.0000], respectively. "Slapped-cheek" appearance and reticular or lace-like rash were seen in only 30.1% of the children. No adult presented this typical rash. The lack of the typical rash pattern in a large proportion of parvovirus B19 and the similarity of clinical manifestations to other rash diseases, specially to rubella, highlight the difficulty of diagnosing B19 infection on clinical grounds alone.

Report of The Commission on Assisted Human Reproduction

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Building a Culture of Patient Safety - Report of the Commission on Patient Safety and Quality Assurance

The Commission on Patient Safety and Quality Assurance was established in January 2007 and reported to the Minister in July 2008. The report was considered by government in January 2009 which agreed the implementation process. The overall objective of the Commission was to develop clear and practical recommendations to ensure that safety and quality of care for patients is paramount within the healthcare system. The Commission’s report set out a wide range of policy measures that will drive the safety and quality agenda in Irish healthcare in the coming years. The establishment of the Commission was prompted by an increasing awareness of patient safety issues in general and high profile health service system failures at home and abroad and in particular by the Lourdes Hospital Inquiry. These have underlined the need for an increased focus on patient safety and quality. Download document here Download summary document on the Report

The Leas Cross Commission The Commission of Investigation (Leas Cross Nursing Home) Final Report June 2009

The Leas Cross CommissionThe Commission of Investigation (Leas Cross Nursing Home) Final Report June 2009 Click here to download PDF 1.2mb

First Quarterly Progress Report of the Implementation Steering Group on recommendations of the Report of the Commission on Patient Safety and Quality Assurance

First Quarterly Progress Report of the Implementation Steering Group on recommendations of the Report of the Commission on Patient Safety and Quality Assurance Click here to download PDF 56kb

Fourth Annual Report of the Independent Monitoring Group for A Vision for Change - the Report of the Expert Group on Mental Health Policy - June 2010

  Click here to download PDF 222KB Please scroll down for related documents   Related Documents: HSE National and Regional Progress Reports HSE – Key Deliverables 2009 – Report PDF 55KB HSE – National Report PDF 363KB HSE – Regional Report – Dublin Mid Leinster PDF 82KB HSE – Regional Report – Dublin North East PDF 89KB HSE – Regional Report – West PDF 91KB HSE – Regional Report -South PDF 152KB HSE Local Area Progress Reports HSE – Tipperay South PDF 395KB HSE – Tipperary North PDF 367KB HSE Sligo/Leitrim and West Cavan PDF 359KB HSE – Roscommon PDF 352KB HSE – Mayo PDF 338KB HSE – Louth/Meath PDF 525KB HSE – Limerick PDF 395KB HSE – Laois/Offaly PDF 366KB HSE – Kildare/West Wicklow PDF 317KB HSE – Galway West PDF 297KB HSE – Galway/Mayo and Roscommon Child and Adolescent PDF 59KB HSE – Galway East PDF 400KB HSE – Dun Laoghaire PDF 262KB HSE – Dublin West South West PDF 346KB HSE – Dublin South City PDF 361KB HSE – Dublin North PDF 371KB HSE – Dublin North West PDF 432KB HSE – Dublin North – Dublin Central & part of NW Dublin – Child and Adolescent PDF 53KB HSE – Dublin North Central PDF 341KB HSE – Donegal PDF 485KB HSE – Cork West PDF 424KB HSE – Cork South Lee PDF 469KB HSE – Cork North PDF 423KB HSE – Cavan/Monaghan PDF 371KB HSE – Carlow/Kilkenny PDF 451KB Progress Reports from Government Departments Department of Community Rural and Gaeltacht Affairs PDF 20KB Department of Education and Science PDF 121KB Department of Enterprise Trade and Employment PDF 25KB Department of Environment Heritage and Local Government PDF 47KB Department of Health and Children PDF 50KB Department of Justice Equality and Law Reform PDF 19KB Department of Social and Family Affairs PDF 27KB Submissions Received by the IMG Amnesty International Ireland submission PDF 87KB Association of Occupational Therapists submission PDF 81KB College of Psychiatry of Ireland submission PDF 21KB Disability Federation of Ireland submission PDF 81KB Health Research Board submission PDF 24KB Inclusion Ireland submission PDF 18KB Independent Mental Health Sevice Providers submission PDF 82KB Irish Association of Consultants in Psychiatry of Old Age submission PDF 37KB Irish College of General Practitioners submission PDF 25KB Irish Hospital Consultancts Association submission PDF 155KB Irish Medical Organisation submission PDF 63KB Irish Mental Health Coalition submission PDF 90KB Mental Health Commission submission PDF 64KB Mental Health Nurse Managers submission PDF 206KB National Council for the Professional Development of Nursing and Midwifery submission PDF 67KB National Disability Authority submission PDF 49KB National Service Users Executive submission PDF 28KB Neurobehaviour Clinic – National Rehabilitation Hospital submission PDF 24KB Neurological Alliance of Ireland submission PDF 20KB

Final Report of the Implementation Steering Group (ISG) on the recommendations of the Report of the Commission on Patient Safety and Quality Assurance

Final Report of the Implementation Steering Group (ISG) on the recommendations of the Report of the Commission on Patient Safety and Quality Assurance Click here to download PDF 235KB

Prevalence of Clostridium spp. and Clostridium difficile in children with acute diarrhea in São Paulo city, Brazil

Species of Clostridium are widely distributed in the environment, inhabiting both human and animal gastrointestinal tracts. Clostridium difficile is an important pathogen associated with outbreaks of pseudomembranous colitis and other intestinal disorders, such as diarrhea. In this study, the prevalence of Clostridium spp. and C. difficile, from hospitalized children with acute diarrhea, was examined. These children were admitted to 3 different hospitals for over 12 months. Eighteen (20%) and 19 (21%) stool specimens from children with (90) and without (91) diarrhea respectively, were positive to clostridia. Only 10 C. difficile strains were detected in 5.5% of the stool samples of children with diarrhea. None healthy children (without diarrhea) harbored C. difficile. From these 10 C. difficile, 9 were considered as toxigenic and genotyped as tcdA+/tcdB+ or tcdA-/tcdB+, and 1 strain as nontoxigenic (tcdA-/tdcB-). They were detected by the citotoxicity on VERO cells and by the multiplex-polymerase chain reaction. Thirty clinical fecal extracts produced minor alterations on VERO cells. The presence of C. difficile as a probable agent of acute diarrhea is suggested in several countries, but in this study, the presence of these organisms was not significant. More studies will be necessary to evaluate the role of clostridia or C. difficile in diarrhoeal processes in children.

Seasonal pattern of abundance of Aedes aegypti (Diptera: Culicidae) in Buenos Aires city, Argentina

In Buenos Aires, the most crowded city of Argentina, there is a potential risk of dengue virus transmission by the mosquito Aedes aegypti during late summer. The temporal patterns of oviposition activity and abundance of breeding sites of this vector were studied in two cemeteries of the city. Between September 1998 and August 1999, we examined 142 ovitraps weekly and a total of 18,010 water-filled containers. Both study areas showed remarkable differences in the percentages of positive ovitraps (19% vs 8%) and breeding sites (18% vs 1%), but similar temporal abundance patterns. The percentage of breeding sites was higher in summer and autumn than in spring and winter, and the percentage of positive ovitraps was higher in summer than in the other three seasons. Immatures were recorded from the first week of October to the second week of July, and oviposition activity from the third week of October until the end of April. In both cemeteries and with both methodologies the highest infestation levels were registered in March (ovitraps: 41.8% and 20.6%, breeding sites: 39.2% and 3.4%). These highest abundances took place after several months with mean temperatures above 20ºC and accumulated rainfalls above 150 mm. A sharp decline in oviposition activity was observed when monthly mean temperature decreased to 16.5ºC, and no eggs were found below 14.8ºC. Seasonal fluctuation of Ae. aegypti abundances in mid-latitudes like Buenos Aires would allow reduction of the egg mosquito population through the elimination of containers during the coldest months, which are free of adults.

Feeding preference of the sand flies Lutzomyia umbratilis and L. spathotrichia (diptera: Psychodidae, Phlebotominae) in an urban forest patch in the city of Manaus, Amazonas, Brazil

Precipitin tests were performed on blood meals of 199 sand flies (161 Lutzomyia umbratilis, 34 L. spathotrichia, two Lutzomyia of group shannoni, one L. anduzei) in a non-flooded upland forest on the Campus of the Universidade Federal do Amazonas. This is the second largest forest fragment in an urban setting in Brazil. Results on L. umbratilis, which is considered to be the principal leishmaniasis vector in this region, indicated rodents as its predominant blood source in contrast to previous reports in which blood meal analysis indicated that this species fed principally on Xenarthra (particularly sloths)

The prevalence of human immunodeficiency virus type 1 and hepatitis C virus among injection drug users who use high risk inner-city locales in Miami, Florida

In order to estimate the prevalence of human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) co-infection in hard-to-reach intravenous drug users, 199 subjects from high-risk inner-city locales, the so called "shooting galleries", were consented, interviewed, and tested in Miami, FL, US. Positive HIV-1 status was based on repeatedly reactive ELISA and confirmatory Western Blot. Positive HCV status was based on reactive ELISA and confirmatory polymerase chain reaction techniques. Overall, 50 (25%) were not infected with either virus, 61 (31%) were HIV-1/HCV co-infected, 17 (8%) infected by HIV-1 only, and 71 (36%) infected by HCV only. The results of the multivariable analyses showed that more years using heroin was the only significant risk factor for HCV only infection (odds ratio = 1.15; 95% confidence interval = 1.07, 1.24) and for HIV-1/HCV co-infection (odds ratio = 1.17; 95% confidence interval = 1.09, 1.26). This paper demonstrates that HIV-1/HCV co-infection is highly prevalent among so called "shooting galleries".

Funding: North Dublin City & County Regional Drugs Task Force

The North Dublin City and County Regional Drugs Task Force invites applications for this once-off funding which will be provided through four pillars by way of a grant up to €3,000 for innovative initiatives: • Prevention, Education & Awareness – to develop programmes and supports in the community which offer information and education in order to generate awareness. • Treatment & Rehabilitation – to develop additional short-term supports for those undertaking treatment for drug misuse or innovative rehabilitative supports. • Research – to undertake local research into drug misuse in North Dublin within the RDTF area. • Supply Reduction – to reduce access to all drugs, in particular those that cause most harm, among young people in neighbourhoods where misuse is most prevalent. Terms and conditions apply. To request an application pack or for more information contact 01 813 1786 orThis resource was contributed by The National Documentation Centre on Drug Use.

Blood transfusion and iatrogenic risks in Mexico city: anti-Trypanosoma cruzi seroprevalence in 43,048 blood donors, evaluation of parasitemia, and electrocardiogram findings in seropositive

Iatrogenous transmission of Trypanosoma cruziby blood transfusion was suggested as a potential risk by Pellegrino (1949). Seropositive blood donors in Mexico were first reported in 1978, however, limited information is available due to small sampling, the use of heterogeneous serologic assays, and geographically limited studies. A wide survey carried out in 18 out of the 32 states of Mexico, showed a national mean of 1.6% seropositive among 64,969 donors, ranging from 0.2 to 2.8%. In the present study, we have screened 43,048 voluntary blood donors in a period of five years at the Instituto Nacional de Cardiología I. Chávez, a concentration hospital located in Mexico city which serves mainly the metropolitan area and accepts from all over the country. Standardized ELISA and IIF were used to identify seropositive individuals in addition to hemoculture, PCR and standard 12 lead ECG tests that were applied to a group of seropositive patients (29/161). The result showed a seropositivity of 0.37% (161/43,048). From the group of seropositive individuals 40% (12/29) were potential carriers of T. cruzi at the donation time and 5/29 had subclinical ECG abnormalities. Parasitological tests performed in 70 erythrocyte and platelet fractions from seropositive units (70/161) showed negative results. Our findings strongly support T. cruzi screening in the transfusion medicine practice and identify subclinical heart disease among seropositive blood donors.

Are We Choosing Health? Annual Public Health Report from Healthcare Commission and Audit Commission

A new report by the Healthcare Commission and Audit Commission assesses the impact government policy has had on: narrowing health inequalities; improving sexual and mental health; and reducing smoking, alcohol misuse and obesity.