JAMA : the journal of the American Medical Association
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The Centers for Disease Control and the American College of Obstetricians and Gynecologists have recommended that pregnant women who are at increased risk for acquired immunodeficiency syndrome be tested for antibodies to human immunodeficiency virus. When this recommendation is implemented, some clinicians who undoubtedly have had limited experience with patients infected with human immunodeficiency virus will be responsible for the care of pregnant women found to be asymptomatically infected with human immunodeficiency virus. There is, therefore, a need for information that will ensure that adequate counseling is provided and that appropriate medical and infection control measures are instituted. This article will review issues related to counseling and antepartum, intrapartum, and postpartum care of seropositive pregnant women.
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Randomized Controlled Trial Comparative Study Clinical Trial
Evaluation of dressing regimens for prevention of infection with peripheral intravenous catheters. Gauze, a transparent polyurethane dressing, and an iodophor-transparent dressing.
Four dressing regimens for peripheral venous catheters were studied in a prospective randomized clinical trial with 2088 Teflon catheters: (1) sterile gauze, replaced every other day, and three dressings left on for the lifetime of the catheter; (2) gauze; (3) a transparent polyurethane dressing; and (4) an iodophor-transparent dressing. The four dressings provided comparable coverage, except moisture accumulated more frequently under the transparent dressings (26% to 28% vs 20% to 21%). ⋯ Stepwise logistic multivariate analysis showed cutaneous colonization of the insertion site (relative risk [RR] of infection, 3.86), contamination of the catheter hub (RR, 3.78), moisture under the dressing (RR, 2.48), and prolonged catheterization (RR, 1.75) to be significant risk factors for catheter-related infection. These data indicate that it is not cost-effective to redress peripheral venous catheters at periodic intervals; for most patients, either sterile gauze or a transparent dressing can be used and left on until the catheter is removed.