Pyoderma (pustular diseases) of the skin. Pustular skin diseases and their prevention at the enterprise Prevention of purulent skin diseases
Purulent diseases and their development depend on the following conditions: penetration of pyogenic microbes into the body tissues, the state of the body and environmental conditions. Therefore, all measures to prevent acute purulent diseases must take into account the listed reasons on which the appearance and development of these diseases depends.
Causes of purulent diseases. One of the main reasons for the occurrence of purulent diseases is, as stated, the penetration of certain pyogenic microbes from outside into the tissues or blood of the body through various damage to the skin or mucous membranes. Therefore, one of the important ways to prevent many purulent diseases is to prevent injuries both at work and at home.
In the presence of any open injury, the timely provision of rational first aid in compliance with the general rules of asepsis and antisepsis, as well as the immediate treatment of minor injuries by trained persons or through self- and mutual aid, is of particular importance.
For any damage to tissues and organs, no matter what they arise from (wounds, operations), the prevention of purulent complications is very important. It consists of a number of measures aimed at preventing the entry of purulent microbes into wounds and the further development of infection. In this regard, the organization and quality of first and emergency care for all persons accidentally injured plays an exceptional role.
Purulent diseases prevention A. Prevention of wound infection (and, consequently, possible purulent complications) consists, first of all, in careful compliance with all modern rules of surgical asepsis when providing medical care (when applying dressings, injections, dressings, etc.).
To prevent the penetration of pyogenic microbes into the wound, many methods have been proposed. The simplest of them is to lubricate minor damage to the skin with iodine tincture or an alcohol solution of brilliant green. Even better results are obtained by using N. N. Novikov’s liquid, which has the following composition: tannin - 1.0, brilliant green - 0.2, 96° alcohol - 0.2, castor oil - 0.5 and collodion - 20.0 . Using a pipette or glass rod, this liquid or BF-6 glue is applied directly to the damaged area of the skin and the surrounding skin surface. After 1-2 minutes, a dense elastic film forms over the damaged area of skin. For minor injuries, you can use another method: the wound and its circumference are wiped (washed) with a 3-5% soap solution or a 0.25 - 0.5% ammonia solution using gauze or cotton balls, dried, lubricated with iodine tincture, sprinkled a mixture of penicillin and streptocide and carefully sealed with an adhesive plaster. To prevent infection during microtrauma, a colloidal solution of furatsilin or brilliant green can also be used.
In the prevention of purulent diseases during wounds and operations, the prophylactic use of antibiotics or sulfonamide drugs is very important. Paramedics and nurses should make extensive use of them when providing first aid for wounds. For this, they use, for example, sprinkling the wound with penicillin, streptocide, or even better - a mixture of them.
For large wounds, open fractures or burns, penicillin or bicillin should be administered intramuscularly. If injections are not possible, antibiotics are given orally in tablet form. After this, patients who have wounds that require primary surgical treatment are referred to a doctor. When a doctor treats fresh wounds, as well as during various operations (in the pre- and postoperative period), general and local use of antibiotics is also widely used.
The prophylactic use of antibiotics for various open injuries and operations contributes to better wound healing, a significant reduction in purulent complications and their severity, and a faster recovery and restoration of the working capacity of patients.
In preventing the further spread of acute purulent processes and the appearance of various complications, timely and rational treatment of primary inflammatory diseases, especially in the initial stages of their development, is of great importance. Thus, timely use of antibiotics and surgical intervention for a limited abscess can prevent its transition to a more common and severe disease - phlegmon, as well as the appearance of complications such as lymphangitis, lymphadenitis. Timely and rational treatment of one boil can prevent its transition to furunculosis, timely surgery for acute appendicitis or other acute purulent process in the abdominal cavity prevents the development of general peritonitis, etc. The fight against pustular diseases (pyodermitis) at work and at home is also of great importance .
Speaking about the prevention of purulent diseases, it should be emphasized that all medical personnel must meticulously observe the rules of personal hygiene (frequent hand washing, changing gloves and gowns), since dirty hands and dirty clothes contribute to the spread of purulent infection. In this regard, purulent diseases among medical personnel (boils, abscesses), as well as diseases such as tonsillitis and influenza, are of particular danger to surgical patients. The presence of these diseases among personnel can lead to infection of patients and their wounds and to the possible appearance of certain purulent diseases in them.
In addition to pyogenic infection, the occurrence and development of various purulent diseases largely depend on the body's defenses. Therefore, in the prevention of any diseases, including purulent diseases, activities that strengthen the human body are of great importance: regular exercise and sports, proper work and rest schedule, wet rubdowns, air baths, etc. General strengthening and hardening of the body increases its resistance to various infections and, to one degree or another, determines a more favorable course and outcome in the event of the development of a purulent disease.
In the prevention of many purulent diseases, the improvement of the external environment in which a person lives and works, i.e., improving working and living conditions, is of great importance. For example, in the prevention of a number of purulent diseases (furunculosis, pyodermatitis, etc.), general hygiene measures and skin care (especially hands) play an important role.
This includes proper sanitary-hygienic and sanitary-technical working conditions in industrial enterprises and agricultural work, combating dust and contamination of premises, rational and clean workwear, organization of showers, baths, laundries, measures to combat skin contamination (various oils and liquids). ), as well as the struggle to improve everyday life (regular washing in the shower or bath, changing linen). To prevent diseases of the skin of the hands in some industries, it is advisable to use various protective ointments and methods of sanitation (health improvement) of the hands.
It should be remembered that continuous improvement of the culture of work and life is the main way to reduce morbidity in general and various purulent processes in particular.
Finally, in the prevention of many purulent diseases, sanitary and educational work among the population is of great importance. The role of sanitary educational work among the population (conversations, lectures, the use of print, radio, television) is especially great in the prevention of various microtraumas and pustular diseases (often the cause of more dangerous acute purulent processes), as well as complications of acute diseases of the abdominal organs (appendicitis, cholecystitis, peritonitis). Purulent diseases, as a rule, require urgent hospitalization of patients and immediate surgical intervention.
Reasonable promotion of the initial signs of purulent diseases and advice on the need for early medical help lead to a significant improvement in outcomes and a reduction in the number of various complications.
PREVENTION OF PUTENTAL DISEASES
Pyoallergides
With long-standing pyococcal skin lesions, peculiar secondary skin lesions - pyoallergides - can occur. Most often they are observed in chronic streptococcal skin diseases (chronic diffuse streptoderma, long-standing impetigo, intertriginous streptoderma), much less often - in staphylococcal, in particular atypical, forms of pyoderma.
Pyoallergides appear suddenly, symmetrically on the skin of the trunk and limbs. They look like bright pink spots of various sizes and shapes, covered in the center with small lamellar scales, or small follicular papules or papulovesicles, papulopustules. A disseminated rash of blisters and blisters that are dense to the touch is often noted on the palms and soles. It is accompanied by itching and often an increase in body temperature up to 38 °C. In such cases, the general condition of the patient is disturbed (headache, fatigue, weakness). Intensifying over several days, the skin rash can become widespread. After holding out for 7-10 days, the disease begins to regress.
Pyoallergides develop as a result of hematogenous spread of microbes or their decay products coming from the main pyogenic focus, in the presence of a pronounced allergic condition. The immediate cause of the appearance of pyoallergides is often irritating external preparations applied to the main lesions, the administration of immunobiological drugs, intercurrent diseases (influenza, etc.).
Treatment. For high fever and general malaise, antibiotics are indicated; in the absence of general symptoms, intravenous injections of calcium chloride or intramuscular injections of calcium gluconate. Externally - indifferent mash and powder.
The significant incidence of pyodermatitis among the population and the disability they cause dictate the extreme importance of carrying out extensive preventive measures.
The occurrence of pustular diseases is determined not only by the special properties of their pathogens, but also by the influence of unfavorable external factors, as well as disturbances in the general condition of the body. For this reason, the prevention of pyodermatitis consists of various measures. The main ones are:
1) accurate recording and analysis of the incidence of pyodermatitis, making it possible to establish its true causes;
2) sanitary and hygienic measures aimed at maintaining cleanliness of the skin and eliminating excessive contamination in everyday life and at work;
3) sanitary and technical measures, the purpose of which, by improving and improving the sanitary and technical conditions of production, is to eliminate the harmful factors operating in the work process that contribute to the occurrence of pustular diseases;
4) measures aimed at strengthening the physical condition of people, increasing their resistance to infection;
5) sanitary educational work.
The widest possibilities for carrying out all of these activities are available in relation to the organized part of the population, in particular workers in various branches of industry and agriculture, as well as military personnel. Among sanitary and hygienic measures, the creation of conditions for maintaining personal hygiene is of particular importance.
In enterprises, workers must be provided with washbasins with hot and cold water, sufficient soap, and towels to be able to clean contaminated skin during breaks and at the end of the working day. To fully clean the skin from industrial contaminants (lubricating oils, emulsions, kerosene, etc.), in addition to liquid or dry soap, it is recommended to use special cleaning agents.
To protect the skin from contamination and the irritating effects of chemicals that come into contact with it during work, it is of great importance to provide workers with clothing that matches the specifics of production. Regular washing is necessary, since contaminated overalls, aprons, mittens, shoes, etc. sometimes cause more harm than their absence. It is also important to maintain the sanitary condition of residential (dormitories, barracks) and working (shop, workshop, machine park, etc.) premises and, if possible, ensure normal temperature conditions in them. If it is impossible to comply with the latter (hot shop, field work in the summer, especially in the southern regions), it is extremely important to create conditions for washing in the shower after work.
Systematic hypothermia of the body also plays an equally important role as a predisposing factor contributing to the occurrence of pustular diseases (especially furunculosis), and therefore it is important to provide warm clothing to persons working outdoors in cold weather.
Sanitary measures include: monitoring the correct maintenance of production tools, cleaning workplaces from production waste (metal shavings, sawdust, nails, etc.), which helps reduce microtrauma; technical measures aimed at preventing contamination of workers’ skin with chemicals; correct organization of first aid for microtraumas. In workrooms, shops, workshops, garages, and field camps there should be first aid kits with a 1-2% alcohol solution of brilliant green or other dye, a 2% alcohol solution of iodine, and sterile dressing material. For the treatment of microtraumas, Novikov liquid (Tannini 1.0, Viridus nitentis 0.2, Spiritus aethylici 96% 0.2 ml, ol. Ricini 0.5 ml, Collodii 20.0), bactericidal adhesive plaster, furaplast, 5% iodine solution is recommended in ethylcellosolve.
During sanitary and educational work, as well as during special instructions, workers should be taught self- and mutual assistance.
Medical examination of workers, concern for improving living conditions, monitoring public catering, etc. are of great importance. Widespread promotion of physical methods of health promotion is necessary: physical exercise and sports, daily rubbing of the skin with cool water, and in the summer, sun and air baths, bathing, etc. In the overall complex of preventive measures, sanitary and educational work is of great importance: familiarizing workers with the pathogenesis of diseases and the necessary preventive measures.
Preventive measures should also include early detection of the initial forms of pustular diseases and their timely treatment.
Depending on the specifics of the industry, individual workshops, the characteristics of the activities of state farms, etc., working and living conditions, as well as climatic factors, specific plans for preventive measures, based on an analysis of the incidence of pyodermatitis, must be developed locally and strictly implemented.
FUNGAL DISEASES (DERMATOPHYTIAS)
Fungal skin diseases develop as a result of the introduction of pathogenic microfungi into it. When living outside the human or animal body, fungi can maintain their viability and virulence for several years. This explains the possibility of infection through indirect contact - through various objects contaminated with scales falling from the skin of patients or fragments of hair containing elements of the fungus.
There is no single and generally accepted classification of fungal diseases. More often they use the classification developed in the department of mycology of the Central Scientific Research Institute of Dermatovenerology of the USSR Ministry of Health. In accordance with this classification, 4 groups of mycoses are distinguished.
1. Keratomycosis: pityriasis versicolor, etc. According to tradition, along with pityriasis versicolor, a similar disease of erythrasma was considered, which is caused, as has recently been proven, not by fungi, but by corynebacteria and belongs to pseudomycoses (see “Athletes inguinalis” ).
2. Dermatophytosis: epidermophytosis inguinal (true); mycosis caused by interdigital trichophyton (athlete's foot); mycosis caused by red trichophyton (rubromycosis); trichophytosis; microsporia; favus.
3. Candidiasis.
4. Deep mycoses: chromomycosis, etc. Along with deep mycoses, the textbook discusses actinomycosis, a bacterial disease currently classified as pseudomycosis.
In the diagnosis of most mycoses, microscopic examination of scales, vesicle covers, nail plates, and hair plays a significant role. The causative agent of the fungal disease can be detected after the horny substance clears in a hot solution of caustic alkali.
Treatment. Antifungal drugs are used to treat mycoses. Griseofulvin is prescribed orally. It is believed that this antibiotic does not have a fungicidal, but only a fungistatic effect. Coming from the intestines into the blood, it is adsorbed by the cells of the epidermis and accumulates in the stratum corneum and appendages of the skin, as a result of which they become inaccessible for the introduction of the fungus. This is proven by the fact that after approximately 2-3 weeks from the start of treatment, a healthy fungus-free zone appears in the proximal part of the hair (or nail), while fungal elements remain in the distal part. With further use of griseofulvin, the affected part of the hair (or nail) is gradually “pushed out” by the growing part. That is why it is recommended to shave the growing hair every 7-10 days when treating with grisefulvin.
Griseofulvin is taken in tablets (0.125 each) with meals and washed down with 1 teaspoon of sunflower oil or fish oil. The first control test for fungi is carried out 12-14 days from the start of treatment, subsequent ones - every 3-4 days until negative results, then every 5-7 days. The criteria for cure are clinical recovery and triple negative tests. The daily and course doses of griseofulvin depend on the body weight and age of the patient.
Some patients during treatment with griseofulvin experience headache, abdominal pain, diarrhea, vomiting in the blood - minor eosinophilia, as a very rare phenomenon - measles or scarlet fever-like toxicderma, urticaria. Sometimes disorientation develops; therefore, griseofulvin is not recommended for outpatient administration to drivers of all types of transport.
Contraindications: diseases of the liver, kidneys, blood, malignant neoplasms, cerebrovascular accidents, stroke, porphyria (griseofulvin can enhance photosensitization), pregnancy, breastfeeding. Griseofulvin can be replaced with drugs of the imidazole group (ketoconazole, etc.).
Anticandidal antibiotics include amphoglucamine, prescribed 200,000 units (2 tablets), then 500,000 units 2 times a day after meals; mycoheptin - 250,000 units (5 tablets or capsules) 2 times a day; levorin - 500,000 units (1 tablet) 2-3 times a day; nystatin - 2,000,000-3,000,000 units (4-6 tablets) per day. The sodium salts of nystatin and levorin dissolve better in the gastrointestinal tract. The duration of treatment with anticandidal antibiotics is 10-14 days. Locally for mycoses, 2-5% alcohol solutions of iodine, nitrofungin, Castellani liquid, as well as ointments - 5-15% sulfur and tar, Wilkinson's ointment (Picis liquidae, Sulfuris depurati aa 15.0; Calcii carbonatis praecipitati 10.0; Saponis) are used viridis, naphthalani aa 30.0; Aq. destill 4 ml), 5% amikazole, 0.5-1% decamin, 1% esulan, zincundan, undecine, mycoseptin, canesten, etc. Selective anticandidiasis also has antibiotics mycohepgin, nystatin and levorin, used in the form of ointments and solutions, amphotericin and decamine ointment. For acute inflammatory processes, ointments containing corticosteroids and antifungal agents are recommended: dermozolon, mycozolon, lorinden S. For better penetration of fungicidal drugs into the affected skin, their solutions in dimexide (DMSO) are used.
Class hour “Hygiene rules. Infectious diseases and their prevention"
Form of conduct: conference in the form of information messages.
Target:
Protect students from a careless attitude towards hygiene rules (focus their attention on personal items);
Warn children about the dangers of hepatitis C;
Talk about the flu and its prevention.
Preparation
Find interesting material about infectious diseases.
Make a stand “Health is in your hands.”
Copy the leaflets “Drugs and hepatitis are death.”
Invite specialists to discuss these issues: a biology teacher, a school doctor, a district epidemiologist.
Health is more valuable than anything else. Health comes out in pounds and comes in in ounces.
Russian proverb
Teacher: Guys, in their youth, many people take lightly the most precious thing they have received from nature - their health. Unfortunately, at present we can say that due to chronic diseases of parents, their unhealthy lifestyle and deteriorating environmental conditions, many children are already born sick or with a weakened immune system and are exposed to various diseases in the first days of their existence. Therefore, in order not to follow the expression: “what we have we don’t keep, when we lose it we cry,” it is necessary to be armed with special knowledge about the most dangerous infectious diseases that await us at every step. And to know means not to be afraid, it means to be able to actively resist them!
Conversation one - “Tender” killer
This is the name given to hepatitis C, which was discovered only in 1989, because of its “silent” course. In some patients, clinical symptoms appear only after liver cancer has already developed. The number of patients with hepatitis C in Russia increases every year by an average of 100%, and many doctors are already talking about an epidemic of this virus. How can infection be prevented, who is most susceptible to it, what treatment methods exist? We will try to answer these and some other questions today.
What to do to avoid getting infected with the virus? Avoid contact with blood and other infectious materials; Avoid using general hygiene products (toothbrushes, razors), as well as items such as earrings, etc. Always follow the rules of safe sexual intercourse, including the use of condoms.
How do you know if you are infected with the hepatitis C virus?
As a rule, at the initial stage the disease is very mild, so it can only be detected using a biochemical analysis of blood serum. Then a virological study is carried out. If necessary, liver tissue obtained through biopsy may be examined.
How is the hepatitis C virus transmitted?
Since the virus is contained in the blood of infected people, the main route of transmission of the virus is contact with blood and its products (this is possible not only through blood transfusions, but also through the use of unsterile injection needles and other medical instruments). The virus can also be transmitted sexually, in utero, or during childbirth from an infected mother to her child (rarely). Transmission of the virus is possible through the use of shared personal toilet items - toothbrush, razor, scissors.
How quickly can liver cirrhosis develop due to hepatitis C virus infection?
In 25-30% of patients, cirrhosis develops within 15-20 years, which entails a high risk of developing liver cancer. In 65-75% of patients, acute hepatitis C progresses to the chronic stage.
How is the hepatitis C virus different from other viruses?
Unlike viruses B and D, acute hepatitis C can occur with less severe liver damage, and often without any symptoms at all. Some patients have a fever and may experience nausea and abdominal discomfort. Some people develop jaundice. The disappearance of the virus from the blood within 6 months occurs only in 20% of cases. Next, we need to talk about the chronic stage of the disease, which in most cases is also asymptomatic until the later stages, when cirrhosis of the liver and its complications develop.
Is there a vaccine for hepatitis C virus?
No, there is no vaccine today, but there are modern and effective methods of control and they consist of antiviral therapy, which must be carried out under the strict supervision of a doctor.
Conversation two “About ear hygiene”
Those who use a telephone, player, headphones, or stethoscope for a long time need to remember that these devices should be for individual use.
You can get an infection in your ear by talking from a pay phone, especially if you have abrasions or irritations in your ear. You can expect trouble with a weakened immune system, anemia, gout, but most often with diabetes.
In addition, people for whom headphones and a telephone receiver are a working tool can also suffer from ear dermatitis. These are telephone operators and secretaries. Even doctors can suffer due to frequent use of a phonendoscope, and those who wear a hearing aid or player for a long time.
Symptoms of the disease are discharge from the ear canal and pain when pressing on the auricle.
For itching and mild pain, when the purulent process has not yet developed, the ear canal is lubricated with brilliant green. It dries the skin and reduces itching. This should be done with cotton wool, wound in a thin layer on a match, barely touching the walls of the ear. Do not rub in under any circumstances. Improper lubrication may cause increased itching and watery discharge. Then things will get worse. You should not lubricate the sore spot with “ear” sticks, which are now sold everywhere. Their thickness is not suitable for this procedure. Unfortunately, they can move the decomposed skin closer to the eardrum.
For ear dermatitis, you can drop 1% menthol oil into the ear with a pipette or a teaspoon, 4-5 drops 2-3 times a day. At the same time, tilt your ear so that the instilled solution does not flow out of it.
The disease can also be treated with boric alcohol. Soak a loose cotton wick in it and gently insert it into your ear. You need to keep it for 1 or 2 days and not touch it. The cotton wool itself will spread throughout the skin of the ear canal. To prevent the cotton wool from being dry, you can additionally drip boric alcohol onto it. Then you need to introduce a new wick. The first 2-3 times the procedure is best done under medical supervision.
Treatment with boric alcohol is that it destroys the surface layer of the skin, which dries out and comes off in scales. This is how diseased cells disappear.
If you suffer from allergies, it is best to lubricate the ear canal with hormonal ointments, for example, prednisolone or hydrocortisone. It must be administered using a cotton filter. Under the influence of heat, the ointment in the ear will spread on its own. In severe cases, the disease is treated with antibiotics.
During illness, you need to take multivitamins and B vitamins. Patients with diabetes during an exacerbation of dermatitis need to consult an endocrinologist and strictly adhere to the diet.
Ear dermatitis can be prevented by following basic hygiene rules. To avoid damaging the skin of the ear canal, never remove wax with a needle or pin. Rinsing the ear with dirty water can also lead to the development of the disease. This should only be done by a doctor, who will prescribe special drops to soften the wax and remove it under sterile conditions.
Those who use a telephone, headphones, or stethoscope for a long time need to remember that these devices should be for individual use. If a stranger was talking on your phone, wipe the handset with alcohol or cologne.
Conversation three “What is chlamydiasis?”
The disease is caused by bacteria of the chlamydia genus. In nature, there are two types of chlamydia: the first type affects animals and birds and can cause an infectious disease in humans - psittacosis; the second type of chlamydia is called Chlamydia trachomatis. About 15 of its varieties are known, some of them cause trachoma and lymphogranulomatosis venereum. Two of the 15 varieties of chlamydia infect the human genitourinary system, causing urogenital chlamydia.
In terms of their properties, chlamydia occupy an intermediate position between viruses and bacteria. Therefore, chlamydia is still more difficult to diagnose and treat than ordinary bacterial infections. Urogenital chlamydia is a sexually transmitted disease. There is often a combination of chlamydia with other genitourinary infections - trichomoniasis, gardnellosis, ureaplasmosis.
How does chlamydia manifest?
The incubation period for chlamydia is
approximately 1-3 weeks. A person with chlamydia notices a characteristic glassy discharge from the urethra in the morning. There may be itching or discomfort when urinating, sticking of the sponges of the external opening of the urethra. Sometimes the general condition worsens - weakness is noted, body temperature rises slightly. It should be noted that chlamydia often occurs without obvious symptoms or without them at all.
Even without treatment, after some time (about 2 weeks), the symptoms of the disease disappear. In this case, chlamydia becomes chronic; the chlamydial infection is, as it were, “preserved” in the body, waiting for an opportunity to remind itself again.
What complications can chlamydia cause?
The main danger of chlamydia lies precisely in the complications it can cause. After some time, chlamydia “gets” to the prostate gland, to the seminal vesicles, causing chronic prostatitis and vesiculitis. Further, the chronic process spreads to the epididymis, which can lead to an obstructive form of male infertility.
Chlamydia can also get on the bladder wall and cause hemorrhagic cystitis. Chronic inflammation of the urethra caused by chlamydia leads to the development of its narrowing (stricture). In women, chlamydial infection often causes obstruction of the fallopian tubes, ectopic pregnancy, and postpartum or post-abortion endometritis. Pregnancy in a patient with chlamydia often occurs with complications.
In addition to various complications affecting the genital organs, chlamadia can cause damage to other organs. Then this disease will already be called Reiter's disease or syndrome. With Reiter's syndrome, the eyes (chlamydial conjunctivitis), joints (usually ankles, knees and spine), skin, and internal organs (usually hepatitis, but almost any organs can be affected) can be affected.
What is the diagnosis of chlamydia?
Diagnosing chlamydia is more difficult than diagnosing a bacterial infection. The simplest methods have an accuracy of no more than 40%. The most accurate and accessible method for determining chlamydia in urethral discharge today is the immunofluorescence reaction (RIF) using antibodies labeled with a special substance - FITC.
How difficult is it to treat chlamydia?
Due to the characteristics of chlamydia, antibacterial drugs against them are not as effective as against ordinary bacteria, therefore the treatment of chlamydia is more complex and time-consuming. In addition to the course of antibacterial therapy, it necessarily includes immunomodulatory therapy, multivitamin therapy, normalization of lifestyle, diet, and abstinence from sexual activity for the duration of treatment. Treatment must be carried out by both partners. At the end of the course, control tests are carried out. If chlamydia is not detected, then tests are carried out 2 more times after 1 month (in women - before menstruation). Only after this will it be possible to talk about the effectiveness of the therapy.
What are the preventive measures for chlamydia?
Chlamydia is easier to avoid than to cure. Therefore, we will once again present the rules of sexual hygiene that will protect you from various sexually transmitted diseases:
A permanent partner whom you trust;
Avoid casual sex or use a condom. However, remember that a condom is an effective, but not 100% means of protection against sexually transmitted infections;
If you have the slightest suspicion of infection, consult a urologist;
Remember: an old disease is more difficult to treat.
Conversation four: “Let’s talk about the flu”
Influenza is an acute infectious disease with an airborne transmission mechanism, with epidemic and pandemic (global) spread. Belongs to the group of acute respiratory viral infectious diseases (ARVI), caused by an RNA-containing virus and manifested by high but short-term fever, severe intoxication, and damage to the respiratory system.
Influenza has been known since the time of Hippocrates. The disease received the name “influenza” in the 14th century. The first description of influenza dates back to the beginning of the 17th century.
Virus is the causative agent of the disease
The viral nature of influenza was established in 1918. Influenza viruses belong to the orthomyxovirus family. The genetic information is located in the core of the virus and consists of eight chains of ribonucleic acid (RNA), which encodes the composition of eight structural proteins.
Currently, there are three genera of orthomyxoviruses that cause influenza: A, which was first cultivated in 1939; B - in 1940 and C - in 1947. Cells of the immune system form antibodies to the virus proteins (antigens), which inactivate the virus and protect against recurrence of the disease. The surface antigens most important for antibody production are two: hemagglutinin, designated H, and neuraminidase-N. The structure of virus antigens is variable: depending on their composition, serotypes or strains are distinguished within type A.
Epidemics and pandemics
Approximately every 20-70 years, due to mutation of virus A, a new pandemic strain (i.e., a strain causing a global epidemic) appears, characterized by its own set of hemagglutinin and neuraminidase. Virus A also affects some animals, such as waterfowl and pigs, which are believed to be the source of the new pandemic strain, which usually appears in rural areas of China. Influenza epizootics (epidemics in animals) have not been described in the specialized literature.
Within 2-3 years, an epidemic serotype arises within this strain, which is a variant of the virus with minor deviations in the structure of surface proteins. It causes major epidemics that engulf entire countries. The first recorded influenza epidemic in history occurred in 1889, followed by the devastating Spanish influenza A (H1N1) pandemic in 1918, which killed more than 20 million people. The next pandemic A (H2N2) was noted in 1957-1958. and claimed the lives of 70 thousand people in the United States.
The last influenza A (H3N2) pandemic took place in 1968-1969, during which 34 thousand people died in the United States. The birthplace of the strain is Hong Kong. Another subtype of the A virus, common in our time, A (H1N1), periodically caused large epidemics, but not on the same scale as in 1918-1919. When Asian influenza A (H2N2) appeared in 1957, the A (H1N1) virus disappeared. The A(H2N2) virus also disappeared when the Hong Kong virus was identified in 1968. In 1977, the A (H1N1) virus reappeared and has since spread along with the A (H3N2) virus.
Every year, between 5 and 15% of people worldwide fall ill with influenza. During epidemics, up to 20-40% of the population is affected.
Source of infection. A patient with influenza, especially before the 4-5th day of illness, a recovering person (up to 2-3 weeks), a healthy virus carrier (the virus is in a defective form) contains seven RNA fragments.
The transmission mechanism is airborne. Droplets of mucus when coughing and sneezing spread over a distance of up to 3-3.5 m. The virus can be transmitted through household items (dishes, towels, door handle, etc.). However, it is unstable in the external environment and is destroyed at room temperature in a few hours, and quickly dies when exposed to ultraviolet rays and when dried.
The affected population is people who lack immunity to this variant of the virus. The incidence among children and adolescents is 4.6 times higher than among adults.
Mechanisms of disease development. The virus penetrates the epithelial cells of the mucous membrane of the upper respiratory tract: the nose, then the larynx, trachea and bronchi. Toxic substances (components of the virus, cell decay products, complexes of bacteria with viruses, biologically active substances - kinins and biogenic amines) enter the blood. Severe intoxication and fever develop; the virus penetrates the central nervous system, lungs, heart and skeletal muscles, where it sharply disrupts blood circulation in microvessels: capillaries dilate, the permeability and fragility of their walls increases, blood flow slows down, hemorrhages and swelling occur. These changes cause the appearance of muscle pain, and sometimes the development of inflammation of the heart muscle. Coronary heart disease, peptic ulcers and other chronic diseases may worsen. With the development of disseminated intravascular coagulation (hyperactivation of the blood coagulation system with subsequent depletion and development of bleeding), the danger of damage to the adrenal glands with symptoms of infectious-toxic shock increases. Recovery from uncomplicated influenza, regardless of treatment, occurs on average within 7-12 days.
Immunity, i.e. immunity to infection, appears after an illness. The production of antiviral antibodies (mainly to hemagglutinin and neuraminidase) ensures the creation of specific immunity to a given type and strain of the virus. In some cases, two waves of the disease are observed: first, a person suffers from a mild form of influenza (due to the presence of antibodies from a previous disease), then a more severe form (due to the lack of immunity to the new strain). In people who have had influenza A, immunity lasts on average for about 2-3 years, influenza B - 3-5 years, influenza C - for life. Immunity can be transmitted from mother to fetus and persist in the newborn until the age of six months.
Post-vaccination immunity is developed after 7-15 days and lasts about 4 months. (maximum up to 2 years).
Clinical picture of the disease. The incubation period lasts from 3-4 hours to 3 days. Clinical manifestations for different types of influenza are the same, with the exception of those for influenza C, which is characterized by a predominantly mild course:
1st day: acute onset in 90-92% - chills, general weakness, fever, redness of the face, temperature rises rapidly and reaches high numbers in 6-12 hours (38.5-40°C), muscle pain and joints, headache (behind the eyes, in the temples and parietal region), patients note rawness and dryness in the nasopharynx, sneezing. In the lungs of 60% of patients, scattered dry rales are heard, dullness of percussion sound and tympanitis are detected due to local plethora and edema, swelling of the interstitial tissue of the lungs, and the development of emphysema. The x-ray may show increased pulmonary pattern and thickening of the bronchi. Heart sounds may be muffled, and the heart rate may not correspond to the height of the fever (relative bradycardia);
2-3 days: high fever remains (possibly decreasing by the end of the second day to normal numbers), severe intoxication remains, in 70-80% catarrhal syndrome develops: serous or serous-mucous, slight nasal discharge, cough appears, accompanied by chest pain. Often associated with: hoarseness, a feeling of tightness in the chest, mild shortness of breath. In most patients, by the end of 2-3 days the cough becomes wet and less frequent. In 20-30% of cases, the flu occurs without a runny nose (“dry catarrh”);
Days 4-7: recovery period. The temperature normalizes (usually by the end of 4 days), intoxication gradually decreases (by the 5th-6th day), catarrhal symptoms persist until the 10th-12th day, post-influenza asthenia, general weakness, and increased fatigue appear.
"Intestinal" flu. With influenza, the gastrointestinal tract is not affected, although there may be complaints from the digestive organs. This is usually incorrectly referred to as gastritis or enteritis, possibly associated with an enterovirus infection or food intoxication accompanied by high fever.
Differential diagnosis of influenza. It is carried out by a doctor with an unclear diagnosis - with acute respiratory diseases of a different etiology (parainfluenza, respiratory syncytial infection, rhinovirus infection, adenoviral infections, acute respiratory infections of mycoplasma etiology), tonsillitis, ornithosis; measles, enterovirus infections, typhoid fever, pneumonia. For this purpose, special examinations may be prescribed.
Early criteria for influenza severity. Be sure to consult your doctor if you experience any of the following symptoms that indicate: about severe influenza:
Unusual complexion (pallor at high temperatures, cyanosis, purplish coloration of the skin);
Sharp immobility, lethargy, rarely - agitation;
Severe diffuse headache, severe dizziness, fainting, insomnia;
Severe tachycardia, irregular pulse, decreased systolic (“upper”) blood pressure (below 90 mm Hg);
Shortness of breath, respiratory arrhythmia, suffocation;
Vomiting in combination with any of the above symptoms;
Nosebleeds;
Body temperature is above 40°C.
Complications of influenza. In most cases, the disease self-destructs within 7-12 days, but sometimes complications develop that can pose a threat to the patient’s life. Complications are divided into two groups: those associated directly with the course of influenza and with the addition of a second bacterial infection.
Group I (1-2 days of illness): hemorrhagic pulmonary edema, meningoencephalitis (serous), infectious-toxic shock. Children with high fever may experience febrile seizures;
Group II complications: pneumonia (most often), otitis media, glomerulonephritis, purulent meningitis and septic conditions. Bacterial complications after the patient feels better: high fever may rise again, cough with sputum, chest pain, etc. They may be delayed for up to 1-2 weeks.
Bed rest for at least 5 days.
Plenty of hot drinks, light dairy and vegetable foods.
Antihistamines (diphenhydramine 0.05 g 2-3 times a day).
Ascorbic acid up to 1.5-3 g/day.
In children with influenza, aspirin is not prescribed, since it is possible to develop a rare specific lesion of the central nervous system - Reye's syndrome, which initially manifests itself as uncontrollable vomiting and deterioration of the general condition, with mortality in 20-40% of cases. In 1984, 204 cases of this disease were described in the United States in influenza and chickenpox.
For the treatment of children, the average single dose of paracetamol (regardless of the dosage form - tablets or rectal suppositories) is 5-10 mg/kg of body weight (daily - approximately 65 mg/kg) every 4-6 hours. Children under 12 years of age should not take paracetamol more often 5 times a day. Paracetamol is generally a safer drug than aspirin, but when used in high doses, drug damage to the liver and kidneys is possible.
Conclusion
Teacher: From our conversation about various infectious diseases, you received qualified answers to many questions. Discussion of these problems showed that any disease is accompanied by suffering, painful stress, general physiological ailments and poses a great danger, especially for children. The main conclusion you should make for yourself is not to get sick! And this means being attentive to preventive measures, supporting the protective functions of your body, i.e. your immunity.
Remember: “A healthy person doesn’t need a doctor!”
Pustular diseases mostly affect patients who violate the rules of personal hygiene; they are often suffered by untidy people who poorly monitor the cleanliness of their body, clothes, home and workplace.
On the skin of a person who does not wash regularly enough, billions of pyogenic cocci accumulate, which can cause boils, folliculitis, hidradenitis, ecthyma, etc. It is necessary to take a bath or visit a sauna 1-2 times a week and change underwear. This is especially true for those people whose skin is easily contaminated due to the nature of their work (cooling and lubricating oils, dust, etc.). Some jobs require you to shower daily.
A person who has received a microtrauma should immediately sanitize the wound by lubricating it with iodine tincture or brilliant green.
It is necessary to widely use protective pastes and ointments. In time When working with coal tars, mineral oils, solvents and varnishes, you can use Khiot-6 paste. After work, the paste should be washed off the skin first with cold and then with warm water and soap. When in contact with petroleum products, workers must wear kerosene and oil-proof clothing and gloves.
After treatment of boils and hidradenitis, if there is still infiltration at the base of the elements, therapeutic efforts must be continued. Otherwise, the boil may recur again. A poorly treated first boil is the beginning of a second one. Overcrowding, untidy housing, accumulation of dust in rooms and on objects, furniture, poor ventilation of apartments, lack of sunlight, dampness, clutter with unnecessary objects, and dirt are the causes of pyodermatitis. The general condition of the body, decreased resistance, recent infections, anemia, malnutrition, hypo- and vitamin deficiency, stress, diabetes, and family history are also important. Methods of hardening the body should also occupy a major place in measures to prevent pustular diseases: water procedures, gymnastics, hiking, sports, skiing, walking in the forest, air and sunbathing. Sun treatment and treatment with ultraviolet rays, sea bathing, radon and other mineral baths can only be permitted after consultation with a doctor.
For the prevention of pustular diseases in recent times time began to use antimicrobial underwear, containing chemically bound hexachlorophene. Experience has shown that in those enterprises where workers used this linen, the incidence of illness decreased by 30%. In addition, antimicrobial underwear prevents the appearance of new relapses of staphyloderma. Such underwear is also used in maternity hospitals by women in labor to prevent mastitis and furunculosis.
The use of antimicrobial linen, as the experience of Soviet authors has shown, is completely harmless and does not cause any negative effects.
A few words about the diet for pyodermatitis. She occupies an important place. In the prevention of such forms of pyodermatitis as chronic furunculosis, hidradenitis, sycosis, it is necessary to exclude honey, chocolate, cakes, jam from the diet, and limit the consumption of sugar and potatoes. We recommend carrot juice, liquid yeast, a tablespoon 3 times a day. day during meals, purified sulfur on the tip of a knife 2-3 times a day day, zinc sulphide 0.05 g 3 times a day day before meals, vitamins A, C, B1.
For prevention, all skin injuries should be treated with alcohol solutions of iodine or brilliant green. The skin should not be overheated, as sweating promotes the development of pustules. If a skin infection has started, do not wash the affected areas with soap and water; you should wipe them with alcohol to prevent the infection from spreading further.
It is better to treat any pustular rash by a dermatologist - this will more reliably protect you from pustules and prevent complications
- Fungal diseases of the SKIN
Mycosis
Typical skin infections caused by certain pathogens
(fungi) and are often found in certain groups of people
Special microorganisms belonging to a large group of fungi affect the skin and its appendages (hair, nails, etc.). Fungal skin diseases, due to their prevalence and high contagiousness (danger of infection), are devoted to a significant section of dermatology. Although improved hygienic conditions have greatly reduced the development of these diseases, conditions can still be found today, mainly in rural areas, that favor the growth of fungal infections. Let's look at some of the causative agents of these forms of the disease.
What are "mushrooms"?
The plant kingdom consists of higher plants, or green plants, and lower plants, which the great Linnaeus called cryptogams (spore-bearing plants). The reproductive organs of fungi are hidden and not visible upon superficial examination. On the contrary, in higher plants the reproductive organs are formed by flowers. Cryptogams include thallophytes, which, among other things, are divided into mycetes, or fungi (mycophytes). The same group of thallophytes also includes schizomycetes (bacteria), i.e. actual bacteria. Their body consists of more or less branched threads called fungal hyphae. The interweaving of these hyphae forms the mycelium. Not all mycetes are pathogens, and not all pathogens lead to skin diseases. The ones we're talking about are called dermatophytes or dermatomycetes.
For a long time, the most common pathogen among mycetes were trichophytons and especially T. violaceum. Today they seem to be retreating slightly. The causative agent of scab (favus) is found mainly in countries with poor hygienic conditions. In most of the population of poor countries it occurs epidemically, i.e. constantly.
Thus, Tinea tonsurans occurs spontaneously at 13-14 years of age, during puberty, and adults never get sick with it. This is explained by the antifungal effect of fatty acids, which appear during puberty in the secretion of the sebaceous glands of the scalp. Hormones of the sex glands, which are active at this age, can also prevent the development of mycetes.
Microscopy
Microsporia in humans is caused primarily by Microsporon audouinii, in animals - by Microsporon canis or lanosum, which has become very widespread in recent years. It affects almost exclusively children aged 4-10 years and is extremely contagious, since the fungi are transmitted by direct touch or indirectly through combs, towels, etc. For this reason, epidemics often occur in schools and kindergartens. In adults, the lesion occurs not only on the scalp, but also on the cheeks and chin (in persons with a beard). At first, this is a reddish round spot, which is most often ignored, since its true essence can only be revealed by special research. The spot enlarges, the reddish color intensifies, small scabs form on the skin and hair breaks easily. A typical picture of the disease develops: the lesions are large (2-6 cm in diameter), grayish in color and can cover most of the scalp. All hairs break off at a height of 0.5 cm from the base and one visual assessment is enough to make sure that they are diseased. They are surrounded by a fibrous grayish shell, mycelium formed by hyphae. Also added here are spores, which lie like a frame around the hair and, under a microscope, give an accurate idea of the changes taking place. For a better understanding, you should know that hair consists of an outer shaft (visible part) and a root. The root thickens downwards into the hair follicle, which is located in the hair papilla. The hair root is surrounded by a so-called hair follicle in the form of a sac; a shaft grows from the opening of this hair follicle. The fungus infects the hair in the area of this hole, attaches to it and multiplies by longitudinal division of its cells.
Trichophytosis
It is also typical for children. The fungus only affects humans. Infection can occur directly or indirectly through hygiene items (combs, towels, etc.). If the fungus gets on the stratum corneum, it forms threads that cover the entire hair up to the hair follicle. But the damage is more serious than with microsporia, and the hair breaks off at the base of the follicle. There are fewer spots on the skin, diseased hair is mixed with healthy ones.
Modern treatment is based on removing diseased hair using hair removal tongs (the surgical intervention is not easy and is carried out carefully and methodically). It is also recommended to extirpate (pull out) healthy hair around the lesion along a circumference of 1 cm in diameter in order to deprive the fungus of the ability to infect new hair. Iodine and sulfur, which have an antifungal effect, are used locally. The development of griseofulvin, an antibiotic that replaced expensive and complex treatment methods, such as not entirely safe x-ray therapy, is considered a therapeutic “breakthrough.” The duration of such treatment is about 40 days. All suspicious cases should be named to the doctor, and after a successful diagnosis, all sick children should be immediately separated from healthy ones. It is enough to free them from school, leave them at home and not allow them to contact their peers. It is clear that this first step to prevent the spread of the disease depends entirely on parents and educators, who must be nearby, supervise the children and ensure that contact with the doctor is maintained.
Favus (head scab)
Favus, or scab, has been known for a long time. It is caused by a fungus that exclusively affects humans. The disease is especially contagious and primarily affects children and young people. Unlike other fungi, it does not lose its danger with the onset of puberty and also affects adults. These are primarily individuals living in disadvantaged environments and communities.
There are cases of constant occurrence of scab in many generations in ONE family or in people in one village. The disease can be transmitted directly through touch or indirectly through general hygiene items, such as combs, brushes and others. A significant distinguishing feature compared to other types is the poor outcome of this disease, since if left untreated it leads to irreversible hair loss and the formation of scar tissue.
A typical sign of favus is the formation of scales. They are small sulfur-yellow, round convex crusts up to 3 mm high. There is a depression in the center where the hair is located. The scale consists of a compact mass of fungal filaments that the fungus forms around the opening of the follicle after it infects the hair all the way to the root. It increases, but never exceeds 2 cm in diameter. Several of these scales may fuse together and form large, crusty lesions that smell like mouse urine. Favus develops more or less slowly into alopecia (baldness), since the diseased hair is a foreign body, which first leads to inflammation and then to scarring of the scalp.
In addition, the fungus can produce toxic substances that have a destructive effect on the epidermis. The spot is smooth, slightly depressed and completely hairless. Famous personalities such as Julius Caesar suffered from this form of scab. It was said that for this reason he always wore a laurel wreath. Scab developing into alopecia requires decisive treatment. Initially, the patient must be isolated. Then the scales of the crust should be cleaned off, the hair near the lesions should be removed. Regular antifungal ointments or liquids should be used for two months.
Women really enjoy trying on shoes in stores, even if they have no intention of buying them. Not everyone knows that in such a situation you can meet not only a prince in a white suit, but also a much less handsome “gentleman”. Fungus is a very insidious disease! - likes to live in shoes and sandals, patiently waiting for a new owner.
According to statistics, every fifth resident of Russia suffers from a fungal disease, and with age, the likelihood of becoming infected with a fungus increases several times. Shoes are far from the only opportunity to pick up a “companion”, which is then very difficult to get rid of. Infection occurs with equal frequency in public places: showers, baths, gyms and swimming pools.
If you are going to visit (where you will, of course, be asked to wear slippers), put special nylon socks in your purse. This method is also suitable for trying on shoes. The fungus is tenacious and unpretentious, like the last surviving soldier of evolution, but it also has its own preferences - weaknesses, so to speak. He likes warm and humid places with a lot of people, preferably naked. Therefore, when going to the pool or the beach, treat the skin of your feet with antifungal ointment. Try to wear flip-flops. When getting a manicure or pedicure at a salon, make sure your technician has disinfected the tools and that the towel is clean and starched.
The fungus is not a desperate brave man; it attacks when it sees an environment suitable for itself or the absence of the necessary protection. The disease can be caused by tight shoes, in which the foot rubs and becomes sore. It is also very convenient for the fungus to “cling” to a person whose body’s barrier functions are weakened due to taking antibiotics.
One of the signals of a skin fungus (dermatomycosis) is an itchy rash in which areas that are constantly exposed to high humidity itch: the perineum, feet (including between the toes), and sometimes the armpits. Fungi can affect any part of the body, but dry areas are much less itchy.
Some fungi even eat music, or rather, its media - CDs. If you do not treat the fungus, then you will give yourself up to it “to be devoured.” But self-medicating this disease is more expensive for yourself. If you have the slightest suspicion, be sure to contact a specialist. The fact is that there are a lot of types of fungal infections, and only a specialist, necessarily after a laboratory examination of the scraping, can understand what kind of fungus has affected your skin.
Please note that amateur “diagnosticians” can be deceived by ordinary sneakers. If worn frequently, rubber shoes can cause an allergic reaction to overheating. In this case, redness and rash can be removed with baths with herbal decoctions. Therefore, be sure to get tested.
After diagnosis and consultation with a doctor, if a “fungal enemy” has been discovered, it is necessary to develop a treatment strategy. With the consent of the doctor, you can combine medicines with “folk” ones. The most “salty” way to treat fungal diseases of the skin of the feet and nails was invented by halotherapists (from the Greek word “halos” - salt). At night, cleanly washed and dried feet are advised to sprinkle with salt (especially between the toes), bandage, put on socks and go to bed. There is also a “sweet” “grandmother’s” recipe: repeatedly rubbing in the juice of a tangerine slice or peel. You just need to realize that “traditional” medicine offers mostly superficial “technologies”, and they, no matter how tempting their simplicity may be, can give, at best, only a very short-term effect.
One should not think that scientists are sitting with their hands folded, watching how the confrontation between fungal bacteria and humans will end. Every year new tools appear, dissertations are written and conferences of mycologists are held. However, in each individual case it is extremely difficult to assess the effectiveness of a new drug - this disease, unfortunately, knows how to hide well. In the long list of remedies against skin fungus, it is perhaps necessary to highlight “Travogen”. This cream is very convenient to use, as it can be used only once a day. In addition, it effectively counteracts fungus both on the surface of the skin and in the body.
It is necessary to fight the fungus on “all fronts.” First, thoroughly disinfect everything that the fungus may have come into contact with. Start the hunt for harmful bacteria in the bedroom. Underwear, stockings, socks, tights can be “neutralized” by boiling for 15-20 minutes in a 2% soap-soda solution. Then they should be ironed with a hot iron. Then look into the bathroom. Nail scissors are disinfected by immersing them in alcohol and then burning them over a burner flame. The walls and bottom of the bathtub must be treated with a mixture of equal parts of washing powder and bleach or chloramine. In the hallway you will have to do a lot of work with shoes. Wipe the insoles and sides of the shoes with a swab moistened with a solution of formaldehyde (25%) or acetic acid (40%). Place the tampon in the toe of the shoe, and place the shoe itself in a hermetically sealed plastic bag for 24 hours. Do not forget that acetic acid has a rather strong odor, so finally, thoroughly air your shoes on the balcony.
Along with disinfection, it is necessary to use complex therapy - tablets, varnishes, liquids and ointments. Remember that the main task is to expel the fungus from the body. The absence of visual symptoms can deceive the patient, and the disease will return at the most inopportune moment. Therefore, during the treatment process, monitor the body’s condition using tests.
