The rate of healthcare-associated infections can be regarded as an important outcome parameter of the hygienic quality of care in nursing homes. Our study aimed to evaluate the applicability of repeated prevalence investigations as a tool for surveillance of healthcare-associated infections in nursing homes. From December 2006 to September 2007 a total of five prevalence investigations were conducted in four nursing homes each (n=2,369 residents). Initially, defined structural and procedural parameters of the hygienic quality of the four nursing homes were evaluated based on a detailed inspection and a checklist including 40 parameters. The results showed a uniformly high level of the hygienic quality with only minor variation (mean 84%, range 75%-93% of parameters fulfilled). In total, the prevalence of healthcare-associated infections was 6.8%, with a marked increase with higher categories of dependency (3.5%, 4.0%, 8.5%, and 12.3%, respectively, in the categories 0, I, II, and III of the German grading of skilled nursing care). Respiratory tract (4.1%), skin/soft tissue (1.5%), and urinary tract infections were the most prevalent healthcare-associated infections. Respiratory tract infections showed a marked seasonal pattern. During the second prevalence investigation (February 2007), an outbreak of upper respiratory tract infections occurred in one of the nursing homes (attack rate, 17%). The crude prevalence rates showed considerable differences between the four nursing homes; however, after adjusting for the different categories of dependency, the standardized infection rates (SIR) were largely comparable (excluding the outbreak). After inclusion of the outbreak, the SIR of the specific nursing home was significantly higher compared to all other nursing homes. In conclusion, our study shows that repeated prevalence investigations can be an easy to use tool for surveillance of healthcare-associated infections as a surrogate parameter of the hygienic quality in nursing homes. This implies a knowledge of the seasonality of specific infections and a risk adjustment according to the categories of dependency. The primary intention of surveillance should be the identification of hygienic problems. However, the resources should preferentially be focused on hygienic structures and processes.

Traumatic hip dislocations in children are not frequent but constitute true emergencies. They require urgent reduction because of the risk of consecutive avascular necrosis of the femoral head. We report a 6-year-old boy with traumatic posterior hip dislocation on a vacation abroad. After closed reduction the day of the accident, a hip spica cast was applied and the patient was transferred home. Once home, X‑ray and CT diagnostics were completed by MRI. In future, long-term clinical and radiological investigations for avascular necrosis and growth disorders, as well as thoroughly informing the parents, should be mandatory.

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In der Sache Schr./Sehr. wegen Anfechtung der Ehelichkeit ordnete das Hans. OLG. menschliehen Erkenntnis wird der vollen Auswertung dieses Beweismittels nicht mehr im Wege stehen dfirfen." Der gleiche Senat stellt jetzt fest, dab die wissenschaftliehe Erforschung dieses Gebietes seitdem erhebliche weitere Fortschritte gemacht hat, und dab es im besonderen gelungen ist, das Gebiet der Zweifel, die an der ~iehtigkeit der Bernsteinsch6n Theorie noch bestehen k6nnen, zu beschrs Er ist der Uberzeugung, daft ein Vaterscha~tsausschluft nach dieser Theorie berechtigt ist, vorausgesetzt, daft es sich bei der fraglichen AB-Gruppe um den Typus A-groft handelt. ])as erkennende Gericht berficksichtigt dabei, daft auch der 8. Senat des KG. seine bisherige ablehnende Haltung gegenfiber der Blutprobe aufgegeben hat, werm er auch hinsichtlich der AB-Fglle ,,besonders sorgfgltige Unter-