Cytogenetic studies of familial and sporadic Alzheimer disease

We present cytogenetic findings in 7 familial and 5 sporadic Alzheimer disease (AD) patients and 34 unaffected relatives, spouses, and normal controls. Our study was prompted by reports of increased chromosome abnormalities in patients and family members at risk for AD. Coded peripheral blood chromosome preparations were evaluated for aneuploidy, aberration rates, and banding patterns. Statistical analyses of our results showed no increase in aneuploidy or aberrations in AD patients, their relatives, or normals. Chromosome loss or gain in aneuploid cells was not specific except in two individuals. These two older persons studied, one with AD and one unaffected, were observed to have increased sex chromosome aneuploidy. This finding was attributed to aging and was not considered to be an effect of AD.     

Novel laser-activated solder for sealing corneal wounds

PURPOSE: To compare the effectiveness of a laser-activated biological tissue solder with that of standard sutures for sealing corneal incisions. METHODS: Two keratome knives measuring either 3.0 mm or 2.85 mm were used to create a non-self-sealing peripheral oblique corneal wound (POCW) or a central perpendicular corneal wound (CPCW) in fresh rabbit cadaver eyes. Wounds were sealed with a solder strip (POCW; n = 5), a solder patch (CPCW; n = 5), or three interrupted nylon 10-0 sutures (n = 5). After the solder was placed on the wound, a diode laser was used to activate the solder, resulting in cross-linking to tissue. Wound stability was tested by a stepwise infusion of saline, and pressure changes were monitored with a digital manometer. Leaking pressure was recorded. RESULTS: The pressurized mean baseline IOP in the intact globe was 131.13 mm Hg (SD, 4.66). Mean IOP after CPCW was 1.7 mm Hg (SD, 0.13); for POCW it was 3.62 mm Hg (SD, 3.09). For the CPCW group, the mean leaking pressure in the sutured eyes was 82.76 mm Hg (SD, 6.55), whereas in the solder patch it was 101.42 mm Hg (SD, 29.92; P = 0.2222). For the POCW group, the mean leaking pressure in the sutured eyes was 33.44 mm Hg (SD, 9.38), and the mean IOP achieved in the solder repaired eyes was 125.16 mm Hg (SD, 9.85; P = 0.0079). CONCLUSIONS: The tested laser-activated solder was as effective as sutures when used as a patch and superior to sutures for clear corneal incisions in this animal ex vivo model.     

Hyperlipidemia associated with HIV protease inhibitor use: pathophysiology, prevalence, risk factors and treatment

Despite potent antiretroviral activity, the HIV-1 protease inhibitors have recently been associated with abnormal serum lipoprotein concentrations. The purpose of this review is to describe serum lipid abnormalities related to protease inhibitor use. A MEDLINE search up to June 1, 1999, and abstracts from recent scientific meetings were primary data sources. Lipid disturbances in HIV-infected patients receiving protease inhibitors generally consist of elevated triglycerides and total cholesterol levels; HDL cholesterol is often reduced. The pathophysiological mechanism by which the protease inhibitors induce these lipid abnormalities has been hypothesized, but is unknown. Cases of pancreatitis and coronary heart disease have been described in hyperlipidemic patients receiving protease inhibitors. Treatment of protease inhibitor-related hyperlipidemia is unknown. Exchanging the offending protease inhibitor for nevirapine may be helpful in certain patients. Atorvastatin in combination with gemfibrozil has been used with limited success in a small number of individuals.     

Central Venous Catheter Protective Connector Caps Reduce Intraluminal Catheter-Related Infection

BackgroundCentral line-associated blood stream infection (CLABSI) rates in adult care intensive care units have been decreasing across the board. However, we continued to see just a few infections in patients whose catheters are in for >4 days. Therefore, we looked at infections associated with intraluminal contamination to help reduce our infection rate.MethodsA protective cap trial was developed and implemented in 2 intensive care units. All of the central venous catheter and intravenous tubing access valves were covered with a protective cap saturated with alcohol. This intervention eliminated the need to wipe off intravenous access points with an alcohol swab. The study was done as a nonrandomized prospective trial occurring March 1, 2011 through February 29, 2012.ResultsDuring 2010, there were 4 CLABSI-related infections. By the end of the trial, we had incurred 1 catheter-associated blood stream infection. CLABSI rate reduced from 1.9 in 2010 to 0.5 during the 1-year trial period.ConclusionsThe implementation of the port protector cap system resulted in lower infection rates compared with an alcohol swab technique. Our results indicate that consistent use of the caps in tandem with strict compliance does influence CLABSI rates.