Candida albicans Adherence to Surface-Modified Denture Resin Surfaces

Purpose: The purpose of this study was to investigate two innovative methods in reducing adhesion of Candida albicans to denture base resins through modification of the surface characteristics of denture resin by incorporation of surface charge and application of a self-bonding polymer on denture resins.
Materials and Methods: Three groups were tested [Group 1: control, pure poly(methyl methacrylate) (PMMA); Group 2: modified PMMA (mPMMA) with 16% methacrylic acid; Group 3: pure PMMA coated with self-bonding polymer (SBP)]. Twenty resin specimens for each group were polymerized, and four experimental subgroups for each surface type were devised, consisting of 2, 4, 6, and 12 days of incubation in C. albicans suspension. The surface area of adherent C. albicans stained with Gram's crystal violet was examined under a light microscope at 400× magnification. Four areas were photographed on each block, one on each quadrant. The images were analyzed using Scion Image 1.63 software to calculate the percent surface area containing adherent C. albicans . Kruskal–Wallis test and Tukey's honest significant difference (HSD) procedure were used to compare the groups.
Results: At day 2, the modified resin had statistically significantly lower levels of Candida than both the control group and the SBP group ( p < 0.036). Both the mPMMA group and SBP group had statistically significantly lower levels of Candida accumulation at days 4, 6, and 12, compared to the control.
Conclusions: The amount of C. albicans adhering to the resin surfaces reduced significantly with modification of surface charge and application of self-bonding polymer. Modification of surface characteristics of polymeric biomaterials is an effective method in reducing adhesion of C. albicans to PMMA surfaces.     

Enhancing the management of deteriorating patients with Australian on line e‐simulation software: Acceptability,transferability, and impact in Hong Kong

International concerns relating to healthcare professionals’ failure to rescue deteriorating patients exist. Web‐based training programs have been developed and evaluated in Western settings but further testing is required before application in non‐Western countries, as traditional modalities of learning may differ between cultures. We trialed an Australian English language online simulation program for the management of deteriorating patients, Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST²ACTWeb), to test cultural acceptability, transferability, and educational impact. The study was designed as a quasi‐experimental evaluation of the FIRST²ACTWeb program with final year nursing students from a Bachelor of Nursing program at the University of Hong Kong. Participants completed pre‐course and post‐course tests, three interactive scenarios, and program evaluations. The program was positively evaluated, with significant improvements in knowledge, skills, self‐rating of performance, confidence, and competence. Outcomes were comparable to earlier evaluations with Australian students, demonstrating that an interactive simulation‐based program of patient deterioration management has cultural and language acceptability and transferability across communities with significant educational impact.     

The impact of hematocrit drop on long‐term survival after cardiac catheterization: Insights from the Dartmouth Dynamic Registry

Background : The long‐term prognostic implication of post‐procedural hematocrit drops in patients undergoing cardiac catheterization outside the clinical trial setting is not well defined. Methods : Data was prospectively collected from 12,661 patients undergoing diagnostic or interventional cardiac catheterization between July 1998 and July 2006. Patients were divided into three cohorts based upon the degree of hematocrit change: drop greater than 6, drop between 3 and 6, and drop less than 3. In‐hospital major adverse events, 30‐day mortality, and long‐term all‐cause mortality were recorded. Results : Patients with larger reductions in hematocrit were more likely to be older, female, and have a higher baseline hematocrit, present with acute myocardial infarction, develop cardiogenic shock, require emergent catheterization, develop retroperitoneal bleeds and large hematomas, receive transfusions, have longer index hospitalizations, develop subacute stent thrombosis, and have higher 30‐day and long‐term mortality. An increase in long‐term mortality was observed with progressive hematocrit drop. This finding is largely driven by early (30 day) mortality, as trends were no longer significant after rezeroing mortality. Hematocrit drop was not an independent risk factor for 30‐day mortality. Transfusion and low baseline hematocrit were identified as independent predictors of near and long‐term mortality. Conclusions : Periprocedural bleeding, defined by hematocrit drop, is associated with increased near‐term and long‐term mortality in patients undergoing diagnostic and therapeutic cardiac catheterization procedures. Long‐term mortality is largely driven by up front 30‐day mortality. Hematocrit drop was not an independent predictor for near‐term mortality. Transfusion and low baseline hematocrit were independent predictors for near and long‐term mortality. © 2009 Wiley‐Liss, Inc.