Cross-infection control: attitudes of patients toward the wearing of gloves and masks by dentists in the United Kingdom in 1987

Dental patients in the United Kingdom were surveyed in February 1987 with respect to their views on whether dentists should wear gloves and/or masks. Most patients believed that gloves should be worn and few saw no need for either. Patients receiving care in a dental hospital were more enthusiastic than those seen in general practice in the belief that dentists should wear gloves and/or a mask.     

A review: secondary ion mass spectrometry (SIMS) of polymeric biomaterials

This paper comprises a short review of the application of secondary ion mass spectrometry (SIMS) to the surface chemical analysis of biomaterials, with the main emphasis on biomedical polymers. By the use of appropriate examples, the technique is shown to provide detailed information on the surface chemical structure of the top 1-2 nm of a range of biodegradable polymers, copolymers, surface modified materials and drug delivery systems. Semi-quantitative information on the surface composition of copolymeric materials can also be obtained. The molecular specificity of the technique can be exploited to identify the presence of additives (eg. drugs, peptides) or contaminants in the surfaces of biomaterials. This approach can be extended to situations where biomolecules of interest are covalently immobilised on biomaterial surfaces. Finally, SIMS imaging analysis is shown to provide a means of determining the lateral distribution of additive molecules in surfaces.     

Influence of Procedural Success on Immediate and Long-Term Clinical Outcome of Patients Undergoing Percutaneous Revascularization of Occluded Coronary Artery Bypass Vein Grafts

Objectives. This study sought to determine whether successful recanalization of an occluded vein graft is associated with improvement in long-term clinical outcome.

Background. Coronary angioplasty of occluded vein grafts is associated with a lower initial success rate and a higher complication rate than angioplasty of vein grafts with subtotal stenoses and native coronary arteries. Whether successful angioplasty improves clinical outcome is unknown.

Methods. We analyzed 77 consecutive patients who underwent angioplasty of an occluded saphenous vein coronary artery bypass graft between August 1983 and June 1994. Patients with a myocardial infarction in the previous 24 h were excluded from the study.

Results. The mean age of the study cohort was 65 years; the mean (±SD) age of the treated grafts was 7.5 ± 3.9 years. As an adjunct to balloon angioplasty, stents were used in 9% of procedures, laser in 30%, and atherectomy in 16%, and thrombolytic therapy was administered in 23% of patients. The angioplasty success rate was 71%. Major complications within 30 days of the procedure included death in 5.2% of patients, Q wave myocardial infarction in 1.3% and repeat bypass surgery in 7.8%; these events occurred with similar frequency in patients in whom angiographic success was and was not achieved. Kaplan-Meier analysis comparing patients in whom angioplasty was successful (n = 55) and not successful (n = 22) revealed no differences in survival or occurrence of myocardial infarction or recurrent severe angina between the two groups in the 3 years after the procedure. Univariate analysis identified the age of the graft and use of newer interventional devices as predictors of death or myocardial infarction during this time period; procedural success was not associated with freedom from these adverse events after adjusting for these variables.

Conclusions. Angioplasty of occluded vein grafts is associated with a low initial success rate and a high complication rate. Successful angioplasty does not appear to reduce the occurrence of adverse events in the 3 years after the procedure.

(J Am Coll Cardiol 1996;28:1732–7)>     

Broad neutralization by a combination of antibodies recognizing the CD4 binding site and a new conformational epitope on the HIV-1 envelope protein

Two to three years after infection, a fraction of HIV-1-infected individuals develop serologic activity that neutralizes most viral isolates. Broadly neutralizing antibodies that recognize the HIV-1 envelope protein have been isolated from these patients by single-cell sorting and by neutralization screens. Here, we report a new method for anti-HIV-1 antibody isolation based on capturing single B cells that recognize the HIV-1 envelope protein expressed on the surface of transfected cells. Although far less efficient than soluble protein baits, the cell-based capture method identified antibodies that bind to a new broadly neutralizing epitope in the vicinity of the V3 loop and the CD4-induced site (CD4i). The new epitope is expressed on the cell surface form of the HIV-1 spike, but not on soluble forms of the same envelope protein. Moreover, the new antibodies complement the neutralization spectrum of potent broadly neutralizing anti-CD4 binding site (CD4bs) antibodies obtained from the same individual. Thus, combinations of potent broadly neutralizing antibodies with complementary activity can account for the breadth and potency of naturally arising anti-HIV-1 serologic activity. Therefore, vaccines aimed at eliciting anti-HIV-1 serologic breadth and potency should not be limited to single epitopes.     

Investigating the Efficacy of Web-Based Transfer Training on Independent Wheelchair Transfers Through Randomized Controlled Trials

Objectives

To determine the efficacy of a web-based transfer training module at improving transfer technique across 3 groups: web-based training, in-person training (current standard of practice), and a waitlist control group (WLCG); and secondarily, to determine subject factors that can be used to predict improvements in transfer ability after training.

Discrepancies Between US Food and Drug Administration Vaccine Licensure Indications and Advisory Committee on Immunization Practices Recommendations: Provider Knowledge and Attitudes

Purpose

In the United States, the Center for Biologics Evaluation and Research at the US Food and Drug Administration (FDA) is responsible for licensure of vaccines. The Advisory Committee on Immunization Practices (ACIP) is a federal advisory committee that provides guidance to the Centers for Disease Control and Prevention (CDC) on use of vaccines. Discrepancies between FDA licensure indications and ACIP/CDC vaccine recommendations exist, challenging health care providers. The objectives of this study were: (1) to categorize differences between FDA vaccine licensure indications and ACIP/CDC vaccine recommendations for vaccines; and (2) to assess knowledge, attitudes, and practices of pediatricians, family physicians, and obstetrician-gynecologists regarding their understanding of differences.

Measurement of blood flow from first-pass radionuclide angiography: influence of bolus volume.

Fractionation of cardiac output on first-pass radionuclide angiography is a recently described technique for measuring blood flow. In order to determine the influence of bolus volume, splenic blood flow (SBF) and renal blood flow (RBF) were measured from widely differing bolus volumes given in sequence over a period of a few minutes in patients undergoing routine bone scintigraphy with technetium 99m methylene diphosphonate. A bolus volume of 0.5 ml, followed by 20 ml of rapidly delivered saline "chaser", was regarded as a "gold standard" bolus. A 50 ml bolus, but not a 20 ml bolus, resulted in a significant underestimation of both SBF and RBF. Thus, using a left ventricular region of interest to generate an arterial first-pass time-activity curve, RBF from a 50 ml bolus was 58% (SEM 4%) that given by a 0.5 ml bolus, while RBF for a 20 ml bolus was 98% (8%). Corresponding values for SBF were 52% (10%) and 102% (12%). A quality control adjustment did not correct the underestimation given by the 50 ml bolus. Bolus volumes greater than 20 ml give unreliable estimates of organ blood flow by this technique.