Pseudomonas aeruginosa: a probe to detail change with age in corneal receptor(s)

This in vitro study used Pseudomonas aeruginosa as a probe to examine the change with age of the host receptor(s) facilitating bacterial adherence to cornea in the immature eye and to pinpoint in time, when the host receptor(s) was no longer able to be recognized by the bacterium. Scanning EM was used to quantitate adherent organisms at the corneal surface of mice of select ages (5-37 postnatal days, P, and 28 months) at 15, 30 and 60 min following bacterial application. Organisms were most numerous at the surface of the 5-P eye at all time periods. In 9-21-P mice, no bacterial binding was observed until 30 min, and bacterial adherence modestly increased at 60 min after bacterial application. In the 37-P and in aged 28-month-old mice, no binding to cornea was observed until 60 min after bacterial application. Statistical analysis of these data revealed significant differences in the mean number of bacteria binding to cornea between age groups.     

Are women who have abortions different from those who do not? A secondary analysis of the 1990 national survey of sexual attitudes and lifestyles

Studies of women undergoing termination of a pregnancy are often used to make recommendations about family planning and health education policy. However, it is not clear how similar the women in these studies are to the general population of women of childbearing age. Our secondary analysis of the National Sexual Attitudes and Lifestyles Survey allowed us to test the hypothesis that women who have undergone an abortion are the same as those who have not (in terms of socio-demographic characteristics, lifestyles, and attitudes). Our findings show significant differences between these two groups of women, particularly regarding ethnicity, marital status, number of natural children, lifetime number of sexual partners, and attitudes to abortion. We conclude that family planning/reproductive health services and health education policies need to take these differences into account and that further research is required to explain why these differences arise.     

Concurrence of Clostridium difficile toxin A enzyme-linked immunosorbent assay, fecal lactoferrin assay, and clinical criteria with C. difficile cytotoxin titer in two patient cohorts.

The accurate and sensitive diagnosis of Clostridium difficile-related diarrhea, normally treated with vancomycin, has become increasingly important in light of the emergence of dangerous new strains of vancomycin-resistant enterococci. In order to improve the threshold for C. difficile diagnosis and treatment, a number of commonly used assays for the diagnosis of C. difficile diarrhea were examined. These included an enzyme-linked immunosorbent assay for C. difficile toxin A (ToxA), a CHO cell culture assay for fecal C. difficile (cyto)toxin B, and a lactoferrin latex agglutination assay for fecal lactoferrin (LFLA). We studied 722 fecal specimens submitted by physicians for C. difficile toxin testing at the Salem, Va., Veterans' Affairs Hospital and at the University of Virginia Medical Center in Charlottesville. Charts were reviewed from 123 Veterans' Hospital patients and 114 University of Virginia patients for clinical criteria indicative of C. difficile diarrhea. An increasing titer of CHO cell cytotoxicity was correlated with an increasing likelihood of ToxA positivity (5 to 90%), LFLA positivity (39 to 77%), and clinical agreement (28 to 85%). However, some data indicate that the CHO cell cytotoxicity assay may be nonspecific when positive only at low titers. When the CHO assay result is positive at high titers, it remains the best diagnostic tool. Yet, when it is positive at a low titer, careful interpretation of the results in conjunction with other assays and the clinical setting is warranted, especially in light of new drug-resistant strains of microorganisms.     

Pilot study of granulocyte colony stimulating factor (G-CSF)-mobilized peripheral blood stem cells in amyotrophic lateral sclerosis (ALS).

Amyotrophic lateral sclerosis (ALS) is characterized by degeneration of upper and lower motor neurons in the brain, brainstem, and spinal cord. It has been proposed that bone marrow (BM)-derived cells might supply motor neurons and other cells with a cellular milieu more conducive to survival in ALS. Direct injection of stem cells in ALS is problematic because of the large expanse of the neuraxis that would need to be injected. We reasoned that transiently increasing the number of circulating hematopoietic stem cells might be a useful therapeutic approach. However, agents stimulating the activation and mobilization of hematopoietic stem cells may have adverse effects such as activation of microglial cells. We conducted a small pilot trial of the collection and reinfusion of granulocyte-colony stimulating factor (G-CSF)-mobilized peripheral blood stem cells (PBSC) in ALS patients and found no adverse effects, paving the way for a properly powered therapeutic trial with an optimized regimen of G-CSF.     

The adoption of dispensing technology: an occasion for restructuring hospital pharmacy work

Objective To understand the ways in which hospital dispensary work is being restructured following the implementation of dispensing technology. We examine the evolving role of pharmacists, technicians and assistants in their use of the technology. Setting The implementation of dispensing robots in two hospital dispensaries in a metropolitan region of the UK were examined over a 2‐year period. Method A qualitative case‐study design was used. Non‐participant observation, interviews and organisational documentary sources were the primary data sources. Analysis of first‐order themes identified common issues. Drawing on literature within organisational studies, second‐order themes were developed iteratively. Key findings Pharmacists render the dispensary less dependent on their physical presence by inscribing key dispensary practices into the robot, enabling them to move into more cognitive work roles. Technicians quickly adapt to the new dispensing process, gaining technical skills and competences through training on the robot and daily maintenance. This modernises the role of technicians and improves their visibility in the dispensary and within the pharmacy profession. Assistants become users of technology and become increasingly dependent on others for technical support. They lose autonomy as their work becomes more interdependent. The robot takes on the role as a team member, christened with a name, and referred to in anthropomorphising terms. Conclusion Dispensary workers and managing pharmacists should go beyond viewing the adoption of new technology at a functional level of efficiency and error rates. Rather, the findings highlight the changing nature of tasks and roles that are evolving with the restructuring of dispensing work. These need to be considered by those managing change processes associated with the implementation of these technologies, as they are shaped by workers' perception of the technology in use.     

Mixed lymphocyte cultures using automated blood cell counters

We compared the standard mixed lymphocyte culture technique with a new technique based on cell count and size distribution in a series of histocompatibility tests on 24 patients and 39 potential donors for bone marrow transplantation. We found that suspensions in which lymphocytes were undergoing transformation could be distinguished from those in which they were not after a 10-day incubation period by measuring the leucocyte count and size distribution in a Coulter S+ IV automated counter. The leucocyte count was higher and the size distribution was wider in suspensions where the lymphocytes were transforming. The correlation between relative response indices calculated using tritiated thymidine uptake or total nuclear mass was close (r = 0.7; p less than 0.001) although there were major differences in the response as assessed by each of the two techniques in some individual cases. We feel this method is suitable to screen large numbers of unrelated donors.