The effects of autologous platelet gel on wound healing

Laser resurfacing techniques have become a popular means of achieving rejuvenation of damaged skin. Interest is great in attempting to speed re-epithelialization and healing so that patients can return to their normal activities as quickly as possible. Previous studies have demonstrated that wounds heal more quickly when they are covered and kept moist than when they are left open to the air. Until now, no study has been conducted to investigate whether the healing process of a superficial skin burn might be accelerated by the use of an autologous platelet gel as a biologic dressing. Our study of five pigs showed that autologous platelet gel can influence wound healing by stimulating an intense inflammatory process that leads to highly significant increases in the production of extracellular matrices and granulation tissue. The platelet gel accelerated vascular ingrowth, increased fibroblastic proliferation, and accelerated collagen production. However, the gel did not appear to accelerate re-epithelialization. The aggressive production of granulation tissue and the acceleration of collagen production might mean that autologous platelet gel will have a future role in the treatment of burns because the highly vascularized bed it helps create should promote the success of skin grafting in patients with deep partial-thickness and full-thickness burns.     

The Mirror syndrome

This is a case report illustrating a patient who developed pre-eclampsia with non-immunological hydrops fetalis associated with fetal tachycardia. It illustrates how successful treatment of a fetal disorder can lead to resolution of the maternal disorder.     

Shiga toxin-producing Escherichia coli

Shiga toxin-producing Escherichia coli (STEC) are emerging as a significant source of foodborne infectious disease in the developed world. Multistate outbreaks of E. coli O157 and non-O157 serogroups in the United States are facilitated by the centralization of food processing and distribution. Our ability to recognize the clonality of these clusters has been advanced by developments in molecular detection techniques and in the establishment of active surveillance practices. These studies have helped identify important risk factors for both sporadic and outbreak STEC infection, allowing us to develop appropriate prevention strategies. Identification of these factors is of critical importance because of the lack of adequate treatments available. This brief review of the literature discusses major developments in the epidemiology, pathogenesis, diagnosis, treatment, and prevention of STEC disease published in the past few years.     

Non-albicans oral candidosis in HIV-positive patients

Specimens from HIV-positive patients with oral candidosis were taken for culture, species identification and azole susceptibility testing, which was correlated with treatment outcome. Of 921 specimens, 95 yielded non-albicans species, mainly from patients with low CD4 lymphocyte counts and extensive previous azole exposure. Most non-albicans isolates were from specimens co-infected with Candida albicans, complicating the interpretation of in-vitro susceptibility results, which accurately predicted antifungal failure when the non-albicans species was isolated alone. Eighty-five non-albicans isolates were resistant to fluconazole in vitro. Of 149 courses of azole therapy prescribed, 115 failed to clear non-albicans candidosis clinically. Culture media that discoloured in the presence of non-albicans colonies might, therefore, guide therapy.     

Genetic diversity of sapovirus infections in Danish children 2005–2007

BackgroundSapoviruses are known to cause gastroenteritis mainly in young children.ObjectivesTo establish a collection of sapoviruses and to gain knowledge about the genetic diversity and epidemiology of sapoviruses circulating in children in Denmark.Study designDuring a 24-month period in 2005–2007 samples from 1104 children, aged 0–3 years, submitted for acute gastroenteritis diagnostics, were analysed for sapoviruses by real-time PCR. Genotyping of positive findings was carried out by sequencing part of the capsid gene, and in several cases also part of the polymerase gene.ResultsSapoviruses were detected in stool samples from 97 children (9%), with the highest prevalence in the 7–18 months age group. Viruses from three genogroups and seven genotypes were found. Genotype I.1 was demonstrated in half of the positive samples and was observed throughout the study period. The less common types seemed to appear during shorter periods, often in succession of each other. Positive samples were detected throughout the study period. The only months, in both years studied, with high proportions of positive samples were September, November and February.ConclusionsSapoviruses were commonly found in children with gastroenteritis in Denmark. No clear seasonal pattern could be seen. Genotype I.1 was clearly the most common genotype found, but several other genotypes circulated during shorter periods.     

Patient perceptions of “awake” brain tumour surgery

Summary Background. Awake brain tumour surgery allows intraoperative patient assessment and is done to optimise safe tumour removal. It is an established technique but little is known about patient perceptions of the procedure.Method. Fifteen adult patients filled out a dedicated questionnaire to assess 10 aspects of patient perceptions of the procedure.Findings. All patients, who were awake for a median of 45 minutes (range 10–105), stated they were adequately prepared for the operation. Most recollected various aspects of the procedure, although 3 patients (20%) had little memory of actually being awake during the surgery despite being cooperative. A minority reported more than minor discomfort (20%), fear (15%) or anxiety (29%), and most felt they coped with the cortical stimulations and functional testing well. Sources of discomfort and pain were the cranial pin holding device, operative position, inadequate infiltration of the cranial wound with local anesthetic, a full bladder causing a desire to micturate and a hard and uncomfortable operating table.Conclusions. These results, are very similar to a previous American report using a different anesthetic technique, in that most patients tolerate awake craniotomy remarkably well if the procedure is explained to them and some simple precautions are taken. Additionally between 8%–37% of patients (95% Confidence Interval, summing data from the two studies, n=35) will have no recollection of being awake. Ways of minimising discomfort and problems of anxierty in this patient cohort are discussed.     

Beta-adrenergic activities of octopamine and synephrine stereoisomers on guinea-pig atria and trachea

The activities of the (-)- and (+)-forms of m- and p-octopamine and m- and p-synephrine on beta 1- and beta 2-adrenoceptors in guinea-pig atria and trachea have been compared with that of noradrenaline. The rank order of potency of the (-)-forms on beta 1-adrenoceptors was noradrenaline greater than m-synephrine greater than m-octopamine = p-octopamine greater than p-synephrine. m-Synephrine was 100-fold, m- and p-octopamine about 6000-fold, and p-synephrine about 40,000-fold less active than noradrenaline. The (+)-forms were 1-2 orders of magnitude less active than their (-)-counterparts. The four (-)-compounds were more than four orders of magnitude less active than noradrenaline on beta 2-adrenoceptors, and the (+)-forms had no detectable activity in concentrations as high as 10(-4) M. If m- and p-octopamine are co-released with noradrenaline in amounts proportional to their concentration, their activities at these structures are too low to be physiologically significant.     

Comprehension instruction: a cautionary tale

Powerful new ideas about the teaching of reading are sweeping through the ranks of professional reading specialists, elementary reading teachers and teacher educators. Are classroom teachers prepared to assume new roles crucial to the implementation of these ideas? For the past three years, the Eastern Washington University Department of Education has conducted research which casts cautious doubt, not on teachers' capabilities, but on teachers' preparation in the vita! area of reading comprehension: instruction. The results of this research indicate that few practicing teachers can discriminate comprehension: instruction from other activities related to the teaching of reading comprehension. This article details research methods, findings and implications.