Review of the use of neuraminidase inhibitors for prophylaxis of influenza

Influenza causes significant morbidity and mortality particularly in vulnerable population groups. Although vaccination is recommended as the primary method of preventing influenza, antiviral drugs may play a complementary role. The National Institute for Clinical Effectiveness (NICE) has recently published guidance on the use of anti-viral drugs in the treatment of influenza, and further guidance on their use for prophylaxis is expected later in the year. In anticipation of this guidance this paper reviews the evidence for the effectiveness of the prophylactic use of neuraminidase inhibitors. Results of this review show that neuraminidase inhibitors are effective in preventing laboratory-confirmed clinical influenza in healthy adults, both when used as post-exposure prophylaxis for close and household contacts, and as seasonal prophylaxis in the wider community. Direct evidence in the elderly and institutions is too limited to draw firm conclusions about their effectiveness in that setting. However it seems probable that neuraminidase inhibitors would also be effective in these groups.     

Prostate cancer patients' support and psychological care needs: Survey from a non-surgical oncology clinic

While there are numerous uncertainties surrounding prostate cancer's detection and treatment, more research focusing on the psychological needs of prostate patients is required. This study investigated the support and psychological care needs of men with prostate cancer. Patients were approached during urological oncology clinics and asked to complete the: Support Care Needs Survey (SCNS), Support Care Preferences Questionnaire, EORTC QLQ-C30 (Version 3) Measure plus Prostate Module, and the Hospital Anxiety and Depression Scale (HADS). Of the 249 patients meeting study entry criteria, there was an 89% response rate resulting in a cohort of 210 patients. The data showed that significant unmet need exists across a number of domains in the areas of psychological and health system/information. The more commonly reported needs were 'fears about cancer spreading (44%),' 'concerns about the worries of those close to you (43%),' and 'changes in sexual feelings (41%).' Half of all patients reported some need in the domain of sexuality, especially men younger than 65 years. Needs were being well met in the domain of patient care and support. A significant number of patients reported having used or desiring support services, such as information about their illness, brochures about services and benefits for patients with cancer (55%), a series of talks by staff members about aspects of prostate cancer (44%), and one-on-one counselling (48%). Quality of life (QoL) was most negatively impacted in those who: were < or =65 years old, had been diagnosed within one year, or had metastatic disease. Men < or =65 had decreased social functioning, greater pain, increased sleep disturbance, and were more likely to be uncomfortable about being sexually intimate. Patients recently diagnosed had increased fatigue, more frequent urination, greater disturbance of sleep, and were more likely to have hot flushes. Those with advanced disease scored lower on 12 out of 15 QoL categories. PSA level had no effect on QoL or anxiety/depression scores. Men with advanced disease had greater levels of depression and those < or =65 years old were more likely to be anxious. Although most men with prostate cancer seem to function quite well, a substantial minority report areas of unmet need that may be targets for improving care.     

Vector competence of Musca domestica (Diptera: Muscidae) for Yersinia pseudotuberculosis

The vectoR potential of adult house flies. Musca domestica L., for Yersinia pseudotuberculosis (Pfeiffer), a pathogen of domestic animals and humans, was investigated. Adult flies were allowed to feed on trypticase soy broth (TSB) containing Y. pseudotuberculosis for 6 h and then transferred to sterile containers with sterile TSB as a source of water and nutrients. At 6-h intervals, all flies were transferred to sterile containers with sterile TSB and 10 randomly selected flies were examined for the pathogen. Yersinia pseudotuberculosis did not establish a permanent population in the house fly colony; however, viable cells were detected from the digestive tract of flies for up to 36 h after the initial exposure, and flies contaminated their environment (sterile TSB) for up to 30 h after the exposure. These results demonstrated that house flies can carry Y. psedotuberculosis for a considerable period and therefore must be considered as a potential mechanical vector of pseudotuberculosis infection.     

Chromatographic techniques for the determination of putative dietary anticancer compounds in biological fluids

Although a great number of papers demonstrate an association between high intake of fruits and vegetables and reduced risk of certain types of cancer, the epidemiological evidence is not conclusive. The identification and quantification of specific dietary anticancer compounds in plasma, urine and tissues is an important aspect of this research. We surveyed the recent literature for original papers which involved the use of separation techniques for the detection and quantification in biological fluids and tissues of putative anticancer compounds which are present in the diet. The compounds included in this review are flavonoids, phytoestrogens, carotenoids, retinoids, vitamin E and ascorbic acid. The review covers papers published in the last 3 years. For each class of compounds we discuss the sample preparation, chromatographic conditions, and validation of the methods used, in order to identify current trends in the bioanalysis of each class of these substances.     

A comparison of hydroxylapatite coated implant retained fixed and removable mandibular prostheses over 4 to 6 years

In a 6-year prospective clinical study, 181 hydroxylapatite coated endosseous dental implants were placed into the anterior mandible of 48 patients. Twenty-one patients were treated with fixed prostheses and 27 patients with an overdenture. When the implants were exposed all 181 had integrated. To date, there is 100% survival of all implants and they all retain a functioning prostheses. The initial results were very promising, in both groups the interval success was over 95% in the first 4 years of the study. However, by year 6, the interval success rates had fallen to 83% for both the fixed and removable groups. This study also compares the construction and maintenance complications for the two types of restorations. The clinical time taken, after implant exposure, to construct the prostheses was similar whether the fixed (mean of 8 visits) or removable option (mean of 7 visits) was chosen. However, the removable restoration cost less than half the price of the fixed when both technical time and implant component costs were evaluated. Maintenance for both groups was higher than expected, but patients required more appointments in the removable group both in the first year and beyond. Regarding the prostheses itself, the incidence of remakes, relines and general adjustments was higher in the removable group. This study has shown that the overdenture offers an effective and initially a more economical alternative to the fixed prostheses, in the treatment of the edentulous mandible. However, long-term maintenance of such a prosthesis can be significant.     

Three-dimensional forward-viewing intravascular ultrasound imaging of human arteries in vitro

The aim of this work was to investigate the suitability of a novel forward-viewing intravascular ultrasound (IVUS) technique for three-dimensional imaging of severely stenosed or totally occluded vessels, where the conventional side-viewing IVUS systems are of limited use. A stiff 3.8 mm diameter forward-viewing catheter was manufactured to scan a 72 degrees sector ahead of its tip. Conical volume data were acquired by rotating the catheter over 180 degrees by means of a motorised mechanical system. Operating at 30 MHz, the catheter was integrated with an IVUS scanner and a radiofrequency data acquisition system. Postmortem carotid and femoral arteries were scanned in vitro. Correlation of the reconstructed images with histology demonstrated the ability of this forward-viewing IVUS system to visualise healthy lumens, bifurcations, thickened atherosclerotic walls and, most importantly, severe and complete vessel occlusions. A rotating-sector forward-viewing IVUS system is suitable for anatomical assessment of severely diseased vessels in three dimensions.     

A 35-item version of the Caring Dimensions Inventory (CDI-35): multivariate analysis and application to a longitudinal study involving student nurses

The present study was designed to investigate the perceptions of caring among student nurses and how these develop throughout the course of a programme of pre-registration nurse education. A 35-item version of the caring dimensions inventory was administered to a cohort of nursing students in a department of nursing in Scotland at entry to the programme, after 12 months and after 24 months on the programme. Caring was largely perceived through a technical dimension, demonstrated by factor analysis, but other dimensions such as intimacy, support and unnecessary and inappropriate aspects of nursing also became apparent as students progressed through the programme.