How to evaluate sharp safety-engineered devices

With increasing concerns of occupational exposure to bloodborne viruses in healthcare settings, NHS trusts are under pressure to consider opting for safer sharps devices that are designed to protect users from needlestick injuries. However, with an ever-increasing range of 'sharp safety' devices on the market, deciding what to purchase is a complex issue. In addition, evidence shows that purchasing safety devices alone will not eliminate the problem of needlestick injuries. This article discusses the criteria that should be taken into account when trusts consider introducing sharp safety devices into their workplace.     

Molecular surveillance of methicillin-resistant Staphylococcus aureus by multiple-locus variable number tandem repeat fingerprinting (formerly multiple-locus variable number tandem repeat analysis) and spa typing in a hierarchic approach

In this study, clonal relatedness of 202 Staphylococcus aureus (mostly methicillin-resistant) isolates recovered in 29 Polish hospitals was investigated by multiple-locus variable number tandem repeat fingerprinting (MLVF) and spa typing. Our analysis yielded 69 MLVF patterns and 34 spa types. Almost all isolates (97.4%) identical by MLVF were also indistinguishable by spa typing. Therefore, the MLVF method can be a cheap and fast screen before spa typing. Moreover, results obtained by MLVF suggest a set of simple criteria for grouping of spa types. The proposed algorithm groups isolates into the same cluster when spa sequences differ by a single mutation event: i) a single deletion or insertion of repeat unit(s) at the X region of the protein A gene or ii) a single nucleotide polymorphism within a repeat sequence. The combined use of these 2 methods, MLVF in local laboratories and spa typing of selected isolates in reference centers, can improve the monitoring of hospital-to-hospital strain transmission events and public health interventions on a huge scale.     

Novel mutation in KCNA1 causes episodic ataxia with paroxysmal dyspnea

Episodic ataxia type 1 (EA1) is an autosomal-dominant neurological disease caused by point mutations in the potassium channel-encoding gene KCNA1. It is characterized by attacks of ataxia and continuous myokymia. Respiratory muscle involvement has not been previously reported in EA1. We clinically evaluated a family with features of EA1 and paroxysmal shortness of breath. Coding and flanking intronic regions of KCNA1 were sequenced. We identified a novel 3-nucleotide deletion mutation in KCNA1 in the affected individuals. Our findings of a deletion mutation with unusual respiratory muscle involvement expand the genetic and clinical spectrum of EA1.     

Truncated CASK does not alter skeletal muscle or protein interactors

CASK (Ca2+, calmodulin-associated serine/threonine kinase) is an essential mammalian cell junction protein and is also crucial at Drosophila neuromuscular synapses. We have shown that CASK is present in mammalian skeletal muscle at the postsynaptic membrane of the neuromuscular junction. CASK interacts biochemically with channels at central synapses, and studies in cultured cells have led to proposed functions for CASK. However, in vivo functions of CASK in skeletal muscle remain unknown. To test hypotheses of CASK functions, we generated two lines of transgenic mice, which overexpress full-length and truncated CASK protein in skeletal muscle. Extensive analyses showed that overexpression of CASK protein did not affect the morphology or physiology of skeletal muscle, the morphology of the neuromuscular junction, or the levels or distribution of protein interactors. These results contrast with previous cell culture experiments and emphasize the importance of in vivo analysis of protein function.     

Status of chronic kidney disease prevention programs: International Federation of Kidney Foundation Members 2005/2007

The International Federation of Kidney Foundations surveyed its members on chronic kidney disease 'prevention' programs in their regions and countries in 2005 and 2007. A profile was developed, representing 28 countries (56% response). Some form of screening activity was reported in 24 of the 28 countries (85.7%). Two countries (7%) had, or anticipated development of, legislated national screening. Programs were conducted by kidney foundations or research groups, and were variously population based, focused on high risk groups or opportunistic. Tests in 63% of responding programs included weight, height, blood pressure, blood glucose, dipstick urinalysis and serum creatinine. Several programs used the USA's Kidney Early Evaluation Program's and International Society of Nephrology's templates. World Kidney Day activities contributed significantly. Stated needs were for more government recognition, firm policies and approaches, and critically, resources. Repeat responders reported progress in 2007, particularly in government interest and education delivery. Despite difficulties, programs are developing in many regions. Most need more resources and some members need substantial and sustained assistance.     

Hierarchy of supramolecular synthons: persistent hydroxyl...pyridine hydrogen bonds in cocrystals that contain a cyano acceptor

An analysis of the Cambridge Structural Database reveals >99% occurrence of the hydroxyl...pyridine supramolecular heterosynthon in crystal structures that contain hydroxyl and pyridine moieties in the absence of other hydrogen-bonding moieties. The occurrence of the hydroxyl...cyano supramolecular heterosynthon in crystal structures that contain hydroxyl and cyano moieties is ca. 77%. Such high frequencies indicate that these heterosynthons are strongly favored over the competing hydroxyl...hydroxyl supramolecular homosynthon. However, the CSD does not contain enough information to evaluate which supramolecular heterosynthon prevails when only OH, pyridine, and CN moieties are present in a crystal structure. We have addressed the competition between the hydroxyl...pyridine and the hydroxyl...cyano supramolecular heterosynthons by characterizing a series of 17 cocrystals that are composed of cocrystal formers which contain a permutation of OH, pyridine, and CN functional groups. Structural analysis reveals that all cocrystals are sustained by the hydroxyl...pyridine heterosynthon.     

Simvastatin-induced prevention of the increase in TNF-alpha level in the acute phase of ischemic stroke

Like other proinflammatory cytokines, TNF-alpha may play an important role in the development of central nervous system injury following ischemic stroke. The aim of this study was to evaluate the influence of early treatment with simvastatin, an HMG-CoA reductase inhibitor, on serum TNF-alpha level in acute ischemic stroke (AIS). Patients with AIS (n = 36) were randomly assigned to the two groups: Group I (n = 18) treated with simvastatin 40 mg/day within 24 h after the onset of stroke and Group II (n = 18) not treated with the statin. Blood samples were obtained on days 1, 3 and 7 after stroke onset. Serum TNF-alpha level was significantly elevated on day 3 after the stroke onset in comparison to day 1 only in the simvastatin-treated group (increase in median values by 16.2% [p = 0.028] and 6.1% within 3 days in Group II and I, respectively). These findings indicate that simvastatin given within 24 h after the onset of stroke could prevent the increase in serum TNF-alpha level within 3 days.