A Case-Study of Implementation of Improved Strategies for Prevention of Laboratory-acquired Brucellosis

BACKGROUND: In 2012, the Alaska Section of Epidemiology investigated personnel potentially exposed to a Brucella suis isolate as it transited through three laboratories. METHODS: We summarize the first implementation of the United States Centers for Disease Control and Prevention 2013 revised recommendations for monitoring such exposures: (1) risk classification; (2) antimicrobial postexposure prophylaxis; (3) serologic monitoring; and (4) symptom surveillance. RESULTS: Over 30 people were assessed for exposure and subsequently monitored for development of illness. No cases of laboratory-associated brucellosis occurred. Changes were made to gaps in laboratory biosafety practices that had been identified in the investigation. CONCLUSION: Achieving full compliance for the precise schedule of serologic monitoring was challenging and resource intensive for the laboratory performing testing. More refined exposure assessments could inform decision making for follow-up to maximize likelihood of detecting persons at risk while not overtaxing resources.

Recuperação do espaço biológico: uma discussão das medidas utilizadas nas cirurgias de aumento de coroa clínica com osteotomia / Biologic width recovery: a discussion of the measurements utilized on crown lengthening procedures with osteotomy

Os aspectos fisiológicos dos tecidos gengivais supracrestais, que compreendem sulco gengival, epitélio juncional e inserção conjuntiva, bem como suas medidas biológicas, têm sido amplamente estudados em Periodontia, principalmente relacionados às cirurgias de aumento de coroa clínica com osteotomia. Quando há invasão do espaço biológico faz-se necessário sua recuperação. A osteotomia visa restabelecer as distâncias anatômicas dos tecidos gengivais supracrestais, de modo a torná-los saudáveis. Há diversos trabalhos científicos sobre a suposta distância ideal na recuperação dos tecidos gengivais supracrestais, com medidas que variam de 3,0 a 5,25. Recentes estudos têm demonstrado alto grau de equivalência entre as distâncias dos tecidos gengivais supracrestais de dentes contralaterais, em um mesmo indivíduo. Estes fatos ratificam a necessidade de que o parâmetro fixo de 3,0 mm pré-estabelecido nos procedimentos cirúrgicos de aumento de coroa clínica com osteotomia seja revisto. O presente trabalho propõe discutir, baseado na literatura pertinente, as diferentes medidas utilizadas na recuperação da distância dos tecidos gengivais supracrestais.

The physiological aspects of the supracrestal gingival tissues, which include gingival sulcus, junctional epithelium and connective tissue attachment have been widely studied in Periodontology, mainly related to crown lengthening procedures with osteotomy. If the biologic width is violated, it is necessary to be recovered. The osteotomy aims to restore the anatomical dimensions of the supracrestal gingival tissues. There are several scientific studies about the optimal distance in the supracrestal gingival tissues recovery, with measures ranging from 3.0 to 5.25. Recent studies have showed a high similarity between the supracrestal gingival tissues of contralateral teeth in the same individual. These facts corroborate the need to review the parameter of 3.0 mm utilized on crown lengthening procedures with osteotomy. This paper aims to discuss, based on the literature, the different measures used on the supracrestal gingival tissues recovery.