Tolerability and acceptability of three alcohol-based hand-rub gel formulations: a randomized crossover study.

BACKGROUND: Healthcare workers often experience skin dryness and irritation from performing hand hygiene frequently. Tolerability and acceptability are barriers to hand hygiene compliance, but there is little in the literature about exactly which types of alcohol-based hand rubs (ABHRs) have a higher dermal tolerance. AIM: To compare the tolerability and acceptability of three different ABHR gel formulations in a population of adult volunteers. METHODS: Thirty-eight participants were randomized to three different sequences, testing three hand-rub gel formulations: isopropanol-based (Hopigel®); ethanol-based (World Health Organization (WHO) gel formulation); and ethanol-based containing superfatting agents (Saniswiss Sanitizer Hands H1). Participants tested each of the formulations over a series of three five-day interventions, followed by a nine-day washout period. At the end of each intervention, skin condition was assessed and feedback was collected. FINDINGS: Whereas no statistically significant difference was observed regarding tolerability between the three ABHR gel formulations tested, there were differences in acceptability. Participants preferred the smell of the H1 and WHO gel formulations (P = 0.003 and P = 0.040, respectively); H1 had a better texture than the WHO gel formulation (P < 0.001); and H1 was considered more pleasant overall than Hopigel (P = 0.037). Overall preference varied, but H1 was rated the favourite most often among participants, and the least favourite least often. CONCLUSION: A high variability was observed in the participants' reactions to the different formulations tested. These results highlight the importance of giving healthcare workers a choice between different high-quality hand rubs to ensure maximum acceptability.

Integrated teaching of basic and clinical sciences in anxiety and pain management.

Like many other UK Dental Schools, Leeds Dental Institute has undertaken a commitment to integrated learning within its new curriculum. From an educational viewpoint, contextualisation of learning presents opportunities for deeper levels of learning. This can be particularly useful in embedding basic sciences in the dental curriculum. The General Dental Council in their document 'The First Five Years' endorse this approach to learning. The Year 1 Anxiety and Pain Management course has been designed to integrate basic and clinical sciences, interdisciplinary learning and learning with other members of the dental team. This paper describes the structure of the course, its place within the horizontal and vertical learning themes, as well as describing the response of staff and students to this type of course.

Betulinic acid derivatives: a new class of specific inhibitors of human immunodeficiency virus type 1 entry.

A novel series of omega-aminoalkanoic acid derivatives of betulinic acid were synthesized and evaluated for their activity against human immunodeficiency virus (HIV). The anti-HIV-1 activity of several members of this new series was found to be in the nanomolar range in CEM 4 and MT-4 cell cultures. The optimization of the omega-aminoalkanoic acid side chain is described. The presence of an amide function within the side chain was found important for optimal activity. RPR 103611 (14g), a statine derivative, was found to be inactive against HIV-1 protease, reverse transcriptase, and integrase as well as on gp120/CD4 binding. "Time of addition" experiments suggested interaction with an early step of HIV-1 replication. As syncytium formation, but not virus-cell binding, seems to be affected, betulinic acid derivatives are assumed to interact with the postbinding virus-cell fusion process.

Severe hemolytic disease of the newborn due to anti-Vw and detection of glycophorin A antigens on the Miltenberger I sialoglycoprotein by Western blotting.

Anti-Vw detecting an antigen on Miltenberger I (Mi I) variant glycophorin A (GPA) has rarely been reported as a cause of hemolytic disease of the newborn (HDN). We report an infant with severe HDN due to anti-Vw. Examination of the Vw+ erythrocytes of the father and paternal grandmother by sodium dodecylsulphate polyacrylamide gel electrophoresis showed an extra trypsin-sensitive, periodic-acid-Schiff staining band, consistent with Mi I variant GPA. Staining of Western blots by monoclonal antibodies showed that normal paternal GPA expressed blood group M, while Mi I variant GPA expressed blood group N. Mi I variant GPA expressed the trypsin-sensitive antigenic determinant detected by MoAb 10F7, indicating that the alterations known to occur in the trypsin-sensitive fragment of Mi I variant GPA do not affect expression of the antigen detected by 10F7.

Peritoneal washings in ovarian tumors. Potential sources of error in cytologic diagnosis.

Peritoneal washings were performed on 48 patients with suspected or known ovarian carcinoma. The procedure was part of the initial surgical staging in 27 patients with presumed stage I and II ovarian cancer and was performed during second-look operations in 21 other cases with proven ovarian malignancy. This paper presents the microscopic features of the washings, with particular emphasis on the cytologic differentiation between benign and malignant findings outside of the ovary. Thirty-four cases showed benign or reactive mesothelial cells and no evidence of peritoneal disease. The washings of six patient showed malignant cells, which were confirmed histologically. Notable atypia that mimicked ovarian carcinoma was found in eight patients who had benign or borderline lesions. These findings included papillary and glandlike epithelial structures, with varying degrees of cellular atypia and psammoma bodies. The histologic counterparts of these atypicalities were Müllerian inclusions, mesothelial proliferations and borderline serous tumors. The differential diagnosis between these entities is essential because false-positive cytologic diagnoses may alter postoperative treatment in some patients.