Controlled management of public relations following a public health incident.

This paper describes the management of public relations following an outbreak of multidrug resistant TB at a London hospital. Eight patients were involved, all of the secondary cases occurred in HIV seropositive patients, and three cases died. The paper describes how the the Incident Committee undertook to recall contacts of the cases for screening, inform the general practitioners of all of the contacts about their patients' exposure, warn other organizations and professionals interested or involved in the management of HIV in the London area as to the nature of the incident, and establish a helpline, before informing a wider audience through the EPINET, Communicable Disease Report and national press.

Client preferences for HIV inpatient care delivery.

This study was concerned with preferences for inpatient models of care by the HIV/AIDS client group, in particular the difference between gay white men (European) and black heterosexuals of African/Caribbean origin. Satisfaction with the care currently provided was also an area of interest. Thirteen per cent (n = 79) of the were surveyed. Seventy per cent (n = 56) of the HIV/AIDS client group indicated a preference for a dedicated care model. Significant results were obtained demonstrating differences in the care model preferred by gay white men and black heterosexuals (p < 0.01). Gay white men were much more likely to state they would leave the trust to receive dedicated care (p < 0.01). Black heterosexuals were more likely to state that they would change treatment areas to avoid dedicated care (p < 0.01) Differences in concern about confidentiality were noted between the two groups. Confidentiality may be one of a number of factors influencing preference of care for African/Caribbeans and this needs to be studied further. The clients surveyed were not universally satisfied with the care they had been receiving. Following the results of the survey radical changes in the management of HIV inpatient care were made.

The American Cancer Society starts a campaign.

Dr. Goldstein has summed it up for the Hawaii Medical Association: "Because of the decrease in the ozone layer and the marked increase of melanomas and skin cancers, as well as sun-related cataracts and other environmental problems, we are very pleased that the American Cancer Society has decided to choose skin cancers/melanomas to alert our population to the dangers of excessive UV exposures." The volunteers of the American Cancer Society hope that idea is developed and molded into something big enough to significantly reduce the incidence of skin cancer in Hawaii.

Effect of limited proteolysis with alpha-chymotrypsin on semen with an abnormal sperm penetration assay and possible application for in vitro fertilization or intrauterine insemination.

PURPOSE: This study was designed to assess the impact of limited proteolysis with alpha-chymotrypsin on the sperm penetration assay (SPA) of infertile patients and to identify a group whose results would normalize with this pretreatment. Further, the application of this treatment to semen of these patients during in vitro fertilization (IVF) and intrauterine insemination (IUI) was reported. RESULTS: Three groups were identified. In one, SPA was abnormal and improved to normal with pretreatment; in the second, SPA was abnormal and did not normalize; and in the third, SPA was normal and improved significantly (included in this group are three known fertile controls). CONCLUSION: Chymotrypsin pretreatment and repeat SPA are advocated for patients with abnormal SPA. If normalization occurs, pretreatment of semen for IVF or IUI is a therapy to be considered.

Effects of in vitro incubation on a zona binding site found on murine spermatozoa.

Murine cauda epididymal sperm possess a site, the acceptor, on the plasma membrane over the apical cap region of the acrosome which recognizes both a proteinase inhibitor of seminal vesicle origin and homologous zonae. The acceptor site may participate in both capacitation and zona binding. This presentation explores the effect of in vitro incubation in a medium known to induce capacitation on the binding capabilities of this site. Approximately 80% of fresh cauda epididymal sperm will bind the seminal inhibitor in vitro. Incubating sperm, pretreated with inhibitor for 2 hr in a medium (M199-M) known to support capacitation, reduces by 60% the number of sperm showing evidence of the inhibitor. No such decrease is seen when sperm are incubated in a medium (M199) that does not support capacitation. During the 2-hr incubation in either medium, 60-70% of the sperm retain two diverse components on the plasma membrane over the acrosome: a receptor for the Fc portion of IgG and an epitope recognized by a monoclonal antibody to the acceptor site. These observations suggest that the plasma membrane in the acrosome region of the cell remains structurally intact during incubation. Furthermore, sperm retain the ability to bind the seminal inhibitor during incubation. After a 2-hr incubation in M199-M, sperm pretreated with heat-solubilized zonae no longer bind the inhibitor. These sperm, however, retain the plasma membrane over the acrosomal cap region. When the sperm are incubated in M199, no decrease in inhibitor binding due to zona treatment is noted.(ABSTRACT TRUNCATED AT 250 WORDS)