Incidence of needlestick injuries in hospital personnel: implications for prevention.

A retrospective review of needlestick injuries was conducted for the period January 1979 through May 1981 at a major university teaching hospital. The objective of this review was to determine the needlestick injury rate among employees according to department, occupation, activity, shift, and full- or part-time status. Two hundred eighty-six incidents of needlestick injuries were recorded. Almost 90% of injuries occurred in nursing, housekeeping, and clinical laboratory personnel. Direct handling of needles primarily involved nursing and laboratory personnel. Housekeeping personnel were injured primarily as "innocent victims" hauling trash. Significantly elevated incidence rates were observed in part-time and night-shift personnel. Incidence rates in registered nurses significantly exceeded rates in licensed practical nurses. On the basis of these findings, it is suggested that prevention of such incidents should be focused on such high-risk groups.

Pilot studies using melanoma tumor-associated antigens (TAA) in specific-active immunochemotherapy of malignant melanoma.

Highly purified melanoma TAA which induce melanoma-related cellmediated immune responses have been further characterized using hyperimmune TAA antisera after affinity chromatography for double immunodiffusion-immunoelectrophoresis and indirect immunofluorescence studies. An additional study of antigenic modulation was performed in 23 nonanergic and seven anergic melanoma patients, tested simultaneously with melanoma TAA prepared from primary and metastatic tumors, which had been obtained from one patient at different time periods. The results of pilot clinical trials are reported, including toxicity, timing and dosage studies in 20 patients and subsequent studies of patients with metastatic melanoma treated at three separate centers, using a single lot of purified, allogeneic melanoma TAA. The results of these latter studies in 51 patients with Stage III (distantly metastatic) melanoma and in five patients with earlier stages of disease indicate that: (1) when the interval from primary therapy to recurrence is greater than one year and when liver, bone and brain are not involved, partial or total clinical regression may be noted in up to 25% of patients with metastatic disease receiving immunochemotherapy; (2) when total regression does occur, the effect usually lasts from one to three years; (3) cytoreductive (debulking) surgery, when possible, in cutaneous, nodal retroperitoneal, and visceral regions may enhance the response to specific active immunochemotherapy, although some debulked patients had less tumor burden and this factor alone may lead to an improved prognosis in patients undergoing any subsequent treatment; (4) when circulating inhibitory factors are modified through preimmunization chemotherapy, an enhanced host response may be seen; and (5) Cancer Serum Indices (CSI) may be useful in predicting recurrence and in following tumor load and response to therapy. Information obtained from these studies suggest the need for further trials to determine the effect of immunization on patients with earlier stages of disease where recurrence rates remain high, and to evaluate the mechanisms of tumor rejection or tumor progression in the face of immune stimulation.

Cancer serum index: a useful nonspecific test as a parameter in multimodality screening and assessment of patients with cancer of the prostate.

A satisfactory, simple test for screening and monitoring of patients with prostatic cancer is still being sought. We suggest the use of a nonspecific test in combination with other tests. The ratio of two serum proteins (alpha 1 acid glycoprotein [AGP] and prealbumin [PAB]), may be useful markers for a cancer serum index (CSI). By separating serum components by gradient polyacrylamide gel electrophoresis, staining and quantitating these proteins by scanning densitometry, and dividing the area of AGP by that of PAB, indices can be obtained. In a test of sera from 450 patients with prostatic cancer, other urologic problems, and normal controls, CSIs of 360 sera presently decoded were found to be: (Formula: see text). The CSI should prove highly valuable when used in combination with selected prostatic cancer tests.

Hong Kong influenza infection in swine: experimental and field observations.

The recovery of influenzaviruses indistinguishable from A/Hong Kong/68 virus from pigs in Taiwan in 1970 provided the first direct evidence of the interspecies transfer of influenzaviruses. Pigs were infected experimentally with that virus and transmitted the virus to pen mates. There was no evidence of A/Hong Kong/68 antibodies in serum collected from pigs prior to 1968. Such antibodies were detected in serum collected from pigs that lived during the period when Hong Kong influenza was epidemic in the human population.