Automated decontamination of surface-adherent prions.

At present there is no routinely available decontamination procedure in washer-disinfectors to allow the reliable inactivation and/or elimination of prions present on reusable surgical instruments. This means that is not possible to provide assurance for preventing iatrogenic transmission of prion diseases. We need effective procedures in prion decontamination that can be integrated into the usual routine of reprocessing surgical instruments. This article reports on the evaluation of an automated process designed to decontaminate prions in washer-disinfectors using a quantitative, highly sensitive in vivo assay for surface-adherent 22L prions. The automated process showed great advantages when compared with conventional alkaline cleaning. In contrast, the new process was as effective as autoclaving at 134 degrees C for 2h and left no detectable prion infectivity, even for heavily contaminated surfaces. This indicates a reduction of surface-adherent prion infectivity of >7 log units. Due to its compatibility with even delicate surgical instruments, the process can be integrated into the large scale reprocessing of instruments in a central sterile supply department. The system could potentially make an important contribution to the prevention of iatrogenic transmission of prions.

Metabolic control in patients with type 2 diabetes using Humalog Mix50 injected three times daily: crossover comparison with human insulin 30/70.

OBJECTIVE: Patients with type 2 diabetes most frequently use injections of premixed insulin formulations twice daily, but intensified insulin therapy may provide better control. This study was designed to compare metabolic control with three daily injections of Humalog Mix50 or premixed human insulin 30/70 (30 % regular/70 % NPH) twice daily in accordance with normal prescription practice. RESEARCH DESIGN AND METHODS: The study cohort of 40 patients with type 2 diabetes used a two-way, crossover design. Patients were randomized to either Mix50 at each main meal or human insulin 30/70 at breakfast and dinner for 3 months, followed by the alternate treatment for 3 months. Blood glucose was measured by the patients at baseline and at the end of each treatment sequence. No significant carryover effects were observed, so treatment sequences were combined and data analyzed by unpaired t-tests. RESULTS: Mean blood glucose level was significantly (p = 0.010) decreased with Mix50 but not with 30/70 (p = 0.237), and there was a significant difference between treatments at the endpoint (p = 0.035). Fasting blood glucose was increased pre-breakfast and decreased at bedtime with Mix50 but was not significantly changed pre-lunch or dinner or at any time with 30/70 insulin. Blood glucose excursions were significantly decreased with Mix50 after breakfast (p = 0.002), lunch (p < 0.001) and dinner (p = 0.037) but not significantly changed from baseline with 30/70 insulin. The decrease from baseline in HbA (1c) was significantly (p = 0.021) greater with Mix50 than with 30/70 insulin. There were no significant differences between treatments regarding incidence of hypoglycemia or adverse events. CONCLUSIONS: In patients with type 2 diabetes, a regimen of Humalog Mix50 administered three times daily before meals maintains glucose control more effectively than premixed human insulin 30/70 administered before breakfast and dinner.

Effect of testosterone and oestradiol-17beta on canine hair follicle culture.

Skin biopsies were taken from four body sites (head, thorax, flank and perineum) of three male entire Beagles and the primary hair follicles were isolated. Culture conditions were established to keep the hair follicles growing for up to 7 days. Additionally, hair follicles were incubated in supplemented medium (containing insulin, transferrin, glutamine and sodium selenite) with or without the addition of testosterone (T) (1, 10 or 100 ng/ml) or oestradiol-17beta (E2beta) (0.01, 0.1 or 1 ng/ml), respectively and the daily growth of hair follicles was measured. In vitro daily growth of hair follicles from the thorax was stimulated by the low concentration of both hormones, but the growth of those from the flank was inhibited by the high concentration of both hormones. Hair follicles from the head were positively influenced by the lowest concentration of T and the medium concentration of E2beta. The daily growth of hair follicles from the perineum was not significantly influenced by either hormone.

[Validity of potential support--a pilot study of myocardial infarct patients]. / Zur Validität potentieller Unterstützung--Eine Pilotstudie bei Herzinfarktpatienten.

This investigation examines the validity of potential (anticipated) support as an indicator of social action. A comparison of anticipated support with received support in the past is problematic; other research variants have to be found. A comparison of two samples offers possible validation: asking one sample about the potential support, with regard to a possible crisis, and asking the second sample about actually received crisis support. This study examines received social support in a population of 30 myocardial infarction patients, and anticipated social support among 30 healthy individuals (on the assumption that they would suffer from a cardiac-infarct). The findings suggested that patients self-reported support values are lower than the expected support of the disease-free population. In particular, the healthy individuals expected support from their spouses and grown-up children. On the contrary the patients often name their doctors in this context. In general the findings suggested that the expected support with regard to an imagined crisis is a problematical indicator (validity problem). Alternative explanations are possible; the explanation that results are effects of patients perception bias is less likely.