Mechanical properties and in vitro characterization of polyvinyl alcohol-nano-silver hydrogel wound dressings.

Polyvinyl alcohol (PVA) hydrogels are materials for potential use in burn healing. Silver nanoparticles can be synthesized within PVA hydrogels giving antimicrobial hydrogels. Hydrogels have to be swollen prior to their application, and the common medium available for that in hospitals is saline solution, but the hydrogel could also take up some of the wound's fluid. This work developed gamma-irradiated PVA/nano-Ag hydrogels for potential use in burn dressing applications. Silver nitrate (AgNO3) was used as nano-Ag precursor agent. Saline solution, phosphate-buffered solution (PBS) pH 7.4 and solution pH 4.0 were used as swelling media. Microstructural evaluation revealed an effect of the nanoparticles on PVA crystallization. The swelling of the PVA-Ag samples in solution pH 4.0 was low, as was their silver delivery, compared with the equivalent samples swollen in the other media. The highest swelling and silver delivery were related to samples prepared with 0.50% AgNO3, and they also presented lower strength in PBS pH 7.4 and solution pH 4.0. Both PVA-Ag samples were also non-toxic and presented antimicrobial activity, confirming that 0.25% AgNO3 concentration is sufficient to establish an antimicrobial effect. Both PVA-Ag samples presented suitable mechanical and swelling properties in all media, representative of potential burn site conditions.

Field comparison of solar water disinfection (SODIS) efficacy between glass and polyethylene terephalate (PET) plastic bottles under sub-Saharan weather conditions.

Concerns about photodegradation products leaching from plastic bottle material into water during solar water disinfection (SODIS) are a major psychological barrier to increased uptake of SODIS. In this study, a comparison of SODIS efficacy using glass and plastic polyethylene terephalate (PET) bottles was carried out under strong real sunlight and overcast weather conditions at Makerere University in central Uganda. Both clear and turbid natural water samples from shallow wells and open dug wells, respectively, were used. Efficacy was determined from the inactivation of a wild strain of Escherichia coli in solar-exposed contaminated water in both glass and PET bottles. The studies reveal no significant difference in SODIS inactivation between glass and PET bottles (95% CI, p > 0.05), for all water samples under the different weather conditions except for clear water under overcast conditions where there was a small but significant difference (95% CI, p = 0.047) with less viable bacterial counts in PET bottles at two intermediate time points but not at the end of the exposure. The results demonstrate that SODIS efficacy in glass under tropical field conditions is comparable to PET plastic. SODIS users in these regions can choose either of reactors depending on availability and preference of the user.

Measurement of the growth of a floc forming bacterium Pseudomonas putida CP1.

Pseudomonas putida CP1 formed clumps of cells when grown on mono-chlorophenols but not on phenol or glucose. An increase in cell numbers for the organism grown on mono-chlorophenols was accompanied by a decrease in the dry weight. The change in shape of the bacterium from rod shape to coccus shape coupled with a reduction in cell size when the organism was grown under nutritional stress was found. This result together with cell aggregation affected the measurement of growth parameters in the system by conventional methods (optical density measurements, dry weight measurements and the plate count technique). Monitoring growth of Pseudomonas putida CP1 by a direct microscopic count technique was found to be more representative than conventional methods including optical density measurements, dry weight measurements and the plate count technique when grown on phenolics.

Substrate-dependent autoaggregation of Pseudomonas putida CP1 during the degradation of mono-chlorophenols and phenol.

A bacterium, CP1, identified as Pseudomonas putida strain, was investigated for its ability to grow on and degrade mono-chlorophenols and phenols as sole carbon sources in aerobic shaking batch culture. The organism degraded up to 1.56 mM 2- and 3-chlorophenol, 2.34 mM 4-chlorophenol and 8.5 mM phenol using an ortho-cleavage pathway. P. putida CP1, acclimated to degrade 2-chlorophenol, was capable of 3-chlorocatechol degradation, while P. putida, acclimated to 4-chlorophenol degradation, degraded 4-chlorocatechol. Growth of P. putida CP1 on higher concentrations of the mono-chlorophenols, >or=1.56 mM 4-chlorophenol and >or=0.78 mM 2- and 3-chlorophenol, resulted in decreases in cell biomass despite metabolism of the substrates, and the formation of large aggregates of cells in the culture medium. Increases in cell biomass with no clumping of the cells resulted from growth of P. putida CP1 on phenol or on lower concentrations of mono-chlorophenol. Bacterial adherence to hydrocarbons (BATH) assays showed cells grown on the higher concentrations of mono-chlorophenol to be more hydrophobic than those grown on phenol and lower concentrations of mono-chlorophenol. The results suggested that increased hydrophobicity and autoaggregation of P. putida CP1 were a response to toxicity of the added substrates.

Why don't patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee.

STUDY OBJECTIVES: To understand reasons for compliance and non-compliance with a home based exercise regimen by patients with osteoarthritis of the knee. DESIGN: A qualitative study, nested within a randomised controlled trial, examining the effectiveness of physiotherapy in reducing pain and increasing mobility in knee osteoarthritis. In the intervention arm, participants undertook a series of simple exercises and repositioning of the kneecap using tape. In depth interviews were conducted with a subset of participants in the intervention arm using open ended questions, guided by a topic schedule, to encourage patients to describe their experiences and reflect on why they did or did not comply with the physiotherapy. Interviews were audiotaped, fully transcribed and analysed thematically according to the method of constant comparison. A model explaining factors influencing compliance was developed. SETTING: Patients were interviewed at home. The study was nested within a pragmatic randomised controlled trial. PARTICIPANTS: Twenty participants in the intervention arm of the randomised trial were interviewed three months after they had completed the physiotherapy programme. Eight were interviewed again one year later. MAIN RESULTS: Initial compliance was high because of loyalty to the physiotherapist. Reasoning underpinning continued compliance was more complex, involving willingness and ability to accommodate exercises within everyday life, the perceived severity of symptoms, attitudes towards arthritis and comorbidity and previous experiences of osteoarthritis. A necessary precondition for continued compliance was the perception that the physiotherapy was effective in ameliorating unpleasant symptoms. CONCLUSIONS: Non-compliance with physiotherapy, as with drug therapies, is common. From the patient's perspective, decisions about whether or not to comply are rational but often cannot be predicted by therapists or researchers. Ultimately, this study suggests that health professionals need to understand reasons for non-compliance if they are to provide supportive care and trialists should include qualitative research within trials whenever levels of compliance may have an impact on the effectiveness of the intervention.

Degradation of mono-chlorophenols by a mixed microbial community via a meta- cleavage pathway.

A mixed microbial community, specially designed to degrade a wide range of substituted aromatic compounds, was examined for its ability to degrade mono-chlorophenols as sole carbon source in aerobic batch cultures. The mixed culture degraded 2-, 3-, and 4-chlorophenol (1.56 mM) via a meta- cleavage pathway. During the degradation of 2- and 3-chlorophenol by the mixed culture, 3-chlorocatechol production was observed. Further metabolism was toxic to cells as it led to inactivation of the catechol 2,3-dioxygenase enzyme upon meta- cleavage of 3-chlorocatechol resulting in incomplete degradation. Inactivation of the meta- cleavage enzyme led to an accumulation of brown coloured polymers, which interfered with the measurement of cell growth using optical density. Degradation of 4-chlorophenol by the mixed culture led to an accumulation of 5-chloro-2-hydroxymuconic semialdehyde, the meta- cleavage product of 4-chlorocatechol. The accumulation of this compound did not interfere with the measurement of cell growth using optical density. 5-chloro-2-hydroxymuconic semialdehyde was further metabolized by the mixed culture with a stoichiometric release of chloride, indicating complete degradation of 4-chlorophenol by the mixed culture via a meta- cleavage pathway.

Prognostic criteria in rheumatoid arthritis: can we predict which patients will require specific anti-rheumatoid treatment?

UNLABELLED: Longitudinal studies of rheumatoid arthritis (RA) have shown that joint damage often occurs early in the disease. Therefore, the early treatment of RA with "disease modifying" drugs is gaining acceptance. However, many patients presenting with inflammatory polyarthropathy will follow a benign course. Rheumatologists need to be able to target the use of potentially toxic drugs to those cases where the benefits clearly outweigh the risks. This approach requires reliable assessment of the prognosis at an early stage in the disease process. We have critically evaluated a large number of published studies which claim to provide clinically useful information regarding the prognosis of RA. CONCLUSION: The majority of studies have methodological flaws which limit their value. A small number of published studies exist which provide useful data about estimating the prognosis of RA. Currently evaluated prognostic indicators are only moderately successful and there is an urgent need for methodologically sound research in this area.