The effect of periradicular endodontic pathosis on the apical region of adjacent implants.

Implants have become standard for dentate individuals. A potential problem to consider is implant lesions from microbial contamination; these may occur if there is not careful diagnosis and treatment planning. A factor of concern during treatment planning is the pulpal and periradicular condition of teeth adjacent to the implant site. Periradicular pathosis may jeopardize the implant. Therefore, if endodontic pathosis is identified, root canal treatment or extraction should be initiated before implant placement to prevent microbial contamination of the implant during healing. In reviewing clinical cases, the authors found several that illustrated problems with adjacent teeth that contributed to inflammation surrounding the implant.

A putative integrase gene defines the distal end of a large cluster of ToxR-regulated colonization genes in Vibrio cholerae.

A large cluster of virulence genes encoding proteins involved in Vibrio cholerae accessory colonization factor (ACF) expression and toxin-coregulated pilus (TCP) biogenesis is flanked by sequences that resemble bacteriophage attachment (att) half-sites. Adjacent to the attL-like site is a gene (int) that encodes a protein related to the integrase family of site-specific recombinases. The putative vibrio integrase appears to be most closely related to the Escherichia coli cryptic prophage (CP4-57) integrase protein (52% identity, 73% similarity). Genomic analysis of numerous V. cholerae strains (O1, non-O1 and O139) revealed that only vibrios capable of causing epidemic Asiatic cholera possess the TCP-ACF colonization gene cluster in association with the integrase. The fact that the integrase gene is absent in avirulent strains suggests that epidemic strains of V. cholerae obtained the TCP-ACF colonization gene cluster via horizontal transfer.

Technical support for biomedical equipment decision making.

Biomedical equipment in a hospital is diagnostic, therapeutic, monitoring, communication, and recordkeeping equipment that is directly or indirectly connected to the patient. This equipment continues to proliferate as developments in microcircuitry allow it to be smaller, more flexible, and thus more adaptable. One result of the equipment's increased flexibility is the ability to integrate individual equipment, clinician-users, patients, and hospital facilities into complex systems that enable the hospital to enhance patient care. Therefore, decision making regarding the acquisition and use of new equipment in the hospital must take into account the potential impact of the equipment on all the other elements of the system, including clinical and support staffs.

The role of clinical engineers in hospitals: essential or expedient?

This article explores the capabilities of those technicians and clinical engineers who manage biomedical equipment. Equipment technicians maintain the equipment in hospitals and may participate in some basic equipment management. Clinical engineers, on the other hand, may augment this management effort in equipment-intensive hospitals by designing the specifications and procedures needed to integrate equipments into properly working systems and to maintain them under local conditions. In addition, clinical engineers can improve equipment management by providing an engineering viewpoint to such areas as technology assessment, computer applications, quality improvement, and in-service education.

What administrators need to know about clinical engineers. Understanding the equipment manager's responsibilities and concerns.

Despite the proliferance of computer systems in hospitals, many administrators--both new and experienced--have only a passing knowledge of technology management and managers. To make both the administrators' and the clinical engineers' jobs less difficult and more effective, the authors offer a profile of the "typical" clinical engineer. In the process, they underscore how health-care-administration programs need to increase students' exposure to and training in technology management.

Clinical engineering in a downsizing environment.

Hospitals are currently facing cost-cutting pressures. To meet the challenge, some hospitals have downsized by reducing costs and by promoting new lines of business. In this environment, clinical engineers may need a proactive strategy to maintain the integrity of their service, demonstrate its value, and develop new business opportunities including shared-service maintenance, technology assessment, microcomputer applications, and training.