High prevalence of hepatitis C (HCV) in the emergency department (ED) of a London hospital: should we be screening for HCV in ED attendees?

An unlinked anonymous study was conducted to estimate the prevalence of hepatitis C virus (HCV) infection in emergency department (ED) attendees at a London Hospital. Nine hundred and ninety-seven samples collected over a 12-day period were tested for HCV antibody (Ab) and reactive samples were further tested for HCV RNA. The HCV seroprevalence was 2·6% (26/997) with 1·2% (12/997) HCV RNA positive. A peak HCV RNA-positive prevalence of 4·8% (3/63) was found in males aged 35-44 years, this was compared to 0% (0/136) in males aged <35 years (P = 0·0614) and 1·4% (4/278) in males aged ⩾45 years (P = 0·2415). Assuming the cost for HCV Ab is £6 and HCV RNA is £40 per test, screening ED attendees aged 25-54 years would cost £360 per viraemic infection and identify 82% of those who were HCV RNA positive, yielding the most favourable cost/benefit ratio. HCV screening of ED attendees aged 25-54 years in this population could be an effective way of identifying patients and limit onward transmission.

The effects of vincristine on platelet aggregation studied by a filter loop technique in the rat.

1 A method for measuring aggregation of platelets of adenosine diphosphate (ADP) is described using a filter inserted into the flowing aortic blood in the rat. 2 Repeated infusions of ADP resulted in a fall in the calculated aggregation index without significant changes in the platelet count. 3 Vincristine (0.05 mg/kg) intravenously caused significant inhibition of ADP-induced platelet aggregation. 4 Infusion of ADP caused some peripheral vasodilatation though it is unlikely that this contributed to the effects seen to any great extent.

Tissue specificity of spontaneous point mutations in lambda supF transgenic mice.

Transgenic mice carrying multiple copies of a recoverable lambda phage shuttle vector carrying the supF mutation reporter gene (lambda supF) were constructed for the purpose of studying mutagenesis in a whole animal. Spontaneous mutations in rescued supF target genes from mouse liver and skin were analyzed. The mutation frequency was similar in both tissues (in the range of 2 x 10(-5)), but the spectrum of point mutations was distinct, with transitions common in the skin and transversions more prominent in the liver (P = 0.01). These results may help to elucidate pathways of endogenous mutagenesis in vivo, and they illustrate potentially important tissue-specific differences in genetic instability.

Quinidine photosensitivity.

A 55-year-old woman developed a dermatitis confined to light-exposed areas while taking quinidine gluconate, warfarin sodium, furosemide, spironolactone, and digoxin after cardiac surgery. Phototesting indicated a normal erythematous response to 290- to 320-nm ultraviolet radiation, but she developed erythema from 6 joules/sq cm of 320- to 400-nm radiation (ultraviolet A [UV-A]), a much lower dose than needed to produce a reaction in normal individuals. Two days after she discontinued quinidine and warfarin, phototesting showed no reaction to as much as 20 joules/sq cm of UV-A. One week after resuming quinidine (but not warfarin), she again reacted to 8 joules/sq cm of UV-A. No reactivity was elicited when the preparation was applied to the skin or injected into the dermis either with or without subsequent UV-A irradiation.

Modified Goeckerman therapy for psoriasis. A two-year follow-up of a combined hospital-ambulatory care program.

Two groups totaling 162 patients hospitalized for modified Goeckerman treatment of severe psoriasis were matched for sex, age, and season of admission and followed up for two years after discharge. One group remained hospitalized throughout their average 20.8-day course; the other half was hospitalized 14 days, then transferred to an ambulatory center for the remainder of a course averaging 20.8 days. No difference was detected between the groups in the duration that improvement equaled or exceeded progress achieved at discharge. The percentage of patients remaining continuously improved after discharge was 80% at one month, 55% at six months, 40% at 12 months, and 20% at 24 months. rates of relapse requiring readmission or alternate therapy were also similar: 75% had not relapsed by 12 months and 60% had not relapsed by 24 months.

Effect of acetylsalicylic acid on platelet aggregation and thromboxane B2 production in flowing aortic blood in the rat studied with a filter loop technique.

A method of measuring in vivo platelet function using a filter loop technique has been used to study platelet aggregation in response to Adenosine Diphosphate (ADP) and Sodium Arachidonate infusion in flowing aortic blood in the rat. ADP infusion produced reversible platelet aggregation in vivo with no change in thromboxane B2 (TXB2) levels whereas sodium arachidonate infusion resulted in virtually irreversible aggregation with a rise in TXB2 levels. Oral Acetylsalicylic Acid (ASA) in doses of 1-100 mg/kg had no effect on ADP induced aggregation but prevented platelet aggregation in vivo induced by sodium arachidonate and the concomitant rise in TXB2 levels.

Embryonic development of an endoparasitoid, Microplitis croceipes (Hymenoptera: Braconidae) in cell line-conditioned media.

Embryos of the parasitoid Microplitis croceipes develop from pregerm band stage to first larval instar in cell culture medium conditioned by a cell line (IPLB-LdFB) derived from fat body from an atypical host Lymantria dispar. However, the percentage of eggs that develop normally to the first larval instar stage is significantly less than for those maintained in IPL-52B medium conditioned with host fat body tissue. Therefore, we examined the capacity of five insect cell lines to promote growth and development of pregerm band eggs in five media, IPL-52B, TC-199, TC-100, Grace's, and ExCell 400. The developmental response of M. croceipes was dependent both on the cell line and the cell culture medium used. TC-100, TC-199, and Grace's media promoted development to the germ band stage without the need for conditioning with host tissue. IPL-52B supported development to the germ band stage when a defined lipid concentrate was added. In IPL-52B medium, the IPLB-LdFB cell line promoted a significantly higher number of eggs developing to germ band relative to the other cell lines; however, none of the cell line-conditioned IPL-52B medium significantly stimulated egg hatch relative to the control medium. None of the cell line-conditioned Grace's media had a significant effect on eggs attaining germ band stage compared with the Grace's control medium. However, Grace's medium conditioned with the IAL-TND1 and IPLB-LdFB cell lines promoted development beyond germ band, resulting in a significantly higher percentage of hatching eggs than the Grace's control medium.(ABSTRACT TRUNCATED AT 250 WORDS)

"Be smart, be safe, be sure". The revised Pregnancy Prevention Program for women on isotretinoin.

OBJECTIVES: After studying the information in this article, the reader should be able to: 1. Describe the purpose of the pregnancy prevention program. 2. Discuss the five most common reasons for unintended pregnancy. 3. List the components of the expanded pregnancy prevention program. Preventing unintended pregnancy is currently an unsolved problem in the United States, especially among teens. However, successful programs to minimize unintended pregnancy do exist and can serve as a model for other efforts. One such program is the Pregnancy Prevention Program, for use when prescribing isotretinoin to women with childbearing potential. Isotretinoin is a known teratogen and is prescribed disproportionately to teens, who are at higher risk of unintended pregnancy. The program has shown impressive effectiveness despite these handicaps, but since exposure to isotretinoin is so harmful to the fetus and some women still become pregnant while taking the drug, the program has been revised to reduce the failure rate further.

Effect of personality on magnitude-estimation scaling of complex auditory stimuli.

The purpose of the present study was to examine the effect of the personality trait of extraversion/introversion on magnitude-estimation scaling of complex auditory stimuli. Two groups of subjects, 10 who liked rock music (M age = 22.4 yr.) and 10 who disliked rock music (M age = 21.9 yr.), were tested. Subjects were instructed to assign numerical values to a random series of nine suprathreshold intensity levels of a 10-sec. sample of rock music. Each subject was given the Eysenck Personality Inventory, a test designed to measure the personality trait of extraversion/introversion. Statistical analyses indicated that the personality trait of extraversion/introversion did not appear to have an effect on the way the subjects scaled the rock-music stimulus.

Simulations of stuttered speech: numbers and types of dysfluencies.

The purpose of this study was to assess whether stuttered speech could be simulated by normal-speaking individuals and to identify significant parameters used in the simulation process. The subjects were 24 normal-speaking graduate students in speech-language pathology. The subjects were assigned the task of simulating stuttered speech given specific levels of severity. Then they were asked to listen to the simulated samples and identify the number and types of dysfluencies presented. Analysis showed agreement among subjects on the number of dysfluencies, with the exception of samples simulating severe stuttering behavior. Judging the number of dysfluencies in the simulated samples of severe stuttering appeared to be a more difficult task. The types of dysfluencies noted by the listeners were restricted primarily to repetitions and prolongations. Simulated stuttered speech was therefore judged to be composed of fewer types of stuttering behavior than actual stuttered speech is reported to be.

Comparison of listeners' judgments of simulated and authentic stuttering using magnitude estimation scaling.

The purpose of this study was to evaluate whether normal listeners can differentiate authentic and simulated stuttering. The subjects were 40 graduate and undergraduate students in hearing and speech sciences who were asked to listen to segments of authentic and simulated stuttered speech at varying severities. Using magnitude estimation scaling, each subject was asked to judge the samples of stuttered speech by providing a numerical response that matched the severity of the segment listened to. Analysis showed that the subjects discriminated between different severities of both the authentic and stuttered speech. They did not differentiate between authentic segments of stuttered speech and simulated ones.

Nurses' guide to the drug development process and the current regulatory environment.

Health care professionals are frequently asked to answer patients' questions about how medications reach the market and the lengthiness of the process. Misconceptions about the process require nurses to understand how the Food and Drug Administration (FDA) enforces its laws, and how the agency works in the enforcement of its responsibilities. The purpose of this article is to familiarize nurses' with the FDA's history and the drug development process. In addition, nurses need to be familiar with the current environment at the agency and issues that are currently under debate (Franke, 1992).

Basic principles of photobiology and photochemistry for nurse phototherapists and phototechnicians.

Phototherapy administration requires a team approach to be safe and effective. Implementing the treatment plan requires the knowledge, skills, and expertise of the entire health care team. Understanding the relationship between natural light, artificial light sources, administration of phototherapy, and the short and long-term consequences of the therapy can enhance the experience for the patient and provide an increase in employment satisfaction for the therapist.

UVB therapy: dermatology nursing considerations.

Each patient responds uniquely to phototherapy treatment. Not every patient can tolerate daily treatment. Different areas of the body require different amounts of light in order to clear. Precise documentation of erythema is important for both treatment and legal reasons. A negative response to UVB therapy can be from either ineffective treatment or an adverse reaction to UVB.

Psoralen photochemotherapy.

Psoralens and sunlight have been used by the Egyptians and Indians for hundreds of years for treating vitiligo. The combination of oral psoralens and artificial ultraviolet A (PUVA) therapy was approved for managing severe psoriasis by the Food and Drug Administration in 1982. Since then, PUVA therapy has been an effective modality for treating many cutaneous conditions (psoriasis, atopic dermatitis, vitiligo, and mycosis fungoides). However, proper knowledge and administration of PUVA therapy are vital to treatment success and reducing side effects.

Phototherapy equipment.

Treating patients with phototherapy is like dosing patients with medication. The purpose of this continuing education article is to describe various phototherapy equipment and how to conduct safe and efficacious therapy.

Acne: therapeutic perspectives with an emphasis on the role of isotretinoin.

This article provides nurses with information about drug therapy for acne. Various therapeutic modalities are discussed with an emphasis on the use of isotretinoin. The risks associated with pregnancy during isotretinoin therapy are discussed to help nurses work effectively with physicians and patients in the treatment of severe acne in women of childbearing potential.

Staff responsibilities for phototherapy administration.

Caring for the phototherapy patient is a multifaceted role; however, the primary nursing responsibility is quality patient education. The opportunities to implement this responsibility are as endless as the disease itself.