Automated dead-end ultrafiltration of large volume water samples to enable detection of low-level targets and reduce sample variability.

AIMS: A Portable Multi-use Automated Concentration System (PMACS) concentrates micro-organisms from large volumes of water through automated dead-end ultrafiltration and backflushing. The ability to detect microbial targets from ground, surface and cooling tower waters collected using standard methods was compared with samples from the PMACS in this study. METHODS AND RESULTS: PMACS (100 l) and standard grab samples (100-500 ml) were collected from sites in Florida and South Carolina, USA. Samples were analysed for the presence of faecal indicator bacteria (FIB; ground and surface water) or Legionella pneumophila (Lp; cooling tower water). FIB were enumerated by growth on selective media following membrane filtration or in IDEXX defined substrate media. Lp cells were detected by direct fluorescence immunoassay using FITC-labelled monoclonal antibodies targeting serogroups 1, 2, 4 and 6. FIB were found in PMACS samples from ground and surface waters when their concentrations were below detection limits in grab samples. The concentrations of Lp in cooling tower samples collected over 5 months were more consistent in PMACS samples than grab samples. CONCLUSIONS: These data demonstrate that PMACS concentration is advantageous for water monitoring. FIB were detected in PMACS samples when their concentrations were below the detection limits of the standard methods used. PMACS processing provided more representative samples of cooling tower waters reducing sample variability during long-term monitoring. SIGNIFICANCE AND IMPACT OF THE STUDY: This study highlights the utility of PMACS processing for enhanced monitoring of water for low-level microbial targets and for reducing sample variability in long-term monitoring programmes.

Seasat scatterometer: results of the gulf of alaska workshop.

The Seasat microwave scatterometer was designed to measure, globally and in nearly all weather, wind speed to an accuracy of +/- 2 meters per second and wind direction to +/- 20 degrees in two swaths 500 kilometers wide on either side of the spacecraft. For two operating modes in rain-free conditions, a limited number of comparisons to high-quality surface truth indicates that these specifications may have been met.

Retention of a model pathogen in a porous media biofilm.

The inadvertent or the deliberate introduction of pathogens into drinking water can lead to public health consequences. Distribution system sampling strategies are needed to provide information on the identity, source and fate of the introduced pathogens. Porous media biofilm reactors conditioned with undefined drinking water biofilms were tested for their ability to immobilize Escherichia coli 0157:H7. Biofilms were established by applying continuous flow of biologically activated carbon treated water with natural microflora and supplemented nutrient solution (0.5 mg l(-1) C) for 2 or 3 weeks. Control reactors were clean and were not colonized with biofilm. All reactors were injected with slug doses of approximately 1 x 10(9) cfu E. coli O157:H7. On the basis of the plate count enumeration of the introduced pathogen, reactors pre-colonized for 2 or 3 weeks retained significantly more cells (0.75 and 9.37% of the introduced spike dose, respectively) compared with uncolonized control reactors (0.22%). Compared with cultivation, microscopic direct counts and quantitative PCR suggested significantly higher and lower numbers of pathogens, respectively. Plate counts were thus considered as the method of choice for pathogen enumeration in this study. In addition to providing general insights into interactions between pathogens and drinking water biofilms, the study concluded that engineered biofilm systems may be considered as a device to capture pathogens from the bulk flow for monitoring purposes.

Postoperative pain assessment and management in adolescents.

A 3-year study investigated the experience and management of postoperative pain following elective surgery in an adolescent sample, using a variety of valid, reliable instruments and semi-structured interviews. In addition to the adolescent subjects, the views of one parent of each adolescent were sought and a sample of health professionals comprising surgeons, anaesthetists and nurses were interviewed about acute pain in adolescent patients. This paper presents some of the main findings pertaining to pain assessment and management. Pain, experienced by most adolescents on the 1st and 3rd postoperative days, was influenced by the presence of anxiety and depression, in addition to the maturational stage; differences between in-patients and day cases are highlighted. Recommendations for practice include the need for more effective pain management and raising awareness of the importance of both psychological state and adjustment to adolescence in this age-group.

Prep-A-Gene: a superior matrix for the purification of DNA and DNA fragments.

A new chromatographic matrix, Prep-A-Gene, is described for the isolation and purification of high quality DNA suitable for restriction analysis, ligation, transformation and sequencing protocols. This matrix selectively binds DNA greater than approximately 200 base pairs in length, while RNA, proteins, cellular components, agarose and other contaminants are washed free in minutes. This eliminates the need for time-consuming and laborious RNase treatments, gel extractions and phenol extractions. The DNA that is desorbed from the matrix is available immediately as a substrate for subsequent protocols. DNA purified in this manner exhibits no detectable shearing, even with more fragile chromosomal DNA.

In vitro exposure of a novel polyesterurethane graft to enzymes: a study of the biostability of the Vascugraft arterial prosthesis.

The biostability of the Vascugraft arterial prosthesis, a porous synthetic graft made by a novel spinning process from a unique poly(ester urethane) polymer, has been studied by means of an in vitro enzyme incubation technique. Samples of the Vascugraft were exposed to buffered solutions of collagenase and pancreatin, as well as the buffer solutions alone, for periods of up to 100 days at 37 +/- 1 degrees C. On removal and after cleaning, a number of different analytic methods, including X-ray photoelectron spectroscopy for chemical analysis (ESCA), attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), differential scanning calorimetry (DSC), size exclusion chromatography (SEC), scanning electron microscopy (SEM), interference microscopy, moisture content and contact angle measurements, were used to examine the changes in chemical structure and surface morphology of the samples. During incubation in both enzymes the molecular weight of the polyurethane appeared to decrease in the presence of enzyme but increase in the presence of buffer. Further microphase separation in the polyurethane material developed during incubation in buffer solutions. Such changes in microstructure were associated with increased surface hydrophilicity, increased moisture content and a significant improvement in the extent of order and preferred orientation of the hard segment domains within the fibres. In the sampling depth of about 5 nm, both enzymes decreased the carbonate group content at the surface of the prosthesis to as little as 40% of their original values. The results from ATR-FTIR and DSC demonstrated that this phenomenon was limited primarily to the soft segment phase. While the Vascugraft prosthesis did exhibit some limited chemical modifications on exposure to concentrated enzyme solutions, nevertheless such changes were confined to the surface layer of the polyurethane microfibres. The importance and significance of those results will be more adequately determined by in vivo investigation.

Archival exploration of anorexia nervosa.

This study explores the use of hospital archives to establish a wider view of the history of anorexia nervosa and similar symptomatic presentations in the nineteenth and early twentieth centuries. The research incorporates a detailed investigation of admission registers and case records relating to over 36 000 admissions to two general infirmaries and four asylums. In addition, an extensive search has been made of printed medical sources for this period. The study clarifies both the range and limitations of information derived from hospital records and gives perspective to the accepted nineteenth century accounts of anorexia nervosa.

Ultrastructural observations on (pseudo-) exfoliation of the lens capsule: a re-examination of the involvement of the lens epithelium.

One lens each from 2 separate patients suffering from pseudoexfoliation and one lens from a normal eye were examined ultrastructurally. The normal lens capsule was internally lamellar in places and externally of a somewhat reduced electron density but otherwise of a homogeneous appearance and free of inclusions. Observations on the abnormal lenses revealed an electron dense and mainly granular but sometimes fibrillar material along the surface of the peripheral one-third of the capsule. Material of similar ultrastructural appearance was also found deeper in the capsule and in the immediately underlying epithelium. Since the capsule close to the pole of the lens was completely free of these abnormal inclusions and the underlying epithelium also lacked this material, it is concluded that the lens epithelium is a source of the surface debris in pseudoexfoliation. These findings therefore support previous authors who proposed a lenticular involvement in this disease. The present study does, however, not rule out the possibility of a uveal contribution of abnormal material but disputes its exclusive involvement in this disease, as has previously been postulated. Build-up of exfoliated material close to the capsular surface caused an apparent peeling of the lens capsule. It is therefore concluded that the anomalous lenses suffered from a true exfoliative process that may be more correctly termed 'exfoliation of the lens capsule.'

Renal cortical necrosis and Purtscher's retinopathy in hemorrhagic pancreatitis.

A patient presented with acute hemorrhagic pancreatitis complicated by both renal cortical necrosis and Purtscher's retinopathy. Either of these two complications is rare and never before have both been reported in the same patient. The patient's renal insufficiency required hemodialysis; it gradually improved over two years when dialysis could be discontinued. The patient's retinopathy included bilateral hemorrhages and cotton wool spots; visual fields and acuity remained normal. Funduscopic lesions disappeared by three months after the acute event. These two rare vasculo-occlusive complications of pancreatitis simultaneously occurring in one individual might suggest complement-mediated leukostatic mechanisms.

Cancer patients' knowledge, beliefs, and behavior regarding pain control regimens: implications for education programs.

The inadequate control of cancer-related pain is a matter of great concern. Misconceptions about pain medications on the part of professionals and the public have been implicated as causes of this problem. Another cause may be noncompliance with prescribed regimens. A study of 82 cancer patients who were prescribed pain medications was conducted to further investigate the problem of pain control in this population. Patients were interviewed twice: on the day after they received pain prescriptions (T1) and again two weeks later (T2). There was a significant decrease in patients' reported pain between T1 and T2 (P = 0.0001). By their own report, the level of patients' compliance with prescribed pain control regimens was very high. At T2 77% of the patients recalled the correct names of their pain medications and 88% had been taking them. However, an important gap in patients' knowledge was revealed by their general inability to recall any of the common side effects of pain medications (constipation, nausea, and sedation). None of the measures of pain--pain level at T1 and T2 and change in pain between T1 and T2--was related to the patients' education, age, attending physician, prescribed medication schedule, or medication strength. More women than men reported increased pain during the study period (P = 0.04). In general, the patients' concern about possible addiction or tolerance to prescribed medications were low. However, there was a positive relationship between intensity of pain and concern about tolerance to drugs (P = 0.0003).(ABSTRACT TRUNCATED AT 250 WORDS)

Postoperative pain: a comparison of adolescent inpatient and day patient experiences.

This three-year study investigated the experience of postoperative pain and its management following elective surgery in an adolescent population aged 12-18 years (n=351) in 5 NHS trusts. In addition to the adolescents, one parent of each adolescent and a range of health professionals including surgeons, anaesthetists and registered nurses were interviewed concerning their views on acute pain in adolescent patients. The results presented in this paper are those related to the management of day and inpatient surgery in this adolescent population. Data were collected pre-operatively and postoperatively (days 1 and 3) using semi-structured interviews, telephone interviews, self-completion questionnaires and standardised tools to measure pain intensity (Adolescent Pediatric Pain Tool), psychological adjustment to adolescence (Offer Self-Image Questionnaire-Revised) and emotional state (Hospital Anxiety and Depression Scale). Day cases were discharged on the day of surgery while most inpatients were discharged on the first postoperative day.

Psychological disturbance in children with haemophilia.

OBJECTIVE: To assess the need for formal psychotherapeutic intervention in children attending a children's haemophilia clinic after some of them had been diagnosed as positive for HIV. DESIGN: Comparison of haemophiliac children with matched control groups of diabetic and healthy children. SETTING: The West of Scotland Children's Haemophilia Centre, Glasgow. PATIENTS: 43 Children aged 3 to 16 years with mild, moderate, and severe clotting disorders were matched with control groups of 46 diabetic children and 42 physically healthy children. INTERVENTIONS: Parents of children aged 3-5 years were interviewed with the behaviour screening questionnaire. Children aged 6 to 16 were assessed by parental and teacher report using standardised questionnaires and self report using a computerised depression inventory. All were scored numerically according to the presence of symptoms of emotional and behavioural problems. MAIN OUTCOME MEASURES: The groups were compared for mean scores on each rating device and for number of children achieving scores within the pathological range. RESULTS: In the 6-16 age group five haemophiliac children, five diabetic children, and three healthy children scored in the pathological range on the parent questionnaire, as did two, three, and five respectively on the teacher questionnaire and four, four, and eight on the depression inventory. There was no significant difference across the three groups. Analysis of mean scores similarly showed no significant difference across groups. In contrast, the single measure used for younger children showed an increase in behavioural difficulties among the diabetic children. CONCLUSION: Haemophiliac children attending the West of Scotland Centre were no more disturbed than their diabetic or healthy peers despite the identification of HIV infection within the clinic and the widespread adverse publicity associated with AIDS and HIV infection.

Documented acquired asteroid hyalosis in a case of early diagnosed diabetes mellitus.

BACKGROUND: There have been many reports in the literature of the possible linkage of asteroid hyalosis (AH) to diabetes mellitus (DM). The controversy regarding an association between AH and DM has been one of the longest disputes in the ophthalmic literature. Here we present a case in which AH developed in a patient followed for 9 years after being diagnosed with DM. CASE REPORT: The patient had been examined on nine occasions (since his initial visit in June 1989) and asteroid hyalosis was not discovered until July 1996, when he came in with newly diagnosed diabetes mellitus. This suggests there may well be an association of asteroid hyalosis and diabetes mellitus. DISCUSSION: The patient in this case had a number of risk factors for the development of this ocular condition. He had a long history of systemic arterial hypertension, which has been reported to be linked to the formation of AH. He also had a chronic case of cystoid macular edema, which indicated a vascular compromise to the retinal vessels in the posterior pole, and this leakage may be responsible for serous constituents leaking into the vitreous, which may have caused AH. CONCLUSIONS: This may be the first time in the reported literature that AH was found to occur in a previously normal-appearing vitreous, which was documented over a 9-year period. We would suggest that asteroid hyalosis may be secondary to some form of vasculopathy in many incidences and that diabetes mellitus is one of the conditions that may be associated with the formation of AH.