Alcohol-free hand sanitizer and other quaternary ammonium disinfectants quickly and effectively inactivate SARS-CoV-2.

BACKGROUND: SARS-CoV-2 is the virus responsible for the current global pandemic, COVID-19. Because this virus is novel, little is known about its sensitivity to disinfection. METHODS: We performed suspension tests against SARS-CoV-2 using three commercially available quaternary ammonium compound (Quat) disinfectants and one laboratory-made 0.2% benzalkonium chloride solution. FINDINGS: Three of the four formulations completely inactivated the virus within 15 s of contact, even in the presence of a soil load or when diluted in hard water. CONCLUSION: Quats rapidly inactivate SARS-CoV-2, making them potentially useful for controlling SARS-CoV-2 spread in hospitals and the community.

Gambling as an addictive disorder among athletes: clinical issues in sports medicine.

This article examines the role of gambling as an addictive disorder experienced by athletes, both college and professional. Gambling may often be seen as a comorbid factor with other addictions and with depression among athletes. The focus on addictions among athletes has gained considerable attention among sports medicine clinicians. Diagnostic indicators, risk and protective factors, and a stage model of addiction among athletes are addressed. An algorithm and pathway of care for athletes with an addictive disorder is offered as are recommendations that sports physicians, sports medicine specialists, coaches and counsellors need to address athletes who have an addictive disorder.

Biotransformation of the anti-angiogenic compound SU5416.

SU5416 [3-(3,5-dimethyl-1H-pyrrol-2-ylmethylene)-1, 3-dihydro-indol-2-one], an inhibitor of VEGF (vascular endothelial growth factor) receptor tyrosine kinase, Flk-1/KDR (fetal liver kinase 1/kinase insert domain-containing receptor), also known as VEGF receptor 2 (VEGFR2) is in advanced clinical trials for treatment of AIDS-related Kaposi's sarcoma and colorectal and nonsmall cell lung cancers. Since this chemical class has not been studied previously with therapeutic intent, the present study was designed to investigate the in vitro metabolism of SU5416 by mouse, rat, dog, monkey, and human liver microsomes and to identify the major metabolites of SU5416. An HPLC procedure was developed and validated to resolve and quantify SU5416 and its metabolites. To evaluate the in vitro metabolism of SU5416, pooled liver microsomes from mice, rats, dogs, monkeys, and humans were incubated with SU5416 (25 microM) in the presence of an NADPH-generating system. In the presence of NADPH, mouse, rat, dog, monkey, and human liver microsomes converted SU5416 to at least 12, 9, 9, 7, and 6 polar metabolites, respectively. Microsomal metabolism of SU5416 showed marked species differences in the levels of different metabolites formed. The overall rate of SU5416 metabolism by liver microsomes from the species examined followed the rank order: monkey > or = mouse approximately rat > dog > human. Two major metabolites of SU5416 were identified, a hydroxymethyl derivative of SU5416 (M12) and a carboxylic acid derivative of SU5416 (M6), by spectroscopic methods and comparison with authentic compounds. Both of these oxidative metabolites were further metabolized in vivo through glucuronidation. The metabolic fate of SU5416 in microsomes from various species as well as data from in vivo biotransformation in the rat are discussed.

Sports medicine in the new millennium: a vision for 2020.

Globalisation, empowerment and technological change will determine the emerging directions in sports medicine in the new millennium. Networks and alliances of scientist and clinician services, as well as electronic profiling of athletes' learning styles, genetic predisposition and other variables, will enhance the spectrum of sports medicine services. Visionary direction will require changes in the organisational paradigms employed, the communication of information to athletes and coaches and the methodologies of assessment. An emphasis on prevention science and clinical and educational interventions will require a clearer focus. The sports medicine scientist and clinician of today must utilise the endowments suggested by Covey and the multiple intelligence models advanced by Gardner in capturing the clarity of focus for sports medicine in the new millennium.

The psychiatric consultant in professional team sports.

The role of the sport psychiatrist consulting to a professional sports team is complex, challenging, and varied. Sport psychiatrists enhance the psychosocial development of the athlete by removing obstacles to growth and by facilitating lines of communication that support exchange of information, sharing of feelings, and the development of solid winning relationships on the team and throughout the organization. The consultant psychiatrist often provides input both to players and to management, however; these dual responsibilities raise ethical concerns and often require the services of additional treating psychiatrists and other mental health professionals.

Comprehending role conflicts in the coaching of children, adolescents, and young adults. Transference, countertransference, and achievement by proxy distortion paradigms.

Relationship violations have been documented in all service professions, particularly those involving a power differential in the relationship. Although the coach-athlete relationship is not a typical therapeutic interaction, there should be professional and ethical boundaries. Boundary violations, including sexual abuse of a minor, do occur. Five clinical cases of relationship disturbances are presented. The authors use the paradigms of transference, countertransference, and achievement by proxy distortion to discuss these worrisome vignettes. Colleagues are encouraged to collaborate in an effort to develop awareness and prevention programs through research and education. Developing an enlarged workbook of similar case studies for use as a stimulus for seminars and discussions in training environments is an immediate goal.

The Wellcome Trust population initiative.

This paper describes what the Wellcome Trust has done and aims to do through its population initiative. The Trust is required to spend its funds to improve the physical welfare of mankind, and in this context there can be no more important issue than the rapid changes that are occurring in the human population. The Trust's first involvement was to help fund the New Delhi population summit covered by the world's scientific academics in 1993 and, following discussions with authorities in the field, initiated its funding programme in 1995. Through this programme, the Trust hopes to bring about improved understanding of the relationship between reproductive health, population growth, and sustainable development and create cadres of high quality research scientists in relevant disciplines. Uniquely, funding is available under this programme to suitably qualified applicants from any country other than the USA.

PIP: In 1993, the Wellcome Trust entered the population field by contributing funding to the 1993 New Delhi population summit that called for an integrated global policy on population and sustainable development and provided a framework for discussion at the UN's 1994 International Conference on Population and Development. This meeting stimulated the Trust to explore how it could contribute to population research by reviewing current international expenditure in population-related aid and research. As a result of this analysis, the Trust committed up to 50 million British pounds over a period of 5 years to a new funding initiative to improve understanding of the relationship between reproductive health, population growth, and sustainable development while contributing to the training of cadres of high quality researchers. This paper presents an overview of the following funding activities of the Trust's population studies panel: 1) research training fellowships in reproductive biology; 2) research training fellowships in population studies and reproductive health; 3) project and program grant support in the fields of population studies and reproductive health; 4) development of an international research center in Africa; and 5) other awards and activities such as funding of a World Health Organization consultation on preclinical and clinical requirements for non-latex male condoms and a consultation on the toxicology of intrauterine quinacrine. Future developments will involve research training, reproductive health-related research, and identification of research priorities in population and development. The Trust will fulfill its mandate of supporting research conducive to improving the physical conditions of humankind by offering funding to qualified applicants from any country except the US.

Growth potential in the new aortic arch after non-end-to-end repair of aortic arch interruption in infancy.

BACKGROUND: Complete repair of infants with interrupted arch and ventricular septal defect through a midline incision has been the preferred method for more than 20 years. End-to-end anastomosis can result in restenosis if there is excess tension. Two methods of reducing this tension have been described, and the subsequent growth of the new aortic arch is demonstrated. METHODS: In 2 infants (5 and 9 months old) the duct was used to create a new aortic arch. In 3 other younger infants the left carotid artery was divided, turned down, and anastomosed to the descending aorta to form the new arch. These operations were performed through the midline at the same time as the ventricular septal defect was closed. RESULTS: All 5 patients are well now 8 to 19 years postoperatively. One patient required reoperation for stenosis at the anastomotic site, but all have subsequently shown good growth on follow-up angiographic and magnetic resonance imaging studies. CONCLUSIONS: Although end-to-end repair is best, these alternative methods have shown very satisfactory aortic growth into adult life.

Intrapericardial lymphangioma presenting as neonatal cardiac tamponade.

We report a unique case of cardiac tamponade in a newborn due to an intrapericardial lymphangioma. Echocardiography and magnetic resonance imaging suggested that the mass, which was situated between the right atrium and the aortic root, was unsuitable for primary resection. A pericardial window was performed, and over the next 16 months the tumor spontaneously regressed.

Technique for extraanatomic bypass in complex aortic coarctation.

A variety of approaches and surgical techniques have been described for the management of recurrent coarctation. When there is an additional intracardiac defect that requires surgical correction it is preferable to correct both lesions simultaneously and through the same incision. This article reports two new techniques of connecting ascending to descending aorta using an intrathoracic conduit and performed through a median sternotomy.

Delayed presentation of traumatic diaphragmatic hernia.

Nine cases of delayed presentation of diaphragmatic hernia secondary to blunt trauma are presented. The delay in presentation varied from one to 16 years from the time of the original injury. The chest radiography was abnormal in all cases. In some, herniation could be reasonably inferred but in others there were only non-specific signs. Once the diagnosis of delayed presentation of traumatic diaphragmatic hernia is suspected, we have found barium studies to be the most useful confirmatory investigations.