Planning and execution of a successful hepatitis B immunization program.

Today's college students occupy a "window" between older adults, whose need for hepatitis B vaccination is minimal, and younger people who receive the vaccine as part of their childhood immunization series. However, because of the high-risk activities that are often part of student behavior, college students are among the individuals who are at the highest risk for this disease; 75% of all reported hepatitis B cases occur in persons between the ages of 15 and 39 years. It is therefore imperative that college health professionals take seriously their responsibility to educate students about issues related to hepatitis B and make available programs that enable the students to receive immunizations. This article briefly describes a successful hepatitis B education and immunization program at an institution that has no mandatory prematriculation immunization requirements.

Development of a health service at a rural community college in Appalachia.

The successful implementation by a large public university health service of a satellite clinic involves a number of processes and funding issues. The authors discuss the development of such a program at a small community college in Appalachia. The first 4 years' experience in operating the satellite clinic created a number of valuable management lessons that they believe could assist others with similar goals for extending their services.

Accidental exposures to blood and other body fluids in a large academic medical center.

Healthcare workers' and students' exposures to blood-borne pathogens during a 1-year period (1997) at a large university academic medical center were analyzed. The university health manages the Blood-Borne Pathogen Post-Exposure Control Program at the university and treats all reported exposures of students, faculty, and staff. Comparative exposure rates for all categories of healthcare workers, the work site where injuries occurred, and the circumstances involved in 298 exposure incidents are outlined. A standardized postexposure prophylaxis protocol provides for definition of the health status of all known source patients and assessment of the potential need for treatment of the exposed clinician. Implications of the study for focusing on improvements in training healthcare workers in proper procedures and the use of personal protective equipment in dealing with blood-borne pathogens are discussed.

Effects of a novel purine nucleoside phosphorylase inhibitor, BCX-34, on activation and proliferation of normal human lymphoid cells.

The antiproliferative effect of BCX-34 was tested in normal human peripheral blood mononuclear cells (PBMCs) induced to proliferate with OKT3, tetanus toxoid, the mixed lymphocyte reaction, or IL-2. In the case of OKT3, tetanus toxoid, or the MLR the IC50s ranged between 0.7 and 4 microM. With IL-2, the IC50 was 14.6 microM. In T-cells purified by rosetting the IC50 with IL-2 was 0.62 microM. In CD4 or CD8 cells obtained by magnetic activated cell sorting the IC50s with IL-2 were 0.24 and 0.62 microM, respectively. BCX-34 inhibition of proliferation in human PBMCs may not depend entirely upon the accumulation of intracellular dGTP because tetanus toxoid-induced proliferation was inhibited in the absence of deoxyguanosine and was not reversed by deoxycytidine. BCX-34 did not inhibit IL-2 release from PBMCs and did not alter PBMC viability. The results of these studies show that BCX-34 is a potent inhibitor of normal human T-cell proliferation induced by antigenic or IL-2 stimulation. BCX-34 in normal human T-cells has a deoxyguanosine-independent mechanism to suppress in vitro proliferation. BCX-34 appears to have little effect on T-cell viability. The data suggest that BCX-34 may be useful in the treatment of T-cell proliferative disorders.

Five-Year Football Injury Survey.

The authors devised a football injury classification system to help physicians make accurate predictions of disability, which in turn helps coaches make plans for the team.