Diagnosis based injury severity scaling: investigation of a method using Australian and New Zealand hospitalisations.

OBJECTIVE: To assess the performance of the International Classification of Diseases (ICD) based injury severity score, ICISS, when applied to two versions of the 10th edition of ICD, ICD-10 and ICD-10-AM. DESIGN: ICISS was assessed on its ability to predict threat to life using logistic regression modelling. Models used ICISS and age as predictors and survival as the outcome. SETTING: Australia and New Zealand. Patients or SUBJECTS: Hospitalisations with an ICD-10-AM principal diagnosis in the range S00-T89 from 1 July 1999 to 30 June 2001 (Australia) or 1 July 1999 to 31 December 2001 (New Zealand). INTERVENTIONS: None. MAIN OUTCOME MEASURES: The models were assessed in terms of their discrimination, measured by the concordance score, and calibration, measured using calibration curves and the Hosmer-Lemeshow statistic. RESULTS: 523 633 Australian and 124 767 New Zealand hospitalisations were selected, including 7230 and 1565 deaths respectively. Discrimination was high in all the fitted models with concordance scores of 0.885 to 0.910. Calibration results were also promising with all calibration curves being close to linear, though ICISS appeared to underestimate mortality somewhat for cases with an ICISS score less than 0.6. Overall ICISS performed better when applied to the Australian than the New Zealand hospitalisations. Australian and New Zealand hospitalisations were very similar. ICISS was also only a little more successful when ICD-10-AM rather than mapped ICD-10 was used. CONCLUSIONS: ICISS appears to be a reasonable way to estimate severity for databases using ICD-10 or ICD-10-AM. It is also likely to work well for other clinical variants of ICD-10.

The effects of water filtration systems on fluoride: Washington, D.C. metropolitan area.

According to the U.S. Environmental Protection Agency (EPA), approximately one in eight Americans is exposed to potentially harmful microbes, pesticides, lead, or radioactive radon whenever they drink a glass of tap water or take a shower. One reason for this exposure is that the water plants are aging or ill equipped to process the huge amounts of raw sewage and agricultural pollutants that are still being discharged into our drinking-water sources. Other compounds such as fluoride and chloride have been added to the community water supplies for health benefits. Water filtration systems are becoming more popular as people become concerned with pollutants in the public water supply and questions are being raised as to whether fluoride is affected by these filters. The aim of this pilot study was to assess the efficacy of three types of water filtration systems and to determine their impact on fluoride content of the water in the Washington, D.C. metropolitan area. One sample of water was collected daily for fourteen days, from one location. The sample was divided to use as a control and the test samples which were processed through various filter systems. With the use of a fluoride ion specific electrode, the fluoride concentration level was tested in all samples in order to determine the percentage of fluoride removed. This study was intended to prove that the water filtration systems did not affect the advantage offered by optimum water fluoride levels. The experimental samples were ascertained and compared to the control group, resulting in three of the four carbon filters showing statistically significant amounts of fluoride removed from the water. Both Reverse Osmosis and Distillation, as expected, removed the fluoride at a high rate.

Microleakage evaluation of two newly introduced hybrid glass ionomer cements.

This study evaluated the microleakage of Photac-Fil Aplicap (ESPE) and Fuji II LC (GC) glass ionomer cements. Polished Class V restorations were compared with non-polished restorations. No measurable microleakage was detected after thermocycling and staining in India ink dye. Polishing the restorations had no effect on the degree of microleakage.

A histometric evaluation of the effect of citric acid preparation upon healing of coronally positioned flaps in nonhuman primates.

Facial recession defects were created on maxillary canine teeth of six Macaca irus monkeys and left untreated and exposed to oral fluids for 6 to 12 weeks. Notches were placed in the exposed root surfaces at the level of the free gingival margins. Following root planing with the addition of topical citric acid application on experimental surfaces, pedicle flaps were coronally positioned over the previously exposed roots. After euthanasia, block sections representing postsurgical time periods of 0, 3, 7, 14, 21, 28 and 42 days were secured and tissues were processed for histologic evaluation. All citric acid-treated surfaces exhibited new connective tissue attachment of pedicle flaps to previously exposed areas by 14 days with transmission electron micrographs confirming beginning cementum deposition. In contrast, controls demonstrated epithelial migration to, or apical to, reference notches. Although the total number of samples available for statistical comparison was small, a two-tailed t test for correlated samples showed citric acid application did not result in enhanced clinical root coverage, but did result in significantly greater amounts of new connective tissue attachment (P less than 0.05, df = 3). Pedicle flap healing against teeth with devital pulps was identical to that seen in teeth with vital pulps, while citric acid application to root-planed surfaces of vital teeth had no observable effect upon pulpal tissues.

Electron microscopy observations on Trypanosoma brucei: freeze-cleaving and thin-sectioning study of the apical part of the flagellar pocket.

Observations on the apical part of the flagellar pocket of Trypanosoma brucei using the freeze-cleaving and thin-sectioning techniques of electron microscopy are reported. The flagellar pocket is shown as a flask-shaped depression in the body, continuous with the pellicle and flagellar sheath. The membranes of the apical part of the pocket on the flanged side of the body compress the flagellar sheath, forming part of a "neck region". This region is completed on the broad body side of the flagellar pocket when it embraces the flagellar sheath. The possible role of the neck region in the dynamic function of pinocytosis is discussed.

Trial of an oral antigen against upper respiratory-tract infection. Results in the second year (1973-74).

A double-blind trial in two randomly structured groups of boarders (44 girls and 66 boys) aged 7 to 13 years was undertaken in two Bristrol schools. Dosage was 1 ml a day of fluid (antigen or placebo) orally for the first four weeks of the autumn term, absenteeism being the main parameter measured, using a structured recording code. There was a highly significant difference in the number of days lost from upper respiratory-tract infection in the treated as opposed to the placebo group (x2 = 40-00 P less than 0-001 (v = 1). The number of colds was also significantly lower in the treated group (x2 = 8-05 P less than 0-005 (V less than i)).

Freeze-etching observations of trophozoites of pathogenic Entamoeba histolytica.

Pathogenic Entamoeba histolytica trophozoites were studied by the freeze-etching (FE) technique of electron microscopy. Surface replicas of intact cell membranes were highly convoluted with numerous invaginations, evaginations, and undulations. Sperical depressions and elevations varying from 0.5 mu to 1.0 mu in diameter were commonly present on the external cell membrane and appeared to represent an extracellular secretory mechanism of trophozoites. Cleaved surfaces of amebae exhibited a granular and lumpy cytoplasm in which there were many vesicles and vacuoles that ranged in diameter from 0.2 mu to 9.0 mu. Some vacuoles contained tightly enveloped bacteria, while others contained bacteria and host cytocomponents. Occasional vesicles and vacuoles appeared to be fused to each other. Replicas of FE nucleus were enclosed by double nuclear membranes which were fenestrated by numerous sperical pores measuring approximately 640 A in diameter and spaced at intervals of 650 A. Counts of nuclear pores were possible and indicated 35 pores per square micron on the nuclear envelope. Golgi apparatus, mitochondria and well formed endoplasmic reticulum were absent in FE replicas. This was in agreement with electron microscope observations on thin sections previously reported by other investigators.