Silicone adhesive multilayer foam dressings as adjuvant prophylactic therapy to prevent hospital-acquired pressure ulcers: a pragmatic noncommercial multicentre randomized open-label parallel-group medical device trial.

BACKGROUND: Silicone adhesive multilayer foam dressings are used as adjuvant therapy to prevent hospital-acquired pressure ulcers (PUs). OBJECTIVES: To determine whether silicone foam dressings in addition to standard prevention reduce the incidence of PUs of category 2 or worse compared with standard prevention alone. METHODS: This was a multicentre, randomized controlled medical device trial conducted in eight Belgian hospitals. At-risk adult patients were centrally randomized (n = 1633) to study groups based on a 1 : 1 : 1 allocation: experimental groups 1 (n = 542) and 2 (n = 545) - pooled as the treatment group - and the control group (n = 546). The experimental groups received PU prevention according to hospital protocol, and a silicone foam dressing on the relevant body sites. The control group received standard of care. The primary endpoint was the incidence of a new PU of category 2 or worse at the studied body sites. RESULTS: In the intention-to-treat population (n = 1605), PUs of category 2 or worse occurred in 4·0% of patients in the treatment group and 6·3% in the control group [relative risk (RR) 0·64, 95% confidence interval (CI) 0·41-0·99, P = 0·04]. Sacral PUs were observed in 2·8% and 4·8% of the patients in the treatment group and the control group, respectively (RR 0·59, 95% CI 0·35-0·98, P = 0·04). Heel PUs occurred in 1·4% and 1·9% of patients in the treatment and control groups, respectively (RR 0·76, 95% CI 0·34-1·68, P = 0·49). CONCLUSIONS: Silicone foam dressings reduce the incidence of PUs of category 2 or worse in hospitalized at-risk patients when used in addition to standard of care. The results show a decrease for the sacrum, but no statistical difference for the heel and trochanter areas.

Differentiating attention-deficit/hyperactivity disorder from pervasive developmental disorder not otherwise specified.

This study investigated early clinical differences between children with a diagnosis of pervasive developmental disorder not otherwise specified (PDD-NOS) and children with attention-deficit/hyperactivity disorder (ADHD). Differential diagnoses between the two disorders is often difficult in infancy or early childhood. Twenty-seven children with PDD-NOS were matched with 27 children with ADHD as to IQ and chronological age. Their parents were retrospectively questioned on pre-, peri-, and postnatal complications and on atypical or delayed development of the children between 0 and 4 years of age. This exploratory study revealed almost no differences between both groups with respect to pregnancy or birth complications. The results suggest that differences between the two groups become more pronounced and specific with growing age. Consequently, this investigation offers sufficient guidelines for more specific research with larger samples.

X-ray diffraction method for the investigation of contacts between solid surfaces.

A coherent X-ray scattering method for investigating the formation of the contact region between two solid surfaces is presented. Diffraction of X-rays from two crossed cylindrical quartz surfaces, coated with Cr and TiO(2), revealed a total contact area of 90 +/- 10 microm. In the so-called Hertz model for two surfaces in non-adhesive contact, this value is directly related to the displacement of the surfaces and the applied external force. Values of 40 +/- 3 nm for the displacement and 24 +/- 3 mN for the force are found. The method is also useful for studying liquids in confinement.

Focusing x-ray beams to nanometer dimensions.

We address the question: what is the smallest spot size to which an x-ray beam can be focused? We show that confinement of the beam within a narrowly tapered waveguide leads to a theoretical minimum beam size of the order of 10 nm (FWHM), the exact value depending only on the electron density of the confining material. This limit appears to apply to all x-ray focusing devices. Mode mixing and interference can help to achieve this spot size without the need for ultrasmall apertures.

How do smectic liquid crystals of different molecular length mix in thin films?

We present a model for the structure of binary mixtures of smectic compounds in freely suspended films of 2-7 layers. The compounds are the hexyl (6AB) and dodecyl (10AB) homologues of p, p'-dialkylazoxybenzene that differ by about 40% in molecular length. X-ray reflectivity indicates that no demixing occurs between 6AB and 10AB molecules, while also there is no indication found of increased roughness at the film surfaces. However, the surface layers are somewhat expanded compared to the interior layers. This can be explained by backfolding of the dodecyl end chains of 10AB molecules at the surface via two gauche kinks, which ensures dense packing. This model is supported by surface tension measurements that indicate an increased amount of alkyl groups at the surfaces.