16 research outputs found
Should eye protection be worn during dermatological surgery: prospective observational study
Background There is a potential risk of infection with blood-borne viruses if a doctor receives a blood splash to a mucous membrane. The quantification of facial
contamination with blood has never been documented in the context of dermatological surgery.
Objectives (i) To identify the number of facial blood splashes that occur during skin surgery and to identify the procedures that present higher risks for the operator and assistant. (ii) To assess the provision of eye protection and attitudes to its use in dermatological surgery in the U.K.
Methods (i) Prospective, observational study in the skin surgery suite of a U.K. teaching hospital assessing 100 consecutive dermatological surgery procedures, plus 100 consecutive operations in which an assistant was present. Primary outcome:
number of face-mask visors with at least one blood splash. Secondary outcomes:
to identify if any of the following variables influenced the occurrence of
a blood splash: grade of operator, site and type of procedure, and the use of
electrocautery. (ii) A postal survey of all U.K.-based members of the British Society
of Dermatological Surgery (BSDS) was conducted assessing facilities available
and the attitudes of U.K.-based clinicians to the use of face masks during
surgery.
Results (i) In 33% of all surgical procedures there was at least one facial splash to
the operator (range 1ā75) and in 15% of procedures the assistant received at
least one splash (range 1ā11). Use of monopolar electrocautery was significantly
less likely to result in splashes to the mask compared with bipolar electrocautery
[odds ratio (OR) 0Ć04; 95% confidence interval (CI) 0Ć01ā0Ć19]. Compared with
the head/neck, operations on the body were significantly more likely to result in splashes to the mask (OR 6Ć52) (95% CI 1Ć7ā25Ć07). The type of procedure and
the status of the operator did not have a bearing on the likelihood of receiving a splash to the mask. (ii) From the survey, 33 of 159 (20Ć8%) of BSDS members had no face masks available and 54 of 159 (34Ć0%) did not wear any facial protection while operating. The majority (53Ć5%) thought they received a splash in Ā£ 1% of procedures.
Conclusions There is a substantial risk of a splash of blood coming into contact with the face during dermatological surgery for both the operator and assistant,
regardless of the procedure. The risk of receiving a blood splash to the face may be substantially underestimated by U.K.-based dermatologists. The use of protective
eyewear is advisable at all times, but particularly when using bipolar electrocautery, or when operating on high-risk individuals
A conserved metalloprotease mediates ecdysis in Caenorhabditis elegans
Molting is required for progression between larval stages
in the life cycle of nematodes. We have identified four
mutant alleles of a <i>Caenorhabditis elegans</i> metalloprotease
gene, <i>nas-37</i>, that cause incomplete ecdysis. At each molt
the cuticle fails to open sufficiently at the anterior end and
the partially shed cuticle is dragged behind the animal. The
gene is expressed in hypodermal cells 4 hours before ecdysis
during all larval stages. The <i>NAS-37</i> protein accumulates
in the anterior cuticle and is shed in the cuticle after
ecdysis. This pattern of protein accumulation places NAS-
37 in the right place and at the right time to degrade the
cuticle to facilitate ecdysis. The nas-37 gene has orthologs
in other nematode species, including parasitic nematodes,
and they undergo a similar shedding process. For example,
<i>Haemonchus contortus</i> molts by digesting a ring of cuticle
at the tip of the nose. Incubating <i>Haemonchus</i> larvae in
extracted exsheathing fluids causes a refractile ring of
digested cuticle to form at the tip of the nose. When
<i>Haemonchus</i> cuticles are incubated with purified NAS-37,
a similar refractile ring forms. NAS-37 degradation of the
<i>Haemonchus</i> cuticle suggests that the metalloproteases and
the cuticle substrates involved in exsheathment of parasitic
nematodes are conserved in free-living nematodes
Comprehensive Diagnostic Assessment of Health Status of Patients with Asthma or COPD: A Delphi Panel Study among Dutch Experts
Item does not contain fulltex
Sublethal consequences of urban life for wild vertebrates
Urbanization is modifying previously pristine natural habitats and creating "new" ecosystems for wildlife. As a result, some animals now use habitat fragments or have colonized urban areas. Such animals are exposed to novel stimuli that they have not been exposed to in their evolutionary history. Some species have adapted to the challenges they face- A phenomenon known as synurbanization-while others have not. Here we present a review of the sublethal consequences of life in the city for wild vertebrates, and demonstrate that urban animals face an almost completely different set of physiological and behavioural challenges compared to their rural counterparts. We focus on the negative fitness-related impacts of urbanization, but also identify instances where there are benefits to wildlife. The effects of urbanization appear to be both species-and context-dependent, suggesting that although the field of urban ecology is far from nascent, we are still just beginning to understand how the intricacies of biodiversity on our planet are affected by our presence
Primary care professionals' views on population-based expanded carrier screening: an online focus group study
Background Population-based expanded carrier screening (ECS) involves screening for multiple recessive diseases offered to all couples considering a pregnancy or during pregnancy. Previous research indicates that in some countries primary care professionals are perceived as suitable providers for ECS. However, little is known about their perspectives. We therefore aimed to explore primary care professionals' views on population-based ECS. Methods Four online focus groups with 14 general practitioners (GPs) and 16 community midwives were conducted in the Netherlands. Results Our findings highlight various perspectives on the desirability of population-based ECS. Participants agreed that ECS could enhance reproductive autonomy and thereby prevent suffering of the child and/or parents. However, they also raised several ethical, societal, and psychological concerns, including a tendency towards a perfect society, stigmatization, unequal access to screening and negative psychosocial consequences. Participants believed that provision of population-based ECS would be feasible if prerequisites regarding training and reimbursement for providers would be fulfilled. most GPs considered themselves less suitable or capable of providing ECS, in contrast to midwives who did consider themselves suitable. Nevertheless, participants believed that, if implemented, ECS should be offered in primary care or by public health services rather than as hospital-based specialized care, because they believed a primary care ECS offer increases access in terms of time and location. Conclusions While participants believed that an ECS offer would be feasible, they questioned its desirability and priority. Studies on the desirability and feasibility of population-based ECS offered in primary care or public health settings are needed