Aspect ratio of nano/microstructures determines Staphylococcus aureus adhesion on PET and titanium surfaces

Aims: Joint infections cause premature implant failure. The avoidance of bacterial colonization of implant materials by modification of the material surface is therefore the focus of current research. In this in vitro study the complex interaction of periodic structures on PET and titanium surfaces on the adhesion of Staphylococcus aureus is analysed. Methods and Results: Using direct laser interference patterning as well as roll-to-roll hot embossing methods, structured periodic textures of different spatial distance were produced on surfaces and S. aureus were cultured for 24 h on these. The amount of adhering bacteria was quantified using fluorescence microscopy and the local adhesion behaviour was investigated using scanning electron microscopy. For PET structures, minimal bacterial adhesion was identified for an aspect ratio of about 0·02. On titanium structures, S. aureus adhesion was significantly decreased for profile heights of < 200 nm. Our results show a significantly decreased bacterial adhesion for structures with an aspect ratio range of 0·02 to 0·05. Conclusions: We show that structuring on surfaces can decrease the amount of S. aureus on titanium and PET as common implant materials. Significance and Impact of the Study: The study highlights the immense potential of applying specific structures to implant materials to prevent implant colonization with pathogen bacteria.Fil: Meinshausen, A. K.. Otto-von-Guericke-Universität Magdeburg; AlemaniaFil: Herbster, M.. Otto-von-Guericke-Universität Magdeburg; AlemaniaFil: Zwahr, C.. Technische Universität Dresden; AlemaniaFil: Soldera, Marcos Maximiliano. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigación y Desarrollo en Ingeniería de Procesos, Biotecnología y Energías Alternativas. Universidad Nacional del Comahue. Instituto de Investigación y Desarrollo en Ingeniería de Procesos, Biotecnología y Energías Alternativas; ArgentinaFil: Müller, A.. Otto-von-Guericke-Universität Magdeburg; AlemaniaFil: Halle, T.. Otto-von-Guericke-Universität Magdeburg; AlemaniaFil: Lasagni, A. F.. Technische Universität Dresden; AlemaniaFil: Bertrand, J.. Otto-von-Guericke-Universität Magdeburg; Alemani

Implementation of the Patient Self-Determination Act: A Comparison of Nursing Homes to Hospitals

The Patient Self-Determination Act (PSDA) requires all health care facilities receiving Medicare or Medicaid funds to provide information about advance directives and the right of patients to refuse medical treatment. Administrators of 155 nursing homes in the state of Georgia completed surveys to assess implementation practices employed to comply with the PSDA mandates, knowledge of the law, and perceived effects of the passage of the PSDA. Responses from nursing home administrators were summarized, reported, and compared to results obtained from Georgia hospitals. Important differences were discovered. Nursing homes routinely provide more types of information to residents and spend more time with residents explaining relevant information than do hospitals, but hospital administrators demonstrated better knowledge of the PSDA and state law than nursing home counterparts. The implications of findings regarding the implementation of the PSDA and its overall effectiveness are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67652/2/10.1177_073346489701600204.pd