Biomedicine International Journals
Volume:1 Issue: 2, 2010

The objective of this study is to evaluate the incidence and cost of needlestick injuries (NIs) in the United States, United Kingdom, Germany, France, Italy, and Spain. Comprehensive search of peer-reviewed literature to gather information on the incidence and costs associated with NIs and a Web-based search to identify pertinent gray literature, trade associations, and key stakeholders for the prevention of NIs. The estimated annual incidence of NIs is 384,000 in the United States, 100,000 in the United Kingdom, 700,000 in Germany, 29,719 in France, 28,200 in Italy, and 21,815 in Spain. The economic burden of NIs varies from country to country; for instance, annual costs are estimated at €7 million in Italy and $118 million to $591 million in the United States. An accurate assessment of the incidence and economic burden of NIs is difficult to obtain because of widespread under-reporting. Furthermore, the projected costs do not account for long-term treatment costs resulting from possible infection with a blood-borne pathogen, absenteeism, worker’s compensation, or emotional repercussions. A significant proportion of NIs stem from injections and intravenous-related tasks, accounting for roughly one to two thirds of NIs in all countries examined. The US General Accounting Office estimates that 29% of NIs that occur in hospitals could be prevented through the adoption of safety-engineered needles or needle-free devices. In conclusion, findings on the incidence and economic burden of NIs indicate the need for safety-engineered needles or needle-free technology, along with increased education regarding safer practices in the work environment.

Computational modeling is a fundamentally new approach to medical treatment planning and the development of pre-dictive methods for clinical applications. Abdominal aortic aneurysm (AAA) is a common clinical problem that requires determination of hemodynamic conditions and prediction of subsequent rupture. The objective of this paper is to solve a set of three-dimensional nonlinear finite element equations in order to model clinically relevant hemodynamic conditions that are important in predicting the risk of rupture of AAAs. The solution exploits the mixed velocity-pressure (v-p) finite element method by implementing the Galerkin method and the implicit incremental-iterative procedure. The physiologi-cally realistic pulsatile blood flow dynamics imposed upon the AAA model was solved using the Navier-Stokes and con-tinuity equations that represent a viscous incompressible fluid. This pulsatile condition simulates an in vivo aorta at rest. The finite element technique developed here was validated using the well-known analytical solution of the Womersley model. The velocity flow fields, flow-induced wall shear stress and pressure distributions from the resulting technique were quantified.

The profunda femoris artery is a major collateral vessel of the lower limb that aids in maintaining a viable limb in the face of femoropopliteal occlusive disease. The status of the profunda femoris artery is particularly important in regard to the indications and choice of lower limb vascular reconstructive surgeries such as profundaplasty. The aim of this study was to delineate the morphology of the profunda femoris artery in patients with superficial femoral artery occlusive disease (SFAO), the most common form of lower limb arterial insufficiency. Fifty-six patients with lower limb arterial disease and SFAO (mean age of 59 years; male/female, 7/1) were examined for the pattern and severity of concomitant profunda femoris artery involvement. The levels of distal arterial run-off, if present, were determined in the limbs with complete SFAO. There were 21 diabetic and 35 non-diabetic patients; a total of 63 sides had SFAO. Diabetics had more frequent (84% versus 42.1% for non-diabetics) and multisegmental/diffuse profunda femoris stenosis while non-diabetics more often than not had unisegmental and short lesions at the origin or proximal one third of the artery. In limbs with complete SFAO, arterial run-offs were present in 60.5% in non-diabetic patients while in 81.8% in diabetic patients. We believe that this information may be useful for clinicians and vascular surgeons who deal with lower limb arterial disease.

The aim of this study was to determine the dermatoglyphic features of obese patients from the Ibibio ethnic group. One hundred individuals were examined: 50 obese (20 male and 30 female) and 50 normal (25 male and 25 female) subjects. Dermatoglyphic features such as digital and total ridge counts, DAT (angle formed by the triradius below the index finger) and ATD (angle formed by the triradius close to the wrist of the hand) were assessed. The results showed that on digital prints, the arch pattern was most common on the first right digits of obese males (54.5%) and females (42.33%), while in normal individuals, an ulnar loop was seen more frequently (P < 0.05, chi-square test). The ATD and DAT angles on the right hands of both male and female obese patients were significantly greater than those of normal male and female subjects (P < 0.05, z-test). This study therefore showed that certain dermatoglyphic patterns are associated with obesity among the Ibibio population of Nigeria. The potential utility of these dermatoglyphic patterns in identifying individuals at high risk for obesity may be considered in future studies.

Cardiac memory is characterized by an altered T wave during sinus rhythm that is induced by a period of ventricular pac-ing or arrhythmia. Returning to sinus rhythm (normal activation) after an interval of abnormal ventricular depolarization (ventricular pacing or arrhythmia) may result in a change in the T wave vector that persists for a time period of minutes to weeks. Cardiac memory, expressed as a specific pattern of T-wave change on an ECG, is associated with reduced tran-sient outward potassium current (Ito), reduced epicardial mRNA levels of Kv4.3 (one of the molecular correlates of Ito) and altered L-type calcium channel kinetics. The molecular and genetic changes associated with cardiac memory have been studied but the triggers responsible for inducing memory remain unknown. We hypothesize that mechanoelectrical feedback contributes to the initiation of cardiac memory. Two lines of evidence support this hypothesis. First, cardiac an-giotensin II synthesis and release as a consequence of altered stretch imposed by ventricular pacing is accompanied by a reduction in Ito density and an increased ICa,L. Second, alterations in ventricular activation by pacing are associated with regional changes in myocardial strain, and myocardial strain strongly influences the repolarization properties of myo-cytes. Confirmation of this hypothesis will elucidate the electrophysiological trigger responsible for inducing cardiac memory.

The anthracycline doxorubicin (Dox) is widely used as an effective antitumor drug. Cardiotoxicity leading to congestive heart failure is the primary factor limiting the clinical use of Dox. Cardiac inflammation and generation of oxidative stress are known to contribute to Dox-induced cardiomyopathy. Cytokine release mediated by activation of the innate immune system is believed to be involved in the pathogenesis of Dox-induced cardiotoxicity. The innate immune system has long been regarded as the first line of defense against foreign pathogens. Toll-like receptors (TLRs) are a part of the innate immune system and are germline-encoded receptors involved in the cardiac stress reaction. They are key compo-nents of the innate immunity and are activated in response to pathogens as well as non-pathogenic components of dam-aged tissues. Among the TLR family, TLR4 is the most extensively studied in the pathogenesis of cardiomyopathy. TLR4 activation not only triggers an inflammatory response but also results in extracellular matrix degradation and causes a vicious cycle of which the outcome is cardiomyopathy. On the other hand, TLR4 deficiency improves left ven-tricular function and attenuates key pathophysiological mechanisms in Dox-induced cardiomyopathy. Consequently, any substance that blocks the TLR4 receptor or disrupts its signaling may provide protection against cardiomyopathy in Dox-treated patients. Statins are currently-marketed reductase inhibitors that are used to reduce levels of LDL; they also have other beneficial effects including decrease of oxidative stress and vascular inflammation. More recently, statins have been shown to inhibit the TLR4-mediated inflammatory response in individuals with a specific TLR4 genotype. It is pos-sible that these agents could be used off-label to diminish the likelihood of doxorubicin cardiotoxicity, permitting higher doxorubicin doses. We propose the hypothesis that statins can prevent doxorubicin-induced cardiomyopathy.

It has been hypothesized that long term application of new generation antibiotics could result in bacterial species which are susceptible to old generation antibiotics. However, there are several factors which make such a hypothesis questionable. Resistance could be reversible but bacteria will die due to the presence of the antibiotic in the bacterial population. Furthermore, if a microorganism becomes resistant to a second generation of antimicrobial agents it will also be resistant to the first generation of that class. In addition, the turnover time for cycling is unknown, the use of new generation antimicrobial agents is expensive, producing a new generation of an antimicrobial class may not be straightforward, and there are different administrations for different generations of a class of an antibiotic. Antimicrobial resistance in bacterial populations is an example of Darwinian evolution. Is it possible that a species with a ‘superior’ phenotype resulting in natural selection of that species over others would lose that phenotype in the future? Considering the aforementioned points, we suggest that cycling antibiotic resistance does not occur, and that it would be extremely unlikely to do so.

Ancient Egyptian and Greek pharmacopoeias reveal frequent use of different drugs, somniferous or narcotic, which contain poisonous elements. Among the toxic plants enumerated by Dioscorides, we find poppy and others. Egyptians were fond of taking these narcotic or euphoric substances attributed to nepenthes, but it is difficult to prove whether ancient people were aware of modern aspects of addiction. Poppy (Papaver somniferum L.) and opium have a more interesting history. Probably introduced into Egypt in the Ancient Kingdom, poppy was widely cultivated during the times of Akhenaton and Tutankhamon and even later. Opium was used to make people sleep, to relieve pain and to quiet the nerves because it acts on the nervous system and psychic functions. Even today, the etymologies of the twenty or so alkaloids it comprises, among them morphine, thebaine and heroin, sometimes recall Greek beliefs and Egyptian places. The Smith and Ebers Papyri show medical applications of poppy plants: to cure breast abscesses, to calm crying children, as eye drops and in ointments. Composed of many grains, poppy capsules were believed to have aphrodisiac properties and were a symbol of fertility. There are a few other indications that these drugs were used, but no signs of addiction among ancient people.

The aim of this review was to explore the use of olive oil in conjunction with deep friction massage (DFM) for the prevention and treatment of sports injuries in the ancient world, and to investigate its potential use in modern medicine. For this purpose, the writings of major ancient philosophers and physicians such as Hippocrates, Aristotle, Philostratos and Lucian have been analysed leading to the conclusion that the application of olive oil during DFM was an effective preventive and curative treatment for ancient athletes. Various studies suggest that application of olive oil during DFM helps to reduce muscle fatigue, remove lactic acid and further prevent the occurrence of sports injuries by conferring flexibility on the skin. Further experimental and clinical studies are required to investigate the potential beneficial effects of the application of olive oil during DFM in terms of preventing and treating various sport injuries.

An inferior alveolar nerve with multiple roots is a rare variation encountered during dissection of cadavers. We present one such variation found in the right infratemporal fossa of an adult male cadaver. The nerve had three roots, one each from the posterior division of the mandibular nerve, auriculotemporal nerve and lingual nerve. The second part of the maxillary artery was encircled by the roots originating from the posterior division of the mandibular nerve and auriculotemporal nerve. This close topographical relationship may contribute to the etiology of nerve compression syndrome. Thus, knowledge of such variations may prove useful in diagnosis and treatment of that syndrome and may be relevant to several operations involving the infratemporal region.

Interpreting the significance of non-organ-specific auto-antibodies is clinically challenging. A 58-year-old Egyptian immigrant woman presented with cutaneous bullous lesions and acute renal failure. She was suffering from hepatitis C infection and vasculitis with arterial and arteriolar intraluminal eosinophilic material, potentially representing cryoglobulin aggregate, as well as inflammatory infiltrates within the vessel walls. Her hospital course was complicated by an acalculous cholecystitis. The auto-antibody profile was positive for anti-proteinase-3, myeloperoxidase, cardiolipin IgG and phospholipid IgG. The presence of non-organ-specific antibodies was reported at a high frequency in cryoglobulinemia associated with hepatitis C genotype 4; this association is uncommon in the United States but prevalent in Egypt.

Fulminant hepatitis is a rare complication of hepatitis B virus infection. This condition has a high mortality rate and liver transplantation is often necessary to save life. The present report highlights the value of a short course of oral hepatitis B vaccine therapy in the treatment of a patient with fulminant hepatitis secondary to HBV infection. This information could be of value in the development of new therapeutic measures based on the immune tolerance mechanisms for this fatal condition. The use of oral vaccine therapy for treatment of fulminant hepatitis needs approval for use in appropriately-sized clinical trials.