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Objective: This paper presents a novel wound healing protocol for the treatment of MRSA-infected lower extremity wounds of various etiologies, and describes the healing rate at 30, 60 and 90 days., Method: A total of 40 participants with singular wounds were enrolled and treated with a specially designed protocol, which involves elements of the de-escalation theory together with a wound dress containing Oakin, in a private practice setting or a wound care center. The primary endpoint was the number of participants who achieved wound closure at 90 days. Data analysed and collected included wound etiology, wound size, gender, healing time by setting, and days to heal overall. Due to the anticipated small cohort of wound types, several statistical calculations were considered, including one-way ANOVA, Pearson correlation, and Levene's test., Results: All wounds were classified by etiology: 58% (n=23), diabetic neuropathic ulcers (DNU), 25% (n=10) venous insufficiency ulcers (VU), and 17% (n=7) pressure ulcers (PU). Overall, 35% (n=14) healed within 30 days (22.14 ± 4.47), 60% (n=24) healed in 60 days (31.76 ± 13.02), and 78% (n=31) healed in 90 days (40.81 ± 22.23). After 90 days, the remaining 23% (n=9) of participants were no longer followed., Conclusion: This clinical evaluation demonstrated the overall effectiveness of this treatment protocol by attaining nearly 80% wound closure within 90 days. This protocol is intended to provide a roadmap for clinicians to follow and adapt to their wound care practice should a high prevalence of MRSA-infected wounds be present., Declaration of Interest: The author has disclosed that he has worked doing clinical case studies for Amerx Health Care Corp. and is on their speaker bureau. The author has also disclosed that he has no financial relationship or vested interest with Amerx Health Care Corp. No funding was provided by the NIH, Wellcome Trust, HHMI, or others.

The search continues for alternative low-temperature sterilization technologies that do not exhibit adverse toxicological or environmental effects. Low-temperature plasma sterilization is one technology that is under investigation as an alternative to ethylene oxide and formaldehyde. This article examines the process and reports on the current status of the technology.

Thirteen random-source dogs provided 54 experimental and 50 control teeth. Controls received either a periodontal ligament (PDL) injection only, or no injection, with deep cavities prepared and restored. Experimental teeth received both a PDL injection and the deep cavity preparation and were then restored with an IRM base and acid-etched composite. Teeth were surgically removed for observation periods of one and 18 weeks and prepared for histologic evaluation. Results indicated that, in this model system, there was little additive effect to the pulpal reaction due to the PDL injection. Controls that were prepared had essentially the same pulpal response as did the experimental teeth (PDL injection/preparation). In both experimental and control pulps, the effects were primarily related to the depth of the cavity preparation.

Phage and colicin-resistant mutants were derived from Escherichia coli K-12P678. Two classes of phage T6 and colicin K-resistant mutants (genotype tsx) were isolated. Tsx-2 mutants, which demonstrated mucoid growth and increased sensitivities to many antibiotics, became sensitive to colicin K when pretreated with ethylenediaminetetraacetate (EDTA), whereas Tsx-1 mutants did not. Reassociation of EDTA-released material partially restored resistance to colicin K for Tsx-2 mutants. When EDTA-released material from strain P678 was associated with either class of K-resistant mutant, an increase in colicin K sensitivity resulted. Observations suggest that colicin K can act on its target site once it penetrates the cell surface. In addition, results suggest that functional colicin K receptors can be transferred from sensitive to resistant strains, thus conferring colicin sensitivity.

Arthrographic examination of the temporomandibular joint for perforations of the meniscus was found to be a reliable diagnostic test in a retrospective review of 45 surgical cases. Clinically palpable crepitus was also found to be an accurate indicator of the existence of perforations in patients who could open beyond 26 mm. The combination of palpable crepitus and a positive arthrogram was found to be complementary in diagnosing perforations and was confirmed by surgical observations.

The primary objective of decontamination is to protect healthcare workers who handle medical devices from infectious diseases that may be present on those devices. Ideally, the decontamination process should provide both cleaning and biocidal activity. A wide range of equipment, from automatic washer/sterilizers to semi-automated washer/sanitizers are commercially available to satisfy this need. The primary difference between these pieces of equipment, from a microbiology perspective, is in the level of safety they provide. A summary comparison of the decontamination methods is shown in Table 1. Without a doubt, steam sterilization as a method of decontamination provides a greater safety level than may be required. However, the question is, "Do disinfection and sanitization provide an adequate safety level?" Although items do not necessarily need to be sterile to be safe to handle, sterilization processes provide the greatest margin of safety because of the significant microbial lethality and the ability to effectively monitor the process via biological indicators. Sterilization effectively eliminates the concern regarding the nearly unanswerable question of bioburden. Unfortunately, not all items are capable of being processed through a washer/sterilizer. Therefore, consideration must be given to the process compatibility of each device. Disinfection processes provide the next level of safety. Unfortunately, there is no recognized or accepted method for quantitatively describing or monitoring a thermal disinfection process. As is the case with sterilization consideration must be given to the process compatibility of each device. Sanitization provides the lowest level of safety for the decontamination process.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacillus subtilis 5230 spores were lyophilized in 0.067 M phosphate buffer and stored at 2 to 8 degrees C for 9 to 27 months. The lyophilized spores were reconstituted with buffer or 0.9% saline, and the heat resistance was determined in a thermoresistometer. Lyophilization had no effect on the heat resistance of the spores but did result in a slight decrease in population (

A case of gingival fibrolipoma is described. The lesion presented as a tumor-like mass with a broad base arising from the attached gingiva adjacent to the mandibular left first bicuspid. Microscopic evaluation of the lesion revealed an admixture of mature adipose tissue and fibrous connective tissue. Fibrolipomas are an infrequent variant of lipomas. A review of the literature indicates that a gingival location for such lesions is rare.

Two transcranial radiographic methods for determining anterior disk displacement in the TMJ were evaluated in comparison with results obtained from arthrography. Both transcranial radiographic methods could only accurately predict the presence of an anteriorly displaced disk in a range of 26% to 56% of the time (for example, the methods gave false-negative results 44% to 74% of the time). The methods were more valuable in correctly identifying joints that were free of disease, achieving this identification anywhere from 64% to 96% of the time. Although noninvasive, these two transcranial radiographic techniques produced results that lacked validity and, therefore, remain of questionable value to the clinician who is diagnosing anterior disk displacement.

The use of interocclusal orthopedic appliances is the most common method for managing nocturnal bruxism and associated craniomandibular symptoms. Yet there is no consensus on the mechanism of action or best design for optimal clinical results. Posterior disocclusion through canine or anterior guidance is believed to be a key feature. The purpose of this study was to compare a canine versus molar guidance appliance in eight chronic bruxist patients. The appliances were used for 10 to 14 nights. The two appliances provided nearly equivalent effects on nocturnal bruxism in seven of eight subjects. Clinical examination and subjective pain ratings did not differ with the two guidance patterns. These results question the common assumption that canine guidance is a critical design feature for the management of nocturnal bruxism and associated craniomandibular symptoms.

1. The basophilic granule of blood and marrow cells does not show the brown color reaction with benzidine solutions that is characteristic of the neutrophilic and eosinophilic granules. It differs from these types also in other important microchemical and physical particulars. 2. The hemic basophil which bears these granules is peculiar from a purely cytological standpoint, while physiologically it appears to be devoid of any functional activity comparable with that of the other granulocytes. 3. The peculiarities exhibited seem in every instance, at least for mammalian blood, best explained as evidence that the basophil is a degenerated or degenerating cell. It is probably derived from the eosinophilic cells and perhaps in rare cases from those of neutrophilic type.