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Appropriate Precautions (appropriate + precaution)
Selected AbstractsETHICAL PROBLEMS IN CONDUCTING RESEARCH IN ACUTE EPIDEMICS: THE PFIZER MENINGITIS STUDY IN NIGERIA AS AN ILLUSTRATIONDEVELOPING WORLD BIOETHICS, Issue 1 2010EMMANUEL R. EZEOME ABSTRACT The ethics of conducting research in epidemic situations have yet to account fully for differences in the proportion and acuteness of epidemics, among other factors. While epidemics most often arise from infectious diseases, not all infectious diseases are of epidemic proportions, and not all epidemics occur acutely. These and other variations constrain the generalization of ethical decision-making and impose ethical demands on the individual researcher in a way not previously highlighted. This paper discusses a number of such constraints and impositions. It applies the ethical principles enunciated by Emmanuel et al.1 to the controversial Pfizer study in Nigeria in order to highlight the particular ethical concerns of acute epidemic research, and suggest ways of meeting such challenges. The paper recommends that research during epidemics should be partly evaluated on its own merits in order to determine its ethical appropriateness to the specific situation. Snap decisions to conduct research during acute epidemics should be resisted. Community engagement, public notification and good information management are needed to promote the ethics of conducting research during acute epidemics. Individual consent is most at risk of being compromised, and every effort should be made to ensure that it is maintained and valid. Use of data safety management boards should be routine. Acute epidemics also present opportunities to enhance the social value of research and maximize its benefits to communities. Ethical research is possible in acute epidemics, if the potential challenges are thought of ahead of time and appropriate precautions taken. [source] The radioactive autopsy: safe working practicesHISTOPATHOLOGY, Issue 3 2007M Singleton Autopsy cases involving individuals retaining radioactive substances are fortunately rare, but when they occur they can impose significant radiation safety and legal requirements. This review aims to improve the understanding of these issues so that appropriate precautions are implemented when necessary. This review describes the properties of ionizing radiations, natural and man-made sources of ionizing radiation and its use in healthcare. It identifies the most likely circumstances leading to radioactive substances being present during autopsy and sources of information, including radiation protection advice. It discusses precautions that may need to be implemented prior to, during and following autopsy. Despite the issue of appropriate information to patients and next of kin, it is inevitable that some cases will be identified only at autopsy and it is important that robust local procedures are maintained. Information must be communicated to assist safe management of the body and liaison between relevant professional groups may be needed to standardize methods of communication. Provided that appropriate precautions are implemented, determined through consultation with a qualified expert in radiation protection and by completion of risk assessment, the radioactive autopsy can be undertaken safely and in compliance with relevant legislative requirements. [source] Practical guidelines for treating inflammatory bowel disease safely with anti-tumour necrosis factor therapy in AustraliaINTERNAL MEDICINE JOURNAL, Issue 2 2010W. Connell Abstract Anti-tumour necrosis factor (TNF) therapy is an effective but expensive option for treating inflammatory bowel disease (IBD). Its use is generally reserved for patients with severe refractory disease, often involving long-term administration. Anti-TNF therapy has the potential to be associated with various adverse effects, such as infection, malignancy and immunogenicity. Clinicians and patients should be familiar with these possibilities and adopt appropriate precautions prior to and during treatment to minimize risk. Guidelines have been developed for Australian prescribers intending to use anti-TNF therapy in IBD by a Working Party commissioned by IBD-Australia, a Special Interest Group affiliated with the Gastroenterology Society of Australia. [source] Development of a Lyophilization Formulation that Preserves the Biological Activity of the Platelet-inducing Cytokine Interleukin-11 at Low ConcentrationsJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 1 2000CHRISTOPHER PAGE Recombinant human interleukin-11 (rhIL-11) is a licensed biological therapeutic product in at least one country and is used to combat thrombocytopenia during chemotherapeutic regimens, as well as undergoing clinical trials for a range of other disorders. Following attempts to lyophilize IL-11 at low concentrations, it was clear that a significant loss of recoverable biological activity occurred. Investigation of a variety of factors, including the type of container in which the rhIL-11 was lyophilized, revealed that surface adsorption to glass was a major factor resulting in loss of activity of rhIL-11 in solution (> 40% reduction after 3 h at room temperature), in addition to losses of activity post-lyophilization. To overcome this problem, different formulations containing combinations of human serum albumin (HSA), trehalose and Tween-20 have been investigated. Two formulations were successful in entirely preserving the biological activity of rhIL-11 through lyophilization and subsequent reconstitution (potency estimates of formulated relative to original material being ,0.97). Accelerated degradation studies, performed at intervals over a six-month period, demonstrated the stability of freeze-dried rhIL-11 using these formulations (predicted annual reduction in potency after storage at ,20°C ,1.4%). In conclusion, we have developed a working combination of excipients (0.5% HSA, 0.1% trehalose and 0.02% Tween-20 in potassium phosphate buffer (pH 7.4)) to formulate a stable rhIL-11 freeze-dried product in glass containers, with no loss in potency. These findings should facilitate development of low dose rhIL-11 products and be an indicator of caution to those using this and other material with similar physical properties, without taking appropriate precautions to avoid losses through adsorption. [source] Presence of Listeria and Salmonella spp. in retail chicken in Northern IrelandLETTERS IN APPLIED MICROBIOLOGY, Issue 5 2003N. Soultos Abstract Aims: Retail packs of fresh chicken in Northern Ireland were sampled to determine the frequency with which they were contaminated with Salmonella and Listeria spp. Methods: Packs of chicken were chosen from supermarkets ensuring a diverse range of EU producer codes were sampled. Salmonellas were isolated using BS EN 12824: 1998 methodology, biotyped and serotyped whilst Listeria spp. were isolated based on EN ISO 11290-1: 1996 procedures and identified using a multiplex PCR system utilizing genus and species specific primers. Significance and Impact of the Study: Only three of 205 samples yielded Salmonella spp. indicating that measures undertaken by the poultry industry to control this pathogen have apparently been successful. However, Listeria spp. were present in 38 of 80 samples tested (48%) and 14 (18%) yielded Listeria monocytogenes. Thus Salmonella controls do not markedly affect this pathogen and retail packs of raw chicken must be considered a potential source of L. monocytogenes, and appropriate precautions taken to prevent infection. [source] Glowworms: a review of Arachnocampa spp. and kinLUMINESCENCE: THE JOURNAL OF BIOLOGICAL AND CHEMICAL LUMINESCENCE, Issue 3 2007V. B. Meyer-Rochow Abstract The term ,glowworm' is used in connection with the flightless females of lampyrid fireflies and to describe the luminescent larvae of certain fungus gnats that belong to the subfamilies Arachnocampinae, Keroplatinae and Macrocerinae of the dipteran family Keroplatidae. This review focuses on the luminescent larval fungus gnats. The weakly luminescent species of the Holarctic feed mainly on fungal spores, but some, such as Orfelia fultoni, have turned to a carnivorous diet. Larval Australian and New Zealand Arachnocampa spp. produce brighter in vivo (but not necessarily in vitro) lights, live in cool, damp and dark places and are exclusively predatory. They lure their prey (usually small flying insects) with the help of their blue-green light emissions towards snares consisting of vertical silk threads coated with sticky mucus droplets. Fungus gnats with similar ,fishing lines' are found in the Neotropics, but they are not luminescent. The larval stage is longest in the life cycle of Arachnocampa, lasting up to a year, depending on climatic conditions such as temperature and humidity as well as food supply. In A. luminosa, but not the Australian A. flava, female pupae and even female imagines are luminescent. However, it remains to be demonstrated whether it is the light of the female, a pheromone or both that attract the males. Light organs and the chemical reactions to produce light differ between the holarctic and the Australian/New Zealand species. Prey is attracted only by the glowworm's light; odours of the fishing lines or the glowworms themselves are not involved. Recognition of the prey by the glowworm involves mechano- and chemoreception. The eyes of both larval and adult glowworms are large and functional over a spectral range covering UV to green wavelengths. Adults are poor fliers, live only for a few days, have degenerate mouth parts and do not feed. Maintenance of glowworms in captivity is possible and the impact of tourism on glowworms in natural settings can be minimized through appropriate precautions. Copyright © 2007 John Wiley & Sons, Ltd. [source] Successful Cervical MR Scan in a Patient Several Hours after Pacemaker ImplantationPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 10 2009DORITH GOLDSHER M.D. Recent data showed that patients with electrical implanted devices may under certain conditions be scanned safely by magnetic resonance imaging (MRI). The device must have been in place preferably for at least 4,8 weeks [Correction added after online publication 31-Aug-2009: number of weeks has been updated.] prior to MR imaging to allow healing and pacemaker pocket formation. We report on a patient with quadriplegia and suspected epidural hematoma referred for MR scan a day after he had a pacemaker implantation. The patient was also pacemaker-dependent. After considering the risk/benefit ratio in this patient, it was decided to perform the scan. The pacemaker was reprogrammed. MRI was performed under strict monitoring. A spinal cord contusion at the level of C1,3 was diagnosed. Based on the imaging findings no invasive procedure was done. Device interrogation found no change in sensing or pacing parameters or in the pacemaker's battery. At the end of the scan, the device was reprogrammed back to the initial settings. In this population, each scan should be discussed thoroughly and the risks to benefit ratio should be considered. Given appropriate precautions, in well-experienced imaging centers, MRI may be safely performed in patients with permanent cardiac electronic implantable devices. [source] Laboratory studies to assess the risk of development of resistance to zoxamidePEST MANAGEMENT SCIENCE (FORMERLY: PESTICIDE SCIENCE), Issue 11 2001David H Young Abstract Laboratory studies were conducted to evaluate the risk of developing field resistance to zoxamide, a new Oomycete fungicide which acts on microtubules. Zoxamide, metalaxyl and dimethomorph were compared with respect to the ease with which fungicide-resistant mutants could be isolated and their level of resistance. Attempts to generate mutants of Phytophthora capsici and P infestans with resistance to zoxamide by mycelial adaptation on fungicide-amended medium were unsuccessful. Similarly, changes in sensitivity to zoxamide were small (resistance factors ,2.2) in mutants of P capsici isolated by chemical mutagenesis of zoospore cysts. In parallel experiments with metalaxyl, highly resistant mutants were obtained using both adaptation (P capsici or P infestans) and chemical mutagenesis (P capsici). For dimethomorph, chemical mutagenesis (P capsici) yielded moderately resistant mutants (maximum resistance factor,=,20.9), and adaptation (P capsici or P infestans) did not induce resistance. It is proposed that failure to isolate mutants resistant to zoxamide results from the diploid nature of Oomycete fungi and the likelihood that target-site mutations would produce a recessive phenotype. Our studies suggest that the risk of a highly resistant pathogen population developing rapidly in the field is much lower for zoxamide than for metalaxyl. However, as with any site-specific fungicide, appropriate precautions against resistance development should be taken. © 2001 Society of Chemical Industry [source] Sensitivity of Botrytis cinerea from vegetable greenhouses to boscalidPLANT PATHOLOGY, Issue 4 2007C. Q. Zhang Between 2004 and 2006, 228 isolates of Botrytis cinerea from two regions in China were characterized for baseline sensitivity to boscalid, a new active ingredient that interferes with succinate ubiquinone reductase in the electron transport chain. The isolates showed similar sensitivity in different years and regions. Baseline sensitivities were distributed as unimodal curves with mean EC50 values of 1·07 (± 0·11) and 0·42 (± 0·05) mg L,1 for inhibition of mycelial growth and conidial germination, respectively. Laboratory studies were conducted to evaluate the risk of development of resistance to boscalid. Boscalid-resistant mutants were obtained by UV-treatment at lower frequencies and with smaller resistance factors than pyrimethanil-resistant mutants. All boscalid-resistant mutants were also significantly more sensitive to Qo inhibitors than their wild-type parents and showed reduced sporulation in vitro and pathogenicity on aubergine leaves. The results suggested that the risk of resistance developing for boscalid was lower than for pyrimethanil. However, as B. cinerea is a high-risk pathogen, appropriate precautions against resistance development should be taken. Synergism between the activity of boscalid and that of kresoxim-methyl was observed. [source] Electrosurgery after Cochlear Implantation: Eighth Nerve Electrophysiology,THE LARYNGOSCOPE, Issue 12 2004David M. Poetker MD Abstract Hypothesis: Monopolar electrosurgery below the neck in cochlear implant recipients can be performed without damage to the internal cochlear stimulator, electrode array, and the cochlear nerve. Study Design: Prospective pre- and postintervention electrically evoked compound action potential (ECAP) study of cochlear nerve function and behavioral sound perception assessment. Methods: Neural response telemetry (NRT) was used to measure ECAPs before and after the use of monopolar electrosurgery during coronary artery bypass surgery to assess prosthetic device function and electrophysiologic function of the cochlear nerve. In addition, electrode voltage impedances and behavioral sound perception was measured at the same time intervals. Results: ECAPs, behavioral sound perception, and electrode voltage impedances were within the normal range, within compliance, and similar preoperatively and on postoperative day 6. Conclusion: The studies reported herein were a series of measurements designed to test neural integrity and prosthetic device function before and after the use of monopolar electrosurgery. With appropriate precautions, use of monopolar electrosurgery below the neck in cochlear implant recipients can be performed safely. [source] | ||||||||||||||||