How do I diagnose and treat wound infection?

ACRP30--adipocyte complement-related protein of 30 kDa or AdipoQ--is an abundant serum protein, secreted exclusively from fat cells, which is implicated in energy homeostasis and obesity [1,2]. ACRP30 is a close homologue of the complement protein C1q, which is involved in the recognition of microbial surfaces [3-5] and antibody-antigen complexes [6,7] in the classical pathway of complement. We have determined the crystal structure of a homotrimeric fragment from ACRP30 at 2.1 A resolution. The structure reveals an unexpected homology to the tumor necrosis factor (TNF) family. Identical folding topologies, key residue conservations, and similarity of trimer interfaces and intron positions firmly establish an evolutionary link between the TNF and C1q families. We suggest that TNFs--which control many aspects of inflammation, adaptive immunity, apoptosis and energy homeostasis--arose by divergence from a primordial recognition molecule of the innate immune system. The evolutionary connection between C1q-like proteins and TNFs illuminates the shared functions of these two important groups of proteins.     

Using wound care products to promote a healing environment

Healing is characterized by the synthesis of new tissue and scar formation. Despite the complexity of healing with full-thickness injury, the repair process occurs in a predictable manner. There are four basic principles of wound care: (1) debride necrotic tissue and cleanse the wound to remove debris, (2) provide a moist wound healing environment through the use of proper dressings, (3) protect the wound from further injury, and (4) provide nutritional substrates essential to the healing process. Most importantly, any underlying pathophysiology must be treated or the wound will not heal. Products selected to create a healing environment must be chosen thoughtfully and scientific rationale must support their use. Intensive care nurses have the opportunity to get the patient off to the right start by attending to the basic principles elucidated in this article. Accurate wound assessment and appropriate product choices can promote a healing environment. Intensive care of patients includes differentiating wound types and making appropriate wound care product decisions that ultimately affect patient outcomes.     

Will all pressure ulcers heal?

Clinicians today are faced with the need to justify their care through outcomes data. However, this is difficult with chronic, nonhealing wounds or pressure ulcers, which do not follow the expected trajectory of wound healing. Therefore, outcomes are unpredictable. This paper discusses the phases of wound healing and progress toward identifying outcomes for chronic wounds, as well as future directions in research.     

How to write a recruiting policy

Occupational health professionals have an important role to play in ensuring that individuals recruited by any organization are medically capable of performing their required duties in an efficient manner. To achieve this, the physician's knowledge of the workplace should be used to establish the necessary medical standards whilst their occupational health expertise and experience should be called upon to establish the relevant means of objectively assessing attainment of the established criteria. A written policy detailing the procedures, both medical and administrative is essential.     

How to read a scientific article

Medical literature is too prolific and user's guides are necessary to extract useful information for optimal treatment of our patients. The goal of this paper is to help doctors find relevant articles and to read them efficiently for applying the results to their patients. An excerpt has been written concerning the subject by the Mac Master team and the members of the Cochrane Collaboration in the JAMA, the BMJ and on the Internet: a web site is now devoted to user's guides to medical literature. Simple rules facilitating access to relevant papers and interpretation of the results have been given. They have been applied to oncology, especially to papers concerning effectiveness of therapeutic interventions. It is essential that doctors use simple rules and learn how to select relevant articles and understand and use them to treat their patients according to Evidence-Based Medicine Group.     

How to critique a published article.

Few replies get published. Many that do get published could be more effective. A reply can be effective only if it is published, readable, and credible. This article suggests guidelines for writing good replies. The guidelines begin with things to keep in mind—for example, that you might be wrong—and things to do before you begin to write. The latter include considering not responding, considering alternative viewpoints, and distancing yourself from the task. Things to do while writing include using the principle of charity, avoiding ad hominem and emotionally laden arguments, and keeping the rebuttal short. After completing the first draft, you should put it aside for awhile as well as get a second opinion. A good reply complements rather than discredits the argument of the target author. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

一种改进的SUSAN快速算法在钨矿初选上的应用

在钨矿初选过程中,为了提高钨矿石的选出率和合格率,同时考虑到经济因素,提出一种改进型的SUSAN快速算法。利用黑钨图像独特的色泽及纹理特征,在SUSAN算法的基础上,提出了自适应阈值t选取和快速提取边缘的方法,并用VC++编程实现该算法,最终应用到钨矿图像的边缘检测提取。试验表明,图像边缘检测准确度高,速度快。与原来的算法相比,该方法提高了运算速度,改善了边缘检测的效果。在钨矿初选工艺上有很强的实用性。     

How to appoint a senior house officer

A considerable body of evidence exists to suggest that genes play a dominant role in the etiology of the dental anomalies reviewed. It has been postulated that some kind of genetically controlled interrelationship may exist for some of these coincidental dental anomalies, as evidenced by their frequency of association. It has also been speculated that a "common genetic defect" may give rise to different phenotypic manifestations, including missing, malformed, and even ectopic and malpositioned teeth. The maxillary teeth that develop in the critical marginal areas of the dental lamina, namely the lateral incisors, canines and second premolars, seem most susceptible. Such dental anomalies may be symptoms of an inheritable developmental disturbance of tooth structures. Knowing that these dental anomalies can be inherited, a familial history and early clinical or radiographic detection of one anomaly, could alert parents and clinicians to the high likelihood of detection of other defects in the same individual and similar defects in other family members. Early diagnosis is important so that interceptive pediatric and orthodontic opportunities in relation to missing, malformed and ectopically erupting teeth are not overlooked. Further family studies are necessary to reveal the mode of inheritance of some of these dental anomalies and twin studies comparing monozygous and dizygous twins would enable an estimation of the extent of their inheritance.