Networks in workers' compensation medical delivery

Medical networks offer discounted fees, control of the workers' compensation case, quality monitoring, and managed care services. As channeling of workers' compensation cases to networks increases, credentialed physicians will benefit.     

In vitro degradation of dermal sheep collagen cross-linked using a water-soluble carbodiimide

Bacterial collagenase was used to study the susceptibility of dermal sheep collagen (DSC) cross-linked with a mixture of the water-soluble carbodiimide 1-ethyl-3-(3-dimethyl aminopropyl)-carbodiimide hydrochloride and N-hydroxysuccinimide (E/N-DSC) towards enzymatic degradation. Contrary to non-cross-linked DSC (N-DSC), which had a rate of weight-loss of 18.1% per hour upon degradation, no weight loss was observed for E/N-DSC during a 24 h degradation period. The tensile strength of the E/N-DSC samples decreased during this time period, resulting in partially degraded samples having 80% of the initial tensile strength remaining. The susceptibility of E/N-DSC samples towards enzymatic degradation could be controlled by varying the degree of cross-linking of the samples. Ethylene oxide sterilization of E/N-DSC samples made the material more resistant against degradation compared with non-sterilized E/N-DSC samples. This may be explained by a decrease of the adsorption of bacterial collagenase onto the collagen owing to reaction of ethylene oxide with remaining free amine groups in the collagen matrix.     

Infection control in the dental practice with emphasis on the orthodontic practice

Infections present a significant hazard in the orthodontic office because they can be transmitted by blood or saliva through direct or indirect contact, droplets, aerosols, or contaminated instruments and equipment. Because the incidence of certain microbial cross-infections in the dental environment has not been well documented, orthodontic personnel may not take the problem of cross-infection as seriously as they should, and they may transmit or contract more infections than they realize. The use of effective infection-control procedures in the orthodontic office and laboratory will prevent cross-contamination that may extend to the orthodontist, office staff, assistants, and patients. The goal of this article is to present infection control in a simple, yet comprehensive, manner, and to encourage all orthodontic practitioners to implement essential infection-control procedures in their practices.     

Pilocytic astrocytomas of the posterior fossa. A follow-up study in 33 patients

The extent of resection in pilocytic astrocytoma of the posterior fossa often remains undefined and the indications for further treatment in incompletely resected tumours are a matter of debate. It has been also realized that the problem of hydrocephalus in patients with pilocytic astrocytoma of the posterior fossa has not yet been solved and the diagnostic impact of postoperative CT findings remains questionable. We retrospectively reviewed the data from 33 patients harbouring a pilocytic astrocytoma of the posterior fossa to evaluate the impact of surgical technique in terms of radicality and of postoperative imaging results upon prognosis and adjunctive treatment. In addition, the issue of hydrocephalus was considered and related to different treatment modalities. Thirty patients underwent surgical treatment whereas 3 had open biopsy of the tumour. Macroscopically gross total resection of the tumour was performed in 20 patients, whereas resection was partial in 10. Follow-up was obtained in 29 patients for a period which ranged between 2 and 184 months (85 months +/- 56 months). Outcome was good in 24 patients who had only slight neurological deficit and poor in 3 patients, who were severely disabled. Two patients died during the follow-up period. Recurrent tumour growth occurred in 2 cases with incompletely resected tumours. From the series presented, it was concluded that long-term follow-up with CT seems mandatory in cases with contrast-enhancing residual tumour. Recurrent tumour growth should be assumed in postsurgical patients with an enlarging area of enhancement shown in follow-up CT studies. Permanent ventriculoperitoneal shunting is required in certain patients with pre- or postoperative hydrocephalus.(ABSTRACT TRUNCATED AT 250 WORDS)     

Impurity Distribution Behavior in Caprolactam Extraction with Environmentally Benign Mixed Solvents

In a previous study a solvent mixture of heptane containing 40 mass % heptanol was selected as an alternative in the industrial extraction of caprolactam to replace benzene, toluene, or chlorinated hydrocarbons. This work reports the equilibrium distribution ratio of caprolactam and four model impurities of organic nature, namely, cyclohexanone, aniline, n‐methylcaprolactam, and cyclohexane‐carboxamide, comparing the mixed solvents with toluene as a reference. The resulting phase equilibria were interpreted using the equilibrium stage model. Based on these calculations it was found that, compared to toluene, the co‐extracted fraction of cyclohexanone and aniline was higher, that of n‐methylcaprolactam was comparable, and that of cyclohexane‐carboxamide was lower using the mixed solvent. Overall, the mixed solvent reduced the fraction of co‐extracted impurities by almost 10 %.     

Occurrence of the mycotoxins ochratoxin A, zearalenone and deoxynivalenol in feed components.

The mycotoxin contamination of feed components used by the Dutch cooperative feed industry was surveyed to estimate the risk for animal production losses. Of 89 randomly and 6 selectively taken samples of raw materials harvested in 1988 and 1989 27% were contaminated with ochratoxin A (OCHRA), 31% with zearalenone (ZEA) and 20% with deoxynivalenol (DON). The mean content (microgram/kg) of all positive randomly taken samples was 18 (OCHRA), 62 (ZEA) and 630 (DON). The highest level (microgram/kg) for all samples was 120 (OCHRA) in barley, 3100 (ZEA) in corn cob mix and 1900 (DON) in maizegluten feed. The results of this survey show that feed components are often contaminated with mycotoxins. However, the contamination level could only sporadically cause production losses in animal husbandry.