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[Bacterial contamination of infant urine samples obtained from filter papers used in neuroblastoma-screening tests. (6) Protective effects of preaddition of chlorhexidine digluconate in filter papers or containers for urine on bacterial break-down of creatinine, vanillylmandelic acid and homovanillic acid].

The effects of chlorhexidine digluconate preadded to urine samples for a neuroblastoma-screening test in preventing the break-down of creatinine (Cre), vanillylmandelic acid (VMA), and homovanillic acid (HVA) by creatinine-cleaving bacteria and the influence of the added disinfectant on the HPLC determination of urinary Cre, VMA, vanillillactic acid (VLA) and HVA. Laboratory or field experiments showed that preadded disinfectant (0.02% volume) nearly completely inhibited the growth of the bacteria and satisfactorily protected urinary Cre, VMA, and HVA from bacterial decomposition. Chlorhexidine digluconate was comparable to benzalkonium chloride in its inhibitory effects on the growth and activities of creatinine-cleaving bacteria. Unlike benzalkonium chloride, chlorhexidine digluconate added to urine samples gave no troubles in subsequent analytical processes. Addition of the disinfectant (0.02% volume) to standard Cre, VMA, VLA, and HVA solution did not affect retention times and sensitivities in HPLC analyses. To estimate influences of the added disinfectant on the serial HPLC determinations of VMA, VLA, and HVA on a large number of urine samples (40, 80, 120, 160, 200, or 5, 500), HPLC analyses were performed on standard VMA, VLA, and HVA solution with repeated injection of the disinfectant in great amounts into a column. The results showed no appreciable changes in the retention times and sensitivities of VMA, VLA, and HVA, and almost complete elution of the disinfectant retained on the column were possible with water-methanol (1:1, 2:8) or methanol washing.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Infections↗

Forms in general practice. Paper war or paper tiger?

OBJECTIVE: To measure GP attitudes to forms in general practice, particularly the common and important ones, and to record the frequency of their use. DESIGN: Qualitative and quantitative methods were used. The former included focus group discussions (three groups) and telephone interviews (25 GPs) and the latter included a questionnaire sent to a random sample of 500 Australian GPs along with a data collection form to record the use of forms during a 3 week survey period. MAIN OUTCOME MEASURES: To describe current problems GPs encounter in completing forms, to obtain recommendations on how these problems could be overcome, and to document the use of forms in general practice. RESULTS: GPs believe that there are significant frustrations with existing forms, including uncertainties about the precise information that some questions request, the length of forms and who is responsible for payment. However, GPs distinguish between the design of forms and their content and recognise greater problems with government entitlement applications than with forms originating from non government sources. Professional bodies such as the Royal Australian College of General Practitioners should have input into the construction of forms. CONCLUSION: Reform in this area would be helpful given that inaccurate data are likely to be collected if forms are inadequate. However, there are barriers to reform, including the multiplicity of forms and the laws which govern them. The introduction of computerised forms may force both the profession and the organisations responsible for their production to rethink what are their essential features.

Adult↗

An analysis of papers published in the British and European Journals of Orthodontics.

UNLABELLED: The aims of this study were to assess the type, subject, setting and methods of papers published in British Journal of Orthodontics (BJO) and European Journal of Orthodontics (EJO) between 1989 and 1993 to allow all published randomized controlled trials (RCTs) to be identified and a comparison of the papers published in the journals to be made. A hand search of all papers published in BJO and EJO between 1989 and 1993 was performed, and the type, subject, setting, and methods of each paper were classified and recorded. Of the studies, 59.3 per cent related to clinical orthodontics, but only three RCTs were identified in each journal. This comprised 2.8 per cent of the clinical research papers which were analysed. The remaining studies used non-randomized controls or were uncontrolled. Significant differences were found between the type (P < 0.001), subject (P < 0.001), setting (P < 0.01) and methods (P < 0.05) of papers published in the two journals. Relatively more papers in BJO were case reports, clinical opinions and update articles, reported on orthodontic materials or assessed methods of measuring the outcome of treatment. Ninety per cent of papers in EJO reported the results of research projects and relatively more papers, than in BJO, were related to animal studies, and were laboratory based or epidemiological. OBJECTIVES: To identify all randomized controlled trials (RCTs) and compare papers published in two orthodontic journals. DESIGN: A retrospective, observational study. SETTING: The British Journal of Orthodontics (BJO) and European Journals of Orthodontics) (EJO). DATA SOURCE: Papers published between 1989 and 1993. METHOD: A hand search of all papers was performed. The type, subject, setting and methods of each paper were classified and recorded. RESULTS: 200 papers were identified in BJO and 275 in EJO. Six RCTs were identified which represents 2.8 per cent of clinical research papers. Significant differences were found between the type (P < 0.001), subject (P < 0.001), setting (P < 0.01), and methods (P < 0.05) of papers published in the two journals. More papers in BJO were case reports, clinical opinions, and update articles, and reported on orthodontic materials or assessed methods of measuring the outcome of treatment. Ninety per cent of papers in EJU reported the results of research projects. More papers were related to animal studies; were laboratory based on epidemiological. CONCLUSION: Despite the RCT being regarded as the 'Gold Standard' for the evaluation of therapeutic interventions and materials only six (5.1 per cent) of such studies used this method. Significant differences in the type, setting and subject of papers published in BJO and EJO between 1989 and 1993 were found.

Animals↗

Identification and quantification of estrogenic compounds in recycled and virgin paper for household use as determined by an in vitro yeast estrogen screen and chemical analysis.

The use of recycled paper for the manufacture of food contact materials is widespread, but very little is known about the presence of potential contaminants in the paper. The purpose of this study was to assess the worst-case migration of estrogenic active compounds using extracts of paper for household use. Twenty different brands of kitchen rolls, nine of which were made from recycled paper and the remainder from virgin paper, were obtained from retail shops. Paper extracts were subjected to (a) determination of the total estrogenic activity by using an in vitro estrogen screen based on yeast cells stably transfected with the human estrogen receptor alpha and (b) chemical analysis and quantification by GC/MS, GC/FTIR/MS, and GC/FID for detection of a variety of estrogenic compounds. A marked estrogenic response was observed in nine of the extracts, seven of which were made from recycled paper and two from virgin paper. The chemical analysis revealed that extracts made from recycled paper contained levels of bisphenol A ranging from 0.6 to 24 mg/kg of kitchen roll, whereas extracts from virgin paper contained no bisphenol A or only negligible amounts. In contrast, 4-tert-octylphenol, 4-nonylphenols, and di-n-butyl and diisobutyl phthalate were present to a varying degree in both recycled and virgin paper with no apparent preferable distribution between the two paper types. The estrogenic response of the two extracts made from virgin paper appeared to be due partly to the presence of the preservative propyl paraben. Diisopropylnaphthalene, which turned out to be weakly estrogenic active in vitro (EC(50) = 53 microM), was detected in minor amounts in most of the extracts with the major part, ranging from 0.3 to 4.7 mg/kg of paper, found in recycled paper. Our findings that recycled kitchen rolls contain bisphenol A and other xenoestrogens may apply to other types of recycled paper used for food packaging and emphasize the importance of identifying this and other contaminants in recycled paper in general. These data indicate that bisphenol A may be useful as a purity indicator for recycled paper.

Benzhydryl Compounds↗