CDC ponders new HIV guidelines

Article Abstract:

A new version of a publication from the Centers for Disease Control (CDC), Recommendations for Prevention of HIV Transmission in Health-Care Settings, is under development. The revision must take into account the recent news about the apparent transmission of HIV (human immunodeficiency virus, which causes AIDS) from an infected dentist to a patient. A report is presented regarding a CDC Consultants' Meeting in August 1990 that addressed the issue of transmission of blood-borne pathogens (disease-causing agents) to patients during invasive medical procedures. Participants came from medical and dental associations, hospitals, governmental regulatory agencies, legal groups, labor, academia, and the armed services. Infection with hepatitis B was also discussed. A consensus emerged that HIV transmission from dentists or physicians to patients is bound to occur at some time. Concern regarding possible restrictions on procedures performed by health care professionals was at a high level. After two days of airing extreme and less extreme viewpoints, some conclusions emerged. Overall, the chances of a patient contracting HIV from a physician or dentist are very slight: assessment of risk should take this low probability into account. Follow-up of patients of surgeons who die of AIDS could provide valuable data on the extent of transmission. Everyone agreed that safer devices and instruments ('engineering controls') are needed. Attempts were made to define 'invasive procedure', and opinions regarding whether they should be performed by infected practitioners ranged from 'Never!' to 'Yes, if risk is carefully defined'. The group recognized the difficulties in restricting infected clinicians, if such a move were found to be justified. The subject is one that consumers and practitioners will always see differently, demonstrating the 'intrinsic conflict' between the two groups. (Consumer Summary produced by Reliance Medical Information, Inc.)

Conferences, meetings and seminars, Physicians, Medical professions, Employment, HIV infection, HIV infections, Diseases, Dentists, Disease transmission, Hepatitis B, Surgeons, United States. Centers for Disease Control and Prevention, AIDS virus carriers, HIV carriers

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Cerebral percutaneous transluminal angioplasty in second year of trials

Article Abstract:

Cerebral percutaneous transluminal angioplasty (PTCA) may be an effective, safe and fairly painless treatment for atherosclerosis of the vessels supplying blood to the brain. This procedure involves inserting a balloon-tipped catheter to widen the opening of a blood vessel that is blocked by atherosclerotic plaques. PTCA was used successfully to treat 127 patients between 35 and 80 years old who suffered transient ischemic attacks or strokes. It is a relatively inexpensive procedure that is simple to learn for many surgeons. Only 8% of patients who undergo PTCA re-develop blockage of the same blood vessel within one to two years, and the procedure can be repeated if necessary. Several medical centers are conducting clinical trials, or research studies involving patients, of PTCA. The use of a balloon catheter in also being investigated for treating a cerebral vasospasm, or contraction of blood vessels in the brain, after a blood vessel has ruptured.

Usage, Atherosclerosis, Cerebrovascular disease, Cerebrovascular disorders, Transluminal angioplasty, Balloon angioplasty

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Caring for all of those who fall in combat

Article Abstract:

The US army needs to develop safer anesthesia equipment for use during combat. The Ohmeda Portable Anesthesia Complete is a lightweight anesthesia device used by the army that allows a patient to draw in anesthesia without oxygen. But the Ohio 885A, a piece of anesthesia equipment that uses oxygen, is not considered safe enough for use in peace-time hospitals. During Desert Storm, the European and Canadian armies had better anesthesia and resuscitative equipment than the US army. The US army initially lacked essential medical equipment and many drugs. Many of the anesthesiologists who served in Desert Storm were citizen-soldiers from the Reserve or the National Guard, and they needed more training and experience in combat medicine. Many aspects of combat anesthesiology can be adapted for the treatment of trauma patients in civilian life.

Equipment and supplies, Surgery, Anesthesia, War wounds

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