Nurses at risk for occupationally acquired blood-borne virus infection at a South African academic hospital

Aim. We aimed to ascertain if there had been any improvement in thenumber of nurses being immunised against hepatitis B virus (HBV) infection in a large academic hospital in which, 10 years previously,only 30.6% of the nurses were immune to infection with the virus,and to ascertain the incidence of infection with hepatitis C virus(HCV) and human immunodeficiency virus (HIV) in these nurses.Methods. We studied 170 predominantly black nurses.Their blood was tested for the presence of active or past HBVinfection using appropriate immunoassays, HCV infection bychromatographic immunoassays confirmed by polymerase chainreaction assays, and HIV using a rapid test confirmed by enzymelinkedimmunosorbent assays.Results. Serum of 89 (52.4%) nurses was positive for hepatitisB surface antibody (anti-HBs). Of these nurses 18 said that theyhad not received the vaccine; the serum of 9 of these was positivefor anti-hepatitis B core antibody (anti-HBc) as well as anti-HBs,indicating natural infection with the virus. Of the nurses positivefor anti-HBs, 89 were tested for anti-HBc; 28.2% tested positive foranti-HBc. Three nurses gave dates of immunisation that fell outsideof their nursing careers; 3 (1.8%) were actively infected with thevirus; 2 (1.8%) were infected with HCV; 10 nurses (5.9%) werepositive for HIV.Conclusion. Nurses at this academic hospital remain at high riskof work-related HBV infection

Circadian influences on myocardial infarction

Components of circadian rhythm maintenance, or “clock genes,� are endogenous entrainable oscillations of about 24 h that regulate biological processes and are found in the suprachaismatic nucleus (SCN) and many peripheral tissues, including the heart. They are influenced by external cues, or Zeitgebers, such as light and heat, and can influence such diverse phenomena as cytokine expression immune cells, metabolic activity of cardiac myocytes, and vasodilator regulation by vascular endothelial cells. While it is known that the central master clock in the SCN synchronizes peripheral physiologic rhythms, the mechanisms by which the information is transmitted are complex and may include hormonal, metabolic, and neuronal inputs. Whether circadian patterns are causally related to the observed periodicity of events, or whether they are simply epi-phenomena is not well established, but a few studies suggest that the circadian effects likely are real in their impact on myocardial infarct incidence. Cycle disturbances may be harbingers of predisposition and subsequent response to acute and chronic cardiac injury, and identifying the complex interactions of circadian rhythms and myocardial infarction may provide insights into possible preventative and therapeutic strategies for susceptible populations.ECU Open Access Publishing Support Fun