Primary antibody deficiency and diagnostic delay.

AIMS: To assess the occurrence of diagnostic delay in primary antibody deficiency in the period 1989-2002, since a similar study in 1989, and to assess the impact of UK national guidelines communicated in 1995. METHODS: A retrospective case note review was performed of 89 consecutive patients with antibody deficiency referred to a regional referral centre for clinical immunology in north west England and north Wales. The delay in diagnosis and the estimated resulting morbidity in terms of infections were assessed. RESULTS: Fifty six of the 89 patients experienced delay in diagnosis. The overall median delay was 2 years (mean, 4.4), resulting in substantial morbidity (equivalent to two major infections and one minor infection). This shows a moderate improvement since the previous study in 1989 and since the introduction of UK national guidelines in 1995. Respiratory infections are the most frequent presenting infections, and respiratory physicians the most common source of referral. CONCLUSIONS: There is still considerable delay in the diagnosis of primary antibody deficiency, but the data suggest an improvement in practice since the previous study in 1989 and the distribution of national guidelines in 1995.

Biomimetic mineral-protein composites formed by an automated alternate soaking process

Biomineralized composite materials found in nature have a compromise of good mechanical properties and relatively small embodied energies in the process of their formation. The Alternate Soaking Process (ASP) is a laboratory technique that has only recently been applied to replicating composite biomineralization. The nexus of the ASP - heterogeneous nucleation - makes it ideal for replicating biominerals where the mineral is templated onto an organic substrate, such as occurs in avian eggshell. Here we demonstrate the deposition of a calcium carbonate gelatin composite on either glass cover slips or demineralized eggshell membranes using an automated ASP. SEM images and FTIR spectra of the resulting mineral show that by altering the amount of gelatin in the growth solutions the final organic component can be controlled accurately in the range of 1-10%, similar to that of natural eggshell. This study shows for the first time the co-precipitation of a CaCO3 - gelatin composite by an ASP and that the organic fraction of this mineral can be tuned to mimic that of natural biomineralized composites. © 2012 Materials Research Society.