Influenza surveillance in England and Wales: October 1995 to June 1996

This report summarises information collected for the surveillance of influenza virus infection in England and Wales from October 1995 to June 1996 (weeks 40/95 to 25/96). Total respiratory disease' activity, as reported by the Birmingham Research Unit of the Royal College of General Practitioners, rose to peaks in weeks 48/95, 51/95, and 01/96. The first peak coincided with a peak in "influenza and flu-like illness'. The subsequent peaks were accounted for by an increase in reports of acute bronchitis, including bronchiolitis, and may have been associated with the annual rise in infections with respiratory syncytial virus. Influenza A virus was responsible for most infections, with moderate activity occurring in the early part of the winter, peaking in December (week 48/95). Influenza A subtype H3N2 predominated until week 07/96, after which subtype H1N1 accounted for most infections. Influenza activity was first seen in central and northern England, followed by the south of England, Wales, and Scotland. Circulating influenza viruses were antigenically similar to the components of the 1995/96 vaccine. International surveillance during 1995/96 has led to a different H3N2 component being included in the influenza vaccine recommended for 1996/97.     

Influenza surveillance in England and Wales: October 1996 to June 1997

This report summarises information collected for the surveillance of influenza in England and Wales during the winter of 1996/97. Consultations for 'influenza and influenza-like illness' with sentinel general practitioners in England and Wales began to increase towards the end of November and peaked at the start of January. In England, consultations for 'aggregated respiratory disease' (ARD) began to increase a little earlier, perhaps as a result of increased respiratory syncytial virus activity, but also peaked in early January. Influenza A (H3N2) viruses were first detected in early October, but rarely until November, and activity peaked in early January, coinciding with the peak in consultations for flu-like illness. A few influenza B viruses were detected in late November and early December, and substantial activity was recorded in mid-January. Approximately equal numbers of influenza A(H3N2) and B viruses were identified over the winter as a whole, and circulating strains were antigenically similar to those included in the vaccine for 1996/97. Although influenza activity was 'moderate' in terms of consultations and laboratory confirmed infections, a large peak in death registrations occurred at the same time as influenza A(H3N2) virus activity peaked. The number of deaths during the winter was similar to that seen in 1989/90, when the last severe influenza epidemic occurred in England and Wales.     

Catecholamine-induced muscle weakness

Infusions of epinephrine or levarterenol bitartrate into a rabbit nerve-muscle preparation decreased the force of the evoked twitch of anterior tibial and gastrocnemius-soleus muscles. The adverse effect of the catecholamines was not directly on skeletal muscle. The alpha-receptor blocking drug phenoxybenzamine hydrochloride prevented the adverse effect of the catecholamines if it was given prior to catecholamine infusions and unmasked a weak augmentation of twitch tension. Taken with the finding of abnormal accumulation of catecholamine in human dystrophic muscles, the production of an experimental myopathy resembling human dystrophy by the monoamine oxidase inhibitor pargyline hydrochloride, and the finding of excessive levels of catecholamines in the tissues and urine of dystrophic animals, these experiments support the hypothesis that catecholamines could play a pathogenetic role in some dystrophic diseases of muscle.     

The DSM's theory-neutral nosology is scientifically progressive: Response to Follette and Houts (1996).

W. C. Follette and A. C. Houts (1996) argued on philosophy-of-science grounds that the Diagnostic and Statistical Manual of Mental Disorders (DSM) is scientifically unprogressive and should be replaced by competing theory-laden manuals. The author responds to their various arguments as follows: (a) The ways things can go wrong with the mind are inherently diverse, so failure to reduce the DSM's categories to 1 parsimonious theory is not necessarily scientifically unprogressive; (b) it is empirically untrue that growth in the number of a taxonomy's categories is inconsistent with scientific progress; (c) progress in theoretically fragmented fields requires shared theory-neutral categories, not theory-laden definitions of basic concepts; (d) at present in the mental health field, theoretical integration is scientifically more progressive than competition, and integration is promoted by the DSM's theory-neutral nosology; and (e) FoIlette and Houts's proposed behaviorist alternative to the DSM is incoherent. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Generalized weakness in pre-existing achalasia

Several endoscopic dilatations of the distal esophagus had been performed on this 77 year old woman with achalasia and secondary epiphrenic diverticulum. At present, swallowing was not essentially hampered and the body weight was stable. She was admitted for general weakness and a fall. The investigations revealed a traumatic pelvic fracture, as well as microcytic hypochromic anemia and marked hypoproteinemia. Endoscopy of the upper gastrointestinal tract showed an extreme inflammatory reaction of the mucosa. It was postulated that bacterial overgrowth had spread from the esophageal diverticulum to the upper intestinal tract and induced infectious anemia and protein-loosing enteropathy. Anemia and hypoproteinemia responded well to a treatment with cotrimotazole but relapsed after discontinuation of the antibiotics.     

Interdisciplinary forum: from Genetic Diagnosis to Gene Therapy in Oncology. 26 September-1 October, 1996, Madrid, Spain

Alzheimer's disease (AD) represents a heterogeneous disorder, and several factors have been associated with its development. The presence of the apolipoprotein E type (APOE) epsilon 4 allele has been proposed as a risk factor for AD, but how it influences the development of the characteristic hallmarks of the disease remains unknown. In the present study, the neuropathological changes and levels of both core PHF-tau and normal tau protein in 4 neocortical areas, cerebellum and medial temporal cortex were determined in 18 AD cases. The extent of these changes was compared between 10 cases possessing an epsilon 4 allele and 8 cases without. These two groups were indistinguishable in terms of neurofibrillary pathology, whereas cases with an epsilon 4 allele had more diffuse plaques, particularly in the temporal neocortex. Biochemically, there was no difference in the levels of PHF-tau protein between the two groups. These data indicate that APOE epsilon 4 allele may influence deposition of diffuse amyloid, but altered tau protein processing, which underlies the development of the neurofibrillary pathology in AD, is not influenced by this allele.     

Isolated triceps weakness in exercise-induced radial neuropathy

OBJECTIVE: We report a case of isolated triceps weakness resulting from radial neuropathy. PATIENT: A middle-aged healthy man, a keen athlete, developed acute weakness of the triceps brachii muscle due to radial neuropathy. No other radial nerve innervated muscles were involved. Triceps function completely recovered in six weeks clinically and electrophysiologically suggesting focal conduction block secondary to demyelination. DISCUSSION: Acute radial neuropathy after strenuous arm exercise resulting from a compression lesion with acute conduction block, has been previously described. However, all reported cases involved severe weakness of radial nerve innervated distal muscles with wrist drop, while isolated weakness of the triceps brachii muscle in radial neuropathy has never been previously described. CONCLUSIONS: We suggest that selective weakness in the triceps could be the sole manifestation of an exercise-related radial neuropathy. This particular type of radial neuropathy could be a variant of neuralgic amyotrophy.     

Coronary intervention 1996

BACKGROUND AND OBJECTIVES: This study sought to determine whether the number of alcohol-containing beverages consumed by adolescents attending a "typical" high school weekend party was planned or spontaneous. A second objective was to understand the role of the designated driver and whether he or she honored a pledge of sobriety. METHODS: A printed, anonymous survey with signed informed consent was distributed to 52 high school students from three different suburban high schools during three weekend high school parties. In addition, subjects underwent breath alcohol testing using the Intoximeter breath alcohol instrument. Salivary alcohol measurements were also obtained using Alco-Screen. Levels were measured in volunteers on entry and exit from the party. RESULTS: Fifty-two students volunteered to participate in the survey. Eleven participants volunteered to be designated drivers, nine of whom did not drink alcohol at this party. By the end of each party, the 26 boys had consumed a mean of 10 drinks, and the 16 girls had consumed 4.1 drinks, almost exactly what they had predicted at the time of arrival. By departure time, 22 (54%) of the drinkers had a breath alcohol value of .10 g/dL or greater, while only three (7%), had alcohol values of .02 g/dL or less. Blackouts were common and had been experienced by 73% of all the students surveyed. Twenty-seven percent of those surveyed had been involved in some form of physical violence while drinking. Eleven percent of the female participants reported being sexually assaulted while they or their attacker were drunk. Most of the 42 drinkers believed that it was acceptable for designated drivers to drink at least two beers. Two intoxicated designated drivers were driven home by sober friends. CONCLUSIONS: High school students in this study knew before attending a party the quantity of beer they would consume. Survey participants believed that it is acceptable practice for designated drivers to drink alcohol at parties; 13% of those who intended to drive after these parties were intoxicated.