The regulation of an age-structured population by a fatal disease

A model describing the effect of a fatal disease on an age-structured population which would otherwise grow is presented and analysed. If the disease is capable of regulating host numbers, there is an endemic steady age distribution (SAD), for which an analytic expression is obtained under some simplifying assumptions. The ability of the disease to regulate the population depends on a parameter R(alpha), which is defined in terms of the given age-dependent birth and death rates, and where alpha is the age-dependent disease-induced death rate. If R(alpha) < 1 the endemic SAD is attained, while R(alpha) > 1 means the disease cannot control the population's size. The number R(0) is the expected number of offspring produced by each individual in the absence of the disease; for a growing population we require R(0) > 1. A stability analysis is also performed and it is conjectured that the endemic SAD is locally asymptotically stable whenever it is attained. This is demonstrated explicitly for a very simple example where all rates are taken as constant.     

The Boulder model's fatal flaw.

The author argues that the Boulder model contained a fatal flaw that has distorted and damaged the development of clinical psychology ever since. It is suggested that the uncritical acceptance of the medical model, the organic explanation of mental disorders, with psychiatric hegemony, medical concepts, and language was the fatal flaw. The author contends that after World War II, psychologists were needed to provide psychiatric services for the vast number of veterans needing interventions for mental and emotional disorders. He maintains that by placing psychology graduate students in psychiatric settings for training and service, psychologists lost their students to the invalid, ideological tattered, often incompetent psychiatric worldview. In addition, the author suggests that there are major political differences between a medical/organic/brain-defect model to explain mental disorders and a social-learning, stress-related model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biochemical diagnosis of a fatal case of Günther''s disease in a newborn with hydrops foetalis

Immunohistochemical and flow cytometric multiparameter analysis of proliferating cell nuclear antigen (PCNA) was performed on fifteen formalin fixed, paraffin embedded lymph nodes with malignant lymphoma (eleven non-Hodgkin's lymphomas, four Hodgkin's lymphomas), and fifteen lymph nodes with metastatic carcinomas. A general concordance between PCNA measurement by both methods has been observed: the percentage of positively stained cells in tissue sections correlated well with the percentage of cells expressing this antigen in cell suspensions (r = 0.76). Both diploid and aneuploid tumors expressed PCNA, and a correlation between PCNA and the percent cells in S-phase was evident in both: in PCNA-positive tumors the mean percent of cells in S-phase was 16.5%, and in PCNA-negative tumors, 5.9%. The data indicate that PCNA can be detected in formalin-fixed tissues by either classic immunohistochemical analysis or by flow cytometry.     

A fatal case of alimemazine poisoning

The genetic diversity of two samples of Cestoda (Bothriocephalus funiculus, Renaud and Gabrion, 1984) parasitizing two sympatric teleostean species was assessed using random amplified polymorphic DNA (RAPD). A total of 72 Bothriocephalus were analyzed individually, and electrophoretic analysis of the amplification products of 65 primers among the 68 tested revealed monomorphic patterns, reflecting the close genetic relatedness within and between the parasites of the two samples. However, 3 primers showed polymorphic patterns at 6 RAPD sites. Analysis of the distribution of these genomic fragments, assuming random mating, showed strong linkage disequilibria (only 8 genetic combinations were observed among the 32 expected). Two genetic entities displaying a high degree of host specificity were evidenced within our two samples of funiculus. This powerful molecular technique can be used as a diagnostic tool in studies concerning the biodiversity of related genetic entities and could have broad applications in parasitology.     

An audit of fatal acute pancreatitis

Acute pancreatitis has a mortality of about 10%: this figure has not changed over the last 20 years. A retrospective audit of fatal acute pancreatitis was performed in a teaching hospital with a catchment population of about 750,000 patients to examine patient characteristics. Using Hospital Activity Analysis code 577.0, all fatal cases of acute pancreatitis were studied in a six-year period 1987-93. Additionally, all post mortem diagnoses of acute pancreatitis were traced. The overall post mortem rate in Nottingham at the time of the study was about 35%. All available records, X-ray and biochemical data were studied and appropriate information recorded and analysed for 65 fatal cases. Only 15% were post mortem diagnoses, lower than in previous series; 72% had respiratory and 67% had renal complications. Only 34% had been admitted to the intensive care unit. A third of patients had had surgery; 67% of these was some form of external drainage. Of the 14 patients with proven gallstone pancreatitis only three had endoscopic retrograde cholangiopancreatography; 42% of patients had idiopathic disease. Not all the patients diagnosed ante mortem had the full biochemical predicted severity criteria analysed: pO2 and calcium analysis was performed in about 80%. Pre-mortem diagnoses of pancreatitis was achieved more frequently than in other comparable series.     

A fatal case of benzene poisoning

Chronic effects following repeated exposure to low doses of benzene have been well assessed, whereas few data are available about acute exposure to benzene. We report a case of fatal acute intoxication which occurred aboard a chemical cargo ship. Autopsy findings included blood clots inside the heart and main vessels, multi-organ congestion, pulmonary edema and the presence of many vibices in the hypostatic areas. Toxicological analysis of blood and urine showed a benzene concentration of 31.67 and 2.26 micrograms/mL, respectively; high concentrations of benzene (microgram/g) were also found in the lungs (22.23), liver (378.60), brain (178.66), heart (182.57) and kidneys (75.15). The above data provide evidence for benzene distribution in various organs.     

Felbamate-associated fatal acute hepatic necrosis

Thirty-six cases of hepatic toxicity associated with felbamate therapy have been collected by the Food and Drug Administration. Five patients died. We describe a case of massive acute hepatic necrosis and death within 40 days of initiation of felbamate therapy for a generalized tonic-clonic seizure disorder. We describe the clinical and histopathologic features.     

The alcoholized pedestrian as victim of fatal traffic accidents (author's transl)

The following results were obtained in an analysis of the road accidents which occurred in Vienna and its environs over the past ten years with a fatal outcome for the involved pedestrians: 39.3% of the pedestrains who died in an accident had a blood alcohol concentration of at least 0.8%, the average amounting to 2.15%. As many as 60.2% of the male victims were alcoholized, whereas only 7.6% of the women were alcoholized. The female victims were mostly elderly, 86% being older than 60 years, whereas many of the male victims were middle-aged. These middle-aged male pedestrians were frequently drunk; among the men aged between 40 and 49 the rate of alcoholization soared to 88%. The peak time of fatal traffic accidents involving alcoholized pedestrians lies in the hours before midnight. The number of pensioners among the sober victims is raised in comparison with the population rate, whilst an unexpectedly high percentage of unskilled workers found in the alcoholized group. In 7.6% of the alcoholized victime the autopsy revealed cirrhosis of the liver; 27.1% had fatty degeneration of the liver. Nearly as many female pedestrians met with a fatal road accident as males within the city boundaries. Accordingly, the percentage of alcoholized victims in the city (31.7%) is low compared with the rural areas, where about 60% of the victims had a blood alcohol concentration of at least 0.8%.     

Accidental acute fatal sodium nitrite poisoning

OBJECTIVES: To report two patients who developed reactive arthritis in association with Staphylococcus aureus infection. METHODS: A review of the case notes of two patients. RESULTS: Two adult female patients have developed sterile arthritis in association with Staph aureus infection. The first patient has had two episodes of arthritis; the first followed olecranon bursitis, the second followed infection of a central venous catheter used for dialysis. The second patient developed sterile arthritis while being treated for pyomyositis. Both patients had a self limited arthritis and were HLA-B27 negative. CONCLUSION: Reactive arthritis may rarely follow Staph aureus infection. HLA-B27 negativity may be associated with a self limited arthritis in these cases.     

Effect of vitamin E and beta carotene on the incidence of primary nonfatal myocardial infarction and fatal coronary heart disease

BACKGROUND: Oxidized low-density lipoprotein is involved in the pathogenesis of atherosclerosis. In epidemiological studies antioxidants have been inversely related with coronary heart disease. Findings from controlled trials are inconclusive. METHODS: We studied the primary preventive effect of vitamin E (alpha tocopherol) and beta carotene supplementation on major coronary events in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, a controlled trial undertaken primarily to examine the effects of these agents on cancer. A total of 27 271 Finnish male smokers aged 50 to 69 years with no history of myocardial infarction were randomly assigned to receive vitamin E (50 mg), beta carotene (20 mg), both agents, or placebo daily for 5 to 8 years (median, 6.1 years). The end point was the first major coronary event, either nonfatal myocardial infarction (surviving at least 28 days; n = 1204) or fatal coronary heart disease (n = 907). RESULTS: The incidence of primary major coronary events decreased 4% (95% confidence interval, -12% to 4%) among recipients of vitamin E and increased 1% (95% confidence interval, -7% to 10%) among recipients of beta carotene compared with the respective nonrecipients. Neither agent affected the incidence of nonfatal myocardial infarction. Supplementation with vitamin E decreased the incidence of fatal coronary heart disease by 8% (95% confidence interval, -19% to 5%), but beta carotene had no effect on this end point. CONCLUSIONS: Supplementation with a small dose of vitamin E has only marginal effect on the incidence of fatal coronary heart disease in male smokers with no history of myocardial infarction, but no influence on nonfatal myocardial infarction. Supplementation with beta carotene has no primary preventive effect on major coronary events.     

Necropsy findings in fatal hypothermia cases

A series of 22 cases of fatal accidental or suicidal hypothermia is presented. Necropsy findings on which the diagnosis can be based were analysed. Purple skin and swelling of face, hands and feet, as well as violet patches on elbows or knees were the most frequent external signs (Frequency 54--59%). The most conspicuous internal macroscopic signs were gastric erosions or haemorrhages, which were seen in half of the cases. Other less frequent signs were pulmonary oedema and acute renal and hepatic degeneration. Microscopically the myocardium showed small degenerative foci and/or fuchsinophilic fibres in two thirds of the cases. The myocardium was macroscopically normal. Histamine and serotonin assays from urine did not indicate increased excretion during exposure. Catecholamine concentrations in urine were high (greater than 0.1 mug/ml) in most hypothermia deaths indicating increased excretion due to cold. The best diagnostic signs seem to be purple skin and oedema in face and ears, stomach erosions, degenerative foci in myocardium and high concentration of catecholamines in the urine.     

Acute cocaine intoxication with fatal outcome

The clinical course and some toxicologic-analytical aspects of an acute intoxication with cocaine are presented. Diagnosis was made by the induced toxicologic emergency investigation since neither symptoms nor clinical test results or anamnestic data showed relevant diagnostic information. Based on the results of the analytic investigation, we concluded it was a suicide based on long-term abuse of cocaine. Because of the unusually high concentrations of cocaine und cocaine metabolites in the body of liquids and tissues, it seemed probable that the patient was intoxicated with a lethal dose of at least 1 g cocaine. This case report underlines the importance of clinical and toxicological investigations in the diagnostic procedure of unclear comata and the importance of forensic toxicological analysis in clarifying anamnestic questions.     

Orbital aspergillosis. A fatal masquerader

The limited contribution of nursing research and the utilisation of research findings in the field of bone marrow transplantation (BMT) in Europe have been identified as issues needing further attention. Reasons behind these issues include the lack of nursing training in research techniques, problems with funding nursing research, staff shortages and language barriers. An overall research strategy for nurses has been suggested as well as academic research support for those nurses who do not feel confident carrying out research projects. A small scale study in four European BMT centres identified that the main nursing research priorities included isolation techniques, psychosocial and quality of life issues, staff issues, central line catheter care and mouth care/management of oral mucositis. The same study also showed that only 20% of the BMT units regularly use research and research findings in their day-to-day nursing practice.     

Neuronal apoptosis in fatal familial insomnia

BACKGROUND: Neurobehavioral symptoms have been reported anecdotally with aspartame. OBJECTIVE: This study sought to determine whether aspartame can disrupt cognitive, neurophysiologic, or behavioral functioning in normal individuals. DESIGN: Forty-eight healthy volunteers completed a randomized, double-blind, placebo-controlled, crossover study. The first month was aspartame free. Subjects then consumed sodas and capsules with placebo, aspartame, or sucrose for 20 d each. Order was randomized and subjects were assigned to either a high- (45 mg x kg body wt(-1) x d(-1)) or low- (15 mg x kg body wt(-1) x d(-1)) dose aspartame group. Neuropsychologic and laboratory testing was done on day 10 of each treatment period to determine possible acute effects and on day 20 for possible chronic effects. RESULTS: Plasma phenylalanine concentrations increased significantly during aspartame treatment. Neuropsychologic results; adverse experiences; amino acid, insulin, and glucose values; and electroencephalograms were compared by sex and by treatment. No significant differences were found for any dependent measure. CONCLUSION: Large daily doses of aspartame had no effect on neuropsychologic, neurophysiologic, or behavioral functioning in healthy young adults.