The Canadian influenza decision, 1976

This paper explains the Canadian decision process following the isolation and identification of A/New Jersey/8/76 at Fort Dix, New Jersey in February 1976. The cause for concern was the emergence of a swine-like strain related to that which caused the 1918-19 pandemic, together with proved man-to-man transmission. This concern was reinforced since all new influenza A strains known to have infected the number of persons involved at Fort Dix have become strains of epidemic importance. The Fort Dix outbreak gave sufficient warning to allow implementation of a national vaccination program, to prevent and protect against influenza. In the past such an opportunity had not occurred, and vaccine use had, at best, constituted an intervention in the course of an outbreak. The National Advisory Committee on Immunizing Agents had all available information when it reached its decision to recommend vaccination with bivalent (A/Victoria and A/New Jersey) or with monovalent (A/New Jersey) vaccine for selective, high-risk groups. This was an independent, scientifically based decision.     

Adolescent development and family characteristics associated with a diagnosis of schizophrenia

Studied persons who had initially been referred to a psychiatric hospital during adolescence (between 1938 and 1950) and who had at some time received a diagnosis of schizophrenia. Those who received an adolescent diagnosis of schizophrenia were divided into poor and favorable adult-outcome groups. Cases with subsequent adult onset of schizophrenia were classified according to prior clinical history. Three adult onset groups with neurotic, acting-out, and manic-depressive components were indicated. Comparisons among groups suggested the existence of a purely schizophrenic group (relative absence of nonschizophrenic psychopathology) including both patients and families in the poor-outcome adolescent-onset cases. The group with acting out in adolescence and a schizophrenic diagnosis as adults was most distinct. Family comparisons indicated a more mixed clinical picture for this group with a combination of psychosis, mental deficiency, acting out, alcoholism, broken homes, and parental neglect. This pattern was not typical for the other groups. Different developmental patterns and family characteristics indicated within-sample differences that suggest more homogeneous subgroups beyond common prognostic discriminations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Levels of prostaglandins in the small intestine of rats during primary and secondary infection with Nippostrongylus brasiliensis

The level of PGE is increased 10-fold in intestinal tissues during primary infection of the rat with Nippostrongylus brasiliensis. Peak levels (ca. 7,000 pg/cm) were assayed in the jejunal site of infection on day 7 of infection and similar levels were recorded in 'post-infection' (ileal) segments at this time. The level of PGE in 'post-infection' segments showed further increase to 12,000 pg/cm on day 10. The level of PGE also increased in 'pre-infection' (duodenal) but this was delayed by 4-5 days. The level of PGF also increased during primary infection (from about 100 to 950 pg/cm) but this occurred after expulsion. Increase in the level of PGE occurred earlier (at 3-4 days) during secondary challenge given 19 days after primary infection, but the PGE levels followed the primary response when challenge was given 10 weeks after primary infection. It is suggested that PGE plays a dual role in parasite immunity. (1) PGE may directly affect metabolism of the parasite. In this event it is also suggested that protective antibodies cause the release of PG. (2) Elevated levels of PGE act indirectly by affecting gastrointestinal function which alters the microenvironment at the site of infection. The duodenal migration of parasites may be due to this effect of PGE.     

The behavior of hypersexual delinquent girls

The author presents case reports of seven girls with histories of hypersexual behavior associated with delinquency, aggressive behavior, and hypomania. Six of the girls had been exposed to virilizing hormones in utero or in childhood. Most of the girls in the sample were hirsute, tended toward mesomorphic build, and had been young at menarche. The author postulates that exposure to virilizing hormones can result in the kind of hypersexuality and delinquent behavior observed in his sample; he points out the need for adequate medical attention to this type of patient.     

Cost of management of patients with haemophilia

The cost of managing 114 adult haemophiliacs in the west of Scotland was assessed for the period 1 March 1971 to 28 February 1974. Altogether 23 of them (20%) accounted for 80% of the resources used. The cost of hospital treatment of these patients during the period was compared with the predicted cost of home treatment, given the availability of freeze-dried factor VIII concentrate in sufficient amounts. We calculate that adequate on-demand home treatment would cost only 16% more than the present treatment, which is substantially less efficient.     

Emergency open lung biopsy

Twenty-eight patients underwent open lung biopsy on an emergency basis. The clinical course in each case was deteriorating rapidly, and all were in respiratory failure. The correct diagnosis was established in 96% of the biopsies (27 of the 28 patients). The clinical diagnosis prior to biopsy was in error or incomplete in 15 (55%) of the patients. Specific therapy was lifesaving in 12 of the 28 patients. The value of the procedure outweighed the complications. Thrombocytopenia and positive end-expiratory pressure ventilation were not contraindications to biopsy.     

NIH funding and biomedical publication output

An investigation of the relationship between NIH funding and biomedical publication output is reported for 229 major NIH supported institutions. A correlation of 0.95 was found between the amount of NIH funding and the number biomedical publications for 132 U.S. universities. For 52 hospitals a correlation of 0.89 was found. For all 229 institutions it was found that NIH provided 91% of the boimedical research support from major federal agencies, and more than half of the total extramural biomedical research support. There was no indication of either economies or diseconomies of scale in the number of publications produced by the institutions, which ranged from a few publications per year to over 700 per year.     

Althesin infusion for cardiac catheterisation

A trial of a continuous intravenous infusion of Althesin is described for sedation during cardiac catheterisation, both for children and adults. The conditions produced for the procedure were very satisfactory. The advantages and problems of its use are discussed. The technique justifies further trials.     

Murine model for human secondary amyloidosis: genetic variability of the acute-phase serum protein SAA response to endotoxins and casein

The serum precursor SAA of the secondary amyloid protein AA has been detected by solid-phase radioimmunoassay as a normal serum alpha-globulin of mol wt 160,000, which dissociates to a more stable 12,500 dalton moiety on treatment with formic acid. In 12 strains of mice, including T-cell-deficient nude mice, treated with the amyloid-inducing agents lipopolysaccharide (LPS) or casein, SAA behaved as an acute-phase reactant. SAA concentration rose to about 750 mug/ml by 24 h and returned to less than 1 mug/ml by 48 h. Since the amyloid-resistant colchicine-treated mice and AJ mice had a normal SAA response to LPS, it appears that their resistance to amyloid induction is due to the nature of their SAA processing rather than decreased SAA production. C3H/HeJ mice, which have defective B-lymphocyte responses to LPS, required extremely high dosages of LPS to cause SAA elevation, although their SAA response to casein was normal. This suggests that SAA is an acute-phase protein produced as a result of B-lymphocyte stimulation. Preliminary evidence suggests that at the height of an acute SAA response, liver homogenates are particularly rich in protein AA cross-reacting material.