Echocardiographic evaluation of tricuspid valve endocarditis: an M mode and two dimensional study

To investigate the reflex mechanisms of sighs (spontaneous large breaths) (VT greater than 2 X control VT) in infants, recordings of respiratory flow and tidal volume (VT) were made during sleep. The frequency of sighs was greater at 1 than at 5 days of age, while respiratory frequency and control VT did not change. Most sighs (93%) had a biphasic pattern of inspiratory flow characterized by an inspiratory duration nearly twice that of control breaths, with an abrupt change in flow rate halfway through inspiration. Interruption of ventilation (3-7 s of airway occlusion) appeared to generate a stimulus for biphasic sighs, since sighs occurred during the first breath after termination of airway occlusion more frequently after long than after brief occlusions. However, a biphasic inspiratory pattern in airway pressure was rarely observed while the airways were occluded, regardless of occlusion duration. This suggests that increase in lung volume during the initial part of the biphasic inspiration following occlusion is a stimulus for the second part. Thus the underlying reflex mechanism of sighs in human infants appears to be the same as occurs in the so-called Head's paradoxical response to lung inflation.     

Symptomatic gastroesophageal reflux: incidence and precipitating factors

The incidence and precipitating factors associated with symptomatic gastroesophageal reflux were evaluated by a questionnaire in 446 hospitalized and 558 nonhospitalized subjects. Of 385 control subjects 7% experienced heartburn daily, 14% noted heartburn weekly, and 15% experienced it once a month, giving a total of 36% of subjects having heartburn at least monthly. Daily heartburn occurred at a significantly greater (P less than 0.05) rate for 246 medical inpatients (14%) and for 121 patients seen in outpatient gastroenterological clinic (15%). Pregnant women seen in uncomplicated obstetrical clinic had symptoms of significantly greater (P less than 0.01) incidence: daily (25%) and at least once monthly (52%). Age, sex, or hospitalization did not significantly affect incidence. Fried foods, "spicy" foods, and alcohol were the most common precipitating factors.     

Methodological aspects of Klebsiella pneumoniae serotyping and its use for characterization of clinical isolates

The method for serological typing of Klebsiella pneumoniae making use of Russian commercial K-sera manufactured by the Ilya Metchnikoff firm has been used to characterize 85 strains isolated from newborns at an obstetrical hospital and department of newborn diseases and from children with acute enteric infections hospitalized at the hospital for infectious diseases. The authors emphasize that their methods of serotyping are to be accurately performed, specifically, the selection of capsular forms and identification of serovars in strains which can be agglutinated by several sera. Serovars were identified by the proposed serotyping method in 89.4% of the studied strains. A wide spectrum of K-serovars typical of this or that hospital has been defined for each institution. K. pneumoniae K2 predominated in the obstetrical hospital, K. pneumoniae K24 and K25 prevailed in department for newborn diseases, and the K14 variant in the infectious diseases hospital.