Wound photography: an alternate use.
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Aged↗
Biomedical subjects
A Barnard
Publications and source records attributed to A Barnard.
The reading habits of RACGP Training Program doctors.
AIM: To describe the reading habits of a cohort of Western Australian RACGP Training Program doctors undertaking general practice terms in 1992. METHOD: A questionnaire that included a list of journals and books relevant to general practice was distributed to trainees. Information obtained included demographic data, the frequency of journal reading and the number of books read. RESULTS: There were 68 respondents from a total of 100. Time spent in medical reading ranged from one to 12 hours per week, with a mean of 3.3. The number of journal titles read in the past six months ranged from three to 16. The number of books actually read (from the 39 titles presented) ranged from zero to 17. The most frequently read were the reference type books. Very few of the 'core' books about the nature, scope and philosophy of general practice had been read. CONCLUSIONS: RACGPTP doctors read mainly for information. To produce educated doctors knowledgeable about their chosen discipline, the Training Program will need to place greater emphasis on introducing their vocational trainees to the writings of the thinkers and philosophers of general practice and family medicine.
Adult↗
Cell-mediated immunity to Bordetella pertussis: role of Th1 cells in bacterial clearance in a murine respiratory infection model.
A murine respiratory infection model was used to study the mechanism of protective immunity to Bordetella pertussis. We found that nude mice, which are deficient in T cells, developed a persistent infection and failed to clear the bacteria after aerosol inoculation. In contrast, normal adult nonimmune mice cleared a respiratory infection approximately 35 days after challenge. Before bacterial clearance, antipertussis antibody levels in serum were low or undetectable, whereas consistent antigen-specific T-cell responses were demonstrated throughout the course of infection. The in vitro responses detected in immune spleen cells were mediated by a population of CD4+ major histocompatibility complex class II-restricted Th1-like cells that secreted interleukin-2 and gamma interferon but not interleukin-4. Adoptive transfer of immune spleen cells into nude or sublethally irradiated immunosuppressed mice before challenge resulted in bacterial clearance within 14 to 21 days. In contrast, injection of serum from convalescent mice before challenge only marginally reduced the bacterial load early in the course of infection. Furthermore, transfer of enriched T cells or purified CD4+ T cells but not CD8+ T cells from immune mice conferred a high level of protection. Recipients of CD4+ T cells cleared the bacteria from the lungs within 20 days of challenge, at which time B. pertussis-specific antibodies in the serum were undetectable. Although we do not rule out a contribution of mucosal immunoglobulin A, our findings suggest that cellular responses mediated by CD4+ Th1 cells play an important role in protective immunity to B. pertussis.
Animals↗
Effective immunization against Bordetella pertussis respiratory infection in mice is dependent on induction of cell-mediated immunity.
A murine respiratory challenge model was used to examine the induction of cellular and humoral immune responses and their role in protection against Bordetella pertussis following immunization or previous infection. Spleen cells from mice convalescing from a B. pertussis infection exhibited extensive in vitro T-cell proliferation and secreted high levels of interleukin-2 (IL-2) and gamma interferon but not IL-4 or IL-5, a cytokine profile typical of CD4+ Th1 cells. Serum from these mice had low or undetectable anti-B. pertussis antibody levels. In contrast, mice immunized with an acellular pertussis vaccine had high levels of B. pertussis antibodies and spleen cells secreting IL-5 but not gamma interferon, a profile characteristic of CD4+ Th2 cells. Immunization with an inactivated whole-cell vaccine induced both CD4+ Th1 and serum antibody responses. After exposure to a B. pertussis respiratory challenge, the convalescent mice and those immunized with the whole-cell vaccine eliminated the bacterial infection significantly faster than mice immunized with the acellular vaccine. These findings show that the selection of antigens and their form of presentation are important in determining whether the subsequent immune response is cellular, mediated by Th1 cells, or humoral, mediated by Th2 cells. In the murine model, the induction of a Th1-mediated cellular immune response appears to be a key element in acquired immunity to a B. pertussis infection.
Animals↗
Modelling net expenditure of hospitals in the Cape Province.
Modelling the net expenditure of provincial hospitals in the Cape Province during 1989/90 on the number of inpatient days and outpatient visits (emergencies included) showed that on average the cost of a single outpatient visit is equivalent to 43% of the cost of an inpatient day in small hospitals. In specialist and academic hospitals this proportion increases to 70%. The current proportion of 33% used in the standardisation of hospitals is therefore inadequate. Multiple regression can be used to estimate the expected net expenditure for each hospital, which can then be used as a reference value. The need for separate accounting and reporting of the expenditure on outpatients is identified.
Data Collection↗
The syndromic status of sclerosteosis and van Buchem disease.
We have examined 50 persons with sclerosteosis in the Afrikaner community of South Africa and 15 individuals with van Buchem disease in Holland. The clinical and radiographic manifestations of these conditions are very similar, the only notable differences being greater severity and syndactyly in the majority of the patients with sclerosteosis. The Afrikaners have Dutch antecedants and it seems likely that these autosomal recessive disorders result from homozygosity of the same faulty genes. The phenotypic variation may be due to the epistatic effect of modifying genes in the Afrikaner population.
Adult↗
Intracranial calcification in oculodento-osseous dysplasia.
Oculodento-osseous dysplasia (ODOD) is a rare genetic disorder characterized by microphthalmia, hypoplasia of the dental enamel, dysplastic and sclerotic changes in the skeleton and various digital malformations. The occurrence of basal ganglion calcification in this condition is of considerable interest, particularly as it has some biochemical features in common with hypoparathyroidism and pseudohypoparathyroidism. The 2 patients presented in this article did not show any features of an extrapyramidal disorder, but both experienced progressive spasticity in the limbs. The neurological disturbance was not due to compression of the neuraxis by bony overgrowth, but to an associated neurological lesion of undetermined nature. The biochemical abnormalities are discussed but as yet no explanation for the association between intracranial calcification and ODOD can be offered.
Abnormalities, Multiple↗
[Primary health care as an instrument of development in Mexico].
A Primary Health Care (PHC) score is obtained by averaging thirteen indicators of PHC of each state of Mexico with data of 1985. Some correlations between the PHC score with other indicators of development, such as education and urbanism, are analyzed. The socioeconomic and educational status of women impinge directly in the processes of PHC. Based upon results of basic research some features of coverage and selectivity of PHC strategies are analyzed.
Developing Countries↗
[The extension of health services coverage].
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Community Health Services↗