Application of the readability concept to patient-oriented drug information.
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Biomedical subjects
Publications and source records attributed to A Myers.
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Osmotic and mechanical fragilities of erythrocytes were determined for seven goats having 3.4-71 per cent fusiform erythrocytes. The osmotic fragility was related to the erythrocyte shape in that the osmotic resistance was considerably higher for bloods containing more than 26 per cent fusiform erythrocytes. A decrease in the proportion of fusiform erythrocytes in the same goats was related to an increase in the osmotic fragility. Anaemia was induced in two goats by removal of 200-400 ml of blood at three or four day intervals for eight weeks. Red cell values decreased by 28-43 per cent within three weeks, but further bleeding produced either no or less (0-21 per cent) reductions in these values. Slight reticulocytosis was seen during the anaemic phase and there was a concomitant increase in the mean corpuscular volume and mean corpuscular haemoglobin values. Reticulocytosis diminished before the start of recovery from anaemia and disappeared during the recovery phase. The most significant finding was the change in the erythrocyte morphology during production of and recovery from anaemia. The development of anaemia was associated with a gradual reduction in the proportion of fusiform erythrocytes or discoid cells and simultaneous increase in the proportion of erythrocytes exhibiting distinct poikilocytosis. Recovery from the anaemia was rapid (within five weeks), but reversal of the erythrocyte shape took several months. Severe blood loss anaemia in the goat is known to induce synthesis of haemoglobin C, and in these anaemic goats formation of a new haemoglobin, most likely haemoglobin C, was demonstrated by electrophoretic and column chromatographic analyses. It was concluded that the formation of haemoglobin C was responsible for the morphological changes in the erythrocytes.
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Multiple myeloma commonly produces neurologic symptoms when it involves the cranium or vertebrae, but rarely invades the CNS or meninges. Intracranial or intraspinal myeloma without lesions in the adjacent bone is extremely rare. To our knowledge, there are only ten reported cases of isolated myeloma in dura and/or brain, and only two limited to the leptomeninges. We wish to report the third case of isolated leptomeningeal myeloma. Both myeloma cells and abnormal globulins were present in the CSF, but absent from serum and bone marrow. Analysis of these 13 cases in dura, brain, or leptomeninges strongly supports the concept that abnormal proteins do not reach the CSF from the serum but are produced by myeloma cells in situ.
We report a case in whom there was right ventricular outflow tract obstruction by a solitary metastatic deposit from an ovarian primary. The patient presented with signs of right ventricular overload and the outflow tract obstruction was recognised at cardiac catheterisation, but the final diagnosis was only revealed at necropsy.
Seventy-eight clinically euthyroid patients with atrial dysrhythmias, either established or paroxysmal, and sixty-three patients in sinus rhythm with coronary disease were screened for hyperthyroidism using thyroid function tests including the thyroid-stimulating hormone (TSH) response to thyrotrophin-releasing hormone (TRH). All had normal levels of serum thyroxine (T4) apart from three with dysrhythmias who were found to have hyperthyroidism. Twenty per cent of patients with atrial dysrhythmias and 10% of those in sinus rhythm had exaggerated TSH response to TRH. Thirty-six per cent of patients with an exaggerated response of TSH to TRH had significant titres of thyroid auto-antibodies compared with 15% with positive antibodies in those with normal TSH response to TRH. Auto-immune thyroid disease may be more closely related to heart disease than has previously been recognized. Rapid atrial dysrhythmias may occur in the presence of a normal serum thyroxine, high levels of TSH and positive thyroid antibodies.
It was hypothesized that older and more cognitively developed children would be less likely to use both attributive and contrast projection. Real and ambiguous target figures were used to assess the effect of the type of target on projection. 30 boys and 31 girls between the ages of 7 yr., 10 mo. and 14 yr., 10 mo. predicted a favored classmate's preferences in each of several categories. They also predicted the preferences of an unfavored classmate and of favored and unfavored ambiguous targets. These predictions were compared with the subjects' own preferences to measure attributive and contrast projection. Type of target affected the amount of projection. There was significantly more contrast projection onto ambiguous targets (dolls) than onto real targets (classmates). There was significantly more attributive than contrast projection for the real targets only. A significant negative correlation of -.26 (df = 59) was obtained between age and contrast projection onto the real targets. There were no significant correlations between the other measures of projection and the indices of cognitive ability, including age.
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The time intervals between spontaneous behaviors of 209 infants were tallied. The frequency distributions of time intervals between spontaneous behaviors showed that behaviors were usually spaced closely in time. However, none of the spontaneous behaviors occurred with a set interval between successive behaviors. All spontaneous behaviors conformed to a single pattern of temporal organization, regardless of the particular behaviors displayed, the infant's sex, or sleep state. The pattern approximated a systematic alternation of periods of increasing and decreasing time intervals between successive behaviors. These data conflict with Wolff's theory of neural discharge but support Wolff's hypothesis about substitution.
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A new genetic variant of the red cell enzyme glucose-6-phosphate dehydrogenase is described. It was observed in a patient presenting with severe haemolytic anaemia and renal failure following ingestion of an overdose of Beserol (paracetamol and chlormezanone). The enzyme in the red cell had 12% of the activity of a normal B+ control, but only slightly lower activity in the kidney compared with a normal control. The red cell enzyme showed normal electrophoretic mobility and thermostability, a biphasic pH optimum curve, higher than normal utilization of the substrate analogues 2-deoxy-glucose-6-phosphate and deamino-NADP, and lower than normal Michaelis constants for both substrates, glucose-6-phosphate and NADP. The enzyme was strongly inhibited in vitro by high concentrations of paracetamol and chlormezanone. The extent of inhibition was similar to that for the enzyme from a normal B+ individual.
The deaths of 100 men due to coronary artery disease which occurred so suddenly and unexpectedly as to merit a coroner's necropsy have been studied, with special reference to the exact circumstances of their occurrence. The most significant relationship of sudden death was with acute psychological stress. Moderate physical activity, the time of day, the day of the week, and a recent meal, especially if accompanied by alcohol, were also significantly related. Very strenuous exercise, the season of the year, the environmental temperature or recent change of it, and chronic psychological stress were not so related. Neither were the actual smoking of a cigarette nor the composition of the meal immediately preceding death. Compared with previous series of proved acute myocardial infarction the necropsies in these cases showed that the right coronary artery had been recently occluded by a thrombus more often than the left anterior descending. Stenosis or occlusion of the right coronary artery bore a significant relation to the suddenness of death. Special analysis of the 52 cases in which neither recent thrombus nor infarction were found did not disclose any circumstances attending death which differed from the remainder. Some comparisons are made with the circumstances attending the onset of symptoms in 100 men studied while recovering from an acute myocardial infarct.
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