Primary changes of voltage responses during retention of associative learning.
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Biomedical subjects
Publications and source records attributed to A West.
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Malnutrition has been linked in field studies with increased susceptibility to infection, often associated with severe marasmus or kwashiorkor. However, studies by Jose and colleagues revealed an apparent paradox: while B-cell immunity was decreased by chronic moderate malnutrition, several aspects of T-cell immunity were enhanced. In extensive experimental studies we have analyzed the effects of dietary restriction in immunologic function and development of disease. Our investigations may be grouped into three related areas. 1) Differential effects of protein or protein-calorie malnutrition on B-cell and T-cell immunity. While antibody-mediated immunity was impaired in animals moderately restricted with respect to protein or total calories, several T-cell functions were consistently enhanced in mice, rats, guinea pigs, and monkeys. 2) Influence of restricting a single nutritional element, the trace metal zinc, on immunologic function. Zinc deficiency produces progressive thymic involution and a progressive loss of T-cell immunity functions in mice and rats. While congenital failure to absorb this element normally is the single cause of hereditary acrodermatitis enteropathica, a frequently lethal disease both in humans and in cattle, acrodermatitis enteropathica has also been linked with common variable immunodeficiency disease, total parenteral alimentation with preparations lacking zinc, several forms of cancer, marasmus, and kwashiorkor. 3) Inhibition by dietary restriction of development of the diseases of aging. Disorganization of thymus-derived immunity, and development with aging of genetically determined diseases in several strains of mice, can be sharply curtailed or even prevented by reducing the intake of total calories or fat. Similarly, development of mammary cancer in C3H female mice is prevented by restricting dietary intake of fat.
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Two patients had infective endocarditis due to Actinobacillus actinomycetemcomitans. One, a 52-year-old woman with a prosthetic aortic valve, was successfully treated with carbenicillin and gentamicin. The other, a 47-year old man with calcific aortic valve disease, required emergency valvectomy and prosthetic valve replacement and responded to a combination of penicillin and gentamicin.
A case is described of bacterial endocarditis caused by Lancefield group D Streptococcus bovis. Because of its sensitivity to the less toxic antibiotics such as penicillin, the importance of laboratory differentiation from the more resistant enterococci is emphasized. Treatment in this case was complicated by penicillin allergy and cardiac failure. The condition finally responded to clindamycin therapy and aortic valve replacement.
A questionnaire was developed for use with a large sample of passengers travelling in British Rail stock on a cross-section of main line routes serviced by London Midland Region. The questionnaire was distributed to a stratified random sample of 1500 passengers-covering both male and female travellers in five different carriage types. The aim of the study was to determine the improvements passengers would most like to see in existing carriage design, and generally what they felt about the quality of their environment. The questionnaire included sections covering personal and travel details, a check list of conceivable improvements, and the use of the semantic differential technique for obtaining passengers' impressions and perceptions. The findings allowed comparisons to be made between the different carriage interiors and resulted in recommendations for the possible modification of certain carriage designs.
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An infection control program was instituted at The Victoria General Hospital, an 800-bed acute care hospital, in July 1977. Serratia marcescens had infected or colonized (I/c) 225 to 232 patients yearly for each of the three previous years. Since this organism is usually acquired nosocomially, we decided to use Serratia I/C as a marker for our infection control program. During the years 1977 to 1980, we identified and eliminated several reservoirs of Serratia (contaminated urine measuring containers, urometers, diabetic urine testing equipment and in-use contamination of 2% Hibitane). Readmission of previously I/C patients proved to be an increasingly important reservoir. During 1980, only 120 patients were I/C, and gentamicin-resistant isolates of S.marcescens had dropped from 44% in 1977 to 4.4% in 1980. Use of Serratia as a marker enabled us to monitor the efficacy of our infection control program and allowed us to prove to our health care workers the usefulness of many of the measures we introduced.
Contemporary developments in the management of chronic diseases such as diabetes and asthma offer possibilities for optimal control, but patients increasingly need to take on responsibilities for self care. Health professionals require comprehensive assessments of outcome that include data reflecting patients' perceptions of their disorder and its management. Disease-specific, patient-centered questionnaires for evaluation of adults' health-related quality of life are available for diabetes and asthma. Little progress is evident in relation to pediatric instruments. This paper describes the development of such an instrument for measurement of 8- to 11-year-olds' perceptions of their asthma--the CAQ-B Psychometric characteristics of the CAQ-B are reported: principal axis factor analysis resulted in the derivation of four subscales reflecting children's perceptions of both active and passive aspects of living with asthma, together with their perceptions of its severity and any associated distress. Preliminary explorations with CAQ-B included comparisons of parents', doctors', and children's ratings of severity; comparisons of data from asthmatic and nonasthmatic children; comparisons of data from boys and girls.
Osteochondroma represents the most common benign bone tumor and occurs most frequently in the proximal humerus, tibia, and distal femur. The bones of the foot, by comparison, are less commonly involved. The tumor appears to be a developmental defect of bone preformed in cartilage rather than a true neoplasm. However, on rare occasions it may undergo chondrosarcomatous degeneration, thus demonstrating neoplastic behavior. A review of the literature, including clinical features of osteochondroma, radiologic and histologic characteristics, and theories on pathogenesis, is presented. Information concerning principles of surgical treatment, techniques of diagnosis, and facts to aid in the differential diagnosis of osteochondroma is presented also. Finally, a series of case reports is presented to demonstrate the surgical treatment of osteochondroma of the foot. Included are three cases of phalangeal osteochondroma, one of metatarsal osteochondroma, and an unusual report of osteochondroma of the talus. A case report and discussion of a patient with juxtacortical circumscripta myositis ossificans of the foot is also presented to demonstrate how information on lesions included in the differential of osteochondroma can be utilized clinically to make the diagnosis.