Differentiated practice: a three-dimensional model.
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Biomedical subjects
Publications and source records attributed to N Hill.
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The malaria vector population consisted mainly of Anopheles gambiae s.s. with a small contribution from An. funestus and An. rivulorum. The mosquitoes coming to bite in bedrooms were monitored with light traps set beside untreated bednets. When impregnated bednets were provided for all the other beds in a village the Anopheles populations declined but the Culex quinquefasciatus populations were unaffected. The survival of An. gambiae (as measured by the mean number of ovarian dilatations) and the sporozoite rate declined following introduction of the nets and the estimated sporozoite inoculation rates into people not under their nets declined by more than 90%. The net introductions caused sharp declines in the number of mosquitoes resting indoors, but the evidence was inconclusive regarding diversion to outdoor resting, animal biting, earlier biting or outdoor biting. DDT spraying greatly reduced the Anopheles populations.
DNA fingerprinting should permit the identification of individual human hosts of haematophagous arthropods, providing epidemiologically useful information, for example, the biting rates on different people and the impact of insecticide-impregnated bednets. Investigations reported here demonstrate that it is possible to extract, amplify and fingerprint human DNA from the bloodmeals of individual female Anopheles gambiae mosquitoes kept at 24 degrees C for up to 10-15 h post-ingestion.
Using 111In-labeled autologous platelets, we studied the kinetics of pulmonary platelet deposition and clearance in relation to hemodynamic and structural events during thrombin-induced pulmonary microembolism in rabbits. Autologous platelets were radiolabeled and returned to animals prior to infusion of thrombin (100 units/kg over 15 min) (n = 20) or saline (n = 6). All animals were pretreated with tranexamic acid, an inhibitor of fibrinolysis. Thrombin-treated animals manifested progressive increases in mean pulmonary platelet activity, reaching a maximum of 38% above baseline (p less than .0001), whereas no change was observed in saline-treated controls. Animals that died during, or immediately following, thrombin infusion manifested significantly greater increases in pulmonary platelet uptake (mean 1.55 +/- 0.47 times baseline), compared to surviving animals (1.14 +/- 0.16; p less than .05 survivors vs. nonsurvivors). In surviving animals, following cessation of thrombin, pulmonary platelet activity cleared gradually, with a half-time of approximately 12 min. Thrombin reduced circulating platelet counts (p less than .001), increased mean pulmonary artery pressure (13 +/- 3 mm Hg to 18 +/- 6 mm Hg; p less than .0001), and reduced mean systemic arterial pressure (55 +/- 10 mm Hg to 44 +/- 7 mm Hg; p less than .001). The time courses of these events approximated that of thrombin-induced pulmonary platelet uptake. Furthermore, the increase in pulmonary artery pressure occurred predominantly in the group of animals in which the increase in pulmonary radiolabeled platelet activity exceeded the median value of 20%. Postmortem histology showed extensive pulmonary thrombus extending from small arterial to capillary levels in animals that died during, or immediately following, thrombin infusion, but not in surviving animals. Our findings suggest that platelet aggregation plays an important role in the pathogenesis of hemodynamic change following thrombin-induced pulmonary embolization.
After 20 mg sublingual nifedipine in 12 men with clinical stable chronic cor pulmonale the mean arterial pressure and systemic vascular resistance fell, cardiac index rose, and mean pulmonary arterial (Ppa) and wedge (Ppaw) pressures, right atrial pressure, and PaO2 remained unchanged. After 20 mg orally every 6 hours for 24 hours in 11 patients, the mean arterial pressure fell further, systemic vascular resistance remained low, and the cardiac index returned to baseline, whereas the Ppa and Ppaw decreased, but the pulmonary vascular driving pressure (Ppa-Ppaw), right atrial pressure, PaO2, and spirometry and ejection fractions remained unchanged. Of eight patients receiving maintenance therapy four developed untoward side effects in 1 to 3 weeks and one was noncompliant. The remaining three patients evaluated at 6 weeks failed to improve and had unchanged resting hemodynamics. Thus in the absence of a potentially reversible hypoxic pulmonary hypertension, nifedipine may not improve pulmonary arterial pressure and cardiac function in clinically stable patients with cor pulmonale.
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Laboratory tests of insect repellents by various different methods showed that An.stephensi Liston was consistently more susceptible than An.gambiae Giles, An.albimanus Wiedemann or An.pulcherrimus Theobald. The six repellents tested were di-ethyl toluamide (deet), di-methyl phthalate (DMP), ethyl-hexanediol, permethrin, citronella and cedarwood oil. Testing systems in which the mosquitoes were presented with a choice gave consistently lower ED50 values than when there was no choice, i.e. the standards of tolerance are not absolute but depend on the options available. In field tests in an experimental hut a curtain with a high dose of di-ethyl toluamide (deet) reduced biting in the hut but had to be re-impregnated frequently. Deet-impregnated anklets gave about 84% protection against Culex quinquefasciatus Say for 80 days after one impregnation, in a trial in which the anklets were brought out of sealed storage and tested for 2 h nightly. Similar protection was found against An.funestus Giles but the protection against An.gambiae s.l., An. coustani Laveran and Mansonia spp. was not as good. There were highly significant differences between the four collectors' mosquito attractiveness but this varied highly significantly between the mosquito species.
A dental-palatal prosthetic device, which had been demonstrated to aid laryngectomees who use the glossal press method of esophageal speech, was used on a patient whose primary method of air charging was bilabial plosive injection and who had a right hemiparesis of the tongue. Cointervention of a prosthodontist and a speech pathologist is described.
Changes in lymphocyte responses to mitogens and other lymphocyte markers were studied during a 14-day period of storage of blood at 4 degrees C and 22 degrees C in plastic bags. The following tests were done: (a) absolute lymphocyte and neutrophil counts, (b) blastogenic response to PHA, PWM, Con-A, and LPS and (c) determination of T and B cells using E-rosette and EAC-rosette techniques. The neutrophils disappeared rapidly at 22 degrees C. The absolute lymphocyte count doubled in a week. The responses to PHA, PWM, and Con-A declined rapidly and were absent by the 6th day. The response to LPS disappeared on day 14. The ability to form E-rosettes and EAC-rosettes was lost by days 4 and 6, respectively. The results obtained at 4 degrees C were similar except that these changes were delayed varying from 1-7 days.
An outbreak of head lice infestation (pediculosis) occurred in elementary school children in Barrow County, Georgia, in January 1974. An investigation was initiated to define the magnitude of the outbreak, determine factors that contribute to transmission, and disseminate information on control. All elementary school children in the county were examined for head lice and answered a questionnaire. Fifty-three (3%) of 1,783 white pupils were infested, but none of the 500 black pupils was infested. Distribution of infestation in the white pupils was influenced by grade, bed-sharing, socioeconomic status, infestation of other family members, crowding in the home, and family size; distribution was not influenced by hair length or the sex of the pupil. Recommendations for control based on the results of the investigation included procedures for identifying and processing cases, distributing free pediculicides, continuing surveillance, educating school personnel and parents on how to control the parasite.
Allergic reaction to an antitumor agent, cis-dichlorodiammineplatinum(II) (DDP) was investigated. A 15-year-old white male with pulmonary metastases from embryonal carcinoma of testis was treated with a combination of DDP, bleomycin, and vinblastine. The dose of DDP varied from 2 to 2.25 mg/kg given i.v. He received 7 doses of DDP in 9 months. An anaphylactic reaction was seen within 3 min of the initiation of i.v. infusion of the 8th dose of DDP. The reaction was due to atopic hypersensitivity, as confirmed by an immediate wheal and flair reaction and increased histamine release from leukocytes with DDP. His serum IgE level was elevated. Neither the presence of chloride nor the amine grouping in DDP was essential for reactivity. The replacement of platinum with palladium abrogated the reactivity. There was no cross-reactivity with 3 other platinum complexes of known antitumor activity (platinum blue, platinum(II) 1,2-diaminocyclohexane malonate, and platinum(II) ethylenediamine malonate). This was also confirmed by the lack of reaction to subsequent i.v. administration of platinum(II) 1,2-diaminocyclohexane malonate (10 mg/kg) in this patient.
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