Vaccination against hepatitis A for travellers. All relevant costs and consequences should be measured.
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Biomedical subjects
Publications and source records attributed to R Hardie.
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One hundred patients with osteoarthritic knees were randomized either to have their patella resurfaced or not resurfaced using the same total knee replacement. These patients were assessed preoperatively and a minimum 2 years postoperatively using disease-specific (Knee Society Clinical Rating System) and functional capacity (30 second stair climbing and knee flexor and extensor torques) outcome measures. Two patients in the not resurfaced group required reoperation because of anterior knee pain. At 2 years' followup, the not resurfaced group had significantly less pain and better knee flexor torques than did the resurfaced group, whereas the results of the Knee Society Function Scores, 30 second stair climbing, and knee extensor torques were similar. These results suggest that longer-term followup is required, but that one should keep an open mind regarding patellar resurfacing during total knee replacement.
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Six patients severely affected by hereditary motor and sensory neuropathy (HMSN), four type I and two type II, had clinical evidence of diaphragmatic weakness. One presented with cardiorespiratory failure secondary to nocturnal hypoventilation, and three others were unable to lie flat because of dyspnoea. Diaphragmatic paralysis should be considered as a cause of respiratory or cardiac failure in cases of HMSN.
An outbreak of waterborne cryptosporidiosis affecting 27 persons, diagnosed stool positive, occurred in Ayrshire in April 1988. Twenty-one in 27 confirmed cases required some form of fluid replacement therapy. Local general practitioners indicated a two- to fivefold increase in diarrhoeal disease during the outbreak, and following enquiries made by Environmental Health Officers it became apparent that many hundreds of people had suffered a diarrhoeal illness at that time. Cryptosporidium spp. oocysts were detected in the treated chlorinated water supply system, in the absence of faecal bacterial indicators. Oocyst contamination of a break-pressure tank containing final water for distribution was the cause of this waterborne outbreak. An irregular seepage of oocyst-containing water, which increased during heavy rains, was the cause of the break-pressure tank contamination, rather than a failure of the water-treatment processes. The waterborne route should be considered when clusters of cryptosporidiosis-associated with potable water occur. Waterborne cryptosporidiosis can occur in the absence of other faecal indicators of contamination.
A 9-month-old boy died of a disseminated echovirus 7 (E7) infection with virus being cultured from his liver and spleen. His hepatic failure was complicated by candidiasis and marrow hypoplasia and aggravated by a possible immune deficiency.
The purpose of this study was to compare the pull-out forces of 3.8-mm and 6.5-mm diameter cancellous screws and a round peg 10 mm in diameter, implanted in bovine vertebral cancellous bone and two different grades of polyurethane. The relationships between the pull-out forces and the properties of the material into which they were inserted were also examined. For the same depth of insertion, the pull-out force of a 6.5-mm diameter screw was two times larger than that of a 3.8-mm diameter screw. Despite its smaller diameter, a 6.5-mm diameter screw demonstrated a pull-out force 13.6% greater than that of an optimally press-fitted 10-mm diameter round peg when both were inserted to the same depth; however, optimal compression for the peg was strongly dependent upon the size of predrilling and the modulus of elasticity of the material into which the peg was inserted. The pull-out force of a cancellous screw has a linear relationship with the shear strength of the material into which it is inserted. The pull-out force of a peg exhibits a linear relationship with the modulus of elasticity of the material into which it is inserted.
Twelve cases of listeriosis are described. Nine patients had meningitis, two primary listerial bacteraemia and one had bacteraemia from a focus of infection in the genito-urinary tract. Clinical presentation and treatment are described.
The peptide boronic acid, MeOSuc-Ala-Ala-Pro-boroVal-pinacol (AAPbV), is an effective inhibitor of both pancreatic and leukocyte elastase. Initial work showed that AAPbV diminishes the effect of emphysema induced by pancreatic elastase. This initial work has been expanded to show that AAPbV provides a high degree of protection against elastase-induced increases in lung volume and mean linear intercept when given intratracheally at 200 mg/kg either 15 min before, simultaneous with, or 15 min after instilling elastase. Intraperitoneal administration, although less effective, is dose dependent and dependent on the time of treatment. We conclude that a reversible protease inhibitor can be used to prevent aberrant proteolysis in vivo.
A highly effective, reversible elastase inhibitor, MeOSuc-Ala-Ala-Pro-boroVal-OH, was tested for its ability to prevent emphysema induced by intratracheally administered elastase in hamsters. Anesthetized hamsters were given elastase intratracheally with or without the inhibitor or were given elastase intratracheally and the inhibitor intraperitoneally. Two weeks after administration, lungs were removed, and static air pressure volume curves were performed followed by intratracheal fixation and morphometric determination of mean linear intercepts. The results indicate significant preservation of structure and function whether the inhibitor is given intratracheally or intraperitoneally and suggest that this inhibitor may be useful in controlling diseases arising from aberrant proteolysis by elastolytic enzymes.
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Levodopa is widely regarded as the treatment of choice in Parkinson's disease although complications gradually emerge during long-term therapy. The addition of adjuvants may be worthwhile, but it must be recognized that drug therapy offers incomplete and diminished symptom relief.
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The performance of earmuffs in the actual working environment was studied with two modified dosimeters. It was found that personal hearing protection, at least with earmuffs, is a potentially adequate method of protection against noise-induced hearing loss in most industrial working situations. Most of the problems involving the use of hearing protectors in a hearing conservation program can be overcome by education and proper fitting.