Leads from the MMWR. An outbreak of Pseudomonas folliculitis associated with a waterslide--Utah.
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A collection of 1,069 human PCR-based genetic markers has been developed, and their distribution over the 22 autosomes and the X chromosome has been determined. Each marker was developed around a short-tandem-repeat DNA sequence. The majority (85%) of the markers described here were selected to contain tetranucleotide repeats, because these repeats show better stability during PCR than do dinucleotide repeats. Linkage maps constructed from genotypes collected with these markers in four CEPH pedigrees (1331, 1332, 1362, and 884) covered 3,417 cM of the human genome. More than 600 of the loci revealed heterozygosities > .70. Overall, 444 loci were ordered, with odds > 100:1 against inversion of adjacent loci. The average distance between markers was 7.4 cM on the autosomes and 24.8 cM on the X chromosome. Likely locations (100:1 odds intervals) were assigned for the remaining 621 short-tandem-repeat polymorphisms, as well as for 160 other markers that are present on the framework maps published by the Cooperative Human Linkage Center. Four markers specific to the Y chromosome are also reported here. From our maps, 347 markers were chosen to define "index" maps for each of the 22 autosomes. The index markers detect loci with an average heterozygosity of .85 and cover 3,169 cM of the autosomes, with an average distance between markers of 9.2 cM. These polymorphic short tandem repeats will be highly useful as reagents for the ongoing genetic and physical mapping of the human genome and for characterization of genetic changes in cancer.
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An electrohydraulic total artificial heart (EHTAH) has been developed and evaluated by long-term in vivo studies. The EHTAH is composed of blood pumps with an interatrial shunt (IAS), an energy converter, and electronics. The EHTAH with external electronics was implanted in four calves weighing from 81-90 kg. Two animals died on the 1st and 5th post operative days, the third animal survived for 32 days, and the fourth for 159 days. The IAS was free of thrombus at autopsy in all animals. The longest surviving animal increased in size from a pre operative weight of 81 kg to 134 kg on day 144. Cardiac output ranged from 9.3 to 10.5 L/min, whereas right and left atrial pressures increased with the calf's growth from 4-10 to 16-20 mmHg and from 8-14 to 18-22 mmHg, respectively. The animal favorably tolerated up to 3.4 km/hr of treadmill exercise, both hemodynamically and metabolically. The elevation of atrial pressures during treadmill exercise was significantly alleviated by employing an automatic control mode. It is concluded that the device has the potential to be a totally implantable system for permanent use.
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On-line documentation by nurses and a comprehensive text management system are functional in several facilities of intermountain Health Care (IHC). The following articles detail factors in the design and implementation of this computerized network as experienced at LDS Hospital, part of the IHC system. Areas discussed are the system's applications for medical decision support, communication, patient classification, nurse staffing versus cost, emergency department usage, patient problem/event recording, clinical outcomes, and text publication. Users express satisfaction with the time saving, consistency of reporting, and cohesiveness of these applications.
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