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Abnormal T-cell subpopulations in hemophilic patients receiving factor VIII concentrates from voluntary donors.

Recently, Acquired Immune Deficiency Syndrome (AIDS) has been reported in hemophiliacs in the USA, Canada and Spain, and this has caused considerable concern amongst hemophiliacs regarding the use of factor VIII concentrates. The aim of this study was to determine whether hemophiliacs in Australia have T-lymphocyte subpopulation changes similar to those observed in patients with AIDS. Factor VIII produced in Australia is derived from a totally volunteer blood donor system and none of the hemophiliacs in this study had received commercial blood products. For the hemophiliacs, the T-helper cell to T-suppressor cell ratio was 1.1 +/- 0.6 (mean +/- SD) which was significantly less (p less than 0.001) than that of the normal age and sex-matched controls. There was a significant relative (p less than 0.001) and absolute (p less than 0.05) reduction of the helper cell subsets and a significant relative (p less than 0.001) and absolute (p less than 0.05) increase of the suppressor cell subsets, in the hemophiliacs compared to the normal controls. There appears to be no correlation between the amount of factor VIII therapy received during the last three years and the T-cell subset changes. All patients with Christmas disease had T-cell subsets within the normal range. All patients were negative for the hepatitis B virus antigen, but all were positive for the antibody, indicating that there had been exposure to the hepatitis virus in all cases. Cytomegalovirus titres were uniformly low and immunoglobulin levels were normal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Spooning and basketing: children's dealing with accidental gaps in the lexicon.

The abilities of 2-, 5-, and 7-year-old children to interpret, judge the acceptability of, and produce class extensions were assessed. Class extensions are linguistic constructions in which a word that normally functions as a member of one syntactic category is used as a member of another, as in the sentence He is pianoing Christmas songs. Subjects in each age group understood sentences containing class extensions to some extent. However, the 2-year-olds' performance was depressed relative to the near-maximal performance of the older subjects, because they were generally insensitive to word-order cues in the stimulus sentences. Only the 7-year-olds consistently judged sentences containing class extensions to be deviant; the 5-year-olds confused syntax and semantics in making their judgments. The 7-year-olds were also able to produce class-extension phrases "on demand" more frequently than the 5-year-olds. It is concluded that the increasing ability with age to deal appropriately with class extensions is primarily due to general advances in language acquisition rather than to any development unique to the class-extension word-formation process. It is noted that the pattern of results reported, as well as observations that children's use of class extensions in spontaneous speech declines with age, may both be accounted for if word-formation rules are assumed to be "nonproductive, general rules," with a generative component and a later-acquired inhibitory component.

Adult↗

Prevalence and determinants of alcohol consumption among schoolchildren in Barcelona, Spain.

The pattern of use of alcoholic beverages and factors influencing it among Barcelona schoolchildren were studied; 2,255 fifth and eighth grade students from 71 schools completed a self-administered questionnaire. Between fifth-eighth grades, important changes take place in attitudes--strongly opposed to alcohol among the younger, much more moderate among the older. Family celebrations such as Christmas or birthdays are the earliest source of exposure to alcohol, at which one-third of fifth grade students and two-thirds of eighth grade students drink. In eighth grade, though daily consumption is relatively rare (4.4% for boys), a considerable proportion have been drunk at least once (16% of girls and 19% of boys) or have had four or more drinks in a row, while a small but significant proportion (2.5%) have been drunk two or more times in the last six months. A discriminant analysis uncovered some features predicting this "higher risk" use of alcohol: age and gender (being a boy in eighth grade), lower socioeconomic status, higher weekly allowance available for personal expenses, a pattern of usual consumption by both the father and friends, smoking regularly, and having a moderate or high physical activity level, as well as holding opinions in favor of drinking.

Adolescent↗

The therapeutic role of epsilon-aminocaproic acid (EACA) for dental extractions in hemophiliacs.

The results of a double-blind controlled trial, previously reported, showed that EACA is a useful adjunct to preoperative therapeutic concentrates of factor VIII or IX for dental extractions in hemophilia and Christmas disease. To estimate the amount of factor VIII and IX conserved in hemophiliacs receiving EACA for dental surgery compared with those not receiving EACA we have surveyed the usage of therapeutic materials in ten hemophilia centers in the U.S. and at Oxford. The amount of postoperative factor-VIII containing materials given to 20 U.S. hemophiliacs not receiving EACA averaged 11 062 units of factor-VIII activity per patient; 4,146 units for each of 22 U.S. patients receiving EACA; and 717 units for each of 56 patients at Oxford receiving EACA. Conservation of factor-IX-containing material was not as great. At Oxford 62.5% of patients receiving preoperative factor-VIII or -IX concentrates sufficient to raise the deficient factor to 50% of normal together with EACA, 24 g per day for ten days, required no postoperative therapeutic materials to control bleeding. The remainder required an average of two postoperative doses to control bleeding.

Adult↗

An outbreak of Norwalk-like gastroenteritis associated with contaminated drinking water at a caravan park.

During the 1989 Christmas holiday period, a large outbreak of gastroenteritis occurred among persons staying at a caravan park in southern New South Wales. Review of local hospital records found that 77 per cent of patients presenting with infective diarrhoea between 29 December and 3 January had stayed at the caravan park. In a retrospective cohort study we compared rates of illness among caravan park patrons exposed to different water sources. Stools were tested for pathogens and convalescent sera for viral antibodies. Rain and reticulated river water sampled from the caravan park were tested for bacteria and viruses. Of 351 persons interviewed at the caravan park, 305 (87 per cent) reported an illness characterised by diarrhoea, vomiting and abdominal pain. Of 196 persons who used reticulated river water for drinking or ablutions, 175 (89 per cent) became ill compared with 47 of 72 persons (65 per cent) who did not use this water (relative risk 1.4, 95 per cent confidence interval 1.2 to 1.6). The outbreak was probably caused by a 27-28 nm small round structured virus found in the stool from one ill person. High levels of faecal coliforms in the reticulated river water and enterovirus in sediment samples suggest that the outbreak was caused by sewage contaminating the reticulated river water through a break in the pipe directly over the underground water tanks. To prevent such outbreaks, poor water and sewerage system layouts should be avoided and nonpotable water should be clearly labelled. Where feasible, all camping-ground water should stem from town supplies.

Abdominal Pain↗

A drop in suicides around major national holidays.

To study the fluctuation of suicides around the holidays, we examined 188,047 U.S. suicides from 1973 to 1979. Correcting for the effects of extraneous variables, such as seasons and days of the week, we found that suicides dropped by an annual average of -102.5 in the period surrounding the holidays. One set of holidays (Memorial Day, Thanksgiving, and Christmas) was associated with an unusually low risk of suicide before, during, and after the holiday. Another set of holidays (New Year's Day, July 4th, and Labor Day) was associated with a low risk of suicide before the holiday and a high risk just afterwards. Almost all demographic groups experienced a low risk of suicide around the holidays: whites, blacks, males, females, retired persons, and persons of working age. Only white teenagers deviated from this pattern. Thus, the evidence does not support the widespread popular assumption that holidays are a risk factor in suicide.

Adult↗

A study of collective disturbed behaviour among psychiatric patients.

An investigation was conducted over a 40-week period in which staff completed weekly a list of 34 items representing aspects of disturbance for all patients in a modified therapeutic community comprising male and female wards. Four principal components accounted for about half the variance in both the men's and women's disturbance data. The first components in both groups represented general disturbance. Subsequent components in the men concerned rejection and withdrawal, nocturnal disturbance, and physical aggression, whilst among the women the later components reflected hysterical acting-out, withdrawal and 'opting out', and self-directed and indirect forms of aggression. There was only an insignificant relationship between the general disturbance levels in the two wards. A number of variables, including the level of disturbance predicted from the diagnostic composition of the ward, average length of stay, and numbers of patients in the wards were found to correlate with the weekly levels of disturbance. In the men's ward, a 12-week cycle of general disturbance was found. An occasion of disruption to the routine of the unit (Christmas) was implicated in an episode of high disturbance.

Adult↗

[Food-borne outbreak of gastroenteritis caused by small round structured virus. 2. An outbreak associated with bakery product consumption].

In December 1989, an outbreak of gastroenteritis associated with cake consumption occurred in a day-care center with 60 children and 12 staff in Saitama prefecture. Children were served cakes at the Christmas party held in the day-care center and ate them with their families. Thirty-three of the 59 children (56%), 16 of the 74 families (22%) and 1 of the 10 staff (10%) eating the cakes became ill. Illness consisted primarily of nausea, vomiting, diarrhea and fever; the median incubation period was 31 hours. Bacteriological analysis of stool specimens did not reveal a causative agent. Small round structured viruses (SRSV) were detected in fecal specimens from 10 of the 17 ill children (59%) and 2 of the 6 ill families (33%) by electron microscopy. Cakes were purchased from a bakery where an employee who prepared the cake denied symptoms, and SRSV was not detected in the fecal specimen from the employee. Thus, it was not determined that the cake was contaminated by a food handler.

Adolescent↗

METEOROLOGICAL EVALUATION OF THE SOURCES OF IODINE-131 IN PASTEURIZED MILK.

An examination of possible sources of radioiodine found in samples of milk in the midwestern states during May and early June 1962 shows that atmospheric testing at Christmas Island was the principal contributor to incidents of significant concentrations of iodine-131 in milk (exceeding 300 picocuries per liter). Underground testing at Nevada played at most only a minor role during this period. There is a cause-and-effect relationship between the penetration of thunderstorms into high concentrations of nuclear debris in the lower stratosphere and the subsequent amount of iodine-131 in milk. Analyses of samples of rainwater confirm the importance of this "scavenging" mechanism. The relative contributions of atmospheric and underground testing to the iodine-131 found in milk samples from September 1961 to December 1963 has been reviewed and only one incident in which the amount of iodine-131 exceeded 300 picocuries per liter could be attributed to an underground test.

Animals↗

Transcription mapping of the Escherichia coli chromosome by electron microscopy.

The distinctive double Christmas tree morphology of rRNA operons as visualized by electron microscopy makes them easy to recognize in chromatin spreads from Escherichia coli. On the basis of the pattern of nascent transcripts on nearby transcription units and the relative distances of the operons from one another and the replication origin, we are now able to specifically identify five of the seven rRNA operons in E. coli. The use of rRNA operons as markers of both position and distance has resulted in the morphological mapping of a significant portion of the E. coli chromosome; over 600 kilobase pairs in the 84- to 90-min and 72-min regions can now be recognized. Since individual rRNA operons could be identified, direct comparisons could be made of their transcriptional activities. As judged by the densities of RNA polymerases along the operons, rrnA, rrnB, rrnC, rrnD, and rrnE were all transcribed at similar levels, with one RNA polymerase every 85 base pairs. The ability to recognize individual operons and specific regions of the chromosome allows direct comparisons of various genetic parameters.

Chromosome Mapping↗

Ultrastructural appearances of a lens with marked polychromatic lustre: evidence for diffraction as a cause.

A human lens showing polychromatic lustre associated with cortical opacities (Christmas tree cataract) has been examined by slit-lamp photography, thin-section light microscopy, and electron microscopy. Anterior epithelial cells were fibroblast-like, and an area of breakdown of cortical lens fibres was observed in the anterior lens, containing feathery fibres, whorls, and process bodies. Parallel sided stacks of fused cell membranes were found beneath the watery area at the same depth as the polychromatic lustre seen in the slit-lamp. The dimensions of these membrane plates are consistent with the diffraction of light by a parallel thin film to give coloured points of light. Deeper areas of small granules between the lens fibres are associated with the main trunk-like opacity and its branches seen with the slit-lamp.

Aged↗

Variations in number of births and perinatal mortality by day of week in England and Wales.

Analysis of the births that occurred in England and Wales during 1970-6 showed that they followed a seven-day cycle, being concentrated from Tuesdays to Fridays and least numerous on Sundays. This pattern became increasingly pronounced during the period examined. Relatively few births occurred on bank holidays, especially Christmas Day and Boxing Day. In general perinatal mortality was higher among babies born at weekends than among those born on weekdays. It is likely that the pattern seen in the numbers of births is associated to a large extent with elective intervention. It is not possible to draw any conclusions about the pattern seen in perinatal mortality as so far the analysis has been confined to crude rates.

Birth Rate↗

Un-health promotion: results of a survey of alcohol promotion on television.

To estimate how widely and to whom alcoholic drinks are promoted 1258 television advertisements were studied over a 10 week period that included the Christmas and New Year holidays in 1986-7. A total of 156 advertisements (12%) promoted alcohol, and this percentage increased significantly over the holiday period to 17%. These advertisements were longer than those advertising other products, and just over half (56%) occupied the first position in commercial breaks. During sports programmes and between the hours of 1800 and 1900 there was an increase in the number of advertisements for alcohol, but there was no difference before and after 2100. It was found that the extent and influence of the promotion of alcohol were great and that such advertising is seen by many children and adolescents.

Advertising↗

Follow up of New Zealand participants in British atmospheric nuclear weapons tests in the Pacific.

OBJECTIVE: To study the health of Royal New Zealand Navy personnel who participated in atmospheric nuclear weapons tests conducted by the United Kingdom at Malden Island and Christmas Island in 1957 and 1958. DESIGN: Blinded, controlled follow up of up to 30 years. SETTING: New Zealand. SUBJECTS: 528 Men known to have participated in the tests and a control group of 1504 men who were in the Royal New Zealand Navy during the same period but did not participate in the tests. MAIN OUTCOME MEASURES: Mortality and incidence of cancer. RESULTS: Follow up for the period 1957-87 was 94% complete in test participants and 91% complete in the controls. There were 70 deaths among test participants and 179 deaths among controls, yielding a relative risk of 1.08 (90% confidence interval 0.85 to 1.38, p = 0.29). The relative risk of death from causes other than cancer was 0.96 (0.71 to 1.29, p = 0.59) whereas the relative risk of death from cancer was 1.38 (0.90 to 2.10, p = 0.09) and of the incidence of cancer was 1.12 (0.78 to 1.60, p = 0.29). For cancers other than haematological malignancies the relative risk was 1.14 (0.69 to 1.83, p = 0.31) for mortality and 1.01 (0.67 to 1.50, p = 0.48) for incidence. There were seven deaths from haematological cancers among test participants (relative risk 3.25, 90% confidence interval 1.12 to 9.64, p = 0.02), including four leukaemias (5.58, 1.04 to 41.6, p = 0.03). The relative risk for incidence of haematological cancers was 1.94 (0.74 to 4.84, p = 0.10) and that for leukaemia was 5.51 (1.03 to 41.1, p = 0.03). There were no cases of multiple myeloma in the test participants during the follow up period, but the expected number was only 0.3. CONCLUSIONS: Although the numbers are small, the findings for leukaemia are similar to those for British participants in the nuclear weapons test programme. Some leukaemias, and possibly some other haematological cancers, may have resulted from participation in this programme. There is little evidence of an increased risk for non-haematological cancers, and there is no evidence of an increased risk for causes of death other than cancer.

Cause of Death↗

Multiple congenital coagulation deficiencies.

A 6-week-old infant is presented who suffered from a congenital haemorrhagic disorder which caused death from subdural haemorrhage following mild trauma. Haematological investigation revealed deficiencies of factor VII and Christmas factor. Prower-Stuart factor was probably also deficient although investigation of this clotting factor was carried out only on serum obtained at necropsy.

Blood Coagulation↗

The rate of blood loss from skin punctures during the Ivy bleeding time test.

The rate of blood loss from skin punctures during the performance of the Ivy bleeding time test has been measured by a simple technique in normal individuals, in patients without defects of the haemostatic or coagulation system, and in patients with known haemorrhagic disorders.A wide range was found in normal individuals, but repeated tests on a single individual showed a smaller variation. Nearly half of the tests on patients with von Willebrand's disease, thrombocytopenia, ;capillary type' of bleeding, or haemorrhagic renal failure gave abnormally high rates of blood loss. Haemophilic, Christmas disease, and Dinedevan-treated patients gave low volumes and rates of blood loss.A group of patients has been encountered in whom the bleeding time was normal but the rate of blood loss was increased. The majority of these had haemorrhagic symptoms and other evidence of a defective haemostatic or coagulation system. It is suggested that a consideration of the rate of blood loss in those patients with a normal bleeding time gives additional help in interpreting the Ivy test. A high rate may indicate the need for further investigation of the haemostatic and coagulation system.

Bleeding Time↗

Coagulation tests on capillary blood. A screening procedure for use in small children.

A method of investigating the coagulation mechanism is described.Results obtained by this procedure are compared with those of tests carried out on venous blood obtained simultaneously from normal subjects and patients with a variety of clotting defects. Good correlation was found between the results of P and P tests on venous and capillary blood, and also between thromboplastin screening tests on capillary blood and antihaemophilic and Christmas factor levels. The methods described have proved reliable as a pre-operative screening procedure in routine use over a period of nearly two years.

Blood Coagulation↗

Coagulation factors in chronic liver disease.

Coagulation studies were carried out on 30 patients with chronic liver disease. The clotting defect was complex and involved factors V, VII, IX (Christmas factor), and prothrombin. Some patients showed a significant depression of factor IX in the presence of a normal one-stage prothrombin time. Thrombotest was found to be a good indicator of factor IX deficiency in this group of patients and may be of use as an additional liver function test. The screening of patients with liver disease for surgery or liver biopsy should assess the coagulation factors involved in both intrinsic and extrinsic thromboplastin generation.

Adult↗