Chloroethanes: review of toxicity.
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Biomedical subjects
Publications and source records attributed to J M Lane.
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Three adolescents with bilateral slipped capital femoral epiphyses complicating renal disease are presented. In one case, the severity of the deformities necessitated total hip replacement. Pathological specimens were available for evaluation. In all 3 cases, epiphysiolysis was accompanied by severe subperiosteal reabsorption along the medial aspect of the femoral neck, widening of the cartilaginous growth plate, and coxa vara. The radiographic diagnosis of a minimally displaced femoral epiphysis may precede the clinical symptoms. Early recognition of this complication is important, since the treatment of choice is prophylactic surgical stabilization before disabling deformities occur.
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National Nutrition Surveillance includes nutritional assessment surveys to ascertain the extent of malnutrition in populations, to identify possible causes, to establish baseline data for monitoring nutrition, and to select mechanisms for nutrition surveillance (in a restricted sense). An example of the results from a recent nutritional assessment survey in the United States is the negative association of obesity with energy intake, exercise and socioeconomic status, which has implications for public nutritional policy. Nutritional monitoring measures changes in population nutrition over time. An example of the results from nutritional monitoring is the unexpected and presently unexplained decrease in serum cholesterol levels of middle-aged women in the United States over the past decade. Nutritional surveillance in the restricted sense not only identifies malnutrition but is administratively organized to intervene rapidly. National Nutrition Surveillance depends on metabolic and clinical research to decide on its priorities. This research indicates that malnutrition involves more than under-nutrition, and greater emphasis should be given in National Nutrition Surveillance to this wider context of malnutrition. These results will in turn help set priorities for basic and applied research in nutrition. It is important that the research community participate in the review presently under way of the role of the National Center for Health Statistics in National Nutrition Surveillance.
Utilizing a sciatic nerve-transection model in rats, we studied the collagen content of normal control nerves, the long-term collagen accummulation in the distal stump of the transected nerve, the content of collagen of the posterior tibial nerve distal to the transection, and the myofibrosis of the gastrocnemius muscle. The distal stump of the sciatic nerve accumulated significant amounts of collagen with time but the posterior tibial nerve at a distance from the site of transection showed no progressive collagen accumulation. The histologically evident myofibrosis of the denervated gastrocnemius muscle was shown to be the result of a selective loss of muscle elements and not of an accumulation of collagen. cis-Hydroxyproline, a proline analogue, limited neuroma formation following neurorrhaphy. The findings suggest that the results of delayed repair of nerves should not be impaired by intraneural scarring if enough of the transected nerve beyond the point of intraneural scar formation is resected.
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Smallpox transmission was interrupted in the Republic of Guinea in January 1969, 13 months after the beginning of the National Smallpox Eradication Program, and after approximately 60% of the population had been mass vaccinated. The eradication strategy was founded on the recent epidemiology of smallpox in Guinea and surrounding countries. Tactics were based on use of mobile teams specifically trained for mass vaccination, assessment, surveillance, and epidemic investigation. Guinea was one of 15 West African countries officially certified by the World Health Organization in 1976 as having eradicated smallpox. Continued vigilance to detect any possible importation is needed and would best be part of a program to improve quarantinable disease surveillance. An acceptable immunity level to smallpox should be maintained in priority groups until worldwide smallpox eradication is achieved.
This paper proposes a simple and inexpensive method for the field assessment of certain objective indicators of nutritional status in children of preschool age. It emphasizes the need for statistically valid sample selection and presents a design for randomly selecting 30 children from each of 30 village sites in each region for which quantitative inferences are to be made, the main purpose being to estimate the prevalence of protein-energy undernutrition and anaemia. The need to train indigenous paraprofessional workers as assessors and periodically to control their accuracy is stressed. The method used is limited to an estimate of the location and magnitude of common childhood malnutrition and it is recommended that it be supplemented by detailed ecological analysis to determine causal factors and propose remedial action.
This paper presents recommendations for the analysis and presentation of height and weight data from surveillance or surveys involving nutrition and anthropometry in young children up to the age of 10 years. These recommendations are only for the analysis of data collected on a cross-sectional basis. The basic indices recommended are height for age and weight for height, each considered either in terms of centiles or in a cross-classification scheme using standard deviation scores. It is hoped that these methods of analysis and presentation will prove widely acceptable, so that international comparisons will be made easier.
Articular cartilage explants were incubated at various oxygen tensions and the results of 35SO4 and 3H-thymidine incorporation indicate that proteoglycan and DNA synthesis is depressed at low oxygen tensions. The studies of oxygen consumption and glucose/lactate metabolism in the cartilage suggest a shift in energy pathways as the oxygen environment is altered. In low O2 tensions chondrocytes follow anaerobic glycolysis while at physiologic oxygen tensions chondrocytes follow a combination of both aerobic and glycolytic metabolism. The data suggest that hypoxia, frequently found in inflammatory arthritides, would have deleterious effects on chondrocyte metabolism and would significantly impair any reparative potential of the injured chondrocytes.
In rabbits, joint resurfacing with autologous osteoarticular condylar grafts composed of the articular cartilage and subchondral bone (two to eight millimeters thick) from the lateral femoral condyles was investigated. By means of morphological, histochemical, autoradiographic, and biochemical studies, the grafts were compared with sham and normal controls. When adequately fixed, the grafts remained viable and functionally and structurally intact during the twelve months of the experiment. The subchondral bone underwent rapid replacement in less than six weeks without loss of its supportive function. Resurfacing of a joint using an osteochondral graft is feasible in rabbits.
In time of food shortage, accurate assessment of nutrition status is important so that effective aid may be directed to those in greatest need and, in the future, the impact of this aid on the nutritional situation may be assessed. Using a population proportional sampling method and the index weight for height (which is relatively independent of sex, race, and age) as a criterion of nutritional status, CDC investigators determined that about 10% of the sampled population (aged about 6 months through 6 years) in Mali, Mauritania, Niger, and Upper Volta and over 20% in the sampled population in Chad were severely and acutely undernourished. Apparently younger children were affected first, but as the food shortage became more severe the prevalence of undernourished older children increased. This method of nutrition surveillance has proven itself during a stressful period and should be considered a fundamental tool when rapid assessment of acute undernutrition in children in developing nations is required.
Using a random start, fixed interval method of population proportionate sampling, the survey teams visited 219 villages in rural Nepal and collected data on height, weight, and age from 6501 preschool children. During training and at specific times during the survey, systematic standardization methods were utilized to improve the quality of the collected data. Using 80% of the reference median weight-for-height as the cut-off point, the prevalence of acute undernutrition was 6.7%. Using 90% of the reference median height-for-age as the cut-off point, the prevalence of chronic undernutrition was 52%. The prevalence of chronic undernutrition was significantly higher in the hilly areas. Mean haemoglobin values of blood samples collected from one-fifth of the survey population increased with age with no difference between hill and terai areas. A Nepal urban elite population was measured for comparison. The survey method used indicators that are economical in terms of money, time, and personnel and that provide objective data on the extent and distribution of protein/energy undernutrition and of low haemoglobin values in preschool children.