Dengue fever in returned travellers.
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Biomedical subjects
Publications and source records attributed to K Read.
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The first detailed measurements of the centrality dependence of strangeness production in p-A collisions are presented. Lambda and K(S) dn/dy distributions from 17.5 GeV/ c p-Au collisions are shown as a function of "grey" track multiplicity and the estimated number of collisions, nu, made by the proton. The nu dependence of the Lambda yield deviates from a scaling of p-p data by the number of participants, increasing faster than this scaling for nu</=5 and saturating for larger nu. A slower growth in K(S) multiplicity with nu is observed, consistent with a weaker nu dependence of K&Kmacr; production than YK production.
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The use of glass ionomers as a novel bone cement is currently being investigated. Although acceptable for use as a dental restorative material, there is little information regarding how ionomers interact with inflammatory macrophage cell types. The specific objective of this experiment was to investigate the possible interrelationship between RAW and human monocyte/macrophage cells at the biochemical and morphological level after being in contact with three different dental cement ionomers (Fuji Duet, Fuji IX, and GC-Fuji-Ortho, GC America Inc., Chicago IL) for 72 hours. Transformed RAW macrophages were obtained from the American Type Culture collection (ATCC), and the non-transformed human macrophages were obtained from the peripheral blood of 25 male and female volunteers. The cells were plated at a density of 4 x 10(6) cells/ml in twenty-four well plates. Each plate was divided into four groups of six cells/group. Twenty-four hours after plating, the cells in groups I-III were incubated with Fuji Duet, Fuji IX, GC Fuji Ortho, respectively, and cells in Group IV were incubated with media alone to serve as controls. Immediately after addition of the ionomers, the cellular morphology was monitored for both transformed and non-transformed cells. Cell number data revealed that normal non-transformed cells were similar in number to control cells in media alone. This result suggests that the polymer treatment did significantly alter cellular viability. On the other hand, RAW cell number was markedly reduced in cells treated with ionomers in comparison to cell growing in media alone. The data suggests that the prescence of the ionomer may reduce the proliferation rate of RAW cells. Biochemical analysis of cellular supernatants to determine cellular alterations at 72 hours revealed increased levels of lactate dehydrogenase activity and levels of malionaldehyde bis diethyl acetal in all ionomer-treated groups of RAW cells compared with media alone. Non-transformed macrophages treated with the same ionomers did not differ significantly from the control cells in media alone. However, when comparing the levels of lactate dehydrogenase activity between the transformed and non-transformed cells it was apparent that the normal cells exhibited statistically higher activity than the RAW transformed cells. The results of this study suggest that although the three ionomers tested were found to be highly biocompatible with fully differentiated non-transformed macrophages, the behavior of transformed and non-transformed phagocytic cells towards these ionomers may not be similar under similar conditions.
Mental healthcare in Wolverhampton had sunk to such depths that two years ago the purchasing authority was openly discussing commissioning its services from another town. Today the situation is transformed. David Jolley and colleagues explain how such marked progress was achieved.
A 3-year prospective study examined 76 frontal (F) and 45 lateral (L) motor vehicle crash (MVC) patients with regard to seatbelt restraint use and occupant compartment contact and intrusion injuries. These 121 MVC victims with multiple injuries (39 belted [B] and 82 non-belted [NB]), admitted to a level I trauma center, were studied by accident reconstruction and medical data analysis. They had a MVC mean impact velocity (delta V) of 30 +/- 11 mph and an injury Severity Score of 29 +/- 12. Proper restraint use reduced brain injury in F MVCs (30% FB vs. 47% FNB) but had no effect in L MVCs (63% LB vs. 30% FB [p < 0.06]). Belt use did not protect against lung, liver, spleen, pelvis, or lower extremity (LE) injury. These appeared to be more a function of crash direction, with LE injuries higher in F crashes (p < 0.04) and pelvis injuries (p < 0.001) higher in L crashes. In FB crashes, however, properly used safety restraints were the primary cause of bowel or colon injuries (p < 0.006). Belts did not prevent thoracic or abdominal solid organ injuries in L crashes. Contact-intrusions (CI) of the car occupant compartment in F crashes were the main cause of brain (A-pillar), lung and liver (steering wheel and instrument panel), and LE (toepan) injuries; but in L crashes, side-door CI caused lung, aorta, liver, and pelvic injuries. In contrast, contact-only (CO) injuries of the steering assembly were mainly responsible for injuries to the lung, heart, and liver in F crashes, and side-door CO for lung, liver, and spleen injuries in L crashes. Deaths and complications after injury were higher among F MVC occupants, or when delta V was > or = 30 mph. Hospital and professional costs reflect the complex care needed for victims of multiple injuries: FB, $99,000; FNB, $95,000; LB, $75,000; LNB, $79,000; total, $10.7 million. Present vehicle safety standards are not adequate, and structural design changes are needed to improve restraints and protect occupants from intrusion-related injuries.
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Spiraling costs of high-technology medicine and gaps in insurance are creating a gulf in the nation's healthcare system. Solving problems in the U.S. healthcare system may seem an overwhelming task, but leaders in academics, bioethics, medical technology, and within HFMA discuss guidelines and specific aspects of the system warranting concern. Their analysis of the issues clarifies the questions to ask, but the decisions ultimately must come from the public.
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