Syphilis in London circa 2004: new challenges from an old disease.
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Biomedical subjects
Publications and source records attributed to S Luck.
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Accidents of the city gasworks in the end of the fifties at Schwaan, a small town south of Rostock, resulted in an emission of tar and waste water into the river Warnow, from which the city of Rostock is supplied with drinking water about 20 km downstream. The tar contaminated river sediment (old deposit) covering an area of about 200 m2 has a high pollutant inventory: Steam-distillable phenolic compounds 407 mg/kg in the fresh sediment, polycyclic aromatic hydrocarbons (PAH) 400 to 1100 micrograms/l in the aqueous eluate. The mutagenic potential was detected by the AMES-test. As shown by PAH determinations there were no other pollutant sources in the catchment area, in the tributaries or on other places of the river. The mean PAH concentrations of the river Warnow and his tributaries during 1991 to 1994 were found to be in the range lower than 10 ng/l. Further investigations showed a continuous emission of PAH from the tar laugh in small amounts. An additional emission of pollutants (PAH) and their transportation in the river is expected in the case of sediment disturbances. This emission and their possible consequences are difficult to estimate, even though the seston and the humic substances content of the river seems to reduce the PAH risk. Concluding from our results the probability is very low that pollutants were transported downstream to Rostock and pass the water works but may not totally be excluded. Nevertheless from the viewpoint of care a removal of the old deposit is necessary.
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For the first manned flight of Hermes there will be a capability of performing EVA. The European EVA Space Suit will be an anthropomorphic system with an internal pressure of 500 hPa of pure oxygen. The pressure reduction from the Hermes cabin pressure of 1013 hPa will induce a risk for Decompression Sickness (DCS) for the EVA crewmember if no adequate protective procedures are implemented. Specific decompression procedures have to be developed. From a critical review of the literature and by using knowledge gained from research conducted in the past in the fields of diving and aerospace medicine safe protective procedures are proposed for the European EVA scenario. An R factor of 1.2 and a tissue half-time (t1/2) of 360 minutes in a single-tissue model have been identified as appropriate operational values. On the basis of an acceptable risk level of approximately 1%, oxygen prebreathing times are proposed for (a) direct pressure reduction from 1013 hPa to a suit pressure of 500 hPa, and (b) staged decompression using a 700 hPa intermediate stage in the spacecraft cabin. In addition, factors which influence individual susceptibility to DCS are identified. Recommendations are also given in the areas of crew selection and medical monitoring requirements together with therapeutic measures that can be implemented in the Hermes scenario. A method for demonstration of the validity of proposed risks and procedures is proposed.
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Docosahexaenoic acid [22:6 omega 3; 22:6-(4,7,10,13,16,19)] is the major polyunsaturated fatty acid in the photoreceptor membranes of the retina and in cerebral gray matter. It must be obtained either from the diet or by synthesis from other omega 3 fatty acids, chiefly alpha-linolenic acid (18:3 omega 3). We tested the effect of dietary omega 3 fatty acid deprivation during gestation and postnatal development upon the fatty acid composition of the retina and cerebral cortex and upon visual function. Rhesus monkeys (Macaca mulatta) were fed semipurified diets very low in 18:3 omega 3 throughout pregnancy, and their infants received a similar diet from birth. A control group of females and their infants received a semipurified diet supplying ample 18:3 omega 3. In near-term fetuses and newborn infants of the deficient group, the 22:6 omega 3 content of phosphatidylethanolamine was one-half of control values in the retina and one-fourth in cerebral cortex. By 22 months of age, the content of 22:6 omega 3 in these tissues approximately doubled in control monkeys, but it failed to increase in the deficient group. Low levels of 22:6 omega 3 in the deficient animals' tissues were accompanied by a compensatory increase in longer-chain omega 6 fatty acids, particularly 22:5 omega 6. Functionally, the deficient animals had subnormal visual acuity at 4-12 weeks of age and prolonged recovery time of the dark-adapted electroretinogram after a saturating flash. Abnormally low levels of 22:6 omega 3 may produce alterations in the biophysical properties of photoreceptor and neural membranes that may underlie these functional impairments. The results of this study suggest that dietary omega 3 fatty acids are retina and brain.
This case report describes the antenatal diagnosis of a fetal pulmonary anomaly. Early detection afforded detailed parental counseling and prompt neonatal diagnosis and treatment.
We provided parenteral nutrition to 40 very low birth-weight premature infants (birth weight 815 +/- 17 grams, gestational age 27 +/- 2 weeks) with a superior vena cava catheter. To avoid the risk of transport, catheterization was performed under sterile conditions in the intensive care nursery. The central venous catheter facilitated administration of calories to sustain growth, especially in infants whose catheters remained in place for 3 weeks or longer. The overall incidence of catheter related sepsis was high (30%) but the majority of cases were due to Staphylococcus epidermidis and resolved without incident. Other complications of parenteral nutrition were minimal. This approach is a safe and effective means of providing nutrition to the very low birth-weight infant.
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The recent pattern of immigration from Indochina and Latin America to the United States suggests that tuberculosis will remain a significant public health problem. Two infants recently seen with probable congenital tuberculosis prompted critical evaluation of the 24 cases of congenital tuberculosis reported in the English literature since the introduction of isoniazid in 1952. Failure to thrive, jaundice, and central nervous system involvement, all reported in previous reviews and textbooks to be very common, were unusual presenting manifestations. In contrast, hepatomegaly, a finding not mentioned in the recent literature, was common. Diagnostic procedures previously underutilized but found in this review to be useful included liver biopsy, biopsy of skin lesions when present, and cultures of gastric aspirates. Factors which enable differentiation of congenital from early postnatally acquired tuberculosis include (1) the presence of known maternal tuberculosis at delivery, (2) whether infant and mother were separated from birth until the onset of illness, and (3) whether other tuberculous exposure of the infant can be determined. Insufficient data prevent recommendation of a preferred regimen of drugs in addition to isoniazid for the treatment of congenital tuberculosis. However, the responses of our patients suggest that streptomycin can be omitted without hazard. Information regarding the long-term prognosis of survivors is lacking, but early diagnosis and institution of appropriate therapy has markedly decreased the mortality of this previously fatal disorder.
The response to intravenous challenge with sheep erythrocytes was determined in Sprague-Dawley rats following autotransplantation of splenic tissue into the subcutaneous tissue, peritoneal cavity, or a surgically created omental pouch. There was a marked rise in heterophil antibody titer following intravenous challenge in ten control animals, and no rise in titer in nine of ten asplenic animals. Heterophil antibody titers increased in all of the animals with transplants, but the response in some was less than that in control animals. Thus autotransplanted splenic tissue demonstrated immunologic responses similar to those of normal, intact spleen.
The multimedia CD-ROM program, Take Charge of Diabetes, was found to be accurate, easy to use, and enjoyable by the clients and health professionals who completed the pilot study. Participants perceived an increase in knowledge after completing the five modules. Two of the participants verbally stated that the program clarified information for them and they wished they had had such a program when they were first diagnosed with diabetes. Further evaluation is needed to generalize the effect of the program on knowledge of diabetes because the pilot study was not designed to fully evaluate the effectiveness of the program on knowledge level or behavior change. Behavior change resulting in better control of blood sugar levels and hemoglobin A1c within normal range is the goal for diabetes education. The person who lives with diabetes must learn self-care methods. To accomplish that, the person must be able to comprehend the material presented. CAI programs provide an individualized, interactive, and interesting way to learn about diabetes and self-care, using visual effects and audio to support the written text. CAI can provide an element of excitement that is not available with other conventional methods. Providing prompt reinforcement of correct answers in quiz sections and including positive written messages can increase patients' self-confidence and self-esteem. Computer-assisted instruction is not intended to replace personal contact with physicians and diabetes educators, but rather complement this contact, reinforce learning, and possibly increase self-motivation to take charge of one's diabetes.
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