Intentionality in the human-environment encounter in an ambulatory care environment.
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The bronchopulmonary system is at particular risk from environmental pollution. At the same time, numerous natural and personal confounding variables are also effective, and investigations need to give then careful consideration. In particular such diseases as pulmonary emphysema, bronchitis, obstructive airways diseases and carcinoma of the lung may be due to environmental factors. Highly reliable methods of detecting such diseases are presented. The use of these methods by specially trained staff with the requisite skills and knowledge, is a precondition for reliable results. Numerous uncertainties associated with these requirements led to a certain unreliability of the results obtained in earlier studies. Provided that the above requirements are met, the present state of the technological art makes it possible to identify even more subtle damage that can be caused by environmental factors.
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During the period from January 1987 to June 1988 DNA fingerprinting was used to identify carriers of the disease-causing strain of Neisseria meningitidis among the patients contacts. A total of 432 persons were screened during nine episodes. The overall carrier-rate was 16.2%, and the causative strain was found in 3.4% of the contacts. Eleven carriers were successfully treated with rifampicin, whereas two of three carriers treated with penicillin remained carriers. We conclude that DNA fingerprinting is a valuable tool for rapid identification of carriers of the causative organism in order to eradicate the epidemic strain of N. meningitidis.
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