Attributions for undesirable life events, type A behavior and depression

This investigation examined attributions for life events and Type A behavior of 22 undergraduate women. It was expected that Type A students would make attributions associated with learned helplessness for undesirable life events. As hypothesized, Type A students engaged in more self-blame for important undesirable life events and also rated their desirable life events as less important than Type B students. Differences in attributional strategies of the two groups might mediate the relationship between Type A, helplessness, and heart disease.

Localization of osteomyelitis with 99mtechnetium sulphur colloid

Thirty-two patients with fractures of the limbs were studied 15-30 min following 99mtechnetium sulphur colloid injection. In 17 of the 19 patients where osteomyelitis was superimposed on the various fractures, significant uptake of sulphur colloid was noted at the fracture sites. The sensitivity for the test was 89.5%. In 12 of the 13 cases where osteomyelitis was absent, the sulphur colloid scan was negative giving a specificity of 92.3%. Hence a technetium sulphur colloid scan has shown to be a successful method for detecting osteomyelitis complicating a limb fracture.

Acyl-CoA Synthetase Is Located in the Outer Membrane and Acyl-CoA Thioesterase in the Inner Membrane of Pea Chloroplast Envelopes

Both acyl-CoA synthetase and acyl-CoA thioesterase activities are present in chloroplast envelope membranes. The functions of these enzymes in lipid metabolism remains unresolved, although the synthetase has been proposed to be involved in either plastid galactolipid synthesis or the export of plastid-synthesized fatty acids to the cytoplasm. We have examined the locations of both enzymes within the two envelope membranes of pea (Pisum sativum var Laxton's Progress No. 9) chloroplasts. Inner and outer envelope membranes were purified from unfractionated envelope preparations by linear density sucrose gradient centrifugation. Acyl-CoA synthetase was located in the outer envelope membrane while acyl-CoA thioesterase was located in the inner envelope membrane. Thus, it seems unlikely that the synthetase is directly involved in galactolipid assembly. Instead, its localization supports the hypothesis that it functions in the transport of plastid-synthesized fatty acids to the endoplasmic reticulum.

Comparison of an elemental and polymeric enteral diet in patients with normal gastrointestinal function

In a prospective controlled clinical trial, 70 patients with normal gastrointestinal function were randomised to receive either an elemental diet based on Vivonex HN or an isonitrogenous isocalorie polymeric diet based on Clinifeed 400, administered by continuous 24 hour nasogastric infusion. The two groups of patients were well matched for age, sex, diagnosis, prior starvation, duration of feeding, initial nutritional status, and metabolic status. Nitrogen losses were significantly less on the polymeric feed, despite similar intakes. Serum transferrin rose significantly (1.85 +/- 0.2 to 2.30 +/- 0.2 g/l, p less than 0.05) only in the Clinifeed group, but nutritional parameters were otherwise maintained in both groups. The incidence of diarrhoea (Vivonex, 23.5%; Clinifeed, 30.6%) was not significantly different and was attributable to antibiotics in most cases. Hypokalaemia, which occurred in nearly half the patients, was equally distributed in the two groups, but hypophosphataemia occurred more often in the Vivonex group (p less than 0.05). Liver enzyme disturbances were similar in both groups. The present findings, therefore, provide no evidence that chemically defined 'elemental' diets containing free amino acids as their nitrogen source are in any way superior to polymeric diets containing whole protein and fat when administered to patients with normal gastrointestinal function.

Non-steroidal anti-inflammatory drugs and blood pressure

The effects of aspirin (1950 mg/day orally) or indomethacin (75 mg/day orally) on blood pressure were investigated in normotensive volunteers and hypertensive patients receiving antihypertensive medication. Aspirin (1950 mg/day) did not change blood pressure or body weight in normotensive or treated hypertensive subjects. No significant change in plasma renin concentration was seen with aspirin (1950 mg/day) in treated hypertensive subjects. Indomethacin (75 mg/day) significantly increased blood pressure in normotensive subjects and treated hypertensive subjects. Body weight increased significantly in the treated hypertensive subjects but not normotensive subjects. In treated hypertensive subjects indomethacin (75 mg/day) did not change plasma volume, but significantly decreased plasma renin concentration.

Biochemical characterization of canavalin, the major storage protein of jack bean

The structure of canavalin, a jack bean (Canavalis ensiformis) protein homologous to phaseolin, the major seed storage protein of Phaseolus vulgaris, has been investigated by x-ray crystallography and found to be a hexamer composed of three identical pairs of similar but nonidentical subunits related by a perfect 3-fold axis and pseudo dyad axes (strict C(3) and pseudo D(3)). One member of each pair of subunits is derived from the amino terminal half of a precursor polypeptide of molecular weight 49,000 and the other from its carboxy terminal half. Thus, the crystallographic evidence indicates that the precursor polypeptide is a tandem duplicate and is structurally redundant (McPherson A. 1982 J Biol Chem 255: 10472). A number of physical and chemical properties of the protein in both the uncleaved and the cleaved form were investigated. These included the native molecular weights, amino acid analyses, number of exposed sulfhydryl groups, carbohydrate content, metal ion analysis, crystallization behavior, and the fate of the protein in developing seeds. It was also found that the purified precursor protein possesses a substantial level of alpha-d-mannosidase activity and seems to share a number of other physical and chemical properties with that enzyme.

Diuretic radionuclide renography in upper urinary tract obstruction

Diuretic renography using radioidine sodium hippurate and a frusemide stimulus was used to differentiate between obstructive and nonobstructive dilatation of the urinary tract. Information was recorded by a gamma camera on line to a computer. Sixty-seven uretero-renal units (URU) were studied in 33 patients with an average age of 91/2 years. The diuretic renogram correctly indicated obstructions in 18 URU but gave false positive results in another five. Of these five, four had severely impaired function. The renogram indicated nonobstruction in 49 URU, and gave false negative results in another two; of these two one patient had a duplex kidney with a poorly functioning ureteric segment and the other patient had gross reflux and megaureters. The diuretic renogram is useful in the investigation of equivocal upper urinary tract obstruction but may be unreliable in situations of inadequate renal function.

Haemodynamic response to ACTH administration in essential hypertension

1. The haemodynamic and volume response to ACTH administration was investigated in six patients with mild, untreated essential hypertension and two patients with Addison's disease on maintenance steroids. Blood pressure, heart rate and weight were recorded daily. Plasma volume (125I-HSA) and cardiac output (thermo-dilution) were measured during the control period and on the 5th day of ACTH treatment. 2. In the hypertensive subjects, mean arterial pressure rose from 94.3 +/- 2.2 to 105.7 +/- 2.8 mmHg on the 5th day of ACTH administration (P less than 0.02). Plasma volume rose from 29.8 +/- 2.2 to 34 +/- 2.2 ml/kg. Cardiac index increased from 2.85 +/- 0.21 to 3.32 +/- 0.14 l/min per m2 (P less than 0.05). Cardiac output rose from 5.81 +/- 0.69 to 6.72 +/- 0.59 l/min. Calculated total peripheral resistance, heart rate and body weight were unchanged. No such changes were seen in patients with Addison's disease. 3. The haemodynamic characteristics of ACTH in patients with mild untreated essential hypertension are similar to those in the experimental model of ACTH induced hypertension in sheep.

Franco-British Disparities in Medicine

A questionnaire in French and English was sent to physicians practising geriatric medicine in France and the UK concerning certain aspects of their clinical practice. It also enquired of the doctors their place of practice, year of qualification, present position held, and in which part of the respective country they worked. Most of the answers reflect major divergencies in methods of clinical practice between the two countries. These answers are reported, highlighted, commented on, and speculation made of the possible reasons for the differences. We feel that international questionnaires are a useful way of alerting doctors to areas of practice which are falsely assumed to be correct; they may also reveal the possible basic solutions to common clinical problems.

Rewarding effects of hypothalamic self-stimulation altered by unilateral lesions of superior colliculus in rats

The effects of unilateral lesions of the superior colliculus were determined on self-stimulation of the medial forebrain bundle. It was found that the lesions had different effects depending upon the precise location of the stimulating electrode: self-stimulation on far-laterally located electrodes was abolished while on more medially placed electrodes this behaviour was enhanced. These data are inconsistent with explanations of intracranial self-stimulation which treat it as a unitary phenomenon.

Peers as tutors in the mainstream: trained "teachers" of handicapped adolescents

Objective: The Peer Tutoring Model developed by the authors was designed to train eighth and ninth grade students as "teacher tutors" in a junior high school. The tutor's role was to increase the learning success and on task behavior of mainstreamed peers in content area classes.

Oral contraception and congenital abnormalities

Of 10 479 single births in South Glamorgan between January 1974 and June 1976, 27.3 per cent of infants were born to women who had used oral contraception in the three months prior to their last menstrual period (users) and 72.3 per cent were born to women who had not used oral contraception during the same period (non users). There were significantly more infants with neural tube defects among users compared with non users. Abnormalities of the digestive, genito-urinary and cardiovascular system, bones, muscle, skin and connective tissues, endocrine glands, blood chromosomes and oral clefts, were of similar incidence in the two groups.

m-[o-(2-Chloro-5-Fluorosulfonylphenylureido)Phenoxybutoxy]Benzamidine: Affinity Labeling Reagent Which Can Identify Secondary Binding Sites of Coagulation Complement and Fibrinolytic Serine Proteases

We have determined that m-[o-(2-chloro-5-fluorosulfonylphenylureido)phenoxybutoxy]benza-midine [mCP(PBA)-F] is an affinity labeling reagent which labels both polypeptide chains of thrombin, factor Xa, complement component CIS and plasmin. As this means it is reacting outside of the catalytic center, we have called this reagent an exo-site affinity labeling reagent. Progressive irreversible inhibition of these enzymes by this reagent is rapid (k1st 2.5-4.6 x 10-3sec-1), the kinetics of inactivation are consistent with inhibition proceding via formation of a specific enzyme-inhibitor complex analogous to a Michaelis-Menton complex (KL - 115-26 μM), and diisopropylfluorophosphate or p-amidino-phenylmethanesulfonyfluoride Prevent labeling by [3H]mCP(PBA)-F. A molecular model of mCP(PBA)-F shows that the reactive SO2F group can be 17 A from the cationic amidine. The data are consistent with the hypothesis that both peptide chains are required for the specific proteolytic activity exhibited by these proteases and that the peptide chain which does not contain the active site serine is close to the catalytic center. (Supported by NIH and AHA grants

Medical staffing of hospital geriatric units

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An investigation into the ability of elderly patients continuing to take prescribed drugs after discharge from hospital and recommendations concerning improving the situation

An investigation was made by an Occupational Therapist into the problems encountered by 50 elderly patients in the self-administration of drugs prior to discharge home. The questions asked the patients are enumerated and recommendations are made concerning how improvements can take place so that many more of the elderly will take the prescribed drugs in the right doses at the right time on discharge home.

The difficulties of old people taking drugs

There is considerable interest in the problems of the elderly taking drugs correctly and appropriately. A recent survey (Parkin et al. 1976) showed that these problems that have long been known in geriatric practice have now been noted by general physicians. This review was undertaken when an occupational therapist in a geriatric unit team noted that, although patients and their relatives were taught methods of dressing, toileting, shaving, bathing, eating, walking, transferring to a chair, wheelchair mobility and communication by the occupational therapist, physiotherapist and speech therapist, no advice or teaching was given concerning the accurate taking of the drugs prescribed. The results of a detailed investigation are reported elsewhere (Atkinson, Gibson & Andrews 1978). Repeatedly, patients ready for discharge were handed a batch of drugs by a nurse at the last possible moment, even while sitting by their luggage awaiting the ambulance. Following this, special attention was paid to problems such as intellectual impairment, loss of memory and confusion, poor sight, inability to handle containers, failure to take drugs and lack of patient-education. During ward rounds, particularly when a geriatric health visitor was present, attention was drawn to special topics such as the number of patients who inadvertently kill themselves and the numbers needing readmission due to failure to take drugs, overdosage or underdosage or mixing of drugs (Wade 1972). Ferguson Anderson's comment (1974) that 7.15% of hospital admissions are due to drug reactions was also noted.

Mecillinam serum levels following intravenous injection: a comparison with pivmecillinam

Serum mecillinam concentrations have been obtained in 6 volunteers after intravenous injection of 200 mg mecillinam and two 200 mg tablets containing pivmecillinam hydrochloride. Initial concentrations were between 6 and 9 mg/1 and peak concentrations of about 2-0 mg/1 occurred at 1 to 1-5 h after the tablets. Analysis of the intravenous data shows the concentration/time curve to be biphasic and similar to that previously reported for penicillin G. The biexponential curves describing the data have been calculated using nonlin. Comparison of the areas under the serum mecillinam concentration/time curves suggests a bioavailability of 65 to 70% for the tablets. However, the two preparations contain therapeutically equivalent amounts of antibiotic, as two 200 mg tablets of pivmecillinam contain 30% more mecillinam than the 200 mg injection.

Cefoxitin: a hospital study

Cefoxitin is a new cephamycin antibiotic that has recently become available for clinical trial. We report here the results of an uncontrolled trial of cefoxitin treatment in 31 hospital patients with various acute infections, 20 of whom were cured. Serum, urine, and bile concentrations of cefoxitin greatly exceeded the minimum inhibitory concentration (MIC) required for clinically important Gram-negative organisms. We conclude that cefoxitin will have a place in the management of serious infections, particularly in the abdominal cavity and renal tracts.

An investigation into the medical state of patients over sixty-five years of age admitted to the Regional Eye Unit for surgery

Patients over 65 years of age admitted to an ophthalmic ward were routinely screened in a standard way practiced in Geriatric Assessment Units. The previous drug therapy of all patients was particularly noted. A classification of the patients with undetected pathology was made and an attempt to categorise the percentage of those who required follow-up in the geriatric department and those who purely needed clinical information passed on to their family doctor, apart from the remainder who needed no medical advice. We postulate that this clinical assessment and subsequent treatment was of practical benefit to a large number of patients and therefore an attempt should be made to introduce this type of service more widely.

The prevalence of ampicillin, cephalosporin and sulphonamide resistance amongst urinary tract pathogens

A total of 2,031 clinical isolates of Gram negative bacilli was obtained from hospitals in 4 centres and these cultures were tested for resistance to ampicillin, cephazolin and sulphonamide. Ampicillin and sulphonamide resistance in outpatients ranged from 15 to 28 per cent of E. coli strains and 4 to 11 per cent of Proteus mirabilis strains. Resistance to cephazolin in outpatients ranged from 0 to 3 per cent of E. coli and 0 to 6 per cent of Proteus mirabilis. Resistance patterns for E. coli, Proteus mirabilis and Klebsiella strains isolated from inpatients were much higher and varied widely. These patterns are presented and the reasons for these variations discussed.

Rapid intravenous injection of tobramycin: suggested dosage schedule and concentrations in serum

A single, rapid intravenous injection of tobramycin in doses of 1.5 mg/kg or 80 mg administered to subjects with normal renal function produced a wide range of concentrations in serum. Serum concentrations peaked at greater than 20mug/ml in one third of the subjects, but these peaks were transitory. At 6 hr the serum levels were less than 2 mug/ml in all but one subject and were less than 0.1 mug/ml in 50% of the subjects. A dosage interval of 6 hr with a total dosage of 6 mg/kg per day is recommended. The variation in individual dose responses emphasizes the need for monitoring of levels of tobramycin in serum during treatment. Serum concentrations of 4-6 mug/ml 1 hr after injection can be considered indicative of adequate therapy. Levels in serum 6 hr after administration should also be monitored, particularly in the elderly. No immediate or delayed toxic effects were observed after intravenous injection of tobramycin.

Sensitivity of Haemophilus influenzae to antibiotics

The use of many different antibiotics to treat chest infection has led us to test the sensitivity of 68 strains of Haemophilus influenzae to 15 different compounds. These included established compounds such as ampicillin and tetracycline and newer agents such as cephalosporins and clindamycin. The minimum inhibitory concentrations of the compounds for H. influenzae were then compared with blood levels attained after the usual dose regimens. There has been a significant increase in tetracycline resistance in the last few years, but all strains were sensitive to ampicillin, chloramphenicol, sulphamethoxazole, and trimethoprim, Several antibiotics were found to be microbiologically unsuitable for treating H. influenzae infections.