STUDIES ON THE RELATION OF TETANUS BACILLI IN THE DIGESTIVE TRACT TO TETANUS ANTITOXIN IN THE BLOOD

1. The sera of twenty-six individuals who carried tetanus bacilli in their digestive tracts all contained appreciable amounts of antitoxin. 2. The sera of thirty individuals in whose stools no tetanus-like organisms were found were, with two exceptions, free from tetanus antitoxin. 3. Although we have been unable to measure accurately the antitoxin content of these human carriers of tetanus bacilli, 0.1 cc. of serum neutralizes 10 or more M.L.D. of toxin and it is evident that they have acquired an active immunity due to the bacilli in the intestinal tract. 4. These results definitely prove that tetanus bacilli grow in the intestinal tract of man. 5. Many of the individuals who have no tetanus bacilli in their intestinal tracts and whose serum is free from antitoxin show agglutinins to tetanus bacilli. It is probable that they have been carriers of the bacilli in the past and that the agglutinins have persisted longer than the antitoxins. It seems likely, therefore, that these individuals are potentially immune to tetanus. 6. If tetanus bacilli can be established in the digestive tract of man we have a means of immunization which might be useful in armies or in regions where tetanus infections are common, though we do not recommend this method of immunization at present.     

THE TETANUS BACILLUS AS AN INTESTINAL SAPROPHYTE IN MAN

1. The only reliable method that can be used for the detection of tetanus bacilli is the culturing of the suspected material, the isolation of tetanus-like organisms and the demonstration that the pure cultures form a spasm-producing toxin that is neutralized by tetanus antitoxin. 2. Using this method we have demonstrated tetanus bacilli in 34.7 per cent of stools from 78 individuals in Peking. 3. The tetanus bacillus is growing in the digestive tract, for it is present in individuals who have been on a practically sterile diet for a month or more, and one individual may eliminate several million spores of tetanus bacilli in a single stool.     

THERAPY OPTIONS IN ALZHEIMER'S DISEASE

SUMMARY The aetiology of Alzheimer's disease and senile dementia of the Alzheimer type (AD/SDAT) are unknown, and primary prevention is thus infeasible. As overactivity in the hypothalamicpituitary-adrenal axis (possibly indicating maladaptation to stress) and vitamin B₁₂ deficiency are common, secondary prevention should focus on stress and dietary factors. Nerve growth factors and ganglioside GM₁ have been used to inhibit progression of the disorder, but this treatment is still at an experimental stage, as are efforts to prevent the formation of amyloid. Breakthroughs in AD/SDAT treatment have been seen in trials with supplementation of neurotransmitter deficits. Tacrine, a drug that inhibits acetylcholinesterase, has proved to have a cognitive-enhancing effect, but this is limited in time and the drug has side-effects. Selective serotonin reuptake inhibitors have a proven effect on the emotional disturbances seen in AD/SDAT.     

OBJECTIVE VERIFICATION OF TETANUS IMMUNE STATUS IN AN APPARENTLY NON-IMMUNE POPULATION

SUMMARY Patients who are not known to be immunised to tetanus are considered to be non-immune. The appropriate treatment is the commencement of active immunisation with a course of three tetanus toxoid inoculations; if the wound is considered to be tetanus-prone, 250 IU of human anti-tetanus immunoglobulin is given concurrently. This study determined the true immune status of 166 patients who were considered to be non-immune on the basis of the available history. The majority (90 of 166) had protective levels of immunoglobulin (greater than 0.06 IU/ml) and further treatment was not indicated. Only two patients were non-immune. The remainder had protective levels (between 0.01 and 0.06 IU/ml) and required a tetanus toxoid booster.     

小剂量芬太尼在胸科手术全麻复合高胸位硬膜外阻滞中的应用

目的观察胸科手术小剂量芬太尼在全麻复合高胸位硬膜外阻滞中的麻醉作用。方法40例科手术患者随机分为实验组(GE组)和对照组(GA组),GE组为全麻复合高胸位硬膜外阻滞,单纯全麻组为GA组,记录术中麻醉药用量,术毕苏醒时间和血压(BP)、心率(HR)。脑电双频指数(BIS)和白细胞介素-6(IL-6)。结果2组麻醉效果均满意,术毕拔管时间和异丙酚用量GE组显著小于GA组(P<0.05),血压、心率GE组均低于GA组,2组IL-6术后均比术前升高,但2组间无显著性差异,BIS值均在手术应在的常规范围内,但拔管时GE组略高于GA组。结论小剂量芬太尼在全麻复全高胸位硬膜下阻滞下胸科手术中能达到满意的麻醉效果。     

老年带状疱疹后神经痛患者的自主神经功能观察

目的:观察老年带状疱疹后神经痛患者的自主神经状态。方法:选取老年带状疱疹后神经痛患者33例为观察组(P组),正常老年人50例为对照组(C组)。采用HRV检测仪,观察两组的心率变异性情况。结果:P组心率变异性频谱分析低频正常化单位(LF%)、低高频功率比值(LF/HF)明显高于C组(P>0.05);高频功率(HF)、低频功率(LF)和高频正常化单位(HF%)与C组相比无统计学差异性(P>0.05)。结论:老年带状疱疹后神经痛患者自主神经功能紊乱,交感神经功能处于优势。     

A STUDY OF AUTONOMIC CARDIOVASCULAR REFLEXES IN ELDERLY PATIENTS WITH PNEUMONIA

People recovering from pneumonia are often weak for no apparent reason. Clinical features such as postural hypotension, arrhythmia and syndrome of inappropriate ADH have, in other circumstances, been attributed to impaired autonomic function. The aim of this study was to see whether elderly patients with pneumonia had impaired autonomic cardiovascular reflexes and, if so, how long this persisted. We compared healthy elderly controls, elderly controls with trauma (fractured femoral neck) and elderly patients with pneumonia. Thirty-eight subjects were studied in a series of cardiovascular autonomic function tests. Results suggest that elderly people have a high prevalence of impaired cardiovascular autonomic reflexes in the immediate post-pneumonic phase, and that this improves significantly after six weeks, with a further improvement by six months. Elderly patients recovering from pneumonia are predisposed to the adverse effects of drugs and other factors which can further impair autonomic cardiovascular reflexes.     

RESEARCH DESIGNS IN SPORTS PHYSICAL THERAPY

Research is designed to answer a question or to describe a phenomenon in a scientific process. Sports physical therapists must understand the different research methods, types, and designs in order to implement evidence‐based practice. The purpose of this article is to describe the most common research designs used in sports physical therapy research and practice. Both experimental and non‐experimental methods will be discussed.     

芬太尼透皮贴治疗癌性疼痛46例疗效观察

目的：评价芬太尼透皮贴治疗癌性疼痛的疗效。方法：应用芬太尼透皮贴治疗癌性疼痛46例,剂量2.5～5mg粘贴皮肤,维持72小时。结果：总有效率91.3%,其中显效39.1%,有效52.2%,无效8.7%。毒副反应主要为便秘、恶心和嗜睡。结论：芬太尼透皮贴能有效减轻癌性疼痛,副作用低微。