Hepatic structure and function in Papua New Guineans with leprosy

Hepatic function, including plasma bromsulphthalein (BSP) clearance was studied in 20 Papua New Guineans with leprosy: 11 lepromatous (LL) (6 had erythema nodosum leprosum (ENL)) (group A), and 9 tuberculoid or borderline (BT or BB) (group B); 12 controls (group C) were also studied. Four of five with abnormal BSP results had significant complicating or additional factors (hepatic amyloidosis, pustular ENL, hepato-cellular carcinoma and a pyogenic abscess), compared with two of 15 with normal results (tuberculous osteitis and pyogenic osteomyelitis). In nine (five from group A, and four from group B) needle liver biopsy histology was assessed: foci of vacuolated phagocytes and histiocytes, and tuberculoid granulomata were the most frequent lesions; none had cirrhosis.Leprosy is not associated with impaired hepatocellular function unless a severe complication or coincident disease is concurrently present. In this limited study therapeutic agents were not associated with abnormal liver structure or function. When liver function is abnormal in leprosy, another cause (e.g. secondary amyloidosis, sepsis or malignancy) should be searched for.     

Frozen stored Leishmania tropica vaccine: the effects of dose,route of administration and storage on the evolution of the clinical lesion. Two field trials in the Israel Defense Forces

The first field trial of frozen vaccine against cutaneous leishmaniasis yielded a 100% take rate and a high ulceration rate at a dose of four million units. Two further trials were designed to investigate differences in response rates on the basis of duration of storage, sex of vaccinee, vaccination dose and method of administration.257 soliders (151 males and 106 females) were inoculated in 1978 with an isolate of Leishmania tropica major that had been stored at the temperature of liquid nitrogen for 11 months before use. Those inoculated with an intradermal jet injector and those receiving half a million units by conventional injection yielded very low take rates. For those receiving two million and one million units, no difference in response was demonstrated between males and females or between doses. The over-all take rate for these groups after six months of follow-up was 71·6% with an ulceration rate of only 23·7%.In a subsequent trial in 1979, 131 men were inoculated with one of two frozen isolates of L. tropica major that had been stored for 11 and 18 months, respectively, at doses of either two million or four million units. The take rate after 12 months of follow-up was 91% and 93% for the four and two million units dose, respectively. The corresponding ulceration rates were 39·5% and 25%. The lesions produced by the higher dose developed more rapidly than those produced by the lower dose. The ability of the parasites to produce lesions rapidly with high ulceration rates appears to decline during prolonged storage, even in the frozen state.     

Casual blood pressure: Its relationship to several cardiovascular risk factors in middle-aged men

The relationship between casual blood pressure and other cardiovascular risk factors in presumably healthy middle-aged men (in the age range of 50–60 years) was investigated in a cross-sectional study. It was found that people with high casual blood pressure (> 160 and/or > 95 mmHg) and who have no history of previous cardiovascular disease were older, heavier, had higher heart rates and blood glucose, smoked more and had more evidence of L.V.H. on E.C.G. than a control group who had normal or borderline casual blood pressure. It was concluded that even casually found hypertension in seemingly healthy individuals is associated with higher prevalence and degree of certain behavioral, physical and biochemical parameters frequently seen in people with ischaemic heart disease.     

Social bonds in a healthy elderly sample: characteristics and associated variables

Social bonds were examined in 256 healthy, independent-living elderly men and women using the Interview Schedule for Social Interaction (ISSI). Multivariate techniques were used to test for relationships between six dimensions of social bonds, as measured by the ISSI, and demographic characteristics as well as scores from the Kellner-Sheffield Symptom Questionnaire, the Jacobs Cognitive Screening Exam, the Halstead Category Test and the Wechsler Memory Scale. The study participants reported involvement in a range of satisfying, supportive, interpersonal relationships. Significant associations were found between social bonds and income, marital status, work status and health status. Emotional status, cognitive functioning, and memory were found to be independent of social bonds in our statistical model.     

A review of the carcinogenicities of nickel,chromium and arsenic compounds in man and animals

Increased incidences of cancers of the respiratory tract have been reported among (a) workers in nickel refineries; (b) industrial workers who have been engaged in production of chromates or in processing of chrome pigments; and (c) workers who have had diverse occupational exposures to arsenic compounds (metallurgical, chemical and agricultural workers). Human subjects who have developed clinical manifestations of arsenicalism as a result of environmental, occupational or iatrogenic exposures have been reported to have increased incidences of cancers of the skin and possibly of internal organs. Certain nickel and chromium compounds (e.g., nickel subsulfide and calcium chromate) that have been administered to rodents by parenteral or respiratory routes have induced cancers at the sites of deposition. Experimental induction of cancers in animals has not been reported as a consequence of administration of arsenic compounds.     

Strategies for prevention using allied health professionals.

Preventive services which are directed at groups and individuals who are at high risk of some unfavorable outcome should be incorporated into the fabric of medical care practice. Allied health professionals have the required skills to provide preventive services with a greater sense of job satisfaction than do physicians. Experiences to date attest to the usefulness of allied health professionals in meeting the gaps in health care which are largely preventive in nature.     

A hypertension treatment program at the workplace to complement community care

A worksite hypertension control program was established for employees of the state of Maryland. Employees were screened for hypertension, and individuals identified as hypertensive were encouraged to seek care from community physicians. For those choosing not to seek such community care, a treatment program was initiated at the worksite. Of the 417 hypertensives identified, 54 (13%) elected to have their blood pressure treated at the worksite. Comparisons between the group choosing worksite care and the group choosing community care revealed that the worksite group was generally a higher risk group by virtue of having less awareness of their hypertension, being less likely to be on antihypertensive treatment, and being less likely to have their hypertension controlled by medication. This group made relatively little use of community physicians. Increases in hypertension treatment and control were greater in the worksite group after a 2-year follow-up examination. The project suggests an important role for worksite treatment programs for hypertension as a complement to existing community care.     

Efficacy of cervical cytologic screening in the control of cervical cancer

Cervical cancer mortality in the U.S. has been declining, and this has been attributed to cervical cytologic screening. This report reviews data on the incidence and mortality of cervical cancer in order to evaluate the effect of cytologic screening. U.S. cervical cancer mortality has been declining consistently since 1946, with little change in the mortality trend after widespread cytologic screening. Incidence of invasive cervical cancer in specific geographic areas has also declined. However, the rate of diagnosis of carcinoma in situ has increased sharply and parallels increasing cytologic screening rates. A causal association of cytologic screening with the decreasing mortality and incidence of invasive cervical cancer cannot be established using current data, especially considering declining mortality prior to widespread screening and increasing removal of women from the population at risk by hysterectomy.     

中西医结合诊治眩晕初探

通过对眩晕含义界定,对其病因病机分析、辨证治疗,将眩晕概括为风、痰、火、瘀、虚五个方面,辨证分型与施治分别为：（１）痰湿中阻眩晕：主方可选用半夏白术天麻汤、泽泻汤合二陈汤、小半夏加茯苓汤。（２）气血精虚眩晕：①心脾两虚、气血双亏型可选用归脾汤;②脾肾两虚、虚风上旋型可选用守中汤;③中气不足型可选用补中益气汤;④肾精不足型可选用左归丸。（３）瘀血内停眩晕可选用血府逐瘀汤加减。（４）阴虚生风眩晕可选用     

Studies in community nutrition: Estimation of sodium output

A practical procedure for estimating dietary intake of salt would facilitate examination of the possible relationship between salt intake and hypertension and could provide feedback to aid persons in changing salt intake when such is recommended. This is a study with 19 subjects of a sampling procedure of estimating sodium output which requires less patient cooperation than that needed for a 24-hr urine sample. Each subject provided timed urine samples for portions of the entire 24-hr period for three consecutive days. Sodium excretion for any one of the entire 24-hr periods correlated well with the mean 24-hr excretion for the 3-day period. The mean sodium excretion of the three 9-hr overnight urine samples correlated equally well with the mean 24-hr excretion for the entire 3-day period. This latter procedure, which puts far less a burden of compliance on the subjects, is suggested as preferable to obtaining a 24-hr urine sample. For purposes of checking compliance with dietary suggestions, it is possible to replace the analysis for sodium with a simple titrator strip that measures chloride.     

Kala-azar in Zambia: first report of two cases

Two autochthonous cases of kala-azar, the first such report of the disease from Central and Southern Africa, are described. Both patients presented with generalized macules, papules and nodules without ulceration and both also had tuberculosis. Amastigotes were cultured from blood and identified in skin, bone marrow, liver and spleen.     

The adverse consequences of heavy Trichuris infection

Sixty-seven children with heavy Trichuris trichiura infection (Group A) were compared to 73 control children of similar socio-economic status but with light or no T. trichiura (Group B), for nutritional status, rates of concomitant bacterial and protozoal, and symptoms and clinical signs associated with heavy T. trichiura infection. Anoscopy was used to determine heavy T. trichiura infection. Measurements and physical examination were done on Group A on admission to and discharge from hospital; 46% were seen on follow-up visit two to eight months later. Children in Group B were seen only once. There were significant differences for nutritional status (p less than 0.01) and rates of bacterial and protozoal co-infection (p less than 0.01) and a significantly greater rate of invasive amoebiasis in Group A. After treatment, nutritional parameters of Group A children improved significantly, symptoms and clinical signs decreased and there was also a significant decrease in the rate of concomitant bacterial and protozoal infection. Subgroups of Group A children, with and without concomitant enteropathogens, revealed that infection with Entamoeba histolytica and bacterial enteropathogens had had no significant impact on clinical and nutritional status.     

Immunogenicity of axenic Entamoeba histolytica antigen and its fractions

Amoebic antigen prepared from axenic Entamoeba histolytica (NIH:200 strain) grown at 37 degrees C in TPS I medium was chromatographed on a Sephadex G-200 column. Three fractions (F-I, F-II, F-II) were obtained, the molecular weights of which ranged from 650,000 to 1,450. Fractions were concentrated by lyophilization and antisera against each fraction and whole antigen were raised in rabbits. Partially purified fractions were used in various serological tests and their reactivities were compared with whole amoebic antigen. Main haemagglutinating and precipitating activities were confined to Fraction I, which had 14% of total protein and the highest molecular weight (650,000). 5 micrograms/ml of protein contained in this fraction gave antibody titres comparable to those obtained with whole antigen with 40 micrograms/ml or protein. Other fractions, although they had precipitin activity, lacked haemagglutinating activity. The protective efficacies of these fractions are being investigated in our laboratory.     

百尺竿头须进步,精益求精争上游——祝贺《环境与职业医学》杂志创刊30年

谈到人生的历练时,人们总会想到孔子的名言,他在《论语·为政》中提到＂吾十有五而志于学。三十而立,四十而不惑,五十而知天命,六十而耳顺,七十而从心所欲,不逾矩。＂＂三十而立＂意味着已能自立于社会,这是孔子对于自己在30岁时所达到人生状态的自我评价。《环境与职业医学》杂志前身为《劳动医学》杂志,自1984年创办以来,随着我国预防医学事业的发展而逐渐成长,从一本内部刊物发展成为具有一定影响力和知名度的学术期刊,在预防医学领域内占有了一席之地。