Domiciliary hospice care: a survey of general practitioners

A survey of general practitioners in two London health districts was undertaken to gauge their reaction to a domiciliary hospice team which had been available in those districts for two years. Seventy-two per cent of the 226 respondents had used the service, 23% more than four times, and 94% indicated satisfaction at having such a service available, with only 1% expressing dissatisfaction. Although the overall response to the questionnaire was positive, much constructive criticism was also received. Conducting the survey has encouraged more doctors to use the service.     

Terbutaline metered-dose inhalation vs metaproterenol by hand-held nebulization: a comparison in black inner-city COPD patients

A greater percentage of the inner-city black population suffers from chronic obstructive pulmonary disease (COPD) than does the white population in general. Urban black patients are also more likely than urban white patients to receive primary care for their COPD symptoms in area emergency rooms, which can affect the resources available for medical care in these institutions. The present study compared the standard of therapy at Provident Medical Center, metaproterenol, administered by a hand-held nebulizer (HHN), with therapy using terbutaline, administered by a metered-dose inhaler (MDI) with a spacer, in 60 black patients with mild to moderate respiratory distress.     

Domiciliary visits by pathologists: an evaluation

Domiciliary visits by pathologists may confer benefits of various kinds: enabling many illnesses to be managed safely at home rather than by admission to hospital or attendance at the outpatient department; reassurance of patients, relatives, and family practitioners; the mutual education of family practitioners and pathologists; and the improvement of outcome of disease by early investigation.

An analysis of the financially definable costs and benefits of 1,182 domiciliary visits by two pathologists during an eight-year period shows that the savings are much greater than the costs.

     

Domiciliary terminal care: demands on statutory services

The work of a specialist advisory home care service for the terminally ill during 1980 is reported, with reference to the demands it made on community services. Whilst there was no change in demand for home helps, there was a 44 per cent increase in visiting by community nurses for male patients and a 117 per cent increase for female patients. Commodes, ripple mattresses and backrests were all essential and an increased need of over 100 per cent in each was recorded. Patients were attended on average for three months (men) and six months (women) and 41 per cent were able to remain at home until their death.     

Sixty day trial of a new inhalant dosage form of metaproterenol.

A 5% solution of metaproterenol, 10 whiffs (1.5 mg) q.i.d., was administered from a hand bulb nebulizer to 28 asthmatics for 60 days. Spirometry in double-blind, crossover tests against an 0.5% isoproterenol solution on days 0-1 and 59-60 and global evaluations of response showed that metaproterenol was more effective and longer acting. No tolerance to metaproterenol developed. Side-effects were negligible.     

Misdiagnosed Salmonella septicemia and endarteritis due to a lactose-fermenting strain: bacteriologic and epidemiologic considerations.

In a case of septicemia and endarteritis the causative agent was initially misidentified. The Salmonella had atypical biochemical properties and was resistant to numerous antibiotics. Therapy with gentamicin and cephalothin failed to eliminate the organism. Identification of the organism as a lactose-fermenting Salmonella serotype typhimurium var. copenhagen was confirmed. The possible dissemination of the isolate from Brazil was analyzed by serologic studies of family members and friends.     

Ear infections with Shewanella alga: a bacteriologic, clinical and epidemiologic study of 67 cases

Objective: To present bacteriologic and clinical data on 67 patients from the island of Funen, Denmark, with Shewanella alga , a bacterium rarely seen in Scandinavia, isolated from ear swabs. Included in the study is an examination of the occurrence of S. alga in sea water around the island.
Method: Bacteriologic examination and antibiotic susceptibility testing of 67 clinical isolates, 11 sea-water isolates and two reference strains were conducted. Clinical information was obtained from the referring physicians.
Results: During 6 months S. alga was isolated from 67 patients, in 33 cases in pure culture. Seventy per cent of the patients were children between 3 and 15 years old who had clinical symptoms of acute or chronic otitis media. Previous ear disease was common (76%). Most of the cases (85%) occurred in August or September, and 47 of 55 patients reported contact with sea water shortly before symptoms developed. From seven of the patients, S. alga was isolated more than once. The species was also isolated from five of 10 bathing areas around the island of Funen.
Conclusions: The patients were probably infected with S. alga during sea-water bathing in the unusually warm summer of 1994. Infections with marine bacteria are possible in countries with a temperate climate; patients with previous ear disease are at special risk.     

Understanding Latin abbreviations: a survey

A questionnaire was sent to general practitioner principals and trainees and to retail pharmacists in the west of Scotland to ascertain how well they translated 20 Latin abbreviations. The results showed that pharmacists had a high level of understanding, but that general practitioner principals and trainees misunderstood some of the less commonly used terms. Misunderstanding was more likely among trainee general practitioners than principals.     

Genetics of immune response: a survey

The mouse has served as an invaluable model for investigations of immune response (Ir) genes. Of most importance has been major histocompatibility complex (MHC) linked Ir genes. The MHC genes have been demonstrated to be the prime factor in determination of the ability to respond to an antigenic stimulus. One of the more intriguing findings has been the capacity of a relatively small number of Ir genes to determine immune reactivity to a diverse collection of antigens. This review will deal with the extent of the antigen diversity and the nature of the antigenic determinants. Data are summarized for over 100 independent antigen systems involving infectious agents (bacteria, viruses, parasites), as well as living but not infectious agents (histoincompatible cells). Finally, the more recent findings utilizing antigenically defined (to varying degrees) proteins are presented. The contributions of each antigen type to the understanding of Ir gene function are discussed. Even though studies on synthetic polypeptides have enabled defining and elucidation of immune response genes, we have not extensively covered this area in this survey. Several excellent reviews of this studies are available.     

Breast image registration techniques: a survey

Breast cancer is the most common type of cancer in women worldwide. Image registration plays an important role in breast cancer detection. This paper gives an overview of the current state-of-the-art in the breast image registration techniques. For the intra-modality registration techniques, X-ray, MRI, and ultrasound are the primary focuses of interest. Inter-modality techniques will cover the combination of different modalities. Validation of breast registration methods is also discussed. S. Laxminarayan died on September 29, 2005     

Psychotherapy and black women: a survey

A survey of black and white psychiatrists on the subject of nonpsychotic black female patients in psychotherapy yielded 93 usable responses. Among the findings are a profile of the average black woman in psychotherapy, responses to questions on clinical and therapeutic issues, and the role of racism as reported by the psychiatrists.