Serum glycoproteins in the liver diseases. VIII. Desialylated glycoproteins in the liver cirrhosis.

Serum desialylated glycoprotein livel of cirrhotic patients was determined and a diagnostically significant elevation of these proteins was observed. The level of these patients was usually 2--10 times of that seen in normal subjects and the elevation was signifi-ant (p less than 0.001) when compared to the level in patients with chronic aggressive hepatitis, severe (2B). Serial determinations of these proteins in the cirrhotic patients showed no correlation between them and SGPT as a whole but in several cases in which SGPT fluctuated the former associated with the latter. In patients with decompensated cirrhotic liver these proteins returned nearly to the level of compensated patients when it was improved. The level of these proteins in cirrhotic patients correlated, not always, with serum albumin (r = -0.46, p less than 0.02) and indocyanine green clearance rate (r = -0.73, p less than 0.05), but not with SGPT as well as the other liver function tests.     

Abstention in the General Population of the U.S.A.

Data on abstention from a 1979 general population survey in the U.S.A. were analyzed and compared to data from a similar 1964 survey. Trend comparisons for the 15 year interval revealed few changes in abstention rates among various demographic categories. There was no evidence that the difference between male and female abstention rates has narrowed, that a more abstemious older generation is being replaced by a less abstemious younger generation, that there has been a regional convergence of abstention rates, or that the influence of religion on abstention has declined. A cluster analysis of reasons for abstaining (among lifelong abstainers) identified four sets of reasons: moral objection to drinking, dislike of the consequences of drinking, ‘inconsequential’ reasons, and abstinent family background. Compared to drinkers, abstainers consistently and significantly tended to disapprove of drinking by others in a variety of situational contexts. Militancy on these issues was stronger among abstainers from dry regions and among abstainers who were fundamentalist Protestants. Militancy was not, however, related to age or education. Lifelong abstainers who cited moral reasons for abstaining were more militant than those who did not.     

Ischaemic colitis in the experimental animal. II. Role of hypovolaemia in the production of the disease.

Hypovolaemia alone did not lead to ischaemic colitis but when venesection was induced immediately after the acute ligation of the common colic artery large bowel ischaemia ensued. Similarly, hypovolaemia induced one month after two major blood vessels had been occluded led to ischaemic colitis. These findings suggest that states of low blood flow in the presence of previous arterial constriction or blockage may lead to enough reduction in mesenteric perfusion for intestinal ischaemia to develop. Using an electromagnetic flowmeter placed in the cranial mesenteric artery of the dog, it was shown that hypovolaemia may lead to 50-75% reduction in mesenteric blood flow without producing any significant change in the systemic blood pressure.     

The nutritional status of the aged in the U.S.A.

An attempt was made to evaluate the nutritional status of the aged based on three large-scale federally sponsored surveys and several smaller studies. The evaluation is confounded by economic, socio-cultural, and genetic differences of the elderly as well as lack of agreement in methodology used and interpretation of the data obtained. Some general conclusions, however, can be reached. Calories, calcium, iron, thiamin, riboflavin, niacin, vitamin A and ascorbic acid were consumed in amounts less than two-thirds of the RDA by substantial percentages of the elderly (approaching 50% for many nutrients). Protein intake tended to be adequate. Hemoglobin values were low for approximately 1 out of 10 elderly whites and 1 out of 4 elderly blacks. Biochemical indices of vitamin status were much less likely to be inadequate, i.e., 1% to 17% of the populations surveyed. Obesity, apparently related to physical inactivity rather than caloric excess, was a major finding. Inadequate nutrient intakes of the aged tended to be associated with inadequate income, being female and/or being black. This paper as a part o f the mini-symposium on nutrition and aging organized by Charles Ho Barrows, Jr., and presented on Thursday, September 29, 1977 as part of the 7th Annual Meeting of the American Aging Association in New York City.     

Rheumatic diseases in the U.S.S.R

Despite our inability to precisely prognosticate disease, accumulation of knowledge about risk factors allows us to form a real basis for attempts at primary prevention of rheumatic disease. Because rheumatic diseases are multifactorial in nature, it may be suggested that the more factors an individual has the higher is the risk of disease. Relative risk values are certain to have a known limitation, since they are not independent. In addition, the number of risk factors may be significantly more than that known today. Increasing our knowledge in disease etiology and pathogenesis will definitely increase the number of risk factors. At the same time, available data may serve as a basis for developing a system for individual and group prognosis, the latter being to a certain degree tentative for the majority of diseases. All factors affecting disease development and course are divided into the controllable and the uncontrollable. The majority of the factors mentioned--especially, the environmental--are controllable ones. So the challenge facing practitioners and scientists involves development of a comprehensive system of recommendations aimed at elimination or maximum lessening of unfavorable risk factors, which is the only real basis for primary rheumatic disease prophylaxis.     

Malaria in the Republic of the Philippines. A review.

Malaria in the Republic of the Philippines is caused principally by P. falciparum and P. vivax, with the former as predominant species. P. malariae is occasionally reported, while P. ovale is very rare and has been reported only in the island of Palawan. Malaria is widespread in distribution with prevalence varying from one area to the other. In 1970, the malaria morbidity rate was reported to be 77.6 per 100,000 while the mortality rate was 1.8 per 100,000. Case detection activities revealed that, in 1973, the slide parasite rate was 7.2%, the annual parasite index was 6.1% and the annual blood examination rate was 8.4%. The principal vector of malaria in the Philippines is An. minimus flavirostris which breeds in clear, fresh-water streams in foothills and mountain slopes. An. mangyanus and An. maculatus appear to play a secondary role. The vectorial capacity of the former appears to be confined only where conditions are primitive, while the latter is associated with malaria transmission in high altitudes. In the absence of fresh-water streams, the salt-water breeder mosquito, An. litoralis, assumes the vectorial role. The epidemiology of malaria in the Philippines is discussed. Emergence of strains of P. falciparum with diminished sensitivity to the commonly used antimalarial drugs is reported in Palawan and Rizal provinces. The development of malaria control activities in the Philippines are presented. As of 1972, Cagayan Valley, Palawan, Mindoro, Sulu and circumscribed areas in Mindanao are still considered hard-core malarious areas with on-going persistent transmission.     

Cholera in the Gilbert Island. I. Epidemiological features.

An explosive epidemic of cholera due to Vibrio cholerae, biotype El Tor, serotype Inaba, was centered on the coral atoll of Tarawa, Gilbert Islands. This outbreak was a unique experience in the South and Central Pacific region. The principal mode of spread during the peak of the outbreak was probably through contamination of the main water supply. Tarawa lagoon water and shellfish were found to be contaminated with V. cholerae and ingestion of raw fish and shellfish from the lagoon also served as a source of transmission. This outbreak raises the concern of Rother outbreaks of cholera occuring on remote and poorly equipped Pacific islands where the environmental circumstances are conducive to cholera spread.     

Arthritis in the elderly.

Rheumatic diseases affect individuals of all ages. Both incidence and prevalence vary between age groups, and the diagnosis and management of the same rheumatic disease may be very different at the various ages. It is thus important to recognize the spectrum of rheumatic disorders in age-specific groups. The functional decline of cells, tissues and organs does not occur at the same rate in all individuals. This results in an increased variation with aging. It has important clinical consequences in the diagnosis of disease in the elderly with risk of both underdiagnosis and overdiagnosis. The increasing number of elderly, the high prevalence and the specific diagnostic and therapeutic problems of rheumatic disorders in the elderly call for some rheumatologists to focus an interest in geriatric rheumatology.     

Pneumonia in the elderly.

Pneumonia is not only a major cause of death for elderly persons, but also imposes substantial personal morbidity and burdens on the health care system. Timely, accurate diagnosis and therapy depend on recognition of important differences in the pathogenesis of pneumonia according to the settings in which it occurs. Active elderly persons living in the community, institutionalized seniors with "nursing home pneumonia," and those with hospital-acquired infections have different microbial causes of their respiratory infections that, together with altered host defenses and iatrogenic factors, dramatically influence outcomes. The presence of other common medical illnesses in older persons obscures the clinical presentations of pneumonia, predisposes to respiratory infection, and adversely influences prognosis. These clinical relationships and the variability and vulnerability of individual patients underlie largely empiric, setting-specific antimicrobial therapy. Whenever possible, prevention of this devastating illness is essential.