BCG Treatment of Crohn''s Disease

Among 53 patients with documented Crohn's disease, 30% manifested a defect in delayed hypersensitivity demonstrated by negative DNCB skin tests and significant (p less than 0.01) T-lymphocyte hyporeactivity. A double-blind controlled trial was conducted to evaluate oral Bacillus Calmette-Guerin (BCG) therapy in nine of these patients with Crohn's disease and deficient cellular immunity. All patients had a Crohn's Disease Activity Index (CDAI) greater than 150 (at least moderate activity) upon randomization to BCG (five patients) or placebo (four patients) treatment for six to 12 months. No significicant differences between BCG and placebo treatment were found in the CDAI, laboratory tests and gastrointestinal roentgenograms. We conclude that the disturbance in cell-mediated immunity in patients with Crohn's disease probably is a manifestation of the disease rather than an etiological factor and that immunostimulation with oral BCG is not effective therapy.     

Psychological and social adjustment of obese children and their families

The psychological and social adjustment of 30 obese children and their families was examined. Mothers completed the Child Behaviour Checklist and the Family Environment Scale; children completed the Self-Perception Profile for Children. The results consistently indicate that the obese children were less socially competent, had more behaviour problems, and had poorer self-perceptions than the non-obese normative samples. Families of obese children differed significantly from families in the non-distressed normative sample in that they interacted in a more negative way. The findings are discussed in terms of an 'at risk profile' and the implications for the behavioural treatment of obese children.     

健康扶贫政策目标与因病致贫情境的确认评价——以贵州省赤水市健康扶贫实践为例

目的:探讨健康扶贫政策目标与因病致贫情境的匹配情况。方法:采用案例研究法,对贵州省赤水市(国家集中连片特殊困难地区贫困县)42例因病致贫案例进行深度访谈,描绘因病致贫逻辑情境图,确认政策目标与情境的匹配情况。结果:通过大病和慢病的致贫逻辑情境图,呈现出了农户从健康冲击—应对策略—应对失败的"贫困—疾病—贫困"情境。结论:健康扶贫政策目标符合贫困情境;但目前仍存在政策情境例外的情况,如大病导致劳动力丧失、健康冲击后再面临应激事件等。例外情况体现健康扶贫的长期性和协同性,它需要持续开展,且将重点转移至疾病预防;同时,协同其他扶贫举措,能更好地推动贫困地区脱贫致富。     

Emotion-related Gastritis

The relationship of emotional stress to abnormalities of the gastric mucosa was considered in a review of 788 consecutive upper gastrointestinal endoscopies. Fifty-three precent of patients with gastritis not related to any generally accepted predisposing or precipitating cause had significant emotional problems documented on their clinical records, while only 10% of the comparable group of duodenal ulcer patients and 25% of a similar group of medical in-patients had significant emotional problems documented. Since this difference was statistically significant (P less than 0.01 and P less than 0.05, respectively), the data suggest that emotional stress may play a contributing role in the production of gastric mucosal abnormaltieis.     

Resetting of DDD Pacemakers Due to EMI

Multiprogrammable pacemakers have long been subject to inappropriate reprogramming and electromagnetic interference (EMI). A limited clinical experience with DDD pacing systems precludes the significance of such phenomena in these units. Since August 1981, in a series of 140 DDD systems, certain units demonstrated consistent and reproducible resetting to the back-up modes caused by electrocautery. One unit was permanently reset to the VOO mode. These observations suggest the need for renewed caution at the time of surgery; they also underscore the importance of a thorough understanding of any DDD system and careful follow-up so that such phenomena will not be misinterpreted as pacemaker failure, resulting in erroneous pacemaker removal.     

Recurrent Ventricular Tachycardia Induced by an Atrial Synchronous Ventricular-Inhibited Pacemaker

Atrial synchronous pacemakers have been known to cause a variety of cardiac arrhythmias. Of particular concern are those arrhythmias invoiv ing a pacemaker stimuius occurring on a T wave, because these may lead to ventricuiar tachycardia. The Medtronic 2409 ASVIP pacemaker is an atrial synchronous pacemaker with several features de signed to decrease the likelihood of such arrhythmias. We report a patient in whom a normally func tioning Medtronic 2409 ASVIP pacemaker, despite these features, induced recurrent ventricular tachycardia. Conditions which predisposed this patient to pacemaker-induced re-entrant arrhythmias are discussed. [PACE, Vol. 5, July-August, 1982]