An evaluation of sepsis Web sites for patient and family education.

More and more consumers are using the Internet to find answers to questions about healthcare. Unfortunately, information at health Web sites may be incorrect, biased, and outdated. The purpose of our project was to identify Web sites on sepsis that could be used for patient and family education. We evaluated 30 sites on the basis of the Health on the Net criteria for medical and health Web sites, key content areas that patients and families should know in relation to sepsis, and readability. This article shares the process we used to evaluate the Web sites and identify the top sites for patient education.     

Pelizaeus-Merzbacher disease: classical or connatal?

The clinical features and investigation results of 7 patients with Pelizaeus-Merzbacher disease (PMD) are described; one patient had a brain biopsy and two patients had an autopsy. This paper tries to differentiate the clinical features of the connatal and classical types of PMD. Transient stridor and nystagmus were early signs in both types of PMD. Our findings support the view that the more severe connatal form shows rapid neurological deterioration from an early age leading to death usually in the first decade. In younger patients in whom the evolution is still unclear, severe feeding problems and extrapyramidal features may suggest the connatal form. By contrast, in the classical form of PMD, cerebellar signs and cognitive deterioration are more prominent with a more slowly progressive course. Nuclear magnetic resonance imaging and brainstem auditory evoked potentials were very helpful in supporting the diagnosis of PMD either in a known affected family or in sporadic cases, but were not useful in distinguishing between the two types of PMD. Genetic counseling in this condition is difficult, particularly in the connatal form in which inheritance may be either X-linked or autosomal recessive.     

Effective and organ doses from thoron decay products at different ages.

The dosimetry of radon-220, often known as thoron, and its decay products has received less attention than has that of radon-222. Dose coefficients used by international bodies such as UNSCEAR and ICRP and by the UK's former National Radiological Protection Board are based on calculations from the 1980s. We present calculations for thoron decay products using the most recent ICRP models. These indicate that the effective dose is dominated by the doses to lung and that, under the present models, these doses are somewhat higher than under the previous consensus. Conversely, the present models give doses to organs outside the respiratory tract that are somewhat lower than those previously calculated. Dose coefficients for children are somewhat higher than those for adults. However, breathing rates for children are lower than those for adults and there are no great differences in annual doses.     

Expression of c-fos, fos B, and egr-1 in the medial preoptic area and bed nucleus of the stria terminalis during maternal behavior in rats

The spatial and temporal pattern of expression of the protein products of immediate early genes (IEGs) c-fos, fos B, and egr-1 were mapped in medial preoptic area (MPOA) and ventral bed nucleus of stria terminalis (VBST) during maternal behavior in rats. Immunocytochemical analysis indicated significant increases in the number of cells expressing c-Fos after 2 h of pup exposure, while Fos B levels showed a delayed response, reaching maximal levels after 6 h.     

Preliminary evaluation of cyto-rich: An improved automated cytology preparation

A new cervical cytology monolayer preparation system called Cyto-Rich was evaluated. Using samples from 557 patients, Cyto-Rich monolayers were compared to matched conventional smears. After conventional smears were prepared and spray fixed, residual exfoliated cells were transferred to preservative fluid. The cell suspensions were gently disaggregated and the epithelial component enriched with gradient centrifugal sedimentation. The batched samples were then placed on the Cyto-Rich work station where slides are automatically prepared and stained. The results demonstrate that Cyto-Rich prepared monolayers are vastly superior to the conventional smears for cell presentation. While the study showed 99% overall concordance, Cyto-Rich improved the detection of low-grade cervical intraepithelial lesions.     

Terminal acute myelogenous leukemia in a patient with congenital agranulocytosis

Congenital agranulocytosis terminating in acute myelogenous leukemia has been previously reported in only two cases of adolescent males. We describe the clinical and laboratory features of a 13-year-old male with congenital agranulocytosis, treated with G-CSF with initial good neutrophil response, who subsequently developed acute myeloid leukemia. This rare complication may define a preleukemic subset of patients for whom G-CSF therapy is ineffective. The diagnostic challenges of this case are presented.