Follow-up of Gambian children recruited to a pilot safety and immunogenicity study of the malaria vaccine SPf66

A pilot safety and immunogenicity trial of the malaria vaccine SPf66 was undertaken in The Gambia in 1993. One hundred and fifty infants aged 6–11 months were immunized with either 0.5 mg or 1.0 mg of SPf66 produced either in Colombia or in the USA or with a control vaccine. Children who received SPf66 experienced more clinical attacks of malaria than did children in the control group during the first period of surveillance and the difference in incidence between children who had received high dose Colombian vaccine and the control children was statistically significant at the 5% level. During the 1995 malaria transmission season, 127 children from the original cohort of 150 were observed. During 18 weeks of intensive surveillance, the incidence of clinical malaria was again higher among children who had received SPf66 than among children who had received inactivated polio vaccine (6.23 vs 4.89 clinical attacks per 1000 days at risk), the effect being most marked among children who were in the high dose groups, but differences between groups were now no longer statistically significant .     

New optical technologies for earlier endoscopic diagnosis of premalignant gastrointestinal lesions

Gastrointestinal malignancies continue to be the second leading cause of cancer-related deaths in the developed world. The early detection and treatment of gastrointestinal preneoplasms has been demonstrated to significantly improve patient survival. Conventional screening tools include standard white light endoscopy (WLE) and frequent surveillance with biopsy. Well-defined endoscopic surveillance biopsy protocols aimed at early detection of dysplasia and malignancy have been undertaken for groups at high risk. Unfortunately, the poor sensitivity associated with WLE is a significant limitation. In this regard, major efforts continue in the development and evaluation of alternative diagnostic techniques. This review will focus on notable developments made at the forefront of research in modern gastrointestinal endoscopy based on novel optical endoscopic modalities, which rely on the interactions of light with tissues. Here we present the 'state - of - the - art' in fluorescence endoscopic imaging and spectroscopy, Raman spectroscopy, optical coherence tomography, light scattering spectroscopy, chromoendoscopy, confocal fluorescence endoscopy, and immunofluorescence endoscopy. These new developments may offer significant improvements in the diagnosis of early lesions by allowing for targeted mucosal excisional biopsies, and perhaps may even provide 'optical biopsies' of equivalent histological accuracy. This enhancement of the endoscopist's ability to detect subtle preneoplastic changes in the gastrointestional mucosa in real time and improved staging of lesions could lead to curative endoscopic ablation of these lesions and, in the long term, improve patient survival and quality of life.     

Tree Species Identification on Aerial Photographs: The State of the Art

The world literature on identification of tree species from aerial photographs is reviewed. The different factors affecting the importance and development of the art in northern temperate forests, tropical forests and Australian forests are discussed. The Australian experience is summarised and compared with that from the rest of the world. Directions for future Australian efforts are suggested.     

Inhibition of [3H]dopamine uptake by platelets by the dopamine-D2 receptor agonist RU 24926

Abstract— We have examined the effect of the dopamine-D₂ receptor agonist RU 24926 (N-n-propyl-di-β(3-hydroxy-phenyl)-ethylamine HCl) on [³H]dopamine uptake by human platelets. RU 24926 reduced the uptake of [³H] dopamine by platelet-rich plasma and this affect was not reversed by the dopamine-D₂ receptor antagonist haloperidol, or the dopamine-D₁ receptor antagonist SCH 23390 (8-chloro-2,3,4,5-tetrahydro-3-methyl-5-phenyl-1H-3-benzazepine-7-ol). These data suggest that RU 24926 reduces [³H]dopamine uptake by platelets by competing for the dopamine uptake mechanism on the platelet and not by activation of the dopamine-D₂ receptor.     

ADH ad hoc committee report: the use of restraints in the delivery of dental care for the handicapped—legal, ethical, and medical considerations

Presented is the final report of the Ad Hoc Committee on the Use of Physical Restraints. The report discusses legal, ethical, and medical issues of physical restraint of patients. Conclusions included: there is no consensus among the states on definition of restraint—dental practitioners should check with their own states for currrent rulings; the current national view is that restraint should only be used when absolutely necessary, and the least restrictive form should be used, and it shall not be used as punishment or for the convenience of the staff; use of restraint is acceptable dental practice when appropriately used for behavior control of patients with developmentally disabling conditions; documentation is required; physical restraint should cause no physical injury; and informed consent should be used, after checking with authorities as to proper form.     

Late Endocardial Pacing Lead Body Migration Compromising Fontan Physiology

Migration of intracardiac transvenous pacing leads may occur. There is a known risk of intrapul- monary ventricular pacing lead migration in patients with endocardial lead systems. In the current report we present the late intrapulmonary migration of an endocardial atrial pacing lead body. The patient had undergone antitachycardia pacemaker placement to control recurrent atrial tachyarrhythmias following the Fontan procedure. Although the lead electrode remained in place and continued to pace, the lead body migrated, causing severe obstruction to blood flow. This resulted in severe cardiac decompensation, which was ultimately ameliorated by lead repositioning.     

Treatment of Inflammatory Facial Acne with the 1,450 nm Diode Laser Alone versus Microdermabrasion Plus the 1,450 nm Laser: A Randomized, Split-Face Trial

BACKGROUND: The 1,450 nm laser has been effective in treating acne. Microdermabrasion may help treat acne and reduce skin barriers to increase the delivery rate of topical anesthetics. OBJECTIVES: To evaluate the efficacy, safety, and pain associated with the treatment of inflammatory facial acne with the 1,450 nm laser alone versus microdermabrasion plus the 1,450 nm laser. METHODS: Twenty patients with facial acne were treated with the 1,450 nm laser alone and microdermabrasion plus the 1,450 nm laser in a randomized, split-face trial. RESULTS: Laser alone and microdermabrasion plus laser significantly reduced the total number of acne lesions. Mean reductions of 53.5% and 55.6% were found after three treatments for laser alone and microdermabrasion plus laser, respectively. Clinical improvement was maintained 12 weeks after the last treatment. Mean pain scores were 5.3 6 1.5 for microdermabrasion plus laser and 5.2 6 1.5 for laser alone. There was no statistical difference between treatment levels for efficacy or pain. There was an average 10% increase in sequential pain as the laser treatment progressed. CONCLUSION: The 1,450 nm laser is effective, well tolerated, and safe for treating facial acne. This small pilot study did not demonstrate increased clinical efficacy or decreased associated pain with the addition of microdermabrasion to treatment with the 1,450 nm laser. A larger study may be needed to demonstrate any additional benefit.     

Reproducible Induction of "Atypical" Torsades de Pointes by Programmed Electrical Stimulation:

Sotalol-Induced Polymorphic VT. We present a patient with sotalol-induced polymorphic ventricular tachycardia that was seen only with programmed ventricular stimulation. Electrophysiologic studies performed prior to initiation of sotalol therapy revealed inducible monomorphic ventricular tachycardia. Possible underlying electrophysiologic mechanisms are discussed.