Species specific grass pollen sensitivity: diagnosis and treatment with single grass species Allpyral vaccines

Skin test titrations and nasal provocation tests in sixty patients with hay fever showed specific reactions to extracts of individual grass species. There was, however, no correlation between skin and nasal sensitivity. Repeat testing after treatment with Allpyral vaccines consisting of only the grass species to which the nasal reaction was most severe, or only one of several pollens to which reactions were equally severe, showed marked diminution of skin and nasal sensitivity not only to the single pollen used for immuno-therapy but to all five common pollens used in the Allpyral grass mix. Clinical results seemed much improved as compared with results in the same year for Allpyral five grass mix vaccines, especially in the case of patients treated with Timothy, rye, or cocksfoot. It was concluded that these three grasses were to be preferred for treatment in England, and that these grasses contain common allergens.     

Oxygen and Redox-Active Drugs: Shared Toxicity Sites

Oxygen and Redox-Active Drugs: Shared Toxicity Sites. Brown,O.R. and Seither, R.L. (19S3).Fundam. Appl. Toxicol. 3:209-214.Paraquat and nitrofurantoin can accept single electrons and,under appropriate conditions in tissues and cells, can passthese electrons to oxygen, thus participating in redox cycling.Similarities in the response of the target organ (the lung)and in subsequent pathology have also been observed among animalspoisoned by oxygen and by these chemicals. We report evidenceprimarily obtained from Escherichia coli for common biochemicalsites of toxicity for these agents. Common sites for oxygenand paraquat involve biosynthesis of specific amino acids, inductionof genetic stringency via unloaded tRNAs resulting from aminoacid deficiencies, decreased thiamin content, and impaired biosynthesisof pyridine nucleotide coenzyme biosynthesis for paraquat andoxygen. Inhibition of specific amino acid biosynthesis and inductionof stringency also have been observed for nitrofurantoin. RNAand DNA biosynthesis are also impaired by oxygen; this has notbeen examined for paraquat or nitrofurantoin. There is a biochemicalbasis and preliminary data to support inhibition of NAD biosynthesisas a component of mammalian toxicity for these agents. Niacinmay act to circumvent the consequences of the biochemical lesionat quinolinate phosphori-bosyl transferase in NAD biosynthesis.     

Controlled trial of external cephalic version

Summary. A prospective randomized, controlled trial involving 640 singleton breech presentations after 30 weeks gestation was conducted to assess the value of external cephalic version. In 310 patients external cephalic version was attempted; the other 330 patients in whom version was not attempted constituted a control group. There were three perinatal deaths directly attributable to external cephalic version. No significant differences were found between the study and control groups respecting the incidence of vaginal breech delivery, caesarean section rate, perinatal mortality and morbidity. Our results suggest that there is no place for external cephalic version before 36 weeks gestation.     

A computer-based test item-bank for cognitive assessment of medical students during a clinical medicine clerkship

The development and utilization of multiple-choice test items and the utilization of computer technology have significantly altered evaluation practices in medical schools. This paper describes the development and implementation of a computer-based multiple-choice test item-bank for use in a junior medicine clerkship. The computer program, ITEMBANK, is an interactive system that stores and edits test items and constructs and prints an original copy of each test. Tests can be produced almost immediately by the clerical staff and the total developmental costs have been minimal. The program has reduced the amount of teaching time required to develop tests, and has enhanced the learning of essential information by medical students and residents. Teaching staff and student response has been enthusiastic and positive. Statistically significant Pearson correlation coefficients have been obtained between student performance on these tests and clinical evaluation and NBME Part II scores. The program has made a valuable contribution to the improvement of evaluation procedures in the Internal Medicine clerkship.