Family practice patients' experiences and beliefs in faith healing

Faith healers have become more visible as an alternative to traditional medicine because of the growth of television evangelism. The extent to which patients engage in alternative therapies such as faith healing, however, is not fully known. To further explore patients' involvement in faith healing, a cross-sectional survey was administered to 207 patients in one rural family practice. Most respondents (58 percent) reported that faith healers are "quacks," but 29 percent believed that faith healers can help some people who physicians cannot help. Twenty-one percent had attended a faith-healing service. Six percent stated they had actually been healed by faith healers, and 15 percent reported they personally knew someone who had been healed. Participation in faith-healing services was significantly higher among blacks (P less than .01) and those with less than a high school education (P less than .01). The finding that many patients embrace faith healing has implications for traditional family practice and may explain why patients sometimes reject medical treatment. Physicians need to be sensitive to patients' beliefs about "faith," and must determine the extent to which patients reject the scientific approach before physicians can become effective "healers."     

Initial therapy of bacterial meningitis with cefuroxime: Experience in 167 children

The morbidity and mortality of patients with bacterial meningitis treated initially with cefuroxime were studied and compared with the results of a previous prospective study of patients treated initially with ampicillin plus chloramphenicol in the same institution from 1979 to 1983. A retrospective chart review was completed in all cases of microbiologically confirmed bacterial meningitis admitted to the Hospital for Sick Children in Toronto, Ontario between January 1, 1984 and August 1, 1988. During this period all patients were treated initially with intravenous cefuroxime. The 167 children reviewed ranged in age from six weeks to 17.1 years (median 11.6 months). The case fatality rate was 7.8% and the rate of hearing deficit 13%. There were no statistically significant differences in abnormal neurological outcome (20 versus 20%, respectively), hearing loss (12.9 versus 13%, respectively), and case fatality rate (6.4 versus 7.8%, respectively) between the cohort of 1979-83 and the present study. The rate of hearing loss following meningitis caused by Haemophilus influenzae type b increased from 7.3 to 11.7% (P=0.26).     

Glucose tolerance in Papua New Guinea: ethnic differences, association with environmental and behavioural factors and the possible emergence of glucose intolerance in a highland community

That Melanesians of non-Austronesian genetic ancestry may be relatively resistant to glucose intolerance was supported by the results of a study of two semitraditional non-Austronesian villages in the Papua New Guinean highlands in 1983, in which an absence of diabetes and a high degree of glucose tolerance and insulin sensitivity were observed. The second of this series of surveys was conducted in 1985 in three non-traditional communities: a periurban, non-Austronesian village in the highlands, and rural and periurban Austronesian villages in coastal locations. Although an absence of diabetes was demonstrated once again in the highlanders, these periurban subjects showed an unexpectedly high insulin response which may be a precursor of glucose intolerance. The notion that highland communities that are living in non-traditional circumstances in Papua New Guinea presently are in "metabolic transition" towards diabetes and other non-communicable diseases, if correct, is of importance to the public health of the nation. In the periurban, coastal-dwelling Austronesians, diabetes with severe hyperglycaemia was demonstrated, and there was some evidence of a secular trend towards increasing glucose intolerance. The two-hour plasma glucose concentrations were shown to be associated with obesity, modernity and Seventh-Day Adventist religious persuasion. However, important and unexplained differences in glucose tolerance remained between rural and periurban coastal dwellers after taking these factors into account.     

Aspergillus Terreus Causing Invasive Pulmonary Aspergillosis With Air-Crescent Sign

Aspergillus terreus is an uncommon cause of human disease. A patient with acute myelomonocytic leukemia is described who developed an invasive pulmonary infection with A terreus characterized by an air-crescent sign on chest roentgenogram. Previous reports of A terreus infections and the pathogenesis and significance of an air-crescent sign in invasive pulmonary aspergillosis are reviewed.     

No association between the Pro197Leu polymorphism in the glutathione peroxidase (GPX1) gene and schizophrenia

OBJECTIVE: Oxidative stress such as free radical-mediated neuronal dysfunction may be involved in the pathophysiology of schizophrenia. The human glutathione peroxidase (GPX1) is a selenium-dependent enzyme, which plays an important role in the detoxification of free radicals. We therefore hypothesized that the GPX1 gene, which is located on chromosome 3p21.3, may be involved in the pathophysiology of schizophrenia. The aim of this study is to examine whether a potentially functional polymorphism, a proline (Pro) to leucine (Leu) substitution at codon 197 (Pro197Leu) of the human GPX1 gene, is associated with susceptibility to schizophrenia. METHODS: We genotyped the Pro197Leu polymorphism in a total of 113 nuclear families that had a proband with schizophrenia. Genetic association was tested using the transmission disequilibrium test (TDT), the sib transmission disequilibrium test (STDT), and the family-based association test (FBAT). RESULTS: The minor allele (Leu) frequency was calculated to be 0.282. We could not find significant transmission disequilibrium of the alleles for the Pro197Leu polymorphism in the GPX1 gene in association with the presence of schizophrenia in our family sample (TDT, chi2=0.03, degrees of freedom=1, P=0.86; combined TDT-STDT, Z'=-0.052, P=0.47; FBAT, Z=0.000, P=1.000). CONCLUSION: The results of this study suggest that the GPX1 polymorphism is unlikely to be associated with susceptibility to schizophrenia.     

Crystalline morphology of block-copoly(oxypropylene/oxyethylene/oxypropylene) by small-angle X-ray and Raman scattering

Block-copoly(oxypropylene/oxyethylene/oxypropylene)s, with central-block lengths of 39 and 75 oxyethylene units and end-block lengths in the range 1 to 13 oxypropylene units, were investigated in their solid states by small-angle X-ray diffraction and low-frequency Raman spectroscopy, supplemented by differential scanning calorimetry. Low-frequency Raman transitions were assigned to longitudinal modes (LAM) of either unfolded or once-folded chains. The solid state comprised stacked monolayer lamellae in which the chains were usually tilted with respect to the lamellar end plane.     

Effects of methacholine and uridine 5'-triphosphate on tracheal mucus rheology in mice

We compared the action of methacholine (MCh) and uridine 5'-triphosphate (UTP) with and without pretreatment with the chloride channel blocker 4,4'-diisothiocyano-2,2'-stilbenedisulfonate (DIDS) on the transepithelial potential difference (PD), the mucus collection rate (MCR), and tracheal mucus rheology using anesthetized C57BL/6 mice. The cystic fibrosis transmembrane conductance regulator (CFTR) blocker 5-nitro-2-(3-phenylpropylamino)benzoate (NPPB) was also used as a pretreatment for MCh. After collecting baseline mucus for 1.5 h, mucus secretion was stimulated by instilling 5 microl of 10(-2) M MCh or UTP around the upper trachea. There was a significant increase in PD after MCh or UTP stimulation (-21.3+/-2.0 mV MCh versus -14.1+/-1.6 mV control; -25.4+/-2.5 mV UTP versus -19.2+/-1.9 mV control). When UTP administration was preceded by DIDS, PD shifted from -15.2+/-2.9 to -12.0+/-2.2 mV. When MCh was preceded by DIDS or by NPPB, there was no change in PD. There was a significant decrease in mucus rigidity index, logG*, with MCh (2.54+/-0.09 versus 2.99+/-0.14 for control), similar to that previously reported in other species. With UTP, 14 of 16 mice responded in terms of PD becoming more negative, and of these, there was a significant difference in logG* after UTP administration (2.29 +/-0.10 versus 2.57+/-0.10 for control), whereas there was no change in logG* with DIDS administration before UTP. When DIDS administration preceded MCh, there was a diminished but still significant decrease in logG* from control, whereas there was no change in logG* when NPPB was preadministered. The control mucus collection rate was 0.19+/-0.09 mg/h, whereas after MCh stimulation, it increased to 2.83+/-0.78 mg/h. No significant difference was measured in the MCR after either UTP or DIDS+UTP stimulation. DIDS+MCh and NPPB+MCh both resulted in significant increases in MCR, but of a much smaller magnitude than that for MCh alone. We conclude that hypersecretion owing to UTP in C57BL/6 mice is less vigorous than with MCh, reflecting the limited population of Ca(2+)-dependent Cl(-) channels stimulated by UTP P(2) receptors. The action of MCh on tracheal mucus secretion in mice appears to involve both CFTR- and non-CFTR-dependent chloride channels.