The automatic implantable cardioverter-defibrillator: efficacy, complications, and device failures

Twenty-six patients with refractory ventricular arrhythmias received the automatic implantable cardioverter-defibrillator. A patch lead only was placed during arrhythmia surgery in 7 other patients. During 13 +/- 6 (SD) months, the device discharged in 10 patients because of a sustained ventricular arrhythmia. No sudden deaths occurred. There were 31 complications in 17 patients, including postoperative refractory heart failure, coronary artery erosion, subclavian vein thrombosis, postoperative stroke after conversion of atrial fibrillation, atelectasis with pneumonia, symptomatic pleural effusions, and infection at the generator site. The cardioverter-defibrillator discharged in 9 asymptomatic patients, failed to terminate ventricular fibrillation during postoperative testing in 3 patients, and had premature battery failure in 4 patients. Tachycardia slowing during chronic amiodarone therapy and unipolar ventricular pacing during ventricular fibrillation precluded or delayed arrhythmia sensing. Thus, the cardioverter-defibrillator can be life saving, but its potential complications and interactions with antiarrhythmic drugs and pacemakers must be considered at patient selection.     

Behavioral evidence of depolarization block of mesencephalic dopamine neurons by acute haloperidol in partially 6-hydroxydopamine-lesioned rats.

The effects of acute haloperidol (HAL) and apomorphine (APO) administration were tested on the responsiveness of rats to medial forebrain bundle (MFB) brain stimulation reward (BSR) before and 28 days after partial dopamine (DA) depletion. Before 6-hydroxydopamine (6-OHDA) lesioning, HAL (50-100 micrograms/kg) and APO (25 micrograms/kg) both caused moderate decreases in the animals' responsiveness to BSR. In contrast, the same moderate doses of HAL completely abolished BSR after lesioning. However, postlesion responding for BSR after HAL could be reinstated by APO. The results of this study provide behavioral evidence that is consistent with recent electrophysiological data showing that acute HAL causes DA cells that survive 6-OHDA lesions to be driven into a state of depolarization block.     

Control of the freshwater fouling bivalveCorbicula fluminea by halogenation

Mortality levels for adult and juvenile Asiatic clam,Corbicula fluminea, were determined after exposure to halogens (chlorine, bromine) in 28 to 32-day laboratory and field (industrial water supply) tests. Low levels of mortality (<53%) were generated in laboratory studies on exposure to constant doses of total residual chlorine (TRC) when mean test temperatures were <16C. Mortality levels were elevated (>53%) when test specimens were exposed to comparable TRC levels (0.2 to 1.0 mg/L) at temperatures in excess of 18C. Mortalities generated among adults by an initial 14-day low dose (0.25 mg/L TRC) followed by an 18-day high dose (0.50 to 1.00 mg/L TRC; >80% mortality) were comparable to those from a constant high dose (0.50 to 1.00 mg/L; 60 to 95% mortality). Adults and juveniles were comparably sensitive to halogen concentrations adequate for control. There is no substantial difference in the effectiveness of either chlorine or bromine in controlling adult and juvenile stages ofC. fluminea. Field studies conducted in the spring and fall produced markedly dissimilar results. Mortality levels during the spring field study exceeded 90% after 28 days of exposure to 0.25 mg/L TRC, while ambient temperatures rose from 20 to 25C. Mortality levels not exceeding 23% were observed among test organisms after 28 days of exposure to elevated TRC levels (<0.50 mg/L), while ambient temperatures were declining from 20 to 12C during October and November 1985.     

Reasons for poor prognosis in British patients with cutaneous malignant melanoma

One hundred and twenty five patients presenting in the west of Scotland with primary cutaneous malignant melanoma answered a detailed questionnaire to establish whether there was any evidence of inappropriate delay in receiving surgical treatment for a new or changing pigmented lesion. The survey was carried out because of the relatively high proportion of patients in Scotland with melanoma presenting with primary lesions categorised as "thick, poor prognosis" and the poor five year survival figures as compared with many other countries. Of the 125 patients questioned, only 20 (16%) had received appropriate surgical treatment within three months of becoming aware of a suspicious cutaneous pigmented lesion; 63 (50%) had received surgical treatment three to 12 months after first noticing such a change, and in 42 cases (34%) this interval was over one year. In 102 of 105 patients in whom the interval exceeded three months the patient alone was responsible for the delay; in only three cases was the family doctor partially at fault. No evidence of delay by the hospital service was identified. Because of these findings a public education campaign was launched in the west of Scotland in June 1985 with the aim of improving recognition of early malignant melanoma. In the next six months the proportion of patients in the west of Scotland with primary melanomas categorised as "thin, good prognosis" had risen from 38% to 62%, and the proportion with tumours categorised as "thick, poor prognosis" had fallen from 34% to 15%.     

Supplementation of an adapted formula with bovine lactoferrin: 1. Effect on the infant faecal flora

The development of the infant faecal flora was studied over the first three months of life in infants receiving breast milk, a modern adapted formula and adaptations of this formula. Breast-fed infants developed a flora rich in Bifidobacterium sp. Facultative anaerobes were ubiquitous, but in relatively small numbers within the diet group. Other obligate anaerobes, such as Clostridium sp. and Bacteriodes sp. were rarely isolated. Standard formula produced a flora rich in bifidobacteria, but the growth of facultative organisms was not suppressed by this diet. Clostridium sp. and Bacteroides sp. were more common in this feeding group. After the addition of lactoferrin at 10 mg/100 ml to the formula diet, a flora similar to that of the standard formula-fed babies was achieved. Lactoferrin at 100 mg/100 ml was able to establish a "bifidus flora" in half of the babies given this formula, but only at age three months. Clostridium sp. and Bacteroides sp. were common faecal isolates from babies receiving both the lactoferrin diets.     

Examining the Correlates of Adolescent Food and Nutrition Knowledge

Food literacy is a set of skills and knowledge that are integral to diet. It is common among teenagers to not have basic food literacy skills needed to consume a healthy diet. This study examined: (1) the current state of food and nutrition knowledge among adolescents 13–19 years of age in the census metropolitan area of London, ON, Canada; and (2) correlates of food knowledge and nutrition knowledge among adolescents. Data for this study were drawn from baseline youth and parent survey data collected from a larger population health intervention study. Statistical analysis of the survey data indicates that higher parental education and higher median neighbourhood family income, the use of mobile health applications, liking to cook, as well as confidence in reading and understanding food labels were all consistently associated with increased food and nutrition knowledge. Findings may help guide future research towards optimal methods for delivering food literacy interventions to effectively educate teenagers. Results of this study may help guide policy makers, researchers, and public health professionals in developing appropriate food and nutrition programs and curriculums to combat the decline in food literacy skills.