Invasive hemodynamic monitoring in children

Invasive monitoring is an important aspect of the care of the infant or child with multisystem organ dysfunction or severe acute respiratory failure. The indications for these procedures in children vary little from current recommendations for adults. The size, anatomy, physiologic responses, and pathophysiologic processes in children frequently require modifications in the placement and maintenance of these lines, and in the interpretation of the data. The literature suggests that although the absolute numbers may vary, broad therapeutic goals may be identified and treated in pediatric patients as in older patients.     

Operations on the saccus endolymphaticus and vestibular nerve: have they fulfilled their promise?

The rationale for operations on the saccus and vestibular nerve in patients incapacitated by Meniere's disease as a replacement for total labyrinthectomy, has been the expectancy that less radical procedures will protect these patients from total auditory incapacity. Aware of postoperative hearing losses in some patients after 3 years, we have studied the results in 21 Shambaugh saccus decompression (SD) and 29 middle fossa vestibular nerve section (VNS) operations, in order to assess the claims made for these procedures. We found that while control of vertigo was similar to that reported elsewhere, worse hearing (AAOO criteria) developed in many cases. With SD this increased from 14% at 1 year to 58% at 10 years, and with VNS it increased from 17% at 1 year to 48% at 10 years, when the worse preoperative audiogram was used. Only 17% of SD and 11% VNS ears with serviceable best preoperative hearing had retained this at 10 years. Nineteen percent developed audiometric evidence of contralateral disease during the first 10 postoperative years. It is concluded that although, regrettably, neither of these surgical therapies appears to have the capability of preventing the progress of hearing loss, the reality of bilateral disease justifies the continued use of SD or VNS by adequately trained surgeons.     

DNA binding of a 38,000-dalton herpes-simplex-virus-2-specific protein

Western transfer and immunoenzymatic staining with affinity-purified monospecific antiserum was used to detect a 38-Kd protein that bound to native and denatured DNA cellulose. This protein has previously been shown to be a delayed early herpes simplex virus type-2 specific protein.     

Epidemiology of chlamydial eye diseases in a mixed rural/urban population of West Germany

4260 conjunctival specimens of 2850 outpatients with keratoconjunctivitis of presumed infectious etiology were studied. Two thousand six hundred sixty-eight specimens (63%) revealed growth of bacteria, and 80 (2%) growth of fungi. One hundred ninety-nine specimens (5%) were McCoy cell culture or direct stain (monoclonal antibody or Giemsa) positive for Chlamydia trachomatis. two patients had a C. psittaci infection (ELISA techniques). In patients with keratoconjunctivitis of bacterial etiology, overall incidence of McCoy cell culture-proven chlamydial infections was 7%; in the 20 to 30-year age group it was 12.5%. Simultaneous infections of chlamydiae and other bacteria were seen in 34 patients. Since sensitive and specific tests to diagnose chlamydial infections are available, ophthalmologists may be able to prevent these infections by agent-specific antibiotic therapy.     

Improvement in men inpatients in an alcoholism rehabilitation unit: a week-by-week comparison

The Brief Symptom Inventory (BSI), a 53-item psychiatric symptom checklist, was administered to 57 alcoholic inpatients on days 2, 10, 18 and 26 of their 28-day stay in an alcoholism rehabilitation unit at a Veterans Administration hospital. The results of the test show a steady decline in the patients' psychiatric symptomatology from week 1 to week 4 with the most dramatic improvement evidenced between weeks 1 and 2.