Factors Stimulating Erythropoiesis in Frogs

1. Sublethal levels of hypoxia do not stimulate erythropoiesis in the frogas measured by the incorporation of thymidine-2-C¹⁴ into peripheral erythrocytes, whereas bleeding of approximately one-third of the blood volume increases erythropoiesis 70-fold as judged by this criterion. This is taken as evidence that for the frog, the fundamental stimulus for erythropoiesis may notbe hypoxia.

2. Cobaltous ion administration does not increase erythropoiesis in the frog.

3. The serum of bled frogs increases the incorporation of thymidine-2-C¹⁴into the erythrocytes of frogs into which it is injected. This serum does notstimulate erythropoiesis in the polycythemic mouse. Serum from an anemicpatient which contains large amounts of erythropoietin as measured in thepolycythemic mouse does not stimulate erythropoiesis in the frog.

Submitted on January 9, 1963 Accepted on March 16, 1963     

Respiratory Cancer in a Scottish Industrial Community: A Retrospective Case-control Study

A retrospective case-control study was undertaken as part ofan enquiry into possible causes of an epidemic of lung cancerin an industrial town in central Scotland. Relatives of thecases and controls answered a questionnaire which encompassedaspects of the social and occupational personal history of thedeceased. Despite the length of time intervening between theperiod of mortality and this investigation, enough questionnaireswere completed to allow the histories of the cases and controlsto be usefully compared. The results indicate that smoking and occupation contributedlittle to the aetiology of the outbreak of lung cancer in Armadale. ⁰Dr O. LI. Lloyd, Environmental Epidemiology and Cancer Centre, Wolfson Institute of Occupational Health, Department of Community Medicine, Level 5, Medical School, Ninewells, Dundee.     

The clinical utility of an SCN1A genetic diagnosis in infantile‐onset epilepsy

Aim Genetic testing in the epilepsies is becoming an increasingly accessible clinical tool. Mutations in the sodium channel alpha 1 subunit (SCN1A) gene are most notably associated with Dravet syndrome. This is the first study to assess the impact of SCN1A testing on patient management from both carer and physician perspectives. Method Participants were identified prospectively from referrals to the Epilepsy Genetics Service in Glasgow and contacted via their referring clinicians. Questionnaires exploring the consequences of SCN1A genetic testing for each case were sent to carers and physicians. Results Of the 244 individuals contacted, 182 (75%) carried a SCN1A mutation. Carers of 187 (77%) patients responded (90 females, 97 males; mean age at referral 4y 10mo; interquartile range 9y 1mo). Of those participants whose children tested positive for a mutation, 87% reported that genetic testing was helpful, leading to treatment changes resulting in fewer seizures and improved access to therapies and respite care. Out of 187 physicians, 163 responded (87%), of whom 48% reported that a positive test facilitated diagnosis earlier than with clinical and electroencephalography data alone. It prevented additional investigations in 67% of patients, altered treatment approach in 69%, influenced medication choice in 74%, and, through medication change, improved seizure control in 42%. Interpretation In addition to confirming a clinical diagnosis, a positive SCN1A test result influenced treatment choice and assisted in accessing additional therapies, especially in the very young.     

A Conceptual Framework for Optimizing the Equity of Hospital-Based Emergency Care: The Structure of Hospital Transfer Networks

Policy Points

• Current pay-for-performance and other payment policies ignore hospital transfers for emergency conditions, which may exacerbate disparities.
• No conceptual framework currently exists that offers a patient-centered, population-based perspective for the structure of hospital transfer networks.
• The hospital transfer network equity-quality framework highlights the external and internal factors that determine the structure of hospital transfer networks, including structural inequity and racism.