False-positive DNA probe test for Legionella species associated with a cluster of respiratory illnesses.

Between 11 November 1986 and 28 February 1987, legionellosis was diagnosed in 23 patients at one hospital with a recently marketed Legionella-specific DNA probe for respiratory secretions. Only 10 of the 23 probe-positive patients showed findings typical of Legionella pneumonia, including a temperature of greater than or equal to 100.5 degrees F (approximately 38.1 degrees C) and radiographic evidence of pneumonia. No differences were found in the results of laboratory studies, demographic features, or underlying risk factors for these 10 probe-positive patients when compared with the 13 probe-positive patients with nonpneumonic illnesses. A case-control study comparing probe-positive and -negative patients failed to identify any different features of disease or epidemiologic characteristics. Probes of repeat specimens of sputum were still positive 2 to 13 weeks after the initial test in 5 (50%) of the 10 probe-positive patients. The clinical features in most patients were atypical for legionellosis, and the diagnosis could not be confirmed by traditional laboratory tests performed on duplicate specimens processed at the Centers for Disease Control. This report emphasizes the need for clinical microbiology laboratories to confirm test results from new procedures by accepted diagnostic methods.     

Dietary vitamin E and pulmonary biochemical responses of rats to cigarette smoking

The effect of dietary vitamin E on cellular susceptibility to cigarette smoking was studied in rats. Young male rats maintained on a basal vitamin E-deficient diet with or without 100 ppm vitamin E supplementation for 4 or 5 weeks were exposed to either sham or cigarette smoke for up to 7 days. Higher animal mortality rate was observed in the animals fed the vitamin E-deficient diet than in the supplemented group when they were subjected to acute levels of cigarette smoking. Relative to the respective sham groups, a greater alteration of biochemical parameters, such as reduced glutathione (GSH) and related enzymes, was found in the lungs of smoked rats fed the deficient diet than in the supplemented group. Animal lungs exhibited a greater biochemical response to whole smoke than the gaseous phase of smoke. The results suggest that the nutritional status of vitamin E may influence the cellular susceptibility of rats to cigarette smoking.     

Evaluation of automatic disposable rotating cartridge skin staplers

Burn surgeons commonly employ skin staples for the application of skin grafts and to secure dressings on donor site dressings and over skin grafts. Disposable skin staplers with rotating cartridges are ideally suited for wound closure because the position of their cartridges can be manually adjusted to facilitate placement of their staples. In response to the burgeoning interest in disposable automatic skin staplers with rotating cartridges, three different models are now commercially available. This report describes the design configuration and mechanical performance of these disposable automatic staplers and their staples. Mechanical performance of these staplers and staples has been assessed by standardized tests that can be replicated in any research laboratory. On the basis of these objective design and performance parameters, the Premium stapler is recommended for wound closure. This stapler provides maximal visualization of the wound as well as the staple during its formation. It delivers the staple into the skin or wound in a manner that the cross member of the staple is above the skin or wound surface. In addition, the Premium stapler has a prepositioning mechanism that can be controlled by the surgeon with minimal force. This mechanism allows the stapler to hold its staple securely, even when its pointed legs extend beyond the delivery end of the stapler. Force required to form its staples is so low that the surgeon can staple repetitively without fatigue. Finally, the Premium stapler delivers a staple that has a uniform geometry and sharp points that can easily penetrate tissue.     

Training and service in public health practice, 1951-90--CDC's Epidemic Intelligence Service

The Epidemic Intelligence Service (EIS) was created at the Centers for Disease Control (CDC) in 1951 as a combined training and service program in the practice of applied epidemiology. Since 1951, more than 1,700 professional have served in this 2-year program of the Public Health Service. In the decade of the 1980s, EIS underwent dramatic changes in response to the increased breadth of the CDC mission and the rapid expansion of epidemiologic methods. Modifications in the experience of an EIS Officer have resulted from the increased need for more sophisticated analytic methods and the use of microcomputers, as well as CDC's expanded mission into chronic diseases, environmental health, occupational health, and injury control. Officers who have entered the EIS in the past decade tend to be older than their predecessors, tend to enter the program with more experience and training in epidemiology, and are more likely to stay in public health either at the Federal level or in State and local health departments. The EIS Program continues to be a critical source for men and women to respond to the need and demand for epidemiologic services both domestically and internationally.     

A proposal for more informative abstracts of review articles

This proposal presents guidelines for preparing informative abstracts of review articles. Six guidelines are proposed: 1. The abstract should begin with a precise statement of the primary objective of the review. 2. The data sources for the review should be succinctly summarized. 3. The criteria used to select studies from the data sources and the method by which these criteria were applied should be specified. 4. The guidelines used for abstracting data and assessing data quality should be described. 5. The main results of the review and the methods used to obtain these results should be stated. 6. Conclusions and potential applications of the review's results should be clearly and succinctly stated. Application of these guidelines can lead to efficient identification of relevant, scientifically sound review articles, a greater awareness of the vital elements of a good review article, more precise computerized literature searches, and improved peer-review processes.     

Automatic wire twister

This automatic wire twister used in surgery consists of a 6-inch needle holder attached to a twisting mechanism. The major advantage of this device is that it twists wires significantly more rapidly than the conventional manual techniques. Testing has found that the ultimate force required to disrupt the wires twisted by either the automatic wire twister or manual techniques did not differ significantly and was directly related to the number of twists. The automatic wire twister reduces the time needed for wire twisting without altering the security of the twisted wire.     

An evaluation of influenza mortality surveillance, 1962-1979. I. Time series forecasts of expected pneumonia and influenza deaths

Proposed in this paper is a new method of forecasting the expected number of pneumonia and influenza deaths based on a time series analysis of the historical mortality data. Currently, the method for forecasting the expected pneumonia and influenza deaths used by the Center for Disease Control is based on regression analysis. These forecasts are used to estimate the excess deaths attributable to pneumonia and influenza. Careful comparative analysis demonstrates that the proposed method provides a more accurate forecast of pneumonia and influenza mortality than the existing method.     

Comparison of three tests for the serological diagnosis of lymphocytic choriomeningitis virus infection.

Levels of lymphocytic choriomeningitis virus antibody were assayed in 62 infected persons. The three tests used were indirect fluorescent antibody (IFA), complement fixation, and neutralization in mice. The sera first became positive by the IFA test, and IFA titers rapidly rose to a relatively high level, with the sera remaining positive long after the antibody detectable by complement fixation had disappeared. The IFA test appeared to be specific. The sera became positive last by the mouse neutralization test; with this test, antibody first appeared several weeks after infection. Virus-infected cells were stable when stored at -60 C, allowing diagnostic sera to be tested promptly by the IFA test. The IFA test for lymphocytic choriomeningitis antibody should increase the number of serological diagnoses, since it is not only rapid and specific, but detects cases not diagnosed by the other methods.     

Dynamic lower extremity alignment in children with achondroplasia

The purpose of this study is to analyze lower extremity dynamic malalignment during gait using a 3-dimensional kinematics and kinetics in 13 children (3-17 years old) with achondroplasia and to compare measurements of alignment and malrotation between gait, radiographic, and clinical measures. Gait analysis in the coronal plane showed a varus malalignment of the knee (19 +/- 13 degrees) and variable tibial torsion abnormalities (13 [internal] +/- 15.7 degrees). Radiographs also showed knee varus malalignment (16 +/- 9 degrees); however, there was poor correlation with gait analysis measures (P > 0.05). In the sagittal plane, radiographs showed genu recurvatum deformity (23.5 +/- 13.2 degrees), although the sagittal plane knee kinematics were normal. Kinetic analyses of the knee showed high internal knee valgus moments (external varus moments, 0.48 +/- 0.25 N m/kg), which were significantly different from the normal population (P < 0.05). In conclusion, there is a 3-dimensional, complex, dynamic deformity of the lower extremity present in children with achondroplasia. We recommend a very careful assessment of the limb focusing on both the static and dynamic varus deformity and tibial torsion using a combination of radiographic, clinical, and gait analysis.