Treatment of spermagglutination with proteolytic enzymes. I. Sperm motility, vitality, longevity and successful disagglutination

The treatment of antibody-mediated spermagglutination by corticosteroidtherapy has a high incidence of side-effects and sperm washingis often followed by re-agglutination. The possibility of enzymaticdisagglutination was therefore investigated. In the first partof the study the effects of four proteases on sperm motility,vitality and longevity were evaluated. Subtilisin had prohibitivelydetrimental effects even at 10 U/ml. However, chymotrypsin (500U/ml), trypsin (500 U/ml) and papain (50 U/ml) had no adverseeffects. In the second series of experiments one or more ofthese latter three enzymes was found to disagglutinate spermatozoawhich had previously been incubated with sperm-agglutinatingantibody-positive sera in 87% of cases. Although further investigationis required, enzymatic disagglutination may be beneficial forthe treatment of immunologically mediated spermagglutination.     

Electronic signature of computerized patient records

The article describes the computerized system developed and used at the Ohio State University Medical Center in Columbus, Ohio to affix a physician's signature electronically. The system electronically sends dictated reports (e.g., discharge summaries, history and physical examinations, and operative reports) and attestation statements to the physician for review. The physician selects the report individually and may approve or enter comments. Comments are forwarded electronically to medical information management. The article describes the fiscal intermediary's requirements and approval process and the impact on delinquent records and accounts awaiting attestation signature before billing.     

Improving readiness and fitness of the active military force through occupational medicine tenets

The United States Military deploys its forces with minimal lead time. These forces must be medically qualified and physically fit for any locale and mission scenario. Historically, up to half of the force identified for deployment at any given time were not medically qualified. Matching individuals to specific occupations using validated medical and physical performance standards is an occupational medicine tenet that increases the effectiveness and efficiency of the workforce. To establish a cost-effective, valid medical program ensuring a fit and ready force, the military must: (1) develop validated physical fitness/occupational standards; (2) consolidate one fitness standard for males/females on the basis of workload requirements; (3) eliminate differing age standards; (4) provide statistically relevant medical screening, testing for health maintenance, and fitness for duty; and (5) mandate one joint medical standard for all military services.     

The impact of family planning service provision on contraceptive-use dynamics in Morocco

This article uses linked data from the 1995 Morocco DHS calendar and the 1992 Morocco DHS service-availability module to study the effect of service environment on contraceptive discontinuation, switching, and adoption of a modern method following a birth. The 1995 Morocco DHS also collected information on the source of supply for each episode of use of a modern method recorded in the calendar, allowing study of the association between the source of supply and discontinuation and switching rates. Multilevel event-history models are used to evaluate the impact of individual-level sociodemographic characteristics and community-level indicators of family planning service provision. The findings show that the presence of a nearby public health center is associated with higher modern-method adoption after a birth and lower method-failure rates; the presence of a pharmacy is associated with lower discontinuation due to side effects or health concerns. The degree of method-choice potential has a positive impact on both the rate of switching from the pill to another modern method and on modern-method adoption after a birth.     

Ondansetron is more effective than metoclopramide for the treatment of opioid-induced emesis in post-surgical adult patients. Ondansetron OIE Post-Surgical Study Group

Nausea and vomiting are common side effects of opioids administered for pain control. This double-blind, randomized, parallel-group study evaluated the anti-emetic efficacy and tolerability of single intravenous (i.v.) doses of ondansetron 8 mg, ondansetron 16 mg and metoclopramide 10 mg in the treatment of opioid-induced emesis. Adult patients undergoing low emetogenic surgical procedures, using a standardized anaesthesia regimen were assessed for 24 h following administration of study anti-emetic to treat established post-surgical opioid-induced emesis. A total of 4511 patients were enrolled of whom 1366 experienced opioid-induced emesis and received randomized study medication. Ondansetron 8 mg and 16 mg were significantly better than metoclopramide 10 mg (P < 0.05) for both complete control of emesis, complete control of nausea and other efficacy measures. There were no significant differences between the two ondansetron groups. All three treatments were well tolerated. In conclusion, this large, multicentre study demonstrates that ondansetron is more effective than metoclopramide in the treatment of opioid-induced emesis following administration of post-surgical opioids to control pain.     

Comparison of GENEHUNTER and MFLINK for analysis of COGA linkage data

We compared the NPLALL statistic from GENEHUNTER with two-point and three-point MALODs and MFLODs from MFLINK for all autosomal markers in the Collaborative Study on the Genetics of Alcoholism (COGA) data set. In general MFLINK produced more significant results than GENEHUNTER and implicated two regions containing candidate genes (ADH3 and DRD2). Many regions of interest identified in other studies reported at this workshop produced MALODs significant at p < or = 0.05, but these would not have been picked up by GENEHUNTER unless a less significant threshold were used.