Physiological anticoagulants and activated protein C resistance in childhood stroke

Immunological and functional protein S, protein C and antithrombin III levels and anticoagulant responses to activated protein C were measured in 24 patients with stroke in childhood. No hereditary deficiencies were found. The protein S levels in healthy controls of younger age did not differ from the adult levels. For optimal screening of protein S deficiency, measurements using functional as well as immunological assays are recommended. Appropriate criteria for the diagnosis of the deficiencies must be carefully applied if unnecessary anxiety and inappropriate treatment of children are to be avoided.     

Evaluation of attempted prevention of unexpected infant death in very high-risk infants by planned health care

Three hundred and ninety-six babies born in Sheffield between 1982 and 1990 identified as being at "very high risk" of unexpected infant death by means of a scoring system, received an intensive programme of health care including a case discussion between a paediatrician, the GP and the health visitor held in the family doctor's surgery, weekly visits from the health visitor and informal hospital admission. Significantly fewer sudden unexpected infant deaths occurred in this group than were expected by logistic regression anlysis or occurred in the best available control group with comparable scores ( p = 0.024). Problems in evaluation include identification of an adequate control population, ethical difficulties in introducing a controlled study when the programme is already perceived as effective, and the calculation of "expected death rates". The results of this study indicate that very energetic programmes of intervention may prevent some deaths in vulnerable infants.     

Evidence into action: changing practice in primary care. Occasional Paper 84.: Jane Hughes, Charlotte Humphreys, Stephen Rogers, Trisha Greenhalgh (eds). (51 pages, {pound}10.) Royal College of General Practitioners, 2002. ISBN 0-85084-284-0.

It is wonderfully ironic that the same forces driving the developmentof what used to be called evidence-based medicine (EBM) areseen increasingly as impediments to its uptake. Those driversincluded extension of the ‘new public management’(with its focus on outcomes, target setting, performance managementagainst objectives, etc.) into all areas of health care. Theculture of the internal market required purchasers to demonstratethat they were getting the best bang for their     

Fibromatosis of bone in children

Radiographs, computed tomograms, and radionuclide bone scans were obtained preoperatively in three children with fibromatosis involving the bones and soft tissues of the extremities. Two of the children had identical scar-like bone lesions of the proximal tibia, which, to the authors' knowledge, have not been reported before in this disease. The lesions recurred in two children.     

CYTOKININS: DISTRIBUTION IN SPECIES OF YEAST TRANSFER RNA

Transfer RNA fractions from Saccharomyces lactis and Saccharomyces cerevisiae have been tested for cytokinin activity in the tobacco bioassay. Cysteine tRNA has been identified as a cytokinin-containing tRNA species in S. cerevisiae. Acid hydrolysates of S. lactis tRNA fractions (containing arginine tryptophan, and valine acceptor activities) and S. cerevisiae tRNA fractions (containing alanine, asparagine, aspartic acid, glutamic acid, glycine, histidine, tryptophan, and valine acceptor activities) were inactive in the tobacco bioassay. Cytokinins have been found only in those tRNA species corresponding to codons beginning with U.