Active case-finding--for the whole community or for tuberculosis contacts only?

The prevalence of tuberculosis in the household contacts of 67 smear-positive patients was compared with that in a 'non-contact' population. The prevalence of smear-positive cases among adult contacts was 3.03% as opposed to 1.35% in non-contacts; 27.9% and 11.43% respectively of children in the two groups had positive tuberculin tests (Heaf grade III or IV). The differences in children are statistically significant and could be used to justify the contention that active case-finding in underdeveloped areas should be limited to intensive contact-tracing. It is argued, however, that this may be an inherently conservative response that will not meet the needs of tuberculosis control. A plea is therefore made for a redistribution of resources in order to meet these needs.     

Spontaneous bacterial peritonitis in fulminant hepatic failure

Ascites may be associated with fulminant hepatic failure (FHF), but spontaneous bacterial peritonitis (SBP) is an extremely rare complication. We report on two patients with FHF who developed SBP. One patient died and the other recovered.     

EVIDENCE FOR DIRECT INTERACTION OF KETAMINE WITH α- AND β2-ADRENOCEPTORS

1. Ketamine has a number of effects that suggest that it may interact with α- and β-adrenoceptors. To date, the experimental evidence for this has been indirect and has been based on physiological studies using competitive blocking agents. In the present study we sought to determine from receptor binding studies whether ketamine binds directly to α- and β-adrenoceptors. 2. Membrane preparations o. α₁- and β₂-adrenergic binding sites were obtained from urinary bladder and urethrae of sheep. These binding sites were characterized by saturation analyses using [³H]-prazosin for α₁-adrenoceptor binding sites and [¹²⁵I]-cyanopindolol (CYP) for the β₂-adrenoceptor binding sites. The receptors were further characterized by displacement studies using selective and non-selective antagonists. 3. Studies in which ketamine was used to displac. [³H]-prazosin revealed a K_d of 3.40±1.23× 10^?3 mol/L for ketamine binding to ai-adrenoceptors. Displacement studies of [¹²⁵I]-CYP by ketamine showed a K_d of 0.35±0.03× 10^?3 mol/L for ketamine binding to β₂-adrenoceptors. 4. We conclude that ketamine interacts directly with both ai- an. β₂-adrenoceptors and that such interactions probably explain the reported effects of this agent on the vasculature and the bronchial tree.     

Short term bioassay of cigarettes containing Cytrel tobacco supplement

The toxicity of smoke from cigarettes containing tobacco, Cytrel tobacco supplement, or mixtures of the 2 materials, was investigated using 6 short term test methods. The tests used were rat trachea organ culture and mouse skin thickening tests, which may provide information on carcinogenicity, a ciliatoxicity test, an alveolar macrophage viability test, a haemolysis assay and a thiol inactivation test to provide measures of irritant and cytotoxic effects. In each case a response to the smoke from cigarettes containing tobacco alone was detected, while the magnitude of this response declined as the proportion of tobacco supplement in the blend increased. The least response was found with smoke from cigarettes containing Cytrel tobacco supplement alone.     

The advantages of delayed imaging and radiographic correlation in scintigraphic localization of gastrointestinal bleeding

Two cases in which gastrointestinal bleeding was localized by serial scintigraphic imaging with red blood cells labeled in vivo with 99mTc-PYP are reported. The importance of both early serial imaging and delayed imaging and of the correlation with other radiographic techniques is demonstrated. Reflux of blood from the sigmoid into the proximal colon was observed in both cases. In one case, contrast material injected into a resected specimen confirmed the scintigraphic localization of the site of bleeding.