Job ending among youth and adults with severe mental illness

This study examined job leaving over a 36-month period among 326 persons (74 youth and 252 adults) with severe mental illness who were participating in an urban vocational rehabilitation program. Data from 627 job endings indicated that younger clients displayed job-ending patterns that were different in some aspects from such patterns for nondisabled youth (such as displaying a lower average job tenure) yet similar to job-ending patterns for nonhandicapped youth in other ways (such as displaying a high frequency of job changing). Youth and their adult counterparts with mental illness displayed similar tenure on agency-sponsored placements but significantly different tenure on independent jobs. While adults held their independent jobs for an average of seven months, youth averaged only three months at competitive employment. Youth also were significantly more likely than adults to be fired from both placements and independent jobs. These findings and others are discussed in terms of their implications for development of public policy and service delivery models for providing on-going job support to youth and adults with severe psychiatric disabilities.     

Lyme borreliosis: Ten years after discovery of the etiologic agent,Borrelia burgdorferi

Summary Since the recovery of its causative agent,Borrelia burgdorferi, in 1981, Lyme borreliosis has become the most prevalent tick-borne disease in the United States as well as in Europe. Its steadily increasing clinical spectrum now includes erythema migrans, acrodermatitis chronica atrophicans, lymphadenosis beniga cutis, arthritis, myocarditis, progressive meningoencephalitis, myositis, and various ocular and skin disorders. The true incidence of Lyme borreliosis in the world is unknown. In the United States, it has increased from 2,000 cases in 1987, to more than 8,000 in 1989. It occurs now in regions where the tick vectors,Ixodes dammini andIxodes pacificus, are absent and where other species of ticks may be responsible for maintaining and distributing the spirochete. In Europe, Lyme borreliosis has been reported from 19 countries; its occurrence coincides with the distribution of the vector tick,Ixoides ricinus and possiblyIxodes hexagonus. Specific and dependable serological tests are still not available, but development of probes for specific antigens and the polymerase chain reaction appear promising in detecting ongoing infection and in identifyingB. burgdorferi in ticks, animal, and human hosts. Brief reference is made to advances in the preparation of whole cell and genetically engineered vaccines.

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Lyme-Borreliose: Zehn Jahre nach Entdeckung des ätiologischen Agens, Borrelia burgdorferi

Zusammenfassung Die Lyme-Borreliose ist seit der Entdeckung des kausalen ErregersBorrelia burgdorferi im Jahre 1981 die häufigste durch Zecken übertragene Krankheit in den USA und in Europa geworden. Zu ihrem immer umfangreicher werdenden klinischen Spektrum gehören Erythema migrans, Acrodermatitis chronica atrophicans, Lymphadenosis benigna cutis, Arthritis, Myokarditis, progressive Meningoenzephalitis, Myositis und verschiedene andere Störungen, die die Augen und die Haut betreffen. Über die weltweite Inzidenz der Lyme-Borreliose gibt es keine Daten. In den USA haben die Fallzahlen von 2000 im Jahr 1987 auf mehr als 8000 im Jahr 1989 zugenommen. Die Lyme Borreliose tritt jetzt in Gegenden auf, in denen die ZeckenvektorenIxodes dammini undIxodes pacificus nicht vorkommen, wo aber andere Zeckenspezies für die Persistenz und weitere Verbreitung der Spirochete verantwortlich sein können. 19 europäische Länder haben Fälle von Lyme Borreliosis mitgeteilt, dabei korreliert das Vorkommen mit der Verbreitung der ZeckenvektorenIxodes ricinus und möglicherweise auchIxodes hexagonus. Immer noch fehlt es an spezifischen und zuverlässigen serologischen Tests. Vielversprechend erscheint die Entwicklung von spezifischen Antigenproben und der Polymerasekettenreaktion Für den Nachweis einer bestehenden Infektion und die Identifizierung vonB. burgdorferi in Wirten wie Zecken, Tieren und dem Menschen. Fortschritte in der Präparation von Gesamt-Zell-Vakzinen und gentechnologisch hergestellten Vakzinen werden kurz mitgeteilt.

     

Immunoprophylaxis and immunotherapy of gram-negative sepsis and shock with antibodies to core glycolipids and lipid a of bacterial lipopolysaccharides

Conclusions The results obtained by numerous investigators reveal the ability of antibodies to cross-reactive LPS antigens to protect against infections caused by various gram-negative pathogens and their endotoxins. Based upon experimental and clinical experience, one could postulate that these antibodies are a promising approach for the prophylaxis and therapy of sepsis. The recognition of high-risk patients would allow early start of combined therapy with appropriate immune preparations and antibiotics, which along with life-supporting measures (corticosteroids, electrolyte and nutrition infusions, etc.), would be a useful tool in the treatment of gram-negative sepsis and endotoxin shock.     

Acetyl-Carnitine and Alzheimer''s Disease

In a double-blind, randomized, controlled clinical trial, progression of Alzheimer's disease was significantly reduced in patients who received acetyl-carnitine (2 g/day) for one year.