Surveillance of foodborne infections— the role of the Communicable Disease Surveillance Centre

The paper describes the work of the Public Health Laboratory Service, popularly referred to as “Colindale”, and reviews the types of infection which are commonly food or waterborne and their relative importance. Cholera, typhoid and paratyphoid are rare diseases usually acquired abroad. Bovine tuberculosis, brucellosis and foodborne helmenthiasis have been almost eliminated as indigenous diseases. However, salmonellosis and Campylobacter enteritis are increasing. The increase has not been satisfactorily explained but is probably due to bovine and poultry infections. Although most notified food poisoning incidents are due to salmonella, a number of other organisms have been implicated, the cause being defective food hygiene. Viral foodborne diseases, including hepatitis A, have been associated mainly with shellfish. The incidence of new foodborne infections may be increasing.     

Cardiac stimulus intensity and heartbeat detection: Effects of tilt-induced changes in stroke volume

The effects of variations in stroke volume on the intensity of cardiac stimuli was examined in a series of three experiments that empolyed classical psychophsical methods to assess heartbeat detection. Stroke volume was manipulated by passive body tilt and recorded using impedance cardiography while subjects performed heartbeat detection tasks. The postural manipulation generated little or no change in contractility or momentum but did produce substantial changes in stroke volume. However, this potential source of variation in cardiac stimulus magnitude did not influence either the precision of heartbeat detection or the temporal location of heartbeat sensations. It is concluded that the intensity dimension of the heartbeat stimulus is not determined by stroke volume.     

Sensitivity to mechanical stimuli and the role of general sensory and perceptual processes in heartbeat detection

Sensitivity to heartbeat sensations is commonly assessed using tasks that require individuals to judge the simultaneity of heartbeats and tones. In two experiments, we investigated the suitability of this paradigm for examining cardioception. In the first experiment, participants judged the simultaneity of near–threshold vibrations and suprathreshold tones. Precision in judging vibration–tone simultaneity was directly related to the detectability of the mechanical stimuli, thereby supporting use of the simultaneity paradigm to assess heartbeat detection. In the second experiment, we examined the influences of sensitivity to mechanical stimuli and the ability to make intermodality simultaneity judgments on the precision of heartbeat detection. We measured participants' vibrotactile thresholds, precision in judging light–tone simultaneity, and precision in judging heartbeat–tone simultaneity. The ability to judge the simultaneity of lights and tones accounted for 24.3% of the variance in precision of heartbeat detection, and mechanical sensitivity accounted for a further 8.5%.     

Effects of data limitations on heartbeat detection in the method of constant stimuli

In the method of constant stimuli applied to measuring heartbeat detection, subjects judge the simultaneity of heartbeats and exteroceptive comparison stimuli presented at various intervals after the R-wave (0, 100, 200, 300, 400, and 500 ms). Using versions of this procedure, investigators have found that between 20% (Yates, Jones, Marie, & Hogben, 1985) and 54% (Brener, Liu, & Ring, 1993) of subjects can detect heartbeat sensations. Whereas Yates et al. used a single comparison stimulus on each trial and Brener et al. used 10, the present study examined whether this disparity in heartbeat detection performance could be attributed to the number of comparison stimuli presented on each trial. In each of 360 trials, 30 subjects judged the simultaneity of heartbeat sensations and tones following 1, 5, or 10 comparison stimulus presentations. Significantly fewer subjects met the criterion for heartbeat detection with I tone presentation (13%) than with either 5 (43%) or 10 (47%) tone presentations. It is concluded that a single stimulus presentation imposes data limitations that result in underestimation of the accuracy of heartbeat detection. The presentation of at least 5 stimuli in each trial alleviates this limitation.     

Psychological status of men with haemophilia and HIV infection: two-year follow-up

This study aimed to assess the psychological status of men with haemophilia and HIV infection and to monitor changes in psychlogical status over time, in order to evaluate the need for psychological support. The study included 24 HIV seropositive men and a control group of 21 HIV seronegative men who attended the Haemophilia Centre in Bari (Italy). Subjects underwent psychological tests (STAl-Y: State and Trait Anxiety Inventory; SDS: Self-Rating Depression Scale) and completed a questionnaire on the emotional impact of AIDS. Assessment was repeated at 6-monthly intervals over a 2-year period. Contrary to expectation, HIV seronegative men with haemophilia had worse anxiety and depression scores, reported more confusion and fear, and had more reluctance towards the use of blood products (despite their present safety) than HIV seropositives. Possible reasons for these findings are considered, and their implications for clinical practice discussed.     

Anaphylactoid reactions to infusions of plasma protein and human serum albumin Role of aggregated proteins and of stabilizers added during production

Six patients suffering from anaphylactoid reactions after infusion of pasteurized plasma (PP) or human serum albumin (HSA) were investigated. Clinical symptoms ranged from urticaria and hypotension to cardiac arrest. Immunoglobulin levels, especially of IgA, were normal, as were concentrations of complement factors C3, C4 and factor B. In skin and lymphocyte transformation tests patients, with the exception of one severely allergic to protein, did not react to the monomeric pure HSA. Five out of six patients reacted against HSA aggregates and three patients to the HSA modified by caprylate added as stabilizer during commercial HSA production. It is concluded that the anaphylactoid reactions developing after PP or HSA infusion result from a non-specific reaction to protein aggregates and in some cases possibly from a specific immune response to the caprylate-modified HSA.     

Mikrosporon canis — Familienepidemie — in Mecklenburg

Es wird über eine seit 30 Jahren erstmalig in Deutschland sicher wieder nach-gewiesene Mikrosporon canis-Infektion am Kopf von vier Kindern berichtet. Die isolierte Kultur wird kurz beschrieben.
Die Familieninfektion blieb auf den Ursprung selbst beschränkt. Reihenunter-suchungen der Kinder des kleinen mecklenburgischen Dorfes ergaben keinen weiteren positiven Befund. Es handelt sich um den ersten Befund eines Mikrosporon canis Bodin 1902 in Mecklenburg.
Während der Drucklegung berichtete H. Koch (Derm. Wschr. 136 [1957], 741) über 6 Fälle von Mikrosporon canis-Erkrankungen im Hamburger Raum aus den Jahren 1951–1955. Wir halten diese Fälle nicht für sichere Mikrosporon canis-Erkrankungen, da keine Tierversuche zur Sicherung der Diagnose durch-geführt wurden und nur diese letzten Endes jeden diagnostischen Zweifel beseitigen können.     

Inflammatory bowel disease and hospital treatment in Italy: the RING multi-centre study

AIM: To explore the management of chronic inflammatory bowel disease, specifically Crohn's disease and ulcerative colitis, in Italian gastroenterology units. METHODS: The RING (Ricerca Informatizzata in Gastroenterologia) project is an observational study collecting hospital discharge forms from 56 centres. Factors associated with the length of hospital stay were studied using multivariate logistic regression. RESULTS: In 24 months starting from August 2000, out of 29,376 hospital discharge forms, 2131 (7.3%) were collected for inflammatory bowel disease (1163 for Crohn's disease and 968 for ulcerative colitis). The Crohn's disease and ulcerative colitis groups were compared according to demographic characteristics, diagnoses, procedures and hospital stay. In Crohn's disease, computed tomography/magnetic resonance imaging, x-rays/barium enema, number of procedures and number of diagnoses were significantly associated with a hospital stay longer than 10 days. In ulcerative colitis, this association was found for parenteral nutrition, malnutrition, computed tomography/magnetic resonance imaging and number of procedures. CONCLUSIONS: Crohn's disease was confirmed as a disabling disorder requiring more frequent hospital treatment than ulcerative colitis. For the latter, parenteral nutrition and malnutrition were related to a longer hospital stay. The number of procedures, especially abdominal computed tomography/magnetic resonance imaging, was a major item for both pathologies.