A survey of Q-fever in Sweden

Coxiella burnetii, the etiological agent of Q-fever has recently been isolated from sheep in southern Sweden. In this region 24–30% of sheep farmers have been exposed to the organism as shown by serological measurements. In veterinarians, another group with high risk of exposure to C. burnetii, about 12% have antibodies to the bacteria. The seropositive veterinarians are scattered all over the country. In two non-risk groups, draftees and hospital employees, 5–7% were found to be positive. This survey showed that Q-fever is a domestic disease which is spread throughout Sweden.     

Effect of Systemic Pretreatment With Betamethasone on the Bacterial Flora,Inflammatory Response,and Polyp Formation in Experimentally Infected Rabbit Maxillary Sinus Mucosa

To investigate possible effects of corticosteroids on polyp formation and local bacterial colonization, pneumococcal sinusitis was experimentally induced in rabbits pretreated with betamethasone or saline. After 7 days, macroscopic polyps were counted post-mortem and on histologic slides after serial sectioning. Histologic sections were also examined with light microscopy. Macroscopic polyps were significantly fewer in animals given betamethasone, while there was no difference regarding the number of microscopic polyps. Ingrowth of pathogenic microorganisms was found in five of eight rabbits given placebo but in none of the animals treated with corticosteroids (P < 0.05). The reduced number of pathogenic strains in these animals may be explained by a better-preserved local host defense. The lower number of macroscopic polyps in the same animals could be because of a delayed mucosal repair and subsequent polyp formation.     

A case of Q fever acquired in Sweden and isolation of the probable ethiological agent, Coxiella burnetii from an indigenous source

Serologically verified indigenous Q fever is described in a 52-y-old male, who presented with persistent fever, muscle and joint pain, headache and non-purulent cough. Institution of doxycycline resulted in prompt recovery. Coxiella burnetii was isolated from mouldy hay in a barn. The strain differs from previously isolated ones in Sweden.     

The ballet of baseball: lessons of the game for hospice

As Yogi Berra once said, "The future ain't what it used to be." In the era of rapid change in health care, hospice and palliative care programs will survive only through organizational teamwork. Using the lessons of baseball, we present a stadium-eye perspective on how programs can take the three fundamentals of baseball--pitching, batting, and fielding--and translate them into the three fundamentals of organizational teamwork--clinical, operational, and financial. The best clinicians (pitchers) are of no use if the office operations (batting) keep the patients (fans) out of the stadium and no program can survive without the financial resources (fielding.) When you come to a fork in the road, take it.     

Anger, hostility, and male perpetrators of intimate partner violence: a meta-analytic review

There has been significant interest in, and controversy about, whether anger and hostility problems are meaningfully related to male-to-female intimate partner violence (IPV). In this meta-analytic review, we empirically evaluated whether the constructs of anger and hostility discriminated between IPV perpetrators and nonviolent comparison males. Thirty-three studies reporting data from 28 independent samples were included for analysis. IPV perpetrators consistently reported moderately higher levels of anger and hostility than nonviolent men across assessment methods (i.e., self-report, observational, and spouse-specific). In prior reviews, relationship distress has been proposed as a moderating variable between relationship distress and IPV. In this review, IPV perpetrators also consistently reported moderately higher levels of anger and hostility than relationship-discordant nonviolent men. Additionally, comparisons of subtypes of IPV perpetrators found that men in moderate-high severity IPV subtypes reported higher levels of anger and hostility than low-moderate IPV subtypes. While the pattern of results in this review suggests that elevated anger and hostility are distinguishing characteristics of IPV perpetrators, empirically based conclusions regarding the functional and contextual relationship between anger, hostility, and IPV remain elusive. The implications and limitations suggested by this review are discussed in the context of emerging models of anger and IPV and treatment programs for abusive men.     

Thermocamera, a Macroscopic Method for the Study of Pollution with Nitrous Oxide in Operating Theatres

Nitrous oxide (N₂O) is used in high concentrations in inhalation anaesthesia and can serve as a tracer of other, more potent anaesthetic agents polluting the air of operating theatres. It has the quality of absorbing infra-red light with a characteristic peak at 4.5 μm in the absorption spectrum. N₂O in the operating-room atmosphere will absorb infra-red light emitted from a heat screen, and can therefore be registered by an infra-red-camera equipped with a filter eliminating waves outside the 4.5 μm waveband. The method was tested during paediatric inhalation anaesthesia. The infra-red-camera measurements are semi-quantitative and sensitive to an extinction of about 1000 ppmcm, comparable to a N₂O concentration of 100 ppm measured by an infra-red N₂O monitor. It was demonstrated that major pollution occurs during mask anaesthesia and after extubation. The polluting gas is insufficiently evacuated by the operating theatre ventilation. The method makes it possible to visualize the dispersion of spilled or leaking N₂O, and is therefore of value when constructing and evaluating new scavenging equipment and in producing educational material.