Naloxone eye drops reverse the miosis in runners--implications for an endogenous opiate test

Naloxone 0.16% ophthalmic drops or placebo drops were self-administered to one eye by 13 runners 250 times in a double-blind fashion over three weeks of various intensities and durations of running. An increasing incidence of miosis after running and ipsilateral mydriasis after the naloxone eye drops were administered was noted to correlate with increased run durations. During 34 runs of over 30 minutes duration, 20 subject runs (59%) developed miosis in both eyes and mydriasis in the eye treated with naloxone, but none of 10 subject runs over 30 minutes (9 of which showed miosis) developed mydriasis after placebo drop administration. Calculations (means, SEM) of pupil sizes in various run durations revealed an increased occurrence of miosis which was reversed with naloxone in over 30 minute runs at a significance level greater than 0.005 (single tailed "t" test). It is suggested that exercise generated endogenous opiates cause pupillary miosis, and that ophthalmic naloxone to one eye can block this exercise pupillary effect resulting in ipsilateral mydriasis. Suggestions are given for a simple "Naloxone Anisocoria Test" for the presence or absence of elevated endogenous opiates.

Prospective immunological assessment of arthritis induced by rubella vaccine

A prospective study was carried out to correlate the development of joint symptoms after rubella immunization with pre- and post-immunization rubella-specific immunological responses. Arthralgia or arthritis or both occurred in 10 of 37 adult female volunteers at a mean time of 17.0 days after immunization with the RA 27/3 rubella vaccine. All individuals studied before immunization were seronegative for rubella by either the hemagglutination inhibition or the single radial hemolysis technique. In contrast, rubella enzyme-linked immunosorbent assay or lymphoproliferative responses or both were positive in 27 of 37 (73%) individuals tested before receiving the vaccine. Rubella enzyme-linked immuno-sorbent assays carried out before immunization were positive at high levels (mean E = 0.536) in four individuals who developed recurrent episodes of arthritis after administration of the vaccine while remaining at low levels preimmunization in subjects who developed transient arthralgia (E = 0.238) or no joint manifestations at all (E = 0.288). These data provide preliminary evidence suggesting that rubella vaccine-associated arthritis may occur as a consequence of secondary, rather than primary, infection with rubella virus and that the presence of circulating, nonneutralizing rubella antibody may enhance the development or severity (or both) of the associated postinfection joint manifestations. Assessment of rubella hemagglutination inhibition, hemagglutination inhibition (immunoglobulin M), and enzyme-linked immunosorbent assay serological responses at 6 weeks and 6 months post-immunization revealed no significant differences between patients who developed and those who did not develop joint manifestations. Rubella lymphoproliferative responses were elevated at 6 weeks post-immunization in the group developing arthralgia or arthritis or both, with no difference between the groups observed at 6 months post-immunization.

Variations in hand position, cerebral lateralization, and reading ability among right-handed children

A group of 121 right-handed children between the ages of 7 and 9 with a range of hand positions between normal and inverted were assessed for verbal and visuospatial lateralization and reading comprehension. Results indicate that (a) children with a normal hand position tended to be more verbally lateralized than children with nonnormal positions, although the effect was not strong or always consistent, (b) the closer the child was to the normal position, the higher the child's reading scores, and (c) poor readers were as lateralized for verbal and visuospatial functions as were good readers. Coupled with the results of previous research, these findings suggest that hand position indexes both maturation and lateralization, and that the relationship between hand position and reading is primarily mediated by the former.

Pulsed Doppler echocardiography in the diagnosis and estimation of severity of aortic insufficiency

Detection and estimation of the degree of chronic aortic insufficiency with pulsed Doppler echocardiography was attempted in 27 patients documented to have aortic insufficiency on aortography. Twenty-five patients had associated aortic stenosis or mitral valve disease, or both. A disturbed diastolic flow within the left ventricular outflow tract was recorded in all but one patient (Doppler sensitivity 96 percent). Aortic insufficiency was clinically undetected in three patients (clinical sensitivity 89 percent). In a small number of patients Doppler echocardiography also appeared to be highly specific for this disorder. The Doppler technique estimated the degree of aortic insufficiency by assessing the distribution of diastolic flow within the outflow tract and the body of the left ventricle. A significant correlation between the Doppler method and the angiographic estimation of aortic insufficiency was found (r = 0.88, p less than 0.01).

Continuous assessment of knee function and patient mobility

A technique is described for measuring and analysing the load profile of the knees during daily routine. The method has been used on patients with chronic arthritis of the knee, both before and after joint replacement. Results are presented, and the logistics of carrying out such work are discussed. The method is applicable to joints other than the knee, diseases other than arthritis, and treatments other joint replacement.

Influence of short term fasting on chicken alimentary canal mucosa

Little is known about the physiological effects of short-term fasting in avian species. The present study was developed to examine the alimentary mucosal changes in fasted birds by scanning and transmission electron microscopy. Chickens of various ages were fasted for periods of 3, 5, and 7 days. Water was provided ad libitum. At the end of the fasting periods the birds were sacrificed along with ad libitum fed controls. Tissue samples from crop, duodenum, and ileum were processed by standard methods for scanning and transmission electron microscopy (SEM and TEM). The SEM samples were prepared by vacuum drying methods. The TEM samples were embedded in Spurrs embedding medium. Mucosal sloughing was observed in the crop and small intestine with SEM only in fasted birds. With TEM, separation was observed between the mucosal cells of fasted birds with membranous whorls in these spaces. Sloughed cells may be an endogenous protein source for the fasting bird.

Conceptual frameworks and the philosophical foundations of general living systems theory

The continued expansion and fragmentation of biological disciplines impede education, communication, and efficient advance of biological research. Reversing these trends may require a unification of theories and concepts from all levels of biological organization. One form of this unification is the statement of generalizations that apply to all living systems. We explore the philosophical foundations of general theories of living systems by analyzing conceptual frameworks as they apply to biology. This analysis examines the relation of empirical observation, theories, and conceptual frameworks within the context of an individual scientist's conceptual continuum. Also presented are a small set of translevel generalizations that articulate our conceptual framework of living systems in terms of organismic system organization, the environmental system-organismic system dyad, system capacity, and system incorporation. A set of procedural rules are stated which suggest minimum criteria for the evaluation of the explanatory adequacy of biological theories. The relation of this work to other similar analyses and syntheses of biological knowledge is discussed.

Staff attitudes towards the care of the critically ill in the medical intensive care unit

In an attempt to study the basis for conflict and tension surrounding decision making in ICU settings, a questionnaire was used to examine staff attitudes in a newly opened medical ICU in four major areas: (1) ethical issues; (2) decision-making process; (3) communications; and (4) emotional reactions of staff. All of the 36 house officers and 32 of 34 nurses (all RNs) completed the questionnaire. Results showed there was no monolithic nursing as opposed to physician position on any issue. Futhermore, professional role exerted a more profound influence on attitudes than gender or religious background. There was remarkable agreement between physician and nurse groups on ethical issues. However, nurses were less satisfied with the decision-making process and communication in the medical ICU and were more aware than physicians of their own and other's emotional reactions. The results suggested four ways to reduce tension in the medical ICU: (1) frankly recognize the inevitability of conflict and tension in a system where physicians have ultimate authority; (2) avoid perpetuating stereotypes; (3) maximize the continuity of physician care; and (4) maximize communication between and within professional groups.

A user study of manual and MEDLINE literature searches in the hospital library

To determine possible uses for MEDLINE in the hospital library, health practitioners requesting literature searches were provided with both a manual and a MEDLINE search. Patron receptivity to MEDLINE was good, but the manual search was more often preferred. The health practitioners responding to a questionnaire apparently had delegated literature searching and evaluation of material to the hospital librarians, especially when clinically related information was needed. In the community hospitals where both the search and the selection of material are the responsibility of the librarian, MEDLINE can be used as the primary search tool or to supplement material provided.