The development of a support group organization for headache sufferers

People with a wide variety of problems use support groups. We describe the development, structure and current functioning of a support group organization for headache sufferers, which has grown from ten members to 300 in four years. About one-half of the members participate in ten currently functioning support groups. In addition to these support groups, the organization plays an active role in the community by sponsoring public awareness seminars, publishing a quarterly newsletter, providing emergency treatment cards, and making knowledgeable speakers available to local business groups. The membership has been described by means of a questionnaire. Information regarding medical history, impact of headaches on everyday functioning, and involvement with the organization is presented. Future directions of the organization are discussed.

Novel 5-HT3 antagonists: indol-3-ylspiro(azabicycloalkane-3,5'(4'H)-oxazoles)

The synthesis and biochemical evaluation of a series of spirofused indole oxazoline 5-HT3 antagonists is described in which the oxazoline ring acts as a bioisosteric replacement for esters and amides. The effect of substitution about the indole ring has shown the steric limitations of the aromatic binding site. Incorporation of a variety of azabicyclic systems within the rigid spirofused framework has allowed the definition of a binding model which incorporates a number of known antagonists and agonists. In this model steric constraints limit substitution around the indole ring although there is some bulk tolerance at the 1- and 2-positions. The importance of constraining the basic nitrogen within an azabicyclic system is underlined by comparison with the monocyclic piperidine. The highest affinity was observed for those compounds in which the basic nitrogen occupies a bridgehead position, the most potent analogue in this group being the azabicyclic [3.3.1] system (pIC50 = 8.95), suggesting lipophilic interactions may play a role in increasing affinity. A suggested model for agonist binding is included in which the basic nitrogens are superimposed and the 5-hydroxyl group of 5-HT is superimposed on the H-bond-accepting atom of the heterocyclic linking group.

In-house recruiters: new role needs clear direction to benefit

Physician recruiters are fast becoming part of the hospital's personnel arsenal. But how do administrators use these positions within the confines of their institution and when do they hire outside consultants to do the work or at least, supervise it? In the following article, the author discusses how to effectively formulate and utilize such a position in the hospital.

Novel 5-HT3 antagonists. Indole oxadiazoles

The synthesis and biochemical evaluation of a series of indole oxadiazole 5-HT3 antagonists are described. The key pharmacophoric elements have been defined as a basic nitrogen, a linking group capable of H-bonding interactions, and an aromatic moiety. The steric limitations of the aromatic binding site have been determined by substitution about the indole ring. Variation of the heterocyclic linking group has shown that while two hydrogen-bonding interactions are possible, only one is essential for high affinity. The environment of the basic nitrogen has been investigated and shown to be optimal when constrained within an azabicyclic system. These results have been incorporated into a proposed binding model for the 5-HT3 antagonist binding site, in which the optimum distance between the aromatic binding site and the basic amine is 8.4-8.9 A and the steric limitations are defined by van der Waals difference mapping.

Primary health care for the children of Sarawak

Rosalind Benster and Judith Stanton went to Sarawak to study child health care. Their aim was to highlight areas of most need so that the tiny health budget could be channelled in the relevant directions. They found cultural and environmental differences to account for significant differences in the nutritional status of children from different tribes. They suggest remedies to this situation.

A total body irradiation stand for bone marrow transplant patients

A stand designed for the immobilization of patients standing during total body irradiation (TBI) with horizontal 10 MV X rays is described. The stand reduces patient movement and facilitates the initial positioning and repositioning of patients during 11 fractions of TBI over a 3 2/3 day period. Details of design and use are presented. The stand is regularly used to treat TBI patients.

Cellular and subcellular effect of heavy ions: a comparison of the induction of strand breaks and chromosomal aberration with the incidence of inactivation and mutation

Radiobiological effects of heavy charged particles are compared for a large variety of ions from Helium to Uranium and energies between 1 and 1000 MeV/u which correspond to LET values between 10 and 16000 keV/micrometers. The different cross section for the induction of strand breaks and chromosomal aberrations as well as for inactivation and mutation induction exhibit striking similarities when compared as function of the linear energy transfer (LET). At LET values below 100 keV/micrometers all data points of one specific effect form one single curve as a function of LET, independent of the atomic number of the ion. In this LET range, the biological effects are independ from the particle energy or track structure and depend only on the energy transfer. Therefore, LET is a good parameter in this regime. For LET values greater than 100 keV/micrometers, the curves for the different ions separate from the common curve in order of increasing atomic numbers. In this regime LET is no longer a good parameter and the physical parameters of the formation of particle tracks are important. The similarity of the sigma-LET curves for different endpoints indicates that the 'hook-structure' is produced by physical and chemical effects which occur before the biologically relevant lesions are formed. However, from the existing data of biological effects, it can be concluded that the efficiencies for cell killing are always smaller than those extrapolated from X-ray data on the basis of the energy deposition only. Therefore, cells which are directly hit by an HZE particle are not killed and undergo a finite risk of mutation and transformation.

Rapid diagnosis and management of parainfluenza I virus infection in common marmosets (Callithrix jacchus)

During 1983 a severe episode of respiratory infection occurred in a marmoset colony at these laboratories. Of 91 marmosets, 69 showed clinical signs of disease, one died and nine were so ill that euthanasia was necessary. Eight were examined post mortem and all showed consolidation of the lungs. Laboratory studies were carried out in an attempt to establish the cause of the outbreak and an interstitial pneumonia was found in seven animals which were examined histologically. Direct electron microscopy of nasal swabs and lung samples revealed the presence of a high titre of a paramyxovirus, and subsequent immunofluorescence studies established that the particular paramyxovirus involved was parainfluenza virus type I. Subsequent studies showed that surviving affected animals had seroconverted to parainfluenza I virus while animals that had not been implicated in the outbreak had not.

United Kingdom scheme for external quality assessment in virology. Part II. Specimen distribution, performance assessment, and analyses of participants' methods in detection of rubella antibody, hepatitis B markers, general virus serology, virus identification, and electron microscopy

Methods for the preparation and pre-distribution testing of specimens for external quality assessment in virology have been defined and criteria for allocation of scores for participants' reports on each category of specimen have been established. Specimens for detection of rubella antibody or markers of hepatitis B infection consist of human serum samples, which are distributed after detailed assessment of the expected results. In testing for rubella antibody or hepatitis B surface antigen (HBsAg) the scores given for reports of positive, equivocal, or negative depend on the specimen's content of antibody or HBsAg as established in the external quality assessment laboratory. For general virus serology two serum samples must be tested against a designated antigen by the complement fixation method; the score allocated for each participant's results depends on the ratio of the two titres he records, which is then compared with a target value derived from the results of a panel of participating laboratories. In virus identification and electron microscopy specimens are prepared from cultures or from clinical samples, and scores depend on the accuracy of identification. The pre-distribution tests necessary to establish the virus content and stability of these specimens have been defined, and media suitable for transporting specimens for virus culture, fluorescent antibody staining, or electron microscopy have been developed. A participant's overall success rate for each specimen is judged from the mean score (maximum 2) calculated from the scores of all participants examining the specimen. Mean scores were highest for detection of rubella antibody or HBsAg (from 1.67 to 1.96) and lowest for specimens containing certain small enteric viruses distributed for electron microscopy (0.82 to 1.12). Participants' reports on the methods used for each specimen have been analysed. Current changes and developments in methods have been recorded, and attempts have been made to relate the use of various techniques and test kits to successes or failures with various types of specimen.

Study of discrepancies in rubella haemagglutinin titrations and a reappraisal of diluents used in the rubella haemagglutination inhibition technique

To elucidate inconsistencies in rubella haemagglutinin assays the components of the assay technique were examined. The results of carefully controlled assays of rubella haemagglutinin antigens from different sources in various plates and diluents with four species of indicator cells are reported. The quality and quantity of gelatin in the dextrose-gelatin-veronal buffered diluent commonly used in rubella haemagglutinin assays had a profound effect on the haemagglutination pattern and antigen titre. The veronal buffered saline used in the complement fixation test offered a valid alternative to the more complex diluents incorporating gelatin currently used in rubella haemagglutinin assays and haemagglutination inhibition tests.

Assessment of nutritional correlates of blood pressure

Nutritional factors are thought to contribute to the development of hypertension in susceptible humans. This review categorizes the types of nutrition-related data currently available on the relation between diet and blood pressure and provides guidelines for interpreting and using these data. The nutrition data base and the net effect of specific nutrients on blood pressure are discussed, and examples from the Health and Nutrition Examination Survey are given to compare demographic characteristics of various nutrients with demographic characteristics of hypertension in our society. Criteria for evaluating the strength and relevance of a specific nutrient's influence on blood pressure are presented. A comprehensive, continued assessment of all studies of diet and blood pressure control should assure better understanding of the pathogenesis and treatment of human hypertension.

Sustaining board trains future trustees

The sustaining board of fellows of Mount Sinai Medical Center, Miami Beach, FL, serves as a training ground for future members of the hospital's board of trustees. The sustaining board also sponsors numerous hospital projects, including a student scholarship program and various community outreach programs.