Phage typing of Staphylococcus intermedius

Staphylococcus intermedius, a coagulase-positive staphylococcal species, is a common canine pathogen and a rare human wound pathogen. A total of 145 strains of S. intermedius (ATCC 29663, 4 reference strains, 4 human isolates, 44 canine infection isolates, and 92 isolates from canine gingiva) were screened for lysogenic phage by a modified Fisk method. Nineteen phage preparations were prepared for preliminary typing experiments. Lytic activity was observed on 93 of 145 (64.1%) isolates, yielding 44 lytic patterns with individual strains susceptible to one or more phages. Five phages lysed only a single strain, but lytic patterns varied from 1 to 11 lytic phages per isolate. A distinct lytic pattern did not separate canine or human wound isolates from canine gingival isolates. All human wound isolates fell into the two most common canine gingival or wound patterns; the single human nasopharyngeal isolate was not lysed by any phage. Twenty-two of 44 (55%) canine wound isolates and 65 of 92 (71%) gingival isolates yielded lytic patterns. Lysogenic phages are common in S. intermedius. This preliminary study suggests that phage typing may be a useful tool in distinguishing epidemiologically related strains.

Comparison of CAGE questionnaire and computer-assisted laboratory profiles in screening for covert alcoholism

To identify the most effective method of screening for covert alcoholism Ewing's CAGE questionnaire was compared with several computer-assisted laboratory data profiles in a prospectively gathered, random sample of 915 adults admitted to a general hospital. Whether a subject was alcohol dependent (n = 244) or not (n = 671), as defined by DSM-III-R, was determined on the basis of a structured interview. The CAGE questionnaire was highly sensitive (76%) and specific (94%) for recognition of alcohol dependence (positive predictive power 87%). None of the discriminant laboratory functions gave recognition rates greater than chance alone. Until the sensitivities, specificities, and positive predictive powers of computer-assisted methods improve, brief interview alone remains the best screening method for general hospital populations.

The natural history of burst fractures at the thoracolumbar junction

Conservative management of 54 patients with thoracolumbar (T12 and/or L1) burst fractures was investigated. The fractures were subdivided according to the Denis classification and a modification was suggested. Most type A and B fractures showed good results regarding reduction and neurological improvement. However, severe type B (with anterior column compression and spinal canal narrowing exceeding 50%), D, and E fractures were to a large extent complicated by intractable low back pain, neurological involvement, and signs of instability. This study suggests predictors for complications in patients with burst fractures in the thoracolumbar junction. These are (a) compression rate of the anterior column exceeding 50%, (b) narrowing of the spinal canal exceeding 50%, (c) signs of rotational malalignment in fracture level, and (d) level of the injury (L1 fractures).

Staphylococcus intermedius in canine gingiva and canine-inflicted human wound infections: laboratory characterization of a newly recognized zoonotic pathogen

Staphylococcal gingival flora was characterized in cultures from 135 dogs. Staphylococcus intermedius was isolated in 39% of the cultures, S. aureus was isolated in 10%, and both were isolated in 2.0%. S. aureus was isolated more often from dogs of working breeds with weights of greater than 40 lb (ca. 18 kg) and with outdoor habitats than was S. intermedius, which was associated with dogs of nonworking breeds with weights of less than 40 lb and indoor habitats. S. intermedius was distinguished from S. aureus by the following characteristics: coagulation of rabbit plasma at 4 h (26 versus 100%, respectively), hemolysis of sheep blood at 24 h (30 versus 79%, respectively), and mannitol fermentation at 24 h (4 versus 93%, respectively). A clear separation of the two species was apparent only with the acetoin (modified Voges-Proskauer) reaction (100% of the S. aureus isolates versus 0% of the S. intermedius isolates) and beta-galactosidase activity on the API Staph-Ident strip (0% of the S. aureus isolates and 100% of the S. intermedius isolates). Susceptibilities of S. intermedius and S. aureus were 72 and 7%, respectively, to penicillin G, and 100% of both species to oxacillin. Fourteen previously collected strains of coagulase-positive staphylococci from infected canine-inflicted human wounds were reanalyzed; 3 of 14 (21%) isolates were S. intermedius. We conclude that S. intermedius is a common canine gingival flora and is responsible for some canine-inflicted human wound infections, thus representing a newly recognized zoonotic pathogen.

Screening for alcoholism

Alcoholism is one of the largest public health problems of the nation and is a significant cofactor in such ubiquitous diseases as hypertension, developmental abnormalities, heart failure, liver failure, and many other conditions. The cost to the nation's health is immense. One strategy for reducing morbidity and cost has been to establish methods for screening in order to increase recognition rates leading to increased rates of therapeutic intervention. In this article, the rationale for two methods of alcohol screening, brief interviews and biological markers of excessive drinking, the relevant statistical issues bearing on this problem, and the current research on screening exams are reviewed and summarized. Finally, some of the newer approaches toward alcoholism screening as well as the consequences to the medical care system should alcohol screening eventuate on a large scale are briefly described.

Penicillamine-induced pemphigus. Immunoglobulin from this patient induces plasminogen activator synthesis by human epidermal cells in culture: mechanism for acantholysis in pemphigus

The incubation of cultured epidermal cells with IgG obtained from a 56-year-old man with penicillamine-induced pemphigus resulted in an increase in extracellular and intracellular plasminogen activator. This suggests that penicillamine-induced pemphigus and spontaneously occurring pemphigus share common pathophysiologic processes in the induction of blister formation.

The effect of corticosteroids, dapsone and gold upon plasminogen activator synthesis and secretion by human epidermal cells cultured with pemphigus antibody

Human epidermal cells were cultured with pemphigus antibody in the presence of hydrocortisone, methylprednisolone sodium succinate, dapsone and gold. Hydrocortisone and methylprednisolone reduced the production of the enzyme plasminogen activator but dapsone and gold had no effect. These results support the hypothesis that corticosteroids have dual effects on pemphigus through inhibition of plasminogen activator production by epidermal cells and suppression of pemphigus antibody production by B lymphocytes.

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Comparative evaluation of hypnotic efficacy of flunitrazepam in psychiatric in-patients

Flunitrazepam in 2-mg and 4-mg doses was compared with flurazepam 30 mg and nitrazepam 10 mg for hypnotic efficacy in a double-blind, multiple cross-over trial involving 41 psychiatric in-patients. In the vast majority of comparisons involving a number of sleep parameters differences did not reach significance level. Flunitrazepam 4 mg tended to produce the shortest latency time and the longest duration of sleep but also the most side-effects. Nitrazepam 10 mg appeared to have a slight advantage over the other drugs in terms of patient preference. For severe sleep disturbance flunitrazepam 2 mg tended to be the most satisfactory drug in terms of efficacy and paucity of side-effects.

Physique, personality and mental illness in southern Chinese women

A number of anthropometric measurements were made on Southern Chinese women. These were 317 schizophrenics, 44 with affective disorder, 47 neurotics and normal controls. All groups and sub-groups compared were matched for mean age and socio-economic status. It was found that the intercorrelations between body build, personality and type of mental illness were on the whole similar to those reported for Caucasians.

The role of culture in psychosomatic disorders

The paper summarizes and evaluates the work so far carried out on the role of culture in determining similarities and differences in prevalence and manifestations of psychosomatic disorders, and attempts to identify the possible cultural elements that account for such variations. It concludes that the evidence is insufficient to support beliefs about the existence of major differences between cultures in psychosomatic disorders as a whole, and that cultural factors provide but a superficial colouration to a primary core of illness common to all cultures; but that, nevertheless, real differences exist in the prevalence of certain conditions in a minority of cultures.

Abnormal homicide in Hong Kong

The different classifications of homicide used make comparative studies difficult. For our purposes we will sub-divide homicide as follows: (i) ‘Abnormal homicide’, comprising (a) ‘murder-suicide’ in which the murder suspect commits suicide, and (b) ‘abnormal murder’, comprising cases where (i) the murder suspect is mentally ill, or (ii) the court returns a verdict of manslaughter by reason of diminished responsibility. (2) ‘Normal homicide’, a term we will use synonymously with ‘normal murder’, i.e. murder committed by the mentally normal.