Effects of the paralysis tick, Ixodes holocyclus, on the electrocardiogram of the Spectacled Flying Fox, Pteropus conspicillatus

OBJECTIVE

To evaluate cardiac electrical function in the Spectacled Flying Fox (bat) infested with Ixodes holocyclus.

DESIGN

Prospective clinical investigation of bats treated for naturally occurring tick toxicity.

PROCEDURE

ECGs were performed on bats with tick toxicity (n = 33), bats that recovered slowly (n = 5) and normally (n = 5) following treatment for tick toxicity, and on normal bats with no history of tick toxicity (n = 9).

RESULTS

Bats with tick toxicity had significantly prolonged corrected QT intervals, bradycardia and rhythm disturbances which included sinus bradydysrhythmia, atrial standstill, ventricular premature complexes, and idioventricular bradydysrhythmia.

CONCLUSIONS

The QT prolongation observed on ECG traces of bats with tick toxicity reflected delayed ventricular repolarisation and predisposed to polymorphic ventricular tachycardia and sudden cardiac death in response to sympathetic stimulation. The inability to document ventricular tachycardia in bats shortly before death from tick toxicity may be explained by a lack of sympathetic responsiveness attributable to the unique parasympathetic innervation of the bat heart, or hypothermia-induced catecholamine receptor down-regulation. Bradycardia and rhythm disturbances may be attributable to hypothermia.

An audit of oral care practice and staff knowledge in hospital palliative care

Mouth care is considered one of the most basic of nursing activities, and palliative care patients are especially vulnerable to oral problems (Macmillan Practice Development Unit, 1995). This article describes a project on developing oral care practice and staff knowledge, by nursing staff and Macmillan nurses at a hospital in central England. A baseline audit (audit I) was carried out to examine all aspects of current oral care practice and nursing knowledge, including assessment, implementation, prescribing and evaluation of care. Oral care guidelines and a programme of ward-based teaching were then introduced. Several months later a follow-up audit (audit II) was conducted. Results showed an improvement in all aspects of oral care and staff knowledge. Additional benefits of this process included improved professional relationships and the promotion of further audits in hospital palliative care. Recommendations include the need for further nursing research into oral care to build the evidence base further. Additionally, it is suggested that nurses must recognize their important and central role in improving this aspect of palliative care. Education and training is pivotal to this process.

Ground reaction force and spatiotemporal measurements of the gait of the mouse

Measurement of ground reaction forces with force plates permits quantification of the subtle changes in movement associated with a variety of pathophysiological states. The apparatus used here permits simultaneous recording of other spatial and temporal characteristics of gait. Since the mouse is becoming increasingly important for modeling human disorders, we have recorded ground reaction forces (P) in this species. To date, we have measured the vertical component (Pz) and found it to be similar to that of other species, in that a greater Pz is exerted via the forelimb, although the areas under the force/time curves, are not different. Different points of discontinuity are seen in the forelimb and hindlimb curves, indicating differential deployment. Pz varies consistently with stance time and is consistent across the adult life of the mouse. It is suggested that the technique has potential for the study of a variety of mouse models of disease and of their therapies.

Covering up what can't be seen: concealable stigma and mental control

In these studies the authors examined the effects of concealing a stigma in a social interaction relevant to the stigma. An interview paradigm called for undergraduate female participants who either did or did not have eating disordered characteristics to play the role of someone who did or did not have an eating disorder (ED) while answering stigma-relevant questions. The data suggest that the participants who concealed their stigmas become preoccupied with the control of stigma-relevant thoughts. In Study 1, participants with an ED who role-played not having an ED exhibited more secrecy, suppression, and intrusive thoughts of their ED and more projection of ED-related thoughts onto the interviewer than did those with an ED who role-played someone with an ED or those without an ED who role-played someone without an ED. This finding was replicated in Study 2, and the authors found both increasing accessibility of ED-related words among those participants with concealed stigmas during the interview and high levels of accessibility following the interview.

Covering up what can't be seen: concealable stigma and mental control

In these studies the authors examined the effects of concealing a stigma in a social interaction relevant to the stigma. An interview paradigm called for undergraduate female participants who either did or did not have eating disordered characteristics to play the role of someone who did or did not have an eating disorder (ED) while answering stigma-relevant questions. The data suggest that the participants who concealed their stigmas become preoccupied with the control of stigma-relevant thoughts. In Study 1, participants with an ED who role-played not having an ED exhibited more secrecy, suppression, and intrusive thoughts of their ED and more projection of ED-related thoughts onto the interviewer than did those with an ED who role-played someone with an ED or those without an ED who role-played someone without an ED. This finding was replicated in Study 2, and the authors found both increasing accessibility of ED-related words among those participants with concealed stigmas during the interview and high levels of accessibility following the interview.

The temporal relationship among anti-parasite immune elements expressed during the early phase of infection of the rat with Trichinella spiralis

Immunological parameters were measured during the first 20 days of infection with Trichinella spiralis in the rat. Expulsion of adult worms was complete by day 15 postinfection. Eosinophil and neutrophil numbers rose in the blood of infected rats above preinfection levels on days 3 and 6, respectively, and remained high to day 20 postinfection. Release of cytokines by Trichinella-antigen-stimulated mesenteric lymph node cells was measured, and a significant elevation in interferon (IFN)-gamma release was detected during the early stage of infection. Although initiated later, interleukin (IL)-10 release showed a pattern similar to IFN-gamma. Biphasic release of IL-5 was seen with significant elevation above the preinfection level on day 3 and after day 6 postinfection to the end of the study. IL-4 and IL-2 showed biphasic secretion as well, with the level of IL-4 high in the early and middle part of infection, while the level of IL-2 was detectable only at days 2, 3 and 6 postinfection. Serum anti-parasite IgE rose above preinfection levels after day 6 postinfection. Anti-parasite Ig-positive mesenteric lymph node (MLN) cells were evident by day 3 postinfection for IgM, and day 9 postinfection for IgA and total IgG. The number of Ig-positive MLN cells for all antibody classes returned to preinfection levels by day 20 postinfection. Evaluation of the temporal interactions of the key anti-parasite immune components with which the host engages Trichinella shows a complex interplay between Th1 and Th2 helper subsets.

Deep cognitive activation: a new approach to the unconscious

Deep cognitive activation occurs when a thought is so accessible as to have measurable effects on behavior or judgement, but is yet not consciously reportable. This state of mind has unique properties mimicking some characteristics of the psychoanalytic unconscious, but following theoretically from a consideration of processes of cognitive activation. The sources and consequences of deep cognitive activation are examined, with a view toward understanding how this state is implicated in the assessment, etiology, and treatment of psychopathology.

Deep cognitive activation: a new approach to the unconscious

Deep cognitive activation occurs when a thought is so accessible as to have measurable effects on behavior or judgement, but is yet not consciously reportable. This state of mind has unique properties mimicking some characteristics of the psychoanalytic unconscious, but following theoretically from a consideration of processes of cognitive activation. The sources and consequences of deep cognitive activation are examined, with a view toward understanding how this state is implicated in the assessment, etiology, and treatment of psychopathology.

Non-culture diagnosis and serogroup determination of meningococcal B and C infection by a sialyltransferase (siaD) PCR ELISA

Rapid, non-culture, serogroup determination of meningococcal infection is important in contact management where vaccination may be possible. The impending availability of polysaccharide-protein conjugate vaccines for serogroup C disease requires maximal case ascertainment, with serogroup determination, at a time when the number of culture confirmed meningococcal infections is decreasing. A polymerase chain reaction assay (PCR), based on a restriction fragment length polymorphism (RFLP) in the meningococcal serogroup B and C sialytransferase (siaD) gene, was developed to combine the non-culture diagnosis of meningococcal infection from CSF, whole blood and serum with serogroup (B and C) identification. The PCR assay was adapted to an ELISA format incorporating hybridization with serogroup-specific B and C oligonucleotide probes. Specificity for CSFs was 100% and sensitivities were respectively 81, 63 and 30% for CSFs, whole blood and sera. The serogroup-specific PCR ELISA is a significant addition to currently available tests for non-culture diagnosis of meningococcal infection and outbreak investigation.

Relation of threatened egotism to violence and aggression: the dark side of high self-esteem

Conventional wisdom has regarded low self-esteem as an important cause of violence, but the opposite view is theoretically viable. An interdisciplinary review of evidence about aggression, crime, and violence contradicted the view that low self-esteem is an important cause. Instead, violence appears to be most commonly a result of threatened egotism--that is, highly favorable views of self that are disputed by some person or circumstance. Inflated, unstable, or tentative beliefs in the self's superiority may be most prone to encountering threats and hence to causing violence. The mediating process may involve directing anger outward as a way of avoiding a downward revision of the self-concept.

HIV awareness at work

Shared personal and professional awareness of and commitment to HIV issues in employment prompted Sue Ellis and Liz Smart to set up a project which, through collaborative working between health promotion, personnel functions and trade unionists, would devise training materials to address employment issues and reduce concern about HIV infection in the workplace.

Familial cold urticaria. Investigation of a family and response to stanozolol

BACKGROUND

Familial cold urticaria is a rare cutaneous and systemic reaction to cold with autosomal dominant inheritance, distinctive clinical features, and unknown pathogenesis. Release of a chymotrypsinlike substance has been postulated. To date, no effective treatment has been reported.

OBSERVATIONS

Eight cases from a large family pedigree are described. Three members showed a very favorable response in their cold urticaria, when treated with stanozolol; the response was reproducible. Histologic examination of an early lesion in one case revealed evidence of mast cell degranulation.

CONCLUSIONS

The biochemical observations are probably secondary epiphenomena. Correction of a deficiency of an inhibitory protein is a possible mechanism of action of stanozolol as in hereditary angioedema.

Pneumococcal septic arthritis after splenectomy in Felty's syndrome

A patient with Felty's syndrome who developed bilateral knee septic arthritis and septicaemia due to Streptococcus pneumoniae is described. She had had a previous splenectomy for symptomatic thrombocytopenia, having received pneumococcal vaccine before the operation. Measurement of antibody to the 23 vaccine serotypes showed protective concentrations before infection to just two. The infecting serotype was not represented in the vaccine, but a vigorous antibody response to this serotype occurred. The patient also developed glomerulonephritis due to immune complex deposition.

Erythema elevatum diutinum--an unusual association with ulcerative colitis

We report the association of erythema elevatum diutinum (EED) with ulcerative colitis (UC). The patient, whose history included rheumatoid disease, diabetes mellitus (type I) and hypothyroidism developed EED during a severe acute exacerbation of UC which resolved following colectomy. To our knowledge this is the first report of such an association. Also of interest was the observation of Köebner phenomenon occurring at the sites where blood vessels were damaged.

Factors affecting the duration of breast feeding: 2. Early feeding practices and social class

Breast milk intake by babies on the third and the sixth postpartum day was measured by a test-weigh procedure in a group of 47 mothers and babies. Women who gave the largest amount of breast milk to their babies on the third postpartum day continued to breast feed for longer than women who gave smaller amounts. These mothers also suckled most frequently, gave least additional fluid to their babies, and their infants regained their birth weight most rapidly. However, an increased early milk intake and duration of breast feeding were both associated with higher social class. These results suggest that, although practices in the initiation of breast feeding are relevant, factors in the background and environment of the mother are also of fundamental importance. Thus recent emphasis on the importance of breast-feeding practices in the immediate puerperium should not divert attention from the equally important task of establishing the optimum conditions for breast feeding in the home environment of mothers.

Sodium-dependent choline binding in rat hippocampal synaptosomes

The binding of radiolabelled choline to lysed rat hippocampal synaptosomes was investigated. A portion of the binding sites was (a) detectable only when sodium ions were present, (b) sensitive to low concentrations of hemicholinium-3 (KD less than or equal to 70 nM), and (c) significantly reduced following electrolytic lesion of the septum. The similarity between this component of choline binding and the requirements of the sodium-dependent high affinity choline uptake process suggests that these binding sites are related to the choline transport system.

Competitive inhibition of sodium-dependent high affinity choline uptake by harmala alkaloids

The actions of five harmala alkaloids on the sodium dependent high affinity choline uptake activity in rat striatal synaptosomes was investigated. All five compounds were found to be competitive inhibitors of the uptake system. Harmalol (Ki approximately 3.4 microM) and 2-methylharmine (Ki approximately 5.7 microM) were found to be relatively potent inhibitors in a series with an ascending order of inhibitory potency of harmaline less than 2-methylharmaline less than harmine less than 2-methylharmine less than harmalol.

The effect of harmaline and related harmala alkaloids on ouabain-stimulated contractions of the guinea-pig ileum

Harmaline, harmine, 2-methylharmine and harmolol, members of the harmala family of alkaloids were tested for their action on ouabain-elicited contractions of the guinea-pig ileum. All four alkaloids were found to relax tissue previously contracted by ouabain, but they differed in their potency and reversibility. Harmaline was equipotent with harmine but more easily reversible. 2-Methylharmine and harmolol were found to be less potent and readily reversible. It is evident that the inhibition mediated by harmaline occurs at a site other than that which ouabain binds. Ca-free Tyrode caused relaxation of tissue contracted by ouabain. This effect was partially reversed in the presence of normal Tyrode solution. In presence of high K the response to ouabain was almost abolished. Harmaline inhibited Ca-induced contractions in a non-competitive manner while neither 2-methylharmine nor harmalol had any effect. In the discussion the action of harmala alkaloids is shown to be directly related with CA ion movements.

The effect of harmaline and related beta-carbolines on the acetylcholine-stimulated contractions of guinea-pig ileum

Five members of the Harmala family of alkaloids, four commercially available and one synthetic homologue, were tested for their actions on the acetylcholine-elicited contractions of the guinea-pig ileum. Under normal Tyrode conditions over comparable concentration ranges harmalol was without effect, harmaline and harmine exhibited competitive-noncompetitive inhibition whilst the related 2-methylated derivatives effected purely competitive antagonism. Binding studies using [3H]QNB have further confirmed the competitive aspect of this antagonism. The competitive-noncompetitive inhibitory property of harmaline on smooth muscle muscarinic receptors has not been previously reported. Harmaline is known to compete with Na+ binding sites and significantly complete substitution of Na+ by K+ in the Tyrode medium was found to abolish the noncompetitive component of harmaline inhibition. Explanations are offered for both the competitive and noncompetitive components of the inhibition produced by the Harmala alkaloids.

How long should a breast feed last?

Patterns of milk flow were studied in 50 mothers who were breast-feeding normal birth-weight babies on days 5-7 of the puerperium by progressive test weighing at 5-min intervals during two consecutive feeds. Compared with a regime in which mothers attempted to feed for 10 X 10 min on alternate breasts, a regime of 5 X 5 X 5 X 5 min increased the amount of milk taken in the first 10 min did not influence the final milk intake of the suckling-induced prolactin release. The wide variation of breast-feeding patterns between mothers was demonstrated in respect of the duration of the feed (mean 17.3 min; S.D. +/- 3.1; range 7-30 min), the initial rate of milk flow (mean 6 g/min; S.D. +/- 4.2, range 1-14 g/min) and the final milk intake (mean 70.9 g; S.D. +/- 20.5, range 42-125 g). The advice to breast-feed for 20 min was in appropriate for the majority of mothers because the nutritive feeding time was 15 min or less in 75% of the feeding episodes. The milk intake correlated with the initial rate of milk flow but not with the duration of the feed, the infant's birth weight, or the time since the last feed. It is suggested that the duration of a breast feed should be determined by the infant's response and not by an arbitrary time schedule.