Acquired von Willebrand syndrome due to an inhibitor specific for von Willebrand factor antigens

A patient with acquired von Willebrand syndrome associated with polycythemia rubra vera is described. Her plasma factor VIII procoagulant activity (67 U/dl) and factor VIII-related antigen (117 U/dl) were normal but no von Willebrand factor activity could be detected. Factor VIII crossed immunoelectrophoresis revealed decreased levels of less anodic polymeric forms of factor VIII. Mixture of her plasma or immunoglobulin G (IgG) fraction with normal plasma resulted in complete recovery of factor VIII activity and related antigen but no measurable von Willebrand factor activity, confirming the presence of an unique inhibitor. The limited specificity of this inhibitor to antigenic sites solely on the von Willebrand portion of the factor VIII bimolecular complex is distinct from all previous reports of this syndrome. This unique inhibitor offers a molecular probe to examine the von Willebrand factor: platelet interaction.

A geriatric special-care unit: experience in a university hospital

Responding to a perceived need for specialized care for the acutely ill elderly, a 14-bed geriatric special-care unit was established in the University of Massachusetts Hospital in January 1980. Patients were selected for admission after assessment of their potential to benefit from restorative care. Most patients were admitted from the emergency room or outpatient clinics or were scheduled admissions; a few were in-hospital transfers. This report deals with a retrospective analysis of the first 514 admissions (431 patients) to the unit. Admissions by major service were: Medicine, 64 per cent; Surgery, 14 per cent; Neurology, 10 per cent; Orthopedics, 7 per cent; and other, 5 per cent. Approximately 64 per cent of patients were between the ages of 70 and 84. The overall average length of stay per admission was 11.5 days. Mortality rate of patients undergoing surgery (n = 125) was 4 per cent. The percentage of admissions that were discharged home was 78.7 per cent. Only 7.3 per cent of admissions were discharged to a nursing home, when those that were admitted to the unit from a nursing home are excluded. The authors conclude that a special nursing unit for acutely ill elderly patients may serve several purposes in a university hospital: overall patient care may be improved; length of hospital stay may be shortened; and medical students, housestaff, and attending physicians may gain an opportunity to learn the fundamentals of geriatric medicine as demonstrated by the staff of the unit.

VIDA II: a computerised diagnostic recording system for veterinary investigation centres in Great Britain

"Veterinary Investigation Diagnosis Analysis" II is a computerised recording system for all the diagnoses made at 33 Government diagnostic laboratories in Great Britain. It was created in 1975 and the records of 150,000 specimens are stored on it each year. The system depends on an agreed list of 393 possible diagnoses (101 cattle, 96 sheep, 72 pigs, 71 birds and 53 for other species). Diagnostic records are sent each month to a computer centre which produces an annual record of all diagnoses made and a monthly record of the number of submissions and financial charges. The computer file can be interrogated from a terminal at the epidemiology unit Weybridge and the diagnostic records are available to research workers.

Effects of rapeseed meal on laying hens (Gallus domesticus) in relation to fatty liver-haemorrhagic syndrome and egg taint

Fatty liver-haemorrhagic syndrome (FLHS) occurred in the controls and was modified in hens that received a diet containing 10 per cent rapeseed meal. This diet increased the extent and severity of the hepatic haemorrhage without affecting the reticulin content of the liver but decreased the body weight and liver lipid levels and so weakened the correlation between these parameters and haemorrhage score found in FLHS. Plasma aspartate transaminase and beta-glucuronidase activities tended to increase with the score. The rapeseed meal diet also produced thyroid hypertrophy and since this was greater in the hens that produced tainted eggs and was positively correlated with the trimethylamine (TMA) content of the eggs it was postulated that rapeseed meal goitrogens may be involved as secondary factors in producing the disturbance in TMA metabolism that causes the egg taint. This abnormality was associated with a reduction in the soluble protein content of the liver, which reflected a decrease in TMA oxidase activity, but was not related to hepatic haemorrhage, steatosis or reticulolysis, or to lipid levels and the activities of lysosomal enzymes and transaminases in the plasma.

Coughing in horses--an historical aspect

A brief historical review is given of the incidence and types of respiratory disease that occurred in Britain in the 18th and 19th centuries. The significance of poor stabling and overcrowding in the causation and spread of coughing is emphasised and its dramatic reduction by simple methods of hygiene and ventilation.

Problems, diseases and diagnoses: a personal view

Diseases and diagnoses are familiar words in the veterinary vocabulary and we seldom give much thought as to how we use them; we are more concerned about the practical problems they imply. However, there are occasions when it is essential that we use familiar words and concepts in a way that leaves no doubt as to the logical implications of our statements. The growing interest in surveys, monitoring and the use of computerised systems for epidemiological purposes points to the need for this discipline. In order to air the matter this paper presents some personal opinions that were based on Scadding (1967) and subsequently moulded by experience when designing a computerised data bank.

Headaches and migraine in colour retouchers

Taylor, P. J., Pocock, S. J., Hall, S. A., and Waters, W. E. (1970).Brit. J. industr. Med.,27, 364-367. Headaches and migraine in colour retouchers. A method is described for the study of headaches and migraine in occupational groups. The prevalence of headaches was studied in 158 colour retouchers and 115 page planners in the photogravure industry by means of a self-administered questionnaire and a clinical interview. There was no difference in types of headaches although the first group used the word `migraine' more frequently than the second. Questionnaire findings were very similar to those obtained from a sample of 727 males in South Wales, although infrequent headaches were more common in both printing groups.