Demographics, political power and economic growth.

"Growth theory may be used to predict the response of saving, capital formation, and output growth to large demographic shifts. Such large shifts would also be expected to alter the demand for government services and the desired levels of taxation in the population. This paper extends the overlapping-generations model of economic growth to predict the evolution of government tax and spending policy through the course of a major demographic shift. Simulations suggest that this approach may yield valuable insights into the evolution of policy in the United States and other industrialized economies."

Evaluation of the TALON Cooperative Acquisitions Program for monographs.

The TALON Cooperative Acquisitions Program for monographs (TALON/CAP) was implemented in 1979 by eleven resource libraries in the South Central Regional Medical Library Program. Each participating library acquired books from selected publishers within a profile covering subject and format. The program was evaluated by comparing interlibrary loan requests, surveying participants, and analyzing cataloging records. The results were that ten of the eleven libraries significantly increased their coverage of assigned publishers, and that academic medical libraries are not all buying the same books, even from major medical publishers. The fifty-six publishers in the program accounted for 60% to 83% of the titles with 1977-80 imprints held by participating libraries. The computer-generated collection analysis reports provide a baseline for future collection management studies.

Effect of therapy on the neutropenia of hyperthyroidism.

Observations in a patient with recurrent hyperthyroidism, each time associated with neutropenia which resolved after therapy, prompted a chart review of other patients referred for radioactive iodine therapy. Of 99 untreated patients, 18 had neutrophil counts of less than 2,000/cu mm. After therapy with either thionamides or 131I, 41 of 53 (77%) evaluable patients had an increase in neutrophil count. Eleven of these evaluable patients had neutropenia before therapy; after therapy, all 11 had an increase in their neutrophil counts into the normal range, with a mean increase of 170%. In one patient, studies on the mechanism of neutropenia indicate that bone marrow production and reserve remain normal and that circulating neutrophils are normally marginated. A decreased neutrophil circulation time may be the cause of neutropenia associated with hyperthyroidism.

Is staging laparotomy for Hodgkin's disease still justified?

The records of 50 consecutive patients who underwent staging laparotomy for Hodgkin's disease were reviewed. Preoperative clinical stages were as follows: stage I, 12 patients; stage II, 20 patients; and stage III, 18 patients. The accuracy of preoperative lymphangiography, confirmed pathologically, was 80 percent. Early experience with computed axial tomographic scanning is promising. The stages of 20 patients (40 percent) were changed by laparotomy, and their treatment was altered as a result. Fourteen patients were upstaged and 6 downstaged. Patient who were upstaged to stage IIIB and IV received chemotherapy; those downstaged to stage I and II received radiotherapy only. Sixty-seven percent of patients with preoperative constitutional symptoms (class B) had positive findings at laparotomy, compared with only 28 percent of patients without such symptoms (class A). Patients with mixed cellularity or lymphocyte-depleted histology were more likely to have positive findings at laparotomy. There were four complications and operative deaths. We conclude that staging laparotomy retains a useful role in the diagnosis and management of Hodgkin's lymphoma.

Consumer health information: libraries as partners.

The need for consumer health information delivery is becoming more evident to librarians. The results of a user survey at a large medical center library and a metropolitan public library confirm that the general public is making demands for health information at both types of libraries. Issues facing librarians are discussed; roles are suggested for public libraries, for academic health sciences libraries, and for hospital libraries. The importance of library involvement in the delivery of consumer health information is emphasized. Librarians are urged to define a role for themselves and to work hard at identifying the library profession to all others involved in the delivery of consumer health information.

Cadmium and nickel influence on blood pressure, plasma renin, and tissue mineral concentrations.

Weanling rats were fed a casein-based diet containing either 150 ppm cadmium, 500 ppm nickel, or the combination of these metals for 16 wk. Blood pressure of rats fed the diet with cadmium decreased after 8 wk, but this effect was counteracted by dietary nickel. Cadmium caused a depletion of iron and resulted in an accumulation of zinc in liver and kidney of rats. Nickel partially counteracted the iron loss due to cadmium. In a second experiment, the inclusion of 10 or 20 ppm cadmium in drinking water for 24 mo did not result in elevated blood pressure in normal or genetically hypertensive rats. Cadmium had no effect on the plasma renin levels in either experiment. Low intake of cadmium (10 or 20 ppm) in drinking water resulted in elevated cadmium content in hair. Thus, our data do not indicate that high levels of cadmium contribute to hypertension.