The impact of an educational program on improving diabetes knowledge and changing behaviors of nurses in long-term care facilities.

Nursing staffs from two long-term care facilities attended a multisession educational program about the care of residents with diabetes (treatment group). A control group consisted of the nursing staffs from two other similar facilities who did not participate in the educational program. Both groups were given a knowledge pretest and posttest. A chart review also was conducted following the educational intervention to determine any changes in the diabetes care provided by the treatment group. Following the educational program, the treatment group had a significant increase in their mean score on the knowledge test compared with the control group. However, a review of the residents' charts revealed no significant increases in specific behaviors related to diabetes care. The findings suggest that, in addition to educational programs, more focused training concerning diabetes care is needed to improve the care of residents with diabetes in long-term care facilities. Implications for diabetes educators are discussed.

von Willebrand factor in lysates of washed canine platelets.

Canine and human platelets (washed 4 times in a solution containing EDTA, prostaglandin E1, and theophylline to prevent release of alpha-granule constituents) were lysed by being frozen and thawed in the presence of detergent. Radioelectroimmunoassay for von Willebrand factor (vWf) in 5 human platelet lysates produced precipitin rockets, shaped like those produced from vWf in plasma from healthy human beings, and indicated that the mean von Willebrand factor antigen (vWf:Ag) content in platelets from healthy human being was 526 +/- 87 human U/10(12) platelets. Radioelectroimmunoassay for vWf in platelet lysates from 17 healthy dogs with normal plasma. vWf:Ag concentration produced precipitin rockets that looked different from those produced from canine plasma and indicated vWf:Ag content of 59 +/- 35 canine U/10(12) platelets. Inclusion of protease inhibitors in the lysing solution did not normalize the appearance of the precipitin rockets or substantially alter the measured platelet content of vWf:Ag. The array of vWf multimers revealed by sodium dodecyl sulfate-agarose gel electrophoresis of canine platelet lysates had a distinct appearance that differed from that of vWf in canine or human plasma and platelets; the intensity of the canine platelet vWf multimer bands was skewed, with relatively greater density in the lower molecular weight region and faint or undetectable multimer bands in the higher molecular weight region. Electrophoretograms with visible multimers in the high molecular weight region had vWf components that had higher molecular weight than did any vWf components in canine plasma. Radioelectroimmunoassay for fibronectin in these same canine platelet lysates indicated that the fibronectin content in platelets was 2.89 +/- 1.10 mg/10(12) platelets.(ABSTRACT TRUNCATED AT 250 WORDS)

Local and metastatic tumor growth and membrane properties of LM fibroblasts in athymic (nude) mice.

LM fibroblasts grown in a chemically-defined, serum-free medium readily incorporated choline or one of three analogues of choline, namely N,N-dimethylethanolamine, N-monomethylethanolamine, or ethanolamine into membrane phospholipids. The effect of these phospholipid manipulations in vitro on tumor growth and metastasis was examined in nude mice. Serum and choline-fed cells most frequently metastasized (74% and 68%, respectively), while frequency of lung metastasis was 46%, 42% and 17% in mice injected with cells fed with dimethylethanolamine, monomethylethanolamine, and ethanolamine, respectively. Metastases from cells cultured with serum, choline or dimethylethanolamine, but not from monomethylethanolamine or ethanolamine, were extensive and highly invasive. The specific activity of the (Na+ + K+)-ATPase but not of 5'-nucleotidase was significantly decreased in local tumor plasma membranes from choline analogue-fed cells as compared to tumor plasma membranes from choline-fed cells. When compared to the choline-fed tumor cells, the specific activities of three mitochondrial enzymes, namely NADH dependent, rotenone insensitive NADH-dependent, and rotenone sensitive NADH-dependent cytochrome-c reductase, were significantly increased in the choline analogue-supplemented cells. The arachidonic acid content of phosphatidylcholine in plasma membranes, microsomes, and mitochondria was significantly decreased in tumor membranes from choline analogue-fed cells as compared to tumor membranes from choline-fed cells. As compared to local tumor plasma membranes, the lung metastasis plasma membranes had elevated (Na+ + K+)-ATPase specific activity, phospholipid oleic and arachidonic acid content, and fluidity. In contrast, the 5'-nucleotidase specific activity, the content of cholesterol, phospholipid, and phosphatidylethanolamine were decreased in lung metastasis plasma membranes. In summary, membrane alterations of LM tumor cells in vitro (1) were not completely reversed in vivo, and (2) affected metastatic ability.

Oral Mucosa Bleeding Times of Normal Cats and Cats with Chediak-Higashi Syndrome or Hageman Trait (Factor XII Deficiency).

A commercially available, disposable blade in a spring-loaded cassette was used to measure oral mucosa bleeding times (OMBT) of ketamine/acepromazine-anesthetized cats. The OMBT were determined in cats homozygous for Chediak-Higashi syndrome (CHS, n = 7), cats heterozygous for CHS (n = 6), and cats homozygous for Hageman factor (factor XII) deficiency (n = 5). In addition, OMBT were determined in three groups of normal cats: random-source cats (n = 14), inbred normal relatives of the cats with CHS (n = 7), and inbred normal relatives of Hageman factor deficient cats (n = 9). No significant differences were found in the OMBT of the three groups of normal cats. The mean OMBT for all 30 normal cats was 1.9 minutes +/- 0.5 minutes s.d. Compared to the normal cats, those homozygous for CHS had significantly prolonged OMBT (14.1 +/- 3.3 minutes; p < 0.05). The mean OMBT of cats heterozygous for CHS (2.6 +/- 0.8 minutes) was also significantly longer than the OMBT of the combined normal group. The mean OMBT of the CHS heterozygotes, however, was not significantly longer than that of their normal relatives (OMBT = 1.8 +/- 0.5 minutes), probably because of the low number of cats in this subgroup of normals. As expected, the OMBT of cats homozygous for Hageman factor deficiency (2.3 +/- 0.3 minutes) were not significantly prolonged.

Salt consumption and the effect of salt on mineral metabolism in horses.

The voluntary salt consumption of mature unexercised horses was measured weekly for up to 45 weeks. Voluntary intake among horses was quite variable ranging from 19 to 143 g of salt per day and was inversely related to total salt intake (salt in feeds plus voluntary intake). Mean daily voluntary salt consumption was 53 g. Season of the year did not influence voluntary intake. In preference tests which evaluated every two choice combination of 0.2% and 4% NaCl in test diets fed daily for four days, ponies generally preferred diets containing the lower amount of salt. In similar preference studies which used NaHCO3 as a sodium source, ponies always preferred the diet containing the lower level of NaHCO3. Metabolism studies employing diets containing 1, 3 or 5% NaCl showed that urinary excretion was the major excretory pathway for sodium and chloride. Fecal excretion, intestinal absorption and retention of sodium were not affected by level of salt intake. Urinary calcium excretion was unaffected by salt intake but calcium and phosphorus absorption and retention were enhanced when ponies were fed diets containing 3 or 5% sodium chloride. Magnesium and copper metabolism were unaffected by salt intake. Horses voluntarily consume relatively large amounts of sodium chloride but it is likely that not all voluntary consumption is related to the salt requirement of the horse. Habit and taste preference could also be involved. Salt consumption at the levels used in these studies does not appear to be detrimental to the metabolism of other minerals in the horse.

The cultural and biochemical characters of Streptococcus milleri strains isolated from human sources.

A collection of 346 strains of Streptococcus milleri from a variety of human sources was examined culturally and biochemically, and for the presence of Lancefield group antigens. Most of the strains were non-haemolytic and ungroupable, but 25% were beta haemolytic and 19% were alpha haemolytic; 28% possessed a group antigen (A, 5%; C, 6%, F, 14%, G, 3%). These antigens were present in 69% of beta-haemolytic but in only 13% of alpha-haemolytic or non-haemolytic strains; beta haemolysis occurred in 82% of group-F strains, 43% of other groupable strains and 11% of ungroupable strains.The following reactions were given by > 80% of S. milleri strains: hydrolysis of arginine and aesculin, a positive Voges-Proskauer reaction, and acidification of trehalose, lactose, salicin and sucrose. A minority of strains showed enhancement of growth by CO(2), bile tolerance, NaCl tolerance, and ability to acidify other sugars, notably mannitol, raffinose and melibiose. Departures from the modal pattern of biochemical reactions showed a weak correlation with the type of haemolysis and the presence or absence of a group antigen but were not sufficiently systematic for clear-cut subdivisions to be recognized within the species.S. milleri therefore appeared to comprise a ;central' group of non-haemolytic strains that rarely formed a Lancefield-group antigen, in which the aesculin reaction was nearly always positive, lactose was usually acidified, and a considerable minority showed enhancement of growth by CO(2) and bile tolerance. Deviations from this pattern were of two main types. (1) ;Loss' of one or more of these reactions, which tended to be associated with beta-haemolysis and presence of a group antigen. In these respects, alpha-haemolytic strains tended to occupy an intermediate position. (2) ;Gain' of the ability to acidify additional sugars, notably raffinose and melibiose or mannitol; this occurred mainly among otherwise typical non-haemolytic strains that were rarely groupable.Only 12% of isolations from the bloodstream of patients suffering from systemic infections were beta haemolytic and only 18% possessed a group antigen, but a considerably greater proportion of those from visceral abscesses were beta haemolytic (28%). Among isolations from superficial lesions in some body sites there were considerably greater proportions of beta-haemolytic and groupable strains; thus, nearly one-half of those isolated from the abdomen other than the female genital tract were beta-haemolytic and over one-half were groupable. On the other hand, strains from the teeth and gums were nearly always non-haemolytic and ungroupable, and most vaginal isolations were of non-haemolytic strains with a wide sugar-fermentation pattern.

Neonatal streptococcal infections.

Most serious neonatal streptococcal infections are caused by group-B streptococci. The pattern of serious group-B neonatal disease in Britain resembles that described in other countries; both "early-onset" and "late-onset" forms are seen, but reliable incidence rates have not yet been determined. Serological-type III strains predominate in neonatal meningitis in Britain, but not so markedly as in some parts of the U.S.A. A deficiency of group-II strains in meningitis is, however, apparent in both countries. Present information about the carriage of group-B streptococci suggests that antibiotic prophylaxis administered to mothers or infants is unlikely to reduce greatly the frequency of "early-onset" disease. The continuous presence of a suitable chemical disinfectant in the vagina during labour might be more effective. Insufficient is known about the epidemiology of "late-onset" neonatal disease for rational preventive measures to be designed. More information is required about the postnatal acquisition of group-B streptococci by neonates and its sources, and about passive transfer of type-specific antibody from the mother to her child.

Antibiotic susceptibilities of streptococci from the mouth and blood of patients treated with penicillin or lincomycin and clindamycin.

Patients undergoing dental extractions were non-randomly allocated to three groups, one of which received no antibiotic, one benzylpenicillin followed by oral penicillin for 5 days, and the third intramuscular lincomycin followed by oral clindamycin. Dental extraction was performed at the beginning of the course of chemotherapy. Streptococci were isolated from the extracted teeth, from blood cultures collected before and immediately after dental extraction, and from sutures removed from the gums 5-7 days after the operation. The species of these organisms was determined, and their susceptibilities to penicillin, clindamycin, cephaloridine, erythromycin and tetracycline were assessed. The majority of streptococci isolated from teeth belonged to the species Streptococcus sanguis, S. mitior, S. mutans and S. milleri. Occasional isolates of each of these organisms collected before the antibiotic could take effect were resistant to penicillin. Three of these species, but not S. mutans, were the commonest streptococci to be isolated from the blood after dental extraction. Penicillin completely suppressed dental bacteriaemia under the conditions of our investigation, and lincomycin reduced the incidence by about 60 per cent. The commonest streptococci from sutures were also S. sanguis, S. mitior, S. mutans and S. milleri. S. faecalis was also isolated, but only in patients who had received antibiotics. Among the non-faecalis organisms, penicillin resistance was significantly more frequent among isolates from patients given penicillin than from patients not given this antibiotic, and clindamycin resistance was significantly more frequent among isolates from patients given lincomycin and clindamycin than from patients not given these antibiotics.