Classification rules for basic phonological processing disabilities and nonverbal learning disabilities: formulation and external validity.

Rules for the classification of two subtypes of learning disabilities (LD), namely, Basic Phonological Processing Disabilities (BPPD) and Nonverbal Learning Disabilities (NLD), are reported. These rules (refined as a result of application to two separate samples of children with LD) were used to select children from an entirely new sample who could be classified as having "definite" or "probable" BPPD or NLD. As a first step in the external validation of these rules, the patterns of psychosocial functioning exhibited by these two subtypes of LD were determined. As predicted, the vast majority of the BPPD subtype exhibited a pattern most consistent with normal or relatively normal psychosocial adjustment, and no appreciable increase in the incidence of significant psychosocial disturbance with advancing years. Also, as predicted, an increasing incidence of internalized psychosocial dysfunction (a form of significant psychosocial disturbance) was evident in the NLD subtype with advancing years. It is clear that children classified as having BPPD or NLD using these rules exhibit quite different, and predicted, relative patterns of psychosocial functioning. Thus, in this sense, the rules have concurrent validity. Finally, sets of rules/criteria for classification are presented that reflect their actual incidence in the two subtypes of LD generated for use in the validation phase of this investigation. These rules would appear to be useful for clinical purposes. It is also clear that they should be subjected to further validation studies in a broader age range for clinical and research purposes.

Short-term effects of coronary angiographic contrast agents on thyroid function.

OBJECTIVE: To determine the effect of two iodine-containing contrast agents used for coronary angiography on subsequent thyroid hormone concentrations. METHODS: We prospectively studied thyroid function in 56 patients, with no previous history of thyroid disease and normal findings on thyroid examinations, who underwent nonemergent cardiac catheterization. Thyroid hormone concentrations were assessed at baseline and at day 1 and day 7 after administration of a radiographic iodinated contrast agent (Renografin or Omnipaque). RESULTS: Use of Omnipaque and Renografin was not associated with significant changes in thyroid-stimulating hormone, total thyroxine, triiodothyronine resin uptake, free thyroxine index, or total triiodothyronine. Three patients had slightly increased thyroid-stimulating hormone concentrations at 7 days after angiography. CONCLUSION: Administration of iodinated contrast agents for cardiac catheterization does not result in hyperthyroidism in patients with previously normal findings on thyroid examination.

Elastin derived peptides protect elastic fibres degradation by human neutrophil elastase: in vitro and in vivo studies using a mechanically induced rat gingival inflammatory model.

An elastin peptide (kE57) obtained from organoalkaline hydrolysis of calf ligamentum nuchae insoluble elastin, was isolated by gel permeation on Sephadex G150 and high performance liquid chromatography on a TSK G 3000 SW column. It possessed an average Mr = 57,000 and similar amino acids composition as its insoluble counterpart. kE57 behave as a competitive inhibitor of human neutrophil elastase (HNE) with Ki = 1.4 microM; it also inhibited porcine pancreatic elastase (PPE) but less efficiently Ki = 180 microM. Identification of elastic fibres in rat gingiva was ascertained by light and electron microscopic studies. Morphometric studies indicated that rat gingiva contained similar levels of elastic fibres (= 2%) as human skin; elastic fibres networks from both tissues also displayed high structural analogy. Gingival chronic inflammation was induced in rats by mechanical impaction associated with an hyperglucidic diet. After 5 weeks, the levels of rat gingiva elastic fibres, decreased from Vv = 1.94 +/- 0.1% to Vv = 1.02 +/- 0.06%. Local injections of kE57: 100 micrograms per day, 5 days a week for 5 weeks did restore the integrity of the gingiva elastic fibres network: Vv = 1.84 +/- 0.1. Without influencing leucocyte infiltration, it is proposed that elastin-derived peptides, acting as potent competitive inhibitor of neutrophil elastase involved in periodontitis, might be of therapeutic value.

Social support, locus of control and psychological health in family members following head or spinal cord injury.

Perceived stress and psychological health were comparatively examined in relation to social support and locus of control in family members of patients who had sustained moderate to severe closed head injury (CHI) or spinal cord injury (SCI). In the group with CHI, family members reported significantly greater symptoms of depression, and greater perceived stress in relation to difficult personality characteristics of the patient and day-to-day problems involved in caregiving. The family members of the patients with SCI reported significantly greater social support within the family. In the group with CHI, an internal locus of control and greater social support from friends, but not other family members, were significantly correlated with lower levels of perceived stress and better psychological health. In the group with SCI, greater social support from both family and friends was significantly correlated with lower levels of perceived stress and better psychological health. The results of this study are consistent with the notion that social support and locus of control may significantly, albeit differentially, moderate the effects of profound life changes in these groups. The implications of these findings are discussed in terms of intervention strategies that may be utilized to facilitate family adjustment following CHI or SCI.

[A career in nursing sciences?]. / Une carrière en sciences infirmieres?

A research study was conducted in a francophone high school in Northern Ontario to examine students' perceptions of nursing and the influence of these perceptions on nursing as a career choice. All students in grades 11, 12 and 13 were invited to participate. Fifty-eight percent (n = 268) completed the questionnaire. Results showed that 37 percent of the respondents considered pursuing a career in the health sciences. Only 14% percent were interested in nursing. Respondents' comments suggest that the nurse is viewed favorably but the profession is perceived as a career that does not involve pleasant tasks, good working conditions or opportunities for professional advancement. Reasons advocated for choosing nursing were altruistic rather than career-oriented. Students saw nursing practice as occurring mainly in a hospital setting. Half of the respondents who had chosen nursing as a career opted to enroll in a university program and the other half chose a college program. Results suggest that nursing continues to face an image problem regarding its role in the health care system. In these times of job losses and budget cuts, the profession still needs to attract young recruits. This is the challenge we have to face.

[Facing AIDS in Zambia]. / L'Approche du SIDA en. Une entrevue avec monique racine, bsclnf.

An alternative approach to AIDS in Zambia. Zambians have lived with what we now call AIDS for 20 years. Today, an estimated eight percent of newborns are infected with the virus. Yet dealing with AIDS in this traditional society is an onerous task. While the country's 10,000 nurses are educated in the ways of modern medicine, they are matched by an equal number of traditional healers. And it is traditional values that Zambians turn to when faced by diseases for which modern medicine has few answers--diseases like cancer and AIDS. This author, a nurse educator with The Missionary Sisters of Our Lady of Africa, challenges young nurses to help Zambians respond effectively to this complex situation.

Evaluation of the IFCC reference method for alanine aminotransferase: spurious blank ALT activity due to contamination of D-alanine with L-alanine, and recommendations for a correction.

During an evaluation of the IFCC reference method for alanine aminotransferase (ALT, EC 2.6.1.2), we noted that the specimen blank activity reaction was markedly increased. Experience with five different lots of D-alanine from four commercial sources indicated that substantial and varying negative bias (up to -10%) could be introduced into the blank-corrected ALT activity, depending on the lot of D-alanine used. Although the IFCC procedure for ALT mentions the possibility of this L-alanine contamination, we believe that the degree of contamination in commercial reagents is underestimated. Analyzing the five lots of D-alanine for L-alanine, we found the magnitude of negative bias to be correlated directly with L-alanine contamination. Here, we describe a quick, sensitive assay based on coupled reactions of L-amino acid oxidase/peroxidase for quantifying L-alanine in the concentration range of 0-15 mmol/L without a sample-dilution step. Results by this alternative L-alanine assay agreed well with those recommended in the IFCC ALT procedure. Further examination suggested an even simpler solution to the L-alanine contamination problem, because we found no difference in the blank-corrected ALT activity determined in Tris HCl buffer, with or without D-alanine (free of L-alanine). We therefore propose that D-alanine be omitted from the IFCC reference ALT procedure.

Concentration of Mycobacterium avium by hospital hot water systems.

Water from 34 sites on two temporarily vacant hospital floors was analyzed for the presence of mycobacteria. These sites included 18 cold water taps and 16 hot water taps, including shower heads. A total of 14 sites (41%) demonstrated the presence of Mycobacterium avium as confirmed by biochemical characterization, DNA/rRNA probe analysis, and seroagglutination. Of positive sites, 11 were hot water sources with an average temperature of 55 degrees C and yielding up to 500 colony-forming units per 100 mL. Seven of 11 strains analyzed for glycolipid antigens were identified with the type 4 serovar, the preponderant serovar of M avium in patients with acquired immunodeficiency syndrome from the Boston area. Potable hot water systems, particularly those that generate aerosols, may contain concentrations of M avium greater than those found in cold water systems and could serve as an environmental source for colonization and infection of immunocompromised persons.

Mycobacteria in public water supplies: comparative resistance to chlorine.

The isolation of mycobacteria from municipal and hospital water supplies prompted an investigation of the susceptibility of environmental and clinical isolates of mycobacteria other than Mycobacterium tuberculosis and Mycobacterium bovis to free chlorine. Experiments revealed that free chlorine concentrations of 1.0 mg l-1 eliminated 100,000 c.f.u. of the mycobacterial strains tested within 8 hours of exposure, whereas a concentration of 0.15 mg l-1 had virtually no bacteriocidal effect. Free chlorine residual levels of 0.1 mg l-1 or less, depending on the water temperature, within Boston, suggest that current disinfection procedures may not be adequate for effective control of potentially pathogenic mycobacteria in public water supply systems serving a population with increased risk factors.

Detection of IgA specific for toxoplasmosis in serum and cerebrospinal fluid using a non-enzymatic IgA-capture assay.

A non-enzymatic immuno assay was optimized for detection of immunoglobulin A in serum and cerebrospinal fluid specific in acquired and congenital toxoplasmosis. An antihuman IgA monoclonal antibody was coated onto a polystyrene to capture total IgA. Suspensions of Toxoplasma gondii were used as a visible antigen. Eight hundred specimens (sera, cord blood serum, and cerebrospinal fluid) were tested. These were collected from 300 patients with acquired toxoplasmosis and from 28 children with congenital toxoplasmosis. In acquired toxoplasmosis, the assay allowed early detection of specific IgA, with kinetics similar to those of specific IgM expression. In congenital toxoplasmosis, anti-T. gondii IgA could be detected in the neonatal period. This assay was useful for diagnosis, follow-up, and posttherapeutic evaluation of toxoplasmosis. Specific IgA was also detected in the cerebrospinal fluid of infected newborn children. This simple IgA capture assay improves serological diagnosis of acquired and congenital toxoplasmosis when used in combination with analysis of T. gondii specific IgG and IgM.

[An experience of quality of life at work.]. / Une expérience de qualité de vie au travail.

In May 1974, Steinberg initiated with twenty employees a semi-autonomous production group in one of their depots. During the ten ensuing years, this group exemplified one of the most interesting experiences in Quebec relating to the quality of life at work. The author follows the evolution of this project from its birth to its completion in October 1983. He highlights the results obtained for the company as well as those concerned with the social welfare of the employees. He describes the problems encountered, the successes obtained and the traps to look for when setting up programs on the quality of life at work or in any other model of work organization.

[A case of a well-tolerated spontaneous post partum uterine inversion]. / Un cas d'inversion utérine spontanée du post-partum très bien tolérée.

The authors report the unusual case of spontaneous inversion of the uterus that occurred three days after a normal delivery. Clinically this was very well tolerated. There did not seem to be a constriction ring which normally occurs in there cases. The authors were therefore able to wait until it was quite safe to give the patient an anaesthetic. Manual replacement was easy bu inversion recurred immediately. A pack was therefore put inside the uterus, and the uterus closed down satisfactorily on it in the right position. When the pack removed under anaesthesia 48 hours later inversion did not recur.

[Supraventricular tachycardia in utero. Apropos of a personal case, review of the literature]. / La tachycardie supraventriculaire in utero (TSVF). A propos d'un cas personnel, revue de la littérture.

After describing a case of early hydrops fetalis in a fetus demonstrating supraventricular tachycardia (TSVF) the authors review the literature: First they note the increase in the number of cases of TSVF published in the last few years, thanks to better means of monitoring pregnancies and to the place taken by TSVF among the different other troubles of fetal heart rhythm than can occur. The second section enumerates and analyses the pathological associations and the complications that have been observed in cases of TSVF that have been indexed. All have a poor prognosis: as far as those cases where there are faults in the rhythm which are associated with or alternate with TSVF, congestive heart failure occurs in 50% of cases, and organic heart pathological conditions in 20% of cases. 19.1% die. The third section analyses the means available for diagnosis and prognosis and the value of these means. Diagnosis rests on screening by clinical observation (careful auscultation in every pregnancy, observation of the raised height of the uterine fundus and a lessening in active fetal movements) and by monitoring. Only the ECG can confirm the diagnosis. Congestive heart failure is diagnosed by using ultrasound. A cardiac malformation should be searched for thoroughly by ultrasound. Monitoring in labour has no use as a prognostic indicator. Only repeated measurements of pH can demonstrate fetal distress in labour. The last section is concerned with management: digitalisation is strongly to be recommended before the fetus is mature. Propranolol should be reserved for resistant and severe cases: when there is no congestive heart failure a wait and see policy under strict observation can be followed. If there is congestive heart failure, caesarean section must be carried out. After delivery resuscitation with vagal stimulation is often sufficient, but when it is not digitalisation can be used and very rarely electric cardioversion is needed. Relapses are frequent and treatment must be followed for a year.

[Prognosis for delivery in women with previous cesarean section. Apropos of 209 cases]. / Pronostic de l'accouchement chez la femme antérieurement césarisée. A propos de 209 cas.

The authors have attempted to show the following with the help of 209 cases of delivery in women who had previously had Caesarean sections: Vaginal delivery is possible in approximately one out of every two cases, providing certain precautions have been taken and these are: Maternal morbidity rises to about 12% when a woman is delivered after a previous Caesarean section, whether the delivery is vaginal or, a repeat Caesarean. Furthermore, morbidity rises greatly after a failure of a trial of labour for which the indications should be very carefully considered. The outlook for the fetus is better after a vaginal delivery. In fact, this result seems to be allied to pathology which results from the surgical procedure itself. All the same, respiratory distress in the newborn is more frequent after Caesarean operation, which exposes the fetus to the risks of a uterine rupture and also of increased incidence of instrumental delivery following a previous Caesarean.

Ureaplasma urealyticum incriminated in perinatal morbidity and mortality.

Perinatal morbidity and mortality are associated with colonization of the chorionic surface of the placenta by Ureaplasma urealyticum or Mycoplasma hominis or both. These organisms are more strongly associated with unfavourable gestational outcome than group B streptococci. Chlamydia trachomatis does not appear to be important in the etiology of reproductive casualties. The mechanisms linking the mycoplasmas to perinatal disorders and death are not clear but merit investigation.