High density lipoprotein cholesterol concentrations in physically active and sedentary spinal cord injured patients.

Individuals with traumatic spinal cord injury (SCI) are extremely inactive yet little is known about the long-term consequences of chronic inactivity. Current research investigated the concentrations of high density lipoprotein cholesterol (HDLc) and its subfractions HDL2 and HDL3 in 66 extremely sedentary SCI admissions to a rehabilitation center. High density lipoprotein cholesterol is a primary risk factor for cardiovascular disease with decreased levels associated with increased cardiovascular risk. The concentrations of HDLc observed in the SCI sedentary population were compared with 22 olympic caliber wheelchair athletes (SCI athletes) and 126 able-bodied controls. Total HDLc, HDL2, and HDL3 was significantly lower in the male SCI sedentary population (34.2 mg/dl, 8.9 mg/dl, 25.3 mg/dl) than the male SCI athletes (42.7 mg/dl, 13.9 mg/dl, 28.8 mg/dl) or male able-bodied control populations (47.1mg/dl, 11.3mg/dl, 35.8 mg/dl). A similar pattern emerged for the female subjects. The reduction in HDLc seen in the SCI sedentary would predict over a 60% increased risk of heart attack compared to nondisabled controls. The primary difference between the two SCI groups was the level of physical activity, suggesting that this may be an important parameter for elevating total HDLc and HDL2, and presumably decreasing the risk for coronary heart disease. Therefore, physical activity positively affects total HDL and the supposedly antiatherogenic subfraction HDL2 in the SCI patient.

Meningococcal colonization and infection in children and their household contacts.

A bacteriologic survey was performed to estimate the prevalence and duration of meningococcal carriage in children in Montreal, Canada. Infants and children with proven meningococcal infection, or with asymptomatic meningococcal nasopharyngeal (NP) carriage, and their household contacts, were also studied to define communicability. N. meningitidis was present in 30 (2.4%) of the NP cultures from 1238 asymptomatic infants and children in this civilian population during a non-epidemic period. Meningococcal carriage was not found in 278 subjects 1--60 days of age; there was no difference in carriage rates between the sexes and between hospitalized and non-hospitalized children in all age groups. Meningococci were initially isolated from 11 of 106 household contacts of 29 ill index cases and from 15 of 104 contacts of 29 asymptomatic carriers; 35% of all contacts (index cases and carriers) were colonized by the eighth week of surveillance. Duration of NP carriage was longer (mean 15.2 weeks) in disease-free families than in families of ill patients (mean 5.5 weeks). Serogroups B and C were most commonly isolated from both ill and asymptomatic subjects. Resistance to sulfadiazine (MIC greater than or equal to mg/100 ml) was present in 6.5% and 39.4% of group B and group C strains, respectively. Although chemoprophylaxis was not used, there were no secondary cases among the 29 families of index cases.

Oxolinic acid therapy for urinary tract infections in children.

Thirty hospitalized children with Gram-negative bacillary urinary tract infections were treated with oxolinic acid for 14 to 21 dyas. Fifteen of 17 patients with uncomplicated and 11 of 13 with complicated urinary infections had favorable bacteriologic responses. Resistant organisms developed in four treatment failures. Oxolinic acid urine concentrations were well above the minimal inhibitory concentration for most strains of Escherichia coli, Klebsiella, Enterobacter, Proteus mirabilis, P vulgaris, P morganii, and P rettgeri. Approximately half of these patients experienced mild symptoms possibly related to oxolinic acid therapy; in no instance did they require cessation of therapy. Our experience indicates that if the urine is not sterile by the end of five days of treatment, bacterial resistance to oxolinic acid is likely to have developed, and therapy with another agent should be considered and antibiotic susceptibility tests repeated.

Immunization today--a review.

Immunization practices are frequently changing as our understanding of the basic concepts of host-parasite interactions grows and research in the area of new vaccines continues. The present review attempts to summarize current practices and the scientific data on which they are based. A complete historical review of the subject is beyond the scope of this report which is only intended to survey developments in the field over the past few years and up until October 1972.

Host factors and capsular typing of body fluid isolates in fulminant pneumococcal infections.

A 10-year retrospective study was made to determine the spectrum of underlying disease in, and the capsular types of pneumococci isolated from, blood and body fluids of 140 hospitalized patients. Fifteen serotypes were found among 82 typed isolates, 53% of which were types 8, 14, or 23. There was a predominance of males and a high incidence of underlying pneumonia, chronic liver disease, nephrotic syndrome, cerebrospinal fluid rhinorrhea, and malignancy. Mortality rates were higher among the very young and aged, and the immunologically comprised host at either extreme of life was more susceptible to disseminated pneumococcal infection. Pneumococci of the higher capsular types were prominent in children, and those of the lower types in adults, a finding in agreement with other recent studies.