[Changes in the etiologic structure of Sonne shigellosis in its multiyear dynamics]. / Izmeneniia étiologicheskoi struktury shigelleza Zonne v mnogoletnei dinamike.

The dynamics of Sonne dysentery morbidity in connection with changes in the structure of S. sonnei circulating among the population of Leningrad for the period of 1959-1984 was studied. Considering such sign as the leading fermentovar, three smaller periods were established in this stretch of time. Changes in the structure of circulating shigellae were accompanied by changes in the intensity and direction of tendencies or decrease in the manifest and asymptomatic forms of infection, as well as in annual morbidity levels and seasonal rises. A slow decrease in morbidity, which started in 1974, occurs in the presence of the predominant circulation of S. sonnei, fermentovar II, among the population; this fermentovar showed greater virulence and immunogenicity than other biovars. One of the decisive moments characterizing the dynamics of the epidemic process of Sonne dysentery is the intensity of the circulation of shigellae in the S-form, and the intensity of the population immunity of the host, linked with this fact, is subject to phasic fluctuations during each annual epidemic cycle.

[Manifestations of genotypic and phenotypic heterogeneity in populations of Shigella sonnei and of humans at different phases of the development of the epidemic process]. / Proiavleniia genotipicheskoi i fenotipicheskoi neodnorodnosti populiatsii shigell Zonne i liudei na raznykh fazakh razvitiia épidemicheskogo protsessa.

The study of the structure and developmental dynamics of S. sonnei populations and the state of local immunity to this infection in children under school age has revealed that the interaction of the heterogeneous populations of the parasite and the host is the internal motive force of the self-regulating phasic development of the epidemic process. In the course of this process complementary changes in the virulence of the infective agent and in the immunoresistance of children are generated on the basis of negative feed-back.

Plasma glucose, cholesterol, triglyceride, and glycerol concentrations in the postmature rabbit.

Plasma cholesterol, triglycerides, glycerol, and glucose concentrations were measured in term and postmature rabbits. The data show that the term and postmature mothers have significantly higher glycemia than their fetuses. However, triglyceride and cholesterol concentrations are lower in the postmature mother than in her fetus. Postmature fetuses are characterized by very high plasma triglyceride and cholesterol concentrations. The results demonstrate that postmaturity is accompanied by maternal and fetal lipid metabolic changes related to a decrease in the transfer of maternal fatty acids through the placenta and to a diminution in fetal liver glucose utilization. The postmature fetus is then in a relative state of fasting and must rely on its own supply of fuel (glycogen and lipids) to provide cells for growth and survival. The maternal metabolic changes can possibly be explained by a decreased utilization of maternal substrates by the fetus, the placenta becoming insufficient. The close interrelationship of fetal and maternal lipid metabolism with the activity of the placenta suggests that an accurate knowledge of the metabolic changes taking place in the fetus during alteration of the maternal environment is indispensable to the understanding of the short- and long-term effects of maternal disease on the fetus.

Placental uptake and transfer of lipid in the postterm rabbit.

Gonadotropin-injected pregnant rabbits were delivered by cesarean section near term (30 days after conception (term, 31 days) and 3 1/2 and 4 days post term. Lipid metabolism of the postterm and near-term fetus was compared. Fetal and placental uptake of radioactivity and rate of lipid entry into the fetus, as well as fetal and maternal plasma free fatty acid (FFA) specific activities (at equilibrium) were determined following a single maternal injection of [1-14C]palmitate (50 muCi) administered at cesarean section. Evidence of placental malfunction in the postterm period includes decreased placental uptake and transport of labeled FFA occurring while maternal and fetal FFA dynamics (half times) remain unchanged and a loss in "organization": The strong positive correlation (p less than 0.001) between placental uptake and transfer to the fetus at 30 days' gestation is lost 5 days later. A comparison of maternal and fetal plasma FFA specific activities indicates a substantial (62%) near-term fetal contribution to its own circulating FFA pool. Total plasma FFA is elevated in the postterm fetus concomitant with a decreasing maternal supply. A postterm fetus must therefore contribute lipid from its own reserves (probably liver) in excess of amounts attributed to a near-term fetus, i.e., greater than 62%.

Family mental health maintenance: a new approach to primary prevention.

The authors describe an approach to primary prevention in which indirect services are redefined to include community services aimed at promoting mental health and preventing emotional and mental disorders. At the Peninsula Hospital Community Mental Health Center such services are family-focused and include consultation, education, collaboration with other agencies, and early intervention with children and families with special needs. The authors describe some of the programs that have been developed and discuss how mental health Centers can conceivably, under contract, develop such community services for health maintenance organizations and other prepayment plans that provide comprehensive health maintenance and medical care.

[Place of laparoscopy in the diagnosis of acute surgical diseases of the organs of the abdominal cavity]. / Mesto laparoskopii v diagnostike ostrykh khirurgi-cheskikh zabolevanii organov briushnoi polosti

The author reports the results of 76 laparoscopies performed in 75 patients with clinically suspected acute surgical diseases (22), peritonitis (38), injuries to internal organs in a blunt abdominal trauma (16 patients). As a result of laparoscopic studies the precise clinical diagnosis was established in 39 patients, and the necessity of urgent therapy was supported, in 3 cases the operation was postponed. Acute surgical diseases were excluded in 33 of 75 examined subjects. There were no cases of pseudonegative diagnosis.

Art and drama: partners in therapy.

An art-drama therapy group for latency-age boys made possible the exploration of personal symbols and intense fantasies which resulted in a therapeutically powerful and productive experience. This paper describes the background, rationale, and dynamic process of this group. Multimodal expressive arts therapy is supported.