Randomized trial comparing the tolerability of sargramostim (yeast-derived RhuGM-CSF) and filgrastim (bacteria-derived RhuG-CSF) in cancer patients receiving myelosuppressive chemotherapy.

A prospective, randomized, double-blind, multicenter study in cancer patients receiving myelosuppressive chemotherapy was undertaken to evaluate and compare the tolerability of sargramostim (yeast-derived recombinant human granulocyte-macrophage colony-stimulating factor, RhuGM-CSF) and filgrastim (bacteria-derived recombinant human granulocyte colony-stimulating factor, RhuG-CSF) in the prophylaxis or treatment of chemotherapy-induced neutropenia. In all, 137 evaluable patients received sargramostim (300 micrograms; 193 mg/m2) or filgrastim (481 mg; 7 mg/kg) once daily by self-administered s.c. injection, usually beginning within 48 h after completion of chemotherapy. With the exception of a slightly higher incidence of grade 1 fever (< 38.1 degrees C) with sargramostim, there were no statistically significant differences in the incidence or severity of local or systemic adverse events possibly related to the growth factors. Although the study was not designed to evaluate efficacy directly, there also were no statistically significant differences between treatment groups in total days of growth factor therapy, days of hospitalization, or days of i.v. antibiotic therapy during the treatment period. Both sargramostim and filgrastim were comparably well tolerated when given by s.c. injection in this group of patients, and no clinically significant differences between the growth factors were demonstrated.

Locomotor ecology of Lepilemur edwardsi and Avahi occidentalis.

A well-known principle holds that where food supply is limited, two sympatric species with the same diet, morphology, and behavior will compete, leading to exclusion of one species or differentiation of their ecological niches. Avahi occidentalis and Lepilemur edwardsi are two saltatory, nocturnal folivorous lemurs of similar body size which live sympatrically over much of their range and may often be seen feeding in the same trees. We report a study of their locomotor behavior, carried out in order to determine to what extent locomotion might contribute to niche separation. Avahi lives at a higher level in the forest and is the more committed leaper, with a much larger home range and nightly travel distance, while Lepilemur climbs more and has a very small nightly travel distance. Avahi uses small, low-angled supports more often, while Lepilemur makes more use of large, high-angled supports (however, neither species uses vertical supports at a frequency greater than the availability of such supports in the forest stratum in which they live). Both species tend to land on larger-diameter supports on longer leaps, but Avahi also takes off from larger-diameter supports in longer leaps, reducing loss of energy to the substrate during takeoff. We suggest that the differences in locomotion and ranging behavior between them are consistent with niche differentiation on the basis of food quality, Avahi investing more energy in harvesting better quality but more patchy food, Lepilemur minimizing expenditure in harvesting a less selective, quantitatively poorer diet.

Some properties of the mammalian locomotory and respiratory systems in relation to body mass.

Video and ciné films of mammals running at the trot-gallop transition were analysed to measure breathing frequencies. Breathing frequency at the trot-gallop transition (fb, in Hz) was shown to decrease with increasing body mass (M, in kg) and was described by the equation fb = 5.08 M-0.14. The stiffness of the thorax and diaphragm of mice, rats, rabbits and wallabies was calculated and this, together with the mass of the viscera, was used to calculate the natural frequency of the system (nft, in Hz). The relationship between nft and body mass can be described by the equation nft = 5.02M-0.18. The significance of these results is discussed in relation to models of mechanical linkage between respiratory and locomotory movements.

The intersection of disability and child abuse in England and the United States.

This article reports the findings of a World Rehabilitation Fund Fellowship study on the intersection of child abuse, family support, and disability in England. These findings are then compared to the American picture in this arena, and implications for new directions are delineated.

Preliminary survey of family abuse of children served by United Cerebral Palsy centers.

Two preliminary surveys were performed of children under six years of age to determine: whether handicapping conditions may have occurred as a result of abuse, and the incidence of abuse among children who already had disabilities. The first group of children were in preschool programs operated by United Cerebral Palsy affiliates and the second group were in respite care programs operated by such affiliates. 42 preschool programs with 2771 children and 14 respite care programs with 435 children responded to the survey questionnaire. The results suggest a high incidence of abuse among handicapped children in preschool programs, but a lower incidence in respite care programs. There is a need for greater awareness and reporting of abuse in programs for young handicapped children.

One day versus seven days of preventive antibiotic therapy in orthopedic surgery.

Three hundred fifty-eight patients undergoing total hip arthroplasty, total knee arthroplasty, and hip fracture repair were given preventive antibiotics 20 minutes before surgery; administration of antibiotics was continued for either 24 hours or seven days. The 24-hour group (186 operations) had three (1.6%) deep wound infections. The difference in infection rates between groups was not significant.

Testing and clarifying a macro model of socioeconomic change and fertility.

PIP: This study examines human reproduction and its causal links to the socioeconomic conditions of society within the framework of the demographic transition. A theoretical fertility model for 100 countries -- 28 more developed countries (MDCs) and 72 less developed countries (LDCs) -- is subjected to path analysis. Findings for the 100 countries were mainly a function of the LDCs. Stronger support was found in the LDCs for the indirect fertility-inhibiting effect of economic development than for its fertility-promoting effect. This indirect effect was by far the most important cause of fertility decline, although there were smaller positive direct effects of economic development and government attitudes towards family planning. When education/literacy was controlled, economic development became a negative, but insignificant, influence on fertility, and the effect of government attitudes toward family planning exhibited no effect on fertility. These findings suggest strongly that improvement of education and literacy may be an answer to fertility control. Changes in health service and infant mortality seem natural results of the betterment of education and literacy. This study reconciles the 2 distinct views as to whether fertility increases or remains stable and high while mortality declines during early demographic transition. Both offer valid explanations for the transition in LDCs. Results for the LDCs are compared with those for the MDCs, and policy implications are discussed.^ieng

Abnormal pulmonary gallium accumulation in P. carinii pneumonia.

The potentially fatal interstitial pneumonia of Pneumocystis carinii is a frequent opportunistic invader of patients treated for malignancy with immunosuppressive and cytotoxic agents. Generalized Ga-67 pulmonary localization which is markedly disproportionate to the clinical and radiographic findings has led to earlier diagnoses by open lung biopsy in this setting. The potential usefulness of gallium scintigraphy in patients with suspected P. Carini pneumonia is presented.