[Can physicians efficaciously promote the purchase of bicycle helmets?]. / Les médecins, peuvent-ils efficacement promouvoir l'achat de casques de vélo?

OBJECTIVE: To evaluate the effectiveness of physician intervention in the purchase of bicycle helmets. DESIGN: Randomized single-blind controlled trial; randomization by clusters. SETTING: July 11, 1992, cycling path in Beauport, Quebec. PARTICIPANTS: Non-helmeted cyclists riding alone and groups of two to six cyclists in which at least one member was not wearing a helmet were invited to participate in the study; 274 individuals or groups of cyclists (total n = 485 cyclists) were randomized for the study. INTERVENTION: For the study group a physician handed out and explained the Canadian Medical Association's (CMA) pamphlet on bicycle helmets. This pamphlet includes a discount coupon for the purchase of a helmet. All of the participants in both the study group and the control group completed a questionnaire, including queries about sociodemographic characteristics, name, and telephone number. MAIN OUTCOME MEASURE: Proportion of previously non-helmeted cyclists purchasing a helmet within 2 to 3 weeks of the intervention. RESULTS: Telephone contact was made with 340 of the 416 non-helmeted cyclists (from 224 groups of cyclists). Of the 174 cyclists who had received a CMA pamphlet, 13.8% (n = 24) had purchased a helmet, compared to 3.0% (n = 5) of the 166 control group cyclists (RR = 4.6, 95% CL = 1.8-11.7). Similar results were achieved by cluster analysis of cyclists. CONCLUSION: Physician intervention using the CMA pamphlet could be effective in promoting the purchase of bicycle helmets.

Crystal-induced neutrophil activation. I. Initiation and modulation of calcium mobilization and superoxide production by microcrystals.

The effects of monosodium urate and calcium pyrophosphate dihydrate crystals on the levels of cytoplasmic free calcium and on the oxidative burst in normal human blood neutrophils were examined. The pattern of sensitivity to granulocyte-macrophage colony-stimulating factor, colchicine, cytochalasin B, pertussis toxin, diglyceride kinase, and protein kinase C inhibitors differentiated the mechanism(s) of neutrophil activation by the crystals from that involved in the responses to soluble chemotactic factors and indicated that individual crystals can use several activation pathways.

[Staphylococcal endocarditis on a heart valve prosthesis. Apropos of 28 cases]. / Les endocardites infectieuses à staphylocoques sur prothèse valvulaire. A propos de 28 cas.

The purpose of this retrospective study of 28 cases of staphylococcal endocarditis on cardiac valve prosthesis was to evaluate the prognosis of that disease and the possible causes of its recent improvement. Between March 1977 and May 1987, 69 patients were treated for bacterial endocarditis on cardiac valve prosthesis. Among these, 28 patients (19 men, 9 women, mean age 53.2 +/- 14.3 years) had staphylococcal endocarditis (Staph. epidermidis in 18 cases, Staph. aureus in 10 cases) of early (10 cases) or late (18 cases) onset. Complications were present in no less than 27 out of 28 patients, the most frequent being heart failure, embolism or neurological disorders. The mortality rate was high (61 p. 100). Among the clinical variables studied, only a state of shock seemed to be predictive of death. Mortality was higher in the group treated medically (100 p. 100) than in the group treated surgically (50 p. 100). Since 1984, however, a significant decrease of mortality was noted; it coincided with the systematic use of vancomycin but also with surgical treatment in all cases. As a result of this study, we suggest that all patients with staphylococcal endocarditis on cardiac valve prosthesis should be operated upon and that this should be done as soon as possible, before the end of the classical antibiotic therapy period.

[Prevention of infectious endocarditis following manipulations of the urogenital tract]. / Prophylaxie de l'endocardite infectieuse suite à des manipulations du tractus urogénital.

Instrumentation of the genito-urinary tract may cause transient bacteremia, it can result in bacterial endocarditis in predispose subject. We studied the incidence of transient bacteremia following urogenital procedure and discovered a 2.6% rate in 196 patients. Therefore we studied antimicrobial prophylaxis against strains isolated from urocultures (35 strains) and blood cultures (6 strains). The strain's minimal inhibitory concentration (MIC) confirms antibioprophylaxis suggested by American Heart Association (AHA). Mean-while, according to our results, netilmicin is the best choice.