A retrospective analysis of open fractures sustained by U.S. military personnel during Operation Just Cause.

A retrospective analysis was conducted of 37 open fracture cases sustained by U.S. military personnel during the recent low-intensity conflict in Panama (Operation Just Cause). The etiology, location, classification, and management of open fractures sustained in combat is presented. A significant difference was noted in the infection rate for type III open fractures that were debrided in Panama (22%) as compared to those that were debrided only after transport to CONUS (66%). This study supports the critical importance of adequate battlefield surgical support in low-intensity conflicts, and reemphasizes the crucial role of early surgical debridement for the prevention of wound infection.

Hepatitis B vaccine uptake amongst general practitioners in the Republic of Ireland.

A total of 1179 GP's responded to a questionnaire on hepatitis B vaccine uptake. 1060 (90%) felt that GP's should be vaccinated. Only 400 (34%) had actually received the vaccine. 472 (61%) stated that they "had not got round to it". Among the vaccinated GP's, 275 were under 45 years., of those not vaccinated 276 (35%) considered themselves a low risk, 130 (17%) said it was too expensive, 31 (4%) didn't wish to be vaccinated. A total of 510 (43%) of those surveyed considered themselves at high risk.

Lymphoreticular and myeloid pathogenesis of Venezuelan equine encephalitis in hamsters.

Ultrastructural, histopathologic, and virologic studies of adult hamsters infected with virulent Venezuelan equine encelphalomyelitis (VEE) virus (Subtype I-B) demonstrated precise chronologic and topographic progression of lesions and viral replication in extraneural sites. Thymus contained the earliest lesions and the highest initial and subsequent viral titers. No particular cytotropism was observed as highly efficient viral replication and severe cytonecrosis proceded. Early cortical necrosis of splenic periarteriolar lymphocytic sheath was followed by lymphoblastoid repopulation of the peripheral zone. Massive bone marrow necrosis was accompained by ultrastructural evidence of VEE viral particle production in reticulum cells, rubricytes, myeloid cells, lymphoblastoid cells, and megakaryocytes. Speed, efficiency, destructiveness, and relative sensitivity of virtually all lymphoreticular and hematopoetic cells were hallmarks of virulent VEE infection in the hamster.

Possible nosocomial transmission of group B streptococci in a newborn nursery.

Within a six-day period in March, 1974, three infants born at a hospital in central Arkansas developed meningitis caused by group B, type III Streptococci. Three factors suggested nosocomial transmission of the organism in the nursery: (1) the three infants were born in a six-day period, (2) four weeks after their infants' births, none of the parents had positive cultures for group B streptococci, and (3) 31% of infants born in the hospital in March were colonized with group B, type III streptococci, while in April, after control measures in the nursery were instituted, only 2% of infants were colonized with this type (p less than 0.0002). Colonized infants were treated with penicillin, but follow-up cultures at two and six weeks showed that half the infants tested were still colonized. The number of personnel colonized with group B streptococci was not significantly different in personnel exposed to infants when compared with those that were not, and handwashing and environmental cultures were negative for group B streptococci. The results of this investigation give additional support to the concept that nosocomial transmission of group B streptococci can occur and may be effectively interrupted by control measures in the nursery.