Application of liquid-based preparation to non-gynaecologic exfoliative cytology.

Thin-layer cytology (TLC) is an automated method for processing cells harvested in a liquid solution and collected onto a single slide. The leftover material can be used for other techniques such as immunocytochemistry, molecular biology and flow cytometry. TLC has been applied with good results in exfoliative cytology of pulmonary, urinary, gastrointestinal and oral districts as well as in the evaluation of serous effusions. The main advantages of TLC over conventional techniques (CS) are: (a) simplification of the sampling technique; (b) decrease in cellular artefacts leading to a lesser amount of inadequate diagnoses; and (c) applicability of additional investigations. The limits of TLC are: (a) changes in the morphologic picture of some lesions; (b) increase of the workload for technical staff; and (c) increased cost. The application of TLC to non-gynaecologic specimens favours many innovative developments and can be regarded as an appropriate substitute for CS.

The self-perceived role and educational needs of pharmaceutical representatives: a survey.

INTRODUCTION: Despite considerable debate in the medical literature about the educational utility of pharmaceutical representatives (PR), little is known about their attitudes towards their role as marketers and/or educators, their ability to provide comprehensive information about products and their learning needs. DESIGN: A survey. SUBJECTS AND METHOD: Questionnaires were mailed to 606 PRs from five Canadian pharmaceutical companies. RESULTS: Of 309 (51%) respondents, 98% strongly agreed or agreed they had a role in educating doctors, while 52% strongly disagreed or disagreed their main goal was marketing. Overall, 92% agreed they had received adequate training to perform a well-informed detail, and 96% reported the information they provide is accurate. The majority (66%) felt a university-accredited program would improve the quality of their detailing. CONCLUSION: Most PRs believe their main goal is education. Despite most reporting that they had received adequate training, they felt that a university-accredited educational program would improve the quality of detailing. The number of years that a PR spent in the industry appears to have an effect on how they perceive their role.

Trench-parallel flow beneath the nazca plate from seismic anisotropy.

Shear-wave splitting of S and SKS phases reveals the anisotropy and strain field of the mantle beneath the subducting Nazca plate, Cocos plate, and the Caribbean region. These observations can be used to test models of mantle flow. Two-dimensional entrained mantle flow beneath the subducting Nazca slab is not consistent with the data. Rather, there is evidence for horizontal trench-parallel flow in the mantle beneath the Nazca plate along much of the Andean subduction zone. Trench-parallel flow is attributale utable to retrograde motion of the slab, the decoupling of the slab and underlying mantle, and a partial barrier to flow at depth, resulting in lateral mantle flow beneath the slab. Such flow facilitates the transfer of material from the shrinking mantle reservoir beneath the Pacific basin to the growing mantle reservoir beneath the Atlantic basin. Trenchparallel flow may explain the eastward motions of the Caribbean and Scotia sea plates, the anomalously shallow bathymetry of the eastern Nazca plate, the long-wavelength geoid high over western South America, and it may contribute to the high elevation and intense deformation of the central Andes.

Evidence for amiloride-sensitive sodium channels in alveolar epithelial cells.

To maintain alveolar air spaces relatively fluid free, the alveolar epithelium appears capable of vectorial transport of water and solutes. Active transepithelial transport of sodium by alveolar epithelial cell monolayers has previously been demonstrated, indicating that alveolar pneumocytes must possess ion transport mechanisms by which sodium can enter the cells apically for subsequent extrusion via Na(+)-K(+)-adenosinetriphosphatase activity at the basolateral surface. In this study, sodium entry mechanisms were investigated by directly measuring 22Na uptake into rat alveolar epithelial cells grown in primary culture. Cells exhibited increasing 22Na uptake with time over a 30-min interval. Total sodium uptake was compared in the presence and absence of several sodium transport inhibitors. Uptake was inhibited by the sodium channel blockers amiloride and benzamil but was not affected by two amiloride analogues (bromohexamethylene amiloride and dimethylamiloride) with diminished specificity for blocking sodium channels and enhanced specificity for inhibiting the Na(+)-H+ antiporter. Uptake was also unaffected by the chloride transport inhibitor bumetanide or by the absence of glucose. These data suggest that sodium uptake occurs primarily via sodium channel and that Na(+)-H+ antiport, Na(+)-K(+)-2Cl- cotransport, and Na(+)-glucose cotransport do not contribute significantly to sodium uptake under these experimental conditions. The presence of sodium channels in the alveolar epithelial cell membrane may provide the major entry mechanism by which sodium enters these cells for subsequent active extrusion, thereby effecting net salt and water reabsorption from the alveolar spaces.

[Preoperative cytologic diagnosis of medullary carcinoma of the thyroid]. / La diagnosi citologica preoperatoria nel carcinoma midollare della tiroide.

The Authors emphasize the importance of preoperative aspiration cytology in the diagnosis of 5 medullary types out of 58 thyroid carcinomas observed in the Institute of Pathology of the Università Cattolica del S. Cuore of Rome in the period 1983-88. All the cases were diagnosed preoperatively by mean of a fine-needle aspiration cytological specimen; the case where morphological diagnosis was doubtful were studied with immunohistochemical techniques for calcitonin and CEA. Out of all cases, they report one case of multiple endocrine adenomatosis type II with medullary thyroid carcinoma and pheochromocytoma and another one with cervical node metastases without a clinically detectable thyroid swelling. Therefore, the authors propose the fine-needle aspiration cytology as a simple and important mean in the preoperative diagnostic procedure in case of medullary thyroid carcinoma.

Poverty: a major deterrent to America's good health.

Poverty has a major impact on the nation's state of health. Although its effects are difficult to separate from that of old age and the problems of minorities, there are definite correlations between indicators of economic well being and mortality/morbidity rates United States vital statistics and extensive health interview surveys provide ample documentation of the role of poverty as a health determinant. The success the Indian Health Service has had in lowering mortality rates mirrors the nation's as a whole and demonstrates what can be done if socioeconomic conditions, as well as health care delivery, is improved. The message should not be lost sight of it this era of cutbacks in social programs.

Infant feeding practices by ethno-cultural grouping.

PIP: This study attempts to assess infant breastfeeding practices among 200 low income families in New York City and in New Jersy, and to measure differences in feeding practices among 5 different ethno-cultural groups, U.S. Blacks, West Indians, Puerto Ricans, Haitians, and Hispanics. 58.5% of mothers were not born in the U.S., but the majority, or 77.5% had lived in the U.S. for more than 5 years. Only 6% of families reported an annual income above $10,000. 29% of mothers in the entire study group attempted breastfeeding, the majority being West Indian mothers (64%), followed by Puerto Ricans (34%), Hispanics (33%), Haitians (21%), and U.S. Blacks (15%). Average duration of breastfeeding was highest among Hispanics, with 10.2 weeks, and lowest among Haitians, with 2.3 weeks. 94.5% of mothers had used an artificial formula feeding in conjunction or as a substitute for breastfeeding during the first 4 months of infancy, the most widely used milk feeding being Similac, 41.5%, followed by ordinary cow's milk, 31%; less than 10% of families were using formula feeding beyond 6 months of age. 1/3 of mothers reported using iron supplements in addition to the iron already contained in some formulas. 17 infants had diets deficient in iron intake; those infants were fed an iron-poor formula, and half of them presented evidence of iron deficiency anemia. Introduction of solid foods differed little among the various ethnic subgroups. This study corroborates other published reports in indicating that there is a growing interest in breastfeeding among the lower socioeconomic population. Still, education on proper nutrition for infants is lacking within the same group, and infant feeding counseling programs should be sensible to such lack of professional guidance.^ieng

The comparative efficacy of minocycline and penicillin-V in Staphylococcus aureus skin and soft tissue infections.

The antistaphylococcal properties of orally administered minocycline and penicillin-V were compared for one hundred and fifteen patients receiving minocycline and one hundred and twenty-eight receiving penicillin-V for various types of cutaneous infections. The majority of bacterial isolates were staphylococcal organisms. Of these 82 percent showed initial in vitro sensitivity to minocycline while only 20 percent did to penicillin-V. The percentage of clinical cures was higher with minocycline (74 percent) than with penicillin-V (54 percent), however, most patients, in both groups, showed clinical improvement. The rate of clinical improvement appeared to be significantly faster with minocycline. There was a higher percentage of adverse, chiefly vestibular, effects in the minocycline group (16 percent vs 7 percent). The study clearly demonstrates the superior antistaphylococcal properties of minocycline as compared with penicillin-V.

Congenital lentiginosis.

Because lentiginosis may be associated with multiple somatic anomalies (as in the "LEOPARD syndrome"), its recognition is important clinically. A case of lentiginosis detected in the neonatal period, without accompanying defects, is reported. The significance of histologic confirmation and the importance of searching for other abnormalities are discussed.

The comparative efficacy of cephalexin and sulfisoxazole in acute urinary tract infection in children.

A double blind, comparative study of the efficacy of cephalexin versus sulfisoxazole was conducted on 100 children with initial episodes of urinary tract infections. The overall bacteriologic and clinical cure rates were comparable for both antimicrobials. Children treated with cephalexin had a clinical cure rate of 86 per cent and a bacterial cure rate of 84 per cent, while those given sulfisoxazole were found to have rates of 82 and 92 per cent respectively. However, cephalexin was noted to have a rather high rate of failure in the therapy of Proteus micrabilis infections (4/8), casting some doubt on its use in urinary infections caused by the organism. Untoward effects associated with either medication were minimal.

The effectiveness of diphenhydramine HCI in pediatric sleep disorders.

Fifty children with a variety of sleep disorders were studied in a placebo-controlled, double-blind clinical trial of diphenydramine elixir given in a dosage of 1.0 mg/kg at bedtime. Sleep records measuring latency time, number of awakenings, and duration of sleep were compiled by the patient's parent. A global assessment as to the severity of sleep disturbance and the therapeutic effect of the medication and placebo was made on a weekly basis. Diphenhydramine was significantly better than placebo in reducing sleep latency time and the number of awakenings per night, while sleep duration was marginally increased. There were no essential differences between diphenhydramine and placebo in the other study parameters, i.e., restlessness, nightmares, and difficulty awakening. Diphenhydramine was judged to be more effective than placebo on the weekly global assessment. The results indicate that diphenhydramine is a safe, effective bedtime sleep aid for pediatric patients.