Some international efforts of medical schools to improve health care systems.

With growing frequency, medical schools are challenged to redirect their educational and research programs to better respond to the inadequacies of healthcare delivery systems. Some of the accomplishments and difficulties that may arise when this is attempted can be found in the experience of three new schools linked to large healthcare systems in different areas of the world.

Campylobacter jejuni septicemia--epidemiology, clinical features and outcome.

In 33 cases of Campylobacter jejuni septicemia, the disease was more common at the extremes of age: infants made up a third of the reported cases while 24% of patients were older than 50 years. Fever was noted in more than 80% of patients and chills in about a fourth. Enteritis was present in 70% of cases, and the gastrointestinal tract was the principal source of septicemia. Half of the patients did not have significant underlying disease but were at extremes of age, which may reflect relative host impairment. Mortality (25%) owing to C jejuni septicemia occurs mostly in compromised hosts.

Societal influences on health and life-styles.

Strong sociocultural forces affect individual attitudes toward health and choice of life-style. Economic deprivation fosters negative health behaviors. Positive health habits are reinforced by discrete societal groups. The news media, particularly television, disseminate much useful health information, though the overall educational value is diminished by the content of commercial messages and programming. The automobile is a major societal influence, but neither individual drivers nor the car manufacturers give enough priority to highway safety, leaving that role to governmental regulation. American industry is becoming a positive influence in the encouragement of good health habits, and fashion is lately an important ally in personal health maintenance.

Human infection with vibrio fetus.

Vibrio fetus, a slowly growing, microaerophilic, Gram-negative rod which causes infectious abortion in cattle, occasionally induces disease in man. Since persons receiving immunosuppressive agents are among those most susceptible to this infection, recognition of the disease may become increasingly important as transplantation operations increase. Vibrio infections may produce a spectrum of acute and chronic illnesses or may be asymptomatic. Vibriosis may develop at any age but it seems most devastating in the very young or in older debilitated patients. The organism is sensitive to many common antibiotics but has a propensity to produce chronic relapsing illness if treatment is not continued long enough. The method of transmission of the agent is uncertain. Fewer than 100 cases of human vibriosis have been reported, perhaps because of fastidious growth requirements and the initial ease of antibiotic suppression; however, the true incidence of human infection is likely much higher.