Guidelines for the investigation of individuals who were place under surveillance for tuberculosis post-landing in Canada. Canadian Thoracic Society,the Tuberculosis Directors of Canada and the Department of National Health and Welfare.

There are 2 parts to this article. Part 1 is a preamble, jointly prepared by Immigration and Overseas Health Services, Medical Services Branch and the Bureau of Communicable Disease Epidemiology, LCDC, Department of National Health and Welfare, to provide background information regarding the medical assessment of immigrants prior to landing in Canada. Part 2 is a set of guidelines for the investigation of individuals who were placed under surveillance for tuberculosis post-landing in Canada. It was jointly prepared by the Canadian Thoracic Society, the Tuberculosis Directors of Canada and the Department of National Health and Welfare in consultation with the provincial and territorial epidemiologists and has been approved by the Canadian Lung Association and the Canadian Thoracic Society.     

Radiation Protection in Canada: Part II. * The Role of the Radiation Protection Division in Safeguarding the Health of Radiation Workers

The current status of radiation protection in Canada is discussed in the second of a three-part series and particular emphasis is placed on the role of the Radiation Protection Division of the Department of National Health and Welfare. Administrative and operational control procedures have been developed, involving prior approval of health safeguards in the radioisotope user''s facilities and techniques, and systematic monitoring and inspection. Where necessary, a medical follow-up of accidents and excessive radiation exposures is carried out. In 1963 more than 1600 radioisotope licences were issued. Filmmonitoring service was provided to about 15,500 isotope and x-ray workers. Semiautomatic handling procedures have been developed to meet the increasing demand for film-monitoring services.Monitoring and inspection services have been provided for x-ray workers, and a committee has been formed to develop administrative procedures for health and safety control in x-ray work. Committees have also been set up to review the health and safety aspects of the operation of nuclear reactors and particle accelerators.     

Radiation Protection in Canada: Part III. * The Role of the Radiation Protection Division in Safeguarding the Health of the Public

The current status of radiation protection in Canada is discussed in the last of a three-part series. Particular emphasis has been placed on the role of the Radiation Protection Division of the Department of National Health and Welfare. A radioactive fallout study program has been established involving the systematic collection of air and precipitation samples from 24 locations, soil samples from 23 locations, fresh-milk samples from 16 locations, wheat samples from nine areas and human-bone specimens from various hospitals throughout Canada. A whole-body-counting facility and a special study of fallout in Northern areas have also been initiated. For any age group, the highest average strontium-90 concentration in human bone so far reported has been less than four picocuries per gram of calcium compared with the maximum permissible level of 67 derived from the International Committee on Radiation Protection (ICRP) recommendations. By the end of 1963 a general downward trend of levels of radioactivity detected in other parts of the program has been observed. Programs to assess the contribution to the radiation exposure of members of the population from medical x-rays, nuclear reactor operations and natural background-radiation sources have also been described. The annual genetically significant dose from diagnostic x-ray examinations in Canadian public hospitals has been estimated to be 25.8 mrem. Results from the reactor-environment monitoring programs have not suggested the presence of radioactivity beyond that contributed from fallout.     

Smallpox Control in Canada

During the period 1961 to 1963 there were 10 separate importations of smallpox cases by aircraft into England and Wales, Germany, Sweden, Poland and Canada. A feature of the resulting outbreaks was the number of cases and deaths of physicians and other health personnel. With the increasing volume of international air traffic there is a risk of importing incubating cases of smallpox into Canada, as occurred in 1962. Millions of Canadians have been protected against smallpox. Some complications of smallpox vaccination have occurred in Canada; such complications can be minimized by proper attention to contraindications to vaccination. The Food and Drug Directorate, Department of National Health and Welfare, has circularized all physicians in Canada to request their co-operation in reporting adverse reactions to drugs. This includes serious, unusual or unsuspected reactions to immunizing agents (vaccines, toxoids and antitoxins). The latter information will be shared with the Epidemiology Division, Department of National Health and Welfare, and the provincial epidemiologist and manufacturer concerned. The importance of maintaining the smallpox immunity of physicians, nurses and other hospital and health personnel in Canada is emphasized.     

Habilitation of Patients with Congenital Malformations Associated with Thalidomide: Psychiatric and Psychological Aspects

Nearly 100 cases of congenital malformations associated with thalidomide ingestion by the mother have been reported in Canada to the Department of National Health and Welfare. Depression and selfcastigation have been the specific psychiatric reactions noted, particularly in the mother. In most cases it is preferable psychologically for the parents and the child if the child is kept at home rather than placed in an institution. Parents should be fully informed concerning the child''s prognosis for future development. Most of the children followed up for about two years showed no intelligence defects. A prosthesis, if required, should be applied early (at three to six months) so that it may become a part of the child''s body-image, but it should not interfere with play activities. Assessment by a psychiatrist and a psychologist is indicated at about six months.     

Guidelines for the identification,investigation and treatment of individuals with concomitant tuberculosis and HIV infection. Bureau of Communicable Disease Epidemiology,Canada Department of National Health and Welfare.

The following recommended guidelines, jointly prepared by the Canadian Thoracic Society, the Tuberculosis Directors of Canada, and the Department of National Health and Welfare in consultation with the provincial and territorial epidemiologists, AIDS coordinators and HIV caregivers, and approved by the Canadian Lung Association and the Canadian Thoracic Society are provided to assist health care workers who are caring for patients in the overlapping group.     

Academic family medicine in Canada.

Fifty years ago family practice in Canada had no academic presence. Stimulated by a number of general practitioners and with the support of the Canadian Medical Association, the College of General Practitioners of Canada (CGPC) was founded in 1954. In 1962, conferences on education for general practice attended by the Association of Canadian Medical Colleges and the CGPC led to pilot postgraduate residencies in family practice supported by Department of National Health and Welfare. The first certification examination was held in 1969 and, by 1974, all Canadian medical schools had a family medicine residency program. Today departments of family medicine contribute substantially to undergraduate education in all 16 schools. In Canada, the medical profession, governments and the medical schools have demonstrated the importance they place on appropriate education for family physicians.     

Sulfite Additives

The CMA recommends that sulfites be banned as food preservatives when satisfactory and safe alternatives are available. When there is no suitable substitute strict labelling requirements on foods should be imposed for sulfite additives. The association supports the efforts of the Health Protection Branch of the Department of National Health and Welfare to regulate sulfites in the food and drug industry to prevent adverse reactions in people sensitive to sulfites. The CMA recommends that the Department of National Health and Welfare establish a federal-provincial liaison group that has the authority to introduce additive standards for food producers, distributors and restaurants and to monitor foods at the consumer level for the presence of allergenic additives.     

Hepatitis B follow-up among Indochinese refugees.

During 1979 and 1980 the Department of National Health and Welfare carried out a survey and later routine testing to determine the prevalence of serologic markers of hepatitis B in Indochinese refugees entering Canada. Between March and July 1981 the hepatitis-B-marker status of 220 selected refugees in the Ottawa-Hull area was reassessed. Overall, 173 (79%) of the participants had the same serologic markers when retested, but in 47 (21%) the markers had changed. The most significant changes were the loss of antigenemia in 22% of those who had been HBsAg-positive and the appearance of evidence of infection in 18% of those who had been seronegative. Most of these changes occurred among persons under 30 years of age, especially females aged 10 to 19 years.     

Use of cimetidine in hospital patients.

The use of cimetidine in 137 patients in a large Canadian teaching hospital was assessed prospectively. About 80% of the patients received the drug for treatment and 20% received it for prophylaxis. All of the prophylactic indications as well as some of the treatment indications have not been approved by the health protection branch of the Department of National Health and Welfare, nor do most have adequate literature documentation. The duration of therapy varied from less than 3 days to more than 2 months. The average cost of cimetidine therapy was $40.71. The dosage was not adjusted in over 50% of the patients in whom impairment of renal function was serious enough to warrant consideration of a dosage reduction. Approximately half of the patients received concurrent antacid therapy. Although cimetidine is relatively safe, its use in this institution was less than optimal.     

A formulation of the lifetime distribution and the existence of its moments

Summary The lifetime distribution is formulated in terms of g(t), defined as the ratio of the hazard function to the tail probability function, to study the properties of the lifetime distribution. A criterion is provided for the asymptotic behaviour of g(t) and the hazard function. Criteria for the existence and non-existence of the moments of any probability distribution of a non-negative random variable are obtained in terms of the derivatives of g(t). Examples are given to illustrate the use of the criteria and applications made to stochastic models of population growth as well as other lifetime distributions.This research was supported under National Health Research and Development Project No. 605-7-434 (22)(48) of the Department of National Health and Welfare of Canada.     

An improved technique for the separation of glucose 6-phosphate dehydrogenase isoenzymes by disc electrophoresis on polyacrylamide gel

A new method has been developed for the separation of glucose 6-phosphate dehydrogenase (G6PD) isoenzymes by means of disc electrophoresis. The effects of gel concentration, method of preparation, and application of samples on the separation of types A and B enzymes and hemoglobin were examined. The method not only separated the isoenzymes but also subresolved each isoenzyme into subbands. The formation of subbands may be related to the existence of enzyme subunits.Aided by project grants No. 408 and No. 251 from Department of Health, Education and Welfare, Children's Bureau, and USPHS grant No. 02609 from the National Institute of Child Health and Human Development, National Institutes of Health.     

Impact of the Walton report on cervical cancer screening programs in Canada.

It is almost 4 years since the Walton report on cervical cancer screening programs was published. In an effort to assess the impact of this report on such programs across Canada the Department of National Health and Welfare carried out a survey using questionnaires. It appears from the evaluation that physicians, laboratories and provincial departments of health are giving thoughtful but cautious consideration to implementing the report''s recommendations. Stated areas of controversy include the recommended frequency of cervical smear examination, the establishment of province-wide cytology registries and the recommended size of laboratories. Perhaps the pace will quicken as additional knowledge and experience are gained. Perhaps, too, if a national mechanism to encourage provincial implementation were instituted hesitancy would decrease.     

Initiation and characterization of a diploid cell line from larval tissues ofAedes dorsalis (Meigen)

Summary Mosquito cell cultures were initiated from the minced tissues of newly hatchedAedes dorsalis (Meigen) larvae. Continuous cell division occurred only after an adaptive period of approximately 6 months. Optimal growth of the cells required a relatively low pH of 6.5. Karyological studies showed that the cells have remained diploid (2n=6) for 60 serial passages and that the cultures are free of contaminating cells. The cultures also were shown to be free of bacteria (includingMycoplasma), fungi and virions. Subpopulations (strains) of the original parental cultures have been selected and characterized on the basis of morphology, karyology, growth rate and monolayer formation. These studies were supported in part by funds from the Office of Naval Research, by Research Grant AI03028 from the National Institute of Allergy and Infectious Diseases, and by General Research Support Grant I-SO1-FR-05441 from the National Institutes of Health, U.S. Department of Health, Education and Welfare.     

Partial covalent structure of two basic chromosomal proteins from human spermatozoa

The partial covalent structure of the basic chromosomal proteins I and II isolated from human spermatozoa was determined by automatic Edman degradation and digestion with carboxypeptidases A and B. The partial covalent structures obtained are compared with complete and partial known sequences of the basic chromosomal proteins from other animals.A. H. J. K. was supported pursuant to Contract NIH-NICHD-73-2700 with the National Institute of Child Health and Human Development, U.S. Department of Health, Education, and Welfare.     

Adrenergic innervation of the male reproductive ducts in some mammals

Summary The distribution of adrenergic nerves to the male reproductive ducts were studied by applying the highly specific method of Falck and Hillarp for the cellular demonstration of the adrenergic transmitter. In rats, guinea-pigs, and rabbits, the ducts of the testis and the caput epididymidis were found to lack adrenergic varicose terminals, as they also lack cholinesterase positive structures. Adrenergic terminals extend in the vas deferens and epididymis from the prostatic end as far as the upper mid-corpus level of the ductus epididymidis, occurring in the muscle layers and, except in the rat, in the lamina propria. In the cat, ductuli efferentes and caput epididymidis also receive an adrenergic innervation.For skilful technical assistance we are grateful to Mrs. Ulla Flyger and Miss Berith Hansson. The investigation has been supported by a research grant (B 66-257) from the Swedish Medical Research Council.On sabbatical leave from the Biology Department, University of Oregon, Eugene, Oregon, with the aid of a Senior Research Fellowship from the National Council of Child Health and Human Development, National Institutes of Health, U.S. Department of Health, Welfare and Education. The use of facilities of the Department of Physiology I, Karolinska Institutet, with the kind permission of Professor U. S. von Euler and Research Docent R. Eliasson during the course of this study also is greatly appreciated.     

Research ethics training in Peru: a case study

With the rapidly increasing number of health care professionals seeking international research experience, comes an urgent need for enhanced capacity of host country institutional review boards (IRB) to review research proposals and ensure research activities are both ethical and relevant to the host country customs and needs. A successful combination of distance learning, interactive courses and expert course instructors has been applied in Peru since 2004 through collaborations between the U.S. Naval Medical Research Center Detachment, the University of Washington and the Department of Clinical Bioethics of the National Institutes of Health to provide training in ethical conduct of research to IRB members and researchers from Peru and other Latin American countries. All training activities were conducted under the auspices of the Peruvian National Institute of Health (INS), Ministry of Health. To date, 927 people from 12 different Latin American countries have participated in several of these training activities. In this article we describe our training model.     

Culture of epithelial cells from the rat pleura

Summary Cells obtained by tryptic digestion of the surface of intact adult and fetal Fischer 344 lungs were plated on glass fragments. Epithelial cell lines were readily established by selecting fragments with 2 to 10 cells 2 days after plating and growing them in F12 K media containing 10% fetal bovine serum (FBS). These cell lines and new lines that can be easily obtained provide a reliable source of diploid, density-inhibited epithelial cells. These cells of mesothelial origin may serve as models for the study of mesothelial cells in situ. This work was supported through National Institutes of Health Grant HL-19737 from the Department of Health, Education and Welfare.     

Thymidine kinase activity and human chromosome No. 18

Somatic cell hybridization studies have suggested that the locus for human thymidine kinase is on a No. 17 or No. 18 chromosome. To evaluate further this possibility, fibroblast cell cultures from patients with partial monosomy 18 and trisomy 18 were assayed for thymidine kinase activity; the enzyme levels in these cell extracts were normal. If the enzyme activities reflect a simple gene dose effect, these results suggest that the human thymidine kinase locus is not situated on the No. 18 chromosome.Supported in part by Grant # MR 0504A-69 from the Division of Mental Retardation, Social and Rehabilitation Service, Department of Health, Education and Welfare, and by the Institute of Child Health and Human Development, Grant # DO 4612, Mental Retardation Research Center, UCLA/NPI.     

Emergency Health Planning

This paper outlines the development of emergency health planning as a function of government. Ten provinces have the basic responsibility for the organization, preparation and operation of medical, nursing, hospital and public health services in an emergency. The Department of National Health and Welfare is responsible for the provision of advice and assistance to the provincial and municipal governments in such matters. Eight provinces have now hired full-time planning staffs to co-ordinate the health planning of the Provincial Departments of Health and Provincial Emergency Measures Organization.Four major programs have been established. The first program provides for the continuity of leadership and guidance by health authorities at the federal, provincial and municipal level. Essential records have been developed and emergency legislation prepared. This program, however, will be of little use unless health services are organized at the municipal level. In this organizational program, advice and assistance have been provided to existing hospitals and departments of health in the conduct of disaster planning. The efforts of these agencies are co-ordinated by municipal health authorities into a community disaster plan. The third program deals with information and education of the general public and the health workers. This program is designed to make the family unit self-sufficient for up to seven days and the health worker prepared to undertake his emergency role. The first three programs are directed to the organization and training of manpower; the fourth program provides the necessary supplies. From the national medical stockpile of $18,000,000, some $12,000,000 has been received, packaged for long-term storage and distributed to regional depots across the country. To ensure their ready availability in time of emergency an agreement has been reached with seven provinces for the release of hospital disaster kits.