Vitamin-D-deficient rickets in Manitoba, 1972-84.

Vitamin-D-deficient rickets still exists in children in Manitoba and adjacent areas. Between 1972 and 1984, 48 cases were documented at Winnipeg Children''s Hospital. The patients ranged in age from 1 to 49 months; 40 were Canadian natives (38 Indians and 2 Inuit), most of whom lived in the Island Lake area of northern Manitoba. Of the 48, 16 had clinical signs of rickets, 12 had tetany due to hypocalcemia and 38 had radiologic evidence of rickets. Hypocalcemia was found in 27, and hypophosphatemia in 19; hyperaminoaciduria was found in 7 of 20. All 48 had elevated serum alkaline phosphatase levels. In addition to rickets, 16 patients aged 12 months or more had evidence of malnutrition. Climate and lifestyle in northern areas of the Canadian midwest result in little or no biosynthesis of vitamin D by solar radiation; therefore, adequate dietary vitamin D intake is essential to prevent deficiency. The diets of pregnant women and infants in these areas are deficient in vitamin D. The authors recommend vitamin D supplements for all pregnant women and infants in areas of risk to eradicate this preventable disease.     

Cell and tissue fixation, 1972-1982

Conclusions There have been changes in the practice of fixation over the past 10 years. There seem to be at least two different pressures working. On the one hand, there is increasing diversity in cell biological techniques which in turn demands more variable fixation procedures. Some of these have been outlined. Some of this change in practice has percolated through to pathology where it has been found to be diagnostically useful. In surgical pathology on the other hand, there is the continuing financial pressure for more rapid through-put of specimens which includes more rapid fixation, often with the loss of potential for subsequent chemical investigations. These are the horns of the dilemma; both are wanted at the same time.It seems that there is no magical fixative in sight which will permit all investigations on all tissues. Rather, it seems that the future will hold increasing diversity in fixation procedures which will demand that practitioners be well informed as to possibilities which, hopefully, may lend to better understanding of the problems and mechanisms of fixation.     

A serologic survey of pronghorns in Alberta and Saskatchewan, 1970-1972.

To determine the exposure of free-ranging pronghorns (Antilocapra americana Ord) to selected pathogens, serum samples were obtained from 33 live-trapped animals from southwestern Saskatchewan in 1970, and from 26 and 51 animals from southeastern Alberta, in 1971 and 1972, respectively. Antibodies were found to the agents of parainfluenza 3, bovine virus diarrhea, eastern and western encephalomyelitis, infectious bovine rhinotracheitis and the chlamydial group. No serologic reactors were found to the agents of bluetongue, epizootic hemorrhagic disease, brucellosis, or leptospirosis (4 serotypes).     

Experience of the Manitoba Perinatal Screening Program, 1965-85.

The Manitoba Perinatal Screening Program is guided by a committee of medical specialists with skills in the diagnosis and management of disorders of metabolism in the newborn. The program is voluntary and is centralized at Cadham Provincial Laboratory, in Winnipeg. A filter card blood specimen is collected from newborns on discharge from hospital, and a filter card urine sample is collected and mailed to the laboratory by the mother when the infant is about 2 weeks of age. The overall compliance rates for the blood and urine specimens are approximately 100% and 84% respectively. The blood specimen is screened for phenylalanine and other amino acids, thyroxine, galactose, galactose-1-phosphate and biotinidase. The urine specimen is screened for amino acids, including cystine, as well as methylmalonic acid and homocystine. Between 1965 and 1985, 83 cases of metabolic disorders were detected, including 23 cases of primary hypothyroidism, 14 of classic phenylketonuria, 5 of galactosemia variants, 3 of galactosemia, 2 of maple syrup urine disease and 1 of hereditary tyrosinemia. The direct cost per infant screened is $5.50, and the cost:benefit ratio is approximately 7.5:1. Maternal serum alpha-fetoprotein screening is being made available as the necessary supporting clinical facilities become available. On the basis of this experience, the author outlines the components that are important for an effective screening program.     

Work of a day-bed unit 1972-8.

From 1972 to 1978 inclusive 32 311 patients were managed in a 24-bedded day-bed unit in a district general hospital. The principal specialties using this were urology, gastroenterology, general surgery, gynaecology, haematology, orthopaedics, and radiology. Patient selection, a high standard of secretarial work, and good liaison with general practitioners, the community nursing service, and the ambulance service are most important. Day care forms a large, important, and increasing part of the work of the hospital, and without it many of the specialties would be unable to cope with the demand, and their waiting lists would lengthen continuously.     

Incidence of infantile hypertrophic pyloric stenosis in Saskatchewan, 1970-85.

We reviewed the incidence rates of infantile hypertrophic pyloric stenosis (IHPS) and pylorospasm in Saskatchewan from 1970 to 1985 and found a marked decrease in the rates after 1976. As expected, there was a preponderance of males among those with IHPS and among those with pylorospasm discharged from hospital between 1 and 3 months of age. No seasonal pattern was observed. We believe that the decrease in incidence rates was related to environmental influences, such as changes in the methods of feeding observed since 1977.     

Isolation of virus strains from mosquitoes collected in Queensland, 1972-1976.

171,348 mosquitoes and 4,353 other arthropods collected at three centres in Queensland in 1972-1976 yielded 151 strains of 18 viruses. Culex annulirostris was the major source of virus isolation but 42 strains from Aedes normanensis indicate it to be a vector of importance. Ross River and Kokobera viruses were isolated at Kowanyama in the dry season, a finding of interest as being compatible with year-round survival in vector-vertebrate cycles. Culex fatigans has in part replaced Culex annulirostris in peridomestic breeding sites at Kowanyama; the infrequency of virus isolation from it suggests that this replacement may lower arbovirus infection rates. Twelve strains were identified as viruses antigenically distinct from any previously isolated in Australia or New Guinea: Ch16129, showed by the International Reference Centre for Arboviruses to be a previously undescribed member of the Simbu Group (Facey's Paddock virus), Ch16313 (Murweh), Ch19520 (Parker's Farm) and Ch19546 (little Sussex). The remaining strains were identified as viruses previously known in Australia, but included many new host or geographical records.     

Violent and accidental mortality among four immigrant groups in Canada, 1970-1972.

For most people immigration to a new country such as Canada entails a positive move and an improvement in life. The many challenges associated with resettlement may, however, lead to insurmountable difficulties, stresses and conflict for a significant number of newcomers. The mortality experience of immigrants, as reflected in cause-of-death statistics, may provide indication of the extent of stress and conflict in their migration experience. This situation is most clearly exhibited in mortality from suicide, homicide, and motor vehicle accidents. In this study, hypotheses concerning immigrant mortality in Canada are developed and tested with a log-linear model for rates pertaining to rare events. Overall, the results give support for the importance of country-of-origin effects in explaining suicide propensities, but not for homicide and motor vehicle accidents mortality. Income discrepancies are a significant determinant of variability in death rates overall, but discrepancies between the immigrants in this study and the Canadian-born are not of much significance. The strongest net effect on the cause-specific death rate is associated with group membership. This effect likely reflects a number of residual unmeasured sources of variation including the influence of the immigrant ethnic community as a source of social support, and the potential confounding effects of migration selectivity.     

Complex adaptive systems, aging and longevity.

Mortality and reproduction are intimately entwined in the study of aging and longevity. I apply the modern theory of complex adaptive systems (nonlinear, stochastic, dynamic methods) to questions of aging and longevity. I begin by highlighting major questions that must be answered in order to obtain a deeper understanding of aging. These are: (i) What should (in an evolutionary sense) mortality trajectories look like? (ii) Why does caloric restriction slow aging? (iii) Why does reproduction cause delayed mortality? (iv) Why does compensatory growth cause delayed mortality? I show how dynamic state variable models based on stochastic dynamic programming (Clark & Mangel, 2000) can be used to embed genetic theories of senescence (either mutation accumulation or antagonistic pleiotropy) in the somatic environment, as George Williams called for in 1957, and how they make the disposable soma theory of aging operational. Such models will allow unification of genetic and phenotypic theories of aging.     

Primary immunisation and febrile convulsions in Oxford 1972-5.

A three-year study of febrile convulsions in Oxford with comprehensive notification from general practice and hospitals showed a 3% risk for all children of suffering at least one febrile convulsion by the age of 5 years. Children were most at risk between 6 and 27 months, and febrile convulsions were most likely to be prolonged in children aged 9-15 months. The association between febrile convulsions and primary immunisations in the preceding 28 days was compared in case and control children, matched for age and sex. Results suggested that such association was a chance relationship with age. If association was direct, the febrile convulsion rates per 1000 immunisation doses were estimated as follows: diphtheria, pertussis, tetanus--0-09 per 1000; poliomyelitis--0-6 per 1000; and measles--0-9 per 1000. Hence if any of these vaccines had a secific causal relationship with febrile convulsions, these rates would probably have been much higher.