Over het gebruik van d-glutaminezuur bij het bacteriologische wateronderzoek

Samenvatting In het d-glutaminezuur werd een chemisch zuivere, relatief goedkoope stof gevonden, die het pepton in de voedingsbodems voor het bacteriologische wateronderzoek lijkt te kunnen vervangen; waarmede de moeilijkhedem uit de wereld zouden zijn, die, vooral bij het colionderzoek, kleven aan het gebruik van peptonen van verschillende herkomst. Hoewel het niet mogelijk bleek, de false presumptive tests geheel te vermijden, wordt toch het voordeel groot genoeg geacht om een proefneming op grooteren schaal in waterleidingbedrijven aan te bevelen.Summary The fact is stressed, that in bacteriological wateranalysis many false presumptive tests occur, where B. coli can not be isolated from strongly fermenting tubes. The view is held, that an improvement may be possible, when substituting peptone by a nitrogen compound, that is easily taken by B. coli and not by the organisms causing the false presumptive test. Therefore d-glutamic acid (as a sodium- or ammoniumsalt) is tried and found to be perfectly suitable to grow B. coli, but equally good to the other organisms. Nevertheless glutamic acid has a distinct advantage on peptone, being a chemically pure and relatively cheap substance, so that difficulties, arising from the use of different brands of commercial peptones, of unknown composition, may be avoided. Investigation of natural waters, using a solution of 1 % lactose, 1 % glutamic acid, 0.1% K₂HPO₄ and 0.05 % MgSO₄ in distilled water, coloured with bromo thymol blue and neutralised with sodium hydroxide to p₄ 7.0, gives the same results as the same liquid, wherein peptone (Witte) substitutes the glutamic acid. Further experience will have to decide on its suitability in large scale practice.     

Huisartsgeneeskundige zorg in het verzorgingshuis

Dutch GP's (General Practitioners) take care of people living in homes for the elderly. The population of these homes is selected on the basis of poor functioning on ADL (activities of daily living). We expected to find a group of elderly people within these homes that need more complex primary care. We describe the characteristics of care for an institutionalized elderly population and compare these to the care provided to their independently living peers. The design of this study is a matched case-control study in a Dutch General Practice in the study period 1/1/1998 to 1/7/2004. Our main results show that the rate of cognitive problems is two times, the prevalence of depression even three times higher in older people living in a home for the elderly than in those who live independently. Locomotory problems are a frequent problem in homes for the elderly. Rates of chronic pulmonary problems, atherosclerosis-related diseases and urinary tract infection are higher, whereas no significant differences for CVA, diabetes and cancer were found. Institutionalized older patients use more different types of medication. GP's do not have more contacts with people living in a home for the elderly than with older people living independently. We conclude that people living in homes for the elderly have complex problems, and need special attention for their specific vulnerability. Differences in care are not primarily explained by chronic disease but by problems with mobility, confusion, depression and cognition.