Maintenance Digoxin in Elderly Patients

Digitalis glycosides remain the cornerstone of treatment in cardiac failure. The increasing frequency of toxic effects is a cause for concern. Review of 80 elderly patients receiving digoxin on a maintenance basis, some of whom had toxic effects, shows that in almost three-quarters of the group digoxin was stopped without detriment. Elderly patients on maintenance treatment should be reviewed, and in the absence of a known primary cardiac lesion an attempt should be made to withdraw digoxin.     

Sub-specialization or Super-specialization in Surgery?

A special centre for prosthetic hip replacement set up 10 years ago has been successful in its primary objectives, producing high quality work at low cost and stimulating research. The project has not yet been successful in achieving a permanent staffing structure, but this is the effect of certain British ideologies in surgical training, with the result that craftsmanship and technology cannot be reconciled with pure intellectual attainment.The success of the project suggests the importance of isolating elective surgery from emergency surgery in the interests of cost-effectiveness. Problems of isolation from teaching hospitals are not insurmountable, but isolation to some degree is essential to achieve the minimum size necessary for efficiency and to ensure unbroken professional team-work among all levels of staff. While maximum efficiency in this field can be achieved only in special centres, too many primary operations will be required every year to insist that total hip replacement should be done only in special centres. A special feature of this field is the need for a permanent staffing structure to hand on technical expertise as an unbroken tradition.     

Monitored Environment System to Control Cell Growth, Morphology, and Metabolic Rate in Fungi by Oxidation-Reduction Potentials

A device for the adjustment, maintenance, and monitoring of a desired oxidation-reduction potential in a liquid environment is described. The filamentous species, Penicillium lilacinum and Trichophyton schoenleinii, and the dimorphic species, Histoplasma capsulatum, developed budding yeastlike cells when grown in a liquid medium with a low oxidation-reduction potential. When the organisms were inoculated into fresh medium, they returned to the filamentous condition as the oxidation-reduction potential was restored to a more positive (oxidizing) environment.     

Multiple forms of porcine pancreatic α-amylase

Porcine pancreatic α-amylase can be fractionated into two components by DEAE-cellulose chromatography and by disc electrophoresis. The basis for fractionation is tentatively ascribed to a charge difference. The two components displayed the same specific activity and their thermal and pH stability, as well as the variation of V_max and K_m with pH, were identical within experimental error. It is concluded that the multiple forms of the amylase are physically distinct, but structurally related, with a common active site.     

Methods for Detecting Food-borne Enteroviruses

A method previously reported for detecting virus in a model system composed of cottage cheese contaminated with coxsackievirus type A9 has been adapted to detecting selected strains of enteroviruses in a variety of foods. Bentonite is omitted and serum is added for extracting virus from low-protein foods. Samples of foods, usually 25 g, must contain at least 3 to 4 plaque-forming units for a 50% probability of detecting virus. Sensitivity in detecting echovirus type 6 was lower than that for the other viruses used. After extraction from potato salad, poliovirus type 2 was completely reactivated if it had been neutralized with coproantibody, but it was only partially reactivated if neutralized with hyperimmune rabbit serum.     

Salmonellae Associated with Further-processed Turkey Products

"Further-processed" turkey products, prepared from chilled, eviscerated, and thawed carcasses at two commercial turkey-processing plants, were evaluated, for the presence of salmonellae. These organisms were isolated from swab samples from 12% of chilled, eviscerated turkey carcasses, 27% of finished products, and 24% of processing equipment. The same serotypes as those found throughout a plant on any one visit were recovered from 31% of rinse-samples taken from hands and gloves of processing personnel. Salmonellae were found in samples taken on 37 of 48 visits; a greater number of recoveries were made on days when freshly killed turkeys were processed (87%) than when frozen-defrosted carcasses were processed (59%). The predominant serotype isolated from meat and environment usually changed from visit to visit. Salmonella sandiego and Salmonella anatum were the most frequent among 23 serotypes recovered. Most of the isolated serotypes are commonly associated with turkeys and have been incriminated as causative agents of human salmonellosis. The implication is that further-processed turkey products, if inadequately cooked by the consumer and if improperly refrigerated between the time of manufacture and consumption, could directly transmit salmonellae. These same products might also contaminate other foods by introducing salmonellae into food-preparation areas.     

Rapid Sulfonamide Disc Sensitivity Test for Meningococci

Minimal inhibitory concentrations (MIC) of 90 strains of Neisseria meningitidis were determined by a plate dilution technique that employed twofold changes in concentrations of sulfadiazine. The geometric mean of three MIC determinations on each strain was correlated with inhibition zones produced by a 300-mug sulfathiazole disc. The linear relationship between the logarithm of the geometric mean MIC values and the zone diameters was highly significant. Strains were separated into sensitive and resistant populations by both test procedures. Quantitative criteria for interpreting the sensitivity of a strain by the disc test were established.