Rhodococcus equi pneumonia in foals: an assessment of the early diagnostic value of serum amyloid A and plasma fibrinogen concentrations in equine clinical practice.

Early diagnosis and prevention of Rhodococcus equi pneumonia in foals represent important goals for equine clinicians. Recent protocols for diagnosis and treatment of Rhodococcosis in foals typically rely on a multimodal approach based on sonographic evidence suggestive of pyogranulomas, sonographic abscess scores and laboratory findings including plasma fibrinogen concentrations, blood biochemistry testing and platelet and leukocyte counts. The aim of this study was to assess the utility of weekly testing of serum amyloid A (SAA) and plasma fibrinogen concentrations in foals to achieve early diagnosis of R. equi pneumonia prior to the onset of clinical signs. This testing was used to simulate a clinically practical screening procedure and compared with thoracic ultrasonography performed in parallel. The present study suggests that SAA does not represent a reliable early marker of Rhodococcosis when plasma concentrations are tested weekly. However, when clinical signs of R. equi pneumonia are present, SAA concentrations may allow clinicians to obtain 'real-time' indications concerning both the progress of infection and the effectiveness of therapy. This study raises the possibility that plasma fibrinogen monitoring starting at 1 week of age and repeated on a weekly basis, could serve as a screening test allowing clinicians to identify foals as suspected of R. equi infection. Future investigations regarding both physiological plasma fibrinogen concentrations in foals as well as fibrinogen kinetics in foals affected with R. equi pneumonia, including the establishment of appropriate reference intervals for the test method employed in this study, will be necessary in order to clarify this possibility.

Enhanced low-density lipoprotein degradation and cholesterol synthesis in monocyte-derived macrophages of patients with adult xanthogranulomatosis.

Adult xanthogranulomatosis is an uncommon disorder in which dermal macrophages accumulate cholesterol intracellularly despite normal plasma cholesterol levels. In an attempt to elucidate an underlying biochemical abnormality in this disorder, we studied the rates of 125I-labeled low-density lipoprotein degradation, and intracellular cholesterol synthesis, in human monocyte-derived macrophages of three patients with adult xanthogranulomatosis. In all three patients, the rates of cellular 125I-low-density lipoprotein degradation and of cholesterol synthesis were 22-37% and 14-84% higher than those of the respective normal controls (p < 0.01). These findings suggest that in MDM of adult xanthogranulomatosis patients, the uptake and degradation of low-density lipoprotein-derived cholesterol and intracellular cholesterol biosynthesis are enhanced. Because dermal macrophages are derived from blood monocytes, it is possible that such an enhancement might play a role in the accumulation of cholesteryl esters in the macrophages that form the xanthogranulomatosis lesions.

Jellyfish envenomation: a summer epidemic.

During the summer of 1987 the shores of Israel were infested by waves of jellyfish. Thirty patients, mainly children, suffering various degrees of painful injuries to different parts of their bodies were treated in our emergency ward. A typical case is reported and the appropriate treatment recommended.

Drug use among Israeli army personnel: an epidemiological study.

A survey of drug use among Israeli army personnel was conducted as part of a national survey of drug use initiated by the Anti Drug Authority of Israel during 1990. One thousand one hundred and twenty-five male and female soldiers from various units and ranks were selected by the use of randomized cluster sampling. Seventy to eighty-five per cent of the soldiers presented negative attitudes towards the use of illicit drugs and its users. Only 67 (6.1%) soldiers reported the use of some illicit drugs in the last 30 days; half of them started to use drugs before the age of 18. The main reported use was of hashish, marijuana and tranquillizers. The use of opium, heroin, cocaine was rarely reported. The use of cigarettes and alcohol within the last 30 days was much higher and was reported by 44.6% and 69.0% of the soldiers, respectively. Using multiple logistic regression analysis it was shown that illicit drug use in the last 30 days was significantly associated with higher number of individuals per household, less satisfaction with military service, and positive attitudes towards the use of drugs. The results of the present study, along with a comparison with different populations that were surveyed parallel to our research indicate that military service in the Israel Defence Force (IDF) is not associated with significant use of illicit drugs. Our results indicate the need for more attention to alcohol and cigarette use among army personnel.

Promotion of a lifestyle conducive to cardiovascular health in the Israel Defence Force.

This article reviews the characteristics and components of intervention programs that are conducted by the Israel Defence Forces (IDF) in an attempt to reduce future cardiovascular (CV) morbidity and mortality among Israeli military personnel. Various populations have been targeted for intervention, ranging from selected high-risk individuals to the entire military population. The four basic elements of the activity are educational programs, environmental changes, legislation, and enforcement of the rules. Important characteristics of the program, which probably will contribute to its success, are (1) the establishment of a standing joint committee for developing and implementing health promotion programs in the IDF; and (2) the adoption and the follow-up of the suggested intervention programs by the head of the Manpower Branch, together with commanders of the other relevant branches. The effectiveness of the intervention programs will be measured in the future mainly by a follow-up on the prevalence of CV risk factors among Israeli military personnel.

Group psychotherapy with inner-city grandmothers raising their grandchildren.

A year-long psychotherapy group consisting of two co-therapists and eight grandmothers who were parenting their daughters' children is presented. Three models that correspond to the co-therapists' psychoanalytic developmental orientation were used to describe the group phases of development. A number of themes that emerged at different points in the group's life are delineated. They include: authority, control, sibling rivalry, the generation gap, dealing with schools, illness and mortality, isolation, defensiveness, anger, fear of going crazy, guilt, shame, separation, and abandonment. Transference and countertransference issues are also discussed.

[Cutaneous leishmaniasis: incidental outbreak in a new endemic area?].

In the autumn of '94 we saw 32 patients with cutaneous leishmaniasis from a newly populated areas south of Yerucham. Yerucham had never previously been reported as a focus of leishmaniasis. Ongoing construction in the town and the health hazards that resulted may play a part in this new situation. There are a number of ways of controlling and preventing outbreaks leishmaniasis. They include elimination of the vector, Phlebotomus and its host, the gerbils as well as their food supply, "maloach" bushes, other health hazards and vaccination of the population. Patients were treated according to the severity of disease. It is still too early to determine whether our efforts to limit the spread of the outbreak have been successful.

Tyrphostins suppress the growth of psoriatic keratinocytes.

Tyrosine kinase inhibitors of the tyrphostin family which block EGF receptor kinase are reported to arrest the growth of psoriatic keratinocytes in vitro. Three tyrphostins with the potency ratio AG555 >> AG18 >> AG814 were found to arrest growth with no adverse cytotoxic effects. The potency ratio to inhibit keratinocyte proliferation follows their potency to inhibit EGF receptor kinase activity in vitro. These compounds represent novel leads for the therapy of psoriasis.

Rapid method for mapping morbidity and mortality during epidemics.

A rapid method for mapping health information during epidemics is described. We divided maps of cities into coded squares and assigned a code to each street which corresponded to its location on the map. Thus, health data information could be easily transferred from the field by indicating the number of cases in each square and readily transferring this information onto a map. By applying density data of the civilian population in each neighborhood it was possible to calculate incidence and prevalence rates at any given time.

Maternal responsiveness to infants in three societies: the United States, France, and Japan.

This study examines and compares prominent characteristics of maternal responsiveness to infant activity during home-based naturalistic interactions of mother-infant dyads in New York City, Paris, and Tokyo. Both culture-general and culture-specific patterns of responsiveness emerged. For example, in all 3 locales infants behaved similarly, mothers also behaved similarly with respect to a hierarchy of response types, and mothers and infants manifest both specificity and mutual appropriateness in their interactions: Mothers responded to infants' exploration of the environment with encouragement to the environment, to infants' vocalizing nondistress with imitation, and to infants' vocalizing distress with nurturance. Differences in maternal responsiveness among cultures occurred to infant looking rather than to infant vocalizing and in mothers' emphasizing dyadic versus extradyadic loci of interaction. Universals of maternal responsiveness, potential sources of cultural variation, and implications of similarities and differences in responsiveness for child development in different cultural contexts are discussed.