Severe pruritus associated with lymphoma in a dog.

A dog with chronic pruritus that was refractory to antibiotic, corticosteroid, and antihistamine treatment was found to have lymphoma involving the spleen and associated lymph nodes. Pruritus rapidly resolved on removal of the tumor and recurred on reappearance. The association of generalized pruritus with an occult malignant process may be difficult to assess, but after excluding the more common causes of pruritus, a visceral malignancy should be considered.

Developing a health information infrastructure for Arizona.

Network connectivity is critical in Arizona, where travel distances are great, academic programs dispersed, and health care practitioners often geographically isolated. Accordingly, the University of Arizona (UA) applied for $50,000.00 in National Library of Medicine/National Science Foundation (NLM/NSF) Connections Program funding to promote statewide collaboration in supporting UA's health sciences education and research programs by expanding network connectivity to hospitals and other health-related institutions. The proposal outlined three strategies: Each major nonuniversity teaching hospital would secure and maintain a leased communications line dedicated to network connectivity, and NSF funds would be used to buy some necessary hardward. NSF funds would be used to establish a modern bank for dial-up Internet access by rural practitioners and teaching sites. Co-principal investigators of the project would promote and support the use of this new statewide connectivity and foster its continued expansion. The proposal was based on a conservative philosophy: familiar technologies and, where possible, existing networks and equipment would be used. The proposal was approved, and NSF funds hastened creation of an expanded health information network in Arizona. Once that network was in place, participants moved quickly from managing the mechanics of connectivity to planning for a computing and communications platform with services. Private funds were obtained to help organize the Arizona Health Information Network to direct these expanded services.

Synthesis and structure-activity relationships of some 6 beta-acrylamido penicillins.

Syntheses are described for penicillins (4b approximately 4i, 5a and 5b) which possess a 6 beta-(2-heteroaryl-3-substituted)-propenamido side-chain of fixed geometry. In vitro results for these compounds against a range of Gram-positive and Gram-negative bacteria showed in most cases good stability against both penicillinase and TEM-1 beta-lactamase; analogues (4b approximately 4i) bearing a 2-(2-aminothiazol-4-yl) unit showed the best intrinsic activity, the cyclohexyl compound (4b) being the most promising. The 1-acetoxyethyl ester (6) of 4b was also prepared; in experimental animal studies the in vivo properties of this compound compared favourably with cefuroxime axetil and are reported together with selected in vivo data for the other compounds.

The integrated academic information management system at Columbia-Presbyterian Medical Center.

Over the past seven years, Columbia-Presbyterian Medical Center has been planning and implementing an integrated academic information management system. Accomplishments to date include establishing an institutional information architecture, installing a campus-wide network of workstations, recruiting the staff needed to develop and implement the system, and developing various applications. This paper presents the rationale and steps involved in these accomplishments, as well as data on use of the system so far.

An initial assessment of the cost and utilization of the Integrated Academic Information System (IAIMS) at Columbia Presbyterian Medical Center.

The concept of "one stop information shopping" is becoming a reality at Columbia Presbyterian Medical Center (CPMC). The goal of our effort is to provide access to university and hospital administrative systems as well as clinical and library applications from a single workstation, which also provides utility functions such as word processing and mail. Since June 1987, CPMC has invested the equivalent of $23 million dollars to install a digital communications network that encompasses 18 buildings at seven geographically separate sites and to develop clinical and library applications that are integrated with the existing hospital and university administrative and research computing facilities. During June 1991, 2425 different individuals used the clinical information system, 425 different individuals used the library applications, and 900 different individuals used the hospital administrative applications via network access. If we were to freeze the system in its current state, amortize the development and network installation costs, and add projected maintenance costs for the clinical and library applications, our integrated information system would cost $2.8 million on an annual basis. This cost is 0.3% of the medical center's annual budget. These expenditures could be justified by very small improvements in time savings for personnel and/or decreased length of hospital stay and/or more efficient use of resources. In addition to the direct benefits which we detail, a major benefit is the ease with which additional computer-based applications can be added incrementally at an extremely modest cost.

Productivity, diet, and environmental contaminants in bald eagles nesting near the Wisconsin shoreline of Lake Superior.

Bald eagles (Haliaeetus leucocephalus) nesting in the Apostle Islands National Lakeshore and along the Wisconsin shoreline of Lake Superior produced an average of 0.8 young/occupied nest and had an average nest success of 57% during 1983-1988, compared to 1.3 young/occupied nest and 77% nest success in inland Wisconsin. Contaminant levels in nestling bald eagle carcasses collected from nests near Lake Superior were higher than those collected inland, suggesting local contamination. Prey remains collected at nests consisted of fish (50%); birds, primarily herring gulls (Larus argentatus) (48.4%); and mammals (1.2%). Organochlorine and polychlorinated biphenyl (PCB) residues were present at low levels (DDE: means = 0.07 micrograms/g wet wt, PCP: means = 0.21 micrograms/g wet wt) in fish. Herring gulls contained higher concentrations (DDE: means = 5.5 micrograms/g wet wt, PCB: means = 16.95 micrograms/g wet wt) and appear to be the major source of elevated contaminant levels in bald eagles nesting near Lake Superior.

Reinventing the medical librarian.

The caliber of the librarian is a health sciences library's most important resource. This paper explores factors which have influenced who has, or who has not, entered the profession of medical librarianship, and discusses several attributes which the author considers critical for restructuring the profession to meet current and future needs.

Responses of older and younger women to exercise in dry and humid heat without fluid replacement.

Eight older (52 to 62 yr old) post-menopausal and 8 younger (20 to 30 yr old) women were matched with respect to body size, fatness, and maximal oxygen consumption, heat-acclimated, and then exercised at 35 to 40% maximal oxygen consumption in a warm-humid (37 degrees C, 60% relative humidity) environment. Results were compared with similar data from a hot-dry (48 degrees C, 15% relative humidity) environment. No fluid replacement was provided during either of these sessions. In each environment, the older women stored more heat as evidenced by a higher rectal temperature response, but there were no inter-group differences in skin temperature or percent maximal heart rate. Four of the older women were unable to complete either the hot-dry or the warm-humid exposure, although they completed the full 2 h during acclimation sessions when water was provided ad libitum. In the hot-dry environment, the younger women's whole body and local sweat rates were significantly higher than those of the older women; in the warm-humid environment, there was no age-related difference in sweat rate. When local skin temperature and wettedness were artificially elevated, both groups exhibited the same pattern and rate of sweating. Percent decrease in plasma volume was greater for the older women in both conditions, but significantly so only in the warm-humid environment.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative prevalence of rabies antibodies among household and unclaimed/stray dogs as determined by the immune adherence haemagglutination assay.

The immune adherence haemagglutination assay (IAHA), widely used for human viral disease diagnosis, has been adapted for detection of rabies virus antibodies in dog sera. Rabies virus antibody titres obtained by the IAHA correlated well with those obtained by the currently accepted test for rabies antibody determination, the rapid-fluorescent-focus-inhibition test (RFFIT). Although it is not known if the antibodies detected in IAHA test represent neutralizing antibodies against rabies, IAHA has several advantages over the RFFIT: the IAHA is rapid, requiring about seven hours for results to be available; it is relatively inexpensive and easy to perform; uses reagents commonly available in any routine virology laboratory; and uses inactivated rabies virus, thus eliminating hazards associated with the use of live virus in RFFIT. Using this test we found that rabies antibody titres were significantly higher, and at the same time more prevalent, among household dogs than among the unclaimed/stray dogs. The results re-emphasize the increased hazard associated with unclaimed/stray dogs and the need for vaccination of all dogs.

Effect of age on heat-activated sweat gland density and flow during exercise in dry heat.

Physiological responses of eight postmenopausal older women (age 52-62 yr) and eight younger women (age 20-30 yr) were compared during moderate intensity exercise in a hot dry environment (48 degrees C dry bulb, 25 degrees C wet bulb). The age groups were matched on the basis of maximal O2 consumption (VO2max), body surface area, and body fatness. After heat acclimation the women walked at 40% VO2max for up to 2 h in the hot dry environment while heart rate (HR), rectal temperature (Tre), mean skin temperature (Tsk), whole-body sweating rate (Msw), and local sweating rates (msw; forearm, chest, and scapula) were measured. Additionally, the density of heat-activated sweat glands (HASG) was determined and average sweat gland flow (SGF) was calculated for the scapular area. Although no differences between age groups were found in HR response (when analyzed as percent of maximal HR) or Tsk, the older women had a significantly higher Tre throughout the heat-exercise session. The greater heat storage of the older women may be explained by their significantly lower Msw and msw. There were no differences between the younger and older women in the density of HASG after 30 min; therefore, the lower msw reflects a diminished output per HASG rather than a decrease in the number of sweat glands recruited. The diminished thermoregulatory ability of the older women, unrelated to differences in VO2max, appears to reflect either 1) a diminished response of the sweat glands to central and/or peripheral stimuli, or 2) an age-related structural alteration in the eccrine glands or surrounding skin cells.

IAIMS at Columbia: a strategic plan and model project.

This report describes the Integrated Academic Information Management System (IAIMS) prototype project at the Columbia-Presbyterian Medical Center, the factors that led to the selection of this particular project, and the planning for its implementation. The lessons learned to date and implications for the library are summarized.

A simple exercise test for the prediction of relative heat tolerance.

A medical screening exercise test is presented which accurately predicts relative heat tolerance during work in very hot environments. The test consisted of 15-20 min of exercise at a standard absolute intensity of about 600 kcal/hr (140W) with the subject wearing a vapor-barrier suit. Five minutes after the subject exercised, recovery heart rate was measured. When this heart rate is used, a physiological limit (+/- approximately 5 min) can be predicted with 95% confidence for the most intense work-heat conditions found in nuclear power stations. In addition, site health and safety personnel can establish qualification criteria for work on hot jobs, based on the test results. The test as developed can be performed in an office environment with the use of a minimum of equipment by personnel with minimal expertise and training. Total maximal test duration is about 20-25 min per person and only heart rate need be monitored (simple pulse palpation will suffice). Test modality is adaptable to any ergometer, the most readily available and least expensive of which is bench-stepping. It is recommended that this test be available for use for those persons who, based upon routine medical examination or past history, are suspected of being relatively heat intolerant.

Seep oil and gas in gulf of Mexico slope sediment.

Concentrations in Gulf of Mexico slope sediment of material soluble in methanol and benzene as high as 4.5 percent are shown to be attributable to biodegraded petroleum. Associated carbonate deposits and organic sulfur are the products of the microbial oxidation of petroleum and sulfate reduction. The results of chemical and carbon isotope analyses indicate that high concentrations of hydrocarbon gases, from methane to pentane, are petroleum rather than microbiologically derived. These hydrocarbons, believed to have been produced thermally at depth, probably reached the surface through faults and fractures associated with salt diapirs.

Application of indomethacin as a potentiator of lymphocyte blastogenesis in Brucella abortus exposed cattle.

Lymphocytes from Brucella abortus field strain infected, strain 19 vaccinated, non-exposed and field strain infected, but immunologically unresponsive cattle were incubated with B. abortus antigen and indomethacin. There were significant increases (P less than 0.005) in the blastogenic responses, as measured by [3H] thymidine uptake, in cultures with indomethacin as compared to cultures without indomethacin. Lymphocyte blastogenic responses to B. abortus antigen were potentiated by indomethacin in both B. abortus exposed and non-exposed cultures. However, potentiation of sensitized lymphocyte blastogenic responses by indomethacin was significantly greater (P less than 0.005) than that in non-exposed lymphocytes. Additionally, indomethacin significantly potentiated Brucella-induced lymphocyte blastogenic responses in lymphocytes from anergic cattle.