Family outbreak of fatal Yersinia enterocolitica pharyngitis.

A family outbreak of fatal Yersinia enterocolitica pharyngitis is reported. Two members of a family were hospitalized for pharyngitis and posed a diagnostic dilemma until cultures of throat, blood, and stool revealed Y. enterocolitica. Neither patient responded to erythromycin therapy. The first patient died, and her husband's life-threatening illness seemed to respond to aminoglycoside and trimethoprim/sulfamethoxazole therapy. Y. enterocolitica should be considered as an etiologic agent in the differential diagnosis of a patient with pharyngitis whose condition deteriorates during erythromycin or penicillin therapy.

Difficulties in diagnosing trichinella encephalitis.

Trichinella encephalitis remains a rare but life-threatening illness. Although well known to clinicians of another era, this disease currently may represent a diagnostic dilemma because of its infrequent occurrence and varied presentations. This report of trichinella encephalitis, presenting as quadriplegia, demonstrates that technological advances such as CAT scan, angiogram, and EEG are of no diagnostic assistance and add nothing to traditional diagnostic modalities, i.e., eosinophilia, sedimentation rate, and muscle biopsy. In some cases of trichinosis encephalitis where hypersensitivity reaction and/or vasculitis is believed to be the inciting factor, cortical steroids may have a role in treatment.

Vertebral osteomyelitis: nontypeable beta-lactamase-negative Haemophilus influenzae in an adult: case report.

Adult pyogenic vertebral osteomyelitis due to Haemophilus influenzae is exceedingly rare. After a search of the literature, we deemed our case to be the seventh case of H. influenzae pyogenic osteomyelitis. Vertebral osteomyelitis in itself is a rarity. The most common organisms associated with vertebral osteomyelitis are Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Of the six previously reported cases of adult pyogenic vertebral osteomyelitis due to H. influenzae, four of the six cases were caused by Type B H. influenzae, one case was attributed to Type C, and the other strain was not typed.

Curiosity and stimulation seeking across the adult life span: cross-sectional and 6- to 8-year longitudinal findings.

Giambra (1977-1978, 1979-1980) found that 2 scales of the Imaginal Processes Inventory measuring curiosity (i.e., information seeking) did not change across the adult life span, but 2 measuring stimulation seeking (i.e., boredom) for external stimulation need significantly decreased with age. In this study, these outcomes were replicated (1,356 men and 1,080 women 17 to 92 years old). In addition, a 6- to 8-year longitudinal repeat was obtained on 222 men and 124 women. Significant longitudinal declines were obtained for the stimulation-seeking measures. Furthermore, women showed an increase in impersonal-mechanical curiosity and a decline in interpersonal curiosity, though the amount of change was modest. Men were unchanged on both curiosity measures. Gender differences in longitudinal changes apparently reflected effects of socialization as well as tendencies toward displaying increased androgyny with advancing age.

Introducing psychiatric care into nursing homes.

A consultation-liaison psychiatry program in a teaching nursing home helped implement six guiding principles including: make the patient human to the staff; assume no behavior is random; look for depression of psychosis as a source of problems; reduce medications and medication doses; create a more homelike environment; and use conditions in which learning still occurs in dementia.

The InterpreCare System: overcoming language barriers in long-term care.

Differences in the language spoken by residents and staff in long-term care create a variety of problems. The InterpreCare System represents an intervention for dealing with this issue. We describe the nature and purpose of this intervention, and provide detailed instructions on the construction of Language Boards. Examples are given from our experience at Menorah Park Center for the Aging in enabling English-speaking staff to use Russian phrases while delivering care. Beneficial effects produced by the intervention are discussed.

Montessori-based activities for long-term care residents with advanced dementia: effects on engagement and affect.

Sixteen residents in long-term care with advanced dementia (14 women; average age = 88) showed significantly more constructive engagement (defined as motor or verbal behaviors in response to an activity), less passive engagement (defined as passively observing an activity), and more pleasure while participating in Montessori-based programming than in regularly scheduled activities programming. Principles of Montessori-based programming, along with examples of such programming, are presented. Implications of the study and methods for expanding the use of Montessori-based dementia programming are discussed.

An intergenerational program for persons with dementia using Montessori methods.

An intergenerational program bringing together older adults with dementia and preschool children in one-on-one interactions is described. Montessori activities, which have strong ties to physical and occupational therapy, as well as to theories of developmental and cognitive psychology, are used as the context for these interactions. Our experience indicates that older adults with dementia can still serve as effective mentors and teachers to children in an appropriately structured setting.

Chemotaxis of radiolabeled equine neutrophils.

A method for the isolation of equine neutrophils was developed using metrizamide cushions. A purity of greater than 95% was routinely obtained with greater than 90% viability. These cells were radiolabeled and tested for their chemotactic response in Boyden chambers to zymosan-activated equine serum, the partially purified equine complement component C5a, and formyl-L-methionyl-L-leucyl-L-phenylalanine. The time and ionic requirements for chemotaxis of radiolabeled equine neutrophils were investigated and maximal movement was observed at 2 hours' incubation and 1.0 mM Ca and 0.5 mM Mg. Dinitrophenol in a concentration range of 10(-2) to 10(-6) M also inhibited cell movement. A Zigmond-Hirsch checkerboard assay demonstrated the pronounced chemotactic activity of zymosan-activated equine serum and the partially purified equine C5a. The equine neutrophil did not respond to formyl-L-methionyl-L-leucyl-L-phenylalanine.

Genital herpes. How to relieve patients' physical and psychological symptoms.

Genital herpes simplex virus is being encountered at an increasing rate by the primary care physician. Recurrences of this disease create not only medical but psychological and social problems, of which the physician must be aware. Although acyclovir (Zovirax) has become a useful palliative tool, compassion, sensitivity, and understanding are essential in the treatment of this disease. Physician-provided education is still currently the thrust for prevention.

Necker cube reversals in young, middle-aged, and elderly females.

This research dealt with the reversing Necker cube illusion and its relationship to age in healthy, community-dwelling female adults. 36 respondents representing three age groups (20-39, 40-59, and 61-80 yr.) were tested. Age was unrelated to experiencing the Necker cube illusion contrary to predictions based on previous research and stimulus persistence theory. The role of sampling effects in gerontological research outcomes is discussed.

Age and living conditions as related to perceptions of ambiguous figures.

For ambiguous figures, reversing and embedded/hidden subfigures, data were obtained from four groups of 20 subjects each varying in age (young or elderly) and living environments (in college, in the community, and in nursing homes or confined to an institution). 10 men and 10 women were tested in each of the four groups. Dependent measures were the number of reversals passively reported for the Necker cube, the Mach book, the Schroeder staircase within 90 sec. on each task, and the number of embedded/hidden figures located. Younger subjects generally saw more reversals and found more embedded figures than elderly ones. The subjects' living situation, education, and verbal ability also were correlated with perceptual performance. These results suggest generalization of age associations with scores in 90 sec. must be tempered by consideration of other factors which affect intactness, basic competence, and how competence is measured.

The use of fact retrieval vs. inference in young and elderly adults.

The relationship between age and utilization of fact retrieval versus inferential question-answering processes was examined. Four groups of participants were used (n = 10; N = 40), representing a 2 x 2 stratification of age (24 to 31 vs. 65 to 76) and information available for question-answering (high vs. low). Two experimental tasks, introspection and choice reaction time, were used. In both tasks, older adults engaged in more inferential processing than younger adults, although this difference was statistically significant in the reaction time task alone. These results were discussed in terms of a possible advanced stage of cognitive development or a reaction to internalized negative stereotypes about memory loss.

A comparison of various strength of association measures commonly used in gerontological research.

An increased usage of measures of strength of association or effect size (ES) has been noted in the gerontological literature. Potential confusion could be generated by the fact that different researchers have reported different measures of ES from study to study. This paper involves a comparison of six ES measures commonly used by gerontological researchers as these measures relate to one another in both the analysis of variance and multiple regression models. Three other issues involving ES measures are discussed: (1) the ES of a contrast; (2) orthogonal and nonorthogonal designs; (3) partial Ess.

Equine complement activation as a mechanism for equine neutrophil migration in Onchocerca cervicalis infections.

Extracts of Onchocerca cervicalis, an equine parasite, were incubated with radiolabeled equine neutrophils and neutrophil migration was assessed for factors derived from the parasite itself or for host-derived factors after incubation of these same parasite extracts with equine serum. No stimulus for cell migration was observed in saline extracts of adult worms, uterine microfilariae, or skin microfilariae at any dosage tested. However, after incubation of saline extracts with fresh normal equine sera a marked stimulus for neutrophil migration was observed. Ablation of this biologic activity was noted if equine serum had been pretreated with 10 mM EDTA or heated at 50 and 56 degrees C for 30 min. However, if equine serum was treated with 10 mM EGTA, made 10 mM with respect to Mg2+ ions, no reduction in neutrophil migration was noted, thereby suggesting that the equine alternative complement pathway was the means of generating the serum-derived neutrophil migration stimulus. Preliminary gel filtration of the activated equine serum suggested that although there was a neutrophil stimulus associated with a C5a-like molecule, other complement or serum components could be involved.

Signal detection analysis of recognition memory in depressed elderly.

The purpose of this study was to examine the relationship of late-life depression to memory complaint and objective performance in a recognition memory task. Fifty-seven individuals between the ages of 58 and 88 were evaluated for depression using the Beck Depression Inventory (short form). They were then shown two stimulus lists, each consisting of high-imagery and low-imagery words. Recognition for these words was subsequently tested. Error rates and nonparametric signal detection measures were analyzed as indices of performance. Respondents gave global self-assessments of memory and, during the recognition task, also made self-ratings of performance. Depressed individuals showed more conservative response biases than nondepressed respondents, reflected in a higher false-negative error rate but a lower false-positive rate. Neither overall memory sensitivity as assessed by signal detection analysis nor self-ratings of performance were related to depression, though global memory self-ratings were. Elderly depressed individuals thus presented a pattern of greater memory complaint and unwillingness to venture responses in spite of showing small or no information-processing deficits.

Covert versus overt self-recognition in late stage Alzheimer's disease.

Some persons with Alzheimer's disease (AD) lose the ability to recognize themselves, as when they cannot overtly recognize their reflection in a mirror. There is evidence, however, that covert or unconscious self-recognition might be displayed in such individuals. In this study, 3 persons with AD lacking the ability to overtly self-recognize demonstrated multiple instances of unconscious or covert self-recognition. A variety of interventions, inspired by research with prosopagnosics, was implemented to remediate this loss. Interventions enabled all participants to exhibit overt self-recognition, though each did so with the aid of a different intervention. In addition, successful overt self-recognition required a verbal probe and was entirely intervention-dependent: When the intervention was removed, overt self-recognition was lost. Results support a dissociation between explicit-declarative versus implicit-nondeclarative memory systems, and extends this dissociation into the realm of self-recognition in AD.