Continued weight loss in the newborn during the third day of life as an indicator of early weaning.

Little information is available about continued weight loss (CWL) of the newborn during the third day of life as an additional factor in early weaning. The purpose of the present study was to establish the value of CWL as an indicator of early weaning. The study group comprised 54 normal newborns of non-smoking healthy mothers. Newborns with CWL were compared with those whose weight remained stable or increased (controls). Follow-up was conducted by telephone interview at 10 days, 6 weeks, and 3 months after birth. It was found that mothers in the control group breastfed for a much longer period than those in the study group (P = 0.014); at age 3 months 66.7% of the controls vs. 46.3% of the study group continued to breastfeed. CWL and/or absence of or inadequate breastfeeding guidance for the mother places infants at high risk of early weaning. These mothers require very early and strong support in order to avoid early weaning of their infants.

Effect of weather conditions on acute gouty arthritis.

82 patients were retrospectively evaluated for the effects of maximal and minimal temperatures, barometric pressure, wet and dry temperatures and heat stress on the five consecutive days preceding an acute gouty attack. Maximal temperature on day four preceding the attack was higher than the monthly mean [p < 0.01], the fifth day's lower than the monthly mean minimal temperature [p < 0.05], and the mean barometric pressure of the fifth day before the attack higher then the monthly mean [p < 0.02]. On day four before the acute gouty arthritic attack heat stress was significantly higher than the mean monthly heat stress [p < 0.03]. The same findings were noted between the difference of the fifth night wet and fourth night dry temperatures, which were higher than those on the day of the attack [p < 0.05 and p < 0.03 respectively]. These weather changes were not specific to a certain month. Weather changes which occur four to five days before an acute gouty attack may play a significant role in precipitating the attack.

A blue naevus of the prostate: a light microscopic study including an investigation of S-100 protein positive cells in the normal and in the diseased gland.

A blue naevus of the prostate in an 80-year-old patient is presented, including electronmicroscopical examination and the demonstration of S-100 protein positivity. Cells expressing S-100 protein were sought in prostates of infants, young adults and elderly patients with hyperplasia and carcinoma. Positive staining was found in stromal cells, but the number diminished with age and disease. These findings could explain the rarity of blue naevus and the virtual absence of primary malignant melanoma in the prostate.

Doxycycline prophylaxis for shigellosis.

The efficacy of oral doxycycline, 100 mg/d for 14 days, in reducing the incidence of shigellosis in newcomers to an area hyperendemic for the disease was examined in a double-blind, placebo-controlled trial. Of 107 entrants, 100 completed the study; 50 received the drug and 50 received a placebo. Diarrheal disease and associated symptoms were monitored for 8 weeks. Starting on the 3rd day of the trial, an outbreak was observed, and Shigella flexneri type 2a was isolated from 6 subjects. Eight of the subjects in the treatment group had diarrhea (16%) compared with 37 in the placebo group (74%), providing a 79% protection rate. There was no significant difference in the occurrence of accompanying symptoms between the subjects suffering from diarrhea in both groups, but the duration of disease was shorter in the treatment group. Serologic study of the outbreak showed no significant difference in antibody response to S flexneri between the treatment (14 of 43) and placebo (18 of 39) groups. Doxycycline prophylaxis apparently is effective and probably does not prevent subclinical infection.

Detection of the disabled in a rural area.

A rural Jewish and Arab population of about 24,000 was selected for a rehabilitation study on the disabled. The detection consisted of the collection of existing data from local sources and a door-to-door screening based on an interview schedule. About 22,000 (93%) individuals responded to the interview. In subjects under the age of 65, the degree of agreement between the findings of the door-to-door screening and the information obtained from official local sources was 45.4% among disabled Jewish villagers, and 24% for disabled Arab villagers. On the other hand, in the same age group, the door-to-door interview failed to reveal between 12 to 18% of the subjects reported as disabled by the various local authorities. The reason for this low percentage of agreement is discussed. The disablement rate in the 0- to 13-year age group was 9% for Arab and 12.5% for Jewish children. In the working age group (14 to 64 years) the disablement rate was 5.3% for Arabs and 7.9% for Jews. More than 30% of both Arabs and Jews in this age group had impairments and chronic conditions that did not interfere with their functioning in normal life. In the pensionable age group (65+ years), 8.3% of Arab villagers and 2.3% of Jewish villagers were totally dependent. Special efforts were made to detect the functional limitations of housewives and of the homebound. The interview schedule had a marked educational effect on the professionals and on the villagers. This facilitated the establishment of a rural rehabilitation service in an Arab village, the first service of its kind in Israel.