Enthusiasm for primary care: comparing family medicine and general internal medicine.

Objective: To compare attitudes and perceptions of primary care among faculty, students, and residents oriented toward family medicine (FM) and general internal medicine (GIM).

Design: Descriptive study using confidential telephone interviews.

Participants: National stratified probability sample of FM and GIM faculty (n = 68), residents (n = 196), and students (n = 81).

Developmental regulation of vesicle transport in Drosophila embryos: forces and kinetics.

In Drosophila embryos, microtubules oriented along apical-basal directions support saltatory vesicle movement. Vesicle traffic includes lipid droplets whose distribution shifts twice during early embryogenesis. Using microscopy, optical tweezers, and a novel squashed-mount embryo preparation, we tracked single droplets and measured the forces these generated.

Vision profile of the athletes of the 1995 Special Olympics World Summer Games.

Background: Special Olympics were organized in 1968 by Eunice Shriver as a program of physical fitness for individuals with mental handicaps. Numerous epidemiologic studies report an increase in visual problems in this population.

Methods: A comprehensive vision screening was conducted at the 1995 Special Olympic World Summer Games to identify the prevalence of visual anomalies in this select group.

Chlamydia pneumoniae in acute otitis media.

Background: Aerobic bacterial pathogens are recovered from 65 to 85% of patients with acute otitis media (AOM). Although Chlamydia pneumoniae is a common pathogen of pediatric pneumonia, it has rarely been cultured from children with chronic otitis media and its role in AOM is unknown.

Methods: We cultured for C.

Palliative care in undergraduate medical education. Status report and future directions.

Objective: To describe the status of palliative care education in the undergraduate medical curriculum and to offer recommendations for improvement.

Data Sources: Review of literature on palliative care and of recently submitted grants on medical education for end-of-life care.

Study Selection: English-language reports of educational programs targeted toward medical students were examined, as well as surveys of medical schools.

Infant immunization with pneumococcal CRM197 vaccines: effect of saccharide size on immunogenicity and interactions with simultaneously administered vaccines.

Six pentavalent pneumococcal conjugate vaccines (Pn-CRM197) were evaluated among 400 infants. The vaccines differed in saccharide chain length (oligosaccharide [OS] or polysaccharide [PS]) and saccharide quantity (0.5, 2, or 5 microg).

Kinesin hydrolyses one ATP per 8-nm step.

Kinesin is a two-headed, ATP-dependent motor protein that moves along microtubules in discrete steps of 8 nm. In vitro, single molecules produce processive movement; motors typically take approximately 100 steps before releasing from a microtubule. A central question relates to mechanochemical coupling in this enzyme: how many molecules of ATP are consumed per step? For the actomyosin system, experimental approaches to this issue have generated considerable controversy.

Increased parenteral nutrition calcium and phosphorus for very-low-birth-weight infants using computer software assisted ordering.

Background: Providing adequate calcium (Ca) and phosphorus (P) in an appropriate ratio to preterm very-low-birth-weight (VLBW: BW < 1500 g) infants receiving parenteral nutrition (PN) is difficult because Ca:P solubility in PN is relatively low. Computer software assisted ordering (CSAO) was developed to integrate PN Ca:P solubility with clinical data to improve parenteral Ca and P administration. Our hypothesis was that CSAO would improve the system of designing PN by increasing the amount of Ca and P ordered without Ca:P precipitation.

Hb T-Cambodia, a beta chain variant with the mutations of Hb E and Hb D-Punjab, confirmed by DNA analysis.

Hemoglobin variants with two amino acid substitutions affecting one globin chain are relatively rare. Hb T-Cambodia, a doubly substituted beta-globin variant, was characterized previously by amino acid sequencing as having sequence alterations in beta 26 (beta 8)Glu-->Lys and beta 121(GH4) Glu-->Gln (1). It is a variant that migrates cathodic to Hb A2 on alkaline electrophoresis and with Hb A on acid citrate agar electrophoresis.

Future indications for macrolides.

The antimicrobial spectrum of azithromycin and clarithromycin suggests a number of further uses for these newer macrolides. Favorable clinical and bacteriologic responses have been reported with both antibiotics in children with community-acquired pneumonia. Response rates were high for overall patient populations and for subgroups with infection caused by Mycoplasma pneumoniae and Chlamydia pneumoniae.

Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media.

Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are the most frequently isolated pathogens in patients with acute otitis media (AOM). Other potential causative pathogens include Streptococcus pyogenes in older children and Chlamydia pneumoniae in younger children. The recent emergence of penicillin-resistant S.

Renal function in the elderly: impact of hypertension and cardiac function.

In senescence renal function is thought to decline markedly even in the absence of renal disease. It has also been proposed that the changes in renal function with age are not uniform and that confounding factors such as hypertension or atherosclerosis may play a role. We performed a comprehensive study to compare several aspects of renal function in four groups: (i) young healthy normotensive subjects (N = 24; 13 males; mean age 26 +/- 3 years); (ii) elderly healthy normotensive subjects (elderly NT; N = 29; 13 males; 68 +/- 7 years); (iii) elderly treated and untreated hypertensive patients (elderly HT; N = 25; 13 males; 70 +/- 6 years); and (iv) elderly patients with compensated mild to moderate heart failure (elderly HF; N = 14; 6 males; 69 +/- 6 years).

Stretching DNA with optical tweezers.

Force-extension (F-x) relationships were measured for single molecules of DNA under a variety of buffer conditions, using an optical trapping interferometer modified to incorporate feedback control. One end of a single DNA molecule was fixed to a coverglass surface by means of a stalled RNA polymerase complex. The other end was linked to a microscopic bead, which was captured and held in an optical trap.

Human germinal matrix: venous origin of hemorrhage and vascular characteristics.

Purpose: To examine the vascular supply and architecture of the germinal matrix in the preterm neonatal brain and to determine whether veins or arterioles are the source of germinal matrix hemorrhage.

Methods: Brains from eight preterm neonates (24 to 35 weeks' gestation) and two full-term infants were fixed in alcohol, embedded in celloidin, sectioned at 100- and 500-micron thicknesses, stained for alkaline phosphatase, and examined with light microscopy. High-resolution contact radiographs of 500-micron-thick sections were also mounted on glass slides for microscopic examination.

Trovafloxacin, a new fluoroquinolone with potent activity against Streptococcus pneumoniae.

An in vitro study of the activity of 15 antibacterial agents against 202 recent pediatric isolates of Streptococcus pneumoniae from urban and rural Nebraska and rural Kentucky identified trovafloxacin, ofloxacin, clindamycin, and vancomycin as the most active agents and equally active against both penicillin-susceptible and--resistant strains. In contrast, six beta-lactams, three macrolides, and trimethoprim-sulfamethoxazole were less active overall, especially against penicillin-intermediate and--resistant strains. Trovafloxacin inhibited all strains at a concentration of < or = 0.

Visual anomalies in young children exposed to cocaine.

Purpose: The number of children exposed to cocaine in utero each year is increasing. Recent reports suggest significant visual anomalies in infants prenatally exposed to cocaine. The purpose of this retrospective study was to determine if children exposed prenatally to cocaine were at a greater risk for visual abnormalities, such as strabismus and significant refractive errors.

Academia's chilly climate for primary care.

Objective: To describe the attitudes toward and perceptions of primary care education and practice among academic health center constituents.

Design And Participants: Descriptive study using confidential telephone interviews (October 1993 to March 1994) of national stratified probability samples of first- and fourth-year medical students, residents, clinical faculty, internal medicine and pediatrics residency training directors and chairs, and deans (N=2293).

Results: Five areas were examined: respondents' specialty orientation, attitudes toward the competence of primary care physicians, encouragement and positive regard for primary care, exposure to primary care-related educational experiences, and socioemotional orientation.