Comparison of antipseudomonad activity of chlorine dioxide/chlorous acid-containing gel with commercially available antiseptics.

A chlorine dioxide-containing gel was compared with 3 commercially available antimicrobials and 1 antibiotic intended for topical use. This gel was tested at 0.5 X and 4 X and was found to be more effective as a 4 X gel in treating Pseudomonas aeruginosa-infected excised wounds on mice.

Controlled wound repair in guinea pigs, using antimicrobials that alter fibroplasia.

The repair processes of incised wounds depend, in part, on fibroplasia induced by soluble mediators from monocytic macrophages. Two topical antimicrobials were evaluated, each of which effectively controlled wound sepsis and yet each had widely different effects on fibroplasia and wound strength. Paired-incision dermal wounds on the flanks of guinea pigs were treated with a substance containing reactive chlorine (Alcide) or with a compound that is a mixture of two surfactants.

Alcoholism as an addiction: the disease concept reconsidered.

The concept of alcoholism as a disease is compared to the concept of addiction in regard to individual intentionality, the resultant social and legal accountability and especially the total phenomenology of the addictive process. It is held that alcoholism is essentially an addiction like any other that if active, can culminate in various diseases and in death but that its most significant and characteristic volitional disorder: starting to drink when sober, is not explained by the disease concept. The concept of alcoholism as a disease is basically due to a reversal of the perception of cause and effect and has thereby impoverished full understanding and treatment of the entire process of addictive emotionality, addictive relationships and the addictive way of life.

The long-term results of the surgical management of paralytic pes cavus by soft tissue release and tendon transfer.

Twenty-six patients with paralytic pes cavus were managed by early soft tissue correction and tendon transfer. Eighteen had spina bifida, 6 had peroneal muscular atrophy and two had cerebral palsy. The most frequent operations were flexor hallucis longus tenodesis, Girdlestone's flexor to extensor tendon transfer and plantar release.

Treatment of malignant hypercalcaemia with clodronate.

We have assessed the effects of clodronate (dichloromethylene diphosphonate; Cl2MDP 0.8-3.2g daily by mouth for up to 3 months) in 17 episodes of hypercalcaemia and osteolysis due to carcinoma.

Defective macrophage function in wound repair of P/J mice.

The strength of healing full-thickness incised dermal wounds in P/J mice was less than that of CD-1 mice although the strength of intact skin was similar for each strain. Five days after surgery, P/J mice had wounds with tensile strengths of 65 +/- 18g while CD-1 mice had wounds with strengths of 85 +/- 15g. The wound breaking strength of P/J mice was restored to normal values (86 +/- 18g) by administering glucan.

Abnormal vitamin D metabolism in Paget's disease of bone.

We have studied several biochemical indices of bone turnover and vitamin D metabolism in 32 untreated patients with Paget's disease and in 32 age-matched control subjects. patients with Paget's disease, as expected, were characterized by high bone turnover, as judged by alkaline phosphatase and urinary excretion of hydorxyproline. Serum values of 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) and the ratio of 24,25(OH)2D3 to 25-OHD were significantly lower in patients than in control subjects.

Pulmonary function of London firemen.

In a longitudinal study of a sample of firemen in London 1006 firemen were interviewed and examined in 1976 and 895 were seen a second time 12 months later. On each occasion a Medical Research Council respiratory questionnaire was administered and forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were measured. The average levels of FEV1, FVC, and FEV1/FVC in both years compared favourably with conventional predicted values.

Keller's arthroplasty: is distraction useful? A prospective trial.

There are many operations for hallux valgus and hallux rigidus, but Keller's operation remains one of the most popular, particularly for the older patient. A prospective trial was carried out to compare the results of Keller's operation modified by Kirschner-wire distraction with those of the standard operation. The results suggest that there is no advantage in using temporary Kirschner-wire distraction; indeed, degenerative changes in the interphalangeal joint and a subjectively worse result may result from its use.

Bone marrow biopsy technic. Artifact induced by aspiration.

Bone marrow aspiration and trephine biopsy specimens are of additive value when assessing various marrow disorders. Many physicians obtain both an aspirate and a trephine core when taking a biopsy of bone marrow, but opinions differ about which biopsy specimen should be obtained first. Some authors mention the possibility of artifactual hypocellularity and hemorrhage in the trephine biopsy specimen when trephine biopsy follows aspiration at the same site.

A computerised resident medical officer rostering system.

A computerised Resident Medical Officer (RMO) rostering system was developed by the authors over a period of two years to aid in the preparation of yearly and daily rosters for RMOs. The main aim of the system is to save the time required for repetitive rostering activities, such as preparing the weekly rosters and pay sheets. No new philosophies of resident rostering have been introduced and the program simply does more quickly what used to be done under the manual system.

The use of dichloromethylene diphosphonate for the management of hypercalcaemia in multiple myeloma.

We have assessed the effects of the diphosphonate, dichloromethylene diphosphonate (Cl2MDP), in 19 patients with hypercalcaemia and increased bone resorption due to myeloma. Cl2MDP (800-3200 mg daily by mouth or 300 mg daily by intravenous infusion) decreased plasma calcium and biochemical indices of increased bone resorption in 16 of 19 patients. This effect persisted for the duration of treatment (up to 14 weeks).

Drug treatment of primary hyperparathyroidism: use of clodronate disodium.

Clodronate disodium (dichloromethylene diphosphonate), a specific inhibitor of bone resorption, was given by mouth (1.0-3.2 g daily) to nine patients with primary hyperparathyroidism for two to 32 weeks so that its clinical and metabolic effects could be evaluated.

Ultrastructural features of the osteoclasts from Paget's disease of bone in relation to a viral aetiology.

The ultrastructure of the osteocytes, osteoblasts, osteoclasts, haemopoietic and other connective tissue cells was examined in 27 biopsies from 22 patients with Paget's disease of bone. Electron microscopy showed characteristic nuclear and cytoplasmic inclusions in the osteoclasts of all of the 25 biopsies exhibiting histological evidence of Paget's disease. Such inclusions were absent from all the other types examined.

Epidemic of hospital-acquired infection due to methicillin-resistant Staphylococcus aureus in major Victorian hospitals.

During 1979, the Victorian Health Commission received reports of a rising proportion of methicillin-resistant Staphylococcus aureus (MRSA) isolates from an increasing number of institutions. At least 31 metropolitan hospitals were involved, and six of these reported MRSA totaling between 20% and 40% of all Staph. aureus isolates.

Effects of 24,25-dihydroxy-vitamin D3 on its plasma level in man.

Small doses of 24,25-dihydroxy-vitamin D3 (24,25(OH)2D3; 2 micrograms daily) given by mouth increased plasma levels of 24,25(OH)2D3 several-fold in normal subjects and in patients with metabolic bone disease. When oral treatment was stopped, or following the intravenous administration of 24,25(OH)2D3, plasma disappearance of 24,25(OH)2D3 was slow (t1/2 approx. 16 days).

Paget's disease: improvement of spinal cord dysfunction with diphosphonates and calcitonin.

The clinical and radiographic features of spinal cord dysfunction secondary to Paget's disease are described. Long-term medical management with the use of the diphosphonates, calcitonins and mithramycin resulted in marked and rapid clinical improvements in 8 of 10 of our own patients. These results are comparable to those seen in 19 other patients previously described in the literature, and are also similar to those obtained by surgical treatment.

Spinal cord dysfunction in Paget's disease of bone. Has medical treatment a vascular basis?

The medical treatment of eight patients with paraparesis associated with Paget's disease of the vertebrae is described. Treatment, for 3 to 87 months, with calcitonin or with diphosphonates produced marked clinical improvement in seven of these patients. From this series and a review of 19 additional case reports it is concluded that favourable clinical response is seen in about 90 per cent of patients, and that this may occur very rapidly.

Biochemical markers of bone turnover in Paget's disease.

The two most commonly used biochemical markers of bone turnover are the serum alkaline phosphatase and the urinary excretion of peptide-bound hydroxyproline, both of which are increased in Paget's disease. Serum alkaline phosphatase is assumed to be derived from osteoblasts during the process of bone formation, whereas small peptides containing hydroxyproline are excreted in the urine following the degradation of bone collagen. The alkaline phosphatase is probably the more useful measurement for diagnosis and for following response to treatment, whereas hydroxyproline, although very sensitive, presents technical difficulties in collection and measurement.