Deinstitutionalization: a new scenario.

Deinstitutionalization appears to be an issue that is still pretty much up in the air. The public, courts, and state hospital administrators agree that large state, warehouse-like facilities are inadequate. The appropriate mental health delivery system for each state and the communities within each state need careful planning and implementation to be successful.

Diarrhea associated with intestinal Cryptosporidiosis in turkeys.

Turkey poults were suffering from diarrhea on a farm in which several previous grow-outs of turkeys had experienced a clinically identical problem. Upon necropsy, significant gross lesions were restricted to the gastrointestinal tract. Segments of small intestine were pale and distended with cloudy mucoid material and a few gas bubbles.

Prolonged selective urokinase infusion in totally occluded coronary arteries and bypass grafts: two case reports.

Reports are presented demonstrating a technique for dissolving thrombus in coronary arteries and bypass grafts by using prolonged selective infusion of urokinase via an infusion wire. This allows one to pass a steerable guide wire through the culprit stenosis and perform angioplasty on a distal lesion which could not be previously seen.

Assessment of the Albuscreen microalbuminuria kit in diabetic outpatients.

Diabetic patients who have albumin excretion rates of greater than 30 micrograms/min (30 mg/L at normal urine volumes) are at increased risk of the development of diabetic nephropathy. The Albuscreen microalbuminuria kit detects albuminuria at concentrations of 30 mg/L and above by an agglutination-inhibition reaction. One hundred and ninety-five random urine samples from diabetic outpatients were assessed by Albuscreen and Albustix testing for albuminuria and the results were correlated with those of a sensitive radioimmunoassay technique.

Anomalous thyrotropin values.

We studied problems associated with use of an "ultrasensitive" thyrotropin (TSH, thyroid-stimulating hormone) assay for diagnosis of hyperthyroidism. Of 955 TSH assays performed in our laboratory during four months, 135 gave TSH values less than 0.1 milli-int.

Hypomyelination in Weimaraner dogs.

Dogs from two separate litters of Weimaraners developed tremors by 3 weeks of age. Light and electron microscopic findings in one dog from each of the litters were compared to those of two age-matched controls. Many axons in the brain and spinal cord were either thinly myelinated or nonmyelinated in the affected dogs relative to the controls, while the peripheral nervous system was normally myelinated.

Adolescents' knowledge of nuclear issues and the effects of nuclear war.

Three hundred fifty-seven college students were surveyed to assess later adolescents' awareness of the status of nuclear arms development and possible effects of a nuclear war on people and the environment. Chi-square analyses were performed to determine whether the frequency of correct responses differed with regard to participants' sex, political orientation, and position toward the United States' possession of nuclear weapons. Results suggest that later adolescents are extremely uninformed regarding the current status of nuclear issues and the consequences of a nuclear war.

Wheelchair use by ambulatory nursing home residents.

In a survey of wheelchair use in two nursing homes, the authors found a substantial number of cognitively intact nursing home residents who walked, but who also used a wheelchair. Using chart review and interviews with the residents, it was found that multiple physical factors, including pain, strength, endurance, vision and balance, and multiple social and environmental factors, including the fear of falling, were related to the resident's decision to use a wheelchair as an alternative means of mobility. A physical examination focused on aspects of mobility was completed on each resident and was intended to characterize the physical limitations in groups studied.

Studies on orthoreoviruses isolated from young turkeys. III. Pathogenic effects in chicken embryos, chicks, poults, and suckling mice.

The pathogenicity of four clone-purified reoviruses (81-51, 81-68, 81-311, and 82-88) was studied in experimentally infected specific-pathogen-free (SPF) chicken embryos and chicks. SPF and specific-antigen-and-antibody-negative (SAAN) turkey poults, and suckling mice. In SPF embryos, all four viruses caused death or lesions characteristic for avian reoviruses.

Medicare's prospective payment system for hospitals: the impact on nursing home quality.

How are changes in Medicare affecting the quality of long term care? Finding an answer to this question is made difficult by the many variables that must be considered and the lack of concrete data on the subject. The variables include the care requirements of Medicare patients being discharged from hospitals to nursing homes, the availability and accessibility of skilled-care beds, the trends in utilization of skilled-care beds, and the capability of nursing homes to provide the care required by these patients. Anecdotal data suggest that Medicare patients are being discharged from hospitals earlier, sicker, and with more complex skilled nursing requirements than before the implementation of prospective payment, that there has been limited collaboration among hospitals and nursing homes during this period of transition in the Medicare system, and that nursing home administrators and staffs are increasingly concerned about the actual cost of providing care to a sicker group of patients and about the qualifications of staff to meet more complex care needs.

Phialemonium obovatum infection in a burned child.

Phialemonium obovatum is reported for the first time as an opportunistic fungal pathogen of man. The fungus was recovered from biopsy specimens consisting of cutaneous and subcutaneous tissue obtained from thermal burn wounds antemortem and from spleen tissue and three burn sites postmortem. The hyaline hypae of P.

Acute urinary retention secondary to benign prostatic hyperplasia. Effect of alpha-adrenergic blockade.

The alpha-adrenergic blocker phenoxybenzamine has been shown to be useful in the treatment of prostatism. To assess the place of phenoxybenzamine in the management of acute retention, 43 patients presenting with acute urinary retention secondary to benign prostatic hyperplasia were catheterized suprapubically. They were then randomized to receive either oral phenoxybenzamine (10 mg b.

The use of intestinal D-xylose absorption and other parameters to determine the pathogenicity of and immunity to Eimeria acervulina.

The degree of pathogenicity of Eimeria acervulina infection in broiler chickens was evaluated by body weight gain, feed conversion ratio, oocyst production, gross morphologic lesion score, and intestinal D-xylose absorption. The least pathogenic effects, after challenge, occurred in birds immunized with 5 X 10(4) oocysts and challenged on Day 14 with 3 X 10(6) oocysts. Intestinal D-xylose absorption was found to be a sensitive method for evaluating the effects of coccidial infection and correlated well with body weight gain and feed conversion ratio.

Studies on orthoreoviruses isolated from young turkeys. II. Virus distribution in organs and serological response of poults inoculated orally.

Day-old specific-antibody-negative turkey poults were inoculated orally with cloned turkey reovirus isolate 81-68. Virus reisolations from 11 different tissues revealed widespread distribution at 3, 5, and 7 days postinoculation (PI). Virus was isolated from the intestines until 21 days PI.

Gastrointestinal transit times in normal and reovirus-inoculated turkeys.

Brilliant pigment powder was used to measure minimum gastrointestinal transit times (GTT) in control and cloned-reovirus-inoculated turkey poults. Compared with controls, inoculated poults had longer GTT at 120 hr (P less than 0.05) but not at 24 and 72 hr after receiving a single oral dose of cloned reovirus.

Studies on orthoreoviruses isolated from young turkeys. I. Isolation and characterization.

Four virus isolates were recovered from the intestinal tracts of turkey poults with diarrhea, abnormal feathering, stunted growth, and increased mortality. The isolates were clone-purified and characterized according to cytopathic effect (CPE) in chicken embryo kidney cells, size, morphology, physicochemical properties, and replicative cycle. The isolates were identified as members of the family Reoviridae, genus Orthoreovirus.