Organic aciduria in neonatal multiple carboxylase deficiency.

A Samoan patient and a Saudi-Arabian patient were found to have abnormalities in the pattern of organic acid metabolites characteristic of 3-methylcrotonylglycinuria, propionic acidaemia and lactic acidosis. Both patients died early in life. The metabolic pattern is diagnostic of multiple carboxylase deficiency and an enzymatic diagnosis was made in a subsequent affected sibling of the first patient.

Nonsteroidal anti-inflammatory agents in rheumatoid arthritis and ankylosing spondylitis.

The relative effectiveness of six nonsteroidal anti-inflammatory agents was studied in 33 patients with rheumatoid arthritis and 32 patients with ankylosing spondylitis in a double-blind, randomized, prospective study employing a six-way multiple crossover design with six-week trials of each agent. In ankylosing spondylitis, naproxen, indomethacin, and fenoprofen calcium were the most effective agents. In rheumatoid arthritis, relatively little mean difference between drugs was found.

Reiter's syndrome following epidemic shigellosis.

To define the epidemiology of post-dysenteric Reiter's syndrome (RS), 1,162 persons were questioned about compatible symptoms soon after 3 separate outbreaks of shigellosis. We diagnosed RS for 3 women of 204 persons ill during an outbreak of Shigella flexneri 1b, for 3 women of 206 ill during an outbreak of S. flexneri 2a, and for none of 85 ill during an outbreak of S.

Physicians measure up. A study of 13 surgical procedures.

The Colorado Foundation for Medical Care Professional Standards Review Organization performed a six-month study in the latter half of 1978 to determine if the following surgical procedures were performed in accordance with the appropriate indications: primary appendectomy, cataract surgery, cholecystectomy, coronary arteriography, uterine dilation and curettage, surgical repair of hiatal hernia, abdominal hysterectomy, vaginal hysterectomy, lumbar disk excision, meniscectomy, tonsillectomy, adenoidectomy, and tonsillectomy and adenoidectomy. Data were collected concurrently by nurse reviewers on 4,850 hospitalized Medicare and Medicaid patients in Colorado hospitals. Cases that did not meet explicit indications were referred to physician reviewers for final determination.

Rheumatoid hand deformities: pathophysiology and treatment.

Rheumatoid disease, as it affects the hand, is a disease of the synovium lining the joints and sheaths of the tendon. The proliferating synovium destroys the articular surfaces of the joint, interferes with the gliding mechanism of the tendons and weakens the supporting ligaments of the joints. The degree and variety of deformities is multifold.

Understanding rheumatoid arthritis. Evaluation of a patient education program.

We evaluated a patient education program on understanding rheumatoid arthritis; 94% of those responding to our questionnaire considered the program helpful in increasing their understanding of their condition, and 93% said it enhanced their communication with their family. A total of 85% reported one or more behavioral changes, such as not abusing joints (63%), getting more rest (56%), and using medications more meticulously (48%) after participating in the program. We recommend patient education as an effective means of helping patients understand and hence comply with physicians' instructions as well as helping patients to assume greater responsibility for their own health care.

Multicenter comparison of naproxen and indomethacin in rheumatoid arthritis.

In a double-blind, crossover study, naproxen, 250 mg twice a day, naproxen, 500 mg taken at bedtime, and indomethacin, 25 mg four times a day, were compared in 132 patients with rheumatoid arthritis; six centers participated in the study. Objective indices of arthritis activity, such as number of clinically active joints, walking time, and duration of morning stiffness, were nearly identical for the three treatment regimens. Of particular interest was the observation that efficacy of a single daily dose of naproxen was comparable to that of the twice-daily dosage.

Partial hepatectomies with a hand-held laser knife: An experimental study.

Fifteen mongrel dogs underwent a left lateral non-anatomical partial hepatectomy using a carbon dioxide laser, diathermy or a surgical scalpel. An original prototype of a compact hand-held laser was used and its effects were compared with those of the other two instruments. An improved dry cat surface was achieved by placing a rubber snare proximal to the planned incision.

Treatment of rheumatoid arthritis: a review including newer and experimental anti-inflammatory agents.

Treatment of rheumatoid arthritis is often frustrating for patient and physician alike because of its chronic nature and our lack of knowledge about precise cause. It can be confused by the vast array of anti-inflammatory drugs now available, with new agents being added all the time. We present here an outline for a systematic treatment program that must be tailored to each patient's needs.

Subpopulations of peripheral lymphocytes in juvenile diabetes.

Subpopulations of peripheral lymphocytes were studied in 26 children with insulin-treated juvenile diabetes and in 27 control children of comparable age. T-lymphocytes were quantitated by spontaneous rosette-formation with sheep erythrocytes and B-lymphocytes by indirect immunofluorescence with the use of monovalent, fluorescein-labeled rabbit antiserum specific to the heavy chains of human IgG IgM, or IgA. No significant quantitative difference in subpopulations of the peripheral lymphocytes, T-cells, and B-cells with IgG, IgA, or IgM markers found between children with juvenile diabetes and the control group, although the B-lymphocytes with IgG or IgA markers tended to be higher and those with IgM markers lower in the diabetic than in the control group.

Isolation of P22 specialized transducing phage followong F'-episome fusion.

A P22 specialized transducing phage has been constructed which carries the structural gene for aspartate transcarbamylase (ATCase). This gene (pyrB) was first brought close to the P22 attachment site by fusing an F' pyrB(+) episome to an F' prolac episome which carries a P22 prophage attachment site. A prophage was added to these fused F' episomes and the lysogen was UV-induced.