The dangers of dairy farming: the injury experience of 600 workers followed for two years.

In order to better understand the work-related injuries sustained on central New York dairy farms, we undertook a two-year population-based study of 600 farmers and farm workers on 201 dairy farms. During the observation period, 1984-1986, 151 persons had 200 injuries, giving an injury rate of 16.6%/year (166 injuries/1,000 workers/year).

Primary lymphoma of the penis with rationale of treatment.

Appropriate care of a patient with primary lymphoma of the penis requires consideration of the diagnoses, thorough evaluation, and knowledge of the various therapeutic approaches. A patient is presented with brief review of similar cases together with the rationale for the use of radiation therapy and chemotherapy rather than surgery.

Cornstarch fermentation by the colonic microbial community yields more butyrate than does cabbage fiber fermentation; cornstarch fermentation rates correlate negatively with methanogenesis.

Fermentations of cornstarch and a cabbage-fiber preparation by human fecal suspensions were studied. The molar percent of butyrate of total short-chain fatty acid products was significantly higher when cornstarch was the substrate. Higher molar percents of butyrate were also produced from cornstarch as compared with endogenous substrate when rat fecal suspensions were used.

Effect of variation in infusion time and macrophage blockade on organ uptake of amphotericin B-deoxycholate.

Amphotericin B is administered as a colloidal suspension due to its insolubility in water. Macrophages, particularly those in the liver, have been implicated as the predominant cell type responsible for the uptake of colloidal amphotericin B. We examined the effect of infusion time and macrophage function to confirm the role of the macrophage in the uptake of amphotericin B.

Trauma experience of a rural hospital.

We sought to evaluate the ability of a small rural hospital with level 2 trauma capability to provide adequate care to the patient with multiple trauma. Using the TRISS method, we reviewed 163 patients with trauma admitted to our institution over 2 years. An outcome equivalent to those level 1 centers that contributed to the Major Trauma Outcome Study is documented.

Gentamicin pharmacokinetics in patients with malignancies.

The pharmacokinetics of gentamicin were investigated in 880 patients with leukemia (24 patients), other malignancies (211 patients), or no malignancies (645 patients) by using data collected by our Clinical Pharmacy Service. A significant difference was seen in the initial calculated creatinine clearance between the patients with leukemia and the other two groups. No differences in gentamicin pharmacokinetics were seen in patients with other malignancies versus those with no malignancies.

Comparative effects of an elemental and a complex enteral feeding formulation on the absorption of phenytoin suspension.

The effect of an elemental formula (Vivonex TEN) and a lactose-free complex formula (Ensure) on the oral absorption of a single dose of phenytoin suspension was determined in 10 normal volunteers. Following an overnight fast, subjects were randomly administered 400 mg of phenytoin suspension alone, phenytoin plus Vivonex TEN (unflavored), and phenytoin plus Ensure. The enteral feedings were given every 4 hours throughout the first 24 hours.

Increased iron absorption in uroporphyrin-treated rats.

Rats were given 59Fe (28 micrograms) together with doses of 0, 2 and 200 micrograms of uroporphyrin III in paired observations. Absorption of 59Fe was determined by comparing whole body counts of the rats 30 min and 7 days after dosing. Prior treatment with 200 micrograms of uroporphyrin twice daily for 3 days was associated with significantly increased 59Fe absorption of 6.

Isolation and properties of a fatty acid-binding protein from the Pacific lamprey (Lampetra tridentata).

1. A survey of 12 vertebrate species showed that palmitate was bound by an albumin-like serum protein in all classes tested except the dogfish and the lamprey. 2.

Prolonged nausea and vomiting associated with buprenorphine.

We conducted a trial to evaluate the histamine-releasing characteristics of morphine, meperidine, and buprenorphine when administered intravenously to 20 healthy adults without pain. Substantially more nausea and vomiting occurred with buprenorphine than with the other compounds, and was more intense on ambulation. High-affinity receptor binding may play a role in the long duration of nausea and vomiting after a single dose of this agent.

[Crisis in the American health care system].

According to Federal US law it is forbidden to reject patients or to curtail their care. The law may be seen as a democratic expression of the American people's wish to give all citizens access to the country's health services. Nevertheless it is estimated that millions of people in the USA wholly lack health insurance and very few of them succeed in paying their hospital bills.

Malakoplakia of the prostate.

Malakoplakia of the prostate is a rarely reported granulomatous inflammatory disorder which may clinically mimic carcinoma of the prostate gland. A case of a 70-year-old man, with long follow-up, is reported. Histologic diagnosis allows for effective antibiotic treatment.

Occupational health and the rural worker: agriculture, mining, and logging.

More than 50 million Americans live in rural areas. These rural residents often work for small businesses or in the extraction industries (farming, mining, and logging). Because of the size of the businesses, the mandate of the Occupation Safety and Health Administration (OSHA) does not cover these workers and they are seldom afforded the same protection as urban workers.

The effect of activated charcoal on phenytoin pharmacokinetics.

Study Objectives: To examine the effect of administration of oral activated charcoal with or without sorbitol on the elimination of phenytoin.

Setting: Emergency department of a rural teaching institution.

Type Of Participants: Eight normal volunteers.

Small bowel injuries following blunt abdominal trauma. Early recognition and management.

We reviewed the cases of 15 patients with intestinal perforation following blunt abdominal trauma, which occurred between 1971 and 1988. Twelve patients were treated at The Mary Imogene Bassett Hospital (Cooperstown, NY); three other patients were treated at surrounding area hospitals. These injuries included 11 motor vehicle accidents, three low-velocity impact injuries, and one blast injury.

Comparative bioavailability characteristics of commercial quinidine polygalacturonate and sulfate tablets.

This study compared the relative bioavailability characteristics of quinidine polygalacturonate (QP) and quinidine sulfate (QS) after oral administration of commercial tablets and a liquid form prepared from crushed tablets in 13 healthy adult male volunteers. Each subject received the following four single-dose treatments in a randomized, crossover manner with a one-week washout period between treatments: 400 mg QS liquid, two 200-mg QS tablets, 550 mg QP liquid, and two 275-mg QP tablets. All four treatments were equivalent in terms of the dose of quinidine base.

Medial external fixation with lateral plate internal fixation in metaphyseal tibia fractures. A report of eight cases associated with severe soft-tissue injury.

Eight patients with unstable fractures involving the articular surface and metaphyseal-diaphyseal bone of the proximal or distal tibia associated with severe soft-tissue injury or compounding wound were treated with irrigation, debridement, tetanus inoculation, antibiotic prophylaxis, and combined internal fixation with one-half frame external skeletal fixation for neutralization. All patients were followed to complete healing and functional restoration of the extremity. All fractures healed, but one superficial and one deep infection occurred.

Self-extubations. A 12-month experience.

Unplanned removal of an endotracheal airway tube by a patient (SXT) represents a potentially life-threatening incident. Prospective monitoring of all intubated adult ICU patients for one year revealed that 12 of 112 extubated themselves (overall incidence, 11 percent). Comparison of SXT patients with the NXT group disclosed no risk factors for this occurrence.

Systemic steroid therapy for acute gout: a clinical trial and review of the literature.

Nonsteroidal antiinflammatory drugs are frequently used as initial therapy in acute gout. In select cases, however, colchicine has been recommended as an alternative therapy. A review of the literature raises significant concerns regarding the cost to benefit ratio of using colchicine in this setting.

Pancreaticoduodenectomy for bleeding periampullary tumors.

Periampullary neoplasms with necrosis or ulceration may have potentially troublesome and occasionally life-threatening bleeding. Four patients required pancreaticoduodenectomy for control of bleeding; three had adenocarcinoma of the duodenum and head of the pancreas, and one had an ulcerated carcinoid tumor of the duodenum. In two of these patients, incomplete resection was performed, and in one there was evidence of metastatic disease to the liver.