Community-based outbreaks of tuberculosis.

Numerous recent reports have detailed outbreaks of tuberculosis in hospitals and other congregate settings. The characteristics of such settings, including high concentrations of infectious patients and immunocompromised hosts, the potential for sustained daily contact for weeks and often months, and improper precautions taken for protection, make them well suited for tuberculosis transmission. However, community-based outbreaks, which are the source of much public concern, have not been reviewed since 1964, when 109 community outbreaks were examined.

Antimicrobial effects of granulocyte-macrophage colony-stimulating factor in protein-energy malnutrition.

Objectives: To evaluate, in a murine model of protein-energy malnutrition, whether granulocyte-macrophage colony-stimulating factor (GM-CSF) improves the host response to a septic challenge and to determine the potential mechanisms involved.

Design: Nonblinded study of GM-CSF in mice with protein-energy malnutrition.

Setting: A university-based surgical laboratory and animal facility.

Physician reluctance to discuss advance directives. An empiric investigation of potential barriers.

Background: To determine the relative impact of five proposed barriers to physician usage of advance directives with the aim of increasing the number of advance directives generated.

Methods: Questionnaires were sent to 460 internal medicine resident and attending physicians at a large New York, NY, hospital. Of these, 277 (60%) responded.

Improvement in visual function after displacement of the retinal elevations emanating from optic pits.

Objective: To define the functional deficit that correlates with the inner layer separation and the outer layer detachment that have been observed in optic pit maculopathy and to determine the effect of a gas tamponade that compresses or displaces the two layers.

Design: The central visual field before and after a gas tamponade on the posterior pole were charted on a 1-m tangent screen and compared with the changes in the retina observed biomicroscopically and with stereophotography.

Setting: The gas operations were done at four hospitals in the New York, NY, area and one in Cleveland, Ohio.