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Asthma is a very common chronic disease among preschool children in primary health care. Research has shown that planned and systematic patient education positively affects the management of asthma by parents. This study focuses on the question of whether an asthma patient education protocol that is used by general practitioners (GPs) has an effect on medical care consumption. The treatment group consisted of 28 GPs, representing 47 asthmatic infants. The control group contained 18 GPs, representing 38 patients. Data were collected from medical records (with a written instrument) for a 12-month period preceding and after the intervention period in which the education protocol was tested. Results indicated that sociodemographic variables and pretest data on asthma severity and medical care utilization were largely comparable for patients in both study groups. Furthermore, the treatment group showed a significantly greater decrease than the control group from pre- to post-test measurement in the number of contacts with the GP and the number of emergency visits to the physician's office.

Since recent insights indicate that most patients with heart failure and a normal cardiac rhythm (HFNR) should not be treated with digitalis, we investigated the treatment policy of general practitioners in this respect. Our descriptive study consisted of a questionnaire followed by a computer based review of patient records of 14 family practices cooperating in the Registration Network of Family Practice (RNFP) and 10 'external' practices. All GPs (n = 51) received the questionnaire on the prescription policy of the GP and cooperating specialists, and on their experience with adverse effects of digitalis therapy. After 2-4 months the GPs of the RNFP (n = 41) received a floppy disc with an algorithm selecting from their problem lists patients with a registered diagnosis of heart failure. The external GPs (n = 10) received an algorithm selecting patients treated with digitalis, since their problem lists were not completely up to date. In all, data of 63,500 patients were examined. On anonymised standard forms, generated by the practice computer, the GPs provided data on the exact diagnosis, medication and adverse effects. Outcome measures of the study were: prescription attitudes (questionnaire) and actual digitalis use (in the selected cases). 33% of the GPs stated that they used digitalis as the preferred therapy of heart failure with normal cardiac rhythm; 30% of the 82 selected HFNR patients had digitalis, while in 42% of the 149 selected patients treated with digitalis a HFNR was registered. Adverse effects had been observed in 3 cases, but could not be excluded retrospectively in 70 cases (49%). Many GPs have not yet adapted their prescription behaviour to recently published insights. Development of a 'digitalis standard in general practice' is recommended.

An acute Sendai virus epizootic occurred simultaneously in a breeding colony, in experimental and stock animal rooms, and in a colony of aging mice. During the 2-month period that the infection was at its maximum, death rates were approximately doubled. In some strains, the preweanling death rate reached 100%. RFM and BALB/c mice were most susceptible and NZB mice least susceptible. The mortality during the period of Sendai virus infection was increased for most strains and age groups except for the oldest female RFM and NZB mice. Death rates during the epizootic were lowest in young adult mice (greater than 10 weeks of age) and highest in the very young mice (less than 10 weeks of age) and in the oldest male and the moderately aged female mice. Although a substantial number of older mice died during the epizootic, examination of the age-specific death rates indicated that the increase in deaths remained relatively constant for all ages over 10 weeks. This showed that the older mice were not more susceptible to Sendai virus infection. As a sequela of the epizootic, focal chronic pneumonia was found in 10-40% of the mice coming to necropsy even 1 year later.

Sendai virus infected a hysterectomy derived, barrier maintained breeding colony and a conventional aging rat colony. The virus produced seroconversion in the colonies followed by a 7-month period of decreasing titers. Clinical signs were absent during the months when titers were highest, and there was no increase in mortality, but multifocal interstitial pneumonia with perivascular and peribronchial cuffing by lymphocytes and plasma cells was present in rat lungs examined histologically. Such lesions were absent before the period of seroconversion. During the months of declining titers, the interstitial and perivascular lesions decreased in frequency and severity. The peribronchial lesions did not decrease, however, and were still present in many rats 7 months after the acute infection. Attempts to isolate the virus from weanling rats were unsuccessful.