Search

The efficiency of the Ziehl-Neelsen method for staining acid-fast bacteria was compared with that of the strip-staining procedure in which one kind of impregnated strip is used to stain the bacteria and another kind for simultaneous decolorization and counter-staining of the smear. The methods were evaluated in 1 136 duplicate smears prepared from digested sputum and 307 pairs of direct smears. The efficiency of the strip method was comparable to that of the Ziehl-Neelsen method with digested sputum; with direct smears, however, it generally depended on the quality of the smear. With thick, uneven smears, lower bacterial counts were obtained by strip staining. On the basis of this trial, the authors suggest improvement of the strip method.

A total of 2000 commercial chickens (1000 males and 1000 females) were used in an exploratory experiment designed to estimate the effect of two daily feed denial treatments (8 and 12 hr) extended from either 8 to 21 days or 15 to 28 days of age. Mortality was unaffected by these treatments. Body weight at 28 days was reduced, and feed conversion was improved by the feed denial treatments. The length of the daily feed denial period showed a greater impact than age of imposition, and the 12-hr daily denial time diminished the growth performance. At 49 days body weight and monetary returns were higher for the chickens exposed to the 8-hr daily feed denial treatment extending from 8 to 21 days compared with the control group (P less than .10).

The Winnipeg Children's Hospital child protection centre is a hospital-based provincial protection program that focuses on the diagnosis, treatment and prevention of child abuse and neglect in Manitoba. The multidisciplinary group of professionals working in the centre differs from most hospital-based teams in that it has a strong government liaison both functionally and financially, has strong ties to the welfare system and has legal counsel relating to the court system. The centre represents the philosophy that medical participation in welfare matters relating to children need not be relegated to the sidelines. This paper describes the centre's history and structure, and it outlines some of its research projects.

A prospective follow-up study was conducted to determine whether neonatal hypoglycaemia in infants of diabetic mothers affects subsequent neurological and intellectual performance. 37 such infants (25 hypoglycaemic and 12 non-hypoglycaemic) were examined for physical, neurological and developmental performance at an average age of 4 1/2 years. 11 children were abnormal, with generalised retardation and neurological abnormalities, or delays in particular areas of development; three children were possibly abnormal; and 23 children were normal. Abnormality at follow-up could not be related to neonatal blood glucose level, to the duration of hypoglycaemia or to any other measurement made in the neonatal period, nor to any factor relating to the maternal diabetes. Compared with the normal children, the abnormal group had slightly small head-circumferences at birth relative to their gestational age, but a follow-up there was no difference in head size. At follow-up the children of diabetic mothers tended to be shorter than average. The poor prognosis of the infants in this study was not due to brain damage caused by neonatal hypoglycaemia.

There has been an increasing number of older children adopted in Manitoba, Canada, often with adverse results because of early deprivation of the children concerned. 33 children from adoption "breakdowns" and 12 control adoptions were studied. Assessment was made of the time of placement, number of previous moves, development and intelligence quotients, and the behaviour pattern of the children. There were no differences between the control and adoptive breakdown groups with regard to the motivation of the adopting parents, the degree to which the adopted child was considered at risk, or the manner in which placement was carried out. Common to both groups was the difficult behaviour of the children which appeared to stem from early experiences of deprivation. Adopting parents should be told about the possible problems arising from environmental deprivation and appropriate counselling should be given before adoption and after placement. Specific policies in the placement of such high-risk children are given.

Apnoeic oxygenation (AO) combined with extracorporeal CO2 removal (ECCO2R), using venovenous perfusion across a membrane area of 0.1 m2 has been shown to be feasible in six healthy anaesthetized rabbits. In a further twelve rabbits, ECCO2R has been randomly compared with conventional mechanical ventilation (CMV) following saline lavage to induce respiratory failure. Blood gases were maintained for up to 6 h within the same range (PaO2 = 8-20 kPa, PaCO2 = 4-6 kPa) in two groups of six by varying airway pressures and the oxygen fraction delivered either to the membrane lung (ECCO2R group) or to the ventilator (CMV group). The influence of single hourly sustained inflations (SI) on oxygenation was studied. ECCO2R subjects remained stable and survived. CMV subjects deteriorated and had 80% mortality. Hyaline membranes were absent from ECCO2R subjects and present in all CMV subjects. The response to SI suggests that a lung volume recruitment is maintained during AO for up to 1 h but is ineffective during CMV.

A 12-year study has (1) assessed the predictive efficiency of a preschool test battery in relation to short- and long-term school achievement; (2) evaluated socioeconomic locale and operational school structure as indicators of subsequent progress; (3) observed the effects of some correctional experiences on later school performance. Almost 1,000 children have been involved; 606 remain in the project. Mental ages have ranged from 54 to 104 months though the mean chronologic age at school entry was 74 months. Twenty-three percent failed to complete first-grade requirements in the first year. Failure rates within separate schools ranged from three to 71% and had an inverse relationship to socioeconomic level. Within the middle-class area, children in an open-space school had double the failure rate of their peers in traditional classrooms.

Haemolysis of human blood has been examined in vitro as a function of pH in the range 7.2-8.0. The hydrogen ion concentration of freshly donated blood from 11 donors was manipulated in 42 experiments, entirely by altering the carbon dioxide fraction of air with which the blood was equilibrated using a membrane lung. In contrast to the known alkalaemic haemolysis which occurs in canine blood, we observed no correlation between plasma haemoglobin concentrations and blood pH. We conclude that alkalaemic haemolysis is unlikely to complicate the clinical application of extracorporeal carbon dioxide removal in the management of acute respiratory failure.

Twenty-two infants in whom hypoglycemia (blood sugar less than 20 mg./100 ml.) was noted during the first few days of life were followed up when eight to 30 months of age. In eight such symptoms as muscular tremors, cyanosis, apneic spells and convulsions were associated with the hypoglycemia; five of these had abnormal central nervous system signs and retarded development. One other had possible impairment of development and another had a recurrence of hypoglycemia after having been well for four years. Fourteen of the 22 infants had no symptoms associated with the hypoglycemia, and on follow-up only two of these showed possible impairment. The rest were normal.This preliminary study suggests that hypoglycemia associated with neurological symptoms in the newborn period carries a poor prognosis with respect to permanent neurological damage. Asymptomatic hypoglycemia may have a relatively good prognosis.

The experience of the Children's Hospital of Winnipeg from 1957 to 1971 with abused infants and children is presented with statistical data on 132 children. Details as to incidence, source and types of abuse are presented along with a discussion of the management of the problem. A follow-up study on a group of the abused children is also presented with comments directed towards some preventive measures.

In this investigation a simple urine test for phenotyping isoniazid inactivators is evaluated. In the new method, isoniazid is artificially acetylated in urine and determined by the same colour reaction as that used for acetylisoniazid. Comparative studies showed that the test is reliable and can be performed with accuracy and ease even in poorly equipped laboratories. In contrast to other urine tests, it does not require an expensive spectrophotometer, tedious hydrolysis processing of the samples, or standard curves. The results can be read on a plain colorimeter, or even without any instrument.