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Nasal lavage was compared with nasopharyngeal aspiration for diagnosis of respiratory syncytial virus infection. Nasal lavage and nasopharyngeal aspiration were performed on 50 occasions in 32 infants (median age 5.6 months) with acute viral wheezing. Compared with nasopharyngeal aspiration, nasal lavage had a positive predictive value of 95.6% and negative predictive value of 92.5%. These comparable results and lack of adverse effects make nasal lavage the preferred method.

DNA isolated from biopsies of endemic Burkitt's lymphoma (BL) from New Guinea was analysed for the presence of Epstein-Barr virus (EBV) sequences using the polymerase chain reaction. Primers were designed to amplify sequences within the Epstein-Barr virus nuclear antigen (EBNA) 1 and 2 genes. These analyses detected the EBNA1 sequence in all the biopsies studied. Additional sets of primers directed against the EBNA2 gene were used in order to categorize the EBV strains as A-type or B-type (39% A-type; 50% B-type; 5% A- and B-type; 5% untypeable). These results indicated that DNA sequence heterogeneity within the EBNA2 gene region may exist in different strains of EBV. The extent of DNA sequence heterogeneity among different strains of EBV was determined by sequencing of a region within the EBNA2 gene in a number of different A-type and B-type strains of EBV originating from Africa or New Guinea. The results demonstrated DNA sequence heterogeneity within the EBNA2 gene in different strains of EBV. This heterogeneity was more extensive among A-type strains than B-type strains of EBV.

Eighteen patients with chronic low back pain were interviewed before and after a programme of conservative treatment and again 4 months later. Measures were made of severity and attitude towards disability, including the Kelly Repertory Grid. The best predictor of improvement was the degree of meaningfulness of the concept 'self in pain' as measured by the Repertory Grid.

Ethopharmacological procedures and a two-compartment black and white test box were used to examine behavioural effects produced by the benzodiazepine receptor inverse agonist, methyl-6,7-dimethoxy-4-ethyl-beta-carboline-3-carboxylate (DMCM), when given by intraperitoneal injection (0.4 and 1.0 mg/kg) to pair-housed adult CD1 male mice. Control mice received injections of the solvent. Behaviour in the light-dark box was examined at 30 min after the injection and behaviour during encounters with an untreated group-housed male, in a neutral cage, was then assessed by ethological procedures. In dominant mice, aggressive behaviour was significantly reduced and the ratio of flight, relative to aggression received, was significantly increased by DMCM at 0.4 mg/kg. At 1 mg/kg but not 0.4 mg/kg, DMCM decreased time spent by dominant mice in the light compartment of the test box. In both dominant and subordinate mice, flight was increased by DMCM at 1 mg/kg to a level close to statistical significance. Treatment with DMCM had no other detectable effect on the behaviour of subordinate animals. It is suggested that anxiogenic activity of this compound might induce a shift of agonistic behaviour from aggression to "fear-induced flight".

A multivariate clustering technique known as the Andrews Plot was applied to a set of previously published data describing a series of pharmaceutical tablet formulations. Dependent variable data were subjected to a trigonometric transform algorithm and unique sinusoidal patterns were obtained for each of 18 formulations characterized by a total of 12 granulation and tablet parameters. Three main formulation clusters were observed in close agreement with a previously published analysis of the same data set using principal components methodology. Interpretation of cluster behavior lead to conclusions closely aligned to those of the original investigators, although some alternate hypotheses also arise. Limitations of the Andrews plotting technique were explored. The method appears to have value in the analysis of complex data sets derived from pharmaceutical formulation characterizations.

The author records his views about the future of medical rehabilitation. He reports some of the evidence on which to advocate the psychosomatic approach for the management of all disease and injury prone to chronic morbidity. As the causes of distress are multiple, clinical service is required from a multiprofessional team. The success of outcome is to be judged in the social adaptation achieved, recognising that this is influenced by such intangible concepts as morale and motivation.

The paper by Gaudette and Keeping on "An Attempt at Determining Probabilities in Human Scalp Hair Comparison" in the Journal of Forensic Sciences (Vol. 19, No. 3, July 1974, pp. 599-606) has provoked considerable controversy. This paper highlights two of the sources of the controversy and shows how the probability, 1/4500, quoted by Gaudette and Keeping should be treated with caution. The necessity of the use of a likelihood ratio statistic is described. It is suggested that the hair examination form resulting from the responses to the questionnaire recently distributed by the authors and also the discussions at Quantico (Proceedings of the International Symposium on Forensic Hair Comparisons, 25-27 June 1985, Quantico VA) should be used to facilitate the collection of the data which will be necessary to enable a likelihood ratio statistic to be estimated effectively.

Inter- and intralaboratory reproducibility of susceptibility testing requires stable control strains. The Food and Drug Administration diffusion procedure recommends the Seattle strains of Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922) for this purpose. It was of interest to determine the present reproducibility of control cultures maintained in various laboratories over several years. Fifteen cultures each of S. aureus and E. coli were obtained from laboratories in different parts of the country. Their performance was compared with strains directly derived from ATCC. Diffusion susceptibility tests using a modified overlay technique were made with four replicates. Seven of the eight statistically significant differences in responses of the staphylococci were to penicillin, methicillin, or cephalothin. One culture was a penicillinase producer with a zone 15 mm less than the standard strain. Eleven of the 15 cultures showed no significant deviations or differences greater than 2 mm from the results with the strain derived directly from ATCC. All except the penicillinase producer were of identical phage type. Among 150 organism-antibiotic combinations tested with E. coli, all but one reading were within 2 mm of the standard. Four of the six statistically significant differences were in a culture from one laboratory. The stability of the cultures appears to have been influenced by the method of storage. Cultures that were kept frozen during extended storage were remarkably stable. Significant differences were found in cultures from four of five laboratories that maintained cultures in refrigerators or at ambient temperature.

Psychosomatic medicine embrances the influence of psychological factors on the development and course of diverse physical symptoms. Reasons are given why it is recognized that physical morbidity is influenced by such factors, with illustrations from the authors' research on acute ischemic heart disease, peptic ulcer and bronchial asthma. The nature of the psychological factors can be elucidated with the use of recently developed psychometric tests; these relate particularly to mood disturbance, either attributable to affective disorder or prominent personality traits. To insure that samples studied are representative of the disease or symptom being considered, and that all relevant variables are taken into account, the research approach usually necessitates a multidisciplinary team.

There is an apparent diversity of opinion with respect to the probative value of hair in the United Kingdom and in North America. A questionnaire was devised and widely circulated in an attempt to discover the reasons behind this diversity and to seek the views of a broad range of hair examiners. This paper reports on the statistical analyses of the answers to the closed form questions. The majority of replies to most questions favored the number of categories given in the questionnaire. The general impression is that U.K. scientists tend to want fewer categories for classification of microscopic features than the North Americans. The largest divisions of opinion concerned pigment distribution and density and the medulla, where North American scientists want more categories for classification and the U.K. scientists fewer. The implications of these results in the choice and description of features to be examined in human hairs is considered in the second paper concerned with this questionnaire.

Broth dilution minimal inhibitory concentration (MIC) readings were compared after different incubation periods and with different inoculum concentrations. The purpose was to determine the best conditions for obtaining early results as close as possible to overnight readings. Initially, 76 antibiotic-organism combinations were tested using the International Collaborative Study technique and inoculum and were read after 3, 8, and 18 h of incubation. Approximately 28% of tests showed fourfold or greater increases in MICs after 18 h of incubation compared with the 3-h readings. No overnight MICs were lower than early readings. MICs of single antibiotics against seven organisms were also read with an automatic particle counter to confirm the validity of the visual readings. Experiments were made to determine whether inoculum manipulation could reconcile the differences between 3- and 18-h MIC results. One hundred and eight organism-antibiotic combinations were tested comparing 3-h MIC readings using an inoculum of 10(7) organisms per ml with overnight readings using 10(5) per ml. In 71 cases, readings with both inocula were within the range tested and 57 (86%) were within +/-1 log(2) of each other and followed an approximately normal distribution. Improved comparability between early read and overnight MICs thus may be achieved by inoculum manipulation, and this may be a suitable approach in the future development of automated procedures.

In the developed world, comprehensive services for disabled patients are usually well established for children and elderly people. Services for rehabilitation of middle-aged patients generally consist of specific treatment facilities, such as for physiotherapy. On the other hand, a range of services of psychiatric patients is now established, with a model suitable for most disorders. Arrangements are flexible, ranging from crisis intervention to long-term care, in some places being remarkably comprehensive and well coordinated. There is a need to plan development of medical and social services for patients prone to chronic morbidity from whatever cause; this plan for the physicially disabled should take account of their many needs, and of the many facilities now available, some statutory, some voluntary. There is reason to believe that redeployment of resources existing in many countries could improve the standard of medical rehabilitation for patients of all ages.

The pathogenesis of psychosomatic distress is considered. This emphasises interest in aetiology of distress rather than solely of disease. The influence of psychological aspects is as important whether the disease is of known or unknown aetiology, and can be of greater importance in poorer socio-economic circumstances. The doctor's role is to tease out the influence of these many factors. Certainly a holistic approach is necessary to assess and manage appropriately patients with disability. There is an important role for psychiatrists within services for management of such patients. Leadership by all doctors and psychiatrists in particular to apply the holistic approach should be encouraged.

It used to be fashionable to begin consideration of psychosomatics about philosophy of mind and body. Nowadays it is a topic about health and practical care of patients--principally about the psychological aspects of any illness. Pathogenesis is becoming understood with some risk factors clearly identifiable. The high incidence of symptoms attributable to emotional disturbance has now been described in so many conditions that it is altering the delivery of health services. The boundaries of psychosomatics are extending. No longer is the topic confined to a few chronic diseases, even including new ones like AIDS, but it now includes support for carers and education about behaviour for health, to name two currently important aspects. The responsibility for the biopsychosocial approach does not lie alone with doctors, and certainly not only psychiatrists, but the many professionals involved in clinical care. The aim is not simply reducing symptoms, but improving functional capabilities and preventing social disadvantage. The more the advance of knowledge, the more intriguing become the questions awaiting answers. The risk factors due to predisposition or unhealthy behaviour and stress still only account for a small contribution to aetiology. Coping mechanisms, whether in personality or social support, still defy enough understanding to predict which patients will develop emotional disturbance, and which patients will respond to appropriate treatment. Perhaps, the most intriguing question is why, when certain relevant facts about unhealthy behaviour are beyond dispute, such as the effect of drinking excessive alcohol, smoking nicotine, having unsafe sex, poor family caring or receiving insensitive treatment, it remains so difficult to bring about improvement.(ABSTRACT TRUNCATED AT 250 WORDS)

The initiatives raised by the International Year of Disabled Persons led to an understanding that the community may well be the best place to help disabled people. It is important to ensure that any major switch of resources from institutional to community care should be properly appraised, not just on cost-effectiveness grounds but also on the needs of the disabled persons themselves. Apart from the traditional medical input there is an imperative need to involve other professional and informal helpers to ensure the best possible outcome.

Three enzyme immunoassays were used for the serodiagnosis of Trypanosoma evansi in camels in the Sudan in order to evaluate their ability to discriminate between infected and non-infected animals. Two assays were used for the detection of trypanosomal antibodies, one using specific anti-camel IgG conjugate and another using a non-specific Protein A conjugate. The third assay detected the presence of trypanosomal antigens using anti-T. evansi antibodies in a double antibody sandwich assay. Inspection of the frequency distribution of assay results suggested that the ELISA for circulating trypanosomal antibodies using specific antisera and the ELISA for circulating antigens can distinguish between non-infected camels and infected camels exhibiting patent infections or not. The ELISA using Protein A conjugate to bind non-specifically to camel immunoglobulin did not appear to discriminate between infected and non-infected animals.

Comments received in response to a questionnaire seeking opinion about hair examination have been considered. The questionnaire was in two parts: the first was concerned with the description of microscopic features and the second with the use of numerical features and data sheets in hair examinations. The same format is used to present a synopsis of the many individual comments and suggestions contained in questionnaire returns. It is argued that a hair examination form can contribute to more effective hair examinations although not replacing direct side-by-side comparisons. A hair examination form is presented with recommendations for its use.