IME does not permit for a review of the literature on the treatment T of viral and rickettsia1 infections with chemical and antibiotic substances. The results of such investigations have been reported recently by several groups of workers.In this preliminary report are presented some of the data obtained with the newly described antibiotic, Aureomycin, in experimental infections of embryonated eggs, mice, and guinea pigs with the agents of lymphogranuloma venereum, psittacosis, murine typhus, epidemic typhus, Rocky Mountain spotted fever, Q fever, rickettsialpox, and scrub typhus. Materials and MethodsIn most instances the antibiotic was resuspended in one-twentieth molar phosphate buffer pH 7.0. Buffered suspensions of this type, conttining 5 mg. of Aureomycin per ml., have a final p H of 6.8. Any solution left over mas usually discarded, although subsequent studies indicate that if the unused material is frozen immediately, the potency appears unimpaired for at least 2 weeks.Chemotherapy Experiments in Eggs. The following method was used to determine if the chemotherapeutic agent under investigation showed antiviral or antirickettsial activity. Seven-day-old embryonated hens' eggs were inoculated into the yolk sac with 0.2 ml., containing the desired dosage of Aureomycin. The control group received the samc amount of buffered saline. Thirty minutes later all groups of eggs were reinjected into the yolk sac with 0. I ml. of the various ten-fold dilutions of infectious inoculum. All dilutions of the infectious inoculum mere made with cold 0.1 per cent casein solution, pH 7.0, and all inociilum dilutions were kept refrigerated until used. All eggs were sealed with collodion, stored in an incubator at 96" F. and candled a t least once a day for a total of 13 days.In most instances, deaths of embryos before the fourth day were considered to be non-specific and were not included in the analysis of the results. All embryos dying on the fourth day and thereafter were thoroughly examined for the presence of elementary bodies or rickettsiae, using yolk-sac or amniotic-sac smears stained by the Macchiavello method. All embryos surviving after the 13th day were examined in the same manner. 290 1 Wong & Cox: Rickettsia1 & Viral Infections 291Chemotherapy Experiments in Mice. Swiss albino mice, weighing from 14 to 16 grams, were infected by the intracerebral or intraperitoneal route with 0.03 ml. or 0.25 ml., respectively, of an appropriate dilution of infectious inoculum. Aureomycin was administered to mice by mouth or injected subcutaneously, usually in a single dose given once a day. Mice treated orally were given the drug by means of a 1 or 2 ml. tuberculin syringe fitted with a round-end 18 gauge needle, 1% inches long. The mice were grasped firmly by the back of the head and turned over with the head, slightly elevated, held away from the operator. The full length of the needle was slid slowly past the esophagus into the stomach and the required amount of Aureomycin was then given. Chemotherapy Experiments in GuineaPig...
Pregnant women should receive information about what they might expect to experience during their delivery. Despite this, research shows many women are inadequately prepared for anaesthetic interventions during labour. We surveyed 903 postnatal women across 28 Greater London hospitals about: the analgesic and anaesthetic information that they recalled receiving during pregnancy and delivery; their confidence to make decisions on analgesia; and their satisfaction with the analgesia used. Wide variation was observed between hospitals. Overall, 67 of 749 (9.0%) women recalled receiving antenatal information covering all aspects of labour analgesia, and 108 of 889 (12.1%) covering anaesthesia for caesarean section. Regarding intrapartum information, 256 of 415 (61.7%) respondents recalled receiving thorough information before epidural insertion for labour analgesia, and 102 of 370 (27.6%) before anaesthesia for caesarean section. We found that 620 of 903 (68.7%) women felt well enough informed to be confident in their analgesic choices, and 675 of 903 (74.8%) stated that their analgesia was as expected or better. Receiving information verbally, regardless of provider, was the factor most strongly associated with respondents recalling receiving full information: odds ratio (95%CI) for labour analgesia 20. 66 (8.98-47.53; p < 0.0001); epidural top-up for caesarean section 5. 93 (1.57-22.35; p = 0.01); and general anaesthesia for caesarean section 12. 39 (2.18-70.42; p = 0.01). A large proportion of respondents did not recall being fully informed before an anaesthetic intervention. Collaboration with current antenatal service providers, both in promoting information delivery and providing resources to assist with delivery, could improve the quality of information offered and women's retention of that information.
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