The clinical significance of the fastidious organism DF-3 isolated from stool cultures is unclear. We sought to improve our understanding of this organism and to further define its association with human disease. Stool cultures for DF-3 were obtained from three sources: an ongoing study of enteric pathogens in patients infected with the human immunodeficiency virus, a screening procedure in which all stool samples submitted for Clostridium difficile toxin assay were cultured for DF-3, and stool samples submitted specifically for DF-3 culture. Retrospective clinical data were obtained from chart reviews of patients with positive cultures. Antimicrobial susceptibility testing and cell wall fatty acid analysis were performed for each DF-3 isolated. Eight isolates of DF-3 were obtained over a period of 8 months. All patients either had severe underlying disease or were immunocompromised, including three patients coinfected with human immunodeficiency virus and two patients with inflammatory bowel disease. The spectrum of clinical disease ranged from chronic diarrhea with a well-defined response to therapy for DF-3 to an asymptomatic carrier state. Cell wall fatty acid analysis of these isolates demonstrated a consistent pattern with a large peak of 12-methyltetradecanoate. DF-3, a fastidious gram-negative coccobacillus, can be recovered from stool cultures of immunocompromised patients
It would be well if every physician could analyze his own habits, customs, traits, and strong and weak points as a self-administered critique along the lines suggested in this book. Some of the things considered are what the patient offers to the doctor and the doctor's responses ; elimination of inappropriate diagnoses by the physical examination ; the incidence and evaluation of neurotic symptoms ; the various levels of diagnosis ; the collusion of anonymity among doctors; general practitioner and consultant, and the perpetuation of the teacher-pupil relationship. In the realm of psychotherapy, topics considered are advice and reassurance, how to start, when to stop, the special psychological atmosphere of general practice, and the general practitioner as psychotherapist. In various places we find the general practitioner's resistance to the advice and fortnulations of psychiatrists. With further discussion and better insight, fair compromises are reached in many areas well off the beaten path from ordinary general practice. I find very little to quarrel with in this extremely thoughtful book, which represents a great advance in doctrine and practice and points hope¬ fully to a closer rapprochement between physicians and psychiatrists. It is very refreshing to find a psychiatrist who admits ignorance and the need for research. If more psychiatrists would advance from their defensive posture into this inquiring attitude, they would regain their place of respect in the field of medicine.
Summary The characteristics of the allergen producing asthma caused by inhaled miller moth particles were investigated by skin testing and by Sephadex fractionation. No major difference in skin test reactivity was found between the wings and the bodies of the moths. Two fractions of the moth extracts were found to contain allergic reactivity. The importance of detailed history‐taking in order to discover such causes of asthma is stressed.
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