No abstract

In a study of the phagocytosis of staphylococci by human leukocytes it has been observed that strains of staphylococci producing human infection were phagocytized by human polymorphonuclear leukocytes in vitro under conditions in which virulent pneumococci, streptococci, or Klebsiella were rarely engulfed. In the presence of human leukocytes in plasma there was a rapid fall in the numbers of viable staphylococci of both pathogenic and non-pathogenic strains, the beginning of which was detectable in 10 to 15 minutes. The fall in culturable pathogenic microorganisms was considerably less marked, however, and a rapid resurgence of growth occurred in 4 to 8 hours, whereas the number of culturable non-pathogenic microorganisms remained low for 18 to 24 hours. These differences appear to be explained by the observation that a significant number of microorganisms of pathogenic strains were able to survive within human leukocytes. Such intracellular survival was found to be associated with evidence of destruction of the leukocytes. In contrast, non-pathogenic strains of staphylococci failed to survive within human polymorphonuclear leukocytes following ingestion.

Introduction: This literature review summarises the current evidence on

Despite increased numbers of medical-school graduates and opportunities for "primary-care" specialty training since the mid-1960's, many believe that the shortage of physicians delivering generalist care will continue through the 1980's. Missing, however, is solid information on the role of physician specialists in providing such care. Two national studies have shown that one of every five Americans now receives continuing general medical care from a specialist physician. Our study suggests that, despite the current shortage of generalist-physician services, continuing specialist participation in primary care will lead to sufficient generalist medical services by the mid-1980's. Whether specialist participation is the most appropriate or cost-effective way to improve access to such care is unclear. However, until this question is resolved, more governmental regulation of graduate medical education may be unwise. Offering all physicains, regardless of specialty, more primary-care experience during residency training might better deal with this aspect of American medical practice.