1317handwashing studies show that chlorhexidine hand cleanser is an easy, practical method of removing such organisms from the hands of staff, and these findings agree with those of Lowbury et all" who studied alcoholic solutions for the preoperative disinfection of surgeon's hands.The reduction in klebsiella colonisation or infection of newlyadmitted patients that coincided with increased staff handwashing, and which was sustained over two-years, provides perhaps the most convincing evidence that hands are a major, but correctable, route of transmission for Klebsiella spp.Transmission of klebsiellae from hands explains several epidemiological features of klebsiella infection we have previously observed in this ward. It explains how the serotypes contaminating food may be transmitted from the bowel of a colonised patient to clinical lesions in others, and why food types relate to patient-isolates on this ward as a whole while individual patients do not always acquire the strain that they have themselves ingested. Furthermore, such a route of transmission would contribute, via cross-infection, to the "clusters" of clinical infection and colonisation with the same serotype that we observed between 1969 and 1973. Hands may also be an important route of transmission in types of hospital-acquired klebsiella infection of obscure epidemiology, such as the spread of gentamicin-resistant klebsiella strains. Medical_Journal, 1977, 2, 1317-1319 Summary A double-blind controlled study of the effect of piperazine oestrone sulphate on sleep, depression, anxiety, and hot flushes was performed in 34 perimenopausal women. Half of the patients were given six weeks' placebo followed by eight weeks' oestrogen, and half remained on placebo throughout. Sleep was recorded electrophysiologically every week, and mood and anxiety were rated daily by means of visual analogue scales. Hot flushes were counted daily. Observer rating scales of anxiety and depression were completed at intervals.During the first month of active treatment the amount of intervening wakefulness in the first six hours of sleep decreased significantly more in the oestrone group than in those on placebo. Between the baseline period and the second treatment month the oestrone group showed a significantly greater decrease in the total amount of intervening wakefulness and in the frequency of awakenings. Their total amount of rapid eye movement sleep increased. Mood and anxiety improved and the number of hot flushes decreased to a similar degree in both groups.Although oestrogen did reduce the number of episodes of wakefulness in perimenopausal women complaining of insomnia, its effects on their psychological symptoms were little different to those of placebo.
2. Bullough. W.S. (1948) Mitotic activity in the adult male mouse Mus niusculrrs L. The diurnal cycles and theL relations to waking and sleeping. I?acredhw oJ'rlic Royal Sociery. Series B, 135,212-233. 3. Halbcrg, I:., Zandcr. H.A., Houglum, M.W. k Miihlemann. H.R. (1954) Daily variations in tissue mitoses, blood eosinophilr and rectal temperatures of rats. American Journal of Physiology. 111, 361-366. 4. Halberg. C., Calicich. J.H., Ungar, C. k French, L.A. (1965) Ckcadian rhythmic pituitary adrenocorticotropic activity, rectal temperature and pinnal mitosis of starving, dehydrated C mice. Proceedings of the Society for Experimental Biology and Medicine. 118.4 14-41 9.
In the course of the past few years, a series of related studies (Aserinsky and Kleitman, 1955; Goodenough et al., 1959; Wolpert and Trosman, 1958) has demonstrated beyond doubt the association of normal dreaming with the appearance of rapid, binocularly synchronous eye-movements. It has also been claimed that the rapid eye-movements (REMs) represent scanning movements made by the dreamer as he “watches” the visual events of the dream (Dement and Kleitman, 1957a; Dement and Wolpert, 1958). The REMs are absent during dreaming among those with life-long blindness, but are retained for some years by those whose blindness arises later than childhood (Berger et al., 1962a). In a study of undisturbed nocturnal sleep by Dement and Kleitman (1957b) periods of eye-movements were observed to occur fairly regularly at about 90-minute intervals throughout the night in association with the lightest phases of cyclic variation in depth of sleep, as indicated by the electroencephalogram (EEG). These REM periods had a mean duration of about 20 minutes, and 4–6 occurred per night.
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