Acute anterior poliomyelitis: a review of our present knowledge, with illustrative cases

There are few diseases of early life that present so many interesting problems as does Anterior Poliomyelitis, and there are still fewer in which our knowledge As to causation and prevention has made so little advance in spite of the many and thorough investigations which have been made into the spontaneous disease in the human subject.It was not until comparatively recently that the association was noted between the obscure early symptoms of this disease, and the flagrant resultant paralysis. Poliomyelitis, seven years ago, was not definitely classed as an infectious disease: and it is only within the last few years that extensive research has been made into the pathology and cause of this important scourge to infant life.Unfortunately, there is little in the early febrile stage to distinguish this, from the many other feverish attacks so common during childhood, and it is only when the devastating paralysis supervenes that the true nature of the complaint is made evident. As a result of this, the disease - except in epidemic form, when the profession is exceptionally alert to the possibility of infection - is rarely diagnosed in the early stages; and therefore the practitioner's efforts are mainly palliative.The child is crippled, and in order that everything may be done to prevent or lessen deformity, the case is transferred from the physician to the orthopaedic surgeon. In consequence, the medical aspect of such case has beer apt to be overlooked. Within the last few ears, however, progress has been rapid; epidemics have been prevalent, and skilled observers have studied every aspect of the affliction. Foremost in the field we find Wickman, M ller and Flexner, to whom we are indebted for much of our present knowledge. The disease has been produced experimentally in monkeys, and it has been found that in these animals, the clinical results and pathological findings correspond with great accuracy to those found in man. Attempts to transmit poliomyelitis to other animals have been unsuccessful.The preliminary fever has been conclusively proved' to be the first expression of the disease, and should an effective treatment be discovered in the future, it is to this pre -paralytic stage that our efforts must be directed. We at present possess no such remedy.As we have just seen it is of great importance to the patient that we diagnose his case early, but an early recognition of poliomyelitis must be encouraged for another reason.It has been proved beyond doubt that the dise ;se is of an infective nature, and consequently any attempt at isolation should be commenced in this stage: if this quarantine be rigorously carried out, much distress and suffering may be averted.There is also a certain class of case which causes much confusion, and is of great danger to the community at large. This is the abortive type of the disease, when the patient never develops paralysis at all, but is just as contagious to his neighbours as if he did so.We are unable to state in what proportion these abortive cases occur, for they are rarely diagnosed except in epidemics and then only with absolute certainty if the neutralisation test be resorted to, a proceeding which is not often practicable.The literature on this fascinating disease is normous, and in the following pages a brief attempt will e made tt ree¡ee,our present knowledge on the subject, and to give special attention to its clinical and experiental aspects. Several cases which have been under he author's care are detailed at length towards the end of this exposition.One case being of exceptional value, as the disease roved fatal and at the post mortem the cord was removed and sections of this were cut. Microphotographs of the most interesting of these are reproduced.Another case of some rarity is that of a man, aged 22 years, proving that the disease is by no means limited to the very young, as was formerly believed.NOMENCLATURE: This affection has at various times had many names, and perhaps a list of the most important would be of interest. These include; -1. Essential paralysis of children. Rileict and Barthez, 1853. 2. Infantile spinal paralysis, Heine, 186x. 3. Myogenic paralysis. Bouchert, 1862. 4. Anterior spinal paralysis. Cornil, /863. 5. Atrophic fatty paralysis of children.Duchenne, 1864. 6. Acute anterior poliomyelitis. Schultze, 1876. 7. Polioencephalomeningo myelitis. Cadwalder, 1908. 8. Epidemic paralysis. Ball, 1909. 9. Acute epidemic paralysis. Krause, 19e9.The names that survive today and are in common use, re- Heine' s - Infantile Spinal Paralysis, and Schultze' s cute Anterior Poliomyelitis

Persuasion as a Prelude to Proof: Theory Acceptance in Accounting Research

In his 2013 presidential scholar address to the American Accounting Association, Michael Jensen, an early author of agency theory, makes an appeal for a new language and new paradigm to introduce his proposed theory of integrity in accounting. In the 1970s, agency theory was promoted over other theories because it demonstrated empirical evidence of the accounting procedures actually used in practice, compared to those that “should” be used according to established rules (see Jensen and Meckling, 1976). Contrarily, in this paper, we show scientific theories (Latour, 1987), and in particular accounting theories, are actually accepted by a larger persuasion than just the empirical evidence. The early empirical evidence on agency theory was often not even statistically significant. As Jensen now demonstrates, consistent with Latour (1987), this persuasion begins with a new language and a new world view, and continues with a strategy of properly framing expectations for the data outcomes and the empirical evidence

A real-time simulator of a turbofan engine

A real-time digital simulator of a Pratt and Whitney F100 engine has been developed for real-time code verification and for actuator diagnosis during full-scale engine testing. This self-contained unit can operate in an open-loop stand-alone mode or as part of closed-loop control system. It can also be used for control system design and development. Tests conducted in conjunction with the NASA Advanced Detection, Isolation, and Accommodation program show that the simulator is a valuable tool for real-time code verification and as a real-time actuator simulator for actuator fault diagnosis. Although currently a small perturbation model, advances in microprocessor hardware should allow the simulator to evolve into a real-time, full-envelope, full engine simulation

GP planning in a pandemic

There are a number of good reasons why GPs will need to be prepared for pandemic influenza (PI). These include: workload/business continuity, medico-legal, ethical and personal reasons

Monitoring Hoary Marmots: Matching Objectives to Available Effort

Monitoring provides information necessary for managers to make informed decisions related to the status of populations. However, collecting sufficient data to reliably detect trends in abundance over a large area is costly in time and resources. Instead, detecting changes in distribution may be a more feasible goal, while still providing useful information. Hoary marmots are alpine obligates, patchily distributed throughout the mountains of western North America. This species requires deep winter snowpack to survive during winter and populations at the edges of their distribution are most likely to be vulnerable to changes in climate. We sought to design a monitoring plan that could identify changes in distribution of hoary marmot populations. We used occupancy methods to create a predictive habitat map for hoary marmots in western Montana. We evaluated designs that could be implemented by existing staff or with 2 dedicated technicians and assessed tradeoffs in the number of sites and surveys needed to detect a change in distribution. We also evaluated the effort needed to sample throughout Montana or within selected mountain ranges. Based on our analyses, managers will need to complete surveys at ?65 sites at least twice a season and without dedicated technicians, the area sampled will be limited. Hoary marmots likely will be negatively impacted by climate change, especially in isolated mountain ranges at the southern extent of their distribution. Assessing the magnitude of these changes will be impossible without sufficient data, highlighting the importance of identifying monitoring objectives before data collection begins

ASPREN surveillance system for influenza-like illness - a comparison with FluTracking and the National Notifiable Diseases Surveillance System

Public health surveillance systems are fundamental to the prevention and control of infectious diseases. Data obtained by sentinel surveillance systems may be used to inform public health decision making, priority setting and subsequent action

A microprocessor-based real-time simulator of a turbofan engine

A real-time digital simulator of a Pratt and Whitney F 100 engine is discussed. This self-contained unit can operate in an open-loop stand-alone mode or as part of a closed-loop control system. It can also be used in control system design and development. It accepts five analog control inputs and its sixteen outputs are returned as analog signals