Fatal meningitis and encephalitis due to Bartonella henselae bacteria

Bacterial infection due to Bartonella henselae commonly develops in children and young adults following cat/dog contacts and/or cat/dog scratches. Regional lymphadenopathy is its most common clinical expression. However, encephalitis and Parinaud's syndrome (oculoglandular syndrome) have also been reported as has systemic illness. A review of the international literature in all languages revealed no fatal complications in immunocompetent hosts. A four-year-old white child with no underlying illness began to have seizure-like activity. She was taken to a local hospital and subsequently transferred to a medical center. The child was treated aggressively for seizures and fever of unknown origin. However, her condition rapidly declined and she died without a specific diagnosis. At autopsy there was marked cerebral edema with no gross evidence of acute meningitis. Microscopic exams revealed multiple granulomatous lesions as well as a meningitis and encephalitis. A variety of cultures and stains were negative for acid fast and fungal organisms. Warthin-Starry stains of involved tissue including brain and liver revealed pleomorphic rod shaped bacilli consistent with Barronella henselae. Analysis of brain tissue with polymerase chain reaction (PCR) and Southern blot for the deoxyribonucleic acid (DNA) was definitive for DNA of Bartonella henselae bacteria.     

Punched with a fist: the etiology of a fatal depressed cranial fracture

We report a case in which a 33-year-old man was discovered unconscious following a fistfight with another man. Emergency neurosurgical efforts to repair a depressed temporoparietal skull fracture and associated brain injuries were unsuccessful. The forensic anthropologist and pathologist worked in tandem to sort out a complex combination of cranial evidence, including healed antemortem trauma, perimortem blunt force trauma, remote and recent neurosurgical intervention, and the craniotomy cut performed at autopsy. The victim had suffered head injuries and a right temporoparietal craniotomy ten years prior to death. The perimortem cranial fractures were centrally located within a surgically repaired roundel of bone involving portions of the right temporal and parietal bones. Reportedly, the victim was punched on the right side of his head as he was lying on the ground with the left side of his head against an asphalt surface. A primary question in the case was whether a blow with a fist could have produced the observed cranial injuries. To adequately answer that question, known data on the minimum amount of force required to fracture the temporoparietal region were compared to data on the amount of force generated by a blow with a fist. A biomechanics expert demonstrated that a single blow with a fist to the rigidly supported head of the victim could generate the required force to produce the observed fractures. The previous medical condition possibly predisposed the victim to the cranial fractures and contributed to the depressed nature of the fractures. Although depressed cranial fractures do not typically result from a blow with a fist, it was determined in this case that the fracture pattern was consistent with a punch to the head.     

IMPLEMENTING AN EMPLOYMENT AND TRAINING PROGRAM FOR FOOD STAMP RECIPIENTS: DILEMMAS AND CHOICES

The food stamp legislation of December 1985 provided another opportunity to experiment with welfare to work reform, this time through employment and training programs for food stamp recipients. This new program can be seen both as an opportunity to move people toward self-sufficiency and as a bundle of programmatic contradictions which threaten that opportunity. Federal requirements for the program are described as are the dilemmas to which they give rise. These dilemmas concern program coverage of food stamp recipients, utility of the program components, the use of sparse funds, and the incorporation of such values as the harmonization of programs, administrative simplicity, and fairness to food stamp recipients.     

For a Few Dollars More: Public Trust and the Case for Transporting Nuclear Waste in Dedicated Trains

The debate about the use of dedicated trains for shipping spent fuel and high level nuclear waste has been going on for the past 15 years. The nuclear industry and its regulatory agencies would like to consider the case closed. The recent passage of the Hazardous Materials Transportation Uniform Act of 1990, however, opens the door once more, giving the railroads and other proponents of dedicated trains another chance to present their case. This paper argues that earlier conclusions favoring regular trains over dedicated trains were based on incomplete cost and risk information and neglected other factors which are not technical, but social and institutional in nature. The paper finds that the additional cost of a dedicated system is lower than previously thought and concludes that it is a small price to pay for reduced public opposition and increased levels of trust.     

Pluralistic programming and radio diversity: a review and a proposal

While radio is America's most abundant medium, its content is characterized more by sameness than by diversity. Stations find it more profitable to duplicate mass appeal programming formats than to program to minority tastes. Such rational business decisions come at the expense of the listening audience which is given few formats from which to choose. The regulatory system, which speaks to the value of program diversity, has been unsuccessful in creating effective incentives to foster radio diversity. The article suggests a novel approach to radio regulation that combines economic incentives with new methods for identifying audience preferences such that a profit-maximizing radio industry would serve more tastes than are presently served.An earlier version of this paper was presented to the Mass Communication and Society Division of the Association for Education in Journalism, Boston, August 1980.