Document OZdxa5gbL5rYb0OeoZ6JzD2K

FROM: TO: pit- Dr. Sunshine Mr. Burgess MEMORANDUM o Th e Ac a d e my o f Me d ic in e o f Cl e v e l a n d 10515 CARNEGIE AVENUE CLEVELAND 6, OHIO TELEPHONE: CEdar 1-5500 October 1962 For Your Information * )D 9fi l)u xS.C/^L^J JUKsLl aJ The Paint Eaters >n Us current issue, the Ciuversily Med-ei*e; Close-up tells about young chil- 4'tn :i> poorer Cleveland neighborhoods wh<. eat peeling pamt off houses and con tract lead poisoning U recites details worth repetition "If undetected or unchecked they ac cumulate a level of toxicity in their systems which can exptode in the presence of a minor infection The resulting violent re action of acute lead poisoning can end in permanent brain damage or death. " A partial victory has been achieved in a war on Jead poisoning which has been waged for the past five years in Cleveland. From 1151! to 1958 there were 17 deaths from this cause in the city; there have been no deaths in the past 2'* years. But more casej of leas poisoning are being reported all the time.' Tbe work of the Poison Information Center and other agencies has been intpres- aive. ip making people aware of tbe danger and in overcoming poison. Bu'. there is still much to l>e ckne.. In the "paim eating season" this sum mer. as we understand it, four children a! mos* were fatalities, being brought through only by superior medical work. If they had died, you-can imagine the outcries The tact that the' were "near tnissei' shojid not Mind our eyes to the pessior.it> 'tint one v, more of th* four -- and ottim ihiidier. n< I s< seven ly stri^ker -- might nave s'lii'cec bran; damage which will be at: affliction .`cm them and also a community resijomibi'it;. lo' the >>st of thri; lives f he pamt which causes fouble is old coat? with a high lead content which im proved ne-.ve; nviiiures don't hive Inci dcm.- ot poisoning is InvahxeS in slums and near-slums, wherr maintenance- is poet and where young children are not watched closely and may have dietarv deficiencies. As we ie said much good work has bem;. done in diagnosis and treatment But should there nof now be a concerted dnve at the other end of the problem--to strive to ehrr.ir ale all th* peeling paint in side and ouUiue older horses'' An amendment may be ir> order for the il ICleveland housing code, creating penalties fagainst the ;e wh.> allow peeling paint to go ujuoucheej h- human Hand8 except for youngsters If landlord1. other property owners and pa-ents were sit made aware th.,' peeling paint is potentials as danger- ou.v as an unused refrigerator, numbers of ' ehikirth micht be saved from permanent merits', handicap* And mspeetton- by hous ing cheAeri should pay er* attenttor tr w- peeled piim -_______--' GLD38102 i A THIRTY MINUTE MOVIE in color which gives a skillfully condensed and highly graphic pres entation of an examination of the human eyfc is the first of a series of such features to be produced at the University Medical Center to aid in the teaching of third year medical students. Director of the produc tions, Dr. Gerald T. Kent, has called upon the resources of experts in each field and teaching materials from four hospitals affiliated with the WRU School of Medicine. . A grant of $50,000 from the Republic Steel Cor poration has made possible the scheduling of five movies over a two year period. "The Examination of the Eye", with Dr. Charles I. Thomas, professor of ophthalmology, has been completed, "The Neurologi cal Examination", with Dr. Joseph M. Foley, professor of neurology, is more than half finished, and work has started on "The Skeletal Examination", with Dr, Charles H. Herndon, professor of orthopedics. Still in the planning stage arc features on the respiratory system and the cardiovascular system. The movies are designed to supplement and to bring a degree of uniformity to the regular curriculum in physical diagnosis, which is the largest single course in the medical school, with some 40 instructors teach ing at University Hospitals, Cleveland Metropolitan General Hospital, Highland View Hospital and Crile VA Hospital. A vast amount of material, roughly the equivalent of 10 to 15 lectures, is being processed for use in each film by Dr. Kent, associate clinical professor of medi cine, who is in charge of the teaching of physical diagnosis, Dr. Edward M. Chester of Metropolitan, associate professor of clinical medicine. Dr. Norman P. Shumway of Crile, professor of clinical medicine and Dr. Leif G. Suhrland of Highland View, assistant pro fessor of medicine. About 30 camera sessions are needed for each production. Impact of the filmed demonstration is increased with extensive use of visual aids in addition to action shots of physician and patient. This makes possible a presentation of the normal and the abnormal and detailed sketches of anatomical background and patho logical lesions. In some instances, the camera follows the examining instrument right into the body opening. Only routine diagnostic procedures arc shown, although the producers feel that future films done on a higher technical level would have seal value for use in the post graduate area. Considerable interest has been expressed by other medical schools in obtaining copies of the films for incorporation into their own teaching programs. AN UNUSUAL PROGRAM in medical educa tion which has attracted much attention since it was set up by the WRU School of Medicine and Univer sity Hospitals has swung into its second year of GLD38103 tfNivmrrY*Em btMUfidHor .,.* fwnt tetter fctooitftknlnf :.&***.***** V.: '- .... f MOfHMIS Of CUM&AND ."... ... ,.. vtakwH* HaapMtl : *,v .. - : 5? yjr^-^BWlTrVifHc n* >.-*- -v v y*-jteitwtrdOMm*Hotpttd .-' ,v . i ' ' ` Vpli.najtu. --w1n ^no--1t,,i *n o- tp n -ii -.. ,,_____ _ JAwnw Owteni) ft. Ohio ^ ftfelwn* Mndodih 1-7000.CxL>39 f l liiniiMTilb^iifemiii~~ M ' operation with every indication that it is fulfilling the original hopes of its sponsors. Designed to prepare young physicians for a career in academic medicine with responsibilities in the areas of research and patient care, the plan enables the Department of Medicine to give a group of its resi dents and graduate fellows at least two years of graduate training in basic science in another department or insti tution, returning them then to the department for further training in internal medicine. The program is supported by a five-year, $435,000 grant from the United States Public Health Service. Advantages of the project to both the department and the men involved are many. It provides depart ment heads with an opportunity to develop the best type of fellowship training needed for a faculty posi tion in a medical center. It enables the trainee to get an individual program of research going early in his career. Flexibility of the program is illustrated by the second year appointments which were announced recently. Dr. Ralph Wieland, who has been a house officer and a graduate fellow in the department, will receive support to continue another year in the laboratory of Dr. Hans Hirschmann, professor of biochemistry in the Department of Medicine, working in the field of steroid chemistry on some of the hormones secreted by the adrenal glands. His next year in the department will be divided between laboratory and clinical work. Dr. Irving Kushner, who has been on the medical service of Cleveland Metropolitan General Hospital for several years, will spend a year at the Institute des Recherches Scientifiques in Villejuif, France, working on an analysis of some of the constituents of carcinoma of the stomach. He will return to Metropolitan for research, teaching and clinical experience in the Arthritis Clinic there. Three men appointed when the program started arc beginning their second year of research in Medical Center laboratories. Dr. George Naff is attempting to purify a component of human blood serum in the De partment of Pathology, Dr. Shelley Beard is doing research on proteins and enzymes in the Department of Biochemistry and Dr. Thomas Daniel is studying THERE IS NO MYSTERY about the cause of lead poisoning in children. Its victims, usually from one to three years of age, nearly always live in run down residential areas where there is a minimum of parental supervision. They eat the paint chips peeling off of sills and walls. If undetected or unchecked they accumulate a level of toxicity in their systems which can explode in the presence of a minor infection. The resulting violent reaction of acute lead poisoning can end in permanent brain damage or death. A partial victory has been achieved in a war on lead poisoning which has been waged for the past five years in Cleveland. From 1952 to 1958 there were 17 deaths from this cause in the city; there have been no deaths in the past two and a half years. But more cases of lead poisoning are being reported all the time. Health authorities take satisfaction from the fact that most of these cases are of a milder variety, that symptoms are being detected at a time when it is still possible to prevent dangerous complications. They are inclined to credit a joint effort on the part of several local agencies with a good job of educating the medical profession and the public to the dangers of lead inges tion. Gt_D36104 Vi Joining forces in the drive against lead poisoning are The Cuyahoga County Coroner's Office, the Cleveland City Health Department, the Academy of Medicine Poison Information Center, University and Cleveland Metropolitan General Hospitals and WRU School of Medicine. A series of studies defining the sources of lead poisoning and pinpointing the areas of the city where it might be expected to occur was done with the cooperation of the departments of Preventive Medicine, Medicine, Pharmacology, and Pathology of the Medical School and the Cuyahoga County Coroner's Office. A vigorous educational campaign has been carried out at two levels by the staff of the Poison Information Center. To alert the medical profession to early signs oflead poisoning, articles have appeared in local medical journals, talks have been given to medical societies, and house staffs of all Cleveland hospitals have been briefcd.fi The causes and dangers of lead poisoning have beenjj brought home to the public by radio and televisions talks, discussions with area councils and PTA groupsjf and exhibits circulating through several neighborhoods) THE FIRST OPPORTUNITY for nurses in the Cleveland area to receive graduate training in psychi atric nursing will open up when the Frances Payne Bolton School of Nursing initiates a course in that field, probably within the next year. The School has received a mental health training grant of $20,000 from the United States Public Health Service to develop such a program and will get it under way as soon as a director is appointed and a curriculum is organized. Paralleling this future development of psychiatric nursing specialists will be a project developed by the School to define the appropriate psychological and social content ofgraduate programs in other fields of nursing specialization. Another USPH A grant of $20,500 will support this pilot study. Once the desired curriculum content has been determined, the School will embark on an intensive short-term training program for faculty members currently teaching in other specialties. ONE WAY TO FIND OUT what type of aspirin is most readily absorbed into the blood stream is to watch television commercials. Another way is ito follow the experimental course taken by Dr. Jack R. Leonards, which comes up with rather more reliable answers. Dr. Leonards, associate professor of biochemistry in the WRU School of Medicine, has been engaged for several years in research into two aspects of acetylsalicylic acid metabolism, the process by which different types of aspirin products achieve their effect in treating headaches, mild arthritis pains, muscular aches and fever. He is tracking scientifically the rate at which they pass through the human intestinal tract into the blood stream and is attempting to determine how undesirable side effects can be avoided. Very careful studies are being done on all types of aspirin products by giving normal human subjects the usual dose of two tablets or their equivalent and taking blood samples at regular intervals to check up on the amount of drug present. Aspirin causes intestinal bleeding in some people, usually in amounts so small it is unnoticed and is very hard to detea. Dr. Leonards is using the sensitive tool of radioactivity to follow this process. He is injeaing radioactive red blood cells into a group of volunteer subjects who then take varying doses of aspirin pro ducts. Their stools are checked for radioactivity, which gives an accurate index of the presence and extent of any bleeding. According to Dr. Leonards, the results on this phase of his work have been very encouraging. Observations made to date indicate that if aspirin is dissolved in water before being taken., bleeding will not result. Dr. Leonards is now working on developing a liquid form of aspirin which will allow for an adequate dosage of the drug without the undesirable side effects of stomach upsets or intestinal bleeding. GLD38105 Q3X$3ft69tf NtfAlHJ ,,dfl'3$013,, H31N33 IV 310 3 W A1ISM3 AINft 3H1 JO onssj M9f| HjlOA SI 3H3H %^ WHO 0HVT3A3T0 s o o t av artonj ooou QNVT3A3T0 JO rtyJLWSOH UlfJOAlHO j u is o n n o 3Aajsaa h h u s j m mm V EXPLORING THE POSSIBILITY that multiple sclerosis may be triggered by a viral infection is the goal of an important research project by Dr. Joseph M. Foley and Dr. William A. Sibley which is being underwritten by a three-year, $65,000 grant from the National Multiple Sclerosis Society. Dr. Foley, professor of neurology in the WRU School of Medicine and director of the division of neurology in University Hospitals, has a background of activity in the field of multiple sclerosis. Dr. Sib ley, assistant professor of neurology, has already done much laboratory work developing the skills and tech niques which will be needed in the study. Multiple sclerosis is a seriously crippling disease which attacks the tissues sheathing the spinal cord, interfering with the pattern of nervous impulses and causing visual troubles, staggering, loss of balance, weakness and other neurological symptoms. It is gener ally known as a disease of young adults, although bodr children and older people can be stricken. At present both the cause and the cure arc unknown. There is considerable evidence that multiple sclerosis may be related to a virus infection. Dr. Foley cites the fact that there is a higher incidence of the disease in areas where viruses, especially respiratory viruses, are more common. He also points out that there is a natu rally occurring disease, post infectious encephalomye litis, which can follow mumps, chicken pox and other virus diseases, whose lesions look something like those of multiple sclerosis. The possibility that multiple sclerosis could be a perverted form of the body's immunity mechanisms stems from observations that multiple sclerosis patients develop in their spinal fluid an increased amount of gamma globulin, the factor in blood and body fluids which is thought to carry the reaction of immunity. Science has already shown that there is a relationship between streptoccocal infection and rheumatic fever. What Dr. Foley and Dr. Sibley are seeking is an organism which might have the same relationship to multiple sclerosis. Under the study setup, the doctors take blood monthly from multiple sclerosis patients, putting the samples in the deep freeze and testing the serum to see if there axe viral antibodies present which would indicate a previous infection. When a multiple sclerosis patient gets a virus disease, all the other collected bloods will be checked to see if the other patients may have had an immune reaction to that virus, with no symp toms present. GLD38106