[sci.med] HICN232 News Part 3/5

ATW1H%ASUACAD.BITNET@oac.ucla.edu (Dr David Dodell) (09/05/89)

--- begin part 3 of 5 cut here ---
common rabid domestic animal,  rabies vaccination programs should target  cats
as well as dogs.
    Delaware, New Mexico, Alaska, Connecticut, and South Carolina reported the
greatest relative increases in animal rabies in 1988. The increase in Delaware
was  due  to  continuing  transmission  among  raccoons in one county that was
initially affected by the mid-Atlantic epizootic in 1987.  New Mexico  had  an
increase  in  rabid  skunks  in  several counties;  this increase was possibly
associated with an increase  in  the  skunk  population.  Similarly,  Alaska's
increase  was  a  result  of  periodic  increases  in  rabid red foxes and fox
populations  in  several  areas.   Connecticut's  large  percentage  increase,
however, was attributable to expected fluctuations in small numbers.  In South
Carolina,  some of the increase was a result of a  29%  increase  in  testing,
possibly  due to a new public-education campaign.  Other increases reported by
Florida,  Georgia,  and Pennsylvania were attributed to the spread of  raccoon
rabies in those states.
    The  mid-Atlantic  outbreak  began  two  decades  after  the  southeastern
epizootic (Figure 19) (1).  Although the number of rabid raccoons in the  mid-
Atlantic  epizootic has decreased steadily since 1983,  the number of affected
counties increases each year.  In 1988,  the sharp increase of rabid  raccoons
from  the  southeastern  epizootic  represented  the largest relative increase
(50%) in 10 years and may indicate further  spread  of  this  epizootic  after
several  years  of  relative  equilibrium.  Further spread of the mid-Atlantic
epizootic to highly populated areas of eastern Pennsylvania, Delaware, and New
Jersey, where raccoons commonly live in close proximity to people,  may result
in  large numbers of persons exposed to rabies.  In 1987,  the Delmarva Rabies
Initiative,  a  cooperative  of  state  and  federal  health,  wildlife,   and
agriculture  agencies,  established  a  zone of immune raccoons by vaccinating
raccoons along the Chesapeake and Delaware Canal to protect animal populations
in the southern part of the Delmarva Peninsula.  In 1988,  two rabid  raccoons
were  trapped  within  the  zone,  for  the  first time demonstrating that the
epizootic had reached this area; however, no rabid animals were found south of
the zone.
    Transmission of rabies from one domestic animal to another  rarely  occurs
in  the United States.  Dog-to-dog transmission may or may not be occurring in
the two Texas counties. Nevertheless, this epizootic emphasizes the importance
of maintaining high vaccination levels.
    Monoclonal antibody  analysis  of  rabies  virus  isolates  from  domestic
animals  have  demonstrated  that  most domestic animals are infected by bites
from the dominant terrestrial wildlife reservoir in the area (2).  The similar
distribution of rabid domestic animals to skunks and  raccoons  suggests  that
skunks are the main source of rabies for domestic animals in the North Central
and  South  Central  states  and  that  raccoons are the primary source in the
Middle Atlantic and South Atlantic states.  In addition,  the distribution  of
rabid  animals  by month suggests that skunks are the primary source of rabies
in cattle.  The seasonal peaks of rabies in skunks,  raccoons,  and  bats  may
reflect  increased  activity  (e.g.,  during  the  mating  season),  increased
likelihood of detection because of increased contact with people, or both.
    The two cases of imported canine rabies  emphasize  the  need  to  educate

Health InfoCom Network News                                             Page 20
Volume  2, Number 32                                      September  4, 1989

travelers  of  the  risk  of  canine  rabies in developing countries.  Persons
traveling to developing countries should use great caution when importing pets
from these countries.

References

1.  Jenkins SR,  Winkler WG.  Descriptive epidemiology from  an  epizootic  of
raccoon  rabies  in  the  middle  Atlantic states,  1982-1983.  Am J Epidemiol
1987;126:429-37.

2. Smith JS, Baer GM. Epizootiology of rabies: the Americas.  In: Campbell JB,
Charlton KM, eds.  Developments in veterinary virology: rabies. Boston: Kluwer
Academic Publishers, 1988:267-99.

3.  CDC.  Rabies Surveillance,  United  States,  1987.  In:  CDC  Surveillance
Summaries, September 1988. MMWR 1988;37(No. SS-4):1-17.

4.  Fishbein DB, Arcangeli S.  Rabies prevention in primary care:  a four-step
approach. Postgrad Med 1987;82:83-95.

5.  World Health Organization.  World survey of rabies XXII (for  years  1984-
1985).  Geneva:  World Health Organization, Division of Communicable Diseases,
Veterinary Public Health Unit, 1987.

6.  Zoonosis Control Division.  Rabies in  Texas.  Zoonosis  Update,  February
1989:1-2.

7.   CDC.  Imported  dog  and  cat  rabies--New  Hampshire,  California.  MMWR
1988;37:559-60.

8.  Helmick CG.  The epidemiology of human  rabies  postexposure  prophylaxis,
1980-1981. JAMA 1983;250:1990-6.

Health InfoCom Network News                                             Page 21
Volume  2, Number 32                                      September  4, 1989

===============================================================================
                                  Dental News
===============================================================================

               Dental News from the American Dental Association
                                    ------
    A new videotape and self-help manual entitled "Infection  Control  in  the
Dental Environment" is available.

A  videotape  series  and  training  manual,  "Infection Control in the Dental
Environment:  A Video Training Manual," is the result of the collaboration  of
the  Department  of  Veterans  Affairs  working with the ADA,  the Centers for
Disease Control,  the Food and Drug Administration and the National  Institute
of Dental Research.
    The  infection control training program includes a three-tape video series
and a study manual designed to  help  dentists  educate  their  staff  to  use
infection  control  techniques for all patients.  Step-by-step suggestions for
setting up an office infection control regimen for commonly  performed  dental
procedures are featured on the tapes.
    The  five organizations that produced the program reviewed the scripts and
rough cuts of the videotapes at each stage of production to  ensure  not  only
that  the  information included was correct,  but that it also agreed with the
agencies' own policies on infection copntrol.  The  program  was  designed  to
complement  existing  materials on infection control the agencies have already
provided to dentists.
    Funding from CDC, FDA and NIDR awill enable distribution of the program to
state and local dental societies;  dental schools;  dental hygiene,  assisting
and laboratory technician training programs; state and local health directors;
and all VA facilities throughout the country.

How to order

Individual copies of the program can be purchased for dental offices,  clinics
or hospitals for $75,  depending on  sales  tax  regulations  in  each  state.
Prices  are  higher for non-ADA-members.  To order the videotapes and training
manual, contact the ADA's saleable materials department, WATS ext. 2639.

                     Special care groups need coordination

A host of government-supported  and  private-sector  programs  and  activities
exist designed to boost access to dental care for special patients.
    These  diverse  groups  have  had  success in bringing oral health care to
traditionally underserved populations -- the  poor,  elderly,  physically  and
mentally  handicapped  and others.  What they lack,  though,  is a coordinated
effort clearly focused on common goals,  according  to  Dr.  Lawrence  Meskin,
speaking at the first National Conference on Special Care Issues in Dentistry.
    The  Federation  of Special Care Organizations -- composed of the American
Association of Hospital Dentists,  the Academy f Dentistry for the Handicapped
and the American Society of Geriatric Dentistry -- will join the ADA's Council
on Community Health,  Hospital, Institutional and Medical Affairs to develop a
strategic plan to coordinate activities to address the needs  of  the  special
patient.
    Dr. Meskin told conference members that a commitment to focus on universal
goals  is  mandatory  for  success.  He  urged planners to seek the counsel of
outside experts to develop the strategic plan.

Health InfoCom Network News                                             Page 22
Volume  2, Number 32                                      September  4, 1989

    Other speakers at the conference recommended the development of coalitions
on the national and grassroots levels  and  stressed  care  in  the  place  of
residence,  in  addition  to  improved  public  health education geared to the
special patient.

            Patients don't want to be treated by a doctor with AIDS

Most Americans said they would look for a new doctor if they found  out  their
family  physician  was  infected  with  the AIDS virus,  according to a recent
survey.
    A team of researchers at the University of  California  at  San  Francisco
interviewed 2,000 Americans nationwide,  seeking opinions about HIV infection,
the cause of AIDS.  Fifty-six percent of those called said they  would  change
physicians  if they learned their doctor had HIV infection and 25 percent said
they'd switch from a doctor they  believed  was  treating  patients  with  HIV
infection.
    The  latter  finding  is  especially  disturbing,  because  the  need  for
physicians from all specialties to provide care to AIDS patients  is  growing.
Some  doctors  are reluctant to treat HIV patients for fear it will hurt their
regular practice.  If healthy  people  shun  doctors  who  merely  treat  HIV-
infected  patients,  it  could  add to the growing burden of providing medical
care for AIDS patients, the researchers concluded.
    Interestingly,  many people who said they would leave the  practice  of  a
physician  infected  with  HIV  also  said  they  know  the  virus wouldn't be
transmitted through contact in the doctor's office.
    Even though knowledge about AIDS is growing  and  most  people  understand
that  the  infection  doesn't  spread  through casual contact,  survey results
demonstrate the need for more public education about AIDS.

                            Glove shortage abating

The acute national shortage of medical gloves, which increased sharply in l987
with stringent infection  control  measures,  has  abated,  according  to  the
American Association of Hospital Dentists.
    Foreign  and  domestic suppliers have increased their manufacturing output
to meet the escalating demand.  However,  purchasers are complaining that  the
quality of many gloves has substantially deteriorated.
    As  a  result,  the  federal government has initiated a regulatory process
that will lead to its testing batches of nonsterile patient examination gloves
and possibly seizing those that  prove  defective.  It  is  feared  that  this
impending  quality control crackdown by the Food and Drug Administration (FDA)
will rekindle the shortage.
    As of April l3, the FDA is revoking exemptions that applied to examination
gloves regarding filing of premarket notifications and compliance with current
good manufacturing practice regulations.  These  exemptions  were  granted  in
l980  because  no  adverse experiences had been related to patient examination
gloves.  Also,  the role  of  gloves  as  a  protective  barrier  against  HIV
transmission  was  not  the  public health concern it is today,  and the risks
associated with glove failure were not as well understood.
    Manufacturers now will be required  to  include  descriptions  of  product
testing,  methodology,  the standard employed in making the gloves, as well as
the "acceptable quality level."
    The FDA may reconsider reinstituting the exemptions  if,  over  time,  the
agency finds that gloves are meeting safety and effectiveness criteria.

Health InfoCom Network News                                             Page 23
Volume  2, Number 32                                      September  4, 1989

                     Oral complications of cancer therapy

The  oral  cavity  is frequently a common site of complications resulting from
cancer therapies.
    At a National  Institutes  of  Health  (NIH)  conference  held  in  April,
discussions focused on the most effective means of limiting oral complications
by  pretherapy interventions as well as strategies for the management of acute
and chronic complications arising during cancer therapy.
    The  consensus  development  panel,  consisting  of  representatives  from
medicine,  dentistry  and nursing,  evaluated scientific evidence presented by
experts in the management of cancer patients.  Pretherapy  intervention  There
is evidence that pre-existing oral pathoses unrelated to cancer or therapy may
increase  the  risk  of  oral complications.  Therefore,  a comprehensive pre-
treatment dental evaluation should  be  performed  before  the  initiation  of
cancer therapy.
    Pretreatment  strategies  include  evaluation,  treatment  of pre-existing
dental disease, prevention of oral mucosal infections, interventions to modify
salivary gland dysfunction and prevention of mucositis,  among others.  During
cancer  therapy  Oral complications occurring during treatment include mucosal
inflammation and ulceration, oral candidiasis,  bacterial and viral infections
and mucosal bleeding.
    There  is  currently  no  single  agent completely effective in preventing
therapy-related mucositis.  Patients at risk for oral herpes simplex virus may
benefit from the use of either oral or intravenous  acyclovir.  Topical  forms
of therapy for oral candidiasis include nystatin and clotrimazole.
    Severe  thrombocytopenia  may predispose patients to bleeding from routine
mechanical oral hygiene procedures.  In these patients,  dental plaque can  be
managed effectively by daily mouth rinsing with a chlorhexidine solution.

                           Following cancer therapy

Management  of  chronic  xerostomia  involves  a  combination  of  strategies,
including continuous maintenance of  effective  oral  hygiene  to  reduce  the
proliferation of oral pathogens, use of water or artificial saliva to keep the
mouth  moist,  and stimulation of residual salivary parenchyma to produce more
saliva.
    In the event that  dental  extraction  is  required  following  radiation,
meticulous  surgical  technique  and  antibiotic  prophylaxis  are  necessary.
Directions for the future  Emphasis  must  be  placed  on  devising  accurate,
quantifiable and reproducible criteria for assessing the oral complications of
cancer  therapy,  as  well  as establishing large-scale databases to determine
incidence, prevalence and risk factors for oral complications.
    The panel felt that the therapeutic team should be  multidisciplinary  and
sensitive  to patients' emotional and physical needs.  Through coordination of
committed members of  the  dental,  medical  and  nursing  professional,  many
research goals can be reached.

                        Danes get free dental check-ups

More  than one million edentulous Danes will be offered free oral examinations
this fall,  as part of the Danish Dental  Association's  contribution  to  the
campaign "Europe Against Cancer."
    A  publicity  campaign  has  been  launched and patient leaflets are being
distributed at clinics throughout Denmark.  At a  number  of  conferences  and
exhibitions,  the  Associaiton  is  seeking to draw patients' attention to the

Health InfoCom Network News                                             Page 24
Volume  2, Number 32                                      September  4, 1989

risk of oral cancer.  In the future,  the  education  of  dental  students  in
Denmark  will  feature a greater emphasis on prevention and early diagnosis of
oral cancer.

                         Dentsply supports 'glasnost'

Dentsply and the All-Union Scientific Industrial Association  Stomatologia  of
the  USSR  formed a joint venture for the production of dental products within
the USSR, the first venture of its kind in the dental industry.
    The joint venture will lead to the production of several  dental  products
within  the  Soviet  Union  and the sale of those products within the USSR and
other countries.
    The new enterprise will initially  produce  modern  composite  restorative
materials.  The products will be manufactured in Kharkov, USSR, in an existing
facility,  which  will  be  equipped with modern,  state-of-the art production
equipment and quality control laboratories.
    In addition,  Dentsply will establish educational centers in major Russian
cities  to  train Soviet dentists and dental laboratory technicians in the use
of the new products.  The company noted that there are  approximately  l20,000
stomatologists (dentists) and 40,000 dental laboratory technicians in the USSR
serving a population estimated at 280 million.

                               Civil war trivia

Thanks  to Dr.  Peter H.  Jacobsohn,  associate editor of the Wisconsin Dental
Association Journal, for the following:

During the American Civil War,  desertion by  soldiers  was  commonplace.  Men
left  the battlefield in large numbers and just went home.  Self-mutilation to
avoid the draft or to be discharged from front line duty was a problem seen by
both military recruiters and regimental surgeons.
    The destruction of anterior teeth was a common method used  to  avoid  the
draft  or  to  be transferred to non-combatant status.  The war weapon used by
the average soldier of the day was a  single-shot,  muzzle-loading  musket  or
rifle.  It required 11 separate steps to load and fire.  The first step was to
tear  open  a  paper cartridge with the incisor teeth.  Anyone unable to do so
because these  teeth  were  absent  was  unable  to  serve  as  a  front  line
infantryman.
    In  an  effort  to  discourage  the  practice  of  dental mutilation,  the
following announcement from the War Department appeared in local newspapers of
the time:
    "Those drafted persons who have knocked out their front teeth  to  procure
    exemption  are  informed that they will be accepted in the Cavalry,  where
    front teeth are not needed to bite off cartridges."

o American Druggist, a publication for the nation's pharmacists,  reported the
    most commonly dispensed prescription drugs in retail pharmacies for l988:

    l.  Amoxil                Infections
    2.  Lanoxin               Arrythmia/congestive heart failure
    3.  Xanax                 Anxiety
    4.  Zantac                Ulcers
    5.  Premarin              Menopause
    6.  Dyazide               Hypertension
    7.  Tagamet               Ulcers

Health InfoCom Network News                                             Page 25
Volume  2, Number 32                                      September  4, 1989

    8.  Tenormin              Hypertension/Angina
    9.  Naprosyn              Pain/Arthritis
    l0. Cardizem              Angina

Health InfoCom Network News                                             Page 26
Volume  2, Number 32                                      September  4, 1989

===============================================================================
                                    Columns
===============================================================================

                                 Black Bag BBS
                            =======================
                             Current as of 8/25/89

     The following list is a list of medical, fire/EMS, science, alcohol, AIDS
and disABILITY related bulletin board systems.  All have been  checked  within
the last twenty five days. You are granted the right to distribute the list in
electronic  form  as  long  as it remains unaltered.  Please remember how much
time and effort goes into this and abide  by  this  simple  yet  unenforceable
request.  Please  excuse  the  fact that it is one month late.....  I needed a
break from the modem.
     Please take the time to read the comments at the end of the list.

                                   Enjoy,

                            Edward Del Grosso M.D.
                     Black Bag BBS (150/140) 302-731-1998

           CIS : 71565,1532                   Genie  : E. DELGROSSO

          Name                 Number      Baud      Codes     LastCall
========================================================================
                           ***** ALASKA  *****

Alaska EMS                  907-789-1694  2400 8N1    F           8/14/89

                           ***** ARIZONA *****

St.Joseph Hospital (114/15) 602-235-9653  2400 8N1  *             8/14/89
Eye Net (114/14)            602-941-3747  2400 8N1  * O           8/25/89

                         ***** CALIFORNIA *****

LifeLine                    213-398-5433  2400 8N1  * L  CALAN    8/25/89
Legacy                      213-652-7537  1200 8N1  *    CALAN    8/14/89
Shrink Tank                 408-257-8131  2400 8N1  * P  CASJO    8/14/89
Non Smokers BBS             408-298-4277  2400 8N1  *    CASJO    8/14/89
MacScience BBS (143/36)     408-866-4933  2400 8N1  * S  CASJO    8/25/89
Recovery II   (125/9)       415-223-1119  2400 8N1  * L  CAOAK    8/14/89
Cowtown Lafayette           415-284-1872  2400 8N1  * S  CAOAK    8/14/89
Chemist's Comport (125/190) 415-359-6036  9600 8N1  * C  CASFA    8/20/89
Children's Hospital         415-428-3039  1200 8N1  *    CAOAK    8/14/89
Compuchem                   415-487-0310  2400 8N1  * X  CAPAL     GONE
California State EMS        415-499-7891  2400 8N1  * F  CASFA    8/14/89
AIDS Info BBS               415-626-1246  2400 8N1  * A  CASFA    8/14/89
Disabled Children           415-642-7387   300 8N1  * D  CAOAK    8/20/89
OASIS (Over Eaters)         415-658-5397  2400 8N1  *    CAOAK    8/20/89
Nightingale (10/475)        415-731-2422  2400 8N1  * R  CASFA    8/14/89
Friends of Bill W.          415-833-1780   300 8N1    L           8/25/89
Cowtown Berkeley            415-841-1411  2400 8N1  * S  CAOAK    8/25/89

Health InfoCom Network News                                             Page 27
Volume  2, Number 32                                      September  4, 1989

Baytalk                     415-864-6430  1200 8N1  * D  CASFA    8/14/89
Digex SDCS Disabled         619-454-8078  1200 8N1  * D  CASDI    8/14/89
Medical Management          619-532-9183  2400 8N1  *    CASDI    8/14/89
Balboa Naval Hospital BBS   619-532-8022  2400 8N1  *    CASDI    8/14/89
Survival Forum (125/7)      707-545-0746  2400 8N1    F           8/14/89
911 EMS                     707-664-1639  2400 8N1    F           8/14/89
COMP SEA                    714-865-8586  2400 8N1                8/25/89
12 & 12 Anonymous BBS.      714-539-8644  2400 8N1  * A  CASAN    8/14/89
Beckman Inst (103/524)      714-773-8818  2400 8N1  * X  CASAN    8/14/89
LLUMC Medical Lib (10/211)  714-824-4328  2400 8N1  *    CACOL    8/14/89
WellSpring                  714-856-7996  2400 8N1  *    CASAN    8/14/89
WellSpring Node 2           714-856-5087  1200 8N1  *    CASAN    8/15/89
Calif Self Help             714-952-2110  2400 8N1  * P  CASAN    8/14/89
Nine Lives                  805-836-8531  2400 8N1                8/14/89
The ARB Research Bulletin   916-324-6997  2400 8N1  *    CASAC    8/14/89
Project Disable (119/500)   916-343-3742  2400 8N1    D            GONE
RBBS BioMed                 916-362-4298  1200 8N1  * B  CASAC    8/14/89
CompuHelp                   916-786-3923  1200 8N1    D           8/14/89

                          ***** COLORADO *****

Nurse Link (104/52)         303-270-4936  2400 8N1  * R           8/14/89
P2 B2 S (104/51)            303-329-3337  2400 8N1  * P           8/14/89
The Watch Desk (104/66)     303-450-0822  2400 8N1  * F           8/14/89
Med Link  (104/444)         303-499-1022  2400 8N1  *             8/14/89
Deaf Net BBS                303-989-9245  1200 8N1  * D           8/14/89
SCI LINE  (128/48)          719-578-9127  2400 8N1    S           8/14/89
Fire Net Leader (128/16)    719-591-7415  2400 8N1    F           8/14/89

                         ***** CONNECTICUT *****

Handicap News (141/420)     203-337-1607  1200 8N1    D           8/14/89
Hippocampus (141/205)       203-481-7475  2400 8N1                8/14/89
Dr. Fido (141/315)          203-937-2686  2400 8N1                8/14/89

                          ***** DELAWARE *****

Black Bag BBS (150/101)     302-731-1998  2400 8N1            Call-ALWAYS

                      ***** DISTRICT OF COLUMBIA *****

Science Line 2              202-265-4496  2400 8N1  * S           8/14/89
American Otolaryngology     202-289-7338  2400 8N1  *             8/14/89
Science Line                202-328-5853  2400 8N1  * S           8/15/89
APGO                        202-466-2893  2400 8N1  * G            GONE
ACOG                        202-479-0005  2400 8N1  * G           8/14/89
Synapse (109/110)           202-543-9176  2400 8N1    D           8/14/89
American Inst of Bio. Sci.  202-628-2427  2400 8N1  * Q           8/14/89
Science Resources (NSF)     202-634-1764  2400 8N1  * S           8/14/89
State and Local EMS         202-646-2887  2400 8N1  * F           8/14/89
The Steps of DC (109/133)   202-659-5270  1200 8N1  * L           8/14/89
PIE                         202-872-9141  2400 8N1  * P           8/14/89
ShanErin (109/20)           202-941-8291  2400 8N1  *             8/24/89

Health InfoCom Network News                                             Page 28
Volume  2, Number 32                                      September  4, 1989

                             ***** FLORIDA *****

Medical Software Ex (135/3) 305-325-8709  2400 8N1  *             8/14/89
CG Medterm (135/8)          305-444-5615  2400 8N1  *              GONE
The Way Out (135/35)        305-445-6917  2400 8N1  * L           8/12/89
Metro Fire (135/14)         305-596-8611  2400 8N1  * F           8/12/89
Epics Division (135/9)      305-883-6892  2400 8N1  * X           8/14/89
The Firehouse BBS (135/53)  305-948-4382  2400 8N1  * F           8/14/89
UCF Health Topics (363/507) 407-281-5522  2400 8N1                8/14/89
Nurses Corner (363/15)      407-299-4762  2400 8N1    R           8/14/89
The Pharmacy BBS            407-363-1143  2400 8N1    M           8/15/89
Med Net                     407-433-3977  2400 8N1                8/14/89
The Firehouse BBS (3609/8)  407-439-0341  2400 8N1    F           8/14/89
Central Florida Psych       407-645-1658  1200 8N1    P           8/14/89
Central Florida TDD Info    407-657-7011  1200 8N1    D           8/14/89
Entropy                     813-264-6344  2400 8N1  * S           8/20/89
MACNET/MEDNET               813-377-7032  2400 8N1                8/14/89
APCO National RBBS          904-423-1312  2400 8N1    F           8/15/89
Medlink (3600/3)            904-431-1575  2400 8N1                8/15/89
Naval Hospital              904-452-6613  2400 8N1                 GONE

                             ***** GEORGIA *****

Psychology OnLine           404-252-8810  2400 8N1  * P           8/15/89
Atlanta Medical Forum       404-351-9757  2400 8N1  *             8/20/89
CDC Aids Info Line          404-377-9563  2400 8N1  * A           8/14/89
CEAM                        404-546-3402  2400 8N1    F           8/14/89
Middle GA Med.For (133/210) 912-477-8741  2400 8N1                8/14/89

                            ******* HAWAII ******

HAWAII EMS BBS              808-261-4268  2400 8N1    F            GONE

                             ***** ILLINOIS *****

Check Source  (233/13)      217-244-6954  2400  8N1   S           8/25/89
Sig Bio (233/4)             217-333-9660  2400  8N1   S           8/14/89
RBBS Biomed                 312-227-7455  1200  8N1 * B           8/20/89
COPH 2 (115/778)            312-286-0608  2400  8N1 * D           8/14/89
ENA BBS                     312-649-0490  2400  8N1 * R           8/14/89
Cope (115/777)              312-790-0187  2400  8N1 * D           8/14/89
Hazardous Management        312-972-3275  2400  8N1 * F           8/14/89
T.I.E.                      312-945-5575  2400  8N1 * S           8/25/89

                              ***** INDIANA *****

Testing Station             317-846-8917  2400 8N1    P           8/14/89

                                ***** IOWA *****

Anesthesiology BBS          319-353-6528  2400 8N1    N           8/14/89
Great Plains Hemophilia     319-356-1632  1200 8N1                8/14/89

                              ***** KANSAS *****

Health InfoCom Network News                                             Page 29
Volume  2, Number 32                                      September  4, 1989

Doc Talk                    913-588-1998  2400 8N1  *             8/14/89

                             ***** KENTUCKY *****

Operating Room              502-245-3516  2400 8N1                8/14/89
Fido Racer (11/301)         502-762-3140  2400 8N1    D           8/14/89
Science Spoken Here         606-233-5413  1200 8N1    S           8/14/89

                            ***** LOUISIANA *****

VICE (396/8)                504-286-7294  2400 8N1    D           8/15/89
Health Text                 504-456-9440  2400 8N1                8/14/89
Tulane Med Center  AIDS     504-584-1654  2400 8N1    A           8/14/89
Tulane Medical Center       504-588-5743  2400 8N1                8/14/89
The Fire Scene (390/2)      504-641-4789  2400 8N1    F           8/15/89
LA Medsig                   504-737-8173  2400 8N1                8/14/89

                             ***** MAINE *****

Maine EMS                   207-289-5336  1200 8N1    F           8/14/89
National Assoc. EMS         207-326-8800  2400 8N1    F           8/14/89

                             ***** MARYLAND *****

The Firefighter Sig         301-229-9570  2400 8N1  * F           8/25/89
MIEMSS                      301-328-3842  1200 8N1    F           8/14/89
Maryland Med Sig (261/1039) 301-332-7386  2400 8N1                8/20/89
Fusion Connection           301-353-6167  2400 8N1  * S           8/14/89
IMEEC                       301-433-4833  1200 8N1    X           8/20/89
Science Lab                 301-444-0551  2400 8N1    S           8/15/89
AAPT Physics Teachers       301-454-2086  2400 8N1  * S           8/20/89
Maryland  Fire (261/1047)   301-536-1935  2400 8N1    F           8/25/89
EPA Superfund and Hazard    301-589-8366  2400 8N1  * F           8/14/89
HEX  TDD                    301-593-7033  300  8N1  * D           8/14/89
HEX                         301-593-7357  1200 8N1  * D           8/14/89
Nerve Center (261/1000)     301-655-4708  2400 8N1    D           8/14/89
--- end part 3 of 5 cut here ---