The papers on HLA and mate choice, by Hedrick and Black (1997), who studied South Amerindian tribes, and by Ober et al. (1997), who studied the relatively closed and partially inbred Hutterite populations, as well as the invited editorial by Beauchamp and Yamazaki (1997), point out the conflicting evidence for this potential relationship and some of the possible reasons for it. I would like to suggest an alternative approach. My colleagues and I have shown that there is a relationship between recurrent spontaneous abortion and genes linked to HLA-DR and between unexplained infertility and genes linked to HLA-DQ (Gill 1992; Jin et al. 1995). It is important to note that the data showed that genes linked to the genes encoding HLA antigens-and not the HLA genes themselves-are involved in these associations between HLA and reproductive defects. The same conclusion has been proposed for the association between HLA and susceptibility to rheumatoid arthritis (Dizier et al. 1993), between HLA-DR and HLA-DQ and insulin-dependent diabetes mellitus (Clerget-Darpoux et al. 1991; Dizier et al. 1994), and between HLA and multiple sclerosis (Francis et al. 1991). I propose that the potential association between HLA and mate selection may reside in the HLA-B-DR-DQ region and that this association should be explored in detail. Inclusion of the HLA-A locus in the analysis can obscure this potential effect considerably (Ho et al. 1994). Hedrick and Black (1997) typed only for HLA-A and HLA-B, and Ober et al. (1997) did not give the details of the genetic structure of the haplotypes in the various mating combinations. The latter group, however, has published on the relationship between HLA-DR and fertilization or implantation in the same Hutterite populations (Ober et al. 1992; Ober 1995); thus, it seems reasonable that, if mate selection has an association with genes in the HLA complex, these genes may reside in the HLA-B-DR-DQ region. If a relationship between the major histocompatibility complex (MHC) and mate selection is borne out in humans , it may reflect an evolutionary reproductive drive to avoid homozygosity for MHC-linked recessive reproductive genetic defects (Gill 1997a, 1997b). It is interesting to speculate that this type of evolutionary drive may also be the basis for the near-universal human taboo against incest.

Objective:Pulse oximetry has been recognized as a promising screening tool for critical congenital heart disease (CCHD). The aim of this research was to study the feasibility of implementation in a community hospital setting.Study Design:Meetings were conducted to determine an implementation plan. Pulse oximetry was performed on the right hand and foot after 24 h of age. Newborns with a saturation ⩽95% or a ⩾3% difference were considered to have a positive screen. Screening barriers, screening time and ability to effectively screen all eligible newborns were noted.Result:From January 2009 through May 2010, of 6841 eligible newborns, 6745 newborns (98.6%) were screened. Of the nine infants with positive pulse oximetry screens, one had CCHD, four had CHD and four others were determined to have false positive screens. Average screening time was 3.5 min (0 to 35 min).Conclusion:Pulse oximetry can be implemented successfully in community hospitals without an excessive number of false positives or additional nursing staff.

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These findings suggest that some cardiovascular complications during ECMO are more common than previously thought, and cardiovascular complications may adversely impact outcome.

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Although blood cultures remain the most specific indicator of Group B streptococcus (GBS) sepsis, a potentially life-threatening infection in neonates, test results may not be available for 24 to 48 hours. Detection of GBS antigen in the urine by latex particle agglutination (LPA) may speed diagnosis. This study analyzed the sensitivity of the GBS urine LPA assay under clinical conditions. The urine of neonates with early-onset GBS bacteremia was analyzed for GBS antigen over a three-year period at six military medical centers. Overall, 53.5% (38/71) of infants with positive blood cultures had a positive urine LPA test. Only one medical center routinely followed manufacturer's recommendations to concentrate urine specimens before testing. These data suggest that the sensitivity for the urine LPA assay, when performed on unconcentrated urine, is lower than previously reported. Clinicians should insist that the laboratory maximize sensitivity by concentrating urine prior to GBS LPA testing.