In a prospective study of 9,503 parturients during the past 47 months, 12.3% were colonized with GBS. 25 infants born to these mothers developed GBS disease (attack r a t e 2.611000 l i v e b i r t h s ) .195 mothers delivered a t 4 3 2 weeks gestation. 664 mothers experienced premature membrane rupture (PROM). Colonization with GBS among these groups of p a r t u r i e n t s = 32% and 20% respectively.The incidence of preterm labor a t < 32 weeks gestation = 5.7% among women colonized with GBS i n comparison to 1.7% among women known not t o be colonized (p C .005). Similarly PROM occurred i n 12.3% of colonized p a t i e n t s vs 6.8% of those not colonized (p <.005).In addition t o these observations we have noted 28% GBS colonization among products of spontaneous abortion s e r i a l l y cultured during the past 12 months.These associations between events leading t o premature termination of pregnancy and colonization with GBS. when compared t o the observed a t t a c k r a t e f o r GBS disease have led us to speculate that the magnitude of the threattheGBS poses to the newborn l i e s more i n its r o l e i n the egress of prematurity than i n its potent i a l f o r infection.ASPIRIN AND ACETAMINOPHEN LEVELS I N CHILDREN WITH REYES SYNDROME. G.C. Rod e r s L.B. Weiner J.A.490 M d i l l a n (spon. by W. H. i e r g~t r o m ) . s U N~, '~p s t a t e Medical Center, Dept. of Pediatrics, Syracuse, New York.The records of 61 pts. with Reyes Syndrome (RS) seen a t the Upstate Medical Center during the past 8 years were reviewed. Measurements of serum s a l i c y l a t e and acetaminophen (APAP) concent r a t i o n s were made a t the time of admission i n 37 and 21 pts. respectively. Measurable levels of s a l i c y l a t e were found i n 28 pts. (76%) with a mean value of 5.5 mgldl (range 0.2 mgldl t o 36 mgldl). S a l i c y l a t e l e v e l s a r e summarized i n the following t a b l e according t o presenting stage.Total I U with measurable l e v e l Mean l e v e l (mgldl) Stage I 22 6 4.3 s t a g e 11 31 17 7.3 Stage 1 1 1 -I V 8 5 1.0 The mean l e v e l s i n t h i s t a b l e a r e not s i g n i f i c a n t l y different. S a l i c y l a t e and APAP levels did not c o r r e l a t e with the degree of l i v e r enzyme elevations, blood ammonia l e v e l s o r phenobarbital half-life. Nine of 22 pts. who expired o r had serious sequelae had admission s a l i c y l a t e levels measured. The mean l e v e l was 8.8 mgldl. In 19 of 39 survivors without sequelae i n whom the s a l icylate l e v e l was measured the mean l e v e l was 4.0 mgldl (pc.1). I n the 21 pts. i n whom admission APAP values were determined, measurable levels were noted i n 7 pts. (mean 11.4 vglml, range 2.2-40 uglml). The high prevalence of measurable s a l i c y l a t e l e v e l s suggests a possible relationship between s a l i c y l a t e ingestion and US. These data a l s o indicate a correlation between s a l i c y l a t e l e v e l and outcome. Between November 1979 and March 1980, t h e stools of 183 nursery patients were studie...
Three standard hemagglutination-inhibition (HAI) methods were compared with 11 commercially available diagnostic test kits for determination of immunity and serologic diagnosis of rubella using a panel of 100 sera. The three standard HAI methods involved removal of serum inhibitors with kaolin, heparin-MnCl2, or dextran sulfate-CaCl2. The HAI kaolin (Flow Laboratories, McLean, Virginia) and Rubelisa (Microbiological Associates Bioproducts, Walkersville, Maryland) kits gave the best specificity as judged by the absence of false-positive results. Rubacell (Abbott Laboratories, Chicago, Illinois), Rubindex (Ortho Diagnostics, Raritan, New Jersey), Fiax (International Diagnostic Technology, Santa Clara, California), and Rubesure (Calbiochem-Behring, La Jolla, California) gave the best sensitivity as judged by the absence of false-negative results. The kits with the highest degree of both specificity and sensitivity were HAI kaolin (Flow), HAI heparin-MnCl2 (Flow), Rubacell (Abbott), and Rubindex (Ortho). In paired sera from five patients with clinical rubella, seroconversions were shown by seven of the kits. One of the kits, Cordia R (Cordis Laboratories, Miami, Florida), showed no significant rise in antibody titer with one pair of sera. Antibody titers in the same serum varied widely between the different kits.
Healthy homosexual men between the ages of 21 and 65 years, from the Washington, DC (n = 162), and New York City (n = 89) areas, were studied for antibodies in the serum against cytomegalovirus (CMV), herpes simplex virus (HSV) types 1 and 2, and Epstein Barr virus (EBV) viral capsid antigen (VCA). CMV-specific antibodies were assayed by enzyme-linked immunosorbent assay (ELISA), anti-HSV-1 and -2 antibodies were measured by indirect hemagglutination (IHA), and antibodies to EBV VCA were measured by the immunofluorescence assay. Antibodies to human T lymphotrophic virus III (HTLV-III) were detected by ELISA and Western blot procedures. T lymphocytes were enumerated using OKT4 monoclonal antibody. Healthy male volunteer blood donors (n = 90) matched for age range and race proportions were used as controls. The percentage of seropositive individuals in the homosexual group was higher (90-98%) for all the viruses tested than in the control group (47-87%). Comparisons of the geometric mean titers, expressed as reciprocal serum dilutions, of seropositive individuals in homosexual (H) vs control (C) group were as follows: CMV-IgG (ELISA) H = 1:794, C = 1:68; HSV-1 (IHA) H = 1:248, C = 1:14; HSV-2 (IHA) H = 1:56, C = 1:17; EBV-VCA (IFA) H = 1:385, C = 1:131. The homosexual group also showed a higher frequency of individuals with elevated titers than the control group. The CMV IgM antibody was prevalent in 17.7% of the homosexual group and 5% of the control group; arithmetic means for ELISA values for CMV IgM were 0.207 for the homosexual group and 0.05 for the control group. In the homosexual group, the anti-CMV antibody titers increased with age (P = 0.01) and with numbers of sex partners (P = 0.06). Both anti-HSV-1 and anti-HSV-2 antibodies correlated with the number of sex partners (P = 0.04 and P = 0.05, respectively). Neither age nor partner number correlated with response to EBV, and no particular sex act was related to the EBV VCA titer level. HTLV-III seropositivity was associated with higher herpes virus group antibody titers, probably because of life style cofactors. Among the HTLV-III-seropositive subjects, those with less than or equal to 400 T-helper lymphocytes/mm3 had lower antibody titers than those with greater than 400 T-helper lymphocytes/mm3 counts, suggesting an impaired immune response secondary to immunosuppression.
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