Objectives-This report presents 1998 period infant mortality statistics from the linked birth/infant death data set (linked file) by a variety of maternal and infant characteristics.Methods-Descriptive tabulations of data are presented.

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t~, William F. ~e r r n k i n d~, Michael J. childress3, Rodney ~e r t e l s e n~, William sharp2, Thomas ~a t t h e w s~, J e n n i f e r M. Field4, Harold G. ~a r s h a l l ' is experiencing an unprecedented series of ecological disturbances. In 1991, following reports of other ecosystem perturbations, we observed widespread and persistent blooms of cyanobacteria that coincided with the decimation of sponge communities over hundreds of square kilometers. Juvenile Caribbean spiny lobsters Panulirus argus, among other animals, rely on sponges for shelter; the impact of sponge loss on the abundance of lobsters and their use of shelter, in particular, has been dramatic. The loss of sponges on 27 experimental sites in hard bottom habitat in central Florida Bay resulted in the redistribution of juvenile lobsters among the remaining shelters, an influx of lobsters into sites where artificial shelters were present, and a decline in lobster abundances on sites without artificial shelters. Diver surveys of sponge damage at additional sites in central Florida Bay confirmed that the sponge die-off was widespread and its occurrence coincided with areas that had been exposed to the cyanobacteria bloom. This cascade of disturbances has dramatically altered the community structure of affected hard bottom areas and demonstrates the coupled dynamics of this shallow marine ecosystem.

The antiherpetic effects of a novel purine acyclic nucleoside, 9-(1,3-dihydroxy-2-propoxymethyl)guanine (DHPG), were compared with those of acyclovir in cell culture § and in mice. The

The synthesis of a new acyclic analogue of deoxyguanosine, 9-[(1,3-dihydroxy-2-propoxy)methyl]guanine (DHPG, 1), is described starting from epichlorohydrin via condensation of 2-O-(acetoxymethyl)-1,3-di-O-benzylglycerol (5) with N2,9-diacetylguanine (6). In vitro studies indicate that DHPG is a potent and broad-acting (herpes simplex virus types 1 and 2, cytomegalovirus, and Epstein-Barr virus) antiherpetic agent. In vivo studies indicate its lack of toxicity [LD50 (mice) = 1-2 g/kg, ip] and its superiority over acyclovir [oral ED50 = 7 (mg/kg)/day vs. 550 (mg/kg)/day in HSV-2 infected mice].

Seventy-two AIDS patients treated with ganciclovir for cytomegalovirus (CMV) disease were prospectively monitored for the development of drug-resistant virus. No resistant strains were found in 31 patients before therapy or among seven culture-positive patients treated for less than or equal to 3 months. Of 13 culture-positive patients treated for greater than or equal to 3 months, 5 excreted virus resistant (ED50, greater than 12 microM, or ED90, greater than 30 microM) to ganciclovir. Thus, 38% of patients and receiving ganciclovir for greater than 3 months and excreting virus or, overall, 7.6% of the patients were excreting CMV resistant to the drug.

Aim: To identify risk factors for sudden infant death syndrome (SIDS) in the sleeping environment of Irish infants. Methods: A five year population based case-control study with parental interviews conducted for each case and three controls matched for age, place of birth, and last sleep period. A total of 203 SIDS cases and 622 control infants born 1994-98 were studied. Results: In a multivariate analysis, co-sleeping significantly increased the risk of SIDS both as a usual practice (adjusted OR 4.31; 95% CI 1.07 to 17.37) and during the last sleep period (adjusted OR 16.47; 95% CI 3.73 to 72.75). The associated risk was dependent on maternal smoking (OR 21.84; 95% CI 2.27 to 209.89), and was not significant for infants who were >20 weeks of age (OR 2.63; 95% CI 0.49 to 70.10) or placed back in their own cot/bed to sleep (OR 1.07; 95% CI 0.21 to 5.41). The use of pillows, duvets, and bedding with tog value >10 were not significant risk factors when adjusted for the effects of confounding variables, including maternal smoking and social disadvantage. However, the prone sleeping position remains a significant SIDS risk factor, and among infants using soothers, the absence of soother use during the last sleep period also significantly increased the SIDS risk (OR 5.83; CI 2.37 to 14.36).Conclusion: Co-sleeping should be avoided in infants who are ,20 weeks of age, or whose mothers smoked during pregnancy. The prone position remains a factor in some SIDS deaths, and the relation between soother use and SIDS is a complex variable requiring further study.

The activities of the purine acyclic nucleoside 9-(1,3-dihydroxy-2-propoxymethyl)guanine (DHPG) against two human and five animal strains of cytomegalovirus were compared with those of acyclovir. DHPG was significantly more active than acyclovir against all but one (mouse cytomegalovirus) of the strains tested, with 5Oo% effective doses ranging from 5 to 13 ,uM, as determined by plaque reduction assays in human embryonic lung (MRC-5) and human embryonic tonsil cells. Both DHPG and acyclovir inhibited virus replication at concentrations considerably lower than those necessary to inhibit cell proliferation. In mode-of-action studies, the triphosphates of DHPG and acyclovir inhibited human cytomegalovirus DNA polymerase. DHPG phosphorylation to the active triphosphate was enhanced in infected cells; however, this enzymatic activity was unrelated to thymidine kinase. In animal studies, DHPG was slightly more effective than acyclovir in reducing mouse cytomegalovirus-induced mortality.Much effort has been expended within the last few years to find selective inhibitors of cytomegalovirus (CMV) replication. Although acyclovir is the most active compound in this area, its effectiveness against human CMV appears to be less than against other viruses of the herpes group (27). 2'-Fluoroarabinofuranosyl pyrimidines have shown high activity against human CMV in vitro, but they have a very small therapeutic index (9).Recent in vitro tests with a novel acyclic nucleoside, 9-(1,3-dihydroxy-2-propoxymethyl)guafine (DHPG, also known as 2'-NDG, BIOLF-62, and BW759U), showed this agent to be significantly more active than acyclovir against strains of human CMV (7,12,20,27,30,31,33). This report deals with the activity of DHPG against a broader range of animal and human CMVs. The effects of DHPG in vivo against mouse CMV also are presented, as are the results of a limited investigation of the mode of action of DHPG.MATERIALS AND METHODS Compounds. DHPG, acyclovir, and the triphosphates of each acyclic nucleoside were obtained as described previously (22, 27, 29). The nucleosides used in the thymidine kinase (TK) and DNA polymerase assays were BVdU[(E)-5-(2-bromovinyl)-2'-deoxyuridine], provided