Sentinelle traces of an epidemic of acute gastroenteritis in France.
Explore the source record for details and available documents.
Acute Disease↗
Biomedical subjects
C Diaz
Publications and source records attributed to C Diaz.
Mycobacterium tuberculosis infection in pregnant and nonpregnant women infected with HIV in the Women and Infants Transmission Study.
BACKGROUND: Prevalence of Mycobacterium tuberculosis (TB) infection and anergy were evaluated in a cohort of pregnant and nonpregnant women infected with the human immunodeficiency virus who were enrolled in a prospective natural history study (the Women and Infants Transmission Study) conducted in New York, NY; Boston and Worcester, Mass; Chicago, Ill; and San Juan, Puerto Rico. METHODS: One hundred eighty-three women (65 pregnant, 118 nonpregnant) were evaluated for TB. The TB history and risk factors were assessed by interview and medical record review. Intradermal skin testing with tuberculin, mumps, and tetanus antigens and CD4+ lymphocyte count were performed. RESULTS: Overall prevalence of TB infection or disease by documented medical history and/or a tuberculin skin test induration of 5 mm or more was 14% (26 of 183). History of TB infection or disease was documented in 11% of the women who were interviewed. Tuberculin and anergy skin test results were evaluable for 124 women; 6% (seven of 124) had tuberculin skin test induration of 5 mm or more, including 11% (five of 46) of the pregnant women who were tested. Induration between 2 and 5 mm was observed in four more women, three of whom were pregnant. Anergy was observed in 42% (52 of 124); prevalence of anergy was higher in nonpregnant women (38 [49%] of 78) than in pregnant women (14 [30%] of 46). While anergy was more common in women with a CD4+ cell count of 0.5 x 10(9)/L or less, 27% of those with a CD4+ cell count of more than 0.5 x 10(9)/L were also anergic. CONCLUSION: These data support current Public Health Service recommendations for tuberculin skin testing in persons infected with the human immunodeficiency virus, and emphasize that evaluation should include pregnant as well as nonpregnant women. The prevalence of anergy does not appear increased in pregnancy in women infected with the human immunodeficiency virus. Health care providers should include tuberculin and anergy skin testing as part of the standard prenatal care for women infected with the human immunodeficiency virus.
Adult↗
Differential regulation of endogenous endonuclease activation in isolated murine fibroblast nuclei by ras and bcl-2.
Transfection of a murine fibroblast cell line with an activated form of the Harvey ras oncogene conferred sensitivity to apoptosis induced by various agents. This intrinsic sensitivity to apoptosis correlated with the expression of endogenous endonuclease activity in isolated nuclei that was undetectable in the untransfected parental cell line. Subsequent transfection with the human bcl-2 oncogene prevented the morphological and biochemical features of apoptosis in whole cells, although it failed to confer complete protection against cell death. Furthermore, transfection of the bcl-2 oncogene also inhibited the enhanced endonuclease activity in isolated nuclei. Our results indicate that some of the effects of Ha-ras and bcl-2 and potentially other oncogenes, are exerted on the biochemical machinery of apoptosis at the level of the nucleus.
Animals↗
[Trichoblastoma. A tumor with follicular differentiation].
The purpose of this article is to inform about neoplasms with follicular differentiation, particularly trichoblastoma. In 1970 Headington divided neoplasms of the hair germ (trichogenic tumours) into four groups: purely epithelial without inductive changes (trichoblastomas), mixed epithelial-mesenchymal with inductive changes (trichoblastic fibromas), mixed epithelial-mesenchymal with inductive changes and advanced hair follicle formations (trichogenic trichoblastomas), and predominantly mesenchymal with an abortive dermal hair papilla (trichogenic myxoma). Meanwhile a new classification of neoplasms with follicular differentiation has been presented, according to which every neoplasm with follicular differentiation, benign structure (symmetrical, circumscribed, with vertical growth), and predominance of follicular germinative cells is called a trichoblastoma. Whether this neoplasm is malignant and if so to what degree is under discussion. This classification is gaining in acceptance among histopathologists but has not been accepted in the field of clinical dermatology.
Basal Cell Carcinoma↗
Seroreversion in human immunodeficiency virus-exposed but uninfected infants.
The goal of this study was to describe seroreversion (SR) in a cohort of human immunodeficiency virus-exposed but uninfected infants. Groups of patients who seroreverted very early or late were examined for salient clinical and immunologic characteristics of the mother or infant. The mean time (+/- s.d.) to seroreversion by enzyme-linked immunoabsorbent assay (ELISA) was 50.1 +/- 14.8 weeks, or 11.6 months (n = 84); the range of times to antibody loss by ELISA was 17.9 to 82.0 weeks. The mean time to seroreversion by Western blot was 68.3 +/- 12.6 weeks, or 15.8 months (n = 51), with a range of 44.9 to 94.1 weeks. Initial anti-human immunodeficiency virus titer as measured by cord blood ELISA optical density (OD) was found to relate significantly to mean time to seroreversion. No relationship to time to seroreversion was demonstrated for gestational age, maternal or neonatal serum immunoglobulin concentrations, maternal CD4 cell counts, maternal alcohol consumption, infantile diarrhea or failure to thrive. The lengthy time to seroreversion seen here demonstrates the 1994 revised Centers for Disease Control and Prevention definition of human immunodeficiency virus infection (based on seropositivity by both ELISA and confirmatory tests persisting beyond 18 months of age) to be accurate in our population. We recommend Western blot testing be used as confirmation for positive ELISAs only after 18 months of age.
AIDS Serodiagnosis↗
Appearance of drug-resistant tuberculosis in rural Tennessee.
Drug-resistant tuberculosis (DRTB) is a growing national health concern in both urban populations and rural areas and is exacerbated by the growing epidemic of human immunodeficiency virus (HIV) infection. Between 1989 and 1992, 7 cases of DRTB (5 with multidrug-resistance) were diagnosed in an eight-county region of East Tennessee. During 1990 and 1991 alone, 5 of 100 patients with tuberculosis had drug-resistant strains (5%). All 7 patients with DRTB had 100% resistance to isoniazid; 5 also had resistance to streptomycin, 2 to rifampin, and 1 to pyrazinamide and ethambutol. All patients were white, U.S.-born, and without evidence of HIV infection. Contact investigation revealed that more contacts of patients with DRTB (13 of 74, 18%) were infected than were contacts of patients with drug-sensitive tuberculosis (46 of 290, 16%). Our study demonstrates that DRTB is not confined to geographically distinct areas, but may be a subtle and easily missed diagnosis in presumably low-risk rural populations.
Adult↗
Rapid reocclusion of left primary bronchus by fibrinomucinous cast in a case of large cell lung cancer.
This report describes a case of large cell carcinoma of the lung in a patient whose left primary bronchus became completely occluded by a fibrinomucinous cast that recurred within 24 hours despite extensive lavage and removal of the cast via flexible bronchoscopy. The primary tumor involved the aortopulmonary window and was affixed to the pulmonary artery and the aorta, arising from the left upper lobe and extending to the left primary bronchus. The occurrence of a large fibrinous endobronchial cast removed by flexible bronchoscopy forceps, such as we report here, is extremely rare.
Airway Obstruction↗
Evaluation of palpable breast masses with 201Tl scintigraphy.
39 female patients (age range: 31-84 years) with palpable breast masses detected by physical examination, underwent 201Tl scintigraphy in order to assess its value in the detection of breast carcinomas and to differentiate them from benign breast masses. Planar images were carried out at 20-30 min and 2-3 h after intravenous administration of 111-185 MBq (3-5 mCi) of 201Tl chloride. In 12 patients single photon emission tomography (SPET) studies were also performed. In 18 patients the scintigraphic studies were positive and in 17 of these cases, breast carcinomas were confirmed. Tumour sizes ranged from 1.3 to 6 cm in diameter. In the remaining patient a false positive result was obtained where there was benign breast change. In three of seven cases, malignant axillary nodes were also detected. All 21 patients with negative scintigraphy had benign breast lesions. There were no differences between images obtained at 20-30 min and 2-3 h or between planar images and SPET studies. In 10 patients there was disagreement between mammography and 201Tl scans. 201Tl scans confirmed the presence of carcinoma in three cases and discarded malignancy in the other six cases. In the remaining case, 201Tl scan was false positive. 201Tl scintigraphy is useful in distinguishing malignant from benign breast masses, even when compared with mammography.
Adult↗
Prenatal sonographic findings of a large fetal cardiac fibroma.
Explore the source record for details and available documents.
Adult↗
[Peritoneal dialysis in cases of associated pathology].
There are two aspects to considerations of the value of peritoneal dialysis (PD) in the treatment of renal insufficiency with associated pathology. The first involves the effects of the treatment on the symptoms or evolution of the pathology. Examples include the improvement of dyspnea due to cardiac insufficiency (CI) and of cirrhotic ascites (CA). However, there is also an undefined risk of reactivation lupus. The second facet is the increased risk of peritoneal infection, particularly for patients who are HIV + or who are immunosuppressed due to lupus or myeloma. In certain types of case (lupus with intractable vascular thrombosis, intolerance of ultrafiltration in cases of CI, AC or generalised amyloidosis) PD has particular advantages. Nevertheless, there has been no appropriate prospective study to demonstrate or otherwise the advantages in terms of survival. The use of PD remains therefore a matter of choice for individual patients and experienced health care team.
HIV Infections↗
Allergic contact dermatomucositis to budesonide.
Explore the source record for details and available documents.
Adult↗
Blood culture in the first 6 months of life for the diagnosis of vertically transmitted human immunodeficiency virus infection. The Women and Infants Transmission Study Group.
Serial blood cultures over the first 6 months of life in 310 infants with vertical exposure to human immunodeficiency virus (HIV) in the Women and Infants Transmission Study were analyzed to determine their value for early diagnosis of HIV infection. Cultures were done at 0-7 days and 1, 2, 4, and 6 months of age: 55 infants were infected. Blood culture sensitivity in infected children was 24% (7/29) during the first week of life and 85%, 91%, 82%, and 88%, respectively, at 1, 2, 4, and 6 months. The sensitivity, specificity, and positive and negative predictive values of a single culture between 1 and 6 months of age were, respectively, 86.9%, 99.6%, 97.9%, and 97.5%. Two negative cultures between 1 and 6 months of age defined an uninfected infant with a specificity of 99.2%-100.0%. Blood culture done between 1 and 6 months of age in children of HIV-positive mothers is a sensitive and specific test for HIV infection, with high positive and negative predictive values.
Blood↗
Posttransfusion and community-acquired hepatitis C in childhood.
Following a longitudinal study of chronic non-A, non-B hepatitis in Italy and Spain, we evaluated the epidemiologic and clinical features of chronic hepatitis C in 77 consecutively observed children (35 male; mean age, 4 years) without underlying systemic diseases. All subjects were positive for antibody to hepatitis C virus in serum by second-generation tests. Forty-six patients had received blood transfusions in the perinatal period; 12 had a mother with antibodies to HCV in serum (five of these mothers were drug users or partners of a drug user); seven had a history of putative percutaneous exposure; and 12 had not been exposed to any risk factors for viral hepatitis. At presentation, only 22% were symptomatic, mean alanine-aminotransferase levels were three times the upper normal value, and liver histology showed active disease in only nine of 28 cases (32%). During a mean observation period of 6 years, only 11 of 57 patients (19%) complained of symptoms and 11 of 40 cases (27%) had histologic features of active hepatitis. Two patients had severe hepatitis with associated cirrhosis. However, only six of 57 cases (10%) achieved sustained biochemical remission. The clinical features and the outcome were similar in both the posttransfusion and the community-acquired cases. These results indicate that transfusions in the perinatal period are the single most important cause of hepatitis C in otherwise healthy children. Community-acquired cases represent an heterogeneous epidemiologic group in which maternal transmission, whether perinatal or postnatal, could be relevant.(ABSTRACT TRUNCATED AT 250 WORDS)
Child↗
Thymosin alpha 1 is a native peptide in several tissues.
Failure to detect thymosin alpha 1 (T alpha 1) in tissue extracts prepared by procedures that prevent proteolytic activity has hitherto supported the suggestion that T alpha 1 is not a natural peptide, but the product of uncontrolled proteolysis of prothymosin alpha (ProT alpha), a polypeptide that includes T alpha 1 at its NH2 terminus. In this work, purification by isoelectric focusing of a product with the same isoelectric point as synthetic T alpha 1, and its further characterization, demonstrated that T alpha 1 is present as a native peptide in calf thymus and in several lymphoid and non-lymphoid rat tissues. T alpha 1 shows abnormal chromatographic behaviour which appears to be due to association with other components in tissue extracts. In all the tissues studied, T alpha 1 was present in higher concentration than ProT alpha (80-183 and 44-123 micrograms per gram of tissue, respectively). The ProT alpha/T alpha 1 ratio did not change when no measures were taken to prevent proteolysis during tissue homogenization.
Animals↗
Analysis of the tissue distribution and inheritance of heteroplasmic mitochondrial DNA point mutation by denaturing gradient gel electrophoresis in MERRF syndrome.
MERRF (Myoclonic Epilepsy and Ragged-Red Fibres) syndrome is one of the maternally inherited diseases for which a mitochondrial DNA (mtDNA) point mutation has recently been identified. The mutation is always heteroplasmic, that is normal and mutant mtDNA coexist within the same individual. We studied mtDNA heteroplasmy in two families with MERRF syndrome, using a denaturing gradient gel electrophoresis technique that avoids the errors in the evaluation of wild/mutant mtDNA ratios caused by restriction enzyme cutting in the situation of amplification of a heteroplasmic DNA. In two patients, the proportion of muscle mutant mtDNA was in agreement with the severity of muscle mitochondrial proliferation, energy defect and fibre type I predominance. In nine patients from three generations of one family, mutant mtDNA proportion in leukocytes was in relative agreement with the clinical severity of the disease. Transmission of mutant mtDNA through these three generations did not show any tendency toward homoplasmy. Homogeneity of the mutant mtDNA proportion among different tissues from one patient was demonstrated in brain, liver, muscle and heart but a possibility of divergence of the mutant mtDNA proportion during mitosis was documented in cultured skin fibroblasts.
Adolescent↗
N-cadherin and N-CAM in myoblast fusion: compared localisation and effect of blockade by peptides and antibodies.
The expression and distribution of two cell adhesion molecules, N-cadherin and N-CAM, at the surface of cultured leg muscle cells from 11-day-old chicken embryos were studied and compared. N-cadherin, which was expressed by fusing myoblasts, was down-regulated on old myotubes while N-CAM was still present. Both molecules, as viewed by confocal microscopy, appeared to have coaccumulated at the areas of contact between fusing myoblasts. However, immunogold electron microscopy did not reveal significant colocalization of N-cadherin and N-CAM, and their segregation after antibody-induced patching suggested the absence of direct interactions between N-cadherin and N-CAM. The role of the Ca2+ dependent cell adhesion molecule N-cadherin in myogenesis was investigated. Myoblast fusion was inhibited (1) with a synthetic peptide containing the H-A-V sequence and (2) with a monoclonal anti-N-cadherin antibody, demonstrating that N-cadherin-mediated cell adhesion is required for myoblast fusion. Under the same conditions no effect of anti-N-CAM antibodies was observed. Taken together these observations suggest that N-cadherin, acting independently from N-CAM, is a major cell adhesion molecule involved in embryonic myoblast fusion in vitro.
Amino Acid Sequence↗
Relationship between milk expected progeny differences of polled Hereford sires and actual milk production of their crossbred daughters.
One hundred sixteen spring-calving Polled Hereford x Angus cows were milked using milking machines after receiving 20 IU of oxytocin. Sires of the cows had been divergently selected on yearling weight (YW) and total maternal (MAT) EPD to form four groups: high YW, high MAT EPD; high YW, low MAT EPD; low YW, high MAT EPD; and low YW, low MAT EPD. Average milk production after 12-h calf separation was 3.7 +/- 1.3 kg. Actual milk production of cows was regressed on their sires' milk EPD, where the milk EPD estimates the additive maternal genetic contribution of a sire to the weaning weight of his daughters' calves. The regression of actual 12-h milk production on sire milk EPD was .038 +/- .014 kg/kg, and the correlation was .26 (P less than .006), close to its expected value, based on the accuracy of the prediction, heritability of the trait, and the relationship between sire and daughter. Extension of results of a single milking to an entire lactation is difficult, but over the range of sire milk EPD sampled (-10 to 16 kg), the range in daughters' milk production predicted from the regression analysis was 27% of the mean actual milk production, corresponding to an increase of about 1% more milk per kilogram of milk EPD.
Animals↗
An improved polymerase chain reaction assay to detect Trypanosoma cruzi in blood.
Amplification by the polymerase chain reaction of Trypanosoma cruzi satellite DNA was used to enhance sensitivity in the detection of the parasite in blood, with the ultimate goal of improving diagnosis of the chronic phase of Chagas' disease. Two contiguous oligonucleotides were synthesized corresponding to the most conserved region of the 195-basepair repeated sequence and used as primers for the amplification reaction. Nineteen femtograms of parasite DNA that was amplified in the presence of 15 micrograms of human or mouse DNA produced a visible band upon electrophoresis in agarose gels and staining with ethidium bromide. In reconstitution experiments, one parasite in 10 ml of blood could be unambiguously determined when the DNA was isolated from nuclei after the blood was treated with NP40 and centrifuged. Polymerase chain reaction assays were carried out to detect T. cruzi in chronically infected mice. Most mice were parasite-positive when organs or tissues were tested, but all were negative when total blood was tested.
Animals↗