Risk of non-Hodgkin lymphoma and Kaposi's sarcoma in homosexual men.
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
C S Rabkin
Publications and source records attributed to C S Rabkin.
Maternal activity and birth weight: a prospective, population-based study.
To determine the association between maternal activity and pregnancy outcome, the authors investigated the separate influences of time, physical effort, and posture at work, both at a job and in the home, on birth weight. Study subjects were 1,507 of 1,889 women appearing consecutively for antenatal care at a district general hospital in inner London, England, in 1982-1984. Data were collected prospectively by interview and examination at several stages of pregnancy. Multivariable linear regression was used to distinguish associations with physical activity from confounding by other factors. The mean birth weight of infants born to women in full-time employment was 49 g less than that for births to women not in paid work (95 percent confidence interval (Cl) 1-97 g). However, the difference was due to confounding, and after adjustment, full-time employment was associated with a 12-g increase in birth weight (95 percent Cl -39 to 63 g). There was little difference in birth weight related to gestational stage at leaving work. Duration, physical effort required, and energy expenditure in paid work and in work at home had no discernible association with birth weight. A small increase in birth weight was associated with increased hours of sleep. These data allow estimates of associations with birth weight as precise as 80 g. Within the range of activities performed by pregnant women in the population studied, birth weight is unlikely to be associated with maternal physical activity.
Adolescent↗
Kaposi's sarcoma in three HIV-1-infected cohorts.
We describe the Kaposi's sarcoma (KS) experience in three cohorts of homosexual men, subjects with hemophilia, and human immunodeficiency virus type 1 (HIV-1) seroconverters. The risk of KS was higher in HIV-1-infected homosexual men from New York City as compared with Washington, D.C. and was very low in the hemophilia subjects. While KS accounted for a decreasing proportion of AIDS cases in homosexual men, the absolute risk per year did not diminish. Survival was similar after diagnosis of KS vs. opportunistic infection including Pneumocystis carinii pneumonia. Percent CD4+ and CD8+ T cells, and beta 2-microglobulin levels were less abnormal in subjects who later developed KS than in those who developed opportunistic infections; conversely, serum neopterin abnormalities were greater in those who developed KS. The additional risk of KS in homosexual men may explain their apparently higher incidence of AIDS. Further investigation of the differences in intermediate markers of KS and opportunistic infections may shed light on the pathogenesis of these particular manifestations of AIDS.
Acquired Immunodeficiency Syndrome↗
Frequency of nosocomial transmission of HIV infection among health care workers.
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Acquired Immunodeficiency Syndrome↗
Creutzfeldt-Jakob disease probably acquired from a cadaveric dura mater graft. Case report.
A case of Creutzfeldt-Jakob disease (CJD) is reported in a 28-year-old woman who had received a cadaveric dural graft 19 months earlier after resection of a cholesteatoma. The circumstances of the case point to the graft as the most likely source of the disease. Cadaveric dura should be added to the list of materials that may transmit CJD, and it must be very carefully screened if it is used at all for grafting. Autologous tissue should be considered whenever possible.
Adult↗
Outbreak of echovirus 11 infection in hospitalized neonates.
Between July 18 and August 5, 1986, a cluster of echovirus 11 infections occurred in hospitalized neonates. Ten infants were affected and one died. All cases occurring after the index case were infants who were in the nursery for at least 1 day when the index patient was also present. Risk factors for secondary infection included low birth weight or gestational age and receipt of antibiotics, red blood cell transfusions, nasogastric intubation or gavage feedings. Because viral infection had not been suspected in the index patient, isolation measures were not instituted until after onset of secondary cases. We conclude that more severely ill infants receiving intensive levels of care are at increased risk for nosocomial enteroviral infection. These infants may have a greater likelihood of exposure to the virus and/or increased host susceptibility. Outbreaks caused by cross-infection may be preventable by early recognition of patients colonized or infected with potentially pathogenic agents and prompt institution of appropriate isolation measures.
Adolescent↗
Current status of Pseudomonas cepacia typing systems.
Pseudomonas cepacia is an important nosocomial pathogen for which measures of isolate relatedness are being developed. Typing systems based on 4 different strain characteristics have been proposed: serologic reactions, biochemical reactions, plasmid profiles, and bacteriocin production and susceptibility. Serology and bacteriocins distinguish many types, but the sensitivity and specificity of these techniques have not been determined. Improved methods for typing P. cepacia are needed to determine the reservoirs and modes of transmission of this emerging nosocomial pathogen.
Bacteriological Techniques↗
Thermophilic bacteria: a new cause of human disease.
We studied a group of 31 bacterial isolates from clinical specimens, received by the Centers for Disease Control since 1961, which have been denoted thermophilic for their unusual ability to grow at 50 degrees C. Microbiological characteristics were determined for the group, and an assessment of their clinical significance was made based on retrospective chart review. These bacteria are all gram-negative, nonfermentative, nonsporulating rods, most of which grow better at 42 or 50 degrees C than at 35 degrees C. Some of the bacteria could be implicated as the etiological agents for meningitis, endocarditis, and septicemia. Thermophilic bacteria should be considered potential pathogens when isolated from appropriate clinical specimens.
Adolescent↗
Brain abscess: a complication of cystic fibrosis in adults.
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Adult↗
Quantitation of DNA in buccal cell samples collected in epidemiological studies.
Buccal cell samples are increasingly used in epidemiological studies as a source of genomic DNA. The accurate and precise quantitation of human DNA is critical for the optimal use of these samples. However, it is complicated by the presence of bacterial DNA and wide inter-individual variation in DNA concentration from buccal cell collections. The paper evaluated the use of ultraviolet light (UV) spectroscopy, Höechst (H33258) and PicoGreen as measures of total DNA, and real-time quantitative polymerase chain reaction (PCR) as a measure of human amplifiable DNA in buccal samples. Using serially diluted white blood cell DNA samples (at a concentration range of 300 to 0.5 ng microl-1), UV spectroscopy showed the largest bias, followed by Höechst, especially for low concentrations. PicoGreen and real-time PCR provided the most accurate and precise estimates across the range of concentrations evaluated, although an increase in bias with decreasing concentrations was observed. The ratio of real-time PCR to PicoGreen provided a reasonable estimate of the percentage of human DNA in samples containing known mixtures of human and bacterial DNA. Quantification of buccal DNA from samples collected in a breast cancer case-control study by PicoGreen and real-time PCR indicated that cytobrush and mouthwash DNA samples contain similar percentages of human amplifiable DNA. Real-time PCR is recommended for the quantification of buccal cell DNA in epidemiological studies since it provides precise estimates of human amplifiable DNA across the wide range of DNA concentrations commonly observed in buccal cell DNA samples.
Cheek↗
Pseudomonas cepacia typing systems: collaborative study to assess their potential in epidemiologic investigations.
To determine the utility of available Pseudomonas cepacia typing systems for confirming the relatedness of isolates, we applied these methods to isolates associated with previously investigated nosocomial outbreaks. We compared chromosome analysis, serologic reactions, biochemical tests, bacteriocin production and susceptibility, and antimicrobial susceptibility in their ability to determine outbreak relatedness. Chromosome analysis, serologic reactions, and biochemical tests were each demonstrated to be epidemiologically useful methods for typing isolates. Determination of the sensitivity and specificity of these typing techniques will facilitate their application in the epidemiologic study of this increasingly important nosocomial pathogen.
Chromosomes, Bacterial↗
Prevalence of antibody to HTLV-III/LAV in a population attending a sexually transmitted diseases clinic.
To determine whether HTLV-III/LAV is transmitted to men by heterosexual contact and whether contact with prostitutes plays a role in such transmission, a serosurvey was conducted in clinics for sexually transmitted diseases in New York City. Two hundred ninety-five male heterosexual nonusers of intravenous drugs were studied. Antibody to HTLV-III/LAV was found in sera from ten men (3.4%); this rate is approximately 15 times the prevalence found in healthy blood donors. Seropositivity was associated with serologic evidence of syphilis (odds ratio, 11.2; 95% confidence interval, 2.1-52) and hepatitis B infection (odds ratio, 9.1; 95% confidence interval, 2.0-55). Antibody to HTLV-III/LAV was not associated with self-reported exposure to prostitutes (odds ratio, 0.8; 95% confidence interval, 0.08-4.2). These findings suggest heterosexual transmission of HTLV-III/LAV to men but fail to implicate contact with prostitutes as a mode of such transmission.
Acquired Immunodeficiency Syndrome↗