A report--chronic fatigue syndrome: guidelines for research.
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Biomedical subjects
Publications and source records attributed to H P Lambert.
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We used an immunoblotting technique to compare the serum antibody responses to pertussis toxin (PT), filamentous hemagglutinin (FHA), a 69-kilodalton (kDa) adenylate cyclase-associated protein (69 KD protein), and Bordetella pertussis outer membrane proteins (OMPs) following either B. pertussis infection or immunization with whole-cell pertussis vaccine. Infection and vaccination induced nearly equally intense antibody responses to PT and to FHA, but vaccination induced stronger antibody responses to the 69 KD protein and to many OMPs. The importance of serum antibody responses to the 69 KD protein and to B. pertussis OMPs other than PT and FHA in conferring immunity to pertussis after vaccination is unknown. Serum antibody responses to PT following either infection or vaccination were almost exclusively to the 28-kDa enzymatic subunit (S1) and only rarely and weakly to the lesser molecular weight binding subunits (S2-S5).
Class antibody responses to pertussis toxin (PT), filamentous hemagglutinin (FHA), and agglutinogens 2 and 3 (Agg 2/3) were studied in 114 patients with pertussis, 49 family contacts of patients with pertussis, and 139 infants attending vaccination clinics. IgG responses to FHA and PT were similar in patients with pertussis and in infants immunized three times with whole-cell pertussis vaccine. IgA responses to FHA and PT were greater in patients with pertussis than in vaccines, and a serum log10 titer of IgA to PT greater than 1.9 was a useful discriminant of Bordetella pertussis infection. When compared with patients with pertussis, vaccinees had a greater IgG response to Agg 2/3 and an equivalent IgA response to Agg 2/3. Serologic responses to FHA, PT, and Agg 2/3 were common in family contacts but were smaller than the responses in patients with pertussis. Initial titers of IgG to FHA and IgA to FHA were significantly higher (P less than .005 and P less than .05, respectively) in family contacts aged 3-10 y than in patients with pertussis in an identical age group.
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The flora of both faeces and small bowel lumen was studied in children with gastroenteritis from London, England, and Kingston, Jamaica. Clinical and laboratory differences between these two groups are described. All bacterial groups in the faeces were greatly altered during gastroenteritis and this particularly affected anaerobic organisms. These changes generally reverted rapidly to normal after the illness. The small bowel flora was also altered during gastroenteritis; there was a tendency for a wider range of organisms including anaerobes to be isolated from the children in Jamacia than from those in England.
The jejunal and stool flora of children with gastroenteritis in London and in Jamaica was examined. Although bacterial colonization of the small bowel was commonly detected, it was unusual to find the same serotype of E. coli in both jejunum and stool, and none of the jejunal strains of E. coli produced either heatlabile or heat-stable enterotoxin. Some strains of E. coli causing infant gastroenteritis are neither toxigenic nor invasive, and other mechanisms must be sought to account for their pathogenicity.
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Concentrations of antibiotics in bronchial secretion vary widely and cannot be easily related to physico-chemical characteristics. Serum and sputum concentrations do broadly correlate in the case of penicillins, some cephalosporins and some tetracyclines. Antibiotic concentrations in bronchial secretion (although not necessarily in lung tissue) are always much lower than in serum, with a ratio of about 20% for tetracycline, 3--4% for ampicillin, 4--50% for gentamicin and tobramycin. Concentrations will often be adequate to inhibit highly sensitive pathogens but marginal or ineffective for those less sensitive, e.g. carbenicillin or gentamicin for Ps. aeruginosa.
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Total hydroxyproline/creatinine ratio (THP:Cr) was measured in random urine specimens from 18 infants with gastroenteritis. THP:Cr was sometimes increased during the acute phase of the illness and the reasons for this are discussed. Seven patients failed to thrive after the acute phase and THP:Cr was low in all of these. The test appears to be a sensitive indicator of the onset of failure to thrive, and it is suggested that it may be of value in the management of these patients.
The theoretical basis of the use of erythromycin in peri-operative prophylaxis after bowel surgery will be discussed and the results of the use of erythromycin in such patients and the sensitivity to the antibiotic of isolates from human peritonitis described. This work will be related to results obtained in a rabbit experimental model for the study of peritonitis.
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The faecal flora of 55 children (aged 8 days to 8 years) and 16 adults was determined. All the children were artificially fed from birth. The faecal flora of the youngest age group was generally less complex and less predictable than that of adults. Some bacterial groups commonly found in adult stools, for example bacilli, lactobacilli and yeasts, were rarely found in the youngest infants. Most of the changes towards the adult pattern took place between 4 and 12 months. The faecal flora of children aged 1-4 years generally resembled that of adults, although lactobacilli were still infrequently isolated.
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