MHV subgenomic negative strand function.
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Animals↗
Biomedical subjects
K M Curtis
Publications and source records attributed to K M Curtis.
A simple strategy to assemble infectious RNA and DNA clones.
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Animals↗
Improving surveillance for maternal and perinatal health in 2 districts of rural Tanzania.
OBJECTIVES: As part of a community-based reproductive health project in rural Tanzania, a maternal and perinatal health care surveillance system was established to monitor pregnancy outcomes. This report presents preliminary results. METHODS: Village health workers were trained to collect data during health education visits to pregnant and postpartum women. Maternal and fetal or infant survival or deaths were tracked on a community monitoring board. RESULTS: Among 904 pregnancies, the fetoneonatal mortality rate was 69.4 deaths per 1000 live births and fetal deaths; 4 maternal deaths occurred. Intrapartum and early neonatal deaths of infants with birthweights of 1500 g or greater represented a large proportion of deaths. CONCLUSIONS: These preliminary results will be used to prioritize project interventions, including increasing access to skilled delivery care.
Adult↗
Thymic function after hematopoietic stem-cell transplantation for the treatment of severe combined immunodeficiency.
BACKGROUND: Immune function can be restored in infants with severe combined immunodeficiency by transplantation of unfractionated bone marrow from HLA-identical donors or T-cell-depleted marrow stem cells from haploidentical donors, with whom there is a single haplotype mismatch, without the need for chemotherapy before transplantation or prophylaxis against graft-versus-host disease. The role of the thymus in this process is unknown. METHODS: We analyzed the phenotypes of circulating T cells and the proliferative responses of peripheral-blood mononuclear cells to phytohemagglutinin in 83 patients with severe combined immunodeficiency who received allogeneic marrow transplants without T-cell ablation from related donors over an 18-year period. We also tested for the presence of episomes of T-cell antigen receptors (extrachromosomal DNA circles formed during intrathymic T-cell development) to assess thymus-dependent T-cell reconstitution. RESULTS: Before and early after transplantation, the numbers of circulating T cells were low, with a predominance of mature CD45RO+ T cells (primarily resulting from the transplacental transfer of maternal cells); T-cell antigen-receptor episomes were undetectable in peripheral-blood mononuclear cells. In 73 of the infants, thymus-derived T cells expressing CD45RA and T-cell antigen-receptor episomes were detected within three to six weeks after transplantation. The mean (+/-SD) value for thymus-dependent T-cell antigen-receptor episomes peaked (at 7311+/-8652 per microgram of peripheral-blood mononuclear-cell DNA) 1 to 2 years after transplantation and declined to low levels (less than 100 episomes per microgram of DNA) within 14 years, as compared with a gradual decline from birth to the age of about 80 years in normal subjects. CONCLUSIONS: The vestigial thymus in infants with severe combined immunodeficiency is functional and can produce enough T cells after bone marrow transplantation to provide normal immune function.
Hematopoietic Stem Cell Transplantation↗
Strategy for systematic assembly of large RNA and DNA genomes: transmissible gastroenteritis virus model.
A systematic method was developed to assemble functional full-length genomes of large RNA and DNA viruses. Coronaviruses contain the largest single-stranded positive-polarity RNA genome in nature. The approximately 30-kb genome, coupled with regions of genomic instability, has hindered the development of a full-length infectious cDNA construct. We have assembled a full-length infectious construct of transmissible gastroenteritis virus (TGEV), an important pathogen in swine. Using a novel approach, six adjoining cDNA subclones that span the entire TGEV genome were isolated. Each clone was engineered with unique flanking interconnecting junctions which determine a precise systematic assembly with only the adjacent cDNA subclones, resulting in an intact TGEV cDNA construct of approximately 28.5 kb in length. Transcripts derived from the full-length TGEV construct were infectious, and progeny virions were serially passaged in permissive host cells. Viral antigen production and subgenomic mRNA synthesis were evident during infection and throughout passage. Plaque-purified virus derived from the infectious construct replicated efficiently and displayed similar plaque morphology in permissive host cells. Host range phenotypes of the molecularly cloned and wild-type viruses were similar in cells of swine and feline origin. The recombinant viruses were sequenced across the unique interconnecting junctions, conclusively demonstrating the marker mutations and restriction sites that were engineered into the component clones. Full-length infectious constructs of TGEV will permit the precise genetic modification of the coronavirus genome. The method that we have designed to generate an infectious cDNA construct of TGEV could theoretically be used to precisely reconstruct microbial or eukaryotic genomes approaching several million base pairs in length.
Animals↗
Violence in the emergency department.
Violence in the emergency department is a frequently encountered problem that is often not promptly or adequately addressed. This article outlines the epidemiology of violence in the emergency department, including patients at greatest risk for aggressive behavior. The necessary steps to identify and approach these patients and recommended methods for sedation and restraint are discussed.
Emergency Service, Hospital↗
The effect of pesticide exposure on time to pregnancy.
The Ontario Farm Family Health Study provided data for examination of the effects of pesticide exposure on time to pregnancy. In this retrospective cohort study of farm couples in Ontario, Canada, the farm operator, husband, and wife completed questionnaires during 1991-1992. We asked about pesticides used on the farm and pesticide activities of the husband and wife for each month of trying to conceive. After exclusions, 2,012 planned pregnancies remained for analysis. We used an analog of the Cox proportional hazards model to calculate conditional fecundability ratios (conditional on pregnancy). There was no strong or consistent pattern of associations of pesticide exposure with time to pregnancy. During exposure intervals in which women participated in pesticide activities (during most of which the men also participated), however, 6 of 13 pesticide exposure categories were associated with a decrease in fecundability (conditional fecundability ratio range = 0.51-0.80). For exposure intervals in which only the men participated in pesticide activities or in which neither men nor women participated in pesticide activities but pesticides had been used on the farm, conditional fecundability ratios ranged from 0.75 to 1.50, with no apparent consistency among pesticide classes, chemical families, or active ingredients.
Agriculture↗
Exposure to phenoxy herbicides and the risk of spontaneous abortion.
The Ontario Farm Family Health Study was designed to assess retrospectively the potential adverse effects of exposure to pesticides on pregnancy. Information on the health and life style of approximately 2,000 farm couples, as well as a history of use of pesticides on the farm, was collected by questionnaire. This analysis focuses on pre- and postconception exposure to phenoxy herbicides and the risk of spontaneous abortion using the complete (to date) pregnancy history for each woman. Preconception exposure (from 3 months before conception to the month of conception) was weakly associated with the risk of spontaneous abortion at <20 weeks' gestation [adjusted odds ratio (OR) = 1.1; 95% confidence interval (CI) = 0.6-1.9]. When the analyses were restricted to spontaneous abortions of <12 weeks, the risk was more than doubled (adjusted OR = 2.5; 95% CI = 1.0-6.4), but the results were sensitive to the cutpoint used. If the husband did not normally wear protective equipment during application, the crude OR for early spontaneous abortions was 5.0 (95% CI = 0.7-36.2). Exposure to phenoxy herbicides during the first trimester was generally not associated with increased risk of spontaneous abortion. The results suggest a possible role of preconception (possibly paternal) exposures to phenoxy herbicides in the risk of early spontaneous abortions.
Abortion, Spontaneous↗
Visits to emergency departments for gynecologic disorders in the United States, 1992-1994.
OBJECTIVE: To assess rates of visits to emergency departments for gynecologic disorders among women of reproductive age in the United States. METHODS: Data from the National Hospital Ambulatory Medical Care Survey for 1992-1994 were analyzed to determine rates of visits to emergency departments among women, ages 15-44 years. Average annual rates per 1000 women were calculated using age, race, and region-specific population estimates. Rate ratios were used to compare rates among subgroups. RESULTS: Approximately 1.4 million gynecologic visits were made to emergency departments annually, for an average annual rate of 24.3 visits per 1000 women, ages 15-44 years (95% confidence interval [CI] 22.0, 26.6). The most frequent diagnoses were pelvic inflammatory disease (average annual rate 5.8, 95% CI 5.0, 6.6), lower genital tract infections including sexually transmitted diseases (average annual rate 5.7, 95% CI 4.8, 6.6), and menstrual disorders (average annual rate 2.9, 95% CI 2.3, 3.5). Nearly half of all gynecologic visits resulted in diagnoses of genital tract infections. Younger women (ages 15-24 years) were 2.3 (95% CI 2.0, 2.6) times as likely as older women (ages 25-44 years), and black women were 3.6 (95% CI 2.9, 4.3) times as likely as white women, to visit emergency departments for gynecologic disorders. Rate ratios for genital tract infections were 10-20 times higher for younger black women than for older, white women. CONCLUSION: Almost half of gynecologic visits to emergency departments were related to genital tract infections, which largely are preventable.
Adolescent↗
Male pesticide exposure and pregnancy outcome.
Potential health effects of agricultural pesticide use include reproductive outcomes. For the Ontario Farm Family Health Study, the authors sampled Ontario farms from the 1986 Canadian Census of Agriculture, identified farm couples, and obtained questionnaire data concerning farm activities, reproductive health experience, and chemical applications. Male farm activities in the period from 3 months before conception through the month of conception were evaluated in relation to miscarriage, preterm delivery, and small-for-gestational-age births. Among the 1,898 couples with complete data (64% response), 3,984 eligible pregnancies were identified. Miscarriage was not associated with chemical activities overall but was increased in combination with reported use of thiocarbamates, carbaryl, and unclassified pesticides on the farm. Preterm delivery was also not strongly associated with farm chemical activities overall, except for mixing or applying yard herbicides (odds ratio = 2.1, 95% confidence interval 1.0-4.4). Combinations of activities with a variety of chemicals (atrazine, glyphosate, organophosphates, 4-[2,4-dichlorophenoxy] butyric acid, and insecticides) generated odds ratios of two or greater. No associations were found between farm chemicals and small-for-gestational-age births or altered sex ratio. Based on these data, despite limitations in exposure assessment, the authors encourage continued evaluation of male exposures, particularly in relation to miscarriage and preterm delivery.
Abortion, Spontaneous↗
Effects of cigarette smoking, caffeine consumption, and alcohol intake on fecundability.
Data from the Ontario Farm Family Health Study were analyzed to determine whether smoking, caffeine, or alcohol use among men and women affect fecundability (the monthly probability of conception). In this retrospective cohort study of farm couples in Ontario, Canada, the farm operator, husband, and wife completed questionnaires during 1991-1992, yielding information on 2,607 planned pregnancies that had occurred over the previous 30 years. Fecundability ratios were calculated using an analog of the Cox proportional hazards model. Cigarette smoking among women and men was associated with decreased fecundability (fecundability ratio = 0.90, 95% confidence interval (CI) 0.82-0.98 and fecundability ratio = 0.88, 95% CI 0.81-0.95, respectively). Caffeine consumption of 100 mg or less versus more than 100 mg in women and men was not associated with fecundability (fecundability ratio = 0.98, 95% CI 0.91-1.07 and fecundability ratio = 1.05, 95% CI 0.97-1.14, respectively). Decreases were observed among women who were coffee drinkers (fecundability ratio = 0.92, 95% CI 0.84-1.00) and men who were heavy tea drinkers (fecundability ratio = 0.85, 95% CI 0.69-1.05), regardless of caffeine content. Alcohol use among women and men was not associated with fecundability. These data are consistent with previous studies of the adverse effect of tobacco on fecundability in female smokers and suggest an effect of smoking among males. Continued evaluation of coffee and tea is warranted to address constituents other than caffeine.
Adult↗
The validity of the Rorschach for assessing cognitive and affective changes.
Exner's (1985) Rorschach norms of children 5 to 16 years old were used to test predictions based on developmental theory, previous cognitive studies, and Achenbach and Edelbrock's (1981) norms on behavior problems in children. In the cognitive realm, the Rorschach scores reflected the predicted increase in complexity, integration, and precision of thinking; richness of ideas; conformity to socially acceptable ways of thinking; and the concomitant decrease in unrealistic, egocentric ideas. In the affective realm, the Rorschach scores reflected the predicted decrease in uncontrolled expression of affect, increase in controlled expression of affect, and increase in inwardness. However, the Rorschach scores failed to reflect the predicted decrease in anxiety and increase in depression. Finally, there was no evidence of increased accuracy of perception.
Adolescent↗