Updated recommendations for safety-testing of viral inocula used in volunteer experiments on rhinovirus colds.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to R B Turner.
Explore the source record for details and available documents.
The antibody response to three Haemophilus influenzae type b vaccines was examined in 134 infants 17 to 22 months of age. Sera were collected from each subject before and 1 month after vaccination with either purified H. influenzae type b capsular polysaccharide (polyribosyl-ribitol phosphate (PRP] or one of two protein-conjugated vaccines (PRP-D or HbOC). Comparison of the two conjugate vaccines revealed that HbOC produced an antibody response greater than or equal to 1.0 micrograms/ml in 96% compared with 72% who were vaccinated with PRP-D (P less than 0.05). The isotype distribution of the antibodies produced by the two vaccines was similar. While all of the vaccines resulted in higher concentrations of anticapsular IgG1 than IgG2, the IgG1:IgG2 ratio was significantly higher in subjects immunized with HbOC. The IgG1:IgG2 ratio was similar in subjects immunized with PRP or PRP-D. The clinical significance of these observations remains to be determined.
The purpose of this study was to determine whether acute pulmonary exacerbations of cystic fibrosis associated with nonbacterial infections are clinically distinguishable from other exacerbations. Eighty exacerbations in 54 patients were studied. Exacerbations associated with influenza (n = 8) were compared with those associated with other nonbacterial infections (n = 15) and those in which no nonbacterial infection was detected (n = 57). Patients with influenza had lower Shwachman scores and were more likely to be seropositive for C-reactive protein than patients in the other two groups. Patients with influenza had a mean decrease in forced expiratory volume per second of 26%, compared with test results obtained before the exacerbation. In contrast, the mean decrease in forced expiratory volume per second was 6% for other nonbacterial infections and 12% for the group without nonbacterial infection (p less than 0.05 for both comparisons). The forced expiratory flow in first 25% of vital capacity decreased 44% in the influenza group compared with 13% and 17% in the other two groups, respectively (p less than 0.01 for both comparisons). The influenza group also had a higher proportion of patients with at least a 20% decrease in forced expiratory volume per second and forced expiratory flow in first 25% of vital capacity than the other two groups had (p less than 0.05 for all comparisons). These data suggest that influenza is associated with severe exacerbations in patients with cystic fibrosis and support recommendations for efforts to prevent influenza in this population.
Explore the source record for details and available documents.
The purpose of this study was to determine the number and volume of red blood cell (RBC) transfusions and the number of donors a newborn is exposed to during his or her newborn intensive care unit (NICU) stay. On one day at the Medical University of South Carolina (MUSC) and two days at the University of Virginia Hospital (UVH) all babies who had or were receiving RBCs comprised the study group. Patient records were reviewed at discharge. Fifty-two (70%) of the 75 NICU babies had or were receiving RBCs and were enrolled. The average number of RBC transfusions was nine (range 1 to 28, median 7) and the average transfusion volume was 16.5 ml (range 5 to 60) for a total volume of 148 ml transfused during a NICU stay. Each baby was exposed to an average of 6.9 donors (range 1 to 25, median 6.5). The practice of splitting RBC packs to share among different infants and of giving multiple small volume transfusions maximizes donor exposure and transfusion-related infectious risks in this population.
The safety, tolerance, and levels of drug in the nasal cavity produced by an ocular formulation of interferon were determined at four dosages in a placebo-controlled, double-masked trial. Interferon given by the ocular route was generally well tolerated, although a dose-related occurrence of subjective symptoms was detected.
The chest roentgenogram is an accepted tool for the diagnosis of pneumonia. Little information is available, however, addressing the ability of physicians to distinguish bacterial from nonbacterial pneumonias by examination of the chest roentgenogram. Five different observers evaluated 36 chest films from patients with pneumonia who had a laboratory proven etiologic diagnosis. The sensitivity of roentgenogram diagnosis of bacterial pneumonia ranged from 42-58 percent. When clinical and laboratory data were provided to the observers the sensitivity ranged from 42-92 percent. This study indicates that chest film examination is too insensitive to be useful for the selection of patients who have bacterial pneumonia from those whose pneumonia is non-bacterial.
Polymorphonuclear leukocytes (PMNLs) appear in the nasal mucosa during rhinovirus colds before the onset of symptoms. This study describes a chemoattractant for PMNLs that is elaborated by human embryonic lung fibroblast cells infected with rhinovirus. Chemotaxis assays were done in a 48-well microchemotaxis chamber with normal adult PMNLs. Medium supernatants from rhinovirus-infected cell culture attracted 87 +/- 6 (mean +/- SE) PMNLs/10 high-power fields (x450) compared with 38 +/- 6 PMNLs/10 high-power fields attracted by medium from uninfected cell cultures (P less than .0001). Elaboration of the chemoattractant was not a result of cell destruction and did not require the presence of infectious virus. This chemoattractant produced by human fibroblast cells may contribute to the influx of PMNLs into the nasal mucosa during rhinovirus infection. The PMNLs may, in turn, have a role in producing symptoms of the common cold.
Bacterial conjunctivitis appears to resolve more rapidly when treated with appropriate topical antimicrobial agents. In this multicenter, randomized, double-blind study of efficacy and safety, patients with presumed bacterial external eye infections were assigned to topical therapy with 0.3% norfloxacin or 0.3% tobramycin. A total of 120 patients were enrolled. Of the total, 65 had documented bacterial infections and were evaluable; 59 of these patients had bacterial conjunctivitis. All of the patients with documented infections were cured or improved regardless of the drug treatment regimen or in vitro susceptibility testing results. The most common bacteria isolated were Haemophilus influenzae, Streptococcus pneumoniae, alpha-hemolytic streptococci, Staphylococcus aureus, and Staphylococcus sp. No patients had serious adverse reactions attributed to their therapy. Norfloxacin ophthalmic solution seems to be a safe, effective, and appropriate agent for the treatment of bacterial external eye infections.
The cause and clinical manifestations of pneumonia were studied in 98 pediatric outpatients. A viral diagnosis was established in 38 (39%) of the 98 patients, and a bacterial diagnosis in 19 (19%). Ten (53%) of the 19 patients with bacterial pneumonia had a concurrent viral infection. No clinical, laboratory, or radiographic findings that would reliably differentiate viral from bacterial infection were identified. This study suggests that bacterial pneumonia is more common in pediatric outpatients than previously reported, and that the clinical, laboratory, and radiographic findings in patients with bacterial infection may be indistinguishable from findings in patients with viral infection.
Explore the source record for details and available documents.
Spread of rhinovirus infection in the nose was studied after point inoculation of 25 microL of rhinovirus suspension either under the right inferior turbinate via the test duct (26 volunteers) or onto the posterior nasopharyngeal wall (through the mouth under direct vision) (six volunteers). Epithelial brush samples obtained daily from the anterior and posterior portions of the inferior turbinate in both nasal cavities and the nasopharynx were cultured for rhinovirus. Point inoculation of rhinovirus produced a high infection rate, but the entire nasal lining was not infected at the time of peak symptoms. Virus was usually first detected at the nasopharyngeal site, with subsequent spread of infection anteriorly to one or both inferior turbinates. Spread to the left turbinate was not detected in seven of 17 volunteers during the first five days after right eye inoculation. Virus recovery from the mucosa declined by day 16 and ceased by day 21.
Fifty-five volunteers treated with either intranasal recombinant interferon (rIFN; 2 X 10(6) IU/day) or placebo for 15 days were exposed to coronavirus by direct intranasal inoculation on the eighth day of treatment. Symptom scores were recorded, and cultures of virus were taken daily for all volunteers for seven days after inoculation. Nineteen (73%) of the 26 placebo recipients met symptom-score criteria for a cold, compared with 12 (41%) of the IFN recipients (P = .02). The mean nasal symptom scores in the placebo and IFN groups were 9.2 and 5.4, respectively (P = .03), and the mean total symptom scores in the two groups were 23.2 and 9.4, respectively (P = .003). The mean number of days with a total symptom score greater than 4 was 1.6 in the placebo recipients and 0.5 in the rIFN recipients (P = .02). Prophylactic intranasal rIFN effectively shortened the duration and reduced the severity of coronavirus cold symptoms.
The effect of immunoperoxidase staining and centrifugation on the sensitivity and rapidity of herpes simplex virus detection in mink lung cell cultures was determined with 730 clinical specimens. In standard tube cultures, the use of immunoperoxidase staining resulted in detection of 31 (91%) of 34 positive cultures after overnight incubation, compared with 25 (74%) detected without the stain (P less than 0.05). The effect of centrifugation of specimens onto the monolayer followed by overnight incubation and immunoperoxidase staining was studied with 431 specimens. Of 107 positive specimens, 103 (96%) were detected by this method, compared with 91 (85%) detected in standard cell cultures observed for 5 days (P less than 0.02). Standard cell cultures that were examined after overnight incubation detected only 62 (58%) of the 107 positive specimens (P less than 0.001). Centrifugation of clinical specimens onto cell monolayers followed by overnight incubation and immunoperoxidase staining is more rapid and sensitive than are standard cell culture techniques for the laboratory diagnosis of herpes simplex virus infection.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A multiple illumination wavelength multiparameter flow cytophotometer system, using laser sources and controlled by a small, general-purpose digital computer, has been produced for use in the development of new flow cytometric techniques. Three different laser wave-lengths can be used simultaneously to illuminate different regions of the flow chamber; as many as five measurements of light scattering at various angles, extinction, and fluorescence at one or more wavelengths can be made at each illuminated station. Cells in suspension may be examined at rates of 1000 cells/sec, with seven correlated optical measurements being recorded for each cell. A library of programs for data manipulation and statistical analysis make it possible to use the system to develop and implement cell characterization, counting and classification procedures for basic and clinical research applications.
Explore the source record for details and available documents.