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Sulfa Or Sulfone Prophylaxis And Geographic Region Predict Mutations In The Pneumocystis Carinii Dihydropteroate Synthase Gene, Laurence Huang, Charles B. Beard, Jennifer Creasman, Deborah A. Levy, Jeffrey S. Duchin, Sherline Lee, Norman Pieniazek, Jane L. Carter, Carlos Del Rio, David Rimland, Thomas R. Navin

Journal Articles: Epidemiology

To determine factors associated with mutations in the Pneumocystis carinii dihydropteroate synthase (DHPS) gene, a prospective study of human immunodeficiency virus (HIV)-infected patients with confirmed P. carinii pneumonia was conducted in Atlanta, Seattle, and San Francisco. Clinical information was obtained from patient interview and chart abstraction. DHPS genotype was determined from DNA sequencing. Overall, 76 (68.5%) of 111 patients had a mutant DHPS genotype, including 22 (81.5%) of 27 patients from San Francisco. In multivariate analysis, sulfa or sulfone prophylaxis and study site were independent predictors of a mutant genotype. Fourteen (53.8%) of 26 patients who were newly diagnosed with …

Genetic Variation In Pneumocystis Carinii Isolates From Different Geographic Regions: Implications For Transmission, Charles B. Beard, Jane L. Carter, Scott P. Keely, Laurence Huang, Norman J. Pieniazek, Iaci N. S. Moura, Jacquelin M. Roberts, Allen W. Hightower, Michelle S. Bens, Amanda R. Freeman, Sherline Lee, James R. Stringer, Jeffrey S. Duchin, Carlos Del Rio, David Rimland, Robert P. Baughman, Deborah A. Levy, Vance J. Dietz, Paul Simon, Thomas R. Navin

Journal Articles: Epidemiology

To study transmission patterns of Pneumocystis carinii pneumonia (PCP) in persons with AIDS, we evaluated P. carinii isolates from patients in five U.S. cities for variation at two independent genetic loci, the mitochondrial large subunit rRNA and dihydropteroate synthase. Fourteen unique multilocus genotypes were observed in 191 isolates that were examined at both loci. Mixed infections, accounting for 17.8% of cases, were associated with primary PCP. Genotype frequency distribution patterns varied by patients' place of diagnosis but not by place of birth. Genetic variation at the two loci suggests three probable characteristics of transmission: that most cases of PCP do …

Intimate Partner Violence Among Men And Women In South Carolina, 1998, Ann L. Coker, Christina Derrick, Julia L. Lumpkin, Robert Oldendick, R H. Potter

CRVAW Faculty Journal Articles

Few studies provide population-based estimates of intimate partner violence (IPV) for men and women, especially at the state level. IPV may result in adverse health effects for victims and perpetrators (1-3). To estimate the lifetime incidence of IPV by type of violence (e.g., physical, sexual, and perceived emotional abuse) and to explore demographic correlates of reporting IPV among men and women, the South Carolina Department of Health and Environmental Control and the University of South Carolina conducted a population-based random-digit-dialed telephone survey of adults in the state. This report summarizes the results of the survey, which indicated that approximately 25% …

Surveillance For Waterborne-Disease Outbreaks--United States, 1997-1998., Rachel S. Barwick, Deborah A. Levy, Gunther F. Craun, Michael J. Beach, Rebecca L. Calderon

Journal Articles: Epidemiology

PROBLEM/CONDITION: Since 1971, CDC and the U.S. Environmental Protection Agency (EPA) have maintained a collaborative surveillance system for collecting and periodically reporting data relating to occurrences and causes of waterborne-disease outbreaks (WBDOs).

REPORTING PERIOD COVERED: This summary includes data from January 1997 through December 1998 and a previously unreported outbreak in 1996.

DESCRIPTION OF THE SYSTEM: The surveillance system includes data regarding outbreaks associated with drinking water and recreational water. State, territorial, and local public health departments are primarily responsible for detecting and investigating WBDOs and voluntarily reporting them to CDC on a standard form.

RESULTS: During 1997-1998, a total …

Resurgence Of Sleeping Sickness In Tambura County, Sudan, Anne Moore, Michaleen Richer, Mario Enrile, Edward Losio, Jacquelin Roberts, Deborah A. Levy

Journal Articles: Epidemiology

Endemic foci of human African trypanosomiasis are present in southern Sudan. In 1996 and 1997, trypanosomiasis increased sharply in Tambura County. To define the magnitude and geographic distribution of the outbreak, we conducted a prevalence survey using population-based cluster sampling in 16 villages: 1,358 participants answered questions about routine activities and tsetse fly contact and received serologic testing. Seroprevalence in the surveyed area was 19.4% (95% confidence interval = 16.9%, 21.8%). We confirmed infection in 66% of seropositive persons who received one parasitologic examination and in 95% of those who had serial examinations of lymph node fluid and blood. Activities …

Surveillance For Waterborne-Disease Outbreaks -- United States, 1995-1996, Deborah A. Levy, Michelle S. Bens, Gunther F. Craun, Rebecca L. Calderon, Barbara L. Herwaldt

Journal Articles: Epidemiology

PROBLEM/CONDITION: Since 1971, CDC and the U.S. Environmental Protection Agency have maintained a collaborative surveillance system for collecting and periodically reporting data that relate to occurrences and causes of waterborne-disease outbreaks (WBDOs).

REPORTING PERIOD COVERED: This summary includes data for January 1995 through December 1996 and previously unreported outbreaks in 1994.

DESCRIPTION OF THE SYSTEM: The surveillance system includes data about outbreaks associated with drinking water and recreational water. State, territorial, and local public health departments are primarily responsible for detecting and investigating WBDOs and for voluntarily reporting them to CDC on a standard form.

RESULTS: For the period 1995-1996, …

Initial Multicenter Experience With Double Nucleoside Therapy For Human Immunodeficiency Virus Infection During Pregnancy., N S Silverman, D H Watts, J Hitti, D M Money, E Livingston, J Axelrod, J M Ernest, D Robbins, M M Divito

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To study maternal and neonatal effects of combination nucleoside analog therapy administered to human immunodeficiency virus (HIV)-infected pregnant women for maternal indications.

METHODS: A multicenter, prospective observational study was undertaken at six perinatal centers in the United States and Canada that supported regional referral programs for the treatment of HIV-infected pregnant women. Demographic, laboratory, and pregnancy outcome data were collected for 39 women whose antiretroviral treatment regimens were expanded to include more than one nucleoside analog for maternal indications. The 40 newborns were monitored at pediatric referral centers through at least three months of age to ascertain their HIV …

Determinants Of Antepartum Human Immunodeficiency Virus Testing In A Non-Medicaid Obstetric Population., E Cardonick, S Daly, M Dooley, K Elles, N S Silverman

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To determine voluntary human immunodeficiency virus (HIV) testing rates and factors influencing testing in a private obstetric practice.

METHODS: Antepartum patients were offered HIV testing after completing a self-assessment questionnaire. Perceived risks and demographics were correlated with testing rates.

RESULTS: Overall, 348/600 (58%) women consented to HIV testing. In a univariate analysis, patients with "any" perceived risk(s) were more likely to be tested. Single women and those with an at-risk partner(s) or a history of sexually transmitted disease (STD) were more likely to desire testing. These factors remained independently associated with voluntary testing in a multivariate regression model. No …

The History Of The Present Illness As Treatment: Who's Listening, And Why Does It Matter?, Herbert M. Adler, Md, Phd

Department of Family & Community Medicine Faculty Papers

BACKGROUND: The history of the present illness (HPI) is examined as a narrative communication that has the potential to be therapeutic.

METHODS: The general principles that influence the therapeutic potential of the HPI are induced from participant observation of personal experience and natural observations of conventional social interaction. These principles are corroborated by evidence from cross-cultural healing practices, clinical experience, and experimental psychology.

RESULTS: To facilitate a therapeutic HPI, the clinician should convey a sense of safety, sensitivity, affective competence, and cognitive competence. Furthermore, the effective clinician joins the patient in coprocessing the illness experience.

CONCLUSIONS: The (HPI) is not …

Cd40-Cd40 Ligand Interactions In Experimental Allergic Encephalomyelitis And Multiple Sclerosis., Koen Gerritse, Jon D. Laman, Randolph J. Noelle, Alejandro Aruffo

Dartmouth Scholarship

We investigated the role of CD40-CD40 ligand (CD40L) interactions in multiple sclerosis (MS) and experimental allergic encephalomyelitis (EAE). Activated helper T cells expressing CD40L (gp39) surface protein were found in MS patient brain sections, but not in brain tissue sections of normal controls or patients with other neurological disease. CD40L-positive cells were co-localized with CD40-bearing cells in active lesions (perivascular infiltrates). Most of these CD40-bearing cells proved to be of the monocytic lineage (macrophages or microglial cells), and relatively few were B cells. To functionally evaluate CD40-CD40L interactions, EAE was elicited in mice by means of proteolipid-peptide immunization. Treatment with …

A Call To Action: The Institute Of Medicine Report On Emergency Medical Services For Children., J F. Knapp

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Comparison Of Cytotoxic Properties Of Neonatal And Adult Neutrophils And Monocytes And Enhancement By Cytokines., E . R. Stiehm, R. L. Roberts, B. J. Ank, S. Plaeger-Marshall, N. Salman, L. Shen, M. W. Fanger

Dartmouth Scholarship

We studied cytotoxic capabilities of newborn polymorphonuclear leukocytes (PMNs) and monocytes and their enhancement by cytokines and antibodies. Umbilical cord PMNs were assessed for their ability to kill various target cells spontaneously, after activation with phorbol myristate acetate, in the presence of antiserum (antibody-dependent cellular cytotoxicity), and in the presence of dually specific antibody (heteroantibody-mediated cytotoxicity). Target cells included the K562 cell line (natural killer cell target), chicken erythrocytes (CRBCs), and herpes simplex virus-infected CEM cell lines. Newborn PMNs were equivalent to adult PMNs in their cytotoxic capacity in several cytotoxicity assays. Neither adult nor newborn PMNs lyse tumor cell …

Murine Gamma Interferon Fails To Inhibit Toxoplasma Gondii Growth In Murine Fibroblasts., Joseph D. Schwartzman, Steven L. Gonias, E R. Pfefferkorn

Dartmouth Scholarship

Although treatment of human macrophages or fibroblasts with human gamma interferon results in the inhibition of intracellular Toxoplasma gondii, murine gamma interferon stimulated only murine macrophages, not murine fibroblasts, to inhibit T. gondii. This species difference may be important in understanding the control of acute and chronic toxoplasmosis.

Effects Of Methylene Chloride On Immune Function In Mice And The In Vitro Effect Of Methylene Chloride In Immunologic Assays, Man-Ping Wang

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

A number of toxicities associated with methylene chloride have been found in both human subjects and mice. However, relatively few studies have probed immunotoxicities of methylene chloride. In order to examine possible immunotoxicities or immunomodulating effects of methylene chloride, several tests of cellular immune function were performed using both human in in vitro studies and a mouse model.

Body weights and specific organ weights of thymus, spleen, liver, and kidney were normal in CD-1 mice given various concentrations of methylenechloride. However, a significantly reduced mitogenic response to phytohemagglutinin (PHA} and reduced interleukin-2 (IL-2} production was found in these methylene-chloride-treated mice. …

Inhibition Of T Lymphocyte Mitogenesis By 1,25-Dihydroxyvitamin D3 (Calcitriol)., William F.C. Rigby, Terryl Stacy, Michael W. Fanger

Dartmouth Scholarship

Recent studies have suggested that vitamin D may have other important biologic activities in addition to its well-characterized role in the maintenance of calcium homeostasis. Discovery of cytosolic receptors for vitamin D in human peripheral blood monocytes and lectin-stimulated lymphocytes prompted us to study the effects of 1,25-dihydroxyvitamin D3 (calcitriol), the most biologically active metabolite of vitamin D, upon phytohemagglutinin (PHA)-induced lymphocyte blast transformation. We have found that calcitriol is a potent inhibitor of PHA-induced lymphocyte proliferation, achieving 70% inhibition of tritiated thymidine incorporation after 72 h in culture. Furthermore, calcitriol suppressed interleukin-2 (IL-2) production by PHA-stimulated peripheral blood mononuclear …

Inhibition Of Growth Of Toxoplasma Gondii In Cultured Fibroblasts By Human Recombinant Gamma Interferon., E. R. Pfefferkorn, Paul M. Guyre

Dartmouth Scholarship

The growth of Toxoplasma gondii in cultured human fibroblasts was inhibited by recombinant human gamma interferon at concentrations of 8 to 16 U/ml. The interferon was titrated by observing a total inhibition of parasite plaque formation 7 days after infection. Inhibition of the growth of T. gondii in the early days after infection was measured by marked reductions in the incorporation of radioactive uracil, a precursor that can only be used by the parasites. This assay showed that when cells were pretreated with gamma interferon for 1 day and then infected, inhibition of T. gondii growth could be readily detected …

Gamma Interferon Induces Monocytoid Differentiation In The Hl-60 Cell Line., Edward D. Ball, Paul M. Guyre, Li Shen, John M. Glynn, Charles R. Maliszewski, Paul E. Baker, Michael W. Fanger

Dartmouth Scholarship

We investigated the ability of purified, recombinant DNA-derived interferons (IFN) to induce phenotypic changes in cells of the HL-60 promyelocytic leukemia cell line. Changes in cell surface markers detected by monoclonal antibodies as well as morphologic, histochemical, and functional changes were monitored. We found that gamma-IFN, but not alpha- or beta-IFN, induced the expression of antigens characteristic of monocytes and granulocytes (AML-2-23, 63D3, and 61D3), as well as changes in morphology consistent with monocytoid differentiation. These included induction of alpha-naphthyl acetate esterase, increased cell size, and a decrease in azurophilic granules. The gamma-IFN dose dependency and time course of the …

Monoclonal Antibodies To Novel Myeloid Antigens Reveal Human Neutrophil Heterogeneity., Edward D. Ball, Robert F. Graziano, Li Shen, Michael W. Fanger

Dartmouth Scholarship

Three cytotoxic murine monoclonal antibodies that recognize myeloid-specific antigens have been produced by immunization with normal human neutrophils or myeloblasts from a patient with acute myelomonocytic leukemia. Two of these, PMN 6 and PMN 29, are specific for neutrophils; the third monoclonal antibody, AML-2-23, is reactive with the majority of normal monocytes as well as a subpopulation of mature neutrophils. Although neutrophils from all individuals tested expressed these antigens, cytofluorographic analysis revealed that the percentage of cells bearing the PMN 6 and AML-2-23 antigens varied among individuals. Significant additional heterogeneity in the density of each antigen among antigen-bearing cells was …

The Incidence Of Avian Tuberculosis In Mammals Other Than Swine, L. Van Es, H. M. Martin

Nebraska Agricultural Experiment Station: Historical Research Bulletins

The recognition of a very widespread and intense distribution of avian tuberculosis on the farms of a wide area of the United States, as well as the involvement of a mammalian species also, brought to the foreground the question whether or not the great prevalence of poultry tuberculosis could be of importance also from a public health point of view. This phase of the problem not only pertains to the people on the farms but likewise is of fundamental importance to the consumers of poultry produce. European authors had already identified the avian tubercle bacillus in human lesions while in …

Studies On The Ascaris Lumbricoides, H. M. Martin

Nebraska Agricultural Experiment Station: Historical Research Bulletins

The Ascaris lumbricoides, in one phase or another, has attracted the attention of parasitologists for many years, and during the last decade this parasite has been studied by a large number of investigators. The recent observations have been, to a great extent, directed along one line, the study of its life history. These investigators have established two important points: (a) That the life history of Ascaris is more complex than was supposed, as it has been found that a vasculo-pulmonary circuit of the larvae is necessary before they settle down in the intestine, where they develop to the adult …