CONTEXT: Parvovirus B19 infection during pregnancy has been associated with fetal death. However, the incidence of and risk factors for infection in pregnant women have not been well studied. OBJECTIVES: To estimate a pregnant woman's risk of infection with parvovirus B19 in epidemic and endemic situations and to study risk factors for infection. DESIGN: Population-based cohort study conducted between November 1992 and June 1994. SETTING: Three regions in Denmark. PARTICIPANTS: A total of 30946 pregnant women from a consecutive and population-based screening. MAIN OUTCOME MEASURES: Specific IgG antibodies in serum samples obtained in the first trimester of pregnancy and from the newborn infant to assess past infection and seroconversion. Information on family structure, educational background, socioeconomic status, and pregnancy outcome was obtained from national registers. RESULTS: Based on 30 946 serum samples, 65.0% of pregnant women had evidence of past infection. Annual seroconversion rates among susceptible women during endemic and epidemic periods were 1.5% (95% confidence interval [CI], 0.2%-1.9%) and 13.0% (95% CI, 8.7%-23.1 %), respectively. Baseline seropositivity was significantly correlated with increasing number of siblings, having a sibling of the same age, number of own children, and occupational exposure to children. Risk of acute infection increased with the number of children in the household as follows: 0 children odds ratio (OR), 1 (reference); 1 child OR, 3.17 (95% CI, 2.24-4.49); 2 children OR, 5.47 (95% CI, 3.55-8.45); 3 or more children OR, 7.54 (95% CI, 3.80-14.94). Having children aged 6 to 7 years resulted in the highest rate of seroconversion among mothers (6.8%; OR, 4.07; 95% CI, 1.89-8.73). Compared with other pregnant women, nursery school teachers had a 3-fold increased risk of acute infection (OR, 3.09; 95% CI, 1.62-5.89). Population-attributable risk of seroconversion was 55.4% for number of own children and 6.0% for occupational exposure. CONCLUSIONS: The risk of infection is high for susceptible pregnant women during epidemics and associated with the level of contact with children. Nursery school teachers have the highest occupational risk, but most infections seem to be the result of exposure to the woman's own children.

Acute Disease↗

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Human leukocyte antigen-A, -B, -C tissue types in patients with middle ear cholesteatoma.

Two series of consecutive, nonrelated patients with middle ear cholesteatoma verified by operation were tissue typed for human leukocyte antigens (HLAs) in order to demonstrate any associations. The first series (102 patients) showed only a possible increase of HLA-B8 and HLA-A2. Because HLA-B8 is one of the antigens most often involved in associations with organ-specific autoimmune diseases, and because of the close relationship between HLA-B8 and HLA-DR3, the second series (48 patients) was tissue typed for these two antigens. This second series showed a similar increase of HLA-B8/DR3, but the difference was not statistically significant.

ABO Blood-Group System↗

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Long-term treatment of nasal polyps with beclomethasone dipropionate aerosol. I. Treatment and rationale.

Beclomethasone dipropionate is a potent corticosteroid, which when applied by a pressurized metered dose aerosol in the airways has pronounced anti-allergic effects with no risk of systemic steroid side effects at the recommended dosage. An impressive effect in hay fever and perennial rhinitis has been demonstrated. A double-blind short-term trial showed that the drug was effective in about 80% of patients suffering from moderate to severe nasal polyposis. A study of the long-term effects on the nasal mucosa is indicated.

Aerosols↗

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Long-term treatment of nasal polyps with beclomethasone dipropionate aerosol. II. Clinical results.

The effect of a one-year treatment with intranasal beclomethasone dipropionate in 33 patients with long-standing nasal polyps was determined. About 80% of the patients obtained good or excellent relief of symptoms. No adverse reactions of any importance occurred. It is suggested that intranasal beclomethasone dipropionate is close to the ideal basic treatment for patients with nasal polyps.

Adult↗

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[Long-term treatment of nasal polyps with beclomethasone dipropionate aerosol. III. Morphological studies and conclusions].

Morphological studies during the treatment of patients with nasal polyps with beclomethasone dipropionate aerosol for one year showed a trend towards a decrease in the number of eosinophils in nasal smears and falls in the increased concentrations of albumin, IgG and IgE in the nasal secretion. No change in the histological picture of the polypous tissue except increased density was observed. By scanning electron microscopy, no change in the surface structure of the nasal mucous membrane was noted. As morphological studies did not reveal any sign of adverse effects, beclomethasone dipropionate may be regarded as a valuable drug in the treatment of nasal polyps. The indications for its clinical use and supplementary therapy are discussed.

Adult↗

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Temporal integration of acoustic energy.

Perception of sound shows an increase in loudness related to the duration of the acoustic stimulus. This phenomenon has been studied at threshold (temporal integration) in normal and impaired ears. Normal ears showed an improved threshold with impulse durations up to 200 msec. In cochlear hearing loss, regardless of pathology, the threshold improvement was reduced. A method to evaluate these changes has been designed (Brief Tone Audiometry). When using this method, a quantitative comparison showed the same reduction in temporal integration in ears with hearing loss, regardless of pathology. By using a loudness balance test, the increase in loudness related to prolongation of the stimulus was investigated (Loudness Summation). Loudness growth was measured at various intensities and the results from normal and hearing-impaired ears were compared. At a given sound intensity both normal and hearing-impaired ears showed the same Loudness Summation, which in turn showed a simple relationship to Brief Tone Audiometry in impaired ears. Physiological and diagnostic aspects of these findings are discussed.

Acoustic Stimulation↗

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Conductive hearing loss evaluated by brief tone audiometry.

Bone-conduction measurements are inaccurate and often troubled by masking problems. Determination of the temporal integration of acoustic energy by Brief Tone Audiometry permits an estimate of the cochlear threshold. In 71 patients with middle ear pathology, the conductive impairment was measured using both conventional audiometry and Brief Tone Audiometry. In 85% of the patients, the estimates coincided within 15 dB. Results from pre- and post-operative measurements are given, and it is demonstrated that Brief Tone Audiometry can be used as an alternative to bone-conduction audiometry to determine the degree of conductive loss with the same accuracy, but without the latter's limitations.

Audiometry↗

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Cortical centres underlying auditory temporal processing in humans: a PET study.

We have used positron emission tomography (PET) to test a specific hypothesis of a neural system subserving auditory temporal processing (acoustical stimulus duration discrimination). Maps of the cerebral blood flow distribution during specific stimulations were obtained from five normally-hearing and otherwise healthy subjects. The auditory stimuli consisted of sounds of varying duration and of auditorily presented words in which the duration of the initial phoneme was manipulated. All stimuli alternated with conditions of silence in a subtraction paradigm. The blood flow distribution was mapped with O-15-labelled water. The results demonstrated that stimuli requiring recognizing, memorizing, or attending to specific target sounds during temporal processing generally resulted in significant activation of both frontal lobes and the parietal lobe in the right hemisphere. Based on these results, we hypothesise that a network consisting of anterior and posterior auditory attention and short-term memory sites subserves acoustical stimulus duration perception and analysis (auditory temporal processing).

Adult↗

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Prehospital treatment of patients with i.v. heroin overdose: what are we treating?

OBJECTIVE: To measure blood levels of morphine and additional drugs in patients suspected of intravenous (i.v.) heroin abuse and to evaluate the effects of antidote treatment. DESIGN: Prehospital blood sampling in 52 patients. RESULTS: Forty-five patients were blood-positive for heroin, eight of whom were hospitalized. Forty-one patients also had abused additional drugs: minor tranquilizers, ethanol, amphetamine, cocaine, and/or carbamazepine. Seven patients had taken either only methadone or ketobemidione: one was admitted. Treatment with increasing doses of naloxone indicated a necessity for hospitalization. Six of 14 patients treated with naloxone (1.8 mg were hospitalized. Seven patients had an extremely high blood level of morphine (0.2 mg/kg), that could be reverted with naloxone in moderate doses. CONCLUSION: This study indicates that under prehospital conditions, it is difficult to identify a patient intoxicated only with intravenous heroin. Nearly all patients treated were cases of multiple drug/alcohol overdoses. Even the symptoms associated with extremely high blood levels of morphine could be reversed with naloxone in moderate doses.

Adult↗

PubMedDate not supplied

The nasal mucosa during long-term treatment with beclomethasone dipropionate aerosol. A light-and scanning electron microscopic study of nasal polyps.

Blind examination by light- and scanning electron miscroscope of a total of 142 biopsies from nasal polyps was carried out before and after continuous intranasal treatment with beclomethasone dipropionate aerosol, 400 microgram/day, for a period of 9-36 months. The degree of tissue oedema, the number of infiltrating eosinophil cells and the number of goblet cells in the epithelium decreased significantly. There was no change in the type of surface epithelium during treatment, and no tendency towards squamous cell metaplasia. The study suggests that beclomethasone dipropionate treatment for a period of a few years will not cause atrophic rhinitis.

Aerosols↗