Epidemiology of meningococcal infection.
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Biomedical subjects
Publications and source records attributed to D M Jones.
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Examination of the trends of meningococcal infection in Norway, Iceland, Faroe Islands, Denmark, England and Wales, and the Netherlands, has shown that Neisseria meningitidis B:2b:P1.2 and/or B:2a:P1.2 phenotypes were associated with peaks of infection in the Netherlands in 1966, in Iceland 1976-77, and in England and Wales in 1973-75. These strains were present in all six countries in the decade 1970-80 but their prevalence is now practically negligible. In contrast the prevalence of the B:15:P1.16 phenotype has risen. In the Faroe Islands and northern Norway this change in serotype prevalence has been followed by rises in incidence of meningococcal disease; the same is happening in England and Wales but not yet in the other countries.
The effects of two single oral doses of binedaline (50 and 100 mg), imipramine (75 mg) and placebo were compared on a range of psychological tasks (logical reasoning, the Stroop test, and five-choice serial reaction) in healthy young volunteers. The tasks, together with a mood adjective check-list, were completed prior to drug administration and 1, 2, 4 and 8 h post-dose. Binedaline had no significant effect on any of the task parameters. Imipramine impaired performance on all but the Stroop test at 2 h after drug administration. At 1, 2 and 4 h, ratings on the "deactivation" dimension of the mood adjective check-list were significantly higher following imipramine when compared to placebo. The results are discussed in terms of some general considerations about the selection and scoring of tasks to be used in the screening of drugs.
The interactive effects of mood induction and alcohol consumption were examined in a combined visual digit detection and tracking task. Although tracking ability was independently sensitive to both time on task and alcohol, no interaction between alcohol and mood was observed. However, correct reaction times on the digit detection task were sensitive to such interactive effects. Those individuals who both consumed alcohol and watched a descriptive film performed worse on this part of the task throughout the session compared to those who watched a humorous film and did not take alcohol. Correlational analyses between performance on the tracking and digit detection tasks do not necessarily support the contention that alcohol may serve to disrupt the operation of a timesharing process.
We report a case of meningitis due to Neisseria meningitidis group 29E. The organism was serum-sensitive and therefore not expected to be encountered in an immunologically competent young man. Trauma sustained in a road traffic accident 18 months earlier had affected the tympanic membrane and middle ear, allowing direct infection of the meninges. Myringoplasty was performed to prevent recurrent infection.
Different cellular proteins of the gastric campylobacter-like organism (GCLO) were shown to be immunogenic for man. Antibodies to GCLO were detected in sera by both complement fixation and enzyme-linked immunoabsorbent assay. Antibody was found in 133 (52%) of 254 patients attending for gastroscopy. There was a high correlation between presence of antibody and a positive GCLO culture from the gastric mucus. Patients with normal endoscopic appearances, duodenal ulcer, duodenitis and oesophagitis had similar prevalences (c. 50%) of antibody. Only patients with endoscopically visible gastritis or gastric ulcer had a higher frequency (c. 80%) of antibody. In a normal population, antibody was uncommon in individuals less than 20 years old, but the prevalence of antibody increased (to c. 50%) with age. There was little evidence to support an important pathological role for GCLO in disorders of the upper gastrointestinal tract, although the possibility that it may be a co-factor in the pathogenesis of gastric ulcer cannot be excluded.
The cognitive function and psychomotor performance of 10 healthy male volunteers were measured following single oral doses of: zopiclone (7.5 mg), flurazepam (15 mg), lormetazepam (1 mg), triazolam (0.25 mg) and placebo. The performance tests selected (stroop task, five choice serial reaction time, memory span, logical reasoning, mood and saccadic eye movement analysis) were thought to reflect aspects of normal daily activity. The tests demonstrated a clear reduction of performance for all active treatments. No drug emerged as the most potent sedative overall, as each of the tests was affected to a different degree by each drug. Drug effects were not qualitatively different between active treatments so that zopiclone was indistinguishable from the three benzodiazepines with which it was compared.
Using the method of magnitude estimation, annoyance ratings of thirty-six different masking sounds obtained from a group suffering from tinnitus were compared with ratings from a normal-hearing group in an attempt to assess the acceptability of potential tinnitus maskers. The key findings were as follows: In both groups bandpass noise was rated as less annoying than tones or triangular waves. The annoyance value of bandpass maskers increased with bandwidth. Interrupted maskers were rated as more annoying than continuous maskers. Most of the differences between the tinnitus and normal group could be explained in terms of the high-frequency hearing loss and loudness recruitment associated with the tinnitus group. Control over the centre frequency and the bandwidth of a noise masker was important in optimising the acceptability of the tinnitus masker.
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Condoms and other rubber products immobilize sperm, but the mechanism is unknown. Sperm motility and eosin Y exclusion were measured following exposure of samples of semen to latex condoms of various types. Sperm motility was markedly reduced by exposure to all latex condoms, but eosin Y exclusion was unchanged. While there appeared to be some variability between semen samples and in time to complete immobilization of all sperm, condoms from one batch were similar. The immobilizing effect was not altered by prewashing the condom with buffer, chelating agent or acid. After immobilization, motility was not recovered by sperm washed in buffer, mixed with normal mid-cycle cervical mucus, or exposed to caffeine or adenosine triphosphate after demembranation with detergent. Studies with components of condoms indicated that raw latex and zinc dimethyl- and dibutyl-dithiocarbamate accelerators immobilized sperm within 30 min. In contrast, silicone rubber had no effect on sperm motility for up to 4 h. Enhancement of the sperm immobilizing effect might improve the contraceptive efficacy of condoms, while a useful non-toxic sperm collecting device for semen analysis, artificial insemination or in vitro fertilisation might be developed by omitting the toxic components from the rubber.
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Five hundred strains of thermophilic Campylobacter spp. from sporadic cases of enteritis and from epidemiologically related infections connected with outbreaks were serotyped. The haemagglutination method of Penner and the slide agglutination method of Lior were used together. Greater discrimination was obtained by the use of two methods together than by either alone; 96% of sporadic strains were typed using a restricted set of typing sera. Of the sporadic strains, 50% fell within five Penner serotypes and 50% fell within four Lior serotypes, so the increased discrimination obtained by using both methods was particularly useful amongst these most common serotypes. In outbreaks associated with one serotype both methods gave consistent results, and in outbreaks due to multiple serotypes the two methods complimented each other.
The epidemiology of meningococcal infections that arose in England and Wales during the period 1912-1983 has been reviewed. The outcome of meningococcal disease was dramatically improved when treatment with sulphonamides was introduced. With the emergence of sulphonamide-resistant strains, penicillin has become the drug of choice. Despite modern treatment, however, the mortality ratio during the last 30 years has remained about the same. Prompt diagnosis as well as immediate and effective treatment are cardinal needs. Even so, when infection is overwhelming there is little chance of saving the patient. Immunisation is probably the only effective answer but as yet there is not an effective vaccine to prevent group B infections which predominate in this country.
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H.261, a new transition state inhibitor of human renin with an IC50 of 6.9 X 10(-10) M, was given by intravenous infusion to six anaesthetized baboons. The inhibitor was infused first at 0.1 mumol/kg/h for 15 min, then at 1.0 mumol/kg/h for a further 15 min. After a recovery period of 2 h in which the animals received 5% dextrose, they were infused with captopril, 25 mumol/kg/h for 15 min. At both rates of infusion H.261 markedly and significantly reduced the enzymatic action of renin in plasma, the blood concentration of angiotensin I, the plasma concentration of angiotensin II and mean arterial pressure. All changes reverted towards or to control values in the subsequent control period. Captopril also lowered plasma angiotensin II concentration and mean arterial pressure markedly and significantly but, as expected for an inhibitor of the angiotensin I-converting enzyme, plasma active renin concentration and blood angiotensin I concentration increased. The changes of angiotensin II and arterial pressure were similar with captopril and H.261.
Microaerophilic spiral organisms may be isolated frequently from samples of gastric mucus taken from patients undergoing gastroscopy. The ultrastructure of these gastric campylobacter-like organisms ('Campylobacter pyloridis') shows that they have greater affinities with Spirillum than with Campylobacter.
Infusion of H.261, the inhibitor of human renin in the baboon, lowered blood angiotensin I, plasma angiotensin II, and arterial pressure suggesting that in the sodium-depleted state angiotensin II contributes to the maintenance of arterial pressure. In a second experiment dose-response infusions of angiotensin II were given in conscious sodium-depleted dogs before and during infusion of the renin inhibitor H.77. These suggested that the contribution of angiotensin II to the maintenance of arterial pressure in this state was made mainly by a circulating peptide. Preliminary results in normal humans show that infusion of H.142 intravenously lowered angiotensin I, angiotensin II, and arterial pressure.
Fibreoptic endoscopy was performed in 1056 monomorphic birds of 144 different species belonging to 15 Orders. The purpose was to establish their sex by direct inspection of the gonads. The results suggest that although the technique involves surgical intervention it is generally more practical and accurate than chromosome analysis of lymphocytes or analysis of faecal steroids. Surgical anaesthesia is recommended on practical and humane grounds but this and the technique itself can be hazardous in old and fat birds, where a mortality rate of as high as 2 per cent was encountered. Cloacal examination of as high as 2 per cent was encountered. Cloacal examination is a more practical technique for sex determination in penguins.