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Biomedical subjects

J L Sever

Publications and source records attributed to J L Sever.

333 records · Page 19Linked to original sources
PubMedDate not supplied

Delayed manifestations of congenital rubella.

The manifestations of congenital rubella syndrome (CRS) can be grouped according to time of onset into newborn, extended, and delayed CRS. The delayed manifestations are not present in early life and include the following: endocrinopathies: diabetes, thyroid disease, and growth hormone deficiency; deafness; ocular damage: glaucoma, keratic precipitates, keratoconus, corneal hydrops, and absorption of the cataractous lens; vascular effects: fibromuscular proliferation of the intima, sclerosis of arteries, systemic hypertension secondary to renal disease, and subretinal neovascularization; and progressive rubella panencephalitis. Several mechanisms of pathogenesis of the damage have to be considered for the delayed manifestations, including growth of the virus in tissues, resulting in a reduced growth rate and shortened life-span of the cells; autoimmune responses, initially stimulated by the infection; genetic susceptibility; vascular damage by the viral infection with further stenosis or occlusion of the vessels later; reactive hypervascularization; and chronic persistence of the virus in the tissue with subsequent extension of the infection to other areas.

Adolescent↗
PubMedDate not supplied

HIV and HTLV-I antibody studies: pregnant women in the 1960s, patients with AIDS, homosexuals, and individuals with tropical spastic paraparesis.

To investigate the possible occurrence of human immunodeficiency virus (HIV) or human T-cell lymphotropic virus, type I (HTLV-I) infections in the United States prior to 1979-1981, when acquired immune deficiency syndrome (AIDS) was first recognized, we tested sera from 310 pregnant women who participated in the Collaborative Perinatal Project during the period 1959-1964 for HIV and HTLV-I antibody. These samples included sera from 53 pregnant women who were intravenous drug users. The remainder were from women who had cervical epithelial abnormalities, who developed cervical carcinomas, who had had children with erythroblastosis fetalis, who had had children that developed malignant neoplasms early in life, or normal pregnant women. None of the 310 women had confirmed HIV or HTLV-I antibody. The rate of false-positive reactions with the HIV enzyme-linked immunosorbent assay (ELISA) antibody test in these long-frozen samples was similar to that observed in fresh sera. HIV antibody was detected in homosexual patients with AIDS; HTLV-I antibody was not detected in any of these sera. HTLV-I antibody was detected in 17 of 20 patients with tropical spastic paraparesis (TSP) and in two of seven patients with other neurological diseases diagnosed as transverse myelopathy and multiple sclerosis, and in none of nine normal controls; HIV antibody was not detected in any of these sera patients. Thus, we conclude that there was no serological evidence of infection with HIV or HTLV-I in the pregnant women studied; however, HIV antibody was present in all AIDS patients tested, and HTLV-I antibody was found in the majority of patients with TSP.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

In utero diagnosis of congenital infections by direct fetal sampling.

Counseling for infections during pregnancy has traditionally focused on the clinical and laboratory findings of infection in the mother and the estimated risk of fetal damage associated with possible transmission of infection to the child. Now, with the use of techniques for fetal sampling, it is possible to diagnose infections of the fetus in utero and to correlate that information with the occurrence of fetal damage. The techniques that are available for sampling include amniocentesis, cordocentesis and chorionic villus sampling. The laboratory tests include: a) isolation of the organism in appropriate laboratory systems; b) detection of the DNA or RNA of the organism directly or with amplification with techniques such as PCR; c) detection of the organism by fluorescence or in situ hybridization; and d) identification of IgM or IgA fetal antibody to the organism by ELISA or similar methods. In utero infections can be documented for agents such as rubella, cytomegalovirus, parvovirus, Toxoplasma gondii and human immunodeficiency virus type 1. Further information is needed concerning the sensitivities and specificities of these methods for identifying fetal infection and predicting fetal damage.

Amniocentesis↗
PubMedDate not supplied

Early diagnosis and immunologic changes in HIV-1 infected pregnant women and their children.

The diagnosis of HIV infection in pregnant women is usually based on the detection of HIV-specific antibodies. These tests become positive a few weeks to months after infection. In the United States, it is recommended that tests be offered to all women and encouraged where the rate of infection is > or = 1/1,000 or the woman is at increased risk for infection. The great majority of infected pregnant women are asymptomatic, and questioning patients about risk behavior will identify only about one-half of the infected women. In Washington, D.C. about 1.5% of the pregnant women who reside in the city are HIV positive. The diagnosis of HIV in the child in the first month of life is difficult and requires the use of polymerase chain reaction tests and/or culture. Other tests become positive later. Immunological tests in most HIV-infected mothers in the USA are normal; however, about 12% of patients are symptomatic and show decreased CD4 T cell counts and 6% have AIDS. These patients may have other evidence of decreased T cell responses and are at increased risk for opportunistic infections. At birth, almost all children of HIV-infected mothers have normal immunological findings. However, about 50 of these children become ill by 1 year of age and many develop decreased T cell counts and other immunological changes.

Female↗