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Biomedical subjects

J Schachter

Publications and source records attributed to J Schachter.

At least 181 records · Page 10Linked to original sources
PubMed1988

Isolation of Chlamydia trachomatis from sexually abused female adolescents.

Cultures for Chlamydia trachomatis were obtained from 127 female adolescents (13-17 years of age) evaluated for reported sexual abuse. The rate of positive cultures for C trachomatis in this population was 14% (18 of 127). Neisseria gonorrhoeae was found in 12% (15 of 127) of these patients. All but two of the culture-positive patients admitted sexual activity before the abuse, and it is likely that most of the infections were acquired during this previous sexual activity. Concomitant infection with N gonorrhoeae was found in seven adolescents positive for C trachomatis. No adolescents in this study exhibited a positive VDRL. Victims of abuse should be tested for both gonococcal and chlamydial infection. These data show that if antibiotic prophylaxis is used for the sexually abused adolescent, it should be directed against both C trachomatis and N gonorrhoeae.

Adolescent↗
PubMed1988

Oral immunization with chlamydial major outer membrane protein (MOMP).

The effect of vaccination to stimulate mucosal immunity with a purified subunit vaccine of chlamydial major outer membrane protein (MOMP) on subsequent ocular challenge with Chlamydia trachomatis was studied in cynomolgus monkeys. Monkeys were immunized with MOMP by intraperitoneal priming plus oral boosting, with or without ocular boosting, or by ocular immunization alone. Cholera toxin was used as an adjuvant with the oral doses of MOMP vaccine. Animals were challenged with viable purified elementary bodies 35 days after the first immunization. The immunizing schedules used provided a transient decrease in the potentially deleterious inflammatory response in the eye but no reduction in duration of infection. Immunoblotting studies showed that anti-MOMP antibodies were induced by oral vaccination in some animals, but the antibody response following ocular challenge as determined by microimmunofluorescence (MicroIF) serology was similar in vaccinated and nonvaccinated animals. This study demonstrates that the stimulation of mucosal immunity by a vaccine of purified chlamydial MOMP was only partially effective in protecting against chlamydial eye infection. The lack of clear protection in these studies may be due to the failure of the various immunizing regimes to induce an antibody response prior to challenge.

Administration, Oral↗
PubMed1987

Pathogenesis of trachoma: the stimulus for inflammation.

Active trachoma is characterized by chronic inflammation of the conjunctiva, and repeated episodes of reinfection are thought to be necessary to sustain this inflammation. It is currently believed that much of the tissue damage is immunologically mediated. To identify which antigens might be responsible for stimulating this continued inflammation, cynomolgus monkeys that had recovered from a previous ocular infection with Chlamydia trachomatis were challenged with various antigen preparations. Purified preparations of formalin- or UV-inactivated elementary bodies did not elicit any inflammation even with daily inoculation. In addition, neither purified chlamydial major outer membrane protein nor lipopolysaccharide, including recombinant organisms expressing the lipopolysaccharide group antigen, elicit inflammation. A soluble triton extract of the organism rapidly induced marked inflammation when inoculated in the eyes of immune monkeys but had no effect in naive animals. These studies suggest that the continual inflammation in trachoma may not be due to repeated exposure to chlamydial surface antigen(s) but rather to a labile product released by the living organisms.

Animals↗
PubMed1987

Flow cytometric analysis of Chlamydia trachomatis interaction with L cells.

Immunofluorescent staining and flow cytometric analysis have been investigated as means of studying the early stages of in vitro infection of Chlamydia trachomatis. The lymphogranuloma venereum strain of C. trachomatis was grown in vitro in L cells, fixed in p-formaldehyde, stained with fluorescein isothiocyanate (FITC)-conjugated monoclonal antibody to the chlamydial major outer membrane protein, and analyzed flow cytometrically. Infected cells stained 50-100 times more intensely than uninfected cells, and they could easily be discriminated by flow analysis. The number of infected cells and the fluorescence intensity of individual cells were proportional to the multiplicity of infection. The attachment of purified elementary bodies to L cells could be analyzed by immunofluorescence and flow cytometry. Cells exposed to 0.26 inclusion-forming units/cell could be discriminated from an unexposed population. Flow analysis of purified elementary bodies was possible after fluorescent staining with the aid of a laser-based cytometer and gating on low volume.

Animals↗
PubMed1987

Chlamydia trachomatis infection and pregnancy outcome.

Chlamydia trachomatis is now recognized as the most common sexually transmitted disease organism in the United States. Although the potential for vertical transmission of C. trachomatis from pregnant women to their infants is well established, the extent to which infection adversely affects pregnancy and causes perinatal complications remains controversial. We report herein the results of a prospective study of 270 pregnant women with endocervical C. trachomatis compared with 270 matched control subjects (age +/- 1 year, race, and socioeconomic status). Among the entire group (n = 540), the rates of pregnancy complications were: premature rupture of the membranes, 54/270 (10%); preterm delivery, 55 (11%); amnionitis, 20 (4%); intrapartum fever, 23 (4.3%); small for gestational age, 76 (14.5%); postpartum endometritis, 31 (6%); and neonatal sepsis, 10 (1.8%). No statistically significant differences were noted between cases and controls for any of these variables. In the subset of women with recent or invasive chlamydial infection, indicated by the presence of IgM antibody against C. trachomatis, preterm delivery occurred in 13/67 IgM-positive versus 8/99 IgM-negative (p = 0.03) cases. Premature rupture of the membranes was present in 13/67 IgM-positive versus 8/99 IgM-negative (p = 0.03).

Cervix Uteri↗
PubMed1987

The medical and psychosocial needs of children entering foster care.

The estimated three to four hundred thousand children in foster care represent a population at high risk for medical and psychosocial problems. Their problems are compounded by the lack of adequate resources available to them while in foster care. This study provided a medical and psychosocial screening of 149 abused and neglected children entering the foster care system. The goal was to generate a profile of the medical and psychosocial needs of children entering the foster care system as a first step toward development of a better health care delivery system. Results indicated that these children have a much greater incidence of chronic medical conditions, are likely to weigh significantly less and be significantly shorter than the general population, require significant amounts of medical sub-specialty care, have a high incidence of developmental delays, and major deficits in adaptive behavior and have a large number of behavioral problems often associated with psychiatric disorders. Results are discussed in terms of the development of a regional model to effectively manage the health care needs of children entering foster care.

Adolescent↗
PubMed1987

Role of Chlamydia trachomatis and Mycoplasma pneumoniae in acute pharyngitis in children.

In a group of children with acute, nonstreptococcal pharyngitis, only one (2%) of the 44 children tested showed serologic or direct-immunofluorescence evidence of a recent Chlamydia trachomatis infection. Only two (5%) of the 43 children tested showed serologic evidence of a recent Mycoplasma pneumoniae infection. Neither C. trachomatis nor M. pneumoniae appears to be an important cause of acute pharyngitis in children.

Acute Disease↗
PubMed1987

The use and limitations of endocervical Gram stains and mucopurulent cervicitis as predictors for Chlamydia trachomatis in female adolescents.

We evaluated the presence of polymorphonuclear cells on endocervical Gram stains and clinical indices of cervicitis as predictors of Chlamydia trachomatis infection in 193 sexually active female adolescents; 148 (77%) subjects had no complaints. C. trachomatis was isolated from 34 (18%) subjects. The incidence of C. trachomatis differed by race: it was isolated from 30% of black subjects and 7% of nonblack subjects. Polymorphonuclear cells on Gram stains were found to be associated with the presence of C. trachomatis (chi 2 = 33.2, p less than 0.0001). The sensitivity, specificity, and positive predictive value for polymorphonuclear cells to predict the presence of C. trachomatis were 91% (31/34), 65% (103/159), and 36% (31/87), respectively. When examined by ethnicity, polymorphonuclear cells remained significantly associated with C. trachomatis for black subjects (chi 2 = 24.3, p less than 0.001) but not for nonblack subjects (chi 2 = 2.49, p less than 0.1). Mucopurulent discharge, friability, or erythema-edema of ectopy were not reliable indicators for C. trachomatis. Endocervical Gram stains alone are useful to identify populations at risk for C. trachomatis infection. Caution must be advised when interpreting data from different population groups because of the variability in C. trachomatis prevalence.

Adolescent↗
PubMed1987

Is there a role for Chlamydia trachomatis and genital mycoplasma in male infertility?

We believe that, without evidence of inflammation (greater than 5 WBC on VB1), there is no indication for routine culture or antibiotic treatment of infertile men. In the presence of active inflammation and positive cultures for chlamydia, treatment with antibiotics is appropriate. However, active inflammation and positive chlamydial cultures were rare findings in our population (2 of 52 and 1 of 52, respectively). Thus, we find no evidence for a role of current asymptomatic mycoplasma or chlamydial infection in male infertility.

Adult↗
PubMed1987

Microflora of the urethra in adolescent boys: relationships to sexual activity and nongonococcal urethritis.

Urethral cultures were obtained from 90 adolescent youth, 16 of whom denied previous sexual activity. Among the sexually active boys was a group of 32 with clinically significant pyuria, consistent with the diagnosis of urethritis, on a first-part urinalysis (FPU) specimen. To relate differences in urethral microflora to sexual activity, 42 sexually active patients with a negative FPU were compared with the never sexually active group. The profile of anaerobic, but not aerobic, bacteria isolated from the urethra was related to the presence or absence of previous sexual activity. Mycoplasma species and Ureaplasma urealyticum were isolated from sexually active patients only, and may be markers of sexual activity in adolescent boys. Of the 32 patients with FPU evidence of urethritis, 22 (69%) had cultures positive for Chlamydia trachomatis, and an additional three (9%) had cultures positive for Neisseria gonorrhoeae. The findings in sexually active patients with a positive FPU were otherwise similar to those of sexually active patients without evidence of urethritis. C. trachomatis appears to be the most important agent of urethritis among adolescent boys with a positive FPU.

Adolescent↗
PubMed1987

Role of natural killer cells in infection with the mouse pneumonitis agent (murine Chlamydia trachomatis).

Natural killer (NK) activity is increased in both spleen and lung early in pulmonary infection by murine Chlamydia trachomatis in both susceptible nude and resistant heterozygous (nu/+) mice. Ablation of the rise in NK activity by giving the mice antiasialo GM-1 antibody or stimulation of NK activity by immunomodulators did not affect quantitative tissue counts of the mouse pneumonitis biovar of C. trachomatis or significantly affect survival. Studies are needed to further define the role of NK cells in host defense, immunoregulation, and immunopathology during chlamydial infection.

Animals↗
PubMed1987

Primary murine Chlamydia trachomatis pneumonia in B-cell-deficient mice.

Mice were rendered deficient in B-cell activity by treatment with anti-mu antibody from birth. These animals were then infected intranasally with murine Chlamydia trachomatis (murine pneumonitis agent [MoPn]). They produced neither local nor systemic antibody to MoPn but had intact delayed-type hypersensitivity to MoPn. Anti-mu-treated mice were not significantly more susceptible to primary invasive infection with MoPn than were control mice, and unrestricted multiplication with MoPn did not occur. The dominant immune response controlling this type of infection is not likely to be antibody.

Animals↗
PubMed1987

Failure of multiple passages to increase chlamydial recovery.

Because of a previous publication indicating that increasing the number of blind passages to five resulted in a marked increase in Chlamydia trachomatis isolation rates, we evaluated a multiple-blind-passage system in vials. Cervical specimens from 119 pregnant women and 82 specimens from other sources were tested for chlamydial infection. The recovery rate for C. trachomatis was not markedly increased after the first blind passage. Thus, we conclude that multiple blind passages are not necessary to maximize the C. trachomatis isolation rate in a vial system.

Chlamydia Infections↗
PubMed1987

Five-year follow up of patients treated with inpatient psychotherapy at the Cassel Hospital for Nervous Diseases.

Twenty-eight patients who were admitted consecutively to a single-adult unit of the Cassel Hospital in 1977/8 were followed up 5 years after discharge. Those who were found to have improved at the end of treatment remained well 5 years later. These could be distinguished by their combination of neurotic psychopathology, considerable depression, superior intelligence, and lack of a chronic outpatient history. Patients who had improved 5 years after discharge did not show these characteristics, but had all spent at least 9 weeks on the waiting list and had the capacity to form close and helpful relationships. Patients who were judged to have improved were less dependent on the Health Service and their economic productivity was improved, often as a consequence of returning to education or training. Those who did not improve clinically continued to be admitted to hospital and tended to become less economically productive.

Adult↗