Four children, 7 to 24 months old, were found to have anti-M at the time of admission to the hospital for severe acute bacterial infections. All were M-N+. Two patients had meningitis, one had septic arthritis, and the fourth had a third-degree burn of the left hand. In follow-up studies the anti-M of patients No3 and No4 were no longer detectable after 12 and 11 months respectively. In all patients no demonstrable antibody was in either maternal or cord sera at time of birth. The clinical data and bacterial isolations lead us to postulate that bacterial infections account for the formation of naturally occurring anti-M in M-negative persons.

Acute Disease↗

PubMedDate not supplied

Three new antibodies to high-incidence antigenic determinants (anti-El, anti-Dp, and anti-So).

Explore the source record for details and available documents.

Adult↗

PubMedDate not supplied

Accumulation of genetic alterations in brain metastases of sporadic breast carcinomas is associated with reduced survival after metastasis.

Tumor progression is characterized by stepwise accumulation of genetic alterations. To identify alterations associated with breast cancer metastasis, an analysis of comparative loss of heterozygosity (LOH) was performed on 38 primary sporadic breast carcinomas and 16 distant metastases. Two loci at 5q21 and 18q21 were chosen because of their reported increased deletion frequency in metastatic tumors. LOH at 17q21, 13q12-13, 17p13.1 and 11q22-23 was analyzed to determine whether there is a specific involvement of these breast cancer-associated gene loci in the metastatic process. Our data show that distant metastases are characterized by markedly increased LOH frequency at all loci examined. In both gene locus groups, significantly more distant metastases are affected by combined LOH. Furthermore, a significantly reduced postmetastatic survival time has been observed in patients with brain metastases affected by synchronous allelic loss at the four breast cancer-associated gene loci. Our results suggest that cumulative LOH of breast cancer-related gene loci is associated with a more aggressive phenotype of metastatic breast tumors.

Ataxia Telangiectasia Mutated Proteins↗

PubMedDate not supplied

Cardiac abnormalities in stroke patients with negative arteriograms.

Sixty-five consecutive patients with recent unequivocal TIA (33) or stroke (32), but nondiagnostic arteriograms, had two-dimensional echocardiograms (2DE) and electrocardiograms (ECG) to determine the incidence of cardiac abnormalities which could cause embolic stroke. Abnormalities were classified according to increasing probability of causing an embolic event: non-specific, possible emboligenic abnormality (PEA) or definite emboligenic abnormality (EA). Although 2DE was abnormal in 33 patients (51%), and ECG in 38 (59%), many abnormalities were nonspecific. Only four patients (6%) had EA on ECG and two (3%) on 2DE. Since one patient had EA on both tests, 2DE identified only one patient (mitral valve prolapse) not already identified by ECG. All patients with EA had a prior history of cardiac disease. PEA was present on ECG in 11 patients (17%), and on 2DE in 25 (38%). There was no correlation between age, CT results, or neurologic symptoms commonly associated with embolic stroke and the presence of EA or PEA on ECG or 2DE. Although TIA and stroke patients with negative arteriograms have a high incidence of abnormalities on ECG and 2DE, the percentage of patients with EA is low, and cardiac history and ECG identify most patients. 2DE provides little additional information.

Adult↗

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Dressing changes by specialized personnel reduce infection rates in patients receiving central venous parenteral nutrition.

In 60 pediatric patients, 75 central venous catheters representing 1866 patient days were placed to provide parenteral nutrition. During the 21-month study period, surgical residents were responsible for dressing changes during the first 16 months and a specially trained nurse was responsible during the final 5 months. Twenty percent of the lines became infected. The infection rate was significantly higher in the lines cared for by residents, 28.8% compared to 3.3% in the lines cared for by the nurse. This occurred in spite of the lines being in place significantly longer in the nurse group (31.7 vs 20.3 patient days/line). These data indicate that a specially trained person using aseptic techniques can reduce infection rates in patients receiving central venous parenteral nutrition.

Bacterial Infections↗

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Upper respiratory infection: stress, support, and the medical encounter.

BACKGROUND: The purpose of this study was to examine the relationship between stress and social support to behaviors of patients and physicians during an episode of upper respiratory infection (URI). METHODS: This was a cross-sectional study of 104 patients older than age 14 from three family practice sites; all of the patients had experienced a URI during an 8-week period. Stress scores were calculated for each patient's family using several standard instruments. Clinical and medical care utilization data were also reviewed. Data were analyzed to determine if there were relationships among stress and support scores and measures of patient and physician behaviors. RESULTS: Measures of stress and support were related to the use of medical services, seeking additional medical care, extra phone calls, and longer perceived duration of illness. Physicians prescribed more medications, ordered more laboratory tests, and scheduled more return visits for patients with high stress or low support scores. CONCLUSIONS: Stress and support are related to patient utilization of health services and perception of illness severity. Physicians respond to patients with high stress and low support by offering more medical services.

Adolescent↗

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Differential diagnosis and pathogenesis of anorexia nervosa.

Anorexia nervosa is a disease of increasing frequency with serious medical and psychological consequences. The presentation is one of significant weight loss. The initial assessment of such a patient must differentiate between an underlying systemic medical illness and an eating disorder. This paper will review the more common medical conditions causing weight loss and their distinguishing characteristics, including malignancy, inflammatory bowel disease, infections and metabolic disorders. Once an organic disease is ruled out, anorexia nervosa must then be differentiated from other eating disorders such as bulimia or other psychological diseases such as depression, schizophrenia, drug abuse, conduct disorders, and anxiety reactions. The pathogenesis of anorexia nervosa includes complex societal, family, and individual factors which require evaluation in the treatment process.

Adolescent↗

PubMedDate not supplied

Sulphur and selenium analogues of psoralen as novel potential photochemotherapeutic agents.

Some heteropsoralens, obtained by replacing one or both the intracyclic oxygen atoms with sulphur and/or selenium, were studied. In preliminary tests, these compounds showed strong photobiological activity, in some cases more than two orders of magnitude higher than that of psoralen. Heteropsoralens containing sulphur undergo intercalation inside duplex DNA, showing evident affinity for the macromolecule; when selenium replaces furan oxygen, the psoralen isoster also undergoes intercalation but with lower efficiency, while psoralen isosters in which pyrone oxygen is replaced by selenium practically do not intercalate. Parallel behaviour was also observed for DNA photobinding and crosslink formation. The cycloadduct between furan selenium and pyrone sulphur isoster and thymine was isolated and characterized. The capacity of the various psoralen isosters to generate singlet oxygen and superoxide radical anion was studied. For the former the yield varies markedly for the various compounds, while for the latter the yield is similar for all compounds.

Chemical Phenomena↗