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[A case of miliary tuberculosis during pregnancy in a patient on hemodialysis].

A 33-year-old woman had been on hemodialysis since she was 25 years old. In September, 1993, she had cough, which gradually increased in severity, and was accompanied by slight fever. No abnormality was observed on the chest radiography taken on November 2. However, bilateral diffuse miliary shadows were observed on the radiograph taken on November 30. Tubercle bacilli were detected by the examination of sputum smear. As she was pregnant 20 weeks, therapeutic abortion was done on December 8. A case of miliary tuberculosis occurring during pregnancy in a patient on hemodialysis has not been documented in Japan to date, and the first case in Japan was reported with a review of the literature.

Abortion, Therapeutic↗

[Acute hepatitis caused by Listeria monocytogenes infection].

We report the case of a 40 year-old woman, pregnant for 4 months, with acute hepatitis revealed by jaundice, fever and high serum aminotransferase levels. Infection by Listeria monocytogenes was demonstrated by blood cultures. The course of the disease was characterized by abortion and complete recovery of hepatitis within 4 weeks after antibiotic administration. This report shows that listeriosis can cause acute severe hepatitis.

Abortion, Spontaneous↗

[Causes, diagnosis and therapy of habitual abortions].

Recent knowledge concerning the etiology of habitual abortions is reviewed by the author. The anatomic, genetic, endocrine and immunologic causes furthermore the assumed role of maternal diseases and infections are summarised. Besides diagnostic procedures and therapeutic possibilities are discussed.

Abortion, Habitual↗

Transmission of brucellosis from reindeer to cattle.

Sixteen reindeer (Rangifer tarandus tarandus) naturally infected with Brucella suis biovar 4 were penned with 6 male and 2 female cattle for 30 days, then removed and euthanatized. During this period, 5 reindeer had fawns, and 2 reindeer aborted. Brucella suis biovar 4 was recovered from all adult reindeer at necropsy. Nine reindeer had B suis biovar 4 in uterus, udder, and/or milk. The cattle were euthanatized 2 months after the reindeer were removed. Clinical or pathologic signs of disease were not observed in the cattle. Brucella suis biovar 4 was isolated from 2 male and from both female cattle at necropsy. The female cattle had positive reactions on the buffered plate antigen test, brucellosis card test, tube agglutination test, complement fixation test, and indirect enzyme immunoassay for most of the experiment, but the males had inconsistent reactions on these tests. The indirect enzyme immunoassay was the only test to detect all cattle from which bacteria were cultured. This study revealed that caution is warranted before moving reindeer or caribou into areas of traditional agriculture.

Abortion, Veterinary↗

[Abortive myxovirus infection of Ehrlich ascites carcinoma cells. Analysis of virus-specific structures in the ascitic fluid].

In the course of classical fowl plague virus reproduction in Ehrlich ascites carcinoma cells both hemagglutinins and S-antigen accumulate and titers of the infectious activity increase. However virus reproduction does not terminate in formation of virus, and subviral structures are found in the liquid fraction of the infected cells. Analysis of these structures has shown them to have a sedimentation coefficient of 350-370S and buovant density 1.29 g/ml. The rapidly sedimenting structure has complement-fixing hemagglutinating activity but bow infectivity.

Amino Acids↗

[Reliability of the advice given at genetic counselling: follow-up study].

A follow up investigation was carried out in order to estimate the reliability of the advice given at our genetic counselling clinic. Data were collected mainly by questionnaires sent by mail in November, 1983 to 556 clients counselled during the period January, 1976 - December, 1982. The outcome of 444 pregnancies for 361 clients was revealed. They were divided into three groups according to the risks estimated and suggested by the counsellors; below 2% (Group I), 2 - 9% (Group II) and 10% or more (Group III). The following results were obtained. The incidence of those who had not become pregnant following the day of counselling was higher in Groups II and III than in Group I. The rate of spontaneous abortion was higher in Group III than in Groups I and II. The incidence of pregnancies with children affected by birth defects for which the risks were estimated was 1.5% in Group I, 6.5% in Group II and 26.5% in Group III. Six to nine percent of babies of all groups suffered from other diseases such as intrauterine fetal death, congenital anomalies, developmental abnormalities or severe infectious diseases. The recurrence rate for regular trisomic Down's syndrome was 1.8%. These results suggested that the risk estimates and advice were quite reliable and helpful.

Abortion, Spontaneous↗

Prevalence of antibodies to IBR and BVD viruses in dairy cows with reproductive disorders.

We determined the prevalence of antibodies to infectious bovine rhinotracheitis virus (IBRV) and bovine viral diarrhea virus (BVDV) in sera of dairy cows on 4 different farms in the Republic of Croatia. A high percentage (60.8%) of cows had various reproductive disorders. The results showed that seroprevalence of infectious bovine rhinotracheitis (IBR) was 85.8% and that of bovine viral diarrhea (BVD) was 79.2% in tested cows. Antibodies to both viruses were found in 80.8% of cows with reproductive disorders but in only 46.8% of cows without reproductive disorders. This difference was statistically significant (P<0.01), and indicated a connection between reproductive disorders and simultaneous infections with IBR and BVD viruses in dairy cows.

Abortion, Veterinary↗

In utero infection of swine fetuses with infectious bovine rhinotracheitis virus (bovine herpesvirus-1).

The pathogenesis of infectious bovine rhinotracheitis (IBR) virus (bovine herpesvirus-1) was studied in porcine fetuses after in utero inoculation. Laparotomies were performed on 8 seronegative pregnant sows at 34 to 86 days of gestation, and all fetuses in 1 uterine horn of each sow were exposed to IBR virus via inoculation into the amniotic sacs. Fetuses in the other horn served as controls. Clinical signs of infection were not observed in the sows, except for 2 sows that aborted at postinoculation days (PID) 11 and 15. Fetuses of the remaining 6 sows were collected at slaughter on PID 15 to 28. Fetuses were examined for gross abnormalities, presence of IBR virus in tissues, and the formation of neutralizing antibodies to IBR virus. Of 33 inoculated fetuses from 6 sows, 10 were mummified, 11 were hemorrhagic and/or edematous, and 12 were alive. Necrotic lesions were observed on the skin and in the liver of dead and live fetuses. Virus was recovered from 29 of 33 inoculated fetuses. Infectious bovine rhinotracheitis virus was isolated from fetal skin, liver, lungs, kidney, spleen, stomach contents, brain, amniotic fluid, and placenta. Virus was isolated from 4 of 11 fetuses recovered from 1 aborting sow. Antibodies to IBR virus were not detected in sera from the sows. However, antibodies were detected in 6 of 15 fetuses inoculated at 63 to 86 days of gestation and collected at slaughter at 86 to 112 days of gestation. The youngest fetus with detectable IBR antibody was estimated to be 74 days of gestation by measuring crown-rump length of the fetus.

Abortion, Veterinary↗

The transforming prototype of Epstein-Barr virus (B95-8) is also a lytic virus.

The B95-8 isolate of the Epstein-Barr virus (EBV) has been described as a non-lytic transforming virus. We have performed experiments in order to determine if the B95-8 EBV is capable of super-infecting and replicating in EBV-genome-positive non-producer lymphoblastoid cells. Using concentrates of B95-8 EBV, prepared from 6 different B95-8 cell lines treated with 12-O-tetradecanoylphorbol-13-acetate (TPA), we demonstrated that virus concentrates could transform human or cotton-top tamarin B-lymphocytes and also lytically replicate in Raji cells, inducing EBV antigens and infectious virus. While the virus obtained from B95-8 super-infected Raji cells was able to transform cord-blood lymphocytes (CBLs) and super-infect Raji cells, transformation was abortive, with cell cultures only growing for up to 6 weeks. Transformation titers of the B95-8 virus concentrates ranged from 10(5) to greater than 10(8) transforming units/ml; early antigen (EA) induction ranged from 1% to 50% after superinfection of Raji cells, depending on the virus stock used, as determined by immunofluorescence. Southern blot analysis was carried out on the DNA prepared from B95-8 cells and virion DNA. The results were consistent with the published EcoRI restriction pattern for B95-8 EBV. The issue of whether the B95-8 cells produce virions with a dual biological phenotype or, rather, 2 biologically distinct viruses, is addressed.

Cell Line↗

Synthesis of virus deoxyribonucleic acid during abortive infection of simian cells by human adenoviruses.

Rapp, Fred (Baylor University College of Medicine, Houston, Tex.), Lawrence A. Feldman, and Manley Mandel. Synthesis of virus deoxyribonucleic acid during abortive infection of simian cells by human adenoviruses. J. Bacteriol. 92:931-936. 1966.-Inoculation of green monkey kidney cells (GMK) with adenovirus types 2 or 12, under conditions where neither infectious virus was synthesized, resulted in an increase in the uptake of H(3)-thymidine into deoxyribonucleic acid (DNA). Extraction of the DNA from infected cells, followed by identification by isopycnic analysis in CsCl gradients, revealed the presence of virus DNA. Cells infected with adenovirus type 2 yielded DNA giving bands with peak densities of 1.699 g/ml [GMK DNA with 40 moles% guanine + cytosine (GC)] and 1.714 g/ml (adenovirus type 2 DNA with 55 moles% GC). Cells infected with adenovirus type 12 also yielded the GMK DNA and a band at 1.706 g/ml (adenovirus type 12 DNA with 47 moles% GC). The rate of synthesis of adenovirus type 2 DNA in KB cells (productive cycle) and in GMK cells infected only with adenovirus (nonproductive cycle) or with adenovirus and simian virus 40 (adeno-productive cycle) was not significantly different.

Adenoviridae↗

Role of hemagglutinin cleavage and expression of M1 protein in replication of A/WS/33, A/PR/8/34, and WSN influenza viruses in mouse brain.

The combined presence of WSN gene segments 6 (neuraminidase), 7 (M1 and M2), and 8 (NS1 and NS2) in reassortants of WSN with A/Aichi/2/68 (H3N2) has been found by others to be necessary for full expression of neurovirulence in mice. We are examining the expression of the analogous three gene segments in brains of mice after intracerebral infection with non-neuroadapted strains A/WS/33 (WS) (from which WSN was derived) and A/PR/8/34 (PR8). Our aim is to determine possible mechanisms by which one or more of the five gene products may restrict replication of these strains in mouse brain cells to a single cycle, yielding noninfectious hemagglutinating particles (incomplete growth cycle). We found that minority subsets of such particles did produce plaques, provided they were activated by trypsin (analogous to other abortive systems producing virions with uncleaved HA), a step obviated for some WSN virions by indirect promotion of hemagglutinin cleavage by the neuraminidase of that strain. The percentage of such potentially infectious virions, relative to total hemagglutinating particles, was significantly lower in WS- or PR8-infected than in WSN-infected brains, suggesting possible defects in synthesis or function of M1 protein in the former. Cells in immunostained sections and appropriate bands in Western blots (immunoblots) of viral proteins electrophoretically separated from lysates of PR8-infected brains reacted with antibody to nucleoprotein but not to M1 protein. Either method revealed the presence of both proteins in WSN-infected brains. In contrast, Western blot analyses of particles concentrated from PR8-, WS-, or WSN-infected brains by hemadsorption, elution, and pelleting did reveal NP and M1 bands with comparable relative peroxidase-antiperoxidase staining intensities. The findings suggest that availability of M1 protein is a factor influencing the extent or rate of assembly of potentially infectious (i.e., trypsin-activated) progeny virions in mouse brains and that in this respect the two non-neurovirulent strains differ from WSN quantitatively rather than qualitatively.

Animals↗

Viral prophylaxis in organ transplant patients.

Viral pathogens have emerged as the most important microbial agents having deleterious effects on solid organ transplant (SOT) recipients. Antiviral chemoprophylaxis involves the administration of medications to abort transmission of, avoid reactivation of, or prevent progression to disease from, active viral infection. Cytomegalovirus (CMV) is the major microbial pathogen having a negative effect on SOT recipients. CMV causes infectious disease syndromes, augments iatrogenic immunosuppression and is commonly associated with opportunistic superinfection. CMV has also been implicated in the pathogenesis of rejection. Chemoprophylactic regimens for CMV have included oral aciclovir (acyclovir) at medium and high doses, intravenous and oral ganciclovir, and the prodrugs valaciclovir (valacyclovir) and valganciclovir. CMV prophylactic strategies should be stratified, with the highest-risk patients receiving the most 'potent' prophylactic regimens. Herpes simplex virus (HSV) reactivation in SOT recipients is more frequent, may become more invasive, takes longer to heal, and has greater potential for dissemination to visceral organs than it does in the immunocompetent host. Prophylactic regimens for CMV are also effective chemoprophylaxis against HSV; in the absence of CMV prophylaxis, aciclovir, valaciclovir or famciclovir should be used as HSV prophylaxis in seropositive recipients. Primary varicella-zoster virus (VZV) after SOT is rare and most commonly seen in the paediatric transplant population because of VZV epidemiology. Zoster occurs in 5-15% of patients, usually after the sixth post-transplant month. Prophylactic regimens for zoster are neither practical nor cost effective after SOT because of the late onset of disease and low proportion of affected individuals. All SOT recipients should receive VZV immune globulin after contact with either varicella or zoster. Epstein-Barr virus has its most significant effect in SOT as the precipitating factor in the development of post-transplant lymphoproliferative disorders. Antiviral agents that could be effective are the same as those used for CMV, but indications for and effectiveness of prophylaxis are poorly established. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are important pathogens in the SOT population as indications for transplantation. So-called 'prophylaxis' for recurrent HBV and HCV after liver transplantation is controversial, suppressive rather than preventive, and potentially lifelong. Influenza infection after SOT is acquired by person-to-person contact. During epidemic periods of influenza, transplant populations experience a relatively high frequency of infection, and influenza may affect immunosuppressed SOT recipients more adversely than immunocompetent individuals. Antiviral medications for prevention of influenza are administered as post-exposure prophylaxis to SOT recipients, in addition to yearly vaccine, in circumstances such as influenza epidemics and nosocomial outbreaks, and after exposure to a symptomatic individual during 'flu season'.

Antiviral Agents↗

[Infectious causes of perinatal mortalities in ruminants (author's transl)].

The advantages and disadvantages of the different diagnostic techniques e.g. pathological and microbiological studies, immunoglobulin and specific antibody determinations and fluorescent antibody studies in relation to these mortalities are discussed. The most important pathological lesions in the placentas and foetuses are described.

Abortion, Veterinary↗

Acute interstitial pneumonia in mink kits: experimental reproduction of the disease.

Organ homogenates from kits that died of interstitial pneumonia were inoculated into adult Aleutian disease virus (ADV)-negative mink and shown to contain infectious ADV. Acute interstitial pneumonia was experimentally reproduced with the organ homogenate but only by inoculation of newborn kits born from ADV-negative dams. Older kits and kits from ADV-positive dams did not develop interstitial pneumonia, but later developed the classic form of Aleutian disease. Electron microscopic examination was done on purified suspensions of defined ADV isolates and on purified organ homogenates from kits with spontaneous or experimental interstitial pneumonia. In kits from both groups a virus, morphologically resembling the defined ADV isolates, was demonstrated. Findings of intranuclear inclusion bodies and intranuclear ADV antigen in alveolar type-II cells in affected lungs and the lack of immunologically mediated lesions suggest that lung lesions result from primary viral injury to alveolar type-II cells. Experiments also showed that infection of dams with ADV before pregnancy decreased the number of kits per mated dam and infection with ADV in mid-pregnancy caused fetal death, fetal resorption, or abortion.

Acute Disease↗

Case-control study of early-term abortions (early fetal losses) associated with mare reproductive loss syndrome in central Kentucky.

OBJECTIVE: To identify factors associated with abortions during early gestation classified as mare reproductive loss syndrome (MRLS). DESIGN: Case-control study. ANIMALS: 324 broodmares from 43 farms in central Kentucky, including 121 mares from 25 farms that had early-term abortions (ETAs) associated with MRLS (case horses), 120 mares from the same farms but that did not abort, and 83 mares from 18 farms that were not severely Impacted by MRLS. PROCEDURE: Farm managers were interviewed to obtain data on various management practices and environmental exposures for the mares. Data for case and control horses were compared to identify risk factors for mares having MRLS-associated ETAs. RESULTS: Several factors increased the risk of MRLS-associated ETAs, including feeding hay in pasture, greater than usual amounts of white clover in pastures, more eastern tent caterpillars in pastures, abortion during a previous pregnancy, and sighting deer or elk on the premises. CONCLUSIONS AND CLINICAL RELEVANCE: Analysis indicates that certain characteristics of pastures predisposed mares to MRLS-associated ETAs. Methods for limiting exposure to pasture (keeping mares in stalls longer) during environmental conditions similar to those of 2001 (ie, sudden freezing in mid-April following warmer-than-usual springtime temperatures and larger-than-usual numbers of eastern tent caterpillars in and around pastures) should reduce the risk of mares having MRLS-associated ETAs. It was not possible to determine whether exposure to white clover or caterpillars were causal factors for MRLS or were merely indicators of unusual environmental conditions that resulted in exposure of mares to a toxic or infectious agent.

Abortion, Veterinary↗