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Microbiology of the lower genital tract and amniotic fluid in asymptomatic preterm patients with intact membranes and moderate to advanced degrees of cervical effacement and dilation.

The purpose of this prospective investigation was to evaluate the microbiology of the lower genital tract and amniotic fluid in asymptomatic women with preterm labor. We limited inclusion in the study to patients at 20 to 36 weeks' gestation whose membranes were intact and whose cervix was at least 50% effaced and 2 cm dilated. At the time of admission, we obtained an endocervical specimen for culture for Neisseria gonorrhoeae and for enzyme-linked immunoabsorbent assay for Chlamydia trachomatis and a vaginal specimen for culture for group B streptococci (GBS). We also performed transabdominal amniocentesis to collect amniotic fluid for Gram's stain, latex fixation test for GBS, and aerobic and anaerobic cultures. All patients received parenteral tocolytics. Women who had an immature lecithin to sphingomyelin ratio also received betamethasone. Only 1 of 72 women (1.4%, 95% confidence interval 0 to 4.1%) had a positive amniotic fluid culture. One patient (1.4%) had a positive Gram's stain, and two (2.8%) had positive latex fixation tests. None of these individuals subsequently had a positive culture. Eight women (11.1%) had positive tests for chlamydia, and four (5.5%) had positive vaginal cultures for GBS. None of the patients developed clinical evidence of chorioamnionitis, and only one had puerperal endometritis. None of the neonates had any complications due to infection. We conclude that, in our population, intra-amniotic infection is not a common cause of preterm labor in asymptomatic patients with intact membranes and that amniocentesis should not be performed routinely to assess the bacteriology of the amniotic fluid.

Amniocentesis↗

[Latex reaction with toxoplasma antigen].

The author describes the latex fixation test (LFT) with Toxoplasma antigen. The main parts of this technique are as follows: the sensibilization of latex particles and incubation of the sensitized particles with sera examined in an icebox (overnight) followed by spinning at 5000 G 10 minutes.--The sera giving negative results with LRT reacted also in 78,3% with complement-fixing test (CFT) in 79.3% and with indirect fluorescent test (IFAT) in 61.8% and with microprecipitating test (MPT) in 100% negatively.--The sera reacting strongly positively with LFT reacted also with CFT in high titers (titer 160 and higher) in 60.9% and in 55% with IFAT (titers 128 and higher).

Antigens↗

Antibody response of swine experimentally infected with Mycoplasma hyosynoviae.

Antibody responses of swine inoculated intranasally with M. hyosynoviae were determined using complement-fixation, latex-agglutination, metabolic-inhibition, and mycoplasmacidal tests. The infected swine developed latex-agglutinating antibodies by 6 days postinoculation, complement-fixing and metabolic-inhibiting antibodies by 9-12 days, and mycoplasmacidal antibodies which were first detected from 12 days to 8 weeks postinoculation. Antibody titers persisted for as long as 6 months postinoculation. Complement-fixing and mycoplasmacidal antibodies were mainly IgG, and latex-agglutinating antibodies were IgM. Early metabolic-inhibiting antibodies were IgM while later antibodies were mainly IgG. None of the pigs had detectable complement-fixing antibodies to Mycoplasma hyorhinis.

Animals↗

Flocculation tests in hydatid disease.

A new serological technique of diagnosing human hydatid disease, employing polystyrene latex particles coated with hydatid cyst fluid, and a modified technique using bentonite particles are described. Comparison of the latex test with the complement-fixation test performed on 102 sera has shown a total agreement of 98% and an agreement of 93.1% in the positive specimens. The bentonite test and the complement-fixation test performed on 126 sera have shown a total agreement of 97.6% and an agreement of 90.1% in the positive specimens. Both flocculation tests are simpler to perform than the complement-fixation test. They are specific, and sensitivity closely parallels that of the complement-fixation test, with 6.9% and 6.1% of the positive specimens showing higher sensitivity in the latex and bentonite tests respectively. The bentonite test was less sensitive than the complement-fixation test in one case. None of the latex tests showed less sensitivity. The antibody active in the latex test has been demonstrated in a gamma globulin fraction of the antiserum. Some differences in the behaviour of flocculating and complement-fixing properties of sera are discussed.

Antibodies↗

When does rheumatoid disease start?

Stored serum specimens collected in connection with a community-oriented epidemiologic study were available from 30 subjects who later developed seropositive rheumatoid arthritis. In 9 of these pre-rheumatoid specimens, the Rose-Waaler test result was positive, and in 16, the latex fixation test was positive. Two-thirds of the samples were positive when the interval between taking the blood specimen and onset of the disease was less than 4 years, and one-third were positive when the interval was greater than or equal to 4 years. The occurrence of rheumatoid factor preceded the onset of clinical disease more often in males than in females.

Adult↗

Prospective comparison of laser nephelometry with standard agglutination techniques for detection of rheumatoid factor.

IgM rheumatoid factor was assayed by three routine methods: latex fixation; haemagglutination; and end point laser nephelometry in 69 patients with definite or classical rheumatoid arthritis and 58 patients with other non-rheumatoid arthropathies, selected prospectively according to the American Rheumatism Association clinical criteria. The operators of the assays were unaware of the clinical diagnoses. In the group with rheumatoid arthritis 75.4% were positive by latex fixation, 73.9% by haemagglutination, and 55.1% by nephelometry. In the group with non-rheumatoid arthropathies 10.4% were positive by latex fixation, 8.6% by haemagglutination, and 10.4% by nephelometry. Thus the simple and inexpensive latex fixation test was as good as the haemagglutination test, and both were significantly better than nephelometry in the laboratory confirmation of the clinical diagnosis of definite or classic rheumatoid arthritis (chi 2 = 5.40 and 4.56, and p less than 0.025 and less than 0.05, respectively). None of these tests was significantly better or worse than the others in producing positive results in the group with non-rheumatoid arthropathies.

Adolescent↗

Immunoglobulin phagocytosis by granulocytes from sera and synovial fluids in various rheumatoid and nonrheumatoid diseases.

(1) The phagocytosis of human IgG, IgM, and C3 by granulocytes from various rheumatoid and nonrheumatoid sera and synovial fluids (SF) was investigated by direct examination of the patient's leucocytes and indirect testing by incubation of normal donor leucocytes with various sera and SF. (2) In rheumatoid arthritis (RA) phagocytosis of IgM, IgG, and C3 was common from sera and SF. There was a strong correlation of IgM and C3 phagocytosis with the occurence of rheumatoid factor. The phagocytosed IgM is probably rheumatoid factor. In SF both the direct and indirect test method yielded equally positive results; in serum the direct test was negative throughout. (3) In systemic lupus erythematosus there was phagocytosis of IgG, IgM and C3 from serum (indirect test), IgM not being correlated with the latex-fixation test and probably of antinuclear antibody nature. Phagocytosis decreased after treatment of the disease. Sera from many other rheumatic disease frequently gave weak IgG phagocytosis, but rarely did IgM or C3. (4) IgG, and sometimes C3, was frequently taken up from IgG myeloma sera (indirect test). IgM and IgG were taken up from Waldenström's macroglobulinaemia sera, independent of IgM concentration. It is possible that an aggregation tendancy of particular paraproteins determines Ig uptake from these sera. (5) IgG was taken up from half of the studied sera of infectious diseases in the indirect test, including two cases with Hodgkin's disease as well. Three sera from patients with untreated trypanosomiasis were positive for IgG as well as for IgM. (6) Normal healthy control sera remained negative, even after prolonged preservation or frequent freezing and thawing: only among very old sera were a few positive observations recorded. Immunoglobulin phagocytosis appears to be a common phenomenon in a number of conditions. It seems probable that soluble immune complexes, or in other cases nonimmune aggregates, may cause phagocytosis.

Antibodies, Antinuclear↗

Painful joints. Clues to early diagnosis.

Many cases of joint pain may be diagnosed from clinical findings alone. A careful history and physical examination are essential. Of all diagnostic laboratory tests for joint disease, none is completely specific. Results of latex fixation tests, antinuclear antibody (ANA) tests, and uric acid tests are all strongly suggestive when positive but do not rule out disease when negative. The most valuable laboratory procedure is examination of the synovial fluid. X-ray examination seldom is helpful in differentiation of early joint disease but may be very helpful in later stages.

Antibodies, Antinuclear↗

Rheumatoid arthritis in a rural South African Negro population.

(1) An epidemiological study of a rural African community has been carried out in the Western Transvaal. Altogether 801 respondents over 15 years old were examined; radiographs of the hands and feet were obtained in all these individuals. Serological tests for rheumatoid factor were carried out on 516 blood samples. (2) The diagnosis of inflammatory polyarthritis was based on a modification of the Rome Criteria of 1961. Two categories were defined: 'definite' and 'probable' rheumatoid arthritis. (3) In this population inflammatory polyarthritis was much less common and much milder in its manifestations than in European and American peoples. The prevalence of 'definite' rheumatoid arthritis was 0.12% and of 'definite' and 'probable' rheumatoid arthritis combined, 0.87. Such changes as were encountered on clinical and radiological examination were invariably mild; no respondent in the entire survey had clinical features that would have been accepted in the ordinary way as those of rheumatoid arthritis. (4) The latex fixation test (LFT) was positive in 8.9% of the sera tested; the modified LFT aftaer inactivation of the serum at 56 degrees C was positive in 15.1% of cases. Similar findings in West African populations have been explained on the basis of alteration of the immune response by widespread parasitic infections. No obvious aetiological factor of this type was found in the present survey.

Adolescent↗