Antibodies to human T-lymphotropic virus type III (HTLV-III) in saliva of acquired immunodeficiency syndrome (AIDS) patients and in persons at risk for AIDS

Whole saliva samples collected from available people at risk in Boston for infection with human T-lymphotropic virus type III (HTLV-III/LAV), from late 1984 through early 1985, were analyzed for the presence of antibodies to viral proteins. Fourteen of 20 (70%) acquired immunodeficiency syndrome (AIDS) patients and 14 of 15 (93%) AIDS-related complex (ARC) patients had salivary antibodies that reacted with the virus-encoded glycoproteins gp160 and gp120 of HTLV-III infected cells. All of the AIDS and ARC patients had serum antibodies to the same antigens. Of 20 sex partners of AIDS/ARC patients, nine (45%) showed anti-HTLV-III antibodies, and four of 18 (22%) healthy homosexual males also were positive for such antibodies. Serum and salivary antibody status were the same in these groups. A minority of those patients positive for salivary antibodies to env gene-encoded gp160 and gp120 also had salivary antibodies to gag gene-encoded proteins of 55,000, 24,000, and/or 17,000 daltons. Immunoglobulin A (IgA) class antibodies comprised the majority of the salivary antibody response. The spectrum of HTLV-III proteins detected by the salivary and serum antibodies was similar. The possibility that secretory IgA from the gut-associated lymphoid system may play a role to restrict salivary transmission of HTLV-III should be considered.     

Boron–18F containing positron emission tomography radiotracers: advances and opportunities

Standard [¹⁸F]fluorination methods to form carbon–fluorine bonds can have some limitations such as low yield and the requirement for harsh reaction conditions. Inorganic approaches include the formation of boron–[¹⁸F]fluorine bonds and have the potential to give high specific activities at room temperature forming a bond that is stable in vivo. There is considerable potential in future applications, particularly in relation to multimodal imaging and the provision of rapid efficient labelling protocols. Copyright © 2014 John Wiley & Sons, Ltd.     

The holism of aesthetic knowing in nursing

In 1978, Carper identified 'four fundamental patterns of knowing' that became largely foundational to subsequent epistemological discourse within the nursing discipline. These patterns of empirical, personal, aesthetic, and ethical knowing were presented as conceptually distinct yet related patterns of knowing. In order to provide an alternative conceptualization of aesthetics in nursing, the main tenants of Carper's discussion of aesthetic knowing will be revisited, and the foundations for her arguments will be examined. Specifically, Dewey's Art as Experience will be examined in relation to the 'holism' of nursing, and an alternative position on pragmatic aesthetics in nursing will be offered. A preliminary reintegration of the four patterns of knowing will then be presented as will an example of a potential cultivation of aesthetics in nursing, through an example of Rodin's 19th century sculpture, the Burghers of Calais.     

A hospital-based prevalence survey of bloodstream infections in febrile patients in Malawi: implications for diagnosis and therapy

The etiology of bloodstream infections (BSIs) in febrile (> or =37.5 degrees C) adults (> or =18 years old) in one Malawi hospital were determined during August and September 1997. After clinical evaluation, blood was drawn for comprehensive culture, human immunodeficiency virus (HIV) type 1 testing, and malaria smear. Of 233 patients, 173 (74%) were HIV-1 infected, and 70 (30%) had BSI. BSI pathogens included 25 (33%) Streptococcus pneumoniae and 21 (28%) Mycobacterium tuberculosis. Nine patients (4%) had malaria parasitemia. BSIs were more likely in HIV-1-positive than in -negative patients (62/173 vs. 8/60, P<.01). Clinical predictors of BSI included HIV-1 infection and altered mental status. Mortality among inpatients with BSI was higher than among those without BSI (P<.001). In conclusion, S. pneumoniae and M. tuberculosis are frequent causes of BSI in febrile adults. Similar surveys, performed periodically in developing countries, may assist in the identification of clinical predictors of BSI and in planning appropriate therapy.     

Variation of secretory antibodies in parotid saliva to human immunodeficiency virus type 1 with HIV-1 disease stage

The secretory immune response to pathogens of the gut-associated lymphoid tissue is often independent of the systemic response. We investigated and compared the presence of antibodies to human immunodeficiency virus type 1 (HIV-1) antigens in parotid saliva and serum by Western blotting in 22 HIV-1-infected individuals. Antibodies to the HIV-1 envelope antigen gp160 were detected in saliva samples from 21 of 22 individuals and in serum from all individuals who were classified as CDC Group II, III, or IV. Antibody titers to gp160 were approximately 3000 times higher in serum than in saliva. Antibodies to viral core antigen p24 were detected in 6 of 7 Group II individuals in saliva and in 7 of 7 in serum. Antibodies to p24 were not found in the parotid saliva, but were detected in the sera of 3 of 3 Group III and 11 of 12 Group IV patients. The absence of secretory antibodies to HIV-1 core antigen p24 was correlated with CD4+ cell counts of less than 200/mm3. The results suggest that loss of secretory anti-p24 antibodies may be an early sign of progression to higher CDC clinical stages in HIV-1-infected individuals.     

Analysis of human platelet glycoproteins IIb-IIIa and Glanzmann's thrombasthenia in whole blood by flow cytometry

Antibodies that bind to human platelet membrane glycoproteins IIb and IIIa were used to develop methods for analyzing platelet membrane components by flow cytometry. Platelets were tentatively identified by their low-intensity light scatter profiles in whole blood or platelet- rich plasma preparations. Identification of this cell population as platelets was verified by using platelet-specific antibodies and fluorescein-conjugated antiimmunoglobulin. Two-parameter analysis of light scatter versus fluorescence intensity identified greater than 98% of the cells in the "platelet" light scatter profile as platelets due to their acquired fluorescence. Both platelet-rich plasma and whole blood were used to study platelet membrane glycoproteins IIb and IIIa on a single cell basis in an unwashed system. Prostacycline was included in these preparations as a precautionary step to inhibit platelet aggregation during analysis. Flow cytometry is a successful technique for rapid detection of platelet membrane defects such as Glanzmann's thrombasthenia. Platelets from Glanzmann's thrombasthenic individuals were readily distinguished from platelets with normal levels of glycoprotein IIb and IIIa and from platelets with glycoprotein levels characteristic of heterozygote carriers of this disorder. This technique provides a sensitive tool for investigating platelet functional defects due to altered expression or deficiency of platelet surface proteins.