Effect of leukocyte hydrolases on bacteria

Leukocyte extracts, trypsin, and lysozyme are all capable of releasing the bulk of the LPS from S. typhi, S. typhimurium, and E. coli. Bacteria which have been killed by heat, ultraviolet irradiation, or by a variety of metabolic inhibitors and antibiotics which affect protein, DNA, RNA, and cell wall synthesis no longer yield soluble LPS following treatment with the releasing agents. On the other hand, bacteria which are resistant to certain of the antibiotics yield nearly the full amount of soluble LPS following treatment, suggesting that certain heatlabile endogenous metabolic pathways collaborate with the releasing agents in the release of LPS from the bacteria. It is suggested that some of the beneficial effects of antibiotics on infections with gram-negative bacteria may be the prevention of massive release of endotoxin by leukocyte enzymes in inflammatory sites.     

Type distribution of beta-hemolytic streptococci in Israel: a 10-year study.

A survey was carried out over 10 years on the distribution of beta-hemolytic streptococci, their identification, and the clinical implications. Curtures were typed by the conventional agglutination and precipitation methods and by enzyme production. The present survey indicates the changes in streptococcal ecology of the various serotypes. Epidemics of acute pharyngitis with complete absence of rheumatic fever provided suggestive evidence that not all group A types are associated with rheumatic fever. The survey also emphasizes the occurence of non-group A streptococci in human infection.     

A protective human monoclonal IgA antibody produced in vitro: anti-pneumococcal antibody engendered by Epstein-Barr virus-immortalized cell line

Human lymphocytes that produce anti-pneumococcal antibodies were separated and immortalized by Epstein-Barr virus and then cloned. One clone (NAD-Sel) produces an IgA, kappa antibody which is specific for the polysaccharides of type 8 pneumococcus, while not reactive with any of the polysaccharides derived from 24 other pneumococcal strains. The antibody, which is present in the cell supernatant as monomer and polymer, binds to protein A and does not fix complement. When incubated in vitro with type 8 pneumococci, it induces direct killing and increases the opsonization of these bacteria by mouse macrophages.     

Pregnancy in patients of advanced maternal age

The care of the pregnant patient of AMA is often the care of a high-risk pregnancy. Comorbidities (preexisting or pregnancy-related), combined with high maternal expectation, place these patients at greater need for intervention during pregnancy and parturition. Thirty-eight percent of these patients are treated for preexisting medical conditions and almost half have preexisting medical conditions. Gravidas of AMA are also more likely to develop pregnancy-related illness. Cesarean delivery is more common in older parturients than in women younger than 35 years. Gravidas who have preexisting conditions or who develop illness should be cared for, whenever possible, in a facility capable of managing high-risk pregnancies.     

Variation in the In Vitro Migration of Sensitized Guinea Pig Peritoneal Exudate Cells in the Presence of Coccidioidin

Guinea pigs were immunized by intramuscular injection of arthrospores from the M11 strain of Coccidioides immitis, and the peritoneal exudate cells were harvested 4 to 6 weeks later. After incubation with various concentrations of coccidioidin in tissue culture, the area of all migration was measured. Results of this study indicate that at a critical level, a variance of 0.1 mug of antigen per ml, determined the difference between approximately 88% migration and 5% migration as compared with control cells incubated in the absence of antigen. The concentration of antigen (ASU-9 stock coccidioidin concentrate) required to produce essentially complete inhibition of migration was determined to be 12.5 mug/ml.     

Food-borne outbreak of group G streptococcal sore throat in an Israeli military base

A food-borne outbreak of sore throat caused by Lancefield group G beta-haemolytic streptococci and involving 50 persons occurred in May 1983 in an Israeli military camp. All of the patients available for clinical examination had sore throat and difficulty in swallowing. Exudative tonsillitis occurred in 46% of the patients and the body temperature was above 37.5 degrees C in 81%. The pattern of attack was uniform over the base and 37 became ill during the night and morning of the 5 May. Thirty-two (84%) of the throat cultures taken from 37 patients grew group G beta-haemolytic streptococci. Eight of 29 contacts were positive for group G beta-haemolytic streptococci and 6 of the 28 foodhandlers examined had positive cultures of the same group. The organism was also isolated from one food sample. The epidemiological and laboratory investigations indicated that a food handler, a convalescent carrier of group G streptococci, might have been the source of infection. Assumptions on the potential of non-group A streptococci to cause epidemics are discussed.     

Attenuation of the Preoperative Stress Response with Midazolam: Effects on Postoperative Outcomes

Background. Previously, effects of preoperative sedatives were assessed mainly with respect to preoperative outcomes such as anxiety and compliance. The purpose of this investigation was to evaluate the effects of preoperative sedatives on postoperative psychological and clinical recovery.

Methods: Patients undergoing general anesthesia and outpatient surgery were enrolled in a double-blind, randomized, placebo-controlled trial. Subjects (n = 55) were randomly assigned to receive either 5 mg intramuscular midazolam (n = 26) or a placebo injection (n = 29) at least 30 min before surgery. The anesthetic technique was controlled. Postoperative anxiety, pain, analgesic consumption, clinical recovery parameters, and global health (SF-36) were evaluated up to 1 month after surgery.

Results: Surgery length did not differ significantly between the treatment and placebo groups (118 +/- 45 min vs 129 +/- 53 min;P = NS). Throughout the first postoperative week, subjects in the treatment group reported a greater reduction in postoperative pain compared with subjects in the placebo group (F1,50= 3.5;P = 0.035). Moreover, at 1 week, ibuprofen use was reported by less subjects in the treatment group than in the placebo group (0%vs 17.2%;P = 0.026). Subjects in the treatment group also reported a greater reduction in postoperative anxiety throughout the follow-up period (F1,53 = 9.2;P = 0.04). However, global health indexes (SF-36) did not detect any significant differences between the two experimental groups (multivariate F1,45 = 0.44;P = 0.51).