The initial detection of human immunodeficiency virus 1 and its subsequent spread in prostitutes in Tamil Nadu, India.

To determine the prevalence of HIV-1 antibody and risk factors associated with a positive test in a heterosexually promiscuous female population, we initially screened 412 prostitutes in remand homes in three cites and three towns in Tamil Nadu state (southern India) and then tested all new entrants to one home in Vellore from 1986 to 1990. The proportion of women infected (10 of 102) from the port city of Madras was greater than from all other cities or towns combined (four of 310, p = 0.0002).

Preterm twins and triplets. A high-risk group for severe respiratory syncytial virus infection.

Objective: To assess the impact of multiple births and crowded homes on the severity of respiratory syncytial virus illness in preterm infants with bronchopulmonary dysplasia.

Research Design: Retrospective case-control chart review from a prospective longitudinal respiratory illness study.

Setting: Neonatal High-Risk Follow-Up Clinic (outpatient setting) and tertiary care hospitals (inpatient setting).

Immunoprophylaxis and immunotherapy: role in the prevention and treatment of repiratory syncytial virus.

It is now apparent that neutralizing antibody may play an important role in ameliorating RSV lower repiratory tract illness. At the present time immunoprophylaxis and immunotherapy with polyclonal antibodies show the most promise in the prevention and treatment of RSV illness. Several questions remained to be answered.

Recognition of pneumonia by primary health care workers in Swaziland with a simple clinical algorithm.

In developing countries primary health care workers are being trained to manage and treat acute respiratory infections with a protocol developed by the WHO. We tested the ability of nurses and nursing assistants in Swaziland to recognise the signs and symptoms of pneumonia; with the results of a paediatrician's examination as "gold standard", sensitivities and specificities were calculated. Danger signs of stridor and abnormal sleepiness were poorly recognised (sensitivity 0-50%) by the health care workers, as was audible wheeze.

Assessing consumption of high-fat foods: the effect of grouping foods into single questions.

Questionnaires on the frequency of consumption of foods are commonly used to measure dietary intake in epidemiologic research. To reduce the burden on respondents, questionnaires are often shortened by combining inquiries on similar foods into a single question. The effect of this practice on the reporting of dietary intake has never been investigated, however.

Standardized diagnosis of pneumonia in developing countries.

The World Health Organization recommends the use of raised respiratory rate and chest wall indrawing to enable health workers in developing countries to diagnose pneumonia. We evaluated the current World Health Organization guidelines for management of the child with cough or difficult breathing in Manila, Philippines and Mbabane, Swaziland using an identical protocol in both countries. Raised respiratory rate was defined as greater than or equal to 50/minute for children ages 2 to 12 months and greater than or equal to 40/minute for children 12 months to 5 years.

Respiratory rate: measurement of variability over time and accuracy at different counting periods.

The respiratory rates/minute of 97 children were monitored every 10-15 minutes over one hour, by an observer and by pneumogram, at which times two 30 second and one 60 second counts were obtained. The children were under 5 years of age with lower respiratory tract infections (n = 20), upper respiratory tract infections (n = 34), or controls without acute respiratory infection (n = 43). The difference between respiratory rate count determined simultaneously by observation and pneumogram in relation to their mean count was analysed for the 60 second counting period, 30 plus 30 second period, and the 30 second period doubled.

Etiology of acute respiratory infections in children in tropical southern India.

Nasopharyngeal secretions and throat-swab specimens from 809 children less than 6 years old with acute respiratory infection were examined by culture and indirect immunofluorescence for the presence of virus or viral antigen. Blood was cultured for the presence of bacteria in selected cases of lower respiratory infection (LRI); pleural fluid also was cultured in cases of empyema. Viruses were detected in 163 (49%) of 331 children with LRI.

An RNA hairpin at the extreme 5' end of the poliovirus RNA genome modulates viral translation in human cells.

Several mutations were introduced into an infectious poliovirus cDNA clone by inserting different oligodeoxynucleotide linkers into preexisting DNA restriction endonuclease sites in the viral cDNA. Ten mutated DNAs were constructed whose lesions mapped in the 5' noncoding region or in the capsid coding region of the viral genome. Eight of these mutated cDNAs did not give rise to infectious virus upon transfection into human cells, one yielded virus with a wild-type phenotype, and one gave rise to a viral mutant with a small-plaque phenotype.

Bronchiolitis in tropical south India.

In a prospective hospital-based study of 328 children under 5 years of age with acute lower respiratory infections, 114 (35%) were diagnosed to have acute bronchiolitis. Of them, 87 (76%) were less than 1 year and 107 (94%) were less than 2 years of age. Signs of severe lower respiratory infections, namely tachypnea (respiratory rate greater than 50/min) and subcostal retraction, were present in 95% and 93%, respectively.

Evaluation of simple clinical signs for the diagnosis of acute lower respiratory tract infection.

The reliability of clinical signs that might be used by village health workers in distinguishing acute lower respiratory infection (LRI) from upper respiratory infections (URI) in children was evaluated. 142 infants and 108 preschool children with LRI and 151 infants and 281 preschool children with URI, attending hospital, were studied. Respiratory rates of over 50/min in infants and over 40/min in children 12-35 months of age, as well as a history of rapid breathing and the presence of chest retractions in both age groups, were found to be sensitive and specific indicators of LRI.

Antibody response of children to measles vaccine mixed with diphtheria-pertussis-tetanus or diphtheria-pertussis-tetanus-poliomyelitis vaccine.

The feasibility of giving measles vaccine mixed with either diphtheria-pertussis-tetanus (DPT) or DPT-poliomyelitis (DPTP) vaccine was investigated to simplify the routine immunization schedule. Children 12 to 18 months of age, due for measles immunization, were given measles vaccine alone or mixed with DPT or DPTP. Their prevaccination and four-weeks postvaccination serum samples were tested for the measles virus hemagglutination-inhibition antibody titer.

The antibody response of seronegative infants to inactivated poliovirus vaccine of enhanced potency.

The immunogenic efficacy of inactivated poliovirus vaccine of enhanced potency (IPV-E), containing 40, 8 and 32 D-antigen units of types 1, 2 and 3, respectively, was evaluated in tritypic seronegative infants. Eighty infants aged six to 45 weeks, with no antibody detectable at a 1 : 4 dilution, were given two doses of a quadruple vaccine containing diphtheria-pertussis-tetanus (DPT) vaccine and IPV-E at intervals of four weeks (37 infants, group 1) or eight weeks (43 infants, group 2) between doses. All infants of group 2 responded with antibody to the three types of polioviruses.

The growth of exclusively breastfed infants.

To determine the pattern of growth of exclusively breastfed babies and to establish their incremental weight gains, 329 babies attending a well baby clinic were studied. The weight gains were most rapid over the first 6 weeks and were of the order of 41.4 and 39.

Antibody response of infants to two doses of inactivated poliovirus vaccine of enhanced potency.

The conventional formulation of injectable poliovirus vaccine (inactivated) contains 20, 2, and 4 D-antigen units of types 1, 2, and 3 polioviruses. Primary immunization requires three doses given at intervals of at least four weeks. A new formulation with 40, 8, and 32 D-antigen units of the three poliovirus types has been prepared to reduce primary immunization to two doses.

Myelinated fibers of the deep branch of the ulnar nerve at the wrist in bonnet monkeys (Macaca radiata) and some of its branches to the hand.

In order to estimate the peripheral nervous correlates concerning the motor performance of the hand, the myelinated fibers of the deep ulnar nerve and some of its branches to the intrinsic muscles of the monkey (Macaca radiata) hand have been enumerated and their caliber spectra plotted. The content of the myelinated sensory fibers in the deep ulnar nerve was found to be 70% of the total. This high figure is attributable to the fact that 25-50% of the myelinated fibers in the deep ulnar nerve are destined to innervate the joints of the hand.