A simple monoclonal antibody based ELISA for free protein S. Comparison with PEG precipitation

A simple monoclonal antibody based ELISA for free Protein S, compatible with out existing ELISA for total Protein S has been developed, and its performance compared with the conventional PEG precipitation method of free Protein S assay. The normal range (mean +/- 2 SD) was 0.19-0.54 iu/ml free Protein S. The mean intra assay variation was 5.24% and the mean inter assay variation was 5.50%. A total of 102 routine diagnostic samples from patients referred for prothrombotic investigation (six assays for each method) were assayed by PEG precipitation (mean 0.32 iu/ml, SD 10.60), and the monoclonal ELISA (mean 0.34, SD 0.9). Paired t-test analysis of the two data sets indicated no significant difference between them (P < 0.001). In this sample population, there was no significant difference in free Protein S values when assayed by monoclonal based ELISA or by PEG precipitation. The monoclonal assay has proved to be reliable, accurate and precise. The monoclonal ELISA is simpler, quicker and easier to perform in routine use. Data generated is directly comparable to that generated by PEG precipitation. This methodology would be suitable for laboratories currently measuring Protein S by ELISA.

A mixed foodborne outbreak with Salmonella heidelberg and Campylobacter jejuni in a nursing home

OBJECTIVE

To investigate a mixed Salmonella heidelberg and Campylobacter jejuni foodborne outbreak in a nursing home.

DESIGN

Retrospective cohort study with a nested case-control design. Cases were defined by positive stool-culture results. Controls needed to be both asymptomatic and culture-negative.

SETTING AND PATIENTS

Residents of a 580-bed nursing home in Brooklyn, New York.

RESULTS

Of the 580 residents, 119 (21%) developed illness. Of the 93 symptomatic patients who submitted specimens, cultures were positive for S heidelberg in 24 (26%), C jejuni in 14 (15%), and both microorganisms in 25 (27%). Only the pureed diet was associated highly with infection by either Salmonella (odds ratio [OR], 17.6; 95% confidence interval [CI95], 4.8-68.7; P < .001), Campylobacter (OR, 13.3; CI95, 3.2-59.2; P < .001), or both organisms (OR, 8.9; CI95, 2.7-30.3; P < .001). Among the 42 pureed foods served during the 5 days before the outbreak, five meat or poultry items were associated most strongly with culture positivity. Of these five meat items, only a chopped-liver salad was implicated by the two employees reporting illness. A reported food-handling error occurred when ground, cooked chicken livers were placed in a bowl containing raw chicken-liver juices.

INTERVENTION

Recommendations for proper cleaning and sanitizing of kitchen equipment to prevent cross-contamination between raw and cooked foods.

CONCLUSIONS

Mixed foodborne outbreaks occur rarely. During this outbreak, contamination of a single food item with multiple bacterial pathogens was the likely source of transmission. Improper food-handling techniques that promote growth of one microorganism also allow growth of other pathogens that may be present. Because different sources and routes of transmission may be implicated for different pathogens, specific preventive measures may vary depending on the organisms involved.

Measles vaccination levels of children enrolled in WIC during the 1991 measles epidemic in New York City

OBJECTIVES

This study assessed measles vaccination rates and risk factors for lack of vaccination among preschool children enrolled in the Special Supplemental Food Program for Women, Infants, and Children (WIC) during the 1991 measles epidemic in New York City.

METHODS

Children aged 12 to 59 months presenting for WIC certification between April 1 and September 30, 1991, at six volunteer WIC sites in New York City were surveyed.

RESULTS

Of the 6181 children enrolled in the study, measles immunization status was ascertained for 6074 (98%). Overall measles coverage was 86% (95% confidence interval [CI] = +/- 1%) and at least 90% by 21 months of age (95% CI = +/- 1%). Young age of the child, use of a private provider, and Medicaid as a source of health care payment were risk factors for lack of vaccination (P < .001).

CONCLUSIONS

During the peak of a measles epidemic, measles immunization rates were more than 80% by 24 months of age in a sample of WIC children. The ease of ascertaining immunization status and the size of the total WIC population underscore the importance of WIC immunization initiatives.

Motor actions of eliprodil in the normal and monoamine-depleted mouse: a role in the treatment of Parkinson's disease?

The non-competitive NMDA polyamine site antagonist, eliprodil, was examined for its effects on exploratory activity in non-habituated mice and for its antiakinetic potential in reserpine-treated mice. A low dose of eliprodil (5 mg/kg) weakly stimulated locomotion in naive animals, whilst higher doses depressed rearing (20-40 mg/kg) and grooming (40 mg/kg), consistent with a sedative action. At no dose did eliprodil cause ataxia. In 24 h reserpine-treated mice, eliprodil (10-40 mg/kg) reversed akinesia, but this effect was subject to considerable inter-animal variation and was not statistically significant. Eliprodil did not alter the motor recovery elicited by the dopamine D1 agonist SKF 38393, or the dopamine D2 agonist RU 24213, and suppressed the motor stimulation induced by L-DOPA. These results indicate that eliprodil displays a far lower propensity than many other NMDA receptor antagonists for disturbing posture and gait, but lacks the essential motor stimulant action required to make it a safe and effective antiparkinsonian agent, at least in the reserpine-treated mouse model of Parkinson's disease.

Is fasting necessary before prilocaine Bier's block?

OBJECTIVE

To determine whether fasting is necessary before intravenous regional anaesthesia (Bier's block).

METHODS

A questionnaire study was carried out to assess accident and emergency (A&E) departments' policies and opinions in relation to Bier's block anaesthesia. Questionnaires were sent to 282 A&E consultants, of whom 216 replied (77% response rate).

RESULTS

About 5000 Bier's block procedures are carried out each year in the United Kingdom. Intravenous regional anaesthesia appears safe. Over one third of units did not fast their patients. The complication rate was similar in fasted and unfasted groups.

CONCLUSIONS

Starvation of the patient before intravenous regional anaesthesia is not necessary and should be abandoned.

Mechanisms controlling egg size and number in the rainbow trout, Oncorhynchus mykiss

Female rainbow trout (Oncorhynchus mykiss) produce a single batch of eggs each year; synchronous growth of oocytes, all of which are ovulated at the same time, occurs in the two ovaries. To examine the regulatory mechanisms controlling egg size and number, virgin female rainbow trout were subjected to unilateral ovariectomy (ULO) during early vitellogenesis, and oocyte recruitment and growth in the remaining ovary were monitored. The study also set out to determine whether the presence of a second population of smaller oocytes in the maturing pool (induced by ULO) affected the timing of ovulation and/or the size of the eggs ovulated. Two months after ULO, there was no difference in the gonadosomatic index between ULO fish and controls. Compensatory ovarian hypertrophy resulted from the recruitment of a second population of primary oocytes into the vitellogenic pool. This population of smaller maturing oocytes in the ULO fish displayed growth rates up to twice those of the population of larger oocytes in the same ovary and of oocytes in controls. The growth rate of the population of larger oocytes in the ULO fish was not altered by the recruitment of a second maturing population. One month after ULO, fish had a lower concentration of plasma estradiol-17 beta than did controls; subsequently the concentrations of plasma estradiol-17 beta in the ULO and control groups were similar. After ULO, plasma levels of vitellogenin in the ULO fish did not differ from those in the control group throughout the study. At or close to ovulation, the fecundity of ULO fish was 75-80% that of controls. In the control group, oocytes appeared to reach a certain critical size before they were ovulated, and fish with higher fecundity ovulated later than their less fecund counterparts. ULO did not affect the timing of ovulation, and ULO fish ovulated eggs with a considerably greater size-range than did controls.

Cardiorespiratory, hormonal and haematological responses to submaximal cycling performed 2 days after eccentric or concentric exercise bouts

Eccentric muscle actions are known to induce delayed-onset muscle soreness (DOMS) and muscle weakness (reduced static strength and dynamic peak power output) that may persist for several days. The aim of the present study was to determine whether DOMS-inducing exercise affects physiological responses to subsequent submaximal dynamic exercise. Physiological and metabolic responses to a standardized exercise task were measured 2 days after the performance of an eccentric or concentric exercise bout. Six healthy, untrained male subjects aged 30 +/- 7 years (mean +/- S.D.) performed repeated eccentric contractions during 30 min of bench stepping (47-cm step, 15 steps min-1). On another occasion, they performed concentric contractions by walking uphill (8% incline) for 30 min at 5 km h-1, which elicited a similar heart rate response to bench stepping. Two days after the eccentric or concentric exercise, the subjects cycled for 15 min on an electrically braked cycle ergometer at a work rate (172 +/- 37 W) equivalent to 80% VO2 max. The order of the preceding treatments was randomized and the treatments were carried out 2 weeks apart. Two days after the eccentric exercise, all subjects reported leg muscle soreness and exhibited elevated levels of serum creatine kinase activity (P < 0.01) and plasma cortisol concentration (P < 0.05). After uphill walking, the subjects were not sore and serum creatine kinase activity was unchanged. Minute volume, breathing frequency, respiratory exchange ratio, heart rate, rating of perceived exertion, venous blood lactate concentration and plasma cortisol concentration were all higher (P < 0.05) during cycling after eccentric exercise compared with after uphill walking. Increases in plasma catecholamine concentrations and numbers of circulating leucocytes after cycling at 80% VO2 max for 15 min were similar under both experimental conditions, but the delayed leucocytosis (at 150 min post-exercise) was significantly greater (P < 0.01) for the post-eccentric exercise condition. We conclude that dynamic submaximal exercise performed 2 days following exercise with a large eccentric component produces physiological responses that are indicative of a higher relative exercise stress. It is likely that such effects will significantly limit the level and duration of exercise that can be achieved in subsequent training bouts over several days.

The immunization of children enrolled in the Special Supplemental Food Program for Women, Infants, and Children (WIC). The impact of different strategies

OBJECTIVE

To assess the impact of different interventions to increase measles vaccination coverage among preschool children enrolled in the Special Supplemental Food Program for Women, Infants, and Children (WIC).

DESIGN

Public health intervention trial.

SETTING

Six volunteer WIC sites in New York City.

STUDY PARTICIPANTS

Children aged 12 to 59 months presenting for WIC certification between April 1 and September 30, 1991, who were eligible for measles vaccination.

INTERVENTIONS

Two WIC sites were assigned at random to one of three immunization strategies: (1) escort: child was escorted to a nearby pediatric clinic for immunization; (2) voucher incentive: the family returned monthly, rather than every 2 months, to pick up WIC food vouchers until the child was immunized; or (3) referral: the family was passively referred for immunization.

MAIN OUTCOME MEASURE

Proportion of eligible children receiving measles vaccination.

RESULTS

Of children eligible for measles immunization, 74% (618/836) were immunized. Children at escort sites were 5.5 times (relative risk [RR] = 5.5; 95% confidence interval [CI], 3.7 to 8.1) and those at voucher incentive sites were 2.9 times (RR = 2.9; 95% CI, 1.9 to 4.5) more likely to be immunized than children at referral sites. Children were immunized more rapidly at escort sites (median, 14 days) and voucher incentive sites (median, 26 days) than at referral sites (median, 45 days; P < .001).

CONCLUSIONS

Both escort and voucher incentive models resulted in more children being immunized more rapidly than passive referral. Because of ease of administration, voucher incentives may be a more suitable immunization intervention for use at WIC sites, with addition of escort where feasible.