Pertussis in Massachusetts, 1981-1991: incidence, serologic diagnosis, and vaccine effectiveness

Massachusetts provides diphtheria-tetanus toxoid-pertussis (DTP) vaccine, and since 1980 has monitored pertussis with a statewide diagnostic service. The incidence of bacteriologically confirmed pertussis was 104.5 per 100,000 person-years in 1-month-old infants and declined progressively thereafter. Infants < 6 months old experienced disproportionate morbidity: 44% of bacteriologically confirmed pertussis, 64% of hospitalizations, and 71% of hospital days. Most children with pertussis had received < 3 DTP doses during childhood, whereas 87% of adolescents with pertussis had received > or = 4 doses. Serodiagnosis by single serum anti-pertussis toxin antibody ELISA increased the incidence of confirmed pertussis in persons 11-19 years old from 3.0 to 12.9 per 100,000 and in persons > or = 20 years old from 0.16 to 0.56 per 100,000. Bacteriologic methods underestimate pertussis incidence, but a single serum anti-pertussis toxin antibody ELISA is a practical method for population-based diagnosis in adolescents and adults.     

The ontogeny and significance of infants' facial expressions in the first 9 months of life.

Four studies examined aspects of the differential emotions theory (DET) hypothesis of expressive behavior development. In Study 1, facial-expressive movements of 108 2.5–9-mo-old infants were video recorded in positive and negative mother–infant interactions (conditions). As expected, Max-specified full-face and partial expressions of interest, joy, sadness, and anger were morphologically stable between the 2 ages. Studies 1 and 2 confirmed predicted differential responding to mother sadness and anger expressions and to composite positive and negative conditions. Discrete negative expressions exceeded negative blends, and the amount of both expression types remained stable across ages. Studies 3 and 4 provided varying degrees of support for the social validity of Max-specified infant negative affect expressions. Conclusions include revisions and clarifications of DET. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vocal fatigue among teachers

Recordings were made at the beginning and end of workdays of teachers who experience vocal fatigue (n = 22) and those who do not experience fatigue (n = 17). Those who experienced fatigue were recorded on days in which they did and did not fatigue. Both groups evaluated their vocal characteristics, each time they made a recording. Subsequently, a listener panel evaluated the same characteristics from the recordings. Both groups estimated the amount and characteristics of their talking time, completed a psychological evaluation and provided medical histories. The authors interpret the data obtained as indicating that the vocal characteristics of teachers who fatigue and those who do not fatigue are similar on days the former group does not fatigue and that the two groups are similar in the amount and loudness of their talking time, at work and at home. However, teachers who fatigue tend to spend more time in activities that appear to be vocally demanding and are more likely to perceive situations as being anxiety producing. Teachers who fatigue tend to be in good health, but have had more hearing problems and allergies than their colleagues and more of their family members have had voice problems.     

Postviral gastroparesis: presentation, treatment, and outcome

We describe the clinical features and long-term outcome of 11 children who had persistent gastroparesis after an acute viral illness, eight of whom tested positive for rotavirus. Gastric emptying was delayed in the 10 children evaluated with scintigraphy. Antroduodenal manometry confirmed postprandial antral hypomotility in 10 subjects. All children recovered within 6 to 24 months.     

Polymerase chain reaction in the diagnosis of tuberculosis. Comparison of two target sequences for amplification

Amplification of a 340 bp sequence of the 38 kDa protein gene of Mycobacterium tuberculosis by the polymerase chain reaction has been developed. The sensitivity of this PCR was shown to be 10 fg both by agarose gel electrophoresis and Southern blot hybridisation being equivalent to 2-3 organisms and highly specific to M. tuberculosis and excluding even M. tuberculosis H37Ra and Mycobacterium bovis BCG. Sputum samples from patients with pulmonary tuberculosis gave a positivity rate of 45%. PCR was also performed using pt8 and pt9 primers which amplified a 541 bp sequence of IS6110. 41% of the above samples gave positive amplification. Three samples that were positive for 38 kDa sequence were negative for IS6110.     

Menstrual cycle and age: influence on parenchymal contrast medium enhancement in MR imaging of the breast

PURPOSE: To quantify how frequently mesenteric adenitis clinically mimics appendicitis and to determine its appearance at computed tomography (CT). MATERIALS AND METHODS: The medical records of 651 consecutive patients with an admission diagnosis of appendicitis were reviewed to determine how often mesenteric adenitis was the discharge diagnosis. The CT scans of a separate group of 18 patients with a discharge diagnosis of mesenteric adenitis were reviewed. These patients were part of a group of 100 consecutive patients prospectively evaluated with CT of the appendix for clinically suspected appendicitis. RESULTS: Fifty of 651 patients (7.7%) with an admission diagnosis of appendicitis had a discharge diagnosis of mesenteric adenitis. Mesenteric adenitis constituted 50 of the 252 (19.8%) discharge diagnoses other than appendicitis. All 18 CT scans of mesenteric adenitis showed three or more nodes that measured at least 5 mm in shortest axis clustered in the right lower quadrant, with a normal appendix identified. Eight patients had associated ileal or ileocecal wall thickening. CONCLUSION: Mesenteric adenitis is an important clinical mimic of appendicitis. It appears at CT as clustered, enlarged mesenteric lymph nodes with a normal appendix, and there may be associated ileitis or ileocolitis noted.