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Clinical predictors of bloodstream infections and mortality in hospitalized Malawian children

Abstract

BACKGROUND: In sub-Saharan Africa, bloodstream infections (BSI) are a major cause of pediatric mortality. Because of limited resources and facilities in these developing countries, treatment often must be based solely on clinical observations and patient history and includes the use of broad spectrum antimicrobials, a factor in the emergence of antibiotic resistance.… Read more

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Peripheral blood cell-specific cytokines in persons with untreated HIV infection in Malawi, Africa

Abstract

Human immunodeficiency virus (HIV) infection is the primary cause of morbidity and mortality in Malawi, Africa, because of its many effects on the immune system. Immune cells communicate through cytokines; therefore, we examined the relationships between HIV serostatus and cell-specific cytokine production for 40 asymptomatic, employed adults and 312 acutely ill, hospitalized patients in Malawi.… Read more

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Demographic and immune correlates of human herpesvirus 8 seropositivity in Malawi, Africa

Abstract

BACKGROUND: In the USA, human herpesvirus 8 (HHV-8) is associated with Kaposi’s sarcoma (KS) and HIV infection. We examined HHV-8 seroprevalence in a Malawian cohort, and assessed its relationship with HIV, KS, demographic characteristics, and immune findings.

METHODS: In 1997 and 1998, blood samples were obtained from 272 hospitalized Malawian patients, for whom demographic information was obtained, and 24 healthy volunteers without demographic data.… Read more

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Clinical and immune impact of Mycobacterium bovis BCG vaccination scarring

Abstract

The World Health Organization recommends Mycobacterium bovis BCG vaccination in areas of high tuberculosis prevalence. BCG’s clinical and immune effects, not necessarily Mycobacterium tuberculosis specific, are unclear. BCG vaccine scarring often is used as a surrogate marker of vaccination or of effective vaccination.… Read more

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Automated Evaluation of AIDS Messages with High‐Risk, Low‐Literacy Audiences

Abstract

A series of televised public service announcements (PSAs) about acquired immune deficiency syndrome (AIDS) was evaluated with 100 black participants attending a Sexually Transmitted Diseases Clinic in Atlanta, Georgia. Since the literacy level of the participants was suspected to be low, questions were administered orally and an electronic data collection technique was used which permitted the participants to push buttons, as opposed to speaking or writing responses.… Read more

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Spontaneous cytokine production and its effect on induced production

Abstract

Cytokines regulate cellular immune activity and are produced by a variety of cells, especially lymphocytes, monocytes, and macrophages. Multiparameter flow cytometry is often used to examine cell-specific cytokine production after in vitro phorbol 12-myristate 13-acetate and ionomycin induction, with brefeldin A or other agents added to inhibit protein secretion.… Read more

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Vitamin A levels and immunity in humans

Abstract

In animal studies, vitamin A deficiency induces a shift from type 2 (humoral, Th2) to type 1 (cellular, Th1) cytokines; there are no similar data for humans. Control of human immunodeficiency virus (HIV) and Mycobacterium tuberculosis infections requires type 1 cytokine (cellular) immunity.… Read more

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Age-related differences in cell-specific cytokine production by acutely ill Malawian patients

Abstract

Age-related changes in human cell-specific cytokine responses to acute illness have not been well examined. We therefore evaluated age-related differences in T, B and natural killer (NK) peripheral blood lymphocyte cytokine responses of 309 acutely ill hospitalized people in Malawi, Africa, < 1 month-61 years of age.… Read more

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The effects of iron deficiency on lymphocyte cytokine production and activation: preservation of hepatic iron but not at all cost

Abstract

Worldwide, over 40% of children have iron deficiency anaemia, frequently associated with infections. Certain cytokines are involved in both immune activation/response to infection and iron transport/metabolism. We therefore assessed the relations among iron deficiency, cytokine production and lymphocyte activation markers in 142 hospitalized Malawian children.… Read more

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Comparison of serum and cell-specific cytokines in humans

Abstract

Cytokines function at the cellular, microenvironmental level, but human cytokine assessment is most commonly done at the macro level, by measuring serum cytokines. The relationships between serum and cellular cytokines, if there are any, are undefined. In a study of hospitalized patients in Malawi, we compared cytometrically assessed, cell-specific cytokine data to serum interleukin 2 (IL-2), IL-4, IL-6, IL-8, IL-10, gamma interferon (IFN-gamma), and tumor necrosis factor alpha (TNF-alpha) levels in 16 children and 71 (IL-2, -4, -6, -10) or 159 (IL-8, IFN-gamma, and TNF-alpha) adults, using Wilcoxon rank sum tests and Pearson’s (r(p)) and Spearman’s (r(s)) rank correlations.… Read more

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Intracellular cytokines in the acute response to highly active antiretroviral therapy

Abstract

OBJECTIVES: Successful highly active antiretroviral therapy (HAART) is usually associated with a rapid decline in HIV plasma RNA levels and a gradual increase in CD4 T cells. We examined whether changes in cytokine production and profile precede other immunological changes and whether these might occur in temporal association with plasma HIV RNA changes.… Read more

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Cytokines and malaria parasitemia

Abstract

The balance between pro- and antiinflammatory cytokines may be important in malaria presentation and outcome. Malaria tends to be more severe in children than in adults, presumably because partial immunity develops with age. However, the full nature of, and age-related differences in, anti-malarial immunity are unknown.… Read more

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Natural T, gammadelta, and NK cells in mycobacterial, Salmonella, and human immunodeficiency virus infections

Abstract

NK cells, gammadelta T cell antigen receptor chain-positive cells, and CD3(+)CD16/56(+) (natural T [NT]) cells are involved in innate immunity and immunoregulation; however, their role in clinical infection is not well defined. Cytofluorometric analysis was used to examine peripheral blood from bacteremic, nonbacteremic, and healthy human immunodeficiency virus (HIV)-positive and -negative persons in Malawi, Africa.… Read more

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Immune determinants of organism and outcome in febrile hospitalized Thai patients with bloodstream infections

Abstract

Opportunistic infections (OI) and the human immunodeficiency virus (HIV) cause significant morbidity and mortality in developing countries. Immune cell and cytokine profiles may be related to the type and course of OI and to the OI-HIV interaction. Examining cell-specific cytokine production ex vivo has only recently become feasible.… Read more

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Addressing the public’s concerns about human immunodeficiency virus transmission in health-care settings

Abstract

BACKGROUND: The 1990 report of a cluster of patients infected with the human immunodeficiency virus (HIV) associated with a Florida dentist with acquired immunodeficiency syndrome attracted considerable media coverage and legislative attention. A number of polls found that the public favored mandatory HIV-antibody testing of health-care workers.… Read more

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Educating Young Adults About HIV and AIDS: the Impact of Direct Response Television Public Service Advertising

ABSTRACT Limited resources combined with a desire to reach as many people as possible often make direct response public service announcements an important tool in educational campaigns. To understand the impact of direct-response TV PSAs, and find ways to increase their effectiveness, this study examined 1) the effects of a highly targeted HIV prevention message on young adults’ knowledge, perceptions, and intentions; and 2) whether altering two PSA elements, the telephone number used and the length of time it was displayed, would affect viewers’ recall and intention responses.  … Read more

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Potential use of mass media to reach urban intravenous drug users with AIDS prevention messages

Abstract

To access the potential of using the mass media to reach urban intravenous drug users (IVDUs) with AIDS prevention messages,

we: 1) questioned 353 participants in a Baltimore IVDU cohort study on their media use and sources of AIDS information, 2) analyzed data on Baltimore AIDS public service announcement (PSA) airings during a 3-month period, and 3) discussed with media executives their willingness to air a variety of potential AIDS messages.… Read more

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Hemophilia growth and development study. Design, methods, and entry data

Abstract

PURPOSE: The study design, research questions, and baseline data are presented from a multicenter longitudinal epidemiologic investigation of the impact of human immunodeficiency virus (HIV) infection on three areas of functioning in children and adolescents with hemophilia: physical growth and sexual maturation, immune function, and neurological and neuropsychological functioning.… Read more

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The pediatrician’s role in encouraging parent-child communication about the acquired immunodeficiency syndrome

Abstract

OBJECTIVE: We explored whether communication from pediatrician to parent to child might assist in education about and prevention of human immunodeficiency virus (HIV) infection by comparing parents of children aged 10 through 17 years who did discuss acquired immunodeficiency syndrome (AIDS) with their children with parents of children aged 10 through 17 years who did not discuss AIDS with their children.… Read more

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A system for evaluating the use of media in CDC’s National AIDS Information and Education Program

Abstract

The National AIDS Information and Education Program (NAIEP) commissioned the National Academy of Sciences to design a prototypical system of research for use in the evaluation of the agency’s media campaign. It consists of four types of evaluation: formative, efficacy, process, and outcome.… Read more

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Paid advertising for AIDS prevention–would the ends justify the means?

Abstract

An examination by the Centers for Disease Control and the Research Triangle Institute concluded that “hard-to-reach” populations could be reached with AIDS prevention messages through the broadcast and print media and that a study should be undertaken to assess whether paid placement of these messages could have an effect on HIV-related behaviors.… Read more

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Evaluating the “America Responds to AIDS” Campaign

Abstract

Social marketing is “the design, implementation, and control of programs seeking to increase the acceptability of a social idea or practice in a target group.” It has existed in the United States for over a century and at various times has focused on such health-related behaviors as tobacco use, alcohol and drug use, control of hypertension, cancer screening, seat belt use, and-recently-behaviors placing a person at risk for HIV infection or a sexually transmitted disease.… Read more

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Abuse, neglect, and the HIV-infected child

Abstract

The effect of HIV on child abuse prevention must be considered on three different levels. The first consists of indirect effects: the extent to which this infection will be a burden on the health care, social service, and public assistance systems in this and other countries, leading to decreasing resources for child abuse prevention.   … Read more

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Concordance of polymerase chain reaction with human immunodeficiency virus antibody detection

Abstract

To evaluate the correlation of detection of human immunodeficiency virus (HIV) by polymerase chain reaction (PCR) with detection of HIV antibody, 271 simultaneous serum and peripheral blood mononuclear cell samples were examined from 242 persons whose activities placed them at increased risk for HIV infection: 142 from homosexual men, 86 from hemophilic men, and 43 from heterosexual partners of HIV-infected persons.… Read more

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Pregnancies in human immunodeficiency virus-infected sex partners of hemophilic men. The Hemophilia-AIDS Collaborative Study Group

Abstract

We investigated 24 completed pregnancies of 20 healthy, human immunodeficiency virus (HIV)-seropositive sex partners of 20 seropositive hemophilic men. One woman had recurrent herpes simplex type 2 infection; no woman was known to use illicit drugs or to have other purported cofactors for vertical HIV transmission.… Read more

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Absence of human T-cell lymphotropic virus type I coinfection in human immunodeficiency virus-infected hemophilic men

Abstract

Concern for transmission of human T-cell lymphotropic virus, type 1 (HTLV-1) infection to recipients of infected cellular blood products has prompted development of tests to eliminate blood units with HTLV-I antibodies. Most hemophilic men from the United States became infected with human immunodeficiency virus (HIV) before HIV donor screening and before blood products were processed to inactivate the virus.… Read more

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Geographic variability of hemophilia-associated AIDS in the United States: effect of population characteristics. Hemophilia-Associated AIDS Study Group

Abstract

National AIDS surveillance suggests that approximately 3.5% of all hemophilic patients in the United States have developed AIDS as of February 1988; however, the cumulative incidence of AIDS among seropositive patients at individual hemophilia treatment centers (HTCs) has been reported to be as high as 12%.… Read more

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Prevalence of human immunodeficiency virus type 1 DNA in hemophilic men and their sex partners. Hemophilia-AIDS Collaborative Study Group

Abstract

Polymerase chain reaction (PCR) was used to detect human immunodeficiency virus (HIV)-1 DNA in peripheral blood mononuclear cells to assess in hemophilic men whether any were HIV-seropositive but uninfected or seronegative but infected and in seronegative sex partners of seropositive hemophilic men whether any were infected.… Read more

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Parenting Your Premature Baby

Jason J, van der Meer A. Holt Publishing Company, NY, NY, 1989.

Above book was published in paperback by Dell Publishing Company, New York, NY in June, 1990. German publication rights for above book given in 1991.

Parenting Your Premature Baby was cited in the Library Journal as one of the best lay medical books for public libraries (1988-89).… Read more

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Duration of human immunodeficiency virus infection before detection of antibody

Abstract

To estimate the duration and frequency of the period of HIV infection without detectable antibody, modelling techniques were applied to results of detection of HIV DNA by means of the polymerase chain reaction (PCR) and to data from cases in published reports.  … Read more

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Infectious disease-related deaths of low birth weight infants, United States, 1968 to 1982

Abstract

Infant mortality rates in the United States are higher than in any other developed country. Low birth weight (LBW) is the primary determinant of infant mortality.

 

Despite city, state, and federal programs to prevent LBW, decreases in infant mortality in the 1980s appear to be largely secondary to improved survival of LBW infants rather than to a decline in the rate of LBW births.… Read more

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Sex practice correlates of human immunodeficiency virus transmission and acquired immunodeficiency syndrome incidence in heterosexual partners and offspring of U.S. hemophilic men

Abstract

We assessed the risk of human immunodeficiency virus (HIV) transmission from heterosexual seropositive hemophilic men to their female sex partners through an HIV serosurvey and questionnaire study conducted during 1984-1987. Five percent of 21 female partners of asymptomatic men and 11% of 35 partners of HIV-symptomatic (acquired immunodeficiency syndrome [AIDS], AIDS-related complex [ARC], peripheral generalized lymphadenopathy [PGL]) hemophilic men had been infected when first tested.… Read more

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Risk of developing AIDS in HIV-infected cohorts of hemophilic and homosexual men

Abstract

The latency period and/or incidence of the acquired immunodeficiency syndrome (AIDS) may differ in persons infected with the human immunodeficiency virus by different routes or having different “cofactors.” We compared 79 hemophilic men in Pennsylvania and 117 homosexual and bisexual men in California, all having known dates of infection and long postinfection observation periods, to examine these hypotheses.… Read more

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HIV and hemophilic children’s growth

Abstract

The acquired immune deficiency syndrome (AIDS) often has profound effects on growth; however, the effects of human immunodeficiency virus (HIV) on asymptomatic children’s growth are unknown. Before heat inactivation/HIV donor screening of factor concentrates, many hemophilic children became infected with HIV.… Read more

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Human immunodeficiency virus infection in hemophilic children

Abstract

The following groups were compared: (1) children less than 18 years old who have hemophilia-associated acquired immunodeficiency syndrome (AIDS) with other children with AIDS and with adults who have hemophilia-associated AIDS and (2) asymptomatic HIV-infected hemophilic children with asymptomatic HIV-infected hemophilic adults.… Read more

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Racial differences in care of patients with hemophilia

Abstract

Hemophilia treatment centers were first established in the mid­-1970s to provide optimal and coordinated medical care to patients with the disorder. Our study suggests that blacks with hemophilia may be receiving less coordinated care and less appropriate blood­ product therapy than whites with hemophilia.… Read more

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Hemophilia-associated AIDS in the United States, 1981 to September 1987

Abstract

Between January 1, 1981 and September 4, 1987, 407 cases of hemophilia-associated acquired immunodeficiency syndrome (AIDS) had been reported to the Centers for Disease Control. The number of cases diagnosed each year nearly doubled, except in 1986, when cases increased only 50 per cent.… Read more

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Potential effect of revising the CDC surveillance case definition for AIDS

Abstract

The Centers for Disease Control (CDC) revised the surveillance case definition for acquired immunodeficiency syndrome (AIDS) in August, 1987. To determine the impact of this revision, information was extracted from the medical charts of the 630 patients receiving comprehensive medical care as of 1980 at 6 haemophilia treatment centres, and who were therefore likely to have been infected with human immunodeficiency virus (HIV).… Read more

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The Epidemiology of AIDS

Abstract

Cases of the acquired immune deficiency syndrome (AIDS) were first reported in June and July of 1981, as clusters of Kaposi’s sarcoma and Pneumocystis carinii pneumonia among homosexual men. Since then, epidemiologic surveillance has been used by investigators and public health professionals to identify that an outbreak existed, to characterize the outbreak, and to determine and predict its extent and course.… Read more

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Hemophiliac patient’s knowledge and educational needs concerning acquired immunodeficiency syndrome

Abstract

The Patient Knowledge Assessment Study (PKAS) was conducted among 107 male hemophilic patients, aged 15 to 67 years, at 19 hemophilia treatment centers (HTC). Participants were given a 30-item questionnaire concerning the cause of acquired immunodeficiency syndrome (AIDS), the groups at risk, and modes of transmission.… Read more

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Infectious diseases: preventable causes of infant mortality

Abstract

After almost a century of improvement, the rate of decrease in US infant mortality rates began to level off during the period of 1982 to 1984. Rates actually increased in some states. Because much of the decline in infant mortality in this century can be attributed to advances in infectious disease treatment and prevention programs, we evaluated the current impact of infectious diseases on infant mortality.… Read more

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The course of the epidemic of acquired immunodeficiency syndrome in the United States hemophilia population

Abstract

The time course of the epidemic of acquired immunodeficiency syndrome (AIDS) as it has occurred in the US hemophilia population is examined using surveillance data collected by the Centers for Disease Control (CDC). These data indicate that the epidemic course in hemophiliacs is distinguishable from that in the homosexual/bisexual and intravenous drug-using populations in at least one respect–the epidemic in the hemophilia population is characterized by a lack of consistent increase in the number of new AIDS cases in successive time intervals.… Read more

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Effects of exposure to factor concentrates containing donations from identified AIDS patients. A matched cohort study

Abstract

We compared recipients of eight lots of factors VIII and IX voluntarily withdrawn from distribution because one donor was known to have subsequently developed the acquired immunodeficiency syndrome with a nonexposed cohort matched by age, sex, and factor use. The factor VIII recipient cohorts did not differ in prevalence of antibody to human immunodeficiency virus (HIV) (exposed, 75%; nonexposed, 86%), T-cell subset numbers (median: exposed, 619 T-helper cells per cubic millimeter; nonexposed, 659 T-helper cells per cubic millimeter), T-helper to T-suppressor ratios, or immunoglobulin levels.… Read more

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HTLV-III/LAV-seronegative, virus-negative sexual partners and household contacts of hemophiliacs

Abstract

Public concern about the transmissibility of human T-cell lymphotropic virus type III/ lymphadenopathy-associated virus (HTLV-III/LAV) has been heightened by several reports suggesting the existence of an antibody-negative, virus-positive state in some asymptomatic sex partners of persons who are antibody-positive.  We recently evaluated 88 household members and/or sex partners of persons with hemophilia and found that only two nonhemophiliacs were HTLV-III/LAV antibody-positive.  … Read more

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Conjugal transmission of HTLV-III and lymphadenopathy in Christmas disease

Abstract

The risk of conjugal transmission of the HTLV-III/LAV virus associated with the acquired immunodeficiency syndrome (AIDS) in patients with hemophilia is unknown.  To date, only a few   instances of proven exposure to HTLV-III have been reported among sexual or family contacts of   patients with hemophilia.  … Read more

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HTLV-III/LAV antibody and immune status of household contacts and sexual partners of persons with hemophilia

Abstract

We evaluated the human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) antibody and immune status of 88 persons living with and/or sexual partners of 43 hemophiliacs, 12 of whom had AIDS, five of whom had AIDS-related complex (ARC), 17 of whom were clinically well but HTLV-III/LAV antibody positive, and nine of whom were well and HTLV-III/LAV antibody negative.… Read more

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HTLV-III exposure during cardiopulmonary resuscitation

Abstract

To the Editor: There have been no confirmed occupation-related cases of AIDS in health care workers in the United States. We have been following two nurses who participated in mouth-to-mouth re­suscitation of a patient with the AIDS-related complex, who was positive for human T-cell lymphotropic virus Type- III/lymphade­nopathy-associated virus (HTLV-III/LAV), and we here report their seronegativity nine months after exposure.… Read more

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An historical perspective on controversy surrounding the international code of marketing of breast‑milk substitutes

Jason JM, McGrady GA.

In: Clinical Obstetrics – A Public Health Perspective.  B P Sachs & D Acker (eds).  PSG, Inc. Boston, MA, 1985.

ISBN 0-88416-513-2

An historical perspective on controversy surrounding the international code of marketing of breast‑milk substitutes was last modified: October 20th, 2015 by Jason JM, McGrady GA… Read more
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HTLV-III/LAV antibody status of spouses and household contacts assisting in home infusion of hemophilia patients

Abstract

Thirty-four adult and pediatric hemophilia A and B patients and 50 nonhemophilic members belonging to 28 families were enrolled in August 1984 in a study of human T cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) antibody status and T cell subpopulation numbers.… Read more

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HTLV-I antibody status in hemophilia patients treated with factor concentrates prepared from U.S. plasma sources and in hemophilia patients with AIDS

Abstract

Serum samples from 85 Austrian hemophilia patients treated with lyophilized factor concentrates prepared from U.S. plasma sources, 24 hemophilia patients from Georgia on a home therapy program with factor concentrates, and 10 U.S. hemophilia patients with acquired immunodeficiency syndrome (AIDS) were analyzed by two different methods for the presence of antibodies to the major internal antigen of human T-cell leukemia virus I (HTLV-I) p24.… Read more