Nerve growth factor, brain-derived neurotrophic factor, and neurotrophin-3 levels in human amniotic fluid.

OBJECTIVE: Neurotrophins are proteins that promote neuronal growth and differentiation. In this pilot study we determined whether the neurotrophins nerve growth factor, brain-derived neurotrophic factor, and neurotrophin-3 were present in amniotic fluid specimens to begin to elucidate their developmental regulation. We also explored associations between neurotrophin levels and central nervous system abnormalities and exposure to infection. STUDY DESIGN: One hundred thirty-four amniotic fluid specimens were obtained from women undergoing amniocentesis at University of North Carolina Hospitals. Each specimen was assayed by enzyme-linked immunosorbent assay for nerve growth factor, brain-derived neurotrophic factor, and neurotrophin 3. Associations of maternal age, gestational age, and maternal ethnicity with neurotrophin levels were explored. Neurotrophin levels in pregnancies in which there was enlargement of the fetal cerebral lateral ventricles or exposure to infection were compared with those in control pregnancies. Spearman correlational analyses and analyses of covariance were performed, with adjustment for gestational age. RESULTS: Nerve growth factor, brain-derived neurotrophic factor, and neurotrophin 3 were detected in all amniotic fluid specimens. Nerve growth factor increased with gestational age (P =.045). Brain-derived neurotrophic factor decreased with gestational age (P =.035). Patients with ventriculomegaly (with or without other central nervous system abnormalities) on ultrasonographic examination (n = 6) had significantly lower nerve growth factor levels than control subjects (P =.0046); patients with evidence of infection (n = 5) during pregnancy had significantly lower nerve growth factor (P =.0037) and brain-derived neurotrophic factor (P =.0362) levels. CONCLUSIONS: Nerve growth factor, brain-derived neurotrophic factor, and neurotrophin 3 are detectable in amniotic fluid and vary with gestational age. Decreased nerve growth factor and brain-derived neurotrophic factor levels in amniotic fluid may be a marker for the presence of central nervous system abnormalities, infectious insults in utero, or both.

Latex allergy in patients with spina bifida.

Latex recently has been associated with severe intraoperative IgE-mediated anaphylactic reactions. Pediatric patients with meningomyelocele (spina bifida) appear to be specifically at risk for this type of reaction. This article provides background information on the etiology of latex allergies, identifies some commonly used dental products containing latex, recommends some alternatives to use, and suggests precautions the dental practitioner should take when treating high-risk individuals such as spina bifida patients.

Recidivism among patients with gonococcal infection presenting to a venereal disease clinic.

We studied the incidence of gonorrhea, gonococcal recidivism and related factors in venereal disease clinic patients. A sample of 2029 records, which were selected randomly, were reviewed. Gonorrhea and gonococcal recidivism were more common in nonwhite patients, particularly in nonwhite men. Gonorrhea occurred more than once in 23% of the patients with gonorrhea and those patients accounted for 48% of all cases of gonorrhea. We also interviewed 627 new patients attending the venereal disease clinic. Gonococcal recidivism was reported more often by older men and younger women. Use of contraceptives was less frequent among white women who were gonococcal recidivists. However, contraception was not used by 40% of the patients or their partners. Gonococcal isolation rates were lowest in men who used condoms. The number of sexual partners did not correlate with age, use of contraceptives or results of cultures for gonococci. Men had more sexual partners than women and white women had more partners than non-white women. Nine percent of patients took oral antibiotics prior to their visit to the clinic; antibiotic ingestion did not correlate with the patients' race or the results of their cultures.