ABSTRACT
We evaluated the recently described differential agglutination test (HS/AC test) to differentiate recently acquired toxoplasma infections from those acquired in the more distant past in sera obtained from 38 patients with carefully defined symptomatic and asymptomatic infections. AC antigens detect acute-phase-specific immunoglobulin G (IgG) antibodies against Toxoplasma gondii tachyzoites that are formed only during the acute stage of infection in humans. The HS/AC test correctly identified recently acquired infections in patients with toxoplasmic lymphadenopathy or asymptomatic infections (including infections in 7 women who seroconverted during gestation) in 31 of 33 patients. We also studied 15 individuals who had been infected for at least 2 years. In that group, only 13% had an acute pattern in the HS/AC test. However, the wide range in times from infection (from 2 to 14 years) did not allow for an estimate of when the pattern in the HS/AC test changed from acute to not acute. These results reveal that in the appropriate clinical situation, when both IgG and IgM tests are positive and a question still remains about the acuteness of infection, the HS/AC test may be useful for differentiating between toxoplasma infections acquired recently and those acquired in the more distant past.
Subject(s)
Agglutination Tests , Toxoplasmosis/diagnosis , Animals , Antibodies, Protozoan/blood , Evaluation Studies as Topic , Female , Humans , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/immunology , Time Factors , Toxoplasma/immunology , Toxoplasmosis/complications , Toxoplasmosis/immunologyABSTRACT
We describe a technique for performing intravenous digital subtraction arteriography by peripheral injection and review our experience of 504 studies in 469 patients. The technique gave adequate opacification for anatomical definition of vessels in 93% of patients studied and was suitable for studies of the pulmonary arteries and left ventricle as well as the major systemic arteries. The chief causes of failure were impaired cardiac performance (2.4%) and poor patient cooperation (1.4%). Premature termination was caused by angina pectoris in 1.6% of our cases. These limitations apply also to central venous injection.
