Improvement of four patients with HIV-1 related symptoms after hyperimmunization with killed poliomyelitis (Salk) vaccine.

Four HIV-1 positive patients with characteristic symptoms of this infection experienced amelioration or resolution of symptoms after 2 months of hyperimmunization with inactivated (Salk) poliomyelitis vaccine. The patient who was initially the most symptomatic exhibited a marked improvement in T4/T8 ratio at the sixth month of continued hyperimmunization treatment. With two patients reported previously, six consecutive patients with lymphotropic retrovirus disease have benefited from hyperimmunization with inactivated polio vaccine.

Clinical improvement of two patients with T lymphotropic retrovirus diseases after polio vaccine hyperimmunization.

Patients with acute leukemia have an impaired ability to produce antibodies to poliovirus in response to inoculation with inactivated vaccine. Reimmunization will, however, produce a relative increase in antibodies equivalent to that of healthy subjects. A child with acute lymphocytic leukemia was hyperimmunized with Salk polio vaccine following a relapse and has had no further relapse nor sequelae for 20 years. An adult physician with acquired immunodeficiency syndrome hyperimmunized himself with the same vaccine, and the preliminary results are encouraging. The clinical improvement seen in these two patients following hyperimmunization with killed polio vaccine may reflect a secondary immune amplification that has been observed in humans following live polio virus immunization.

Dexamethasone suppression in depressed elderly outpatients.

The dexamethasone suppression test (DST) was performed as part of the preliminary workup in 85 previously untreated outpatients with major affective disorder, unipolar depressive type, who were over age 60. All patients were given a systematic structured interview (NIMH-DIS), and all had scores over 20 on the 21-item Hamilton Depression Rating Scale (HAM-D). Only 12 patients (14%) had positive DSTs; more of the non-melancholic (6 of 25; 24%) than melancholic (6 of 60; 10%) patients failed to suppress serum cortisol following standard dexamethasone challenge (p less than .10). DST results did not correlate with patients' HAM-D or Zung depression scores, gender, response to treatment, or any other variable studied. These findings suggest that, in comparison to previous reports, a positive DST may be 1) less common in major depressive disorders, 2) no more common in more severely depressed patients, and 3) less relevant to indications for specific treatment.

PCP in amniotic fluid and breast milk: case report.

The presence of phencyclidine (PCP) in breast milk and amniotic fluid of a young drug abuser is described. Implications drawn from these data include the possible use of amniocentesis in women with well-documented histories of drug abuse who have low levels of PCP in urine, and the restriction of breast feeding in women who have abused PCP.

Phencyclidine in umbilical cord blood: preliminary data.

The epidemic abuse of phencyclidine (PCP) has become a major psychiatric issue within the past decade. With the assistance of highly sensitive capillary gas chromatographic-nitrogen detector measurements, PCP's true pervasiveness is only now being appreciated. To further quantitate the severity of the problem, the authors analyzed samples of umbilical cord blood from 200 patients on the obstetrics service of a major university medical center. Preliminary results revealed that 24 (12%) of the samples were positive for PCP (.10-5.80 ng/ml). The authors discuss the significance of this finding with regard to psychiatry, obstetrics, pediatrics, and juvenile law.

Occupational intoxication and long-term persistence of phencyclidine (PCP) in law enforcement personnel.

By utilizing a glass capillary gas chromatographic nitrogen detector (GC2-N) method specific for phencyclidine (PCP) and sensitive to pg/mL in blood or urine samples, we have demonstrated occupational intoxication of law enforcement personnel charged with handling confiscated illegal PCP preparations. Further, we have demonstrated persistence of PCP in blood and urine for at least 6 months after the last known occupational exposure in one officer. Some aspects of the PCP problem are outlined, and possible mechanisms of the occupational intoxication are discussed.

The urban epidemic of phencyclidine (PCP) use: clinical and laboratory evidence from a public psychiatric hospital emergency service.

Routine blood samples of 145 consecutive patients seen in the Los Angeles County Psychiatric Hospital Emergency Room during a 48-hour weekday period in June 1979 were examined for phencyclidine (PCP) using a sensitive and specific gas capillary gas chromatographic nitrogen detector (GC2-N) method. Of these 145 samples 63 (43.4%) were positive and PCP levels ranged 0.34 to 142.9 nanograms/ml (mean 14.6 ng/ml +/- 3.4 S.E.M.). An analysis of the records of these 63 patients revealed a wide variety of psychotic clinical pictures resembling mania, depression or schizophrenia with relatively few of the supposedly characteristic manifestations of PCP intoxication. Each of the 63 patients had at least one manifestation of toxic psychosis and/or acute delirium, in addition to the florid symptoms characteristic of functional states. PCP measurement, pharmacokinetics and the possible relationships of this intoxication to the psychiatric manifestations are discussed.