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Related post: acquisition of a major portion of the enteric disease program. Approximate Level of Support Activity Number Amount Infectious Disease Epidemiology Research Contracts 2 182,948 Research Grants 3 429,631 Fellowships 1 16,118 Diarrheal Diseases Research Contracts 6 749,029 Research Grants 23 1,502,707 Program Projects 1 432,744 Fellowships 3 45,932 Training Grants 1 36,504 Totals 40 3,395,613 Epidemiologic and Biometric Consultation In the area of data monitoring for clinical trials, Dr. William Blackwelder assisted contractors studying abbreviated courses of therapy of amphotericin B and 5-fluorcytosine for cryptococcal meningitis, efficacy of prophylactic penicillin for neonatal infections with group B Streptococcus , and efficacy of antiviral treatment of herpes labial is. As the Institute supports more collaborative clinical trials, these activities will grow as statistical advice is more frequently required in both study design and data monitoring. Dr. Blackwelder concluded the development of methods to facilitate more precise calculation of pneumococcal antibody determined by Tentex Forte Price In India RIA in the laboratory of Dr. Gerald Schiffman. The Branch staff provided statistical consultation to investigators studying pneumococcal vaccine in otitis media and lupus erthyematosus , assisted in managing a large volume of epidemiologic and clinical data generated by one enteric disease center, collaborated with Dr.^David Ailing, LCI, NIAID and Sir Charles Stuart-Harris, Fogarty Scholar, in analyzing national Tentex Forte Tablet influenza and pneumonia data to refine epidemiological association of increased mortality rates and major activity of influenza in the U.S., and assisted investigators at the Walter Reed Army Institute of Research in designing a multi center study to determine the value of an IgE standard developed by the lAIDP and in analyzing the resulting data. Trans-NIH Activities Members of the Branch Staff participated Tentex Forte Himalaya in many trans-NIH and Non-NIH 10-1 committees. Dr. Blackwelder was active in a research advisory group which was convened by the Cystic Fibrosis Foundation and charged with developing a protocol for a multi center clinical trial which might be sponsored by the agency. Dr. Curl in represented the Institute in the Digestive Disease Coordinating Committee and Dr. Kaslow functioned as the Institute's representative to the NIH and PHS Diabetes Committees. Dr. Curl in and Dr. Kaslow both were active in the NIH Epidemiology Committee. Epidemiologic Projects Dr. Richard A. Kaslow, research epidemiologist in the Branch, instituted a collaborative field study of Lyme disease in Wisconsin with Dr. Jeffrey Davis, Wisconsin Department of Health, and Dr. Andrew Spielman, Harvard University School of Public Health. Initial findings suggest the disease is underreported and is localized in areas in which the supected tick vector is found. An effort was begun to increase physician awareness to detect additional cases so definitive epidemiologic studies can be initiated. Epidemiologists in the Branch initiated with Dr. Daniel Mull ally of the Asthma and Allergic Disease Branch, lAIDP, and Dr. William Howard of the Children's Hospital National Medical Center a 20 year retrospective analysis of admissions to the Hospital for asthma. A thorough methodological review was undertaken first to document the increase in asthma admissions suggested by Dr. Howard's preliminary tabulations and then to search for factors that could account for the increase. HLA and Epidemiology A collaborative study of lupus erythematosus in black Americans was initiated with the scientists of the NCI and investigators at the Johns Hopkins School of Medicine. A questionnaire developed by Dr. Kaslow and Dr. Jill B. Schiff will be administered to cases and carefully selected controls to Himalaya Tentex Forte seek possible environmental risk factors, and the HLA type of both cases and controls will be determined. This study seeks to develop an epidemiologic methodology in addition to identifying HLA associations with this disease in the black population. Dr. Kaslow and colleagues at the CDC and Stanford University prepared to expand epidemiologic studies in victims of common source enteric disease epidemics, to define further the extent to which Reiter's syndrome is associated with specific bacterial agents, and to identify immuno- genetic charateri Tentex Forte Tablets sties that regulate development of this Buy Tentex Forte immunologic disease. Dr. Kaslow' s previous work at the CDC identified probable Reiter's syndrome among patients affected in Shigella flexneri epidemics but failed to identify Reiter's syndrome among patients of Shigella sonnei outbreaks. Pursuit of these observations may identify specific bacterial antigens which trigger the pathologic immune response in patients with the HLA-B27 phenotype. Field work began on the contract to Johns Hopkins University to note the influence of HLA in the immune response to viral vaccines in humans. Inter- views were conducted and baseline sera were obtained in the Amish population. Children of all ages from a large proportion of families studied were found to be sero-negative to rubella. Thus, it will be quite feasible to enroll a sufficient number of volunteers to conduct the Tentex Forte Price study. The Amish population will benefit more than anticipated from the vaccinations offered by the study. 10-2 Epidemiology of Nosocomial Infections Support for the CDC SENIC project concluded, and a grant to study the epidemi- ology of nosocomial infections was awarded to the Rhode Island Department of Health. This ambitious effort, which utilizes a sample of patients drawn from all general hospitals in the state, will identify host factors modifying efficacy of infection control programs. Enteric Diseases Centers The initial three-year phase was completed at the three incumbent Infectious Enteric Disease Study Centers. Many of the findings which were previewed in
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