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Penicillin allergy presents a major obstacle to the successful management of some antepartum infections. We studied 15 pregnant women with histories of penicillin allergy confirmed by positive immediate wheal-and-flare skin tests. Thirteen had syphilis, one listeria sepsis, and one Streptococcus viridans endocarditis. Each patient was desensitized over four to six hours by oral administration of increasing doses of penicillin V. At the completion of the procedure, full-dose parenteral therapy with penicillin G or ampicillin was instituted. No extracutaneous reactions were detected. Five of the subjects (33 per cent) experienced pruritus (three) or urticaria (two), but no interruption of desensitization or therapy was necessary. All clinically apparent maternal infections were cured. The pregnancy complicated by listeriosis aborted in the first trimester. The 11 neonates delivered to date are normal. These results indicate that oral desensitization is an acceptably safe approach to therapy in pregnant women who are allergic to penicillin and have infections that require beta-lactam drugs.

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JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. This content downloaded from 185.44.78.113 on Thu, 12 Jun 2014 15:21:34 PM All use subject to JSTOR Terms and ConditionsWe examine the ways that textile production, exchange, and consumption were integrated into the political economy of the Gulf lowlands, Mexico, over the course of two millennia. Archaeological, botanical, and historical data concerning cotton textile production reveal that changes in the industry resulted from alterations in the cotton plant, shifts in the local political economy, and changes in the relationship of the Gulf lowlands to other key regions of Mesoamerica. Initially, textiles did not figure prominently in social displays, and there is little archaeological evidence for spinning of cotton thread. Subsequently, textile production may have been stimulated by elite substitution of locally crafted items for increasingly scarce exotic imports toward the end of Olmec times in the Preclassic period. The political and cultural stature of the Gulf lowlands increased during the Classic period in conjunction with a greater emphasis on cotton processing and use of textiles. During the Postclassic period, ruralization of once-key localities and possible conversion of the western lower Papaloapan Basin to a tributary status correlated with changes in the attributes of whorls and in representations of textiles.En este a rtEcu lo discutimos la mane ra en la que la produccion, el intercambio y el cons umo de textiles estu vieron integrados en la economfa politEca de las tierras bajas del Golfo de Me'xico durante dos milenios. Los datos arqueologicos, bota'nicos e histo'ricos relacionados con la produccion de textiles de algodo'n indican que los cambios en la industria textilfueron el resultado de (I) algunas alteraciones en la planta misma, (2) cambios en la economfa polftica local, y (3) cambios en la relacion que debio existir entre las tierras bajas del Golfo y las otras regiones claves de Mesoame'rica. En un principio, los textiles no parecen haber sido prominentes en los despliegues sociales, y hay poca evidencia arqueologica del hilado de algodo'n. Posteriormente, la produccion textil pudo haberse estimulado por la substitucion de artEculos de fabricacion local sobre los materiales exo'ticos importados que ya habfan comenzado a ser escasos desde fines de la e'poca olmeca en el horizonte Precla'sico. Las tierras bajas del Golfo alcanzaron su papel polftico y cultural ma's eminente durante el horizonte Clasico, a la vez que tambie'n se observo un mayor e'nfasis en la produccio'n del algodon y en el empleo de textiles. Durante el horizontePoscla'sico, la marg.nalizacion del a'rea de la cuenca oeste del bajo Papaloapan, la cual habfa sido antes un a'rea clave, coinc...