We reviewed our practice of universal tuberculosis (TB) screening in an at-risk pregnant population with regards to utility and patient compliance. The Gouverneur Healthcare Services prenatal database was analyzed for compliance with TB screening. Age, ethnicity, country of origin, and education level were also analyzed. Of 4049 patients, 95.0% were compliant with their purified protein derivative (PPD) testing. Universal screening identified 1935 (50.4%) PPD+ patients, with chest X-rays (CXR) available for 95.1%. Only one patient had a CXR consistent with active TB, although sputum testing was negative for acid-fast bacilli. Asian women were more likely to be PPD-compliant (adjusted odds ratio [aOR]: 4.94, 95% confidence interval [CI]: 2.34 to 10.45). Similarly, PPD+ Asian women were more likely to be compliant with CXR (aOR: 12.67, 95% CI: 3.44 to 46.7). U.S.-born women were significantly less likely to be compliant with PPD (aOR: 0.44, 95% CI: 0.30 to 0.64) or with CXR (aOR: 0.22, 95% CI: 0.08 to 0.61). Universal prenatal TB screening is associated with excellent compliance rates and is an effective way to identify a high prevalence of latent TB, but not active disease.

The higher risk of severe perineal laceration in Chinese women compared to other ethnicities can be attributed, in part, to a relative fetal-maternal size disproportion.

Isolated guinea pig adrenocortical cells were maintained in long-term culture in order to perform sequential experiments on the same cell populations. The cells produced fluorogenic steroids, shown by thin-layer chromatography to be at least aldosterone, cortisol, and corticosterone. In addition, they increased production of these steroids when treated with either ACTH or dibutyryl cyclic AMP. Of particular interest was the fact that cultures treated for the initial 24-hour culture period with ACTH maintained enhanced levels of secretion for several days in absence of hormone and had an enhanced response to ACTH later in the culture period. Such enhancement of secretion was not seen following early treatment with dibutyryl cyclic AMP. The fine structure of the ACTH-treated cells was consistent with increased steroidogenesis. They possessed more smooth-surfaced endoplasmic reticulum, larger mitochondrial crystal surfaces, and larger Golgi complexes than the cells in untreated cultures.

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