title: Children with developmental and behavioural concerns in Singapore.

text: INTRODUCTION Childhood developmental and behavioural disorders (CDABD) have been increasingly recognised in recent years. This study evaluated the profiles and outcomes of children referred for developmental and behavioural concerns to a tertiary child developmental centre in Singapore. This is the first such regional database. METHODS Baseline information, obtained through a questionnaire, together with history at first consultation, provided information for referral, demographic and presentation profiles. Clinical formulations were then made. Definitive developmental and medical diagnoses, as well as outcomes based on clinical assessment and standardised testing, were recorded at one year post first consultation. RESULTS Out of 1,304 referrals between January 1, 2003 and December 1, 2004, 45% were 2-4 years old and 74% were boys. The waiting time from referral to first consultation exceeded four months in 52% of children. Following clinical evaluation, 7% were found to be developmentally appropriate. The single most common presenting concern was speech and language (S&L) delay (29%). The most common clinical developmental diagnosis was autism spectrum disorder (ASD) (30%), followed by isolated S&L disorder, global developmental delay (GDD) and cognitive impairment (CI). Recommendations included S&L therapy (57%), occupational therapy (50%) and psychological/behavioural services (40%). At one year, ASD remained the most common definitive developmental diagnosis (31%), followed by S&L disorder, CI and GDD. Most were children with high-prevalence, low-moderate severity disorders who could potentially achieve fair-good prognosis with early intervention. CONCLUSION Better appreciation of the profile and outcome of children with CDABD in Singapore could enable better resource planning for diagnosis and intervention.


Strongyloides stercoralis infection as a manifestation of immune restoration syndrome?


title: Percutaneous Transhepatic Embolization of Bleeding Rectal Varices Using A New Embolic And Sclerotic Mixture Augmented By Amplatzer Vascular Plug 2.

text: We report a case of 59-year-old female with non-alcoholic-steato-hepatitis (NASH) induced cirrhosis, who presented with hematochezia. The patient had a history of bleeding esophageal varices treated with endoscopic variceal ligation (EVL). Colonoscopy showed large rectal varices which were the source of her lower gastrointestinal bleeding (LGIB). Since endoscopic treatment for LGIB are limited, and because the patient had portal vein thrombosis which contraindicated transjugular intrahepatic portosystemic shunt (TIPS), we performed percutaneous transhepatic embolization of her rectal varices using a new mixture of embolic and sclerotic agents, followed by Amplatzer plug 2 (AVP 2). To our knowledge, the use of this new mixture with the AVP 2 in the rectal varices treatment has not been previously published in literature. Our case provides an alternative treatment modality that can be used for rectal varices treatment, when TIPS and endoscopic management fails or is contraindicated.


[Principles in health policy during the SARS-CoV-2 outbreak - major lessons from South East-Asia].


title: Coagulation Panel in Patients with SARS-CoV2 Infection (COVID-19).

text: The 2019 novel coronavirus (SARS-CoV2) is the causal agent of the newly-termed Coronavirus Disease 2019 (COVID-19). In January 2020, the World Health Association (WHO) declared the CO-VID-19 as an epidemic. Abnormal coagulation parameters in COVID-19 patients currently are considered as prognostic factors of severity. Our aim is to summarize the current data available in the literature. MATERIALS AND METHODS An electronic search was performed in the Database of publications on coronavirus disease (COVID-19) of the World Health Organization. Thrombin Time (TT), Prothrombin Time (PT), Fibrinogen (FIB), Activated Partial Thromboplastin Time (APPT), and D-Dimer have been detected as parameters to study in every COVID-19 patient. CLINICAL APPLICATION The coagulation function panel has been described to be altered in critical COVID-2019 patients. DIC, which plays an important role in advanced stage, is known to be associated with sepsis. Anticoagulant therapy, mainly with low molecular weight heparin (LMWH), appears to be associated with better prognosis in patients with severe COV-ID-19. DISCUSSION Coagulation function in patients with SARS-CoV2 infection is significantly deranged compared with normal patients. FIB and D-Dimer/FDP are the most significantly altered values and the early deetection of alteration could be useful to address therapies. D-Dimer/FDP (DD/FDP) alteration correlates with severity. Markedly elevated D-Dimer can be used to guide the introduction of anticoagulation therapy and evaluate prognosis of COVID-19. In every patient admitted with SARS-CoV2 infection PT, FIB, D-Dimer/FDP, and platelets must be ordered. We suggest daily extraction for every patient admitted and tested positive for COVID-19.


title: Control of influenza virus infection by immunity to conserved viral features.

text: Influenza has circulated among humans for centuries and kills more people than many newly emerging diseases. The present methods for control of influenza are not adequate, especially for dealing with a pandemic. In the face of a rapidly spreading outbreak, a race to isolate the virus and prepare a vaccine would probably not succeed in time to avoid great losses. Thus, additional anti-infection strategies are needed. Broad cross-protection against widely divergent influenza A subtypes is readily achieved in animals by several means of immunization. How does cross-protection work in animals, and can we apply what we have learned about it to induce broad cross-protection in humans?


title: [Immunisation strategies for the management of severe acute respiratory syndrome (SARS)].

text: Most patients with severe acute respiratory syndrome (SARS) develop antibodies against the SARS coronavirus and survive the infection. This suggests that active or passive immunisation might be an effective option in preventing or treating SARS. Therefore, the development of SARS vaccination strategies belongs to the most important targets of SARS research. The present study analyses data-bases for the current knowledge on vaccination strategies. Both, passive and active immunisation protocols are presently being developed. Passive immunisation with sera from surviving patients leads to partial success. Whereas the passive immunisation exhibits a promising therapeutic tool, only active immunisation can successfully prevent infection. A number of approaches has been used on the basis of inactivated SARS coronaviruses, recombinant subunits, recombinant DNA, and viral vectors. However, all recently developed candidates need to be evaluated critically before clinical use. The so-called "antibody-dependent enhancement" can improve viral uptake into host cells resulting in increased viral load and exacerbation of disease.


SARS-struck nations step up surveillance efforts.


title: [Laparoscopic cholecystectomy with single incision laparoscopic surgery].

text: UNLABELLED For the last seventeen years laparoscopic cholecystectomy has remained the gold standard procedure for gallbladder surgery The single incision laparoscopic surgery (SILS) approach is a step toward less invasive surgery and the intraumbilical access improves the cosmetic effect (no scar surgery). The aim of the study was to present our preliminary experience in laparoscopic cholecystectomy through single intraumbilical incision. MATERIAL AND METHODS Three patients with gallbladder symptoms (2 female, 1 male) underwent surgery through single intraumbilical incision. In two cases the procedure was performed with three 5 mm Dexide port approach and in one, with a flexible rubber/gel SILSTM-Port (Covidien, USA) access. A simple 5 mm optics was employed. In two procedures the following disposable instruments were used: roticulator Endo dissect, roticulator Endo grasp, mini Sears scissors as well as standard hook and clips while for the third procedure, a conventional multi-use grasp and roticular Endo dissect. The gallbladder was elevated to the integuments by two sutures to expose Calot's triangle and bladder site. Following exposure, the bile duct and the vesical artery were clipsed and cut routinely to remove the gallbladder in a plastic bag through the bell-button. After procedures no drains were left in the peritoneal cavities. RESULTS In all three cases the laparoscopic procedure was performed. The median operative time was 88 min. In one female patient, bleeding into the peritoneal cavity was reported and called for laparotomy within a few hours of laparoscopic procedure. Intraoperatively, the branch of vesical artery was sutured to arrest bleeding. The median hospital stay following procedure was 3, 8 and 5 days respectively. After the procedure, the last female patient was observed to have pharyngitis and enlarged jugular lymph nodes that abated after antibiotic therapy. CONCLUSIONS Single-incision laparoscopic cholecystectomy should be performed by experienced laparoscopic surgeons. For adequate evaluation of the efficacy and safety of this procedure it is necessary to perform further clinical studies on a larger number of patients.


title: 2019 Novel Coronavirus Pandemic: What Do We Know?

text: The pandemic caused by SARS-COV2 Virus/COVID-19, which was initially reported in China in December 2019, has become a major global health concern. COVID-19 can manifest with cytokine storm - an exaggerated systemic inflammatory phenomenon due to over-production of proinflammatory cytokines by immune cells that results in diffuse inflammatory lung disease and acute respiratory distress syndrome. It may be complicated by septic shock and subsequent multi-organ failure. Based on the most recently published evidence, this article will review and discuss comprehensive information on its clinical manifestations, laboratory tests, potential therapeutics, and prevention guidelines.


title: A hospital outbreak of Legionella from a contaminated water supply.

text: The authors performed a cross-sectional epidemiological survey to investigate the source of a hospital Legionella outbreak originating in contaminated water. Water temperature and air humidity were measured around possible contamination sources. A dead-end pipe was found to contain Legionella pneumophila serogroup 1. All individuals who acquired legionellosis had spent at least 30 min within 2 m of the contamination source. Among staff, 41 of 71 were exposed, and 31 of these fell ill. All 7 patients exposed to the contaminated water acquired legionellosis. None of the 94 bed-ridden patients from the same units developed the disease. An aerosol with 60% relative air humidity was formed near the suspect water faucets, but the humidity fell rapidly farther from the water source, suggesting that desiccation decreased the risk of infection. The healthy personnel and patients closest to the source acquired legionellosis, suggesting that risk was related less to compromised patients than to exposure.


title: [Human coronavirus-NL63 was detected in specimens from children with acute respiratory infection in Beijing, China].

text: OBJECTIVE A new human coronavirus, HCoV-NL63, was identified recently from two Dutch children with acute respiratory infection (ARI) by two scientists in the Netherlands in 2004. To investigate if this newly discovered virus is associated with acute respiratory infections in pediatric patients in Beijing, tests were developed to detect HCoV-NL63 gene fragments from throat swab and nasopharyngeal aspirates collected from children in outpatient and inpatient departments with ARI in Beijing from Dec. 2003 to Mar. 2004. METHODS A total of 245 clinical samples, which were negative either for diagnostic tests of human respiratory syncytial virus, influenza virus A and B, adenovirus, parainfluenza virus 1, 2 and 3 by indirect immunofluorescence assay or human metapneumovirus by RT-PCR, were screened for HCoV-NL63 by nested PCR amplifying gene fragments located on the 1b and 1a genes. Amplicon of PCR from 1a gene of HCoV-NL63 was sequenced and the sequences were compared with those in GenBank nucleotide sequence database. RESULTS Three (1.2%) out of the 245 samples were positive for HCoV-NL63 by nested-PCR using primers on 1b gene. These three samples also showed positive results on nested PCR in which primers were designed with sequences complementary to 1a gene segments. These positive samples were collected from hospitalized children under 2 years of age with pneumonia, bronchiolitis and bronchitis, respectively. The partial 1a gene sequences from two positive samples (BJ3140 and BJ3787) of HCoV-NL63 showed 100% homology between each other and high homology (98%-99%) with the sequences of 1a gene of HCoV-NL63 reported from different countries in GenBank. Phylogenetic analysis showed that BJ3140 and BJ3787 fell into the same genetic cluster (group 1). CONCLUSIONS These data suggest that some of acute respiratory infections in young children in Beijing area are related to the newly identified HCoV-NL63.


title: Efficacy of vaccination of sows with serologically related coronaviruses for control of transmissible gastroenteritis in nursing pigs.

text: Three groups of pregnant sows were vaccinated at 8 and 2 weeks before parturition with tissue culture-adapted feline infectious peritonitis (FIP) virus, porcine transmissible gastroenteritis (TGE) small-plaque (SP) virus from a persistently infected cell line, or noninfected cell culture fluids (controls). Pigs nursing vaccinated sows were orally challenge exposed with virulent TGE virus when they were 1 to 3 days old. The morbidity of the nursing pigs was 48% in the SP-TGE group, 82% in the FIP group, and 93% in the controls. The survival rate among the nursing pigs was 77% in the SP-TGE groups, 48% in the FIP group, and 14% in the controls. Virus-neutralizing antibodies of immunoglobulin A were detected in colostrum and milk of the SP-TGE group, but not in the FIP or control groups.


title: Vaccination in conservation medicine.

text: Unprecedented human population growth and anthropogenic environmental changes have resulted in increased numbers of people living in closer contact with more animals (wild, domestic, and peridomestic) than at any other time in history. Intimate linkage of human and animal health is not a new phenomenon. However, the global scope of contemporary zoonoses has no historical precedent. Indeed, most human infectious diseases classed as emerging are zoonotic, and many of these have spilled over from natural wildlife reservoirs into humans either directly or via domestic or peridomestic animals. Conservation medicine has recently emerged as a meaningful discipline to address the intersection of animal, human, and ecosystem health. Interest in the development of novel vaccines for wildlife encounters important challenges that may prevent progress beyond the conceptual phase. Although notable examples of successful wildlife immunisation programmes exist, depending upon key considerations, vaccination may or may not prove to be effective in the field. When implemented, wildlife vaccination requires a combination of novel zoonosis pathogen management strategies and public education to balance conservation, economic, and public health issues.


title: Brazilian recommendations of mechanical ventilation 2013. Part 2.

text: Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in São Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document.


State of Missouri Supported by Four Essential Pillars for COVID-19 Response.


title: Outcome of abdominal wall hernia repair with Permacol™ biologic mesh.

text: The use of biologic mesh in abdominal wall operations has gained popularity despite a paucity of outcome data. We aimed to review the experience of a large healthcare organization with Permacol™. A retrospective study was conducted of patients who underwent abdominal hernia repair with Permacol™ in 14 Southern California hospitals. One hundred ninety-five patients were analyzed over a 4-year period. Operations included ventral/incisional hernia repairs, ostomy closures, parastomal hernia repairs, and inguinal hernia repairs. In 50 per cent of the patients, Permacol™ was used to reinforce a primary fascial repair and in 50 per cent as a fascial bridge. The overall complication rate was 39.5 per cent. The complication rate was higher in patients with infected versus clean wounds, body mass index (BMI) 40 kg/m(2) or greater versus BMI less than 40 kg/m(2), in patients with prior mesh repair, and when mesh was used as a fascial bridge. With a mean follow-up of 2.1 years, morbid obesity was associated with a higher recurrence. To date this is the largest study on the use of Permacol™ in abdominal wall hernia repair. In our patient population undergoing heterogeneous operations with a majority of wounds as Class II or higher, use of Permacol™ did not eliminate wound morbidity or prevent recurrence, especially in morbidly obese patients.


World Health Organization.


title: Inhibition of N-nitrosodimethylamine metabolism in rats by ether anesthesia.

text: Short-term exposure to diethyl ether strongly inhibits the metabolism of N-nitrosodimethylamine (NDMA). Twenty-six 6-week-old male Fischer 344 rats were exposed to ether vapor until their righting reflex was lost (approximately 2 min). The animals were removed from the ether and NDMA was immediately administered by i.v. bolus injection at a dose of 300 microgram/kg via a cannula surgically inserted 20 h earlier. A second group of 28 rats received injections of NDMA in an identical manner but without ether exposure. In the unanesthetized animals blood levels of NDMA declined with a half-life of 11 min; by contrast essentially constant blood levels of NDMA were observed in ether-treated animals for 120 min after removal from the anesthetic. The apparent total systemic clearance for the 5-h experiment was reduced from 43 ml/min/kg without ether to 5 ml/min/kg with ether. Diethyl ether has been found previously to inhibit the metabolism of other drugs requiring oxidative metabolism but the suppression of clearance documented here appears to be unusually pronounced. It is recommended that ether's potential for altering metabolic rates be carefully considered when planning or interpreting animal experiments.


docid: vfdvrekv

title: Induction of a protective immune response to murine coronavirus with non-internal image anti-idiotypic antibodies.

text: Neurotropic murine coronaviruses (MHV) provide an excellent animal model to study experimental modulation of the immune response to a viral pathogen with anti-idiotypic antibodies. It is known that among the various types of anti-idiotypic antibodies (anti-Id), those designated beta (beta) or internal image can molecularly mimic the antigen and induce biological activities such as anti-viral protection and neutralization. We have recently shown that polyclonal non-internal image anti-idiotypic antibodies of the gamma-type could induce protective anti-coronavirus immunity. In the present study, a polyclonal anti-Id (Ab2) was induced against a neutralizing murine monoclonal antibody (MAb1), designated 5B170.11. Mice immunized with this affinity-purified rabbit Ab2 alpha, a non-internal image antibody, were partially protected against lethal infection by the JHM strain of MHV. However, other polyclonal and monoclonal non-internal image Ab2 induced against another neutralizing Mab1, designated 4-11G.6, were not able to protect mice against lethal infection with the A59 strain of MHV. These results demonstrate that anti-viral protection by altering the idiotypic network with non-internal image-bearing anti-idiotype reagents can be achieved even with some anti-Id of the alpha-type.


title: In vitro antiviral activity of plant extracts on goatpox virus replication.

text: Four plants having known medicinal properties were screened for inhibition of goatpox virus (GTPV) replication in vitro. Of the 4 plants, extract of Acacia arabica (Babul) and Eugenia jambolana (Jamun) leaves had inhibition (%) 99.70 and 99.92 at their maximum non toxic concentrations, 99.93 +/- 0.38 and 1999.73 +/- 0.50 microg/ml, respectively in all cytopathic effect (CPE) inhibition assays. Inhibition of GTPV virus replication was further confirmed by PCR and SYBR Green based quantitative real-time QPCR assays specific for GTPV. Results indicated that the extract of Acacia arabica and Eugenia jambolana leaves inhibited GTPV replication in vitro.


title: Core structure of S2 from the human coronavirus NL63 spike glycoprotein.

text: Human coronavirus NL63 (HCoV-NL63) has recently been identified as a causative agent of acute respiratory tract illnesses in infants and young children. The HCoV-NL63 spike (S) protein mediates virion attachment to cells and subsequent fusion of the viral and cellular membranes. This viral entry process is a primary target for vaccine and drug development. HCoV-NL63 S is expressed as a single-chain glycoprotein and consists of an N-terminal receptor-binding domain (S1) and a C-terminal transmembrane fusion domain (S2). The latter contains two highly conserved heptad-repeat (HR) sequences that are each extended by 14 amino acids relative to those of the SARS coronavirus or the prototypic murine coronavirus, mouse hepatitis virus. Limited proteolysis studies of the HCoV-NL63 S2 fusion core identify an alpha-helical domain composed of a trimer of the HR segments N57 and C42. The crystal structure of this complex reveals three C42 helices entwined in an oblique and antiparallel manner around a central triple-stranded coiled coil formed by three N57 helices. The overall geometry comprises distinctive high-affinity conformations of interacting cross-sectional layers of the six helices. As a result, this structure is unusually stable, with an apparent melting temperature of 78 degrees C in the presence of the denaturant guanidine hydrochloride at 5 M concentration. The extended HR regions may therefore be required to prime the group 1 S glycoproteins for their fusion-activating conformational changes during viral entry. Our results provide an initial basis for understanding an intriguing interplay between the presence or absence of proteolytic maturation among the coronavirus groups and the membrane fusion activity of their S glycoproteins. This study also suggests a potential strategy for the development of improved HCoV-NL63 fusion inhibitors.


title: Development of a respiratory virus panel test for detection of twenty human respiratory viruses by use of multiplex PCR and a fluid microbead-based assay.

text: Virology laboratories historically have used direct fluorescent-antibody assay (DFA) and culture to detect six or seven respiratory viruses. Following the discovery of five new human respiratory viruses since 2000, there is an increasing need for diagnostic tests to detect these emerging viruses. We have developed a new test that can detect 20 different respiratory virus types/subtypes in a single 5-h test. The assay employs multiplex PCR using 14 virus-specific primer pairs, followed by a multiplexed target-specific primer extension (TSPE) reaction using 21 primers for specific respiratory virus types and subtypes. TSPE products were sorted and identified by using a fluid microsphere-based array (Universal Array; TmBioscience Corporation, Toronto, Canada) and the Luminex x-MAP system. The assay detected influenza A and B viruses; influenza A virus subtypes H1, H3, and H5 (including subtype H5N1 of the Asian lineage); parainfluenza virus types 1, 2, 3, and 4; respiratory syncytial virus types A and B; adenovirus; metapneumovirus; rhinovirus; enterovirus; and coronaviruses OC43, 229E, severe acute respiratory syndrome coronavirus, NL63, and HKU1. In a prospective evaluation using 294 nasopharyngeal swab specimens, DFA/culture detected 119 positives and the respiratory virus panel (RVP) test detected 112 positives, for a sensitivity of 97%. The RVP test detected an additional 61 positive specimens that either were not detected by DFA/culture or were positive for viruses not tested for by DFA/culture. After resolution of discordant results by using a second unique PCR assay and by using a combined reference standard of positivity, the RVP test detected 180 of 183 true positives, for a sensitivity of 98.5%, whereas DFA and culture detected only 126 of 183 true positives, for a sensitivity of 68.8%. The RVP test should improve the capabilities of hospital and public health laboratories for diagnosing viral respiratory tract infections and should assist public health agencies in identifying etiologic agents in respiratory tract infection outbreaks.


title: Short-term outcomes after minimally invasive oesophagectomy.

text: INTRODUCTION Minimally invasive oesophagectomy (MIO) has gained increasing popularity. This study reports the results of the first patients operated using this technique at our department. METHODS All procedures were prospectively registered in a database. Patients were followed until death, two years after surgery or 1 January 2019. RESULTS A total of 150 procedures were performed (from 23 November 2015 to 27 February 2018). The median proced-ure time decreased from 350 minutes for the initial 75 pa-tients to 320 minutes for the final 75 patients (p < 0.05). Blood loss decreased from 200 ml to 100 ml (p < 0.05), respectively. The conversion rate for the abdominal procedure was 7% for the initial 75 patients and 8% for the final 75 patients (not significant (NS)). For the thoracic procedure, the corresponding figures were 11% and 7% (NS), respectively. Anastomotic leakage was seen in 17% (initial patients) and 11% (final patients) (NS); however, less than 20% of the leakages needed surgical treatment. The median length of post-operative stay was nine days for both groups. For all 150 patients, pulmonary complications were observed in 18% and cardiac complications in 11%. The 30-day mortality rate was 2% and the one-year survival rate was 86% (124 registered patients). CONCLUSIONS MIO was introduced at our department with acceptable morbidity and mortality rates and the short-term oncological result was not compromised. FUNDING none. TRIAL REGISTRATION The study was approved as a quality project by the Region of Southern Denmark (18/37355).


title: [Modelling epidemics: the case of severe acute respiratory syndrome in Canada].

text: OBJECTIVE Severe acute respiratory syndrome propagation in Canada during 2003 is analysed by means of simple models, comparing the influence of isolation measures on two epidemic waves. METHODS Deterministic susceptible-infected and susceptible-infected-removed models were used for both epidemic waves, using official published information. NLREG 6.2 was used for estimating deterministic parameters and analytical solutions were obtained with Maple 9 software. Dynamical indicators were obtained for the epidemic. RESULTS Suitable adjustment of the data was observed with both models, but smaller adjustment was observed during the second wave with the non- removed model. The highest rate of infectiousness was shown (35 new cases per 10 000 susceptible people) during the second wave (with R0 near to one), in spite of presenting greater incidence (8.8 cases per day), compensated for by a high rate of removal (11,5 cases per day) which lasted less than the epidemic (11,1 days), and a lower rate of attack (1 case per each 100 susceptible people). CONCLUSIONS The susceptible-infected model can be useful during an epidemic's initial phase (prior to removal); however, closer monitoring of an epidemic's development is required for modelling the strength of removal and deriving useful information for decision-making.


Mouse hepatitis virus-3 induced prothrombinase (Fgl2) maps to proximal chromosome 5.


title: Comparison of perioperative surgical outcomes between a bipolar device and an ultrasonic device during laparoscopic gastrectomy for gastric cancer.

text: BACKGROUND The use of energy devices during laparoscopic gastrectomy for gastric cancer has increased as the frequency of laparoscopic surgery has increased. Our aim was to compare the perioperative surgical outcomes between using a bipolar device and an ultrasonic device during laparoscopic gastrectomy. METHODS Retrospective review of a prospectively maintained database identified 186 patients who underwent laparoscopic gastrectomy performed by a single surgeon between November 2010 and August 2013. A bipolar device was used for 116 patients, and an ultrasonic device was used for 70 patients. Patient characteristics and perioperative surgical outcomes were compared between groups. RESULTS Clinicopathologic characteristics were similar for both groups. The bipolar group had a significantly shorter operation time (154.9 vs. 167.8 min, p = 0.028) and higher rate of D2 lymph node dissection (29.3 vs. 15.7 %, p = 0.012). The bipolar device group experienced significantly less pain at 12 h [visual analog scale (VAS) pain score: 3.9 vs. 4.7, p = 0.027) and 18 h (VAS pain score: 3.5 vs. 4.1, p = 0.036) postoperatively. The bipolar group had earlier abdominal drain removal (p = 0.001) and a shorter hospital stay (p = 0.024). No significant differences in laboratory value changes, morbidity, or mortality were observed between the groups. CONCLUSION Compared with the ultrasonic device, the bipolar device provided advantages in operation time, degree of postoperative pain, time of drain removal, and length of hospital stay. The bipolar device may be a useful and efficient energy device for laparoscopic gastrectomy. However, larger studies to confirm the safety of bipolar device during laparoscopic gastrectomy are warranted.


title: Mucosal and systemic isotype-specific antibody responses to bovine coronavirus structural proteins in naturally infected dairy calves.

text: Blood, feces, nasal secretions, and tears were collected weekly from 5 randomly selected 1- to 8-week-old calves in a large commercial dairy herd. Clinical signs and bovine coronavirus (BCV) shedding from the respiratory and enteric tracts of calves were monitored through the 8-week period by direct immunofluorescence of nasal epithelial cells, protein A-gold immunoelectron microscopy on feces, and ELISA on nasal secretions and feces. All samples were analyzed for antibody isotypes to BCV structural proteins by immunoblotting. All calves had BCV respiratory tract infections and 4 of 5 calves shed virus in feces. Several calves had multiple or prolonged periods of BCV respiratory tract or enteric tract shedding or both. All calves (except 1) had passive IgG1 antibodies to some BCV proteins (mainly the E2 and E3 proteins) in their serum when they were 1 week old. The presence of these passive serum antibodies (mainly to the E2 and E3 BCV proteins) was associated with decreased or delayed systemic and mucosal antibody responses in calves, in particular IgA responses in nasal secretions and tears to the E2 and E3 BCV proteins, but not to the N protein. Moderate amounts of maternal BCV E2- and E3-specific antibodies in serum did not prevent BCV enteric tract or respiratory tract infections in calves, but may have delayed the development of active antibody responses to these BCV proteins. However, calves with BCV respiratory tract or enteric tract infections had no detectable passive antibodies to any BCV proteins in nasal secretions or feces.


title: [Current Topics of Cancer and HIV].

text: Antiretroviral therapy(ART)has been associated with reduced AIDS- and non-AIDS-related morbidity and mortality in people living with HIV/AIDS(PLWH). Nevertheless, the incidence of many comorbid conditions remains higher in PLWH than in the general population, including AIDS-defining malignancies(ADM)as well as several non-AIDS-defining malignancies (NADM). It's important to prevent ADM/NADM, like periodic health checkup for early diagnosis, to quit smoking, and cooperation with cancer and HIV specialists.


title: Human metapneumovirus in haematopoietic stem cell transplantation recipients: a case series and review of the diagnostic and therapeutic approach.

text: Human metapneumovirus (hMPV) is a paramyxovirus that causes respiratory tract infections ranging from mild upper airway infection to severe pneumonia. Patients with haematological disease, especially haematopoietic stem cell transplantation (HSCT) recipients, are more likely to develop more severe infections. We describe three cases of hMPV infection in HSCT patients. The most reliable diagnostic procedure for hMPV is multiplex ligation-dependent probe amplification (MLPA) on a nasopharyngeal swab. Sensitivity and specificity of MLPA to detect hMPV is high and time to diagnosis is short. A number of other respiratory pathogens can be tested in one test run. Treatment is mainly supportive and only a few antiviral agents are available for treating paramyxovirus infections. Ribavirin and immunoglobulins were reported to be effective in cases of HSCT patients with hMPV pneumonia but their efficacy has not been studied in randomised trials.


title: Concerns and preparedness for an avian influenza pandemic: a comparison between community hospital and tertiary hospital healthcare workers.

text: Little is known about differences in levels of concerns or preparedness for an avian influenza (AI) pandemic among healthcare workers (HCWs) in different types of hospitals. We compared these concerns and preparedness between 326 HCWs of two community hospitals (CHs) and 908 HCWs from a tertiary hospital (TH) using a self-administered questionnaire between March-June 2006. Response rates were 84.2% and 80.0% from the CHs and TH. Most HCWs (71.6%) felt prepared for an AI outbreak and had significant concerns. They perceive an AI pandemic having adverse impacts on their personal life and work, such as people avoiding them (57.1%). A greater percentage of TH compared to CH HCWs expressed concerns such as feeling their jobs put them at great AI exposure (78.3% vs 67.5%, p=0.012). TH HCWs were more likely to report participating in readiness preparation activities, such as training for infection control (90.0% vs 82.2%, p=0.014) and feel that they (74.1% vs 64.7%, p=0.045) and their hospital (86.8% vs 71.8%, p=0.000) were prepared for an outbreak. Healthcare institutions need to include personal, psychological and family concerns on the agenda and increase participation in readiness preparation activities among HCWs to help prepare for such future crises.


Virus-encoded proteinases of the picornavirus super-group.


Capnography Primer for Oral and Maxillofacial Surgery: Review and Technical Considerations.


docid: dqtvxasf

title: Health effects of subchronic exposure to diesel-water-methanol emulsion emission.

text: The U.S. Environmental Protection Agency's National Ambient Air Quality Standards for ozone and particulate matter (PM) require urban non-attainment areas to implement pollution-reduction strategies for anthropogenic source emissions. The type of fuel shown to decrease combustion emissions components versus traditional diesel fuel, is the diesel emulsion. The Lubrizol Corporation, in conjunction with Lovelace Respiratory Research Institute and several subcontracting laboratories, recently conducted a health assessment of the combustion emissions of PuriNOx diesel fuel emulsion (diesel-water-methanol) in rodents. Combustion emissions from either of two, 2002 model Cummins 5.9L ISB engines, were diluted with charcoal-filtered air to exposure concentrations of 125, 250 and 500 microg total PM/m3. The engines were operated on a continuous, repeating, heavy-duty certification cycle (U.S. Code of Federal Regulations, Title 40, Chapter I) using Rotella-T 15W-40 engine oil. Nitrogen oxide (NO) and PM were reduced when engines were operated on PuriNOx versus California Air Resources Board diesel fuel under these conditions. Male and female F344 rats were housed in Hazleton H2000 exposure chambers and exposed to exhaust atmospheres 6 h/day, five days/week for the first 11 weeks and seven days/week thereafter. Exposures ranged from 61 to 73 days depending on the treatment group. Indicators of general toxicity (body weight, organ weight, clinical pathology and histopathology), neurotoxicity (glial fibrillary acidic protein assay), genotoxicity (Ames assay, micronucleus, sister chromatid exchange), and reproduction and development were measured. Overall, effects observed were mild. Emulsion combustion emissions were not associated with neurotoxicity, reproductive/developmental toxicity, or in vivo genotoxicity. Small decreases in serum cholesterol in the 500-microg/m3 exposure group were observed. PM accumulation within alveolar macrophages was evident in all exposure groups. The latter findings are consistent with normal physiological responses to particle inhalation. Other statistically significant effects were present in some measured parameters of other exposed groups, but were not clearly attributed to emissions exposure. Positive mutagenic responses in several strains of Salmonella typhimurium were observed subsequent to treatment with emulsion emissions subfractions. Based on the cholesterol results, it can be concluded that the 250-microg/m3 exposure level was the no observed effect level. In general, biological findings in exposed rats and bacteria were consistent with exposure to petroleum diesel exhaust in the F344 rat and Ames assays.


docid: hkpjtgeq

title: Vomiting and wasting disease, a coronavirus infection of pigs.


title: Early immunity induced by a glycoprotein E-negative vaccine for infectious bovine rhinotracheitis.

text: Four groups of calves were vaccinated with a glycoprotein E-negative vaccine for infectious bovine rhinotracheitis. Two groups of calves were vaccinated intramuscularly and challenged with a wild-type virus 14 and seven days after being vaccinated. The other two groups were vaccinated intranasally and similarly challenged after four and three days; an unvaccinated control group was also challenged. All four vaccination schedules reduced the incidence of clinical signs and the excretion of wild-type virus, and these reductions occurred as early as three days after the intranasal vaccination even in the absence of neutralising antibodies. Because of its marker characteristics, vaccination with this vaccine would not interfere with the detection of infected cattle during an outbreak, and it should therefore provide a useful tool for emergency vaccination campaigns.


title: Heterogeneity of the polyribocytidylic acid tract in aphthovirus: biochemical and biological studies of viruses carrying polyribocytidylic acid tracts of different lengths.

text: In this paper we report a study of a sample of foot-and-mouth disease virus carrying two polyribocytidylic acid [poly(C)] tracts of different lengths. By plaque purification in tissue culture, we isolated two populations of particles, one carrying the long poly(C) tract and the other carrying only the short homopolymer. The fingerprints of both viruses were indistinguishable from each other and from that of the virus present in the original sample, suggesting that the main difference between the two types of particles is limited to the poly(C) tracts of their genomic RNAs, to the flanking sequences of the poly(C) tract, or to both. In addition, some biological properties of these viruses are reported, such as stability upon serial passages in different cell lines, plaque size, and pathogenicity for cattle. The results indicate that the size of the poly(C) tract is not directly related to the virulence of these viruses. However, the size of the homopolymer could play a role in determining their efficiency of replication, and it appears that the particles with the short poly(C) tract might have some replicative advantage over those carrying the long one.


title: Characterization of the nuclear export signal in the coronavirus infectious bronchitis virus nucleocapsid protein.

text: The nucleocapsid (N) protein of infectious bronchitis virus (IBV) localizes to the cytoplasm and nucleolus and contains an eight-amino-acid nucleolar retention motif. In this study, a leucine-rich nuclear export signal (NES) (291-LQLDGLHL-298) present in the C-terminal region of the IBV N protein was analyzed by using alanine substitution and deletion mutagenesis to investigate the relative contributions that leucine residues make to nuclear export and where these residues are located on the structure of the IBV N protein. The analysis indicated that Leu296 and Leu298 are required for efficient nuclear export of the protein. Structural information indicated that both of these amino acids are available for interaction with protein complexes involved in this process. However, export of N protein from the nucleus/nucleolus was not inhibited by leptomycin B treatment, indicating that N protein nuclear export is independent of the CRM1-mediated export pathway.


title: Effect of Erythropoietin on Postresuscitation Renal Function in a Swine Model of Ventricular Fibrillation.

text: Purpose. To investigate the effect of EPO administration on postresuscitation renal function. Methods. Twenty-four female Landrace/Large-White piglets aged 10-15 weeks with average weight of 19 ± 2 kg were randomly assigned to 2 different groups of 12 subjects each. After the end of an 8-minute ventricular fibrillation, the control group (Group C) received saline as placebo, whereas the EPO group (Group E) received EPO 5000 U/kg. The animals were resuscitated according to the 2010 European Resuscitation Council Guidelines for Resuscitation. Results. Five animals (41.67%) from Group C and 11 animals (91.67%) from Group E achieved ROSC (p = 0.027). Eight animals (66.67%, 5 surviving and 3 nonsurviving) from Group C suffered severe kidney damage or AKI compared to animals from Group E, in which none of the swine had evidence of severe kidney damage or AKI (p = 0.001). There was a statistically significant difference in all tested biochemical markers between the two groups, as well as a positive correlation of creatinine with NGAL, L-FABP, and IL-18 (summed mean values' p = 0.049, 0.01, and 0.004, resp.). Conclusions. Administration of EPO protected swine from postresuscitation acute kidney injury.


title: Sepsis associated with immunosuppressive medications: an evidence-based review.

text: OBJECTIVE In 2003, critical care and infectious disease experts representing 11 international organizations developed management guidelines for sepsis associated with immunosuppressive medications that would be of practical use for the bedside clinician, under the auspices of the Surviving Sepsis Campaign, an international effort to increase awareness and improve outcome in severe sepsis. DESIGN The process included a modified Delphi method, a consensus conference, several subsequent smaller meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. METHODS The modified Delphi methodology used for grading recommendations built on a 2001 publication sponsored by the International Sepsis Forum. We undertook a systematic review of the literature graded along five levels to create recommendation grades from A to E, with A being the highest grade. Pediatric considerations to contrast adult and pediatric management are in the article by Parker et al. on p. S591. CONCLUSION Immunosuppressed patients, by definition, are susceptible to a wider spectrum of infectious agents than immunologically normal patients and, thus, require a broader spectrum antimicrobial regimen when they present with sepsis or septic shock. Special expertise managing immunosuppressed patient populations is needed to predict and establish the correct diagnosis and to choose appropriate empiric and specific agents and maximize the likelihood that patients will survive these microbial challenges.


title: The human/animal interface: emergence and resurgence of zoonotic infectious diseases.

text: Emerging infectious diseases, most of which are considered zoonotic in origin, continue to exact a significant toll on society. The origins of major human infectious diseases are reviewed and the factors underlying disease emergence explored. Anthropogenic changes, largely in land use and agriculture, are implicated in the apparent increased frequency of emergence and re-emergence of zoonoses in recent decades. Special emphasis is placed on the pathogen with likely the greatest zoonotic potential, influenza virus A.


title: Natural pathogens of laboratory mice, rats, and rabbits and their effects on research.

text: Laboratory mice, rats, and rabbits may harbor a variety of viral, bacterial, parasitic, and fungal agents. Frequently, these organisms cause no overt signs of disease. However, many of the natural pathogens of these laboratory animals may alter host physiology, rendering the host unsuitable for many experimental uses. While the number and prevalence of these pathogens have declined considerably, many still turn up in laboratory animals and represent unwanted variables in research. Investigators using mice, rats, and rabbits in biomedical experimentation should be aware of the profound effects that many of these agents can have on research.


title: Identification and characterization of severe acute respiratory syndrome coronavirus replicase proteins.

text: The severe acute respiratory syndrome coronavirus (SARS-CoV) encodes proteins required for RNA transcription and genome replication as large polyproteins that are proteolytically processed by virus-encoded proteinases to produce mature replicase proteins. In this report, we generated antibodies against SARS-CoV predicted replicase protein and used the antibodies to identify and characterize 12 of the 16 predicted mature replicase proteins (nsp1, nsp2, nsp3, nsp4, nsp5, nsp8, nsp9, nsp12, nsp13, nsp14, nsp15, and nsp16) in SARS-CoV-infected Vero cells. Immunoblot analysis of infected-cell lysates identified proteins of the predicted sizes. Immunofluorescence microscopy detected similar patterns of punctate perinuclear and distributed cytoplasmic foci with all replicase antibodies and as early as 6 h postinfection. Dual-labeling studies demonstrated colocalization of replicase protein nsp8 with nsp2 and nsp3 in cytoplasmic complexes and also with LC3, a protein marker for autophagic vacuoles. Antibodies directed against mouse hepatitis virus (MHV) virions and against the putative RNA-dependent RNA polymerase (Pol) detected SARS-CoV nucleocapsid and nsp12 (Pol), respectively, in SARS-CoV-infected Vero cells. These results confirm the predicted protein processing pattern for mature SARS-CoV replicase proteins, demonstrate localization of replicase proteins to cytoplasmic complexes containing markers for autophagosome membranes, and suggest conservation of protein epitopes in the replicase and nucleocapsid of SARS-CoV and the group II coronavirus, MHV. Further, the results demonstrate the ability of replicase antibodies to detect SARS-CoV-infected cells as early as 6 h postinfection and thus represent important tools for studies of SARS-CoV replication, inhibition, and diagnosis.


title: Vertebral Augmentation Involving Vertebroplasty or Kyphoplasty for Cancer-Related Vertebral Compression Fractures: A Systematic Review.

text: BACKGROUND Cancers that metastasize to the spine and primary cancers such as multiple myeloma can result in vertebral compression fractures or instability. Conservative strategies, including bed rest, bracing, and analgesic use, can be ineffective, resulting in continued pain and progressive functional disability limiting mobility and self-care. Surgery is not usually an option for cancer patients in advanced disease states because of their poor medical health or functional status and limited life expectancy. The objectives of this review were to evaluate the effectiveness and safety of percutaneous image-guided vertebral augmentation techniques, vertebroplasty and kyphoplasty, for palliation of cancer-related vertebral compression fractures. METHODS We performed a systematic literature search for studies on vertebral augmentation of cancer-related vertebral compression fractures published from January 1, 2000, to October 2014; abstracts were screened by a single reviewer. For those studies meeting the eligibility criteria, full-text articles were obtained. Owing to the heterogeneity of the clinical reports, we performed a narrative synthesis based on an analytical framework constructed for the type of cancer-related vertebral fractures and the diversity of the vertebral augmentation interventions. RESULTS The evidence review identified 3,391 citations, of which 111 clinical reports (4,235 patients) evaluated the effectiveness of vertebroplasty (78 reports, 2,545 patients) or kyphoplasty (33 reports, 1,690 patients) for patients with mixed primary spinal metastatic cancers, multiple myeloma, or hemangiomas. Overall the mean pain intensity scores often reported within 48 hours of vertebral augmentation (kyphoplasty or vertebroplasty), were significantly reduced. Analgesic use, although variably reported, usually involved parallel decreases, particularly in opioids, and mean pain-related disability scores were also significantly improved. In a randomized controlled trial comparing kyphoplasty with usual care, improvements in pain scores, pain-related disability, and health-related quality of life were significantly better in the kyphoplasty group than in the usual care group. Bone cement leakage, mostly asymptomatic, was commonly reported after vertebroplasty and kyphoplasty. Major adverse events, however, were uncommon. CONCLUSIONS Both vertebroplasty and kyphoplasty significantly and rapidly reduced pain intensity in cancer patients with vertebral compression fractures. The procedures also significantly decreased the need for opioid pain medication, and functional disabilities related to back and neck pain. Pain palliative improvements and low complication rates were consistent across the various cancer populations and vertebral fractures that were investigated.


The ABCs of bioterrorism for veterinarians, focusing on Category A agents.


title: [Clinical analysis of 45 patients with severe acute respiratory syndrome].

text: OBJECTIVE To explore the clinical and radiology features of Severe Acute Respiratory Syndrome (SARS). METHODS Analysis the clinical presentations, chest radiographs, courses of disease and the features of severe pneumonia of 45 cases with SARS diagnosed between April 5 and April 20, 2003 in our hospital. RESULTS SARS appears to has high infectivity, and cause of the outbreak. The most common symptom is fever (in 100 percent of the patients). The count of leukocyte is normal or decrease (leukopenia). 80 percent of SARS patients became fever for 24 hours and then have abnormal chest radiographs, serial chest radiographs showed progression of pulmonary infiltrates within 48 hours in 71.1 percent of patients. The percent of severe pneumonia (24.4%) is higher than typical pneumonia. CONCLUSION SARS is a disease with high infectivity, and has its own clinical and radiology features. Early recognition, prompt isolation, and appropriate therapy are the key in combating this infection.


title: PAMP-DAMPs interactions mediates development and progression of multiple sclerosis.

text: Multiple sclerosis (MS) is a disease presumably associated with chronic immune stimulation promoted by either pathogens or autoimmune processes. It has been hypothesized that MS could be the result of previous viral infections rendering a permanent immune stimulation that could be triggered by molecular similarities, or by modulating the antigens expression of major histocompatibility complex (MHC) on target cells, which in turn act as super antigens. During immune stimulation occurs the recruitment of immunological cells, resulting in local tissue damage and leading to the release of damage- associated molecular patterns (DAMPs), which also act as inflammation inducers. Recently, it has been proposed that the association between pathogen-associated molecular patterns (PAMPs) with DAMPs constitutes an additional level of immune regulation. The properties of DAMPs to act as carriers of PAMPs and their role as enhancers or inhibitors of PAMPs could play a role during inflammatory responses triggered by infections. Here, we focused this review in outcomes which support the hypothesis that particular PAMP-DAMPs interactions could regulated the relapse and progressive disability observed in multiple sclerosis.


What life scientists should know about security threats.


title: Development of an immunochromatographic kit for rapid diagnosis of H5 avian influenza virus infection.

text: Highly pathogenic avian influenza (HPAI) caused by the H5N1 subtype has given rise to serious damage in poultry industries in Asia. The virus has expanded its geographical range to Europe and Africa, posing a great risk to human health as well. For the control of avian influenza, a rapid diagnosis by detecting the causative virus and identifying its subtype is essential. In the present study, a rapid diagnosis kit combining immunochromatography with enzyme immunoassay which detects the H5 HA antigen of influenza A virus was developed using newly established anti-H5 HA monoclonal antibodies. The present kit specifically detected all of the H5 influenza viruses tested, and did not react with the other HA subtypes. H5 HA antigens were detected from swabs and tissue homogenates of chickens infected with HPAI virus strain A/chicken/Yamaguchi/7/04 (H5N1) from 2 days post inoculation. The kit showed enough sensitivity and specificity for the rapid diagnosis of HPAI.


title: Establishing enteral feeding in preterm infants with feeding intolerance: a randomized controlled study of low-dose erythromycin.

text: OBJECTIVE A prospective, double-blind, randomized, controlled trial was conducted to evaluate the effect of low-dose erythromycin on the time taken to attain full enteral feedings in preterm infants with very low birth weight and feeding intolerance. METHODS Two groups of preterm infants (birth weight </= 1500 g) with feeding intolerance were randomized to either low-dose erythromycin (5 mg/kg every 8 hours) or 5% dextrose placebo, both of which were discontinued 1 week after full enteral feedings were tolerated. The primary outcome variable was the time taken to attain full enteral feedings of at least 130 mL/kg/d. RESULTS The gestational age at birth was similar in the two groups (erythromycin, 27.1 +/- 1.9 weeks; placebo, 27.5 +/- 2.9 weeks). The mean birth weight of the erythromycin group was lower (806.3 +/- 215.6 g) than the placebo group (981.4 +/- 285.4 g; P = 0.18), and included more infants who were small for gestational age (4/13 = 31% versus 1/11 = 9%; P = 0.224). There was no difference between the two groups with regard to the volume of feedings they were receiving at the time of enrollment. Reduction in symptoms of gastroesophageal reflux was similar in the two groups. 3 of 13 in the erythromycin group and 4 of 11 in the placebo group improved during the study (P = 0.565). The mean time to attain full enteral feedings after enrollment was 24.9 + 2.9 days in the erythromycin group and 30.8 +/- 4.1 days in the placebo group, a difference that did not reach statistical significance (P = 0.17). CONCLUSIONS Low-dose erythromycin did not reduce the time taken to attain full enteral feedings in preterm infants with very low birth weight and feeding intolerance. Gastroesophageal reflux decreased as a consequence of maturation of the gastrointestinal tract and not because of erythromycin. These preliminary results justify verification in larger multicenter trials.


title: Pandemic influenza: imminent threat, preparedness and the divided globe.

text: With generic consensus on certainty of an impending influenza pandemic, concerns are mounting about its devastating global impact. Preparedness and preventive approaches adopted by the nation states are polarised between resource rich and resource challenged countries. India has, rightly, taken a middle path. It seems that the non-pharmaceutical interventions would be the only preventive modality available in large parts of world. Production of any pandemic vaccine would take a minimum of 6 months after isolation of novel virus, and antivirals may not be available where they are required most. Efforts to create a universal pool of resources and stockpiles of antivirals, antibiotics and vaccines for use in first affected countries need to be strengthened with urgency.


docid: wwwcrysa

title: Suspect Odontogenic Infection Etiology for Canine Lymphoplasmacytic Rhinitis.

text: The role of odontogenic infection as an etiology for lymphoplasmacytic rhinitis in dogs was evaluated. An association between odontogenic infection and inflammatory rhinitis was identified in 55% of cases evaluated. Odontogenic infection was unlikely or undetermined in 10% and 35% of the cases, respectively. Cases of lymphoplasmacytic rhinitis had roentgen signs associated with endodontic disease, periodontal disease, or retained tooth roots in 60%, 45%, and 25% of the cases, respectively. A collaborative team based approach assessing inflammatory nasal disease is recommended. Based on the history and signalment of the individual patient, diagnostic modalities should be chosen wisely. In some cases, oral examination and intraoral radiographs may be a more direct and cost effective approach for diagnosis and treatment of inflammatory rhinitis.


title: Head-up tilt rapidly compromises hemodynamics in healthy anesthetized swine.

text: The aims were to explore the effect of head-up tilt (HUT) to 30 and 60 degrees on hemodynamics and tissue oxygenation in anesthetized healthy swine. The data serve as a reference for a study of resuscitation efficacy at HUT such as during transport. Nine healthy swine (49+/-4 kg) were anesthetized and multiple sensors including myocardial pressure-volume loops catheter, carotid flow probe, blood pressure catheters, near infrared spectroscopy (NIRS) tissue oximetry and mixed venous oximetry (SVO2) catheter were introduced and parameters continuously recorded. Experimental protocol consisted of baseline in supine position (15 min), 30 degrees HUT (15 min), recovery at supine position (15 min) and 60 degrees HUT (5 min). Vacuum mattress was used for body fixation during tilts. We found that 30 and 60 degrees inclination led to significant immediate reduction in hemodynamic and oximetry parameters. Mean arterial pressure (mm Hg) decreased from 98 at baseline to 53 and 39, respectively. Carotid blood flow dropped to 47 % and 22 % of baseline values, end diastolic volume to 49 % and 53 % and stroke volume to 47 % and 45 % of baseline. SVO2 and tissue oximetry decreased by 17 and 21 percentage points. The values are means. In conclusions, within minutes, both 30 and 60 degrees head-up tilting is poorly tolerated in anesthetized swine. Significant differences among individual animals exist.


title: Isolation and characterization of Chlamydophila psittaci isolated from laying hens with cystic oviducts.

text: The objective of this study was to isolate and identify a hypothetical Chlamydiaceae pathogen from laying hens with an oviduct cyst, and to characterize its potential causal relation with decreased egg production. Our clinical survey showed that cystic oviducts were prevalent at rates of 10% and 15.1% in breeder and commercial hen flocks, respectively. Chlamydial antigens were detected in 20 of 50 pharyngeal swabs (40%) and in 17 of 20 oviduct tissues (85%) using enzyme-linked immunosorbent assay (ELISA) antigen detection kits. The isolated pathogen was identified as Chlamydophila psittaci via complement fixation test, PCE-ELISA, and immunofluorescence assay. Avian influenza virus, Newcastle disease virus, and infectious bronchitis virus were excluded after oviduct tissues were inoculated onto the chorioallantoic membrane of embryonating eggs. The nucleotide sequence of the omp1 gene (accession no. EF202608) from the isolate was similar to that of C. psittaci avian type C (accession no. L25436). Typical cystic oviducts were observed in specific-pathogen-free hens inoculated intraperitoneally with the isolate. The high presence of chlamydial antigen is consistent with the cystic oviducts and poor egg production. We conclude that the isolated C psittaci is most likely associated with cystic oviducts in laying hens.


title: Nanoparticles and the environment.

text: Nanoparticles are a class of materials with properties distinctively different from their bulk and molecular counterparts. A critical review of the very broad topic of environmental nanoparticles is presented. Because of the vast nature of the topic, the review is focused primarily on gas-borne nanoparticles. The "life history of nanoparticles" is presented, tracking it from its formation to its potential use and eventual fate in the environment. Nanoparticle sources, anthropogenic emissions from industrial and occupational settings, and conversion and formation in the atmosphere are discussed. The ability to characterize and capture these nanoparticles (as would be necessary in a nanoparticle production system), as well as their control (of emissions from an industrial source) is discussed. A description on the use of nanoparticles in environmental technologies and the potential impact on the energy sector is provided. The potential effects on human health and the environment, both adverse and beneficial, are important aspects that need to be considered. As will be evident, the study of "environmental nanoparticles" is a new and fast-growing field. Much work remains to be done before we can fully harness the advantages of nanoparticles and ensure that there are no potential adverse consequences. A set of recommendations for additional work in each area is provided.


title: Simultaneous infection with Borrelia burgdorferi and human granulocytic ehrlichiosis.

text: A 5-year-old child with simultaneous early Lyme disease and human granulocytic ehrlichiosis (HGE) is described. Because of the shared vector, HGE and Lyme disease are increasingly identified as coinfections in tick-exposed patients. Early recognition of concurrent Lyme disease and HGE is important because amoxicillin, an antibiotic of choice for young children with early Lyme disease, is ineffective for HGE.


title: Nanotechnology in global medicine and human biosecurity: private interests, policy dilemmas, and the calibration of public health law.

text: This paper considers how best to approach dilemmas posed to global health and biosecurity policy by increasing advances in practical applications of nanotechnology. The type of nano-technology policy dilemmas discussed include: (1) expenditure of public funds, (2) public-funded research priorities, (3) public confidence in government and science and, finally, (4) public safety. The article examines the value in this context of a legal obligation that the development of relevant public health law be calibrated against less corporate-influenced norms issuing from bioethics and international human rights.


title: Varying temperature-dependence of post-attachment neutralization of human immunodeficiency virus type 1 by monoclonal antibodies to gp 120: identification of a very early fusion-independent event as a neutralization target.

text: Neutralization of human immunodeficiency virus type 1 by adding antibody after the virus has attached to the host cell (post-attachment neutralization:PAN) was investigated using three rat monoclonal antibodies (MAbs) directed against the outer domain of the membrane protein, gp 120. Two of the MAbs are specific for the CD4-binding site region and one for the V3 loop. MAb ICR39.13g (CD4-binding site region-specific; IgG2b) effected PAN efficiently at temperatures from 4 to 35 degree C. MAb ICR41.1i (V3 loop-specific; IgG2c) effected PAN only at temperatures of 24 degree C and below. This suggests that its V3 epitope is masked by a change in gp 120 which occurs at temperatures > or = 26 degree C, or that the virion function which is inhibited by ICR41.1i and is responsible for neutralization has already operated at > or = 26 degree C. Resistance to neutralization by ICR41.1i occurred within 20 min of shifting the temperature up to 35 degree C. Finally, MAb ICR39.3b (CD4-binding site region-specific; IgG2b) did not give PAN at any temperature, indicating that neutralization can only occur if this MAb binds virus before it attaches to the cell. Thus, these studies identify at least one novel fusion-independent event, the neutralization target of a V3 MAb, which occurs very early in the initial stages of virus-cell interaction.


title: Esthetic evaluation of periimplant soft tissue of immediate single-implant placement and provisionalization in the anterior maxilla.

text: PURPOSE To investigate periimplant soft tissue response following flapless extraction and immediate implant placement and provisionalization (IIPP) associated with bovine hydroxyapatite bone and connective tissue grafting in the anterior maxilla. The study evaluated the effectiveness of this technique in terms of soft tissue contours in esthetic areas with the use of the pink esthetic score (PES). MATERIALS AND METHODS In this retrospective study, 39 consecutive patients were treated and followed by two experienced clinicians for single-tooth implant treatment in the esthetic zone. Treatment consisted of flapless extraction, immediate implant placement, inorganic bovine bone filling of the periimplant gap, and connective tissue grafting. A provisional crown was placed at the time of implant placement. The final crown was positioned 5 to 8 months after surgery. To assess the esthetic outcome of the technique, the soft tissue around the tooth to be extracted was scored according to the PES by seven evaluators before the surgery at visit 1 (v1), and at least 1 year after the final prosthesis placement at visit 2 (v2). RESULTS After a mean follow-up of 4 years, the mean total PES score on a scale from 1 to 10 was 5.64 and 7.07 at v1 and v2, respectively. Statistical analysis revealed a significant difference between the PES scores before surgery and at the follow-up examination of the anterior single implants (P = 0.0008). CONCLUSION Within the limitations of this study, postextraction with immediate implant loading associated with bovine hydroxyapatite and connective tissue grafting is a predictable technique. The esthetic outcome is that soft tissue seems to be maintained or improved significantly according to PES assessment compared with baseline.


title: Middle East respiratory syndrome coronavirus: current knowledge and future considerations.

text: A literature review of publically available information was undertaken to summarize current understanding and gaps in knowledge about Middle East respiratory syndrome coronavirus (MERS-CoV), including its origin, transmission, effective control measures and management. Major databases were searched and relevant published papers and reports during 2012-2015 were reviewed. Of the 2520 publications initially retrieved, 164 were deemed relevant. The collected results suggest that much remains to be discovered about MERS-CoV. Improved surveillance, epidemiological research and development of new therapies and vaccines are important, and the momentum of recent gains in terms of better understanding of disease patterns should be maintained to enable the global community to answer the remaining questions about this disease.


Welcome.


Veterinary medicine and the lifeboat test: a perspective on the social relevance of the veterinary profession in the 21st century.


title: Sequence analysis of the membrane protein gene of human coronavirus OC43 and evidence for O-glycosylation.

text: The gene encoding the membrane (M) protein of the OC43 strain of human coronavirus (HCV-OC43) was amplified by a reverse transcription-polymerase chain reaction of viral RNA with HCV-OC43- and bovine coronavirus (BCV)-specific primers. The nucleotide sequence of the cloned 1.5 kb fragment revealed an open reading frame (ORF) of 690 nucleotides which was identified as the M protein gene from its homology to BCV. This ORF encodes a protein of 230 amino acids with an M(r) of 26416. The gene is preceded by the motif UCCAAAC, analogous to the consensus coronavirus transcription initiation sequence. The M protein of HCV-OC43 shows features typical of all coronavirus M proteins studied: a hydrophilic, presumably external N terminus including about 10% of the protein, and a potential N-glycosylation site followed by three major hydrophobic transmembrane domains. The amino acid sequence of the M protein of HCV-OC43 has 94% identity with that of the Mebus strain of BCV, and also contains six potential O-glycosylation sites in the exposed N-terminal domain. Indeed, the glycosylation of the M protein was not inhibited in the presence of tunicamycin, which is indicative of O-glycosylation, as previously reported for BCV and murine hepatitis virus. Virions released from tunicamycin-treated cells contained the M glycoprotein but were devoid of both peplomer (S) and haemagglutinin-esterase (HE) proteins. Thus, inhibition of the N-glycosylation of the S and HE structural proteins prevented their incorporation into progeny virions, an indication that they are dispensable for virion morphogenesis, unlike the M protein.


title: What to think if the results of the National Institutes of Health randomized trial of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus control measures are negative (and other advice to young epidemiologists): a review and an au revoir.

text: The incidence of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) infections continues to rise in National Nosocomial Infections Surveillance system hospitals, and these pathogens are reportedly causing more than 100,000 infections and many deaths each year in US healthcare facilities. This has led some to insist that control measures are now urgently needed, but several recent articles have suggested that isolation of patients does not work, is not needed, or is unsafe, or that a single cluster-randomized trial could be used to decide such matters. At least 101 studies have reported controlling MRSA infection and 38 have reported controlling VRE infection by means of active detection by surveillance culture and use of isolation for all colonized patients in healthcare settings where the pathogens are epidemic or endemic, in academic and nonacademic hospitals, and in acute care, intensive care, and long-term care settings. MRSA colonization and infection have been controlled to exceedingly low levels in multiple nations and in the state of Western Australia for decades by use of active detection and isolation. Studies suggesting problems with using such data to control MRSA colonization and infection have their own problems, which are discussed. Randomized trials are epidemiologic tools that can sometimes provide erroneous results, and they have not been considered necessary for studying isolation before it is used to control other important infections, such as tuberculosis, smallpox, and severe acute respiratory syndrome. No single epidemiologic study should be considered definitive. One should always weigh all available evidence. Infection with antibiotic-resistant pathogens such as MRSA and VRE is controllable to a low level by active detection and isolation of colonized and infected patients. Effective measures should be used to minimize the morbidity and mortality attributable to these largely preventable infections.


docid: rtbgfafp

title: Comparison of the pathogenicity in rats of rat coronaviruses of different neutralization groups.

text: BACKGROUND AND PURPOSE Rat coronaviruses (RCVs) are common natural pathogens of rats that cause clinical illness, necrosis, and inflammation of respiratory, salivary, and lacrimal organs. The aim of the study was to determine whether antigenically different strains of RCV vary in their pathogenic potential in rats. METHODS Neutralization groups were identified by use of RCV strain-specific antisera. Sprague Dawley rats were inoculated oronasally with RCV-SDA, RCV-BCMM, or RCV-W. Histologic examination, immunohistochemical analysis, and reverse transcriptase-polymerase chain reaction analysis were performed on tissues from infected rats. RESULTS Clinical illness was not evident in any of the inoculated rats. The RCV-SDA strain caused mild lesions in the exorbital gland of one rat. The RCV-BCMM strain caused severe lesions in the Harderian and parotid glands and mild lesions in the exorbital glands, lungs, and nasal mucosa. The RCV-W strain caused severe lesions in the Harderian, exorbital, and parotid glands and mild lesions in the submandibular glands, lungs, and nasal mucosa. The RNA concentration was highest in the Harderian, parotid, and exorbital glands of RCV-BCMM- and RCV-W-infected rats at postinoculation day 7. CONCLUSIONS Although RCV-SDA, RCV-BCMM, and RCV-W caused different degrees and patterns of lesions, neutralization groups are not useful for predicting the pathogenic potential of a new RCV isolate.


title: Modification of the structure and function of fibrillin-1 by homocysteine suggests a potential pathogenetic mechanism in homocystinuria.

text: Homocystinuria, a disorder originating in defects in the methionine metabolism, is characterized by an elevated plasma concentration of homocysteine. Most patients have a defect in the cystathionine-beta-synthase, the key enzyme in the conversion of homocysteine to cysteine. Many abnormalities in the connective tissue of patients with homocystinuria resemble those seen in Marfan syndrome, caused by mutations in fibrillin-1. These observations led to the hypothesis that the structure and function of fibrillin-1 is compromised in patients with homocystinuria. To test this hypothesis we produced recombinant human fibrillin-1 fragments spanning the central portion of the molecule (8-Cys/transforming growth factor-beta binding domain 3 to calcium binding EGF domain 22) and extensively analyzed the potential of homocysteine to modify structural and functional properties of these proteins. Circular dichroism spectroscopy revealed moderate changes of their secondary structures after incubation with homocysteine. Equilibrium dialysis demonstrated a number of high affinity calcium binding sites in the tandemly repeated calcium binding epidermal growth factor-like domains 11-22. Calcium binding of homocysteine-modified fragments was completely abolished. Incubation of the recombinant proteins with homocysteine rendered the analyzed calcium binding EGF domains as well as the 8-Cys/transforming growth factor-beta binding domain 3 significantly more susceptible to proteolytic degradation. Furthermore, data were obtained demonstrating that homocysteine can covalently modify fibrillin-1 via disulfide bonds. These data strongly suggest that structural and functional modifications as well as degradation processes of fibrillin-1 in the connective tissues of patients with homocystinuria play a major role in the pathogenesis of this disorder.


title: Understanding wicked problems: a key to advancing environmental health promotion.

text: Complex environmental health problems--like air and water pollution, hazardous waste sites, and lead poisoning--are in reality a constellation of linked problems embedded in the fabric of the communities in which they occur. These kinds of complex problems have been characterized by some as "wicked problems" wherein stakeholders may have conflicting interpretations of the problem and the science behind it, as well as different values, goals, and life experiences. Accordingly, policy makers, public health professionals, and other stakeholders who grapple with these problems cannot expect to effectively resolve them by relying solely on expert-driven approaches to problem solving. Rather, they need to acknowledge that wicked environmental health problems are most likely to yield to (1) the application of effective community health promotion skills, (2) a sustained commitment to sound toxicological and epidemiological science, (3) the application of systems thinking, and (4) transparent communication among all stakeholders.


docid: ckwyucbm

title: Ribosomal frameshifting during translation of measles virus P protein mRNA is capable of directing synthesis of a unique protein.

text: Members of the Paramyxoviridae family utilize a variety of different strategies to increase coding capacity within their P cistrons. Translation initiation at alternative 5'-proximal AUG codons is used by measles virus (MV) to express the virus-specific P and C proteins from overlapping reading frames on their mRNAs. Additional species of mRNAs are transcribed from the MV P cistron by the insertion of extra nontemplated G residues at a specific site within the P transcript. Addition of only a single nontemplated G residue results in the expression of the V protein, which contains a unique carboxyl terminus. We have used an Escherichia coli system to express MV P cistron-related mRNAs and proteins. We have found that ribosomal frameshifting on the MV P protein mRNA is capable of generating a previously unrecognized P cistron-encoded protein that we have designated R. Some ribosomes which have initiated translation of the P protein mRNA use the sequence TCC CCG AG (24 nucleotides upstream of the V protein stop codon) to slip into the -1 reading frame, thus translating the sequence as TC CCC GAG. The resulting R protein terminates five codons downstream of the frameshift site at the V protein stop codon. We have gone on to use a chloramphenicol acetyltransferase reporter system to demonstrate that this MV-specific sequence is capable of directing frameshifting during in vivo translation in eukaryotic cells. Analysis of immunoprecipitated proteins from MV-infected cells by two-dimensional gel electrophoresis allowed detection of a protein species consistent with R protein in MV-infected cells. Quantitation of this protein species allowed a rough estimation of frameshift frequency of approximately 1.8%. Significant stimulation of ribosomal frameshift frequency at this locus of the MV P mRNA was mediated by a downstream stimulator element which, although not yet fully defined, appeared to be neither a conventional stem-loop nor an RNA pseudoknot structure.


title: Avian influenza: an omnipresent pandemic threat.

text: BACKGROUND Humans have faced 3 major influenza pandemics in the 20th century. In recent years, it has become evident that domestic poultry play an important role in the generation of novel influenza strains with the capacity to cross the species barrier and infect and kill humans at an alarming rate. There is particular concern that avian influenza viruses of the H5N1 subtype could cause a pandemic. METHODS A better understanding of the genetic factors that lead to interspecies transmission is essential to prevent the emergence of influenza pandemics. In addition, the stockpiling of antiviral drugs and development of vaccines against potentially pandemic viruses must be considered under the umbrella of pandemic plans. RESULTS The world is ill-prepared to face an influenza pandemic. Only a handful of countries have developed influenza pandemic plans, and even fewer are developing vaccines or stockpiling antiinfluenza drugs to ameliorate the impact of a potential pandemic. Currently the major undertaking in several at risk nations is to implement effective control measures to stop the spread of the virus at its source, that is, avian species. These measures include the culling of domestic poultry to contain the virus, a practice that could eventually bring these countries to a financial and social breaking point. CONCLUSIONS Avian influenza disease is preventable in humans and birds with the concerted effort of governments and poultry producers, large and small, to improve biosecurity and education programs. Pandemic plans can reduce the impact of the pandemic; however, preventing avian influenza in poultry can avert a pandemic altogether.


title: Replication of enterotropic and polytropic murine coronaviruses in cultured cell lines of mouse origin.

text: To understand the virus-cell interactions that occur during murine coronavirus infection, six murine cell lines (A3-1M, B16, CMT-93, DBT, IC-21 and J774A.1) were inoculated with eight murine coronaviruses, including prototype strains of both polytropic and enterotropic biotypes, and new isolates. All virus strains produced a cytopathic effect (CPE) with cell-to-cell fusion in B16, DBT, IC-21 and J774A.1 cells. The CPE was induced most rapidly in IC-21 cells and was visible microscopically in all cell lines tested. In contrast, the coronaviruses produced little CPE in A3-1M and CMT-93 cells. Although most virus-infected cells, except KQ3E-infected A3-1M, CMT-93 and J774A.1 cells, produced progeny viruses in the supernatants when assayed by plaque formation on DBT cells, the kinetics of viral replication were dependent on both the cell line and virus strain; replication of prototype strains was higher than that of new isolates. There was no significant difference in replication of enterotropic and polytropic strains. B16 cells supported the highest level of viral replication. To determine the sensitivity of the cell lines to murine coronaviruses, the 50% tissue culture infectious dose of the coronaviruses was determined with B16, DBT, IC-21 and J774A.1 cells, and compared to that with DBT cells. The results indicate that IC-21 cells were the most sensitive to murine coronaviruses. These data suggest that B16 and IC-21 cells are suitable for large-scale preparation and isolation of murine coronaviruses, respectively.


Pandemic influenza A (H1N1) 2009 in Malaysia--the next phase.


title: Factors that make an infectious disease outbreak controllable.

text: The aim of this study is to identify general properties of emerging infectious agents that determine the likely success of two simple public health measures in controlling outbreaks, namely (i) isolating symptomatic individuals and (ii) tracing and quarantining their contacts. Because these measures depend on the recognition of specific disease symptoms, we investigate the relative timing of infectiousness and the appearance of symptoms by using a mathematical model. We show that the success of these control measures is determined as much by the proportion of transmission occurring prior to the onset of overt clinical symptoms (or via asymptomatic infection) as the inherent transmissibility of the etiological agent (measured by the reproductive number R(0)). From published studies, we estimate these quantities for two moderately transmissible viruses, severe acute respiratory syndrome coronavirus and HIV, and for two highly transmissible viruses, smallpox and pandemic influenza. We conclude that severe acute respiratory syndrome and smallpox are easier to control using these simple public health measures. Direct estimation of the proportion of asymptomatic and presymptomatic infections is achievable by contact tracing and should be a priority during an outbreak of a novel infectious agent.


title: Epidemiology of viral respiratory infections.

text: Acute respiratory tract infections are the most common illnesses in all individuals, regardless of age or gender. Epidemiologic surveys and community-based studies conducted since the beginning of the 20th century have determined the rates of illness and the pathogens involved in such infections. These studies have shown that rhinoviruses cause the great majority of these respiratory illnesses, and their findings have examined the means of transmission of respiratory illness. More recently, advances in diagnostic techniques have enabled more complete identification of the viruses involved in respiratory infections, which has aided in the ability to direct specific therapeutic agents at the causative pathogens.


title: Isolation of bovine coronavirus (bcoV) in vero cell line and its confirmation by direct FAT and RT-PCR.

text: Bovine Coronavirus (BCoV) is widespread both in dairy and beef cattle throughout the world. The virus is one of the largest RNA virus and has specific tropism for intestinal and pulmonary epithelial cells. It is responsible for huge economic losses by causing winter dysentery in adult dairy cattle and respiratory and intestinal tract infections leading to pneumo-enteritis in young calves. Isolation of BCoV has been reported to be difficult. Studies regarding epidemiology, virus isolation and molecular detection from India are very few. In the present study Vero cell line was used for isolation of the BCoV from Enzyme Linked Immunosorbent Assay (ELISA) positive samples. Direct florescent antibody technique (dFAT) and reverse transcriptase-polymerase chain reaction (RT-PCR) were used to confirm the isolated virus strains at antigenic and genomic levels, respectively. Out of the 15 positive fecal samples, virus from only seven was able to infect vero cell line. Subsequently BCoV got adapted to the vero cell line upto three passages, which was confirmed both at genomic and antigenic levels by dFAT and RT-PCR testing. It can be concluded that vero cell line can be used for isolation of BCoV, however due to the enormous stain diversity of the virus it is possible that many stains can't grow and get adapt in this cell line. Further studies are required for isolation of different viral strains, finding the susceptible cell lines and also to confirm the variations among the BCoV isolates at antigenic/genomic levels.


title: Arterivirus discontinuous mRNA transcription is guided by base pairing between sense and antisense transcription-regulating sequences.

text: To generate an extensive set of subgenomic (sg) mRNAs, nidoviruses (arteriviruses and coronaviruses) use a mechanism of discontinuous transcription. During this process, mRNAs are generated that represent the genomic 5' sequence, the so-called leader RNA, fused at specific positions to different 3' regions of the genome. The fusion of the leader to the mRNA bodies occurs at a short, conserved sequence element, the transcription-regulating sequence (TRS), which precedes every transcription unit in the genome and is also present at the 3' end of the leader sequence. Here, we have used site-directed mutagenesis of the infectious cDNA clone of the arterivirus equine arteritis virus to show that sg mRNA synthesis requires a base-pairing interaction between the leader TRS and the complement of a body TRS in the viral negative strand. Mutagenesis of the body TRS of equine arteritis virus RNA7 reduced sg RNA7 transcription severely or abolished it completely. Mutations in the leader TRS dramatically influenced the synthesis of all sg mRNAs. The construction of double mutants in which a mutant leader TRS was combined with the corresponding mutant RNA7 body TRS resulted in the specific restoration of mRNA7 synthesis. The analysis of the mRNA leader-body junctions of a number of mutants with partial transcriptional activity provided support for a mechanism of discontinuous minus-strand transcription that resembles similarity-assisted, copy-choice RNA recombination.


title: The use of facemasks to prevent respiratory infection: a literature review in the context of the Health Belief Model.

text: INTRODUCTION Acute respiratory infections are prevalent and pose a constant threat to society. While the use of facemasks has proven to be an effective barrier to curb the aerosol spread of such diseases, its use in the local community is uncommon, resulting in doubts being cast on its effectiveness in preventing airborne infections during epidemics. We thus aimed to conduct a literature review to determine the factors that influence the use of facemasks as a primary preventive health measure in the community. METHODS A search for publications relating to facemask usage was performed on Medline, PubMed, Google, World Health Organization and Singapore government agencies' websites, using search terms such as 'facemask', 'mask', 'influenza', 'respiratory infection', 'personal protective equipment', 'disease prevention', 'compliance' and 'adherence'. Findings were framed under five components of the Health Belief Model: perceived susceptibility, perceived benefits, perceived severity, perceived barriers and cues to action. RESULTS We found that individuals are more likely to wear facemasks due to the perceived susceptibility and perceived severity of being afflicted with life-threatening diseases. Although perceived susceptibility appeared to be the most significant factor determining compliance, perceived benefits of mask-wearing was found to have significant effects on mask-wearing compliance as well. Perceived barriers include experience or perception of personal discomfort and sense of embarrassment. Media blitz and public health promotion activities supported by government agencies provide cues to increase the public's usage of facemasks. CONCLUSION Complex interventions that use multipronged approaches targeting the five components of the Health Belief Model, especially perceived susceptibility, are needed to increase the use of facemasks in the community. Further studies are required to evaluate the effectiveness of implemented interventions.


title: Ageing and psychological response during the post-SARS period.

text: We studied the psychological impact of the outbreak of Severe Acute Respiratory Syndrome (SARS) to understand if age and residential location were risk factors associated with post-traumatic disturbance, namely intrusion, avoidance, and hyperarousal. One hundred and forty-six volunteers belonging to four groups classified along the dimensions of age (middle-aged versus older-aged) and location (high SARS-prevalent regions versus low SARS-prevalent regions), participated in this study. After controlling for depression, residents in high SARS-prevalent regions, regardless of age, consistently developed more intense post-traumatic disturbance than residents in low SARS-prevalent regions. Furthermore, the prevalence of probable post-traumatic stress disorder (PTSD) cases was significantly higher in older people and in residents of SARS-prevalent regions. Our findings suggest the importance of mental health aftercare in the post-epidemic period of disease epidemics.


title: A simple and rapid strip test for detection of antibodies to avian infectious bronchitis virus.

text: A simple gold-immunochromatographic assay (GICA) based on indirect reaction format was developed for rapid detection of antibodies against avian infectious bronchitis virus (IBV). The detection time of IBV IgG by the GICA was less than 10 min, whereas the HI test and the enzyme-linked immunosorbent assay (ELISA) require 1-2 hr. Reference sera against newcastle disease virus, infectious bursal disease, avian influenza virus H5 and H9 subtypes were all negatives for anti-IBV antibodies using the GICA. Compared with the HI, the sensitivity of the GICA was 92.11% and specificity was 81.71%. The agreement rate between the 2 tests was 85%. Compared with the ELISA, the sensitivity of the GICA was 92.31% and specificity was 97.06%. The agreement rate between the 2 tests was 95%. The GICA test strip is a reliable and useful tool for the on-site surveillance of anti-IBV antibodies.


title: [Management plan for prevention and control of novel coronavirus pneumonia among children in Xiangya Hospital of Central South University].

text: Since December 2019, an epidemic of novel coronavirus pneumonia (NCP) has occurred in China. How to effectively prevent and control NCP among children with limited resources is an urgent issue to be explored. Under the unified arrangement of the Xiangya Hospital of Central South University, the Department of Pediatrics has formulated an action plan with Xiangya unique model to prevent and control NCP among children according to the current epidemic situation and diagnostic and therapeutic program in China.


docid: vxiigwqu

title: Presence of particles other than the Australia-SH antigen in a case of chronic active hepatitis with cirrhosis.

text: Examination of serum specimens from a patient with chronic active hepatitis proved negative to the Australia-SH antigen by immunodiffusion and by complement fixation. Because the sera were anticomplementary they were examined with the electron microscope, and virus-like structures similar to members of the coronavirus group were identified. The possible significance of this finding in human serum and its relation to mouse hepatitis virus are discussed.A sample of the serum pool containing the MS-1 agent was found negative when examined by immunodiffusion, complement fixation, and electron microscopy. The possible lack of immunological identity between infectious and serum hepatitis is discussed.


title: Prevalence of antiviral antibodies in workers handling wastewater and sludge.

text: Serological investigations were performed between 1977-1978 with 972 serum samples from 243 subjects having either direct (group A) or sporadic (group B) occupational contact with wastewater or sludge. the control group (C) was represented by 100 persons having no contact with such material. The sera were tested against influenza, parainfluenza, adeno-, herpes, coronavirus, rickettsial and chlamydial antigens, as well as for the presence of HBsAg and anti-HBs. Statistically significant differences between group A and groups B and C were found as regards the prevalence of antibodies to adenovirus and parainfluenza virus type 1 antigens.


title: Variation in rotavirus virulence: a comparison of pathogenesis in calves between two rotaviruses of different virulence.

text: Variation in virulence between two bovine rotaviruses was investigated using ten female and ten male 10-day-old gnotobiotic calves of five breeds or cross breeds that were inoculated with a virulent strain or a strain of low virulence. Similar numbers of infectious viral particles were detected in feces of calves inoculated with either virus, but diarrhea, xylose malabsorption, and reduction of villus height occurred only after inoculation with virulent virus. The mean percentage of the area of the villus epithelium per villus immunostained for rotavirus antigen was eight times greater in calves inoculated with virulent virus, and the mean percentage of villi on which immunostained enterocytes were detected was twice as large in calves inoculated with virulent virus than in calves inoculated with the virus of low virulence. Mean crypt death and mean crypt cell production rates were increased after inoculation with either virus. Virulence was associated with extensive spread of infection through the small intestine, preferential colonization of the proximal small intestine, and marked damage to enterocytes and villi. The virus of low virulence infected the proximal small intestine poorly, and although it infected more enterocytes in the mid and distal small intestine and replicated in them, causing cytopathic effects, it did not damage intestinal structure and affect function.


title: Plaque assay and propagation in rat cell line LBC cells of rat coronavirus and 5 strains of sialodacryoadenitis virus.

text: Various factors influencing the plaque formation of rat coronavirus (RCV) and sialodacryoadenitis virus (SDAV) in LBC cell monolayers were studied to develop the practical method for plaque assay. By this method, 4 Japanese isolates of SDAV also produced clear plaques. In one-step growth experiments of these viruses, newly formed virus was first recognized within 7.5 h postinfection and showed subsequently a rapid exponential increase. The virus was released rapidly from the infected cells. By indirect immunofluorescence virus specific antigen was detected as perinuclear granules in the cytoplasm of the cells at 5-6 h postinfection, and all the cells revealed fluorescence at 12 h postinfection.