title: Seroepidemiological studies on the occurrence of common respiratory infections in paediatric student nurses and medical technology students.

text: The occupational risk of acquiring minor respiratory infections for paediatric student nurses was estimated by performing serological examinations with influenza A, B, C, parainfluenza, mumps, respiratory syncytial virus, adenovirus and Mycoplasma pneumoniae at 6-month intervals over a period of 4 years in paediatric student nurses at two schools of nursing and students at one school of medical technology. Titre increases against all tested agents occurred 1.86 times more often in the student nurses than in the medical technology students, the most frequent agents in both groups being influenza A and B. No difference in the relative distribution of the agents could be verified in the two occupational groups. Data on the protective value of pre-infectious antibody levels for influenza A, B, and coronavirus OC43 and on the importance of the spread of single agents among classmates are presented.


title: Data-driven modeling reveals a universal dynamic underlying the COVID-19 pandemic under social distancing.

text: We show that the COVID-19 pandemic under social distancing exhibits universal dynamics. The cumulative numbers of both infections and deaths quickly cross over from exponential growth at early times to a longer period of power law growth, before eventually slowing. In agreement with a recent statistical forecasting model by the IHME, we show that this dynamics is well described by the erf function. Using this functional form, we perform a data collapse across countries and US states with very different population characteristics and social distancing policies, confirming the universal behavior of the COVID-19 outbreak. We show that the predictive power of statistical models is limited until a few days before curves flatten, forecast deaths and infections assuming current policies continue and compare our predictions to the IHME models. We present simulations showing this universal dynamics is consistent with disease transmission on scale-free networks and random networks with non-Markovian transmission dynamics.


title: Raising awareness of health care providers about MERSCoV infection in public hospitals in Mecca, Saudi Arabia.

text: It is important that health care workers have good knowledge, attitudes and practices (KAP) towards MERS-CoV, especially in Mecca because of the MERS-CoV threat during hajj and umrah. This study aimed to assess KAP of health care providers in public hospitals in Mecca about MERS-CoV infection and evaluate the effectiveness of a health education intervention to improve KAP. KAP was assessed among 281 participants using a self-administered questionnaire who then underwent the health education intervention using a combination of methods. After 3 months, 188 participants responded to the post-intervention evaluation. Significant post-intervention improvement was found in the median scores for knowledge (P < 0.001), attitude (P = 0.022) and cumulative KAP (P < 0.001); scores improved irrespective of age group and gender. Practice scores did not improve significantly, although reported practices were good before the intervention. The positive effects of the intervention support efforts to continuously implement health education interventions for health care providers in Mecca.


title: Trends in specific morbidity prevalence in male adolescents in Israel over a 50 year period and the impact of recent immigration.

text: BACKGROUND Most Israeli males aged 16-17 undergo a thorough medical examination prior to recruitment into the army. During the last 50 years, extensive data have been gathered enabling a study of time trends in the prevalence of common diseases in this age group. OBJECTIVES To examine the current prevalence of common diseases, compare the results with those of previous cohorts, and assess the influence of the massive immigration during the 1990s. METHODS The health examination at the recruitment centers includes a medical history, complete physical examination, and review of medical documentation provided by the family physician. If needed, additional tests and referral to specialists are ordered. The prevalence of selected diseases and severity was drawn from the computerized database of the classification board. Two cohorts, 1992-94 and 2003-04, were examined and compared with three previous cohort studies in 1957-61, 1977-78 and 1982-84. Data were stratified according to origin and country of birth. RESULTS The prevalence of asthma increased dramatically during the years from 10.2 per 1000 examinees in 1957-61 to 111.6 per 1000 examinees in 2003-04. The prevalence of tuberculosis declined and then increased from 0.6 per 1000 adolescents in 1982-84 to 2.4 per 1000 adolescents in 2003-04. The prevalence of type 1 diabetes mellitus increased from 0.2 cases per 1000 examinees in 1957-61 to 0.8 cases in 1977-78 and 1982-84 and 0.9 cases per 1000 examinees in 2003-04. The prevalence of severe heart defects and severe epilepsy declined in the last 20 years (1.4 and 1.7 cases per 1000 examinees in the 1982-84 cohort to 0.4 and 0.3 cases per 1000 examinees in the 2003-4 cohort respectively). The patterns of disease prevalence were different for immigrants: tuberculosis was more common while asthma and allergic rhinitis were less prevalent. CONCLUSIONS The prevalence of common diseases among adolescents in Israel has changed over the last 50 years. There is a different pattern for immigrants and for those born in Israel.


title: [Recombinant human interferon alpha 2b broad-spectrum anti-respiratory viruses pharmacodynamics study in vitro].

text: This study is to investigate the effect of recombinant human interferon alpha 2b against broad-spectrum respiratory viruses in vitro. At the cellular level, the effect of the recombinant human interferon alpha 2b on influenza A virus was detected using real-time fluorescence quantitative RT-PCR. The effects of the recombinant human interferon alpha 2b on influenza B virus, parainfluenza virus, respiratory syncytial virus (RSV) and coronavirus were detected using cytopathic effect (CPE) method. In this study, the therapeutic index of recombinant human interferon alpha 2b anti-HPIV was 1476.63, the therapeutic index of recombinant human interferon alpha 2b anti-RSV was 141.37, the therapeutic index of recombinant human interferon alpha 2b anti-coronavirus was more than 2820.76, and the antiviral effect of recombinant human interferon alpha 2b was better than ribavirin (RBV). Recombinant human interferon alpha 2b has a stronger inhibitory effect on different influenza A virus RNA than drug control. The therapeutic index of recombinant human interferon alpha 2b anti-influenza B virus was 2.74, with modest effect. Recombinant human interferon alpha 2b in vitro has broad spectrum antiviral activities, low toxicity and high therapeutic index. Recombinant human interferon alpha 2b is expected to become the efficient medicine in clinical against respiratory viruses, as well as provide better services for prevention and treatment of respiratory viruses' infections.


SARS shows no sign of coming under control.


title: [Pathogen role of coronavirus in pediatric intensive care: retrospective analysis of 19 positive samples with indirect immunofluorescence].

text: BACKGROUND Coronaviruses (CV) are ARN-containing agents that are responsible for mild upper respiratory tract infections in adults and children. Their pathogenicity in neonates is not wellknown. POPULATION AND METHODS Eighty five samples of tracheal or nasopharyngeal secretions were obtained from January to October 1991 from 53 children (29 less than 1 month of age; 19 from 1 month to 1 year; five older than 1 year). They were examined for respiratory syncytial virus, adenovirus, myxovirus influenza and parainfluenza and coronavirus by immunofluorescence (IF). RESULTS Nineteen samples from nine newborns and three infants were positive for coronavirus. The mean birth weight of the nine neonates was 2100 +/- 840 g; their mean gestational age was 34 +/- 5 weeks and their mean age at diagnosis was 21 +/- 9 days. Apnea and bradycardia were the main symptoms in this group. Blood C-reactive protein was not elevated and blood cultures were sterile. One infant was admitted for near-miss; the two others were admitted at birth because they suffered from chronic lung disease (pulmonary hypoplasia and bronchopulmonary dysplasia). An acute episode of pulmonary deterioration occurred at the time of coronavirus infection. Both died one at 4 months and the other at 10 months. CONCLUSION Coronaviruses seem to be responsible for respiratory tract infections in hospitalized neonates and chronically ventilated infants.


title: The EC4 European syllabus for post-graduate training in clinical chemistry and laboratory medicine: version 4--2012.

text: Laboratory medicine's practitioners across the European community include medical, scientific and pharmacy trained specialists whose contributions to health and healthcare is in the application of diagnostic tests for screening and early detection of disease, differential diagnosis, monitoring, management and treatment of patients, and their prognostic assessment. In submitting a revised common syllabus for post-graduate education and training across the 27 member states an expectation is set for harmonised, high quality, safe practice. In this regard an extended 'Core knowledge, skills and competencies' division embracing all laboratory medicine disciplines is described. For the first time the syllabus identifies the competencies required to meet clinical leadership demands for defining, directing and assuring the efficiency and effectiveness of laboratory services as well as expectations in translating knowledge and skills into ability to practice. In a 'Specialist knowledge' division, the expectations from the individual disciplines of Clinical Chemistry/Immunology, Haematology/Blood Transfusion, Microbiology/ Virology, Genetics and In Vitro Fertilisation are described. Beyond providing a common platform of knowledge, skills and competency, the syllabus supports the aims of the European Commission in providing safeguards to increasing professional mobility across European borders at a time when demand for highly qualified professionals is increasing and the labour force is declining. It continues to act as a guide for the formulation of national programmes supplemented by the needs of individual country priorities.


title: UHMS Position Statement: Hyperbaric Oxygen (HBO2) for COVID-19 Patients.

text: There have been numerous recent inquiries regarding use of hyperbaric oxygen (HBO2) for patients with COVID-19. Questions have been raised pertinent to two possible mechanisms for HBO2 in this clinical context. The UHMS Hyperbaric Oxygen Therapy Committee, UHMS Executive Committee, with collaborative input from multiple senior UHMS members and researchers have drafted this position statement.


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title: [Transcatheter Arterial Chemoembolization with HepaSphereTM for Gastric Cancer with Mediastinal Lymph Node Metastases Causing Esophageal Compression and Dysphagia-A Case Report].

text: A 50s man was diagnosed with esophagogastric junction cancer. Simultaneously, PET-CT demonstrated mediastinal lymph node metastases. Two months later, 4 courses of systemic chemotherapy(SOX)were provided as preoperative therapy. However, the outcome was PD; therefore, radical gastrectomy could not be performed. Two more months later, esophageal dysphagia developed. Mediastinal lymph nodes that compressed the esophagus and the primary lesion of the cardia were considered to be the causes of dysphagia, and transcatheter arterial chemoembolization targeting those 2 lesions was performed. Cisplatin 20 mg, docetaxel 20 mg, and 5-FU 250mg were the drugs administered. These drugs were injected from the right bronchial artery, left gastric artery, and left phrenic artery, followed by mild embolization with HepaSphereTM. The mediastinal lymph nodes shrunk significantly, and dysphagia improved with 2 sessions. The primary lesion was found to have reduced in size with 6 sessions. Currently, no regrowth of the mediastinal lymph nodes has been observed 16 months(9 sessions) after the first session, and control of the primary lesion has been obtained.


title: Osteonecrosis in children with severe acute respiratory syndrome.

text: Osteonecrosis is a debilitating bone disease affecting adults who have recovered from severe acute respiratory syndrome in Hong Kong and China, but there are no data on its prevalence in children. We report 5 children with magnetic resonance imaging evidence of osteonecrosis. In view of the high prevalence and asymptomatic presentation of osteonecrosis, we suggest magnetic resonance imaging screening for osteonecrosis in children with severe acute respiratory syndrome.


title: Experience of the use of Ketamine to manage opioid withdrawal in an addicted woman: a case report.

text: BACKGROUND Opioids are good painkillers, but many patients treated with opioids as painkillers developed a secondary addiction. These patients need to stop misusing opioids, but the mild-to-severe clinical symptoms associated with opioid withdrawal risk increasing their existing pain. In such cases, ketamine, which is used by anaesthetists and pain physicians to reduce opioid medication, may be an effective agent for managing opioid withdrawal. CASE PRESENTATION We describe the case of a woman who developed a severe secondary addiction to opioids in the context of lombo-sciatic pain. She presented a severe opioid addiction, and her physicians refused to prescribe such high doses of opioid treatment (oxycontin® extended-release 120 mg daily, oxycodone 60 mg daily, and acetaminophen/codeine 300 mg/25 mg 6 times per day). To assist her with her opioid withdrawal which risked increasing her existing pain, she received 1 mg/kg ketamine oral solution, and two days after ketamine initiation her opioid treatment was gradually reduced. The patient dramatically reduced the dosage of opioid painkillers and ketamine was withdrawn without any withdrawal symptoms. CONCLUSION Ketamine displays many interesting qualities for dealing with all symptoms relating to opioid withdrawal. Accordingly, it could be used instead of many psychotropic treatments, which interact with each other, to help with opioid withdrawal. However, the literature describes addiction to ketamine. All in all, although potentially addictive, ketamine could be a good candidate for the pharmacological management of opioid withdrawal.


title: Clinical usefulness of capnographic monitoring when inserting a feeding tube in critically ill patients: retrospective cohort study.

text: BACKGROUND It is not rare for a small-bore feeding tube to be inserted incorrectly into the respiratory system in critically ill patients. Thus, monitoring is necessary to prevent respiratory malplacement of the tube. We investigated the utility of capnographic monitoring to prevent respiratory complications due to feeding tube mispositioning in critically ill patients. METHODS This study was a pre and post-interventional study, including 445 feeding tube placements events studied retrospectively in the medical and surgical intensive care units of the Samsung Medical Center. We compared outcomes between time periods before and after capnographic monitoring and documented any respiratory complications. RESULTS Feeding tubes were inserted in 275 cases without capnographic monitoring. Capnographic monitoring was performed in 170 cases. Sixteen patients (4%) had respiratory complications of all tube placements. Feeding tube was inserted into the trachea in 11 (2%) patients and for a pneumothorax in five (1%) patients. Fourteen cases of respiratory complications were detected in the control group (14/275, 5%, 10 tracheal insertions and four pneumothoraxes). Two respiratory complications were detected in the capnographic monitoring group (2/170, 1%, one tracheal insertion and one pneumothorax). Respiratory complications were detected less frequently in the capnographic monitoring group than that in the control group (P = 0.035). CONCLUSIONS Capnographic monitoring is simple, easy to learn, and may be useful to prevent respiratory complications when placing a feeding tube in a critically ill patient.


title: An overview of the epidemiology of notifiable infectious diseases in Australia, 1991-2011.

text: We reviewed the first 21 years (1991-2011) of Australia's National Notifiable Diseases Surveillance System (NNDSS). All nationally notified diseases (except HIV/AIDS and Creutzfeldt-Jakob disease) were analysed by disease group (n = 8), jurisdiction (six states and two territories), Indigenous status, age group and notification year. In total, 2 421 134 cases were analysed. The 10 diseases with highest notification incidence (chlamydial infection, campylobacteriosis, varicella zoster, hepatitis C, influenza, pertussis, salmonellosis, hepatitis B, gonococcal infection, and Ross River virus infection) comprised 88% of all notifications. Annual notification incidence was 591 cases/100 000, highest in the Northern Territory (2598/100 000) and in children aged <5 years (698/100 000). A total of 8·4% of cases were Indigenous Australians. Notification incidence increased by 6·4% per year (12% for sexually transmissible infections and 15% for vaccine-preventable diseases). The number of notifiable diseases also increased from 37 to 65. The number and incidence of notifications increased throughout the study period, partly due to addition of diseases to the NNDSS and increasing availability of sensitive diagnostic tests. The most commonly notified diseases require a range of public health responses addressing high-risk sexual and drug-use behaviours, food safety and immunization. Our results highlight populations with higher notification incidence that might require tailored public health interventions.


title: Nurse unit draws lessons from its first case of SARS.

text: AN INFECTION control nursing team has started drawing lessons from its successful treatment of a patient with severe acute respiratory syndrome (SARS).


title: Endotracheal Tubes Cleaned With a Novel Mechanism for Secretion Removal: A Randomized Controlled Clinical Study.

text: INTRODUCTION Intubation compromises mucus clearance, allowing secretions to accumulate inside the endotracheal tube (ETT). The purpose of this trial was to evaluate a novel device for ETT cleaning. We hypothesized that its routine use would reduce tube occlusion due to mucus accumulation, while decreasing airway bacterial colonization. METHODS Subjects were randomized to either the use of the device every 8 h, or the institutional standard of care (blind tracheal suction) only. ETTs were collected at extubation and analyzed with high-resolution computed tomography (HRCT) for quantification of mucus volume. Microbiological testing was performed on biofilm samples. Vital signs and ventilatory settings were collected at the bedside. In-hospital follow-up was conducted, and a final evaluation survey was completed by respiratory therapists. RESULTS Seventy-four subjects expected to remain intubated for longer than 48 h were enrolled (77 ETTs, 37 treatment vs 40 controls). Treated tubes showed reduced mucus accumulation (0.56 ± 0.12 vs 0.71 ± 0.28 mL; P = .004) and reduced occlusion (6.3 ± 1.7 vs 8.9 ± 7.6%; P = .039). The HRCT slice showing the narrowest lumen within each ETT exhibited less occlusion in cleaned tubes (10.6 ± 8.0 vs 17.7 ± 13.4%, 95% CI: 2-12.1; P = .007). Data on microbial colonization showed a trend in the treatment group toward a reduced ETT-based biomass of bacteria known to cause ventilator-associated pneumonia. No adverse events were reported. The staff was satisfied by the overall safety and feasibility of the device. CONCLUSION The endOclear is a safe and effective device. It prevents luminal occlusion, thereby better preserving ETT nominal function.


title: [Construction and screening of SARS-CoV S protein-specific phage displayed antigen library].

text: The aim of this study is to construct a SARS-CoV S protein-specific phage displayed antigen library for the epitope characterization of anti-S monoclonal antibodies (mAbs). First, the full-length gene of SARS-S protein was PCR amplified, purified and then digested with DNase I to obtain DNA fragments in the size range of 50-500 bp. The resulting fragments were blunt-end ligated to the modified phage display vector pComb3XSS. The reactions were electrotransformed into XL1-Blue and infected with VCSM13 helper phage. The SARS-CoV S protein-specific phage displayed antigen library was biopanned and screened against two anti-S mAbs, S-M1 and S-M2. The results showed that we successfully constructed the phage displayed antigen library with a size of 5.7 x 10(6). After three-rounds of biopanning, 14 positive phage clones for S-M1 and 15 for S-M2 were respectively identified. Sequence analyses revealed the possible epitopes of two mAbs. Therefore, the S protein-specific phage displayed antigen library provides a crucial platform for the epitope characterization of anti-S antibodies and it is highly valuable for development of SARS vaccines and diagnostics.


[Effect of an intervention on social networks in the time of COVID-19].


Severe acute respiratory syndrome (SARS) in a geriatric patient with a hip fracture. A case report.


title: [Distribution and timing of antibody to SARS-CoV in SARS cases of transmission chain or non-transmission chain].

text: BACKGROUND To find out the timing of serologic responses after illness onset and distribution of IgG antibody to SARS-CoV in SARS cases of transmission chain or non-transmission chain. METHODS The IgG and IgM antibodies to SARS-CoV were tested by indirect ELISA in serum samples from 301 clinically diagnosed SARS cases. RESULTS Totally 158 SARS cases were involved in 15 chains of transmission. The positive rates of SARS-CoV IgG in those chains were 85.70%-100.00% and the overall rate was 94.30% (149/158). The chain of transmission could spread to four generations, but the SARS cases were reduced with increase of generations. There was no significant difference among positive rates of SARS-CoV IgG for generations, Chi square=5.11, P greater than 0.05. The positive rate of SARS-CoV IgG in cases who were not in chain of transmission was 12.59%(18/143) which was statistically significantly different from that of cases in chain of transmission, Chi square=199.64, P less than 0.001. During days 0-7,8-14,15-21,22-30 after onset, the cumulated positive rate of SARS-CoV IgG was 16.67%, 40.00%, 70.00% and 93.10%, respectively, then was kept at the level above 90% and lasted for 217 days. The cumulated positive rate of SARS-CoV IgM during days 0-7 after onset was the same to that of IgG. During days 8-14, 55.17% of cases had seroconversion for IgM which reached a peak (86.96%) during days 21-30. Then the rate rapidly declined. CONCLUSION More than 94% of cases with SARS could produce IgG antibody when they were infected by SARS-CoV. Detecting SARS-CoV IgG could provide a diagnostic evidence for case confirmation. SARS-CoV IgG appeared as early as 7 days after onset and reached the peak at about weeks 4. Then the high rate of antibody was maintained for more than 6 months.


title: RT-nested PCR detection of Mourilyan virus in Australian Penaeus monodon and its tissue distribution in healthy and moribund prawns.

text: Mourilyan virus (MoV) is a newly identified virus of Penaeus monodon prawns that is genetically related to the Uukuniemi virus and other phleboviruses of the Bunyaviridae. This paper describes an RT-nested PCR test that can reliably detect between 2 and 6 copies of a synthetic MoV RNA. Total RNA isolated from the lymphoid organ, gills and haemocytes of P. monodon with moderate infections gave comparable amplicon yields in the RT-PCR step of the test. However, in prawns with extremely low-level infections, haemocytes and gill tissue proved slightly more reliable in detecting MoV RNA following nested PCR. The distribution of MoV in tissues of healthy and moribund P. monodon was examined by in situ hybridisation (ISH) using a digoxigenin-labelled DNA probe to a approximately 0.8 kb M RNA segment cDNA insert in clone pMoV4.1. The DNA probe targeted a region in the MoV M RNA segment containing a coding sequence with homology to the C-terminus of the G2 glycoprotein of phleboviruses. In healthy prawns harbouring an unapparent MoV infection, ISH signal primarily occurred in the lymphoid organ, where it was more prominent in hypertrophied cells of 'spheroids' than within cells of normal tubules. ISH signal was also sometimes detected in cells of cuticular epithelium, segmental nerve ganglion and the antennal and tegmental glands. MoV was distributed widely throughout these and other cephalothoracic tissues of mesodermal and ectodermal origin in moribund P. monodon following experimental infection or collected from farm pond edges during disease episodes. Transmission electron microscopy of gill of moribund, captive-reared P. monodon identified spherical (approximately 85 nm diameter) to ovoid MoV particles (approximately 85 x 100 nm) in and around highly necrotic cells in which the nucleus and other organelles had disintegrated. MoV virions co-existed with rod-shaped virions of gill-associated virus and were often seen clustered within cytoplasmic vacuoles or associated with the outer rim of concentric ring-shaped structures comprised of endoplasmic membranes likely to represent degenerated Golgi.


title: Current concepts in antibiotic resistance.

text: PURPOSE OF REVIEW Although antibiotic resistance is not often considered an exciting topic for pediatric surgical subspecialists, we face the consequences of increasing antibiotic resistance daily in our clinical practice. By the very nature that our patients are often referred to us after extended periods of medical therapy, antibiotic resistance becomes a significant factor in management of patients both medically and surgically. Antibiotic resistance is increasing, and a number of organisms demonstrate multiple-drug resistance. The purpose of this review is to outline the scope of antibiotic resistance as it relates to pediatric otolaryngology. Specifically, the mechanisms of resistance, the pharmacodynamics involved, and selected infections are discussed. RECENT FINDINGS The children particularly at risk for infections with resistant organisms are those 2 years of age or younger with exposure to daycare and treatment with antimicrobials within the last 30 days. Although there is increasing resistance to antibiotics commonly used for outpatient infections such as otitis media, sinusitis, and tonsillitis, many of the first-line therapies still show significant therapeutic advantage. Vaccines to pneumococcal bacteria have been shown to decrease severe infections. However, there has been only a slight decline in the number of outpatient otolaryngologic infections after vaccination. SUMMARY Therefore, children who have received multiple courses of antibiotics, are 2 years of age or younger, attend daycare, or have received antimicrobial therapy within the last 30 days may need high-dose therapy or antimicrobial therapy with an increased spectrum of coverage. Those children with infections that do not respond clinically to appropriate therapy should be treated with the suspicion of multiple-drug resistant strains being present. Continued surveillance of resistance patterns within individual communities, especially areas served by children's hospitals, are important, as there are distinct local and regional differences in antimicrobial resistance.


title: [Investigation report on the SARS infection rate of the second medical team of Peking University First Hospital].

text: Severe Acute Respiratory Syndrome (SARS) is a newly emerged, highly contagious disease. Health care workers remain the majority of total infections. The second SARS Medical Team of Peking University First Hospital was founded on May 1, 2003, which consist of 95 health care workers. During the working days in SARS wards and following isolation period no SARS cases were diagnosed. This investigation is aimed to give a detailed report on infection control precaution taken by this medical team. It was concluded that reasonable and strict infection control precaution help to reduce infection rate among health care workers, and careful supervision helped to achieve the reduction.


title: The adoption of laparoscopic colorectal surgery: a national survey of general surgeons.

text: BACKGROUND Laparoscopic surgery may become the standard of care for the treatment of colorectal disease. Little is known regarding North American patterns of practice or the limiting factors and strategies for adoption among surgeons. METHODS We sent a 28-item questionnaire to all general surgeon members of the Royal College of Physicians and Surgeons of Canada. We derived descriptive and correlative information using chi(2), Wilcoxon rank sum and Student t tests and multivariate logistic regression. RESULTS The return rate was 55% (694/1266). A total of 67% (462/694; 95% confidence interval 63%-70%) of respondents perform colorectal surgery. Of these, 54% perform laparoscopic colorectal surgery. Multivariate logistic regression identified 5 factors related to performing laparoscopic colorectal surgery: fewer years in practice (p < 0.001), male sex (p = 0.015), practising in the province of Quebec (p = 0.005), university-hospital affiliation (p = 0.034) and minimally invasive surgery fellowship training (p = 0.023). Lack of adequate operating time and formal training were the main reasons cited by surgeons not offering laparoscopic colon resections. Most surgeons (67%) felt that site visits from a minimally invasive surgeon would represent the most effective training method for acquiring advanced laparoscopic skills. CONCLUSION About half of Canadian general surgeons offer laparoscopic colorectal resections. Recent graduation, male sex, practice location, university-hospital affiliation and minimally invasive surgery training are significant predictors for offering a laparoscopic approach. Lack of operative time and formal training are the main barriers to adoption of the technique. Site visits by trained laparoscopic surgeons is the preferred method of acquiring advanced skills.


title: [Caveolar endocytosis and virus entry].

text: The endocytic function of caveolae has been controversial for a long time. However, a real-time-imaging analysis of Simian virus 40 (SV40) 's entry in cells has indicated the existence of caveolar endocytosis during virus entry. The caveolae engulfed SV40 virions begin budding from plasma membrane depending on dynamin. SV40 enclosed in caveolae vesicles move to the caveosome, then to the endoplasmic reticulum. In addition, it was demonstrated that human coronavirus-229E enters the cell through caveolae. This review examines the involvement of caveolae in endocytosis used by the viral entry system.


title: Efficacy of methotrexate in management of peripheral psoriatic arthritis - a systematic review.

text: INTRODUCTION Psoriatic arthritis (PsA) is a chronic inflammatory joint disease associated with psoriasis. Treatment consists of disease-modifying antirheumatic drugs with methotrexate (MTX) as first choice, yet documentation of the efficacy of this treatment is limited. The objective of this review is to make an accessible overview of the existing evidence on the clinical effect of MTX in the treatment of peripheral PsA. METHODS A systematic search for randomised controlled trials was conducted using the PubMed, Embase and Cochrane Library databases. Studies examining the effect of MTX on peripheral arthritis in adult patients with PsA were included. Only trials published in English were considered and for each study, the methodological quality was assessed. RESULTS Seven studies qualified given the selected criteria. None of the two placebo-controlled trials included found a significant reduction in tender and swollen joint counts. Trials comparing MTX to combination therapy with TNF-alpha inhibitor or ciclosporin A demonstrated some clinical benefits of MTX; however, combination therapy was superior to MTX monotherapy. In a strategy trial, patients were able to reach minimal disease activity with MTX treatment alone, pointing towards some efficacy of MTX on clinical manifestations. CONCLUSIONS Clinical benefits have been found in the treatment of PsA with MTX. MTX has demonstrated clinical efficacy in the treatment of psoriasis; however, the treatment of peripheral arthritis still lacks supportive evidence. More controlled trials need to be conducted to underpin evidence-based use of MTX.


title: Site-specific alteration of murine hepatitis virus type 4 peplomer glycoprotein E2 results in reduced neurovirulence.

text: Strains of the murine coronavirus mouse hepatitis virus type 4 (MHV-4) which contained a mutation in the E2 peplomer glycoprotein were obtained by selection for resistance to neutralization by monoclonal antibodies. Characterization of six variants representing two independent epitopes on E2, E2B and E2C, by in vitro neutralization and antibody-binding assays demonstrated that selection for an alteration in epitope E2B also resulted in changes in epitope E2C and vice versa. We observed a mutation frequency of approximately 10(-4.3) to 10(-4.6), which is consistent with the expected occurrence of single point mutations. The variant virus strains were attenuated with respect to neurovirulence when compared with wild-type MHV-4. Mice normally develop encephalomyelitis and die after wild-type MHV-4 infection. Mice receiving 2- to 3-log-higher doses of the variant strains survived and developed demyelinating disease. As the disease progressed, evidence of remyelination and ongoing demyelination was observed up to 65 days after infection. Virus reisolated 15 days after infection retained the variant phenotype. The data indicate that the E2 glycoprotein plays a central role in determining the cellular tropism and virulence of MHV-4 in the mouse.


title: GxxxG motif of severe acute respiratory syndrome coronavirus spike glycoprotein transmembrane domain is not involved in trimerization and is not important for entry.

text: Recently, a paper was published in which it was proposed that the GxxxG motif of the severe acute respiratory syndrome (SARS) coronavirus spike (S) protein transmembrane domain plays a vital role in oligomerization of the protein (E. Arbely, Z. Granot, I. Kass, J. Orly, and I. T. Arkin, Biochemistry 45:11349-11356, 2006). Here, we show that the GxxxG motif is not involved in SARS S oligomerization by trimerization analysis of S GxxxG mutant proteins. In addition, the capability of S to mediate entry of SARS S-pseudotyped particles overall was affected moderately in the mutant proteins, also arguing for a nonvital role for the GxxxG motif in SARS coronavirus entry.


title: Structural requirements for low-pH-induced rearrangements in the envelope glycoprotein of tick-borne encephalitis virus.

text: The exposure of the flavivirus tick-borne encephalitis (TBE) virus to an acidic pH is necessary for virus-induced membrane fusion and leads to a quantitative and irreversible conversion of the envelope protein E dimers to trimers. To study the structural requirements for this oligomeric rearrangement, the effect of low-pH treatment on the oligomeric state of different isolated forms of protein E was investigated. Full-length E dimers obtained by solubilization of virus with the detergent Triton X-100 formed trimers at low pH, whereas truncated E dimers lacking the stem-anchor region underwent a reversible dissociation into monomers without forming trimers. These data suggest that the low-pH-induced rearrangement in virions is a two-step process involving a reversible dissociation of the E dimers followed by an irreversible formation of trimers, a process which requires the stem-anchor portion of the protein. This region contains potential amphipathic alpha-helical and conserved structural elements whose interactions may contribute to the rearrangements which initiate the fusion process.


title: Recognition of N-acetyl-9-O-acetylneuraminic acid by bovine coronavirus and hemagglutinating encephalomyelitis virus.

text: The S protein of hemagglutinating encephalomyelitis virus is shown to be a hemagglutinin requiring N-acetyl-9-O-acetylneuraminic acid as a receptor determinant on the surface of erythrocytes. The ability of bovine coronavirus to recognize 9-O-acetylated sialic acid was used to establish a binding assay for the detection of glycoproteins containing this type of sugar. The assay is very fast, because it uses the acetylesterase of the viral HE protein to localize bound virus.


title: Psychological stress and susceptibility to upper respiratory infections.

text: The biologic plausibility of a link between psychological states and host resistance is discussed. Although there is substantial evidence for the association between psychological stress and both cellular and humoral immune response, these data do not necessarily suggest increased susceptibility to infectious agents among stressed persons. Epidemiologic and viral-challenge studies suggest that psychological stress is a risk factor for upper respiratory infections with the strongest evidence provided by recent well-controlled, prospective viral-challenge trials. However, there is still little direct evidence for the nature of neuroendocrine, immune, or behavioral pathways through which stress might alter susceptibility.


title: CD1d mediates T-cell-dependent resistance to secondary infection with encephalomyocarditis virus (EMCV) in vitro and immune response to EMCV infection in vivo.

text: The innate and adaptive immune responses have evolved distinct strategies for controlling different viral pathogens. Encephalomyocarditis virus (EMCV) is a picornavirus that can cause paralysis, diabetes, and myocarditis within days of infection. The optimal innate immune response against EMCV in vivo requires CD1d. Interaction of antigen-presenting cell CD1d with distinct natural killer T-cell ("NKT") populations can induce rapid gamma interferon (IFN-gamma) production and NK-cell activation. The T-cell response of CD1d-deficient mice (lacking all NKT cells) against acute EMCV infection was further studied in vitro and in vivo. EMCV persisted at higher levels in CD1d-knockout (KO) splenocyte cultures infected in vitro. Furthermore, optimal resistance to repeat cycles of EMCV infection in vitro was also shown to depend on CD1d. However, this was not reflected in the relative levels of NK-cell activation but rather by the responses of both CD4(+) and CD8(+) T-cell populations. Repeated EMCV infection in vitro induced less IFN-gamma and alpha interferon (IFN-alpha) from CD1d-deficient splenocytes than with the wild type. Furthermore, the level of EMCV replication in wild-type splenocytes was markedly and specifically increased by addition of blocking anti-CD1d antibody. Depletion experiments demonstrated that dendritic cells contributed less than the combination of NK and NKT cells to anti-EMCV responses and that none of these cell types was the main source of IFN-alpha. Finally, EMCV infection in vivo produced higher levels of viremia in CD1d-KO mice than in wild-type animals, coupled with significantly less lymphocyte activation and IFN-alpha production. These results point to the existence of a previously unrecognized mechanism of rapid CD1d-dependent stimulation of the antiviral adaptive cellular immune response.


title: Site directed mutagenesis of the murine coronavirus spike protein. Effects on fusion.

text: Mutations were introduced in the transmembrane region of the spike protein of the murine coronavirus A59. The maturation of these mutant S proteins was not affected, they were all expressed at the cell surface, and became acylated, however some mutant S proteins did not induce cell-to-cell fusion. An I-->K change in the middle of the predicted transmembrane (TM) anchor and mutation of the first three cysteine residues of the TM domain resulted in a fusion-negative phenotype. We propose a model by which these data can be explained.


docid: tpnjmcbn

title: Animal reservoirs for SARS-like coronavirus in southern China.


Association of a single nucleotide polymorphism in the CD209 (DC-SIGN) promoter with SARS severity.


title: Detection of coronavirus-like particles from mink with epizootic catarrhal gastroenteritis.

text: Coronavirus-like particles have been detected by electron microscopy in fecal samples from naturally occurring cases of epizootic catarrhal gastroenteritis (ECG) of mink. Preliminary transmission trials with bacteria-free filtrates from mink with ECG suggested that a coronavirus plays a role in the disease syndrome.


title: Receptor-independent infection of murine coronavirus: analysis by spinoculation.

text: A highly neurovirulent murine coronavirus JHMV (wild-type [wt] JHMV) is known to spread from cells infected via the murine coronavirus mouse hepatitis virus receptor (MHVR) to cells without MHVR (MHVR-independent infection), whereas a mutant virus isolated from wt JHMV, srr7, spread only in an MHVR-dependent fashion. These observations were obtained by the overlay of JHMV-infected cells onto receptor-negative cells that are otherwise resistant to wt JHMV infection. MHVR-independent infection is hypothetically thought to be attributed to a naturally occurring fusion activation of the wt JHMV S protein, which did not occur in the case of srr7. Attachment of S protein on cells without MHVR during the S-protein activation process seems to be a key condition. Thus, in the present study, we tried to see whether wt JHMV virions that are attached on MHVR-negative cells are able to infect those cells. In order to make virions attach to the cell surface without MHVR, we have used spinoculation, namely, the centrifugation of cells together with inoculated virus at 3,000 rpm for 2 h. This procedure forces viruses to attach to the cell surface, as revealed by quantitative estimation of attached virions by real-time PCR and also facilitated wt JHMV infection to MHVR-negative cells, but failed to do so for srr7. Virions of both wt and srr7 attached on MHVR-negative cells by spinoculation were facilitated for infection in the presence of a soluble form of MHVR that induces conformational changes of both wt and srr7. It was further revealed that wt JHMV S1, but not srr7, was released from the cell surface when S protein was expressed on cells. These observations support the hypothesis that attachment of the virion to MHVR-negative cells is a critical step and that a unique feature of wt JHMV S1 to be released from S2 in a naturally occurring event is involved in an MHVR-independent infection.


title: Comparative analysis of twelve genomes of three novel group 2c and group 2d coronaviruses reveals unique group and subgroup features.

text: Twelve complete genomes of three novel coronaviruses-bat coronavirus HKU4 (bat-CoV HKU4), bat-CoV HKU5 (putative group 2c), and bat-CoV HKU9 (putative group 2d)-were sequenced. Comparative genome analysis showed that the various open reading frames (ORFs) of the genomes of the three coronaviruses had significantly higher amino acid identities to those of other group 2 coronaviruses than group 1 and 3 coronaviruses. Phylogenetic trees constructed using chymotrypsin-like protease, RNA-dependent RNA polymerase, helicase, spike, and nucleocapsid all showed that the group 2a and 2b and putative group 2c and 2d coronaviruses are more closely related to each other than to group 1 and 3 coronaviruses. Unique genomic features distinguishing between these four subgroups, including the number of papain-like proteases, the presence or absence of hemagglutinin esterase, small ORFs between the membrane and nucleocapsid genes and ORFs (NS7a and NS7b), bulged stem-loop and pseudoknot structures downstream of the nucleocapsid gene, transcription regulatory sequence, and ribosomal recognition signal for the envelope gene, were also observed. This is the first time that NS7a and NS7b downstream of the nucleocapsid gene has been found in a group 2 coronavirus. The high Ka/Ks ratio of NS7a and NS7b in bat-CoV HKU9 implies that these two group 2d-specific genes are under high selective pressure and hence are rapidly evolving. The four subgroups of group 2 coronaviruses probably originated from a common ancestor. Further molecular epidemiological studies on coronaviruses in the bats of other countries, as well as in other animals, and complete genome sequencing will shed more light on coronavirus diversity and their evolutionary histories.


title: Characterization of the receptor-destroying enzyme activity from infectious salmon anaemia virus.

text: Infectious salmon anaemia virus (ISAV) infects cells via the endocytic pathway and, like many other enveloped viruses, ISAV contains a receptor-destroying enzyme. We have analysed this acetylesterase activity with respect to substrate specificity, enzyme kinetics, inhibitors, temperature and pH stability. The ISAV acetylesterase was inhibited by di-isopropyl fluorophosphate (DFP) in a dose-dependent fashion but not by other known hydrolase inhibitors, suggesting that a serine residue is part of the active site. The pH optimum of the enzyme was in the range 7.5-8.0 and the enzymatic activity was lessened at temperatures above 40 degrees C. The effect of DFP on agglutination/elution of erythrocytes by ISAV demonstrated that the acetylesterase activity is the bona fide receptor-destroying enzyme. A haemadsorption assay was used to analyse whether the esterase was active on the surface of infected cells or not.


docid: aithnxjl

title: Analysis of synthetic peptides from heptad-repeat domains of herpes simplex virus type 1 glycoproteins H and B.

text: Human herpesviruses enter cells by fusion of their own membrane with a cellular membrane through the concerted action of multiple viral proteins and cellular receptors. Two conserved viral glycoproteins, gB and gH, are required for herpes simplex virus type 1 (HSV-1)-mediated membrane fusion, but little is known of how these proteins cooperate during entry. Both glycoproteins were shown to contain heptad repeat (HR) sequences predicted to form alpha-helical coiled coils, and the inhibitory activity against infection of four sets of synthetic peptides corresponding to HR1 and HR2 of gB and gH was tested. The interactions between these HR peptides were also investigated by circular dichroism, native polyacrylamide-gel electrophoresis and size exclusion high-performance liquid chromatography. gH coiled-coil peptides were more effective than gB coiled-coils peptides in inhibiting virus infectivity. The peptides did not impair fusion when added to cells immediately after infection. In contrast, inhibition of infection was observed, albeit to various extents, when peptides were added to virus before or during inoculation. The results of biophysical analyses were indicative of the existence of an interaction between HR1 and HR2 of gH and suggest that the HRs of gB and gH do not interact with each other.


title: The rubella virus nonstructural protease requires divalent cations for activity and functions in trans.

text: The rubella virus (RUB) nonstructural (NS) protease is a papain-like cysteine protease (PCP) located in the NS-protein open reading frame (NSP-ORF) that cleaves the NSP-ORF translation product at a single site to produce two products, P150 (the N-terminal product) and P90 (the C-terminal product). The RUB NS protease was found not to function following translation in vitro in a standard rabbit reticulocyte lysate system, although all of the other viral PCPs do so. However, in the presence of divalent cations such as Zn2+, Cd2+, and Co2+, the RUB NS protease functioned efficiently, indicating that these cations are required either as direct cofactors in catalytic activity or for correct acquisition of three-dimensional conformation of the protease. Since other viral and cell PCPs do not require cations for activity and the RUB NS protease contains a putative zinc binding motif, the latter possibility is more likely. Previous in vivo expression studies of the RUB NS protease failed to demonstrate trans cleavage activity (J.-P. Chen et al., J. Virol. 70:4707-4713, 1996). To study whether trans cleavage could be detected in vitro, a protease catalytic site mutant and a mutant in which the C-terminal 31 amino acids of P90 were deleted were independently introduced into plasmid constructs that express the complete NSP-ORF. Cotranslation of these mutants in vitro yielded both the native and the mutated forms of P90, indicating that the protease present in the mutated construct cleaved the catalytic-site mutant precursor. Thus, RUB NS protease can function in trans.


title: Global health: setting the agenda for veterinary medical education to enable veterinarians to meet their responsibilities in the field.

text: We regard the set of papers in this issue (OIE Rev. sci. tech. Off. int. Epiz., 28 [2]) as a blueprint for an agenda to bridge the divides within the global scope of the veterinary profession, so that it will meet its responsibilities to the world as it develops in the coming decades. It defines the areas with which all veterinary students should be knowledgeable, provides emphasis on the need to expand the education of all veterinary students in terms of their global health responsibilities, and then provides insights into the educational approaches that can result in the inclusion of global health issues within the veterinary curriculum.


title: Imported dengue virus serotype 1 from Madeira to Finland 2012.

text: Imported dengue cases originating from the Madeiran outbreak are increasingly reported. In 2012 five Finnish travellers returning from Madeira were diagnosed with dengue fever. Viral sequence data was obtained from two patients. The partial C-preM sequences (399 and 396 bp respectively) were found similar to that of an autochthonous case from Madeira. The partial E-gene sequence (933 bp) which was identical among the two patients grouped phylogenetically with South American strains of dengue virus serotype 1.


title: M gene analysis of atypical strains of feline and canine coronavirus circulating in an Austrian animal shelter.

text: Coronavirus-positive samples of faeces collected in an Austrian animal shelter from 12 cats and 10 dogs were analysed by reverse transcriptase-pcr with primers amplifying a segment of the M protein gene, and by sequence analysis. In addition, the samples were subjected to S gene typing, using primers that differentiated between feline coronavirus (fcov) types I and II. A phylogenetic analysis of the M gene sequences revealed not only clearly segregating canine coronavirus (ccov) in the dogs, typical ccov sequences and the recently described fcov-like ccov, but also at least two genetic clusters of fcov in the cats, one species-specific, the other more closely related to fcov-like ccov. The M gene sequences of these new feline strains had at most 88 per cent identity with the fcov-like ccov strain 259/01 and only up to 85 per cent with any fcov sequence available in GenBank. In the phylogenetic tree they occupy an intermediate position between feline and canine coronaviruses.


title: Epidemiology of depression in the Asia Pacific region.

text: OBJECTIVE To summarise studies reporting rates of depression (for the general population and older samples) and suicide in the Asia Pacific region. METHODS Information on local data was collected from the members of the SEBoD International Advisory Board on known epidemiological studies. Additionally, online searches were conducted using Medline and PsycInfo for the period 1994-2004. RESULTS Across the Asia Pacific region, rates of current or 1-month major depression ranged from 1.3% to 5.5%, rates of major depression in the previous year ranged from 1.7% to 6.7%, and lifetime rates ranged from 1.1% to 19.9%, with a median of 3.7%. Rates of suicide in the Asia Pacific region are now similar to those in Europe and the Americas. The exceptions include China and South Korea. CONCLUSIONS Epidemiological studies in Asian populations are rare and use various diagnostic criteria. However, studies indicate that rates of depression in Asia Pacific, whilst lower, are comparable to other western countries. As such, depression as a health issue in Asia Pacific demands greater recognition. It is important that Asian countries should have the human and financial resources to conduct large scale epidemiological surveys not only in the area of depression, but also in the broader field of mental disorders.


title: Characterization of a papain-like cysteine-proteinase encoded by gene 1 of the human coronavirus HCV 229E.

text: Expression of the coronaviral gene 1 polyproteins, pp 1a and pp 1ab, involves a series of proteolytic events that are mediated by virus-encoded proteinases similar to cellular papain-like cysteine-proteinases and the 3C-like proteinases of picornaviruses. In this study, we have characterized, in vitro, the human coronavirus HCV 229E papain-like cysteine-proteinase PCP 1. We show that PCP 1 is able to mediate cleavage of an aminoterminal polypeptide, p9, from in vitro translation products representing the aminoproximal region of pp 1a/pp 1ab. Mutagenesis studies support the prediction of Cys1054 and His1278 as the catalytic amino acids of the HCV 229E PCP 1, since mutation of these residues abolishes the proteolytic activity of the enzyme.


title: Infection control for SARS in a tertiary neonatal centre.

text: The Severe Acute Respiratory Syndrome (SARS) is a newly discovered infectious disease caused by a novel coronavirus, which can readily spread in the healthcare setting. A recent community outbreak in Hong Kong infected a significant number of pregnant women who subsequently required emergency caesarean section for deteriorating maternal condition and respiratory failure. As no neonatal clinician has any experience in looking after these high risk infants, stringent infection control measures for prevention of cross infection between patients and staff are important to safeguard the wellbeing of the work force and to avoid nosocomial spread of SARS within the neonatal unit. This article describes the infection control and patient triage policy of the neonatal unit at the Prince of Wales Hospital, Hong Kong. We hope this information is useful in helping other units to formulate their own infection control plans according to their own unit configuration and clinical needs.


title: Positive and negative affect within the realm of depression, stress and fatigue: the two-factor distress model of the Global Mood Scale (GMS).

text: BACKGROUND The Global Mood Scale (GMS; [Denollet, J., 1993a. Emotional distress and fatigue in coronary heart disease: the Global Mood Scale (GMS). Psychol Med 23, 111-121., Denollet, J., 1993b. The sensitivity of outcome assessment in cardiac rehabilitation. J Consult Clin Psychol 61, 686-695.]) was originally developed as a measure of positive affect (PA) and negative affect (NA) in cardiac patients. The purpose of this study was to examine its two-factor affect model in the realm of stress, depression, and fatigue in working adults. METHODS Affect, stress, depression, and fatigue were assessed with validated questionnaires in a sample of 228 adults (49.6% male; mean = 41.4 +/- 9 years) from the working population. RESULTS The GMS PA and NA scales were internally consistent (Cronbach's alpha = .94 and alpha = .93, respectively), and correlated in the expected direction with their corresponding mood scales from the Positive and Negative Affect Schedule (PANAS). Factor analyses of the 40 mood terms comprising the GMS and PANAS yielded one common PA-dimension, but two NA-dimensions reflecting emotional exhaustion (GMS) and anxious apprehension (PANAS) as different components of the stress process. A relatively high mean NA score of the GMS suggested that these working adults perceived terms that refer to malaise/deactivation as being relevant to describe their negative affective status. The GSM-NA scale was related to stress, depression and fatigue while the GMS-PA scale was positively associated with quality of life. LIMITATIONS This study is based on a cross-sectional design. CONCLUSIONS The association between the PA (negative correlation) and NA (positive correlation) scales of the GMS and perceived stress, depressive symptoms, and fatigue supports the validity of its two-factor model. Assessment of both PA and NA may benefit a better understanding of emotional distress in adults from the working population.


docid: pdiudrfx

title: Comparative lactogenic antibody responses of cattle from European field trials with a new enteric disease vaccine.


title: RNA recombination of coronavirus.

text: We have previously shown that Mouse hepatitis virus (MHV) can undergo RNA-RNA recombination at a very high frequency (S. Makino, et al., J. Virol. 57, 729-737, 1986). To better define the mechanism of RNA recombination, we have performed additional crosses involving different MHV strains. We have obtained recombinant viruses with multiple cross-overs. The isolation of such recombinants further indicates the high frequency of coronavirus RNA recombination. By using cell fusion as a selection marker, we have also obtained recombinants between MHV-2 and A59 strains. Some of these recombinants have cross-overs in the 3'-end genes of the genome, thus demonstrating that recombination could occur along the entire genome. Finally, we have obtained recombinants by selecting with neutralizing monoclonal antibodies. These recombinants have cross-overs within gene C which encodes the peplomer protein. The genetic structure of these recombinants allowed us to determine the important domains of the peplomer proteins.


title: Antigenic characterization of human coronaviruses 229E and OC43 by enzyme-linked immunosorbent assay.

text: Human coronaviruses 229E and OC43 possess three distinct antigens each which are located in peplomer, membrane, and nucleoprotein virion subcomponents. Although specific antigens are associated with similar polypeptides in both viruses, neither shared antigens nor serological cross-reactions have been observed. These findings were confirmed by enzyme-linked immunosorbent assay; rabbit whole-virus-specific antisera reacted with dissociated homologous virus and each of its subcomponents, whereas antisera monospecific to separate subcomponents (peplomers, membrane, or core) recognized only their respective components. Since neither shared antigens nor serological cross-reactions were seen between the two viruses, the specificity of the assay was similar to that of crossed-immunoelectrophoresis, virus neutralization, and complement fixation assays. However, sensitivity was increased at least 1,000-fold; complement fixation antibody titers of 2,000 corresponded to enzyme-linked immunosorbent assay titers of 3,200,000. Similar results were obtained with human convalescent-phase sera. In addition, the most prevalent human antibodies were found to be directed against virion peplomers. However, specific antibodies to core antigens and lesser amounts to membrane antigens were found in the sera of patients, which showed significant antibody rises when purified virion subcomponents were used as antigens. Importantly, rises and declines in titers of antibody to one virus and its specific antigens were independent from levels of titers of antibody to the other virus.


Laparoendoscopic single-site right hemicolectomy versus conventional laparoscopic right hemicolectomy: is LESS more?


Increased S100B in cerebrospinal fluid of infants with bacterial meningitis: relationship to brain damage and routine cerebrospinal fluid findings.


title: An explanation for the seasonality of acute upper respiratory tract viral infections.

text: Despite a great increase in our understanding of the molecular biology of the viruses associated with acute upper respiratory tract viral infections (URTIs) there is a remarkable lack of knowledge and ideas about why URTI should exhibit a seasonal incidence. Most publications in this area either acknowledge a complete lack of any explanation for the seasonality of URTI or put forward an explanation relating to an increased "crowding" of susceptible persons in winter. This review will discuss some of the ideas concerning the seasonality of URTI and put forward a new hypothesis for discussion, namely that seasonal exposure to cold air causes an increase in the incidence of URTI due to cooling of the nasal airway. The hypothesis is supported by literature reports demonstrating that inhalation of cold air causes cooling of the nasal epithelium, and that this reduction in nasal temperature is sufficient to inhibit respiratory defences against infection such as mucociliary clearance and the phagocytic activity of leukocytes. A case is also made to suggest that warming of the nasal airway during fever and nasal congestion may help to resolve a current URTI.


title: Role of infection and antimicrobial therapy in acute exacerbations of chronic obstructive pulmonary disease.

text: Over the past several years, the significance of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in patients with chronic airflow obstruction has become increasingly apparent due to the impact these episodes have on the natural history of disease. It is now known that frequent AECOPD can adversely affect a patient's health-related quality of life and short- and long-term pulmonary function. The economic burden of these episodes is also substantial. AECOPDs represent a local and systemic inflammatory response to both infectious and noninfectious stimuli, but the majority of episodes are likely related to bacterial or viral pathogens. Patients with purulent sputum and multiple symptoms are the most likely to benefit from treatment with antibiotics. Antibiotic choice should be tailored to the individual patient, taking into account the severity of the episode and host factors which might increase the likelihood of treatment failure. Current evidence suggests that therapeutic goals not only include resolution of the acute episode, but also prolonging the time to the next event. In the future, preventing exacerbations will likely become increasingly accepted as an additional therapeutic goal in chronic obstructive pulmonary disease patients.


title: Integrated molecular signature of disease: analysis of influenza virus-infected macaques through functional genomics and proteomics.

text: Recent outbreaks of avian influenza in humans have stressed the need for an improved nonhuman primate model of influenza pathogenesis. In order to further develop a macaque model, we expanded our previous in vivo genomics experiments with influenza virus-infected macaques by focusing on the innate immune response at day 2 postinoculation and on gene expression in affected lung tissue with viral genetic material present. Finally, we sought to identify signature genes for early infection in whole blood. For these purposes, we infected six pigtailed macaques (Macaca nemestrina) with reconstructed influenza A/Texas/36/91 virus and three control animals with a sham inoculate. We sacrificed one control and two experimental animals at days 2, 4, and 7 postinfection. Lung tissue was harvested for pathology, gene expression profiling, and proteomics. Blood was collected for genomics every other day from each animal until the experimental endpoint. Gross and microscopic pathology, immunohistochemistry, viral gene expression by arrays, and/or quantitative real-time reverse transcription-PCR confirmed successful yet mild infections in all experimental animals. Genomic experiments were performed using macaque-specific oligonucleotide arrays, and high-throughput proteomics revealed the host response to infection at the mRNA and protein levels. Our data showed dramatic differences in gene expression within regions in influenza virus-induced lesions based on the presence or absence of viral mRNA. We also identified genes tightly coregulated in peripheral white blood cells and in lung tissue at day 2 postinoculation. This latter finding opens the possibility of using gene expression arrays on whole blood to detect infection after exposure but prior to onset of symptoms or shedding.


title: Managing nursing assistants with a web-based system: an empirical investigation of the mixed-staff strategy.

text: Under the global shortage of Registered Nurses (RNs), some hospitals have integrated nursing assistants (NAs) into their teams to help to provide maximum quality care for acute patients, while keeping the hospital's staff-related costs down. However, the RNs may have to shoulder an increased burden of assigning and overseeing NAs. A web-based Nursing Assistants Management System (NAMS) was developed and evaluated for a case hospital in Taiwan to compare the processes of assigning and managing NAs before and after the NAMS intervention. The results showed that NAMS saved 80% of the time needed for manual operation and there were no more complains about NAs being slow in dealing with patients after the system intervention. The satisfaction levels of all NA managers and RNs were acceptable. Based on the research findings, the implication and limitations of this study were discussed.


title: Update: severe acute respiratory syndrome--United States, May 21, 2003.

text: CDC continues to work with state and local health departments, the World Health Organization (WHO), and other partners to investigate cases of severe acute respiratory syndrome (SARS). This report updates SARS cases reported worldwide and in the United States and highlights recent modifications to the U.S. SARS case definition that define criteria for exclusion of previously reported SARS cases and for reporting travel-associated cases of SARS.


docid: kqwhewav

title: Targeted recombination within the spike gene of murine coronavirus mouse hepatitis virus-A59: Q159 is a determinant of hepatotropism.

text: Previous studies of a group of mutants of the murine coronavirus mouse hepatitis virus (MHV)-A59, isolated from persistently infected glial cells, have shown a strong correlation between a Q159L amino acid substitution in the S1 subunit of the spike gene and a loss in the ability to induce hepatitis and demyelination. To determine if Q159L alone is sufficient to cause these altered pathogenic properties, targeted RNA recombination was used to introduce a Q159L amino acid substitution into the spike gene of MHV-A59. Recombination was carried out between the genome of a temperature-sensitive mutant of MHV-A59 (Alb4) and RNA transcribed from a plasmid (pFV1) containing the spike gene as well as downstream regions, through the 3' end, of the MHV-A59 genome. We have selected and characterized two recombinant viruses containing Q159L. These recombinant viruses (159R36 and 159R40) replicate in the brains of C57BL/6 mice and induce encephalitis to a similar extent as wild-type MHV-A59. However, they exhibit a markedly reduced ability to replicate in the liver or produce hepatitis compared to wild-type MHV-A59. These viruses also exhibit reduced virulence and reduced demyelination. A recombinant virus containing the wild-type MHV-A59 spike gene, wtR10, behaved essentially like wild-type MHV-A59. This is the first report of the isolation of recombinant viruses containing a site-directed mutation, encoding an amino acid substitution, within the spike gene of any coronavirus. This technology will allow us to begin to map the molecular determinants of pathogenesis within the spike glycoprotein.


title: Anti-human coronavirus (anti-HCoV) triterpenoids from the leaves of Euphorbia neriifolia.

text: Euphorbia neriifolia L. is a spiny herb native to Southeast Asia and currently cultivated in southern Taiwan. From the ethanolic extract of E. neriifolia leaves, 23 compounds were isolated, including 22 triterpenoids and one flavonoid glycoside. The anti-human coronavirus (HCoV) activity of the separated triterpenoids was studied revealing the structure-activity relationship (SAR) of these isolates. 3beta-Friedelanol exhibited more potent anti-viral activity than the positive control, actinomycin D, which implies the importance of the friedelane skeleton as a potential scaffold for developing new anti-HCoV-229E drugs.


title: [The significance of bredavirus as a diarrhea agent in calf herds in Lower Saxony].

text: The objective of this investigation was to determine the distribution of Bredavirus in cattle herds in Lower Saxony and to evaluate its significance as potential cause of diarrhea in calves. Fecal samples and paired blood samples of 119 diarrheic and 46 healthy calves up to two months of age were collected from herds where diarrhea of calves was a problem. Fecal samples were examined for Breda-, rota- and coronavirus by solid phase immune electron microscopy and by ELISA, for K99-positive E. coli and salmonella by microbiological methods, and for cryptosporidia in smears. Antibody titers against Bredavirus, total serum protein and serum gamma globulin content were evaluated in the blood samples. Bredavirus was found in fecal samples from 5% (n = 6) of diarrheic calves which came from four different herds, but not in healthy calves. Rotavirus (31.9%), coronavirus (18.5%) and cryptosporidia (29.9%) were detected more frequently in fecal samples than Bredavirus. In this investigation rotavirus, coronavirus and cryptosporidia were present in addition in all herds where Bredavirus was found. In contrast to the low percentage of fecal samples containing Bredavirus, antibody titers in 75% of calves confirmed the high prevalence of Bredavirus infection in the cattle population of Lower Saxony.


Scale of levels of care versus DNR orders.


title: High prevalence of human bocavirus detected in young children with severe acute lower respiratory tract disease by use of a standard PCR protocol and a novel real-time PCR protocol.

text: The human bocavirus (HBoV) was recently isolated from respiratory tract samples. Within a study collective of children with severe lower respiratory tract disease, the patients testing positive for HBoV (12.8%) had a higher rate of underlying cardiopulmonary disease. Viral loads in respiratory tract specimens varied from 10(2) to 10(10) genome equivalents/ml.


title: Improving the indoor air quality of respiratory type of medical facility by zeolite filtering.

text: UNLABELLED This study investigated the indoor air quality (IAQ) conditions of carbon dioxide (CO2), carbon monoxide (CO), ozone (O3), formaldehyde (HCHO), total volatile organic compounds (TVOCs), and bio-aerosols (bacteria and fungi) in a respiratory type of medical facility in Chia-Yi County in southern Taiwan. Among those IAQ conditions, the concentrations of CO, O3, and HCHO exceeded the regulation values of the Taiwan Environmental Protection Administration (EPA) mostly in the morning. The concentrations of bacteria and fungi did not exceed the regulation values but still posed potential health and environment problems for workers, patients, and visitors. Therefore, self-made silver-coated zeolite (AgZ) was used as a filter material in air cleaners to remove bio-aerosols in the respiratory care ward (RCW), and the removals were still effective after 120 hr. The cumulative bio-aerosol removals for bacteria and fungi were 900 and 1,088 colony-forming units (CFU) g(-1) after 24 hr and were above 3,100 and 2,700 CFU g(-1) after 120 hr. From the research results, it is suggested that AgZ filtering could be used as a feasible engineering measure for hospitals to control their bacteria and fungi parameters in IAQ management. Hospitals should maintain their environmental management and monitoring programs and use different engineering measures to improve different IAQ parameters. IMPLICATIONS This study investigated the IAQ conditions in the field at a hospital in Chia-Yi County in southern Taiwan. Although concentrations of most parameters were still within the regulation values, the concentrations of CO, O3, and HCHO were partially exceeded. We propose a method using an air cleaner with silver-coated zeolite (AgZ) as a possible engineering measure, and there were effective reductions of bacteria and fungi to lower levels with antibacterial effects after 120 hr. Furthermore, this study implies that hospitals should continuously maintain environmental monitoring programs and adopt optimal engineering measures for different needs.


docid: mjwaxvvo

title: Rehabilitation of a complex midfacial defect by means of a zygoma-implant-supported prosthesis and nasal epithesis: a novel technique.

text: PURPOSE Several authors have described zygoma implants as a reliable surgical option to rehabilitate severe maxillary defects in case of extreme atrophy or oncological resections. The aim of this study is to report a new technical approach to the rehabilitation of a complex oronasal defect by means of a zygoma-implant-supported full-arch dental prosthesis combined with a nasal epithesis. PATIENTS AND METHODS The patient presented with a subtotal bilateral maxillectomy and total rhinectomy defect because of a squamous cell carcinoma of the nose. No reconstructive surgery was performed because of the high risk of recurrence; moreover, the patient refused any secondary procedure. After surgery, the patient presented a wide palatal defect associated to the absence of the nasal pyramid. Zygoma-retained prostheses are well documented, and they offer good anchorage in rehabilitating wide defects after oncological surgery and a good chance for patients to improve their quality of life. We hereby describe two prosthetic devices rehabilitating two iatrogenic defects by means of a single intraoral implant-supported bar extending throughout the oronasal communication, thus offering nasal epithesis anchorage. RESULTS At 1-year follow-up after functional prosthetic loading, no implant failure has been reported. Clinical and radiological follow-up showed no sign of nasal infection or peri-implantitis. The patient reported a sensitive improvement of his quality of life. CONCLUSIONS Simultaneous oral and nasal rehabilitation of complex oronasal defects with zygoma-implant-supported dental prosthesis and nasal epithesis represents a reliable surgical technique. According to this clinical report, the above-mentioned technique seems to be a valuable treatment option as it is safe, reliable and easy to handle for both surgeon and patient.


Vascular catheters inserted in the trenches versus guideline documents: can the discrepancies be resolved?


title: Alphavirus RNA genome repair and evolution: molecular characterization of infectious sindbis virus isolates lacking a known conserved motif at the 3' end of the genome.

text: The 3' nontranslated region of the genomes of Sindbis virus (SIN) and other alphaviruses carries several repeat sequence elements (RSEs) as well as a 19-nucleotide (nt) conserved sequence element (3'CSE). The 3'CSE and the adjoining poly(A) tail of the SIN genome are thought to act as viral promoters for negative-sense RNA synthesis and genome replication. Eight different SIN isolates that carry altered 3'CSEs were studied in detail to evaluate the role of the 3'CSE in genome replication. The salient findings of this study as it applies to SIN infection of BHK cells are as follows: i) the classical 19-nt 3'CSE of the SIN genome is not essential for genome replication, long-term stability, or packaging; ii) compensatory amino acid or nucleotide changes within the SIN genomes are not required to counteract base changes in the 3' terminal motifs of the SIN genome; iii) the 5' 1-kb regions of all SIN genomes, regardless of the differences in 3' terminal motifs, do not undergo any base changes even after 18 passages; iv) although extensive addition of AU-rich motifs occurs in the SIN genomes carrying defective 3'CSE, these are not essential for genome viability or function; and v) the newly added AU-rich motifs are composed predominantly of RSEs. These findings are consistent with the idea that the 3' terminal AU-rich motifs of the SIN genomes do not bind directly to the viral polymerase and that cellular proteins with broad AU-rich binding specificity may mediate this interaction. In addition to the classical 3'CSE, other RNA motifs located elsewhere in the SIN genome must play a major role in template selection by the SIN RNA polymerase.


title: Transmembrane domain-dependent sorting of proteins to the ER and plasma membrane in yeast.

text: Sorting of membrane proteins between compartments of the secretory pathway is mediated in part by their transmembrane domains (TMDs). In animal cells, TMD length is a major factor in Golgi retention. In yeast, the role of TMD signals is less clear; it has been proposed that membrane proteins travel by default to the vacuole, and are prevented from doing so by cytoplasmic signals. We have investigated the targeting of the yeast endoplasmic reticulum (ER) t-SNARE Ufe1p. We show that the amino acid sequence of the Ufe1p TMD is important for both function and ER targeting, and that the requirements for each are distinct. Targeting is independent of Rer1p, the only candidate sorting receptor for TMD sequences currently known. Lengthening the Ufe1p TMD allows transport along the secretory pathway to the vacuole or plasma membrane. The choice between these destinations is determined by the length and composition of the TMD, but not by its precise sequence. A longer TMD is required to reach the plasma membrane in yeast than in animal cells, and shorter TMDs direct proteins to the vacuole. TMD-based sorting is therefore a general feature of the yeast secretory pathway, but occurs by different mechanisms at different points.


title: DNA-templated CMV viral capsid proteins assemble into nanotubes.

text: This communication describes the in vitro assembly of genetically recombinant Cucumber Mosaic Virus (CMV) viral capsid proteins (CPs) into biological nanotubes, several micrometres long yet with a diameter of only approximately 17 nm, triggered by double-stranded DNAs of different lengths.


title: Reconstruction with latissimus dorsi, external abdominal oblique and cranial sartorius muscle flaps for a large defect of abdominal wall in a dog after surgical removal of infiltrative lipoma.

text: This animal was presented with a large-sized infiltrative lipoma in the abdominal wall that had been noted for 4 years. This lipoma was confirmed by histological examination from a previous biopsy, and the infiltrative features were identified by a computerized tomography scan. The surgical removal created a large-sized abdominal defect that was closed by a combination of latissimus dorsi and external abdominal oblique muscle flaps in a pedicle pattern. A small dehiscence at the most distal end of the muscle flap resulted in a small-sized abdominal hernia and was repaired with cranial sartorius muscle flap 14 days after surgery. The dog was in good general health with no signs of tumor recurrence after 18 months of follow-up.


title: Genetic diversity and selection regulates evolution of infectious bronchitis virus.

text: Conventional and molecular epidemiologic studies have confirmed the ability of infectious bronchitis virus (IBV) to rapidly evolve and successfully circumvent extensive vaccination programs implemented since the early 1950s. IBV evolution has often been explained as variation in gene frequencies as if evolution were driven by genetic drift alone. However, the mechanisms regulating the evolution of IBV include both the generation of genetic diversity and the selection process. IBV's generation of genetic diversity has been extensively investigated and ultimately involves mutations and recombination events occurring during viral replication. The relevance of the selection process has been further understood more recently by identifying genetic and phenotypic differences between IBV populations prior to, and during, replication in the natural host. Accumulating evidence suggests that multiple environmental forces within the host, including immune responses (or lack thereof) and affinity for cell receptors, as well as physical and biochemical conditions, are responsible for the selection process. Some scientists have used or adopted the related quasispecies frame to explain IBV evolution. The quasispecies frame, while providing a distinct explanation of the dynamics of populations in which mutation is a frequent event, exhibits relevant limitations which are discussed herein. Instead, it seems that IBV populations evolving by the generation of genetic variability and selection on replicons follow the evolutionary mechanisms originally proposed by Darwin. Understanding the mechanisms underlying the evolution of IBV is of basic relevance and, without doubt, essential to appropriately control and prevent the disease.


Priorities for communicable disease control in New South Wales, 2003.


title: Structure, Function, and Evolution of Coronavirus Spike Proteins.

text: The coronavirus spike protein is a multifunctional molecular machine that mediates coronavirus entry into host cells. It first binds to a receptor on the host cell surface through its S1 subunit and then fuses viral and host membranes through its S2 subunit. Two domains in S1 from different coronaviruses recognize a variety of host receptors, leading to viral attachment. The spike protein exists in two structurally distinct conformations, prefusion and postfusion. The transition from prefusion to postfusion conformation of the spike protein must be triggered, leading to membrane fusion. This article reviews current knowledge about the structures and functions of coronavirus spike proteins, illustrating how the two S1 domains recognize different receptors and how the spike proteins are regulated to undergo conformational transitions. I further discuss the evolution of these two critical functions of coronavirus spike proteins, receptor recognition and membrane fusion, in the context of the corresponding functions from other viruses and host cells.


title: Risk factors for mortality in patients with Coronavirus Disease 2019 (COVID-19) in Bolivia: An analysis of the first 107 confirmed cases.

text: The present study is aimed to assess the risk factors for mortality in the first 107 rRT-PCR confirmed cases of SARS-CoV-2 infections in Bolivia. For this observational, retrospective and cross-sectional study, the epidemiological data records were collected from the Hospitals and the Ministry of Health of Bolivia, obtaining the clinical and epidemiological data of the COVID-19 cases that were laboratory-diagnosed during March 2-29, 2020. Samples were tested by rRT-PCR to SARS-CoV-2 at the Laboratory of the National Center of Tropical Diseases (CENETROP), following the protocol Charite, Berlin, Germany. The odds ratio (OR) with respective 95% confidence interval (95%CI) for mortality as dependent variable was calculated. When we comparatively analyzed survivors and non-survivors in this first group of 107 cases in Bolivia, we found that at bivariate analyses, age (±60 years old), hypertension, chronic heart failure, diabetes, and obesity, as well as the requirement of ICU, were significantly exposure variables associated with death. At the multivariate analysis (logistic regression), two variables remained significantly associated, age, ±60 years-old (OR=9.4, 95%CI 1.8-104.1) and hypertension (OR=3.3, 95%CI 1.3-6.3). As expected, age and comorbidities, particularly hypertension, were independent risk factors for mortality in Bolivia in the first 107 cases group. More further studies are required to better define risk factors and preventive measures related to COVID-19 in this and other Latin American countries.


title: Pseudorabies virus expressing bovine herpesvirus 1 glycoprotein B exhibits altered neurotropism and increased neurovirulence.

text: Herpesvirus glycoproteins play dominant roles in the initiation of infection of target cells in culture and thus may also influence viral tropism in vivo. Whereas the relative contribution of several nonessential glycoproteins to neurovirulence and neurotropism of Pseudorabies virus (PrV), an alphaherpesvirus which causes Aujeszky's disease in pigs, has recently been uncovered in studies using viral deletion mutants, the importance of essential glycoproteins is more difficult to assess. We isolated an infectious PrV mutant, PrV-9112C2, which lacks the gene encoding the essential PrV glycoprotein B (gB) but stably carries in its genome and expresses the homologous gene of bovine herpesvirus 1 (BHV-1) (A. Kopp and T. C. Mettenleiter, J. Virol. 66:2754-2762, 1992). Apart from exhibiting a slight delay in penetration kinetics, PrV-9112C2 was similar in its growth characteristics in cell culture to wild-type PrV. To analyze the effect of the exchange of these homologous glycoproteins in PrV's natural host, swine, 4-week-old piglets were intranasally infected with 10(6) PFU of either wild-type PrV strain Kaplan (PrV-Ka), PrV-9112C2, or PrV-9112C2R, in which the PrV gB gene was reinserted instead of the BHV-1 gB gene. Animals infected with PrV-Ka and PrV-9112C2R showed a similar course of disease, i.e., high fever, marked respiratory symptoms but minimal neurological disorders, and excretion of high amounts of virus. All animals survived the infection. In contrast, animals infected with PrV-9112C2 showed no respiratory symptoms and developed only mild fever. However, on day 5 after infection, all piglets developed severe central nervous system (CNS) symptoms leading to death within 48 to 72 h. Detailed histological analyses showed that PrV-9112C2R infected all regions of the nasal mucosa and subsequently spread to the CNS preferentially by the trigeminal route. In contrast, PrV-9112C2 primarily infected the olfactory epithelium and spread via the olfactory route. In the CNS, more viral antigen and significantly more pronounced histological changes resulting in more severe encephalitis were found after PrV-9112C2 infection. Thus, our results demonstrate that replacement of PrV gB by the homologous BHV-1 glycoprotein resulted in a dramatic increase in neurovirulence combined with an alteration in the route of neuroinvasion, indicating that the essential gB is involved in determining neurotropism and neurovirulence of PrV.


docid: szyaizxr

title: Infectious agents associated with neonatal calf disease in southwestern Idaho and eastern Oregon.

text: Over a 2-year period, 296 episodes of disease involving 226 1-to-60-day-old calves were referred to the Caldwell Veterinary Teaching Center. Infectious disease agents were found in 96% of the cases. Salmonella spp were the most frequently isolated agents from dairy calves, whereas coronavirus was the agent most commonly associated with diarrhea in beef calves. Multiple agents were found in 20% of the dairy calves and in 12% of the beef calves. Salmonella dublin, which is associated with severe disease in man, made up a large percentage of the Salmonella spp isolated (40%). In vitro drug sensitivities indicated that a high percentage of Salmonella and Escherichia coli were resistant to drugs, especially to the drugs commonly used to treat calf diarrhea.


title: Use of a ray-based reconstruction algorithm to accurately quantify preclinical microSPECT images.

text: This work aimed to measure the in vivo quantification errors obtained when ray-based iterative reconstruction is used in micro-single-photon emission computed tomography (SPECT). This was investigated with an extensive phantom-based evaluation and two typical in vivo studies using 99mTc and 111In, measured on a commercially available cadmium zinc telluride (CZT)-based small-animal scanner. Iterative reconstruction was implemented on the GPU using ray tracing, including (1) scatter correction, (2) computed tomography-based attenuation correction, (3) resolution recovery, and (4) edge-preserving smoothing. It was validated using a National Electrical Manufacturers Association (NEMA) phantom. The in vivo quantification error was determined for two radiotracers: [99mTc]DMSA in naive mice (n = 10 kidneys) and [111In]octreotide in mice (n = 6) inoculated with a xenograft neuroendocrine tumor (NCI-H727). The measured energy resolution is 5.3% for 140.51 keV (99mTc), 4.8% for 171.30 keV, and 3.3% for 245.39 keV (111In). For 99mTc, an uncorrected quantification error of 28 ± 3% is reduced to 8 ± 3%. For 111In, the error reduces from 26 ± 14% to 6 ± 22%. The in vivo error obtained with 99mTc-dimercaptosuccinic acid ([99mTc]DMSA) is reduced from 16.2 ± 2.8% to -0.3 ± 2.1% and from 16.7 ± 10.1% to 2.2 ± 10.6% with [111In]octreotide. Absolute quantitative in vivo SPECT is possible without explicit system matrix measurements. An absolute in vivo quantification error smaller than 5% was achieved and exemplified for both [99mTc]DMSA and [111In]octreotide.


Biochemistry of coronaviruses 1983.


title: Acute upper respiratory tract viral illness and influenza immunization in homes for the elderly.

text: Occupants of 482 long-stay and 33 short-stay beds in 11 Leicester City Council homes for the elderly were studied during a 30-week period from September 1988 to March 1989 to determine the incidence, aetiology, morbidity, and mortality of acute upper respiratory tract viral infections and the use of influenza vaccine. Influenza immunization rates by home ranged from 15.4 to 90% (mean 45%). There were no differences in the distribution of medical conditions by home. The highest immunization rates were seen in people with chest disease (77%), heart disease (60%), diabetes (56%), and those with three medical conditions (75%). There was an average of 0.7 upper respiratory episodes per bed per annum with a mortality of 3.4% (6/179). Half of all episodes were seen by a general medical practitioner and 81 of 90 (90%) referrals were prescribed antibiotics costing approximately 7.50 pounds per patient. Lower respiratory tract complications developed during 45 (25%) of 179 episodes including 3 of 12 coronavirus infections, 3 of 9 respiratory syncytial virus infections, 2 of 4 adenovirus infections, 1 of 11 rhinovirus infections, but none of 5 influenza infections. Respiratory infections were caused mostly by pathogens other than influenza virus during the influenza period documented nationally. This highlights the role of coronaviruses, respiratory syncytial virus, and unidentified agents in the elderly, and questions the assumptions made in American estimates on the impact of influenza and the value of influenza vaccines.


Tolerability of rofecoxib versus naproxen.


title: Management and prevention of SARS in China.

text: The case fatality was the lowest (3.8%) among 1512 cases with severe acute respiratory syndrome (SARS) in Guangdong Province, China. Rational use of corticosteroid, non-invasive ventilation and the integration of traditional Chinese medicine and modern medicine may partly have contributed to the lowest fatality figure. There was a close linkage between civet cats and humans in terms of transmission of SARS. Strict control of the wild-animal market may be significant in preventing a new outbreak of SARS this year.


title: Revised U.S. surveillance case definition for severe acute respiratory syndrome (SARS) and update on SARS cases--United States and worldwide, December 2003.

text: During the 2003 epidemic of severe acute respiratory syndrome (SARS), CDC and the Council of State and Territorial Epidemiologists (CSTE) developed surveillance criteria to identify persons with SARS. The surveillance case definition changed throughout the epidemic as understanding of the clinical, laboratory, and transmission characteristics of SARS-associated coronavirus (SARS-CoV) increased. On June 26, CSTE adopted a position statement to add SARS-CoV disease to the National Notifiable Disease Surveillance System (NNDSS). The position statement included criteria for defining a SARS case for national reporting. On November 3, CSTE issued a new interim position statement with a revised SARS case definition. This report summarizes the new U.S. surveillance case definition for SARS and updates reported cases of SARS worldwide and in the United States.


title: Genome-wide screen identifies host genes affecting viral RNA recombination.

text: Rapid evolution of RNA viruses with mRNA-sense genomes is a major concern to health and economic welfare because of the devastating diseases these viruses inflict on humans, animals, and plants. To test whether host genes can affect the evolution of RNA viruses, we used a Saccharomyces cerevisiae single-gene deletion library, which includes approximately 80% of yeast genes, in RNA recombination studies based on a small viral replicon RNA derived from tomato bushy stunt virus. The genome-wide screen led to the identification of five host genes whose absence resulted in the rapid generation of new viral RNA recombinants. Thus, these genes normally suppress viral RNA recombination, but in their absence, hosts become viral recombination "hotbeds." Four of the five suppressor genes are likely involved in RNA degradation, suggesting that RNA degradation could play a role in viral RNA recombination. In contrast, deletion of four other host genes inhibited virus recombination, indicating that these genes normally accelerate the RNA recombination process. A comparison of deletion strains with the lowest and the highest recombination rate revealed that host genes could affect recombinant accumulation by up to 80-fold. Overall, our results demonstrate that a set of host genes have a major effect on RNA virus recombination and evolution.


title: Monoclonal antibody, but not synthetic peptide, targeting the ectodomain of influenza B virus M2 proton channel has antiviral activity.

text: The proton channels of influenza A virus (A/M2) and influenza B virus (BM2) are essential for viral replication. Previously we have shown that monoclonal antibodies targeting the ectodomain of the A/M2 proton channel have antiviral activity in vitro. In this study, we generated both monoclonal antibody and phage displayed peptide against the eight amino acids comprising the ectodomain of the BM2 proton channel and investigated their antiviral activities in vitro. A cytopathic assay showed that the monoclonal antibody potently protected MDCK cells from homologous, but not heterologous, virus infections. A plaque forming assay showed that viral replication was not completely neutralized, but greatly inhibited, by the monoclonal antibody. In contrast, no antiviral activity was observed for the synthetic native or engineered peptides. These results indicate that antibody targeting the M2 proton channel is a promising therapeutic candidate for treating influenza virus infections, and that antibody structure is important for antiviral activity.


title: Streptococcal acute pharyngitis.

text: Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A β-hemolytic streptococci) is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-streptococcal glomerulonephritis. Symptom onset in streptococcal infection is usually abrupt and includes intense sore throat, fever, chills, malaise, headache, tender enlarged anterior cervical lymph nodes, and pharyngeal or tonsillar exudate. Cough, coryza, conjunctivitis, and diarrhea are uncommon, and their presence suggests a viral cause. A diagnosis of pharyngitis is supported by the patient's history and by the physical examination. Throat culture is the gold standard for diagnosing streptococcus pharyngitis. However, it has been underused in public health services because of its low availability and because of the 1- to 2-day delay in obtaining results. Rapid antigen detection tests have been used to detect S. pyogenes directly from throat swabs within minutes. Clinical scoring systems have been developed to predict the risk of S. pyogenes infection. The most commonly used scoring system is the modified Centor score. Acute S. pyogenes pharyngitis is often a self-limiting disease. Penicillins are the first-choice treatment. For patients with penicillin allergy, cephalosporins can be an acceptable alternative, although primary hypersensitivity to cephalosporins can occur. Another drug option is the macrolides. Future perspectives to prevent streptococcal pharyngitis and post-infection systemic complications include the development of an anti-Streptococcus pyogenes vaccine.


Japanese encephalitis in India.


title: Effect of pancreatic tissue sampling on serum pancreatic enzyme levels in clinically healthy dogs.

text: Little is known about the potential consequences of pancreatic tissue sampling in dogs. The goal of the present study was to evaluate changes in serum trypsin-like immunoreactivity and canine-specific pancreatic lipase after pancreatic fine-needle aspiration and surgical biopsy in 27 clinically healthy dogs. Presurgical, ultrasound-guided aspiration of the pancreas was performed with the dogs under sedation. Subsequently, all the dogs underwent intraoperative pancreatic fine-needle aspiration and clamshell biopsy. After euthanasia, pancreata were sectioned for histopathologic evaluation. Serum pancreatic enzyme levels were measured at 3 time points: baseline, after ultrasound-guided aspiration, and after intraoperative aspiration and biopsy. No significant differences were detected among mean serum pancreatic lipase values at any point (P > 0.05). Serum trypsin-like immunoreactivity did not change from baseline (18.2 +/- 2.1 microg/dl; mean +/- standard error) after ultrasound-guided aspiration (13.6 +/- 2.2 microg/dl) but increased significantly after intraoperative sampling (44.8 +/- 1.9 microg/dl; P < 0.0005). After surgical biopsy, the 20 dogs that had both ultrasound-guided and intraoperative sampling had a higher mean (SE) serum trypsin-like immunoreactivity (44.8 +/- 1.9 microg/dl) than the 7 dogs that had only intraoperative samples taken (36.4 +/- 4.1 microg/dl; P < 0.05). All 27 pancreata were grossly normal before intraoperative sampling. Pancreatic sampling was associated with increased serum trypsin-like immunoreactivity and mild, peracute necrosis, inflammation, hemorrhage, and fibrin deposition. Tissue damage from sampling was not sufficient to cause an elevation in canine-specific pancreatic lipase in the time frame evaluated. Further studies are needed to determine longer-term effects of pancreatic sampling on enzyme levels and clinical outcome.