title: Intestinal lesions containing coronavirus-like particles in neonatal necrotizing enterocolitis: an ultrastructural analysis.

text: Since the outbreaks of neonatal necrotizing enterocolitis occurring in maternity hospitals of Paris and suburbs in 1979-1980, it has been possible to examine by light and electron microscopy gut specimens from ten newborns with this illness. Coronavirus-like particles, enclosed in intracytoplasmic vesicles of damaged epithelial cells of the intestinal mucosa, were observed in the small intestine, appendix, and colon. The ultrastructural study, supported by bacteriologic findings, suggests the role of coronavirus-like particles in the appearance of the lesions. Secondary proliferation of mainly anaerobic bacteria, probably responsible for pneumatosis, may aggravate the disease.


title: New and emerging vaccination strategies for prevention and treatment of dermatological diseases.

text: Accelerated by the rapid advancements of our understanding of the molecular and cellular pathology of diseases and of the components and mechanisms of cellular and humoral immune responses, new vaccination strategies are being developed and explored for treatment and prevention of infectious diseases, cancer, autoimmune disorders and allergies. Many newly developed vaccination strategies are already in clinical trials, some with very promising results. Although most of these strategies are still at very early stages of their development, it is foreseeable that vaccination will evolve to play an important role in prevention, treatment and management of all the above classes of diseases.


title: Inhibition of severe acute respiratory syndrome-associated coronavirus infection by equine neutralizing antibody in golden Syrian hamsters.

text: Equine anti-severe acute respiratory syndrome-associated coronavirus F(ab')(2) has been verified to protect mice from infection with severe acute respiratory syndrome-associated coronavirus (SARS-CoV). However, before potential clinical application, the antibody needs to be tested in as many animal models as possible to ensure its safety and efficiency. In this study, after verification by various methods that the golden Syrian hamster constitutes a model susceptible to SARS-CoV infection, we confirmed that the antibody could protect animals completely from SARS-CoV infection in the preventive setting. More importantly, the antibody could reduce viral titers or copies by approximately 10(3)- to 10(4)-fold in animal lung after virus exposure, compared with negative control. These data provide further evidence to warrant clinical studies of this antibody in the treatment and prevention of SARS.


title: Induction of apoptosis in murine coronavirus-infected cultured cells and demonstration of E protein as an apoptosis inducer.

text: We demonstrated that infection of 17Cl-1 cells with the murine coronavirus mouse hepatitis virus (MHV) induced caspase-dependent apoptosis. MHV-infected DBT cells did not show apoptotic changes, indicating that apoptosis was not a universal mechanism of cell death in MHV-infected cells. Expression of MHV structural proteins by recombinant vaccinia viruses showed that expression of MHV E protein induced apoptosis in DBT cells, whereas expression of other MHV structural proteins, including S protein, M protein, N protein, and hemagglutinin-esterase protein, failed to induce apoptosis. MHV E protein-mediated apoptosis was suppressed by a high level of Bcl-2 oncogene expression. Our data showed that MHV E protein is a multifunctional protein; in addition to its known function in coronavirus envelope formation, it also induces apoptosis.


title: Serosurvey of free-ranging Amur tigers in the Russian Far East.

text: Wild Amur tigers (Panthera tigris altaica, n=44) from the Russian Far East were tested for antibodies to feline leukemia virus, feline corona virus (FCoV), feline immunodeficiency virus, feline parvovirus (FPV), canine distemper virus (CDV), Toxoplasma gondii, and Bartonella henselae. Antibodies to FCoV, CDV, FPV, and T. gondii were detected in 43, 15, 68, and 42% of tigers, respectively. No differences were detected in antibody prevalence estimates between tigers captured as part of a research program and those captured to mitigate human-tiger conflicts. Domestic dogs (Canis familiaris) were tested as a potential source for CDV; 16% were vaccinated against CDV and 58% of unvaccinated dogs were antibody positive for CDV. A high percentage of tigers were exposed to potential pathogens that could affect the survival of this species. We recommend continued monitoring of wild tigers throughout Asia, development of standardized sampling and postmortem examination procedures, and additional research to better understand potential domestic and wild animal sources for these pathogens.


title: Endovascular occlusion of dural cavernous fistulas through a superior ophthalmic vein approach.

text: Dural cavernous fistulas are low-flow vascular malformations with usually benign clinical course and a high rate of spontaneous resolution. Cases with symptom progression must be treated with an endovascular approach by arterial or venous route. We report 30 patients with dural cavernous fistulas treated by coil embolization using surgical exposure and retrograde catheterization of the superior ophthalmic vein (SOV). The procedure resulted in closure of the fistula without other endovascular treatments in all 30 patients and clinical remission or improvement in 20 and eight patients, respectively. Embolization via a SOV approach is a safe and easy endovascular procedure, particularly indicated for dural cavernous fistulas with exclusive or prevalent internal carotid artery feeders and anterior venous drainage.


title: Malignant catarrhal fever in a captive American bison (Bison bison) in Italy.

text: Malignant catarrhal fever (MCF) is a fatal, systemic disease of cattle and other domestic and wild ruminants that, in Europe, is caused by Ovine herpesvirus 2 (OvHV-2). American bison (Bison bison) are highly susceptible to the disease. An adult American bison, housed in a zoo in southern Italy in close cohabitation with a group of domestic sheep (Ovis aries aries) displayed clinical signs that resembled the acute form of MCF. By real-time polymerase chain reaction, OvHV-2 DNA was detected intravitam in blood, in nasal and ocular swabs, and postmortem in tissue samples of the bison. By indirect fluorescent antibody test, high MCF antibody titers were found in the bison serum. Ovine herpesvirus 2 DNA and antibodies were also found in blood samples from the domestic sheep, thus suggesting a potential role of these animals as a source of the infection. To the authors' knowledge, this is the first MCF case in captive ruminants in Italy and the second confirmed case in captive bison of European zoos.


title: Human antibodies from transgenic animals.

text: Laboratory mice provide a ready source of diverse, high-affinity and high-specificity monoclonal antibodies (mAbs). However, development of rodent antibodies as therapeutic agents has been impaired by the inherent immunogenicity of these molecules. One technology that has been explored to generate low immunogenicity mAbs for in vivo therapy involves the use of transgenic mice expressing repertoires of human antibody gene sequences. This technology has now been exploited by over a dozen different pharmaceutical and biotechnology companies toward developing new therapeutic mAbs, and currently at least 33 different drugs in clinical testing--including several in pivotal trials--contain variable regions encoded by human sequences from transgenic mice. The emerging data from these trials provide an early glimpse of the safety and efficacy issues for these molecules. Nevertheless, actual product approval, the biggest challenge so far, is required to fully validate this technology as a drug discovery tool. In the future, it may be possible to extend this technology beyond rodents and use transgenic farm animals to directly generate and produce human sequence polyclonal sera.


title: Analysis of the properties of neutralizing monoclonal antibodies against the hemagglutinating encephalomyelitis virus and inhibition of HEV infection by specific MAb.

text: Eleven monoclonal antibodies (MAbs) that were reactive against the hemagglutinating encephalomyelitis virus (HEV), as seen in the enzyme-linked immunosorbent assay, were obtained. All of these MAbs showed neutralizing activity (1:20,000 to 1:800,000) against the 67N strain of HEV. They also showed hemagglutination inhibition activity (1:400 to 1:409,600). Western blotting tests revealed that all of these 11 MAbs were specific for the S protein of HEV. All MAbs with neutralizing activity showed the same fluorescent staining pattern. Ten-day-old mice pups were immunized with MAb, inoculated with the 10(5) tissue culture-infective dose of HEV at 3 days after immunization, and then examined to determine the viral inhibition. The 1:800-diluted MAb120 inhibited the viral infection in mice pups, though the 1:1,000-diluted MAb120 failed to inhibit the viral infectivity. These MAbs would be a useful tool for rapid and specific diagnosis of HEV and also for antibody-based treatment of the disease.


docid: cvsysniv

title: SARS-CoV-2: a novel deadly virus in a globalised world.


title: A hypervariable region within the 3' cis-acting element of the murine coronavirus genome is nonessential for RNA synthesis but affects pathogenesis.

text: The 3' cis-acting element for mouse hepatitis virus (MHV) RNA synthesis resides entirely within the 301-nucleotide 3' untranslated region (3' UTR) of the viral genome and consists of three regions. Encompassing the upstream end of the 3' UTR are a bulged stem-loop and an overlapping RNA pseudoknot, both of which are essential to MHV and common to all group 2 coronaviruses. At the downstream end of the genome is the minimal signal for initiation of negative-strand RNA synthesis. Between these two ends is a hypervariable region (HVR) that is only poorly conserved between MHV and other group 2 coronaviruses. Paradoxically, buried within the HVR is an octanucleotide motif (oct), 5'-GGAAGAGC-3', which is almost universally conserved in coronaviruses and is therefore assumed to have a critical biological function. We conducted an extensive mutational analysis of the HVR. Surprisingly, this region tolerated numerous deletions, rearrangements, and point mutations. Most striking, a mutant deleted of the entire HVR was only minimally impaired in tissue culture relative to the wild type. By contrast, the HVR deletion mutant was highly attenuated in mice, causing no signs of clinical disease and minimal weight loss compared to wild-type virus. Correspondingly, replication of the HVR deletion mutant in the brains of mice was greatly reduced compared to that of the wild type. Our results show that neither the HVR nor oct is essential for the basic mechanism of MHV RNA synthesis in tissue culture. However, the HVR appears to play a significant role in viral pathogenesis.


title: Judicious use of antibiotics for common pediatric respiratory infections.

text: BACKGROUND Antibiotic resistance among common respiratory infection-producing bacteria such as Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis has become a major global public health problem. The use of antibiotics, whether or not medically justified for a particular illness, contributes to the development of resistant bacteria. To help to contain the proliferation of drug-resistant bacteria, members of the CDC and the American Academy of Pediatrics (AAP) recently published principles for the judicious use of antibiotics in common pediatric respiratory infections including the common cold, otitis media, sinusitis and tonsillopharyngitis. This article reviews the CDC/AAP principles for management of these illnesses and describes results of clinical practice studies in which efforts to improve the judicious use of antibiotics were undertaken. CONCLUSIONS The success of the CDC/AAP principles in containing the increase in antimicrobial resistance depends upon their being practiced. Results of clinical practice studies indicate that judicious use of antimicrobial therapy in pediatric respiratory infections can be realized through education and persistence. More widespread educational and behavior modification efforts are necessary to reduce unnecessary prescription of antibiotics and to curtail the still burgeoning problem of bacterial resistance.


SARS case-fatality rates.


title: Genetic variation of neurotropic and non-neurotropic murine coronaviruses.

text: The murine coronavirus strains MHV JMH, MHV 1, MHV 2, MHV 3 and MHV A 59 were tested for their neurovirulence in weanling rats. The strain JHM was found to be highly neurovirulent for weanling rats, whereas the other strains were not, or only slightly, neurovirulent. MHV 1 caused no lesions in weanling rats. The other strains (MHV 2, MHV 3 and MVH A59) induced predominantly subclinical infections in weanling rats as demonstrated by an increase of antibodies and inflammatory lesions in the liver. Analysis of these strains by cross-neutralization revealed variable degrees of antigenic relationship between these viruses which were not related to their neurovirulence. However, when these strains were compared by analysing the T1-RNase-resistant oligonucleotides of virion RNA, the highly neurovirulent strain JHM was found to differ significantly in its nucleotide sequence from the other less-neurovirulent strains.


title: Acute dystonia with low-dosage aripiprazole in Tourette's disorder.

text: OBJECTIVE To report a case of an acute dystonic episode in a patient with Tourette's disorder (TD) treated with the partial dopamine agonist aripiprazole. CASE SUMMARY An 18-year-old male with TD was prescribed aripiprazole 10 mg orally daily, which produced a significant improvement in his symptoms. However, after 3 days of treatment, he experienced an acute episode of dystonia with facial muscle spasm, oculogyric crisis, and torticolis. All symptoms resolved after a single intramuscular injection of biperidine 5 mg. The Naranjo probability scale indicated that the adverse events were probably caused by aripiprazole. DISCUSSION To our knowledge, as of this writing, this is the first report concerning an aripiprazole-induced dystonic episode in an adult, and it is especially notable because it occurred at low dosage. Aripiprazole is a dopamine partial agonist and a serotonin(2A) antagonist with a favorable adverse effect profile. Short-term clinical trials reported a very low incidence of extrapyramidal symptoms, with akathisia being the most common, although there have been reports of severe extrapyramidal symptoms in a 3-year-old child and in an adolescent with a previous history of such symptoms. CONCLUSIONS Acute dystonic phenomena may be caused by aripiprazole, although the drug's suggested mode of action largely precludes them.


title: Imbroglios of viral taxonomy: genetic exchange and failings of phenetic approaches.

text: The practice of classifying organisms into hierarchical groups originated with Aristotle and was codified into nearly immutable biological law by Linnaeus. The heart of taxonomy is the biological species, which forms the foundation for higher levels of classification. Whereas species have long been established among sexual eukaryotes, achieving a meaningful species concept for prokaryotes has been an onerous task and has proven exceedingly difficult for describing viruses and bacteriophages. Moreover, the assembly of viral "species" into higher-order taxonomic groupings has been even more tenuous, since these groupings were based initially on limited numbers of morphological features and more recently on overall genomic similarities. The wealth of nucleotide sequence information that catalyzed a revolution in the taxonomy of free-living organisms necessitates a reevaluation of the concept of viral species, genera, families, and higher levels of classification. Just as microbiologists discarded dubious morphological traits in favor of more accurate molecular yardsticks of evolutionary change, virologists can gain new insight into viral evolution through the rigorous analyses afforded by the molecular phylogenetics of viral genes. For bacteriophages, such dissections of genomic sequences reveal fundamental flaws in the Linnaean paradigm that necessitate a new view of viral evolution, classification, and taxonomy.


title: High genetic diversity, distant phylogenetic relationships and intraspecies recombination events among natural populations of Yam mosaic virus: a contribution to understanding potyvirus evolution.

text: To evaluate the genetic diversity and understand the evolution of Yam mosaic virus (YMV), a highly destructive pathogen of yam (Dioscorea sp.), sequencing was carried out of the C-terminal part of the replicase (NIb), the coat protein (CP) and the 3'-untranslated region (3'-UTR) of 27 YMV isolates collected from the three main cultivated species (Dioscorea alata, the complex Dioscorea cayenensis-Dioscorea rotundata and Dioscorea trifida). YMV showed the most variable CP relative to eight other potyviruses. This high variability was structured into nine distant molecular groups, as revealed by phylogenetic analyses and validated by assessment of the molecular evolutionary noise. No correlation was observed between the CP and 3'-UTR diversities and phylogenies. The most diversified and divergent groups included isolates from Africa. The remaining groups clustered in a single clade and a geographical distinction between isolates from the Caribbean, South America and Africa was observed. The role of the host in the selection of particular isolates was illustrated by the case of a divergent cultivar from Burkina Faso. Phylogenetic topological incongruence and complementary statistical tests highlighted the fact that recombination events, with single and multiple crossover sites, largely contributed to the evolution of YMV. We hypothesise an African origin of YMV from the yam complex D. cayenensis-D. rotundata, followed by independent transfers to D. alata and D. trifida during virus evolution.


title: Effectiveness of repeat angiographic assessment in patients designated for radioembolization using yttrium-90 microspheres with initial extrahepatic accumulation of technitium-99m macroaggregated albumin: a single center's experience.

text: PURPOSE To evaluate the efficacy of a workflow consisting of repeat assessment in patients planned for yttrium-90 ((90)Y) radioembolization in case of nontarget visceral technetium-99m ((99m)Tc)-macroaggregated albumin (MAA) accumulation despite initial prophylactic coil embolization of nonhepatic arteries. MATERIALS AND METHODS In 341 patients with primary and secondary liver cancer, pretreatment hepatic angiograms, as well as single-photon emission computed tomography coregistered with magnetic resonance imaging scans, were obtained. Extrahepatic tracer deposition was identified in 33 patients (9.7%) necessitating repeat assessment. Images were reviewed to correlate the site of MAA accumulation with causative gastrointestinal vessels, and repeat angiograms served as reference standard. RESULTS At repeat angiography, the source of extrahepatic flow was identified and eliminated in 31 of 33 patients (93.9%). In 20 patients (60.6%), successful embolization of nontarget vessels was achieved, in 13 patients (39.4%), MAA was administered more distally. Afterward, extrahepatic MAA deposition was eliminated in 30 patients (90.9%). CONCLUSION The algorithm of repeat assessment in case of extrahepatic MAA accumulation has proven highly effective to eliminate extrahepatic shunting, thus decreasing the risk of postradioembolization complications due to inadvertent visceral microsphere deposition.


title: Quantitation of antibody to non-hemagglutinating viruses by single radial hemolysis: serological test for human coronaviruses.

text: A single radial hemolysis test was developed for quantitation of specific antibody to non-hemagglutinating viruses. With the human coronaviruses as models, this test utilizes the binding properties of the chromic cation to attach viruses to glutaraldehyde-treated sheep erythrocytes. The most satisfactory system consisted of stabilizing washed sheep erythrocytes with 0.0073% glutaraldehyde for 15 min at 23 degrees C, binding a high concentration of virus to a 25% erythrocyte suspension with 0.0016% chromic chloride for 20 min at 23 degrees C, stopping the reaction with phosphate-saline, and finally mixing the treated, rewashed cells with complement and agarose at 45 degrees C to prepare a slide gel. The gel mix, which was dispensed in plastic plates (23 by 73 mm) in 3-ml volumes, consisted of 1% agarose, 0.1% sodium azide, 5% reconstituted complement, and 0.82% treated cells. Wells 2 mm in diameter were loaded with 5 mul of antiserum, incubated for 18 h at 4 degrees C for diffusion of antiserum and fixation of complement, and then incubated for 8 to 24 h at 37 degrees C for development of hemolysis zones. The diameter of a zone was linearly related to antibody concentration, as determined by conventional serological tests. This single radial hemolysis test was applicable to human and animal coronaviruses and to selected serotypes of the adenovirus, picornavirus, rhabdovirus, and rotavirus groups.


title: Pentoxifylline and severe acute respiratory syndrome (SARS): a drug to be considered.

text: UNLABELLED The recent outbreak of Severe Acute Respiratory Syndrome (SARS) as a new viral disease is causing a great concern for health authorities and general population. Very little is known about the infectious agent (a coronavirus) and its etiopathogeny, having no specific treatment yet. Proinflammatory cytokines released by stimulated macrophages in the alveoli could have a prominent role in pathogenesis of SARS. Current treatment of SARS with antiviral agents such as ribavirin and corticosteroids have not achieved very satisfactory results. Corticosteroids exert an antiinflammatory effect and are indicated for the treatment of respiratory distress, but, in the other hand, they exert an immunosuppressor effect on humoral and cellular arms of Immune System. Based on previous reports and on our own experience in HIV, we propose here pentoxifylline (PTX), a drug commonly used in vascular indications, as a possible treatment for SARS due to its interesting properties. PTX would feature a possible antiviral activity along with a well-known cytokine-modulating activity not as immunosuppressant as that of the corticoids, down-regulating proinflammatory cytokines but leaving functional the rest of the immune response. Other effects of PTX are discussed, as bronchodilation. CONCLUSIONS The antiinflammatory, antiviral, immunomodulatory and bronchodilatory effects of PTX, along with its low cost and toxicity, make it a promising drug to be considered for SARS treatment, alone or as an adjuvant therapy in combination with other drugs. The classical antiviral approach as single treatment for viral diseases should be reviewed in this occasion; immunomodulatory therapies could play an important role in SARS therapy.


title: State-specific prevalence and trends in adult cigarette smoking--United States, 1998-2007.

text: Cigarette smoking in the United States results in an estimated 443,000 premature deaths and $193 billion in direct health-care expenditures and productivity losses each year. During 2007, an estimated 19.8% of adults in the United States were current smokers. To update 2006 state-specific estimates of cigarette smoking, CDC analyzed data from the 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey and examined trends in cigarette smoking from 1998-2007. Results of these analyses indicated substantial variation in current cigarette smoking during 2007 (range: 8.7%-31.1%) among the 50 states, the District of Columbia (DC), Guam, Puerto Rico (PR), and the U.S. Virgin Islands (USVI). Trend analyses of 1998-2007 data indicated that smoking prevalence decreased in 44 states, DC, and PR, and six states had no substantial changes in prevalence after controlling for age, sex, and race/ethnicity. However, only Utah and USVI met the Healthy People 2010 target for reducing adult smoking prevalence to 12% (objective 27-1a). The Institute of Medicine (IOM) calls for full implementation of comprehensive, evidence-based tobacco control programs at CDC-recommended funding levels to achieve substantial reductions in tobacco use in all states and areas.


Guidelines for preventing health-care-associated pneumonia, 2003 recommendations of the CDC and the Healthcare Infection Control Practices Advisory Committee.


title: Gastrointestinal torsions and intussusception in northern koalas (Phascolarctos cinereus) at San Diego Zoo (1976-2012).

text: The recent classification as threatened status of the northern koala (Phascolarctos cinereus) by the Australian Government highlights the importance of the conservation and health management of this iconic Australian marsupial. This case series describes gastrointestinal torsion and intussusception in six northern koalas (three males, three females, 2-11 yr old) at the San Diego Zoo from 1976 to 2012. Two koalas died shortly after presentation. Diagnoses of ileocecal intussusception, resulting from enteritis in one case and cecal torsion in the other, were made at postmortem examination. One koala died 4 days after an exploratory laparotomy, with negative findings, and an acute double colonic intussusception was diagnosed at postmortem examination. Two small intestinal mesenteric torsion and one proximal colon mesenteric torsion cases were successfully corrected surgically. In the case of colonic mesenteric torsion, the koala had recurrent clinical signs 2 wk later, and a second surgery requiring resection and anastomosis of ischemic jejunum was performed, with the koala dying shortly afterward. One koala with small intestinal torsion had a recurrence of torsion 22 mo later and subsequently died. The koala with the second case of small intestinal torsion remains alive 14 mo postsurgical correction. All six koalas presented with signs of colic that included anorexia, lethargy, depression, acute abdominal distension, abdominal stretching, decreased fecal output, open-mouth gasping, or a combination of symptoms. Abdominal radiographs may show stacked gastrointestinal linear gas patterns and contrast stasis. Prevalence of torsion and intussusception is low at this institution (2%), although recurrence in individuals is common (50%) and overall survival is poor (83%), which emphasizes the importance of timely recognition, surgical correction, and postoperative management. While inciting etiologies were unable to be determined in these cases, monitoring generalized gastrointestinal health and differing Eucalyptus sp. effects on individual koala's gastrointestinal function, parasite control, and stress minimization through standardized husbandry practices are likely important.


title: Establishing a European network for wildlife health surveillance.

text: Surveillance of wildlife health in Europe remains informal and reporting wildlife diseases is not yet coordinated among countries. At a meeting in Brussels on 15 October 2009, delegates from 25 countries provided an overview of the current status of wildlife health surveillance in Europe. This showed that every year in Europe over 18,000 wild animals are examined as part of general surveillance programmes and over 50,000 wild animals are examined in the course of targeted surveillance. The participants at the Brussels meeting agreed to set up a European network for wildlife health surveillance. The goals of this network, which was established in February 2010, are to improve procedures for the rapid exchange of information, harmonise procedures for investigation and diagnosis of wildlife diseases, share relevant expertise, and provide training opportunities for wildlife health surveillance.


title: Technical evolution of laparoscopic hepatic resection: a single institutional experience.

text: PURPOSE Laparoscopic hepatic resection (LHR) is still a challenging and developing surgical modality because of technical difficulty and a lack of training opportunities and experience. In this study, we present the results of our initial experiences of LHR, focusing on technical evolution in the management of LHR. METHODS Between April 2011 and March 2012, a total of 12 LHRs were performed. The first 5 of these LHRs were performed under laparoscopic assistance (hybrid-LHR), while the last 7 LHRs were performed totally laparoscopically (pure-LHR). Indications for LHR were hepatocellular carcinoma (n = 9) and metastatic liver cancer (n = 3). LHR procedures consisted of partial resection (n = 2), left lateral segmentectomy (n = 2), and left lobectomy (n = 1) in the hybrid-LHR group, and partial resection (n = 4), left lateral segmentectomy (n = 2), and right lobectomy (n = 1) in the pure-LHR group. Operative outcomes were compared between the groups and technical modifications were evaluated. RESULTS The mean operative time, blood loss, and length of hospital stay in the hybrid- and pure-LHR groups were 3.8 and 6.1 hours, 220 and 611 ml, and 9.4 and 7.4 days, respectively. There were no postoperative complications in both groups. Tumor margins were negative in all cases. CONCLUSIONS LHR is a feasible and effective procedure for patients with various types of liver tumors, although technical challenges still need to be overcome.


RESPIRATORY virus vaccines.


title: Severe acute respiratory syndrome--Taiwan, 2003.

text: On April 22, 2003, the Taiwan Department of Health (DOH) was notified of seven cases of severe acute respiratory syndrome (SARS) among health-care workers (HCWs) at a large municipal hospital in Taipei (hospital A). Subsequent cases at eight hospitals have been associated with exposures at hospital A. Previously, all reported cases had been associated with persons recently returning to Taiwan from SARS-affected regions. This report summarizes epidemiologic findings of the outbreak in Taiwan and describes the impact of health-care--associated transmission of SARS.


title: Feasibility of near-infrared spectroscopic tomography for intraoperative functional cerebral monitoring: a primate study.

text: OBJECTIVE The wide-ranging manipulations to the cardiovascular system that frequently occur during cardiac surgery can expose the brain to variations in its blood supply that could prove deleterious. As a first step to developing a resource suitable for monitoring such changes, we detected the hemodynamic events induced in the brain of a primate model, using high-density near-infrared spectroscopy combined with tomographic reconstruction methods and validated the findings using established radiologic and histologic techniques. METHODS Continuous monitoring of the relative changes in the components of the cerebral hemoglobin signal was performed using high-density near-infrared spectroscopy (270 source-detector channel array) in anesthetized bonnet macaques with the brain exposed to induced ischemia and other acute events. A comparative analysis (exact binomial test) applied to reconstructed 3-dimensional images before and after the events and between cerebral hemispheres, combined with postprocedure magnetic resonance imaging, and postmortem histopathologic examination of the macaques' brains was performed to document and validate the spatial features revealed by the optical findings. RESULTS Relative changes in the measured and calculated components of the hemoglobin signal, in response to the performed manipulations, revealed substantial concurrence among the reconstructed 3-dimensional images, magnetic resonance imaging of the macaques' brains, and postmortem histopathologic examination findings. Concurrence was seen when the manipulated hemoglobin concentration and associated oxygenation levels were either increased or decreased, and whether they were bilateral or restricted to a specified hemisphere. CONCLUSIONS Continuous near-infrared spectroscopy tomography has been shown to accurately capture and localize cerebral ischemia, vasodilatation, and hemorrhage in primates in real time. These findings are directly applicable to clinical intraoperative functional cerebral monitoring.


title: COVID 19 diagnostic multiplicity and its role in community surveillance and control.

text: Diagnosis of persons exposed to/infected with severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) is central to controlling the global pandemic of COVID-19. Currently, several diagnostic modalities are available for COVID-19, each with its own pros and cons. Although there is a global consensus to increase the testing capacity, it is also essential to prudently utilize these tests to control the pandemic. In this paper, we have reviewed the current array of diagnostics for SARS-CoV-2, highlighted the gaps in current diagnostic modalities, and their role in community surveillance and control of the pandemic. The different modalities of COVID-19 diagnosis discussed are: clinical and radiological, molecular based (laboratory based and point-of-care), Immunoassay based (ELISA, rapid antigen and antibody detection tests) and digital diagnostics (artificial intelligence based algorithms). The role of rapid antigen/antibody detection tests in community surveillance has also been described here. These tests can be used to identify asymptomatic persons exposed to the virus and in community based seroprevalence surveys to assess the epidemiology of spread of the virus. However, there are few concerns about the accuracy of these tests which needs to evaluated beforehand.


title: Forecasting the effect of social distancing on COVID-19 autumn-winter outbreak in the metropolitan area of Buenos Aires.

text: Forecasting the extent of the domestic health risk of epidemics by mathematical modeling is a useful tool for evaluating the feasibility of policies for controlling outbreaks. The objective of this study was to develop a time-dependent dynamic simulation model to forecast the COVID-19 autumn-winter outbreak in the metropolitan area of Buenos Aires, and to assess the effect of social distancing on epidemic spread. The model used was the "Susceptible-Exposed-Infectious-Recovered" framework which incorporated appropriate compartments relevant to interventions such as quarantine, isolation and treatment. In a low-intervention scenario including only 2-week isolation for international travelers and their contacts, the model estimated a maximum peak of nearly 90 000 symptomatic cases for early May. For an intervention scenario with mandatory quarantine during a 5-month period, the curve of cases flattened and receded as the proportion of quarantined individuals increased. The maximum peak was expected to appear between May 8 and Jul 8 depending on the quarantine strategy, and the average number of infectious symptomatic cases were 46 840, 30 494, 23 164, 16 179, and 13 196 when 10%, 20%, 30%, 40%, and 50% of the population remained in a 5-month-term continuous quarantine, respectively. Only mandatory quarantine was able to delay the maximum peak of infection and significantly reduce the total number of infected individuals and deaths at a 150-day term. The interruption of the quarantine before 120 days of its beginning could generate an even more serious outbreak 30 days later, and surpass the scarce medical resources available for the intensive care of critically-ill patients.


title: [Human coronavirus infections: importance and diagnosis].

text: POORLY-KNOWN VIRUS: Coronaviruses, so named because of their sun-ray-like aspect, were discovered in the sixties. The biology of these RNA viruses is complex and poorly understood. KNOWN PATHOGENS: Coronaviruses are known pathogens in veterinary medicine, causing disease states in several domestic species. In human medicine, they can cause benign respiratory infections, but few laboratories include coronaviruses in their routine diagnostic tests. SUSPECTED PATHOGENS: There is some data in the literature suggesting coronaviruses might be implicated in more severe diseases including multiple sclerosis, necrotizing enterocolitis, and lower respiratory tract infections, particularly in infants. IMPROVING DIAGNOSTIC METHODS: Due to the lack of reliable and sensitive diagnostic techniques, it is impossible to date to correctly assess the medical impact of these ubiquitous and endemic viruses. Molecular biology techniques enabling detection of human coronavirus infections should be applied to verifying the suspected implication of these viruses in diverse disease states.


title: Oligomerization, transport, and Golgi retention of Punta Toro virus glycoproteins.

text: We have investigated the oligomerization and intracellular transport of the membrane glycoproteins of Punta Toro virus, a member of the Phlebovirus genus of the family Bunyaviridae, which is assembled by budding in the Golgi complex. By using one- or two-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis, chemical cross-linking, and sucrose gradient centrifugation, we found that the majority of the G1 and G2 glycoproteins are assembled into noncovalently linked G1-G2 heterodimers. At the same time, a fraction of the G2 protein, possibly produced independently of the G1 protein, is assembled into G2 homodimers. Kinetic analysis indicates that heterodimerization occurs between newly synthesized G1 and G2 within 3 min after protein synthesis, and that the G1 and G2 glycoproteins are associated as dimeric forms both during transport and after accumulation in the Golgi complex. Analysis of a G1-truncated G2 mutant, which is also targeted to the Golgi complex, showed that these molecules also assemble into dimeric forms, which are linked by disulfide bonds. Both the G1-G2 heterodimer and the G2 homodimer were found to be able to exit from the endoplasmic reticulum. Differences in transport kinetics observed for the G1 and G2 proteins may be due to the differences in the transport efficiency between the G1-G2 heterodimer and the G2 homodimer from the endoplasmic reticulum to the Golgi complex. These and previous results (S.-Y. Chen, Y. Matsuoka, and R.W. Compans, Virology 183:351-365, 1991) suggest that Golgi retention of the G2 homodimer occurs by association with the G1-G2 heterodimer, whereas the Golgi targeting of the G1-G2 heterodimer occurs by a specific retention mechanism.


title: The coronavirus infectious bronchitis virus nucleoprotein localizes to the nucleolus.

text: The coronavirus nucleoprotein (N) has been reported to be involved in various aspects of virus replication. We examined by confocal microscopy the subcellular localization of the avian infectious bronchitis virus N protein both in the absence and in the context of an infected cell and found that N protein localizes both to the cytoplasmic and nucleolar compartments.


title: How would schools step up public health measures to control spread of SARS?

text: The severe acute respiratory syndrome (SARS) is a rapidly progressive, and sometime fatal disease with more than 1800 patients in over a dozen countries in Asia, Europe, and North America (including the United States and Canada) within two months. On 12 March 2003, the World Health Organisation (WHO) issued a global alert about SARS so it became a global challenge. Strengthening the public health measures at schools would protect children as well as providing the students an opportunity to learn about infectious disease control through life event approach. The public health measures at schools include two important components: basic understanding of the disease so schools would put on high alert on caution cases, and the measures to improve environmental hygiene at schools and preventive measures to stop infectious disease transmission. This will help to empower the whole community the readiness to deal with other outbreaks in the future.


The spectacular recent trials of urgent neurointervention for acute stroke: fuel for a revolution.


title: Morphogenesis of Coronavirus HCoV-NL63 in Cell Culture: A Transmission Electron Microscopic Study.

text: NL63 (HCoV-NL63) is a recently discovered human coronavirus that causes respiratory disease in infants and young children. NL63 productively infects LLCMK2 cells and ciliated epithelial cells of human airway cell cultures. Transmission electron microscopic (TEM) studies of NL63 infected LLCMK2 cells revealed that virions are spherical, spiked, and range from 75 to 115 nm in diameter. Virus replication predominantly occurs on the rough endoplasmic reticulum (RER), both perinuclear and cytoplasmic, and the Golgi. Plasma membrane budding was occasionally observed. As virus production increased, aberrant viral forms appeared with greater frequency. Unusual inclusions were present in infected cells including tubular and laminated structures. Pleomorphic double membrane-bound vesicles (DMV), measuring roughly 140 to 210 nm in diameter, were observed. The virus was released via exocytosis and cell lysis. In summary, we report the key morphologic characteristics of NL63 infection observed by TEM analysis.


title: Effect of actinomycin D on simian rotavirus (SA11) replication in cell culture.

text: Rotaviruses are the major cause of viral diarrhea in humans and animals. Actinomycin D (Act D) is an antibiotic that intercalates DNA and therefore inhibits DNA-dependent transcription. The current study was carried out to assess the influence of Act D on the replication of simian rotavirus (SA11) in cell culture. Virus-infected MA-104 cell cultures were studied in the presence of Act D at concentrations of 1.25 and 2.5 microg/ml. Treatment of rotavirus-infected cells with 2.5 microg/ml Act D 48 h post-infection reduced the cytoplasmic metachromasia after staining with acridine orange by 25%. Viral RNA labeled with 3H-uridine in the presence of the drug was separated by polyacrylamide gel electrophoresis. Viral RNA replication was not affected by Act D, but increased 3H-uridine uptake was demonstrable by infected cells in the presence of the drug. This possibly was due to the inhibition of cellular RNA synthesis by Act D, which thus enhances incorporation of the radionuclide into the viral RNA. Act D reduced the number of infected cells presenting virus-specific fluorescence 48 h post-infection by more than 50%. These data suggest that Act D may have complexed with viral RNA and prevented newly synthesized mRNA from being translated, but may not have prevented early replication.


Express delivery.


Diseases of the respiratory system.


Epigenetic factors influencing the morphogenesis of primary neural cell cultures and the concomitant effects on establishing JHMV infections.


title: Clinical experience with treatment of melioidosis in children.

text: We describe the treatment and follow-up results of 30 children with culture-proven melioidosis seen during 1994-1999. Twelve patients had septicemia, and 18 patients had localized infection. Ceftazidime with or without trimethoprim-sulfamethoxazole were used for the acute treatment of severe melioidosis. Oral trimethoprim-sulfamethoxazole was given in the eradication phase in 4 patients with septicemia and in 12 patients for the treatment of localized infection. Trimethoprim-sulfamethoxazole in combination with doxycycline were given to 4 patients, whereas doxycycline alone was given to 2 patients older than 8 years old. No serious adverse reaction was reported. Three patients died suddenly. Twenty-five patients could be followed up; 24 patients were well.


Location of antigenic sites of the S-glycoprotein of transmissible gastroenteritis virus and their conservation in coronaviruses.


title: Transcriptional regulation of cytosol and membrane alanyl-aminopeptidase in human T cell subsets.

text: Aminopeptidase inhibitors strongly affect the proliferation and function of immune cells in man and animals and are promising agents for the pharmacological treatment of inflammatory or autoimmune diseases. Membrane alanyl-aminopeptidase (mAAP) has been considered as the major target of these anti-inflammatory aminopeptidase inhibitors. Recent evidence also points to a role of the cytosol alanyl-aminopeptidase (cAAP) in the immune response. In this study we used quantitative RT-PCR to determine the mRNA expression of both cAAP and mAAP in resting and activated peripheral T cells and also in CD4+, CD8+, Th1, Th2 and Treg (CD4+ CD25+) subpopulations. Both mAAP and cAAP mRNAs were expressed in all cell types investigated, and in response to activation their expression appeared to be upregulated in CD8+ cells, but downregulated in Treg cells. In CD4+ cells, mAAP and cAAP mRNAs were affected in opposite ways in response to activation. The cAAP-specific inhibitor, PAQ-22, did not affect either cAAP or mAAP expression in activated CD4+ or CD8+ cells, whereas in activated Treg cells it markedly upregulated the mRNA levels of both aminopeptidases. The non-discriminatory inhibitor, phebestin, significantly increased the amount of mAAP and cAAP mRNA in CD4+ and that of cAAP in Treg cells.


Pancytopenia and haemorrhage in young beef calves.


title: Molecular basis of the variation exhibited by avian infectious bronchitis coronavirus (IBV).

text: IBV serotype-specific, virus neutralising (VN) antibody is induced by the S1 subunit of the spike (S) glycoprotein. A Portuguese isolate (Port/322/85) is considered to be an in vivo recombinant. VN tests showed that it belongs to the Massachussetts (Mass) serotype. Correspondingly, the sequence of S1 and S2 was extremely similar to that of older Mass isolates. However, the matrix (M) glycoprotein and upstream gene sequences were atypical of these Mass strains and more closely resembled other serotypes isolated in Europe. The recombination event had occurred within the sequence between the M and S genes (corresponding to mRNA 3) or near the 3' terminus of the S2 gene.


title: Successful treatment of suspected organizing pneumonia in a patient with Middle East respiratory syndrome coronavirus infection: a case report.

text: A 54-year-old man with Middle East respiratory syndrome coronavirus (MERS-CoV) infection was transferred to our hospital. We initiated anti-viral drugs and supportive care. The patient's fever and chills disappeared 3 days after admission and the results of serial follow-up reverse transcription-polymerase chain reaction testing for MERS-CoV was negative soon thereafter. He was discharged from the hospital 14 days after admission with no symptoms; however, he presented with a fever 7 days after discharge and was re-hospitalized. Chest radiographs showed newly developed consolidative opacity. His fever persisted for 3 days after commencing empirical antibiotics. Subsequent contrast-enhanced computed tomography (CT) of the chest showed focal patchy airspace consolidation and ground-glass opacities (GGOs) in a subpleural lesion of the right lower and left upper lobes, which was indicative of organizing pneumonia. We initiated empirical corticosteroid treatment for this illness, and his fever markedly subsided 1 day later. A chest radiograph showed improvement in the lung lesions, and he was discharged from the hospital 10 days after re-admission. The corticosteroid dose was gradually tapered over 2 months at the outpatient clinic, and a follow-up CT scan showed complete resolution of the consolidation and GGOs.


Studies of rhinoviruses and coronaviruses at the Common Cold Unit, Salisbury, Wiltshire.


title: Upper respiratory infection of lactating sows with transmissible gastroenteritis virus following contact exposure to infected piglets.

text: Ten breeding sows were left in direct contact with their newborn piglets that had been experimentally infected with transmissible gastroenteritis (TGE) virus. All sows became infected with the virus. The sows developed fever and showed mild clinical signs of the disease for a few days. The sows excreted virus in the nasal secretion, feces, and milk during the acute febrile phase of illness. Virus was isolated from the nasal secretion of one sow as early as 20 hours after contact exposure to the infected piglets. At necropsy, the virus was more frequently isolated from the tissues of the upper respiratory tract than from small intestines; this finding indicated that the TGE coronavirus replicated in the upper respiratory tract and induced an acute respiratory infection in susceptible adult swine. Neutralizing antibody was present in the sera 8 sows after 12 to 36 days during the convalescent period. From these results, we conclude that susceptible sows in direct contact with ill piglets can become infected and by excreting virus can serve as a source of TGE virus for other susceptible pigs on the premises.


docid: mhtzsovl

title: Pandemic influenza in a southern hemisphere setting: the experience in Peru from May to September, 2009.

text: This paper presents a description of Peru s experience with pandemic H1N1 influenza 2009. It is based on data from four main surveillance systems: a) ongoing sentinel surveillance of influenza-like illness cases with virological surveillance of influenza and other respiratory viruses; b) sentinel surveillance of severe acute respiratory infections and associated deaths; c) surveillance of acute respiratory infections in children under the age of five years and pneumonia in all age groups; and d) case and cluster surveillance. On 9 May 2009, the first confirmed case of pandemic H1N1 influenza in Peru was diagnosed in a Peruvian citizen returning from New York with a respiratory illness. By July, community transmission of influenza had been identified and until 27 September 2009, a total of 8,381 cases were confirmed. The incidence rate per 10,000 persons was 4.4 (in the 0-9 year-olds) and 4.1 (in the 10-19 year-olds). During epidemiological weeks (EW) 26 to 37, a total of 143 fatal cases were notified (a case fatality of 1.71%, based on confirmed cases). The maximum peak in the number of cases was reached in EW 30 with 37 deaths. Currently, the impact of the pandemic in the Peruvian population has not been too severe, and fortunately, healthcare centres have not been overwhelmed. However, the future of this pandemic is uncertain and despite the fact that our country has not been seriously affected, we should be prepared for upcoming pandemic waves.


title: Recombinant infectious bronchitis coronavirus Beaudette with the spike protein gene of the pathogenic M41 strain remains attenuated but induces protective immunity.

text: We have replaced the ectodomain of the spike (S) protein of the Beaudette strain (Beau-R; apathogenic for Gallus domesticus chickens) of avian infectious bronchitis coronavirus (IBV) with that from the pathogenic M41 strain to produce recombinant IBV BeauR-M41(S). We have previously shown that this changed the tropism of the virus in vitro (R. Casais, B. Dove, D. Cavanagh, and P. Britton, J. Virol. 77:9084-9089, 2003). Herein we have assessed the pathogenicity and immunogenicity of BeauR-M41(S). There were no consistent differences in pathogenicity between the recombinant BeauR-M41(S) and its apathogenic parent Beau-R (based on snicking, nasal discharge, wheezing, watery eyes, rales, and ciliostasis in trachea), and both replicated poorly in trachea and nose compared to M41; the S protein from the pathogenic M41 had not altered the apathogenic nature of Beau-R. Both Beau-R and BeauR-M41(S) induced protection against challenge with M41 as assessed by absence of recovery of challenge virus and nasal exudate. With regard to snicking and ciliostasis, BeauR-M41(S) induced greater protection (seven out of nine chicks [77%]; assessed by ciliostasis) than Beau-R (one out of nine; 11%) but less than M41 (100%). The greater protection induced by BeauR-M41(S) against M41 may be related to the ectodomain of the spike protein of Beau-R differing from that of M41 by 4.1%; a small number of epitopes on the S protein may play a disproportionate role in the induction of immunity. The results are promising for the prospects of S-gene exchange for IBV vaccine development.


On enteropathogenic bovine coronavirus.


title: A killer mimotope with therapeutic activity against AIDS-related opportunistic micro-organisms inhibits ex-vivo HIV-1 replication.

text: OBJECTIVE To verify whether a synthetic therapeutic killer decapeptide (KP), a functional mimotope of a yeast killer toxin with wide-spectrum microbicidal activity, inclusive of AIDS-related opportunistic micro-organisms, through interaction with beta-glucan receptors, which has been found to possess sequence homology with critical segments in gp160 V1/V2 and V3 loops, may also be inhibiting HIV-1 replication. METHODS Primary peripheral blood mononuclear cells (PBMCs) cultures established from HIV-1-infected patients were treated with KP in comparison with zidovudine and supernatants and cells were harvested for analysis of HIV RNA and proviral contents, respectively. Virus production in exogenous in-vitro PBMCs infection with lymphocytotropic and monocytotropic HIV-1 strains was also assessed in presence of KP by enzyme-linked immunosorbent assay HIV p24 gag antigen detection. The binding affinity of KP to CD4, CCR5 and CXCR4 was evaluated on CD4-CCR5 or CD4-CXCR4 transfected astroglioma cell lines. RESULTS KP was shown to be devoid of cytotoxicity on PBMCs and to inhibit HIV-1 replication in PBMCs of a patient in the acute phase of infection. The antiretroviral activity of KP, which proved to be more potent than zidovudine at micromolar concentrations, is abolished by beta 1,3-glucan but not by beta 1,6-glucan. Down-regulation of CCR5 co-receptor, and/or physical block of the gp120-receptor interaction are possible mechanisms of KP activity. CONCLUSION KP appears to be the first antibody-derived short peptide displaying an inhibitory activity against HIV-1 and related opportunistic micro-organisms by different mechanisms of action.


docid: faytwljd

title: Determination of the functions of the putative metal-binding domain of the SCV helicase.


title: Isolation of enteric pathogens from bats in Trinidad.

text: Bats are one of the most widely distributed mammals in the world, and they are reservoirs or carriers of several zoonoses. Bats were trapped in 27 geographic locations across Trinidad and Tobago, and following euthanasia, gastrointestinal tracts were aseptically removed. Contents were subjected to bacteriologic analysis to detect Salmonella spp., Escherichia coli, and Campylobacter spp. Isolates of Salmonella were serotyped, and E. coli isolates were screened for O157 strains and antimicrobial sensitivity to eight antimicrobial agents; phenotypic characteristics also were determined. Of 377 tested bats, representing 12 species, four bats (1.1%) were positive for Samonella spp, 49 (13.0%) were positive for E. coli, and no bats were positive for E. coli O157 strain or Campylobacter spp. Isolated serotypes of Salmonella included Rubislaw and Molade, both from Noctilio leporinus, a fish-eating bat, Caracas recovered from Molossus major, and Salmonella Group I from Molossus ater, both insect-eating bats. Of the 49 isolates of E. coli tested, 40 (82%) exhibited resistance to one or more antimicrobial agents, and the prevalence of resistant strains was comparatively high to erythromycin (61%) and streptomycin (27%) but lower to gentamycin (0%) and sulphamethozaxole/trimethoprim (2%).


docid: juwbnuqg

title: The influence of the host cell and trypsin treatment on bovine coronavirus infectivity.


title: Expression of the S1 and S2 subunits of murine coronavirus JHMV spike protein by a vaccinia virus transient expression system.

text: The spike (S) protein of murine coronavirus JHMV, variant cl-2, comprises two polypeptides, N-terminal S1 (with an N-terminal signal peptide) and C-terminal S2 (with a C-terminal transmembrane domain). In order to express these subunits, we constructed three different vaccinia virus transfer vectors (VV-TVs) containing cDNAs encoding the S1 protein without a transmembrane domain (pSFS1utt), the S1 protein with a C-terminal transmembrane domain derived from S2 (pSFS1tmd) or the S2 protein with an N-terminal signal peptide derived from S1 (pSFssS2). The S1 and S2 proteins were expressed in DBT cells by infection with vaccinia virus and transfection of these VV-TVs. In cells transfected with the pSFS1utt and pSFS1tmd, 96K and 106K proteins, respectively, were detected by Western blotting. The ssS2 protein expressed by pSFssS2 was 96K, which was slightly larger than the authentic S2 protein. The S1utt and S1tmd proteins were shown by binding studies using a panel of monoclonal antibodies to be antigenically indistinguishable from the authentic S1 protein. The S1tmd and ssS2 proteins were detected on the cell surface by immunofluorescence, whereas the S1utt protein was not. However, when the S1utt protein was expressed together with the ssS2 protein, the S1utt was detected on the cell membrane. This suggested that the S1utt was associated with ssS2 on the cell membrane. These observations indicate that the expressed S1 and S2 proteins associated in a similar manner to the authentic S1 and S2 proteins produced in DBT cells infected with cl-2. However, cell fusion was not observed in cells expressing either S1 or S2 nor in cells coexpressing both S1 and S2, although the whole S protein expressed by VV-TV did induce fusion.


title: Bedside management of an abdominal wound containing an enteroatmospheric fistula: a case report.

text: Enteroatmospheric fistulae (EAF) - unnatural connections between the bowel and the outside environment - are a feared complication of major abdominal operations. EAF pose a life-threatening risk to patients already weakened by surgical insult by altering fluid and electrolyte balance and fostering malnutrition. The authors describe a method of wound management for a 64-year-old morbidly obese woman with a history of coronary artery disease, diabetes mellitus, and bipolar disorder who developed a large abdominal wound containing multiple high-output EAF after an incarcerated abdominal hernia repair, wound infection, and subsequent laparotomy and lysis of adhesions followed by graft placement and negative pressure wound therapy. The volume, consistency, and location of the EAF caused commercial negative pressure devices to fail and simple gauze dressings were ineffective in maintaining a clean wound base and containing odor. Effluent collection and wound healing was achieved utilizing a modified method of EAF management that included two connecting rubberized catheter drains and continuous wound irrigation with wall suction and cotton gauze for debridement. Surgical EAF closure was successful after 6 months of care. This method provided a satisfactory balance between the diagnosis of EAF and the readiness to meet the physiologic demands of definitive surgical treatment.


title: The Global Public Health Intelligence Network and early warning outbreak detection: a Canadian contribution to global public health.

text: The recent SARS epidemic has renewed widespread concerns about the global transmission of infectious diseases. In this commentary, we explore novel approaches to global infectious disease surveillance through a focus on an important Canadian contribution to the area--the Global Public Health Intelligence Network (GPHIN). GPHIN is a cutting-edge initiative that draws on the capacity of the Internet and newly available 24/7 global news coverage of health events to create a unique form of early warning outbreak detection. This commentary outlines the operation and development of GPHIN and compares it to ProMED-mail, another Internet-based approach to global health surveillance. We argue that GPHIN has created an important shift in the relationship of public health and news information. By exiting the pyramid of official reporting, GPHIN has created a new monitoring technique that has disrupted national boundaries of outbreak notification, while creating new possibilities for global outbreak response. By incorporating news within the emerging apparatus of global infectious disease surveillance, GPHIN has effectively responded to the global media's challenge to official country reporting of outbreak and enhanced the effectiveness and credibility of international public health.


title: Role of cell culture for virus detection in the age of technology.

text: Viral disease diagnosis has traditionally relied on the isolation of viral pathogens in cell cultures. Although this approach is often slow and requires considerable technical expertise, it has been regarded for decades as the "gold standard" for the laboratory diagnosis of viral disease. With the development of nonculture methods for the rapid detection of viral antigens and/or nucleic acids, the usefulness of viral culture has been questioned. This review describes advances in cell culture-based viral diagnostic products and techniques, including the use of newer cell culture formats, cryopreserved cell cultures, centrifugation-enhanced inoculation, precytopathogenic effect detection, cocultivated cell cultures, and transgenic cell lines. All of these contribute to more efficient and less technically demanding viral detection in cell culture. Although most laboratories combine various culture and nonculture approaches to optimize viral disease diagnosis, virus isolation in cell culture remains a useful approach, especially when a viable isolate is needed, if viable and nonviable virus must be differentiated, when infection is not characteristic of any single virus (i.e., when testing for only one virus is not sufficient), and when available culture-based methods can provide a result in a more timely fashion than molecular methods.


title: Mechanics of Wound Closure: Emerging Tape-Based Wound Closure Technology vs. Traditional Methods.

text: To date, there is still a lack of understanding of how wound closure methods perform comparatively under daily bodily movement during the course of healing and how they affect the mechanics of healing. The present study is a first step in understanding and objectively quantifying the gap. The study provides both a new method of metrology for noninvasive evaluation of skin mechanics at the onset of wound healing and an emerging tape-based wound closure technology. The latter shows better performance with respect to commonly used staples and sutures, holding the wound intact and providing uniform mechanical support across the incision.


Why study global health?


title: The N-terminal domain of the murine coronavirus spike glycoprotein determines the CEACAM1 receptor specificity of the virus strain.

text: Using isogenic recombinant murine coronaviruses expressing wild-type murine hepatitis virus strain 4 (MHV-4) or MHV-A59 spike glycoproteins or chimeric MHV-4/MHV-A59 spike glycoproteins, we have demonstrated the biological functionality of the N-terminus of the spike, encompassing the receptor binding domain (RBD). We have used two assays, one an in vitro liposome binding assay and the other a tissue culture replication assay. The liposome binding assay shows that interaction of the receptor with spikes on virions at 37 degrees C causes a conformational change that makes the virions hydrophobic so that they bind to liposomes (B. D. Zelus, J. H. Schickli, D. M. Blau, S. R. Weiss, and K. V. Holmes, J. Virol. 77: 830-840, 2003). Recombinant viruses with spikes containing the RBD of either MHV-A59 or MHV-4 readily associated with liposomes at 37 degrees C in the presence of soluble mCEACAM1(a), except for S(4)R, which expresses the entire wild-type MHV-4 spike and associated only inefficiently with liposomes following incubation with soluble mCEACAM1(a). In contrast, soluble mCEACAM1(b) allowed viruses with the MHV-A59 RBD to associate with liposomes more efficiently than did viruses with the MHV-4 RBD. In the second assay, which requires virus entry and replication, all recombinant viruses replicated efficiently in BHK cells expressing mCEACAM1(a). In BHK cells expressing mCEACAM1(b), only viruses expressing chimeric spikes with the MHV-A59 RBD could replicate, while replication of viruses expressing chimeric spikes with the MHV-4 RBD was undetectable. Despite having the MHV-4 RBD, S(4)R replicated in BHK cells expressing mCEACAM1(b); this is most probably due to spread via CEACAM1 receptor-independent cell-to-cell fusion, an activity displayed only by S(4)R among the recombinant viruses studied here. These data suggest that the RBD domain and the rest of the spike must coevolve to optimize function in viral entry and spread.


title: The complication of coinfection.

text: Infectious disease remains one of the largest burdens on humankind. Even with modern medical and public health standards, infectious disease remained the No. 1 killer worldwide at the turn of the century. Often, the most costly disease burdens come from multiple infections at once, i.e., coinfection. Influenza, an annual infection often considered relatively harmless, can increase susceptibility to both deadly bacterial pneumonia and childhood ear infections. Major health threat HIV rarely kills a patient on its own, but instead allows for opportunistic infections and re-emergence of infections such as tuberculosis. What generates these unique relationships is not well understood; herein, we examine in detail three types of coinfection and the unique interactions between infectious agents as well as with the host in each setting. We also begin to address how we may aid further understanding of coinfection and what questions need to be addressed to help direct future treatments.


docid: gcdhtdpn

title: Diagnostic value and safety of long-term video-EEG monitoring.

text: This paper aimed to assess the usefulness and safety of video-EEG (video-electroencephalography) monitoring in patients with refractory epilepsy. We analysed the video-EEG recordings of consecutive patients over a 3-year period from 2002 to 2005. The pre-admission diagnosis, demographic information, number of ictal episodes, adverse events, and final diagnosis were recorded in all patients. The diagnostic labels before and after monitoring were compared in order to assess whether it had led to a change in diagnosis and management. Of the 100 patients who underwent video-EEG, 227 clinical events were recorded in 62 cases. The most common events were complex partial seizures followed by non-epileptic attacks. Video-EEG allowed a diagnosis to be made in 81 patients and the diagnosis at discharge was altered in 19 cases. Major injuries and status epilepticus did not occur during monitoring. In our experience video-EEG is safe and provides important clinical information in over 80% of patients.


title: Reducing outbreaks: using international governmental risk pools to fund research and development of infectious disease medicines and vaccines.

text: The deadliest Ebola outbreak the world has ever seen is currently ravaging West Africa, despite the concerted efforts of the World Health Organization and many national governments. The current picture is troubling, but not altogether unexpected. Ebola was initially identified in 1976, and since that time, few drugs have been developed to combat it. The same is true for myriad other dangerous infectious diseases to which the world is currently susceptible. One proposal that might prevent outbreaks of this scale and magnitude from recurring would be to have the World Health Organization (WHO) and its technical partners assess which of its member states are at high risk for a disease, either directly or indirectly, and facilitate the creation of international governmental risk pools of those member states. Risk pools would offer open-indexed grant contracts to fund vaccine and drug development for a particular disease, and pharmaceutical companies could browse the index to apply for these grants. If the risk-pool states and a particular company sign a contract, a mutually agreed upon amount of the vaccine or drug would be produced at a below-market purchase price for those states. In return, the company would keep any patents or intellectual property rights for the developed vaccines or drugs. Risk-pool countries that did not use their vaccine or drug could resell that supply on secondary markets to other countries outside of the risk pool. This arrangement will increase the supply of tested drug and vaccine candidates available for combatting unexpected outbreaks of any previously discovered major infectious disease in the future.


title: [Dromedary camels and Middle East respiratory syndrome: MERS coronavirus in the 'ship of the desert'].

text: Middle East respiratory syndrome coronavirus (MERS-CoV) is a novel coronavirus, identified in patients with respiratory symptoms in the Middle East. Accumulating evidence points to dromedary camels as being reservoirs. MERS-CoV has been isolated from dromedaries, and dromedary MERS-CoV is nearly identical to human MERS-CoV. Camel and human MERS-CoV genome sequences from the same geographic areas cluster together. Both on the Arabian Peninsula and in Africa high percentages of adult dromedaries are seropositive for MERS-CoV. Young dromedaries (≤ 2 years) are more often acutely infected than adult camels. This means that the risk of human infection may be higher in camel breeding season (spring) when more naïve camels are present. Antibodies appeared to be present in dromedaries as early as 1992, while the first case in humans was recognised in 2012. Underdiagnosis, differences in risk profile, or subtle differences in the genetic make-up of MERS-CoV may explain the absence of MERS in humans before 2012, and in Africa.


title: Round pneumonia: a rare condition mimicking bronchogenic carcinoma. Case report and review of the literature.

text: CONTEXT Round pneumonia is a condition usually described in children, with few reports addressing adult patients. It is an oval-shaped consolidation that, due to its radiological appearance, simulates bronchogenic carcinoma. Its evolution tends to be benign, although diagnostic dilemmas have sometimes required exploratory thoracotomy. Deaths caused by this condition have even been reported. To the best of our knowledge, there have been 31 previous cases of round pneumonia in adults reported in the English and Portuguese-language literature, of which only one was completely asymptomatic. CASE REPORT The case of a 54-year-old female patient presenting a lung mass found on routine imaging evaluation is reported. Respiratory symptoms and signs were absent, but the patient had a significant history of smoking. Her physical examination gave normal results. On chest radiographs, a mass located in the middle third of the right lung was observed. Three weeks after the initial evaluation, the patient was admitted for a complete evaluation and for staging of a pulmonary malignancy, but repeated chest radiographs showed complete resolution.


title: Primary and secondary structural elements required for synthesis of barley yellow dwarf virus subgenomic RNA1.

text: Barley yellow dwarf luteovirus (BYDV) generates three 3'-coterminal subgenomic RNAs (sgRNAs) in infected cells. The promoter of sgRNA1 is a putative hot spot for RNA recombination in luteovirus evolution. The sgRNA1 transcription start site was mapped previously to either nucleotide 2670 or nucleotide 2769 of BYDV genomic RNA (gRNA) in two independent studies. Our data support the former initiation site. The boundaries of the sgRNA1 promoter map between nucleotides 2595 and 2692 on genomic RNA. Computer prediction, phylogenetic comparison, and structural probing revealed two stem-loops (SL1 and SL2) in the sgRNA1 promoter region on the negative strand. Promoter function was analyzed by inoculating protoplasts with a full-length infectious clone of the BYDV genome containing mutations in the sgRNA promoter. Because the promoter is located in an essential coding region of the replicase gene, we duplicated it in a nonessential part of the genome from which a new sgRNA was expressed. Mutational analysis revealed that secondary structure, but not the nucleotide sequence, was important at the base of SL1. Regions with both RNA primary and secondary structural features that contributed to transcription initiation were found at the top of SL1. Primary sequence, but not the secondary structure, was required in SL2, which includes the initiation site. Disruption of base pairing near the sgRNA1 start site increased the level of transcription three- to fourfold. We propose that both primary and secondary structures of the sgRNA1 promoter of BYDV play unique roles in sgRNA1 promoter recognition and transcription initiation.


title: Nursing and infection-control issues during high-frequency oscillatory ventilation.

text: OBJECTIVES To review the specific nursing and infection-control issues that arise during the care of patients receiving high-frequency oscillatory ventilation (HFOV). DATA SOURCE Published articles, governmental guidelines, and hospital procedures and practices. DATA SUMMARY Nurses, respiratory therapists, and other clinicians caring for patients receiving HFOV need to be aware of specific differences in patient assessment, including close observation for symmetric chest-wall vibrations. In addition, management of sedation with or without neuromuscular blockade and effective communication with the patients are essential nursing skills needed with the use of HFOV. From an infection-control standpoint, HFOV is considered a high-risk respiratory procedure because of the inability to effectively filter all respiratory secretions. Appropriate infection-control precautions, including patient location and use of personal protective equipment, need to be considered when implementing HFOV in the intensive care unit. CONCLUSIONS Important infection-control and nursing issues exist that are specific to the use of HFOV. These issues should be addressed with appropriate staff education before the implementation of HFOV in an intensive care unit.


title: Spontaneous exocrine pancreas hypoplasia in specific pathogen-free C3HeB/FeJ and 101/H mouse pups causes steatorrhea and runting.

text: Under specific pathogen-free conditions, 1.3% to 1.8% of litters born in our inbred 101/H and C3HeB/FeJ mouse colonies had pups with steatorrhea and runting. Clinically affected male and female pups were first identified when they were from 14 to 25 d old. Unaffected littermates were healthy and were weaned successfully. Postmortem findings in 8 clinically affected mice included a small, poorly differentiated exocrine pancreas comprising cytokeratin-negative duct-like structures but lacking recognizable acinar cells with their normal carboxypeptidase B-positive zymogen granules. Endocrine pancreas islets were unremarkable and contained insulin-positive beta cells and glucagon-positive alpha cells. There was mild inflammation of the hindgut but no evidence of intestinal pathogens or marked inflammation or necrosis of pancreas, either alone or as part of a multisystemic inflammatory condition. Sera from pups in 4 affected litters did not contain antibodies to reovirus 3, mouse coronavirus, rotavirus, or mouse adenovirus 2. Furthermore, 4 sets of parental mice and sentinel mice from the facility were negative for 13 viruses, bacteria, and parasites. C3HeB/FeJ and 101/H inbred strains may be genetically predisposed because the steatorrhea and runting was absent in 13 other mouse strains and subspecies bred in the specific pathogen-free facility. This condition resembles exocrine pancreas hypoplasia, but the inheritance is complex. A wider implication is that runting coupled with steatorrhea are phenotypic criteria to suspect pancreatic disease that could be used in the context of a mouse N-ethyl-N-nitrosourea-mutagenesis program to identify potential mutants with defects in pancreas development.


title: Functional analysis of an epitope in the S2 subunit of the murine coronavirus spike protein: involvement in fusion activity.

text: The monoclonal antibody (MAb) 5B19.2, which has virus-neutralizing and fusion inhibition activities, binds to an epitope (S2A) consisting of nine hydrophobic amino acids in the S2 subunit of the mouse hepatitis virus (MHV) spike (S) protein. This suggests that the S2A epitope may be involved in binding the virus to the MHV receptor and/or in virus-cell fusion. Co-immunoprecipitation analyses demonstrated that while the binding of virus to the receptor was blocked by anti-S1 MAbs, it was not blocked by the S2A antiserum, indicating that S2A was not involved in receptor-binding. The S proteins prepared in this study with mutations in the S2A epitope were either fusogenic or non-fusogenic and their fusogenicity did not correlate with the hydrophobic feature of the S2A epitope. All of these wt and mutated S proteins were similarly transported onto the cell membrane independent of their fusogenicity capability. These results suggest that S2A may mediate the fusion activity of the MHV S protein during virus entry into cells.


title: Virucidal efficacy of physico-chemical treatments against coronaviruses and parvoviruses of laboratory animals.

text: Virucidal efficacy of chemical disinfectants, heating and ultraviolet radiation against mouse hepatitis virus (MHV), canine coronavirus (CCV), Kilham rat virus (KRV) and canine parvovirus (CPV) were examined. Coronaviruses (MHV and CCV) were inactivated by ethanol, isopropanol, benzalkonium chloride, iodophor, sodium hypochlorite, sodium chlorite, cresol soap and formaldehyde as well as by heating at 60 degrees C for 15 minutes, whereas parvoviruses (KRV and CPV) appeared to be inactivated by disinfectants such as formaldehyde, iodophor, sodium hypochlorite and sodium chlorite. Parvoviruses were stable under heating of up to 80 degrees C for 30 minutes. Ultraviolet radiation inactivated all viruses within 15 minutes. No significant differences in stability against physico-chemical treatments were seen between viruses in the same group.


title: Ultrasound-guided carotid sheath block for carotid endarterectomy: a case series of the spread of injectate.

text: INTRODUCTION We aimed to show the spread of local anesthetic following an ultrasound-guided, double-injection technique of a carotid sheath block before carotid endarterectomy. METHODS The study included 15 patients scheduled for elective carotid endarterectomy. The carotid sheath block was performed after ultrasound-guided localization of the carotid bifurcation (level C4-C6) at the posterior border of the sternocleidomastoid muscle. A mix of 7.5 mL ropivacaine 0.75%, 7.5 mL prilocaine1% and 3 mL iopromidum was injected at the base of the carotid bifurcation. An additional 15 mL of the mixture was administered subcutaneously at the surgical incision line. Thirty minutes after the block, a computed tomography scan of the head, neck region and upper thorax was performed to reconstruct a 3-D distribution of the injectate. RESULTS All patients achieved C2-C4 dermatomal sensory blockade. None required conversion to general anesthesia. The injectate spread ranged from the vertebral body of C1 to the vertebral body of T3. The mean volume of distribution was 97±13 mL, the craniocaudal spread 138±19 mm, dorsoventral 57±8 mm and coronal 53±8 mm. The mean carotid artery circumference contact was 252°±77, with four patients (27%) presenting with a ring formation (360°) around the carotid artery. CONCLUSIONS Ultrasound-guided carotid sheath block provided an extensive spread of local anesthetic. A complete ring formation of local anesthetic around the artery does not seem necessary for a successful anesthesia. The resulting nerve blockade thus appears sufficient for surgery, with minor risks compared to blind methods.


title: [Association of coronavirus infection with hemorrhagic entercolitis in newborn infants].

text: The existence of a widely spread corona virus epidemic enabled us to associate this infection with necrotizing hemorrhagic enterocolitis in newborn infants. Virus is detected in the stools by direct electron microscopic examination. Virions are found agglutinated in the gut during convalescence, as they are by circulating antibodies. Arguments supporting a possible etiological role of this infection are given.


title: Global budgets and provider incentives: hospitals' drug expenditures in Taiwan.

text: PURPOSE This chapter examines how drug prescribing behavior in Taiwanese hospitals changed after the government changed reimbursement systems. In 2002, Taiwan instituted a system in which hospitals are reimbursed for drug expenditures at full price from a fixed global budget before the remaining budget is allocated to reimburse all other expenditures, often at discounted prices. Providers are thus given a financial incentive to increase prescriptions. METHODOLOGY We isolate the effect of this system from that of other confounding factors by estimating a difference-in-difference model to analyze monthly drug expenditures of hospital departments for outpatients during the years 1999-2006. FINDINGS Our results suggest that hospital departments which use drugs more heavily as part of their regular medical care increased their drug prescription expenditures after the implementation of the global budget system. In addition, we find that the response was stronger among for-profit than not-for-profit and public hospitals. IMPLICATIONS Hospital doctors responded to the financial incentive created by the particular global budgeting system adopted in Taiwan by increasing expenditures on drug treatments for outpatients.


docid: esupqnvl

title: Laparoscopic Completion Pancreatectomy for Local Recurrence in the Pancreatic Remnant after Pancreaticoduodenectomy: Case Reports and Review of the Literature.


docid: roynxciv

title: [The incidence and prevention of severe acute respiratory syndrome in 81 hemodialysis units in Beijing].

text: OBJECTIVE To study the situation of severe acute respiratory syndrome (SARS) infection in the hemodialysis units in Beijing. METHODS Eighty-one hemodialysis units were investigated on the incidence and preventive measures for SARS from March to July 2003 by a standardized investigation form. RESULTS (1) Seven hemodialysis patients were diagnosed as SARS clinically and account for 0.24% of total 2885 hemodialysis patients in these units in Beijing. Among the 7 SARS patients, 3 recovered from SARS and 4 died. No case was infected within the hemodialysis units. No SARS case or suspected case was found in the health care workers in hemodialysis units. (2) Additional disinfected measures were carried out in all the hemodialysis units. 98.8% (80/81) of them did not reuse the dialyzer. (3) 98.8% (80/81) of the hemodialysis units developed education about preventing SARS among hemodialysis patients. Before dialysis treatment patients must take temperature, change specific clothes and shoes in over 90% of the hemodialysis units. (4) All health care workers in the hemodialysis units wore hats and gauze masks and 93.7% (74/79) of them wore gloves. Eye shield was worn in 22.8% (18/79) of the dialysis units centers. CONCLUSIONS No ARS case was infected within the hemodialysis units in Beijing. Intensified disinfection of surroundings, self-protection for health care workers and education for patients in personal hygiene habit may be helpful to prevention of SARS in hemodialysis units.


title: Site-specific alteration of transmissible gastroenteritis virus spike protein results in markedly reduced pathogenicity.

text: The pathogenicity of neutralization-resistant mutants of the enteric coronavirus transmissible gastroenteritis virus (TGEV) was examined in the newborn piglet. The parental virus (Purdue-115 strain), as well as several mutants selected using monoclonal antibodies (MAbs) directed to antigenic sites A and B, caused an acute enteritis with 100% mortality. By contrast, most of the site D (MAb 40.1) mutants exhibited a strongly reduced enteropathogenicity, leading to the survival of animals inoculated with up to 1000-fold the 100% lethal dose of parental virus. Such a phenotypical change was correlated with point mutations or a small deletion, all located within the S gene sequence coding for the Pro-145 to Cys-155 segment of the mature polypeptide. These observations suggest that an N-terminal subregion of the S molecule is an essential determinant for pathogenesis in TGEV infection.


The haemagglutinin of bovine coronavirus exhibits significant similarity to the haemagglutinin of type C influenza virus.


Severe acute respiratory syndrome: patients were epidemiologically linked.


title: Stenosis of a colorectal anastomosis solved by transanal endoscopic microsurgery combined with laparoscopy.

text: OBJECTIVE The objective of this case report is to present a minimally invasive technique for solving an anastomotic colorectal stenosis using Transanal Endoscopic Microsurgery (T.E.M.) in combination with laparoscopy. SUMMARY Often a re-intervention is indicated for the resolution of an anastomotic (sub-) obstruction. This re-intervention is associated with the morbidity and mortality of a laparotomy and a prolonged hospital stay. In the case here presented, a 68-year-old man underwent a laparoscopic rectosigmoid resection for a rectal adenocarcinoma. An end-to-end circular stapled colorectal anastomosis was performed. At first without any postoperative problems, the patient presented with a stenosis of the anastomosis 6 months postoperatively. This stenosis did not result in a total obstruction but was sufficiently advanced to cause faecal impaction and discomfort, which was confirmed using a retrograde gastrografine bowel study. Colonoscopic dilatations were insufficient and after several days the patient experienced a recurrence of the original stenosis. A minimally invasive re-intervention with T.E.M. was performed in combination with laparoscopy to solve the stenosis. To our knowledge, this technique has not yet been described. CONCLUSION In this paper we describe a possible minimally invasive technique to avoid laparotomy after colorectal or colo-anal anastomotic stenosis. Both the duration of the hospital stay and patient morbidity can be reduced in this way.


title: [Expression of SARS coronavirus nucleocapsid protein and construction of its DNA vaccine].

text: AIM To express the nucleocapsid (N) protein of SARS coronavirus (SARS-CoV) in E. coli and construct its DNA vaccine. METHODS The prokaryotic expression vector pQEN containing N gene was constructed and transformed into the E. coli. The recombinant N protein was then expressed and purified by Ni(2+)-NTA affinity resin. In addition, the N gene was cloned into the eukaryotic expression plasmid pSecTagB and the eukaryotic recombinant expression vector pSecN was obtained. The DNA vaccine pSecN was injected to immunize the BALB/c mice to produce the antiserum against N protein of SARS-CoV. Subsequently, the reactivity of the antiserum with recombinant N protein and SARS-CoV particles was assayed by ELISA. RESULTS Recombinant N protein reacted strongly and specifically with the sera from immunized mice and SARS patients. Similarly, the sera of immunized mice could also react specifically with SARS-CoV particles. CONCLUSION The recombinant N protein could be used as a good antigen to detect SARS. The DNA vaccine pSecN could also efficiently induce the production of IgG against N protein of SARS-CoV, which offered clues to the development of a potential DNA vaccine.


title: Location of antigenic sites defined by neutralizing monoclonal antibodies on the S1 avian infectious bronchitis virus glycopolypeptide.

text: Neutralizing monoclonal antibodies directed against five antigenic sites on the spike (S) S1 glycopolypeptide of avian infectious bronchitis virus (IBV) were used to select neutralization-resistant variants of the virus. By comparing the nucleotide sequence of such variants with the sequence of the IBV parent strain, we located five antigenic sites on the amino acid sequence of the S1 glycopolypeptide. The variants had mutations within three regions corresponding to amino acid residues 24 to 61, 132 to 149 and 291 to 398 of the S1 glycopolypeptide. The location of three overlapping antigenic sites on the IBV spike protein was similar to the location of antigenic sites on the spike protein of other coronaviruses.


title: Causal factors of acute gastroenteritis in infants and young children.

text: Respiratory, gastrointestinal and skin diseases represent the most common diseases in infants and young children. Causal factors of these diseases are important infectious agents and causes of pathological conditions in children, but they are also very important for their parents, as well as for people in their close environment. Greater incidence of infections in infants and young children can be explained in different ways. A cause can be insufficient maturity of their immune system, but also their exposure to infections within collective accommodations (cribs, nurseries, pre-school institutions), where they are, at the same time, exposed to a number of unknown agents. Today, a great emphasis is devoted to the ways and kinds of children's nutrition. The problem of relation between infected young organism and infectious agent itself, is also reflected in a long resistance and excretion of microorganisms in their exterior environment. It is well-known that microorganisms resist and excrete much longer in younger organisms, compared to adults, where their resistance and excretion is much shorter or very rare. Actually, adults have already formed protective immunity against particular infectious agents. It doesn't prevent infections in adults, colonization of pathogens, nor eventual development of disease. Established immunity can shorten the time necessary for excretion of microorganisms in their exterior environment and, if disease gets developed, it is of shorter duration and slower progress.


Sedation and Analgesia in Unconscious Palliative Care Patients: Can Bispectral Index monitoring add to our understanding?


Monitoring global health: time for new solutions.


docid: jcubgccl

title: Porcine respiratory coronavirus: molecular features and virus-host interactions.

text: Since 1984, a previously unrecognized respiratory coronavirus, causing a mostly unapparent infection, has rapidly and massively spread within the swine population in Europe, and few years later, a virus with similar characteristics has been identified in the USA. The agent, designated PRCV, appears to be derived from the porcine enteric coronavirus TGEV. The aim of the present article is to review comprehensively the state of the knowledge about this new virus and its infection. The review includes the following topics: epizootiology, molecular characterization and antigenic features of PRCV, pathogenesis and clinical aspects, immunity and laboratory diagnosis. The authors' views concerning the impact of the emergence of PRCV on both coronavirus research and swine production are presented in the conclusion.


title: Enhancement of passive immunity with maternal vaccine against newborn calf diarrhea.

text: The effects of a maternal vaccine against newborn calf diarrhea associated with group A bovine rotavirus (BRV), bovine coronavirus (BCV), bovine parvovirus and K99 Escherichia coli (E. coli) were examined on a beef cow-calf herd. After vaccination, serum or colostrum antibody titers to BRV, BCV and E. coli K99 in the vaccinated cows were significantly higher than those in unvaccinated control cows. Serum antibody titers to BRV, BCV and E. coli K99 in calves from the vaccinated cows were also significantly higher than those in calves from the control cows for 3-4 weeks after birth. These results suggested that the immunization of cows with the maternal vaccine enhanced the passive immunity levels in calves against BRV, BCV and K99 E. coli.


title: Treatment of lung tumours with high-energy microwave ablation: a single-centre experience.

text: The purpose of our study is to report safety, technical success, effectiveness, local progression-free survival (LPFS) and overall survival of percutaneous microwave ablation (MWA) to treat lung tumours unsuitable for surgery. Nineteen patients with thirty-one tumours (mean diameter 2.4 cm) underwent percutaneous MWA in 28 sessions. Microwave ablation was carried out using a 2450-MHz generator (Emprint/Covidien, Boulder, CO, USA). Procedures were performed under cone-beam CT (CBCT) and under fluoro-CT (one session) guidance. Safety, technical success, effectiveness, LPFS and overall survival (OS) were evaluated. Safety was defined as the frequency of major and minor complications. The efficacy was evaluated on the basis of imaging characteristics, using RECIST criteria. CT follow-up was performed at 1, 3 and 6 months and yearly. LPFS was defined as the interval between MWA treatment and evidence of local recurrence, if there was any. OS was defined as the percentage of patients who were still alive. We registered one major complication (purulent hydro-pneumothorax). Minor complications were spontaneously resolved (pneumothorax and perilesional haemorrhagic effusion). Technical success was 100%. Residual disease was registered in two cases, one of whom was retreated. Complete ablation was obtained in the remaining cases (90.3%). During available follow-up (mean 9.6 months), 9/31 tumours demonstrated local recurrence. Five tumours were retreated, and none of them presented residual disease during follow-up (LPFS 22.6%). Overall survival was 93.8%. Percutaneous high-energy MWA is a safe, effective and confident technique to treat lung tumours not suitable for surgery.


title: Socio-economic status over the life-course and depressive symptoms in men and women in Eastern Europe.

text: OBJECTIVE Research into social inequalities in depression has studied western populations but data from non-western countries are sparse. In this paper, we investigate the extent of social inequalities in depression in Eastern Europe, the relative importance of social position at different points of the life-course, and whether social patterning of depression differs between men and women. METHOD A cross-sectional study examined 12,053 men and 13,582 women in Russia, Poland and the Czech Republic. Depressive symptoms (16 or above on the CESD-20) were examined in relation to socio-economic circumstances at three phases of the life-course: childhood (household amenities and father's education); own education; current circumstances (financial difficulties and possession of household items). RESULTS Pronounced social differences in depression exist in men and women throughout Eastern Europe. Depression was largely influenced by current circumstances rather than by early life or education, with effects stronger in Poland and Russia. Odds ratios in men for current disadvantage were 3.16 [95% CI: 2.57-3.89], 3.16 [2.74-3.64] and 2.17 [1.80-2.63] in Russia, Poland and the Czech Republic respectively. Social variables did not explain the female excess in depression, which varied from 2.91 [2.58-3.27] in Russia to 1.90 [1.74-2.08] in Poland. Men were more affected by adult disadvantage than women, leading to narrower sex differentials in the presence of disadvantage. LIMITATIONS Cross-sectional data with recall of childhood conditions were used. CONCLUSION Current social circumstances are the strongest influence on increased depressive symptoms in countries which have recently experienced social changes.


title: Single-port access total laparoscopic hysterectomy for stage 1A1 cancer of the cervix.

text: We describe the first case of single-port access total laparoscopic hysterectomy with intracorporeal suturing of the vault performed in Singapore. A 40-year-old woman with microinvasive squamous cell carcinoma of the cervix successfully underwent single-port access total laparoscopic hysterectomy. Unique articulated and multifunction laparoscopic instruments were used to complete the surgery in 118 minutes, with no complications. The patient had minimal pain postoperatively and recovered uneventfully within two weeks. This case illustrates the benefits of single-port access laparoscopic surgery in well-selected cases.


Bovine respiratory disease.


The hazards of a practicing respirologist.


title: Quaternary structure, substrate selectivity and inhibitor design for SARS 3C-like proteinase.

text: The SARS coronavirus 3C-like proteinase is recognized as a potential drug design target for the treatment of severe acute respiratory syndrome. In the past few years, much work has been done to understand the catalytic mechanism of this target protein and to design its selective inhibitors. The protein exists as a dimer/monomer mixture in solution and the dimer was confirmed to be the active species for the enzyme reaction. Quantitative dissociation constants have been reported for the dimer by using analytic ultracentrifuge, gel filtration and enzyme assays. Though the enzyme is a cysteine protease with a chymotrypsin fold, SARS 3C-like proteinase follows the general base catalytic mechanism similar to chymotrypsin. As the enzyme can cut eleven different sites on the viral polyprotein, the substrate specificity has been studied by synthesized peptides corresponding or similar to the cleavage sites on the polyprotein. Predictive model was built for substrate structure and activity relationships and can be applied in inhibitor design. Due to the lack of potential drugs for the treatment of SARS, the discovery of inhibitors against SARS 3C-like proteinase, which can potentially be optimized as drugs appears to be highly desirable. Various groups have been working on inhibitor discovery by virtual screening, compound library screening, modification of existing compounds or natural products. High-throughput in vitro assays, auto-cleavage assays and viral replication assays have been developed for inhibition activity tests. Inhibitors with IC50 values as low as 60 nM have been reported.


title: Diathermy in perioperative practice.

text: Diathermy has revolutionised modern surgery and is an important tool for efficient and safe surgical practice. It has evolved to become the modern day scalpel, being used for cutting and coagulating tissues. This article addresses the functioning and safe use of diathermy in the perioperative setting. The various precautionary checks before surgery, which are prerequisite for safe usage, are highlighted along with the necessary safety drills during and after operation. A specific note is included about the use of electrical equipment in specialised surgeries like cardiac and laparoscopic surgery. The issues regarding the maintenance and repair of equipment are acknowledged and finally, the anticipation for a future with precise and safer cutting and coagulation devices is addressed.