title: Human umbilical cord blood-derived stromal cells: multifaceted regulators of megakaryocytopoiesis.

text: It has been demonstrated that stromal cell precursors exist in human umbilical cord blood. After being cultured in vitro, these cells are called human umbilical cord blood-derived stromal cells (hUCBDSCs). However, the role of hUCBDSCs in hematopoiesis is still unclear. We have previously shown that hUCBDSCs are superior to human bone marrow stromal cells (hBMSCs) at enhancing the expansion of megakaryocyte colony forming units (CFU-Meg). Based on this observation, we postulated that hUCBDSCs might promote megakaryocytopoiesis. to test this hypothesis, we developed a megakaryocyte/hUCBDSC co-culture model and a hematopoietic microenvironment injury model in nude mice. We explored the ability and mechanisms by which hUCBDSCs promoted the proliferation of megakaryocytes in vitro, and we also explored their capacity to restore the hematopoietic microenvironment in vivo. As expected, hUCBDSCs were more efective than hBMSCs at enhancing the proliferation of megakaryocyte lines from HeL cells and restoring megakaryocytopoiesis in a hematopoietic microenvironment injury model in nude mice. thrombopoietin (tpo) and stromal cell derived factor-1 (SDF-1) are two of the key factors underlying this capacity. We also found that gap junction intercellular communication (GJIC) between HeL cells and hUCBDSCs might be partially absent. our data provide the first evidence that hUCBDSCs play a regulatory role during megakaryocytopoiesis, which might be important for designing treatments for patients with megakaryocytic injury.


title: Effects of an epitope-specific CD8+ T-cell response on murine coronavirus central nervous system disease: protection from virus replication and antigen spread and selection of epitope escape mutants.

text: Both CD4(+) and CD8(+) T cells are required for clearance of the murine coronavirus mouse hepatitis virus (MHV) during acute infection. We investigated the effects of an epitope-specific CD8(+) T-cell response on acute infection of MHV, strain A59, in the murine CNS. Mice with CD8(+) T cells specific for gp33-41 (an H-2D(b)-restricted CD8(+) T-cell epitope derived from lymphocytic choriomeningitis glycoprotein) were infected with a recombinant MHV-A59, also expressing gp33-41, as a fusion protein with enhanced green fluorescent protein (EGFP). By 5 days postinfection, these mice showed significantly (approximately 20-fold) lower titers of infectious virus in the brain compared to control mice. Furthermore mice with gp33-41-specific CD8(+) cells exhibited much reduced levels of viral antigen in the brain as measured by immunohistochemistry using an antibody directed against viral nucleocapsid. More than 90% of the viruses recovered from brain lysates of such protected mice, at 5 days postinfection, had lost the ability to express EGFP and had deletions in their genomes encompassing EGFP and gp33-41. In addition, genomes of viruses from about half the plaques that retained the EGFP gene had mutations within the gp33-41 epitope. On the other hand, gp33-41-specific cells failed to protect perforin-deficient mice from infection by the recombinant MHV expressing gp33, indicating that perforin-mediated mechanisms were needed. Virus recovered from perforin-deficient mice did not exhibit loss of EGFP expression and the gp33-41 epitope. These observations suggest that the cytotoxic T-cell response to gp33-41 exerts a strong immune pressure that quickly selects epitope escape mutants to gp33-41.


title: On board.

text: A&E sister Vicky Hamer was among emergency staff at Hope Hospital, Salford, who featured in a BBC One fly-onthe-wall documentary series, Trauma, this summer. Over the four weeks' filming staff came close to having to divert ambulances due to capacity problems and had to manage several suspected cases of severe acute respiratory syndrome (SARS). Ms Hamer said: 'It made us realise how well we worked together and it was good to reflect on that.'


title: Experimental infection of young rabbits with a rabbit enteric coronavirus.

text: The clinical signs and lesions caused by the rabbit enteric coronavirus (RECV) were studied in young rabbits orally inoculated with a suspension containing RECV particles. The inoculated animals were observed daily for evidence of diarrhea. Fecal samples and specimens from the small intestine and from the gut associated lymphoid tissue (GALT) were collected from 2 h to 29 days postinoculation (PI) and processed for immune electron microscopy (IEM) and light microscopy. Coronavirus particles were detected in the cecal contents of most inoculated animals from 6 h to 29 days PI. Lesions were first observed 6 h PI and were characterized by a loss of the brush border of mature enterocytes located at the tips of intestinal villi and by necrosis of these cells. At 48 h PI, short intestinal villi and hypertrophic crypts were noted. In the GALT, complete necrosis of the M cells as well as necrosis of the enterocytes lining the villi above the lymphoid follicules with hypertrophy of the corresponding crypts were observed in all the animals. Five inoculated rabbits had diarrhea three days PI. The presence of RECV particles in the feces of the sick animals and the microscopic lesions observed in the small intestine suggested that the virus was responsible for the clinical signs. A few inoculated rabbits remained free of diarrhea. Fecal material collected at postmortem examination contained RECV particles. The results suggest that the virus could also produce a subclinical infection.


title: Asthma fatalities at the Emergency Department of the Singapore General Hospital.

text: BACKGROUND Bronchial asthma is one of the most common chronic diseases in Singapore and the prevalence is increasing. Despite this, the worldwide mortality rate from asthma has been noted to be low at an average of 2.0 per 100,000 people in developed countries such as the United States. Risk factors for fatal asthma attacks that have been described include excessive use of short acting beta-agonists, errors in clinical judgement, poor compliance, psychosocial disorders, use of three or more groups of asthma medication and indicators of asthma severity. AIM We aim to study the incidence of asthma deaths occurring in the emergency department of a tertiary care hospital in Singapore. METHODS Of the total number of patients at the Department of Emergency Medicine in Singapore General Hospital from January 1999 to June 2005, eight fatalities were attributed to exacerbation of bronchial asthma. The characteristics of these patients are described. RESULTS A low incidence of asthma-related deaths is found in Singapore.


title: Infectious bronchitis virus S2 expressed from recombinant virus confers broad protection against challenge.

text: We developed a recombinant Newcastle disease virus (NDV) LaSota (rLS) expressing the infectious bronchitis virus (IBV) S2 gene (rLS/IBV.S2). The recombinant virus showed somewhat-reduced pathogenicity compared to the parental lentogenic LaSota strain but effectively elicited hemagglutination inhibition antibodies against NDV and protected chickens against lethal challenge with virulent NDV/CA02. IBV heterotypic protection was assessed using a prime-boost approach with a commercially available attenuated IBV Massachusetts (Mass)-type vaccine. Specific-pathogen-free chickens primed ocularly with rLS/IBV.S2 at 4 days of age and boosted with Mass at 18 days of age were completely protected against challenge at 41 days of age with a virulent Ark-type strain. In a second experiment, we compared protection conferred by priming with rLS/IBV.S2 and boosting with Mass (rLS/IBV.S2+Mass) versus priming and boosting with Mass (Mass+Mass). We also modified the timing of vaccination to prime at 1 day of age and boost at 12 days of age. Challenge with virulent Ark was performed at 21 days of age. Based on clinical signs, both vaccinated groups appeared equally protected against challenge compared to unvaccinated challenged chickens. Viral loads in lachrymal fluids of birds receiving rLS/IBV.S2+Mass showed a clear tendency of improved protection compared to Mass+Mass; however, the difference did not achieve statistical significance. A significant difference (P < 0.05) was determined between these groups regarding incidence of detection of challenge IBV RNA in the trachea; viral RNA was detected in 50% of rLS/IBV.S2+Mass-vaccinated chickens while chickens vaccinated with Mass+Mass and unvaccinated challenged controls showed 84 and 90% incidence of IBV RNA detection in the trachea, respectively. These results demonstrate that overexposing the IBV S2 to the chicken immune system by means of a vectored vaccine, followed by boost with whole virus, protects chickens against IBV showing dissimilar S1.


title: Rapid diagnostic assays in the genomic biology era: detection and identification of infectious disease and biological weapon agents.

text: In this special section of BioTechniques, we examine the role of rapid molecular technologies in the detection and identification of agents of infectious disease (ID) and biological weapons (BWs). Besides the threat posed by the global proliferation of BW technologies, there are numerous emerging and reemerging ID agents with significant public health consequences. Further compounding this already complicated situation are the estimated 600 million international tourists annually, many with the potential to the spread disease globally in a matter of hours. While clinical laboratories have key roles in the detection and identification of potential ID/BW agents, most staff are unfamiliar with these agents because of their rarity and the often laborious conventional methodologies needed to identify them. To meet this challenge, a vast array of rapid assay strategies has been developed for use in clinical diagnostics and environmental detection. Technologies have been developed or adapted to the challenges posed by these agents, permitting detection and identification in several minutes to hours. In particular, the development of improved reagents and detection systems has led to dramatic improvements in the sensitivity and specificity of immunological and nucleic acid-based systems, allowing an ever-increasing range of analytes to be identified and quantitated. In the accompanying articles, we have brought together experts from the many overlapping aspects of this arena in order to present a comprehensive and critical analysis of these technologies.


title: In situ hybridization: detecting viral nucleic acid in formalin-fixed, paraffin-embedded tissue samples.

text: In situ hybridization is a method for detecting specific nucleic acid sequences within individual cells. This technique permits visualization of viral nucleic acid or gene expression in individual cells within their histologic context. In situ hybridization is based on the complementary binding of a labeled nucleic acid probe to complementary sequences in cells or tissue sections, followed by visualization of target sequences within the cells. It has been used widely for the detection of viral nucleic acid sequences within individual cells. This review will define the technical approaches of in situ hybridization and its current application to detect viral nucleic acids within formalin-fixed, paraffin-embedded tissue samples, with special reference to the Epstein-Barr virus.


title: [Clinical features of severe acute respiratory syndrome in forty-one confirmed health care workers].

text: OBJECTIVE To investigate the clinical features of severe acute respiratory syndrome (SARS). METHODS Forty-one medical care workers (aged 23 - 55 years, with a average of 32 years; men/women = 8/32) who were admitted to our hospital and diagnosed with SARS during March and April, 2003 were retrospectively analyzed. RESULTS Thirteen of all the patients were physicians and the rest were nurses. The disease was mainly transmitted through air droplet in a short distance, and overwork induced tiredness was involved in disease stimulation. Seventy-three percent of the patients presented fever as their first symptom. Ten patients complained inertia and myalgia. One patient showed no clinical symptoms, and bilateral infiltrates was found in his chest X-ray. Among the 41 cases, 6 (15%) were diagnosed as severe type. At the first week, the counts of white blood cells (WBCs), lymphocyte and platelets were (4.4 +/- 1.5) x 10(9)/L, 0.22 +/- 0.12 and (143 +/- 37) x 10(9)/L, which were significantly lower when compared with those at the 2nd to 4th week. Abnormal liver function was found in 27 cases (mostly with elevated serum ALT), with 70% occurred at the 3rd or 4th week. In terms of CT, 30 patients (73%) showed pathological changes in lungs, and bilateral lung involvement was found in 35.59%. Of 36 cases treated with steroids, 86% received middle or low dosage (80 - 240 mg/d). Artificial ventilation was used for twenty-seven patients, and air pipe mechanical ventilation was used for 1 case. Mortality in this study was 5%. CONCLUSIONS Inertia and myalgia may be the earlier symptoms of health care workers with SARS include, which are parallel to CT manifestations. There is no objective index for the assessment of the severity of the disease at early stage. The medicine associated toxicities may be the main reason of liver lesions. damages. Middle or low dosage of steroid was reasonable to be used as early as possible.


title: Antigenic and molecular characterization of isolates of the Italy 02 infectious bronchitis virus genotype.

text: As part of an epidemiological surveillance of infectious bronchitis virus (IBV) in Spain, four Spanish field isolates showed high S1 spike sequence similarities with an IBV sequence from the GenBank database named Italy 02. Given that little was known about this new emergent IBV strain we have characterized the four isolates by sequencing the entire S1 part of the spike protein gene and have compared them with many reference IBV serotypes. In addition, cross-virus neutralization assays were conducted with the main IBV serotypes present in Europe. The four Spanish field strains and the Italy 02 S1 sequence from the NCBI database were established as a new genotype that showed maximum amino acid identities with the 4/91 serotype (81.7% to 83.7%), the D274 group that included D207, D274 and D3896 strains (79.8% to 81.7%), and the B1648 serotype (79.3% to 80%). Furthermore, on the basis of these results, it was demonstrated that the Italy 02 genotype had been circulating in Spain since as early as 1997. Based on the average ratio of synonymous:non-synonymous (dS/dN) amino acid substitutions within Italy 02 sequences, no positive selection pressures were related with changes observed in the S1 gene. Moreover, phylogenetic analysis of the S1 gene suggested that the Italy 02 genotype has undergone a recombination event. Virus neutralization assays demonstrated that little antigenic relatedness (less than 35%) exists between Italy 02 and some of the reference IBV serotypes, and indicated that Italy 02 is likely to be a new serotype.


docid: qnendlpy

title: The Economic Implications of COVID-19 in the United States.

text: The novel coronavirus disease 2019 (COVID-19) first reported in Wuhan, China, in 2019 has evolved into a pandemic and public health emergency, leading to extensive fatalities and halting global economies. Older adults have emerged as a critically vulnerable population as earlier data suggests a disproportionately increased incidence of COVID-19 in this population, as well as worse health outcomes. Disease attenuating behaviors such as social distancing has been encouraged and mandated across different countries leading to downstream economic ramifications. This paper seeks to outline the economic implications of COVID-19 in the U.S. (particularly in terms of vocational, retail, and service industries), highlighting the role of nursing homes in disease dissemination. We also discuss potential costs associated with COVID-19 management focusing on the senior population who rely on Medicare benefits for health insurance.


Traditional Chinese medicine--is the grass always greener?


Risk of high dose hydrocortisone in patients with aneurysmal subarachnoid hemorrhage.


title: Disease modifying treatment for feline rheumatoid arthritis.

text: Feline erosive polyarthritis includes the more common periosteal proliferative polyarthritis (PPP) and the rarely seen rheumatoid arthritis (RA) (11). During the past three years, 12 patients with definite feline rheumatoid arthritis, which did not respond well to conventional therapy, were treated with 7.5 mg of Methotrexate and 70 mg Leflunomide, given weekly by the oral route. The average age of the cats was 5.9 years (range 2.5 to 10 years). Siamese cats were over represented. Seven of the 12 (58%) cats showed a marked improvement, usually within four weeks. Once maximum improvement was obtained the dosage was decreased. Serious toxicity was not noted and carcinogenetic effect was not seen during the course of this study.


title: Adaptation of Borna disease virus to new host species attributed to altered regulation of viral polymerase activity.

text: Borna disease virus (BDV) can persistently infect the central nervous system of a broad range of mammalian species. Mice are resistant to infections with primary BDV isolates, but certain laboratory strains can be adapted to replicate in mice. We determined the molecular basis of adaptation by studying mutations acquired by a cDNA-derived BDV strain during one brain passage in rats and three passages in mice. The adapted virus propagated efficiently in mouse brains and induced neurological disease. Its genome contained seven point mutations, three of which caused amino acid changes in the L polymerase (L1116R and N1398D) and in the polymerase cofactor P (R66K). Recombinant BDV carrying these mutations either alone or in combination all showed enhanced multiplication speed in Vero cells, indicating improved intrinsic viral polymerase activity rather than adaptation to a mouse-specific factor. Mutations R66K and L1116R, but not N1398D, conferred replication competence of recombinant BDV in mice if introduced individually. Virus propagation in mouse brains was substantially enhanced if both L mutations were present simultaneously, but infection remained mostly nonsymptomatic. Only if all three amino acid substitutions were combined did BDV replicate vigorously and induce early disease in mice. Interestingly, the virulence-enhancing effect of the R66K mutation in P could be attributed to reduced negative regulation of polymerase activity by the viral X protein. Our data demonstrate that BDV replication competence in mice is mediated by the polymerase complex rather than the viral envelope and suggest that altered regulation of viral gene expression can favor adaptation to new host species.


title: An innovative paradigm for surgical education programs in resource-limited settings.

text: The burden of surgical disease in low-income countries remains significant, in part owing to continued surgical workforce shortages. We describe a successful paradigm to expand Rwandan surgical capacity through the implementation of a surgical education partnership between the National University of Rwanda and the Centre for Global Surgery at the McGill University Health Centre. Key considerations for such a program are highlighted.


title: Acceleration in the rate of CNS remyelination in lysolecithin-induced demyelination.

text: One important therapeutic goal during CNS injury from trauma or demyelinating diseases such as multiple sclerosis is to develop methods to promote remyelination. We tested the hypothesis that spontaneous remyelination in the toxic nonimmune model of lysolecithin-induced demyelination can be enhanced by manipulating the inflammatory response. In PBS-treated SJL/J mice, the number of remyelinating axons per square millimeter of lesion area increased significantly 3 and 5 weeks after lysolecithin injection in the spinal cord. However, methylprednisolone or a monoclonal antibody (mAb), SCH94.03, developed for its ability to promote remyelination in the Theiler's virus murine model of demyelination, further increased the number of remyelinating axons per lesion area at 3 weeks by a factor of 2.6 and 1.9, respectively, but did not increase the ratio of myelin sheath thickness to axon diameter or the number of cells incorporating tritiated thymidine in the lesion. After 3 weeks, the number of remyelinating axons in the methylprednisolone or mAb SCH94.03 treatment groups was similar to the spontaneous remyelination in the 5 week PBS control-treated group, indicating that these treatments promoted remyelination by increasing its rate rather than its extent. To address a mechanism for promoting remyelination, through an effect on scavenger function, we assessed morphometrically the number of macrophages in lesions after methylprednisolone and mAb SCH94.03 treatment. Methylprednisolone reduced the number of macrophages, but SCH94.03 did not, although both enhanced remyelination. This study supports the hypothesis that even in toxic nonprimary immune demyelination, manipulating the inflammatory response is a benefit in myelin repair.


Infectious diarrhea in children: Working Group Report of the First World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition.


title: Using conservation of pattern to estimate spatial parameters from a single snapshot.

text: Rapid reaction in the face of an epidemic is a key element in effective and efficient control; this is especially important when the disease has severe public health or economic consequences. Determining an appropriate level of response requires rapid estimation of the rate of spread of infection from limited disease distribution data. Generally, the techniques used to estimate such spatial parameters require detailed spatial data at multiple time points; such data are often time-consuming and expensive to collect. Here we present an alternative approach that is computationally efficient and only requires spatial data from a single time point, hence saving valuable time at the start of the epidemic. By assuming that fundamental spatial statistics are near equilibrium, parameters can be estimated by minimizing the expected rate of change of these statistics, hence conserving the general spatial pattern. Although applicable to both ecological and epidemiological data, here we focus on disease data from computer simulations and real epidemics to show that this method produces reliable results that could be used in practical situations.


Lessons in case management for the physician.


title: Bovine coronavirus genome.

text: The tissue culture-adapted strain (Mebus) of the bovine coronavirus was grown to titers of greater than 10(7) 50% tissue culture infective doses per ml in secondary bovine embryo kidney cells, and the RNA was isotopically labeled with [3H]uridine. The RNA was extracted from purified virus and was found to have the following properties. (i) It consisted primarily of a homogeneous large-molecular-weight species which comigrated electrophoretically with vesicular stomatitis viral RNA and therefore had an apparent molecular weight of 3.8 X 10(6). (ii) It remained as a 3.8 x 10(6)-molecular-weight molecule after heat denaturation when rapidly harvested virus was examined. (iii) It was 80% susceptible to pancreatic RNase A digestion in high (0.3 M) NaCl, and the 20% resistant fraction was 4S to 7S in size. (iv) It was polyadenylated to the extent that 40 and 60% of the native RNA bound to polyuridylic acid-Sepharose and oligodeoxythymidylic acid-cellulose, respectively, under conditions of high (0.5 M) NaCl.


title: Neutrophil degranulation and cell lysis is associated with clinical severity in virus-induced asthma.

text: Acute exacerbations of asthma are frequently caused by viral infections, but the inflammatory mechanisms in virus-induced asthma are poorly understood. The aim of the present study was to determine whether viral infection in acute asthma was associated with increased sputum neutrophil degranulation and increased cellular lysis and whether these changes are related to clinical severity. Adults (n=49) presenting to the emergency department with acute asthma were examined for infection by means of sputum direct-fluorescence antigen detection, sputum culture, and sputum polymerase chain reaction for Mycoplasma, Chlamydia and Legionella pneumophila, and all common respiratory viruses. Subjects infected with one of these agents were classed as having an infective exacerbation. Spirometry and sputum induction were performed on presentation and 4-5 weeks later. Thirty-seven subjects (76%) had virus infection and acute asthma. Those with virus infection had increased sputum neutrophils (p<0.05) and increased neutrophil elastase (p<0.05), this was related to increased elevated sputum lactate dehydrogenase (LDH). Subjects with noninfective asthma had an increase in the proportion of sputum eosinophils. Both groups had elevated sputum eosinophil cationic protein (ECP) concentrations. Higher levels of sputum LDH and ECP were associated with a longer hospital stay. Virus infection and acute asthma is associated with neutrophilic inflammation, cell lysis and more severe clinical disease.


Letter To The Editor - The Covid-19 Pandemic And Mental Health As Issues Considered Within The Context Of Adjustment Disorder And Psychosocial Interventions.


title: The future of health care in the United States.

text: The U.S. government is involved in health care in various ways that include (1) providing services to veterans, (2) paying for care received by Medicare and Medicaid beneficiaries, (3) assuring quality through regulatory activity, (4) financing the discovery of medical breakthroughs, and (5) training members of the health workforce and assuring that the nation has an adequate supply of them. With the aging of the population, the role of the government in these endeavors will increase. This essay considers ways in which the health care of tomorrow will be affected by the intermingling of factors such as demography, epidemiology, economics, technology, globalization, and individual health behavior.


title: Factors associated with transmission of severe acute respiratory syndrome among health-care workers in Singapore.

text: Between 1 and 22 March 2003, a nosocomial outbreak of Severe Acute Respiratory Syndrome (SARS) occurred at the Communicable Disease Centre in Tan Tock Seng Hospital, Singapore, the national treatment and isolation facility for patients with SARS. A case-control study with 36 cases and 50 controls was conducted of factors associated with the transmission of SARS within the hospital. In univariate analysis, contact with respiratory secretions elevated the odds ratio to 6.9 (95 % CI 1.4-34.6, P= 0.02). Protection was conferred by hand washing (OR 0.06, 95% CI 0.007-0.5, P=0.03) and wearing of N95 masks (OR 0.1, 95% CI 0.03-0.4, P=0.001). Use of gloves and gowns had no effect. Multivariate analysis confirmed the strong role of contact with respiratory secretions (adjusted OR 21.8, 95 % CI 1.7 274.8, P=0.017). Both hand washing (adjusted OR 0.07, 95 % CI 0.008-0.66, P=0.02) and wearing of N95 masks (adjusted OR 0.1, 95% CI 0.02-0.86, P=0.04) remained strongly protective but gowns and gloves had no effect.


title: Is there a case for a virus aetiology in multiple sclerosis?

text: Multiple Sclerosis (MS) is a devastating demyelinating disease with a very high prevalence in North-East Scotland and in the Orkney and Shetland Islands. MS appears to be a multifactorial disorder with environmental and genetic elements and it has been proposed that these, in tandem, provoke an autoimmune response giving rise to the disease. Although there is no direct evidence of a specific virus being involved in MS, there are nevertheless grounds for suspecting a viral association. This review discusses these aspects of MS and suggests that a more aggressive approach to unravelling the role of viruses is needed.


title: [Laboratory diagnostics in evaluation of acute respiratory viral infection morbidity in 2010 - 2011 epidemic season].

text: AIM Study of etiological structure of ARVI and evaluation of acute respiratory virus infection morbidity in 2010 - 2011 epidemic season taking into account the data of laboratory diagnostics by method of polymerase chain reaction with hybridization-fluorescent detection. MATERIALS AND METHODS By using reagent kits produced by Central Research Institute of Epidemiology for the detection of primary causative agents of influenza and ARVI 129 children and 94 adult patients monitored in an outpatient setting as well as 103 children hospitalized due to ARI were examined. RESULTS Etiological structure of ARVI was studied; proportion of influenza and other actual causative agents of ARVI in monthly dynamics were established. During epidemic rise of influenza (January-March 2011) the proportion of influenza A viruses was 24% (peak in January--31%), the proportion of influenza B viruses--5%, rhinoviruses--9%, metapneumovirus was detected in 6% of cases, parainfluenza viruses (1 - 4 type) and adenovirses--4% each, coronaviruses--in 3%, respiratory syncytial virus--in 2%, bocavirus--in 1% of the studied samples. In influenza structure A/H1N1pdm2009 virus, its proportion was 70%, influenza virus B (26.9%), influenza virus A/H3N2 (2.6%) predominated. Indexes for monthly morbidity caused by each of the ARVI causative agents were calculated. CONCLUSION The proposed approach allowed to evaluate ARVI morbidity taking into account laboratory-confirmed etiological factors. A 5 time increase in ARI morbidity in adults in February 2011 was shown to be mostly due to an increase in influenza A morbidity as well as involvement of influenza B virus, metapneumoviruses, coronaviruses, parainfluenza viruses and rhinoviruses into the epidemic process. Increase of morbidity of children by 1.4 times was also seen during activization of influenza viruses and metapneumovirus. The analysis of monitoring results allowed to prognose increase of respiratory-syncytial viral infection epidemic activity from September 2011 to February 2012.


Detection of coronavirus in cases of tracheobronchitis in dogs: a retrospective study from 1971 to 2003.


title: Coronavirus disease (COVID-19) pandemic.

text: No abstract provided.


title: [Genetic variation of S1 gene hypervariable region I of infectious bronchitis viruses isolated in different periods in Guangxi].

text: The S1 gene hypervariable region I (HVR I) of 22 infectious bronchitis virus (IBV) strains isolated in Guangxi during the period of 1985-2007 were sequenced and compared to that of the other IBV reference strains and the pigeon coronavirus isolates. A phylogenetic tree based on nucleotide sequences of HVR I of all the IBV showed that they were classified into 5 distinct Clusters. 16 out of 22 IBV isolates were grouped into Cluster I, and had higher homology with pigeon coronavirus isolates but lower homology with the Massachusetts (Mass) type vaccine strains. There were 4 and 3 amino-acid residues inserted at the sites of 33-34 and 34-35 respectively within HVR I in 15 isolates, except in isolate GX-NN6 there had 4 amino-acid residues inserted at the both sites; isolates GX-YL1 and GX-NN2 had close relationship with Mass type vaccine strains, and they shared Cluster II; isolates GX-G and GX-XD of Cluster III had close relationship with the Japanese strain JP Miyazaki 89 which was isolated at the same period; isolates GX-YL6 and GX-NN7 of Cluster V had close relationship with the European strain 4/91. The results showed that there were high phylogenetic diversity among the IBVs prevailed in the field in Guangxi resulting from the commonly occurred mutation or insertion within the S1 gene HVR I of the viruses, and majority of the isolates had lower homology with the commonly used Mass type vaccine strains. There was much higher homology among viruses isolated in the same period of time, but without distinct difference in geographical origins.


docid: ncnsfpya

title: THE HISTORY OF OPHTHALMOLOGY IN EGYPT.


title: Oseltamivir in the management of influenza.

text: Seasonal influenza causes significant morbidity and mortality in adults and children. However, a worldwide influenza pandemic could cause considerably more deaths (20-40 million) and would majorly disrupt everyday life in most countries. Oseltamivir has proven to be safe and effective for the prevention or treatment of all known influenza subtypes, reducing the severity and duration of symptoms, the complications arising from influenza infection (pneumonia, hospitalisation, antibiotic use) and mortality. Oseltamivir has been shown to be effective against pandemic strains of influenza, including the currently circulating strain (H5N1). As a result, the World Health Organization has recommended the stockpiling of oseltamivir in the event of an influenza pandemic.


Structure and function studies of the nucleocapsid protein of mouse hepatitis virus.


title: Propylene glycol-induced lactic acidosis in a patient with normal renal function: a proposed mechanism and monitoring recommendations.

text: OBJECTIVE To report a case of severe propylene glycol-induced lactic acidosis not attributable to renal dysfunction that was secondary to administration of high-dose intravenous lorazepam. CASE SUMMARY A 24-year-old female with community-acquired pneumonia presented with severe acute respiratory distress syndrome. To maintain adequate sedation and ventilation and reduce airway pressure, several relaxation strategies were used including high-dose intravenous lorazepam, fentanyl, and cisatracurium. After 18 days of high-dose continuous infusion of lorazepam (maximum dose 50 mg/h), the patient developed severe lactic acidosis secondary to propylene glycol toxicity, the main diluent of lorazepam. The acidosis temporarily resolved with bicarbonate administration and discontinuation of lorazepam. Her renal function remained stable for a time (serum creatinine 0.5 mg/dL, blood urea nitrogen 10 mg/dL, urine output 100-200 mL/h). However, after several more days, the patient's condition deteriorated, and she ultimately died. DISCUSSION Previous cases of propylene glycol toxicity secondary to high-dose lorazepam infusion have occurred in patients with compromised renal function. Our patient's renal function remained stable throughout the hospital course, which caused us to look further for an explanation for the propylene glycol-induced lactic acidosis. Based on the Naranjo probability scale, propylene glycol was determined to be the probable cause of lactic acidosis. Since this case occurred, our intensive care unit has instituted recommendations for the prevention of lorazepam-associated propylene glycol toxicity. CONCLUSIONS Our case highlights the development of propylene glycol-induced lactic acidosis secondary to high-dose lorazepam infusion not associated with renal dysfunction.


title: Antiviral activity of the novel immune modulator 7-thia-8-oxoguanosine.

text: A novel thiazolopyrimidine nucleoside, 5-amino-3-beta-D-ribofuranosylthiazolo[4,5-d]pyrimidine-2,7(3H,6H) -dione (7-thia-8-oxoguanosine), was evaluated for antiviral activity in rodent models, and at 50-200 mg/kg prevented death in mice inoculated intraperitoneally (i.p.) with Semliki Forest, San Angelo, and banzi viruses when administered i.p. before virus challenge. Similarly, the nucleoside was effective against an intranasal challenge of rat coronavirus in suckling rats, with activity present when treatment started as late as 4 h after virus inoculation. Protection was observed against herpes type 1 and murine cytomegalovirus (both inoculated i.p.) infections, and encephalitis induced by intracerebral inoculation of a human coronavirus in mice. Friend leukemia virus splenomegaly was more severe in drug-treated animals than in placebos. This immune modulator is promising for the treatment of animal and human diseases.


title: Coronavirus mRNA transcription: UV light transcriptional mapping studies suggest an early requirement for a genomic-length template.

text: Mouse hepatitis virus (MHV) synthesizes seven to eight mRNAs, each of which contains a leader RNA derived from the 5' end of the genome. To understand the mechanism of synthesis of these mRNAs, we studied how the synthesis of each mRNA was affected by UV irradiation at different time points after infection. When MHV-infected cells were UV irradiated at a late time in infection (5 h postinfection), the syntheses of the various mRNAs were inhibited to different extents in proportion to the sizes of the mRNAs. Analysis of the UV inactivation kinetics revealed that the UV target size of each mRNA was equivalent to its own physical size. In contrast, when cells were irradiated at 2.5 or 3 h postinfection, there appeared to be two different kinetics of inhibition of mRNA synthesis: the synthesis of every mRNA was inhibited to the same extent by a small UV dose, but the remaining mRNA synthesis was inhibited by additional UV doses at different rates for different mRNAs in proportion to RNA size. The analysis of the UV inactivation kinetics indicated that the UV target sizes for the majority of mRNAs were equivalent to that of the genomic-size RNA early in the infection. These results suggest that MHV mRNA synthesis requires the presence of a genomic-length RNA template at least early in the infection. In contrast, later in the infection, the sizes of the templates used for mRNA synthesis were equivalent to the physical sizes of each mRNA. The possibility that the genomic-length RNA required early in the infection was used only for the synthesis of a polymerase rather than as a template for mRNA synthesis was ruled out by examining the UV sensitivity of a defective interfering (DI) RNA. We found that the UV target size for the DI RNA early in infection was much smaller than that for mRNAs 6 and 7, which are approximately equal to or smaller in size than the DI RNA. This result indicates that even though DI RNA and viral mRNAs are synthesized by the same polymerase, mRNAs are synthesized from a larger (genomic-length) template. We conclude that a genomic-length RNA template is required for MHV subgenomic mRNA synthesis at least early in infection. Several transcription models are proposed.


title: Parvovirus infections in wild carnivores.

text: Various parvoviruses infect carnivores and can cause disease. In this review article the knowledge about infections of free-ranging or captive carnivores with the feline parvoviruses, feline panleukopenia virus, and canine parvovirus, including the antigenic types CPV-2a and -2b, as well as Aleutian disease of mink virus and minute virus of canines are summarized. Particular emphasis is placed on description of the evolution of canine parvovirus which apparently involved wild carnivore hosts.


title: Severe acute respiratory syndrome coronavirus as an agent of emerging and reemerging infection.

text: Before the emergence of severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV) in 2003, only 12 other animal or human coronaviruses were known. The discovery of this virus was soon followed by the discovery of the civet and bat SARS-CoV and the human coronaviruses NL63 and HKU1. Surveillance of coronaviruses in many animal species has increased the number on the list of coronaviruses to at least 36. The explosive nature of the first SARS epidemic, the high mortality, its transient reemergence a year later, and economic disruptions led to a rush on research of the epidemiological, clinical, pathological, immunological, virological, and other basic scientific aspects of the virus and the disease. This research resulted in over 4,000 publications, only some of the most representative works of which could be reviewed in this article. The marked increase in the understanding of the virus and the disease within such a short time has allowed the development of diagnostic tests, animal models, antivirals, vaccines, and epidemiological and infection control measures, which could prove to be useful in randomized control trials if SARS should return. The findings that horseshoe bats are the natural reservoir for SARS-CoV-like virus and that civets are the amplification host highlight the importance of wildlife and biosecurity in farms and wet markets, which can serve as the source and amplification centers for emerging infections.


title: Education and simulation techniques for improving reliability of care.

text: PURPOSE OF REVIEW Multiple factors influence the dependability of intensive care provision. The management of a group of unstable, critically ill patients requires focused attention from the clinical team. Medical simulation is an important tool to improve safety and team work within the ICU. RECENT FINDINGS The critical care healthcare team needs to work both individually and together in such a way as to optimise patient care and prevent error. This involves nontechnical skills including decision making, task allocation, team working and situation awareness, all of which are underpinned by communication, cooperation and coordination. The use of integrated simulators to create realistic patient scenarios with structured debriefing is an excellent method for teaching in these domains. There has been a huge increase in the delivery of training and education using an expanding variety of clinical simulators. SUMMARY This review summarises the evidence and opinion about how simulation tools can be optimally used. In addition, we propose an educational strategy to optimise the impact on clinical practice by embedding simulation training in a multidisciplinary teaching programme based upon a specifically developed curriculum focusing on the teaching of crisis resource management and patient safety.


Methicillin-resistant Staphylococcus aureus, HIV infection, and managed care.


title: Serologic survey for selected viral pathogens in free-ranging endangered European mink (Mustela lutreola) and other mustelids from south-western France.

text: To investigate the possible role of selected pathogens in the decline of endangered European mink (Mustela lutreola) populations and the potential for these pathogens to affect mink survival, a serologic survey was conducted using serum samples collected from March 1996 to March 2003 in eight departments of south-western France. In total, 481 free-ranging individuals of five mustelid species (including the European mink) were tested. Sympatric mustelids can serve as sentinels to determine the presence of antibodies to viruses in the study area that could potentially infect mink. Antibodies to Canine distemper virus (CDV) were detected in all species; 9% of 127 European mink, 20% of 210 polecats (Mustela putorius), 5% of 112 American mink (Mustela vison), 33% of 21 stone marten (Martes foina) and 5% of 20 pine marten (Martes martes). Antibody prevalence was significantly higher in stone marten and polecats, possibly because their ranges overlap more closely with that of domestic species than that of the other species tested. Antibodies to Canine adenovirus were detected in all species but the pine marten; antibody prevalence estimates ranging from 2% to 10%. Antibodies to canine parainfluenza virus were detected in 1% of European mink, 1% of American mink and 5% of tested polecats but were not detected in Martes species. Antibodies to Rabies virus (RV) were detected in three animals, possibly because of interspecies transmission of bat lyssaviruses as the sampling area is considered to be free of RV, or to a lack of test specificity, as antibody titers were low. The high antibody prevalence to potentially lethal CDV suggests that this pathogen could have significant effects on the free-ranging populations and has implications for the conservation efforts for the endangered European mink.


title: Mini-Laparoscopic Repair of Apical Pelvic Organ Prolapse (POP) by Lateral Suspension with Mesh.

text: Background The aim of the present study is to analyze the feasibility, safety and learning curve of Mini- Laparoscopic Lateral suspension (LLS) for the treatment of apical and anterior defects following pelvic organ prolapse. Methods This is a cohort study on a retrospective series of 35 consecutive patients who underwent Mini-LLS for symptomatic POP between January 2014 and July 2016. All 35 patients were operated at the Gynaecological Unit in S. Chiara Hospital by two senior surgeons (S. Tateo and L. Mereu) and by a team with optimal skills in laparoscopic surgery. Patients were divided in two groups according to two different chronological phases: phase 1 identified the initial 12 cases, phase 2 the last 23 cases. We collected pre-, peri- and post-operative information to analyze the surgical outcomes and learning curve after Mini-LLS procedures. Results The mean LLS-Overall Time (OT) was 107.6 min (range, 185- 63 min). None of the patients had intra-operative complications. No conversion to laparotomy was necessary. The mean post-operative hospital stay was 58 hours in total (SD +/-22). Only in 3 cases (8.6 %) post-operative grade I complications were observed. Recurrence of POP was observed in 3 cases (8.6 %) during a mean follow up of 18 months. The mean OT decreased with experience, in particular after the first 12 cases (phase 1: 113.54 minutes versus phase 2: 104.43 minutes). In consequence, the reduction of time per procedure was statistically significant considering the Cusum Time (CT) (P < .05). Conclusions Mini-LLS with mesh is a safe and reproducible technique with good anatomical results, low complication rates and a short learning curve.


title: Physician migration to and from Canada: the challenge of finding the ethical and political balance between the individual's right to mobility and recruitment to underserved communities.

text: Physician migration to and from countries results from many local causes and international influences. These factors operate in the context of an increasingly globalized economy. From an ethical point of view, selective and targeted "raiding" of developing countries' medical workforce by wealthier countries is not acceptable. However, within specific countries, additional factors need to be identified to moderate the situation. I discuss the context in which Canada, a developed country, has struggled with workforce planning, with troubling results. I identify challenges for Canada but emphasize that decisions based on sloppy assumptions or inadequate data can lead to invalid policies, and poorly coordinated implementation can lead to a waste of human capital. Myths and attitudes further complicate physician workforce planning. Implementing recommendations of the recently concluded Task Force on the Licensure of International Medical Graduates will hopefully ameliorate the situation.


title: The role of programmed-1 ribosomal frameshifting in coronavirus propagation.

text: Coronaviruses have the potential to cause significant economic, agricultural and health problems. The severe acute respiratory syndrome (SARS) associated coronavirus outbreak in late 2002, early 2003 called attention to the potential damage that coronaviruses could cause in the human population. The ensuing research has enlightened many to the molecular biology of coronaviruses. A programmed -1 ribosomal frameshift is required by coronaviruses for the production of the RNA dependent RNA polymerase which in turn is essential for viral replication. The frameshifting signal encoded in the viral genome has additional features that are not essential for frameshifting. Elucidation of the differences between coronavirus frameshift signals and signals from other viruses may help our understanding of these features. Here we summarize current knowledge and add additional insight regarding the function of the programmed -1 ribosomal frameshift signal in the coronavirus lifecycle.


title: Exploring the ecologic basis for extreme susceptibility of Pallas' cats (Otocolobus manul) to fatal toxoplasmosis.

text: Recent efforts by North American zoos to establish a genetically viable captive population of Pallas' cats (Otocolobus manul) have been compromised by high newborn mortality (approximately 60%), primarily because of toxoplasmosis. The basis for this extreme susceptibility to toxoplasmosis is unknown. In the present study, the general health status of wild Pallas' cats in Mongolia was evaluated, including assessment of basal hematologic parameters and fecal corticoid metabolite concentrations. The prevalence of exposure to Toxoplasma gondii in Mongolian Pallas' cats, local domestic cats, and prey species also was determined based on serology and/or polymerase chain reaction analysis. Biologic samples (blood, feces, and/or brain tissue) were obtained from 15 wild Pallas' cats, 15 domestic cats, and 45 prey animals (rodents and pikas) captured in Mongolia during the summers of 2000 and 2001. Comparative data were obtained from nine captive Pallas' cats maintained in North American zoos. Based on physical examinations, complete blood counts, and blood chemistry analyses, only minor differences were observed in the general health status of wild and captive Pallas' cats. Fecal cortisol metabolite concentrations did not differ (P > 0.05) between populations, indicating that Pallas' cats in captivity and in the wild have similar basal adrenocortical activity. A pronounced difference (P < 0.01) in seroprevalence to T. gondii was observed between populations. Whereas all captive Pallas' cats exhibited elevated immunoglobulin titers (IgG > 2,048) to T. gondii, only two of 15 (13%) wild Pallas' cats were seropositive, with both cats having lower IgG titers (< 1,024). Furthermore, no evidence of exposure to this parasite was found in any of the Mongolian domestic cats or prey species. These findings suggest that wild Pallas' cats have minimal opportunity for exposure to T. gondii in their natural habitat and, typically, do not become infected with this parasite until being brought into captivity. Accordingly, maintenance of a viable captive population may require implementing effective strategies to prevent exposure of immunologically naive Pallas' cats to T. gondii and to reduce parasite transmission between seropositive females and their highly susceptible offspring.


Watch out for measles.


title: Human metapneumovirus: a newly described respiratory tract pathogen.

text: Human metapneumovirus is an emerging human respiratory pathogen first discovered in 2001. It clinically resembles respiratory syncytial virus, can cause both upper and lower tract disease, and has been associated with serious illness in the young, among the immunosuppressed, and in the chronically ill. Cough and congestion are frequently reported, and respiratory failure may occur. Initial infection occurs during early childhood, and repeated infections throughout life impart only transient immunity. Diagnosis is by reverse transcription-polymerase chain reaction or rising serologic titers. No commercial laboratory tests or treatments are available. Primary care physicians should maintain vigilance for outbreaks of newly discovered and emerging respiratory illnesses.


title: Persistent hepatitis C virus infection in vitro: coevolution of virus and host.

text: The virological and cellular consequences of persistent hepatitis C virus (HCV) infection have been elusive due to the absence of the requisite experimental systems. Here, we report the establishment and the characteristics of persistent in vitro infection of human hepatoma-derived cells by a recently described HCV genotype 2a infectious molecular clone. Persistent in vitro infection was characterized by the selection of viral variants that displayed accelerated expansion kinetics, higher peak titers, and increased buoyant densities. Sequencing analysis revealed the selection of a single adaptive mutation in the HCV E2 envelope protein that was largely responsible for the variant phenotype. In parallel, as the virus became more aggressive, cells that were resistant to infection emerged, displaying escape mechanisms operative at the level of viral entry, HCV RNA replication, or both. Collectively, these results reveal the existence of coevolutionary events during persistent HCV infection that favor survival of both virus and host.


title: The viral spike protein is not involved in the polarized sorting of coronaviruses in epithelial cells.

text: Coronaviruses are assembled by budding into a pre-Golgi compartment from which they are transported along the secretory pathway to leave the cell. In cultured epithelial cells, they are released in a polarized fashion; depending on the virus and cell type, they are sorted preferentially either to the apical domain or to the basolateral plasma membrane domain. In this study, we investigated the role of the coronavirus spike protein, because of its prominent position in the virion the prime sorting candidate, in the directionality of virus release. Three independent approaches were taken. (i) The inhibition of N glycosylation by tunicamycin resulted in the synthesis of spikeless virions. The absence of spikes, however, did not influence the polarity in the release of virions. Thus, murine hepatitis virus strain A59 (MHV-A59) was still secreted from the basolateral membranes of mTAL and LMR cells and from the apical sides of MDCK(MHVR) cells, whereas transmissible gastroenteritis virus (TGEV) was still released from the apical surfaces of LMR cells. (ii) Spikeless virions were also studied by using the MHV-A59 temperature-sensitive mutant Albany 18. When these virions were produced in infected LMR and MDCK(MHVR) cells at the nonpermissive temperature, they were again preferentially released from basolateral and apical membranes, respectively. (iii) We recently demonstrated that coronavirus-like particles resembling normal virions were assembled and released when the envelope proteins M and E were coexpressed in cells (H. Vennema, G.-J. Godeke, J. W. A. Rossen, W. F. Voorhout, M. C. Horzinek, D.-J. E. Opstelten, and P. J. M. Rottier, EMBO J. 15:2020-2028, 1996). The spikeless particles produced in mTAL cells by using recombinant Semliki Forest viruses to express these two genes of MHV-A59 were specifically released from basolateral membranes, i.e., with the same polarity as that of wild-type MHV-A59. Our results thus consistently demonstrate that the spike protein is not involved in the directional sorting of coronaviruses in epithelial cells. In addition, our observations with tunicamycin show that contrary to the results with some secretory proteins, the N-linked oligosaccharides present on the viral M proteins of coronaviruses such as TGEV also play no role in viral sorting. The implications of these conclusions are discussed.


title: Severe acute respiratory syndrome and critical care medicine: the Toronto experience.

text: BACKGROUND The 2003 global outbreak of severe acute respiratory syndrome (SARS) provided numerous challenges to the delivery of critical care. The Toronto critical care community has learned important lessons from SARS, which will help in preparation for future disease outbreaks. OBJECTIVES The objectives of this study were to review the epidemiology and clinical characteristics of the Toronto SARS outbreak, the challenges SARS provided to the delivery of critical care, and how we would like to be better organized for a similar challenge in the future. FINDINGS SARS manifests clinically as atypical pneumonia and ranges in severity from minor nonspecific symptoms to adult respiratory distress syndrome (ARDS). Approximately 20% of patients with SARS will become critically ill and require admission to the intensive care unit. ARDS develops in the majority of these patients. Mortality from ARDS in SARS is high, and outcome is associated with the presence of comorbid disease and the severity of illness at presentation. The influx of critically ill patients and the transmission of SARS to front line workers created a tremendous strain on Toronto's healthcare system. From a critical care perspective, the most important limitation in the response to SARS was the absence of a coordinated leadership and communication infrastructure. Other challenges encountered during SARS include the following: closure of intensive care unit beds and loss of staff through quarantine and illness, implementing novel infection control protocols, educating staff, conducting research to learn about SARS, system planning, and maintaining staff morale during this very difficult period. CONCLUSIONS Communication and leadership strategies were key components in the critical care response to SARS. Ideally, centers should have systems in place to allow for the rapid expansion and modification of critical care services in the event of a disease outbreak. Other critical care communities should consider their crisis response strategies in advance of similar events.


title: Development and evaluation of a multitarget real-time Taqman reverse transcription-PCR assay for detection of the severe acute respiratory syndrome-associated coronavirus and surveillance for an apparently related coronavirus found in masked palm civets.

text: Severe acute respiratory syndrome (SARS)-associated coronavirus (SARS-CoV) is the etiological agent of SARS. It is believed that SARS-CoV originates from wild animals. We have developed a multitarget real-time Taqman reverse transcription-PCR (RT-PCR) assay for the quantitative detection of SARS-CoV. The sequences of the Taqman probes with a minor groove binder and the corresponding primers were based on the sequences of the N gene, open reading frame (ORF) 3, and ORF 8. The overall linear range of this assay was from at least 10(1) to 10(6) copies per reaction, and the detection limit could reach less than 10 copies per reaction. The quantification results for SARS-CoV from cell culture correlated well with those of the RT-PCR by using any two of the three sets of primer and probe used in this assay. However, the results of quantification of SARS-CoV obtained by using a few available throat swab specimens from SARS patients and the N gene as the target were almost 10 times higher than those obtained by using ORF 3 and ORF 8. Using this assay, we also detected an apparently SARS-CoV-related coronavirus in the throat swab specimens from masked palm civets in the west part of Hubei Province, People's Republic of China.


title: Stigmatization of newly emerging infectious diseases: AIDS and SARS.

text: OBJECTIVES We assessed relationships between sociodemographic characteristics and mental health status and knowledge of, being worried about, and stigmatization of 2 emerging infectious diseases: AIDS and SARS. METHODS We conducted a random-digit-dialed survey of 928 residents of the New York City metropolitan area as part of a study of the effects of the September 11, 2001, terrorist attacks. Questions added for this study concerned respondents' knowledge of, worry about, and support of stigmatizing actions to control AIDS and SARS. RESULTS In general, respondents with greater personal resources (income, education, social support) and better mental health status had more knowledge, were less worried, and were less likely to stigmatize. This pattern held for both AIDS and SARS. CONCLUSIONS Personal resources and mental health factors are likely to influence the public's ability to learn about, rationally appraise the threat of, and minimize stigmatization of emerging infectious diseases such as AIDS and SARS.


title: Detection of the influenza virus yesterday and now.

text: Demographic changes and the development of transportation contribute to the rapid spread of influenza. Before an idea of a 'person to person' spread appeared, divergent theories were developed to explain influenza epidemics in the past. Intensified virological and serological tests became possible after isolation of the human influenza virus in 1933. The first influenza virus detection methods were based on its isolation in egg embryos or cell lines and on demonstration of the presence of the viral antigens. Molecular biology techniques associated with amplification of RNA improved the quality of tests as well as sensitivity of influenza virus detection in clinical samples. It became possible to detect mixed infections caused by influenza types A and B and to identify the strain of the virus. Development of reliable diagnostic methods enabled fast diagnosis of influenza which is important for choosing an appropriate medical treatment.


The last medical decade.


title: Acute respiratory viral infections in children in Rio de Janeiro and Teresópolis, Brazil.

text: The frequency of viral pathogens causing respiratory infections in children in the cities of Rio de Janeiro and Teresópolis was investigated. Nasal swabs from children with acute respiratory illnesses were collected between March 2006 and October 2007. Specimens were tested for viral detection by conventional (RT)-PCR and/or real time PCR. Of the 205 nasal swabs tested, 64 (31.2%) were positive for at least one of the viral pathogens. Single infections were detected in 56 samples, 50 of those were caused by RNA viruses: 33 samples tested positive for rhinovirus, five for influenza A, five for metapneumovirus, four for coronavirus and, three for respiratory syncytial virus. For the DNA viruses, five samples were positive for bocavirus and one for adenovirus. Co-infections with these viruses were detected in eight samples. Our data demonstrate a high frequency of viral respiratory infections, emphasizing the need for a more accurate diagnosis particularly for the emerging respiratory viruses. The fact that the emerging respiratory viruses were present in 9.2% of the tested samples suggests that these viruses could be important respiratory pathogens in the country.


title: Assessment of airborne microorganisms by real-time PCR: optimistic findings and research challenges.

text: Most airborne microorganisms are natural components of our ecosystem. Soil, vegetation and animals, including humans, are sources for aerial release of these living or dead cells. In the past, assessment of airborne microorganisms was mainly restricted to occupational health concerns. Indeed, in several occupations, exposure to very high concentrations of non-infectious airborne bacteria and fungi, result in allergenic, toxic or irritant reactions. Recently, the threat of bioterrorism and pandemics have highlighted the urgent need to increase knowledge of bioaerosol ecology. More fundamentally, airborne bacterial and fungal communities begin to draw much more consideration from environmental microbiologists, who have neglected this area for a long time. This increased interest of scientists is to a great part due to the development and use of real-time PCR techniques to identify and quantify airborne microorganisms. Even if the advantages of the PCR technology are obvious, researchers are confronted with new problems. This review describes the methodological state of the art in bioaerosols field and emphasizes the future challenges and perspectives of the real-time PCR-based methods for airborne microorganism studies.


docid: bnpljpft

title: The Novel Coronavirus (SARS-CoV-2) Epidemic.


title: Secondary structural elements within the 3' untranslated region of mouse hepatitis virus strain JHM genomic RNA.

text: Previously, we characterized two host protein binding elements located within the 3'-terminal 166 nucleotides of the mouse hepatitis virus (MHV) genome and assessed their functions in defective-interfering (DI) RNA replication. To determine the role of RNA secondary structures within these two host protein binding elements in viral replication, we explored the secondary structure of the 3'-terminal 166 nucleotides of the MHV strain JHM genome using limited RNase digestion assays. Our data indicate that multiple stem-loop and hairpin-loop structures exist within this region. Mutant and wild-type DIssEs were employed to test the function of secondary structure elements in DI RNA replication. Three stem structures were chosen as targets for the introduction of transversion mutations designed to destroy base pairing structures. Mutations predicted to destroy the base pairing of nucleotides 142 to 136 with nucleotides 68 to 74 exhibited a deleterious effect on DIssE replication. Destruction of base pairing between positions 96 to 99 and 116 to 113 also decreased DI RNA replication. Mutations interfering with the pairing of nucleotides 67 to 63 with nucleotides 52 to 56 had only minor effects on DIssE replication. The introduction of second complementary mutations which restored the predicted base pairing of positions 142 to 136 with 68 to 74 and nucleotides 96 to 99 with 116 to 113 largely ameliorated defects in replication ability, restoring DI RNA replication to levels comparable to that of wild-type DIssE RNA, suggesting that these secondary structures are important for efficient MHV replication. We also identified a conserved 23-nucleotide stem-loop structure involving nucleotides 142 to 132 and nucleotides 68 to 79. The upstream side of this conserved stem-loop is contained within a host protein binding element (nucleotides 166 to 129).


title: [Effect of life style interventions over quality of life in colorectal cancer survivors].

text: INTRODUCTION One third of cancer deaths are related to poor diet, physical inactivity and obesity. The high healthcare costs of cancer treatment and its repercussions on the quality of life have led the scientific community to investigate a variety of other interventions. METHODS Review of experimental and observational studies of the last 5 years, including adult subjects surviving colorectal cancer, subjected to lifestyle interventions of a minimum duration of 12 weeks. The review was guided by the PRISMA statement (data extraction from PubMed, Science Direct and EBSCO: Medline Complete). The selection of the studies was completed using the Covidence platform. RESULTS There are positive associations between physical activity level and quality of life; on the other hand, in survivors of colorectal cancer, inverse relationships between time of sedentary attitude and quality of life are evidenced. CONCLUSION Lifestyle interventions generate an increase in quality of life indicators in survivors of colorectal cancer.


title: Molecular characterization of the major capsid protein VP6 of bovine group B rotavirus and its use in seroepidemiology.

text: The major inner capsid protein (VP6) gene of the bovine group B rotavirus (GBR) Nemuro strain is 1269 nt in length and contains one open reading frame encoding 391 aa. Nucleotide and amino acid sequence identities of the Nemuro VP6 gene compared with the published corresponding human and rodent GBR genes were respectively 66-67 and 70-72 %, which are notably lower than those between human and rodent viruses (72-73 and 83-84 %, respectively). Overall identities of VP6 genes among GBRs were substantially lower than those among both group A rotaviruses (GARs) and group C rotaviruses (GCRs) derived from different species of mammals. These results demonstrate that bovine GBR is remarkably distinct from other GBRs and that GBRs from different species may have had a longer period of divergence than GARs and GCRs. Recombinant VP6 was generated with a baculovirus expression system and used for an ELISA to detect GBR antibodies. All 13 paired sera from adult cows with GBR-induced diarrhoea in the field showed antibody responses in the ELISA. In serological surveys of GBR infection using the ELISA, 47 % of cattle sera were positive for GBR antibodies, with a higher antibody prevalence in adults than in young cattle. In pigs, a high prevalence of GBR antibodies (97 %) was detected in sera from sows. These results suggest that GBR infection is common in cattle and pigs, notwithstanding the scarcity of reports of GBR detection in these species to date.


docid: qsrksowj

title: Australia's notifiable disease status, 2008: annual report of the National Notifiable Diseases Surveillance System.

text: In 2008, 65 communicable diseases and conditions were nationally notifiable in Australia. States and territories reported a total of 160,508 notifications of communicable diseases to the National Notifiable Diseases Surveillance System, an increase of 9% on the number of notifications in 2007. In 2008, the most frequently notified diseases were sexually transmissible infections (69,459 notifications, 43% of total notifications), vaccine preventable diseases (34,225 notifications, 21% of total notifications) and gastrointestinal diseases (27,308 notifications, 17% of total notifications). There were 18,207 notifications of bloodborne diseases; 8,876 notifications of vectorborne diseases; 1,796 notifications of other bacterial infections; 633 notifications of zoonoses and 4 notifications of quarantinable diseases.


title: Resource Allocation and Decision Making for Pediatric and Congenital Cardiac Catheterization During the Novel Coronavirus SARS-CoV-2 (COVID-19) Pandemic: A U.S. Multi-Institutional Perspective.

text: BACKGROUND The novel coronavirus (COVID-19) pandemic has placed severe stress on healthcare systems around the world. There is limited information on current practices in pediatric cardiac catheterization laboratories in the United States (US). OBJECTIVES To describe current practice patterns and make recommendations regarding potential resource allocation for congenital cardiac catheterization during the COVID-19 pandemic. METHODS A web-based survey was distributed regarding case candidacy and catheterization laboratory preparedness. Centers were categorized based on the current degree of disease burden in that community (as of April 1, 2020). Data and consensus opinion were utilized to develop recommendations. RESULTS Respondents belonged to 56 unique US centers, with 27 (48.2%) located in counties with a high number of COVID-19 cases. All centers have canceled elective procedures. There was relative uniformity (>88% agreement) among centers as to which procedures were considered elective. To date, only three centers have performed a catheterization on a confirmed COVID-19 positive patient. Centers located in areas with a higher number of COVID-9 cases have been more involved in a simulation of donning and doffing personal protective equipment (PPE) than low-prevalence centers (46.7% vs 10.3%, respectively; P<.001). Currently, only a small fraction of operators has been reassigned to provide clinical services outside their scope of practice. CONCLUSIONS At this stage in the COVID-19 pandemic, pediatric/congenital catheterization laboratories have dramatically reduced case volumes. This document serves to define current patterns and provides guidance and recommendations on the preservation and repurposing of resources to help pediatric cardiac programs develop strategies for patient care during this unprecedented crisis.


docid: atkwblzz

title: The Strength-Focused and Meaning-Oriented Approach to Resilience and Transformation (SMART): A body-mind-spirit approach to trauma management.

text: This article introduces the Strength-focused and Meaning- oriented Approach to Resilience and Transformation (SMART) as a model of crisis intervention, which aims at discovering inner strengths through meaning reconstruction. Limitations of conventional crisis management and current findings in post-traumatic growth research are discussed. Instead of adopting a pathological framework, the SMART approach holds a holistic view of health, employs facilitative strategies, and promotes dynamic coping. Intervention components include Eastern spiritual teachings, physical techniques such as yoga and meditation, and psycho-education that promotes meaning reconstruction. Efficacy of the SMART model is assessed with reference to two pilot studies conducted in Hong Kong at the time when the SARS pandemic caused widespread fear and anxiety in the community. Response to potential criticisms of the SMART model is attempted.


title: Research agenda on persistent and unpredictable threat of influenza and emerging respiratory infections: a public health necessity in the Eastern Mediterranean Region (Guest Editorial).

text: Infectious diseases continue to represent a significant threat to global health security, particularly in the context of increasing globalization, interconnectedness and interdependence. Chief among such threats are influenza viruses and other respiratory pathogens, such as Middle East Respiratory Syndrome coronavirus (MERS-CoV), because of their risk of high transmissibility and acuity of illness. Annual epidemics of seasonal influenza cause an estimated 3-5 million cases of severe illness and more than 500 000 deaths, with the prospect of pandemic influenza viruses causing far greater impact. In addition, the appearance of severe acute respiratory syndrome (SARS) in 2003, widespread and continued outbreaks of avian influenza A (H5N1) since 2004, the H1N1 pandemic in 2009 and emergence of MERS CoV in 2012 reflect the seriousness of public health challenges posed by influenza and emerging respiratory infections.


title: Inhibition of severe acute respiratory syndrome-associated coronavirus (SARSCoV) by calpain inhibitors and beta-D-N4-hydroxycytidine.

text: We evaluated two types of compounds for efficacy in inhibiting SARSCoV replication in vitro: calpain inhibitors (a class of cellular cysteine proteinases) and a number of nucleoside analogues. Cytopathic effect reduction assays visually determined with spectrophotometric verification by neutral red (NR) uptake assay were used to evaluate cytotoxicity and antiviral potency of the compounds. Significantly inhibitory compounds were then evaluated in virus yield reduction assays. Two calpain inhibitors, Val-Leu-CHO (calpain inhibitor VI) and Z-Val-Phe-Ala-CHO (calpain inhibitor III), were the most potent inhibitors of SARSCoV. By virus yield reduction assay, calpain inhibitor VI had a 90% effective concentration (EC90) of 3 microM and calpain inhibitor III had an EC90 of 15 microM. Beta-D-N4-hydroxycytidine was the most selective nucleoside analogue inhibitor with an EC90 of 6 microM by virus yield reduction assay. These compounds or analogues warrant further evaluation as potential therapies for treating SARS or could be used as lead compounds for discovery of more potent SARSCoV inhibitors.


title: The biopsychosocial model and hypothyroidism.

text: This paper comments on the role and emergence of the biopsychosocial model in modern medical literature and health care settings. The evolution of the biopsychosocial model and its close association with modern pain theory is also examined. This paper seeks to discuss the place of this model with respect to the management of hypothyroidism. This discussion represents a forerunner to a randomised control trial that will seek to investigate the effect of a biopsychosocial-based treatment regime on hypothyroidism.


docid: ugrqgiso

title: Effect of low-dose oral erythromycin on gastric aspirates in ventilated neonates less than 32 weeks of gestation. Preliminary results.

text: In this prospective study, the 24-hour gastric aspirate volume was carefully recorded before, 24 and 48 h after administering 1.7 mg/kg/8-hourly of oral erythromycin to 16 ventilated neonates less than 32 weeks of gestation. Their median gestational age was 28.5 weeks (range 23-31 weeks), their median birthweight was 1,045 g (range 690-1,560 g) and the median day of life at which erythromycin was commenced was 9.5 days (range 4-16 days). Prior to administering erythromycin median 24-hour gastric aspirate volume, expressed as a percentage of the milk volume given over the same period, was 38.5% (range 20.0-100%). It was significantly lower 24 h (median 12%, range 0-41%, p = 0.0004) and 48 h (median 5%, range 0-21%, p = 0.0004) after commencing erythromycin. There was also significant reduction of gastric aspirate volume between 24 and 48 h after commencing erythromycin (p = 0.0024). Milk volume increment over the same period was not significant (p = 0.1022). These preliminary results warrant further evaluation through a randomised controlled trial.


WHO praises China's control measures for SARS.


title: Providing optimal radiology service in the severe acute respiratory syndrome outbreak: use of mobile CT.

text: OBJECTIVE Severe acute respiratory syndrome (SARS) is a serious atypical pneumonia caused by a novel pathogen. We describe our experience using a mobile CT scanner in an improvised isolation ward with life-support systems, portable lead shielding, and strict barrier nursing. This scanner was used exclusively for patients with SARS and patients with other illnesses who were also thought to have SARS. This arrangement freed the other CT scanners in the main department for non-SARS patients. In 5 weeks, 90 studies were performed; no cases of cross infection of health care workers were reported. CONCLUSION Mobile CT may be used to provide dedicated radiology services to seriously ill patients requiring strict isolation during an infectious disease outbreak.


title: Primary ovarian lymphoma: report of two cases and review of the literature.

text: Ovarian lymphoma is a rare entity. Clinicians should be aware of its clinical manifestations and management since surgery alone often is not adequate treatment. Here, we present two cases of ovarian lymphoma and discuss what is known about ovarian lymphoma.


title: Interaction of the coronavirus nucleoprotein with nucleolar antigens and the host cell.

text: Coronavirus nucleoproteins (N proteins) localize to the cytoplasm and the nucleolus, a subnuclear structure, in both virus-infected primary cells and in cells transfected with plasmids that express N protein. The nucleolus is the site of ribosome biogenesis and sequesters cell cycle regulatory complexes. Two of the major components of the nucleolus are fibrillarin and nucleolin. These proteins are involved in nucleolar assembly and ribosome biogenesis and act as chaperones for the import of proteins into the nucleolus. We have found that fibrillarin is reorganized in primary cells infected with the avian coronavirus infectious bronchitis virus (IBV) and in continuous cell lines that express either IBV or mouse hepatitis virus N protein. Both N protein and a fibrillarin-green fluorescent protein fusion protein colocalized to the perinuclear region and the nucleolus. Pull-down assays demonstrated that IBV N protein interacted with nucleolin and therefore provided a possible explanation as to how coronavirus N proteins localize to the nucleolus. Nucleoli, and proteins that localize to the nucleolus, have been implicated in cell growth-cell cycle regulation. Comparison of cells expressing IBV N protein with controls indicated that cells expressing N protein had delayed cellular growth. This result could not to be attributed to apoptosis. Morphological analysis of these cells indicated that cytokinesis was disrupted, an observation subsequently found in primary cells infected with IBV. Coronaviruses might therefore delay the cell cycle in interphase, where maximum translation of viral mRNAs can occur.


title: Treatment of mallet finger deformity with a modified palmaris longus tendon graft through a bone tunnel.

text: OBJECTIVE To investigate the clinical effect of treating mallet finger deformity using a modified palmaris longus tendon graft through a bone tunnel. METHODS Altogether, 21 patients with mallet finger deformity (16 men, 5 women; average age 31 years, range 19-47 years) were treated with a modified palmaris longus tendon graft through a bone tunnel during 18 months (2014-2016). Four index fingers, seven middle fingers, eight ring fingers, and two little fingers were treated for four cutting injuries, eleven finger sprains, four crush injuries, and two twist injuries (7 open and 14 closed injuries). Duration from injury to surgery was 9 h to 13 weeks. Three patients underwent surgery after 6 weeks of unsuccessful conservative treatment. No tendon was attached to the extensor tendon insertion in 16 patients, and 5 had residual tendon of <0.2 cm attached. All patients had distal segment flexion deformity and dorsiflexion disorder. Surgery comprised transverse penetration and vertical drilling of the base of the distal phalanx (2.0 and 2.5 mm diameter drills). Equal shallow semitendinosus pieces of the palmaris longus tendon (4 cm) were obtained from the sagittal end and were passed through a dorsal bone hole, emerging from a transverse bone hole. The two bundles were sutured to the main tendon. Tension was adjusted, and the broken ends were sutured. The distal interphalangeal joints were fixed in hyperextension. RESULTS All patients were followed for 7-16 months (average 6.0 ± 0.3 months) postoperatively. All 21 patients had grade A wound healing, with no complications (e.g., necrotic wound, recurrence, joint stiffness). The mallet finger deformity was corrected with good appearance, no obvious abnormalities, and satisfactory flexion and extension. Two patients had a superficial wound infection. Each recovered after symptomatic treatment. One patient had a mild result, with limited extension. There were no recurrences. Results were evaluated according to Patel et al.'s system, which revealed 15 excellent and 5 good results (combined 95.23% rate), with 1 mild result (limited extension). Patients were satisfied with the appearance and function of the affected fingers, and the desired surgical end result was achieved. CONCLUSION Use of this modified surgery for treating mallet finger deformity, especially with no or little tendon attached at the extensor tendon insertion, results in nearly anatomical reconstruction of the extensor tendon insertion. Its advantages include simple surgery, reliable fixation, fewer complications, and clinical efficacy.


title: Transgenesis for the study and the control of lactation.

text: The study and the control of milk synthesis are required to decipher the mechanisms of gene expression, to improve milk production, to modify milk composition, to induce a resistance to diseases in the mammary gland and to produce recombinant proteins of pharmaceutical interest. Transgenesis has become a mandatory tool to reach these goals. The use of transgenesis is still limited by the difficulty of adding foreign genes in farm animals and mainly by replacing genes by homologous recombination. Transgene expression is also often ill-controlled. The present paper summarizes the current progress in this field with a particular emphasis on expression vectors for transgenes.


docid: lausjltz

title: Respiratory viral infections in adults.

text: Respiratory viral infections in adults cause significant morbidity and mortality, especially in high-risk patients. The impact of influenza virus, rhinoviruses, and respiratory syncytial virus in immunocompromised cancer patients and in asthma and chronic bronchitis patients has been documented in recent publications. Cytomegalovirus pneumonia continues to be a major cause of morbidity and mortality in transplant recipients. Newer rapid diagnostic tests and the use of polymerase chain reaction technology have provided better understanding of the causes and epidemiology of acute respiratory illness in adults. The approved neuraminidase inhibitors for influenza viruses and the nonapproved capsid inhibitors of rhinoviruses may be useful in treating high-risk individuals. The inactivated influenza vaccine has been shown to benefit healthy adults and to be safe in asthmatic adults and children.


Risk and the sense of safety.


title: Pandemic influenza A (H1N1) 2009: risk factors for hospitalization.

text: OBJECTIVE To evaluate pandemic influenza A (H1N1) 2009 in hospitalized patients in order to identify risk factors for hospitalization and, consequently, for the worsening of the disease. METHODS This retrospective observational study was conducted between March and December of 2010. The data were collected from the Brazilian Ministry of Health National Case Registry Database. We included only patients (inpatients and outpatients) in whom H1N1 infection was confirmed (via laboratory testing) during the study period. The variables regarding demographic and clinical characteristics were statistically evaluated in order to compare the hospitalization rates in the presence or absence of these factors. Risk factors were identified by logistic regression analysis. RESULTS We included 4,740 patients with laboratory confirmation of H1N1 infection. Of these, 1,911 individuals were hospitalized, and 258 (13.5%) died. The risk factors for hospitalization were age (20-29 years), African or Indigenous ethnicity, presence of specific comorbidities (heart disease, lung disease, kidney disease, hemoglobinopathy, immunosuppression, diabetes, obesity, puerperium, and smoking), a high number of comorbidities, and specific symptoms (dyspnea, diarrhea, vomiting, chest pain, hemoptysis, pneumonia, and wheezing). Higher levels of education and early use of oseltamivir were found to be protective factors. Hospitalization contributed to an increase in survival. CONCLUSIONS Knowledge of the epidemiological characteristics that can be associated with hospitalization, disease severity, and mortality can be helpful in the adoption of preventive measures, as well as in the early diagnosis and treatment of disease, which might contribute to the reduction in the numbers of hospitalizations and deaths.


docid: oatrrabe

title: Population dynamics of lymphocyte subsets in the central nervous system of rats with different susceptibility to coronavirus-induced demyelinating encephalitis.

text: The inflammatory response in the central nervous system (CNS) of rats with differing susceptibility to demyelinating encephalitis induced by coronavirus MHV4 was characterized. Topographical maps showing the arrangement of infiltrating lymphocyte subsets in virus-infected tissue were developed by digital-image processing of immunohistologically stained CNS sections. The kinetics of the inflammatory process was evaluated by flow-cytometry on lymphocytes isolated from the CNS. Cumulative data obtained with these two techniques demonstrated the following features. In susceptible Lewis (LE) rats, viral antigens were disseminated throughout the CNS, including spinal cord. Onset as well as recovery from neurological disease was associated with a steep rise of infiltrating CD8+ T cells, which localized in close contact to virus-infected cells. Accompanying convalescence was a slight increase in B(OX33+) cells in the CNS and the accumulation of immunoglobulin-containing cells in the centre of virus-infected areas. In clinically resistant Brown Norway (BN) rats, virus-infected cells were mainly restricted to small periventricular foci and the extent of lymphocyte infiltration was never as high as that found at any time during the course of infection in LE rats. There were striking differences in the CD8+ T-cell population compared to LE rats. Cells of this phenotype were identified in virus-affected areas of BN rats only early after infection, and their infiltration profile revealed much lower quantities than in the CNS of susceptible LE rats. Although the population dynamics of B(OX33+) lymphocytes were comparable in BN and LE rats, as determined by flow-cytometry, less immunoglobulin-containing B cells were detected in virus-infected areas of BN rats.


title: Prevention of simian virus 40 tumors by hamster fetal tissue: influence of parity status of donor females on immunogenicity of fetal tissue and on immune cell cytotoxicity.

text: Fetal tissue from primiparous hamsters prevented simian virus 40 (SV40) tumorigenesis in male hamsters, whereas fetal tissue from multiparous hamsters did not. The parity status of normal (uninoculated) hamsters also influenced the cytotoxicity of their lymphoid cells against tumor cells. Lymph node cells from nonpregnant primiparous and multiparous animals were cytotoxic in microcytotoxicity tests against SV40, polyoma, and adenovirus 7 tumor cells, but were not active against control BHK cells. Lymph node cells from virgin female donors were inactive. Peritoneal exudate cells from these donors reacted in similar fashion against SV40 tumor cells in vitro and in adoptive transfer tests in vivo. However, the cytotoxicity of peritoneal exudate cells from multiparous hamsters was greatly reduced during pregnancy, a time when noncytotoxic humoral antibody reactive with surface antigen of SV40 tumor cells is present. This humoral antibody is not detected during first pregnancy, and peritoneal exudate cells obtained from pregnant primiparous hamsters demonstrated a high degree of cytotoxicity.


title: Radiographic appearance and clinical outcome correlates in 26 patients with severe acute respiratory syndrome.

text: OBJECTIVE We aimed to evaluate the appearance of chest radiographs in patients with severe acute respiratory syndrome (SARS) and correlate these findings with clinical outcomes. MATERIALS AND METHODS We retrospectively reviewed the initial radiograph and a series of follow-up chest radiographs in 26 patients who had symptoms and signs consistent with SARS. Twenty-five patients completed the full course of radiographs in the hospital. The initial radiographic features and the distribution of parenchymal, mediastinal, and pleural abnormalities for each patient were evaluated. Follow-up radiographic findings were correlated with clinical outcomes for these patients. RESULTS Initial chest radiographs showed abnormalities in 23 (88%) of 26 subjects. Eighteen patients (69%) had air-space consolidation, two (8%) had ground-glass attenuation, one (4%) had nodules, and two (8%) had mixed consolidation and nodules. Four patients (15%) had pleural effusion. Younger patients and those with normal initial radiographic findings or unifocal lung lesions had better outcomes. CONCLUSION The initial predominant radiographic feature of SARS was air-space consolidation in the lateral and lower lung zones. Progressive deterioration to diffuse unilateral or bilateral consolidation in the series of follow-up chest radiographs is associated with a poor prognosis.


title: Gastrointestinal infections in the immunocompromised host.

text: Persons with HIV infection, leukemia, lymphoma, solid organ and bone marrow transplants, and inherited immune deficiencies as well as those on immunosuppressive drugs are at high risk for infections of the gastrointestinal tract. Pathogenic as well as opportunistic viruses, bacteria, fungi, and protozoa cause infections in the esophagus, stomach, small intestine, and large intestine. Symptoms may be mild but more often are severe and even life threatening. This article reviews what is new in the field of gastrointestinal infections in the immunocompromised host during the past year. I will place specific emphasis on articles that are most pertinent to clinical care.


title: [Work Style Reform from Oncology Field].

text: The doctor's work style reform was enacted in April 2024, and it will enter oncology field without waiting. Oncology clinics already have the 3 powers to realize work style reforms.(1)Efficiency of tasks and task shifting/task sharing that can be advanced only because of the field where team medical care has been performed.(2)Patient understanding and good public skills how to apply medical care that can be obtained only because of the field where emphasis has been placed on collaboration with patients.(3)Improve practice efficiency by introducing ICT that can be realized only in the field where it is easy to introduce ICT, and introduce AI to medical care. I hope that we can make utilize maximally these 3 strengths and promote work style reform from oncology field.


title: Novel 2019 coronavirus SARS-CoV-2 (COVID-19): an overview for emergency clinicians.

text: The novel coronavirus, SARS-CoV-2, and its infection, COVID-19, has quickly become a worldwide threat to health, travel, and commerce. It is essential for emergency clinicians to learn as much as possible about this pandemic to manage the unprecedented burdens on healthcare providers and hospital systems. This review analyzes information from worldwide research and experience on the epidemiology, prevention, and treatment of COVID-19, and offers links to the most reliable and trustworthy resources to help equip healthcare professionals in managing this public health challenge. As the pandemic sweeps the United States, lessons learned from early centers of infection, notably New York and Northern Italy, can help localities to prepare.


title: Protective immunity to lethal challenge of the 1918 pandemic influenza virus by vaccination.

text: The remarkable infectivity and virulence of the 1918 influenza virus resulted in an unprecedented pandemic, raising the question of whether it is possible to develop protective immunity to this virus and whether immune evasion may have contributed to its spread. Here, we report that the highly lethal 1918 virus is susceptible to immune protection by a preventive vaccine, and we define its mechanism of action. Immunization with plasmid expression vectors encoding hemagglutinin (HA) elicited potent CD4 and CD8 cellular responses as well as neutralizing antibodies. Antibody specificity and titer were defined by a microneutralization and a pseudotype assay that could assess antibody specificity without the need for high-level biocontainment. This pseudotype inhibition assay can define evolving serotypes of influenza viruses and facilitate the development of immune sera and neutralizing monoclonal antibodies that may help contain pandemic influenza. Notably, mice vaccinated with 1918 HA plasmid DNAs showed complete protection to lethal challenge. T cell depletion had no effect on immunity, but passive transfer of purified IgG from anti-H1(1918) immunized mice provided protective immunity for naïve mice challenged with infectious 1918 virus. Thus, humoral immunity directed at the viral HA can protect against the 1918 pandemic virus.


title: Structural and biochemical basis for the difference in the helicase activity of two different constructs of SARS-CoV helicase.

text: The non—structural protein 13 (nsp13) of Severe Acute Respiratory Syndrome Coronavirus (SARS—CoV) is a helicase that separates double—stranded RNA or DNA with a 5'—3' polarity, using the energy of nucleotide hydrolysis. We have previously determined the minimal mechanism of helicase function by nsp13 where we demonstrated that the enzyme unwinds nucleic acid in discrete steps of 9.3 base—pairs each with a catalytic rate of 30 steps per second. In that study we used different constructs of nsp13 (GST and H6 constructs). GST—nsp13 showed much more efficient nucleic acid unwinding than the H6—tagged counterpart. At 0.1 second, more than 50% of the ATP is hydrolyzed by GST—nsp13 compared to less than 5% ATP hydrolysis by H6—nsp13. Interestingly, the two constructs have the same binding affinity for nucleic acids. We, therefore propose that the difference in the catalytic efficiency of these two constructs is due to the interference of ATP binding by the histidine tag at the amino—terminus of nsp13.


title: Equine distal limb wounds: new and emerging treatments.

text: Distal limb wounds occur commonly in horses, and treatment can be frustrating for owners and veterinarians. Caring for these wounds is often very expensive, labor intensive, and prolonged. Many commercial products and clinical techniques have been developed to help treat these wounds. Healing of these wounds depends on many factors. With proper wound evaluation and treatment, affected horses can return to function sooner than in the past.


title: Complement-mediated neutralization of canine distemper virus in vitro: cross-reaction between vaccine Onderstepoort and field KDK-1 strains with different hemagglutinin gene characteristics.

text: The properties of neutralization of antigens of canine distemper virus Onderstepoort and a recent field isolate, KDK-1, were investigated with strain-specific dog sera. A conventional neutralization assay indicated antigenic dissimilarity between the strains; however, when guinea pig complement was included in the reaction mixture, the strains were neutralized with not only the homologous but also the heterologous antibodies.


title: Detection of respiratory and enteric shedding of bovine coronaviruses in cattle in an Ohio feedlot.

text: Recently, bovine coronavirus (BCV) has been isolated from new cattle arrivals to feedlots, but the association between respiratory and enteric infections with BCV in feedlot cattle remains uncertain. Fecal and nasal swab samples from 85 Ohio Agricultural Research and Development Center (OARDC) feedlot cattle averaging 7 months of age were collected at arrival (0) and at 4, 7, 14, and 21 days postarrival (DPA). An antigen capture enzyme-linked immunosorbent assay (ELISA) was used to detect concurrent shedding of BCV in fecal and nasal samples. All samples ELISA positive for BCV were matched with an equal number of BCV ELISA-negative samples and analyzed by reverse transcription-polymerase chain reaction (RT-PCR) of the N gene. Paired sera were collected at arrival and 21 DPA and tested for antibodies to BCV using an indirect ELISA. Information on clinical signs, treatments provided, and cattle weights were collected. The overall rates of BCV nasal and fecal shedding were 48% (41/85) and 53% (45/85) by ELISA and 84% (71/85) and 96% (82/85) by RT-PCR, respectively. The peak of BCV nasal and fecal shedding occurred at 4 DPA. Thirty-two cattle (38%) showed concurrent enteric and nasal shedding detected by both tests. Eleven percent of cattle had antibody titers against BCV at 0 DPA and 91% of cattle seroconverted to BCV by 21 DPA. The BCV fecal and nasal shedding detected by ELISA and RT-PCR were statistically correlated with ELISA antibody seroconversion (P < 0.0001); however, BCV fecal and nasal shedding were not significantly related to clinical signs. Seroconversion to BCV was inversely related to average daily weight gains (P < 0.06). Twenty-eight respiratory and 7 enteric BCV strains were isolated from nasal and fetal samples of 32 cattle in HRT-18 cell cultures. These findings confirm the presence of enteric and respiratory BCV infections in feedlot calves. Further studies are needed to elucidate the differences between enteric and respiratory strains of BCV and their role in the bovine respiratory disease complex of feedlot cattle.


Annual Author and Subject Indexes.