title: [Epidemiology of SARS: mission of the emergency medical department of the French Hospital of Hanoi].

text: During the epidemic of severe acute respiratory syndrome (SARS) that occurred in Vietnam in March 2003, the French Ministries of Health and Foreign Affairs dispatched a mission composed of personnel from the emergency medical assistance department (French acronym, SAMU) and one virologist from the Pasteur Institute to the French hospital in Hanoi. The purpose of this mission was to reinforce the local medical staff, to bring medical equipment, and to assist in identifying the cause of the SARS epidemic. Most of the 39 cases observed involved health care personnel working at the hospital. Six including 5 who died presented severe manifestations. Application of strict empirical measures of isolation, hygiene, and personal protection allowed containment of the SARS outbreak in Hanoi.


SARS: are we still at risk?


Review series: lung disease around the world: lung health in India.


title: [Cell entry mechanisms of coronaviruses].

text: Enveloped viruses enter into cells via fusion of their envelope and cellular membrane. Spike (S) protein of coronavirus (CoV) is responsible for entry events. We studied the cell entry mechanisms of two different CoVs, murine coronavirus mouse hepatitis virus (MHV) and severe acute respiratory syndrome coronavirus (SARS-CoV). MHV-JHM that induces syncytia in infected cells entered directly from cell surface, i.e., fusion of envelope and plasma membrane, whereas SARS-CoV and MHV-2 that fail to induce syncytia entered via endosome in a protease-dependent fashion, i.e., fusion of envelope and endosomal membrane. The latter viruses entered directly from cell surface, when receptor-bound viruses were treated with proteases that activate fusion activity of their S proteins. The entry pathway of SARS-CoV could influence the severity of the disease. It was also reveled that a highly neurovirulent JHM spread in a receptor-independent fashion, which could result in a high neuropathogenicity of the virus.


title: Thyroid function in clinical subtypes of major depression: an exploratory study.

text: BACKGROUND Unipolar depression might be characterized by a 'low-thyroid function syndrome'. To our knowledge, this is the first study which explores the possible relationship of DSM-IV depressive subtypes and the medium term outcome, with thyroid function. METHODS MATERIAL Thirty major depressive patients (DSM-IV) aged 21-60 years and 60 control subjects were included. Clinical Diagnosis: The SCAN v 2.0 and the IPDE were used. The psychometric Assessment included HDRS the HAS and the GAF scales. Free-T3, Free-T4, TSH, Thyroid Binding Inhibitory Immunoglobulins (TBII), Thyroglobulin antibodies (TA) and Thyroid Microsomal Antibodies (TMA) were measured in the serum. The Statistical analysis included 1 and 2-way MANCOVA, discriminant function analysis and Pearson Product Moment Correlation Coefficient. RESULTS All depressive subtypes had significantly higher TBII levels in comparison to controls. Atypical patients had significantly higher TMA in comparison to controls. No significant correlation was observed between the HDRS, HAS and GAF scales and thyroid indices. Discriminant function analysis produced functions based on thyroid indices, which could moderately discriminate between diagnostic groups, but could predict good response to treatment with 89.47% chance of success. CONCLUSION Although overt thyroid dysfunction is not common in depression, there is evidence suggesting the presence of an autoimmune process affecting the thyroid gland in depressive patients


The SARS attack on Hong Kong.


title: Prevalence of enteric pathogens in the feces of healthy beef calves.

text: Fecal specimens from 136 healthy beef calves (1 day to 12 weeks of age) were examined for the presence of infectious agents known to cause enteric disease in calves. The calves were selected from 22 herds in which all calves were free of clinically apparent enteric disease. Salmonella sp, enterotoxigenic Escherichia coli, Cryptosporidium, and coronavirus were not detected in any of the calves. Three calves were infected with rotavirus and 1 calf was infected with Yersinia enterocolitica. Campylobacter-like bacteria were isolated from 50 of 130 calves, with 36 of the calves positive for C jejuni. Seemingly, clinically normal calves may be infected more often with enterotoxigenic E coli, Cryptosporidium, coronavirus, or rotavirus in herds in which some calves have enteric disease than in herds free of major enteric disease. Campylobacter jejuni was well adapted to the bovine host and was of similar prevalence in diarrheal and nondiarrheal calves. The K99 positive, nonenterotoxigenic E coli was isolated from the feces of 16 healthy calves. Information in addition to the presence of K99 antigen is useful when diagnosing enterotoxic colibacillosis in calves.


title: Optimization of targeted RNA recombination and mapping of a novel nucleocapsid gene mutation in the coronavirus mouse hepatitis virus.

text: We have recently described a method of introducing site-specific mutations into the genome of the coronavirus mouse hepatitis virus (MHV) by RNA recombination between cotransfected genomic RNA and a synthetic subgenomic mRNA (C. A. Koetzner, M. M. Parker, C. S. Ricard, L. S. Sturman, and P. S. Masters, J. Virol. 66:1841-1848, 1992). By using a thermolabile N protein mutant of MHV (Alb4) as the recipient virus and synthetic RNA7 (the mRNA for the nucleocapsid protein N) as the donor, we selected engineered recombinant viruses as heat-stable progeny resulting from cotransfection. We have now been able to greatly increase the efficiency of targeted recombination in this process by using a synthetic defective interfering (DI) RNA in place of RNA7. The frequency of recombination is sufficiently high that, with Alb4 as the recipient, recombinants can be directly identified without using thermal selection. The synthetic DI RNA has been used to demonstrate that the lesion in another temperature-sensitive and thermolabile MHV mutant, Alb1, maps to the N gene. Sequencing of the Alb1 N gene revealed two closely linked point mutations that fall in a region of the N molecule previously noted as being the most highly conserved region among all of the coronavirus N proteins. Analysis of revertants of the Alb1 mutant revealed that one of the two mutations is critical for the temperature-sensitive phenotype; the second mutation is phenotypically silent.


title: Sympathetic enhancement in futsal players but not in football players after repeated sprint ability test.

text: BACKGROUND Heart rate variability (HRV) can disclose the specific adaptation of sympathovagal modulation to exercise. This study investigated the change in HRV measures after anaerobic and aerobic intermittent exercises in university football and futsal players. METHOD 36 male university students with physically active lifestyle (n=14), football (n=12), and futsal (n=10) participated in this study. The participants completed the repeated sprint ability (RSA) test and Yo-Yo (YY) intermittent recovery test level 1 in randomised order. ECG signals of the participants were recorded in supine position 15 min before and 30 min after exercises. Before exercise, and 5 and 30 min after exercise, the blood pressures were also taken. RESULTS In the RSA protocol, the percentage changes in normalised high-frequency power (nHFP) were significantly decreased, while the percentage changes in the very low/high frequency power ratio (VLHR) and low/high frequency power ratio (LHR) were significantly increased in futsal players after exercise, as compared with the controls. No significant changes in all HRV indices were found in the YY protocol, except the respiratory frequency. CONCLUSIONS After exercise, the percent decrease in vagal modulation in futsal players was significantly reduced, while the percentage increase in sympathetic modulation in futsal players was significantly enhanced in the RSA test, but not in the YY test, as compared with the control group. The increase in sympathetic activity and the decrease in vagal activity in the futsal players were greater than the corresponding increase and decrease in the football players in the RSA test.


title: Severe acute respiratory syndrome: implications for perinatal and neonatal nurses.

text: Severe acute respiratory syndrome (SARS) is an emerging infection that causes a potentially fatal respiratory disease. Although the SARS outbreak lasted less than 1 year, it resulted in significant morbidity and mortality and impacted nursing practices. A literature review was conducted. Only English language research articles in peer-reviewed journals, national organization publications, and book chapters were utilized. Data from 37 relevant articles were extracted, analyzed, and summarized. SARS' clinical description is presented, including its common signs/symptoms, diagnosis, and treatment. Recommended isolation practices for labor and delivery and proper procedures for donning, using, and doffing personal protective equipment are provided. Potential maternal outcomes include spontaneous miscarriage during the first trimester, preterm birth, emergency cesarean section, renal failure, secondary bacterial pneumonia, sepsis, adult respiratory distress syndrome, disseminated intravascular coagulation, surgical site infection, and maternal death. There have been no documented cases of vertical transmission; passive immunity is suspected on the basis of the presence of antibodies in some maternal body fluids. Potential neonatal outcomes include complications related to premature birth, intrauterine growth restriction, respiratory distress syndrome, and severe gastrointestinal manifestations. It is not known if or when SARS will reemerge, but perinatal and neonatal nurses should become familiar with its clinical description and proper infection control procedures to halt potential outbreaks.


title: Outbreak of dysautonomia (Key-Gaskell syndrome) in a closed colony of pet cats.

text: Six of eight pet cats in a closed colony developed overt signs of dysautonomia over a period of seven days; two of them died and one was euthanased. Dysautonomia was confirmed histopathologically in two of these cats, and in the others the diagnosis was based on the characteristic clinical and radiographic findings. In the two apparently unaffected cats abnormal oesophageal motility was demonstrated by fluoroscopy, suggesting that there may be a subclinical form of the disease. The surviving cats had higher and more variable heart rates (mean 165 bpm) than the non-survivors (mean 121 bpm).


title: Bilevel noninvasive positive pressure ventilation for acute respiratory failure: survey of Ontario practice.

text: OBJECTIVE To determine physicians' stated practices regarding the use of bilevel noninvasive ventilation (NIV) for acute respiratory failure and the predictors of practice variation. DESIGN Cross-sectional postal survey. SETTING Province of Ontario, Canada. PARTICIPANTS Attending physicians and residents in four specialties at 15 teaching hospitals. INTERVENTIONS We used literature searches and focus groups to design questions related to NIV utilization with respect to frequency, location of and indications for use, awareness of supporting literature, and perceived efficacy. We assessed the survey's clinical sensibility and reliability. We used regression analyses to evaluate practice variation among hospitals and specialties and to determine predictors of more frequent NIV use, initiation of and continued use in nonmonitored settings, and use for specific indications. MEASUREMENTS AND MAIN RESULTS Three hundred eighty-five (48%) of 808 physicians responded; 242 used NIV. The two most common indications for NIV use were chronic obstructive pulmonary disease and congestive heart failure. NIV guidelines, protocols, or policies were available in 12 of 15 hospitals. We found variation in NIV utilization among specialties but not hospitals. Specialty (critical care and respirology versus internal and emergency medicine), fewer years of postgraduate experience, and a greater number of noninvasive ventilators were predictors of more frequent NIV use (all p < or = .001). Only 6% of respondents reported initiation of use and continued use most frequently in nonmonitored settings, which increased with the number of noninvasive ventilators (p = .02). Physician characteristics such as awareness of the literature were predictive of NIV use for exacerbations of chronic obstructive pulmonary disease, whereas perceived NIV efficacy was predictive of use for many indications, including congestive heart failure. CONCLUSIONS Self-reported practice variation for bilevel NIV exists among specialties but not hospitals and differs with respect to frequency, location of use, and use for specific indications. Some factors associated with variation in NIV use may be suitable targets for utilization improvement interventions.


title: [Current Status of Middle East Respiratory Syndrome Vaccines].

text: Middle East respiratory syndrome is a kind of respiratory disease Caused by Middle East respiratory syndrome Coronavirus. Now the disease has spread to 27 countries around the world, more than 1806 people infected and more than 600 people were killed, and four countries have reported cases of camel infection MERS. Prevention of the disease are very important measures to research and development related to the vaccine. In order to have more resources into the development of safe and effective vaccine, this article summarizes the current some candidate vaccine of MERS research progress for the prevention and treatment of the disease that could trigger a global public health security problems ahead.


title: Autophagy: eating for good health.

text: A renaissance in the autophagy field has illuminated many areas of biology, and infectious disease is no exception. By identifying key components of this broadly conserved membrane traffic pathway, yeast geneticists generated tools for microbiologists and immunologists to explore whether autophagy contributes to host defenses. As a result, autophagy is now recognized to be another barrier confronted by microbes that invade eukaryotic cells. Mounting evidence also indicates that autophagy equips cells to deliver cytosolic Ags to the MHC class II pathway. By applying knowledge of the autophagy machinery and exploiting microbes as genetic probes, experimentalists can now examine in detail how this ancient membrane traffic pathway contributes to these and other mechanisms critical for infection and immunity.


title: Binding of transmissible gastroenteritis coronavirus to brush border membrane sialoglycoproteins.

text: Transmissible gastroenteritis coronavirus (TGEV) is a porcine pathogen causing enteric infections that are lethal for suckling piglets. The enterotropism of TGEV is connected with the sialic acid binding activity of the viral surface protein S. Here we show that, among porcine intestinal brush border membrane proteins, TGEV recognizes a mucin-type glycoprotein designated MGP in a sialic acid-dependent fashion. Virus binding assays with cryosections of the small intestine from a suckling piglet revealed the binding of TGEV to mucin-producing goblet cells. A nonenteropathogenic mutant virus that lacked a sialic acid binding activity was unable to bind to MGP and to attach to goblet cells. Our results suggest a role of MGP in the enteropathogenicity of TGEV.


Malaria control and public health.


title: Respiratory medical societies and the threat of bioterrorism.

text: Respiratory medical societies throughout the world have an important role in helping governments to develop public policy to counter the threat of bioterrorism.


title: Prevalence of coronavirus antibodies in rabbits.

text: Antibodies to coronavirus were detected by an indirect fluorescent antibody test in rabbit sera from six rabbitries. The prevalence ranged from 3 to 40% in different rabbitries and most seropositive rabbits were more than 4 months old. A rabbitry with high prevalence of antibodies and high incidence of diarrhea could serve as a source of virus and aid in studying the natural history of coronavirus infection in rabbits.


title: A noise-optimized virtual monochromatic reconstruction algorithm improves stent visualization and diagnostic accuracy for detection of in-stent re-stenosis in lower extremity run-off CT angiography.

text: PURPOSE To evaluate the impact of noise-optimized virtual monochromatic imaging (VMI+) on stent visualization and accuracy for in-stent re-stenosis at lower extremity dual-energy CT angiography (DE-CTA). MATERIAL AND METHODS We evaluated third-generation dual-source DE-CTA studies in 31 patients with prior stent placement. Images were reconstructed with linear blending (F_0.5) and VMI+ at 40-150 keV. In-stent luminal diameter was measured and contrast-to-noise ratio (CNR) calculated. Diagnostic confidence was determined using a five-point scale. In 21 patients with invasive catheter angiography, accuracy for significant re-stenosis (≥50 %) was assessed at F_0.5 and 80 keV-VMI+ chosen as the optimal energy level based on image-quality analysis. RESULTS At CTA, 45 stents were present. DSA was available for 28 stents whereas 12 stents showed significant re-stenosis. CNR was significantly higher with ≤80 keV-VMI+ (17.9 ± 6.4-33.7 ± 12.3) compared to F_0.5 (16.9 ± 4.8; all p < 0.0463); luminal stent diameters were increased at ≥70 keV (5.41 ± 1.8-5.92 ± 1.7 vs. 5.27 ± 1.8, all p < 0.001) and diagnostic confidence was highest at 70-80 keV-VMI+ (4.90 ± 0.48-4.88 ± 0.63 vs. 4.60 ± 0.66, p = 0.001, 0.0042). Sensitivity, negative predictive value and accuracy for re-stenosis were higher with 80 keV-VMI+ (100, 100, 96.4 %) than F_0.5 (90.9, 94.1, 89.3 %). CONCLUSION 80 keV-VMI+ improves image quality, diagnostic confidence and accuracy for stent evaluation at lower extremity DE-CTA. KEY POINTS • The impact of noise-optimized virtual monochromatic imaging on stent visualization was assessed. • Virtual monochromatic imaging significantly improves stent lumen visualization and diagnostic confidence. • At 80 keV diagnostic performance for detection of in-stent restenosis was increased. • 80 keV virtual monochromatic images are recommended for stent evaluation of lower extremity vasculature.


title: Immunohistochemical screening for viral agents in cheetahs (Acinonyx jubatus) with myelopathy.

text: Numerous cases of acute-onset progressive ataxia, hindlimb paresis and paralysis of unknown aetiology occurred during 1993 to 2003 in cheetahs (Acinonyx jubatus) within the European Endangered Species Programme (eep). This study describes the immunohistochemical investigation of a possible viral aetiology of the "cheetah myelopathy". Antibodies to feline herpesvirus type 1, canine distemper virus, canine parvovirus and Borna disease virus were applied to formalin-fixed and paraffin-embedded brain and spinal cord sections from 25 affected cheetahs aged between three-and-a-half months and 13 years. Using the avidin-biotin complex technique, none of the antibodies gave positive immunosignals in either the brain or the spinal cord tissue.


title: Late-onset rejection of a unilateral donor lung with vascular C4d deposition in bilateral living-donor lobar lung transplantation: an autopsy case report.

text: A 37-year-old woman had undergone bilateral living-donor lobar lung transplantation 11 years previously for idiopathic pulmonary arterial hypertension. Her father donated the right lobe and her brother donated the left lobe. She subsequently developed progressively worsening respiratory dysfunction due to pneumonia. CT showed left dominant pulmonary artery dilatation, bronchial wall thickening and airway stenosis, followed by sudden death. An autopsy showed marked pathologic left dominant rejection of the pulmonary artery, small airway and large airway. Notably, only the left lung showed C4d vascular deposition, thus suggesting that antibody-mediated lung rejection may have occurred.


title: AEGIS: a robust and scalable real-time public health surveillance system.

text: In this report, we describe the Automated Epidemiological Geotemporal Integrated Surveillance system (AEGIS), developed for real-time population health monitoring in the state of Massachusetts. AEGIS provides public health personnel with automated near-real-time situational awareness of utilization patterns at participating healthcare institutions, supporting surveillance of bioterrorism and naturally occurring outbreaks. As real-time public health surveillance systems become integrated into regional and national surveillance initiatives, the challenges of scalability, robustness, and data security become increasingly prominent. A modular and fault tolerant design helps AEGIS achieve scalability and robustness, while a distributed storage model with local autonomy helps to minimize risk of unauthorized disclosure. The report includes a description of the evolution of the design over time in response to the challenges of a regional and national integration environment.


title: Epidemiological features of severe acute respiratory syndrome in Beijing urban and suburb areas in 2003.

text: OBJECTIVE To describe the epidemiologic features of an outbreak of severe acute respiratory syndrome (SARS) in urban and suburb areas in Beijing and to explore their differences between these two areas. METHODS Data of SARS cases were collected from daily notification of China Ministry of Health and a database of infectious diseases was established by the Beijing Municipal Center for Disease Prevention and Control (BCDC). All the data were put into dataset files by Microsoft Excel-2000 and analyzed with SPSS version 10.0 software. RESULTS The respective urban incidence and mortality rate were 29.06 and 2.21 per 100,000, while the case fatality rate was 7.62%. In contrast, the respective suburb incidence and mortality rate were 10.61 and 0.78 per 100,000, and the case fatality rate was 7.32%. No significant differences were found in demographic characteristics between the urban and suburb areas. CONCLUSION Beijing urban area suffered a more serious SARS epidemic than the suburb area in 2003.


title: Severe acute respiratory syndrome coronavirus spike protein expressed by attenuated vaccinia virus protectively immunizes mice.

text: The spike protein (S), a membrane component of severe acute respiratory syndrome coronavirus (SARS-CoV) is anticipated to be an important component of candidate vaccines. We constructed recombinant forms of the highly attenuated modified vaccinia virus Ankara (MVA) containing the gene encoding full-length SARS-CoV S with and without a C-terminal epitope tag called MVA/S-HA and MVA/S, respectively. Cells infected with MVA/Sor MVA/S-HA synthesized a 200-kDa protein, which was recognized by antibody raised against a synthetic peptide of SARS-CoV S or the epitope tag in Western blot analyses. Further studies indicated that S was N-glycosylated and migrated in SDS polyacrylamide gels with an apparent mass of approximately 160 kDa after treatment with peptide N-glycosidase F. The acquisition of resistance to endoglycosidase H indicated trafficking of S to the medial Golgi compartment, and confocal microscopy showed that S was transported to the cell surface. Intranasal or intramuscular inoculations of BALB/c mice with MVA/S produced serum antibodies that recognized the SARS S in ELISA and neutralized SARS-CoV in vitro. Moreover, MVA/S administered by either route elicited protective immunity, as shown by reduced titers of SARS-CoV in the upper and lower respiratory tracts of mice after challenge. Passive transfer of serum from mice immunized with MVA/S to naïve mice also reduced the replication of SARS-CoV in the respiratory tract after challenge, demonstrating a role for antibody to S in protection. The attenuated nature of MVA and the ability of MVA/S to induce neutralizing antibody that protects mice support further development of this candidate vaccine.


title: Proteolytic processing of the polyprotein encoded by ORF1b of the coronavirus infectious bronchitis virus (IBV).

text: We present here evidence demonstrating that four previously predicted Q-S(G) cleavage sites, encoded by the IBV sequences from nucleotide 15,129 to 15,134, 16,929 to 16,934, 18,492 to 18,497, and 19,506 to 19,511, respectively, can be recognised and transcleaved by the 3C-like proteinase. Five mature products with sizes of approximately 100 kDa, 65 kDa, 63 kDa, 42 kDa and 35 kDa are released from the ORF1b polyprotein by the 3C-like proteinase-mediated cleavage at these positions. Meanwhile, expression of plasmids containing only the ORF1b region showed no autocleavage of the polyprotein encoded, suggesting that the 3C-like proteinase may be the sole proteinase involved in processing of the 1b polyprotein. These data may therefore represent a complete processing map of the polyprotein encoded by ORF1b of mRNA1.


title: Workplace hand hygiene and wellness: a survey of knowledge, beliefs, and practices.

text: Community hand hygiene interventions have reduced the spread of infectious disease in elementary schools, daycare centers, and private homes. Despite this success, and the potential for reducing workplace absenteeism and presenteeism, few peer-reviewed hand hygiene intervention studies among workers have been published. This research used the Theory of Planned Behavior (TPB) to guide the development of a model to understand and predict motivations for performing hand hygiene, and to examine related illness, absenteeism, and presenteeism among employees from 39 bank branches in Ohio. Although the TPB has been used extensively to elucidate hand hygiene practices among employees in the health care and food industries, little is known about the ability of the TPB to predict hand hygiene practices among workers in public settings. These survey findings indicate a need for hand hygiene improvement, and support the use of attitudinal beliefs and social norms to guide multimodal approaches for workplace hand hygiene interventions.


title: Promoting a safer practice environment as related to occupational tuberculosis: a nursing care quality issue in Taiwan.

text: As a result of a recent cluster of tuberculosis (TB) transmission among healthcare providers in a regional teaching hospital in Taipei, Taiwan, there has been growing concern about occupational health hazards, especially of communicable diseases, faced by our nurses in practice. Tuberculosis is an invisible killer of nurses in the process of nursing care delivery. This descriptive article briefly reviews the epidemiology of TB in Taiwan, discusses the recent cluster of TB transmission in Taipei, and reviews relevant studies of occupational hazards. This article also focuses nurses' attention on relevant legislation and hospital policies related to occupational hazards in Taiwan. Suggestions and practice implications are discussed.


Role of medical associations in times of disaster.


title: Clinico-radiological Presentation of COVID-19 Patients at a Tertiary Care Center at Bhilwara Rajasthan, India.

text: Background COVID-19 has now become a pandemic. From Wuhan, China, in December 2019 to European countries, USA and now it seems to gain a strong foothold in India. The objective of this work is to report the initial experience with demographic and clinical features, and management of COVID-19 patients admitted in medical college Bhilwara, India. Methods This is a descriptive case series of first 26 COVID-19 patients. Demographical, clinical, laboratory, and radiological characteristics and treatment and outcomes data were obtained with data collection forms and history given by 26 COVID-19 patients. Results and Discussion During this study 26 COVID-19 positive patients were admitted in MG Hospital, Bhilwara. Male patients were 61.54% and majority (88.46%) were below 60 years of age. Approximately 30.76 % patients were asymptomatic. Fever was the most common symptom (61.54%) followed by sore throat (53.84 %), cough (42.30%) myalgia (38.46%)and dyspnea(23.07%). Six patients (23.07%) of total 26 had comorbidities. Leucopenia was seen in in 9 (34.61%) and leukocytosis was seen in 2 patient. Ten patient (38.46%) out of 26 shown increased lymphocyte/neutrophil ratio. Chest X- ray was normal in 20 patients (76.92%). Abnormalities in chest CT were detected among 10 (38.46%) patients. Typical findings were bilateral multifocal patchy peripheral subsegmental areas of consolidation more towards middle and lower zones and bilateral ground glass opacities involving multiple segments. Oseltamivir and chloroquine were given to all 26 patients. Azithromycin was given in 24 patients. Mean duration of conversion of COVID-19 patients was 6.83 days. All discharged patients advised home quarantine for 14 days as per guidelines. Conclusion Patients often present without fever, and many may not have abnormal radiologic findings. Patients with older age and associated comorbid conditions (COPD and diabetes) seem to have greater risk for lung injury.


title: Proximal airway mucous cells of ovalbumin-sensitized and -challenged Brown Norway rats accumulate the neuropeptide calcitonin gene-related peptide.

text: Mucous cell hypersecretion and increased neuropeptide production play a role in the exacerbation of symptoms associated with asthma. The source of these neuropeptides have been confined to the contributions of small afferent nerves or possibly neuroendocrine cells. We tested the hypothesis that repeated exposure to allergen would alter the sources and abundance of neuropeptides in airways. Right middle lobes from rats (8 wk old) exposed to 2.5% ovalbumin (OVA) for five episodes (30 min each) or filtered air were inflation fixed with paraformaldehyde. The lobes were dissected to expose the airway tree, permeabilized with DMSO, and incubated in antibody to rat calcitonin gene-related peptide (CGRP), followed with a fluorochrome-labeled second antibody. CGRP-positive structures were imaged via confocal microscopy. Airways were later embedded in plastic and sectioned for cell identification. In animals challenged with OVA, CGRP-positive cells, not neuroendocrine or neuronal in origin (confirmed by a lack of protein gene product 9.5 signal), were recorded along the axial path. In section, this fluorescent signal was localized to granules within epithelial cells. Alcian blue/periodic acid-Schiff staining of these same sections positively identify these cells as mucous cells. Mucous cells of animals not challenged with OVA were not positive for CGRP. We conclude that episodic allergen exposure results in the accumulation of CGRP within mucous cells, creating a new source for the release of this neuropeptide within the airway.


Value of throat swabs from index cases of meningococcal meningitis.


title: Laparoscopic modified Sugarbaker parastomal hernia repair with 2-point anchoring and zigzag tacking of Parietex™ Parastomal Mesh technique.

text: BACKGROUND The ideal mesh and mesh fixation technique for laparoscopic Sugarbaker (SB) parastomal hernia repair have not yet been identified. METHODS Sixteen patients with parastomal hernia who underwent laparoscopic modified SB repair (LSB) between June 2012 and October 2015 were retrospectively analyzed. LSB was performed using a developed standardized 2-point anchoring and zigzag tacking of Parietex™ Parastomal Mesh (PCO-PM) technique. RESULTS Out of 16 cases, 14 were primary and 2 recurrent hernias; 13 were para-end colostomy and 3 were para-ileal conduit (PIC) hernias. The median longitudinal and transverse diameters of the hernia orifice were 5 cm (2.5-7 cm) and 4.2 cm (2-6 cm), respectively. Five cases had a concomitant midline incisional hernia, which was simultaneously repaired. In all cases, the mesh was placed without deflection. The median operation time was 193 (75-386) min. Perioperative complications occurred in two cases (13 %) with PIC, one intra-operatively and the other postoperatively. The intra-operative complication was enterotomy close to the ureteroenteric anastomosis of the ileal conduit; it was repaired through a mini-laparotomy. LSB was accomplished without any subsequent postoperative complications. The postoperative complication was ureteral obstruction that required creation of nephrostomy. Mini-laparotomy was necessary in those two cases (13 %) because of intra-operative enterotomy and severe intra-abdominal adhesions. The median postoperative length of stay was 9 (5-14) days. No recurrence was observed with a median follow-up of 14.5 (2-41) months. CONCLUSIONS Our LSB using standardized mesh fixation technique is safe and feasible, and the PCO-PM seems to be the most optimal prosthesis.


title: Bioterrorism and emerging infectious disease - antimicrobials, therapeutics and immune-modulators. SARS coronavirus.

text: The purpose of this meeting was to provide a forum for expert presentations and discussion about the threats of bioterrorism and emerging infectious diseases, and to address the issues relating to epidemics, prevention of infection and treatment of some of these emerging infectious diseases classified as potential agents of bioterror. Included in the talks were state-of-the-art presentations about infectious clone technology and recombinant viruses, pathogen and receptor interactions at the cellular and molecular level, genomic responses to infection, and new information on antiviral mechanisms of action. Severe acute respiratory syndrome (SARS) and progress toward understanding the epidemic was addressed, and other sessions were presented concerning immune therapy and immunopotentiation of disease, siRNA and gene silencing, host responses to pathogen infections, as well as the use of genetic engineering to circumvent and direct the immune response. Many discussions were held and data were presented about possible compounds and new drugs that may have antiviral properties, yet there were few discussions of any available new drugs. This report addresses reverse genetics of SARS virus, as well as its epidemiology, and a host of different recent approaches to developing antivirals effective against SARS, including some potential vaccine candidates. Also presented are hypotheses about the human immune response to SARS infection, as well as immune therapies against botulinum and anthrax toxins. This report also addresses antiviral approaches exploiting siRNAs, and different aspects of the host immune response to many of the different dangerous pathogens discussed at this meeting. Finally, approaches to circumventing and directing the immune response using genetic engineering will be reported.


title: [Severe acute respiratory syndrome in 78 patients: a retrospective study].

text: OBJECTIVE To analyze the clinical features of severe acute respiratory syndrome (SARS) and the diagnosis and treatment of the disease. METHODS Seventy-eight patients with SARS referred to the Guangzhou Institute of Respiratory Diseases (GIRD), China from December 22, 2002 to March 2003 were studied retrospectively. The data reviewed included those of clinical manifestations, laboratory investigation and roentgenology. RESULTS The patients consisted of 42 men and 36 women, aged 20 - 75 years (mean 37.5 +/- 11.6 years), including 44 infected health-care professionals. Clinical symptoms of these patients were fever (100%), coughing (88%), and dyspnea (80%). Routine blood test revealed WBCs <4.0 x 10(9)/L in 12 patients (15%), (4.0 -10.0) x 10(9)/L in 49 (63%), and over 10.0 x 10(9)/L in 17 (22%) [average (7.6 +/- 5.0) x 10(9)/L]. The level of neutrophilic granulocyte was 0.75 +/- 0.13 and that of lymphocyte was 0.18 +/- 0.11. Chest X-ray and CT scanning revealed changes related to pneumonia. The transmission of the disease was likely via close contact with contagious droplets. The prevalences of acute lung injury (ALI,37 patients) and acute respiratory distress syndrome (ARDS, 21 of the 37 patients) were considerably high among the patients. Seven patients who developed ARDS complicated with MODS died. CONCLUSIONS A history of close contact, fever, X-ray signs of pneumonia and normal or lowered WBC counts are favorable for the diagnosis of SARS. Recognition of ALI as the important index for critical SARS and comprehensive supportive management are of paramount importance in decreasing the mortality of patients with SARS.


title: Membrane transplantation to correct integral membrane protein defects.

text: In this report we show that the tendency of certain viruses to carry host membrane proteins in their envelopes can be harnessed for transplantation of small patches of plasma membrane, including fully functional, polytopic ion channel proteins and their regulatory binding partners. As a stringent model we tested the topologically complex epithelial ion channel CFTR. Initially an attenuated vaccinia virus was found capable of transferring CFTR in a properly folded, functional and regulatable form to CFTR negative cells. Next we generated viruslike particles (VLPs) composed of retroviral structural proteins that assemble and bud at the host cell plasma membrane. These particles were also shown to mediate functional ion channel transfer. By testing the capacity of complex membrane proteins to incorporate into viral envelopes these experiments provide new insight into the permissiveness of viral envelopment, including the ability of incorporated proteins to retain function and repair defects at the cell surface, and serve as a platform for studies of ion channel and membrane protein biochemistry.


title: Universal oligonucleotides for the detection of infectious bronchitis virus by the polymerase chain reaction.

text: The universality of seven pairs of oligonucleotides for detection of the coronavirus infectious bronchitis virus (IBV) by reverse-transcription polymerase chain reaction (RT-PCR) was examined using 41 isolates of IBV collected over five decades from Europe, Japan and the USA. Oligonucleotides specific for sequences within the S2 region of the spike (S) gene (Lin et al., 1991a) and nucleocapsid (N) gene (Zwaagstra et al., 1992) gave the appropriate products with all 41 isolates. Oligonu-cleotide pair UTR1 - UTR2 +, corresponding to sequences within the 3 untranslated region (UTR) of the genome, also gave the predicted product with all the isolates. Oligonucleotide pair UTR3 - /UTR4 + was internal to oligonucleotides UTR1 - /UTR2 + and was used in a nested-set arrangement for greater specificity and sensitivity, giving the correct product with the 39 isolates examined. Oligonucleotide pair S1Unil - /S1Uni2 + was used to produce a 1.6 kb cDNA, corresponding to most of the S1 region of the S gene, with 24/24 isolates tested. This oligonucleotide pair was less suited than the others for routine detection of IBV but is recommended for the amplification of the S1 region of the S gene of new isolates for subsequent analysis. Other oligonucleotide pairs, yielding cDNA corresponding to the variable region of the IBV genome where genes 3 and 4 (M) overlap, were selected to be largely specific for Massachusetts serotype isolates, in the context of European strains. RT-PCR analysis using these oligonucleotide pairs showed that a number of field isolate preparations also contained a small amount of Massachusetts serotype virus, probably of vaccine origin and indicative of low level persistent infection. These results suggest that any strain of IBV is likely to be detectable by RT-PCR with at least one of our primer pairs.


Parrot proventricular dilation disease.


title: Exposure of feral swine (Sus scrofa) in the United States to selected pathogens.

text: Feral swine (Sus scrofa) are widely distributed in the United States. In 2011 and 2012, serum samples and tonsils were recovered from 162 and 37 feral swine, respectively, in the US to evaluate exposure to important swine endemic pathogens. Antibodies against porcine reproductive and respiratory syndrome virus (PRRSV) and porcine circovirus type 2 (PCV2) were found in 2.5% and 25.3% of tested sera, respectively. Positive serological reactions against Mycoplasma hyopneumoniae and Actinobacillus pleuropneumoniae have been detected in 19.7% and 69.7% of animals. More than 15% of animals presented antibodies against these 2 pathogens simultaneously. Most animals were also seropositive for Lawsonia intracellularis. Feral swine can also be involved in transmission of zoonotic agents. Almost 50% of animals possessed antibodies against Salmonella. In addition, 94.4% of animals were carriers of Streptococcus suis in their tonsils. In conclusion, feral swine may be considered as a potential reservoir for different endemic diseases in domestic pigs, as well as for important zoonotic agents.


title: [Epidemiology of respiratory virus infections].

text: Respiratory viral infections are very common in young children. They sometimes occur as primary infections (and sometimes re-infections) by influenza and parainfluenza virus, respiratory syncytial virus (VRS), adenovirus, rhinovirus and coronavirus. The clinical pictures are very varied and without strict clinico-virological correlation. In adults the role of the site (frail lung, aged persons) and the type of virus play an important part. Many viral infections develop in an epidemiological way (influenza, VRS bronchiolitis, rhinovirus infections...) and several epidemics by different viruses overlap from September-October to March-April making it very difficult to decide the precise cause. Epidemics are followed thanks to networks of medical practitioners (GROG, SENTINELLE...) and by data from hospitalised patients, but precise identification of epidemic viruses is only possible and validated by virological analysis of samples taken from patients.


title: An ultrasensitive young interferometer handheld sensor for rapid virus detection.

text: Future viral outbreaks are a major threat to societal and economic development throughout the world. A rapid, sensitive and easy-to-use test for viral infections is essential to prevent and control such viral pandemics. Furthermore, a compact, portable device is potentially very useful in remote or developing regions without easy access to sophisticated laboratory facilities. In this report we discuss the application of a Young interferometer sensor device for ultrasensitive and real-time detection of viruses. The essential innovation in this technique is the combination of an integrated optical interferometric sensor with antibody-antigen recognition approaches to yield very sensitive, rapid virus detection. The technology is amenable to miniaturization and mass production and, thus, has significant potential to be developed into a handheld, point-of-care device.


title: Detection of feline coronavirus infection in southern African nondomestic felids.

text: Feline coronavirus (FCoV) infects members of the Felidae family with results ranging from seroconversion with no disease to fatal feline infectious peritonitis (FIP). Infection of non-domestic felids with FCoV is of concern, particularly in endangered populations such as cheetahs (Acinonyx jubatus). In this investigation, we tested 342 animals in the Republic of South Africa and Namibia, including 140 animals from wild populations, for evidence of FCoV infection by serology and/or reverse transcription/nested polymerase chain reaction (RT/nPCR) on feces from 1999 through 2001. Past or current infection was evaluated. Of these, 195 animals had evidence of infection and included 41 animals from wild populations. Serology (indirect immunofluorescence) did not always correlate with viral RNA detection, as seronegative animals were occasionally virus-positive, while many seropositive animals were not shedding virus. Serology indicated the infecting virus was most closely related to type I FCoV. Antibody levels in the majority of animals were low, even in those actively infected. Ten of 48 animals tested at more than one time point by RT/nPCR were shedding virus at multiple time points possibly indicating persistent infection. Infection in free-ranging animals was also notable, as over a quarter of the free-ranging animals tested had evidence of current or previous FCoV infection. Testing by serology and RT/nPCR is recommended for screening for FCoV infection.


COVID-19 Testing in South Korea: Current Status and the Need for Faster Diagnostics.


title: Realistic expectations: investing in organizational capacity building for chronic disease prevention.

text: PURPOSE This article presents findings that explore investment in organizational capacity building for chronic disease prevention. Specifically, this analysis examines variation in investment inputs, intervention outputs, and capacity changes to inform expectations of health-promotion capacity-building investment. DESIGN/SETTING This multiple case study involving both qualitative and quantitative data is based on seven provincial dissemination projects involved in the Canadian Heart Health Initiative. METHODS Data on investment, number, and type of capacity-building activities and capacity changes come from a questionnaire, key informant interviews, and project report analysis. Quantitative data were analyzed descriptively and for trends, while qualitative data were analyzed thematically. RESULTS Per capita investments in capacity building ranged from a low of $0.21 in Ontario to $167.41 in Prince Edward Island. Multiple, tailored capacity-building interventions were used in each project. Mostly positive but modest changes were observed in at least five dimensions of capacity in all but one project. CONCLUSION These findings reveal that capacity building for chronic disease prevention requires a long-term investment and is context specific. Even limited investment can produce interventions that appear to positively influence capacity for chronic disease prevention. The findings also suggest an urgent need to expand surveillance to include indicators of capacity-building investments and interventions to allow policy makers to make more informed decisions about investments in public health.


title: Providing critical care during a disaster: the interface between disaster response agencies and hospitals.

text: OBJECTIVE Recent natural disasters have highlighted shortfall areas in current hospital disaster preparedness. These include the following: 1) insufficient coordination between hospitals and civil/governmental response agencies; 2) insufficient on-site critical care capability; 3) a lack of "portability" of acute care processes (i.e., patient transport and/or bringing care to the patient); 4) education shortfalls; and 5) the inability of hospitals to align disaster medical requirements with other competing priorities. CONCLUSIONS Definition of the roles and responsibilities of a hospital during a disaster requires additional planning precision beyond the prehospital response phase. Planners must also better define plans for circumstances when or if a hospital is rendered unusable. Disaster medical training of hospital personnel has been inadequate. This article details the specifics of these issues and outlines various potential approaches to begin addressing and formulating remedies to these shortfalls.


title: Feline leukaemia provirus load during the course of experimental infection and in naturally infected cats.

text: Feline leukaemia virus (FeLV) infection in domestic cats can vary in its outcome (persistent, transient, no infection) for reasons that are not entirely known. It was hypothesized that the initial virus and provirus load could significantly influence the course of retrovirus infection. To determine the role of provirus loads, two methods of PCR, a nested PCR and a fluorogenic probe-based (TaqMan) real-time quantitative PCR, which were specific to the U3 region of FeLV-A were established. FeLV provirus in naturally and experimentally infected cats was then measured. Only 3 weeks after experimental FeLV-A infection, persistently infected cats demonstrated higher provirus loads and lower humoral immune responses than cats that had overcome antigenaemia. Lower initial provirus loads were associated with successful humoral immune responses. Unexpectedly, provirus in the buffy-coat cells of two cats that tested negative for the p27 antigen (a marker for viraemia) was also detected. In 597 Swiss cats, comparison of p27 antigen levels with PCR results revealed broad agreement. However, similar to the experimental situation, a significant number of animals (10%) was negative for the p27 antigen and FeLV-positive by PCR. These cats had a mean provirus load 300-fold lower than that of animals testing positive for the p27 antigen. In conclusion, an association between the provirus load and the outcome of FeLV infection was found. Detection of provirus carriers should contribute to further the control of FeLV. In addition, quantification of provirus loads will lead to a better understanding of FeLV pathogenesis and anti-retrovirus protective mechanisms.


Recovery pathway of post-SARS patients.


title: Infection control and pandemic influenza.

text: If an influenza pandemic occurs, the spread of the virus should be reduced for as long as possible while an effective vaccine is produced. Influenza spreads mainly by large respiratory droplets (> 5 microm) depositing onto the mucosal surfaces of the eye, mouth or respiratory tract. Hands are another major means for spread, and are frequently contaminated by droplets. The most effective way to reduce the spread of the virus is with good infection control practices and social distancing. Infection control practices include the use of personal protective equipment (PPE), hand hygiene, and respiratory hygiene and cough etiquette. Infected people should be isolated and spatial separation observed in common areas where infected people may be present. Any practices that create aerosols (eg, nebulisation) should be avoided, unless performed with appropriate precautions, especially with all people in the room wearing appropriate PPE. Now is the time to re-examine all our current practices so that we are better prepared, well practised and have good infection control practices in place for all transmissible respiratory infections.


title: Prevalence of antibodies to feline parvovirus, calicivirus, herpesvirus, coronavirus, and immunodeficiency virus and of feline leukemia virus antigen and the interrelationship of these viral infections in free-ranging lions in east Africa.

text: While viral infections and their impact are well studied in domestic cats, only limited information is available on their occurrence in free-ranging lions. The goals of the present study were (i) to investigate the prevalence of antibodies to feline calicivirus (FCV), herpesvirus (FHV), coronavirus (FCoV), parvovirus (FPV), and immunodeficiency virus (FIV) and of feline leukemia virus (FeLV) antigen in 311 serum samples collected between 1984 and 1991 from lions inhabiting Tanzania's national parks and (ii) to evaluate the possible biological importance and the interrelationship of these viral infections. Antibodies to FCV, never reported previously in free-ranging lions, were detected in 70% of the sera. In addition, a much higher prevalence of antibodies to FCoV (57%) was found than was previously reported in Etosha National Park and Kruger National Park. Titers ranged from 25 to 400. FeLV antigen was not detectable in any of the serum samples. FCoV, FCV, FHV, and FIV were endemic in the Serengeti, while a transient elevation of FPV titers pointed to an outbreak of FPV infection between 1985 and 1987. Antibody titers to FPV and FCV were highly prevalent in the Serengeti (FPV, 75%; FCV, 67%) but not in Ngorongoro Crater (FPV, 27%; FCV, 2%). These differences could be explained by the different habitats and biological histories of the two populations and by the well-documented absence of immigration of lions from the Serengeti plains into Ngorongoro Crater after 1965. These observations indicate that, although the pathological potential of these viral infections seemed not to be very high in free-ranging lions, relocation of seropositive animals by humans to seronegative lion populations must be considered very carefully.


title: The Alzheimer pandemic: is paracetamol to blame?

text: HISTORICAL BACKGROUND The clinical recognition of a form of dementia closely resembling Alzheimer's disease dates from around 1800. The role of analgesics derived from coal-tar in the spread of the pandemic is traced in terms of the introduction of phenacetin (PN) in 1887; its nephrotoxicity; the observation of lesions characteristic of the disease by Fischer and Alzheimer; the discovery of paracetamol (PA) as the major metabolite of PN; the linking of kidney injury and dementia with high PN usage; and the failure of PN replacement by PA to halt and reverse the exponential, inexorable rise in the incidence of Alzheimer-type dementia. Fischer observed his first case before Alzheimer; it is proposed to rename the syndrome Fischer-Alzheimer disease (F-AD). Disease development: PA-metabolising enzymes are localised in the synaptic areas of the frontal cortex and hippocampus, where F-AD lesions arise. The initiating chemical lesions in liver poisoning comprise covalent binding of a highly reactive product of PA metabolism to proteins; similar events are believed to occur in brain, where alterations in the antigenic profiles of cerebral proteins activate the microglia. β-Amyloid forms, and, like PA itself, induces nitric oxide synthase. Peroxynitrite modifies cerebral proteins by nitrating tyrosine residues, further challenging the microglia and exacerbating the amyloid cascade. Spontaneous reinnervation, N-acetyl cysteine administration and tyrosine supplementation may attenuate the early stages of F-AD development. CONCLUSION F-AD is primarily a man-made condition with PA as its principal risk factor.


title: Vademecum for the treatment of people with COVID-19. Edition 2.0, 13 March 2020.

text: The spread of COVID-19 epidemic in Italy, and particularly in Lombardy determined the need to standardize the therapeutic approach in order to offer the same indications for all hospitals in Lombardy. However, no specific drug has been previously approved for the COVID-19 treatment. The Lombardy Section of the Italian Society of Infectious and Tropical Diseases provided this «vademecum» with the aim to explore the current evidence about the drugs likely to be efficacious in the treatment of COVID-19. Moreover, a multidisciplinary group including critical care specialists has been created in order to provide indications about supporting measures and the use of steroids. A new grading scale has been proposed to help patients' stratification according to the severity of the respiratory conditions. Lastly, a collaborating group with immunologists and rheumatologists has been built with the aim of providing some guidance about the use of tocilizumab, a promising option for the treatment of the hyperinflammatory state occurring in most patients affected by COVID-19.


title: Intracellular Tat of human immunodeficiency virus type 1 activates lytic cycle replication of Kaposi's sarcoma-associated herpesvirus: role of JAK/STAT signaling.

text: Human immunodeficiency virus type 1 (HIV-1) infection significantly increases the risk of Kaposi's sarcoma (KS) occurrence in individuals infected with Kaposi's sarcoma-associated herpesvirus (KSHV). KSHV infection appears to be necessary but not sufficient for KS development without other cofactors. However, factors that facilitate KSHV to cause KS have not been well defined. Previously, we determined that human herpesvirus 6 was one of the cofactors that activated lytic cycle replication of KSHV. Here, we demonstrate that the Tat protein of HIV-1 is a potentially important factor in the pathogenesis of KS, as determined by production of lytic phase mRNA transcripts and viral proteins in BCBL-1 cells. Mechanistic studies showed ectopic expression of Tat induced the production of human interleukin-6 (huIL-6) and its receptor (huIL-6Ra) and activated STAT3 signaling. Neutralization of huIL-6 or huIL-6R or inhibition of STAT3 signaling enhanced the replication. In addition, IL-4/STAT6 signaling also partially contributed to Tat-induced KSHV replication. These findings suggest that Tat may participate in KS pathogenesis by inducing KSHV replication and increasing KSHV viral load. These data also suggest that JAK/STAT signaling may be of therapeutic value in AIDS-related KS patients.


title: The management of acute bronchitis in children.

text: Acute bronchitis is one of the most common infections reported in children under 5 years of age, and is a leading cause of hospitalisation. In general practice, confusion surrounds the clinical diagnosis of acute bronchitis, especially when distinguishing it from asthma. The microbiological causes are mostly known, but the contribution of each is much less clear, and they are non-specific in their clinical expression in individual cases. Viral pathogens, particularly respiratory syncytial virus and rhinoviruses are cited as the leading agents in the development of serious episodes, but other pathogens may also be important. This article covers a range of issues surrounding acute bronchitis, including epidemiology and pathogenesis, as well as the management, prevention and treatment of disease in children.


title: Antiviral activity of substituted salicylanilides--a review.

text: Chemotherapy of viral infections is still challenging. Salicylanilides demonstrated a wide range of biological activities including antiviral potency and the review summarizes this field. Niclosamide was described to be able to affect coronaviruses. Some salicylanilides and salicylamides could inhibit HIV virus by targeting of HIV-1 integrase or reverse transcriptase. Hepatitis C virus is another virus, which could be potentially afflicted by salicylanilides on the level of two enzymes--NS3 protease and NS5B RNA polymerase. Nitazoxanide is a nitrothiazole derivative of salicylamide useful for the treatment of protozoal and bacterial infections with an extended range of antiviral activity and innovative mechanism of action, especially against hepatitis and influenza viruses or rotaviruses. Nitazoxanide, its metabolite tizoxanide and their derivatives are a very promising stream in the development of new antiviral compounds. In this review, we summarize the antiviral activity of structures containing salicylanilide and partly salicylamide moiety.


title: Human paragonimiasis after eating raw or undercooked crayfish --- Missouri, July 2006-September 2010.

text: Paragonimiasis is a parasitic disease caused by Paragonimus trematodes, commonly known as lung flukes. Humans become infected by eating raw or undercooked crayfish (also known as crawfish and crawdads) or freshwater crabs that harbor the parasites. Paragonimiasis most frequently involves the lungs, but can affect other organs, including the brain and skin. In North America, Paragonimus kellicotti causes infections among dogs, cats, and wild carnivores, but rarely infects humans. Paragonimiasis is not a nationally notifiable condition. In September 2009, physicians from the Washington University School of Medicine (WUSM) in St. Louis published details of three paragonimiasis cases diagnosed since July 2006 in persons who had eaten raw crayfish from rivers in Missouri, prompting the Missouri Department of Health and Senior Services (MDHSS), CDC, and WUSM to collaborate in paragonimiasis surveillance and prevention. During September 2009-September 2010, six additional cases were diagnosed in Missouri. These nine patients, aged 10-32 years, had fever, cough, pleural effusion, and eosinophilia. All had eaten raw or undercooked crayfish from rivers in Missouri while on canoeing or camping trips within 4 months of illness onset. Health-care providers should consider paragonimiasis when examining patients with unexplained fever, cough, eosinophilia, and pleural effusion or other chest radiographic abnormalities and should ask those patients whether they have eaten raw or undercooked crayfish.


title: [Attenuated vaccine against rota- and coronavirus enteritis in calves].

text: Tested was the effect of the Bulgarian attenuated vaccine of rota- and corona-viruses 'PoKo-81', via treatment of dry and freshly calved cows (injected into the udder) and newborn calves (peritoneal injection). It was found that calves fed three times daily on milk obtained from cows that had had intramammary injections did not develop clinical signs of a disease following experimental infection with rota- and corona-viruses. When the cows on infected farms were treated in the same way the disease in calves, offered immune milk, dropped to 36 per cent as against calves of unvaccinated cows, with which morbidity ran as high as 85 per cent. Calves vaccinated via the peritoneum did not fall ill after infection with rota- and corona-viruses on the 6th day following vaccination. In experiments on 18 infected farms morbidity among control, unvaccinated calves was 76 per cent, and mortality--6.8 per cent. With vaccinated calves on the same farms morbidity dropped to 44 per cent, and mortality--to 2.5 per cent. The duration of diarrhea in the vaccinated calves was radically lowered. Discussed is the possibility to enhance the protective effect of the vaccine.


title: Canine parvovirus in vaccinated dogs: a field study.

text: The authors report a field study that investigated the canine parvovirus (CPV) strains present in dogs that developed the disease after being vaccinated. Faecal samples of 78 dogs that have been vaccinated against CPV and later presented with clinical signs suspected of parvovirus infection were used. Fifty (64.1 per cent) samples tested positive by PCR for CPV. No CPV vaccine type was detected. The disease by CPV-2b occurred in older and female dogs when compared with that by CPV-2c. The clinical signs presented by infected dogs were similar when any of both variants were involved. In most cases of disease, the resulting infection by field variants occurred shortly after CPV vaccination. Two dogs that had been subjected to a complete vaccination schedule and presented with clinical signs after 10 days of vaccination, had the CPV-2c variant associated. The phylogenetic studies showed a close relationship of the isolates in vaccinated dogs to European field strains. Despite the limited sample size in this study, the findings point to the significance of the continuous molecular typing of the virus as a tool to monitor the prevalent circulating CPV strains and access the efficacy of current vaccines. Adjustments on the vaccine types to be used may have to be evaluated again according to each epidemiological situation in order to achieve the dog's optimal immune protection against CPV.


title: Cocktail therapy for hip necrosis in SARS patients.

text: BACKGROUND There are no treatment guidelines for hip necrosis in severe acute respiratory syndrome (SARS) patients. A new regimen of cocktail therapy that consists of extracorporeal shockwave therapy (ESWT), hyperbaric oxygen therapy (HBO) and oral alendronate was utilized in four patients with eight hips. This study evaluated the outcomes of cocktail therapy with a 4-year followup. METHODS There were 3 women and 1 man with an average age of 26 +/- 3.8 years. Each hip was treated with 6000 impulses of ESWT at 0.62 mJ/mm2 energy flux density in a single session. Each patient received HBO treatment for 100 sessions and oral alendronate for one year. The evaluations included pain score and Harris hip score, radiographs and magnetic resonance imaging (MRI) of the affected hips. RESULTS At the 4-year follow-up, significant improvements in pain score and Harris hip score were observed in all cases (p < 0.001). All patients returned to work as healthcare providers. None required surgical intervention including hip replacement. MRI showed a trend of reduction in bone marrow edema and the size of the lesion, but no changes in the stage of the lesion. CONCLUSION Cocktail therapy seems promising in delaying the disease progression of SARS-associated femoral head necrosis in the short-term.


title: Recent advances in pancreatic transplantation.

text: Pancreatic transplantation has progressed in the past 25 years since its initial stages, proving to be highly promising for those with diabetes and its resultant multiorgan disorders. Several studies have shown that patients who receive transplants have better glycemic control, blood pressure control, lipid control, and show reversal of microscopic diabetic changes including neuropathy and improved cardiovascular risks. Advances in many fields have made it possible for more than 32,000 procedures to be done worldwide, and 1- and 5-year posttransplant survival to be 95% and 83%. We sought to explore what advances have taken place in surgical techniques, patient selection, and immuno-suppressant therapy to allow this improvement and reduction in complications. New techniques (ie, islet cell implantation) promise early results. However, pancreatic transplant is currently the single existing therapy to establish normal glucose without exogenous insulin.


Can chlorine dioxide prevent the spreading of coronavirus or other viral infections? Medical hypotheses.


title: Prospective, randomised, double blind, controlled comparison of metoclopramide and pethidine in the emergency treatment of acute primary vascular and tension type headache episodes.

text: STUDY OBJECTIVE To compare analgesic effects of metoclopramide (MTP), pethidine (PET), and combination of metoclopramide-pethidine (M-PET) in the treatment of adult patients with acute primary vascular and tension type headache admitted in the emergency department (ED). METHODS All consecutive adult patients admitted into a university hospital ED in six months with acute vascular and tension type headache were recruited. The patients whose complaints had lasted no longer than seven days were randomised to four groups and thereby received 10 mg MTP intravenously plus placebo intramuscularly (MTP), 10 mg MTP intravenously plus 50 mg PET intramuscularly (M-PET), 50 mg PET intramuscularly plus placebo intravenously (PET); and intramuscular and intravenous placebo (PLC) in a blinded fashion. The patients were asked to report the degree of pain at 0, 15, 30, and 45 minutes on visual analogue scale (VAS) and demographic data and any side effects encountered were recorded. Rescue medication was used if required by the patient because of poor pain relief. RESULTS Data regarding 336 patients meeting inclusion criteria were analysed. Mean VAS values recorded at 45 minutes were significantly higher in PLC group than in others (p = 0.000). When the PLC group was excluded, VAS scores in MTP and M-PET groups were significantly lower than in PET group (p = 0.038). Though unimportant, the incidence of side effects recorded in PET group was found to be significantly higher than in the other groups (p = 0.003). CONCLUSION These data suggest that MTP produces more effective analgesia than PET in both vascular and tension type headache in patients with acute primary headache episodes.


title: Depression, antidepressants, and peripheral blood components.

text: The biological attributes of affective disorders and factors which are able to predict a response to treatment with antidepressants have not been identified sufficiently. A number of biochemical variables in peripheral blood constituents have been tested for this purpose, as a consequence of the lack of availability of human brain tissue. At first, the biological attributes of mental disorders were sought at the level of concentrations of neurotransmitters and their metabolites or precursors. Later on, attention shifted to receptor systems. Since the 1990s, intracellular processes influenced by an illness or its treatment with psychopharmaceuticals have been at the forefront of interest. Interest in biological predictors of treatment with antidepressants has reappeared in recent years, thanks to new laboratory techniques which make it possible to monitor cellular processes associated with the transmission of nerve signals in the brain. These processes can also be studied in plasma and blood elements, especially lymphocytes and platelets. The selection of the qualities to which attention is paid can be derived from today's most widely discussed biochemical hypotheses of affective disorders, especially the monoamine hypothesis and the molecular and cellular theory of depression. Mitochondrial enzymes can also play an important role in the pathophysiology of depression and the effects of antidepressants. In this paper, we sum up the cellular, neurochemical, neuroendocrine, genetic, and neuroimmunological qualities which can be measured in peripheral blood and which appear to be indicators of affective disorders, or parameters which make it possible to predict therapeutic responses to antidepressant administration.


title: Antihistamines for the common cold.

text: BACKGROUND Although antihistamines are prescribed in large quantities for the common cold, there is little evidence to whether these drugs are effective. OBJECTIVES To assess in patients with a common cold the effects of antihistamines in alleviating nasal symptoms, or in shortening of illness duration. SEARCH STRATEGY We searched the Cochrane Acute Respiratory Infections Group Specialized Register and EMBASE up to December 2002; Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE up to February 2003. We also followed up references in identified papers. We appealed for further articles at a major international conference on Acute Respiratory Infections (1997). We corresponded with experts and got in touch with pharmaceutical companies. SELECTION CRITERIA Randomised, placebo-controlled trials on treatment of common cold with antihistamines, used either singly or in combination, in adults or children. DATA COLLECTION AND ANALYSIS Data were extracted by two reviewers and authors were contacted for further data. Trials were subdivided into monotherapy and combination therapy. Data on general recovery, nasal obstruction, rhinorrhea, sneezing, and side-effects were extracted and summarized in a systematic review. MAIN RESULTS We included thirty two papers describing 35 comparisons; 22 trials studied monotherapy, 13 trials a combination of antihistamines with other medication. A total of 8930 people suffering from the common cold were included. There were large differences in study designs, participants, interventions, and outcomes. There was no evidence of any clinically significant effect - in children or in adults - on general recovery of antihistamines in monotherapy. First generation - but not non-sedating - antihistamines have a small effect on rhinorrhea and sneezing. In trials with first generation antihistamines the incidence of side effects (especially sedation) is significantly higher with active treatment. Two trials, studying a combination of antihistamines with decongestives in small children, both failed to show any effect. Of the eleven trials on older children and adults, the majority show an effect on general recovery and on nasal symptom severity. REVIEWER'S CONCLUSIONS Antihistamines in monotherapy - in children as well as in adults - do not alleviate to a clinical extend nasal congestion, rhinorrhoea and sneezing, or subjective improvement of the common cold. First generation antihistamines also cause more side-effects than placebo, in particular they increase sedation in cold sufferers. Combinations of antihistamines with decongestives are not effective in small children. In older children and adults most trials show a beneficial effect on general recovery as well as on nasal symptoms. It is however not clear whether these effects are clinically significant.


title: Mouse hepatitis virus utilizes two carcinoembryonic antigens as alternative receptors.

text: The cellular receptor for the murine coronavirus mouse hepatitis virus (MHV) has been identified as a member of the murine carcinoembryonic antigen (CEA) family (R. K. Williams, G. S. Jiang, and K. V. Holmes, Proc. Natl. Acad. Sci. USA 88:5533-5536, 1991). However, the receptor protein was not detected in some of the susceptible mouse tissues. We therefore examined whether other types of MHV receptor might exist. By polymerase chain reaction with the conserved sequences of murine CEA gene family members (mmCGM) as primers, we detected two CEA-encoding RNAs in the mouse liver. One of them (1.3 kb) encodes mmCGM1, which has previously been identified as the receptor for MHV, and the other one (0.8 kb) was shown to encode another member of mouse CGM, mmCGM2. The sequence analysis showed that mmCGM2 lacks 564 nucleotides in the middle of the gene compared with mmCGM1. These two CEA transcripts are probably derived from the same gene by an alternative splicing mechanism. Expression of either of these cDNA clones in COS-7 cells rendered these cells susceptible to MHV infection, suggesting that not only mmCGM1 but also mmCGM2 serves as a receptor for MHV. The mmCGM2 was the major CEA species in the mouse brain, which is a main target organ for the neurotropic strains of MHV. Very little mmCGM1 was detected in the mouse brain or in cells of the susceptible mouse astrocytoma cell line DBT. This result indicates that MHV may utilize different CEA molecules as the major receptor in the mouse brain and in the liver. This is a first identification of multiple receptors for a single virus. The presence of different receptors in different tissues may explain the target cell specificity of certain MHVs.


title: Physiological significance of apoptosis during animal virus infection.

text: Apoptosis has been considered to be a host defense mechanism against viral infection in multicellular organisms. This is based on the findings that apoptogenic mutants of insect viruses cannot grow because infected host cells die by apoptosis. This suggests that the apoptotic response of host cells has a deleterious effect on virus infection. Thus, apoptosis is an important host defense mechanism that is capable of inhibiting viral replication during infection. However, in vitro studies indicated that apoptosis alone does not provide the same protection against viral infection in animal cells as it does in the insect cells. Still, most animal viruses have acquired a strategy to overcome host cell apoptosis. In addition, a varying degree of necrosis usually accompanies apoptosis, suggesting a possible contribution of necrosis to the host reactions against virus. To understand the physiological significance of apoptosis during animal virus infection, we have characterized viral growth and the cellular responses against virus infection in a wide variety of virus-cell interaction systems. Mainly based on our own works, we discuss the nature of apoptosis in the animal virus infection and verify its role as a host defense mechanism against virus infection.


title: Teaching Lessons from the Coronavirus Disease 2019 (COVID-19) Pandemic in Telemedicine.

text: The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY.


title: State Medicaid coverage for tobacco-dependence treatments--United States, 2006.

text: Approximately one third of adult Medicaid recipients smoke. The Public Health Service, the Task Force on Community Preventive Services, and the Institute of Medicine recommend that health-insurance coverage be provided for tobacco-dependence treatments. In addition, a Healthy People 2010 national health objective calls for total health-insurance coverage for evidence-based tobacco-dependence treatments in all 51 Medicaid programs (objective 27-8b). The types of tobacco-dependence treatments covered by Medicaid have been reported periodically from surveys conducted by the Center for Health and Public Policy Studies at the University of California, Berkeley. This report summarizes results of the 2006 survey, which determined that 39 state Medicaid programs (including the District of Columbia) covered some form of tobacco-dependence treatment (i.e., medication or counseling) for all Medicaid recipients and one state program provided coverage for all recommended treatments. Two states that previously provided no coverage for tobacco-dependence treatment began coverage in 2006. In addition, 32 states added coverage for a new medication, varenicline (Chantix [Pfizer, Mission, Kansas]), one state expanded its coverage to include the nicotine lozenge, and one state expanded coverage to include individual counseling. If the 2010 objective is to be achieved, Medicaid coverage for tobacco-dependence treatment must increase substantially.


title: Immunodepression induced by Trypanosoma cruzi and mouse hepatitis virus type 3 is associated with thymus apoptosis.

text: Trypanosoma cruzi-infected mice show disturbance in the peripheral immune system such as polyclonal lymphocyte activation, autoantibody production, and immunosuppression of T lymphocytes. Previous observations in our laboratory showed that some stocks of T. cruzi can be contaminated with mouse hepatitis virus type 3 (MHV-3). Literature has shown that MHV-3 infection induces immunologic disorders characterized by thymic involution with marked cell depletion. However, the effects of interactions between MHV-3 and the parasite on the immune system are not well understood. In the present study specific-pathogen-free CBA mice were inoculated with MHV-3, alone or associated with different stocks of T. cruzi. Concurrent murine virus infection resulted in increased pathogenicity of T. cruzi infection shown by profound thymic atrophy; loss of cortical thymocytes; depletion of Thy1.2+, CD4+, and CD8+ cells; enhancement of in situ labeling of nuclear DNA fragmentation; and eventually, death of the animals. Such lines of evidence show that the mechanism underlying this thymic atrophy is associated with apoptosis. These results also suggest that MHV-3 can account for the increased immunosuppression observed during experimental infection with the parasite.


title: Comparison of immunohistochemistry, electron microscopy, and direct fluorescent antibody test for the detection of bovine coronavirus.

text: Bovine coronavirus (BCV) is 1 of the major causes of calf diarrhea and has also been implicated in respiratory infections of young calves and winter dysentery of adult cattle. Currently, transmission electron microscopy (TEM), direct fluorescent antibody (DFA), and enzyme-linked immunosorbent assay (ELISA) techniques are considered standard methods for the diagnosis of BCV infection. However, these techniques are not useful if fresh tissues and intestinal contents are not available for examination. The detection of viral antigens in formalin-fixed, paraffin-embedded tissues using immunohistochemistry (IHC) is a suitable alternative. In the present study, 166 tissue specimens were tested by IHC for the presence of BCV. These tissues were from animals whose feces were positive for rotavirus and/or coronavirus by TEM. Some of these samples were also tested by DFA. Thus, TEM, DFA, and IHC were compared for the detection of BCV. There was 56% agreement among the 3 methods (overall kappa = 0.368). When IHC was compared with TEM, 78% agreement was observed (kappa = 0.475). Similarly, IHC and DFA had 64% agreement (kappa = 0.277). These kappa values indicate a moderate degree of agreement between IHC and TEM; agreement between IHC and DFA was fair. The results of this study indicate that IHC may be a suitable adjunct for the detection of BCV because of its simplicity, ease of use, and relatively close correlation with TEM results.


title: The state of infection surveillance and control in Canadian acute care hospitals.

text: BACKGROUND Nosocomial infections and antibiotic-resistant pathogens cause significant morbidity, mortality, and economic costs. The infection surveillance and control resources and activities in Canadian acute care hospitals had not been assessed in 20 years. METHODS In 2000, surveys were mailed to infection control programs in all Canadian hospitals with more than 80 acute care beds. The survey was modeled after the US Study on the Efficacy of Nosocomial Infection Control instrument, with new items dealing with resistant pathogens and computerization. Surveillance and control indices were calculated. RESULTS One hundred seventy-two of 238 (72.3%) hospitals responded. In 42.1% of hospitals, there was fewer than 1 infection control practitioner per 250 beds. Just 60% of infection control programs had physicians or doctoral professionals with infection control training who provided services. The median surveillance index was 65.6/100, and the median control index was 60.5/100. Surgical site infection rates were reported to individual surgeons in only 36.8% of hospitals. CONCLUSIONS There were deficits in the identified components of effective infection control programs. Greater investment in resources is needed to meet recommended standards and thereby reduce morbidity, mortality, and expense associated with nosocomial infections and antibiotic-resistant pathogens.


title: Molecular determinants of species specificity in the coronavirus receptor aminopeptidase N (CD13): influence of N-linked glycosylation.

text: Aminopeptidase N (APN), a 150-kDa metalloprotease also called CD13, serves as a receptor for serologically related coronaviruses of humans (human coronavirus 229E [HCoV-229E]), pigs, and cats. These virus-receptor interactions can be highly species specific; for example, the human coronavirus can use human APN (hAPN) but not porcine APN (pAPN) as its cellular receptor, and porcine coronaviruses can use pAPN but not hAPN. Substitution of pAPN amino acids 283 to 290 into hAPN for the corresponding amino acids 288 to 295 introduced an N-glycosylation sequon at amino acids 291 to 293 that blocked HCoV-229E receptor activity of hAPN. Substitution of two amino acids that inserted an N-glycosylation site at amino acid 291 also resulted in a mutant hAPN that lacked receptor activity because it failed to bind HCoV-229E. Single amino acid revertants that removed this sequon at amino acids 291 to 293 but had one or five pAPN amino acid substitution(s) in this region all regained HCoV-229E binding and receptor activities. To determine if other N-linked glycosylation differences between hAPN, feline APN (fAPN), and pAPN account for receptor specificity of pig and cat coronaviruses, a mutant hAPN protein that, like fAPN and pAPN, lacked a glycosylation sequon at 818 to 820 was studied. This sequon is within the region that determines receptor activity for porcine and feline coronaviruses. Mutant hAPN lacking the sequon at amino acids 818 to 820 maintained HCoV-229E receptor activity but did not gain receptor activity for porcine or feline coronaviruses. Thus, certain differences in glycosylation between coronavirus receptors from different species are critical determinants in the species specificity of infection.


title: The support of severe respiratory failure beyond the hospital and during transportation.

text: PURPOSE OF REVIEW Given the number and variety of calamities in the past few years, providing support for critically ill and injured casualties has become a global priority. This article reviews and describes the challenges faced in providing critical care and respiratory support in an austere environment and during medical transport. The primary focus to be discussed is mechanical ventilation. RECENT FINDINGS The United States Air Force has developed a programme called the Critical Care Aeromedical Transport Teams. These teams provide dynamic and sophisticated critical care in austere environments, including during medical transport. The Critical Care Aeromedical Transport Teams programme provides a framework for the discussion of supporting respiratory failure in these settings. We will discuss the team concept of operations, the equipment assemblage, methods and techniques of intensive care unit patient care in this setting, and caveats and pitfalls as they pertain to respiratory failure, mechanical ventilation, and respiratory monitoring. SUMMARY The support of respiratory failure with mechanical ventilation during a disaster is complex and challenging. The key to success is pre-planning, flexibility, and portability. Programmes such as the Critical Care Aeromedical Transport Teams can be a useful model for the development of appropriate civil response capabilities in critical care for use during a disaster.


title: Implications of resolved hypoxemia on the utility of desaturation alerts sent from an anesthesia decision support system to supervising anesthesiologists.

text: BACKGROUND Hypoxemia (oxygen saturation <90%) lasting 2 or more minutes occurs in 6.8% of adult patients undergoing noncardiac anesthesia in operating room settings. Alarm management functionality can be added to decision support systems (DSS) to send text alerts about vital signs outside specified thresholds, using data in anesthesia information management systems. We considered enhancing our DSS to send hypoxemia alerts to the text pagers of supervising anesthesiologists. As part of a voluntary application for an investigative device exemption from our IRB to implement such functionality, we evaluated the maximum potential utility of such an alert system. METHODS Pulse oximetry values (Spo(2)) were extracted from our anesthesia information management systems for all cases performed in our main operating rooms and ambulatory surgical center between September 1, 2011, and February 4, 2012 (n = 16,870). Hypoxemic episodes (Spo(2) < 90%) were characterized as either (a) lasting one or more minutes or (b) lasting 2 or more minutes. A single simulated "alert" was modeled as having been sent at the timestamp of the first (a) or the second (b) hypoxemic value. The hypoxemic episode was considered resolved at 1, 3, or 5 minutes after the time of the alert if the Spo(2) value was no longer below the 90% threshold. Two-sided 99% conservative confidence limits were calculated for the percentage of unresolved alerts at the 3 evaluation intervals and compared with 70%, the lower limit of an acceptable true alarm rate for clinical utility. RESULTS There was at least 1 hypoxemic episode lasting 1 minute or longer in 23% of cases, and at least 1 episode lasting 2 minutes or longer in 8% of cases. Only 7% (99% confidence interval [CI] 6% to 8%) of the 1-minute hypoxemic episodes were unresolved after 3 minutes, and only 8% (99% CI 6%to 9%) of 2-minute episodes after 5 minutes (both P < 10(-6) in comparison with 70% minimum reliability rate). CONCLUSIONS Low utility should be expected for a DSS sending hypoxemia alerts to supervising anesthesiologists, because nearly all hypoxemic episodes will have been resolved before arrival of the anesthesiologist in the operating room. These results suggest that the principal research focus should be on developing more sophisticated alerts and processes within rooms for the anesthesia care provider to initiate treatment promptly, to interpret or correct artifacts, and to make it easier to call for assistance via a rapid communication system.


title: Comparison of the clinical manifestations of severe acute respiratory syndrome and Mycoplasma pneumoniae pneumonia.

text: BACKGROUND AND PURPOSE The clinical manifestations of severe acute respiratory syndrome (SARS) and mycoplasma pneumonia are similar. However, administration of corticosteroid to Mycoplasma pneumoniae patients suspected of having SARS may unnecessarily increase the risk of opportunistic infection. We compared the clinical course of 13 SARS patients and 6 patients with mycoplasma pneumonia treated during the outbreak of SARS in Taiwan. METHODS Patients admitted due to suspicion of SARS with a subsequent diagnosis of SARS or Mycoplasma pneumoniae pneumonia were included. RESULTS The initial clinical manifestations were similar in patients with SARS and those with M. pneumoniae infection. However, SARS patients had more severe lymphopenia (p = 0.013) and anemia (p = 0.007), and more persistent pulmonary infiltrates (p = 0.023). Respiratory failure developed in 15.4% of the SARS patients and in none of the M. pneumoniae patients. Recovery from thrombocytopenia was associated with defervescence in 12 SARS patients and radiographic improvement in 6 in the following 5 days. In those with unsatisfactory resolution of the pulmonary infiltrates, corticosteroid therapy was associated with rapid radiographic improvement. CONCLUSIONS Because of similar initial presentations, differentiating SARS from M. pneumoniae pneumonia is very difficult based on symptomatology. In this series, lymphopenia and anemia were more severe in SARS than in M. pneumoniae infection, and SARS patients had more persistent and more new pulmonary infiltrates after hospitalization.


Origins of electron microscopy and viral diagnosis.


title: Utilization of host SR protein kinases and RNA-splicing machinery during viral replication.

text: Although the viral genome is often quite small, it encodes a broad series of proteins. The virus takes advantage of the host-RNA-processing machinery to provide the alternative splicing capability necessary for the expression of this proteomic diversity. Serine-arginine-rich (SR) proteins and the kinases that activate them are central to this alternative splicing machinery. In studies reported here, we use the HIV genome as a model. We show that HIV expression decreases overall SR protein/activity. However, we also show that HIV expression is significantly increased (20-fold) when one of the SR proteins, SRp75 is phosphorylated by SR protein kinase (SRPK)2. Thus, inhibitors of SRPK2 and perhaps of functionally related kinases, such as SRPK1, could be useful antiviral agents. Here, we develop this hypothesis and show that HIV expression down-regulates SR proteins in Flp-In293 cells, resulting in only low-level HIV expression in these cells. However, increasing SRPK2 function up-regulates HIV expression. In addition, we introduce SR protein phosphorylation inhibitor 340 (SRPIN340), which preferentially inhibits SRPK1 and SRPK2 and down-regulates SRp75. Although an isonicotinamide compound, SPRIN340 (or its derivatives) remain to be optimized for better specificity and lower cytotoxicity, we show here that SRPIN340 suppresses propagation of Sindbis virus in plaque assay and variably suppresses HIV production. Thus, we show that SRPK, a well known kinase in the cellular RNA-processing machinery, is used by at least some viruses for propagation and hence suggest that SRPIN340 or its derivatives may be useful for curbing viral diseases.


title: Community-acquired pneumonia in elderly patients.

text: Community-acquired pneumonia continues to have a significant impact on elderly individuals, who are affected more frequently and with more severe consequences than younger populations. As the population ages it is expected that the medical and economic impact of this disease will increase. Despite these concerns, little progress has been made in research specifically focusing on community-acquired pneumonia in the elderly. Data continue to show that a high index of suspicion, early antimicrobial therapy and appropriate medications to cover typical pathogens are extremely important in treating community-acquired pneumonia in older individuals. This review is designed to serve as an update to our previous work published in Aging Health in 2006, with specific emphasis on the most recent evidence published since that time.


title: Some serum acute phase proteins and immunoglobulins concentrations in calves with rotavirus, coronavirus, E. coli F5 and Eimeria species.

text: The purpose of this study was to evaluate the changes in the serum concentrations of haptoglobin (Hp), serum amyloid A (SAA) and IgG, IgA in calves with diarrhea caused by rotavirus, coronavirus, Escherichia coli F5 and Eimeria species. The experiment was carried out on 40 diarrhoeic and 10 non-diarrhoeic calves (group C). A total of 13 calves were infected with rotavirus or coronavirus (group V), 12 calves with E. coli F5 (group B) and 15 calves with Eimeria species (group P). SAA and Hp levels of calves in groups V, B and P were statistically higher than group C (P<0.05). SAA and Hp levels of the group B and group P were significantly higher than the group V (P<0.05). SAA and Hp levels in group B were not significantly higher than the group P. The levels of IgG and IgA were found to be lower in groups B and V compared to other groups. There was a negative correlation between immunoglobulins and the levels of serum Hp and SAA in groups B and V (r=-0.315 and r=-0.369, respectively, P<0.05). Serum SAA, Hp, IgA and IgG levels could be useful for the diagnosis and differential diagnosis of diarrhea caused by rotavirus, coronavirus, E. coli F5 and Eimeria species.


title: Generation and characterization of DNA vaccines targeting the nucleocapsid protein of severe acute respiratory syndrome coronavirus.

text: Severe acute respiratory syndrome (SARS) is a serious threat to public health and the economy on a global scale. The SARS coronavirus (SARS-CoV) has been identified as the etiological agent for SARS. Thus, vaccination against SARS-CoV may represent an effective approach to controlling SARS. DNA vaccines are an attractive approach for SARS vaccine development, as they offer many advantages over conventional vaccines, including stability, simplicity, and safety. Our investigators have previously shown that DNA vaccination with antigen linked to calreticulin (CRT) dramatically enhances major histocompatibility complex class I presentation of linked antigen to CD8(+) T cells. In this study, we have employed this CRT-based enhancement strategy to create effective DNA vaccines using SARS-CoV nucleocapsid (N) protein as a target antigen. Vaccination with naked CRT/N DNA generated the most potent N-specific humoral and T-cell-mediated immune responses in vaccinated C57BL/6 mice among all of the DNA constructs tested. Furthermore, mice vaccinated with CRT/N DNA were capable of significantly reducing the titer of challenging vaccinia virus expressing the N protein of the SARS virus. These results show that a DNA vaccine encoding CRT linked to a SARS-CoV antigen is capable of generating strong N-specific humoral and cellular immunity and may potentially be useful for control of infection with SARS-CoV.


title: Understanding and improving low bystander CPR rates: a systematic review of the literature.

text: OBJECTIVES Cardiopulmonary resuscitation (CPR) is a crucial yet weak link in the chain of survival for out-of-hospital cardiac arrest. We sought to understand the determinants of bystander CPR and the factors associated with successful training. METHODS For this systematic review, we searched 11 electronic databases, 1 trial registry and 9 scientific websites. We performed hand searches and contacted 6 content experts. We reviewed without restriction all communications pertaining to who should learn CPR, what should be taught, when to repeat training, where to give CPR instructions and why people lack the motivation to learn and perform CPR. We used standardized forms to review papers for inclusion, quality and data extraction. We grouped publications by category and classified recommendations using a standardized classification system that was based on level of evidence. RESULTS We reviewed 2409 articles and selected 411 for complete evaluation. We included 252 of the 411 papers in this systematic review. Differences in their study design precluded a meta-analysis. We classified 22 recommendations; those with the highest scores were 1) 9-1-1 dispatch- assisted CPR instructions, 2) teaching CPR to family members of cardiac patients, 3) Braslow's self-training video, 4) maximizing time spent using manikins and 5) teaching the concepts of ambiguity and diffusion of responsibility. Recommendations not supported by evidence include mass training events, pulse taking prior to CPR by laymen and CPR using chest compressions alone. CONCLUSION We evaluated and classified the potential impact of interventions that have been proposed to improve bystander CPR rates. Our results may help communities design interventions to improve their bystander CPR rates.