Incidence of Augmentation in Primary Restless Legs Syndrome Patients May Not Be That High: Evidence From A Systematic Review and Meta-Analysis

Augmentation is a common complication of primary restless legs syndrome (RLS) during treatment; however, its incidence rate remains unclear.The aim of this study is investigate the rate of augmentation during RLS treatment.We searched 6 databases, including PubMed, OVID, Embase, Wiley citations, Web of Science research platform (including SciELO Citation Index, Medline, KCI Korean Journal Database, the Web of Science™ Core Collection), and the Cochrane library, and screened the reference lists of the included trials and recently published reviews.Randomized controlled trials and observational studies that reported augmentation events during RLS treatment.Primary RLS patients older than 18 years.No restrictions regarding intervention types were applied.Three investigators independently extracted and pooled the data to analyze the augmentation rate of the total sample and of patient subgroups with different interventions, treatment durations and drug regimens and different geographic origins. Fixed-effects or random-effects model was used for pooled analysis.A total of 60 studies involving 11,543 participants suggested an overall augmentation rate of 5.6% (95% confidence intervals (CI), 4.0–7.7). The augmentation incidence was 6.1% (95% CI, 4.1–9.1) for long-term treatment and 3.3% (95% CI, 1.4–7.3) for short-term treatment. In addition, 27.1% (95% CI, 12.3–49.5) of the levodopa-treated patients, 6.0% (95% CI, 4.1–8.8) of the patients treated with dopamine agonists, and 0.9% (95% CI, 0.2–3.3) of the patients taking pregabalin or gabapentin developed augmentation. Augmentation occurred in 7.2% (95% CI, 5.0–10.3) of the patients taking immediate-release drugs and in 1.7% (95% CI, 0.6–5.0) of the patients taking transdermal application.The main limitations are that the augmentation rates were not evaluated according to drug dosage, gender, and age and symptom severity.Approximately 5 to 6 in 100 RLS patients developed augmentation during treatment.     

Influence of avian leukosis virus long terminal repeat on biological activities of Marek's disease virus

GX0101 was the first reported field strain of recombinant Marek's disease virus (MDV) that contained a long terminal repeat (LTR) from the reticuloendotheliosis virus (REV). It is a very virulent MDV strain, with relatively high horizontal transmission ability. The REV LTR in GX0101 genome was proved to decrease the pathogenicity but increase the potential for horizontal transmission of the virus. Here we constructed a recombinant MDV GX0101-ALV-LTR to study stability of avian leukosis virus (ALV) LTR at the REV LTR insertion site in GX0101 genome and its influence on biological activities of the recombinant virus. The results showed that GX0101-ALV-LTR was able to replicate stably both in vitro and in vivo. ALV LTR remained stable in chickens infected either by inoculation with the recombinant virus GX0101-ALV-LTR or by horizontal transmission, as well as in cell culture. The pathogenic properties of GX0101-ALV-LTR virus were evaluated in infected specific-pathogen-free chickens. The present study demonstrated that the GX0101-ALV-LTR virus had a weaker inhibitory effect on the growth rates of the infected chickens and induced weaker immunosuppressive effects. Horizontal transmission ability of the GX0101-ALV-LTR virus appeared to be similar with its parental virus GX0101. In short, ALV LTR was stable in GX0101 after replacing REV LTR, and the recombinant virus showed similar horizontal transmission ability but decreased pathogenicity.     

Analysis of Risk and Burden of Dysentery Associated with Floods from 2004 to 2010 in Nanning,China

This study aimed to examine the association between floods and the morbidity of dysentery and to quantify the burden of dysentery due to floods in Nanning, China. A generalized additive mixed model was conducted to assess the relationship between monthly morbidity of dysentery and floods from 2004 to 2010. The years lived with disability (YLDs) of dysentery attributable to floods were then estimated based on the WHO framework of the burden of disease study for calculating the potential impact fraction. The relative risk (RR) of floods on the morbidity of dysentery was 1.44 (95% confidence interval [CI] = 1.18–1.75). The models suggest that a potential 1-day rise in flood duration may lead to 8% (RR = 1.08, 95% CI = 1.04–1.12) increase in the morbidity of dysentery. The average attributable YLD per 1,000 of dysentery caused by floods were 0.013 in males, 0.005 in females, and 0.009 in persons. Our study confirms that floods have significantly increased the risk and the burden of dysentery in the study area. Public health action should be taken to prevent and control the potential risk of dysentery after floods. Vulnerable groups such as males and children should be paid more attention.