Role of Surveillance Biopsy with No Cancer as a Prognostic Marker for Reclassification: Results from the Canary Prostate Active Surveillance Study

Background

Many patients who are on active surveillance (AS) for prostate cancer will have surveillance prostate needle biopsies (PNBs) without any cancer evident.

A molecular and pathological study of peste des petits ruminants virus (PPRV) from field outbreaks in Palestine, 2017–2019

Peste des petits ruminants (PPR) is a severe, highly contagious and fatal viral disease of small ruminants causing high economic losses. Therefore, the disease was targeted for eradication by 2030. The aim of this study was to investigate for the first time the molecular and pathological characterization of the circulating PPR virus (PPRV) in sheep and goat in Palestine. Samples were collected from suspected necropsy cases of sheep and goats during recent outbreaks in two provinces in Palestine between 2017 and 2019. In this study, severe PPR outbreaks occurred in sheep and goats causing typical lesions which include erosive and ulcerative stomatitis, bronchointerstitial pneumonia and severe enteritis. For the molecular investigation of PPRV, suspected animals were examined for the presence of PPRV by RT‐PCR. PPRV genome was detected in all samples. Subsequently, two samples were used for N gene sequencing and phylogenetic analysis of PPRV isolates. The nucleotide sequence and phylogenetic analysis indicated that the Palestinian PPRV isolates were genetically clustered within the lineage IV isolates of the virus among populations of sheep and goats which most prevalent in Asia, the Middle East and recently Africa. Further analysis showed that the Palestinian isolates were closely related to those described in Turkey and Iraq, suggesting a common origin of PPRV isolates in the region. This information is critical to understand the molecular epidemiology of this disease in the region and helps to develop appropriate control measures for eradication of this disease.     

‘La fiebre de Malta’: An Interface of Farmers and Caprine Brucellosis Control Policies in the Bajío Region,Mexico

This article shows that socio‐economic factors, defined here as practices, knowledge, interests, beliefs and experiences have a role in the adoption of brucellosis control strategies in the Bajío region, Mexico. We combined qualitative and quantitative methods to show that socio‐economic factors with regard to goat husbandry and brucellosis control are not taken into account in the current policy to combat the disease in Mexico. Farmers ranked constraints like the price of goat milk more important than the control of the disease. The impact of brucellosis in goats is hidden to farmers, and the term brucellosis is still a strange name to them; it is better known as ‘la fiebre de Malta’ (Malta fever), which farmers are aware of and which they avoid by not drinking goat milk. Brucellosis control measures cause losses such as abortion due to vaccination and ear infections due to ear tagging. In the villages of the state of Michoacán, the uptake of a vaccination and testing programme was almost complete because it was offered for free, whereas in villages of Jalisco, vaccination was not adopted thoroughly because the cost of vaccination was high for farmers and because of a lack of veterinarians offering the service. Neither compensation for culling suspected infected goats does exist nor the infrastructure, like slaughterhouses, to ensure that goats that are brucellosis seropositive are not resold to neighbouring farmers. This article disputes the idea that brucellosis is confined to the lack of awareness and participation of farmers in control measures, but rather that policies are promulgated without a good knowledge of goat husbandry and farmers’ perceptions. We claim that governmental authorities should reformulate the policy to take into account socio‐economic factors shaping farmers’ behaviour so that effective control measures will be adopted by goat farmers.     

Spatio‐temporal analysis of peste des petits ruminants outbreaks in PR China (2013–2018): Updates based on the newest data

Peste des petits ruminants (PPR) is a highly contagious disease of small ruminants. The purpose of this study was to investigate the epidemic characteristics of PPR outbreaks in the People's Republic of China (PR China) from 2013 to 2018. A total of 41,876 PPR outbreaks were recorded in small ruminant populations in PR China during that period. Data from February to June 2018 were used to study new developments in the PPR epidemic in PR China. Spatio‐temporal clusters and temporal distribution patterns were studied based on PPR notifications. We also used multiple logistic regression to examine the contribution of anthropogenic, climatic and topographic factors to PPR outbreaks. Distance to the nearest road (OR = 1.007 [95% CI: 1.001–1.014]), price of mutton (OR = 1.904 [95% CI: 1.358–2.668]) and mean monthly temperature in July (OR 1.156 = [95% CI: 1.110–1.204]) showed positive effects on PPR outbreaks. Negative effects were observed for number of large‐scale farms (OR = 0.962 [95% CI: 0.940–0.985]). We also found that observed patterns of seasonality were characterized by peaks in April of 2014. Spatio‐temporal clusters occurred in Yunnan, Jiangsu, Anhui, Heilongjiang province and Chongqing municipality. Hunan province reported PPR occurrences every year from 2014 to June 2018. Yunnan, Jiangsu and Anhui province have 56, 33 and 30 epidemic locations, respectively. PPR infections were first reported as the cause of death for 19 wild bharals in Qinghai province in 2018. All of this suggests that domestic trading of sheep and goats may be closely related to the spread of PPR. Prophylactic immunization in suspected animal populations or areas is recommended for the control of PPR and wild small ruminants should be monitored. Results presented here provide improved knowledge about PPR dynamics in PR China, which could be helpful in designing more effective prevention strategies.     

The retrospective identification and molecular epidemiology of porcine circovirus type 3 (PCV3) in swine in Thailand from 2006 to 2017

Porcine circovirus type 3 (PCV3) has recently been detected in pigs worldwide, with similar clinical manifestations to porcine circovirus‐associated disease (PCVAD) from porcine circovirus type 2 (PCV2) infection. Here, we report the identification and molecular epidemiology of PCV3 in swine in Thailand from clinical samples retrieved from 2006 to 2017. The epidemiological data revealed co‐infection with PCV2, PRRSV, and PCV2/PRRSV was common in our samples. Circulating PCV3 from this study shared a high similarity of nucleotide and deduced amino acid sequences of the partial capsid gene (96.7%–100% and 96.7%–100% respectively), indicated the genetic stability of PCV3 in Thailand. Phylogenetic analysis based on the capsid gene revealed scatter clustering with current PCV3 having no relation to the geographical origin of the virus strains. In this retrospective study, results have demonstrated that PCV3 has spread extensively within Thai swine from as early as 2006 and may also be involved in PRDC and PCVAD.     

Serological surveillance and clinical investigation of glanders among indigenous equines in India from 2015 to 2018

Equine glanders is an infectious and notifiable bacterial disease caused by Burkholderia mallei. The disease has been reported in South American, African and Asian countries including India. Here, we present the outcome of glanders serosurveillance carried out between January 2015 and December 2018 to know the status of equine glanders among different states in India. A total of 102,071 equid sera from 299 districts of twenty‐one states and one union territory were tested for glanders. Samples were screened with Hcp1 indirect ELISA followed by confirmatory diagnosis by CFT. During this four‐year surveillance, a total of 932 glanders‐positive cases were detected from 120 districts of 12 states. The study also revealed increasing trend of glanders from 2016 onwards with maximum occurrence in northern India. Overall seroprevalence ranged between 0.62% (95% CI, 0.52–0.72) and 1.145% (95% CI, 1.03–1.25). Seasonal shifting from winter to summer (March to June) coincided with highest number glanders incidence with corresponding seroprevalences of 1.2% (95% CI, 1.09–1.30). The present surveillance unveils territorial ingression of glanders to six states like Jammu & Kashmir, Gujarat, Rajasthan, Madhya Pradesh, Delhi and Tamil Nadu. In addition, re‐emerging cases have been reported in Maharashtra, Haryana and Punjab after a gap of 10 years. Lack of awareness, little veterinary care and unrestricted movement of equids across state borders might have led to the introduction and establishment of the infection to these states. We believe that information from this study will provide a baseline data on glanders for devising surveillance and control strategies in India. Being a zoonotic disease, the persistence of glanders poses a potential threat to occupationally exposed humans especially equine handlers and veterinarians. Therefore, targeted surveillance of human population from each glanders outbreak is also recommended.     

Trauma Surveillance and Registry Development in Mozambique: Results of a 1-Year Study and the First Phase of National Implementation

World Journal of Surgery - Mozambique has had no policy-driven trauma system and no hospital-based trauma registries, and injury was not a public health priority. In other low-income countries,...     

Isolation and Identification of Brucella melitensis Biovar 3 from Vaccinated Small Ruminants: A Public Health Threat in Kosovo

In 2011, a human brucellosis case with severe clinical symptoms was reported at the University Clinic for Infectious Diseases in Prishtina, Kosovo. A trace‐back investigation was conducted to find the source of human infection. A total of 49 blood samples and 15 corresponding milk samples from sheep and goats raised on the patient's farm were taken for serological and molecular analysis. Serology using RBT and CFT revealed 11 positive animals. Twelve milk samples were PCR positive. A Brucella strain isolated from a goat's milk sample was classified as Brucella melitensis biovar 3, indicating the first ever isolation and report in Kosovo. The use of the Bruce‐ladder PCR provided differentiation between the field strain and the vaccine strain. Hence, the accidental transmission of the vaccine strain Rev 1 that was previously used for the vaccination of the farm animals could be excluded. The findings of this study show that brucellosis is still a public health threat in Kosovo despite control measures.     

Epididymo‐orchitis due to Brucella melitensis: A case report in a nonendemic area and review of the literature

Brucella epididymo‐orchitis (BEO), first described by Hardy in 1928, is a focal genitourinary complication of human brucellosis. This disease is endemic in many parts of the world, but might present as a diagnostic and therapeutic challenge to practicing physicians in nonendemic areas, such as Hong Kong. In the present study, we describe a case of BEO and present a literature review of the aetiology, diagnosis and management of this rare clinical condition.     

A Comparison of Criteria to Identify Inflammatory Breast Cancer Cases from Medical Records and the Surveillance,Epidemiology and End Results Data base, 2007–2009

Inflammatory breast cancer (IBC) is a relatively rare and extremely aggressive form of breast cancer that is diagnosed clinically. Standardization of clinical diagnoses is challenging, both nationally and internationally; moreover, IBC coding definitions used by registries have changed over time. This study aimed to compare diagnostic factors of IBC reported in a U.S. Surveillance, Epidemiology, and End Results (SEER) registry to clinical criteria found in the medical records of all invasive breast cancer cases at a single institution. We conducted a medical record review of all female invasive breast cancers (n = 915) seen at an NCI‐designated comprehensive cancer center in Detroit from 2007 to 2009. IBC cases were identified based on the presence of the main clinical characteristics of the disease (erythema, edema, peau d'orange). We compared the proportion of IBC out of all breast cancers, using these clinical criteria and the standard SEER IBC codes. In the reviewed cases, the clinical criteria identified significantly more IBC cases (n = 74, 8.1%) than the standard IBC SEER definition (n = 19, 2.1%; p < 0.0001). No IBC cases were identified in the cancer center records using the SEER pathologic coding, which requires the diagnosis of inflammatory carcinoma on the pathology report, a notation that is rarely made. Emphasis must be placed on the documentation of clinical and pathologic characteristics of IBC in the medical record, so that analysis of putative IBC subtypes will be possible. Our results indicate the need for a consensus on the definition of IBC to be utilized in future research.     

Surgical site infections in thyroid and parathyroid surgery in Japan: An analysis of the Japan Nosocomial Infections Surveillance database from 2013 to 2020

Surgical site infections (SSIs) after thyroid surgery are rare complications, with incidence rates of 0.3%–1.6%. Using a Japanese database, we conducted exploratory analyses on the incidence of SSIs, investigated the incidence of SSIs by the National Nosocomial Infections Surveillance risk index, and identified the causative bacteria of SSIs. SSIs occurred in 50 (0.7%) of 7388 thyroid surgery cases. Risk index-0 patients had the lowest incidence rate of SSIs (0.41%). The incidence of SSIs in risk index-1 patients was 3.05 times the incidence of SSIs in risk index-0 patients. The rate of SSI occurrence for risk index-2 patients was 4.22 times the rate of SSI occurrence for risk index-0 patients. Thirty-one bacterial species were identified as the cause of SSIs in thyroid surgery cases, of which 12 (38.7%) SSIs were caused by Staphylococcus aureus and Staphylococcus epidermidis. Of the nine SSIs caused by Staphylococcus aureus, 55.6% (five cases) were attributed to methicillin-resistant Staphylococcus aureus. Therefore, routine prophylactic antibiotic administration should be avoided, while the target for administration should be narrowed, according to the SSI risk. Administration of prophylactic antibiotics, such as 2 g piperacillin or 1 g cefazolin, is considered appropriate.