Anti-Hepatitis A Virus Immunoglobulin M Antibodies in Urine Samples for Rapid Diagnosis of Outbreaks

The main goal of this study was to test the feasibility of using urine for diagnosing hepatitis A virus (HAV) infections. A correlation of 90.78% between the test results of urine and serum samples was obtained. Four outbreaks of hepatitis A were confirmed by testing only urine samples. The levels of anti-HAV immunoglobulin M (IgM) antibodies in urine samples remained stable during 6 months of storage at −70°C but decreased when the samples were stored at 4°C. The results of tests of samples obtained 2 and 6 months after infection suggested that IgM levels decline more rapidly in urine than in serum.     

Passive and active rehabilitation for partial lacerations of the canine flexor digitorum profundus tendon in zone II.

The purpose of this study was to compare the effect of unrestricted active versus passive mobilization on the gliding function and structural properties (ultimate load and stiffness) of repaired and nonrepaired canine flexor digitorum profundus tendons following partial laceration at 1 week. Using a radiographic method, normalized tendon gliding of the flexor digitorum profundus tendon adjacent to the metacarpal bone and total joint rotation were shown to be significantly greater in passive than in active tendons. Each group differed from their control group, however, by an average of only 5%. Both rehabilitation (active vs. passive) and treatment (repair vs. nonrepaired) of the partial tendon laceration significantly affected gap formation. Both active rehabilitation and repair of the laceration significantly increased gap formation compared with passive rehabilitation and nonrepair of the partial laceration. Rehabilitation did not significantly affect the normalized ultimate loads and stiffness in the passive and active groups but the nonrepair groups displayed significantly higher ultimate loads and stiffness than the repair groups.     

Hantavirus Pulmonary Syndrome,Southern Chile, 1995–2012

Hantavirus is endemic to the Region de Los Lagos in southern Chile; its incidence is 8.5 times higher in the communes of the Andean area than in the rest of the region. We analyzed the epidemiologic aspects of the 103 cases diagnosed by serology and the clinical aspects of 80 hospitalized patients during 1995–2012. Cases in this region clearly predominated during winter, whereas in the rest of the country, they occur mostly during summer. Mild, moderate, and severe disease was observed, and the case-fatality rate was 32%. Shock caused death in 75% of those cases; high respiratory frequency and elevated creatinine plasma level were independent factors associated with death. Early clinical suspicion, especially in rural areas, should prompt urgent transfer to a hospital with an intensive care unit and might help decrease the high case-fatality rate.     

Uniaxial mechanical strain: an in vitro correlate to distraction osteogenesis

BACKGROUND: Distraction osteogenesis is a valuable clinical tool; however the molecular mechanisms governing successful distraction remain unknown. We have used a uniaxial in vitro strain device to simulate the uniaxial mechanical environment of the interfragmentary distraction gap. MATERIALS AND METHODS: Using the Flexcell system, normal human osteoblasts were subjected to different levels of cyclical uniaxial mechanical strain. Cellular morphology, proliferation, migration, and the expression of angiogenic (vascular endothelial growth factor [VEGF] and fibroblast growth factor-2 [FGF-2]) and osteogenic (osteonectin, osteopontin, and osteocalcin) proteins and extracellular matrix molecules (collagen IalphaII) were analyzed in response to uniaxial cyclic strain. RESULTS: Osteoblasts exposed to strain assumed a fusiform spindle-shaped morphology aligning parallel to the axis of uniaxial strain and osteoblasts exposed to strain or conditioned media had a 3-fold increase in proliferation. Osteoblast migration was maximal (5-fold) in response to 9% strain. Angiogenic cytokine, VEGF, and FGF-2, increased 32-fold and 2.6-fold (P < 0.05), respectively. Osteoblasts expressed greater amounts of osteonectin, osteopontin, and osteocalcin (2.1-fold, 1.8-fold, 1.5-fold respectively, P < 0.01) at lower levels of strain (3%). Bone morphogenic protein-2 production increased maximally at 9% strain (1.6-fold, P < 0.01). Collagen I expression increased 13-, 66-, and 153-fold in response to 3, 6, and 9% strain, respectively. CONCLUSIONS: Uniaxial cyclic strain using the Flexcell device under appropriate strain parameters provides a novel in vitro model that induces osteoblast cellular and molecular expression patterns that simulate patterns observed in the in vivo distraction gap.     

Cloning the antibody response in humans with inflammatory CNS disease: isolation of measles virus-specific antibodies from phage display libraries of a subacute sclerosing panencephalitis brain.

We have developed a strategy to identify the disease-relevant antigens in a chronic inflammatory CNS disease exhibiting intrathecally expressed oligoclonal IgG. Using subacute sclerosing panencephalitis (SSPE), a chronic inflammatory measles virus infection of the brain as a model system, we constructed a phage display antibody Fab library from the amplified products of IgG expressed in the brain. Selection of the library against measles virus-infected cell lysates yielded four distinct Fabs which, by ELISA and by immunostaining, reacted specifically with measles virus-infected cells. Three Fabs immunoprecipitated a 72 kDa protein from infected cell cultures corresponding to the measles virus phosphoprotein. The fourth Fab immunoprecipitated and recognized by immunoblotting a 60 kDa protein corresponding to the measles virus nucleoprotein. The results demonstrate that functional antibodies from an inflammatory CNS disease can be expressed in bacteria and used to identify disease-relevant antigens. This approach could be applied to chronic inflammatory CNS diseases of unknown cause such as multiple sclerosis.     

Logistics Workers Are a Key Factor for SARS-CoV-2 Spread in Brazilian Small Towns: Case-Control Study

BackgroundData on how SARS-CoV-2 enters and spreads in a population are essential for guiding public policies.ObjectiveThis study seeks to understand the transmission dynamics of SARS-CoV-2 in small Brazilian towns during the early phase of the epidemic and to identify core groups that can serve as the initial source of infection as well as factors associated with a higher risk of COVID-19.MethodsTwo population-based seroprevalence studies, one household survey, and a case-control study were conducted in two small towns in southeastern Brazil between May and June 2020. In the population-based studies, 400 people were evaluated in each town; there were 40 homes in the household survey, and 95 cases and 393 controls in the case-control study. SARS-CoV-2 serology testing was performed on participants, and a questionnaire was applied. Prevalence, household secondary infection rate, and factors associated with infection were assessed. Odds ratios (ORs) were calculated by logistic regression. Logistics worker was defined as an individual with an occupation focused on the transportation of people or goods and whose job involves traveling outside the town of residence at least once a week.ResultsHigher seroprevalence of SARS-CoV-2 was observed in the town with a greater proportion of logistics workers. The secondary household infection rate was 49.1% (55/112), and it was observed that in most households (28/40, 70%) the index case was a logistics worker. The case-control study revealed that being a logistics worker (OR 18.0, 95% CI 8.4-38.7) or living with one (OR 6.9, 95% CI 3.3-14.5) increases the risk of infection. In addition, having close contact with a confirmed case (OR 13.4, 95% CI 6.6-27.3) and living with more than four people (OR 2.7, 95% CI 1.1-7.1) were also risk factors.ConclusionsOur study shows a strong association between logistics workers and the risk of SARS-CoV-2 infection and highlights the key role of these workers in the viral spread in small towns. These findings indicate the need to focus on this population to determine COVID-19 prevention and control strategies, including vaccination and sentinel genomic surveillance.     

Resultados del tratamiento a largo plazo de 209 niños con leucemia linfoblástica aguda: experiencia de un grupo multicéntrico en Venezuela

Introduction

We present the results of the treatment of 209 children suffering from acute lymphoblastic leukaemia (ALL) using th 87-01 treatment protocol from the Dana Farber Cancer Institute (DFCI), modified by the Instituto Venezolano de los Seguros Sociales Cooperative Group (IVSS-CG). Protocol 87-01 IVSS-CG is a prospective multi-centred trial for the treatment of children with newly-diagnosed ALL. Our goals were to compare event-free survival (EVS) in a group treated with doxorubicin (dox) at 30 mg/m² versus a group treated with epirubicin (epi) at 40 mg/m² and to evaluate the use of radiotherapy (XRT) of 18 Gy + met-hotrexate (mtx) intrathecal (IT) administered and IT cytarabine (IT-Ara-C). The original protocol recommended using 24 Gy + IT mtx.

Materials and methods

Between 1989 and 1998, 209 patients were treated. They were classified into three groups of standard risk (SR), high risk (HR) and very high risk (VHR) according to the DFCI ALL protocol. Induction treatment phase: all groups received asparaginase (asp), vincristine (vcr), prednisone (pred), epirubicin (epi) or doxorubicin (dox) and IT Ara-C. The SR patients received mtx 40 mg/m² and the HR and the VHR groups received high dose mtx of 4 g/m². The CNS prophy-laxis in SR was mtx IT and 18 Gy irradiation of the cranium, while the HR and VHR groups received mtx + Ara-c IT + 18 Gy. Intensification treatment phase: SR group received vcr; pred, 6-mercatopurine (6-MP) every 3 weeks plus mtx and asp weekly for 20 weeks. The HR and VHR groups received asp weekly up to the cumulative toxic doses of dox or epi. The VHR group received an initial phase of intensification with high dose mtx and Ara-C. The maintenance in all groups was with POMP until 24 months of continuous complete remission.

Results

There were 80 patients (38%) classified as SR, 102 (49%) as HR and 27 (13%) as VHR. With a median follow-up of 8 years, the 8-year disease-free survival (DFS) was 68% ± 4% (DFS ± SE) for all patients, 72% ± 4% of the 80 SR patients, 62% ± 4% for the 102 HR patients and 63% ± 11% for the 27 VHR patients. Comparison of DFS between groups (SR vs. HR vs. VHR) indicated a Chi² of 3.35 which was not statistically significant (p=0.18). The DFS was 62% for the 72 patients who received dox and which was similar to that of the 57 patients who received epi.

Conclusions

There were no statistically significant differences in results between the patients receiving dox and those receiving epi (p=0.79). Radiation at 18 Gy was as effective as 24 Gy in preventing CNS involvement.