Rhinovirus inactivation by nasal tissues treated with virucide

Rhinovirus colds may be transmitted by hand-to-hand contact followed by self-inoculation of nasal and/or conjunctival mucosa with virus contaminating the fingertips. The purpose of this study was to determine whether impregnation of nasal tissues with virucidal compounds could prevent rhinovirus from passing through the tissue and thus provide a means of preventing hand contamination during nose blowing. Paper tissues treated with a combination of citric acid, malic acid, and sodium laruryl sulfate were compared to placebo tissues containing sodium saccharin. Recovery of infectious virus was significantly reduced by passage of the virus-containing medium through virucidal versus placebo tissue (1/18 vs. 17/18 respectively, P less than 0.001, Fisher exact test). The virucidal effect of treated tissues was demonstrated for multiple rhinovirus serotypes suspended in either cell culture medium or nasal mucus. Virus contained in mucus from infected volunteers was also inactivated.     

Development of a reverse transcription-PCR assay to detect porcine circovirus type 2 transcription as a measure of replication

Porcine circovirus type 2 (PCV2) is a non-enveloped, single-stranded, circular DNA virus. In situ hybridization and PCR assays have detected PCV2 DNA in multiple organs and cell types from infected pigs; however, it is not clear if this represents replicating virus or virion DNA. We describe the development of a single-tube RT-PCR assay to differentiate PCV2 replication products and virus DNA. Primers targeted to the open-reading frame 2 (ORF2) of PCV2 were designed to amplify both virus DNA (984 bp) and the spliced Cap mRNA (594 bp). The 984 bp fragment, but not the 594 bp fragment, was amplified from PCV2 stock, confirming that the spliced Cap mRNA was not present in the PCV2 stock. The 594 bp fragment was amplified from DNase-treated RNA extracted from PCV2-infected PK-15 cells, and was detected as early as 14 h post-infection. No products were amplified from either the PCV1 stock or PCV1-infected PK-15 cells, or from cells infected with UV-inactivated PCV2. Therefore, the presence of the 594 bp fragment is specific for PCV2 replication. This assay will be useful in assessing cell populations that support PCV2 replication in vivo or in vitro and advance the understanding of PCV2 replication and pathogenesis.     

Successful lung retransplantation after extended use of extracorporeal membrane oxygenation as a bridge

Redo lung transplantation remains a major clinical challenge and its indication for patients with early allograft dysfunction is difficult to determine. We report a case of potentially fatal early allograft dysfunction owing to possible acute cellular rejection after single lung transplantation in a patient who underwent redo double lung transplantation after successful use of extracorporeal membrane oxygenation as a bridge, which resulted in a successful outcome.     

The use of computed tomography to assess acetabular morphology in Morquio-Brailsford syndrome

PURPOSE: Morquio-Brailsford syndrome (MS) is an autosomal recessive lysosomal storage disorder, a mucopolysaccharidosis, characterized by abnormal metabolism of glycosaminoglycans. Major treatable concerns in patients with MS involve C1 to C2 instability, genu valgum, and hip subluxation. Untreated hip subluxation has been shown to predispose to early onset of arthritis of the hip. Early appropriate pelvic osteotomies may restore (improve) load transmission and retard the onset of arthritis. Computed tomographic (CT) measurements can help determine the site and severity of acetabular deficiency, aiding in selection of the appropriate acetabular procedure. Acetabular morphology in MS has not been described in the literature. The purpose of this study was to evaluate morphology (shape) of the acetabulum in MS using two-dimensional (2-D) CT scans. METHODS: To assess the acetabular roof, the acetabular index was measured on anteroposterior radiographs of the pelvis. Various CT measures were used to assess the acetabular anatomy in the axial plane. RESULTS: The average acetabular index on the anteroposterior radiographs of the pelvis was 33 degrees (average age-matched difference from normal, 12 degrees). Two-dimensional CT (axial cuts) showed that the average acetabular anteversion angle was close to normal, measuring 10.9 degrees. The average anterior acetabular index was 58.8 degrees (average age-matched difference from normal, 10.6 degrees), and posterior acetabular index was 53.8 degrees (average age-matched difference from normal, 3.8 degrees). Calculated axial acetabular index ranged from 90 to 133 degrees (mean, 112.6 degrees; average difference from normal, 14.5 degrees). CONCLUSIONS: Two-dimensional CT of the hip in patients with MS demonstrated a severe dysplasia of the anterior acetabular wall and the roof of the acetabulum, although the acetabular version was normal. Treatment of hip dysplasia in MS should focus on increasing the overall depth of the acetabulum to better contain the femoral head. Two-dimensional CT is recommended before bony acetabular procedures to assess the degree of acetabular deficiencies. SIGNIFICANCE: Computed tomography of the acetabulum is helpful in preoperative decision making and planning before an acetabular procedure in patients with Morquio-Brailsford syndrome.     

Menopausal hormone therapy (HT) in patients with breast cancer

OBJECTIVES: To assess the effect of menopausal hormone therapy (HT) on reoccurrence, cancer-related mortality, and overall mortality after a diagnosis of breast cancer. METHODS: We performed a quantitative review of all studies reporting experience with menopausal HT for symptomatic use after a diagnosis of breast cancer. Rates of reoccurrence, cancer-related mortality, and overall mortality were calculated in this entire group. A subgroup analysis was performed in studies using a control population to assess the odds ratio of cancer reoccurrence and mortality in hormone users versus non-users. RESULTS: Fifteen studies encompassing 1416 breast cancer survivors using HT were identified. Seven studies included a control group comprised of 1998 patients. Among the 1416 HT users, reoccurrence was noted in 10.0% (95% CI: 8.4-11.6%). Cancer-related mortality occurred at a rate of 2.6% (95% CI: 1.8-3.7%), while overall mortality was 4.5% (95% CI: 3.4-5.8%). Compared to non-users, patients using HT had a decreased chance of reoccurrence and cancer-related mortality with combined odds ratio of 0.5 (95% CI: 0.2-0.7) and 0.3 (95% CI: 0.0-0.6), respectively. CONCLUSIONS: In our review, menopausal HT use in breast cancer survivors was not associated with increased cancer reoccurrence, cancer-related mortality or total mortality. Despite conflicting opinions on this issue, it is important for primary care physicians to feel comfortable medically managing the increasing number of breast cancer survivors. In the subset of women with severe menopausal symptoms, HT options should be reviewed if non-hormonal methods are ineffective. Future trials should focus on better ways to identify breast cancer survivors who may safely benefit from HT versus those who have a substantial risk of reoccurrence with HT use.