Infection of laboratory rats with a new cytomegalo-like virus

This report described the infection of two strains of laboratory rats with a ratvirus (RA-1) with cytomegalovirus-like characteristics. The virus was detected in the spleens and kidneys during the first week post infection. In the salivary glands maximal virus titer was reached at one month post infection; thereafter the titer declined. In Lewis rats virus could be detected in the salivary homogenate of most animals at more than 12 months post infection. In BN rats, in contrast, virus became undetectable in the salivary glands of most animals 5 months after inoculation. However, administration of cyclophosphamide or X-irradiation resulted in reactivation of the virus in virtually all animals. Co-cultivation of spleen cells from either latently or chronically infected animals resulted in recovery of virus. The animals developed antibodies and a T-cell mediated virus specific cytotoxicity.     

World health system performance revisited: the impact of varying the relative importance of health system goals

Background

In 2002, the World Health Organization published a health system performance ranking for 191 member countries. The ranking was based on five indicators, with fixed weights common to all countries.

Methods

We investigate the feasibility and desirability of using mathematical programming techniques that allow weights to vary across countries to reflect their varying circumstances and objectives.

Results

By global distributional measures, scores and ranks are found to be not very sensitive to changes in weights, although differences can be large for individual countries.

Conclusions

Building the flexibility of variable weights into calculation of the performance index is a useful way to respond to the debates and criticisms appearing since publication of the ranking.     

Ventral hernia repair: a study of current practice

Ventral wall hernias are common; despite this, there are no guidelines on the best surgical management. The aim of this study was to examine the types of repair in use for abdominal wall hernias in the West of Scotland over a 3-month period. Data were gathered on 120 patients. There were 60 incisional, 32 umbilical, and 28 epigastric hernias. The main indication for repair was pain (78%), while 12 patients (10%), presented acutely with incarceration or strangulation. The most common method of repair was sutured (55%), followed by mesh (29%) and Mayo repair (16%). There was no correlation between use of mesh and hernia size or whether repair was for a recurrent hernia. Surgical practice varies widely in the repair of ventral wall hernias. Clinical trials are required to establish the best method of repair for this common condition. Electronic Publication