Swine as a principal reservoir of hepatitis E virus that infects humans in eastern China

BACKGROUND AND METHODS: Genotype IV hepatitis E virus (HEV) has been isolated from humans and swine. To study the relationship between the human and swine reservoirs, we estimated their respective viral burden, analyzed the genetic makeup of the virus populations, and assessed the risk of infection associated with swine farming. RESULTS: In 2 swine-farming districts of eastern China, 9.6% of swine and 0.3% of healthy human subjects excreted HEV in stool, as did 68.8% of patients with confirmed HEV infection. The virus population circulating in humans consisted of genotype I and at least 4 phylogenetically distinct subgroups of genotype IV viruses, 2 of which concurrently circulated among swine. Persons engaged in occupations related to swine farming were found to have a 74% higher risk of infection than those engaged in other occupations, and persons living in communities downstream of the swine farms were found to have a 29% higher risk of infection than persons living in communities upstream. CONCLUSIONS: Genotype IV HEV is freely transmitted between humans and swine. Because the size of the swine population and its viral burden are much larger than those of humans, transmission of the virus most likely is directed from swine to humans. Infection can be acquired through contact with swine and their waste.     

Brain injury and violent crime

Primary objective: To test the hypothesis that TBI is associated with violent crime, the prevalence and characteristics of traumatic brain injury (TBI) were compared between men convicted of domestic violence and a matched comparison group.

Methods and procedures: Participants were 20 African American men convicted of domestic violence and 20 African American men without criminal convictions matched for age and socioeconomic status. Participants completed a questionnaire regarding health and behaviour history.

Main outcomes and results: More than half of the participants in both groups had sustained a TBI, although injuries in the offender group were significantly more severe. There were significantly more reports of problems with anger management in the offender group.

Conclusions: Published epidemiological data regarding TBI may underestimate the prevalence in urban populations, which may have confounded earlier studies of TBI and domestic violence. The reported prevalence in this sample of defendants suggests implications for the justice system.     

Big snake,small snake: which wound is worse when bitten?

Snakebites in children and teenagers are relatively uncommon in the metropolitan city of Hong Kong. They are rarely fatal but may cause significant morbidity and fear. We report two cases of snakebites to illustrate that the spectrum of morbidity is independent of the size of the snakes. A 7-year-old boy was bitten in successions by a green snake. Envenomation occurred at the second bite site. He developed local and systemic signs that were promptly relieved with anti-venom therapy at the intensive care unit. An 18-year-old girl was bitten by a large python but only sustained minor local soft tissue injuries. This report serves to alert the public that snake may bite in successions and envenomation may occur with the subsequent bite.
Conclusion:  A small snake may be venomous and a large snake may not be. Avoidable risk factors associated with snakebites (such as avoiding areas known to harbour snakes in the evening in summer and autumn and wearing protective footwear) are highlighted.     

Impaired gist memory in patients with temporal lobe epilepsy and hippocampal sclerosis

Purpose: Temporal lobe epilepsy (TLE) is the most common focal epilepsy and frequently causes memory problems. It is often associated with hippocampal sclerosis (HS) and is useful in exploring memory functions. We aimed to examine the effect of restricted hippocampal lesions on gist memory function in patients with TLE. Methods: Forty‐five patients with TLE and HS (16 left, 15 right, and 14 bilateral lesions) and 22 control subjects were recruited. Patients with magnetic resonance imaging (MRI) or electroencephalography (EEG) evidence of extratemporal lesions were excluded. All participants performed a gist‐based recognition task following the Deese‐Roediger‐McDermott paradigm and were tested for verbal IQ and memory functions. We conducted hippocampal volumetry on MRI of all the participants. Results: Patients showed multidomain memory impairments. Gist memory was impaired in patients with bilateral HS and probably in patients with right HS. Hippocampal volumetry supported such findings that total volume of hippocampi and volume of right hippocampus correlated positively with gist memory function. Discussion: HS has a dose effect and a probable right dominance effect on gist memory; good item memory supports gist memory performance; and a disproportionate deficit was noted in tasks with high relational demand but not in tasks with simple association. We should develop memory skills for patients with TLE by enhancing performance of gist memory related to simple association task.