Serologic evidence of West Nile virus and St. Louis encephalitis virus infections in white-tailed deer (Odocoileus virginianus) from New Jersey, 2001

Serum samples from 689 hunter-killed white-tailed deer (Odocoileus virginianus) collected during the 2001 fall hunting season in New Jersey were tested for neutralizing antibodies to West Nile virus (WNV) and St. Louis encephalitis virus (SLEV) by plaque-reduction neutralization tests. WNV-neutralizing antibodies were detected in six (0.9%) of the samples, and SLEV-neutralizing antibodies were found in 11 (1.6%) of the samples. We provide the first report of WNV infection in white-tailed deer.     

Sera from patients with heparin-induced thrombocytopenia generate platelet-derived microparticles with procoagulant activity: an explanation for the thrombotic complications of heparin-induced thrombocytopenia

Heparin-induced thrombocytopenia is characterized by moderate thrombocytopenia and thrombotic complications, whereas quinine/quinidine-induced thrombocytopenia usually presents with severe thrombocytopenia and bleeding. Using flow cytometry and assays of procoagulant activity, we investigated whether sera from patients with these immune drug reactions could stimulate normal platelets to generate platelet-derived microparticles with procoagulant activity. Sera or purified IgG from patients with heparin-induced thrombocytopenia stimulated the formation of platelet-derived microparticles in a heparin-dependent fashion. Further studies showed that heparin-induced thrombocytopenia sera also produced a marked increase in procoagulant activity. In contrast, sera from patients with quinine- or quinidine-induced thrombocytopenia did not generate platelet-derived microparticles nor generate increased procoagulant activity. However, quinine/quinidine-induced thrombocytopenia sera produced a significant increase in the binding of IgG to platelets in a drug-dependent fashion, whereas sera from patients with heparin-induced thrombocytopenia demonstrated no drug-dependent binding of IgG to platelets. We also observed increased levels of circulating microparticles in patients with acute heparin-induced thrombocytopenia compared with control patients. Our observations indicate that the generation of procoagulant platelet-derived microparticles in vivo is a plausible explanation for the thrombotic complications observed in some patients with heparin-induced thrombocytopenia.     

PEDIATRIC RECTAL DIEULAFOY'S LESION

Dieulafoy's lesions are an unusual cause of gastrointestinal hemorrhage. The overwhelming majority of lesions are found in the upper gastrointestinal tract, particularly along the lesser curvature of the stomach in the region supplied by the left gastric artery. Rectal Dieulafoy's lesions have never before been reported in the pediatric population, and our case represents only the third reported occurrence of a rectal Dieulafoy's lesion in the English medical literature. Successful treatment was administered, i.e. , the combination of sclero-therapy followed by thermocoagulation. We therefore recommend that rectal Dieulafoy's lesion be included in the differential diagnosis of children with severe rectal bleeding and that management follow the same principles used to treat upper gastrointestinal tract Dieulafoy's lesions: injection therapy followed by heater probe coagulation.     

Role of endogenous Schwann cells in tissue repair after spinal cord injury

Schwann cells are glial cells of peripheral nervous system, responsible for axonal myelination and ensheathing, as well as tissue repair following a peripheral nervous system injury. They are one of several cell types that are widely studied and most commonly used for cell transplantation to treat spinal cord injury, due to their intrinsic characteristics including the ability to secrete a variety of neurotrophic factors. This mini review summarizes the recent findings of endogenous Schwann cells after spinal cord injury and discusses their role in tissue repair and axonal regeneration. After spinal cord injury, numerous endogenous Schwann cells migrate into the lesion site from the nerve roots, involving in the construction of newly formed repaired tissue and axonal myelination. These invading Schwann cells also can move a long distance away from the injury site both rostrally and caudally. In addition, Schwann cells can be induced to migrate by minimal insults (such as scar ablation) within the spinal cord and integrate with astrocytes under certain circumstances. More importantly, the host Schwann cells can be induced to migrate into spinal cord by transplantation of different cell types, such as exogenous Schwann cells, olfactory ensheathing cells, and bone marrow-derived stromal stem cells. Migration of endogenous Schwann cells following spinal cord injury is a common natural phenomenon found both in animal and human, and the myelination by Schwann cells has been examined effective in signal conduction electrophysiologically. Therefore, if the inherent properties of endogenous Schwann cells could be developed and utilized, it would offer a new avenue for the restoration of injured spinal cord.     

It Doesn't Happen Here: Eating Disorders in an Ethnically Diverse Sample of Economically Disadvantaged,Urban College Students

The bulk of eating disorder studies have focused on white, middle-upper class women, excluding ethnically and economically diverse women and men. Accordingly, our knowledge of prevalence rates and risk factors is reliant on this narrow literature. To expand upon the current literature, we examined eating disorders in ethnically diverse low-income, urban college students. We surveyed 884 incoming freshmen during an orientation class to assess the frequency of eating disorder diagnosis and the risk factors of child physical abuse and sexual abuse before and after age 13. We found 10% of our sample received an eating disorder diagnosis, 12.2% of the women and 7.3% of the men. The majority of these students were Latino/a or “other,” with White women receiving the fewest diagnoses. For all women, both child physical abuse and both indices of sexual abuse contributed equally to the development of an eating disorder. For men only the sexual abuse indices contributed to an eating disorder diagnosis. These results indicate that ethnic minority populations do suffer from relatively high rates of self-reported eating disorders and that a history of trauma is a significant risk factor for eating disorders in these diverse populations of both women and men.     

Same-day <Superscript>90</Superscript>Y radioembolization: implementing a new treatment paradigm

Purpose

To assess the feasibility of conducting pretreatment mesenteric angiography, coil embolization, ^99mTc macroaggregated albumin (^99mTc-MAA) scintigraphy, and ⁹⁰Y radioembolization treatment in a single, same-day, combined outpatient encounter.

Methods

This was a retrospective study of 78 patients treated during the period 2008 – 2015 who were managed in a single outpatient encounter under the guidance of the Interventional Radiology Department and The Nuclear Medicine Department. Pretreatment planning was performed by reviewing baseline imaging and estimated perfused liver volume bearing the tumor. The region of interest was estimated using 3-D software; this value was used for dosimetry planning. Maximum lung shunting fractions of 10 % for hepatocellular carcinoma and 5 % for liver metastases were assumed. Subsequently, hepatic angiography and ^99mTc-MAA scintigraphy were performed followed by ⁹⁰Y treatment in one outpatient encounter. Total in-room procedure time was recorded.

Results

All patients underwent same-day angiography, ^99mTc-MAA scintigraphy and ⁹⁰Y radioembolization. Of the 78 patients, 16 received multiple segmental treatments to both lobes, 44 received treatment to the right lobe, and 18 received treatment to the left lobe. The median dose was 106 Gy. The median number of ⁹⁰Y vials needed was two (range one to six). The median in-room time was 160 min (75 – 250 min). The residential status of the patients was as follows, 18 % (14/78) were local residents, 55 % (43/78) traveled from outside the city limits, 18 % (14/78) were from out-of-state, and 9 % (7/78) were resident abroad. Of the 78 patients, 61 (77 %) had hepatocellular carcinoma, and 17 (22 %) had liver metastases. The median lung dose was 3.5 Gy.

Conclusion

This study demonstrated the feasibility of same-day ⁹⁰Y evaluation and treatment while maintaining the principles of safe and effective ⁹⁰Y infusion including tumoricidal dosimetry (lobar, segmentectomy), minimization of nontarget flow, and minimization of lung dose. This paradigm translates into expeditious cancer care and significant cost savings.

     

Teaching holistic nursing: the legacy of Nightingale

This article emphasizes the importance of holistic concepts in nursing and curriculum development. Grounded in the work of Florence Nightingale, nursing education prepares practitioners to meet the holistic needs of clients. The basic tenets offered by the American Holistic Certification Corporation and the American Holistic Nurses' Association are used to describe essential content in a nursing program emphasizing holism. Strategies for introducing holistic nursing into curriculum and overcoming barriers to including holistic nursing in nursing education are discussed. Examples are provided through the experiences of two schools of nursing that successfully incorporated holistic nursing concepts.