West Nile encephalitis mimicking herpes encephalitis

A male with a febrile illness, altered consciousness, and seizures was diagnosed with meningoencephalitis. The suspected etiology was herpes simplex virus on the basis of a focal seizure at presentation, and he was treated with acyclovir until this pathogen was excluded. The patient made a complete recovery. Because of a West Nile fever epidemic in Israel at the time, serology tests for West Nile virus were performed; results were positive. This case highlights the diagnostic problems in West Nile fever. The literature is discussed in brief.     

Emergence of Lineage IV Peste des Petits Ruminants Virus in Ethiopia: Complete Genome Sequence of an Ethiopian Isolate 2010

Isolates of peste des petits ruminants virus (PPRV) can be segregated genetically into four lineages. For decades, lineages I–III have been reported across Africa whilst lineage IV has predominantly circulated across Asia. However, the lineage distribution is currently changing in Africa. Importantly, full genome sequence data for African field isolates have been lacking. Here, we announce the first complete genome sequence of a field isolate of peste des petits ruminants virus (PPRV) from East Africa. This isolate was derived from the intestine of a goat suffering from severe clinical disease during the 2010 outbreak in Ethiopia. The full genome sequence of this isolate, PPRV Ethiopia/2010, clusters genetically with other lineage IV isolates of PPRV, sharing high levels of sequence identity across the genome. Further, we have carried out a phylogenetic analysis of all of the available African partial N gene and F gene PPRV sequences to investigate the epidemiology of PPRV with a focus on the emergence of different lineages of PPRV in Africa.     

Parents' search for evidence-based practice: a personal story

Many clients engage in an intense search for evidence related to the diagnosis, prognosis and intervention options of their (or their dependent's) health condition. A client-based search for evidence poses challenges from a client and clinician perspective and evolves the client-clinician relationship. This paper describes the meaning of searching for health evidence by health-care clients such as parents of hospitalised children through a personal story. I discuss the subjective search for evidence-based health information, interpretation and transfer of information as well as its impact on providers. In order to implement client-centred care and evidence-based practice health care organisations and providers need to take an active role in guiding clients in effective health information-seeking behaviour and to develop mechanisms for processing evidence presented by clients.     

Developmental Supports for Newborns and Young Infants with Special Health and Developmental Needs and Their Families: The BABIES Model

Fragile newborns and young infants who are born with a likelihood of lingering developmental concerns require specialized assessment and intervention based on their unique developmental needs. Often these infants are identified as categorically eligible for early intervention and nursing services, based on their medical condition at birth. The medical involvement of many of these infants adds complexity to the evaluation and/or provision of services, let alone how to best provide supports for their families. Increasing data regarding the regulatory disorganization of young infants which leads to later cognitive and mental health challenges provide a rationale for appropriate assessment and intervention strategies for this population. A recent survey of educational needs of Colorado professionals working with this population revealed that many early intervention providers felt only “slightly” prepared to evaluate newborns and young infants and that most providers felt they could benefit from more training on assessment and intervention with this population. Best practice for this increasing population includes specialized and evidence-based training and capacity building necessary to prepare professionals to evaluate, intervene, and support their unique fragility and emerging developmental competencies. The current study describes the development and components of the BABIES approach to supporting early intervention professionals and nurses to best integrate relationship based developmental supports for fragile newborns and young infants.     

Novel immunotherapy for malignant melanoma with a monoclonal antibody that blocks CEACAM1 homophilic interactions

CEACAM1 (biliary glycoprotein-1, CD66a) was reported as a strong clinical predictor of poor prognosis in melanoma. We have previously identified CEACAM1 as a tumor escape mechanism from cytotoxic lymphocytes. Here, we present substantial evidence in vitro and in vivo that blocking of CEACAM1 function with a novel monoclonal antibody (MRG1) is a promising strategy for cancer immunotherapy. MRG1, a murine IgG1 monoclonal antibody, was raised against human CEACAM1. It recognizes the CEACAM1-specific N-domain with high affinity (K(D) ~ 2 nmol/L). Furthermore, MRG1 is a potent inhibitor of CEACAM1 homophilic binding and does not induce any agonistic effect. We show using cytotoxicity assays that MRG1 renders multiple melanoma cell lines more vulnerable to T cells in a dose-dependent manner, only following antigen-restricted recognition. Accordingly, MRG1 significantly enhances the antitumor effect of adoptively transferred, melanoma-reactive human lymphocytes using human melanoma xenograft models in severe combined immunodeficient/nonobese diabetic (SCID/NOD) mice. A significant antibody-dependent cell cytotoxicity response was excluded. It is shown that MRG1 reaches the tumor and is cleared within a week. Importantly, approximately 90% of melanoma specimens are CEACAM1(+), implying that the majority of patients with melanoma could be amenable to MRG1-based therapy. Normal human tissue microarray displays limited binding to luminal epithelial cells on some secretory ducts, which was weaker than the broad normal cell binding of other anticancer antibodies in clinical use. Importantly, MRG1 does not directly affect CEACAM1(+) cells. CEACAM1 blockade is different from other immunomodulatory approaches, as MRG1 targets inhibitory interactions between tumor cells and late effector lymphocytes, which is thus a more specific and compartmentalized immune stimulation with potentially superior safety profile.     

Youth Exposed to Terrorism: the Moderating Role of Ideology

The present review examines the moderating role of ideology on the effects of war, armed conflict, and terrorism on youth. Ideology is an important factor given the central role played by religio-political ideology and nationalism in present-day conflicts. Ideologies or worldviews represent cognitive frameworks that imbue the traumatic situation with meaning and order. Analysis of the pool of studies identified three categories of ideologically based moderating factors, each representing an aspect of social construction of traumatic events, namely, religion, political ideology, and self-concept. The two closely related categories of religion and politico-religious beliefs showed both positive and negative effects on psychological and psychiatric outcomes among youth. The third category of different aspects of self-concept yielded consistently positive moderating effects. The mechanisms by which each category of ideology moderates effects of exposure to war, armed conflict, and terrorism are discussed, and research and clinical implications are presented.