Photocatalytic inactivation of diarrheal viruses by visible-light-catalytic titanium dioxide

Titanium dioxide (TiO2) that had been irradiated with visible light (VL) was demonstrated to inactivate rotavirus, astrovirus, and feline calicivirus (FCV). The virus titers were dramatically reduced after exposure for 24 hrs to the VL-catalytic TiO2. The addition of bovine serum albumin could protect the virus against inactivation by VL-catalytic TiO2 in a dose-dependent manner. This finding implied that the VL-catalytic TiO2 products might somehow interact initially with the viral proteins in the process of virus inactivation. Moreover, we showed partial degradation of the rotaviral dsRNA genome. This was more prominent when the virus was exposed to the VL-catalytic TiO2 treatment for at least 2 days. An attempt was made to elucidate the mechanism underlying the inactivation of the viruses. It was found that upon activation of TiO2 with VL by using a white fluorescent lamp, the reactive oxygen species such as superoxide anions (O2-) and hydroxyl radicals (*OH) were generated in a significant amount after stimulation for 8, 16, and 24 hrs. We therefore assume that virus inactivation by VL-catalytic TiO2 might occur through the generation of O2- and *OH followed by damage to the viral protein and genome. This is the first report, to the best of our knowledge, demonstrating the inactivation of rotavirus, astrovirus and FCV by the presence of TiO2 film under VL as well as describing its mechanism.     

Comprehensive evaluation of atrial septal defects in individuals undergoing percutaneous repair by 64-detector row computed tomography

Transcatheter atrial septal defect closure is becoming more commonplace as it has been demonstrated to be safe, efficacious and associated with low morbidity. Pre-procedural assessment of individuals has primarily relied upon transesophageal echocardiography. We present four individuals who underwent both transesophageal echocardiography as well as cardiac multidetector computed tomography. In all four cases, multidetector computed tomography added incremental information above the transesophageal echocardiogram. Multidetector computed tomography may play an essential role in individuals with atrial septal defects undergoing percutaneous transcatheter closure.     

Utility of the fibrinogen/C-reactive protein ratio for the diagnosis of disseminated intravascular coagulation

Although the presence of decreased plasma fibrinogen has been regarded as an indicator of ongoing disseminated intravascular coagulation (DIC), fibrinogen, which is one of the acute phase reactants, is often increased in the patients with DIC. We investigated the diagnostic and prognostic utility of a new parameter [the fibrinogen/C-reactive protein (CRP) ratio] for predicting DIC in 1,056 patients with suspected DIC and who also had underlying disorders associated with DIC. Among the 535 patients with overt DIC, 46 patients (8.6%) showed low plasma fibrinogen (<100 mg/dl), suggesting that the plasma fibrinogen level is not a sensitive marker for DIC. There was a strong correlation between the increased DIC scores and increased number of patients with low (<104) fibrinogen/CRP ratios. Among the three groups with different serum fibrinogen/fibrin degradation product levels, the fibrinogen/CRP ratio showed a higher difference than did the fibrinogen level. The DIC score was highly correlated with the 28-day mortality and the number of patients with low fibrinogen/CRP ratios. The odds ratio (the relative risk of 28-day mortality) of the low fibrinogen/CRP ratio was 6.15, while the odds ratio of the low fibrinogen level was 2.13. The area under the receiver-operating characteristic curve of the fibrinogen/CRP ratio, when this was used for predicting mortality, showed significantly better discriminative power than did that of the fibrinogen level. This study demonstrates that the fibrinogen/CRP ratio may provide more discriminating power for identifying the patients with active coagulation consumption, and the fibrinogen/CRP ratio has a good predictive value concerning the 28-day mortality in the patients suspected of having DIC. The results of our study suggest that replacement of fibrinogen by the fibrinogen/CRP ratio for calculating the DIC score may lead to enhance diagnostic and prognostic power for DIC.     

Endemic diphtheria in Ho Chi Minh City; Viet Nam: a matched case-control study to identify risk factors of incidence

From 1999 to 2004, Ho Chi Minh City (HCMC), Vie Nam reported 401 clinically suspected and 90 laboratory-confirmed diphtheria. To identify risk factors, a matched case-control study was conducted during 2005 and 2006. In total, 88 cases that occurred in 2003 and 2004 and 352 age- and sex-matched controls were studied. No DPT/DT immunisation (odds ratio, 9.9 [95% CI, 1.9-52.3]) and bathing only once a day or less (OR 1.7 [95% CI, 1.0-2.9]) were associated with diphtheria incidence. Estimated vaccine efficacy of three or more DPT/DT doses was 88%. Immunising children with zero-dose status of diphtheria toxoid inoculation, rather than the introduction of booster doses, and the promotion of skin hygiene were considered to be the priority interventions in controlling the endemic diphtheria in HCMC.     

Target-symptom psychopharmacology: between the forest and the trees

Psychopharmacology practice seeks to fit specific treatments to specific disease processes. Although categorical diagnoses have improved focus on observable symptom constellations, these approximately 300 categories have limited benefits for illuminating underlying disease pathophysiology. Existing medications do not couple well to the symptom constellations of given disorders. Rather, current medications ameliorate symptoms overlapping among various disorders. Harnessing technology to identify a patient's wider symptom constellation, prioritizing and targeting symptoms across disorders, considering symptoms more dimensionally instead of "present or not," and eliciting factors necessary to improve adherence may allow medication selections to be tailored better to individual patients.     

Prediction of anxiety and distress following diagnosis of multiple sclerosis: a two-year longitudinal study

OBJECTIVE: To investigate the course of anxiety, depression and disease-related distress of patients with multiple sclerosis (MS) and their partners in the first years after diagnosis. METHODS: The Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale (IES) were completed at baseline, six-month, one- and two-year follow-up in 101 recently diagnosed patients and 78 partners. The Expanded Disability Status Scale (EDSS) was assessed annually. RESULTS: Mean time since diagnosis at baseline was 7.8 (SD 6.5) months. Mean anxiety scores of patients and partners did not change during the two years of follow-up and remained higher than that observed in the general population at all assessments (P < 0.05). The high levels of disease-related distress at baseline were lower at follow-up. Of the patients and partners with high anxiety scores at baseline (HADS anxiety > or = 8), 69% also had high scores at any time during follow-up, compared to 26% in those with low baseline anxiety scores. For severe distress at follow-up, these percentages were 41 and 14%. The sensitivity and specificity of baseline anxiety screening for the prediction of high anxiety or distress scores at follow-up were 55 and 85%. CONCLUSION: MS patients and their partners continued to have high levels of anxiety and distress in the first years after diagnosis. Screening for anxiety after diagnosis can be used to predict levels of anxiety and distress during two-year follow-up.     

The effect of auditory stressors on cognitive flexibility

Stress is known to activate the noradrenergic system which may have a modulatory influence on cognitive flexibility. We investigated whether an auditory stressor would thus affect performance on cognitive flexibility. A task utilizing cognitive flexibility and two memory tasks were presented in both stressful and non-stressful condition. In the stressful condition performance was impaired for the cognitive flexibility task but not for the memory tasks, arguing against the stressor serving as a general distracter. These findings suggest that stress caused by an auditory stressor may negatively impact performance on more complex tasks requiring a rapid search of the semantic and lexical associative networks.