Coronavirus infection and hospitalizations for acute respiratory illness in young children

There is only limited knowledge on the burden of disease due to both new (HCoV‐NL63 and HKU‐1) and previously discovered coronaviruses (OC43 and 229E) in children. Respiratory specimens and clinical data were prospectively collected in an active, population‐based surveillance study over a 2‐year period from children aged <5 years hospitalized with acute respiratory symptoms or fever. These samples were retrospectively tested by real‐time RT‐PCR for HCoV‐NL63, HKU1, OC43, and 229E. Human coronaviruses (HCoVs) were identified in 2.2% of study children <2 years of age. Rates of HCoV‐associated hospitalization per 10,000 were 10.2 (95% CI 4.3, 17.6), 4.2 (95% CI 1.9, 6.9), and 0 (95% CI 0, 3.7) in children aged <6 months, 6–23 months, and 24–59 months, respectively. Coronaviruses were identified in a modest number of hospitalized children. J. Med. Virol. 81:853–856, 2009. © 2009 Wiley‐Liss, Inc.     

Genetic Diversity among Food-Borne and Waterborne Norovirus Strains Causing Outbreaks in Sweden

A total of 101 food-borne and waterborne outbreaks that were caused by norovirus and that resulted in more than 4,100 cases of illness were reported to the Swedish Institute for Infectious Disease Control from January 2002 to December 2006. Sequence and epidemiological data for isolates from 73 outbreaks were analyzed. In contrast to health care-related outbreaks, no clear seasonality could be observed. Sequence analysis showed a high degree of genetic variation among the noroviruses detected. Genogroup II (GII) viruses were detected in 70% of the outbreaks, and of those strains, strains of GII.4 were the most prevalent and were detected in 25% of all outbreaks. The GII.4 variants detected in global outbreaks in health care settings during 2002, 2004, and 2006 were also found in the food-borne outbreaks. GI strains totally dominated as the cause of water-related (drinking and recreational water) outbreaks and were found in 12 of 13 outbreaks. In 14 outbreaks, there were discrepancies among the polymerase and capsid genotype results. In four outbreaks, the polymerase of the recombinant GII.b virus occurred together with the GII.1 or GII.3 capsids, while the GII.7 polymerase occurred together with the GII.6 and GII.7 capsids. Mixed infections were observed in six outbreaks; four of these were due to contaminated water, and two were due to imported frozen berries. Contaminated food and water serve as important reservoirs for noroviruses. The high degree of genetic diversity found among norovirus strains causing food-borne and waterborne infections stresses the importance of the use of broad reaction detection methods when such outbreaks are investigated.Norovirus (NoV), a member of the Caliciviridae family, is the most common cause of nonbacterial gastroenteritis worldwide and affects humans in all age groups (7, 28). Virus transmission is primarily associated with person-to-person spread or the ingestion of contaminated food or water. Norovirus is highly infectious and causes outbreaks in communities, families, nursing homes, schools, hospitals, and cruise ships (3-6, 8, 11, 15, 19, 21, 23, 28, 41).NoVs are genetically and antigenically diverse; and they have been classified into five genogroups, three of which (genogroup I [GI], GII, and GIV) are found in humans (1, 10, 16, 17, 43). Within genogroups, strains are further classified into genotypes. NoV has a single-stranded RNA genome of approximately 7,500 nucleotides that contains three open reading frames (ORFs). ORF1 encodes the RNA-dependent RNA polymerase, as well as other proteins; ORF2 encodes the major capsid protein (VP1); and ORF3 encodes a small capsid protein (VP2). Both ORF1 and ORF2 are used for diagnostic PCRs, as well as for genotyping by sequencing.Exposure to multiple NoV variants, which may occur in contaminated food or water, increases the chance of recombination. The first naturally occurring human NoV recombinant was described by Jiang et al. (13). In Europe, a significant number of the outbreaks detected between 2000 and 2003 were caused by variants with recombinations at the ORF1-ORF2 junction (20, 33).In the study described here, we investigated gastrointestinal outbreaks of suspected food-borne and waterborne origin reported to the Swedish Institute of Infectious Disease Control (SMI) from January 2002 to December 2006. All outbreaks were primarily analyzed by electron microscopy (EM), and the NoVs detected were further characterized by sequencing.     

Line bisection in left neglect: the importance of starting right

When marking the subjective midpoint of a horizontal line, patients with left unilateral neglect typically deviate rightward. Different accounts of this pattern of performance refer either to a biased competition between the two hemi-segments of the line, with the right part being subjectively perceived as longer than the left part, or to a distortion of a cognitive representation of space, with spatial coordinates progressively relaxing from the right to the left. These accounts make different predictions about the role of the right part of the line, which is crucial in the biased competition account, but less important in the distortion account. To test these predictions, we asked participants to set the endpoints and the centre of perceived and imaginary lines. Contrary to previous studies, we controlled for the direction of performance of the endpoint task, with left-to-right trials and right-to-left trials being performed in separate blocks. Five patients with right-hemisphere lesions and left neglect demonstrated the typical asymmetries when a right-sided stimulus (segment or endpoint) was present, but showed either normal performance or a reversed (leftward) bias while setting the endpoints and the centre of an imaginary line starting from the left side, when no right-sided visual stimulus was present until completion of each trial. We concluded that the right-sided portion of the line has a crucial importance in determining patients' rightward deviations in line bisection, consistent with the biased competition hypothesis and with neurocognitive models of attentional orienting.     

Comparison of glomerular function tests in children with cancer

Evaluation of renal function should be performed as part of the follow-up during and after chemotherapy in pediatric cancer patients. The aim of this study was to compare an isotope clearance method [isotope glomerular filtration rate (iGFR)] with alternative methods to determine GFR in such patients. Isotope GFR [^99mTc-labeled diethylene triaminopentoacetic acid (DTPA) or ⁵¹Cr-labeled ethylenediaminetetra-acetate (EDTA)] was measured in 36 children (112 studies) and compared with simultaneously measured creatinine clearance (CrCl), serum creatinine (SCr), and cystatin C (CysC) concentrations, as well as the results of Schwartz, Counahan–Barratt, and Cockroft–Gault formulae, using general linear mixed models. Our results showed a significant association between iGFR and CysC concentrations (p < 0.001). No linear relationship was observed between CrCl and iGFR (p = 0.7). As expected, the results of height-based formulae (Counahan–Barratt and Schwartz) had significantly (p = 0.004) better correlation to iGFR than the results of a formula based on weight (Cockroft–Gault) (p = 0.19). Despite significant linear correlation, intraclass correlation coefficients showed poor agreement. Tests of similarity between iGFR estimates showed differences between average values of GFR. Therefore, determination of iGFR remains the method of choice in estimation of GFR in cancer patients. In our study population, assay of serum CysC was the most reliable alternative method to measure glomerular function.     

A retrospective study of the efficacy of JAK inhibitors or abatacept on rheumatoid arthritis-interstitial lung disease

Inflammopharmacology - To examine the effectiveness of Janus-kinase inhibitors (JAKis) or abatacept (ABA) in patients with rheumatoid arthritis-interstitial lung disease (RA-ILD). Patients with...     

Rat behavior after chronic variable stress and partial lesioning of 5-HT-ergic neurotransmission: effects of citalopram

Deficits in serotonergic (5-HT-ergic) neurotransmission and stressful life events have been implicated in affective disorders, and chronic variable stress (CVS) can elicit behavioral changes reminiscent of increased emotionality, anxiety and atypical depression after partial 5-HT depletion. This study examined the effect of chronic citalopram treatment (10 mg/kg daily) on these changes. Parachloroamphetamine (PCA) (2 mg/kg) reduced the levels of 5-HT and 5-hydroxyindoleacetic acid (5-HIAA) in the frontal cortex, increased anxiety in the social interaction test, and increased activity in the open field. CVS reduced social activity in the social interaction test and immobility time in the forced swimming test. Reduction of excrements left during immobilization indicated partial adaptation with the CVS. Specific stressors had different effects on body weight gain, shorter lasting stressors having a smaller effect in general than those that lasted longer. Combination of CVS and PCA increased sucrose intake after two weeks of stress. In addition, combination of the two treatments reduced diving in the forced swimming test. Citalopram prevented the increase in sucrose consumption in the PCA+CVS rats, and in 5-HT-depleted animals blocked the increase in struggling and reduced the number of defecations in the forced swim test. In conclusion, citalopram treatment prevented several effects of either 5-HT depletion or combined PCA+CVS treatment, suggesting that these behavioral changes could be used in studies on the neural mechanisms underlying emotional behavior that may have relevance to the neurobiology of depression.     

Predictors of participation in two different smoking cessation interventions at school.

Multinomial logistic regression was used to identify demographic and psychosocial characteristics of Belgian secondary school students (N = 493), aged 16 to 20, to predict which students choose to participate in a group-based smoking cessation program (five 1-hour weekly sessions), requested self-help quitting material, or did neither (comparison group). The participation rate was 29% for requesting self-help material and 21% for participation in the group program. The analysis indicated that students choosing to participate in the smoking cessation program were more likely to be in the 12th grade, technical students, and daily smokers. They were more likely to believe that quitting would be difficult and reported stronger intentions to quit now and to participate in the group program. Students requesting the self-help materials were less likely to be general students but more likely to see the benefits of quitting; they also reported stronger intentions to participate in the group program.