Stress in Parents of Children With Genetically Determined Leukoencephalopathies: A Pilot Study.

Genetically determined leukoencephalopathies comprise a group of rare inherited white matter disorders. The majority are progressive diseases resulting in early death. We performed a cross-sectional pilot study including 55 parents from 36 families to assess the level of stress experienced by parents of patients with genetically determined leukoencephalopathies, aged 1 month to 12 years. Thirty-four mothers and 21 fathers completed the Parenting Stress Index-4th Edition. One demographic questionnaire was completed per family. Detailed clinical data was gathered on all patients. Statistical analysis was performed with total stress percentile score as the primary outcome. Mothers and fathers had significantly higher stress levels compared with the normative sample; 20% of parents had high levels of stress whereas 11% had clinically significant levels of stress. Mothers and fathers had comparable total stress percentile scores. We identified pediatric behavioral difficulties and gross motor function to be factors influencing stress in mothers. Our study is the first to examine parental stress in this population and highlights the need for parental support early in the disease course. In this pilot study, we demonstrated that using the Parenting Stress Index-4th Edition to assess stress levels in parents of patients with genetically determined leukoencephalopathies is feasible, leads to valuable and actionable results, and should be used in larger, prospective studies.

Hyperbaric oxygen for children with cerebral palsy: a randomised multicentre trial. HBO-CP Research Group.

BACKGROUND: The use of hyperbaric oxygen for children with cerebral palsy has spread worldwide, despite little scientific evidence of efficacy. We did a randomised trial to assess the efficacy and side-effects of this form of therapy in children with cerebral palsy. METHODS: 111 children with cerebral palsy aged 3-12 years were randomly assigned hyperbaric oxygen (n=57) or slightly pressurised room air (n=54). All children received 40 treatments over 2 months. Hyperbaric oxygen treatment was 1 h in 100% oxygen at 1.75 atmospheres absolute (ATA); children on slightly pressurised air received air at 1.3 ATA (the lowest pressure at which pressure can be felt, thereby ensuring the maintenance of masking). The main outcome measure was gross motor function. Secondary outcomes included performance in activities of daily living, attention, working memory, and speech. FINDINGS: For all outcomes, both groups improved over the course of the study, but without any difference between the two treatments. The score on the global gross motor function measure increased by 3.0% in the children on slightly pressurised air and 2.9% in those on hyperbaric oxygen. The mean difference between treatments was -0.40 (95% CI -1.69 to 0.90, p=0.544). Other changes were seen in speech, attention, memory, and functional skills. Ear problems occurred in 27 children treated by hyperbaric oxygen and in 15 treated with hyperbaric air (p=0.004). INTERPRETATION: In this study, hyperbaric oxygen did not improve the condition of children with cerebral palsy compared with slightly pressurised air. The improvement seen in both groups for all dimensions tested deserves further consideration.

Effects of hyperbaric oxygen therapy on children with spastic diplegic cerebral palsy: a pilot project.

Hyperbaric oxygen (HBO2) therapy for children with cerebral palsy (CP) is not new. Research documenting the effects in this population has been anecdotal. We evaluated the effects of HBO2 therapy for 25 children (X = 5.6 +/- 1.6 yr) with a functional diagnosis of spastic diplegic CP. Pre- and post-HBO2 evaluations consisted of the following measures: gross motor function measure (GMFM), fine motor function (Jebsen test for hand function), spasticity (modified Ashworth scale), video analysis, and parental questionnaire. The protocol for HBO2 therapy was 20 treatments of 95% oxygen at 1.75 atm abs for 60 min. The Wilcoxon matched-pairs signed-rank test for non-parametric measures was used to compare pre- and post-treatment data. Results showed improved gross motor function in three of the five items in the GMFM test, improved fine motor function in three of the six hand tests, reduced spasticity in three of four muscle groups when assessed by a physician specializing in CP, and improvements for four of nine questions posed to parents.

[The influence of previous infections on the development of experimental swine pleuropneumonia in specific pathogen free pigs]. / Influence d'infections préalables sur l'evolution de la pleuro-pneumonie porcine expérimentale chez des porcs exempts d'organismes pathogènes spécifiques.

This study was designed to determine in six-week old specific pathogen free pigs, the effect of previous experimental exposure to Mycoplasma hyopneumoniae and transmissible gastroenteritis virus on a challenge infection with Actinobacillus pleuropneumoniae. Pigs exposed simultaneously to M. hyopneumoniae and transmissible gastroenteritis virus appeared more resistant to challenge (one week later) with A. pleuropneumoniae. Four pigs out of a group of ten died following the challenge infection, compared to all ten pigs in the control group not submitted to previous infections. Clinical signs and lesions were also less severe in the previously infected group than in the control group. Pigs submitted to a single previous infection with M. hyopneumoniae only appeared to be less resistant to the challenge infection than pigs submitted to the dual previous infection with M. hyopneumoniae and the transmissible gastroenteritis virus. A correlation was found between the resistance of pigs to the challenge infection and their serum gammaglobulin levels.

Enzootic pneumonia in feeder pigs: Association with transmissible gastroenteritis virus infection.

Infection with transmissible gastroenteritis virus (TGEV) was present in some pigs on arrival at a feeder pig farm and was well established three weeks later. TGE infection preceded Mycoplasma hyopneumoniae infection, which was not detected until three weeks after arrival. Severe lesions of enzootic pneumonia were observed at the end of the fattening period.A trial was subsequently done in six-week-old-pigs in order to evaluate the potentiating effect of TGEV infection on experimental M. hyopneumoniae infection. The effects of mycoplasmal infection were aggravated when associated with TGEV infection as determined by the extent of pneumonic lesions observed two weeks later.

Enzootic pneumonia in feeder pigs: Observations on causal factors.

A number of factors were studied in eight feeder pig herds, affected with severe or mild enzootic pneumonia, in order to identify those associated with this disease. Piggeries with poor facilities and management and where procurement of piglets was from sales barns were more severely affected with enzootic pneumonia than were those with good facilities and where pigs originated directly from breeding units. Serological tests and virus isolation revealed that all herds had been exposed to Mycoplasma hyopneumoniae and to many viruses; transmissible gastroenteritis virus infection was the only viral infection that was apparently associated with the severity of enzootic pneumonia and the performance observed in the herds.

Association of bovine viral diarrhea virus with multiple viral infections in bovine respiratory disease outbreaks.

We investigated eleven outbreaks of naturally occurring bovine respiratory diseases in calves and adult animals in the St-Hyacinthe area of Quebec. Specific antibodies to bovine herpesvirus-1, bovine viral diarrhea virus, respiratory syncytial virus, parainfluenza type 3 virus, reovirus type 3, and serotypes 1 to 7 of bovine adenovirus were found in paired sera from diseased animals. Several bovine viruses with respiratory tropism were involved concomitantly in herds during an outbreak of bovine respiratory disease. In addition, concomitant fourfold rises of antibody titers were frequently observed to two or more viral agents in seroconverted calves (61%) or adult animals (38%). Bovine viral diarrhea virus was found to be the most frequent viral agent associated with multiple viral infection in calves only (92%).

Oral lecithin and linoleic acid in Friedreich's ataxia: I. Design of the study, material and methods.

A clinical and biochemical evaluation of twenty-two patients with Friedreich's Ataxia and ten normal controls was undertaken in 1980 to assess the effect of lecithin and linoleic acid supplements on the course of the disease. The trial consisted of two consecutive six months periods on either supplements in a double-blind crossover fashion. Clinical appraisal was performed with regards to the following parameters: joints mobility, muscle strength, equilibrium, coordination, motor accuracy, speech and numerous day to day activities. Blood samples were obtained at the beginning and in the course of the trial for enzymatic determinations. This paper describes the methodology of the study.

Types of avian infectious bronchitis strains isolated in Quebec.

Between 1976 and 1980, 24 isolates of infectious bronchitis virus were obtained from Quebec flocks. The serological classification of these isolates was demonstrated by cross neutralization tests using antisera to 13 different reference virus strains. Of the 24 isolates, ten were identified as Connecticut, six Holland and one SE-17 types. Seven strains did not react with any of the specific antisera.

Inner structures of some coronaviruses.

When treated with formaldehyde, Tween 80, sodium oleate and Nonidet P-40, avian infectious bronchitis virus, porcine transmissible gastroenteritis virus, neonatal calf diarrhea coronavirus, porcine hemagglutinating encephalomyelitis virus as well as the human coronavirus show similar inner structures by negative staining. The first one is an inner membranous bag. This structure could be evaginated following treatments used and does not show the characteristic projections of coronaviruses. Subsequently, the inner fold could be separated from the outer membrane at the point of junction between these two membranes. Each virus does not react in the same way to the action of the different products. The transmissible gastroenteritis virus appears more sensitive to treatments than other viruses. On the other hand, the hemagglutinating encephalomyelitis virus is the most resistant. The variable sensitivities of these viruses are not related to the type of host-cells. Also, a second internal structure, which is more dense than the viral particle, encircles partially the aperture of the internal tongue-shaped structure and seems to emerge from the viral particle through the aperture of the inner bag.

Diagnosis of rotavirus, adenovirus, and herpesvirus infections by immune electron microscopy using a serum-in-agar diffusion method.

The sensitivity of immune electron microscopy (IEM) for the detection and identification of bovine rotavirus, infectious bovine rhinotracheitis virus (IBR), and canine adenovirus has been studied by using the serum-in-agar (SIA) method in which a specific antiserum has been incorporated in agar.

Enzyme-linked immunosorbent assay for serology of infectious bovine rhinotracheitis virus infections.

An enzyme-linked immunosorbent assay was developed to detect antibodies to infectious bovine rhinotracheitis virus in bovine sera. The test used viral antigen purified in a sucrose density gradient, and the antibody titers detected were up to 100 times higher than those seen in the serum neutralization test. When 250 sera were tested by those two tests, 146 were positive and 49 were negative in both tests. Only 1 serum was negative in the immunoassay test and positive in the neutralization test. However, 54 sera negative in the neutralization test were positive in the immunoassay test. These positive results appear to be in agreement with the increased sensitivity of the enzyme immunoassay.

Use of electron microscopy and an enzyme-linked immunosorbent assay for the detection of rotaviruses in neonatal calf diarrhea.

Electron microscopy and an enzyme-linked immunosorbent assay were compared for the diagnosis of rotaviruses associated with neonatal calf diarrhea. One hundred percent correlation was observed when 125 samples were tested by both techniques. Both techniques were equally efficient in detecting rotaviruses. The enzyme-linked immunosorbent assay was more sensitive but being specific could not detect other viruses.

Diagnosis of viral agents associated with neonatal calf diarrhea.

During this study, 134 samples have been examined for the detection of the viruses associated with neonatal calf diarrhea. The presence of Nebraska viruses (rotavirus and coronavirus) has been demonstrated by using the electron microscope and the fluorescent antibody techniques while the presence of other viruses has been detected by the observation of a cytopathic effect on monolayer cells of calf testis. The Nebraska viruses have been demonstrated in 107 (80%) out of 134 field case specimens. An association of rotaviruses and coronaviruses was found in 58 cases (54%) whilst the coronaviruses and the rotavirus were found singly in 34 cases (53%) and in 15 cases (14%) respectively. Four bovine virus diarrhea viruses, two infectious bovine rhinotracheitis viruses and two enteroviruses have also been isolated in the preceding 107 Nebraska positive specimens. For the detection of the Nebraska viruses, the fluorescent antibody techniques were more sensitive than the electron microscopy. However, those two techniques must be used simultaneously for a better detection of a greatest possible number of cases.

Immunization of man and animals against influenza by oral and intranasal routes.

Live human and equine influenza virus strains modified by serial passage on allantois-on-shell system (AOS) in the presence of normal horse serum were administered orally or intranasally to volunteers or horses. Mostly mild clinical short-lasting reactions, replication in nasal mucosae, transmission to placebo recipients and significant local or circulating antibody rises were observed following administration to volunteers of strains modified by five or less serial passages on AOS in the presence of normal horse serum (NHS). Milder clinical reactions, no replication, no viral transmission and lower immunogenicity were observed when up to ten serial passages on AOS+ NHS were carried out. Similar results were observed in horses and colts. Heavy shedding of A/Eq-2 strain following the challenge was observed in placebo recipients. Colts immunized intranasally were completely protected while 33% of those immunized orally shedded small quantities of A/Eq-1 and A/Eq-2 viruses. However, a sharp rise of local antibodies against both strains was measured two days after the challenge in the three groups.

Correlation between the serum neutralization test and the indirect immunofluorescent test for the detection of specific antibodies to infectious bovine rhinotracheitis virus.

Comparative titrations show that immunofluorescence on infected rabbit kidney cells is relatively as sensitive as the neutralization test for the detection of antibodies to the infectious bovine rhinotracheitis virus. When calf testis cells infected with this virus are used for the detection of antibodies by the indirect immunofluorescent test nonspecific staining is high. This nonspecific reaction is absent when rabbit kidney cells are used.