Shipment of insects and related arthropods into and out of India for research or commercial purposes.

This paper provides a concise summary of the guidelines and regulations that govern the shipment of insects and related arthropods into and out of India. It discusses the Plant Quarantine (Regulation of Import into India) Order, 2003, which regulates the import of agents for biological control, and the Biological Diversity Act, 2002, and associated Biological Diversity Rules, 2004, which guide the transfer of insects and related arthropods for identification, taxonomic research, and commercial purposes. Insect trade for some food and feed purposes is also mentioned. Finally, some implications, conclusions and recommendations are presented.

Les auteurs présentent succinctement les directives et réglementations régissant les expéditions d'insectes et autres arthropodes connexes à destination et en provenance de l'Inde. Ils examinent le décret de 2003 relatif à la quarantaine végétale (réglementation des importations en Inde), qui couvre également les importations d'agents destinés à la lutte biologique, ainsi que la loi de 2002 sur la diversité biologique et les dispositions réglementaires de 2004 qui lui sont associées concernant les transferts d'insectes et autres arthropodes connexes à des fins d'identification, de recherche taxonomique et de commerce. Le commerce d'insectes destinés à la production de denrées alimentaires ou d'aliments pour animaux est également mentionné. Enfin, les auteurs exposent un certain nombre de conséquences, de conclusions et de recommandations en la matière.

Los autores resumen sucintamente las directrices y reglas que rigen los envíos de entrada o salida de la India de insectos y otros artrópodos conexos. En este sentido, exponen el Decreto de Cuarentena Vegetal (Reglamento de Importaciones a la India) de 2003, que regula la importación de agentes destinados a actividades de control biológico, y la Ley de Diversidad Biológica de 2002 y el correspondiente Reglamento de Diversidad Biológica de 2004, que rigen el traslado de insectos y otros artrópodos conexos con fines de identificación, investigación taxonómica o comercio. Tras referirse al comercio de insectos con determinados fines de alimentación humana o animal, acaban exponiendo ciertas consecuencias de todo ello y presentando una serie de conclusiones y recomendaciones al respecto.

Can there be a common, risk-based framework for decisions around live insect trade?

A network of scientists involved in shipment of live insects has met and generated a series of articles on issues related to live insect transport. The network is diverse, covering large-scale commercial interests, government operated areawide control programmes, biomedical research and many smaller applications, in research, education and private uses. Many insect species have a record of safe transport, pose minimal risks and are shipped frequently between countries. The routine shipments of the most frequently used insect model organism for biomedical research, Drosophila melanogaster, is an example. Successful large scale shipments from commercial biocontrol and pollinator suppliers also demonstrate precedents for low-risk shipment categories, delivered in large volumes to high quality standards. Decision makers need access to more information (publications or official papers) that details actual risks from the insects themselves or their possible contaminants, and should propose proportionate levels of management. There may be harm to source environments when insects are collected directly from the wild, and there may be harm to receiving environments. Several risk frameworks include insects and various international coordinating bodies, with experience of guidance on relevant risks, exist. All stakeholders would benefit from an integrated overview of guidance for insect shipping, with reference to types of risk and categories of magnitude, without trying for a single approach requiring universal agreement. Proposals for managing uncertainty and lack of data for smaller or infrequent shipments, for example, must not disrupt trade in large volumes of live insects, which are already supporting strategic objectives in several sectors.

À l'occasion d'une réunion d'experts, un réseau de chercheurs travaillant sur l'expédition d'insectes vivants a produit un ensemble d'articles traitant des questions liées au transport des insectes vivants. Ce réseau est diversifié et représente un large éventail d'intérêts privés et de programmes de lutte biologique à grande échelle menés par les pouvoirs publics, en plus du secteur de la recherche biomédicale et de nombreux acteurs intervenant dans des applications de plus petite envergure relevant de la recherche, de l'enseignement ou du secteur privé. Un grand nombre d'espèces d'insectes sont transportées en toute sécurité avec un niveau de risque minimal, y compris lors des fréquentes expéditions internationales. Un exemple de ces expéditions régulières concerne l'espèce la plus utilisée par la recherche biomédicale en tant qu'organisme modèle, à savoir Drosophila melanogaster. Les exemples réussis d'expéditions à grande échelle provenant de fournisseurs d'agents de lutte biologique et de pollinisateurs produits par le secteur privé offrent également un relevé documenté des diverses catégories d'expéditions à faible risque pour des livraisons d'insectes vivants en grandes quantités et répondant à des normes de qualité élevées. Les décideurs politiques devraient pouvoir accéder à plus d'informations (à travers des publications ou des articles officiels) décrivant en détail les risques réels associés aux insectes eux-mêmes ou à leurs contaminants éventuels, et proposer en connaissance de cause des niveaux de gestion proportionnels à ces risques. La récolte d'insectes prélevés directement de la nature peut être dommageable aussi bien pour les environnements source que pour ceux de destination. Plusieurs cadres fondés sur le risque intègrent désormais les insectes dans leurs directives. Par ailleurs, nombre d'organismes internationaux de coordination ont acquis une expérience dans l'élaboration de lignes directrices face à ces risques. Il serait bénéfique pour toutes les parties prenantes de disposer d'une vue d'ensemble intégrée des directives applicables aux expéditions d'insectes, qui recense les différents types de risque et leurs ordres de grandeur sans se prononcer sur une approche unique qui nécessiterait une adhésion universelle. Ni les propositions visant à gérer l'incertitude ni l'insuffisance des données disponibles sur les expéditions d'insectes en petits nombres ou occasionnelles ne doivent perturber les échanges commerciaux d'insectes vivants en grandes quantités, échanges qui participent aujourd'hui aux objectifs stratégiques de nombreux secteurs.

Una red de científicos relacionados de un modo u otro con el transporte de insectos vivos mantuvo un encuentro y generó una serie de artículos en torno a la cuestión. En la red, muy heterogénea, convergen desde intereses comerciales de gran calado hasta programas públicos de lucha biológica en grandes territorios, pasando por la investigación biomédica y por numerosas aplicaciones de menor dimensión en ámbitos como la investigación, la enseñanza u otros usos privados. Muchas especies de insectos cuentan con un buen historial de seguridad en el transporte, presentan un riesgo mínimo y son expedidas a menudo de un país a otro. Buen ejemplo de ello son los envíos sistemáticos de ejemplares de Drosophila melanogaster, que es el insecto utilizado con más frecuencia como organismo modelo en la investigación biomédica. Otro precedente de envíos voluminosos cuyo transporte y entrega se ajusta a los más exigentes criterios de calidad lo sientan las remesas de grandes cantidades de polinizadores y agentes de control biológico remitidos por proveedores comerciales. Los responsables de adoptar decisiones deben disponer de más y más detallada información (publicaciones o documentos oficiales) sobre los riesgos reales derivados de los propios insectos o sus posibles contaminantes para proponer a partir de ahí medidas de gestión proporcionadas. Los perjuicios ambientales pueden darse tanto en origen (cuando hay captura salvaje de insectos, o sea recolección directa en el medio) como en destino. Hay varios sistemas de determinación del riesgo que incluyen a los insectos y también existen diversos organismos de coordinación internacional que ya tienen experiencia en sentar pautas sobre los riesgos en la materia. Todos los interlocutores del sector se beneficiarían de una visión global e integrada del transporte de insectos, que remita a diferentes tipos de riesgo y categorías de magnitud, sin necesidad de buscar un sistema único que exija consenso universal. Las propuestas para gestionar la incertidumbre y la falta de información en el caso de envíos infrecuentes o de pequeñas dimensiones, por ejemplo, no deben interferir en el transporte de grandes cantidades de insectos vivos, que ya está sirviendo a objetivos estratégicos en varios sectores.

Efficacy and safety of montelukast add-on therapy in allergic rhinitis.

Allergic rhinitis is a common airways hypersensitivity disease. Histamine and leukotrienes are involved in the pathogenesis of allergic rhinitis. Conventional treatments include topical steroids and antihistamines. Due to the adverse effects of these treatments, new drugs like leukotriene receptor antagonists are being investigated for the treatment of allergic rhinitis. A total of 90 patients suffering from allergic rhinitis were enrolled in this prospective, randomized, controlled study. Patients were divided randomly into three groups of 30 patients each. Group I was administered fluticasone nasal spray (200 µg in each nostril) once a day, Group II was administered fluticasone nasal spray (200 µg in each nostril) plus cetrizine (10 mg) orally once a day and Group III was administered fluticasone nasal spray (200 µg in each nostril) plus montelukast (10 mg) orally once a day. Efficacy was measured based on daytime and nighttime symptom scores. Safety was evaluated on the basis of psychomotor tests, laboratory investigations and subjective assessment. The present study showed that montelukast add-on therapy is as efficacious as conventional therapies in controlling total symptom score, but it is more efficacious in controlling nighttime symptoms. Furthermore, montelukast add-on therapy does not cause psychomotor impairment as observed with cetrizine.

Can carotid ultrasound predict plaque histopathology?

AIM: European and North American studies have confirmed the benefits of carotid endarterectomy for patients with symptomatic carotid artery stenoses >70%. However, the management of asymptomatic patients and those with lesser degrees of stenosis is less certain. Several studies have suggested that, for these subgroups, the targeting of potentially unstable plaques, may help to identify those most at risk of cerebrovascular accidents and thus most likely to benefit from surgery. The aim of this study was to correlate the ultrasound features of carotid artery stenosis with the histopathological findings of the carotid endarterectomy specimens in order to identify features which will allow preoperative identification of clinically unstable plaques. METHODS: Sixty consecutive patients with symptomatic, critical carotid stenosis were prospectively studied. Plaques were classified preoperatively into one of five types based on their echogenicity and were also assessed for irregularity and ulceration. These findings were then compared with the histopathological findings of the endarterectomy specimen. RESULTS: Of 33 plaques considered on ultrasound to be uniformly or predominantly echolucent (unstable), 27 were found to be largely fatty or haemorrhagic (PPV =82%). Of 17 plaques considered to be predominantly echogenic (stable) on ultrasound, 11 were found to be predominantly fibrotic (PPV = 65%). Correlation between ultrasound irregularity or ulceration and histopathology was poor. CONCLUSION: In routine clinical practice, ultrasound can identify with reasonable accuracy, plaques that are predominantly haemorrhagic or fatty, and therefore potentially unstable. This may have future implications in selection of patients for surgery.

Epizootics of an entomopathogenic fungus Entomophthora aphidis Hoggman on the pomegranate aphid aphispunicae passerini (Homoptera: Aphididae).

Thrips of late are becoming more resurgent in agro-ecosystems especially in India and South Asian countries. One of the reasons attributed is the development of resistance in them to groups of insecticides of organo phosphates, carbamates, synthetic pyrethroids, etc., which form the core of recommendation for thrips management. The chilli thrips, Scirtothrips dorsalis Hood, is no exception and is tending to be an unmanageable pest. In S. dorsalis, besides evidence of resistance, elimination of natural enemies like Orius sp. is evident, which also probably explains the thrips resurgence. Scirtothrips dorsalis is highly polyphagous and of late has become serious on grapes. The damage is manifested as scab on fruit rind, affecting internal and export markets. Fortunately, it does not vector any virus on grapes in India. Farmers have been reporting inefficacy of established chemicals like acephate, dimethoate, monocrotophos, etc. As grapes is an important cash crop of horticulture, management through insecticides, require alternate or new insecticides. So two trials in 2005 on cv. Bangalore Blue following April and October prunings were conducted at the Indian Institute of Horticultural Research (IIHR), Bangalore, S. India to evaluate two doses of a newer molecule viz. Clothianidin [Dantop] on S. dorsalis. Clothianidin 0.006%, Clothianidin 0.008% were compared with monocrotophos 0.05%, dimethoate 0.06% and acephate 0.1125%. There was an untreated check. Each treatment was replicated five times; a vine constituted a replicate. These data were subjected to ANOVA, after arc sine transformation. The critical difference (CD) at p < 0.05 was the test criterion. In the first trial it was found that all the insecticides tried were superior to check and were on par at p < 0.05. However, Clothianidin 0.008% gave the best control with a low mean of 0.26% berry damage/bunch as compared to 4.42% in the unsprayed check. The trend was the same in the second trial also with Clothianidin 0.008% giving the best control with 0.64% berry damage/bunch as compared to 8.49% in the unsprayed check. It was on par with acephate and monocrotophos, but significantly superior to Clothianidin 0.006% and dimethoate.

Ludwig Traube. The man and his space.

The detection of dullness to percussion in the left hemithorax raises the possibility of pleural effusion, consolidation, or atelectasis. Percussion of Traube's space, a semilunar tympanitic area overlying the gas bubble in the stomach, is a valuable maneuver in this regard: obliteration of Traube's space favors a pleural effusion. Knowledge of the remarkable life of Traube, and the ability to demonstrate the utility of his sign on rounds, provides an opportunity in a technologic age to remind the medical student of the romance of bedside medicine.

Disseminated cutaneous cryptococcosis. Comparison of clinical manifestations in the pre-AIDS and AIDS eras.

A review of the literature suggests some differences in the cutaneous manifestations of cryptococcosis present in patients in the pre-acquired immunodeficiency syndrome (AIDS) era compared with those manifestations that are present in today's AIDS era. In both periods, cutaneous manifestations can precede and be the sole clue to disseminated cryptococcal infection. Today, cutaneous cryptococcal involvement is often mistaken for molluscum contagiosum or Kaposi's sarcoma. We describe a patient with disseminated cryptococcosis who presented with skin lesions mimicking molluscum contagiosum, and who was subsequently shown to have AIDS.

Clinical and epidemiologic features of strongyloidiasis. A prospective study in rural Tennessee.

Hospitalized and domiciliary patients were studied to determine the incidence of the endemic nematode Strongyloides stercoralls in stool samples. Strongyloides was found in 14 (6.1%) of 229 hospitalized patients and in nine (2.6%) of 346 domiciliary patients. Clinical symptoms, laboratory data, and underlying diseases were compared for stool-positive and stool-negative patients. Infected patients were more likely to complain of abdominal bloating. They had a higher incidence of eosinophilia and guaiac-positive stools. They were more likely to have been treated with corticosteroids, cimetidine, and antacids. Efficacy of treatment with thiabendazole was studied in all stool-positive patients; a relapse rate of 15% was noted with standard thiabendazole therapy.

Group b Streptococcal pneumonia in the elderly.

Group B streptococcal infections, although well studied in neonates, have only recently been appreciated as important infectious agents in adults. Seven cases of Group B streptococcal pneumonia were verified by transtracheal aspiration, blood and sputum cultures, or multiple stab cultures at autopsy. The infections were largely nosocomial and, ultimately, fatal in all seven patients. Our patients were older (average age, 73 years) and much more debilitated than the 13 cases reported in the literature. Diabetes was less common than previously reported. Previous antibiotic therapy was common. Concomitant isolation of another organism (especially Staphylococcus aureus) occurred in five patients. The morphologic findings at autopsy, in one patient, were characterized by a severely necrotizing destructive process. In our experience, Group B streptococcal pneumonia is more common, more devastating, and occurs in an older population than previously reported.

Bacterial bronchitis and bronchiectasis in human immunodeficiency virus infection.

BACKGROUND: Bacterial pneumonia and sinusitis are important causes of morbidity in patients with human immunodeficiency virus (HIV) infection. We noted an increased incidence of bacterial bronchitis and bronchiectasis in our patients with HIV infection. METHODS: This study was conducted on persons with HIV infection at a county hospital and clinic. Bronchiectasis was diagnosed by bronchogram and computed tomography in one patient and by computed tomography alone in two others. Bacterial bronchitis was defined by a Gram's stain showing an abundance of neutrophils with a predominance of one or more bacteria and by a confirmatory sputum culture. Bronchoscopy with broncho-alveolar lavage was performed in patients with bronchitis to eliminate other causes of bronchial inflammation. RESULTS: Eighteen episodes of bacterial bronchitis in 10 patients are described. The mean CD4 lymphocyte counts for these patients was 0.061 x 10(9)/L (range, 0.001 to 0.203 x 10(9)/L). The most common pathogens in 18 episodes of bacterial bronchitis were Haemophilus influenzae and Streptococcus pneumoniae (five episodes each) and Pseudomonas aeruginosa (four episodes). Response to antibiotic therapy was usually rewarding though recurrences were frequent. Three patients with well-defined bronchiectasis who appeared to have developed, or who became symptomatic during the course of, HIV infection are described. Their mean CD4 cell count was 0.03 x 10(9)/L (range, 0.024 to 0.037 x 10(9)/L). Haemophilus influenzae, Staphylococcus aureus, Pseudomonas cepacia, and P aeruginosa were recovered from these patients; the P aeruginosa was a mucoid strain. CONCLUSIONS: Recurrent bacterial bronchitis should be added to the list of bacterial infections that occur with increased frequency with HIV infection. Repeated bacterial bronchitis may lead to bronchiectasis, which may be more common in HIV infection than generally appreciated.

Clinical and microbiologic consequences of amikacin use during a 42-month period.

In June 1980, 23% of our Pseudomonas aeruginosa isolates and 53% of our Serratia species were resistant to gentamicin and tobramycin. During a 3 1/2-year period of almost exclusive amikacin usage, we noted a fall in overall resistance of gram-negative organisms to tobramycin and gentamicin from 18.8% and 19.3% to 15.2% and 16.2%, respectively. This fall in resistance was most notable for Escherichia coli, Proteus mirabilis, and Serratia species. During this period there was no increase in amikacin resistance. Age, hospitalization, prior antibiotic therapy, and Foley catheter use were predisposing factors in acquiring amikacin-resistant organisms. Amikacin-resistant gram-negative bacilli were usually sensitive to newer penicillins or cephalosporins.

Disseminated echovirus infection in a patient with multiple myeloma and a functional defect in complement. Treatment with intravenous immunoglobulin.

A man with IgG1 multiple myeloma developed fever, confusion, and progressive muscle weakness resulting in paralysis. Echovirus type 11 was isolated from cerebrospinal fluid, pleura, pleural fluid, and muscle, and muscle biopsy disclosed changes consistent with viral myositis. Immunologic evaluation revealed low serum levels of polyclonal IgG subtypes 1 and 3, reduced blood levels of T-helper/inducer and T-suppressor/cytotoxic cells, and a complement abnormality involving the function of the classical pathway C3 convertase, C4b2a. Therapy with intravenous immunoglobulin was associated with clinical recovery. This is the first reported case of disseminated central nervous system enteroviral infection in an adult with a B-cell malignancy, and in association with a documented complement abnormality. The findings suggest the efficacy of immunotherapy in this disease.

Amebic liver abscesses masquerading as pyemic abscesses.

We describe a 50-year-old man who presented with multiple liver abscesses that suggested biliary sepsis or portal pyemia. A wet preparation of a sample of aspirate showed the presence of amebic trophozoites, and subsequent serological testing for amebae was strongly reactive.

Bacterial pneumonia in the elderly.

Bacterial pneumonia in the elderly is common, and causes more morbidity and mortality than in the younger adult. As patients live longer with more underlying disease and more iatrogenic disease, the incidence of nosocomial pneumonia will probably rise. Adequate sterilization of inhalation therapy equipment can reduce the risk of gram-negative nosocomial pneumonia. Methods to prevent colonization and microaspiration need to be investigated. The development of a gram-negative vaccine using Salmonella RE or E. coli J5 mutant would augur well for the future. Most important, the elderly patient with pneumonia should be managed promptly and aggressively in an attempt to determine the specific etiology of the pneumonia. The practice of antibiotic "shotgunning" of the elderly patient is to be avoided. Transtracheal aspiration or sheathed bronchoscopy can be performed if the patient is not able to produce sputum, or Gram stain is difficult to interpret. Morbidity and mortality can be reduced by early appropriate antibiotic therapy directed by Gram stain.

Central venous septic thrombophlebitis--the role of medical therapy.

Suppurative thrombosis of a central vein is a serious complication of central venous catheter use. Surgical removal of the vein, the treatment usually recommended for peripheral vein suppuration, is technically difficult. We describe six patients with central venous septic thrombophlebitis. Four patients were receiving TPN; three from this group were successfully treated medically with removal of the catheter, intravenous antibiotics, and anticoagulants. The fourth patient improved clinically with 2 weeks of medical therapy prior to surgery, which showed the clot to be sterile. In contrast, two patients with suppuration adjacent to and secondarily involving a large vein required surgical drainage of the perivenous collection. Patients with central venous septic thrombophlebitis can be successfully managed with prompt catheter removal, intravenous antibiotics, and anticoagulation, but surgery should be considered when there is a suppurative focus around the vein.

The "typhoid state" revisited.

The "typhoid state" occurs classically with typhoid and typhus fevers but is also seen in other infectious diseases. Clinical descriptions of this state as "muttering delirium" or "coma vigil" refer to the peculiar preoccupied nature of the stupor. Picking at the bedclothes and at imaginary objects (carphology and floccillation) are characteristic, as is muscular twitching (subsultus tendinum). There is strong evidence that the death of Falstaff in Shakespeare's Henry V is a vivid description of the typhoid state.

Enterococcal pneumonia. Occurrence in patients receiving broad-spectrum antibiotic regimens and enteral feeding.

Enterococcal pneumonia occurred as a superinfection in two patients who received broad-spectrum antibiotic therapy. Both patients were receiving enteral hyperalimentation by Dobb-Hoff tube. The organism was isolated from transtracheal aspirate in pure culture and gram-positive cocci were visible on gram-stained smear. Enterococcal pneumonia may occur in patients receiving cephalosporin-aminoglycoside therapy, and may be anticipated as a consequence of third-generation cephalosporin therapy.

Pulmonary strongyloidiasis. Diagnosis by sputum gram stain.

Sputum Gram stain was diagnostic for pulmonary strongyloidiasis in four patients from Tennessee with chronic obstructive lung disease treated with steroids. The case reports of these patients and photomicrographs of the larval forms by Gram stain are presented. Sputum Gram stain may be a useful procedure to screen for pulmonary strongyloidiasis in steroid-treated patients with chronic lung disease who come from an endemic area.

Antibody response to P-protein in patients with Branhamella catarrhalis infections.

Branhamella catarrhalis is now recognized as an important cause of lower respiratory tract infections, especially in the elderly. In most instances, pathogenicity is presumed by recovery of the organism in a sputum culture, a method that is less than conclusive. In order to better diagnose B. catarrhalis infections, an enzyme-linked immunoassay has been developed using P-protein as antigen to measure antibodies to B. catarrhalis. In 17 elderly patients with B. catarrhalis pneumonia and 12 with tracheobronchitis, acute-phase serum antibody titers to P-protein were found to be significantly increased when compared with those of normal subjects (both p less than 0.02). There were no differences in antibody titers between patients with pneumonia and tracheobronchitis. Antibody titers of convalescent-phase sera increased over those of acute-phase sera in 46 percent of pneumonia patients and 50 percent of tracheobronchitis patients. The results demonstrated that lower respiratory tract infections with B. catarrhalis promote a significant elevation in antibody response to P-protein of B. catarrhalis.