Recreational and Commercial Catfishing Injuries: A Review of the Literature.

Catfish injuries are increasingly common from the recreational activities of hobbyists, fishermen, and "noodling" enthusiasts as well as in the commercial catfish industry, most commonly in Brazil. Injuries can range from mild skin abrasions to life-threatening infections and tissue damage requiring urgent treatment. Most injuries and subsequent morbidity associated with catfish encounters involve the dorsal and pectoral fins. These injuries are most often lacerations involving the upper extremities. Deep, penetrating catfish spine injuries can lead to serious injuries, including arterial and nerve lacerations. Catfish venom is released when a spine is torn. The venom may cause reactions that include erythema, edema, local hemorrhage, tissue necrosis, and muscle contractions. When "finned" by a catfish, the fish's spine may separate from the fish, which can cause a foreign body embedment. Some injuries are not thought to be severe enough at the time of injury to require medical care, although symptoms may arise years later. In this literature review of catfishing injuries, references were obtained through a PubMed search of the following terms: catfish injuries, fishing, envenomation, spine, and aquatic infection. Articles were chosen for citation based on pertinence to the topic of catfishing.

The Use of a Pediatric Migraine Practice Guideline in an Emergency Department Setting.

OBJECTIVE: The aim of the study was to evaluate the safety and efficacy of a standardized pediatric migraine practice guideline in the emergency department (ED). METHODS: Migraine Clinical Practice Guideline (MCPG) was created in collaboration with the Division of Pediatric Neurology and Pediatric Emergency Medicine. The MCPG was established on evidence-based data and best practice after a review of the literature. The MCPG was implemented for patients with a known diagnosis of migraine headaches and a verbal numeric pain score (VPS) greater than 6 on a 0 to 10 scale. Patients received intravenous saline, ketorolac, diphenhydramine, and either metoclopramide or prochlorperazine. After 40 minutes, another VPS was obtained, and if no improvement, a repeat dose of metoclopramide or prochlorperazine was administered. If after 40 minutes and minimal pain relief occurred, a consult to neurology was made. A chart review of patients enrolled in the MCPG from April 2004 to April 2013 was conducted. We recorded demographic data, vital signs, ED length of stay, initial VPS, last recorded VPS, adverse events, and admission rate. Nonparametric statistics were performed. RESULTS: A total of 533 charts were identified with a discharge diagnosis of migraine headache of which 266 were enrolled in the MCPG (179 females and 87 males). Mean (SD) age was 13.9 (3.1). Mean (SD) initial VPS was 7.8 (2.0). Mean (SD) discharge VPS was 2.1 (2.8), representing a 73% reduction of pain. Twenty patients (7.5%) were admitted for status migrainosus; mean (SD) age was 14.0 (3.5) years and mean (SD) VPS was 6.3 (2.8). Mean (SD) length of stay in ED was 283 (107) minutes. No adverse events were identified. CONCLUSIONS: Our MCPG was clinically safe and effective in treating children with acute migraine headaches. Our data add to the dearth of existing published literature on migraine treatment protocols in the ED setting. We recommend additional prospective and comparative studies to further evaluate the effectiveness of our protocol in this patient population.

Catfish noodling forearm injury requiring urgent surgical treatment: a case report and review of the literature.

"Noodling" is an ancient form of hand fishing recently gaining in popularity as a hobby and sport. We present one of the first case reports of a noodling injury in an adolescent male seeking to land a large catfish, and also review the literature on catfish-related injuries.

Improvements in Sleep After Shoulder Arthroscopy Are Correlated With Improvements in Various Patient-Reported Outcomes: A Systematic Review.

Purpose: To determine the prevalence of sleep disturbances in patients before and after arthroscopic surgery of the shoulder and to evaluate the association between patient-reported outcomes and standardized sleep disturbance tools after shoulder arthroscopy. Methods: A systematic review, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, was conducted by searching the PubMed, Embase, and Scopus databases using the terms "arthroscopic surgery" and "sleep." Two independent reviewers evaluated the studies based on the inclusion criteria focused on the effects of shoulder arthroscopy on sleep disturbance and the use of outcome measures related to sleep. Data on sleep quality and functional outcomes were collected and analyzed using various assessment tools, including the Pittsburgh Sleep Quality Index and American Shoulder and Elbow Surgeons score. The methodologic quality of included studies was assessed using the Methodological Index for Non-randomized Studies (MINORS) criteria. Results: The review included 15 studies (9 Level IV, 5 Level III, and 1 Level II) comprising 1,818 arthroscopic patients (average age, 57.4 ± 8.86 years; follow-up range, 6 months to 75.7 months). The prevalence rates of sleep disturbances before and after shoulder arthroscopy ranged from 75.8% to 100% and from 19% to 62%, respectively. Every study included in this analysis reported an improvement in rates of sleep disturbances postoperatively compared with preoperatively. Improvements in standardized sleep disturbance scores were associated with functional outcomes. Conclusions: Sleep disturbances are commonly observed before and after arthroscopic surgery of the shoulder. Arthroscopic surgery of the shoulder appears to improve sleep quality, and surgeons can expect functional outcomes, specifically the American Shoulder and Elbow Surgeons score, Simple Shoulder Test score, numeric rating scale or visual analog scale score, and Constant-Murley score, to improve in line with sleep quality. Level of Evidence: Level IV, systematic review of Level II to IV studies.

Factors Associated with Non-Completion of a Pediatric Metabolic and Bariatric Surgery Program.

BACKGROUND: Childhood obesity is a devastating disease process disproportionately affecting minority and low-income populations. Though bariatric surgery leads to durable weight loss and reversal of multiple obesity-related comorbidities, only a small fraction of pediatric patients undergoes the procedure. We sought to identify factors associated with non-completion in a pediatric bariatric surgery program. METHODS: Retrospective review of consecutive patients ≤18-years-old referred to an academic adolescent bariatric surgery program between 2017 and 2022 (n = 20 completers, 40 non-completers) was completed. Demographics and medical and psychosocial histories were summarized by completion status. RESULTS: Of the 33% (20/60; 85% female, 30% racial minorities) who successfully completed the program, the median age was 16 years [IQR 16, 17]. The median age of non-completers was 16 years [IQR 15, 17] (55% female, 56% racial minorities). Non-completion was associated with male gender (15% of completers vs 45% of non-completers, p = 0.022), neighborhood income <150% poverty level (0 completers vs 17.5% of non-completers, p = 0.047), and presence of environmental or family stressors (22% of completers vs 65% of non-completers, p = 0.008). Though not statistically significant, non-completers tended to be racial minorities (p = 0.054). CONCLUSIONS: Non-completion of the bariatric surgery pathway was more prevalent among male patients from lower-income neighborhoods with significant environmental or family stressors. These patients also tended to be racial and ethnic minorities. The findings underscore the need for further investigation into barriers to pediatric bariatric surgery. LEVEL OF EVIDENCE: Level III.

Current state of medical-advice-seeking behaviour for symptoms of colorectal cancer: determinants of failure and delay in medical consultation.

AIM: There are few data on the factors associated with healthcare-seeking behaviour for symptoms of colorectal cancer. This study describes the determinants of failure and delay in seeking medical advice for rectal bleeding and change in bowel habit. METHOD: In total, 1592 persons (56-88 years) were randomly selected from the Hunter Community Study and mailed a questionnaire. RESULTS: In all, 18% (60/332) of respondents experiencing rectal bleeding and 20% (39/195) reporting change in bowel habit had never consulted a doctor. The rate of delay (>1 month) for each symptom was 18% and 37%. The reasons for delay included the assumption that the symptoms were not serious or that they were benign. Triggers for seeking medical advice varied. Healthcare-seeking behaviour for rectal bleeding had not significantly improved compared with a previous community-based study. CONCLUSION: The seriousness of symptoms, importance of early detection and prompt medical consultation must be articulated in health messages to at-risk persons.

Antibody to herpes simplex virus type 2-induced nonstructural proteins in women with cervical cancer and in control groups.

Sera obtained from 15 patients with cervical cancer, 10 patients with breast cancer, and 15 control women, individually matched with the cervical cancer patients, were examined for antibodies to early proteins synthesized in herpes simplex virus type 2 (HSV-2)-infected cells. The method used was an indirect radioimmune precipitation test followed by polyacrylamide gel electrophoretic analysis of immune precipitates. The relative reactivity to a major early nonstructural protein (VP134) was used to compare these selected sera. The results obtained suggest that cervical cancer patients possess sera with a higher reactivity to VP134 than breast cancer patients or matched healthy women,and that serum reactivity is independent of the level of neutralizing antibodies to HSV-2.

Studies on herpes simplex virus and cancer.

Virus-induced polypeptides of cells infected by herpes simplex virus (HSV) types 1 and 2 were investigated by analysis on polyacrylamide gels and by determination of their antigenicity. Some polypeptides, VP154 and VP134, had immunological reactivity common to both virus types, while others (VP175 and VP123) were type specific. Only the glycosylated polypeptides were able to induce neutralizing antibody. The expression of viral genetic information was studied in newborn mice infected with wild-type and ts mutant viruses; some mutants had become attenuated and had lost pathogenicity for newborn mice while others had not. From induction experiments in HSV=transformed hamster cells, it appears that detection of enhanced replication of ts mutants in human cancer cells would be an indication of resident HSV genetic information. Sera obtained from cancer patients were examined for antibodies to early proteins synthesized in HSV-infected cells. The method used was an indirect radioimmune precipitation test followed by polyacrylamide gel electrophoretic analysis of immune precipitates. Cervical cancer patients had sera with a higher reactivity to early nonstructural polypeptides than to breast cancer patients or to matched healthy women. In contrast to the results with early polypeptides, little difference was detectable between the matched sera in their reactivity with a major capsid polypeptide, which is synthesized late in the infectious cycle.

Detection of herpes simplex virus induced polypeptides in rabbit trigeminal ganglia.

The objective of this study was to follow herpes simplex virus type 1 (HSV-1) genome expression in rabbit trigeminal ganglia during primary, latent, and artificially reactivated infections using monospecific antiserum to representatives of the sequentially produced alpha, beta, and gamma group polypeptides. Rabbits with or without electrode implants were inoculated with 10(5) plaque forming units of McKrae strain HSV-1 following scarification and monitored by daily preocular tear film culture. Animals were killed during primary, latent, and artificially reactivated infections. Representative trigeminal ganglion sections from each animal were reacted with either preimmune rabbit serum, anti-HSV-1, anti-ICP-4, anti-ICP-8, or anti-ICP-5 sera. During primary infection, staining was evident in 30-40% of the ganglion cell nuclei with all antisera. During latency, staining with anti-ICP-4 was detected in 14 out of 18 ganglia tested; 10-15% of the ganglion cell nuclei per section exhibited positive staining. A +/- staining pattern with anti-ICP-8 was obtained in 5 out of 14 of the ganglia tested; 1-3% of the nuclei per section exhibited this staining pattern. Staining with anti-HSV-1 and anti-ICP-5 was not detected. During induced reactivation, staining of ganglion cell nuclei with all antisera was observed, but the number of cells staining per section was decreased compared to that observed during primary disease.

Production, binding characteristics, and immunogenicity of heterologous anti-idiotypic antibody to herpes simplex virus glycoprotein C.

A monoclonal antibody specific for glycoprotein C (gC) of herpes simplex virus type 1 (HSV-1) was used to prepare a heterologous anti-idiotypic antibody in rabbits. After absorption with normal mouse immunoglobulin (NMS) the anti-idiotypic (anti-id) antibody retained binding activity for MoAb D4.1, the immunogen. The anti-id (anti-id C) also demonstrated a cross-reactive binding activity, as shown by ELISA, for MoAb D4.2 and MoAb D4.8 which was specific for glycoprotein D (gD) and glycoprotein B (gB) of HSV-1, respectively. Also, anti-id C bound to and eluted from MoAb D4.2 and MoAb D4.8 affinity columns retained the ability to bind all three monoclonal antibodies. This cross-reactive anti-id could inhibit the binding of each of the three monoclonal antibodies to their respective proteins, suggesting an antigen combining site specificity. Subsequently, the idiotope on MoAb D4.8 was shown to be outside the antigen combining site, since anti-id C recognized MoAb D4.8 complexed with gB. The anti-id, however, did not bind MoAb D4.1 or MoAb D4.2, if these monoclonals were bound to gC or gD, respectively, suggesting the cross-reactive determinant was paratopic on those two monoclonals. Immunization of mice with anti-id C could prime splenocytes in vivo to proliferate in response to HSV antigen stimulation in vitro. Thus, spleen cells involved in the HSV immune response in vitro recognized the anti-idiotypic antibody in vivo.

Membrane-associated antigens of herpes simplex virus.

A brief overview is presented concerning the membrane-associated antigens of herpes simplex viruses (HSV). Aspects discussed include certain properties and functional roles of the HSV-specific glycoproteins. In addition, recent findings of an association between certain immediate-early proteins of HSV-1 and the tegument of virions as well as the plasma membrane of virus-infected cells are discussed.

Glycosylation of herpes simplex virus type 1 gC in the presence of tunicamycin.

The presence of O-glycosidic linkages on herpes simplex virus type 1 (HSV-1) glycoproteins was indicated by the synthesis and glycosylation of HSV-1 glycoproteins in the presence of tunicamycin. Monospecific antiserum to HSV-1 gC immunoprecipitated a 92,000-molecular-weight protein synthesized in the presence of tunicamycin and isotopically labeled with glucosamine or galactose. Anti-gAB did not immunoprecipitate a carbohydrate-labeled HSV-1 protein synthesized in the presence of tunicamycin. The purified glucosamine-labeled 92,000-molecular-weight protein synthesized in the presence of tunicamycin and the fully glycosylated forms of gAB and gC were tested for their sensitivity to mild alkaline hydrolysis. Purified gAB was resistant to mild alkaline hydrolysis, whereas gC and the 92,000-molecular-weight protein were both sensitive to mild alkaline hydrolysis. These results suggest that O-glycosidic linkages are associated with the HSV-1 gC glycoprotein.

Effect of herpes simplex virus type 1 on cellular pools of oligosaccharide-lipid.

Incorporation of [3H]mannose into cellular pools of mannosylphosphoryl dolichol (Man-P-Dol), oligosaccharide-lipid, and glycoprotein was measured and compared in herpes simplex virus type 1 (HSV-1)-infected cells and -uninfected cells. While mannose incorporation into the monosaccharide-dolichol fraction was similar in infected or uninfected Vero cells, incorporation into the oligosaccharide-lipid fraction was markedly reduced in HSV-1-infected cells (64% of control levels). In contrast, mannose incorporation into glycoprotein was significantly increased in virus-infected cells versus uninfected cells (194% of control levels). The kinetics of incorporation into the various fractions was examined and it was determined that there was minimal increase in mannose incorporation into oligosaccharide-lipid after 8 hr postinfection in virus-infected cells. This corresponded to the time at which nonglycosylated precursors of the HSV-1 glycoproteins were first detected in association with the nuclear fraction. These data suggest that there is an accelerated turnover of oligosaccharide-lipid in virus-infected Vero cells which is most likely due to extensive glycoprotein synthesis.

Association of a major transcriptional regulatory protein, ICP4, of herpes simplex virus type 1 with the plasma membrane of virus-infected cells.

A major transcriptional regulatory protein, ICP4, of herpes simplex virus type 1 (HSV-1) is localized primarily within the nucleus soon after its synthesis. Recent studies have shown that approximately 100 to 200 molecules of ICP4 are located in the tegument region of purified virions (F. Yao and R. J. Courtney, J. Virol. 63:3338-3344, 1989). As an extension to these studies, we present data suggesting that ICP4 may also associate with the plasma membrane of HSV-1-infected cells. The experimental approaches used included the isolation and purification of plasma membranes from HSV-1-infected cells, the isolation of purified vesicular stomatitis virus containing ICP4, and immunofluorescence of HSV-1-infected cells following selective permeabilization with detergent. The results from the above studies support the suggestion that detectable amounts of ICP4 are associated with the inner surface of the plasma membrane of HSV-1-infected cells.

Differential rates of processing and transport of herpes simplex virus type 1 glycoproteins gB and gC.

The kinetics of processing and transport of herpes simplex virus type 1 (HSV-1) glycoproteins gB and gC was investigated. The conversion of precursor to mature forms and the appearance of the glycoproteins at the infected-cell surface at different times postinfection (p.i.) were studied. gB, synthesized at 4 h p.i., was converted to the mature form with a half-time (t1/2) of 120 min and appeared at the plasma membrane with a t1/2 of 270 min. The gB synthesized at later times p.i. (6, 8, and 10.5 h) was transported less efficiently. Less than 50% of gB synthesized at later times p.i. was processed and transported to the cell surface. gB synthesized in transfected cells was transported to the plasma membrane with kinetics similar to that for gB synthesized at early times p.i. gC was processed efficiently when synthesized at both 8 and 10.5 h p.i., with t1/2 of conversion of pgC to gC of 40 and 60 min, respectively. Approximately 90 to 95% of the gC synthesized was converted to the mature form. The gC synthesized at 8 h p.i. was also transported rapidly to the cell surface, compared with the transport of gB synthesized at the same time, with a t1/2 of 240 min. Greater than 70% of the gC synthesized at 8 h p.i. appeared at the cell surface. The gC synthesized at 10.5 h was transported less efficiently to the cells surface during a 6-h chase.

A major transcriptional regulatory protein (ICP4) of herpes simplex virus type 1 is associated with purified virions.

Herpes simplex virus type 1 was purified by density gradient centrifugation, and the virion-associated proteins were resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. By Western blot (immunoblot) analysis with an anti-ICP4 monospecific serum, the results indicated that ICP4, one of the five immediate-early proteins of herpes simplex virus type 1, was associated with the purified virions. To define the location of ICP4 within the virion, trypsin digestion experiments were performed. Purified virions were treated with trypsin in the presence or absence of detergent. The virus envelope appeared to protect ICP4 from the trypsin, since virus-associated ICP4 was sensitive to digestion only after detergent treatment. In addition, ICP4 remained associated with the virus particle when the virion-specific glycoproteins were removed after detergent treatment. Finally, ICP4 was not detected in purified preparations of type A and B capsids isolated from the nuclear fraction of virus-infected cells. The above-mentioned data suggest that detectable amounts of ICP4 are present within the tegument region of the virion.

Multimeric forms of herpes simplex virus type 2 glycoproteins.

Herpes simplex virus type 2-specific glycoproteins present in detergent extracts of infected cells were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis under conditions designed to permit detection of multimeric forms of these glycoproteins. Two high-molecular-weight glycosylated species were detected when samples were disrupted at lower temperatures or in the absence of any reducing agents. One multimer having an apparent molecular weight of 275,000 was identified as a multimer of the gA or gB glycoprotein or both. The second glycoprotein, having a molecular weight of approximately 230,000, was identified as a multimeric form of the gC glycoprotein. These data indicate that the gC as well as the gA and gB glycoproteins of herpes simplex virus type 2 may exist in a multimeric form.

Topological distribution of virus-specific and cross-reactive antigenic determinants on the gB glycoprotein of the herpes simplex viruses.

The antigenic properties and relations between the herpes simplex virus type 1 and 2 (HSV1, HSV2) gB glycoproteins were investigated. Using several assay systems to analyze the virus-specific reactivity of polyclonal monospecific rabbit anti-gB sera, it was demonstrated that most of the antigenic determinants of the gB glycoproteins exposed at the surface of both virions and infected cells are virus-specific rather than cross-reactive. Comparative examination of the reactivity of human immune sera with HSV1 and HSV2 antigens by immunoblotting also revealed differences in the ability of HSV1 and HSV2 immune sera to recognize homologous vs. heterologous gB antigens. These results indicate that despite the high degree of amino acid sequence homology which exists between the HSV1 and HSV2 gB glycoproteins many of the immunologically relevant antigenic determinants of the gB glycoproteins probably reside in regions of the molecule which are not so highly conserved between the two HSV serotypes.