Time of year, age class and body condition predict Hendra virus infection in Australian black flying foxes (Pteropus alecto).

Hendra virus (HeV) continues to cause fatal infection in horses and threaten infection in close-contact humans in eastern Australia. Species of Pteropus bats (flying-foxes) are the natural reservoir of the virus. We caught and sampled flying-foxes from a multispecies roost in southeast Queensland, Australia on eight occasions between June 2013 and June 2014. The effects of sample date, species, sex, age class, body condition score (BCS), pregnancy and lactation on HeV antibody prevalence, log-transformed median fluorescent intensity (lnMFI) values and HeV RNA status were assessed using unbalanced generalised linear models. A total of 1968 flying-foxes were sampled, comprising 1012 Pteropus alecto, 742 P. poliocephalus and 214 P. scapulatus. Sample date, species and age class were each statistically associated with HeV RNA status, antibody status and lnMFI values; BCS was statistically associated with HeV RNA status and antibody status. The findings support immunologically naïve sub-adult P. alecto playing an important role in maintaining HeV infection at a population level. The biological significance of the association between BCS and HeV RNA status, and BCS and HeV antibody status, is less clear and warrants further investigation. Contrary to previous studies, we found no direct association between HeV infection and pregnancy or lactation. The findings in P. poliocephalus suggest that HeV exposure in this species may not result in systemic infection and virus excretion, or alternatively, may reflect assay cross-reactivity with another (unidentified) henipavirus.

Population genetic structure and secondary endosymbionts of Q Bemisia tabaci (Hemiptera: Aleyrodidae) from Greece.

We investigated the molecular diversity of the major agricultural pest Bemisia tabaci and of its associated secondary endosymbionts in Greece. Analyzing mitochondrial DNA, we found that the Q1 (=Q west) is predominant. We used eight microsatellite polymorphic markers to study the genetic structure of 37 populations from mainland and insular Greece, collected on different host species from outdoor and protected crops as well as from non-cultivated plants. In some cases, gene flow was found to be low even between populations separated by just a few kilometres. Bayesian analysis identified two main genetic groups, the first encompassing populations from south Crete and the second composed of populations from north Crete, two other Aegean islands and mainland Greece. Genetic differentiation was not correlated with different host plant species or habitat, or greenhouse versus open environment populations. Gene flow significantly decreased with geographic distance, but no isolation by distance existed when only the samples from mainland Greece or only the samples from Crete were considered. The secondary symbionts Wolbachia and Hamiltonella were present at high frequencies while Arsenophonus, Cardinium and Rickettsia were absent from Greek populations. Multilocus sequence typing of Wolbachia identified two Wolbachia strains. These two strains were found together in most of the populations studied but never in the same host individual. Their role on the observed population structure is discussed.

Fluctuating asymmetry and fitness correlations in two Engraulis encrasicolus populations.

Correlations among several measures of fluctuating asymmetry (FA) and fitness-related variables were assessed in two populations of the European anchovy Engraulis encrasicolus with fast growth (Aegean Sea) and slow growth (Ionian Sea), respectively. FA levels were borderline significantly higher in the Ionian than in the Aegean for some variables. Variation in otolith shape (deviation from population norm) was lower in the Ionian than the Aegean, contrary to expectation. Within the Aegean, there was no relation between any of the FA indexes and fitness estimators, while in the Ionian a composite otolith FA index was significantly negatively correlated to standard length at age only in 2 year-old individuals. This difference between the Aegean and Ionian may have been related to the lower growth rate in the Ionian, as FA-fitness relations may be more apparent in less-beneficial environments. The absence of significant correlations in the Aegean and the low correlation in one age group in the Ionian suggests that FA is not a sensitive indicator of individual fitness in adult E. encrasicolus.

[What does the primary care physician now about his deceased patients? A study of deaths in a group practice]. / Hva vet primaerlegen om sine døde pasienter? En undersøkelse av dødsfall i en gruppepraksis.

Information about the cause of death is regarded as crucial for quality improvement in medicine. Although patients often consult their general practitioner close to their death, he or she is seldom involved as the attending physician during the terminal stage of life, and is often not told about death and its causes. This study analyses the extent of knowledge among general practitioners about deaths and the causes of death among their patients. Over a 46 month period, 8,627 patients had consulted a suburban group practice outside the city of Oslo, consisting of three general practitioners. 105 patients (0.3%) had died within the period. 40% of the deaths and 65% of the causes of death were unknown to the general practitioners. More than half of the patients died in the local hospital, and one fifth in a nursing home. The general practitioner issued only 7% of the death certificates. Information was lacking in particular on violent deaths and deaths among younger people. A routine should be established to provide general practitioners with information about the death of a patient, and its causes.

[Contact tracing in fighting HIV infections]. / Smitteoppsporingens plass i bekjempelsen av HIV-infeksjon.

The article briefly reviews current knowledge about the effect of telling the partner about HIV-infection. While informing one's partner has been shown to be effective in limiting the spread of classic venereal diseases such as gonorrhea and syphilis, the more complex nature of HIV-infection raises several difficult issues when it comes to telling one's partner. However, sufficient experience has acquired to advocate telling one's partner about HIV-infection, provided that the approach is humane, that no compulsion is exerted and that confidentiality and dignity are respected.

Out-of-hours primary care and the patients who die. A survey of deaths after contact with a suburban primary care out-of-hours service.

OBJECTIVE: To assess how and to what extent out-of-hours primary care facilities care for patients who die shortly afterwards, and whether information about deaths and causes of deaths are fed back to doctors who treated the deceased persons. DESIGN: An observational prospective study of patients who die. SETTING: An out-of-hours primary care facility providing services to a population of 78,000. SUBJECTS: 531 patients who died in the 1-year study period. MAIN OUTCOME MEASURES: Extent of reporting back about deaths to the out-of-hours primary care facility and description of contacts with out-of-hours primary care prior to death. RESULTS: 134 of 531 deceased patients had been treated by an out-of-hours primary care physician within the last 4 weeks of life. The physicians had received information about the cause of death in only 9 of the cases (6%). Six dead patients (5%) had their condition misinterpreted by the out-of-hours primary care physicians, with a possible delay in appropriate care. CONCLUSION: Prompt feedback of causes of death to primary care physicians represents an important, but mostly unexploited, potential for quality improvement.

[Contact tracing in HIV infections]. / Smitteoppsporing ved HIV-infeksjon.

The HIV counselling and testing clinic at the Oslo City Board of Health started in April 1986 to monitor its programme to encourage HIV-infected persons to inform their partners. By 1 April 1989, 65 of 233 potentially identifiable case contacts reported by 167 index patients had been tested and shown to be HIV-antibody positive. For 30 of the case contacts the main reason for seeking counselling and taking a HIV-antibody test was being told that their partner was HIV-infected. We discuss the effectiveness and acceptability of the programme.

Dextran-induced lowering of prekallikrein proactivator and prekallikrein in rat plasma.

The intravenous injection into rats of dextran (average MW 70,000) 10 mg/100 g caused marked hypotension after a delay of about 5 minutes. Blood samples collected by cardiac puncture at this time were tested for the amounts of prekallikrein activator (PKA) and kallikrein after acetone- and then kaolin activation of the plasminogen-free plasma. PKA was assayed by measuring the initial rate of release of benzoyl arginine esterase (BAEe) activity in a preparation of partially purified human prekallikrein, and kallikrein was assayed by measuring the BAEe esterase activity. Significant reductions of both parameters were registered, and the amount of high molecular weight kininogen (HMWK) present in the plasma was also reduced. Pretreatment of the rats with epsilon-aminocaproic acid intraperitoneally (200-300 mg/100 g) abolished the dextran-caused decreases in the plasma levels of the above mentioned factors, and reduced the fall in blood pressure. The addition of purified human HMWK to the plasma before the acetone activation procedure was started, increased the yield of PKA activity in the final enzyme preparation. When PKA was assayed after kaolin activation of plasma at 0 degrees using the method developed by Laake & Vennerød (1973a & b) for the determination of PKA (activated factor XII) in human plasma, no differences were registered between plasma from rats treated with dextran and plasma obtained from control rats. It is suggested that the low PKA activity of the acetone activated enzyme preparation from plasma of rats treated with dextran was due to the loss of HMWK or a fraction of HMWK.

Joint mice in the fetlock joint--osteochondritis dissecans.

Joint mice in the horse is a wellknown condition, but during the last years diagnosed with increasing frequency. Ethiology and prognosis thus become of major interest. 53 cases of mice in the fetlock are examined and divided in 3 groups on the basis of localization and appearance. On one group characterised by a localization in the plantar aspect of the joint and clearly separated from the tuberosites of the first phalanx histological investigations were carried out resulting in the statement that the mice can be the result of osteochondrosis. Surgical intervention in cases with clinical symptoms offers a fairly good prognosis, but it is underlined that the osteochondrotic defect can be restored by filling fibrocartilage.

Voluntary and professional disaster-workers: similarities and differences in reactions.

Forty-three rescuers responding to a bus crash that killed 12 children and 4 adults and injured many more answered questionnaires at 1 and 13 months following the crash. This study compared the responses of the voluntary and professional helpers, using the Impact of Event Scale (IES) and the General Health Questionnaire (GHQ). For all helpers taken together, the decline in IES-intrusion and IES-total scores was significant from 1 to 13 months. The voluntary helpers reported significantly more intrusion and avoidance on the IES at 1 month than professional helpers, and for avoidance the voluntary helpers still evidenced a significantly higher score than professional helpers at 13 months. The GHQ scores at 13 months reflected that the long-term negative impact of the event was low.

[Risk factors and intervention in cardiovascular diseases in general practice]. / Risikofaktorer og intervensjon ved hjerteog karsykdommer i allmennpraksis.

The authors conducted a cross-sectional study including 707 patients with chronic ischaemic heart disease or obstructive peripheral atherosclerotic disease. The patients were monitored by 31 general practitioners in different parts of Norway, from October 1994 to April 1995. 67% of the patients were male and 33% were female. 28% were smokers. In this study the majority of the patients were being adequately treated for hypertension, and the prevalence of antithrombotic treatment with either warfarin or acetylsalicylic acid was comparable with the results from recent intervention trials, for instance the Scandinavian Simvastatin Survival Study (4S). More than 90% of the patients had levels of total cholesterol and LDL-cholesterol which, based on today's international consensus, implied giving dietary advice and treatment with statin-type drugs in order to increase survival and reduce morbidity once atherosclerotic disease has been diagnosed. In this study less than 20% received statins, and only a minority of those treated had reached the established goals for treatment. Based on this study we recommend that much stronger emphasis is placed on serum-cholesterol level reduction in patients with established atherosclerotic disease, both by specialists and in primary health care.

How well are patients with atherosclerotic disease treated? Secondary prevention in primary care.

OBJECTIVE: To examine changing trends in the field of secondary prevention of atherosclerotic disease in Norwegian general practice. DESIGN: A multipractice survey of consecutive patients with atherosclerotic disease consulting general practitioners in 1994/95 compared with a similar survey in 1996/97. SETTING: Primary health care. SUBJECTS: 707 patients attending 31 general practitioners in 1994/95 and 1353 patients attending 63 general practitioners in 1996/97. MAIN OUTCOME MEASURES: The patients were examined and interviewed for risk factors and pharmacological treatment. RESULTS: In 1994/95, 18% of the patients had been prescribed a lipid-lowering agent as opposed to 55% in the later survey. Consequently, the average level of LDL cholesterol in the 1996/97 population was 19% lower than in the 1994/95 population (3.8 mmol/l vs 4.7 mmol/l), which may imply a marked risk reduction. Aspirin and beta-blockers were prescribed to approximately 50% of the patients in both surveys. Diabetic patients had the same drug prescription rate and lipid profile as non-diabetics. In both surveys, about 25% of the patients were smokers. CONCLUSION: Secondary prevention in the majority of patients with atherosclerotic disease though ameliorating is still unsatisfactory. More attention is needed to achieve and sustain treatment goals.

[How well are patients with atherosclerosis treated in general practice? Risk factors and intervention surveyed in 1996-97 as compared to two previous years]. / Hvor godt behandles pasienter med aterosklerotisk sykdom i allmennpraksis? Risikofaktorer og intervensjon kartlagt i 1996-97 sammenliknet med to år tidligere.

In 1996 and 97, a total of 1,353 patients with coronary heart disease and peripheral arterial disease were screened in 63 general practices for their specific risk factors and treatment. 63% of the patients were males and 25% were smokers. 55% of the patients had been prescribed a lipid lowering agent, in most cases by their general practitioner, as opposed to 18% in a similar screening in 1994 and 95. This corresponds with a general increase in the number of prescriptions for this kind of drug. The majority of patients treated were 75 years of age and under. The recommended level of LDL-cholesterol in secondary prevention is 2.6 mmol/l or less. 83% of the patients had values above this level. Neither the treatment with antithrombotic agents and beta-blockers, nor the reduction in the systolic blood pressure in hypertensive patients was found to be satisfactory. The same lipid profile and frequency with which drugs were prescribed was seen in both diabetic and non-diabetic patients. We found that lipid lowering agents were prescribed more frequently and aspirin less frequently than in comparable European surveys. It is essential to develop effective intervention strategies and for general practitioners and specialists to collaborate closely to implement these strategies for patients with atherosclerotic disease.

The effect of joint position on juxta-articular bone marrow pressure. Relation to intra-articular pressure and joint effusion--an experimental study on horses.

Six metacarpo-phalangeal joints of adult horses were studied. Pressure measurements were made in the joint and the metacarpal bone with simultaneous measurement of the systemic arterial blood pressure. Investigations performed to study the effect of joint position on juxta-articular bone marrow pressure showed that an increase in joint flexion was always followed by a rise in intraosseous pressure with a significant increase at flexion above 60 degrees. Increase in intra-articular pressure which was achieved by injection of saline was always followed by a slower rise in intraosseous pressure. Furthermore, it was shown that even a few millilitres of saline in the joint caused a rise in intra-articular pressure. The findings indicate that changes in joint position as well as effusion may block the drainage vessels from the bone marrow as they pass through the joint.

[Quantification of T-lymphocyte subpopulations. Immunological marker in human immunodeficiency virus infections]. / Kvantifisering av T-lymfocytt-subpopulasjoner. Immunologisk markør ved humant immunsviktvirusinfeksjon.

The absolute number of CD4+ and CD8+ T cells was counted directly in the blood of 75 healthy controls and 223 individuals infected with human immunodeficiency virus (HIV). The HIV-seropositive individuals were also classified clinically according to the system recommended by the Centers for Disease Control. We observed a pattern of changes in the T cell subset counts of the patient group. This pattern could be defined by five T cell stages ranging from normal T cell subset values to values representing severe T cell immunodeficiency. A close correlation was observed between the immunological and clinical classification of the patients. Quantification of T cell subsets may provide useful information in the follow-up of individuals infected with HIV, particularly in assessing the indications for antiviral therapy, and its effects.

The perceptibility curve test applied to direct digital dental radiography.

OBJECTIVE: To compare the effect of an additional scintillator layer on the psychophysical properties of a CCD detector for digital dental radiography. METHODS: Radiographs of a test object containing ten holes of increasing depth were obtained throughout the exposure range of two CCD detectors at 70 and 90 kVp. One was the original detector for the Sens-A-Ray system (Regam Medical Systems, Sundsvall, Sweden) and the other the same detector covered by a scintillator layer. Ten viewers evaluated the radiographs for the number of perceptible holes. From these data and the dose response functions for the two detectors, the minimum perceptible exposure difference was found. The reciprocal values of this parameter were plotted against the logarithm of exposure to create Perceptibility Curves (PCs). RESULTS: The four PCs had essentially the same shape and height. There was a shift to lower exposures in the PCs for the detector covered by a scintillator. CONCLUSIONS: The two detectors have essentially the same psychophysical properties. Since the detector covered by a scintillator layer is more sensitive, it should be preferred for clinical practice since the dose to the patient is reduced.