Efficacy of alcohol-based hand sanitizers against human norovirus using RNase-RT-qPCR with validation by human intestinal enteroid replication.

Successful human norovirus (HuNoV) cultivation in stem cell-derived human intestinal enteroids (HIE) was recently reported. The purpose of this study was to evaluate the anti-HuNoV efficacy of two alcohol-based commercial hand sanitizers and 60% ethanol by suspension assay using RNase-RT-qPCR, with subsequent validation of efficacy by HuNoV cultivation using the HIE model. In suspension, when evaluated by RNase-RT-qPCR, 60% ethanol resulted in less than one log10 reduction in HuNoV genome equivalent copies (GEC) regardless of contact time (30 or 60s) or soil load. The two commercial products outperformed 60% ethanol regardless of contact time or soil load, providing 2·2-3·2 log10 HuNoV GEC reductions by suspension assay. Product B could not be validated in the HIE model due to cytotoxicity. Following a 60s exposure, viral replication in the HIE model increased 1·9 ± 0·2 log10 HuNoV GEC for the neutralization (positive) control and increased 0·9 ± 0·2 log10 HuNoV GEC in challenged HIE after treatment with 60% ethanol. No HuNoV replication in HIE was observed after a 60 s exposure to Product A.

Vitamin B6 and cancer: synthesis and occurrence of adenosine-N6-diethylthioether-N-pyridoximine-5'-phosphate, a circulating human tumor marker.

In the course of studies aimed at deciphering the metabolic transformations of [3,4-14C] and [3H]C6-pyridoxine hydrochloride by tumor-bearing rats and tumor cells in culture, biosynthesis of a novel labeled product was observed. Its production began with the onset of tumor growth and increased as cell proliferation increased. Chemical, enzymatic, precursor labeling, and analytical tests on the isolated product indicated this product as adenosine-N6-diethylthioether-N-pyridoximine-5'-phosphate (compound 1). In confirmation, the chemical synthesis and characterization of compound 1 are presented in this study. In addition, blood samples from 28 normal subjects, 28 cancer patients with different malignancies, and 39 patients with a variety of other than cancer ailments were screened for compound 1 on a blind basis using reverse phase ion-paired high-performance liquid chromatography. The results show that the level of the vitamin B6 conjugate in the circulation of control subjects, cancer patients in remission, and patients with other diseases was only minimal. Cancer patients with active disease had 3-4-fold higher levels (P < 0.00001). Our results also confirm previous findings regarding the structure of compound 1 and show its potential value as a circulating human tumor marker that could be successfully used for cancer detection.

Distribution and hormonal regulation of androgen receptor immunoreactivity in the forebrain of the male European ferret.

The distribution and hormonal regulation of androgen-receptor-immunoreactive (AR-ir) cells in the male European ferret forebrain were examined. AR-ir cells were found in many limbic and hypothalamic structures, and their distribution was similar to that reported for cells that either bind androgen or contain AR protein or mRNA in other species. Regulation of brain AR immunoreactivity by gonadal steroids was brain-region dependent. In most regions examined, including the preoptic area, amygdala, and several hypothalamic nuclei, castration reduced the density of AR-ir profiles and the intensity of immunocytochemical staining, and long-term (days) androgen, but not estrogen, replacement restored these parameters of AR immunoreactivity. Other areas, such as the bed nucleus of the stria terminalis, appeared to be relatively resistant to modulation of AR immunoreactivity by castration and long-term androgen treatment. The ability of testosterone to increase AR-ir profile density is not a simple consequence of translocation of AR from the cytoplasm to the nucleus, because short-term (hours) treatment with testosterone did not result in an increase in AR-ir profile density equivalent to that seen after 10 days of testosterone treatment. Thus, androgens appear to be able to increase AR levels within certain brain cell groups, thereby altering target tissue responsiveness to their own action.

Use of two Greenfield caval filters to prevent recurrent pulmonary embolism in a heparin-allergic gravida.

BACKGROUND: Maternal mortality may be reduced by prompt diagnosis and treatment of pulmonary embolism. CASE: A 25-year-old pregnant woman required a second Greenfield filter after developing a heparin allergy and recurrent pulmonary embolism. CONCLUSION: Heparin allergy has not been reported previously in pregnancy. A Greenfield filter may be used in this circumstance. Extension of the thrombus cephalad to the filter can cause recurrent emboli, so deployment of a second caval filter may be an effective remedy.

Scanning electron microscopy of human head louse (Anoplura: Pediculidae) egg and its clinical ramifications.

Pediculosis affects more elementary school students than all other communicable childhood diseases combined, excluding the common cold. The current study using scanning electron microscopy visualized operculums through which developing embryos received oxygen, as well as fracture lines within the adherent sheath by which the egg is attached to the hair. Using microscopic techniques, including freeze-fracturing, the mode of attachment of the sheath to the hair follicle was observed, in addition to the existence of several inner membranes enclosing the embryo within the egg structure. The chemical nature of the sheath is also analyzed using electron dispersive x-ray analysis.

Histochemical analysis of the nit of Pediculus humanus capitis (Anoplura: Pediculidae).

Histochemical stainings of head louse nits were performed and observations indicated that the nit sheath was nonchitinous. One discernable membrane composed of hyaluronic acid was established that encircled the larvae within the egg. The structural framework of the egg included a definite lattice around each aeropyle of the operculum, through which oxygen exchange occurred.

An explant culture system for the study of atrial development.

An explant culture system for the study of chick atrial development was tested using media of varying composition. Right atria from chick embryos of 13 days incubation were excised, placed on stainless steel mesh grids and cultured for 16-21 days in supplemented media. The results indicated that DMEM supplemented with 15% fetal bovine serum maintained the highest percentage (57%) of contractile atria in culture. Even atria cultured in serum free DMEM gradually adapted and became completely contractile over a 15 day period. Gel electrophoresis was performed on NP-40 detergent extracts of contracting explants cultured for 1, 4, 6, 8, and 10 days, and from 13, 15, 16, 18, 20 day embryos and 1 day old chicks. The percent of total protein of five separate protein bands in the range of 17,000 to 60,000 Daltons were plotted against the days in vivo/in vitro. There was a dramatic change in the protein profile during the first day of culture (an increase in concentration in the 60 kDa protein and decreases in the 17, 31, 37 and 50 kDa proteins). The in vivo atria showed a relatively large increase in the concentration of several of the proteins (17, 37, 50 kDA), profiled just prior to hatching with subsequent fall after hatching. A comparison between the biochemical data and the morphology of the explants indicate that although the explants display characteristics of contractility and typical cardiocyte structure, they were operative at a different functional level than their in vivo counterparts. The loss of homeostatic regulation and other in vivo embryonic factors could play a role in this observed change. This culture system provides an alternative to the dissociation method, and will be a useful model to study factors that influence atrial growth and development.

Diabetes home monitoring by telephone data entry.

The use of microcomputers to help physicians manage diabetic patients who perform home glucose monitoring is presented. Patients enter blood glucose information directly into an office database from their homes, using the push-button telephone with voice synthesizer prompts. The computer-enhanced organization of this information as well as future possibilities is discussed.

[Transjugular intrahepatic portacaval shunt. Preliminary results]. / Anastomose porto-cave intra-hépatique par voie transjugulaire. Résultats préliminaires.

Transjugular implantation of a metallic prosthesis between main portal branch and a hepatic vein is a new intrahepatic portosystemic shunt method to treat portal hypertension. Forty-nine cirrhotic patients with portal hypertension were treated using this technique. The success rate of implantation was 94%. Mortality due to the procedure was 2%. Early complications decreased with the operator's learning curve consisting of bleeding (20%): digestive hemorrhage (n = 5; 12%), hemobilia (n = 4; 8%), which ceased after withdrawal of post-operative heparin. Early thrombosis following shunt implantation occurred in 13% of the patients. Shunt implantation resulted in a 53 +/- 16% decrease in the portocaval pressure gradient (21 +/- 5 to 10 +/- 4 mmHg). Shunts were performed in 45 patients to prevent a recurrence of variceal bleeding. Follow-up of 41 patients showed 12.2% with variceal rebleeding and 16 patients (39%) with a stenosis requiring a redilation. Ascites improved in 95% of the patients and hepatic encephalopathy occurred in 17%. One year survival was 85%. Controlled studies are needed to determine the indications of this new treatment for ascites and bleeding.

[Peri-rectal infectious cellulitis with septicemia of anal origin. Suppository on trial]. / Cellulite infectieuse péri-rectale avec septicémie à point de départ anal. Le suppositoire en accusation.

Rectal route with local or general effects, is an interesting possibility of treatment. Easy use and rapid absorption are two major advantages. But this therapeutic modality is not riskless. We report a case of septicemia with peri-rectal cellulitis which was generated by two ano-rectal ulcerations after using Trophires suppositories. The infection was favoured by local application of cortisone. Our original observation, with ano-rectal ulcerations and short use of suppository, confirms the idea of short-term treatment stopped in case of unwanted symptom.

[Transjugular portacaval shunt. Preliminary experience]. / Anastomose porto-cave transjugulaire. Expérience préliminaire.

Transjugular intrahepatic portosystemic stent-shunt (TIPS) is a new technique in interventional radiology. This procedure is based on the creation of an intrahepatic channel between a main branch of the portal vein and an hepatic vein. A metallic stent is implanted to keep this shunt patent. From July 1990 to March 1992, 28 out of 32 patients with a history of gastric or esophageal variceal rebleeding, were treated by TIPS and followed for up to 20 months (mean 9.36 +/- 5.42). According to the Child Pugh's classification, 9 patients had class A cirrhosis, 17 class B and 6 class C. TIPS led to reduction of the portal pressure gradient by 57% and improvement of the portal blood flow by 250%. Early complications were: one technique-related death due to a medial stent implantation on the portal bifurcation (massive extrahepatic bleeding), other cases consisted of hemobilias (3 patients), intra-abdominal bleeding (1 patient) and gastrointestinal bleedings (4 patients). All of the complications except the deat were spontaneously reversed after withdrawal of Heparin. Follow-up showed a considerable improvement of ascites, seen in 55% of the patients with 100% reduction or disappearance after 3 months. Duplex-sonography follow-up found shunt stenosis in 43% of the patients, allowing preventive redilatation to restore patency of the shunt. Variceal rebleeding occurred in 20% of cases. These results remain interesting with regard to the high risk of bleeding in the patients of this preliminary study.(ABSTRACT TRUNCATED AT 250 WORDS)

[Intrahepatic portasystemic shunt and hemorrhagic emergencies in the cirrhotic patient]. / Shunt intrahépatique porto-systémique (SIPS) et urgences hémorragiques du cirrhotique.

From March 1992 to March 1994, 26 patients underwent Transjugular Intrahepatic Portosystemic Shunt (TIPS) for emergency treatment of variceal bleeding. Patients were all cirrhotic, with a mean age 55 +/- 13 yrs, Child's score was A = 4, B = 10, C = 12. TIPS was performed in case of failure or impossibility to obtain hemostasis after endoscopic and/or medical treatment. Hemostasis was successful in all cases of TIPS, and the portocaval gradient was lowered from 19 to 9 mmHg. Early complications occurred in 30% of cases. They consisted of: spontaneously regressive hemobilia (15%) and shunt thrombosis (15%) (3/4 were repermeabilized). Early mortality accounted for 15% of patients in the whole group and 25% in Child C'patients. During follow-up (m = 8 +/- 6 m), only one patient rebled, de novo hepatic encephalopathy occurred in 15% of patients always regressive in response to Lactulose therapy. One year mortality rate was 57%. A comparison between TIPS and other emergency hemostasis methods: endoscopic sclerotherapy, surgical portocaval shunt and esophageal transsection was performed on the early mortality rate according to the percentage of Child C'patients in the various series. TIPS is better than other methods in series with a low percentage of Child C'patients. TIPS should be proposed: in case of failure of endoscopic methods; for patients waiting for liver transplantation; when portal vein patency is compromised by thrombosis. This last indication implies that portal patency must be confirmed with angiography or better by with duplex sonography once primary hemostasis of variceal bleeding has been completed.

Adolescent perceptions of teenage morbidity and mortality in a rural population.

Health-related questionnaires were administered to 742 high school seniors in small towns in rural West Virginia. Students tended to overestimate the immediate threat to their health from cancer, heart disease and AIDS. They recognized a threat from auto accidents to their life and health in the immediate future, but nevertheless indulged in high-risk drinking and driving behavior. A surprisingly high percentage were concerned about stress and depression (40 percent) and suicide (11 percent). One-third of students had either planned or attempted suicide, suggesting that appropriate health education for this age group should include more emphasis on psychosocial issues and stress management.

Electronic recognition of hand hygiene technique and duration.

We captured 3-dimensional accelerometry data from the wrists of 116 healthcare professionals as they performed hand hygiene (HH). We then used these data to train a k-nearest-neighbors classifier to recognize specific aspects of HH technique (ie, fingertip scrub) and measure the duration of HH events.