Association of porcine circovirus type 2 with vascular lesions in porcine pneumonia.

The aim of this study was to evaluate the vasculature in porcine circovirus type 2-infected (PCV2-infected) lungs and to identify the PCV2 subtypes involved in porcine pneumonia. Pulmonary samples from 140 pigs, 2 weeks to 7 months of age, from 36 Hungarian commercial herds with clinical signs of respiratory disease were examined for the presence of respiratory pathogens, with bacterial culture, pathologic evaluation, and immunohistochemistry for PCV2, porcine reproductive respiratory syndrome virus, and swine influenza virus. PCV2 was the most commonly identified pathogen (49 cases) among the 74 of 140 cases (53%) with respiratory pathogens. PCV2 was detected immunohistochemically in the wall of 13% to 100% of pulmonary vessels (mean, 89%) in 38 of 49 cases (78%). Detection of PCV2 antigen was positively correlated with the presence of vascular lesions (P < .001, odds ratio [OR]: 159.54). Other pathogens capable of vascular injury in swine were found in 29 of 49 of the PCV2-positive cases (59%). The probability of detecting vascular lesions in PCV2-infected lung was higher than in infection with porcine reproductive respiratory syndrome virus (P < .002, OR: 14.63), Pasteurella multocida infection (P < .001, OR: 5.75), or Streptococcus spp. infection (not significant, OR: 1.45). Sequence analysis of open reading frame 2 amplicons was possible in 6 PCV2-positive cases, from which 5 cases proved to be PCV2b subtype and 1 case, PCV2a subtype. In conclusion, PCV2 antigen was commonly colocalized with pulmonary vascular lesions in pneumonia in Hungarian swine, and PCV2b was the dominant subtype.

Possible genetic sign of heat stress adaptation in Hungarian Grey Bos taurus breed.

The synthesis of Heat Shock Protein 70.2 mRNA is also regulated by the Upper Promoter elements of the gene. This promoter region is polymorphic in cattle. These polymorphisms have a major effect on the activity of the mRNA transcription. In a comparison of quantity of transcribed mRNA from the wild type and AP2 mutant allele the wild type can produce 2-3-fold more transcripts.The Hungarian Grey Cattle (HG) and Norwegian Red (NFR) as control breed were genotyped with PCR-RFLP method. Our results showed that the frequencies of alleles in breeds (p(wt)HG = 0.859419, p(wt)NFR = 0.5) are different. The effective response to heat stress in the Norwegian Red seems to be less important than in the Hungarian Grey breed. The extensive keeping in hot and arid region during centuries could have been proved as selection pressure for the heat tolerance.Our results combined with the global climate forecasts emphasize the role of autochthonous, well adopted, heat tolerant breeds in the near future.

Reversal of gene expression changes in the colorectal normal-adenoma pathway by NS398 selective COX2 inhibitor.

BACKGROUND AND AIMS: Treatment of colorectal adenomas with selective cyclooxygenase-2 inhibitors can contribute to the chemoprevention of colorectal cancer (CRC), but the molecular background of their effect is not fully understood. We analysed the gene expression modulatory effect of N-(2-cyclohexyloxy-4-nitrophenyl)-methanesulfonamide (NS398) on HT29 cells to be correlated with expression data gained from biopsy samples. METHODS: HT29 colon adenocarcinoma cells were treated with NS398, and global mRNA expression was analysed on HGU133Plus2.0 microarrays. Discriminatory transcripts between normal and adenoma and between adenoma and CRC biopsy samples were identified using HGU133Plus2.0 microarrays. The results were validated using RT-PCR and immunohistochemistry. RESULTS: Between normal and adenoma samples, 20 classifiers were identified, including overexpressed cadherin 3, KIAA1199, and downregulated peptide YY, glucagon, claudin 8. Seventeen of them changed in a reverse manner in HT29 cells under NS398 treatment, 14 (including upregulated claudin 8, peptide YY, and downregulated cadherin 3, KIAA1199) at a significance of P<0.05. Normal and CRC could be distinguished using 38 genes, the expression of 12 of them was changed in a reverse manner under NS398 treatment. CONCLUSION: NS398 has a reversal effect on the expression of several genes that altered in colorectal adenoma-carcinoma sequence. NS398 more efficiently inverted the expression changes seen in the normal-adenoma than in the normal-carcinoma transition.

Prevalence of flea infestation in dogs and cats in Hungary combined with a survey of owner awareness.

A survey was conducted in order to gain current information on flea species (Siphonaptera: Pulicidae) infesting dogs and cats living in urban and rural areas of Hungary, along with data on the factors that affect the presence, distribution and seasonality of infestation. In addition, owner awareness of flea infestation was evaluated. Practitioners in 13 veterinary clinics were asked to examine all dogs and cats attending the clinic and to collect fleas, when present, on 2 days in each month from December 2005 to November 2006. They also completed a questionnaire for each animal examined. A total of 319 dogs (14.1%) were found to be infested; the highest prevalence (27.1%) of infestation on dogs occurred in August and the lowest (5.4%) in May. Prevalence of fleas on cats was higher (22.9%); the highest (35.0%) and lowest (8.1%) prevalences occurred in July and April, respectively. Fleas were more prevalent in rural (387/1924 animals, 20.2%) than in urban (161/1343 animals, 12.0%) areas. Three species, Ctenocephalides felis (Bouché), Ctenocephalides canis (Curtis) and Pulex irritans L., were found. On dogs, the prevalence of C. canis alone was 53.0%, whereas that of C. felis alone was 36.0%. Only 19 specimens of P. irritans were found on 14 dogs from rural habitats only. Prevalence of C. felis only on cats was 94.3%; the remaining cats were infested with either C. canis or with mixed infestations of C. felis and C. canis. More than half (51.4%) of the owners of infested dogs and cats had not used flea control products in the past year or more, and five times as many owners in rural than urban areas had not used flea control products in the same period. Very few owners reported having attempted to kill fleas in their animals' environment; instead, they believed that fleas were acquired from other cats or dogs.

Long-term results of subtotal colectomy for acquired hypertrophic megacolon in eight dogs.

OBJECTIVES: To evaluate the long-term results of subtotal colectomy for acquired hypertrophic megacolon in the dog. METHODS: Eight dogs with acquired hypertrophic megacolon underwent subtotal colectomy with preservation of the ileocolic junction. Long-term follow-up was obtained by clinical records and telephone interviews with the owners. RESULTS: Eight large-breed dogs (age range: 6 to 12 years; mean age: 10.75 years) were enrolled. The use of bone meal, low levels of exercise, chronic constipation with dyschesia and tenesmus refractory to medical management were factors predisposing dogs to acquired hypertrophic megacolon. The diagnosis was confirmed in all animals by abdominal palpation, plain radiography and postoperative histopathological findings. There were no intraoperative complications. One dog died as a result of septic peritonitis. The clinical conditions (that is, resolution of obstipation and stool consistency) of the remaining seven dogs were improved at discharge; all animals returned to normal defecation in five to 10 weeks (mean: 7.3 weeks) and were alive 11 to 48 months (mean: 40.5 months) after surgery. CLINICAL SIGNIFICANCE: Predominantly bony diet and/or low levels of physical activity may predispose dogs to acquired hypertrophic megacolon. Our results emphasise the long-term effectiveness of subtotal colectomy with preservation of the ileocolic junction in this condition.

Study on the role of gastric Helicobacter infection in gross pathological and histological lesions of the stomach in finishing pigs.

The prevalence of gastric Helicobacter infection in finishing pigs and the influence of this infection on gastric lesions was studied. Stomachs of 89 finishing pigs from 27 randomly selected herds were sampled at the slaughterhouse. Forty cases (Group A) were selected based upon the presence of gross pathological lesions in the pars oesophagea, and further 49 cases were obtained at random (Group B). Three samples of gastric tissue (junction of pars oesophagea and pars cardiaca, fundic area, and pyloric area) were collected from each stomach for histological and immunohistochemical examination. Helicobacter antigen was detected in 76 cases (85.4%). No association was found between the presence of Helicobacter in the stomach and the occurrence of gross pathological lesions in the pars oesophagea or gastritis detected on histological examination. However, a significant association was found between the occurrence of Helicobacter in the pyloric area and the presence of erosions/ulcers in the pars oesophagea (OR: 7.01, p = 0.022) in Group B. A significant association was also evident between the presence of Helicobacter and glandular lesions (dilatation of the glands + glandular abscess + degeneration of glandular epithelial cells). In conclusion, Helicobacter infection seems to be a contributing factor to pathological changes in the stomach of finishing pigs.

Emergency oesophagectomy for oesophageal perforation after chemoradiotherapy for oesophageal cancer.

INTRODUCTION: Oesophageal perforation following chemoradiotherapy for oesophageal cancer is a devastating condition but there have been no studies investigating the role of emergency oesophagectomy for this life threatening situation. METHODS: This retrospective study comprised all cases of emergency oesophagectomy for oesophageal perforation after chemoradiotherapy for oesophageal carcinoma at a major centre for oesophageal surgery in Germany between 2004 and 2013. RESULTS: A total of 13 patients (mean age: 58.9 years) were identified. During the same time period, 356 elective oesophagectomies were performed. Tumour entities were squamous cell carcinoma (n=12) and adenocarcinoma of the oesophagus (n=1). Alcoholism (odds ratio [OR]: 25.79, 95% confidence interval [CI]: 6.70-121.70, p<0.0001) and chronic pulmonary disease (OR: 3.76, 95% CI: 1.06-14.96, p=0.027) were more common among the emergency cases. Oesophageal rupture was caused by perforation of an oesophageal stent (10 cases) or perforation during implantation of a percutaneous endoscopic gastrostomy tube (3 cases). Emergency oesophagectomy was carried out either as discontinuity resection (10/13) or oesophagectomy with immediate reconstruction (3/13). Compared with the elective cases, patients undergoing emergency oesophagectomy had significantly higher odds for sustaining perioperative sepsis (OR: 4.42, 95% CI: 1.23-16.45, p=0.01), acute renal failure (OR: 6.49, 95% CI: 1.57-24.15, p=0.005) and pneumonia (OR: 24.33, 95% CI: 3.52-1,046.65, p<0.0001). Furthermore, slow respiratory weaning was more common and there was a significantly higher tracheostomy rate (OR: 4.64, 95% CI: 1.14-16.98, p=0.02). Oesophageal discontinuity was eventually reversed in eight patients. Emergency oesophagectomy patients had odds that were three times higher for fatal outcome (OR: 3.59, 95% CI: 0.77-13.64, p=0.05). The overall mortality was 4/13. The remaining nine patients had a mean survival of 25.1 months (range: 5-46 months). The two-year-survival-rate was 38.5% (5/13). CONCLUSIONS: Despite the most unfavourable preconditions, the results of emergency oesophagectomy for oesophageal perforation after chemoradiotherapy are not desperate. The procedure is not only justified but life saving.

Characterization of virulence plasmid types in Rhodococcus equi isolates from foals, pigs, humans and soil in Hungary.

Rhodococcus equi isolates (204) obtained from foals (lung abscesses, lymph nodes, nasal discharge, rectal swabs) bred in 15 studs located throughout Hungary, isolates from soil samples, lymph nodes of pigs and from lesions of human patients were examined to determine genotypic diversity of virulence-associated plasmids. Isolates were tested for the presence of 15-17 kDa virulence-associated protein antigen (VapA) and 20k Da (VapB) genes by polymerase chain reaction (PCR). Plasmid DNAs were isolated and analysed by digestion with restriction endonucleases for estimation of size and comparison of polymorphisms. Of 146 clinical isolates from foals in 15 studs, 129 (88.3%) gave positive results for the VapA gene, showing a 564 bp product of the expected size in the PCR amplification. Of the 129 clinical isolates from foals, 123 contained an 85 kb type I plasmid and the remaining six contained an 87 kb type I plasmid. Of 48 soil isolates from two horse studs, 26 (54.2%) were positive for VapA gene and contained an 85 kb type I plasmid. Of three pig isolates, one was positive for VapA gene and contained an 85 kb type I plasmid, and the remaining two were positive for the VapB gene, showing a 827 bp product of the expected size in the PCR amplification and were R. equi of intermediate virulence which contained a 95 kb type S5 plasmid. Of the seven human isolates, five were positive for VapB gene by PCR, these were R. equi of intermediate virulence, which contained a 95 kb type S5 plasmid. These results revealed that virulent R. equi strains harbouring a virulence plasmid of 85 kb type I or 87 kb type I, which have been found in clinical isolates from Europe and North and South America, are widespread in Hungary. Furthermore, same intermediately virulence plasmid type was found in both human and pig isolates.

Improving reproductive performance in lactating dairy cows by synchronizing ovulation or inducing oestrus.

Lactating crossbred Holstein-Friesian dairy cows (n = 331) were started on an Ovsynch regimen 68 +/- 8.2 days after calving; 200 micrograms GnRH intramuscularly (i.m.) on Days 0 and 9, and 35 mg prostaglandin F2 alpha i.m. on Day 7. Thirty-eight and 31 cows (11.5 and 9.4%, respectively) were in oestrus on Days 0 to 6 and 7 to 8, respectively, and inseminated, and the remainder were fixed-time inseminated (on Day 10). For these three groups, pregnancy rates (60-65 days after breeding) were 31.6, 38.7 and 34.0%, respectively (P = 0.82) and calving rates were 100, 100 and 89.9% (P = 0.23). In a preliminary trial, twelve lactating cows (45 to 60 days postpartum) with inactive ovaries were given 1500 IU eCG i.m.; 10 were in oestrus within 10 days after treatment (and inseminated) and eight of these were pregnant (30 days after breeding). The Ovsynch program resulted in acceptable reproductive performance in cyclic cows and eCG treatment has considerable promise for inducing oestrus in anoestrous cows.

Spatial analysis of rabies cases in foxes in Hungary between 1990 and 2001: a preliminary report.

In this paper we present the methodology and some preliminary results of the spatial analysis of rabies positive fox cases diagnosed in Hungary between 1990 and 2001. A database has been built based on the data provided by the Animal Health and Food Control Department of the Ministry of Agriculture, of all registered positive cases, specifying the date, location and affected species. We have developed a Geographical Information System for the spatial analysis. The aim of the study is to analyse the spatial patterns of subsequent rabies cases. Beyond the well-documented seasonality of the cases we want to find out whether they show regular spatial patterns and if yes what is their nature. Another important question is whether clustering of data can be observed and how stable or reoccurring these clusters are at a given location or area. The results might be important in a later stage of the eradication campaign when a strategy for the maintenance of large, rabies free areas should be developed.

Serological and molecular detection of Theileria equi infection in horses in Hungary.

The prevalence of Theileria equi infection was studied in 324 healthy horses from 27 farms in Hungary with cELISA and IFAT and the blood samples of 101 horses selected randomly were also examined by PCR. The results indicate that there are many stud farms where one or more horses are infected with T. equi. Among 27 farms 17 (67.9%) were found to have seropositive horses. The seroprevalence of theileriosis among the tested stud farms ranged between 0 and 100%. No marked differences were found in seropositivity between geographical areas. The overall prevalence of positive samples was 32.0% with cELISA as well as with IFAT. The results obtained with cELISA and IFAT in this study had the strongest agreement, except for 9 samples in which the two serological tests gave different results. The prevalence of infection among 101 horses was 49% with PCR. All 14 sequenced samples were found by BLAST analysis to be closest to the T. equi 18S rRNA gene sequences in GenBank with a similarity of ≥ 99%. No significant association was found between the seropositivity and the age of horses. Horses below 5 years of age had three times higher chance to be PCR-positive, than older ones. There was no significant association between the gender and the results of diagnostic tests (cELISA: p=0.40; IFAT: p=0.25; PCR: p=0.41). Based on the findings, the prevalence of equine theileriosis is much higher than expected and it occurs in many regions of the country unlike equine babesiosis. To the authors' knowledge, this is the first report of the serological and molecular survey of T. equi infection in horses in Hungary.

Does the Incidence of Adenocarcinoma of the Esophagus and Gastric Cardia Continue to Rise in the Twenty-First Century?-a SEER Database Analysis.

BACKGROUND: The rising incidence and histological change to adenocarcinoma in esophageal cancer over the past four decades has been among the most dramatic changes ever observed in human cancer. Recent reports have suggested that its increasing incidence may have plateaued over the past decade. Our aim was to examine the latest overall and stage-specific trends in the incidence of esophageal adenocarcinoma. PATIENTS AND METHODS: We used the Surveillance Epidemiology and End Results (SEER) database of the National Cancer Institute to identify all patients with adenocarcinoma of the esophagus and gastric cardia between 1973 and 2009. Both overall and stage-specific trends in incidence were analyzed using joinpoint regression analysis. RESULTS: The overall incidence of adenocarcinoma of the esophagus and the gastric cardia increased from 13.4 per million in 1973 to 51.4 per million in 2009, a nearly 400 % increase. Jointpoint analysis demonstrated that the yearly increase in incidence has slowed somewhat from 1.27 per million before 1987 to 0.97 between 1987 and 1997 and 0.65 after 1997. Stage-specific analysis suggests that the incidence of noninvasive cancer has actually declined after 2003 with a yearly decrease of 0.22. The percentage of patients diagnosed with in situ cancer declined after 2000 and remained under 2.5 % through the study period. CONCLUSIONS: The incidence of esophageal adenocarcinoma continues to rise in the USA. The percentage of patients diagnosed with in situ cancer has declined in the twenty-first century.

Time trends and disparities in lymphadenectomy for gastrointestinal cancer in the United States: a population-based analysis of 326,243 patients.

BACKGROUND: The value of lymphadenectomy in most localized gastrointestinal (GI) malignancies is well established. Our objectives were to evaluate the time trends of lymphadenectomy in GI cancer and identify factors associated with inadequate lymphadenectomy in a large population-based sample. METHODS: Using the National Cancer Institute's Surveillance Epidemiology and End Results Database (1998-2009), a total of 326,243 patients with surgically treated GI malignancy (esophagus, 13,165; stomach, 18,858; small bowel, 7,666; colon, 232,345; rectum, 42,338; pancreas, 12,141) were identified. Adequate lymphadenectomy was defined based on the National Cancer Center Network's recommendations as more than 15 esophagus, 15 stomach, 12 small bowel, 12 colon, 12 rectum, and 15 pancreas. The median number of lymph nodes removed and the prevalence of adequate and/or no lymphadenectomy for each cancer type were assessed and trended over the ten study years. Multivariate logistic regression was employed to identify factors predicting adequate lymphadenectomy. RESULTS: The median number of excised nodes improved over the decade of study in all types of cancer: esophagus, from 7 to 13; stomach, 8-12; small bowel, 2-7; colon, 9-16; rectum, 8-13; and pancreas, 7-13. Furthermore, the percentage of patients with an adequate lymphadenectomy (49 % for all types) steadily increased, and those with zero nodes removed (6 % for all types) steadily decreased in all types of cancer, although both remained far from ideal. By 2009, the percentages of patients with adequate lymphadenectomy were 43 % for esophagus, 42 % for stomach, 35 % for small intestine, 77 % for colon, 61 % for rectum, and 42 % for pancreas. Men, patients >65 years old, or those undergoing surgical therapy earlier in the study period and living in areas with high poverty rates were significantly less likely to receive adequate lymphadenectomy (all p < 0.0001). CONCLUSIONS: Lymph node retrieval during surgery for GI cancer remains inadequate in a large proportion of patients in the USA, although the median number of resected nodes increased over the last 10 years. Gender and socioeconomic disparities in receiving adequate lymphadenectomy were observed.

Spatial clustering of childhood acute lymphoblastic leukaemia in hungary.

The aetiology of childhood acute lymphoblastic leukaemia has been linked with spatially heterogeneous environmental exposures. The presence of spatial clustering would be consistent with geographically localized environmental exposures over long periods of time. The present study is the first to examine spatial clustering amongst children aged 0-4 years using population-based data from Hungary. The data set consisted of 134 children diagnosed with acute lymphoblastic leukaemia who were resident in part of Hungary during the period 1981-2000. Two levels of spatial aggregation were examined: counties and settlements. The Potthoff-Whittinghill and Moran I autocorrelation methods were used to test for spatial clustering. Additionally, an evaluation of the environmental changes during the study period was considered. Specifically analyses were carried out on sub-periods to investigate a possible effect of the Chernobyl catastrophe. There was statistically significant spatial clustering both at the county (estimate of extra-Poisson variation [Formula: see text], P = 0.04) and settlement levels (estimate of extra-Poisson variation [Formula: see text], P = 0.0003). At county level, the finding was attributable to clustering amongst female cases, but at settlement level, the finding was limited to male cases. There was significant spatial autocorrelation in the sub-periods immediately following the accident (1986-1990 & 1991-1995), but not before 1986, nor after 1995. A significant autocorrelation was observed during the 5 year period immediately following the accident (1986-1990, global Moran I = 0.1334, p = 0.005). The centre of significant excesses of ALL cases was located in the county of Baranya. Our study is consistent with an environmental aetiology for acute lymphoblastic leukaemia in children associated with constant exposure to an, as yet unknown, environmental factor in small geographical areas. Although a possible effect of the Chernobyl accident was found in the autocorrelation analysis, the role of chance cannot be excluded.

Endoscopic stent insertion for anastomotic leakage following oesophagectomy.

INTRODUCTION: Intrathoracic anastomotic leakage following oesophagectomy is a crushing condition. Until recently, surgical re-exploration was the preferred way of dealing with this life threatening complication. However, mortality remained significant. We therefore adopted endoscopic stent implantation as the primary treatment option. The aim of this study was to investigate the feasibility and results of endoscopic stent implantation as well as potential hazards and pitfalls. METHODS: Between January 2004 and December 2011, 292 consecutive patients who underwent an oesophagectomy at a single high volume centre dedicated to oesophageal surgery were included in this retrospective study. Overall, 38 cases with anastomotic leakage were identified and analysed. RESULTS: A total of 22 patients received endoscopic stent implantation as primary treatment whereas a rethoracotomy was mandatory in 15 cases. There were no significant differences in age, frequency of neoadjuvant therapy or ASA grade between cases with and without a leak. However, patients with a leak were five times more likely to have a fatal outcome (odds ratio: 5.10, 95% confidence interval: 2.06-12.33, p<0.001). Stent migration occurred but endoscopic reintervention was feasible. In 17 patients (77%) definite closure and healing of the leak was achieved, and the stent was removed subsequently. Two patients died owing to severe sepsis despite sufficient stent placement. Moreover, stent related aortic erosion with consecutive fatal haemorrhage occurred in three cases. CONCLUSIONS: Stent implantation for intrathoracic oesophageal anastomotic leaks is feasible and compares favourably with surgical re-exploration. It is an easily available, minimally invasive procedure that may reduce leak related mortality. However, it puts the already well-known risk of stent-related vascular erosion on the spot. Awareness of this life threatening complication is therefore mandatory.

Recent lesson from a clinical and seroepidemiological survey: low positive predictive value of Borrelia burgdorferi antibody testing in a high risk population.

PURPOSE: The evaluation of the correspondence between positive Borrelia burgdorferi antibody response and the clinical symptoms attributed to Lyme disease is especially important in labour rights-related issues among forestry workers. MATERIAL AND METHODS: Between 1992 and 1995, 1670 forestry workers were surveyed and tested serologically for Lyme borreliosis in Hungary. The collected data was analysed retrospectively. RESULTS: In the case histories of the forestry employees erythema migrans, polyneuropathy and large joint arthritis were mentioned in 128 (7.7%), 192 (11.5%), and 93 (5.6%) workers, respectively. We found positive Borrelia burgdorferi s.l. antibody reaction in 622 workers out of whom 280 (45%) were free of any signs or symptoms referring to B. burgdorferi s.l. infection in their case histories. The frequency of seropositivity increased with age, number of registered tick bites, and erythema migrans in case history, as well as arthralgia. The frequency of polyneuropathy was somewhat more closely corresponding with age than seropositivity. Women gave account of a smaller number of tick bites, and were less likely seropositive while fewer of them were symptom-free. Since the 45% of seropositive forestry workers were symptom-free and they could not recall any symptoms suggestive for present or past Lyme borreliosis, the positive predictive value of Borrelia antibody testing in this high-risk group is surprisingly low, less than 5%. CONCLUSION: Positive Borrelia antibody test result may be especially misleading in a high-risk population.

Surgical management of pleural empyema in the very elderly.

INTRODUCTION: Parapneumonic pleural empyema is a critical illness. Age is an acknowledged risk factor for both pneumonia and pleural empyema. Furthermore, elderly patients often have severe co-morbidity. In the case of pleural empyema, their clinical condition is likely to deteriorate fast, resulting in life threatening septic disease. To prevent this disastrous situation we adapted early surgical debridement as the primary treatment option even in very elderly patients. This study shows the outcome of surgically managed patients with pleural empyema who are 80 years or older. METHODS: The outcomes of 222 consecutive patients who received surgical therapy for parapneumonic pleural empyema at a German tertiary referral hospital between 2006 and 2010 were reviewed in a retrospective case study. Patients older than 80 years were identified. RESULTS: There were 159 male and 63 female patients. The mean age was 60.5 years and the overall in-hospital mortality rate was 7%. Of the 222 patients, 37 were 80 years or older (range: 80-95 years). The frequencies of predominantly cardiac co-morbidity and high ASA (American Society of Anesthesiologists) grades were significantly higher for very elderly patients (p <0.001). A minimally invasive approach was feasible in 34 cases (92%). Of the 37 patients aged over 80, 36 recovered while one died from severe sepsis (in-hospital mortality 3%). There was no significant difference in mortality between the very elderly and the younger sufferers (p = 0.476). CONCLUSIONS: Early surgical treatment of parapneumonic pleural empyema shows excellent results even in very elderly patients. Despite considerable co-morbidity and often delayed diagnosis, minimally invasive surgery was feasible in 34 patients (92%). The in-hospital mortality of very elderly patients was low. It can therefore be concluded that advanced age is no contraindication for early surgical therapy.

The role of spatial factors in the success of an Aujeszky's disease eradication programme in a high pig density area (Northeast Spain, 2003-2007).

We tested the role of several spatial variables on the risk of a sow herd being Aujeszky's disease virus (ADV) seropositive in certain areas of North Eastern Spain and during different periods of the eradication programme. Distance to the nearest slaughterhouse, distance to the nearest conventional road and number of ADV serologically positive sows and ADV serologically positive fattening pigs within different distances (1000, 1500 and 2000 m) of each sow herd, were included in a hierarchical Bayesian binomial model. A variable without spatial characteristics, type of herd (farrow to weaning and farrow to finish), was also included. Presence of positive fattening pigs or positive sows up to a distance of 1500 m of a sow herd increased its risk of being seropositive, although this variable had no effect on the risk when located at distances up to 1000 or 2000 m. The number of seropositive sows increased the risk of a sow herd being ADV seropositive only in the first period of study, when the proportion of serologically positive sow herds was nearly 60%. The spatial pattern of the residuals of the hierarchical Bayesian binomial model (observed versus predicted) was very similar to the observed infection in sow herds in all of the eradication periods, showing that spatial factors might not be the main factors related to the eradication of Aujeszky's disease from sow herds. Other herd-specific risk factors might be much more strongly related to the risk of a sow herd being ADV seropositive.

The RR genotype of codon 72 of p53 gene reduces the development of intestinal metaplasia.

BACKGROUND AND AIMS: Mutations of p53 gene can contribute to the development of gastric cancer. Our aims were to evaluate the premalignant gastric intestinal metaplasia-related p53 alterations, using and comparing capillary sequencing and p53 resequencing chip in gastric biopsy and peripheral blood samples. Furthermore we examined the effect of p53 polymorphism on the protein expression level. PATIENTS AND METHODS: Deoxyribonucleic acid was extracted from antral gastric biopsy samples of 50 intestinal metaplasia patients (27 Helicobacter pylori positive, 23 H. pylori negative) and 51 controls (all H. pylori negative). Exon 4 of p53 gene was examined by capillary sequencing (CS). From 7 intestinal metaplasia patients extra deoxyribonucleic acid samples were extracted from blood and from the corpus and from the antrum of the stomach and 5 additional exons were examined by CS and 10 with GeneChip p53 Assay (Affymetrix). In 19 patients p53 immunohistochemistry was performed. RESULTS: RR genotype on codon 72 was found to significantly (p=0.0087) reduce the chance of intestinal metaplasia in H. pylori positive patients as compared to the normal controls. The p53 alterations were identical in antral, corpus and blood samples. The p53 protein expression was in significant correlation with the genetic alterations. CS and chip method-based sequencing results were not in correlation. CONCLUSIONS: According to our results RR genotype decreases the incidence of IM. The genetic background is reflected in the expression of p53 protein. Chip method-based deoxyribonucleic acid sequence data need careful confirmation.