Magnetic resonance imaging of human variegated squirrel bornavirus 1 (VSBV-1) encephalitis reveals diagnostic pattern indistinguishable from Borna disease virus 1 (BoDV-1) encephalitis but typical for bornaviruses.

Human bornavirus encephalitis is an emerging disease caused by the variegated squirrel bornavirus 1 (VSBV-1) and the Borna disease virus 1 (BoDV-1). While characteristic brain magnetic resonance imaging (MRI) changes have been described for BoDV-1 encephalitis, only scarce diagnostic data in VSBV-1 encephalitis exist. We systematically analysed brain MRI scans from all known VSBV-1 encephalitis patients. Initial and follow-up scans demonstrated characteristic T2 hyperintense lesions in the limbic system and the basal ganglia, followed by the brainstem. No involvement of the cerebellar cortex was seen. Deep white matter affection occurred in a later stage of the disease. Strict symmetry of pathologic changes was seen in 62%. T2 hyperintense areas were often associated with low T1 signal intensity and with mass effect. Sinusitis in three patients on the first MRI and an early involvement of the limbic system suggest an olfactory route of VSBV-1 entry. The viral spread could occur per continuitatem to adjacent anatomical brain regions or along specific neural tracts to more distant brain regions. The number and extent of lesions did not correlate with the length of patients' survivals. The overall pattern closely resembles that described for BoDV-1 encephalitis. The exact bornavirus species can thus not be deduced from imaging results alone, and molecular testing and serology should be performed to confirm the causative bornavirus. As VSBV-1 is likely of tropical origin, and MRI investigations are increasingly available globally, imaging techniques might be helpful to facilitate an early presumptive diagnosis of VSBV-1 encephalitis when molecular and/or serological testing is not available.

High prevalence of pancreatic cysts detected by screening magnetic resonance imaging examinations.

BACKGROUND & AIMS: The prevalence of pancreatic cysts is not known, but asymptomatic pancreatic cysts are diagnosed with increasing frequency. We investigated the prevalence of pancreatic cysts in individuals who were screened by magnetic resonance imaging (MRI) as part of a preventive medical examination. METHODS: Data from consecutive persons who underwent abdominal MRI (n = 2803; 1821 men; mean age, 51.1 +/- 10.8 y) at an institute of preventive medical care were included from a prospective database. All individuals had completed an application form including questions about possible abdominal complaints and prior surgery. MRI reports were reviewed for the presence of pancreatic cysts. Original image sets of all positive MRI reports and a representative sample of the negative series were re-assessed by a blinded, independent radiologist. RESULTS: Pancreatic cysts were reported in 66 persons (2.4%; 95% confidence interval, 1.9-3.0); prevalence correlated with increasing age (P < .001). There was no difference in prevalence between sexes (P = .769). There was no correlation between abdominal complaints and the presence of pancreatic cysts (P = .542). Four cysts (6%) were larger than 2 cm and 3 (5%) were larger than 3 cm. Review of the original image sets by the independent radiologist did not significantly change these findings. CONCLUSIONS: The prevalence of pancreatic cysts in a large consecutive series of individuals who underwent an MRI at a preventive medical examination was 2.4%. Prevalence increased with age, but did not differ between sexes. Only a minority of cysts were larger than 2 cm.

Health outcomes and experiences of direct-to-consumer high-intensity screening using both whole-body magnetic resonance imaging and cardiological examination.

BACKGROUND: Alongside a clinical and research setting, whole body magnetic resonance imaging (WB-MRI) is increasingly offered as a direct-to-consumer screening service. Data is needed on the clinical relevance of findings and associated psychological impact of such screening. Therefore, we conducted a prospective follow-up study to provide insight in the effectiveness and psychological impact of direct-to-consumer screening using both WB-MRI and cardiological examination. METHODS AND FINDINGS: The study population consisted of 3603 voluntary, primarily middle-aged participants who underwent commercial WB-MRI and cardiological screening at one of 6 study clinics in Germany or the Netherlands between July 2014 and March 2016. MRI investigation consisted of directed scans of the brain, neck, abdomen and pelvis. Cardiovascular examination included pulmonary function, resting electrocardiogram, transthoracic echocardiogram and a bicycle exercise stress test. Findings were assessed by experienced radiologists and cardiologists. In addition, participants were inquired about several (psychological) domains, including the expectations and consequences of the screening procedure. Out of 3603 individuals, 402 (11.2%) demonstrated abnormal MRI (n = 381) and/or cardiological findings (n = 79) for which they were advised to undergo further consultation <3 months in regular healthcare. In 59.1% of cases of abnormal MRI findings which were consulted, fully completed consultations were available in 87.1%. After consultation, 77.6% of initial MRI outcomes were adopted. In 40.9% of cases of abnormal MRI findings, recommendations for consultation were not adhered to during the study period. 71.1% of adopted MRI-findings required treatment or monitoring, including 19 malignancies. For abnormal cardiological findings, 70.9% of cases were consulted in regular healthcare. Of these, 91.1% had a completed follow-up procedure of which 72.5% of initial findings were adopted and 83.8% of these findings required treatment or monitoring. The most frequently reported psychological consequences of the screening procedure were getting reassurance (72.0%) and insight into one's own health status (83.0%). 5.0% reported to feel insecure about their health and 6.2% worried more about their health as a consequence of screening. Main limitations of the study were considered the telephonic follow-up of referred clients and the heterogeneity of screening equipment and assessment of radiologists and cardiologists. CONCLUSIONS: Direct-to-consumer screening using whole-body MRI and cardiological testing is feasible and effective for the detection of clinically relevant and treatable abnormalities. Psychological harm was not frequently reported in study participants.

Decrease in toxicity of microcystins LA and LR in drinking water by ozonation.

Unchlorinated treated waters from two Australian reservoirs were spiked with microcystin-LA and -LR extracted from a toxic scum of Microcystis aeruginosa. The two waters had considerably different water quality and therefore ozone demands. The spiked sample waters were ozonated using the batch method of ozonation at a range of doses and the samples were analysed for toxins using high-performance liquid chromatography (HPLC). The toxin content of the samples was also determined using a protein phosphatase type 2A inhibition assay (PP2A) and toxicity via the standard mouse bioassay. The HPLC results correlated well with the PP2A results and toxicity tests for both waters. A loss of both toxins and toxicity was observed with increasing ozone dose, resulting in a complete loss of toxicity for both waters once an ozone residual had been achieved. At this ozone residual no toxin was detected using HPLC. The results indicate that microcystins are not transformed into toxic by-products.

Coronary artery calcification score as tool for risk assessment among families with premature coronary artery disease.

INTRODUCTION: There is discussion about incorporating a family history (FamHis) of premature coronary artery disease (CAD) in risk score algorithms. However, FamHis provides information on individual risk. Coronary artery calcification score (CACS) is a metric of atherosclerosis that may determine the individual risk within families at high risk of premature CAD. METHODS: In asymptomatic individuals (n = 704), we assessed the association between FamHis of CAD and elevated CACS. To assess the predictive value of CACS in individuals with a FamHis of CAD, we performed a post-hoc analysis on the St. Francis Heart Study (n = 834). We assessed, in a case control design, the risk of future CAD in individuals with a FamHis of CAD and either CACS >80th percentile or no CACS at all. RESULTS: Individuals with a FamHis for CAD had an increased risk for elevated CACS (adjusted odds ratio (OR) 2.23 (95% CI 1.48-3.36); p < 0.05), compared to those without a FamHis. In the prospective study (3.5 years follow-up), the event rate equally low in those with a positive FamHis and a negative FamHis (0% vs. 1%), if they had a CAC of 0. However, in those with CACS >80(th) percentile, a FamHis of CAD doubled the CAD event rate (positive FamHis 12.5% vs. negative FamHis 6.8%; adjusted HR 2.08 (95% CI 1.09-3.87; p < 0.05). CONCLUSION: CAC scoring leads to risk discrimination among those with a positive FamHis for premature CAD. These results support testing CAC score in asymptomatic individuals with a positive FamHis to identify a high risk population.

Glass-containing gunshot residue particles: a new type of highly characteristic particle?

In 0.22 caliber rimfire ammunition, the primer often contains lead or lead and barium compounds. As residues from these primers do not contain lead, barium, and antimony, they cannot be uniquely classified as gunshot residue (GSR) under ASTM designation E 1588-95. In many types of 0.22 caliber rimfire ammunition, the cartridge contains a primer sensitized with glass. In this paper we describe a previously unreported type of GSR particle consisting of glass fused with other primer components. As there appear to be few potential environmental or occupational sources of particles composed of lead and barium compounds fused to glass, particularly borosilicate glass, these particles may have high evidential value. Scanning electron microscopy with energy dispersive X-ray detection (SEM-EDX) and time-of-flight secondary ion mass spectrometry (TOF-SIMS) were evaluated for the characterization of glass-containing GSR particles. The occurrence of glass-containing GSR particles was established in the residue from various brands of 0.22 caliber ammunition, and several sub-types were identified.

Stereochemical analysis of methorphan using (-)-menthyl chloroformate.

Forensic laboratories around the world have seen an increase in the number of drug seizures containing methorphan. Levomethorphan is a narcotic and a controlled substance, and its enantiomer dextromethorphan is an antitussive agent used in over-the-counter medications. For the forensic analysis of seized drugs containing methorphan, it is important to report the stereochemical composition of the drug. Ideally, a method based on common forensic laboratory instrumentation is desirable. The use of the chiral derivatizing agent (-)-menthyl chloroformate followed by routine gas chromatography-mass spectrometry analysis of the derivative was shown to successfully determine the stereochemical composition of methorphan. This approach was applied to a street seizure containing methorphan proving that it was pure dextromethorphan. The derivatives of dextro- and levomethorphan were subjected to mass spectroscopic and nuclear magnetic resonance analysis, which confirmed that the structure of the derivatives remained unchanged as a result of the derivatization process.

Degradation in soil of precursors and by-products associated with the illicit manufacture of methylamphetamine: implications for clandestine drug laboratory investigation.

Key precursors and by-products in the Leuckardt, Nagai and dissolving metal reductive syntheses of methylamphetamine undergo degradation in soil as a result of biotic and abiotic processes. Furthermore, methylamphetamine is a product of the degradation of 1-(1',4'-cyclohexadienyl)-2-methylaminopropane and N-formylmethylamphetamine. These findings have implications for the forensic assessment of buried residues recovered from clandestine laboratory sites because markers used to infer the synthetic methods used might be absent as a result of degradation and because methylamphetamine might be present in residues as a result of degradation rather than as a direct result of its manufacture in the laboratory.

Manufacturing by-products from, and stereochemical outcomes of the biotransformation of benzaldehyde used in the synthesis of methamphetamine.

Clandestine synthesis of methamphetamine in Australia has predominantly started from pseudoephedrine extracted from over the counter cold and flu medications. However, recently introduced restrictions on the sale of these products have made pseudoephedrine much more difficult to obtain. As a result clandestine chemists have had to resort to other means of obtaining the necessary chemical precursors. A recent drug raid (Adelaide, January 2008) resulted in the seizure of an unusual reaction mixture that indicated a novel approach involving the fermentation of glucose by yeast in the presence of benzaldehyde to give 1-hydroxy-1-phenylpropanone, also known as l-phenylacetylcarbinol (l-PAC), a known precursor to ephedrine and pseudoephedrine and hence methamphetamine. A study was undertaken into this process with the aim of determining the characteristic reaction by-products associated with methamphetamine made in this way. The study also looked at the stereochemical selectivity of the fermentation reaction and the stereochemistry of the subsequent reaction products, ephedrine and pseudoephedrine, and the final methamphetamine.

Application of time of flight secondary ion mass spectrometry to the in situ analysis of ballpoint pen inks on paper.

Results presented in this paper demonstrate that time of flight secondary ion mass spectrometry (TOF-SIMS) can be used for the analysis of ballpoint pen inks producing mass spectra that were highly characteristic of the constituent dyes and inorganic substances used in their formulations. Analysis was performed directly off the substrate (typically document paper) containing the ink with no interference from the background matrix. The resultant spectra were highly characteristic of the ink formulation and could be used to confidently discriminate between different inks. No extraction or complicated sample preparation was necessary which ensures the integrity of the document under examination. This is not only important in forensic applications but also indicates the potential for the application of this technique to the analysis of inks on documents of historical or archaeological significance. TOF-SIMS was also shown to be capable of analysing ink containing a mixture of dyes, initially separated by thin-layer chromatography, directly on the chromatographic material.