Virological diagnosis of African swine fever--comparative study of available tests.

The rapid and reliable detection of African swine fever virus (ASFV) is essential both for timely implementation of control measures to prevent the spread of disease, and to differentiate African swine fever (ASF) from other pig disease with similar clinical presentations. Many virological tests are currently available for the detection of ASFV (live virus), antigen and genome, including virus isolation, ELISA, fluorescent antibody, polymerase chain reaction (PCR) and isothermal assays. In recent years real-time PCR (rPCR) has become one of the most widely used formats for virological diagnosis providing sensitive, specific and swift detection and quantification of ASFV DNA. The ability to integrate rPCR into automated platforms increases sample throughput and decreases the potential for cross-contamination. In more recent years isothermal assays, which are a lower-cost alternative to PCR more suitable for use in non-specialised or mobile laboratories, have been developed for the detection of ASFV, however these assays have not been fully validated for routine use in the field. The performance of all virological detection assays in ASF diagnostics, as well as prospects for improving diagnostic strategies in the future, are discussed and reviewed in this chapter.

Longitudinal analysis of pulmonary function decline in patients with cystic fibrosis.

BACKGROUND: Chronic progressive lung disease is the most prominent cause of morbidity and death in patients with cystic fibrosis (CF), but severity of lung disease and rate of lung function decline are widely variable. Accurate estimates of decline have been difficult to define and compare because the timing of measurements and duration of follow-up differ in various patient groups. PATIENTS: Three hundred sixty-six patients with CF, born from 1960 to 1974, were selected from a CF database birth cohort if they had two or more measurements of pulmonary function, at least one of which was performed before the age of 10 years. METHODS: Mixed model regression analysis provided estimates of the average rate of decline of spirometry measurements in subgroups on the basis of survival age, sex, pancreatic status, and genotype. RESULTS: Patients who died before the age of 15 years had significantly poorer pulmonary function when first tested and a more rapid decline in pulmonary function thereafter than patients who survived beyond the age of 15 years. In the latter, functional levels at the age of 5 years were normal, but average rates of decline were significantly related to survival age. Female patients had significantly steeper decline than male patients, and those with pancreatic insufficiency had much steeper decline than those with pancreatic sufficiency. In the subset of 197 who survived to 1990 and were subsequently genotyped, rate of decline was greater in those homozygous for the delta F508 mutation, compared with those who were heterozygous for delta F508 or those, who had two other mutations. DISCUSSION: All but the most severely affected patients, who died before age 15, appear to have had normal pulmonary function when first tested in early childhood. Pancreatic sufficiency, male gender, and some non-delta F508 mutations are associated with a slower rate of pulmonary function decline. Mixed model analysis is a valuable tool for describing and comparing pulmonary function decline in groups of patients with CF.

Comparison of dilevalol and enalapril administered once daily for mild hypertension.

This was a multicenter, randomized, double-blind, parallel-group study of the efficacy and safety of dilevalol, 200 mg (n = 86), compared with enalapril, 20 mg (n = 92), administered once daily to patients with mild hypertension. Three weeks of placebo washout were followed by 4 weeks of comparative treatment. Beginning with the first week of treatment, both drugs substantially decreased blood pressure from baselines of approximately 160/100 mm Hg. Decreases in systolic pressure were comparable throughout treatment, but dilevalol tended to have a greater effect on diastolic pressure. At the end of double-blind treatment, average decreases in blood pressure with dilevalol and enalapril were 16/13 and 16/11 mm Hg supine and 15/13 and 15/10 mm Hg standing (p = 0.03 for between-group comparisons of standing diastolic pressure). More dilevalol- than enalapril-treated patients achieved a diastolic pressure less than 90 mm Hg; 73 vs 55% (p = 0.02) supine, and 69 vs 43% (p less than 0.01) standing. The safety profiles of the 2 drugs were comparable. The incidence of adverse effects was low, and few patients discontinued treatment. Headache and gastrointestinal discomfort were reported in both groups. Average postural changes in blood pressure were similar to baseline. Electrocardiographic changes were rare and not treatment related. Changes in laboratory test results were minor. Heart rate decreased modestly with dilevalol relative to enalapril (6 vs 2 to 3 beats/min; p less than 0.01), but no bradycardia was observed.

Semiquantitative cultures and routine tip cultures on umbilical catheters.

One hundred and fourteen umbilical catheters (79 arterial and 35 venous) were cultured with a semiquantitative technique. Twelve cultures were SQC positive with greater than or equal to 15 colonies, and all but two of these had greater than or equal to 100 colonies. Organisms usually considered to be pathogens were associated with SQC positive catheters, whereas organisms generally considered nonpathogens were associated with less than 15 colonies on SQC. Therefore SQC may help to differentiate between contamination and infection related to umbilical catheters. The one case with purulence at the cord base grew 100 colonies of Staphylococcus epidermidis on SQC. S. epidermidis showed a bimodal distribution in colony count and should be considered as a pathogen when high colony counts are present. Duration of catheterization was longer in SQC positive catheters. Empiric antibiotic use was associated with negative SQC. Further study is indicated in a newborn population with a lower rate to antibiotic use for correlation of SQC results with catheter-induced bacteremia and sepsis.

Prevalence of intestinal helminths and protozoans in a rural population segment of the Dominican Republic.

There are few reports of parasitic disease prevalence in the Dominican Republic. The most recent study was that by Mackie et al. (1951). Examination of purged specimens from individuals employed by two sugar plantations demonstrated generally high prevalences of a number of helminths and protozoans. We report here the findings of a prevalence study using a population sample of 453 individuals. Ascaris lumbricoides, Trichuris trichiura, hookworm, Enterobius vermicularis, Giardia lamblia and Entamoeba coli were found.