Epstein-Barr virus infection after adolescence and human herpesvirus 6A as risk factors for multiple sclerosis.

BACKGROUND AND PURPOSE: Infections with human herpesvirus 6A (HHV-6A) and Epstein-Barr virus (EBV) have been linked to multiple sclerosis (MS) development. For EBV, late infection has been proposed as a risk factor, but serological support is lacking. The objective of this study was to investigate how age affects the EBV and HHV-6A associated risks of developing MS. METHODS: In this nested case-control study, Swedish biobanks were accessed to find pre-symptomatically collected blood samples from 670 individuals who later developed relapsing MS and 670 matched controls. A bead-based multiplex assay was used to determine serological response against EBV and HHV-6A. Conditional logistic regression was used to calculate odds ratios and 95% confidence intervals. RESULTS: Seropositivity against EBV exhibited a pattern where associations switched from a decreased risk of developing MS in the group below 20 years of age to an increased risk amongst individuals aged 20-29 and 30-39 years (p for trend 0.020). The age of transition was estimated to be 18.8 years. In contrast, HHV-6A was associated with increased MS risk in all age groups (total cohort odds ratio 2.1, 95% confidence interval 1.6-2.7). CONCLUSIONS: This study suggests EBV infection after adolescence and age independent HHV-6A infection as risk factors for MS.

Characterization of anti-natalizumab antibodies in multiple sclerosis patients.

BACKGROUND: A small proportion of multiple sclerosis (MS) patients treated with natalizumab develop anti-drug antibodies. OBJECTIVE: The objective of this paper is to characterize the anti-natalizumab antibody response and to investigate differences between persistently and transiently antibody-positive patients. METHODS: Screening for anti-natalizumab antibodies was performed using a standardized bridging ELISA. Antibody-positive samples were further analyzed for IgM and IgG1-4 antibodies using ELISA and ImmunoCAP®. RESULTS: Anti-natalizumab antibodies developed in 57 of 1379 (4.1%) treated patients after a median treatment duration of three months. Of the positive patients, 20 (35%) patients reverted to negative, 19 (33%) patients were confirmed persistently positive and 18 (32%) patients were unconfirmed positive. Significantly higher anti-natalizumab antibody levels were detected in persistently compared to transiently positive patients. A cutoff value predicting persistence of antibodies could be determined with a sensitivity of 0.84 and a specificity of 0.80. IgM and IgG4 antibody levels were significantly higher in persistently compared to transiently positive patients, and IgG1, IgG2 and IgG4 increased significantly over time. CONCLUSIONS: The level of total anti-natalizumab antibodies in a first positive sample can be used to predict patients at risk for persisting antibody positivity. However, neither IgM nor IgG1-4 antibodies could be used to discriminate between transiently and persistently positive patients.

Global prevalence of double Benioff zones.

Double Benioff zones provide opportunities for insight into seismogenesis because the underlying mechanism must explain two layers of deep earthquakes and the separation between them. We characterize layer separation inside subducting plates with a coordinate rotation to calculate the slab-normal distribution of earthquakes. Benchmark tests on well-established examples confirm that layer separation is accurately quantified with global seismicity catalogs alone. Global analysis reveals double Benioff zones in 30 segments, including all 16 subduction zones investigated, with varying subducting plate ages and stress orientations, which implies that they are inherent in subducting plates. Layer separation increases with age and is more consistent with dehydration of antigorite than chlorite.

Finite-frequency tomography reveals a variety of plumes in the mantle.

We present tomographic evidence for the existence of deep-mantle thermal convection plumes. P-wave velocity images show at least six well-resolved plumes that extend into the lowermost mantle: Ascension, Azores, Canary, Easter, Samoa, and Tahiti. Other less well-resolved plumes, including Hawaii, may also reach the lowermost mantle. We also see several plumes that are mostly confined to the upper mantle, suggesting that convection may be partially separated into two depth regimes. All of the observed plumes have diameters of several hundred kilometers, indicating that plumes convey a substantial fraction of the internal heat escaping from Earth.

No effect of single dose ofloxacin on postoperative infection rate after first-trimester abortion. A clinical, controlled trial.

In a double-blind stratificated, placebo controlled study the efficacy and safety of a single oral dose of ofloxanin (Tarivid) (400 mg) in preventing postabortal pelvic inflammatory disease (P-PID) in women with induced first-trimester abortions were assessed. The tablets were given 1 1/2-2 h before the abortion, and the women were followed one month after the operation. Group I consisted of 308 with previous PID. Ofloxacin tablets were given to 149 women and 159 women received placebo tablets. In the ofloxacin group 20 women (13.4%) and in the placebo group 27 women (17%) developed P-PID, a non-significant difference (p = 0.39). Group II consisted of 765 women without a history of PID. Ofloxacin tablets were given to 376 women and 389 women received placebo tablets. Thirty-five women (9.3%) in the ofloxacin group and 46 women (11.9%) in the placebo group developed P-PID, a non-significant difference (p = 0.26). A single oral dose of ofloxacin (400 mg) did not reduce the incidence of P-PID either among women with previous PID or among women without previous PID.

[Pelvic inflammation after induced abortion]. / Underlivsinflammation efter abortus provocatus.

A total of 949 women referred for legal termination of pregnancy in the first trimester participated in an investigation to assess the risk of pelvic inflammation in connection with the intervention in women with and without previous pelvic inflammation in connection with previous pregnancies, the gestational age and the clinical experience of the surgeon. Women who had not borne children developed pelvic inflammation more frequently after legal termination of pregnancy (p < 0.01) than women who had previously borne children. Women with previous pelvic inflammation developed renewed pelvic inflammation, if they had not previously borne children (p < 0.01) or if they had previously undergone legal termination of pregnancy (p < 0.05). Women without previous pelvic inflammation developed pelvic inflammation significantly more frequently, if they had not previously been pregnant (p < 0.05). The occurrence of pelvic inflammation was independent of the gestational age and the clinical experience of the surgeon.

[Treatment with rectal diazepam or acetylsalicylic acid in effervescing tablets in ambulatory cervical curettage and biopsy. A double-blind randomized study]. / Behandling med diazepam rektalt eller acetylsalicylsyre-brusetabletter i forbindelse med ambulant cervikal abrasio og portiobiopsi. En dobbeltblind randomiseret undersøgelse.

A double-blind randomised investigation with placebo control was undertaken to investigate the effect of 10 mg diazepam rectally or 1 g acetyl salicylic acid as effervescing tablets on pain and nervousness during and after outpatient cervical curettage and biopsy from the vaginal cervix or the cervical endothelium. A total of 97 women participated and were subdivided at random. Three patients were, however, excluded as they did not participate as planned. No differences were found between the three groups as regards pain and nervousness during the intervention and fatigue and drowsiness after the intervention. No statistically significant difference was found in the degree of satisfaction with the treatment in the various therapeutic groups.

The effect of incisional plastic drapes and redisinfection of operation site on wound infection following caesarean section.

In a randomized prospective multicentre study of post-caesarean wound infection among 1,340 women in eight hospitals, the effect of redisinfection of the skin around the incision before skin closure and the effect of adhesive skin drapes were investigated. The overall rate of wound infection with pus was 5.0% (range 3.5-8.9%). The study showed a reduction in postoperative wound infection associated with redisinfection (P = 5.5%), while no benefit from adhesive plastic drapes could be demonstrated.

Sigmoid mesocolic hernia. Case report.

Internal abdominal hernias are uncommon. A case of sigmoid mesocolic hernia involving cystadenoma of the uterine adnexa is described. Symptoms from internal hernias are vague and uncharacteristic. Most cases are diagnosed at laparotomy for ileus.

Carcinofibroma--a rare variant of mixed müllerian tumor.

We report a case of an endometrial neoplasm of Müllerian origin, consisting of a malignant epithelial component and a benign stromal component. Only 3 similar cases have been described previously. By comparative study of other, more common mixed Müllerian tumors, we have tried to determine the behavior and management of this neoplasm.

Growth potential of cranial suture bone autografts. I. An experimental macrosopic investigation in young rabbits.

On 25 rabbit sucklings a coronal suture-bone graft was transplanted into an experimental unilateral premaxillo-maxillary bone and stuture defect. 21 animals survived the experimental period and were sacrificed fullgrown (6 months). The graft was found to be well incorporated into the recipient site in all cases, its structure being remodelled to a striking similarity with the unoperated side and the suture was still visible. Photographic measurement of the snout deviation revealed that the longitudinal growth of the grafted suture approximately followed the general growth of the facial skeleton. This indicates an up to 3-fold increase of the growth in comparison to its original cranial growth site.

Growth potential of cranial suture bone autograft. II. An experimental microscopic investigation in young rabbits.

On rabbit sucklings a coronal suture-bone graft, covered by periosteum and dura, was transplanted into an experimental unilateral premaxillo-maxillary bone and suture defect. In 21 animals microscopical analysis was carried out using triple fluorochrome vital labelling over a period from the 3rd to the 36th postoperative day. In another 7 animals conventional histological methods were used. The grafts were readily incorporated and during the second postoperative week longitudinal sutural growth was fully restored as compared to the unoperated control side and growth far exceeded that of the original coronal suture.

Explosion effects and earthquakes in the amchitka island region.

Microearthquakes were monitored by a network of seismographs located on Amchitka and nearby islands; the nature of earthquake activity in this region was found to be consistent with the hypothesis of underthrusting of the Aleutian arc by a rigid lithospheric plate. Seismic effects of the nuclear explosion Milrow were small, of short duration, confined to the region immediate to the explosion, and were apparently independent of this geotectonic mechanism.