Opportunistic phaeohyphomycoses in wild saffron cod Eleginus gracilis from waterways of Norton Sound and Toksook Bay, Alaska, USA.

These case reports describe locally invasive black pigmented mycotic infections of the skin and gills of saffron cod Eleginus gracilis associated with 8 different opportunistic ascomycete fungi: Alternaria sp., Cladosporium herbarum, Chaetomium globosum, Cadophora luteo-olivacea, Penicillium sp., Phoma herbarum, Pseudophacidium ledi and Valsa sordida. These fungi were isolated on conventional media, identified according to morphological structures and confirmed by genetic sequencing. Several of these fungi are primary plant pathogens as well as opportunistic human pathogens in immunocompromised individuals. Several have also been described as causing opportunistic infections of fish. This case material represents the first report of C. luteo-olivacea, C. globosum, P. ledi and V. sordida as likely opportunistic fish pathogens in Alaskan watersheds of Norton Sound and south in Toksook Bay and possibly elsewhere.

Estimating the Prevalence of Sleep-Disordered Breathing Among Collegiate Football Players.

BACKGROUND: Obstructive sleep apnea is a clinical disorder characterized by loud snoring, apneic episodes, and chronic sleep disruption. Collegiate football players exhibit several risk factors for OSA, including large neck circumference and high body mass index, although the prevalence of OSA in this cohort is unknown. METHODS: The STOP-BANG questionnaire was administered at random to members of a collegiate football team and used to stratify the players into high and low risk for sleep-disordered breathing (SDB). Those who completed the questionnaire were then evaluated for SDB during preseason camp using a single-channel (finger pulse oximetry) photoplethysmography-based device. SDB was defined as an apnea-hypopnea index of ≥5. RESULTS: Of 56 players who underwent overnight photoplethysmography monitoring, valid results were available for 51. Forty-eight percent of the players were high-risk (neck size = 44.6 ± 2.2 cm, body mass index = 33.0 ± 5.4) versus low-risk (neck size = 41.4 ± 2.8 cm, body mass index = 27.6 ± 3.6) (both P values <.001). An apnea-hypopnea index of ≥5 was found in 2 (8.3%, 95% CI 1.0-20.0%) high-risk and 2 (7.7, 95% CI 1.0-18.4%) low-risk players. Two offensive linemen, a linebacker, and a tight end accounted for the positive cases. CONCLUSIONS: Based on our sample, we estimate the prevalence of SDB among collegiate football players to be 8%, regardless of risk stratification. Given the strong link between SDB and cardiovascular disease, these data underscore the importance of screening and subsequent treatment of SDB in this highly conditioned yet potentially vulnerable group of athletes.

Associations between vasodilatory capacity, physical activity and sleep among younger and older adults.

INTRODUCTION: Exercise promotes cardiovascular health through its direct impact on the vascular endothelium. Conversely, poor sleep quality is associated with endothelial dysfunction, which may explain the increased cardiovascular disease amongst poor sleepers. Yet, the influence of physical activity and poor sleep quality on vascular health is not clear. PURPOSE: This study examined the relationships between forearm vasodilatory capacity, self-reported sleep quality and free-living, actigraphy-derived energy expenditure in a group of young and older community dwelling adults. METHODS: Venous occlusion plethysmography determined baseline and peak forearm blood flow following reactive hyperemia. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Measures of body composition were assessed using dual energy X-ray absorptiometry. RESULTS: A total of 104 (61 young; 43 old) participants completed the study. In general, younger participants were more active, as determined by steps per day and average daily energy expenditure, but reported poorer sleep quality. In the combined sample, those who reported moderate sleep disturbances (PSQI total score; 11-15) had significantly lower vasodilatory capacity (16.8 ± 7.6 ml/100 ml/min) compared to those who reported no sleep disturbance (PSQI total score; 0-5) (22.3 ± 7.2 ml/100 ml/min) or mild sleep disturbance (PSQI total score; 6-10) (22.3 ± 8.1 ml/100 ml/min) (p < 0.01). After adjustment for physical activity, total body fat and age, moderately poor sleep remained an independent predictor of forearm vasodilatory capacity. CONCLUSIONS: These findings suggest that any positive vascular benefits accrued through increased physical activity might be offset by the negative consequences of chronically disturbed sleep.

Impact of Ichthyophonus infection on spawning success of Yukon River Chinook salmon Oncorhynchus tshawytscha.

We examined the impacts of Ichthyophonus infection on spawning success of Yukon River Chinook salmon Oncorhynchus tshawytscha at spawning grounds of the Chena and Salcha Rivers, Alaska, USA. During the period 2005 to 2006, 1281 salmon carcasses (628 male, 652 female) were collected throughout the spawning season and from the entire spawning reaches of the Chena and Salcha Rivers. For each fish, infection status was determined by culture method and visual inspection of lesions of heart tissue as uninfected (culture negative), infected without lesions (culture positive with no visible lesions), and infected with lesions (culture positive with visible lesions), and spawning status was determined by visually inspecting the percentage of gametes remaining as full-spawned (<10%), partial-spawned (10-50%), and unspawned (>50%). Among the 3 groups, the proportion of full-spawned (i.e. spawning success) females was lower for those infected without lesions (69%) than those uninfected (87%) and infected with lesions (86%), but this did not apply to males (uninfected 42%, infected without lesions 38%, infected with lesions 41%). At the population level, the combined (infected and uninfected) proportion of female spawning success was 86%, compared to 87% when all females were assumed uninfected. These data suggest that while Ichthyophonus infection slightly reduces spawning success of infected females, its impact on the spawning population as a whole appears minimal.

PCR testing for diagnosis of Ichthyophonus hoferi: reply to LaPatra & Kocan (2013).

LaPatra & Kocan (2013) critiqued our paper Hamazaki et al. (2013; Dis Aquat Org 105:21-25) for data not supporting the conclusions of 'PCR testing is as accurate as culture…', but they neither pointed out what part of our data did not support our conclusion, nor did they provide any contrary scientific evidence supporting their argument that PCR testing is less accurate than culture. In the absence of any contradictory data, we stand by our data and our conclusion: PCR test is as suitable as culture as a diagnostic and field surveillance tool.

PCR testing can be as accurate as culture for diagnosis of Ichthyophonus hoferi in Yukon River Chinook salmon Oncorhynchus tshawytscha .

We evaluated the comparability of culture and PCR tests for detecting Ichthyophonus in Yukon River Chinook salmon Oncorhynchus tshawytscha from field samples collected at 3 locations (Emmonak, Chena, and Salcha, Alaska, USA) in 2004, 2005, and 2006. Assuming diagnosis by culture as the 'true' infection status, we calculated the sensitivity (correctly identifying fish positive for Ichthyophonus), specificity (correctly identifying fish negative for Ichthyophonus), and accuracy (correctly identifying both positive and negative fish) of PCR. Regardless of sampling locations and years, sensitivity, specificity, and accuracy exceeded 90%. Estimates of infection prevalence by PCR were similar to those by culture, except for Salcha 2005, where prevalence by PCR was significantly higher than that by culture (p < 0.0001). These results show that the PCR test is comparable to the culture test for diagnosing Ichthyophonus infection.

Detection of viruses and virus-like particles in four species of wild and farmed bivalve molluscs in Alaska, U.S.A., from 1987 to 2009.

The U.S. Alaska Department of Fish and Game has regulatory oversight of the mariculture industry that is partially administered through a statewide shellfish health policy. Possession and transport of bivalve molluscs require development of indigenous pathogen histories from diagnostic examinations of wild and farmed populations. These examinations have resulted in the detection of various infectious agents and parasites including viruses: an aquareovirus and aquabirna-like virus isolated by fish cell culture, and papilloma- or polyoma- and herpes-like virus particles within bivalve cell intranuclear inclusion bodies observed by electron microscopy. This study summarizes these results in samples examined from 1987 to 2009 and is the first description of poikilothermic viruses from Alaskan waters isolated from or observed within the tissues of 4 species of bivalve molluscs: geoduck clam Panope abrupta, native littleneck clam Protothaca staminea, purple-hinged rock scallop Crassadoma gigantea and Pacific oyster Crassostrea gigas.

Assessing the accuracy of a polymerase chain reaction test for Ichthyophonus hoferi in Yukon River Chinook salmon Oncorhynchus tshawytscha.

Ichthyophonus hoferi Plehn & Mulsow, 1911, is a cosmopolitan, protistan pathogen of marine fishes. It is prevalent in mature returning Chinook salmon Oncorhynchus tshawytscha in the Yukon River watershed, and may be associated with prespawning mortality. We developed and evaluated a polymerase chain reaction (PCR) test for I. hoferi using primers specific to the parasite's small subunit rDNA. The test has a minimum detection limit of approximately 10(-5) parasite spores per reaction and does not cross-react with the closely related salmon parasites Dermocystidium salmonis or Sphaerothecum destruens. Sensitivity and specificity of the PCR test used on somatic muscle and heart tissue for detecting infected fish were determined using 334 Chinook salmon collected from the Yukon River at 2 locations (Tanana and Emmonak) in 2003 and 2004. The true infection status of the fish was determined by testing somatic muscle, heart and kidney tissue using histological evaluation, culture, and PCR. The severity of infection was grouped into 2 categories, light and heavy infection. The probability of detecting a heavily infected fish (sensitivity of the test) was generally much higher than the probability of detecting light infection, suggesting that more than one tissue and/or method should be used to accurately detect light or early infection by I. hoferi. The probability of correctly identifying a negative fish (specificity of the test) was always greater than 94% regardless of the tissue used, infection severity, sampling site or year of collection.

Variable sac behavior after endovascular repair of abdominal aortic aneurysm: analysis of core laboratory data.

OBJECTIVES: The behavior of the aneurysm sac after endovascular grafting has been the subject of significant speculation. The importance of sac behavior is manifested by the correlation between aneurysm size or size change and risk for rupture, and potentially further extrapolated to define the need for secondary intervention. This study was undertaken to define graft-specific differences and the effect of endoleak on sac remodeling. METHODS: Core laboratory data were obtained for three US Phase II clinical trials. Patients were included if they met anatomic inclusion criteria and underwent placement of the latest version of a bifurcated endovascular prosthesis. Unsupported Dacron (Ancure), supported Dacron (Zenith), and expanded polytetrafluoroethylene (Excluder) grafts were evaluated. Digitized images were electronically assessed for aneurysm size (area, maximum, minimum diameter) with National Institutes of Health Image software. Two blinded reviewers analyzed each radiographic study to ensure accurate image selection and establish the presence or absence of endoleak. A third reviewer adjudicated discrepancies. chi(2) analysis and mixed nonlinear modeling were used to analyze the results. RESULTS: Of 1506 patients evaluated, 723 (227 Ancure, 343 Excluder, 153 Zenith) met inclusion criteria for the study. Mean follow-up was 23.2 months (Ancure, 31.3 months; Excluder, 19.6 months; Zenith, 19.3 months). The incidence of any endoleak was 39.1% (Ancure, 58.1%; Excluder, 34.7%; Zenith, 20.9%; P <.001). Type of prosthesis, presence or absence of endoleak, and baseline size were determinants of rate of aneurysm shrinkage. Reduction in sac size was greatest with the Zenith graft, followed by the Ancure and Excluder grafts. Presence of endoleak had a moderating effect on rate of sac shrinkage with the Zenith and Ancure grafts; however, sac size increased in the presence of endoleak with the Excluder graft. Finally, baseline size was positively correlated with rate of aneurysm shrinkage. CONCLUSIONS: The behavior of the aneurysm sac depends on the type of prosthesis, presence or absence of endoleak, and baseline size of the sac. Differential sac behavior must be considered when determining the need for secondary interventions, timing follow-up studies, and assessing success or failure of endovascular repair.

Thrombus characterization with intravascular ultrasound: potential to predict successful thrombolysis.

PURPOSE: To define analysis methods using radiofrequency (RF) data from intravascular ultrasound (IVUS) to characterize thrombus so that the success or failure of thrombolysis can be predicted. METHODS: Experimentation was done in 2 phases: first, 40 clots created from platelet-rich (n=20) and platelet-poor (n=20) plasma were imaged with 20 and 30-MHz IVUS probes. The digitized RF signals were analyzed to determine the attenuation and slope of attenuation characteristics as a reference standard for the second part of the study. In this phase, 20 perfusion trials were performed with 10 platelet-rich and 10 platelet-poor samples in an in vitro arterial perfusion model; the composition of the samples was blinded during interrogation with IVUS. Alteplase (0.1 mg) was then infused directly into the thrombus for 1 hour; restoration of flow and amount of lysis were quantified. RESULTS: Significant differences were detected for the integrated attenuation value (p<0.001) between platelet-poor and platelet-rich clots interrogated with a 30-MHz probe, but no differences were noted using the 20-MHz catheter. However, both transducers were capable of differentiating platelet-rich and platelet-poor clots using a slope of attenuation analysis, which was successful in identifying all 20 (100%) of the blinded clots in the in vitro model. The speed and completeness of lysis were significantly higher (p<0.05) for platelet-rich (78%) than platelet-poor (21%) clots. CONCLUSIONS: IVUS preprocessed imaging is capable of differentiating various types of thrombus. This information can be used to predict the success or failure of pharmacological lysis techniques.