RÉSUMÉ
SARS-CoV-2 emerged from animals and is now easily transmitted between people. Sporadic detection of natural cases in animals alongside successful experimental infections of pets, such as cats, ferrets and dogs, raises questions about the susceptibility of animals under natural conditions of pet ownership. Here, we report a large-scale study to assess SARS-CoV-2 infection in 919 companion animals living in northern Italy, sampled at a time of frequent human infection. No animals tested PCR positive. However, 3.3% of dogs and 5.8% of cats had measurable SARS-CoV-2 neutralizing antibody titers, with dogs from COVID-19 positive households being significantly more likely to test positive than those from COVID-19 negative households. Understanding risk factors associated with this and their potential to infect other species requires urgent investigation.
Sujet(s)
COVID-19/médecine vétérinaire , Immunité acquise , Animaux , Anticorps neutralisants/isolement et purification , Anticorps antiviraux/isolement et purification , COVID-19/diagnostic , Chats , Chiens , Humains , Italie/épidémiologieRÉSUMÉ
SARS-CoV-2 originated in animals and is now easily transmitted between people. Sporadic detection of natural cases in animals alongside successful experimental infections of pets, such as cats, ferrets and dogs, raises questions about the susceptibility of animals under natural conditions of pet ownership. Here we report a large-scale study to assess SARS-CoV-2 infection in 817 companion animals living in northern Italy, sampled at a time of frequent human infection. No animals tested PCR positive. However, 3.4% of dogs and 3.9% of cats had measurable SARS-CoV-2 neutralizing antibody titers, with dogs from COVID-19 positive households being significantly more likely to test positive than those from COVID-19 negative households. Understanding risk factors associated with this and their potential to infect other species requires urgent investigation. ONE SENTENCE SUMMARY: SARS-CoV-2 antibodies in pets from Italy.
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Using ab initio lattice methods, we calculate the finite temperature thermodynamics of homogeneous two-dimensional spin-1/2 fermions with attractive short-range interactions. We present results for the density, pressure, compressibility, and quantum anomaly (i.e., Tan's contact) for a wide range of temperatures (mostly above the superfluid phase, including the pseudogap regime) and coupling strengths, focusing on the unpolarized case. Within our statistical and systematic uncertainties, our prediction for the density equation of state differs quantitatively from the prediction by Luttinger-Ward theory in the strongly coupled region of parameter space, but otherwise agrees well with it. We also compare our calculations with the second- and third-order virial expansion, with which they are in excellent agreement in the low-fugacity regime.
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We report the incidence and location of deep-vein thrombosis in 312 patients who had sustained high-energy, skeletal trauma. They were investigated using magnetic resonance venography and Duplex ultrasound. Despite thromboprophylaxis, 36 (11.5%) developed venous thromboembolic disease with an incidence of 10% in those with non-pelvic trauma and 12.2% in the group with pelvic trauma. Of patients who developed deep-vein thrombosis, 13 of 27 in the pelvic group (48%) and only one of nine in the non-pelvic group (11%) had a definite pelvic deep-vein thrombosis. When compared with magnetic resonance venography, ultrasound had a false-negative rate of 77% in diagnosing pelvic deep-vein thrombosis. Its value in the pelvis was limited, although it was more accurate than magnetic resonance venography in diagnosing clots in the lower limbs. Additional screening may be needed to detect pelvic deep-vein thrombosis in patients with pelvic or acetabular fractures.
Sujet(s)
Énoxaparine/usage thérapeutique , Fibrinolytiques/usage thérapeutique , Fractures osseuses/complications , Thrombose veineuse/étiologie , Acétabulum/imagerie diagnostique , Acétabulum/traumatismes , Fractures osseuses/imagerie diagnostique , Humains , Angiographie par résonance magnétique/méthodes , Adulte d'âge moyen , Polytraumatisme/complications , Polytraumatisme/imagerie diagnostique , Pelvis/imagerie diagnostique , Pelvis/traumatismes , Phlébographie/méthodes , Études prospectives , Embolie pulmonaire/imagerie diagnostique , Embolie pulmonaire/étiologie , Embolie pulmonaire/prévention et contrôle , Contrainte mécanique , Échographie-doppler/méthodes , Thrombose veineuse/diagnostic , Thrombose veineuse/prévention et contrôleRÉSUMÉ
BACKGROUND: Subcutaneous and sub rectus sheath wound drains are sometimes used in women who have undergone caesarean section. The indications for using drains vary by clinician. OBJECTIVES: To compare the effects of using a wound drain with not using a wound drain at caesarean section, and of different types of drain, on maternal health and healthcare resource use. SEARCH STRATEGY: This review draws on the search strategy developed for the Cochrane Wounds Group as a whole. Electronic databases (MEDLINE, EMBASE, Cinahl and CAB Health), and the reference lists of included articles were also searched up to June 2004 SELECTION CRITERIA: Studies were included if they allocated women to groups at random and they compared any type of wound drain with no wound drainage, or with any other type of drain, in women undergoing caesarean section. DATA COLLECTION AND ANALYSIS: Trials were evaluated for appropriateness for inclusion and methodological quality without consideration of their results. This was done by two reviewers according to pre-stated eligibility criteria. MAIN RESULTS: Seven trials (1993 women) were included in the review. Meta-analysis found no difference in the risk of wound infection, other wound complications, febrile morbidity or endometritis in women who had wound drains compared with those who did not. There was some evidence that caesarean sections may be about five minutes shorter and that blood loss may be slightly lower when drains were not used. AUTHORS' CONCLUSIONS: There is no evidence in the seven small trials included to suggest that the routine use of wound drains at caesarean section confers any benefit on the women involved. These trials do not answer the question of whether wound drainage is of benefit when haemostasis is not felt to be adequate. Further large trials are justified using blinded outcome assessment to examine the role of different types of wound drain at caesarean section. Comparing the use of drains in women with different degrees of obesity and in women having first or repeat caesareans and intrapartum or prelabour caesarean sections would be of interest. Women's views and experience of drains have not been studied in these trials.
Sujet(s)
Césarienne , Aspiration (technique)/méthodes , Césarienne/effets indésirables , Femelle , Humains , Grossesse , Essais contrôlés randomisés comme sujetRÉSUMÉ
BACKGROUND: There is a variety of techniques for closing the abdominal wall during caesarean section. Some methods may be better in terms of postoperative recovery and other important outcomes. OBJECTIVES: To compare the effects of alternative techniques for closure of the rectus sheath and subcutaneous fat on maternal health and healthcare resource use. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register (September 2003), MEDLINE (1966 to September 2003), EMBASE (1980 to September 2003), CINAHL (1983 to September 2003) and CAB Health (1973 to September 2003), and the reference lists of included articles. SELECTION CRITERIA: Randomised trials making any of the following comparisons: (a) any suturing technique or material used for closure of the rectus sheath versus any other; (b) closure versus non-closure of subcutaneous fat; (c) any suturing technique or material used for closure of the subcutaneous fat versus any other; (d) any type of needle for repair of the abdominal wall in caesarean section versus any other; (e) any other comparison of methods of abdominal wall closure. DATA COLLECTION AND ANALYSIS: Both reviewers evaluated trials for eligibility and methodological quality without consideration of their results. MAIN RESULTS: Seven studies involving 2056 women were included. The risk of haematoma or seroma was reduced with fat closure compared with non-closure (relative risk (RR) 0.52, 95% confidence interval (CI) 0.33 to 0.82), as was the risk of 'wound complication' (haematoma, seroma, wound infection or wound separation) (RR 0.68, 95% CI 0.52 to 0.88). No difference in the risk of wound infection alone or other short-term outcomes was found. No long-term outcomes were reported. There was no difference in the risk of wound infection between blunt needles and sharp needles in one small study. No studies were found examining suture techniques or materials for closure of the rectus sheath or subcutaneous fat. IMPLICATIONS FOR PRACTICE: Closure of the subcutaneous fat may reduce wound complications but it is unclear to what extent these differences affect the well-being and satisfaction of the women concerned. IMPLICATIONS FOR RESEARCH: Further trials are justified to investigate whether the apparent increased risk of haematoma or seroma with non-closure of the subcutaneous fat is real. These should use a broader range of short- and long-term outcomes, and ensure that they are adequately powered to detect clinically important differences. Further research comparing blunt and sharp needles is justified, as are trials evaluating suturing materials and suturing techniques for the rectus sheath.
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Paroi abdominale/chirurgie , Césarienne , Techniques de suture , Femelle , Humains , GrossesseRÉSUMÉ
Alterations in hippocampal physiology affect cognition in human immunodeficiency virus type 1 (HIV-1)-associated dementia (HAD). The mechanism for how this occurs is not well understood. To address this, we investigated how changes in synaptic transmission and plasticity are affected by viral infection and macrophage activation using a severe combined immunodeficiency mouse model of human HIV-1 encephalitis (HIVE). HIVE was induced in mice by stereotactic injection of HIV-1-infected human monocyte-derived macrophages (MDM) into the striatum. Animals were sacrificed after 3, 7 and 15 days. Hippocampal slices were prepared from HIV-1, MDM- and sham-injected animals. Electrically evoked field excitatory postsynaptic potentials were recorded in the CA1 region of the hippocampus. Neuronal physiology was assessed by input-output and by long-term potentiation (LTP) assays. We observed that a higher stimulation intensity (mA) was required to induce a 1-mV response in the HIVE mice (0.32+/-0.06) compared with shams (0.17+/-0.01) at day 7. The stimulation intensities at day 15 were 0.44+/-0.07 and 0.23+/-0.05 in the HIVE and shams, respectively. An impairment of synaptic function was detected through measuring synaptic responses induced by stimuli with different intensities. Paired-pulse facilitation (PPF) showed deficits in HIVE mice at days 3, 7, and 15. At day 3, PPF ratios were 1.13+/-0.02 and 1.24+/-0.04 in HIVE and sham. The induction and maintenance of LTP was also impaired in HIVE mice. The average magnitude of LTP was 131.23+/-15.26% of basal in HIVE as compared with sham animals of 232.63+/-24.18%. MDM-injected mice showed an intermediate response. Taken together, the results show a range of neuronal synaptic transmission and plasticity changes in HIVE mice that may reflect the mechanisms of cognitive dysfunction in human HAD.
Sujet(s)
Encéphalite virale/physiopathologie , VIH-1 (Virus de l'Immunodéficience Humaine de type 1) , Hippocampe/physiopathologie , Synapses/virologie , Animaux , Cellules cultivées , Modèles animaux de maladie humaine , Stimulation électrique , Électrophysiologie , Encéphalite virale/anatomopathologie , Potentiels post-synaptiques excitateurs/physiologie , Protéine gliofibrillaire acide/métabolisme , Hippocampe/anatomopathologie , Hippocampe/virologie , Humains , Immunohistochimie , Potentialisation à long terme/physiologie , Souris , Souris SCID/virologie , Protéines associées aux microtubules/métabolisme , Monocytes/métabolisme , Monocytes/virologie , Facteurs tempsRÉSUMÉ
The failure of the adult human spinal cord to regenerate following injury is not absolute, but appears to be amenable to therapeutic manipulation. Recent work has shown that the provision of a growth permissive environment by the neutralization of inhibitory influences, or the grafting of fetal tissue, peripheral nerve, Schwann cells, or olfactory ensheathing cells can enhance regeneration in animal models of spinal cord injury. Stem cells are gaining ever-increasing favour as a treatment option for spinal cord injury. The potential of neural stem cells, embryonic stem cells, and bone marrow stromal cells is discussed. Additional treatment options such as pharmacological interventions, functional electrical stimulation and physiotherapy approaches are also explored. Basic science insights are used as a foundation for a discussion of a variety of clinical perspectives including repair of the chronically injured spinal cord, animal models of human spinal cord injuries and clinical trials. A more holistic approach towards spinal cord injury is suggested, one where a hierarchy of needs is recognised and quality of life is paramount. Finally, this review cautions against overly grandiose claims of an imminent miracle cure for human spinal cord injury.
Sujet(s)
Régénération nerveuse , Traumatismes de la moelle épinière/thérapie , Adulte , Animaux , Transplantation cellulaire , Essais cliniques comme sujet , Électrothérapie , Transplantation de tissu foetal , Humains , Modèles animaux , Techniques de physiothérapieRÉSUMÉ
This study evaluated the efficacy of 2 theory-based preventive interventions for divorced families: a program for mothers and a dual component mother-child program. The mother program targeted mother-child relationship quality, discipline, interparental conflict, and the father-child relationship. The child program targeted active coping, avoidant coping, appraisals of divorce stressors, and mother-child relationship quality. Families with a 9- to 12-year-old child (N = 240) were randomly assigned to the mother, dual-component, or self-study program. Postintervention comparisons showed significant positive program effects of the mother program versus self-study condition on relationship quality, discipline, attitude toward father-child contact, and adjustment problems. For several outcomes, more positive effects occurred in families with poorer initial functioning. Program effects on externalizing problems were maintained at 6-month follow-up. A few additive effects of the dual-component program occurred for the putative mediators; none occurred for adjustment problems.
Sujet(s)
Adaptation psychologique , Divorce , Relations mère-enfant , Psychothérapie/méthodes , Stress psychologique/thérapie , Adulte , Arizona , Enfant , Relations père-enfant , Femelle , Études de suivi , Humains , Contrôle interne-externe , Mâle , Adaptation sociale , Résultat thérapeutiqueSujet(s)
Secteur des soins de santé/législation et jurisprudence , Health Maintenance Organizations (USA)/législation et jurisprudence , Association américaine de médecine , Secteur des soins de santé/normes , Health Maintenance Organizations (USA)/économie , Examen des demandes de remboursement d'assurance/législation et jurisprudence , Négociation , New Jersey , États-UnisRÉSUMÉ
Although previous studies have used magnetic resonance imaging (MRI) to demonstrate qualitative abnormalities of the temporal lobes in patients with panic disorder, no study to date has applied quantitative volumetric methods to evaluate brain changes in panic disorder. The purpose of this study was to measure the volume of the temporal lobe and the hippocampus in patients with panic disorder and healthy control subjects using quantitative MRI measures. The volume of the temporal lobe, hippocampus and whole brain was measured in 13 patients with panic disorder and 14 healthy subjects. The mean volume of the left and right temporal lobes was significantly smaller in panic disorder compared to healthy subjects (16770+/-909 mm(3) vs. 18343+/-1740 mm(3)). This result was significant after controlling for differences in whole brain volume. There was no significant difference in volume of the hippocampus between patients and control subjects. These findings are consistent with smaller temporal lobe volume in panic disorder despite normal hippocampal volume.
Sujet(s)
Trouble panique/anatomopathologie , Lobe temporal/anatomopathologie , Adulte , Analyse de variance , Femelle , Latéralité fonctionnelle/physiologie , Hippocampe/anatomopathologie , Humains , Système limbique/physiologie , Imagerie par résonance magnétique , Mâle , Trouble panique/diagnosticRÉSUMÉ
OBJECTIVE: Elevated levels of glucocorticoids in depression have been hypothesized to be associated with damage to the hippocampus, a brain area involved in learning and memory. The purpose of this study was to measure hippocampal volume in patients with depression. METHOD: Magnetic resonance imaging was used to measure the volume of the hippocampus in 16 patients with major depression in remission and 16 case-matched nondepressed comparison subjects. RESULTS: Patients with depression had a statistically significant 19% smaller left hippocampal volume than comparison subjects, without smaller volumes of comparison regions (amygdala, caudate, frontal lobe, and temporal lobe) or whole brain volume. The findings were significant after brain size, alcohol exposure, age, and education were controlled for. CONCLUSIONS: These findings are consistent with smaller left hippocampal volume in depression.
Sujet(s)
Trouble dépressif/diagnostic , Hippocampe/anatomie et histologie , Adulte , Facteurs âges , Alcoolisme/épidémiologie , Amygdale (système limbique)/anatomie et histologie , Encéphale/anatomie et histologie , Noyau caudé/anatomie et histologie , Comorbidité , , Trouble dépressif/épidémiologie , Niveau d'instruction , Lobe frontal/anatomie et histologie , Latéralité fonctionnelle , Humains , Imagerie par résonance magnétique/statistiques et données numériques , Lobe temporal/anatomie et histologieRÉSUMÉ
This study describes the reliability, validity, and responsiveness of the Sinonasal Outcome Test-16 (SNOT-16), a rhinosinusitis-specific health-related quality-of-life instrument, in the University of Washington Department of Otolaryngology-Head and Neck Surgery patient population. The SNOT-16 was completed by 47, 24, and 22 patients at weeks 0, 6, and 12, respectively. In addition, all 47 patients completed the Short-form 36-item Health Survey (SF-36) at week 0. Furthermore, an additional cohort of patients from the otology clinic who denied symptoms of rhinosinusitis or previous physician diagnoses of rhinosinusitis were asked to complete the SNOT-16. These scores were subsequently used to determine discriminant validity of the instrument. Cronbach's alpha was 0.89, indicating a high degree of homogeneity of the test items. The SNOT-16 demonstrated excellent discriminant validity, and mean total SNOT-16 scores were significantly correlated with patient-reported overall health, overall bother, and 7 of the 8 SF-36 subscales. The standardized response mean calculated between weeks 0 and 6 was 0.69, indicating moderate sensitivity to change. We conclude that the SNOT-16 is a reliable, valid, and responsive instrument for measuring rhinosinusitis-specific health-related quality of life.
Sujet(s)
Indicateurs d'état de santé , Rhinite , Sinusite , Adolescent , Adulte , Sujet âgé , Études d'évaluation comme sujet , Femelle , Humains , Mâle , Adulte d'âge moyen , Reproductibilité des résultatsRÉSUMÉ
The knowledge of and interest in Department of Defense programs to help medical students with their educational expenses in exchange for military service as a physician was studied at three medical schools representing the eastern (University of Medicine and Dentistry of New Jersey/New Jersey Medical School [UMDNJ/NJMS]), midwestern (University of Missouri at Kansas City), and western (University of Utah) United States. Despite staggering indebtedness (40% of the class of 1998 at the University of Medicine and Dentistry of New Jersey were in debt in excess of $100,000 at graduation), surprisingly few students were aware of programs such as the Health Professions Scholarship Program, the Health Professionals Loan Repayment Program, and the Specialized Training Assistance Program. Even fewer were interested when made aware of such financial assistance. Hostility to military service as a physician was common. "Patriotism" was seemingly anathema. Dwindling recruitment and retention of medical corps officers in the reserve components of our nation's armed forces is of grave concern to national security and flies in the face of medical students', hence young physicians', indebtedness for their education. Clearly Department of Defense programs must become more imaginative, certainly more financially appealing.
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Médecine militaire , Étudiant médecine , Adulte , Attitude , Choix de carrière , Femelle , Connaissances, attitudes et pratiques en santé , Humains , Mâle , Écoles de médecine , Étudiant médecine/psychologie , Soutien financier à la formation , États-UnisSujet(s)
Famille/psychologie , Relations dans la fratrie , Adolescent , Adulte , Études transversales , Femelle , Humains , Mâle , Relations parent-enfantRÉSUMÉ
A multiwavelength, high bandwidth (1 GHz) frequency-domain photon migration (FDPM) instrument has been developed for quantitative, non-invasive measurements of tissue optical and physiological properties. The instrument produces 300 kHz to 1 GHz photon density waves (PDWs) in optically turbid media using a network analyser, an avalanche photodiode detector and four amplitude-modulated diode lasers (674 nm, 811 nm, 849 nm, and 956 nm). The frequency of PDW phase and amplitude is measured and compared to analytically derived model functions in order to calculate absorption, mu a, and reduced scattering, mu s, parameters. The wavelength-dependence of absorption is used to determine tissue haemoglobin concentration (total, oxy- and deoxy- forms), oxygen saturation and water concentration. We present preliminary results of non-invasive FDPM measurements obtained from normal and tumour-containing human breast tissue. Our data clearly demonstrate that physiological changes caused by the presence of small (about 1 cm diameter) palpable lesions can be detected using a handheld FDPM probe.
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Tumeurs du sein/diagnostic , Région mammaire/cytologie , Région mammaire/anatomopathologie , Maladie fibrokystique du sein/diagnostic , Hémoglobines/analyse , Oxyhémoglobines/analyse , Spectrophotométrie IR/méthodes , Adulte , Ponction-biopsie à l'aiguille , Tumeurs du sein/anatomopathologie , Femelle , Maladie fibrokystique du sein/anatomopathologie , Humains , Adulte d'âge moyen , Photons , Post-ménopause , Préménopause , Valeurs de référence , Reproductibilité des résultats , Spectrophotométrie IR/instrumentationRÉSUMÉ
A 1-GHz multifrequency, multiwavelength frequency-domain photon migration instrument is used to measure quantitatively the optical absorption (mu(a)) and effective optical scattering (mu(s) ?) of normal and malignant tissues in a human subject. Large ellipsoidal (~10-cm major axis, ~6-cm minor axes) subcutaneous malignant lesions were compared with adjacent normal sites in the abdomen and back. Absorption coefficients recorded at 674, 811, 849, and 956 nm were used to calculate tissue hemoglobin concentration (oxyhemoglobin, deoxyhemoglobin, and total), water concentration, hemoglobin oxygen saturation, and blood volume fraction in vivo. Our results show that the normal and the malignant tissues measured in the patient have clearly resolvable optical and physiological property differences that may be broadly useful in identifying and characterizing tumors.
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BACKGROUND: Recent genetic evidence suggests that the most important environmental influences on normal and pathologic development are those that are not shared by siblings in the same family. We sought to determine the relationship between differences in parenting styles and depressive symptoms and antisocial behavior in adolescence, and to compare the influence of these nonshared experiences with genetic influences. METHODS: We studied 708 families with at least two same-sexed adolescent siblings who were monozygotic twins (93 families), dizygotic twins (99 families), ordinary siblings (95 families), full siblings in step families (181 families), half siblings in step families (110 families), and genetically unrelated siblings in step families (130 families). Data on parenting style were collected by questionnaire and by video recording of interaction between parents and children. RESULTS: Almost 60% of variance in adolescent antisocial behavior and 37% of variance in depressive symptoms could be accounted for by conflictual and negative parental behavior directed specifically at the adolescent. In contrast, when a parent directed harsh, aggressive, explosive, and inconsistent parenting toward the sibling, we found less psychopathologic outcome in the adolescent. CONCLUSIONS: Parenting behavior directed specifically at each child in the family is a major correlate of symptoms in adolescents. Furthermore, harsh parental behavior directed at a sibling may have protective effects for adolescents, a phenomenon we call the "siblin barricade."