Prevalence and distribution of exposure to Schmallenberg virus in Irish cattle during October 2012 to November 2013.

BACKGROUND: Schmallenberg virus (SBV) was first identified in November 2011. It is a novel Orthobunyavirus (family Bunyaviridae) whose main ill effect is congenital malformation of the musculoskeletal and central nervous systems. It is borne by Culicoides spp., and has spread extensively in western Europe. The first case of SBV in Ireland was diagnosed in October 2012. It was anticipated that once the virus emerged in Ireland that there would be wide scale or nationwide spread over the course of the 2013 vector season. The objectives of this study were to determine the seroprevalence and distribution of exposure to Schmallenberg virus in Irish cattle from November 2012 to November 2013. METHODS: Samples of brain for the pathology based surveillance were collected from malformed bovine and ovine foetuses submitted for post mortem examination. These samples were tested for SBV using RT-qPCR. Three serological surveys were carried out on sera submitted for the national brucellosis eradicartion programme. A spatial analysis of both sets of data was carried out. RESULTS: Between October 2012 and 10th May 2013, SBV was confirmed by RT-qPCR in brain tissues from malformed foetuses obtained from 49 cattle herds and 30 sheep flocks in Ireland. In national serosurveys conducted between November 2012 until November 2013 the herd-level and animal-level SBV seroprevalences in cattle were 53 and 36 % respectively for the first survey, 51 and 35 % for the second survey and 53 and 33 % for the third survey. The herd level seroprevalence in counties ranged from 0 to 100 %, with the counties in the south and southeast having the highest seroprevalence (>50 %), the midlands a moderate herd level seroprevalence (10-50 %) while northern and north western counties had a low herd level seroprevalence (0-10 %). There was close spatial agreement between the results of the two different targeted surveillance strategies. CONCLUSIONS: At the end of the 2012 vector season, there was widespread exposure to SBV among herds in southern and south eastern Ireland. During 2013, there was little or no evidence of further outward spread, unlike the situation in several other European countries. Given the lack of evidence for circulation of the virus since 2012, it is likely that the younger age cohort in herds previously exposed to SBV and substantial proportions of animals of all ages on the margins of affected areas are immunologically naïve to SBV, and would be susceptible to infection if the virus were to re-emerge.

Localization of a major susceptibility locus influencing preterm birth.

Preterm birth (PTB) is a complex trait, but little is known regarding its major genetic determinants. The objective of this study is to localize genes that influence susceptibility to PTB in Mexican Americans (MAs), a minority population in the USA, using predominantly microfilmed birth certificate-based data obtained from the San Antonio Family Birth Weight Study. Only 1302 singleton births from 288 families with information on PTB and significant covariates were considered for genetic analysis. PTB is defined as a childbirth that occurs at <37 completed weeks of gestation, and the prevalence of PTB in this sample was 6.4%. An ∼10 cM genetic map was used to conduct a genome-wide linkage analysis using the program SOLAR. The heritability of PTB was high (h(2) ± SE: 0.75 ± 0.20) and significant (P = 4.5 × 10(-5)), after adjusting for the significant effects of birthweight and birth order. We found significant evidence for linkage of PTB (LOD = 3.6; nominal P = 2.3 × 10(-5); empirical P = 1.0 × 10(-5)) on chromosome 18q between markers D18S1364 and D18S541. Several other chromosomal regions (2q, 9p, 16q and 20q) were also potentially linked with PTB. A strong positional candidate gene in the 18q linked region is SERPINB2 or PAI-2, a member of the plasminogen activator system that is associated with various reproductive processes. In conclusion, to our knowledge, perhaps for the first time in MAs or US populations, we have localized a major susceptibility locus for PTB on chromosome 18q21.33-q23.

Differences in pediatric dental services under general anesthesia for Medicaid and military dependent children.

PURPOSE: This study's purpose was to compare pediatric dental services provided for Medicaid and military dependent children to determine if differences in dental treatment choices exist based on site and payment method. METHODS: Subjects included 120 Medicaid patients at the University of Texas Health Science Center at San Antonio and 120 military dependents at Lackland Air Force Base, Texas. Demographic data and treatment information were abstracted for children younger than 6 years old receiving dental treatment under general anesthesia between 2002 and 2006. Data was analyzed using Wilcoxon rank sum, Kruskal-Wallis, and Fisher's exact tests. RESULTS: The Medicaid recipients were younger (40.2 vs 49.8 months, P<.001) and more likely to be Hispanic (78% vs 30%, P<.001). The means of decayed teeth, fillings, and stainless steel crowns did not differ between sites. Medicaid children received more composite fillings (P<.001), fewer amalgam fillings (P<.001), fewer pulp therapies (P<.001), more extractions (P=.01), and fewer sealants (P<.001). Age and gender did not affect decay rates, but those of Hispanic ethnicity did experience more decay than non-Hispanics (9.5 vs 8.6, P=.02). CONCLUSION: This study found no difference in the number of less conservative, albeit more costly, procedures performed with Medicaid children at a university compared to military dependents at a military base.

Salmonella surveillance in raw and cooked meat and meat products in the Republic of Ireland from 2002 to 2004.

The food industry, under the regulation of the Department of Agriculture and Food (DAF) in the Republic of Ireland, is required to undertake all microbiological testing in relation to zoonoses control, in laboratories approved by DAF. These laboratories submit a monthly report of all tests undertaken, together with all presumptive Salmonella isolates for confirmation, typing and storage to the Central Veterinary Research Laboratory (CVRL). Details of Salmonella tests on 110,229 raw and 25,189 cooked meat samples from 25 laboratories were recorded over the 3-year period 2002-2004. Salmonella spp. were isolated from 1.0% of the 110,229 raw meat samples and 0.1% of the 25,189 cooked meat samples tested. The percentage of raw meat samples contaminated with Salmonella decreased over the three-year period from 1.2% to 0.9%. There was no seasonal trend in the isolation of Salmonella from any of the meats or meat products. Recoveries of the organism were highest for turkey and chicken meats at 3.1% and 2.8%, respectively, followed by porcine meats at 2.1%. The recoveries were much lower for ovine meats and meat products at 0.2% and bovine meat and meat products at 0.16%.

Estimation of infection prevalence from correlated binomial samples.

Infection prevalence in a population often is estimated from grouped binary data expressed as proportions. The groups can be families, herds, flocks, farms, etc. The observed number of cases generally is assumed to have a Binomial distribution and the estimate of prevalence is then the sample proportion of cases. However, the individual binary observations might not be independent--leading to overdispersion. The goal of this paper was to demonstrate random-effects models for the estimation of infection prevalence from data which are correlated and in particular, to illustrate a nonparametric random-effects model for this purpose. The nonparametric approach is a relatively recent addition to the random-effects class of models and does not appear to have been discussed previously in the veterinary epidemiology literature. The assumptions for a logistic-regression model with a nonparametric random effect were outlined. In a demonstration of the method on data relating to Salmonella infection in Irish pig herds, the nonparametric method resulted in the classification of herds into a small number of distinct prevalence groups (i.e. low, medium and high prevalence) and also estimated the relative frequency of each prevalence category in the population. We compared the estimates from a logistic model with a nonparametric distribution for the random effects with four alternative models: a logistic-regression model with no random effects, a marginal model using a generalised estimating equation (GEE) and two methods of fitting a Normally distributed random effect (the GLIMMIX macro and the NLMIXED procedure both in SAS). Parameter estimates from random-effects models are not readily interpretable in terms of prevalences. Therefore, we outlined two methods for calculating population-averaged estimates of prevalence from random-effects models: one using numerical integration and the other using Monte Carlo simulation.

Case report: Unusual location of Dirofilaria immitis in a 28-year-old man necessitates orchiectomy.

The fourth case of zoonotic Dirofilaria immitis infection in a California resident is reported. This case was unique in that it involved the spermatic cord, produced significant symptoms, and upon physical examination was suspected of being an incarcerated inguinal hernia. At surgery frozen sections were inconclusive regarding neoplasia and cord involvement precluded removal of the mass without orchiectomy, which was done. Histopathology revealed a well-preserved immature male D. immitis, the canine heartworm, in a branch of the spermatic artery. The morphological identification of the worm was confirmed by polymerase chain reaction (PCR) studies. This case illustrates that D. immitis infections can complicate differential diagnosis of extrapulmonary lesions and suggests that the public health significance of this vector-borne filarial worm needs to be evaluated through appropriate epidemiological studies in enzootic areas.

Non-invasive measurement of organ density in a rat simulated microgravity model.

BACKGROUND: Spaceflight has caused serious concerns to the health and well-being of astronauts, both while in space and post-mission on Earth. The deleterious health effects due to microgravity are not well understood and though these effects may be caused by multiple factors, fluid shifts within the body may play a major role. HYPOTHESIS: We believe that 45 degrees C HDT will cause significant changes in organ density as measured by spiral computed tomography in a 1-h experimental time period. METHODS: There were 20 male Fischer 344 rats that were randomly selected to be in an experimental or control group. The experimental group (n = 12) was subjected to a 45 degrees head down tilt microgravity exposure (45 degrees HDT) for 1 h, and the control group (n = 8) remained in the prone position for the same amount of time. At the end of 1 h, the density of the brain, lungs, heart, liver, and left and right kidneys were measured using spiral computed tomography (SCT) while the rats remained in their experimental positions. RESULTS: With the exception of the right kidney, we demonstrated that there was a significant change (p < 0.05) in the densities of all tested organs in the 45 degrees HDT group when compared with the control group. The brain showed the largest percent increase at 45.6% while the lungs showed the least amount of change at 8.7%. CONCLUSIONS: We conclude there are significant increases in organ density, as measured by SCT, in male 45 degrees HDT rats compared with prone controls.

Birth weight and the metabolic syndrome: thrifty phenotype or thrifty genotype?

BACKGROUND: Inverse correlations have been reported between birth weight and the Metabolic Syndrome (abdominal obesity, insulin resistance, hyperinsulinemia, glucose intolerance, dyslipidemia, and hypertension). These correlations are thought to reflect primarily nutritional inadequacies during fetal and early life. We explored familial influences on these correlations. METHODS: Using birth weight data on 602 subjects from 65 pedigrees, we partitioned phenotypic correlations into familial and non-familial. The former are usually regarded as reflecting primarily genetic influences, although they may also reflect environmental influences that are shared by family members, and the latter reflect random environmental influences. RESULTS: A consistent pattern of positive familial and inverse non-familial correlations were observed. The strongest familial correlations were between birth weight and fasting insulin (r = 0.58, p = 0.002), leptin (r = 0.48, p = 0.021), split proinsulin (r=0.51, p = 0.090), and heart rate (r = 0.39, p = 0.037). An inverse familial correlation was observed with HDL cholesterol (r = -0.28, p = 0.018). Non-familial correlations were weaker and only two-- subscapular-to-triceps skinfold ratio and fasting insulin--were statistically significant. CONCLUSION: Since the familial and non-familial correlations were in opposite directions, we attribute the former to the pleiotropic effects of genes. Specifically, we conclude that genes that increase birth weight also worsen the Metabolic Syndrome in adult life. Since the inverse correlations reported in the literature reflect mainly cohorts born in the early part of the 20th century, improved maternal nutrition since then may have allowed the expression of genetic influences in our participants, all of whom were born after 1950.

A six-week clinical tooth whitening study of a new calculus-inhibiting dentifrice formulation.

This six-week double-blind clinical study compared the toothwhitening effects of a new calculus-inhibiting dentifrice containing pyrophosphate, tripolyphosphate and copolymer in a 0.243 sodium fluoride/silica base (Test Dentifrice) with two commercially available dentifrices: Aquafresh Whitening Toothpaste with Fluoride and Crest Regular Fluoride Toothpaste. After a baseline examination for extrinsic tooth stain, qualifying adult males and females from Manchester, United Kingdom and from Mississauga, Ontario, Canada were randomly assigned into three test groups. Each group was balanced for gender, tobacco habits and levels of tooth stain. Subjects were to brush their teeth twice daily with a soft-bristled toothbrush using the assigned toothpaste. One-hundred and twenty-eight (128) subjects complied with instructions and completed the trial. Subjects using the Test Dentifrice exhibited statistically less stain area and less stain intensity than did either the Aquafresh or Crest groups. Crest Regular Fluoride toothpaste was statistically less effective than Aquafresh Whitening toothpaste in removing stain. Results in this trial support the conclusion that a new dentifrice formulation containing pyrophosphate, tripolyphosphate and a copolymer, in a 0.243% sodium fluoride/silica base, effectively removes extrinsic tooth stain.

A six-week clinical efficacy study of a tooth whitening tartar control dentifrice for the removal of extrinsic tooth stain.

The objective of this double-blind clinical study was to investigate the tooth whitening efficacy of a new commercially available calculus-inhibiting dentifrice (Colgate Tartar Control Plus Whitening Fluoride dentifrice) containing tetra-sodium pyrophosphate, sodium tripolyphosphate, and PVM/MA copolymer in a 0.243% sodium fluoride/silica base (test dentifrice), compared to a commercially available, non-tooth whitening dentifrice containing 0.243% sodium fluoride in a silica base (control dentifrice). Following a baseline examination for, extrinsic tooth stain, qualifying adult male and female subjects from the Manchester, United Kingdom area were randomized into two treatment groups which were balanced for gender, age and level of extrinsic tooth stain. Subjects were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice using a soft-bristled toothbrush. Examinations for extrinsic tooth stain were repeated after six weeks' use of the study dentifrices. Seventy-nine(79) subjects complied with the protocol and completed the entire study. At the six-week examination, subjects assigned to the test dentifrice treatment group exhibited statistically significant reductions of over 40% with respect to both extrinsic tooth stain area and extrinsic tooth stain intensity relative to those subjects assigned to the control dentifrice treatment group.

Standardized perioperative care protocols and reduced length of stay after colon surgery.

BACKGROUND: Recent studies have suggested that critical pathways and standard order sets decrease hospital length of stay and improve quality of care. A recently conducted prospective, randomized study at our institution found that patients undergoing elective colon resections had earlier return of bowel function if perioperative epidural anesthesia and analgesia were provided. All patients in the study were also placed on a standardized perioperative regimen. We hypothesized that the standardized perioperative protocol used in this study contributed to early return of bowel function and hospital discharge compared with similar patients managed off protocol. STUDY DESIGN: To test this hypothesis, we performed a case-controlled study comparing the hospital courses of 36 study patients to 36 control patients undergoing colorectal surgery by the same surgeons during the same calendar year. The distribution of types of operations and anesthetic techniques was similar in both groups. RESULTS: As dictated by the protocol, all study patients had their nasogastric tubes removed, were started on a low fat liquid diet, and ambulated in the first postoperative day. Nasogastric tubes were removed in control patients and study patients 2.2 +/- 0.9 (mean value +/- SD) and 1.0 +/- 0.0 days postoperatively, respectively. Control patients were started on an oral diet, usually clear liquids, an average of 2.9 +/- 1.1 days postoperatively, a specific liquid diet was started 1.0 day postoperatively in study patients (p < 0.001). Return of bowel function, as determined by bowel tones, flatus, and bowel movements, occurred approximately 1 day earlier in study patients. Study patients were discharged 1 day sooner than control patients. CONCLUSIONS: Our results suggest that the return of bowel function and the length of stay of patients undergoing colon surgery are improved if patients are entered into a standardized protocol that eliminates variation in intraoperative and postoperative anesthesia and postoperative surgical care. We believe these results can be reproduced in routine clinical surgery by having a clearly outlined protocol for perioperative care similar to that used in this study.

Efficacy of a mouthrinse containing 0.05% cetylpyridinium chloride for the control of plaque and gingivitis: a 6-month clinical study in adults.

The objective of this 6-month, double-blind, clinical study, conducted following the American Dental Association (ADA) guidelines, was to provide an assessment of the effectiveness of a newly developed mouthrinse containing 0.05% cetylpyridinium chloride (CPC) for the control of supragingival dental plaque and gingivitis. Adult men and women from the Manchester, England, area were entered in the study, and stratified into two treatment groups (CPC mouthrinse and control mouthrinse), which were balanced for baseline Quigley-Hein Plaque Index scores and baseline Löe-Silness Gingival Index scores. Participants were given an oral prophylaxis and instructed to brush their teeth twice daily (morning and evening) for 1 minute with a soft-bristled toothbrush and fluoride dentifrice provided, immediately followed by rinsing for 30 seconds with 15 cc of their assigned mouthrinse. Examinations for supragingival plaque and gingivitis were conducted after 3 months' and again after 6 months' participation in the study. One hundred eleven participants complied with the protocol and completed the entire 6-month clinical study. At both the 3- and 6-month study examinations, the CPC mouthrinse group exhibited statistically significantly less supragingival plaque and gingivitis than did the control mouthrinse group. At the 6-month examination, the magnitude of these differences met or exceeded 24% for all 4 parameters measured (28.2% for Quigley-Hein Plaque Index, 63.4% for Plaque Severity Index, 24.0% for Löe-Silness Gingival Index, and 66.9% for Gingivitis Severity Index). The magnitude of the reductions in supragingival plaque and gingivitis were adequately large to support a claim of efficacy, in accordance with the criteria provided by the published guidelines of the ADA for the demonstration of the efficacy of a chemotherapeutic agent for the control of supragingival plaque and gingivitis. Thus, the results of this 6-month clinical study support the conclusion that a newly developed mouthrinse containing 0.05% cetylpyridinium chloride provides a statistically significant, clinically relevant level of efficacy for the control of supragingival plaque, and for the control of gingivitis, in accordance with the criteria provided by current ADA guidelines.

Decline of tuberculosis mortality in an urban Mexican-origin population, 1935-1984.

Through a series of life table analyses, this paper describes the natural history of tuberculosis mortality in a Mexican-origin community over five decades (1935-84) during which the disease underwent a transition from a major underlying cause of death to a disease conditioned mentioned more often on death certificates as contributing to death than causing death. The decline in death rates from 1940 to 1950 was especially remarkable. Successive birth cohorts of Mexican Americans, separated by as little as five years of age, experienced distinctly lower risk of death from tuberculosis as they entered young adulthood. There was a rapid convergence in age-specific patterns of tuberculosis death rates in Mexican Americans toward those of non-Hispanic whites, so that by 1960 tuberculosis was primarily a cause of death in old age rather than young adulthood. The impact of changing environment, both through improvements of conditions within neighborhoods and through residential mobility, on birth cohorts at risk of tuberculosis needs to be examined in further research.

PIP: This study examines the history of tuberculosis mortality during 1935-84 among a Mexican-origin community in Bexar County, Texas. Data were obtained from death records of the San Antonio Metropolitan Health District. Data coding accounted for the shift in 1949 in formatting underlying cause and primary cause of death. Deaths are estimated from multiple decrement life tables for deaths by age and underlying cause in a hypothetical cohort of 100,000 newborns followed to their deaths. Cause-eliminated life tables show the distributions of deaths if tuberculosis were eliminated. Findings indicate that life expectancy of Mexican-origin people in Bexar County during 1938-42 was about 47 years for males and females. Life expectancy for Anglos was higher but still lower than the national average. By 1980, differences in life expectancies by ethnic group converged. The rapid increases in life expectancy occurred during the 1940s: 12.7 years for Mexican-origin women and 10.3 years for Mexican-origin men. The 1940 risk of tuberculosis death among Mexican-origin people was 5-7 times that of Anglos. Among the 1940s Mexican-origin population, tuberculosis caused heavy fatalities in early adulthood between the ages of 15 and 35 years. By 1960, it was a cause only in old age, as it was among Anglos. Cohort comparisons reveal that the cohort reaching the age of 15 years in 1945 had a mortality probability that was only half as great to age 20 in 1950. The mortality probability declined to near zero by age 25 in 1955. The life table proportion of deaths due to tuberculosis declined linearly and added to life expectancy until 1980. Tuberculosis was the underlying cause of death among 96% of Mexican-origin people in 1938-42 and 41% in 1983-85. Tuberculosis morbidity declined during the 1940s and 1950s due to major housing renewal, slum clearance, code enforcement, and residential mobility.

Antibody isotype responses to experimental infection with bovine herpesvirus 1 in calves with colostrally derived antibody.

Calves, both positive and negative for maternal antibody to bovine herpesvirus 1 (BHV-1), were infected with BHV-1 and their serum antibody isotype responses were measured post-infection. In the case of maternal antibody negative calves there was a classical humoral response to the virus with an early IgM peak followed by IgG1 and IgG2 responses. In maternal antibody positive calves, although infection was established, no active antibody response was detected in serum except for a transient IgM peak in a single calf. By contrast, a delayed-type hypersensitivity test response could be elicited in both groups of calves by intradermal inoculation of nucleocapsid antigen at 4.5 months after the initial infection. The intradermal antigen also stimulated an antibody response. In calves with high levels of maternal antibody at the start of the experiment, and which were not subsequently infected, maternal antibody waned to negative levels by seven months of age. They were skin test negative and did not show a serological response to skin test antigen. It was concluded that isotype specific serology could not be used to distinguish calves with passive immunity to BHV-1 from those with active immunity and putative latent infection. Although the skin test had potential to provide such a distinction, it could compromise future serological monitoring of the animals.

Posttraumatic Budd-Chiari syndrome treated with thrombolytic therapy and angioplasty.

Injury of the hepatic veins or suprahepatic inferior vena cava is a rare cause of Budd-Chiari syndrome. Treatment of this syndrome has primarily involved hepatic venous decompression with a variety of portosystemic shunts. We report a case of thrombosis of the inferior vena cava after blunt injury managed with interventional radiologic techniques.

Improved identification of noisy spectra using higher-ordered correlation spectral analysis.

We used a higher-order correlation-based method of comparison for spectral identification. Higher-order correlations are an extension of the more familiar second-order cross-correlation function and have the significant advantage of being theoretically shown to eliminate noise of unknown spectral density under certain conditions. Specifically, we applied a third-order correlation technique to the identification of similar IR spectra in the presence of noise. We were able to reduce the effects of noise from a second-order correlation measurement by further processing the measurement with a third-order autocorrelation. Our results showed that the third-order correlation-based method increased the probability of detection of a spectrum in the presence of noise, when compared to using a second-order technique alone. The probability of detection increased enough at low signal-to-noise ratios that this technique may be useful when a second-order correlation technique is not acceptable. The third-order technique is applicable to a single experiment, but improved results were found by averaging the results of multiple experiments.

Emergence of diabetes mellitus in a Mexican-origin population: a multiple cause-of-death analysis.

The "New World syndrome" is comprised of disorders that are hypothesized to have resulted from an interaction of the Amerindian genotype with an environment that includes marked changes in lifestyle and diet. The principal component of the syndrome is adult-onset (noninsulin dependent) diabetes mellitus. The purpose of this paper is to describe the emergence of diabetes in a Mexican-origin population. Using a unique file of multiple-cause mortality data, we have computed standardized mortality ratios and relative standardized mortality ratios for Mexican-origin individuals and for other white persons age 30 and over from the 1930's through the middle 1980's. Results for the study population residing in Bexar County (San Antonio), Texas, show that diabetes mortality for Mexican-origin individuals did indeed increase in a pattern consistent with the New World syndrome hypothesis. This study is the first description of the emergence of diabetes using a data set with consistently defined causes of death and demographic characteristics.

Birthweight and adult health outcomes in a biethnic population in the USA.

Recent data indicate that low-birthweight adults are at a higher risk than their high-birthweight peers of developing ischemic heart disease or a cluster of conditions known as the IRS, which includes dyslipidaemias, hypertension, unfavorable body fat distribution and NIDDM. Thus far these observations have been limited to Caucasians from the United Kingdom. we extended these observations to a broader segment of the general population by studying the association of birthweight and adult health outcomes in a biethnic population of the United States. We divided a group of 564 young adult Mexican-American and non-Hispanic white men and women participants of the San Antonio Heart Study into tertiles of birthweight and compared metabolic, anthropometric, haemodynamic, and demographic characteristics across these tertile categories. Additionally, we studied birthweight as a predictor of the clustering of diseases associated with the IRS, defined as any two or more of the following conditions: hypertension, NIDDM or impaired glucose tolerance, dyslipidaemia. Normotensive, non-diabetic individuals whose birthweight was in the lowest tertile had significantly higher levels of fasting serum insulin and a more truncal fat deposition pattern than individuals whose birthweight was in the highest tertile, independently of sex, ethnicity, and current socioeconomic status. Also, the odds of expressing the IRS increased 1.72 times (95% confidence interval: 1.16-2.55) for each tertile decrease in birthweight. These findings were independent of sex, ethnicity, and current levels of socioeconomic status or obesity. In conclusion, low birthweight could be a major independent risk factor for the development of adult chronic conditions commonly associated with insulin resistance in the general population.