Can there be a common, risk-based framework for decisions around live insect trade?

A network of scientists involved in shipment of live insects has met and generated a series of articles on issues related to live insect transport. The network is diverse, covering large-scale commercial interests, government operated areawide control programmes, biomedical research and many smaller applications, in research, education and private uses. Many insect species have a record of safe transport, pose minimal risks and are shipped frequently between countries. The routine shipments of the most frequently used insect model organism for biomedical research, Drosophila melanogaster, is an example. Successful large scale shipments from commercial biocontrol and pollinator suppliers also demonstrate precedents for low-risk shipment categories, delivered in large volumes to high quality standards. Decision makers need access to more information (publications or official papers) that details actual risks from the insects themselves or their possible contaminants, and should propose proportionate levels of management. There may be harm to source environments when insects are collected directly from the wild, and there may be harm to receiving environments. Several risk frameworks include insects and various international coordinating bodies, with experience of guidance on relevant risks, exist. All stakeholders would benefit from an integrated overview of guidance for insect shipping, with reference to types of risk and categories of magnitude, without trying for a single approach requiring universal agreement. Proposals for managing uncertainty and lack of data for smaller or infrequent shipments, for example, must not disrupt trade in large volumes of live insects, which are already supporting strategic objectives in several sectors.

À l'occasion d'une réunion d'experts, un réseau de chercheurs travaillant sur l'expédition d'insectes vivants a produit un ensemble d'articles traitant des questions liées au transport des insectes vivants. Ce réseau est diversifié et représente un large éventail d'intérêts privés et de programmes de lutte biologique à grande échelle menés par les pouvoirs publics, en plus du secteur de la recherche biomédicale et de nombreux acteurs intervenant dans des applications de plus petite envergure relevant de la recherche, de l'enseignement ou du secteur privé. Un grand nombre d'espèces d'insectes sont transportées en toute sécurité avec un niveau de risque minimal, y compris lors des fréquentes expéditions internationales. Un exemple de ces expéditions régulières concerne l'espèce la plus utilisée par la recherche biomédicale en tant qu'organisme modèle, à savoir Drosophila melanogaster. Les exemples réussis d'expéditions à grande échelle provenant de fournisseurs d'agents de lutte biologique et de pollinisateurs produits par le secteur privé offrent également un relevé documenté des diverses catégories d'expéditions à faible risque pour des livraisons d'insectes vivants en grandes quantités et répondant à des normes de qualité élevées. Les décideurs politiques devraient pouvoir accéder à plus d'informations (à travers des publications ou des articles officiels) décrivant en détail les risques réels associés aux insectes eux-mêmes ou à leurs contaminants éventuels, et proposer en connaissance de cause des niveaux de gestion proportionnels à ces risques. La récolte d'insectes prélevés directement de la nature peut être dommageable aussi bien pour les environnements source que pour ceux de destination. Plusieurs cadres fondés sur le risque intègrent désormais les insectes dans leurs directives. Par ailleurs, nombre d'organismes internationaux de coordination ont acquis une expérience dans l'élaboration de lignes directrices face à ces risques. Il serait bénéfique pour toutes les parties prenantes de disposer d'une vue d'ensemble intégrée des directives applicables aux expéditions d'insectes, qui recense les différents types de risque et leurs ordres de grandeur sans se prononcer sur une approche unique qui nécessiterait une adhésion universelle. Ni les propositions visant à gérer l'incertitude ni l'insuffisance des données disponibles sur les expéditions d'insectes en petits nombres ou occasionnelles ne doivent perturber les échanges commerciaux d'insectes vivants en grandes quantités, échanges qui participent aujourd'hui aux objectifs stratégiques de nombreux secteurs.

Una red de científicos relacionados de un modo u otro con el transporte de insectos vivos mantuvo un encuentro y generó una serie de artículos en torno a la cuestión. En la red, muy heterogénea, convergen desde intereses comerciales de gran calado hasta programas públicos de lucha biológica en grandes territorios, pasando por la investigación biomédica y por numerosas aplicaciones de menor dimensión en ámbitos como la investigación, la enseñanza u otros usos privados. Muchas especies de insectos cuentan con un buen historial de seguridad en el transporte, presentan un riesgo mínimo y son expedidas a menudo de un país a otro. Buen ejemplo de ello son los envíos sistemáticos de ejemplares de Drosophila melanogaster, que es el insecto utilizado con más frecuencia como organismo modelo en la investigación biomédica. Otro precedente de envíos voluminosos cuyo transporte y entrega se ajusta a los más exigentes criterios de calidad lo sientan las remesas de grandes cantidades de polinizadores y agentes de control biológico remitidos por proveedores comerciales. Los responsables de adoptar decisiones deben disponer de más y más detallada información (publicaciones o documentos oficiales) sobre los riesgos reales derivados de los propios insectos o sus posibles contaminantes para proponer a partir de ahí medidas de gestión proporcionadas. Los perjuicios ambientales pueden darse tanto en origen (cuando hay captura salvaje de insectos, o sea recolección directa en el medio) como en destino. Hay varios sistemas de determinación del riesgo que incluyen a los insectos y también existen diversos organismos de coordinación internacional que ya tienen experiencia en sentar pautas sobre los riesgos en la materia. Todos los interlocutores del sector se beneficiarían de una visión global e integrada del transporte de insectos, que remita a diferentes tipos de riesgo y categorías de magnitud, sin necesidad de buscar un sistema único que exija consenso universal. Las propuestas para gestionar la incertidumbre y la falta de información en el caso de envíos infrecuentes o de pequeñas dimensiones, por ejemplo, no deben interferir en el transporte de grandes cantidades de insectos vivos, que ya está sirviendo a objetivos estratégicos en varios sectores.

Shipment of insects and related arthropods into and out of India for research or commercial purposes.

This paper provides a concise summary of the guidelines and regulations that govern the shipment of insects and related arthropods into and out of India. It discusses the Plant Quarantine (Regulation of Import into India) Order, 2003, which regulates the import of agents for biological control, and the Biological Diversity Act, 2002, and associated Biological Diversity Rules, 2004, which guide the transfer of insects and related arthropods for identification, taxonomic research, and commercial purposes. Insect trade for some food and feed purposes is also mentioned. Finally, some implications, conclusions and recommendations are presented.

Les auteurs présentent succinctement les directives et réglementations régissant les expéditions d'insectes et autres arthropodes connexes à destination et en provenance de l'Inde. Ils examinent le décret de 2003 relatif à la quarantaine végétale (réglementation des importations en Inde), qui couvre également les importations d'agents destinés à la lutte biologique, ainsi que la loi de 2002 sur la diversité biologique et les dispositions réglementaires de 2004 qui lui sont associées concernant les transferts d'insectes et autres arthropodes connexes à des fins d'identification, de recherche taxonomique et de commerce. Le commerce d'insectes destinés à la production de denrées alimentaires ou d'aliments pour animaux est également mentionné. Enfin, les auteurs exposent un certain nombre de conséquences, de conclusions et de recommandations en la matière.

Los autores resumen sucintamente las directrices y reglas que rigen los envíos de entrada o salida de la India de insectos y otros artrópodos conexos. En este sentido, exponen el Decreto de Cuarentena Vegetal (Reglamento de Importaciones a la India) de 2003, que regula la importación de agentes destinados a actividades de control biológico, y la Ley de Diversidad Biológica de 2002 y el correspondiente Reglamento de Diversidad Biológica de 2004, que rigen el traslado de insectos y otros artrópodos conexos con fines de identificación, investigación taxonómica o comercio. Tras referirse al comercio de insectos con determinados fines de alimentación humana o animal, acaban exponiendo ciertas consecuencias de todo ello y presentando una serie de conclusiones y recomendaciones al respecto.

Re-Emergence of Tetanus in a District Referral Hospital

Tetanus is an acute, potentially fatal disease caused by Clostridium tetani. It is characterized by generalized, painful spasms and rigidity of skeletal muscles. We present two fatal cases and discuss the potential causes that lead to mortality in cases of tetanus infection.

Efficacy and safety of montelukast add-on therapy in allergic rhinitis.

Allergic rhinitis is a common airways hypersensitivity disease. Histamine and leukotrienes are involved in the pathogenesis of allergic rhinitis. Conventional treatments include topical steroids and antihistamines. Due to the adverse effects of these treatments, new drugs like leukotriene receptor antagonists are being investigated for the treatment of allergic rhinitis. A total of 90 patients suffering from allergic rhinitis were enrolled in this prospective, randomized, controlled study. Patients were divided randomly into three groups of 30 patients each. Group I was administered fluticasone nasal spray (200 µg in each nostril) once a day, Group II was administered fluticasone nasal spray (200 µg in each nostril) plus cetrizine (10 mg) orally once a day and Group III was administered fluticasone nasal spray (200 µg in each nostril) plus montelukast (10 mg) orally once a day. Efficacy was measured based on daytime and nighttime symptom scores. Safety was evaluated on the basis of psychomotor tests, laboratory investigations and subjective assessment. The present study showed that montelukast add-on therapy is as efficacious as conventional therapies in controlling total symptom score, but it is more efficacious in controlling nighttime symptoms. Furthermore, montelukast add-on therapy does not cause psychomotor impairment as observed with cetrizine.

Can carotid ultrasound predict plaque histopathology?

AIM: European and North American studies have confirmed the benefits of carotid endarterectomy for patients with symptomatic carotid artery stenoses >70%. However, the management of asymptomatic patients and those with lesser degrees of stenosis is less certain. Several studies have suggested that, for these subgroups, the targeting of potentially unstable plaques, may help to identify those most at risk of cerebrovascular accidents and thus most likely to benefit from surgery. The aim of this study was to correlate the ultrasound features of carotid artery stenosis with the histopathological findings of the carotid endarterectomy specimens in order to identify features which will allow preoperative identification of clinically unstable plaques. METHODS: Sixty consecutive patients with symptomatic, critical carotid stenosis were prospectively studied. Plaques were classified preoperatively into one of five types based on their echogenicity and were also assessed for irregularity and ulceration. These findings were then compared with the histopathological findings of the endarterectomy specimen. RESULTS: Of 33 plaques considered on ultrasound to be uniformly or predominantly echolucent (unstable), 27 were found to be largely fatty or haemorrhagic (PPV =82%). Of 17 plaques considered to be predominantly echogenic (stable) on ultrasound, 11 were found to be predominantly fibrotic (PPV = 65%). Correlation between ultrasound irregularity or ulceration and histopathology was poor. CONCLUSION: In routine clinical practice, ultrasound can identify with reasonable accuracy, plaques that are predominantly haemorrhagic or fatty, and therefore potentially unstable. This may have future implications in selection of patients for surgery.

Epizootics of an entomopathogenic fungus Entomophthora aphidis Hoggman on the pomegranate aphid aphispunicae passerini (Homoptera: Aphididae).

Thrips of late are becoming more resurgent in agro-ecosystems especially in India and South Asian countries. One of the reasons attributed is the development of resistance in them to groups of insecticides of organo phosphates, carbamates, synthetic pyrethroids, etc., which form the core of recommendation for thrips management. The chilli thrips, Scirtothrips dorsalis Hood, is no exception and is tending to be an unmanageable pest. In S. dorsalis, besides evidence of resistance, elimination of natural enemies like Orius sp. is evident, which also probably explains the thrips resurgence. Scirtothrips dorsalis is highly polyphagous and of late has become serious on grapes. The damage is manifested as scab on fruit rind, affecting internal and export markets. Fortunately, it does not vector any virus on grapes in India. Farmers have been reporting inefficacy of established chemicals like acephate, dimethoate, monocrotophos, etc. As grapes is an important cash crop of horticulture, management through insecticides, require alternate or new insecticides. So two trials in 2005 on cv. Bangalore Blue following April and October prunings were conducted at the Indian Institute of Horticultural Research (IIHR), Bangalore, S. India to evaluate two doses of a newer molecule viz. Clothianidin [Dantop] on S. dorsalis. Clothianidin 0.006%, Clothianidin 0.008% were compared with monocrotophos 0.05%, dimethoate 0.06% and acephate 0.1125%. There was an untreated check. Each treatment was replicated five times; a vine constituted a replicate. These data were subjected to ANOVA, after arc sine transformation. The critical difference (CD) at p < 0.05 was the test criterion. In the first trial it was found that all the insecticides tried were superior to check and were on par at p < 0.05. However, Clothianidin 0.008% gave the best control with a low mean of 0.26% berry damage/bunch as compared to 4.42% in the unsprayed check. The trend was the same in the second trial also with Clothianidin 0.008% giving the best control with 0.64% berry damage/bunch as compared to 8.49% in the unsprayed check. It was on par with acephate and monocrotophos, but significantly superior to Clothianidin 0.006% and dimethoate.

Analysis of the prognostic implications of different tumour margin types in renal cell carcinoma.

AIMS: Invasion of perinephric tissues is part of the Union Internationale Contre le Cancer (UICC) (1997) T staging criteria for renal cell carcinoma (RCC) and appears to confer a worse prognosis. However, there are no established histological criteria to determine if this has occurred and histopathologists differ in their interpretation of the tumour margin. The purpose of this study was to determine histological criteria for invasion of perinephric tissues that may be used in staging. METHODS AND RESULTS: We assessed the prognostic implications of different margin types in 176 cases of RCC with good follow-up data. The tumour margin type in each cases was classified as follows: fibrous tumour capsule; rim of kidney; fibrous capsule with 'collar stud' invasion; pushing margin, no capsule; and tumour cell invasion of fat. The margin types were used in univariate and multivariate survival analysis to determine which had most impact on disease-free survival. In Cox regression analysis with all other influential covariates cellular invasion of fat was the only margin type that had any prognostic impact, conferring a 2.9 relative hazard compared with tumours with a fibrous capsule (P = 0.007). CONCLUSIONS: For staging purposes the designation of a tumour as invading perinephric tissues should be limited to those cases that have tumour cells invading the perinephric fat.

Evaluation of a protocol for examining nephrectomy specimens with renal cell carcinoma.

AIMS: To evaluate the practicality of use and the effectiveness of a standard protocol for examining nephrectomy specimens for renal cell carcinoma (RCC), with emphasis on the identification of vascular invasion. METHODS: A standard protocol, devised to identify the major prognostic determinants, was used to examine 79 consecutive tumours submitted to four histopathology departments. The incidence of vascular invasion found was compared with the incidence in a historical series of tumours. RESULTS: The protocol proved easy to follow, and appeared to increase the incidence of observed vascular invasion (40 of 69 cases compared with 69 of 176 cases in the historical series; p = 0.059, Fishers exact test, one sided) CONCLUSIONS: If pathological prognostic determinants are to be used for clinical management, then it is important that they are identified and recorded consistently. The protocol described provides a method of examining nephrectomy specimens that can be used in routine practice and would probably reliably identify recognised prognostic variables.

Diagnostic difficulty arising from displaced epithelium after core biopsy in intracystic papillary lesions of the breast.

This study reports two cases of intracystic papillary carcinoma of the breast, which had been biopsied preoperatively using a 14 gauge (14G) core biopsy needle. In each case, a needle tract containing groups of epithelial cells within granulation tissue could be identified on histology of the excised specimen. Both cases showed extracapsular tumour, which was interpreted as displacement of epithelium related to preoperative core biopsy. Subsequent axillary lymph node sampling showed no evidence of metastasis. In one case, extracapsular tumour appeared to be in blood vessels, but flattened cells lining the spaces containing tumour failed to react with factor 8 related antigen or CD34 on immunohistochemistry. It is likely that intracystic papillary carcinomas are particularly prone to this artefact because friable tumour fragments escape, accompanied by cyst fluid, when the capsule is punctured by a 14G core biopsy needle.

Contribution of grade, vascular invasion and age to outcome in clinically localized renal cell carcinoma.

OBJECTIVE: To determine the relative prognostic importance of microvascular invasion in apparently localized renal cell carcinoma (RCC). PATIENTS AND METHODS: A retrospective clinical and pathological review was conducted of 176 consecutive patients identified from pathology records who had a nephrectomy for RCC with a median follow-up of 44 months. Vascular invasion was recorded and categorized by the level of microvascular invasion (MVI), renal vein invasion (RVI) and inferior vena cava invasion (IVCI). Tumour type, grade and size were also assessed. These variables were assessed by univariate and multivariate analysis to determine their effect on disease-free survival. RESULTS: In the univariate analysis tumour size, grade, vascular invasion and young age each predicted reduced disease-free survival. On multivariate analysis for all 176 patients, grade, vascular invasion and young age were the significant independent predictors of reduced disease-free survival. In a subgroup of 149 patients from whom those with very high risk determinants were excluded (those with grade 4 tumours and/or IVCI) most of the risk of metastasis could be accounted for by vascular invasion and young age alone (MVI vs no vascular invasion, hazard ratio 3.18, 95% confidence interval 1.29-7.84; RVI vs no vascular invasion 2.41, 0.989-5.89; and age per year 0.963, 0.94-0.992). CONCLUSIONS: Grade, vascular invasion and young age are the main independent predictors of relapse in clinically localized RCC after nephrectomy. For most patients, who do not have very high risk indicators, the main adverse predictors are vascular invasion and young age. These findings are important when selecting patients for trials of adjuvant therapy and have implications for pathological staging.

Amebic liver abscesses masquerading as pyemic abscesses.

We describe a 50-year-old man who presented with multiple liver abscesses that suggested biliary sepsis or portal pyemia. A wet preparation of a sample of aspirate showed the presence of amebic trophozoites, and subsequent serological testing for amebae was strongly reactive.

Adrenal insufficiency in HIV infection: a review and recommendations.

Adrenal insufficiency is known to be a complication of HIV infection, although estimates of its prevalence and severity vary. Adrenal insufficiency is the most serious endocrine complication that occurs in persons with HIV infection. Patients with acquired immune deficiency syndrome (AIDS) are considered to be at high risk for primary or secondary adrenal insufficiency. We describe 3 patients with AIDS who had clinical features suggestive of adrenal insufficiency, but their corticotropin (ACTH) stimulation tests were normal. Repeat testing confirmed the diagnosis in one patient, and further testing with the overnight metyrapone test revealed evidence of secondary adrenal insufficiency in the other patients. Persistent clinical improvement was evident on subsequent glucocorticoid therapy. A normal response to the ACTH stimulation test can be dangerously misleading. Patients with AIDS and suspected adrenal insufficiency who have normal screening by the ACTH stimulation test should undergo further testing for secondary adrenal disease.

Peritonsillar abscess-a clinico-bacteriological study.

This study comprised 32 cases of peritonsillar obscess (PTA)constitutint 0.08% of ENT outdoor cases and 0.80% of indoor admission. Age ranged from 14 years to 58 years(mean 34.21 ± 10.25 SD years). Male predominance was seen in the ratio of 1.69:1. A triad of symptoms comprising pain, fever and peritonillar swelling was seen in 29 (90.62%) cases. Ipsilateral jugulodigastric lymphnode enlargement was the commonest sign present in all the cases. Bacterial culture was positive in 25 (78.12%) cases. Most common aerobic organism isolated was Group A beta hemolytic streptococcus (GABHS) seen on 10 (27.77%) cases. Anaerobic culture could be done in 22 cases only. It was positive in 11 (50%) cases. Commonest isolate was Peptostreptococcus seen in 4 (18.18%) cases.

Consistency in the observation of features used to classify duct carcinoma in situ (DCIS) of the breast.

AIM: To determine interobserver and intra-observer agreement in the assessment of cytological grade and intraduct necrosis in pure duct carcinoma in situ (DCIS) of the breast. METHODS: Sixty unselected cases with illustrated diagnostic criteria were circulated to 19 practising histopathologists. RESULTS: Overall agreement was moderate for cytological grade in three categories: 71% agreement; weighted kappa (kappa w), 0.36; intraduct necrosis in three categories (absent, present, extensive): 76% agreement; kappa w, 0.57; and the Van Nuys classification system: 73% agreement; kappa w, 0.48. Agreement was no better among observers participating in the National External Quality Assurance Programme. Intra-observer agreement for cytological assessment (69.6% agreement; kappa w, 0.52) and intraduct necrosis (68.3% agreement; kappa w, 0.48) was moderate, suggesting that individual variation rather than precision of criteria contributes to the lack of agreement. CONCLUSIONS: Moderate agreement on observations can be achieved by non-specialist pathologists, with better agreement on necrosis than cytological grade. There was evidence of consistent individual bias towards over or under scoring cytological grade, which could be corrected with adequate and prompt feedback.

Human immunodeficiency virus infections in adolescents.

Human immunodeficiency virus (HIV) infection, once largely confined to adolescents with hemophilia, has come to involve the general adolescent population. Individuals younger than 22 years comprise up to 25% of the people newly infected with HIV. Unsafe sexual practices, intravenous drug abuse, homelessness, psychiatric disorders, and inadequate psychosocial support are only some of the factors that have contributed to the epidemic. Present data indicate that interventions have had a positive impact on adolescent behavior in preventing the continuing spread of the disease, but more needs to be accomplished before we consider the problem controlled. Although proper medical treatment and providing adequate psychological and social support to adolescents who are already infected constitute an important aspect of care, the true solution of the problem lies in altering the behavior and practices that lead to the acquisition of this infection.

Is a grandmal seizure necessary and sufficient for the efficacy of electro convulsive therapy?

This paper highlights the recent research findings which suggest that the old teaching that a grandma! seizure is both necessary and sufficient for the efficacy of electroconvulsive therapy (ECT) is not correct. It is necessary; but not sufficient. The stimulus intensity should be adjusted so that it is far above the seizure threshold in order to get maximum efficacy of ECT.