Bluetongue and epizootic haemorrhagic disease virus in local breeds of cattle in Kenya

The presence of bluetongue virus (BTV) and Epizootic Haemorrhagic Disease virus (EHDV) in indigenous calves in western Kenya was investigated. Serum was analysed for BTV and EHDV antibodies. The population seroprevalences for BTV and EHDV for calves at 51 weeks of age were estimated to be 0.942 (95% CI 0.902–0.970) and 0.637 (95% CI 0.562–0.710), respectively, indicating high levels of circulating BTV and EHDV. The odds ratio of being positive for BTV if EHDV positive was estimated to be 2.57 (95% CI 1.37–4.76). When 99 calves were tested for BTV and EHDV RNA by real-time RT-PCR, 88.9% and 63.6% were positive, respectively. Comparison of the serology and real-time RT-PCR results revealed an unexpectedly large number of calves that were negative by serology but positive by real-time RT-PCR for EHDV. Eight samples positive for BTV RNA were serotyped using 24 serotype-specific real-time RT-PCR assays. Nine BTV serotypes were detected, indicating that the cattle were infected with a heterogeneous population of BTVs. The results show that BTV and EHDV are highly prevalent, with cattle being infected from an early age.

Lung and heart allocation in the United States

Lung and heart allocation in the United States has evolved over the past 20-30 years to better serve transplant candidates and improve organ utilization. The current lung allocation policy, based on the Lung Allocation Score, attempts to take into account risk of death on the waiting list and chance of survival posttransplant. This policy is flexible and can be adjusted to improve the predictive ability of the score. Similarly, in response to the changing clinical phenotype of heart transplant candidates, heart allocation policies have evolved to a multitiered algorithm that attempts to prioritize organs to the most infirm, a designation that fluctuates with trends in therapy. The Organ Procurement and Transplantation Network and its committees have been responsive, as demonstrated by recent modifications to pediatric heart allocation and mechanical circulatory support policies and by ongoing efforts to ensure that heart allocation policies are equitable and current. Here we examine the development of US lung and heart allocation policy, evaluate the application of the current policy on clinical practice and explore future directions for lung and heart allocation.

Virological diagnosis of African swine fever--comparative study of available tests

The rapid and reliable detection of African swine fever virus (ASFV) is essential both for timely implementation of control measures to prevent the spread of disease, and to differentiate African swine fever (ASF) from other pig disease with similar clinical presentations. Many virological tests are currently available for the detection of ASFV (live virus), antigen and genome, including virus isolation, ELISA, fluorescent antibody, polymerase chain reaction (PCR) and isothermal assays. In recent years real-time PCR (rPCR) has become one of the most widely used formats for virological diagnosis providing sensitive, specific and swift detection and quantification of ASFV DNA. The ability to integrate rPCR into automated platforms increases sample throughput and decreases the potential for cross-contamination. In more recent years isothermal assays, which are a lower-cost alternative to PCR more suitable for use in non-specialised or mobile laboratories, have been developed for the detection of ASFV, however these assays have not been fully validated for routine use in the field. The performance of all virological detection assays in ASF diagnostics, as well as prospects for improving diagnostic strategies in the future, are discussed and reviewed in this chapter.

Bluetongue virus serotype 26: infection kinetics, pathogenesis and possible contact transmission in goats

The aim of this study was to assess the pathogenicity and infection kinetics of Bluetongue virus serotype 26 (BTV-26) in goats. Out of a group of six goats housed in insect free accommodation, five were experimentally infected with BTV-26 and one was kept uninfected as an in-contact control. Samples taken throughout the study were used to determine the kinetics of infection using a pan specific BTV real time RT-PCR assay and a group specific ELISA. The five infected goats did not show clinical signs of BTV, however high levels of viral RNA were detected and virus was isolated from the blood of all 5 goats. Antibodies against BTV were first detected between 7 and 11 dpi in all 5 experimentally infected goats. Interestingly at 21 dpi viral RNA was detected in, and virus was isolated from, the blood of the in-contact control goat, which also seroconverted. These results suggest that BTV-26 replicates to high levels in goats, causing no obvious clinical disease, suggesting that goats may be the natural host for this virus. Preliminary evidence also indicates that BTV-26 may be spread by contact transmission between goats, however a more detailed study is required in order to confirm this observation.

Factors associated with a difficult induction of general anaesthesia

BACKGROUND

Many children experiencing a procedure under general anaesthetic (GA), including those having surgery for cochlear implantation, display behaviours indicative of distress during induction of anaesthesia. It would be useful to ascertain which factors in the pre-operative period are related to the presence of distress at induction in order to target appropriate psychological preparation.

METHODS

The families of 84 children aged 4-7 years undergoing a procedure under GA (including insertion of a cochlear implant) completed three questionnaires assessing temperament, behavioural difficulties, and pre-operative worries. Demographic variables were also recorded. The outcome measure was the amount of behavioural distress at induction.

RESULTS

Statistically significant relationships with the outcome measure of distress at induction were obtained for three factors; an emotional or sociable temperament, and the number of previous procedures. Further, children receiving inhalation inductions displayed greater distress than those receiving intravenous inductions.

CONCLUSION

Undergoing cochlear implantation under GA is a major life event for many recipients. Psychologically preparing children for this has been found to be efficacious, but is not currently available to all children. It is suggested that preparation can be targeted at children, as identified in this study, who have elevated emotionality or sociability scores or who have previous experience of procedures under general anaesthesia. This is of particular current relevance as children are increasingly likely to require re-implantation as they grow older and as unilaterally implanted children are now being offered a sequential bilateral implant, both necessitating further surgery.

Bluetongue virus serotype 26: infection kinetics and pathogenesis in Dorset Poll sheep

Bluetongue virus serotype 26 (BTV-26) has recently been isolated from sheep in Kuwait. The aim of this study was to assess the pathogenicity and infection kinetics of BTV-26 in Dorset Poll sheep. Six sheep were experimentally infected with BTV-26 and samples taken throughout the study were used to determine the kinetics of infection using a pan specific BTV real time RT-PCR assay and two group specific ELISAs. Five of the six sheep showed mild clinical signs characteristic of bluetongue including conjunctivitis, reddening of the mouth mucosal membranes, slight oedema of the face and nasal discharge. Viral RNA was detected in 5 of the 6 sheep by real time RT-PCR, however the levels of viral RNA detected in the samples were lower and of shorter duration than seen with other field strains of BTV. Virus was isolated from the blood of infected animals at the peak of viraemia at around 9 dpi. Antibodies against BTV were first detected by 7 dpi using the early detection BTV ELISA and a little later (7-14 dpi) using a BTV specific competitive ELISA. Four of the five remaining sheep developed neutralising antibodies to BTV-26, measured by a serum neutralisation test (SNT), with titres (log(10)) ranging from 1.40 to 2.08.

Imiquimod 3.75% cream applied daily to treat anogenital warts: combined results from women in two randomized, placebo-controlled studies

OBJECTIVE

To evaluate if new imiquimod formulations using a shorter treatment duration are safe and efficacious to treat anogenital warts.

METHODS

In two studies 534 women ≥12 years of age (mean 33.4) with 2-30 warts (mean 7.9) and total wart area ≥10 mm(2) (mean 166.3) were randomized (1:2:2) to placebo (106), imiquimod 2.5% (212) or 3.75% (216) creams applied once daily until complete clearance or a maximum of 8 weeks.

RESULTS

For placebo, imiquimod 2.5% and 3.75%, respectively, complete clearance of all warts was achieved in 14.2%, 28.3%, and 36.6% of women (intent-to-treat, P = 0.008 imiquimod 2.5%, and P < 0.001 3.75% versus placebo). Mean changes in wart counts were -10.7%, -50.9%, and -63.5% (per-protocol, P < 0.001 each active versus placebo) and safety-related discontinuation rates 0.9%, 1.4%, and 2.3%.

CONCLUSIONS

Imiquimod 3.75% applied daily for up to 8 weeks was well tolerated and superior to placebo in treating women with external anogenital warts.

Emerging adulthood in developmental co-ordination disorder: parent and young adult perspectives

Recent research widely acknowledges that developmental co-ordination disorder (DCD) is a pervasive and enduring disorder, which persists into adolescence and adulthood (Cousins & Smyth, 2003; Kirby, Sugden, Beveridge, & Edwards, 2008). However, few studies have given detailed consideration to the range and level of functioning difficulties in emerging adults with DCD, and no studies to date have gained a parental perspective. Current functioning of 19 young adults with DCD was examined using the Adult Dyspraxia/DCD Checklist (ADC, Kirby, Edwards, Sugden, & Rosenblum, 2010) and parents' views of their child's current functioning was also obtained. Results suggest that whilst some motor skills such as handwriting continue to impact in emerging adulthood, not all skills are as problematic, such as self-care skills. Additionally, executive functioning, and social skills seem to be a key areas of concern for both young adults and their parents. Results provide guidance for areas of intervention that need to be considered, especially focusing on executive functioning skills. Also they highlight the need for gathering information from more than one source to gain a complete picture of functioning.

Infection kinetics of Epizootic Haemorrhagic Disease virus serotype 6 in Holstein-Friesian cattle

Epizootic Haemorrhagic Disease virus serotype 6 (EHDV-6) has recently caused serious outbreaks of Epizootic Haemorrhagic Disease (EHD) on the edges of Europe, in Turkey, Israel and Morocco. The aim of this study was to assess the pathogenicity and infection kinetics of EHD in Holstein-Friesian cattle infected with the two distinct strains of EHDV-6 isolated from the recent Turkish and Moroccan outbreaks. Samples taken throughout the study were used to validate two recently developed diagnostic assays that detect EHDV antibodies and viral genome. Two groups of five Holstein-Friesian cattle were experimentally infected with either the Moroccan or the Turkish isolate of EHDV-6. Cattle in both groups remained clinically unaffected throughout the study, but displayed high levels of viral RNA and virus in their blood, confirming that sub-clinical infection of cattle is likely to play an important role in EHDV transmission. A recently developed and commercialised real-time RT-PCR assay detected viral RNA as early as 2 days post infection (dpi) in both infection studies and viral RNA persisted for the course of the study. Antibodies against EHDV were first detected by 9dpi using a recently developed EHDV blocking ELISA and antibodies persisted up to the end of the study. All animals developed high levels of neutralising antibodies to EHDV-6, measured by a serum neutralisation test (SNT), with titres (log(10)) ranging from 2.20 to 2.38 at the end of the study. Virus was isolated from the blood of infected animals from as early as 2dpi up to 28dpi.

Pigmented vulvar lesions

Pigmented lesions represent an enormous range of conditions, from benign to malignant tumors, and from infectious to post-inflammatory. Pigmented lesions are much less easily diagnosed on anogenital skin, and clinicians should have a low threshold for biopsy confirmation of diseases not classic in appearance.