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1.
PLoS One ; 16(2): e0241652, 2021.
Article in English | MEDLINE | ID: mdl-33544737

ABSTRACT

A mild isolate of Papaya ringspot virus type-P, abbreviated as PRSV-mild, from Ecuador was sequenced and characterized. The most distinguishing symptom induced by PRSV-mild was gray powder-like leaf patches radiating from secondary veins. In greenhouse experiments, PRSV-mild did not confer durable protection against a severe isolate of the virus (PRSV-sev), obtained from the same field. Furthermore, isolate specific detection in mixed-infected plants showed that PRSV-sev becomes dominant in infections, rendering PRSV-mild undetectable at 90-120 days post superinfection. Virus testing using isolate-specific primers detected PRSV-mild in two out of five surveyed provinces, with 10% and 48% of incidence in Santo Domingo and Los Ríos, respectively. Comparative genomics showed that PRSV-mild lacks two amino acids from the coat protein region, whereas amino acid determinants for asymptomatic phenotypes were not identified. Recombination events were not predicted in the genomes of the Ecuadorean isolates. Phylogenetic analyses placed both PRSV-mild and PRSV-sev in a clade that includes an additional PRSV isolate from Ecuador and others from South America.


Subject(s)
Carica/virology , Plant Diseases/virology , Potyvirus/genetics , Genome, Viral , Phylogeny , Potyvirus/isolation & purification
2.
PLoS One ; 14(6): e0215798, 2019.
Article in English | MEDLINE | ID: mdl-31220099

ABSTRACT

The complete genome of a new rhabdovirus infecting papaya (Carica papaya L.) in Ecuador, named papaya virus E, was sequenced and characterized. The negative-sense single-stranded RNA genome consists of 13,469 nucleotides with six canonical open reading frames (ORFs) and two accessory short ORFs predicted between ORFs corresponding to P3 (movement protein) and M (matrix protein). Phylogenetic analyses using amino acid sequences from the nucleocapsid, glycoprotein and polymerase, grouped the virus with members of the genus Cytorhabdovirus, with rice stripe mosaic virus, yerba mate chlorosis-associated virus and Colocasia bobone disease-associated virus as closest relatives. The 3' leader and 5' trailer sequences were 144 and 167 nt long, respectively, containing partially complementary motifs. The motif 3'-AUUCUUUUUG-5', conserved across rhabdoviruses, was identified in all but one intergenic regions; whereas the motif 3'-ACAAAAACACA-5' was found in three intergenic junctions. This is the first complete genome sequence of a cytorhabdovirus infecting papaya. The virus was prevalent in commercial plantings of Los Ríos, the most important papaya producing province of Ecuador. Recently, the genome sequence of bean-associated cytorhabdovirus was reported. The genome is 97% identical to that of papaya virus E, indicating that both should be considered strains of the same virus.


Subject(s)
Carica/virology , Rhabdoviridae/classification , Whole Genome Sequencing/methods , Carica/genetics , Genome Size , Genome, Viral , High-Throughput Nucleotide Sequencing , Open Reading Frames , Phylogeny , Plant Viruses/genetics , Rhabdoviridae/genetics
3.
Am J Surg ; 215(6): 1000-1003, 2018 06.
Article in English | MEDLINE | ID: mdl-29551473

ABSTRACT

INTRODUCTION: Managing trauma in the elderly is challenging and requires a multidisciplinary team approach. The aim of this study is to characterize and compare outcomes in patients 90 years and older in the last two decades. METHODS: Retrospective review of trauma patients 90 years and older admitted from 1996 to 2015. The patients were divided into two groups: Early Decade (ED) and Late Decade (LD). RESULTS: A total of 1697 patients were recorded, 551 (ED) and 1146 (LD). The mean age was 92.92 ±â€¯8(90-108)[ED] and 92.9 ±â€¯2.7(90-105)[LD] years. The most common mechanism and type of injury was falls and extremity trauma. Hospital length of stay (LOS) was shorter in the LD. There was no significant difference in in-hospital mortality or ICU LOS. CONCLUSION: Trauma admission has increased in the last decade. However, in-hospital mortality remains low. It is important for multidisciplinary teams to allocate resources to treat this elderly population.


Subject(s)
Disease Management , Trauma Centers/statistics & numerical data , Wounds and Injuries/therapy , Age Factors , Aged, 80 and over , Female , Follow-Up Studies , Hospital Mortality/trends , Humans , Incidence , Injury Severity Score , Length of Stay/trends , Male , Retrospective Studies , Time Factors , United States/epidemiology , Wounds and Injuries/diagnosis , Wounds and Injuries/epidemiology
4.
J Surg Res ; 219: 296-301, 2017 11.
Article in English | MEDLINE | ID: mdl-29078896

ABSTRACT

BACKGROUND: The safety of transbronchial lung biopsy (TBLB) on positive pressure mechanical ventilation has been controversial due to a presumed risk of pneumothorax. Data are especially limited on TBLB with elective intubation and mechanical ventilation. In this study, we compared complications of TBLB in patients who were electively mechanically ventilated for the procedure to those who were not. MATERIAL AND METHODS: A retrospective review of nonventilator-dependent patients who underwent TBLB in our institution from January 2010 to May 2016 was performed. The mechanical ventilation (MV) and nonmechanical ventilation (NMV) groups were compared with respect to patient demographics, numbers of lobes biopsied (single or multiple), preprocedure and postprocedure diagnoses, and complications. Complications were defined as pneumothorax of any size, major hemorrhage, prolonged intubation, and reintubation within 72 hours from TBLB. RESULTS: A total of 394 patients were identified. The MV group had 351 patients with mean age of 64.6 years, and the NMV group had 43 patients with mean age of 60.0 years. There were no significant differences with regards to age, gender, or number of lobes biopsied. There was no significant difference in the occurrence of pneumothorax (5.4% versus 4.7%, P = 1.00), hemorrhage (1.7% versus 4.7%, P = 0.21), and prolonged intubation or reintubation (3.1% versus 2.3%, P = 1.00) between the two groups. CONCLUSIONS: When performing TBLB, there was no significant difference observed in the rate of complications between MV and NMV groups. Elective positive pressure mechanical ventilation for TBLB for nonventilator-dependent patients is safe and does not increase the risk of complications.


Subject(s)
Bronchoscopy , Intubation, Intratracheal/adverse effects , Pneumothorax/etiology , Positive-Pressure Respiration/adverse effects , Aged , Biopsy , Female , Humans , Lung/physiology , Male , Middle Aged , Retrospective Studies
5.
Phys Rev E ; 96(1-1): 012208, 2017 Jul.
Article in English | MEDLINE | ID: mdl-29347213

ABSTRACT

The propagation of nonlinear waves in a lattice of repelling particles is studied theoretically and experimentally. A simple experimental setup is proposed, consisting of an array of coupled magnetic dipoles. By driving harmonically the lattice at one boundary, we excite propagating waves and demonstrate different regimes of mode conversion into higher harmonics, strongly influenced by dispersion and discreteness. The phenomenon of acoustic dilatation of the chain is also predicted and discussed. The results are compared with the theoretical predictions of the α-Fermi-Pasta-Ulam equation, describing a chain of masses connected by nonlinear quadratic springs and numerical simulations. The results can be extrapolated to other systems described by this equation.

6.
Ann Surg Oncol ; 23(Suppl 5): 1005-1011, 2016 12.
Article in English | MEDLINE | ID: mdl-27531307

ABSTRACT

BACKGROUND: The benefit of thoracic lymphadenectomy in the treatment of resectable non-small cell lung cancer (NSCLC) continues to be debated. We hypothesized that the number of lymph nodes (LNs) removed for patients with pathologic node-negative NSCLC would correlate with survival. METHODS: The National Cancer Data Base (NCDB) was queried for resected, node-negative, NSCLC patients treated between 2004 and 2014. Patients were grouped according to the number of LNs removed (1-4, 5-8, 9-12, 13-16, and ≥17). Patients with <10 LNs removed were also compared with those with ≥10 LNs removed. A Cox regression analysis was performed and hazard ratios (HRs) calculated, with 95 % confidence intervals (CIs). RESULTS: Of 1,089,880 patients with NSCLC reported to the NCDB during the study period, 98,970 (9.0 %) underwent resection without evidence of pathologic nodal involvement. Lobectomy was performed in 83.9 %, sublobar resection was performed in 12.7 % and pneumonectomy was performed in 2.8 % of patients. The number of LNs removed correlated with increasing tumor size and extent of resection. On multivariate analysis, increasing age, male sex, white ethnicity, high tumor grade, larger tumor size, pneumonectomy, and positive surgical margins were all negatively correlated with overall survival. The number of LNs removed and lobectomy/bi-lobectomy correlated with improved survival. The removal of <10 LNs was associated with a 12 % increased risk of death (HR: 1.12, 95 % CI 1.09-1.14; p < 0.001). CONCLUSION: Survival of early-stage NSCLC patients is associated with the number of LNs removed. The surgical management of early-stage NSCLC should include thoracic lymphadenectomy of at least 10 nodes.


Subject(s)
Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/mortality , Lung Neoplasms/surgery , Lymph Node Excision/statistics & numerical data , Lymph Nodes/surgery , Adult , Aged , Carcinoma, Non-Small-Cell Lung/ethnology , Carcinoma, Non-Small-Cell Lung/pathology , Databases, Factual , Female , Humans , Lung Neoplasms/ethnology , Lung Neoplasms/pathology , Lymph Nodes/pathology , Male , Middle Aged , Neoplasm Grading , Neoplasm Staging , Neoplasm, Residual , Pneumonectomy/statistics & numerical data , Proportional Hazards Models , Sex Factors , Survival Rate , Thorax , Tumor Burden , United States/epidemiology
7.
Am Surg ; 81(8): 820-5, 2015 Aug.
Article in English | MEDLINE | ID: mdl-26215247

ABSTRACT

Postoperative unplanned intubation (PUI) is a significant complication and is associated with severe adverse events and mortality. By participating in the National Surgical Quality Improvement Program (NSQIP), we learned that PUI occurred more frequently than expected at our institution. The aim of this study was to identify risk factors that are predictors of PUI at our institution. We reviewed the NSQIP data from our institution and the NSQIP national database for surgery patients from 2010 through 2013. The rate of PUI at our institution was 1.54 per cent compared with the national rate of 1.03 per cent. Perioperative risk factors were analyzed by multivariate logistic regression. Analysis of the national NSQIP database identified 14 independent risk factors for PUI. Analysis of the NSQIP data at our institution demonstrated that emergent cases, preoperative ventilator status, smoking, chronic obstructive pulmonary disease, and older age were independent risk factors. In conclusion, patients at our institution with these five risk factors were at higher risk of requiring PUI. These risk factors could be used to help identify patients at high risk and possibly help prevent postoperative respiratory failure and unplanned intubation.


Subject(s)
Databases, Factual , Hospital Mortality , Intubation, Intratracheal/statistics & numerical data , Postoperative Complications/epidemiology , Surgical Procedures, Operative/adverse effects , Adult , Age Factors , Aged , Causality , Comorbidity , Confidence Intervals , Female , Follow-Up Studies , Humans , Incidence , Intubation, Intratracheal/adverse effects , Intubation, Intratracheal/methods , Intubation, Intratracheal/mortality , Logistic Models , Male , Middle Aged , Multivariate Analysis , Odds Ratio , Pennsylvania/epidemiology , Postoperative Care/methods , Postoperative Complications/diagnosis , Postoperative Complications/etiology , Postoperative Complications/mortality , Postoperative Complications/therapy , Postoperative Period , Predictive Value of Tests , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Retrospective Studies , Risk Factors , Smoking/adverse effects , Smoking/epidemiology , Surgical Procedures, Operative/methods , Survival Rate , Treatment Outcome
8.
J Thorac Cardiovasc Surg ; 148(4): 1450-3, 2014 Oct.
Article in English | MEDLINE | ID: mdl-24703628

ABSTRACT

BACKGROUND: Patients with right heart obstructive lesions develop residual or recurrent right ventricle outflow tract pathology as a result of native or implanted pulmonary valve (PV) dysfunction. Until recently, the standard of care has been surgical placement of a PV or valved right ventricle to pulmonary artery conduit. Catheter-based options are being increasingly applied in patients with PV dysfunction. The purpose of our study was to evaluate outcomes of surgical pulmonary valve/conduit replacement (PVR) at a large pediatric hospital to provide contemporary benchmark data for comparison with developing technologies. METHODS: Retrospective review of patients undergoing PVR not associated with complex concomitant procedures from July 1995 to December 2010 was completed. Inclusion criteria were designed to generally match those applied to patients promoted for catheter-based valve replacement based on age and weight (age≥5 years and weight≥30 kg). RESULTS: There were 148 PVRs with all patients having undergone ≥1 previous interventions (tetralogy of Fallot [53%] and pulmonary atresia [17%]). Surgical indications were PV insufficiency (60%), PV stenosis (26%), and both (13%). Valves used included bioprosthetic (n=108; 73%) and homografts (n=40; 27%). Time-to-extubation, intensive care unit stay, and hospital length of stay were <1 day (interquartile range, 0-1 day), 2 days (interquartile range, 1-2 days), and 5 days (interquartile range, 4-6 days), respectively, with no hospital deaths. Freedom from PV reintervention at 1, 3, and 5 years was 99%, 99%, and 94%, respectively. Multivariable analysis showed age<13 years (P=.003), and smaller valve size (P=.025) were associated with increased risk of valve reintervention. Patient survival at follow-up (mean, 5.0±3.9 years) was 99%. CONCLUSIONS: Surgical PVR is safe with low in-hospital and midterm follow-up mortality and reoperation rates. These outcomes provide a useful benchmark for treatment strategy comparisons.


Subject(s)
Heart Valve Prosthesis Implantation/methods , Heart Valve Prosthesis , Pulmonary Valve Insufficiency/surgery , Pulmonary Valve/surgery , Ventricular Outflow Obstruction/surgery , Adolescent , Child , Female , Heart Defects, Congenital/surgery , Humans , Length of Stay/statistics & numerical data , Male , Pulmonary Valve Insufficiency/complications , Retrospective Studies , Risk Factors , Survival Rate , Treatment Outcome , Ventricular Outflow Obstruction/etiology
9.
J Heart Lung Transplant ; 32(11): 1107-13, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24002006

ABSTRACT

OBJECTIVE: The HeartMate II (HMII; Thoratec, Pleasanton, CA) continuous-flow left ventricular assist device (LVAD) is an established treatment modality for advanced heart failure in adults. The objective of this study was to evaluate outcomes of pediatric patients supported by the HMII LVAD. METHODS: This was a retrospective review of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) of patients supported with a HMII from April 2008 to September 2011. The primary cohort comprised pediatric patients aged 11 to 18 years. Outcomes were compared with a group of young adults aged 19 to 39 years who underwent HMII implant during the same period. Ischemic etiologies for heart failure were excluded. RESULTS: There were 28 pediatric patients, of whom 19 (68%) were males, 14 (46%) were African American, and 7 (25%) underwent device placement in a pediatric hospital. Competing outcomes analysis showed that at 6 months of follow-up, the composite of survival to transplantation, ongoing support, or recovery was 96% for the pediatric group, which was not significantly different from the young adult group (96%, p = 0.330). The 2 groups had similar INTERMACS profiles but differed in diagnosis, weight, and morbidities. Bleeding complications requiring surgical intervention were more common in the pediatric group. CONCLUSIONS: Pediatric outcomes with a HMII LVAD are comparable to that of young adults. As we continue to monitor this growing group, more sophisticated characterization and comparisons will be possible. Also, as technology progress and second- and third-generation devices are introduced, the number of children who will benefit from mechanical support will continue to grow.


Subject(s)
Heart Failure/epidemiology , Heart Failure/therapy , Heart-Assist Devices/classification , Adolescent , Adult , Age Factors , Child , Cohort Studies , Female , Humans , Male , Outcome Assessment, Health Care , Registries , Retrospective Studies , Treatment Outcome , United States/epidemiology , Young Adult
10.
J Thorac Cardiovasc Surg ; 146(3): 512-20; discussion 520-1, 2013 Sep.
Article in English | MEDLINE | ID: mdl-23953299

ABSTRACT

OBJECTIVES: Surgical treatment of aortic valve (AoV) disease in childhood involves complex decisions particularly in very small patients. There is no consensus regarding the optimum surgical option. The objective of this review was to analyze a contemporary experience of AoV surgery in a large children's hospital. METHODS: A retrospective review of children (aged ≤ 18 years) undergoing AoV repair or replacement from June 1995 to December 2011 was carried out. RESULTS: A total of 285 AoV operations (97 repairs, 188 replacements) were performed on 241 patients. Hospital survival for repair was 98% and for replacements was 97%. At follow-up of repairs, there were 16 (17%) reoperations and 3 (3%) late deaths. Follow-up of AoV replacements demonstrated 31 (16%) reoperations (homograft 27, autograft 3, mechanical 1) and 8 (4%) late deaths (homograft 5, autograft 2, mechanical 1). Freedom from reintervention or death (FRD) was found to be lower in repairs for infants (P = .048) and truncal valves (P < .05). For AoV replacements, infants and patients who had concomitant CHD or homografts (P < .0001) had lower FRD. Cox regression analysis for AoV replacements identified infants and homograft root replacements at a higher risk for death/reoperation. CONCLUSIONS: AoV repairs and replacements were generally found to be associated with low death and reoperation rates at long-term follow-up. Infants had a lower freedom from reintervention or death after either an AoV repair or replacement, although truncal valve repairs and AoV replacement in patients with concomitant CHD were associated with lower valve survival. Among the valve options, homograft root replacement had a higher risk of death/reoperation and lowest freedom from reintervention or death.


Subject(s)
Aortic Valve/surgery , Heart Valve Diseases/surgery , Adolescent , Age Factors , Cardiac Surgical Procedures/adverse effects , Cardiac Surgical Procedures/mortality , Child , Child, Preschool , Female , Heart Valve Diseases/mortality , Heart Valve Prosthesis Implantation , Hospitals, Pediatric , Humans , Infant , Infant, Newborn , Kaplan-Meier Estimate , Male , Multivariate Analysis , Postoperative Complications/mortality , Postoperative Complications/surgery , Proportional Hazards Models , Reoperation , Retrospective Studies , Risk Factors , Texas , Time Factors , Treatment Outcome
11.
Vet Immunol Immunopathol ; 152(3-4): 277-88, 2013 Apr 15.
Article in English | MEDLINE | ID: mdl-23375019

ABSTRACT

A single broadly reactive standard ELISA is commonly applied to control small ruminant lentivirus (SRLV) spread, but type specific ELISA strategies are gaining interest in areas with highly prevalent and heterogeneous SRLV infections. Short (15-residue) synthetic peptides (n=60) were designed in this study using deduced amino acid sequence profiles of SRLV circulating in sheep from North Central Spain and SRLV described previously. The corresponding ELISAs and two standard ELISAs were employed to analyze sera from sheep flocks either controlled or infected with different SRLV genotypes. Two outbreaks, showing SRLV-induced arthritis (genotype B2) and encephalitis (genotype A), were represented among the infected flocks. The ELISA results revealed that none of the assays detected all the infected animals in the global population analyzed, the assay performance varying according to the genetic type of the strain circulating in the area and the test antigen. Five of the six highly reactive (57-62%) single peptide ELISAs were further assessed, revealing that the ELISA based on peptide 98M (type A ENV-SU5, consensus from the neurological outbreak) detected positives in the majority of the type-A specific sera tested (Se: 86%; Sp: 98%) and not in the arthritic type B outbreak. ENV-TM ELISAs based on peptides 126M1 (Se: 82%; Sp: 95%) and 126M2 0,65 0.77 (Se: 68%; Sp: 88%) detected preferentially caprine arthritis encephalitis (CAEV, type B) and visna/maedi (VMV, type A) virus infections respectively, which may help to perform a preliminary CAEV vs. VMV-like typing of the flock. The use of particular peptide ELISAs and standard tests individually or combined may be useful in the different areas under study, to determine disease progression, diagnose/type infection and prevent its spread.


Subject(s)
Enzyme-Linked Immunosorbent Assay/veterinary , Lentivirus Infections/veterinary , Sheep Diseases/diagnosis , Amino Acid Sequence , Animals , Antibodies, Viral/blood , Antigens, Viral/genetics , Arthritis-Encephalitis Virus, Caprine/genetics , Arthritis-Encephalitis Virus, Caprine/immunology , Disease Outbreaks/veterinary , Enzyme-Linked Immunosorbent Assay/methods , Enzyme-Linked Immunosorbent Assay/statistics & numerical data , Genes, gag , Goats , Lentivirus Infections/diagnosis , Lentivirus Infections/epidemiology , Molecular Sequence Data , Phylogeny , Pneumonia, Progressive Interstitial, of Sheep/diagnosis , Pneumonia, Progressive Interstitial, of Sheep/epidemiology , Pneumonia, Progressive Interstitial, of Sheep/immunology , Sheep , Sheep Diseases/epidemiology , Sheep Diseases/immunology , Sheep, Domestic , Spain/epidemiology , Viral Proteins/genetics , Viral Proteins/immunology , Visna/diagnosis , Visna/epidemiology , Visna/immunology , Visna-maedi virus/genetics , Visna-maedi virus/immunology
12.
J Am Coll Surg ; 216(4): 699-704; discussion 704-6, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23415555

ABSTRACT

BACKGROUND: The Blalock-Taussig shunt (BTS) was introduced 68 years ago before open repair of cyanotic congenital heart disease (CHD) was possible. The originally described technique has undergone many modifications but remains an integral component of the management of cyanotic CHD. We report our contemporary, single institution experience with the BTS. STUDY DESIGN: We performed a retrospective review of all patients treated with a BTS from June 1995 to December 2011. RESULTS: There were 730 BTS performed in 712 patients; 727 (99.6%) by interposition graft (modified). The BTS was predominantly right-sided (n = 657, 90%). Median age and weight at palliation were 8 days (range 0 days to 18.5 years) and 3.2 kg (1.5 to 51 kg). Median hospital length of stay was 16 days (range 0 to 347 days). There were 241 (33%) BTS performed as initial palliation for ultimate 2-ventricle (2V) circulation, 471 (65%) as part of staged palliation for patients with functionally univentricular lesions (1V), 6 (1%) as a part of 1.5-ventricle palliation, and 12 (1%) for Ebstein's anomaly. There were 473 (65%) BTS placed via sternotomy and the most common site of BTS was the right subclavian to right pulmonary artery (PA; n = 452, 62%). Hospital mortality was higher for BTS in 1V patients (1V 15% vs 2V 3%, p < 0.0001). Overall, 536 (73%) patients were bridged to complete repair or the second stage of 1V palliation after a median duration of 6.5 months (0 days to 15.3 years). Multivariable regression showed that sternotomy approach, use of cardiopulmonary bypass, innominate artery-PA shunt, and diagnosis of Ebstein's were risk factors for in-hospital mortality (p < 0.05). CONCLUSIONS: Although the BTS remains an important component of the surgical treatment of cyanotic congenital heart disease, patients with single ventricle circulation still face significant ongoing risk of mortality.


Subject(s)
Blalock-Taussig Procedure , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Retrospective Studies
13.
J Heart Lung Transplant ; 32(1): 44-9, 2013 Jan.
Article in English | MEDLINE | ID: mdl-23164533

ABSTRACT

BACKGROUND: There have been >1,600 pediatric lung transplantations (LTx) performed worldwide with a trend toward improved outcomes over the last 25 years. The majority of these LTxs have been in older children and adolescents. Less than 4 infant (defined as ≤ 12 months of age) LTxs per year have been performed over the past 20 years, mostly in the USA. However, infant LTx outcomes have not been well documented in a multi-institutional longitudinal fashion. METHODS: The United Network of Organ Sharing database was queried from October 1987 to July 2011. Of the 1,003 pediatric LTxs reported, 84 (8%) were infants. All combined transplantations were excluded. RESULTS: Eighty-one infants received 84 LTxs, of which 95% had a bilateral LTx. Median age and weight at LTx was 4 months (range 0 to 11 months) and 5.3 kg (2.7 to 11.8 kg), respectively. Median ischemic time was 5.2 hours (2.0 to 10.8 hours). Overall Kaplan-Meier graft survival was similar for infants compared with other pediatric age group (OPA: >1 to 18 years) LTx recipients (half-life 4.0 years vs 3.4 years, p = 0.7). Conditional 1-year graft survival for infants was significantly higher than OPA (half-life 7.4 years vs 5.0 years, p = 0.024). Early (1987 to 2000, n = 46) and late (2001 to 2011, n = 38) era graft survival was not significantly different. Graft survival in pre-LTx ventilated infants was significantly better than pre-LTx ventilated OPA (half-life 6.1 years vs 0.9 year, p = 0.004) and was not statistically different from pre-LTx infants not on ventilatory support (half-life 6.1 years vs 2.2 years, p = 0.152). Cox regression of 5 variables (weight, donor arterial PO(2), pre-Tx ventilator, organ ischemic time, center experience) showed that survival was associated with increased center experience (p = 0.03). CONCLUSION: Infants undergoing LTx have outcomes similar to those of all other pediatric LTx patients.


Subject(s)
Graft Survival , Lung Transplantation , Age Factors , Female , Humans , Infant , Infant, Newborn , Male , Retrospective Studies
14.
Vet Microbiol ; 155(2-4): 137-46, 2012 Mar 23.
Article in English | MEDLINE | ID: mdl-21940116

ABSTRACT

An extensive outbreak characterized by the appearance of neurological symptoms in small ruminant lentivirus (SRLV) infected sheep has been identified in Spain, but the genetic characteristics of the strain involved and differential diagnostic tools for this outbreak remain unexplored. In this work, 23 Visna-affected naturally infected animals from the outbreak, 11 arthritic animals (both groups presenting anti-Visna/Maedi virus serum antibodies), and 100 seronegative animals were used. Eight of the Visna-affected animals were further studied post-mortem by immunohistochemistry. All had lesions in spinal cord, being the most affected part of the central nervous system in six of them. A representative strain of the outbreak was isolated. Together with other proviral sequences from the outbreak the virus was assigned to genotype A2/A3. In vitro culture of the isolate revealed that viral production was slow/low in fibroblast-like cells but it was high in blood monocyte-derived macrophages. The long terminal repeat (LTR) of the viral genome of this isolate lacked an U3-duplication, but its promoter activity in fibroblast-like cells was normal compared to other strains. Thus, viral production could not be inferred from the LTR promoter activity in this isolate. Analysis of the viral immunodominant epitopes among SRLV sequences of the outbreak and other known sequences allowed the design of a synthetic SU peptide ELISA that detected the Visna affected animals, representing a tool of epidemiological interest to control viral spread of this highly pathogenic strain.


Subject(s)
Disease Outbreaks/veterinary , Visna-maedi virus/genetics , Visna/diagnosis , Visna/virology , Animals , Antibodies, Viral/blood , Enzyme-Linked Immunosorbent Assay/veterinary , Female , Macrophages/virology , Male , Sheep , Sheep, Domestic , Spain/epidemiology , Terminal Repeat Sequences , Visna/epidemiology , Visna-maedi virus/immunology , Visna-maedi virus/isolation & purification
16.
Vet J ; 190(1): 169-72, 2011 Oct.
Article in English | MEDLINE | ID: mdl-20932787

ABSTRACT

Nucleotide sequences of small ruminant lentiviruses (SRLVs) were determined in sheep and goats, including progeny of imported animals, on a farm in Mexico. On the basis of gag-pol, pol, env and LTR sequences, SRLVs were assigned to the B1 subgroup, which comprises caprine arthritis-encephalitis virus (CAEV)-like prototype sequences mainly from goats. In comparison with CAEV-like env sequences of American and French origin, two putative recombination events were identified within the V3-V4 and V4-V5 regions of the env gene of a full length SRLV sequence (FESC-752) derived from a goat on the farm.


Subject(s)
Arthritis-Encephalitis Virus, Caprine/classification , Arthritis-Encephalitis Virus, Caprine/genetics , Genes, Viral , Goat Diseases/virology , Lentivirus Infections/veterinary , Recombination, Genetic , Sheep Diseases/virology , Animals , Base Sequence , Genes, env , Genes, gag , Genes, pol , Goats , Lentivirus Infections/virology , Mexico , Molecular Sequence Data , Phylogeny , Sequence Alignment , Sheep , Sheep, Domestic , Terminal Repeat Sequences
17.
Vet J ; 186(2): 221-5, 2010 Nov.
Article in English | MEDLINE | ID: mdl-19747864

ABSTRACT

A serological survey of Visna/maedi virus (VMV) infection involving 274,048 sheep from 554 flocks was undertaken during 2002-2007 in Aragón, North-East Spain. One hundred and two of these flocks enrolled in a VMV control programme to reduce seroprevalence by selecting replacement lambs from seronegative dams and gradual culling of seropositive sheep. Twenty-five flocks were also visited to collect flock management and housing data. All study flocks had seropositive animals and 52.8% of animals tested were seropositive. Among flocks that joined the control programme 66 adopted the proposed measures and reduced seroprevalence significantly by between 26.1% and 76.9% whereas the remaining 36 flocks did not apply the measures and seroprevalence significantly increased. Seroprevalence increased with flock size and the number of days the sheep were housed, and decreased with increasing weaning age and shed open area, suggesting a reduced risk of VMV infection in sheep associated with better ventilation. At the end of the period, 24 flocks were certified as VMV-controlled with a seroprevalence <5%, and seven as VMV-free with 0% seroprevalence. These are the first officially recognised VMV-free flocks in Spain and represent a nucleus of VMV-free replacement animals for other flocks. Moreover, they are evidence of the possibility of eliminating VMV infection without resorting to whole-flock segregation or culling of seropositive sheep.


Subject(s)
Pneumonia, Progressive Interstitial, of Sheep , Sheep Diseases , Visna-maedi virus/isolation & purification , Visna , Animal Husbandry/methods , Animals , Housing, Animal , Pneumonia, Progressive Interstitial, of Sheep/epidemiology , Pneumonia, Progressive Interstitial, of Sheep/prevention & control , Risk Factors , Seroepidemiologic Studies , Sheep , Sheep Diseases/epidemiology , Sheep Diseases/prevention & control , Sheep Diseases/virology , Spain/epidemiology , Ventilation , Visna/epidemiology , Visna/prevention & control
18.
Theriogenology ; 72(8): 1085-96, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19729193

ABSTRACT

Antibody-based diagnosis of small ruminant lentiviruses (SRLVs) has been efficiently achieved using serum and milk, but not semen, for which polymerase chain reaction (PCR) has been proposed as a confirmatory technique. This work, involving 296 ovine (Ovis aries) and caprine (Capra hircus) semen donors, investigates whether seminal fluid (SF) can be reliably used in antibody-based SRLV diagnosis. First, a gold standard was established to assess the infection status and determine the sensitivity and specificity of three commercial enzyme-linked immunosorbent assays (ELISAs) in serum testing using Western blot and PCR as confirmatory tests. For SF testing, both gold standard and serum testing results were used as reference. The performance of SF testing was affected not only by the ELISA assay sensitivity (related to antigen spectrum) compared with that of the gold standard (as it occurred in serum testing) but also by SF sample quality and SF working dilution. Nonturbid SF samples, commonly collected in artificial insemination centers (AICs), were required. Compared with serum, SF testing had a decreased sensitivity in two of the ELISA assays (with original serum working dilutions

Subject(s)
Enzyme-Linked Immunosorbent Assay/methods , Goat Diseases/diagnosis , Lentivirus Infections/veterinary , Semen/virology , Sheep Diseases/diagnosis , Animals , Goat Diseases/virology , Goats , Lentivirus Infections/diagnosis , Lentiviruses, Ovine-Caprine/genetics , Lentiviruses, Ovine-Caprine/isolation & purification , Longitudinal Studies , Male , Sensitivity and Specificity , Sheep , Sheep Diseases/virology
19.
Vaccine ; 27(34): 4591-600, 2009 Jul 23.
Article in English | MEDLINE | ID: mdl-19538997

ABSTRACT

RNA transcripts of the B7 family molecule (CD80) are diminished in blood leukocytes from animals clinically affected with Visna/Maedi virus (VMV) infection. This work investigates whether the use of B7 genes enhances immune responses and protection in immunization-challenge approaches. Sheep were primed by particle-mediated epidermal bombardment with VMV gag and env gene recombinant plasmids together with plasmids encoding both CD80 and CD86 or CD80 alone, boosted with gag and env gene recombinant modified vaccinia Ankara virus and challenged intratracheally with VMV. Immunization in the presence of one or both of the B7 genes resulted in CD4+ T cell activation and antibody production (before and after challenge, respectively), but only immunization with CD80 and CD86 genes together, and not CD80 alone, resulted in a reduced number of infected animals and increased early transient cytotoxic T lymphocytes (CTL) responses. Post-mortem analysis showed an immune activation of lymphoid tissue in challenge-target organs in those animals that had received B7 genes compared to unvaccinated animals. Thus, the inclusion of B7 genes helped to enhance early cellular responses and protection (diminished proportion of infected animals) against VMV infection.


Subject(s)
Adjuvants, Immunologic/administration & dosage , B7-1 Antigen/administration & dosage , Pneumonia, Progressive Interstitial, of Sheep/prevention & control , Vaccines, DNA/immunology , Viral Vaccines/immunology , Visna-maedi virus/immunology , Adjuvants, Immunologic/genetics , Adjuvants, Immunologic/pharmacology , Animals , Antibodies, Viral/blood , B7-1 Antigen/genetics , B7-1 Antigen/pharmacology , B7-2 Antigen/administration & dosage , B7-2 Antigen/genetics , B7-2 Antigen/pharmacology , CD4-Positive T-Lymphocytes/immunology , Gene Products, env/administration & dosage , Gene Products, env/genetics , Gene Products, gag/administration & dosage , Gene Products, gag/genetics , Genetic Vectors , Immunization, Secondary/methods , Male , Sheep , T-Lymphocytes, Cytotoxic/immunology , Vaccinia virus/genetics , Visna-maedi virus/genetics
20.
Vet Microbiol ; 138(1-2): 156-62, 2009 Jul 02.
Article in English | MEDLINE | ID: mdl-19339126

ABSTRACT

Small ruminant lentiviruses (SRLVs) cause different clinical forms of disease in sheep and goats. So far in Spain, Maedi visna virus-like (MVV-like) sequences have been found in both species, and the arthritic SRLV disease has never been found in sheep until a recent outbreak. Knowing that arthritis is common in goats, it was of interest to determine if the genetic type of the virus involved in the sheep arthritis outbreak was caprine arthritis encephalitis virus-like (CAEV-like) rather than MVV-like. Alignment and phylogenetic analyses on nucleotide and deduced amino acid sequences from SRLV of this outbreak, allowed a B2 genetic subgroup assignment of these SRLV, compatible with a correspondence between the virus genetic type and the disease form. Furthermore, an isolate was obtained from the arthritic outbreak, its full genome was CAEV-like but the pol integrase region was MVV-like. Although its LTR lacked a U3 repeat sequence and had a deletion in the R region, which has been proposed to reduce viral replication rate, its phenotype in sheep skin fibroblast cultures was rapid/high, thus it appeared to have adapted to sheep cells. This outbreak study represents the first report on CAEV-like genetic findings and complete genome analysis among Spanish small ruminants.


Subject(s)
Arthritis, Infectious/veterinary , Disease Outbreaks/veterinary , Lentivirus Infections/veterinary , Lentiviruses, Ovine-Caprine/genetics , Sheep Diseases/virology , Animals , Arthritis, Infectious/genetics , Arthritis, Infectious/virology , Base Sequence , Choroid Plexus/virology , Cloning, Molecular , DNA, Viral/genetics , DNA, Viral/isolation & purification , Genome, Viral , Lentivirus Infections/epidemiology , Lentiviruses, Ovine-Caprine/classification , Lentiviruses, Ovine-Caprine/isolation & purification , Phylogeny , Polymerase Chain Reaction/methods , RNA, Viral/genetics , Sheep , Spain , Synovial Fluid/virology , Synovial Membrane/virology , Terminal Repeat Sequences/genetics , Visna-maedi virus/classification , Visna-maedi virus/genetics , Visna-maedi virus/isolation & purification
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