A systematic surveillance programme for infectious salmon anaemia virus supports its absence in the Pacific Northwest of the United States.

In response to reported findings of infectious salmon anaemia virus (ISAV) in British Columbia (BC), Canada, in 2011, U.S. national, state and tribal fisheries managers and fish health specialists developed and implemented a collaborative ISAV surveillance plan for the Pacific Northwest region of the United States. Accordingly, over a 3-1/2-year period, 4,962 salmonids were sampled and successfully tested by real-time reverse-transcription PCR. The sample set included multiple tissues from free-ranging Pacific salmonids from coastal regions of Alaska and Washington and farmed Atlantic salmon (Salmo salar L.) from Washington, all representing fish exposed to marine environments. The survey design targeted physiologically compromised or moribund animals more vulnerable to infection as well as species considered susceptible to ISAV. Samples were handled with a documented chain of custody and testing protocols, and criteria for interpretation of test results were defined in advance. All 4,962 completed tests were negative for ISAV RNA. Results of this surveillance effort provide sound evidence to support the absence of ISAV in represented populations of free-ranging and marine-farmed salmonids on the northwest coast of the United States.

Measurement of paralytic shellfish toxins in molluscan extracts: comparison of the microtitre plate saxiphilin and sodium channel radioreceptor assays with mouse bioassay, HPLC analysis and a commercially available cell culture assay.

This study compared five methods of measuring paralytic shellfish toxins (PSTs) including the long-used mouse lethality bioassay, a commercially available cell culture test (MIST Quantification kit), HPLC analysis, and two newly developed radioreceptor assays utilizing mammalian sodium channels and saxiphilin. Methods were challenged with toxic shellfish extracts prepared according to the AOAC official method. The best correlations between predicted toxicity values being 0.9 or better, were those between HPLC analysis when compared with both radioreceptor assays and the mouse lethality bioassay, as well as that between the saxiphilin and the sodium channel radioreceptor assays. In all cases, statistically significant correlations existed between the toxicity measurements of the same extracts. The ratios between some methods were not unitary as measured by the slopes of the regression lines used for correlation analyses. HPLC analysis predicted more toxicity than all of the bioassays. The saxiphilin assay underestimated toxicity relative to the mouse bioassay, the MIST kit determinations and the sodium channel assay. The sodium channel assay predicted there to be less toxicity than the mouse bioassay and the MIST kit. Of all of the techniques used, the MIST kit correlation with the mouse bioassay was nearest to one. Each method possesses differentt virtues and it may be that a multi-method approach would harness the benefits of each method for various aspects of a shellfish testing regime.

Ambulatory systems for managed care.

Providence Health System is successfully making the transition from an acute care-based holding company of health care business to a diversified, operating, managed care company with the mission of improving the health status of the populations it serves, and being at financial risk for doing so. Information systems have been a leading change agent in this transition, not only from the standpoint of consolidating and standardizing practices within Providence Health System, but also by facilitating the exchange and integration of information within the health care community. ProvNet has made available the tools to accomplish this information integration in the physician's office and to extend it not only to Providence, but to other health systems as well.

[Psychiatric handicap--precursor or social sequelae of schizophrenia?]. / Seelische Behinderung--Vorläufer oder soziale Folge der Schizophrenie?

Having finalized the ICD 10, the WHO is now preparing a new version of the "International Classification of Impairments, Disabilities and Handicaps" (ICIDH). At present this threefold scheme is designed to classify the consequences of mental illness. Impairment is defined as either a loss of function or a damage to structure. Disability is the resulting limitation in performance. The restriction in the ability to fulfill social roles is known as role handicap. These three aspects conceptualised in strict sequence have thus far been understood only in terms of the result of the illness. The planned review of the ICIDH will most likely consist of substituting this rather rigid scheme by a more flexible one. This will allow for feedback mechanism between the different levels. Premorbid disabilities/handicaps as possible risk factors for the development of mental illness may even be taken into consideration. The analyses within the Mannheim ABC schizophrenia study have convincingly shown that social disability and role handicaps are present in a high percentage of patients (57%) prior to the onset of the first psychotic symptom. On an average they begin about two to four years before the first hospitalisation and one to three years prior to the first psychotic symptom. While the correlation between social disability and positive symptoms is not significant, disability and negative symptoms are closely related. In addition to this only part of this correlation can be explained as a conceptual overlap (i.e. the SANS subscales Avolition and Anhedonia have items comparable to the Disability Assessment Schedule). In fact, we found comparably high correlations between affective blunting and alogia and social disability as well. Patients with early disability not only have an overall unfavourable course of negative symptoms but negative symptoms are shown to be useful predictors for social disability three years after the first hospitalisation.

Adaptive differentiation of avian exocrine cells alters their pHi response to mAChR activation.

Muscarinic receptor-mediated changes in intracellular pH (pHi) were measured in isolated 2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein-loaded cells, suspended in bicarbonate-containing media, from the exocrine nasal gland of freshwater-fed ducklings (Anas platyrhynchos). The pHi recovery from an acid load was sensitive to amiloride, required sodium ions in the external medium, and was independent of added bicarbonate. These findings are consistent with the hypothesis that the pHi recovery was mediated by a Na+/H+ exchanger. Muscarinic activation of cells resulted in a sustained cytosolic alkalinization that was sensitive to atropine and that was blocked by amiloride. Activation of protein kinase C (PKC) or inhibition of protein phosphatases mimicked the effect of receptor activation on pHi, whereas inhibitors of PKC blocked the response, indicating that phosphorylation of a major pHi control mechanism results in a shift of pHi to more alkaline values. In contrast, fully differentiated salt gland cells isolated from nasal glands of salt-stressed ducklings responded to muscarinic receptor activation with a transient cytosolic acidification. These findings raise the question whether the cytosolic alkalinization in muscarinic acetylcholine receptor-activated naive cells may serve as a signal or a permissive factor for the initiation of adaptive growth and/or differentiation processes observed in the salt glands of salt-stressed birds.

[Current deaths due to tuberculosis in France. Analysis of 126 deaths recorded in tuberculosis sufferers in 1975 and 1976 in the Bas-Rhin region (author's transl)]. / Décès actuels par tuberculose en France. Analyse des 126 décès enregistrés chez des tuberculeux en 1975 et 1976 dans le département du Bas-Rhin.

The authors present a study involving 103 cases of death during active tuberculosis and 23 cases of death as a result of complications related to sequelae of tuberculosis recorded in the Bas-Rhin region in 1975 and 1976. Whilst amongst these 103 deaths, the majority concerned elderly individuals, there were nevertheless 20% of deaths due to tuberculosis below the age of 55. The majority of these tuberculosis sufferers had advanced pulmonary lesions where specific therapy had not had time to act. A certain number of deaths could have been avoided, even in the elderly subjects. Of the 23 cases of death due to sequelae, 2/3 died of respiratory failure and 1/5 of secondary aspergillus infection, illustrating the grave prognosis in certain sequelae of tuberculosis.