Serosurvey of Schmallenberg Virus Infection in the Highest Goat-Specialized Region of France.

The monitoring of both the spread and clinical impact of Schmallenberg virus (SBV) infection within its full host range is important for the control of the epidemic and potential new outbreaks. In France, a national surveillance plan based on voluntary notifications of congenital malformations in newborn ruminants revealed that goats were the less affected host species. However, seroprevalence studies only targeted sheep and cattle, preventing accurate estimations of the real impact of SBV infection in goats. Here, a serological survey was conducted in the highest goat-specialized region of France between June 2012 and January 2013. A total of 1490 goat sera from 50 herds were analysed by ELISA. The between-herd and within-herd prevalences were estimated at 62% and 13.1%, respectively. Seroprevalence was not uniformly distributed throughout the territory and markedly differed between intensive and extensive herds. The low within-herd seroprevalence demonstrates that a large fraction of the French goat population remains susceptible to SBV infection.

Bovine herpesvirus 4 ORF73 is dispensable for virus growth in vitro, but is essential for virus persistence in vivo.

ORF73 orthologues encoded by different rhadinoviruses have been studied extensively. These studies revealed that the ORF73 expression product (pORF73) is a multifunctional protein essential for latency that enables episome tethering to mitotic chromosomes and modulates cellular pathways implicated in growth and survival of latently infected cells. Comparison of pORF73 orthologues encoded by rhadinoviruses reveals important variations in amino acid sequence length and composition. Bovine herpesvirus 4 (BoHV-4) encodes by far the shortest ORF73 orthologue, with a size equivalent to only 22 % of that of the largest orthologues. The present study focused on determining whether BoHV-4 ORF73 is a bona fide gene and investigating whether it is essential for latency, as established for larger ORF73 orthologues. Our results demonstrate that BoHV-4 ORF73 is transcribed as immediate-early polycistronic mRNA together with ORF71. Using a BoHV-4 bacterial artificial chromosome clone, we produced a strain deleted for ORF73 and a revertant strain. Deletion of BoHV-4 ORF73 did not affect the capacity of the virus to replicate in vitro, but it prevented latent infection in vivo using a rabbit model. Interestingly, the strain deleted for ORF73 induced an anti-BoHV-4 humoral immune response comparable to that elicited by the wild type and revertant recombinants. Together, these results demonstrate that, despite its relatively small size, BoHV-4 ORF73 is a functional homologue of larger rhadinovirus ORF73 orthologues, and highlight the potential of ORF73 deletion for the development of BoHV-4 as a vector in vaccinology.

The major portal of entry of koi herpesvirus in Cyprinus carpio is the skin.

Koi herpesvirus (KHV), recently designated Cyprinid herpesvirus 3, is the causative agent of a lethal disease in koi and common carp. In the present study, we investigated the portal of entry of KHV in carp by using bioluminescence imaging. Taking advantage of the recent cloning of the KHV genome as a bacterial artificial chromosome (BAC), we produced a recombinant plasmid encoding a firefly luciferase (LUC) expression cassette inserted in the intergenic region between open reading frame (ORF) 136 and ORF 137. Two viral strains were then reconstituted from the modified plasmid, the FL BAC 136 LUC excised strain and the FL BAC 136 LUC TK revertant strain, including a disrupted and a wild-type thymidine kinase (TK) locus, respectively. In vitro, the two recombinant strains replicated comparably to the parental FL strain. The FL BAC 136 LUC TK revertant strain was shown in vitro to induce a bioluminescent signal allowing the detection of single positive cells as early as 24 h postinfection, while in vivo, it induced KHV infection in carp that was indistinguishable from that induced by the parental FL strain. To identify the KHV portal of entry, carp were analyzed by bioluminescence imaging at different times postinfection with the FL BAC 136 LUC TK revertant strain. These analyses demonstrated that the skin of the fish covering the fins and also the body is the major portal of entry for KHV in carp. Finally, to further demonstrate the role of the skin as the KHV portal of entry, we constructed an original system, nicknamed "U-tube," to perform percutaneous infection restricted to the posterior part of the fish. All the data obtained in the present study demonstrate that the skin, and not the gills, is the major portal of entry for KHV in carp.

Abdominal compartment syndrome and intraabdominal sepsis: two of the same kind?

BACKGROUND: Abdominal compartment syndrome and intra-abdominal hypertension are frequently associated with peritonitis. The aim of this study is to establish the relationship between intra-abdominal hypertension and intra-abdominal sepsis especially in critically ill patients. METHODS: Relevant information was identified through a Medline search (1966-October 2006). The terms used were "intra-abdominal sepsis", "peritonitis", "abdominal compartment syndrome", "intra-abdominal hypertension" and "relaparotomy for sepsis". The search was limited to English- and French-language publications. RESULTS: Only a few clinical trials exist on this specific topic. Further investigations are required to define the incidence of intra-abdominal hypertension in intra-abdominal sepsis, and the prognostic impact of this setting and finally the potential specific treatment. Abdominal compartment syndrome is more likely linked to the abdominal surgery than to peritonitis itself. CONCLUSION: Intra-abdominal pressure monitoring can be valuable in critically ill patients with suspicion of persisting intra-abdominal sepsis after surgical peritonitis treatment.

Abdominal compartment syndrome and intraabdominal sepsis: two of the same kind?

BACKGROUND: Abdominal compartment syndrome and intra-abdominal hypertension are frequently associated with peritonitis. The aim of this study is to establish the relationship between intra-abdominal hypertension and intra-abdominal sepsis especially in critically ill patients. METHODS: Relevant information was identified through a Medline search (1966-October 2006). The terms used were "intra-abdominal sepsis", "peritonitis", "abdominal compartment syndrome", "intra-abdominal hypertension" and "relaparotomy for sepsis". The search was limited to English- and French-language publications. RESULTS: Only a few clinical trials exist on this specific topic. Further investigations are required to define the incidence of intra-abdominal hypertension in intra-abdominal sepsis, and the prognostic impact of this setting and finally the potential specific treatment. Abdominal compartment syndrome is more likely linked to the abdominal surgery than to peritonitis itself. CONCLUSION: Intra-abdominal pressure monitoring can be valuable in critically ill patients with suspicion of persisting intra-abdominal sepsis after surgical peritonitis treatment.

Mechanisms of action of intravenous immunoglobulin in autoimmune and inflammatory diseases.

Intravenous immunoglobulins (IVIg) exert a broad range of immunoregulatory functions that provide a basis for the beneficial effects of IVIg in autoimmune and systemic inflammatory disorders. This review focuses on the effects f IVIg on humoral and cellular immunity that may be of relevance for the treatment of inflammatory neurological diseases.

Circulating PTHrP concentrations in tumor-induced hypercalcemia: influence on the response to bisphosphonate and changes after therapy.

We studied the influence of circulating parathyroid hormone-related protein (PTHrP) concentrations on the response of hypercalcemic cancer patients to bisphosphonate therapy. We also examined the changes in circulating PTHrP levels during the normalization of serum Ca to determine if part of the increase in PTHrP concentrations is not secondary to hypercalcemia itself, as suggested by some in vitro data. We sequentially measured in 45 hypercalcemic cancer patients treated by pamidronate the circulating concentrations of PTHrP (by an amino-terminal RIA; normal values < 9 pmol/liter), Ca, Ca2+, Pi, intact PTH, and the fasting urinary excretion of Ca (Ca/Cr) and cyclic AMP (cAMP). Mean +/- SEM baseline PTHrP levels were 9.5 +/- 1.3, with a median (range) value of 6.0 (< 3.4-43) pmol/liter. PTHrP levels were elevated in 18 of 45 patients, more often in epidermoid than in glandular carcinomas (P < 0.05), and they were significantly (P < 0.05) correlated with the concentrations of Pi (r = -0.46), Ca/Cr (r = -0.31), and urinary cAMP (r = 0.47). Mean pretreatment Ca levels were not significantly different between patients with elevated and patients with normal PTHrP levels, 13.3 +/- 0.4 versus 12.9 +/- 0.4 mg/dl, but the concentrations became significantly different (P < 0.005) 4 days after therapy, 10.2 +/- 0.3 versus 9.2 +/- 0.1 mg/dl, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Detection of right atrial myxoma by Fourier phase analysis.

The usefulness of radionuclide imaging in the detection of cardiac tumors has been demonstrated previously in left atrial myxomas. We report a case of right sided myxoma successfully diagnosed by radionuclide imaging and evaluated by cine display, Fourier phase analysis and paradox image. These three techniques are now available in many computer programs for gated cardiac blood pool imaging and provide an additional tool for assessing cardiac tumors. Particularly, functional paradox and Fourier phase analysis seem promising tools in the detection of both left and right sided tumors.

[The course of renal function in vesicorenal reflux. Study using I-123 Hippuran]. / Evolution de la fonction rénale en présence de reflux vésico-rénal. Etude par l'123 I-Hippuran.

Fifty-two patients with vesicoureteral reflux (age: 6.4 +/- 6.2 years) were examined by IVP, voiding cystouretrography and 123 I-Hippuran studies. 17 patients were not operated; 26 had an antireflux, 9 an urethral surgery. The follow-up was 2 years for 39 of these patients, with at least one evaluation per year. The observations were: Unoperated patients were younger, had a lower radiological grade of reflux and renal functional impairment was less frequent. Functional impairment was initially equally distributed in unilateral (53%) and bilateral (54%) reflux. Radiological grade of reflux had an unsatisfactory predictive value for functional renal status. Functional renal status at 2 years was unchanged in 82% of patients. Improvement was observed in 8%, deterioration in 10%. These results were not influenced by the choice of treatment. However, reflux persistence was more frequently observed in the un-operated group (50% versus 5%). Renal transit times of 123 I-Hippuran did not correlate with the functional status or the radiological grade of reflux.

Thermodilution measurement of right ventricular ejection fraction with a modified pulmonary artery catheter.

In 14 critically ill patients in stable cardiopulmonary status, right ventricular ejection fraction (RVEF) was measured by thermodilution technique and by radionuclear (gated first pass) technique. The pulmonary artery catheter was equipped with a fast-response thermistor and an intracardiac ECG monitor. In addition, the proximal lumen ended in a 3-hole port 21 cm from the tip of the catheter to facilitate mixing of the cold bolus above the tricuspid valve. The use of a new algorithm based on an exponential curve analysis of the thermodilution curve limited the variability of RVEF determinations to 7.6%. The correlation between RVEF measured by thermodilution and radionuclear techniques was significant (y = 12.7 +/- 0.49x, r = 0.67, p less than 0.01). However, the values obtained by thermodilution were usually lower, especially for high RVEF. Nevertheless, although some discrepancy was found, thermodilution techniques allow simple, accurate and repetitive bedside measurements of right ventricular volumes in the critically ill.

Discrepancy between thermodilution and radionuclide right ventricular ejection fraction measurements: the importance of tricuspid regurgitation.

Measurement of right ventricular ejection fraction (RVEF) by the thermodilution technique has become routinely available at the bedside of the critically ill. We describe 2 patients with tricuspid regurgitation in whom RVEF values were considerably lower by thermodilution than by radionuclide techniques. Discrepancies could be due to the regurgitation of the thermodilution signal and possibly to the different nature of the two measurements (forward stroke volume with the thermodilution technique and total stroke volume with the radionuclide technique). We suggest that lower RVEF measurement by the thermodilution technique could be related to unrecognized tricuspid regurgitation. Measurement of an unexpectedly low RVEF by the thermodilution technique should suggest the presence of tricuspid regurgitation.

Importance of deep abdominal palpation in the perinatal diagnosis of urologic malformations.

Deep abdominal palpation was performed prospectively in 900 newborns. Normal kidneys were felt in all but 8. 2 of these had a normal ultrasonography, 2 had an obstructive hydronephrosis, 1 had bilateral renal hypoplasia and 3 had a previously undiagnosed unilateral renal agenesis. Despite the increasing use of prenatal ultrasonography, careful abdominal examination should be performed in all newborns.

[Indirect evaluation of effort angina. Automatic and traditional analysis of the ST segment, the amplitude of the R wave and thallium scintiscanning]. / Evaluation indirecte de l'insuffisance coronaire d'effort. Analyse automatique et traditionnelle du segment ST, de l'amplitude de l'onde R et de la scintigraphie au thallium.

Forty-six patients presenting typical or non-typical angina pectoris were all submitted to analysis of effort angina, traditional or automatic, and to analysis of the amplitude of the R wave and to an effort myocardial scan using thallium 201 (taken as reference substance) during maximal muscle exercise. The following conclusions may be drawn from this study. 1) Autoanalysis of the ECG improves considerably the sensitivity without changing the specificity of the method (92 and 82 p. cent for 79 and 82 p. cent). Analysis of the variations in amplitude of the R wave gave no further information. It should be reserved for patients whose effort ECG was difficult to interpret: e.g. left or right bundle branch block, digitalis effect, very abnormal resting ECG, or average age female population.

Function of the respiratory muscles in acute hemiplegia.

Electromyograms of the parasternal intercostal muscles and of the diaphragm were obtained with surface electrodes in 20 patients with early flaccid hemiplegia due to cerebrovascular accident. In most patients, a striking reduction in activity was observed during voluntary inspirations in both the intercostal muscles and the diaphragm on the side of the paresis. These findings suggest that in most persons the respiratory muscles are innervated primarily by decussated fibers. Dysfunction of the respiratory muscles might be implicated in the respiratory tract infections of patients with early hemiplegia.

Analysis of exercise-induced R-wave-amplitude changes in detection of coronary artery disease in patients with typical or atypical chest pain under digitalis treatment.

Specificity and sensitivity of exercise ECG were compared to exercise stress thallium 201 scanning and coronary arteriograms in 70 male patients with typical or atypical chest pain complaints, without previous myocardial infarction. 50 patients (group I) did not receive any treatment; 20 patients (group II) received digitalis as preventive treatment of atrial arrhythmias or for no particular reason. Only subjects with concordant results in radionuclide and angiography examinations were considered as coronary artery disease patients. Exercise stress tests were performed sitting on the bicycle ergometer using a progressive loading profile (30 W for 3 min), to the symptom-limited capacity (VO2SL). Positive exercise ECG were confirmed on ST decrease (1.5 mm) or on absence or increase in R-wave-amplitude modifications (V5). In the group I patients, ECG-ST-modification sensitivity, specificity, predictive value (+) and efficiency were, respectively, 92, 82, 86 and 88%. R-wave-variation sensitivity, specificity, predictive value (+) and efficiency were, respectively, 41, 74, 65 and 56%. In the group II patients, ST-depression sensitivity, specificity, predictive value (+) and efficiency were, respectively, 100, 33, 59 and 65%. R-wave-variation sensitivity, specificity, predictive value (+) and efficiency were, respectively, 50, 70, 63 and 60%. It was concluded that R-wave-amplitude variations induced lower false positive responses than ST-segment depression in patients under digitalis treatment. False negative responses were unfortunately 50% using the R-wave criterion. Exercise ECG was finally judged as a poor indicator of CAD in patients under digitalis treatment.