Recovery of vision after treatment of hemodialysis related bilateral optic nerve ischemia.

PURPOSE: We present the case of a patient who lost light perception in both eyes after hemodialysis and subsequently recovered vision after treatment with erythropoietin and intravenous steroids. OBSERVATIONS: Our patient reported loss of light perception in both eyes (NLP) 2 hours after hemodialysis. Examination confirmed NLP vision, chronic retinal vascular changes, and no acute changes in optic nerve appearance. A presumptive diagnosis of posterior optic neuropathy was made. The patient was treated with erythropoietin and intravenous steroids according to the protocol of Nikkah. Over a period of 14 hours, he recovered vision to his baseline. CONCLUSIONS AND IMPORTANCE: Bilateral loss of light perception is a rare complication of hemodialysis. The presumed mechanism is posterior ischemic optic neuropathy. Prompt treatment with erythropoietin and intravenous steroids should be considered in similar situations that result in Posterior ischemic optic neuropathy (PION) related to procedure-based hypotension.

Advanced environmental surveillance and molecular analyses indicate separate importations rather than endemic circulation of wild type 1 poliovirus in Gaza district in 2002.

An improved sewage surveillance algorithm (sample acquisition, processing, and molecular analysis) for wild and vaccine-derived polioviruses was developed and validated. It was based on plaque isolation with sensitive and high-throughput methods. The molecular analysis included sequencing; a comparison of the type, rate, and distribution of nucleotide substitutions with a profile for outbreaks evolving from a single progenitor; and phylogenetic analysis for relative similarity. The analyses revealed that two environmental wild type 1 isolates from the Gaza district in 2002 were imported separately, most likely from Egyptian southern governorates, and were not linked by endemic circulation. These findings illustrate the continuous spreading potential of wild-type poliovirus and underscore the value of extensive environmental surveillance employing advanced molecular analysis to monitor wild poliovirus in poliomyelitis-free regions.

Five-year-old girls' ideas about dieting are predicted by their mothers' dieting.

OBJECTIVE: To explore 5-year-old girls' ideas, concepts, and beliefs about dieting. DESIGN: Girls were asked to define dieting, to describe the behaviors dieting comprised, and were queried about links between dieting, weight control, and body shape. Parents completed questionnaires addressing family health history, demographics, and issues related to food, dieting, and weight control. SUBJECTS/SETTING: Participants were 197 girls aged 5 years and their parents. All girls lived with both biological parents, and were without food allergies or chronic medical problems. STATISTICAL ANALYSES PERFORMED: For 5 open-ended questions related to dieting, girls were categorized as either having or not having ideas about dieting. These ideas, concepts, and beliefs were categorized, and logistic regression examined predictors of girls' ideas about dieting. RESULTS: Depending on the question, from 34% to 65% of girls aged 5 years had ideas about dieting. Compared to girls whose mothers did not diet, girls whose mothers reported current or recent dieting were more than twice as likely to have ideas about dieting, suggesting that mothers' dieting behavior is a source of young girls' ideas, concepts, and beliefs about dieting. Among mothers, more than 90% reported recent dieting, and most reported use of both health-promoting and health-compromising dieting behaviors. APPLICATIONS: Women should be informed that weight control attempts may influence their young daughters' emerging ideas, concepts, and beliefs about dieting. Mothers should be encouraged to use health-promoting rather than health-compromising weight control strategies, not only for their own well being, but to reduce the likelihood that daughters will incorporate health-compromising dieting behaviors into their concepts, ideas, and beliefs about dieting.

A new variant of echovirus 4 associated with a large outbreak of aseptic meningitis.

BACKGROUND: A large outbreak of aseptic meningitis which began in April 1997 involved hundreds of cases in all geographical regions of Israel and the Palestinian Authority, peaked between June and September, and lasted until December. OBJECTIVES: We have investigated the virus associated with the outbreak to determine its serotype and molecular type and to establish epidemiological links. DESIGN: Virus strains isolated from 210 clinical samples were serotyped by neutralization using LBM and WHO antiserum pools and two echovirus 4 (EV4)-specific antisera, and by immunofluorescence using a monoclonal antibody. RNA was extracted and a 435 base long fragment derived from the 5'UTR of the genome was amplified by RT-PCR using common primers, and sequenced. Sequences were compared to echoviruses 4, 6 and 7 prototypes from ATCC, and to other echoviruses sequences from the EMBL/Genbank data base. RESULTS: The outbreak isolates were identified by the EV4 type-specific antisera and the monoclonal antibody but not with the WHO pools. Very few isolates could be typed by the LBM pools. The EV4 isolates accounted for 68% of all enterovirus isolates in our laboratory in 1997. The age distribution of the patients was: 0-11 month, 11.2%; 1-4 years, 16.1%; 5-9 years, 31.8%; 10-14 years, 9.9%; 15-20 years, 9.5%; 21-44 years, 21.5%; and > 45 years, 0%. Males between 1 and 14 years of age were affected more frequently than females of the same age. The sequences of 25 of 28 EV4 isolates analyzed were closely related to each other (> 95% homology) and the remaining three isolates had < 95% homology to the others and to each other. Interestingly, the outbreak strains were less closely related to the EV4 prototype, than to several other echoviruses. Three closely related subgroups were identified which correlated with geographical distribution but the temporal distribution did not reveal links leading to the source of the outbreak. CONCLUSION: The outbreak was caused by a variant of EV4 which apparently did not circulate in the area before and thus was capable of causing a widespread infection.

A double-selective tissue culture system for isolation of wild-type poliovirus from sewage applied in a long-term environmental surveillance.

We describe a simple, cost-efficient, double-selective method for isolation of wild-type poliovirus from sewage samples containing vaccine polioviruses and other enteroviruses, with a detection limit of 18 to 50 PFU per 1 to 2 liters of sewage. By this method we were able to process 1,700 sewage samples collected between 1991 and 1996, from which 10,472 plaques were isolated, 41 of them being identified as wild-type polioviruses.

Identification of a new strain of fastidious enterovirus 70 as the causative agent of an outbreak of hemorrhagic conjunctivitis.

A 1994 outbreak of acute hemorrhagic conjunctivitis in Israel was caused by an enterovirus 70 strain that was distinct from previously reported strains. Characterization was by electron microscopy (eye washes), reverse transcription-PCR (RT-PCR; eyewash, specimens, eye swabs, and tears), and sequence analysis of RT-PCR-amplified fragments from the 5' noncoding region and VP1.

Induction of serotonin release from mast cells by lymphocyte activators is dependent upon implantation of lymphocyte plasma membrane components.

Plasma membranes (PM) isolated from mouse splenic lymphocytes were successfully fused to rat basophilic leukemia (RBL) cells using intact Sendai virus virions (SV). A two-step procedure was used in which SV were first fused with the PM to create PM + SV vesicles; the vesicles formed were then incubated with the RBL cells. Insertion of lymphocyte PM into the RBL cell's membrane endows a high rate of serotonin secretion upon stimulation of the implanted RBL cells with antimouse Ig antibodies or with concanavalin-A. The results of the present work clearly suggest that activation signals can be delivered via implantation of foreign membrane preparation containing specific receptors, thus rendering the target cells susceptible to stimulation by specific reagents.