Prevalence survey and first molecular characterization of Echinococcus granulosus in France.

Human cystic echinococcosis (hydatid disease) caused by the Echinococcus granulosus tapeworm continues to be a substantial cause of morbidity and mortality in many parts of the world. France is still considered as endemic area, but the current infestation by E. granulosus of intermediate hosts in France remains currently unknown due to the absence of official data reporting for the last 20 years. A 1-year prevalence survey was conducted in the 24 slaughterhouses of ten departments of the South of France. We demonstrate that the E. granulosus parasite is still currently present at low prevalence at slaughterhouses in the study area (4 cases for 100,000 sheep and 3 cases for 100,000 cattle). In addition, we assess the presence of genotype G1 in infected animals and identify for the first time in France genotypes G2 and G3 of E. granulosus sensu stricto.

Detection of Echinococcus multilocularis in wild boars in France using PCR techniques against larval form.

Recently, new data have been collected on the distribution and ecology of Echinococcus multilocularis in European countries. Different ungulates species such as pig, goat, sheep, cattle and horse are known to host incomplete development of larval E. multilocularis. We report a case of E. multilocularis portage in two wild boars from a high endemic area in France (Department of Jura). Histological examination was performed and the DNA was isolated from hepatic lesions then amplified by using three PCR methods in two distinct institutes. Molecular characterisation of PCR products revealed 99% nucleotide sequence homology with the specific sequence of the U1 sn RNA gene of E. multilocularis, 99 and 99.9% nucleotide sequence homology with the specific sequence of the cytochrome oxydase gene of Echinococcus genus and 99.9% nucleotide sequence homology with a genomic DNA sequence of Echinococcus genus for the first and the second wild boar, respectively.

Development of a qualitative indirect ELISA for the measurement of rabies virus-specific antibodies from vaccinated dogs and cats.

A protocol suitable for the detection of rabies virus-specific antibodies in serum samples from companion animals using an enzyme linked immunosorbent assay (ELISA) is described. This method has been used successfully for the qualitative assessment of rabies virus-specific antibodies in serum samples from a cohort of vaccinated dogs and cats. In two initial field studies, a variable population of field samples from the Veterinary Laboratories Agency (VLA), United Kingdom were tested. In the first study (n = 1000), the number of false-positive and false-negative results was 11 samples (1.1%) and 67 samples (6.7%), respectively. In the second study (n = 920), the number of false-positive and false-negative results was 7 samples (0.8%) and 52 samples (5.7%). In a third study, undertaken at l'Agence Française de Sécurité Sanitaire des Aliments (AFSSA), Nancy, France (n = 440), 1 false-positive sample (0.23%) and 91 (20.7%) false-negative samples were identified. Data generated using this prototype ELISA indicate a strong correlation for specificity when compared to the gold standard fluorescent antibody virus neutralisation (FAVN) test. Although the ELISA has a lower sensitivity than the FAVN test, it is a useful tool for rapidly screening serum samples from vaccinated companion animals. Using a cut-off value of 0.6 EU/ml, the sensitivity (R = % from VLA and 79% from AFSSA) and specificity (R = 97.3%) indices between the ELISA compared favourably with data generated using the FAVN test. The major advantages of the ELISA test are that it is a qualitative tool that can be completed in four hours, does not require the use of live virus and can be performed without the need for specialised laboratory containment. This contrasts with 4 days using conventional rabies antibody virus neutralisation assays. Using the current format, the ELISA assay described would be a valuable screening tool for the detection of rabies antibodies from vaccinated domestic animals in combination with other Office International des Epizooties (OIE) accepted serological tests.

Automatic P-wave analysis of patients prone to atrial fibrillation.

A method is presented for automatic analysis of the P-wave, based on lead II of a 12-lead standard ECG, in resting conditions during a routine examination for the detection of patients prone to atrial fibrillation (AF), one of the most prevalent arrhythmias. First, the P-wave was delineated, and this was achieved in two steps: the detection of the QRS complexes for ECG segmentation, using a wavelet analysis method, and a hidden Markov model to represent one beat of the signal for P-wave isolation. Then, a set of parameters to detect patients prone to AF was calculated from the P-wave. The detection efficiency was validated on an ECG database of 145 patients, including a control group of 63 people and a study group of 82 patients with documented AF. A discriminant analysis was applied, and the results obtained showed a specificity and a sensitivity between 65% and 70%.

Impact of a cost-sharing drug insurance plan on drug utilization among older people.

OBJECTIVES: In August 1996, the Régie de l'assurance-maladie du QuEbec (RAMQ), the government body responsible for medical insurance in the Canadian province of Quebec, introduced a cost-sharing drug insurance plan. Before this plan, individuals age 65 years and older had to pay Canadian (CDN)$2 per prescription, with the remaining cost paid by the RAMQ. With the new plan, beneficiaries may have to pay an amount between CDN$200 and CDN$925 per year, depending on their income. Concerned that this financial constraint imposed on older people might have an impact on the use of medications, we investigated whether the consumption of four classes of medications, antihypertensive agents, anticoagulants, nitrates, and benzodiazepines, was affected by the drug plan implementation. DESIGN: Time series models with pre/post comparison group. SETTING: Administrative computerized databases of the RAMQ. PARTICIPANTS: Random sample of Quebec residents age 65 years and older registered in the provincial drug plan between August 1992 and June 1997: 54,771 users of nitrates, 133,146 users of antihypertensive agents, 45,534 users of anti-coagulants, and 26,165 users of benzodiazepines. MEASUREMENTS: We modeled the monthly consumption of the medications under study between August 1992 and June 1996. Monthly drug consumptions predicted from the models were compared with those observed for the 13 months (August 1996 to August 1997) following the implementation of the new drug plan using 95% confidence intervals. The number of prescriptions dispensed served as an indicator for drug consumption. RESULTS: During the study period we observed a nonstatistically significant decrease in number of prescriptions of 5.1% for nitrates, 1.1% for antihypertensive agents, and 0.8% for benzodiazepines, and a nonstatistically significant increase of 1.6% for anticoagulants. CONCLUSION: Residents of Quebec age 65 years and older were not found to have reduced significantly their consumption of nitrates, antihypertensive agents, anticoagulants, and benzodiazepines during the 13 months that followed the implementation of a cost-sharing drug insurance plan.

Age-related differences in in-hospital mortality and the use of thrombolytic therapy for acute myocardial infarction.

BACKGROUND: Recent guidelines have acknowledged that thrombolysis decreases mortality from acute myocardial infarction (AMI) independently of age. The purpose of this study was to determine the age-related rates of thrombolytic administration and in-hospital mortality and the variables related to the use of thrombolytic therapy for patients with AMI. METHODS: A prospective cohort analysis involved a registry of 44 acute care Quebec hospitals that enrolled 3741 patients with AMI between January 1995 and May 1996. The main outcomes of interest were crude and adjusted age-related in-hospital mortality rates and rates of use of thrombolytic therapy. RESULTS: In-hospital mortality rates increased dramatically with age from 2.1% in patients with AMI who were less than 55 years of age to 26.3% in those who were 85 years of age or older. Overall, 35.8% of the patients received thrombolysis. There was a pronounced inverse gradient in the use of thrombolysis with age, ranging from 46.2% in the youngest age group (< 55 years) to 9.5% in the oldest group (> or = 85 years). After adjustment for potential confounders, the older patients remained significantly less likely to receive thrombolytic therapy. Compared with patients who were less than 55 years of age, the odds ratio of receiving thrombolytic therapy was 0.68 (95% confidence interval [CI] 0.52-0.89) for patients aged 65-74 years, 0.48 (95% CI 0.35-0.65) for patients aged 75-84 years and 0.13 (95% CI 0.06-0.26) for patients aged 85 years or more. Other variables related to thrombolytic therapy were diabetes (odds ratio [OR] 0.77, 95% CI 0.59-1.00), cerebrovascular disease (OR 0.46, 95% CI 0.30-0.72), angina (OR 0.73, 95% CI 0.56-0.95), typical chest pain (OR 2.56, 95% CI 1.88-3.47); ST elevation (OR 8.93, 95% CI 7.24-11.00), Q wave MI (OR 5.26, 95% CI 4.20-6.60) and increased length of time between onset of symptoms and arrival at hospital. INTERPRETATION: Age is an important independent predictor of in-hospital mortality and lower thrombolytic use following AMI. Other studies are required to further evaluate the appropriateness of thrombolytic therapy for elderly patients.

Multiscale MAP filtering of SAR images.

Synthetic aperture radar (SAR) images are disturbed by a multiplicative noise depending on the signal (the ground reflectivity) due to the radar wave coherence. Images have a strong variability from one pixel to another reducing essentially the efficiency of the algorithms of detection and classification. We propose to filter this noise with a multiresolution analysis of the image. The wavelet coefficient of the reflectivity is estimated with a Bayesian model, maximizing the a posteriori probability density function. The different probability density function are modeled with the Pearson system of distributions. The resulting filter combines the classical adaptive approach with wavelet decomposition where the local variance of high-frequency images is used in order to segment and filter wavelet coefficients.

Borna disease: a possible emerging zoonosis.

The Borna disease virus (BDV) causes a disease of the central nervous system (CNS) in several vertebrate species. The progress made over the last 30 years in molecular biology has allowed us to identify the unique characteristics of the virus, such as its persistence in the CNS and the way it is expressed. This has allowed scientists to classify this pathogenic agent in a new family of RNA viruses. BDV affects a very large spectrum of hosts and is responsible for a disease characterised by behavioural anomalies. The large range of intra- or inter-specific symptoms of this disease (from persistence of the virus without clinical symptoms to CNS destruction) make epidemiological studies very difficult. Different diagnostic tools have allowed the detection of this infectious agent in different species around the world (central Europe, USA, UK, Japan, Iran, etc.). The disease can be fatal for sheep and horses (its primary natural hosts) and can infect other species such as rats, cattle, dogs, cats or pigeons. In human beings, BDV could be responsible for certain psychiatric disorders. In France, the limited number of epidemiological studies that have been conducted up until now (in veterinary and medical fields) does not allow scientists to ascertain whether the disease is present in France or not. Due to the suspected large geographical distribution of this infectious agent, however, we could expect the presence of BDV in France.

Long-term survival and functional status in the elderly after cardiac surgery.

BACKGROUND: Hospital mortality and morbidity of cardiac surgery have been well described in the elderly, but there is a paucity of data regarding long-term functional status. OBJECTIVE: To evaluate long-term survival and functional status of patients aged 70 years or older after cardiac surgery. DESIGN: Retrospective observational study. SETTING: University-affiliated tertiary care hospital. PATIENTS: Three hundred and twenty-nine consecutive patients aged 70 or older who had undergone cardiac surgery from January 1990 to December 1993. INTERVENTIONS: Besides postoperative mortality and morbidity, data regarding long-term survival and functional status and preoperative variables affecting these outcomes were analyzed. MAIN RESULTS: Mean age at surgery was 73.9 +/- 2.9 years, and 70.2% of the procedures were performed on an urgent basis. Postoperative mortality was 9.4%. Five-year Kaplan-Meier survival in postoperative survivors was 85.9% and is comparable with the survival of the general sex- and age-matched Quebec population. Preoperative variables affecting long-term survival were atrial fibrillation (RR 3.8; 95% CI 1.4 to 10.0), smoking status on admission (RR 3.6; CI 1.6 to 8.1), peripheral vascular disease (RR 2.9; CI 1.4 to 6.2) and low creatinine clearance (RR 1.4; CI 1.1 to 1.7). Functional status evaluated by the Karnofsky score showed a successful functional outcome in 84.6% of patients at follow-up (mean 2.6 +/- 1.1 years). Preoperative variables unfavourably influencing a successful functional outcome were hypertension (OR 0.34; CI 0.15 to 0.76), cerebrovascular disease (OR 0.35; CI 0.15 to 0.87) and low creatinine clearance (OR 0.73; CI 0.55 to 0.96). CONCLUSIONS: Despite severe cardiovascular and often urgent conditions, sustained functional improvement and good long term survival can be objectively documented in most elderly patients after cardiac surgery.

Feed efficiency, carcass characteristics, and sensory quality of lambs, with or without prolific ancestry, fed diets with different protein supplements.

Data were collected on 130 intact male lambs fed diets based on roughages supplemented with fish meal, soybean meal, or corn gluten-blood meal and slaughtered at 43 kg live weight. A nonsupplemented group served as a control. The lambs represented Romanov (R), Finnsheep (F), a new breed developed in Canada (DLS), Coopworth (C), and Suffolk (S), three first crosses of DLS with R, F, and Booroola Merino (B), and their backcrosses to DLS. Supplemented lambs consumed 16 to 22% less (P less than .05) silage than control lambs. Average daily gains of lambs fed fish meal (226 g) and corn gluten-blood meal (217 g) were higher and feed conversion ratio (4.99 and 5.11) lower than that of lambs fed soybean meal (189 g and 5.48) or control (186 g and 5.76) diets (P less than .05). The cost of feed per kilogram of gain or per kilogram of lean produced was similar in the four treatments but was between C $.23 and .65 cheaper in the protein-supplemented groups when the number of days to reach slaughter weight was considered. The effect of diet on carcass traits and meat quality were minimal. Meat of lambs fed the three protein supplements was less juicy than that of control lambs. With a few exceptions, most of the significant differences among genetic groups in growth, carcass, and sensory traits were mainly between prolific (R and F) and meat-type breeds (C, S, and DLS). Gain in weight was highest in S lambs (199 g/d), but F and R first crosses were the youngest at slaughter (196 and 198 d). The F lambs had higher dressing and kidney fat percentages than meat-type breeds. The DLS lambs had the largest longissimus muscle area (14.0 cm2), whereas C had the smallest (10.7 cm2). The B crosses had larger longissimus muscle area than R and F crosses. The R lambs had more lean and less fat in the 12th rib, whereas C lambs had the lowest lean and a high bone percentage. The toughest and the most tender roasts were those of R and B crossbred lambs, respectively. Roasts from F lambs had the most intense lamb flavor.

A cloned DNA probe identifies the sex of Schistosoma mansoni cercariae.

This report describes a method for the identification of the sex of Schistosoma mansoni cercariae using a cloned DNA probe which is female-specific. The probe is a 339 bp repeat; the sequence is presented. Cercariae from nine mono-miracidially infected snails were used in a double blind study. Mice were infected and the sex of adult worms observed. DNA was isolated from cercariae, digested with EcoRI, subjected to agarose gel electrophoresis, transferred to a matrix and hybridized with the cloned female-specific DNA probe. In all nine cases the sex of the cercariae as determined by DNA analysis agreed with the sex of the adult parasites.

Oncodevelopmental and hormonal regulation of alpha 1-fetoprotein gene expression.

The main features of the oncodevelopmental biology of alpha 1-fetoprotein (AFP) are reviewed. Progress made in the molecular biology of AFP gene regulation is discussed and we present our recent data on the mechanisms of AFP suppression by glucocorticoid hormones. The relationship between AFP gene transcription and cell replication is examined, and it is suggested that the degree of methylation of the AFP gene (or of co-methylated regulatory DNA sequences) conditions its response to hormones.