Transmission of Hepatitis A Virus through Combined Liver-Small Intestine-Pancreas Transplantation.

Although transmission of hepatitis A virus (HAV) through blood transfusion has been documented, transmission through organ transplantation has not been reported. In August 2015, state health officials in Texas, USA, were notified of 2 home health nurses with HAV infection whose only common exposure was a child who had undergone multi-visceral organ transplantation 9 months earlier. Specimens from the nurses, organ donor, and all organ recipients were tested and medical records reviewed to determine a possible infection source. Identical HAV RNA sequences were detected from the serum of both nurses and the organ donor, as well as from the multi-visceral organ recipient's serum and feces; this recipient's posttransplant liver and intestine biopsy specimens also had detectable virus. The other organ recipients tested negative for HAV RNA. Vaccination of the donor might have prevented infection in the recipient and subsequent transmission to the healthcare workers.

Hypothesis driven single nucleotide polymorphism search (HyDn-SNP-S).

The advent of complete-genome genotyping across phenotype cohorts has provided a rich source of information for bioinformaticians. However the search for SNPs from this data is generally performed on a study-by-study case without any specific hypothesis of the location for SNPs that are predictive for the phenotype. We have designed a method whereby very large SNP lists (several gigabytes in size), combining several genotyping studies at once, can be sorted and traced back to their ultimate consequence in protein structure. Given a working hypothesis, researchers are able to easily search whole genome genotyping data for SNPs that link genetic locations to phenotypes. This allows a targeted search for correlations between phenotypes and potentially relevant systems, rather than utilizing statistical methods only. HyDn-SNP-S returns results that are less data dense, allowing more thorough analysis, including haplotype analysis. We have applied our method to correlate DNA polymerases to cancer phenotypes using four of the available cancer databases in dbGaP. Logistic regression and derived haplotype analysis indicates that ~80SNPs, previously overlooked, are statistically significant. Derived haplotypes from this work link POLL to breast cancer and POLG to prostate cancer with an increase in incidence of 3.01- and 9.6-fold, respectively. Molecular dynamics simulations on wild-type and one of the SNP mutants from the haplotype of POLL provide insights at the atomic level on the functional impact of this cancer related SNP. Furthermore, HyDn-SNP-S has been designed to allow application to any system. The program is available upon request from the authors.

Comparison of x-ray films and low-dose computed tomographic scans: demonstration of asbestos-related changes in 2760 nuclear weapons workers screened for lung cancer.

OBJECTIVE: Increased availability and technical improvements of computed tomographic (CT) scanning encourages its use for detecting asbestos-related disease. We compared low-dose scans and x-ray films in 2760 workers potentially exposed to asbestos, to assess their ability to detect interstitial lung disease (ILD) and pleural thickening (PT). METHODS: A total of 2760 nuclear workers received radiography and CT scanning (2006 to 2009). X-ray films were read by a B reader for ILD and PT and CT scans by a thoracic radiologist, using a protocol for nodules, ILD, and PT. RESULTS: Of the 2760 workers, 271 showed circumscribed PT on CT scans, and 73 on x-ray films, 54 (74%) of which were confirmed on CT scans; 76 showed ILD on CT scans, and 15 on x-ray film, 10 (67%) of which were confirmed on CT scans. CONCLUSIONS: Radiographic readings of PT and ILD were generally confirmed on CT scans. Computed tomographic scans detected three to five times more cases; the majority were minor.

In vivo assessment of absorbable knotless barbed suture for single layer gastrotomy and enterotomy closure.

OBJECTIVE: To compare the performance of an absorbable barbed suture device to absorbable monofilament suture after single layer, appositional gastrotomy and enterotomy closure. STUDY DESIGN: Experimental comparative study. ANIMALS: Purpose-bred adult mongrel hounds (n = 14). METHODS: Bursting strengths up to 250 mmHg of incisional closure with either monofilament or barbed suture in a simple continuous, appositional pattern at sites in the stomach (2), jejunum (4), and colon (4) were compared at postoperative Days 3, 7, and 14. Time for incisional closure was compared between materials. RESULTS: Bursting strength was not significantly different between gastrotomies/enterotomies closed with the monofilament suture or the barbed device. Closure time was significantly reduced with the barbed device in jejunal enterotomy closure. CONCLUSION: The barbed device compared favorably with monofilament suture for gastrotomy and enterotomy (small intestine, colon) closure. Results demonstrate comparable burst strengths between monofilament suture and the barbed device. Closure time was significantly reduced in jejunum closure using the barbed device.

Callous and unemotional traits and social cognitive processes in a sample of community-based aggressive youth.

Psychopathic traits are associated with violent, aggressive behaviors and recidivism in adulthood. To increase positive treatment outcomes, it is arguably beneficial to identify and treat psychopathy as early as possible. Furthermore, because research shows that the effectiveness of behavior modification is likely to be affected by the social information-processing patterns of aggressive children, it is important to understand the relationship between conduct-disordered traits and social cognitions. The results of this study showed that callous/unemotional traits in a community-based sample of behavior-disordered youth (57 male, 19 female; 10-19 years of age; 63% African American) significantly predicted values in obtaining a tangible reward and getting into trouble or being punished. However, callous/unemotional traits, impulsivity/conduct problems, and narcissism failed to predict positive expectations regarding receiving a tangible reward, reducing aversive treatment, and demonstration of dominance. Implications for these results are presented.

Update on dexmedetomidine: use in nonintubated patients requiring sedation for surgical procedures.

Dexmedetomidine was introduced two decades ago as a sedative and supplement to sedation in the intensive care unit for patients whose trachea was intubated. However, since that time dexmedetomidine has been commonly used as a sedative and hypnotic for patients undergoing procedures without the need for tracheal intubation. This review focuses on the application of dexmedetomidine as a sedative and/or total anesthetic in patients undergoing procedures without the need for tracheal intubation. Dexmedetomidine was used for sedation in monitored anesthesia care (MAC), airway procedures including fiberoptic bronchoscopy, dental procedures, ophthalmological procedures, head and neck procedures, neurosurgery, and vascular surgery. Additionally, dexmedetomidine was used for the sedation of pediatric patients undergoing different type of procedures such as cardiac catheterization and magnetic resonance imaging. Dexmedetomidine loading dose ranged from 0.5 to 5 mug kg(-1), and infusion dose ranged from 0.2 to 10 mug kg(-1) h(-1). Dexmedetomidine was administered in conjunction with local anesthesia and/or other sedatives. Ketamine was administered with dexmedetomidine and opposed its bradycardiac effects. Dexmedetomidine may by useful in patients needing sedation without tracheal intubation. The literature suggests potential use of dexmedetomidine solely or as an adjunctive agent to other sedation agents. Dexmedetomidine was especially useful when spontaneous breathing was essential such as in procedures on the airway, or when sudden awakening from sedation was required such as for cooperative clinical examination during craniotomies.

PREVALENCE OF EATING DISTURBANCE AND BODY IMAGE DISSATISFACTION IN YOUNG GIRLS: AN EXAMINATION OF THE VARIANCE ACROSS RACIAL AND SOCIOECONOMIC GROUPS.

Eating disorder research has predominantly focused on White adolescent females. More recent research suggests that eating disorders occur in various racial and age groups. The current study examines prevalence and stability of body image dissatisfaction and eating disturbance in 9- and 10-year-old girls and whether there is variability by racial group or socioeconomic status (SES). Five hundred eighty-one girls completed the Children's Eating Attitude Test (ChEAT) and the Body Image Measure (BIM). Results showed that 11% of the sample scored in the Anorexic range at age 9 and about 7% at age 10. When examining body image, 35% of the sample at age 9 and 38% at age 10 selected Ideal Figures that were smaller than their Real Figures on the BIM. There was a significant difference between the racial groups in their reports of eating disturbance, but not body image dissatisfaction. Specifically, the Minority group had higher eating disturbance scores on average at ages 9 and 10 when compared to the White group. SES did not account for eating disturbance or body image dissatisfaction. These results challenge the maxim that eating disturbance and body image dissatisfaction occur primarily in White females from middle and upper SES populations.

Phase 1 clinical experience using intravenous administration of PV701, an oncolytic Newcastle disease virus.

PV701 is a naturally-attenuated, non-recombinant, oncolytic strain of Newcastle disease virus that displays preclinical intravenous (IV) efficacy. PV701 is selective at killing human cancer cells versus normal human cells based on tumor specific defects in the interferon (IFN)-mediated antiviral response. This oncolytic virus displays a broad spectrum of antitumor activity in vitro and in vivo. Preclinical models successfully predicted key clinical parameters including the mechanism of toxicity, two complementary strategies (desensitization and slow infusion) to reduce toxicity, and the starting dose for phase 1 trials. In three phase 1 trials of 114 patients using IV administration of PV701, Wellstat Biologics Corporation has evaluated the effects of dose, schedule, and infusion rate for PV701. Three general classes of side effects were seen: flu-like symptoms; tumor-site-specific adverse events (AEs); and infusion reactions. The first PV701 dose desensitized the patient to the side effects of further doses, allowing a marked increase in the maximum tolerated dose for subsequent doses compared to the first dose. Tumor responses were first noted at the higher doses achieved using desensitization. In the most recent phase 1 trial of 19 patients at Hamilton, Ontario, that employed desensitization, high repeat doses, and a slower infusion rate (Hamilton Regimen), there were six responses (4 major; 2 minor) and a total of six patients with survival for at least 2 years. In addition, patient tolerability improved using the Hamilton Regimen compared to IV bolus dosing used previously. Phase 2 studies of this novel biologic agent are about to begin.

Substantive validity of working memory measures in major cognitive functioning test batteries for children.

Working memory scales of commonly used measures of cognitive functioning for children are evaluated for substantive validity by comparing processes needed for subtest performance to component processes in Baddeley's working memory model. Comprehensive measures of working memory need to assess phonological and visuospatial working memory as well as storage-retrieval and manipulation in both components. The Wechsler Intelligence Scale-Fourth Edition (WISCIV) working memory index and the Woodcock-Johnson III Tests of Cognitive Abilities broad short-term memory factor do not assess visuospatial working memory. The Stanford-Binet Intelligence Scales, Fifth Edition and WISCIV Integrated have potential for being comprehensive, substantively valid measures of working memory, but they need improvement and further investigation. It is imperative that solid, empirically based definitions of constructs serve as the foundation for comprehensive assessment when measures are used to form hypotheses and make decisions regarding a child's future.