RESUMEN
In November 2010, an outbreak of avian influenza (AI) due to the H5N2 subtype virus occurred in a turkey breeder farm in northern Manitoba, Canada. The only clinical signs observed were depression, decrease in food consumption, and loss of egg production. The hemagglutinin (HA) cleavage (HA(0)) site of the isolated H5N2 virus was PQRETR/GLF, consistent with low pathogenic AI viruses. The intravenous pathogenicity index of this virus was zero. Whole-genome sequencing of two isolates that originated from two different barns was performed, and both isolates had 100% identical protein sequence in PB2, HA, NP, M1, M2, NS1, and NS2. The remaining gene segments (PB1, PA, and NA) had a single amino-acid difference when compared with each other. The nucleotide and protein sequences of eight gene segments from both isolates showed 99 or greater identity with other AI viruses that have been circulating in free-living aquatic birds in Canada and the United States within the last 10 yr. Phylogenetic analysis of the HA and neuraminidase (NA) gene segments showed that these viruses are closely related to other H5 strains that have been isolated from Manitoba and other parts of Canada. Serologic testing of archived serum samples collected from these turkeys a week before the outbreak showed no evidence of AI infection. In addition, other farms that were located within 3 km radius from the infected farm and farms that had epidemiologic connection with the farm also tested negative for the presence of H5N2 AI virus or antibody. This indicates that the virus might have been introduced to the farm from wild aquatic birds only a short time before detection. Results of this study highlight the importance of early detection and the significance of ongoing Canada-wide surveillance of AI in domestic poultry as well as in wild aquatic birds/ducks.
Asunto(s)
Brotes de Enfermedades/veterinaria , Subtipo H5N2 del Virus de la Influenza A/genética , Subtipo H5N2 del Virus de la Influenza A/patogenicidad , Gripe Aviar/virología , Enfermedades de las Aves de Corral/virología , Pavos , Animales , Embrión de Pollo , Cloaca/virología , Femenino , Pruebas de Inhibición de Hemaglutinación/veterinaria , Pruebas de Hemaglutinación/veterinaria , Subtipo H5N2 del Virus de la Influenza A/aislamiento & purificación , Gripe Aviar/epidemiología , Gripe Aviar/prevención & control , Masculino , Manitoba/epidemiología , Datos de Secuencia Molecular , Orofaringe/virología , Filogenia , Reacción en Cadena de la Polimerasa/veterinaria , Enfermedades de las Aves de Corral/epidemiología , Enfermedades de las Aves de Corral/prevención & control , Prevalencia , Análisis de Secuencia de ADN/veterinaria , Estudios Seroepidemiológicos , Organismos Libres de Patógenos Específicos , Proteínas Virales/genética , Proteínas Virales/metabolismo , VirulenciaRESUMEN
BACKGROUND: This study explores the utilization of Hospital Discharge (HD) data to obtain estimates of work-related non-fatal injuries rates in NJ to determine if Hispanics workers have an increased risk of specific work-related injuries. In addition, HD data are used to compare the rate ratios between fatal and non-fatal injuries in this population to demonstrate the effectiveness of using HD as a surveillance tool for monitoring injury trends and performing evaluations. METHODS: Several types of fatal and non-fatal injuries were modeled using Poisson regression with the following predictor variables: gender, ethnicity, and year. The estimated number of workers by ethnicity employed in NJ each year was obtained from the U.S. Census Bureau, DataFerrett, Current Population Survey, November 2006, a data mining tool which accesses CPS data. RESULTS: These analyses, utilizing estimates of working population at-risk, indicate that Hispanic workers have an increased risk of four particular work-related injuries compared with non-Hispanics, and Hispanics were injured at a younger age than non-Hispanics. In addition the rankings of the rate ratios from the comparison between non-fatal and fatal risk estimates were similar; indicating that occupational surveillance of non-fatal injuries is a viable component to be considered. CONCLUSIONS: HD data are effective for monitoring trends over time across ethnic groups and injury types. Therefore, non-fatal injury surveillance should be considered for targeting specific worker populations for interventions to reduce exposure to workplace hazards, and can be a valuable surveillance tool in efforts to reduce occupational injuries.
Asunto(s)
Accidentes de Trabajo/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Alta del Paciente/estadística & datos numéricos , Vigilancia de la Población/métodos , Accidentes de Trabajo/clasificación , Accidentes de Trabajo/mortalidad , Adulto , Distribución por Edad , Minería de Datos , Femenino , Humanos , Masculino , Persona de Mediana Edad , New Jersey/epidemiología , Distribución por Sexo , Adulto JovenRESUMEN
Initial treatment of locally advanced esophageal and gastroesophageal junction (GEJ) malignancies for selected patients at some institutions has recently changed from surgical resection to neoadjuvant therapy. The aim of this study is to evaluate the impact of this change in treatment strategy on both the overall disease profile and locoregional endoscopic ultrasound (EUS) staging accuracy for a cohort of patients managed with primary surgical resection over a 10-year period at our institution. All subjects at our institution who underwent primary esophagectomy from 1993 to 2002 following preoperative EUS for known or suspected esophageal and/or GEJ cancers were identified. Patients with dysplasia alone, prior upper gastrointestinal tract surgery, preoperative neoadjuvant therapy, cancer of the gastric cardia or recurrent malignancy were excluded. EUS findings and staging results were compared to surgical pathology following resection. The impact of the gradually increased use of primary chemoradiation during the second half of the study was assessed. Of the 286 operations performed, 184 subjects were excluded. The remaining 102 underwent primary surgical resection a median of 18 days following EUS staging for adenocarcinoma (88%) or squamous cell carcinoma (12%) of the esophagus (69%) or GEJ (31%). Overall EUS locoregional T and N staging accuracy was 72% and 75% respectively; accuracy for T1, T2, T3 and T4 cancer was 42%, 50%, 88% and 50% respectively. Despite an increased frequency of pathologically confirmed T1 and T2 cancers (P = 0.005) and an insignificant trend toward increased N0 malignancy (P = 0.05) during the second half of the study period, no statistically significant changes in T (P = 0.07) or N (P = 0.82) staging accuracies for EUS or disease characteristics were noted between the first and second half of the study period. Despite both inaccurate radial EUS staging and increased relative use of primary surgery for early cancers, recent increased use of primary neoadjuvant therapy did not change overall disease characteristics and accuracy of locoregional EUS staging of esophageal and GEJ cancers managed with primary surgical resection.
Asunto(s)
Adenocarcinoma/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Neoplasias Esofágicas/diagnóstico , Unión Esofagogástrica , Adenocarcinoma/terapia , Carcinoma de Células Escamosas/terapia , Endosonografía , Neoplasias Esofágicas/terapia , Esofagectomía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante , Estadificación de Neoplasias , Cuidados Preoperatorios , Estudios RetrospectivosRESUMEN
BACKGROUND AND AIMS: Animal studies have reported positive effects of glutamine on intestinal absorption and morphology; human studies have been less convincing. The aim of this study was to evaluate the effects of glutamine and diet on intestinal morphology, motility, and absorption. METHODS: A randomized, double blind, placebo-controlled crossover study in 8 patients with short-bowel on a high carbohydrate, low fat (HCLF) diet, was performed. Active treatment was oral glutamine (0.45 g kg(-1)day(-1)) for eight weeks. Intestinal morphology was evaluated by light microscopy. Gastrointestinal transit was measured by dual gamma camera scintigraphy. D-xylose and fecal fat collection was used to evaluate intestinal absorption. Results of active treatment versus placebo were compared by the signed-rank test. RESULTS: Morphology analysis, reported as median active treatment versus placebo, was villus height: 0.48 mm versus 0.50 mm, P=1.0, and crypt depth: 0.11 mm versus 0.10 mm, P=0.469. Percent D-xylose absorption, reported as median active treatment versus placebo, was 7% versus 10.5%, P=0.109. There was not a significant difference in wet weight or fat absorption compared to placebo, P>0.05. Likewise, gastrointestinal transit was not different compared to placebo. CONCLUSIONS: The results of this controlled study would support that 8 weeks of treatment with oral glutamine and a HCLF diet does not significantly improve intestinal morphology, gastrointestinal transit, D-xylose absorption and stool losses in short bowel patients.
Asunto(s)
Motilidad Gastrointestinal/efectos de los fármacos , Glutamina/farmacología , Absorción Intestinal/efectos de los fármacos , Intestinos/patología , Síndrome del Intestino Corto/tratamiento farmacológico , Xilosa/farmacocinética , Adulto , Anciano , Estudios Cruzados , Heces/química , Femenino , Tránsito Gastrointestinal , Humanos , Masculino , Persona de Mediana Edad , Síndrome del Intestino Corto/fisiopatologíaRESUMEN
A series of novel omega-(N,N,N-trialkylammonium)alkyl ester and thioester derivatives [RCOM(CH2)nNR3+ X-, M = O or S. n = 2-6, X = I or Cl] of 11 nonsteroidal antiinflammatory carboxylic acid agents (naproxen, ketorolac, indomethacin, ibuprofen, sulindac, ketoprofen, flufenamic acid, mefenamic acid, zomepirac, etodolac, and tifurac) was prepared and evaluated for their antiinflammatory, analgesic, and gastrointestinal erosive properties. In general, each prodrug retained the antiinflammatory activity characteristic of the corresponding parent drug but exhibited moderately to greatly reduced gastrointestinal erosive properties and significantly reduced analgetic potencies. This profile is likely due to a combination of factors including the rate of hydrolysis of the esters in the stomach, gut, and plasma, changes in the locus of absorption of the prodrug or nonsteroidal antiinflammatory drug (NSAID), and altered metabolic disposition patterns resulting from these changes. The results obtained from the compounds of this series indicate that esters of this general class may offer a means to modulate both the aqueous/lipid solubility and the hydrolytic/enzymatic cleavage indices of NSAID prodrugs which potentially possess a more favorable therapeutic ratio of antiinflammatory to gastrointestinal erosive activities.
Asunto(s)
Antiinflamatorios no Esteroideos/síntesis química , Ácidos Carboxílicos/síntesis química , Compuestos de Amonio Cuaternario/síntesis química , Compuestos de Sulfhidrilo/síntesis química , Animales , Antiinflamatorios no Esteroideos/toxicidad , Artritis Experimental/tratamiento farmacológico , Ácidos Carboxílicos/farmacología , Ácidos Carboxílicos/toxicidad , Fenómenos Químicos , Química , Ésteres/síntesis química , Ésteres/farmacología , Ésteres/toxicidad , Femenino , Enfermedades Gastrointestinales/inducido químicamente , Hidrólisis , Ratones , Ratones Endogámicos , Compuestos de Amonio Cuaternario/farmacología , Compuestos de Amonio Cuaternario/toxicidad , Ratas , Ratas Endogámicas , Compuestos de Sulfhidrilo/farmacología , Compuestos de Sulfhidrilo/toxicidadRESUMEN
In a survey of California almonds, aflatoxin was found in 14% of 74 samples of unsorted, in-shell almonds as received by the processor in 1972, but it occurred at very low levels (below 20 parts per billion (ppb)) in 90% of the contaminated samples. The overall proportion of individual nuts contaminated was especially low and is estimated with 95% probability to have been in the range of 1 nut/55,300 nuts to 1 nut/14,700 nuts. Aflatoxin contamination is not restriced to any particular section of the almond-growing region of California. Commercial sorting procedures are effective in removing most aflatoxin-contaminated nutmeats, since none of 26 samples of processed, whole nutmeats contained aflatoxin. In contrast, 13 of 27 samples of diced almonds were contaminated, but nine of these 13 samples contained less than 20 ppb. Only one of 25 samples of sliced nutmeats contained aflatoxin (4 ppb). Thus, aflatoxin incidence in almonds varies greatly with the category of finished product. The apparent high incidence in diced nutmeats is probably due mostly to the more uniform distribution of aflatoxin occurring in this product (because of its small particle size) than that occurring in the other products. Sample size requirements for monitoring aflatoxin in almonds are discussed.