RESUMEN
INTRODUCTION: Tremor-dominant (TD), indeterminate/mixed (ID/M) and postural instability gait difficulty/akinetic-rigid (PIGD/AR) are commonly used subtypes to categorize Parkinson's disease (PD) patients based on their most prominent motor signs. Three different algorithms to determine these motor subtypes are used. Here, we examined if PD subtypes are consistent among algorithms and if subtype stability over time depends on the applied algorithm. METHODS: Using a large longitudinal PD database, we applied 3 published algorithms of PD motor subtype classification in two sets of analyses: 1) cross-sectional analysis in 1185 patients, determining the prevalence of subtypes in 5-year intervals of disease duration; 2) longitudinal analysis of 178 patients, comparing subtypes of individual patients at baseline (within 5 years of diagnosis) and at follow-up ≥ 5 years after baseline. RESULTS: Cross-sectionally, prevalence of subtypes varied widely among the 3 algorithms: 5-32% TD, 9-31% ID/M, and 59-75% PIGD/AR. For all 3 algorithms, cross-sectional analysis showed a marked decline of TD prevalence with disease duration and a corresponding increase in PIGD/AR prevalence, driven by increasing gait/balance scores over time. Longitudinally, only 15-36% of baseline TD patients were still categorized as TD at 6.2 ± 1.0 years of follow-up. In 15-39% of baseline TD patients, the subtype changed to ID/M, and 46-50% changed to PIGD/AR. This shift was observed using all 3 algorithms. CONCLUSION: PD motor subtypes determined by different established algorithms are inconsistent and unstable over time. Lack of subtype fidelity should be considered when interpreting biomarker-subtype correlation and highlights the need for better definition of PD subtypes.
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Algoritmos , Trastornos Neurológicos de la Marcha/fisiopatología , Enfermedad de Parkinson/clasificación , Enfermedad de Parkinson/fisiopatología , Equilibrio Postural/fisiología , Temblor/fisiopatología , Anciano , Estudios Transversales , Bases de Datos Factuales , Femenino , Trastornos Neurológicos de la Marcha/etiología , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/complicaciones , Prevalencia , Temblor/etiologíaRESUMEN
OBJECTIVES: The use of rotavirus pentavalent vaccine (RotaTeq®) as a sole vaccine within rotavirus universal immunization programmes remains limited. We examined the effectiveness of RotaTeq in preventing rotavirus gastroenteritis (RVGE) hospitalization in Israel, after the introduction of universal immunization against the disease. METHODS: A test-negative case-control study included age-eligible children for universal RotaTeq immunization (aged 2-59 months, born in 2011-2015). Cases (n = 98) were patients who tested positive for rotavirus by immunochromatography; those who tested negative (n = 628) comprised the control group. Information on rotavirus immunization history was obtained through linkage with a national immunization registry. Vaccination status was compared between cases and controls, adjusted odds ratios (aORs) were obtained from logistic regression models, and vaccine effectiveness calculated as (1 - aOR)*100. RESULTS: Immunization with RotaTeq was less frequent in RVGE cases (73.5%) than in controls (90.1%), p < 0.001; this association persisted after controlling for potential confounders. Effectiveness of the complete vaccine series was estimated at 77% (95% confidence interval (CI): 49-90) in children aged 6-59 months, and 86% (95% CI: 65-94) in children aged 6-23 months; whereas for the incomplete series, the respective estimates were 72% (95% CI: 28-89) and 75% (95% CI: 30-91). Vaccine effectiveness was estimated at 79% (95% CI: 45-92) against G1P[8]-associated RVGE hospitalizations and 69% (95% CI: 11-89) against other genotype-RVGE hospitalizations. CONCLUSIONS: High effectiveness of RotaTeq as the sole rotavirus vaccine in a universal immunization programme was demonstrated in a high-income country. Although partial vaccination conferred protection, completing the vaccine series is warranted to maximize the benefit.
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Gastroenteritis/prevención & control , Programas de Inmunización/estadística & datos numéricos , Infecciones por Rotavirus/prevención & control , Vacunas contra Rotavirus/inmunología , Estudios de Casos y Controles , Preescolar , Cromatografía de Afinidad , Femenino , Gastroenteritis/virología , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Israel , Masculino , Rotavirus/inmunología , Infecciones por Rotavirus/diagnóstico , Vacunas contra Rotavirus/uso terapéutico , Vacunación , Vacunas Atenuadas/inmunología , Vacunas Atenuadas/uso terapéuticoRESUMEN
Circular single-stranded DNA viruses infect archaea, bacteria, and eukaryotic organisms. The relatively recent emergence of single-stranded DNA viruses, such as chicken anemia virus (CAV) and porcine circovirus 2 (PCV2), as serious pathogens of eukaryotes is due more to growing awareness than to the appearance of new pathogens or alteration of existing pathogens. In the case of the ubiquitous human circular single-stranded DNA virus family Anelloviridae, there is still no convincing direct causal relation to any specific disease. However, infections may play a role in autoimmunity by changing the homeostatic balance of proinflammatory cytokines and the human immune system, indirectly affecting the severity of diseases caused by other pathogens. Infections with CAV (family Anelloviridae, genus Gyrovirus) and PCV2 (family Circoviridae, genus Circovirus) are presented here because they are immunosuppressive and affect health in domesticated animals. CAV shares genomic organization, genomic orientation, and common features of major proteins with human anelloviruses, and PCV2 DNA may be present in human food and vaccines.
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Infecciones por Circoviridae/veterinaria , Infecciones por Virus ADN/virología , Virus ADN/genética , ADN Circular , ADN de Cadena Simple/genética , Genoma Viral , Anelloviridae/genética , Anelloviridae/aislamiento & purificación , Animales , Animales Domésticos/virología , Archaea/virología , Autoinmunidad , Bacterias/virología , Virus de la Anemia del Pollo/genética , Virus de la Anemia del Pollo/aislamiento & purificación , Infecciones por Circoviridae/inmunología , Infecciones por Circoviridae/virología , Circovirus/genética , Circovirus/aislamiento & purificación , Infecciones por Virus ADN/inmunología , Virus ADN/aislamiento & purificación , Virus ADN/fisiología , ADN Viral , Humanos , Porcinos/virología , Enfermedades de los Porcinos/virologíaRESUMEN
Recent experiments have shown that sexual interactions prior to cell proliferation cause an increase in neurogenesis in adult male rats. Because adult neurogenesis is critical for some forms of memory, we hypothesized that sexually induced changes in neurogenesis may be involved in mate recognition. Sexually naive adult male rats were either exposed repeatedly to the same sexual partner (familiar group) or to a series of novel sexual partners (unfamiliar group), while control males never engaged in sexual interactions. Ovariectomized female rats were induced into estrus every four days. Males were given two injections of 5-bromo-2'-deoxyuridine (BrdU) (200mg/kg) to label proliferating cells, and the first sexual interactions occurred three days later. Males in the familiar and unfamiliar groups engaged in four, 30-min sexual interactions at four-day intervals, and brain tissue was collected the day after the last sexual interaction. Immunohistochemistry followed by microscopy was used to quantify BrdU-labeled cells. Sexual interactions with unfamiliar females caused a significant reduction in neurogenesis in the dentate gyrus compared to males that interacted with familiar females and compared to the control group. The familiar group showed no difference in neurogenesis compared to the control group. Males in the familiar group engaged in significantly more sexual behavior (ejaculations and intromissions) than did males in the unfamiliar group, suggesting that level of sexual activity may influence neurogenesis levels. In a second experiment, we tested whether this effect was unique to sexual interactions by replicating the entire procedure using anestrus females. We found that interactions with unfamiliar anestrus females reduced neurogenesis relative to the other groups, but this effect was not statistically significant. In combination, these results indicate that interactions with unfamiliar females reduce adult neurogenesis and the effect is stronger for sexual interactions than for social interactions.
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Hipocampo/fisiología , Memoria/fisiología , Neurogénesis/fisiología , Neuronas/fisiología , Conducta Sexual/fisiología , Envejecimiento/fisiología , Animales , Giro Dentado/fisiología , Femenino , Masculino , Ratas Long-Evans , Caracteres SexualesRESUMEN
In February 2013, wild poliovirus type 1 (WPV1) was reintroduced into southern Israel and resulted in continuous silent circulation in the highly immune population. As a part of the public health emergency response, a novel real time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) assay was developed, to allow for the sensitive and specific detection of the circulatingWPV1-South Asian (SOAS) strain. Specific primers and probes derived from the VP-1 region were designed, based on sequenced sewage isolates, and used to simultaneously amplify this WPV1-SOAS sequence together with bacteriophage MS-2 as internal control. High titre WPV1-SOAS stock virus was used for assay optimisation and 50 processed sewage samples collected from southern Israel and tested by reference culture based methods were used for analytical validation of the assay's performance. The limit of detection of the multiplex qRT-PCR (SOAS/MS-2) assay was 0.1 plaque-forming unit (pfu)/reaction (20 pfu/mL) for WPV1-SOAS RNA with 100% sensitivity, specificity, positive and negative predictive values when compared to the culture based method. The turnaround time was rapid, providing results for environmental samples within 24 to 48 hours from completion of sewage processing, instead of five to seven days by culture-based analysis. Direct sewage testing by qRT-PCR assay proved to be a useful tool for rapid detection and environmental surveillance of WPV1-SOAS circulating strain during emergency response. Application of the approach for detection of WPV1-SOAS in stool samples obtained during acute flaccid paralysis (AFP) surveillance or field surveys should be further evaluated.
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Poliovirus/genética , Poliovirus/aislamiento & purificación , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/virología , Cartilla de ADN/genética , ARN Polimerasas Dirigidas por ADN , Heces/virología , Humanos , Israel/epidemiología , Poliomielitis , Poliovirus/clasificación , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Análisis de Secuencia , Aguas del Alcantarillado/virologíaRESUMEN
Poliovirus vaccine coverage in Israel is over 90%. The last nine birth cohorts have been vaccinated exclusively with inactivated polio vaccine (IPV). However, between February and July 2013 type 1 wild poliovirus (WPV1) was detected persistently in 10 and intermittently in 8 of 47 environmental surveillance sites in southern and central Israel and in 30 stool samples collected during July from healthy individuals in southern Israel. We report results of sequence and phylogenetic analyses of genes encoding capsid proteins to determine the source and transmission mode of the virus. WPV1 capsid protein 1 nucleotide sequences were most closely related to South Asia (SOAS) cluster R3A polioviruses circulating in Pakistan in 2012 and isolated from Egyptian sewage in December 2012. There was no noticeable geographical clustering within WPV1-positive sites. Uniform codon usage among isolates from Pakistan, Egypt and Israel showed no signs of optimisation or deoptimisation. Bayesian phylogenetic time clock analysis of the entire capsid coding region (2,643 nt) with a 1.1% evolutionary rate indicated that Israeli and Egyptian WPV1-SOAS lineages diverged in September 2012, while Israeli isolates split into two sub-branches after January 2013. This suggests one or more introduction events into Israel with subsequent silent circulation despite high population immunity.
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Epidemiología Molecular/métodos , Poliomielitis/epidemiología , Poliomielitis/transmisión , Poliovirus/genética , Poliovirus/aislamiento & purificación , Teorema de Bayes , Monitoreo del Ambiente/métodos , Heces/virología , Humanos , Israel/epidemiología , Cadenas de Markov , Método de Montecarlo , Filogenia , Poliomielitis/diagnóstico , Poliomielitis/virología , Poliovirus/clasificación , Vigilancia de la Población , Análisis de Secuencia , Aguas del Alcantarillado/virologíaRESUMEN
An emergency response was triggered by recovery of wild poliovirus type 1 (WPV1) of the South Asia (SOAS) lineage from sewage in southern Israel in April 2013 during routine environmental surveillance. Public health risk assessment necessitated intensification of environmental surveillance in order to facilitate countrywide monitoring of WPV1-SOAS circulation. This involved increasing sampling frequency and broadening the geographical area, for better coverage of the population at risk, as well as modifying sewage testing algorithms to accommodate a newly developed WPV1-SOAS-specific quantitative real-time RT-PCR assay for screening of RNA extracted directly from sewage concentrates, in addition to standard virus isolation. Intensified surveillance in 74 sites across Israel between 1 February and 31 August 2013 documented a sustained high viral load of WPV1-SOAS in sewage samples from six Bedouin settlements and two cities with Jewish and Arab populations in the South district. Lower viral loads and intermittent detection were documented in sampling sites representing 14 mixed communities in three of the five health districts in central and northern Israel. Environmental surveillance plays a fundamental role in routine monitoring of WPV circulation in polio-free countries. The rapid assay specific for the circulating strain facilitated implementation of intensified surveillance and informed the public health response and decision-making.
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Monitoreo del Ambiente , Poliomielitis/epidemiología , Poliovirus/aislamiento & purificación , Aguas del Alcantarillado/virología , Humanos , Israel/epidemiología , Poliomielitis/diagnóstico , Poliomielitis/virología , Poliovirus/genética , Vigilancia de la Población , Salud Pública , Reacción en Cadena en Tiempo Real de la Polimerasa , Medición de RiesgoRESUMEN
AIMS: To determine whether antivirus and/or islet cell antibodies can be detected in healthy pregnant mothers without diabetes and/or their offspring at birth in two winter viral seasons. METHODS: Maternal and cord blood sera from 107 healthy pregnant women were tested for islet cell autoantibodies using radioligand binding assays and for anti-rotavirus and anti-CoxB3 antibody using an enzyme-linked immunosorbent assay. RESULTS: Glutamic acid decarboxylase (GAD)65 autoantibodies and rotavirus antibodies, present in both maternal and cord blood sera, correlated with an odds ratio of 6.89 (95% CI: 1.01-46.78). For five, 22 and 17 pregnancies, antibodies to GAD65, rotavirus and CoxB3, respectively, were detected in cord blood only and not in the corresponding maternal serum. In 10 pregnancies, rotavirus antibody titres in the cord blood exceeded those in the corresponding maternal serum by 2.5-5-fold. Increased antibody titres after the 20(th) week of gestation suggested CoxB3 infection in one of the 20 pregnancies and rotavirus in another. CONCLUSION: The concurrent presence of GAD65 antibodies in cord blood and their mothers may indicate autoimmune damage to islet cells during gestation, possibly caused by cross-placental transmission of viral infections and/or antivirus antibodies. Cord blood antibody titres that exceed those of the corresponding maternal sample by >2.5-fold, or antibody-positive cord blood samples with antibody-negative maternal samples, may imply an active in utero immune response by the fetus.
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Diabetes Mellitus Tipo 1/inmunología , Infecciones por Enterovirus/inmunología , Complicaciones del Embarazo/inmunología , Infecciones por Rotavirus/inmunología , Adulto , Autoanticuerpos/inmunología , Autoanticuerpos/metabolismo , Autoantígenos/metabolismo , Enterovirus/inmunología , Infecciones por Enterovirus/transmisión , Femenino , Sangre Fetal/inmunología , Voluntarios Sanos , Humanos , Transmisión Vertical de Enfermedad Infecciosa , Islotes Pancreáticos/inmunología , Israel , Persona de Mediana Edad , Proyectos Piloto , Embarazo , Efectos Tardíos de la Exposición Prenatal/inmunología , Rotavirus/inmunología , Infecciones por Rotavirus/transmisión , Estaciones del Año , Adulto JovenRESUMEN
Israel was certified as polio-free country in June 2002, along with the rest of the World Health Organization European Region. Some 11 years later, wild-type polio virus 1 (WPV1) was isolated initially from routine sewage samples collected between 7 and 13 April 2013 in two cities in the Southern district. WPV1-specific analysis of samples indicated WPV1 introduction into that area in early February 2013. National supplementary immunisation with oral polio vaccine has been ongoing since August 2013.
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Brotes de Enfermedades/prevención & control , Poliomielitis/virología , Poliovirus/aislamiento & purificación , Vigilancia de la Población/métodos , Aguas del Alcantarillado/virología , Enfermedades Transmisibles Emergentes/epidemiología , Humanos , Israel/epidemiología , Vacunación Masiva , Poliomielitis/diagnóstico , Poliovirus/inmunología , Vacuna Antipolio Oral/inmunologíaRESUMEN
Psychogenic nonepileptic seizures (PNES) and psychogenic movement disorders (PMD) are common and disabling problems with abnormal psychological profiles, and they may have common features that could aid in better understanding and management. Since PNES and PMD are investigated and reported separately, comparisons are lacking. Psychogenic nonepileptic seizure and psychogenic movement disorder patients completed demographic, clinical, and psychological inventories including the Short Form (SF)-12 Health Status Survey (Physical and Mental Health Summary Scores), the Brief Symptom Inventory (BSI)-18 (somatization, depression, and anxiety subscales), and the Lorig Self-Efficacy Scale. Psychogenic nonepileptic seizure and psychogenic movement disorder patients had similar psychological profiles with reduced SF-12 Physical Health and Mental Health Summary Scores and increased BSI somatization, depression, and anxiety ratings. They varied slightly in age and gender, but their main distinguishing features were the presenting signs. These similar profiles suggest that PNES and PMD may not be distinct or separate entities and that collaborative investigative efforts and management are warranted.
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Trastornos del Movimiento/diagnóstico , Convulsiones/diagnóstico , Adulto , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Movimiento/psicología , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Pruebas Psicológicas , Psicología , Convulsiones/psicología , AutoeficaciaRESUMEN
There are currently no effective drugs to treat serious complications caused by WNV infection. The inhibition of WNV by the pluripotent immunomodulator AS101 [ammonium trichloro(dioxyethylene-0-0')tellurate] was evaluated in vitro and in vivo, and its mechanism was explored. Adding AS101 to Vero cells 1h or 5 min before infection increased cell survival from 21% to 84% and decreased plaque formation by 87% and virus yield by 2 logs. Following infection, high titer of WNV remained in the culture supernatants indicating interference with virus cell attachment. The binding of α(V)ß(3) integrin to WNV and of Vero cells to anti-α(V)ß(3) antibody were inhibited by AS101, suggesting that AS101 may block this cellular WNV receptor. Daily treatment of mice with AS101 starting 1 day before lethal infection with WNV resulted in 48% survival. However, treatment beginning 3 days post infection resulted only in 16% survival. Similarly, a single dose of anti-WNV IVIG three days post infection resulted in 16% survival compared to 100% if IVIG was given on the same day of infection or 1 day later. However, when mice received combined treatment with AS101 and IVIG starting 3 days post infection, an additive effect of 33% survival was observed. Our study suggests that AS101 has a potential preventive and therapeutic effect against WNV infection.
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Antivirales/administración & dosificación , Antivirales/farmacología , Etilenos/administración & dosificación , Etilenos/farmacología , Virus del Nilo Occidental/efectos de los fármacos , Animales , Supervivencia Celular , Chlorocebus aethiops , Femenino , Ratones , Ratones Endogámicos BALB C , Pruebas de Sensibilidad Microbiana , Receptores Virales/metabolismo , Análisis de Supervivencia , Resultado del Tratamiento , Células Vero , Ensayo de Placa Viral , Acoplamiento Viral/efectos de los fármacos , Virus del Nilo Occidental/patogenicidad , Virus del Nilo Occidental/fisiologíaRESUMEN
OBJECTIVE: To investigate the relationship of resilience to disease severity, disability, quality of life (QoL) and non-motor symptoms in Parkinson's disease (PD). A secondary objective was to investigate whether resilience is distinct from other personality domains in PD. BACKGROUND: Resilience is the ability to reestablish emotional equilibrium in the face of adversity. It may play a pivotal role in disability and quality of life and has not been studied in PD. METHODS: 83 PD patients (Age 66.3 ± 10.6, Total Unified Parkinson's Disease Rating Scale (T-UPDRS) 36.9 ± 17.8) completed the Resilience Scale 15 (RS-15). Scales measuring disability, mental and physical health-related QoL, non-motor symptoms (depression, anxiety, somatization, apathy, fatigue), and personality domains were completed. Pearson's correlations were analyzed between these scales and the RS-15. RESULTS: Greater resilience correlated with less disability (r = -.30, p = .01), and better physical and mental QoL (r = .31, p < .01; r = .29, p = .01), but not with PD severity (T-UPDRS, r = -.17, p > .05). Among non-motor symptoms and personality domains, resilience strongly correlated with less apathy (r = -.66), less depression (r = -.49), and more optimism (r = .54, all p < .001). Moderate correlations were seen between more resilience, reduced fatigue (r = -.40) and anxiety (r = -.34; both p < .001). CONCLUSIONS: Resilience correlated with less disability and better QoL but not with PD severity. Resilience was also highly associated with both non-motor symptoms (less apathy, depression, fatigue) and a personality domain (more optimism). The role of resilience in helping patients adapt to living with symptoms of chronic disease may explain its lack of correlation with PD severity.
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Actividades Cotidianas/psicología , Enfermedad de Parkinson/psicología , Calidad de Vida/psicología , Resiliencia Psicológica , Índice de Severidad de la Enfermedad , Anciano , Femenino , Encuestas Epidemiológicas/métodos , Encuestas Epidemiológicas/normas , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/epidemiología , Enfermedad de Parkinson/fisiopatología , Personalidad/fisiologíaRESUMEN
Environmental poliovirus surveillance (ENV) means monitoring of poliovirus (PV) transmission in human populations by examining environmental specimens supposedly contaminated by human faeces. The rationale is based on the fact that PV-infected individuals, whether presenting with disease symptoms or not, shed large amounts of PV in the faeces for several weeks. As the morbidity:infection ratio of PV infection is very low, this fact contributes to the sensitivity of ENV which under optimal conditions can be better than that of the standard acute flaccid paralysis (AFP) surveillance. The World Health Organization has included ENV in the new Strategic Plan of the Global Polio Eradication Initiative for years 2010-2012 to be increasingly used in PV surveillance, supplementing AFP surveillance. In this paper we review the feasibility of using ENV to monitor wild PV and vaccine-derived PV circulation in human populations, based on global experiences in defined epidemiological situations.
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Erradicación de la Enfermedad , Salud Global , Poliomielitis/epidemiología , Poliomielitis/prevención & control , Monitoreo del Ambiente , Monitoreo Epidemiológico , Humanos , Poliomielitis/virología , Poliovirus/aislamiento & purificación , Vacunas contra Poliovirus , Vigilancia de la Población , Aguas del Alcantarillado/virologíaRESUMEN
We present the findings of a six-year surveillance period (20052010) of human West Nile virus (WNV) infection in Tel Aviv district, Israel. Initial notifications of positively identified patients received from the Central Virology Laboratory were followed by epidemiological investigations of the local district health office. During 20052010, 104 patients, 79 with WNV neuroinvasive and 25 with WNV non-neuroinvasive disease were reported. The median age of the patients with a neuroinvasive disease was 74 years (range: 15 to 95 years) and 53 of such patients had encephalitis, 14 had acute flaccid paralysis, and 12 had meningitis. The case-fatality rate in these patients was 8%. The average annual incidence of neuroinvasive disease during 20052010 was 1.08 per 100,000 population. The incidence declined by 86% steadily between 2005 and 2009 (p for trend=0.005), but increased by more than six-fold in 2010. Elderly (≥65 years) men, comprising 25 patients of whom 24 were chronically-ill, had the highest incidence of WNV encephalitis <0.001). These findings are concordant with previous data, at the national level, published in Israel and the United States. Notably, the percentage of previously healthy patients, who developed a neuroinvasive disease was the highest (37%, p=0.001) in the surveillance period in 2010.
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Hospitalización/estadística & datos numéricos , Vigilancia de la Población , Fiebre del Nilo Occidental/diagnóstico , Fiebre del Nilo Occidental/epidemiología , Virus del Nilo Occidental/aislamiento & purificación , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Israel/epidemiología , Masculino , Persona de Mediana Edad , Mortalidad , Factores de Riesgo , Distribución por Sexo , Fiebre del Nilo Occidental/prevención & control , Fiebre del Nilo Occidental/transmisión , Adulto JovenRESUMEN
Current clinical studies on human annelloviruses infections are directed towards finding an associated disease. In this review we have emphasized the many similarities between human anellovirus and avian circoviruses and the cell and tissue types infected by these pathogens. We have done this in order to explore whether knowledge acquired from natural and experimental avian infections could reflect and be extrapolated to the less well-characterized human annellovirus infections. The knowledge gained from the avian system may provide suggestions for decoding the enigmatic human anellovirus infections, and finding the specific disease or diseases caused by these human anellovirus infections. Each additional parallelism between chicken anemia virus (CAV) and Torque teno virus (TTV) further strengthens this premise. As we have seen information from human infections can also be used to better understand avian infections as well. Increased attention must be focused on the "hidden" or unrecognized, seemingly asymptomatic effects of circovirus and anellovirus infections. Understanding the facilitating effect of these infections on disease progression caused by other pathogens may help to explain differences in outcome of complicated poultry and human diseases. The final course of a pathogenic infection is determined by variations in the state of health of the host before, during and after contact with a pathogen, in addition to the phenotype of the pathogen and host. The health burden of circoviridae and anellovirus infections may be underestimated, due to lack of awareness of the need to search past the predominant clinical effect of identified pathogens and look for modulation of cellular-based immunity caused by co-infecting circoviruses, and by analogy, human anneloviruses.
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Anelloviridae/fisiología , Virus de la Anemia del Pollo/fisiología , Infecciones por Circoviridae/veterinaria , Infecciones por Virus ADN/virología , Enfermedades de las Aves de Corral/virología , Anelloviridae/patogenicidad , Animales , Virus de la Anemia del Pollo/inmunología , Virus de la Anemia del Pollo/patogenicidad , Infecciones por Circoviridae/epidemiología , Infecciones por Circoviridae/inmunología , Infecciones por Circoviridae/transmisión , Infecciones por Virus ADN/complicaciones , Infecciones por Virus ADN/epidemiología , Infecciones por Virus ADN/transmisión , Infecciones por VIH/complicaciones , Humanos , Neoplasias/complicaciones , Aves de Corral , Enfermedades de las Aves de Corral/epidemiología , Enfermedades de las Aves de Corral/inmunología , Enfermedades de las Aves de Corral/transmisiónRESUMEN
Intestinal immunity was studied in a polio-free community immunised with a combined enhanced inactivated/oral polio vaccine (EIPV/OPV) vaccination programme. Poliovirus excretion was evaluated in three groups of infants primed with a partial (2 EIPV+2 OPV) or complete (3 EIPV+3 OPV) dose schedule. Poliovirus replicated in the gut of 59.8-55.8% of infants in the three groups 7 days after administration of an additional OPV dose. Significant decreases in the percent of type-specific-virus excreters appeared after 14 and 21 days for serotypes 1 and 2, and after 21 and 28 days for serotype 3. The percent of excreters was inversely correlated with pre-challenge neutralising antibody (NA) titers (p<0.05). Intrafamilial virus transmission to mothers and siblings was minimal. The principal factor for interruption of disease and virus transmission in the community was a strong and persistent humoral immunity with immunological memory. A satisfactory level of family hygiene contributed towards breaking the chain of transmission of poliovirus to contacts.
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Inmunidad Mucosa , Intestinos/inmunología , Poliomielitis/inmunología , Poliomielitis/prevención & control , Vacuna Antipolio de Virus Inactivados/inmunología , Vacuna Antipolio Oral/inmunología , Poliovirus/inmunología , Adulto , Anticuerpos Antivirales/sangre , Niño , Preescolar , Salud de la Familia , Humanos , Higiene , Lactante , Israel , Persona de Mediana Edad , Madres , Pruebas de Neutralización , Poliomielitis/transmisión , Hermanos , Esparcimiento de VirusRESUMEN
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.
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Monitoreo del Ambiente , Poliomielitis/epidemiología , Poliovirus , Monitoreo Epidemiológico , Geografía , Humanos , Medio Oriente/epidemiología , Datos de Secuencia Molecular , Poliomielitis/virología , Poliovirus/clasificación , Poliovirus/genética , Poliovirus/aislamiento & purificación , Poliovirus/patogenicidad , Vacuna Antipolio de Virus Inactivados , Aguas del Alcantarillado/virología , Salud UrbanaRESUMEN
The authors surveyed 101 patients with Parkinson disease (PD) about their experiences disclosing the diagnosis. Ninety percent disclosed early to family; more than 25% waited at least 1 year to disclose at work. The main concerns about disclosure were fear of reflecting negatively on themselves and fear of upsetting others. Patients who delayed disclosure were more likely male, younger, and employed. There is considerable variability among patients with PD in the time to disclose their diagnosis.
Asunto(s)
Revelación , Enfermedad de Parkinson/psicología , Adulto , Anciano , Anciano de 80 o más Años , Recolección de Datos , Familia , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To make evidence-based treatment recommendations for patients with Parkinson disease (PD) with dementia, depression, and psychosis based on these questions: 1) What tools are effective to screen for depression, psychosis, and dementia in PD? 2) What are effective treatments for depression and psychosis in PD? 3) What are effective treatments for PD dementia or dementia with Lewy bodies (DLB)? METHODS: A nine-member multispecialty committee evaluated available evidence from a structured literature review using MEDLINE, and the Cochrane Database of Health and Psychosocial Instruments from 1966 to 2004. Additional articles were identified by panel members. RESULTS: The Beck Depression Inventory-I, Hamilton Depression Rating Scale, and Montgomery Asberg Depression Rating Scale should be considered to screen for depression in PD (Level B). The Mini-Mental State Examination and the Cambridge Cognitive Examination should be considered to screen for dementia in PD (Level B). Amitriptyline may be considered to treat depression in PD without dementia (Level C). For psychosis in PD, clozapine should be considered (Level B), quetiapine may be considered (Level C), but olanzapine should not be considered (Level B). Donepezil or rivastigmine should be considered for dementia in PD (Level B) and rivastigmine should be considered for DLB (Level B). CONCLUSIONS: Screening tools are available for depression and dementia in patients with PD, but more specific validated tools are needed. There are no widely used, validated tools for psychosis screening in Parkinson disease (PD). Clozapine successfully treats psychosis in PD. Cholinesterase inhibitors are effective treatments for dementia in PD, but improvement is modest and motor side effects may occur.
Asunto(s)
Demencia/terapia , Depresión/terapia , Neurología/normas , Enfermedad de Parkinson/psicología , Enfermedad de Parkinson/terapia , Trastornos Psicóticos/terapia , Demencia/etiología , Depresión/etiología , Humanos , Trastornos Psicóticos/etiología , Garantía de la Calidad de Atención de Salud , Estados UnidosRESUMEN
BACKGROUND: Electronic communication is important in healthcare, but the level of computer proficiency among patients with neurological disorders is unknown. OBJECTIVE: This study sought to determine the proportion of a movement disorder clinic population that was able to perform basic computer skills, and the effect of specific cognitive and motor features on computer proficiency. METHODS: One hundred and four movement disorder patients participated. Seventy-four completed both paper and computerized questionnaires to evaluate data entry skills and thirty subjects completed paper questionnaires only. Basic e-mail messaging and Internet skills were evaluated. Demographic information, Mini-Mental Status Examination (MMSE) score, and Hoehn and Yahr stage were assessed. RESULTS: Ninety-six percent of subjects successfully completed computerized data entry tasks, and over 70% completed e-mail and Internet tasks. Computer data entry had an average accuracy of nearly 95% when compared to paper data entry. Poorer performance on computer tasks was associated with older age, less education, and cognitive impairment. Computer performance was reduced in subjects with a history of parkinsonism and when both tremor and dyskinesia were present during task performance. Nearly three-quarters of subjects have access to a computer. Subjects who completed the paper questionnaire but refused to complete the computer questionnaire were older, less educated and more cognitively impaired. CONCLUSION: The majority of patients visiting a tertiary movement disorders center were able to perform computer data entry, e-mail messaging and Internet usage. These results reinforce the potential value of electronic communication and information systems in neurology practice.