ResearchPad - original-contributions https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Comparing Rapid Scoring Systems in Mortality Prediction of Critically Ill Patients With Novel Coronavirus Disease]]> https://www.researchpad.co/article/elastic_article_16703 Rapid and early severity‐of‐illness assessment appears to be important for critically ill patients with novel coronavirus disease (COVID‐19). This study aimed to evaluate the performance of the rapid scoring system on admission of these patients.MethodsA total of 138 medical records of critically ill patients with COVID‐19 were included in the study. Demographic and clinical characteristics on admission used for calculating Modified Early Warning Score (MEWS) and Rapid Emergency Medicine Score (REMS) and outcomes (survival or death) were collected for each case and extracted for analysis. All patients were divided into two age subgroups (<65 years and ≥65 years). The receiver operating characteristic (ROC) curve analyses were performed for overall patients and both subgroups.ResultsThe median [25th quartile, 75th quartile] of MEWS of survivors versus nonsurvivors were 1 [1, 2] and 2 [1, 3] and those of REMS were 5 [2, 6] and 7 [6, 10], respectively. In overall analysis, the area under the ROC curve for the REMS in predicting mortality was 0.833 (95% confidence interval [CI] = 0.737 to 0.928), higher than that of MEWS (0.677, 95% CI = 0.541 to 0.813). An optimal cutoff of REMS (≥6) had a sensitivity of 89.5%, a specificity of 69.8%, a positive predictive value of 39.5%, and a negative predictive value of 96.8%. In the analysis of subgroup of patients aged <65 years, the area under the ROC curve for the REMS in predicting mortality was 0.863 (95% CI = 0.743 to 0.941), higher than that of MEWS (0.603, 95% CI = 0.462 to 0.732).ConclusionTo our knowledge, this study was the first exploration on rapid scoring systems for critically ill patients with COVID‐19. The REMS could provide emergency clinicians with an effective adjunct risk stratification tool for critically ill patients with COVID‐19, especially for the patients aged <65 years. The effectiveness of REMS for screening these patients is attributed to its high negative predictive value. ]]> <![CDATA[Early Self‐Proning in Awake, Non‐intubated Patients in the Emergency Department: A Single ED’s Experience During the COVID‐19 Pandemic]]> https://www.researchpad.co/article/elastic_article_16666 Prolonged and unaddressed hypoxia can lead to poor patient outcomes. Proning has become a standard treatment in the management of patients with ARDS who have difficulty achieving adequate oxygen saturation. The purpose of this study was to describe the use of early proning of awake, non‐intubated patients in the emergency department (ED) during the COVID‐19 pandemic.MethodsThis pilot study was carried out in a single urban ED in New York City. We included patients suspected of having COVID‐19 with hypoxia on arrival. A standard pulse oximeter was used to measure SpO2. SpO2 measurements were recorded at triage and after 5 minutes of proning. Supplemental oxygenation methods included non‐rebreather mask (NRB) and nasal cannula. We also characterized post‐proning failure rates of intubation within the first 24 hours of arrival to the ED.ResultsFifty patients were included. Overall, the median SpO2 at triage was 80% (IQR 69 to 85). After application of supplemental oxygen was given to patients on room air it was 84% (IQR 75 to 90). After 5 minutes of proning was added SpO2 improved to 94% (IQR 90 to 95). Comparison of the pre‐ to post‐median by the Wilcoxon Rank‐sum test yielded P = 0.001. Thirteen patients (24%) failed to improve or maintain their oxygen saturations and required endotracheal intubation within 24 hours of arrival to the ED.ConclusionAwake early self‐proning in the emergency department demonstrated improved oxygen saturation in our COVID‐19 positive patients. Further studies are needed to support causality and determine the effect of proning on disease severity and mortality. ]]> <![CDATA[Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis]]> https://www.researchpad.co/article/Ncebf9595-8944-48ca-a43d-54d50d9a2feb

Abstract

BACKGROUND

Studies have shown that self-monitoring of blood pressure (BP) is effective when combined with co-interventions, but its efficacy varies in the presence of some co-morbidities. This study examined whether self-monitoring can reduce clinic BP in patients with hypertension-related co-morbidity.

METHODS

A systematic review was conducted of articles published in Medline, Embase, and the Cochrane Library up to January 2018. Randomized controlled trials of self-monitoring of BP were selected and individual patient data (IPD) were requested. Contributing studies were prospectively categorized by whether they examined a low/high-intensity co-intervention. Change in BP and likelihood of uncontrolled BP at 12 months were examined according to number and type of hypertension-related co-morbidity in a one-stage IPD meta-analysis.

RESULTS

A total of 22 trials were eligible, 16 of which were able to provide IPD for the primary outcome, including 6,522 (89%) participants with follow-up data. Self-monitoring was associated with reduced clinic systolic BP compared to usual care at 12-month follow-up, regardless of the number of hypertension-related co-morbidities (−3.12 mm Hg, [95% confidence intervals −4.78, −1.46 mm Hg]; P value for interaction with number of morbidities = 0.260). Intense interventions were more effective than low-intensity interventions in patients with obesity (P < 0.001 for all outcomes), and possibly stroke (P < 0.004 for BP control outcome only), but this effect was not observed in patients with coronary heart disease, diabetes, or chronic kidney disease.

CONCLUSIONS

Self-monitoring lowers BP regardless of the number of hypertension-related co-morbidities, but may only be effective in conditions such obesity or stroke when combined with high-intensity co-interventions.

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<![CDATA[RISES IN TITERS OF ANTIBODY TO HUMAN CORONA VIRUSES OC43 AND 229E IN SEATTLE FAMILIES DURING 1975–1979]]> https://www.researchpad.co/article/N28ecee04-058e-4c8b-99d2-2c28349d33a2

Abstract

Sequential serum specimens were obtained every four months during 1975–1979 from 44 children and adults of 10 Seattle families. The 419 specimens were tested for antibody to human coronaviruses OC43 and 229E by enzyme-linked immunosorbent assay (ELISA). Antibody titers were found to increase with age, and titers as well as frequency of rises were greater for OC43 than for 229E virus in all age groups. Significant antibody rises were most frequent in specimens bracketing the winter interval, but some also occurred in the spring-summer and summer-fall intervals. Concurrent significant antibody rises to OC43 virus in different members of the same family were observed in 15 instances, to 229E virus in seven instances, and to OC43 virus in some members and 229E virus in others in eight instances. Significant antibody rises to OC43 or 229E virus indicating reinfections were frequently observed throughout the three-year period but were always separated by at least two four-month intervals. Concurrent significant antibody rises to both 229E and OC43 viruses were seen only in three persons. Finally, the frequency of significant antibody rises in children, about one per person-year, was almost three times higher than in adults.

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<![CDATA[Epidemic Assistance by the Centers for Disease Control and Prevention: Role of the Epidemic Intelligence Service, 1946–2005]]> https://www.researchpad.co/article/Nd46c9ce3-1422-499d-95ac-c808f937c571

Abstract

Since 1946, the Centers for Disease Control and Prevention has responded to urgent requests from US states, federal agencies, and international organizations through epidemic-assistance investigations (Epi-Aids). The authors describe the first 60 years of Epi-Aids, breadth of problems addressed, evolution of methodologies, scope of activities, and impact of investigations on population health. They reviewed Epi-Aid reports and EIS Bulletins, contacted current and former Epidemic Intelligence Service staff, and systematically searched the PubMed and Web of Science databases. They abstracted information on dates, location, staff involved, health problems, methods, and impacts of investigations according to a preplanned protocol. They assessed the methods presented as well as the quality of reports. During 1946–2005, a total of 4,484 investigations of health events were initiated by 2,815 Epidemic Intelligence Service officers. In the early years, the majority were in response to infectious agents, although environmental problems emerged. Investigations in subsequent years focused on occupational conditions, birth defects, reproductive health, tobacco use, cancer, violence, legal debate, and terrorism. These Epi-Aids heralded expansion of the agency's mission and presented new methods in statistics and epidemiology. Recommendations from Epi-Aids led to policy implementation, evaluation, or modification. Epi-Aids provide the Centers for Disease Control and Prevention with the agility to respond rapidly to public health crises.

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<![CDATA[Methods for Estimating the Case Fatality Ratio for a Novel, Emerging Infectious Disease]]> https://www.researchpad.co/article/N13194e2c-ce8e-44a5-80b6-248a30f93fcb

Abstract

During the course of an epidemic of a potentially fatal disease, it is important that the case fatality ratio be well estimated. The authors propose a novel method for doing so based on the Kaplan-Meier survival procedure, jointly considering two outcomes (death and recovery), and evaluate its performance by using data from the 2003 epidemic of severe acute respiratory syndrome in Hong Kong, People's Republic of China. They compare this estimate obtained at various points in the epidemic with the case fatality ratio eventually observed; with two commonly quoted, naïve estimates derived from cumulative incidence and mortality statistics at single time points; and with estimates in which a parametric mixture model is used. They demonstrate the importance of patient characteristics regarding outcome by analyzing subgroups defined by age at admission to the hospital.

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<![CDATA[AN ANALYSIS OF HOSPITALIZATIONS FOR ACUTE RESPIRATORY DISEASE IN RECRUITS IMMUNIZED WITH ADENOVIRUS TYPE 4 AND TYPE 7 VACCINES1]]> https://www.researchpad.co/article/N946367d9-a55d-4316-9d25-59ebfd9973ac

Abstract

Dudding, B. A., F. H. Top, Jr., R. M. Scott, P. K. Russell and E. L. Buescher (Walter Reed Army Institute of Research, Washington, D. C. 20012). An analysis of hospitalizations for acute respiratory disease in recruits immunized with adenovirus type 4 and type 7 vaccines. Am J Epidemiol 95: 140–147, 1972.—Among 911 recruits immunized with live, oral adenovirus types 4 and 7 (ADV-4 and 7) vaccines, there were 149 hospital admissions to the acute respiratory disease (ARD) wards during the study. Eighteen admissions were not associated with ARD (15 rubella infections, 3 immunization reactions). Of the remaining 131 ARD admissions, 17 were complicated by pneumonia and 114 were judged to have uncomplicated ARD. Within the latter group, evidence for infection by a single respiratory pathogen was obtained from 68 admissions; 11 admissions were associated with multiple infectious agents; and 35 admissions yielded no infectious agent(s). Despite immunization, adenoviruses, primarily ADV-4, were still the most common cause of ARD. Among non-adenovirus associated ARD admissions, rhinoviruses were the most common (10), followed by influenza A2 virus (7), group A streptococci (2) and herpesvirus hominis (2). Thus, in this initial study of ARD among recruits immunized with ADV-4 and ADV-7 vaccines, no other respiratory pathogens emerged to replace adenovirus types 4 and 7 as the major causes of ARD in military trainees.

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<![CDATA[Do Men Have a Higher Case Fatality Rate of Severe Acute Respiratory Syndrome than Women Do?]]> https://www.researchpad.co/article/N4cc145a8-fcf9-4048-9fec-3fec6ee28c60

Abstract

Severe acute respiratory syndrome (SARS) has been reported in 30 countries and regions, with a cumulative total of 8,099 probable cases and 774 deaths as of July 31, 2003, according to the World Health Organization. In Hong Kong, People’s Republic of China, 1,755 SARS cases and 299 deaths had occurred as of September 22, 2003. The authors analyzed data from the Department of Health, Hong Kong SAR. The data series includes details regarding sex, age, and chronic disease history. Using data from early March to September 22, 2003, the authors found that males had a significantly (p < 0.0001) higher case fatality rate than females did, 21.9% versus 13.2%; the relative risk was 1.66 (95% confidence interval (CI): 1.35, 2.05), and it was 1.62 (95% CI: 1.21, 2.16) after adjustment for age. Subgroup analysis was conducted by excluding health care workers (n = 386) from the analysis. The overall crude relative risk of mortality was 1.41 (95% CI: 1.15, 1.74), and the adjusted relative risk was 1.48 (95% CI: 1.10, 2.00). Thus, among SARS patients, males may be more severely affected by the disease than females are. This finding could be related to a nonuniform case definition of SARS disease, a different treatment regimen, a past smoking history, work-environment factors, or gender-specific immune-defense factors, for instance.

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<![CDATA[A COMPARISON OF SUBCUTANEOUS, NASAL, AND COMBINED INFLUENZA VACCINATION. II. PROTECTION AGAINST NATURAL CHALLENGE12]]> https://www.researchpad.co/article/N78813b7f-2829-491e-ae1f-5cb9b03a15c4

Abstract

Edmondson, W. P., Jr., R. Rothenberg, P. W. White and J. M. Gwaltney, Jr. (Univ. of Virginia School of. Medicine, Charlottesville, Va. 22901). A comparison of subcutaneous, nasal, and combined influenza vaccination. II. Protection against natural challenge. Amer J Epidem 93: 480–486, 1971.—Monovalent killed influenza A2 Hong Kong vaccine in doses (400 CCA units) recommended for civilian use was given to insurance company employees and elderly psychiatric patients by injection, nasal spray, or a combination of both methods. Vaccinees and controls were then studied for evidence of immunity to influenza during the 1968–1969 epidemic Parenteral vaccination was well tolerated and effective in reducing influenza infection and illness rates in both groups. Vaccine had no effect on total respiratory illness in the insurance group, although total absenteeism was lowered because of the greater effect of influenza over that of colds in causing time lost from work. Vaccine given by spray into the respiratory tract was ineffective. The addition of spray to parenteral vaccination provided no additional advantage over parenteral vaccination alone.

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<![CDATA[SEROEPIDEMIOLOGIC SURVEY OF CORONAVIRUS (STRAIN 229E) INFECTIONS IN A POPULATION OF CHILDREN]]> https://www.researchpad.co/article/Nfc495369-71cc-4d48-89bc-d7c0df329941

Abstract

The indirect hemagglutination (IHA) test for coronavirus 229E antibodies was used for serodiagnostic and seroepidemiologic studies in a population of children. Subjects ranged in age from 5 to 19 years and lived in a home which participated in a longitudinal surveillance of respiratory illness (1960–1968). During this period 1477 respiratory illnesses were observed; 63 (4%) were associated with sero-response (fourfold or greater antibody rises) to 229E. An additional 105 sero-responses were associated with unreported or subclinical illness. The frequency of these infections was cyclical, and 229E and coronavirus OC 43 infections peaked in different years among the same population. Sero-responses occurred mainly in the fall, winter and spring quarters. Preexisting antibody was demonstrated in one-third of the children with 229E seroresponses. Clinical studies indicated that the most frequent complaints with 229E infections were sore throat, coryza and cough, and the most frequent findings were pharyngeal injection, coryza and fever.

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<![CDATA[Different Epidemic Curves for Severe Acute Respiratory Syndrome Reveal Similar Impacts of Control Measures]]> https://www.researchpad.co/article/Nf94fe703-a199-42f6-a4da-6b3334a308d9

Abstract

Severe acute respiratory syndrome (SARS) has been the first severe contagious disease to emerge in the 21st century. The available epidemic curves for SARS show marked differences between the affected regions with respect to the total number of cases and epidemic duration, even for those regions in which outbreaks started almost simultaneously and similar control measures were implemented at the same time. The authors developed a likelihood-based estimation procedure that infers the temporal pattern of effective reproduction numbers from an observed epidemic curve. Precise estimates for the effective reproduction numbers were obtained by applying this estimation procedure to available data for SARS outbreaks that occurred in Hong Kong, Vietnam, Singapore, and Canada in 2003. The effective reproduction numbers revealed that epidemics in the various affected regions were characterized by markedly similar disease transmission potentials and similar levels of effectiveness of control measures. In controlling SARS outbreaks, timely alerts have been essential: Delaying the institution of control measures by 1 week would have nearly tripled the epidemic size and would have increased the expected epidemic duration by 4 weeks.

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<![CDATA[EPIDEMIOLOGY OF RESPIRATORY SYNCYTIAL VIRUS INFECTION AMONG INFANTS AND CHILDREN IN CHICAGO]]> https://www.researchpad.co/article/N7a235589-e6a1-4d81-8f8d-f5ef1d829d78

Abstract

From January 1, 1967 to December 1971, the temporal pattern of respiratory syncytial virus infection was investigated in infants and children younger than 18 months hospitalized for acute lower respiratory tract disease. Of 4696 infants and children with acute lower respiratory tract disease admitted to the Cook County Hospital, 2530 were tested for virus infection by virus isolation or serologic procedures or both. Overall, respiratory syncytial virus infections were detected in 12% and parainfluenza 3 virus in 10.8% of individuals tested. Other respiratory viruses were less commonly identified. Respiratory syncytial virus epidemics occurred annually and were temporally synchronous with the peak periods of respiratory disease admissions. Only during epidemics of respiratory syncytial virus did admission for respiratory tract disease usually reach 40 patients or more weekly. The peak months of respiratory syncytial virus epidemics were December 1966, January 1968, February-March 1969, April 1970 and January 1971. Epidemics lasted about 17 weeks. No similar annual epidemic pattern was seen with the other myxoviruses.

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<![CDATA[INFLUENZA A/ENGLAND: AN OUTBREAK AT A MILITARY ACADEMY]]> https://www.researchpad.co/article/N2c5ce27a-a48b-4f4d-8cb7-58c3e8bb8dc8

Abstract

Blouse, L E. (Epidemiology Division. USAF School of Aerospace Medicine. Brooks AFB, Texas 78236), L. N. Kolonel and V. Corrado. Influenza A/England: an outbreak at a military academy. Am J Epidemiol 100:216–221. 1974.—The first outbreak of A/England influenza in the United States during the 1972–1973 respiratory season is described. The outbreak was confined to an unvaccinated population of 3935 cadets at the U.S. Air Force Academy, Colorado. During the 10-day period of the outbreak, 778 (19.8 per cent) of the cadets were affected, and specific attack rates for each of the four cadet classes ranged from 170.8/1000 to 227.1/1000. For three days preceding the outbreak, about 400 recently vaccinated naval midshipmen from the U.S. Naval Academy shared quarters with the Air Force cadets. During the four days following the visit, a single midshipman developed possible influenza whereas, in the same period, 352 cadet cases were recognized. The highly significant difference in attack rates (2.5 versus 89.5/1000) provides evidence for the efficacy of the 1972–1973 influenza vaccine against the A/ England/42/72 variant.

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<![CDATA[Conventional Influenza Vaccination Is Not Associated with Complications in Working-Age Patients with Asthma or Chronic Obstructive Pulmonary Disease]]> https://www.researchpad.co/article/Nea9bb405-73c5-4a88-be13-e592a852206f

Abstract

By using a nested case-control design, the authors studied the effectiveness of the influenza vaccine in reducing severe and fatal complications in 4,241 and 5,966 primary care, working-age patients aged 18–64 years who had asthma or chronic obstructive pulmonary disease during the 1998–1999 and 1999–2000 influenza epidemics in the Netherlands. Patients developing fatal or nonfatal exacerbations of lung disease, pneumonia, congestive heart failure, or myocardial infarction during either epidemic were considered cases. For each case, four age- and sex-matched controls were randomly sampled, and patient records were reviewed. Conditional logistic regression and propensity scores were used to assess vaccine effectiveness after adjustment for confounding factors. In seasons one and two, respectively, 87% (47/54) and 85% (171/202) of the cases and 74% (155/210) and 75% (575/766) of the controls had been vaccinated. After adjustments, vaccination was not associated with reductions in complications (season one: odds ratio = 0.95, 95% confidence interval (CI): 0.26, 3.48; season two: odds ratio = 1.07, 95% CI: 0.59, 1.96; pooled odds ratio = 1.07, 95% CI: 0.63, 1.80). Because influenza vaccination appeared not to be associated with a clinically relevant reduction in severe morbidity, other measures need to be explored.

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<![CDATA[AN “OUTBREAK” OF JUVENILE DIABETES MELLITUS: CONSIDERATION OF A VIRAL ETIOLOGY]]> https://www.researchpad.co/article/N9fb2109e-40a2-4bc1-9652-67ce2c540787

Abstract

Huff. J. C., J. C. Hierholzer (Respiratory Virology Section, Center for Disease Control. Atlanta, Ga. 30333) and W. A. Farris. An “outbreak” of juvenile diabetes mellitus: consideration of a viral etiology. Am J Epidemiol 100:277–287. 1974.—Nine of twelve cases of juvenile diabetes mellitus, representing an unusual geographic and temporal cluster, were investigated for evidence that a specific viral infection might be etiologically related to their occurrence. Eight diabetics had experienced recent “viral-like” illnesses, predominantly repiratory, but these illnesses bore no uniform temporal relation to their onsets of diabetes. Diabetics demonstrated no serologic evidence of a recent viral illness common to all. Elevated titers to only one virus, coxsackie B-3, were more prevalent in diabetics than in controls (33% vs. 6%), but geometric mean titers of diabetics to a panel of 26 common viral antigens were similar to those of controls. These data neither support nor negate the hypothesis that infection with a specific virus precipitates juvenile diabetes mellitus.

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<![CDATA[Refined Estimate of the Incubation Period of Severe Acute Respiratory Syndrome and Related Influencing Factors]]> https://www.researchpad.co/article/N7561c3c1-3977-4482-a142-eda37b961d8d

Abstract

Many epidemiologists have agreed that a refined estimate of the incubation period of severe acute respiratory syndrome (SARS) would need a sample size of about 200 cases and appropriate statistical methods enabling the inclusion of cases with defined periods of exposure. However, no such studies have been reported so far. Besides, determinants of the SARS incubation period remain unclear. In this study, 209 probable SARS cases with documented episodes of exposure between March 1 and May 31, 2003, in mainland China were included. A nonparametric method was used to analyze these data with defined periods of exposure to obtain the refined estimate of the SARS incubation period. Furthermore, the authors also explored the influence of various factors on the SARS incubation period by analysis of variance, linear regression analysis, and analysis of covariance. The estimates of mean and variance of the SARS incubation period were 5.29 days and 12.33 days2, respectively; 90% of patients would have an incubation period of less than 11.58 days with a probability of 0.8, and 99% of patients would have an incubation of less than 22.22 days with a probability of 0.9. The affected area showed a highly significant effect on the incubation period (p < 0.001), but the contact pattern, occupation, gender, and age did not.

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<![CDATA[VIROLOGIC STUDIES OF ACUTE RESPIRATORY DISEASE IN YOUNG ADULTS]]> https://www.researchpad.co/article/N1dc9a04c-58bc-4ef0-baba-3c9e82febe28

Abstract

Hamre, D. and M. Beem (DepL Pediatrics, Univ. of Chicago, Chicago, III. 60637). Virologic studies of acute respiratory disease in young adults. V. Coronavirus 229E infections during six years of surveillance. Am J Epidemiol 96: 94–106, 1972.—In a surveillance study of acute respiratory disease in medical students that spanned six consecutive seasons between 1961 and 1968 and encompassed 937 student years of observation, infection with coronavirus 229E was identified by virus isolation and serologic studies. Virus isolation identified 12 infections, 8 in one season, 4 in another. Complement fixing (CF) antibody titer rises identified 133 infections that occurred in all six seasons of surveillance, involving from 15 to 35% of students in three seasons of “high” prevalence, and 1 to 5% in intervening seasons of “low” prevalence. Infection occurred in a winter-spring seasonal pattern and was associated with acute respiratory illness that was not clinically distinctive. Neutralizing antibody to 229E was commonly present in the sera of the students. The level of this did not appear to influence the occurrence of, or likelihood of illness with, reinfection as judged by CF seroconversion; however, the frequency of significant rise in neutralizing antibody titer with reinfection was inversely related to pre-infection levels of this antibody. Infection with other common respiratory viruses did not stimulate significant CF or neutralizing antibody titer rises to 229E.

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<![CDATA[SEROEPIDEMIOLOGIC SURVEY OF CORONAVIRUS (STRAIN OC 43) RELATED INFECTIONS IN A CHILDREN'S POPULATION]]> https://www.researchpad.co/article/N5b2942d3-8ccc-4a3f-b197-3d13d682083b

Abstract

Kaye, H. S. (CDC, Atlanta, Ga. 30333), H. B. Marsh and W. R. Dowdle. Sero-epidemiologic survey of coronavirus (strain OC 43) related infections in a children's population. Amer J Epid 94: 43–49, 1971.—Acute and convalescent serum pairs and control sera collected from subjects living in a children's home over a 7-year period (1960–1967) were examined by hemagglutination-inhibition (HI) test with coronavirus strain OC 43. Ninety-three serologic conversions were observed; 44 were associated with reported illnesses and 49 with no reported illnesses. In three distinct outbreaks during the winter and spring quarter of 1960–1961, 1964–1965, and 1966–1967, 67 conversions occurred. Seroconversions to strain OC 43 were associated with as much as 19% of the respiratory diseases in a single season. Over the 7-year period coronavirus strain OC 43 accounted for 3% of the total 1328 respiratory illnesses. Evidence of preexisting antibody was apparent in one-third of the children showing seroconversions. The HI test was more sensitive for serodiagnosis than the complement-fixaticn test. The major presenting complaints of the children with respiratory disease associated with coronavirus strain OC 43 were sore throat, cough and coryza; the predominating symptoms were pharyngitis, coryza, fever and cervical adenitis.

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<![CDATA[Fifty-Five Years of International Epidemic-Assistance Investigations Conducted by CDC’s Disease Detectives]]> https://www.researchpad.co/article/N31d0c034-e8ed-4759-9871-ad7f6f9814ef

Abstract

For more than 60 years, the Centers for Disease Control and Prevention (CDC) has used its scientific expertise to help people throughout the world live healthier, safer, longer lives through science-based health action. In 1951, CDC officially established the Epidemic Intelligence Service to help build public health capacity. During 1950–2005, CDC’s Epidemic Intelligence Service officers conducted 462 international epidemiologic field investigations in 131 foreign countries and 7 territories. Investigations have included responding to emerging infectious and noninfectious disease outbreaks, assisting in disaster response, and evaluating core components of public health programs worldwide. Approximately 81% of investigations were responses to infectious disease outbreaks, but the proportion of investigations related to chronic and other noninfectious conditions increased 7-fold (6%–45%). These investigations have contributed to detecting and characterizing new pathogens (e.g., severe acute respiratory syndrome–associated coronavirus) and conditions, provided insights regarding factors that cause or contribute to disease acquisition (e.g., Ebola hemorrhagic fever), led to development of new diagnostics and surveillance technologies, and provided information upon which global health policies and regulations can be based. CDC’s disease detectives will undoubtedly continue to play a critical role in global health and in responding to emerging global disease threats.

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<![CDATA[Xanthine Oxidase Inhibition by Febuxostat in Macrophages Suppresses Angiotensin II-Induced Aortic Fibrosis]]> https://www.researchpad.co/article/N005e1f4f-0254-4509-8f8f-73304dc9463c

Abstract

BACKGROUND

Several reports from basic researches and clinical studies have suggested that xanthine oxidase (XO) inhibitors have suppressive effects on cardiovascular diseases. However, the roles of a XO inhibitor, febuxostat (FEB), in the pathogenesis of vascular remodeling and hypertension independent of the serum uric acid level remain unclear.

METHODS

To induce vascular remodeling in mice, angiotensin II (Ang II) was infused for 2 weeks with a subcutaneously implanted osmotic minipump. FEB was administered every day during Ang II infusion. Aortic fibrosis was assessed by elastica van Gieson staining. Mouse macrophage RAW264.7 cells (RAW) and mouse embryonic fibroblasts were used for in vitro studies.

RESULTS

FEB suppressed Ang II-induced blood pressure elevation and aortic fibrosis. Immunostaining showed that Ang II-induced macrophage infiltration in the aorta tended to be suppressed by FEB, and XO was mainly colocalized in macrophages, not in fibroblasts. Transforming growth factor-β1 (TGF-β1) mRNA expression was induced in the aorta in the Ang II alone group, but not in the Ang II + FEB group. Ang II induced α-smooth muscle actin-positive fibroblasts in the aortic wall, but FEB suppressed them. XO expression and activity were induced by Ang II stimulation alone but not by Ang II + FEB in RAW. FEB suppressed Ang II-induced TGF-β1 mRNA expression in RAW.

CONCLUSIONS

Our results suggested that FEB ameliorates Ang II-induced aortic fibrosis via suppressing macrophage-derived TGF-β1 expression.

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