Human Brucella canis Infection and Subsequent Laboratory Exposures Associated with a Puppy, New York City, 2012

Human Brucella canis infection incidence is unknown. Most identified cases are associated with pet dogs. Laboratory-acquired infections can occur following contact with Brucella spp. We identified a paediatric B. canis case, the source and other exposed persons. A 3-year-old New York City child with fever and dyspnoea was hospitalized for 48 h for bronchiolitis. After her admission, blood culture grew B. canis, she was prescribed anti-microbials and recovered. B. canis was also isolated from blood of the child's pet dog; these isolates were genetically similar. The dog originated from an Iowa breeding facility which was quarantined after identification of the dog's infection. Additionally, 31 laboratory workers were exposed and subsequently monitored for symptoms; 15 completed post-exposure prophylaxis. To our knowledge, this is the first report strongly suggesting B. canis zoonotic transmission to a child in the United States, and highlights the need for coordinated control policies to minimize human illness.

Standardized accuracy assessment of the calypso wireless transponder tracking system

Electromagnetic (EM) tracking allows localization of small EM sensors in a magnetic field of known geometry without line-of-sight. However, this technique requires a cable connection to the tracked object. A wireless alternative based on magnetic fields, referred to as transponder tracking, has been proposed by several authors. Although most of the transponder tracking systems are still in an early stage of development and not ready for clinical use yet, Varian Medical Systems Inc. (Palo Alto, California, USA) presented the Calypso system for tumor tracking in radiation therapy which includes transponder technology. But it has not been used for computer-assisted interventions (CAI) in general or been assessed for accuracy in a standardized manner, so far. In this study, we apply a standardized assessment protocol presented by Hummel et al (2005 Med. Phys. 32 2371-9) to the Calypso system for the first time. The results show that transponder tracking with the Calypso system provides a precision and accuracy below 1 mm in ideal clinical environments, which is comparable with other EM tracking systems. Similar to other systems the tracking accuracy was affected by metallic distortion, which led to errors of up to 3.2 mm. The potential of the wireless transponder tracking technology for use in many future CAI applications can be regarded as extremely high.

Nodular recurrence and hypothyroidism following partial thyroidectomy for benign nodular thyroid disease in children and adolescents

OBJECTIVES

Diagnostic and therapeutic processing of a thyroid nodule in children and adolescents may require lobectomy-isthmusectomy (LI) or nodule-resection (NR). Very few data in the literature report the long-term evolution of the remaining thyroid lobe in a defined pediatric population. In this study, we aimed to answer the following questions: Does a nodule recurrence occur in the remainder lobe? Is a post-operative thyroxine treatment necessary?

MATERIAL AND METHODS

This retrospective study describes 28 patients under 18 who underwent LI (22 cases) or NR (6 cases) from January 2004 to March 2012. Ten of them were lost to follow up, 18 could be assessed (4 NR (22%) and 14 LI (78%) - mean follow-up 45±31 months). All patients benefited of post-operative thyroid ultrasonography, and regular endocrinologic follow-up. The following data were analysed: emergence of new thyroid nodules, evolution of pre-existing nodules, occurrence of post-operative hypothyroidism and requirement for completion thyroidectomy.

RESULTS

The mean age at the time of surgery was 14.3±1.9 years. Two patients (11%) had pre-existing nodules in the remaining thyroid gland, none of which showed an increase in size after surgery. De novo nodules developed in five patients (27.8%). Three patients who underwent LI (21.4%) needed thyroxine treatment for post-operative hypothyroidism. One patient (5.5%) needed completion thyroidectomy.

CONCLUSIONS

In this children and adolescents population, after performing LI or NR, remaining thyroid tissue stays free of nodules in 72.2% of the cases. A post-operative thyroxin treatment is necessary in 21.4% of cases after LI.

Domino model for geomagnetic field reversals

We solve the equations of motion of a one-dimensional planar Heisenberg (or Vaks-Larkin) model consisting of a system of interacting macrospins aligned along a ring. Each spin has unit length and is described by its angle with respect to the rotational axis. The orientation of the spins can vary in time due to spin-spin interaction and random forcing. We statistically describe the behavior of the sum of all spins for different parameters. The term "domino model" in the title refers to the interaction among the spins. We compare the model results with geomagnetic field reversals and dynamo simulations and find strikingly similar behavior. The aggregate of all spins keeps the same direction for a long time and, once in a while, begins flipping to change the orientation by almost 180 degrees (mimicking a geomagnetic reversal) or to move back to the original direction (mimicking an excursion). Most of the time the spins are aligned or antialigned and deviate only slightly with respect to the rotational axis (mimicking the secular variation of the geomagnetic pole with respect to the geographic pole). Reversals are fast compared to the times in between and they occur at random times, both in the model and in the case of the Earth's magnetic field.

Zonal shear and super-rotation in a magnetized spherical Couette-flow experiment

We present measurements performed in a spherical shell filled with liquid sodium, where a 74-mm-radius inner sphere is rotated while a 210-mm-radius outer sphere is at rest. The inner sphere holds a dipolar magnetic field and acts as a magnetic propeller when rotated. In this experimental setup called "Derviche Tourneur Sodium" (DTS), direct measurements of the velocity are performed by ultrasonic Doppler velocimetry. Differences in electric potential and the induced magnetic field are also measured to characterize the magnetohydrodynamic flow. Rotation frequencies of the inner sphere are varied between -30 Hz and +30 Hz, the magnetic Reynolds number based on measured sodium velocities and on the shell radius reaching to about 33. We have investigated the mean axisymmetric part of the flow, which consists of differential rotation. Strong super-rotation of the fluid with respect to the rotating inner sphere is directly measured. It is found that the organization of the mean flow does not change much throughout the entire range of parameters covered by our experiment. The direct measurements of zonal velocity give a nice illustration of Ferraro's law of isorotation in the vicinity of the inner sphere, where magnetic forces dominate inertial ones. The transition from a Ferraro regime in the interior to a geostrophic regime, where inertial forces predominate, in the outer regions has been well documented. It takes place where the local Elsasser number is about 1. A quantitative agreement with nonlinear numerical simulations is obtained when keeping the same Elsasser number. The experiments also reveal a region that violates Ferraro's law just above the inner sphere.

A one-year oral toxicity study of sodium stearoyl lactylate (SSL) in rats

The toxicity of sodium stearoyl lactylate (SSL) was examined in Wistar rats fed diets containing 0, 1.25, 2.5, and 5% SSL for one year, equivalent to mean daily intakes of 558, 1115, and 2214 mg/kg/day in males and 670, 1339, and 2641 mg/kg/day in females, respectively. SSL was well tolerated at these dietary levels as evidenced by the absence of toxicologically significant changes in the general condition and appearance of the rats, survival, neurobehavioral endpoints, growth, feed and water intake, ophthalmoscopic examinations, hematology and clinical chemistry parameters, urinalysis, or necropsy findings. The occurrence of uterine endometrial stromal polyps was the only finding of potential significance. Given the frequent occurrence of these benign tumors in rats, wide variability in the reported incidence of this type of polyps in rats, the lack of statistical significance and lack of biological evidence to suggest a mechanism for the slightly greater incidence in the groups fed 2.5 and 5% SSL, it was concluded that the endometrial stromal polyps observed in females fed SSL were not related to treatment. The no observed adverse effect level (NOAEL) of SSL was placed at 5%, the highest dietary level tested (equivalent to 2214 mg/kg/day for males and 2641 mg/kg/day for females).

First Results from the “Patient's Anastrozole Compliance to Therapy Programme” (PACT) Evaluating the Impact of a Standardized Information Service on Compliance in Postmenopausal Women with Early Breast Cancer (EBC) Receiving Adjuvant Endocrine Therapy

Background: In adjuvant treatment of hormone-responsive breast cancer, existing data document that 23% and 50% of patients were non-compliant after the first and fourth year of tamoxifen (TAM) therapy, respectively. Here, we present the PACT-study that aims to increase awareness, motivation and adherence to oral hormonal therapy, namely the aromatase inhibitor anastrozole, in routine clinical practice by simple interventions such as written standardized mailings and reminder services.Materials and Methods: In this two arm, parallel group trial with a primary duration of 12 months and 60 months follow-up, women with hormone receptor positive EBC receiving anastrozole once daily were randomized to either routine clinical care alone or to receiving additional standardized information for the first 12 months of adjuvant therapy. Primary endpoint is compliance rate in the standard versus intervention arm after 12 months, where compliance is defined by an 80% intake of the total medication. Secondary endpoints include persistence on therapy, reasons for non-compliance, influence of baseline characteristics, and of compliance on clinical outcome parameters.Compliance was evaluated by self report using standardized, detailed questionnaires at baseline and after each year of treatment. In addition, the prescription data for each patient from hospital records and physician recall was collected. Finally, quality of life and patient satisfaction were assessed using standardized questionnaires.Results: From July 2006 until November 2008, 4.924 women were enrolled with a median patient age of 64 years. Besides demographic data and patient characteristics results of patient's self reporting data will be shown for the first time at this meeting.Conclusion: PACT is the largest prospective investigation on compliance regarding an aromatase inhibitor as adjuvant therapy so far. The programme's goals are to clarify what aspects influence patients' adherence to prescribed medication and how motivation for regular intake can be accomplished. Furthermore, PACT seeks to prove if a simple intervention such as a standardized information and reminder services throughout the first year of treatment may improve compliance and thus eventually influence treatment outcomes.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6079.