First confirmation of Pseudogymnoascus destructans in British bats and hibernacula

White-nose syndrome (WNS) is a fatal fungal infection of bats in North America caused by Pseudogymnoascus destructans. P. destructans has been confirmed in Continental Europe but not associated with mass mortality. Its presence in Great Britain was unknown. Opportunistic sampling of bats in GB began during the winter of 2009. Any dead bats or samples from live bats with visible fungal growths were submitted to the Animal Health and Veterinary Laboratories Agency for culture. Active surveillance by targeted environmental sampling of hibernacula was carried out during the winter of 2012/2013. Six hibernacula were selected by their proximity to Continental Europe. Five samples, a combination of surface swabs or sediment samples, were collected. These were sent to the Center for Microbial Genetics and Genomics, Northern Arizona University, for P. destructans PCR. Forty-eight incidents were investigated between March 2009 and July 2013. They consisted of 46 bat carcases and 31 other samples. A suspected P. destructans isolate was cultured from a live Daubenton's bat (Myotis daubentonii) sampled in February 2013. This isolate was confirmed by the Mycology Reference Laboratory, Bristol (Public Health England), as P. destructans. A variety of fungi were isolated from the rest but all were considered to be saprophytic or incidental. P. destructans was also confirmed by the Center for Microbial Genetics and Genomics in five of the six sites surveyed.

Treatment of cannabis dependence using escitalopram in combination with cognitive-behavior therapy: a double-blind placebo-controlled study

BACKGROUND

Cannabis is the most frequently used illegal substance in the United States and Europe. There is a dramatic increase in the demand for treatment for cannabis dependence. Cannabis users frequently have co-morbid mood symptoms, especially depression and anxiety, and regular cannabis users may self-medicate for such symptoms.

OBJECTIVES

We report a double-blind, placebo-controlled treatment study, for the prevention of cannabis use in cannabis-dependent individuals.

METHOD

Regular cannabis-dependent users (n = 52) were treated for 9 weeks with weekly cognitive-behavior and motivation-enhancement therapy sessions together with escitalopram 10 mg/day. Urine samples were collected to monitor delta-9 tetrahydrocannabinol (THC) during treatment and questionnaires were administered to assess anxiety and depression.

RESULTS

We observed a high rate of dropout (50%) during the 9-week treatment program. Fifty-two patients were included in the intention-to-treat analysis. Of these, ten (19%) remained abstinent after 9 weeks of treatment as indicated by negative urine samples for THC. Escitalopram provided no advantage over placebo in either abstinence rates from cannabis or anxiety and depression scores during the withdrawal and abstinent periods.

CONCLUSIONS

Escitalopram treatment does not provide an additional benefit either for achieving abstinence, or for the treatment of the cannabis withdrawal syndrome. Due to limitations of our study, namely, a high dropout rate and effects of low abstinence rates on measures of anxiety, depression and withdrawal, it is premature to conclude that selective serotonin reuptake inhibitors are not effective for treatment of the cannabis withdrawal syndrome.

Rethinking "enterotypes"

Classification of the human gut microbiome into distinct types, or "enterotypes," provides an attractive framework for understanding microbial variation in health and disease. However, as discussed here, several different methods of collapsing enterotype variation into a few discrete clusters suggest that enterotype distribution is continuous and can vary widely within an individual.

Beyond NK cells: the expanding universe of innate lymphoid cells

For a long time, natural killer (NK) cells were thought to be the only innate immune lymphoid population capable of responding to invading pathogens under the influence of changing environmental cues. In the last few years, an increasing amount of evidence has shown that a number of different innate lymphoid cell (ILC) populations found at mucosal sites rapidly respond to locally produced cytokines in order to establish or maintain homeostasis. These ILC populations closely mirror the phenotype of adaptive T helper subsets in their repertoire of secreted soluble factors. Early in the immune response, ILCs are responsible for setting the stage to mount an adaptive T cell response that is appropriate for the incoming insult. Here, we review the diversity of ILC subsets and discuss similarities and differences between ILCs and NK cells in function and key transcriptional factors required for their development.

Abstract P6-08-11: Count us, know us, join us global survey: Comparing the feelings and needs of advanced breast cancer patients in the United States with patients in Latin America, Europe, and Asia

Background: Advanced breast cancer (stage III and stage IV/metastatic) (ABC) is the most serious form of breast cancer, with nearly 250,000 people across the globe living with the disease. Because ABC often metastasizes to the brain, bone, or liver, it has important health implications, requires life-long treatment, and is usually fatal. Support needs for this patient group are unique, yet rarely met. Hoping to identify new approaches to meeting the needs of this community, a global survey was commissioned by Novartis Oncology in partnership with the global advocacy community. Method: Harris Interactive conducted an online survey between October 2012 and March 2013. It was completed by 1,273 female metastatic breast cancer patients ages 21+ from 12 countries (United States [US], Canada, Mexico, Brazil, Argentina, United Kingdom, Germany, Russia, India, Lebanon, Taiwan, and Hong Kong). Total sample data are not weighted and are representative only of the individuals surveyed. A global post-weight was applied to ensure that all countries received an equal weight in the global and regional data. Results: Patients in the US (70%) are more likely than patients in most other countries surveyed to feel isolated from the non-metastatic community (40% globally). In addition, US patients (73%) are significantly more likely than their counterparts in most other countries to often feel that no one understands what they are going through (63% globally). Patients in the US (53%) are also more likely than those in most other countries to say that support from friends and family has diminished since their initial advanced diagnosis (41% globally), and employed US patients (34%) are more likely than those in many other countries to believe their colleagues look at them differently as a result of their metastatic breast cancer (17% globally). Women in the US were most likely to be actively seeking information (97%) compared with patients in other countries (77% globally). Although more US women patients are active information seekers, they are most likely to be unsatisfied with the information that is currently available compared to patients in the other countries (31%; 51% globally). Conclusions: Despite the significant amount of attention paid to breast cancer in the US and the resources available, many US women with metastatic breast cancer feel more alone and isolated than do their counterparts in most other countries surveyed. These US women are also significantly more likely than their counterparts in other countries to often feel as though no one understands what they are going through. More needs to be done to help women in the US feel supported emotionally throughout their entire ABC journey.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-08-11.

Accessing the food systems in urban and rural Minnesotan communities

OBJECTIVE

Explore how urban and rural Minnesotans access the food system and to investigate whether community infrastructure supports a healthful food system.

DESIGN

Eight (4 urban and 4 rural) focus groups were conducted.

SETTING AND PARTICIPANTS

Eight counties with urban influence codes of 1, 2, 4, 5, 8, and 10. Fifty-nine (urban, n = 27; rural, n = 32) adults. The sample was of mixed race and had a range of incomes. Almost half of the sample was obese.

MAIN OUTCOME MEASURE

Food systems access and the role of community infrastructure, civic engagement, and reciprocal relationships in food provisioning in counties with different urban influence codes.

ANALYSES

Themes and subthemes were identified through emerging concepts.

RESULTS

Food access varied based on rurality and community infrastructure. Three themes emerged: community infrastructure around the conventional food system and food provisioning, alternative food resources, and perceptions of the effect food and of the influence diet and exercise have on health.

CONCLUSIONS AND IMPLICATIONS

Civic engagement and community infrastructure affected food access. Rural residents rely more on retail grocery stores, gardening, hunting, and informal food exchange systems, whereas urban residents rely more on the retail grocery stores and food safety net systems. Hunting and gardening may contribute valuable nutrients to the diet.