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The aim of this study was to characterize foot-and-mouth disease (FMD) viruses collected between 2004 and 2008 from Sudan, a country where FMD is endemic. Using virus isolation and antigen ELISA, three FMD virus serotypes (O, A and SAT2) were detected in 24 samples that were submitted to the FAO World Reference Laboratory for FMD. Pan-serotypic real-time RT-PCR assays targeting the 5' untranslated region (5'UTR) and 3D genes of FMD virus were also used to contribute to the laboratory diagnosis of these cases. The lack of concordant results between the real-time RT-PCR assays for three serotype O viruses was attributed to four nucleotide mismatches in the 5'UTR PCR primer and probe sites (three substitutions for the sense-primer and one in the TaqMan®probe region). Taken together, the laboratory results showed that recent FMD outbreaks that occurred during 2008 in northern and central Sudan were caused by serotypes O and SAT2, while serotype A was last detected in 2006. Phylogenetic analyses of VP1 sequences from these viruses were used to determine the relationships with 23 older viruses from Sudan and other viruses from West and East Africa. For serotype O, closest genetic identities were between concurrent and historical Sudanese isolates, indicating that within-country circulation is an important mechanism by which FMD is maintained year-on-year in Sudan. A similar pattern was also evident for serotype A and SAT2 viruses; however, these lineages also contained recent representative FMD viral isolates from other countries in the region suggesting that long-distance animal movement can also contribute to FMD dispersal across sub-Saharan Africa. These findings provide the first molecular description of FMD viruses that are circulating in Sudan, and highlight that further sampling of representative viruses from the region is required before the complex epidemiology of FMD in sub-Saharan Africa can be fully understood.

This article reviews the options for use of virus detection techniques for decentralized testing of samples from suspected secondary outbreaks of foot-and-mouth disease (FMD). These options have been expanded by the advent of new tests including disposable lateral flow devices (LFDs) that detect viral proteins and portable RT-PCR equipment that detects viral RNA. LFDs have been developed with similar sensitivity to antigen detection ELISA but with the ability to provide a result 1-30?min after the addition of epithelium or vesicular fluid. Portable RT-PCR platforms are being developed that can detect FMD viral RNA in blood, epithelium or other materials with minimal sample processing and with high sensitivity, in as little as 60?min in some cases. These devices may be used on infected farms as pen-side tests, in regional, local or mobile laboratories, or in National Reference Laboratories (NRL). Advantages and disadvantages of different testing options are considered to inform decisions on the optimal strategies for different national circumstances. Issues include validation and quality control, containment needs, availability of test devices and reagents, the decision tree for declaring an outbreak, training issues and provision of samples for subsequent viral characterization. Tests to confirm the diagnosis of the index case of an outbreak of FMD should continue to be carried out in the NRL.

In 2007, serological evidence for foot-and-mouth disease (FMD) infection was found as a result of differential diagnostic testing of Cypriot sheep suspected to be infected with bluetongue or contagious ecthyma. Seropositive sheep and goats were subsequently uncovered on ten geographically clustered flocks, while cattle and pigs in neighbouring herds were all seronegative. These antibodies were specific for serotype-O FMD virus, reacting with both structural and non-structural (NS) FMD viral proteins. However, no FMD virus could be recovered from the seropositive flocks. FMD had not been recorded in Cyprus since 1964 and there has been no vaccination programme since 1984. Since all the seropositive animals were at least 3?years old and home-bred, it was concluded that infection had occurred approximately 3?years previously had passed un-noticed and died out spontaneously. It therefore appears that antibodies to FMD virus NS proteins can still be detected around 3?years after infection of small ruminants, but that virus carriers cannot be detected at this time. This unusual situation of finding evidence of historical infection in a FMD-free country caused considerable disruption and alarm and posed questions about the definition of what constitutes a FMD outbreak.

This report describes the characterization of a new genotype of foot-and-mouth disease virus (FMDV) type A responsible for recent FMD outbreaks in the Middle East. Initially identified in samples collected in 2003 from Iran, during 2005 and 2006 this FMDV lineage (proposed to be named A-Iran-05) spread into Saudi Arabia and Jordan and then further west into Turkey reaching European Thrace in January 2007. Most recently A-Iran-05 has been found in Bahrain. To the east of Iran, it has been recognized in Afghanistan (2004-07) and Pakistan (2006-07). Throughout the region, this lineage is now the predominant genotype of FMDV serotype A sampled, and has appeared to have replaced the A-Iran-96 and A-Iran-99 strains which were previously encountered. In August 2007, a new A-Iran-05 sub-lineage (which we have called A-Iran-05ARD-07) was identified in Ardahan, Turkey, close to the border with Georgia. This new sub-lineage appeared to predominate in Turkey in 2008, but has, so far, not been identified in any other country. Vaccine matching tests revealed that the A-Iran-05 viruses are antigenically different to A-Iran-96 and more like A22. These findings emphasize the importance of undertaking continued surveillance in the Middle East and Central Asia in order to detect and monitor the emergence and spread of new FMDV strains.

Nine viral diseases included in the World Organization for Animal Health list of notifiable diseases (former list A) were chosen for their contagiousness and high capacity of spreading to improve their diagnosis using new and emerging technologies. All the selected diseases - foot-and-mouth disease, swine vesicular disease, vesicular stomatitis, classical swine fever, African swine fever, bluetongue, African horse sickness, Newcastle disease and highly pathogenic avian influenza - are considered as transboundary diseases, which detection causes the prohibition of livestock exportation, and, thus, it leads to high economical losses. The applied diagnostic techniques can fall into two categories: (i) nucleic-acid detection, including padlock probes, real-time PCR with TaqMan, minor groove binding probes and fluorescence energy transfer reaction probes, isothermal amplification like the CleavaseInvader assay or the loop-mediated amplification technology and the development of rapid kits for 'mobile' PCR and (ii) antigen-antibody detection systems like simplified and more sensitive ELISA tests. Besides, internal controls have been improved for nucleic acid-detecting methods by using an RNA plant virus - Cowpea Mosaic Virus - to ensure the stability of the RNA used as a positive control in diagnostic real-time RT-PCR assays. The development of these diagnosis techniques has required the joint efforts of a European consortium in which nine diagnostic laboratories and an SME who have collaborated since 2004 within the European Union-funded Lab-on-site project. The results obtained are shown in this paper.

Magnetic circular dichroism and resonance Raman spectra have been obtained for three "oxygenated" derivatives of cytochrome c oxidase (ferrocytochrome c:oxygen oxidoreductase, EC 1.9.3.1). The spectra are interpreted and four alternatives for the states of cytochrome a3 and Cuu are evaluated.

A survey of 34 organizations found a great deal of diversity in the ways companies analyze and use wage surveys.

IN HIS clinical and genetic study of male alcoholics Amark presented the risks for psychiatric diseases in the probands' relatives.1 When compared to general population figures the families of the alcoholic probands showed no increase in schizophrenia, manic depressive disease, general paresis, senile and presenile psychoses, epilepsy, or oligophrenia. Psychogenic psychoses were, however, more frequently found in the relatives of alcoholics than in the general population. Although psychogenic psychoses contain three different categories, depressive syndromes, disturbances of consciousness, and paranoid syndromes, the most common form of illness in this group is psychogenic depression. Psychogenic depressions fit into the general framework of affective disorder. Among the first-degree relatives of the alcoholic probands psychopathy was also increased when compared to general population figures. Finally, brothers and fathers of male alcoholics showed considerably more alcoholism than would be expected although female first-degree relatives (sisters and mothers) did not show a remarkably

ALCOHOLISM may not be a single disease.1 A recent study by Pitts and Winokur2 points to the close relationship of alcoholism and affective disorder while other studies have shown the possible tie between alcoholism and schizophrenia,3-5 psychoneurosis,5 and sociopathy.6 In addition, it has been suggested that alcoholism may not be the same disease in the two sexes.4 A workable definition of alcoholism has emerged from Jellinek and the World Health Organization,7,8 but such a definition allows assemblage of a heterogeneous group of alcoholics with other associated psychiatric illnesses.5 An examination of alcoholism both as a primary disease entity and as a secondary complication of other psychiatric illnesses is lacking. The purpose of this paper is to describe an attempt to delineate alcoholism into nosologically homogeneous groups.We shall limit our present discussion to alcoholism in the female.

WE BEGAN the systematic evaluation of drug-modification in electroconvulsive treatment (ECT) with a study1 of the two rapid-acting barbiturates most commonly used for ECT induction, thiopental (Pentothal) sodium and sodium methohexital (Brevital Sodium). The electrocardiogram was used as the index of cardiovascular complication, and two series of patients receiving ECT were compared. ECT was induced with thiopental in one series, and with methohexital in the other series, of 500 consecutive treatments. Many more cardiac arrhythmias occurred with thiopental anesthetic induction, providing preliminary evidence that methohexital is safer, as well as more convenient, than thiopental for the induction of brief anesthesia in ECT.A second study of methohexital and pentothal anesthetic induction for ECT confirmed these differences.2 With each patient serving as his own control while atropinization, muscle relaxation, and resuscitation were held constant, four experimental variables were

PRIOR TO THE introduction of drugmodified electroconvulsive therapy (ECT), vertebral fracture was a frequent, bothersome occurrence.1 Now that complication is relatively rare, ECT is a less fear-inspiring procedure. When ECT is modified by drugs, however, the risk of cardiovascular complication may be increased,2-4 The chief cause of mortality with drug-modified ECT is cardiovascular complications.3-5We began the systematic evaluation of drug-modification in ECT with a previous study6 of the two rapid-acting barbiturates most commonly used for ECT induction, thiopental sodium (Pentothal Sodium) and methohexital sodium (Brevital Sodium). The electrocardiogram was used as the index of cardiovascular complication and two series of patients receiving ECT were compared. One series of 500 patients receiving consecutive ECT was induced with thiopental, the other with methohexital. There were many more cardiac arrhythmias with thiopental anesthetic induction, providing preliminary evidence that methohexital

TO THE EDITOR.— Subacute cutaneous lupus erythematosus (SCLE) is a common form of chronic lupus erythematosus.1,2 It has a wide variety of clinical presentations and prognoses.3,4 Genetic predisposition, altered immunity, hormones, ultraviolet light, drug reactions, and viruses have been cited as possible causal cofactors.5 We report preliminary evidence for a viral cofactor in SCLE that cross-reacts with human immunodeficiency virus (HIV), the infectious agent in acquired immunodeficiency syndrome (AIDS). This is not to suggest that a viral cofactor for SCLE will be a retrovirus, nor that it is sexually transmitted. Rather, the inference is of a similarity between HIV antigens and other antigens to which patients with SCLE have been exposed.We conducted preliminary serologic studies on the longterm use of inactivated polio vaccine as a treatment for symptomatic HIV infection.6,7 A conserved domain of poliovirus has sequence similarities to the anti-HIV agent peptide T.8

To the Editor.—There have been significant increases in both numbers and percentages of medical students who are women in the past decade.1 These increases have resulted from numerous minority rights federal court decisions and the minority admissions demands placed on US medical schools by the federal capitation financial support programs. (These programs also mandated increases in numbers of medical students.)2 The post hoc self-congratulation for this progressive reform by medical educators and the medical politicians is suspect, since there is not a shred of evidence that these changes would have occurred without the mandate associated with the capitation support. This letter is written to emphasize, by demonstrating the actual numbers and percentages, how little has actually been achieved, even though women physicians and medical educators and politicians are apparently delighted.2Tables 1 and 2 show that the number of women medical students increased by a factor