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Sample records for bacterial extrapulmonary dissemination

  1. Lung Dendritic Cells Facilitate Extrapulmonary Bacterial Dissemination during Pneumococcal Pneumonia

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    Alva eRosendahl

    2013-06-01

    Full Text Available Streptococcus pneumoniae is a leading cause of bacterial pneumonia worldwide. Given the critical role of dendritic cells (DCs in regulating and modulating the immune response to pathogens, we investigated here the role of DCs in S. pneumoniae lung infections. Using a well-established transgenic mouse line which allows the conditional transient depletion of DCs, we showed that ablation of DCs resulted in enhanced resistance to intranasal challenge with S. pneumoniae. DC-depleted mice exhibited delayed bacterial systemic dissemination, significantly reduced bacterial loads in the infected organs and lower levels of serum inflammatory mediators than non-depleted animals. The increased resistance of DC-depleted mice to S. pneumoniae was associated with a better capacity to restrict pneumococci extrapulmonary dissemination. Furthermore, we demonstrated that S. pneumoniae disseminated from the lungs into the regional lymph nodes in a cell-independent manner and that this direct way of dissemination was much more efficient in the presence of DCs. We also provide evidence that S. pneumoniae induces expression and activation of matrix metalloproteinase-9 (MMP-9 in cultured bone marrow-derived DCs. MMP-9 is a protease involved in the breakdown of extracellular matrix proteins and is critical for DC trafficking across extracellular matrix and basement membranes during the migration from the periphery to the lymph nodes. MMP-9 was also significantly up-regulated in the lungs of mice after intranasal infection with S. pneumoniae. Notably, the expression levels of MMP-9 in the infected lungs were significantly decreased after depletion of DCs suggesting the involvement of DCs in MMP-9 production during pneumococcal pneumonia. Thus, we propose that S. pneumoniae can exploit the DC-derived proteolysis to open tissue barriers thereby facilitating its own dissemination from the local site of infection.

  2. Primary disseminated extrapulmonary multidrug resistant tuberculosis

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    S K Das

    2012-01-01

    Full Text Available Disseminated tuberculosis is a common mode of presentation of tuberculosis in patients both with and without HIV/AIDS in India. However, primary multidrug resistance in disseminated tuberculosis involving only the extrapulmonary sites in an immunocompetent adult is rare. Here, we report a case of a 19-year-old man who had disseminated tuberculosis involving left pleura, pericardium, peritoneum and intraabdominal lymph nodes. He was initially taking WHO category I antituberculous drugs, but was not responding in spite of 5 months of chemotherapy. Culture of the pleural biopsy specimen grew Mycobacterium tuberculosis which was resistant to isoniazid and rifampicin. He was put on therapy for multidrug resistant tuberculosis,following 24 months of chemotherapyhe had an uneventful recovery.

  3. [Extrapulmonary tuberculosis].

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    Mazza-Stalder, J; Nicod, L; Janssens, J-P

    2012-04-01

    Extrapulmonary tuberculosis represents an increasing proportion of all cases of tuberculosis reaching 20 to 40% according to published reports. Extrapulmonary TB is found in a higher proportion of women, black people and immunosuppressed individuals. A significant proportion of cases have a normal chest X-Ray at the time of diagnosis. The most frequent clinical presentations are lymphadenitis, pleuritis and osteoarticular TB. Peritoneal, urogenital or meningeal tuberculosis are less frequent, and their diagnosis is often difficult due to the often wide differential diagnosis and the low sensitivity of diagnostic tests including cultures and genetic amplification tests. The key clinical elements are reported and for each form the diagnostic yield of available tests. International therapeutic recommendations and practical issues are reviewed according to clinical presentation.

  4. The influence of host and bacterial genotype on the development of disseminated disease with Mycobacterium tuberculosis.

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    Maxine Caws

    2008-03-01

    Full Text Available The factors that govern the development of tuberculosis disease are incompletely understood. We hypothesized that some strains of Mycobacterium tuberculosis (M. tuberculosis are more capable of causing disseminated disease than others and may be associated with polymorphisms in host genes responsible for the innate immune response to infection. We compared the host and bacterial genotype in 187 Vietnamese adults with tuberculous meningitis (TBM and 237 Vietnamese adults with uncomplicated pulmonary tuberculosis. The host genotype of tuberculosis cases was also compared with the genotype of 392 cord blood controls from the same population. Isolates of M. tuberculosis were genotyped by large sequence polymorphisms. The hosts were defined by polymorphisms in genes encoding Toll-interleukin 1 receptor domain containing adaptor protein (TIRAP and Toll-like receptor-2 (TLR-2. We found a significant protective association between the Euro-American lineage of M. tuberculosis and pulmonary rather than meningeal tuberculosis (Odds ratio (OR for causing TBM 0.395, 95% confidence intervals (C.I. 0.193-0.806, P = 0.009, suggesting these strains are less capable of extra-pulmonary dissemination than others in the study population. We also found that individuals with the C allele of TLR-2 T597C allele were more likely to have tuberculosis caused by the East-Asian/Beijing genotype (OR = 1.57 [95% C.I. 1.15-2.15] than other individuals. The study provides evidence that M. tuberculosis genotype influences clinical disease phenotype and demonstrates, for the first time, a significant interaction between host and bacterial genotypes and the development of tuberculosis.

  5. The Influence of Host and Bacterial Genotype on the Development of Disseminated Disease with Mycobacterium tuberculosis

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    Caws, Maxine; Thwaites, Guy; Dunstan, Sarah; Hawn, Thomas R.; Thi Ngoc Lan, Nguyen; Thuong, Nguyen Thuy Thuong; Stepniewska, Kasia; Huyen, Mai Nguyet Thu; Bang, Nguyen Duc; Huu Loc, Tran; Gagneux, Sebastien; van Soolingen, Dick; Kremer, Kristin; van der Sande, Marianne; Small, Peter; Thi Hoang Anh, Phan; Chinh, Nguyen Tran; Thi Quy, Hoang; Thi Hong Duyen, Nguyen; Quang Tho, Dau; Hieu, Nguyen T.; Torok, Estee; Hien, Tran Tinh; Dung, Nguyen Huy; Thi Quynh Nhu, Nguyen; Duy, Phan Minh; van Vinh Chau, Nguyen; Farrar, Jeremy

    2008-01-01

    The factors that govern the development of tuberculosis disease are incompletely understood. We hypothesized that some strains of Mycobacterium tuberculosis (M. tuberculosis) are more capable of causing disseminated disease than others and may be associated with polymorphisms in host genes responsible for the innate immune response to infection. We compared the host and bacterial genotype in 187 Vietnamese adults with tuberculous meningitis (TBM) and 237 Vietnamese adults with uncomplicated pulmonary tuberculosis. The host genotype of tuberculosis cases was also compared with the genotype of 392 cord blood controls from the same population. Isolates of M. tuberculosis were genotyped by large sequence polymorphisms. The hosts were defined by polymorphisms in genes encoding Toll-interleukin 1 receptor domain containing adaptor protein (TIRAP) and Toll-like receptor-2 (TLR-2). We found a significant protective association between the Euro-American lineage of M. tuberculosis and pulmonary rather than meningeal tuberculosis (Odds ratio (OR) for causing TBM 0.395, 95% confidence intervals (C.I.) 0.193–0.806, P = 0.009), suggesting these strains are less capable of extra-pulmonary dissemination than others in the study population. We also found that individuals with the C allele of TLR-2 T597C allele were more likely to have tuberculosis caused by the East-Asian/Beijing genotype (OR = 1.57 [95% C.I. 1.15–2.15]) than other individuals. The study provides evidence that M. tuberculosis genotype influences clinical disease phenotype and demonstrates, for the first time, a significant interaction between host and bacterial genotypes and the development of tuberculosis. PMID:18369480

  6. Glyburide reduces bacterial dissemination in a mouse model of melioidosis.

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    Gavin C K W Koh

    Full Text Available BACKGROUND: Burkholderia pseudomallei infection (melioidosis is an important cause of community-acquired Gram-negative sepsis in Northeast Thailand, where it is associated with a ~40% mortality rate despite antimicrobial chemotherapy. We showed in a previous cohort study that patients taking glyburide ( = glibenclamide prior to admission have lower mortality and attenuated inflammatory responses compared to patients not taking glyburide. We sought to define the mechanism underlying this observation in a murine model of melioidosis. METHODS: Mice (C57BL/6 with streptozocin-induced diabetes were inoculated with ~6 × 10(2 cfu B. pseudomallei intranasally, then treated with therapeutic ceftazidime (600 mg/kg intraperitoneally twice daily starting 24 h after inoculation in order to mimic the clinical scenario. Glyburide (50 mg/kg or vehicle was started 7 d before inoculation and continued until sacrifice. The minimum inhibitory concentration of glyburide for B. pseudomallei was determined by broth microdilution. We also examined the effect of glyburide on interleukin (IL 1β by bone-marrow-derived macrophages (BMDM. RESULTS: Diabetic mice had increased susceptibility to melioidosis, with increased bacterial dissemination but no effect was seen of diabetes on inflammation compared to non-diabetic controls. Glyburide treatment did not affect glucose levels but was associated with reduced pulmonary cellular influx, reduced bacterial dissemination to both liver and spleen and reduced IL1β production when compared to untreated controls. Other cytokines were not different in glyburide-treated animals. There was no direct effect of glyburide on B. pseudomallei growth in vitro or in vivo. Glyburide directly reduced the secretion of IL1β by BMDMs in a dose-dependent fashion. CONCLUSIONS: Diabetes increases the susceptibility to melioidosis. We further show, for the first time in any model of sepsis, that glyburide acts as an anti-inflammatory agent by

  7. Extrapulmonary small cell carcinoma.

    NARCIS (Netherlands)

    Heijden, E. van der; Heijdra, Y.F.

    2005-01-01

    This article reviews the recent literature on extrapulmonary small cell carcinomas. Until now, only four cases have been published in the English literature, two of those in the Southern Medical Journal. Sharing the information on diagnosis and treatment of these cases is important for better unders

  8. Klebsiella pneumoniae Siderophores Induce Inflammation, Bacterial Dissemination, and HIF-1α Stabilization during Pneumonia

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    Holden, Victoria I.; Breen, Paul; Houle, Sébastien; Dozois, Charles M.

    2016-01-01

    ABSTRACT Klebsiella pneumoniae is a Gram-negative pathogen responsible for a wide range of infections, including pneumonia and bacteremia, and is rapidly acquiring antibiotic resistance. K. pneumoniae requires secretion of siderophores, low-molecular-weight, high-affinity iron chelators, for bacterial replication and full virulence. The specific combination of siderophores secreted by K. pneumoniae during infection can impact tissue localization, systemic dissemination, and host survival. However, the effect of these potent iron chelators on the host during infection is unknown. In vitro, siderophores deplete epithelial cell iron, induce cytokine secretion, and activate the master transcription factor hypoxia inducible factor-1α (HIF-1α) protein that controls vascular permeability and inflammatory gene expression. Therefore, we hypothesized that siderophore secretion by K. pneumoniae directly contributes to inflammation and bacterial dissemination during pneumonia. To examine the effects of siderophore secretion independently of bacterial growth, we performed infections with tonB mutants that persist in vivo but are deficient in siderophore import. Using a murine model of pneumonia, we found that siderophore secretion by K. pneumoniae induces the secretion of interleukin-6 (IL-6), CXCL1, and CXCL2, as well as bacterial dissemination to the spleen, compared to siderophore-negative mutants at an equivalent bacterial number. Furthermore, we determined that siderophore-secreting K. pneumoniae stabilized HIF-1α in vivo and that bacterial dissemination to the spleen required alveolar epithelial HIF-1α. Our results indicate that siderophores act directly on the host to induce inflammatory cytokines and bacterial dissemination and that HIF-1α is a susceptibility factor for bacterial invasion during pneumonia. PMID:27624128

  9. Klebsiella pneumoniae Siderophores Induce Inflammation, Bacterial Dissemination, and HIF-1α Stabilization during Pneumonia

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    Victoria I. Holden

    2016-09-01

    Full Text Available Klebsiella pneumoniae is a Gram-negative pathogen responsible for a wide range of infections, including pneumonia and bacteremia, and is rapidly acquiring antibiotic resistance. K. pneumoniae requires secretion of siderophores, low-molecular-weight, high-affinity iron chelators, for bacterial replication and full virulence. The specific combination of siderophores secreted by K. pneumoniae during infection can impact tissue localization, systemic dissemination, and host survival. However, the effect of these potent iron chelators on the host during infection is unknown. In vitro, siderophores deplete epithelial cell iron, induce cytokine secretion, and activate the master transcription factor hypoxia inducible factor-1α (HIF-1α protein that controls vascular permeability and inflammatory gene expression. Therefore, we hypothesized that siderophore secretion by K. pneumoniae directly contributes to inflammation and bacterial dissemination during pneumonia. To examine the effects of siderophore secretion independently of bacterial growth, we performed infections with tonB mutants that persist in vivo but are deficient in siderophore import. Using a murine model of pneumonia, we found that siderophore secretion by K. pneumoniae induces the secretion of interleukin-6 (IL-6, CXCL1, and CXCL2, as well as bacterial dissemination to the spleen, compared to siderophore-negative mutants at an equivalent bacterial number. Furthermore, we determined that siderophore-secreting K. pneumoniae stabilized HIF-1α in vivo and that bacterial dissemination to the spleen required alveolar epithelial HIF-1α. Our results indicate that siderophores act directly on the host to induce inflammatory cytokines and bacterial dissemination and that HIF-1α is a susceptibility factor for bacterial invasion during pneumonia.

  10. Brucella Dissociation Is Essential for Macrophage Egress and Bacterial Dissemination

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    Thomas A Ficht

    2014-03-01

    Full Text Available It has long been observed that smooth Brucella can dissociate into rough mutants that are cytotoxic to macrophages. However, the in vivo biological significance and/or mechanistic de-tails of Brucella dissociation and cytotoxicity remain incomplete. In the current report, a plaque assay was developed using Brucella strains exhibiting varying degrees of cytotoxicity. Infected monolayers were observed daily using phase contrast microscopy for plaque formation while Brucella uptake and replication were monitored using an immunofluorescence assay (IFA. Vis-ible plaques were detected at 4-5 days post infection (p.i. with cytotoxic Brucella 16M∆manBA at an MOI of 0.1. IFA staining demonstrated that the plaques consisted of macrophages with replicating Brucella. Visible plaques were not detected in monolayers infected with non-cytotoxic 16M∆manBA∆virB2 at an MOI of 0.1. However, IFA staining did reveal small groups of macrophages (foci with replicating Brucella in the monolayers infected with 16M∆manBA∆virB2. The size of the foci observed in macrophage monolayers infected with rough Brucella correlated directly with cytotoxicity measured in liquid culture, suggesting that cytotoxicity was essential for Brucella egress and dissemination. In monolayers infected with 16M, small and large foci were observed. Double antibody staining revealed spontaneous rough mutants within the large, but not the small foci in 16M infected monolayers. Furthermore, plaque formation was observed in the large foci derived from 16M infections. Finally, the addi-tion of gentamicin to the culture medium inhibited plaque formation, suggesting that the cell-to-cell spreading occurred only following release of the organisms from the cells. Taken together, these results demonstrate that Brucella induced cytotoxicity is critical for Brucella egress and dissemination.

  11. Brucella dissociation is essential for macrophage egress and bacterial dissemination.

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    Pei, Jianwu; Kahl-McDonagh, Melissa; Ficht, Thomas A

    2014-01-01

    It has long been observed that smooth Brucella can dissociate into rough mutants that are cytotoxic to macrophages. However, the in vivo biological significance and/or mechanistic details of Brucella dissociation and cytotoxicity remain incomplete. In the current report, a plaque assay was developed using Brucella strains exhibiting varying degrees of cytotoxicity. Infected monolayers were observed daily using phase contrast microscopy for plaque formation while Brucella uptake and replication were monitored using an immunofluorescence assay (IFA). Visible plaques were detected at 4-5 days post infection (p.i.) with cytotoxic Brucella 16MΔmanBA at an MOI of 0.1. IFA staining demonstrated that the plaques consisted of macrophages with replicating Brucella. Visible plaques were not detected in monolayers infected with non-cytotoxic 16MΔmanBAΔvirB2 at an MOI of 0.1. However, IFA staining did reveal small groups of macrophages (foci) with replicating Brucella in the monolayers infected with 16MΔmanBAΔvirB2. The size of the foci observed in macrophage monolayers infected with rough Brucella correlated directly with cytotoxicity measured in liquid culture, suggesting that cytotoxicity was essential for Brucella egress and dissemination. In monolayers infected with 16M, small and large foci were observed. Double antibody staining revealed spontaneous rough mutants within the large, but not the small foci in 16M infected monolayers. Furthermore, plaque formation was observed in the large foci derived from 16M infections. Finally, the addition of gentamicin to the culture medium inhibited plaque formation, suggesting that cell-to-cell spread occurred only following release of the organisms from the cells. Taken together, these results demonstrate that Brucella-induced cytotoxicity is critical for Brucella egress and dissemination.

  12. Platelets promote bacterial dissemination in a mouse model of streptococcal sepsis.

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    Kahn, Fredrik; Hurley, Sinead; Shannon, Oonagh

    2013-01-01

    Platelets have been reported to contribute to inflammation and inflammatory disorders. In the present study, we demonstrate that platelets contribute to the acute response to bacterial infection in a mouse model of invasive Streptococcus pyogenes infection. Thrombocytopenia occurred rapidly in infected animals and this was associated with platelet activation, formation of platelet-neutrophil complexes and neutrophil activation. In order to assess the role of platelets during infection, platelets were depleted prior to infection. Platelet-depleted animals had significantly decreased platelet-neutrophil complex formation and neutrophil activation in response to infection. Importantly, significantly fewer bacteria disseminated to the blood, lungs, and spleen of platelet-depleted animals. Platelet-depleted animals did not decrease as significantly in weight as the infected control animals. The results demonstrate a previously unappreciated role for platelets during the pathophysiological response to infection, whereby S. pyogenes bacteria bind to platelets and platelets facilitate bacterial dissemination.

  13. The influence of host and bacterial genotype on the development of disseminated disease with Mycobacterium tuberculosis.

    OpenAIRE

    2008-01-01

    The factors that govern the development of tuberculosis disease are incompletely understood. We hypothesized that some strains of Mycobacterium tuberculosis (M. tuberculosis) are more capable of causing disseminated disease than others and may be associated with polymorphisms in host genes responsible for the innate immune response to infection. We compared the host and bacterial genotype in 187 Vietnamese adults with tuberculous meningitis (TBM) and 237 Vietnamese adults with uncomplicated p...

  14. Asymptomatic cattle naturally infected with Mycobacterium bovis present exacerbated tissue pathology and bacterial dissemination.

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    Álvaro Menin

    Full Text Available Rational discovery of novel immunodiagnostic and vaccine candidate antigens to control bovine tuberculosis (bTB requires knowledge of disease immunopathogenesis. However, there remains a paucity of information on the Mycobacterium bovis-host immune interactions during the natural infection. Analysis of 247 naturally PPD+ M. bovis-infected cattle revealed that 92% (n = 228 of these animals were found to display no clinical signs, but presented severe as well as disseminated bTB-lesions at post-mortem examination. Moreover, dissemination of bTB-lesions positively correlated with both pathology severity score (Spearman r = 0.48; p<0.0001 and viable tissue bacterial loads (Spearman r = 0.58; p = 0.0001. Additionally, granuloma encapsulation negatively correlated with M. bovis growth as well as pathology severity, suggesting that encapsulation is an effective mechanism to control bacterial proliferation during natural infection. Moreover, multinucleated giant cell numbers were found to negatively correlate with bacterial counts (Spearman r = 0.25; p = 0.03 in lung granulomas. In contrast, neutrophil numbers in the granuloma were associated with increased M. bovis proliferation (Spearman r = 0.27; p = 0.021. Together, our findings suggest that encapsulation and multinucleated giant cells control M. bovis viability, whereas neutrophils may serve as a cellular biomarker of bacterial proliferation during natural infection. These data integrate host granuloma responses with mycobacterial dissemination and could provide useful immunopathological-based biomarkers of disease severity in natural infection with M. bovis, an important cattle pathogen.

  15. Clinical implications of oral candidiasis: host tissue damage and disseminated bacterial disease.

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    Kong, Eric F; Kucharíková, Sona; Van Dijck, Patrick; Peters, Brian M; Shirtliff, Mark E; Jabra-Rizk, Mary Ann

    2015-02-01

    The clinical significance of polymicrobial interactions, particularly those between commensal species with high pathogenic potential, remains largely understudied. Although the dimorphic fungal species Candida albicans and the bacterium Staphylococcus aureus are common cocolonizers of humans, they are considered leading opportunistic pathogens. Oral candidiasis specifically, characterized by hyphal invasion of oral mucosal tissue, is the most common opportunistic infection in HIV(+) and immunocompromised individuals. In this study, building on our previous findings, a mouse model was developed to investigate whether the onset of oral candidiasis predisposes the host to secondary staphylococcal infection. The findings demonstrated that in mice with oral candidiasis, subsequent exposure to S. aureus resulted in systemic bacterial infection with high morbidity and mortality. Histopathology and scanning electron microscopy of tongue tissue from moribund animals revealed massive C. albicans hyphal invasion coupled with S. aureus deep tissue infiltration. The crucial role of hyphae in the process was demonstrated using a non-hypha-producing and a noninvasive hypha-producing mutant strains of C. albicans. Further, in contrast to previous findings, S. aureus dissemination was aided but not contingent upon the presence of the Als3p hypha-specific adhesion. Importantly, impeding development of mucosal C. albicans infection by administering antifungal fluconazole therapy protected the animals from systemic bacterial disease. The combined findings from this study demonstrate that oral candidiasis may constitute a risk factor for disseminated bacterial disease warranting awareness in terms of therapeutic management of immunocompromised individuals.

  16. Bacterial Plasminogen Receptors Utilize Host Plasminogen System for Effective Invasion and Dissemination

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    Sarbani Bhattacharya

    2012-01-01

    Full Text Available In order for invasive pathogens to migrate beyond the site of infection, host physiological barriers such as the extracellular matrix, the basement membrane, and encapsulating fibrin network must be degraded. To circumvent these impediments, proteolytic enzymes facilitate the dissemination of the microorganism. Recruitment of host proteases to the bacterial surface represents a particularly effective mechanism for enhancing invasiveness. Plasmin is a broad spectrum serine protease that degrades fibrin, extracellular matrices, and connective tissue. A large number of pathogens express plasminogen receptors which immobilize plasmin(ogen on the bacterial surface. Surface-bound plasminogen is then activated by plasminogen activators to plasmin through limited proteolysis thus triggering the development of a proteolytic surface on the bacteria and eventually assisting the spread of bacteria. The host hemostatic system plays an important role in systemic infection. The interplay between hemostatic processes such as coagulation and fibrinolysis and the inflammatory response constitutes essential components of host defense and bacterial invasion. The goal of this paper is to highlight mechanisms whereby pathogenic bacteria, by engaging surface receptors, utilize and exploit the host plasminogen and fibrinolytic system for the successful dissemination within the host.

  17. Bacterial plasminogen receptors utilize host plasminogen system for effective invasion and dissemination.

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    Bhattacharya, Sarbani; Ploplis, Victoria A; Castellino, Francis J

    2012-01-01

    In order for invasive pathogens to migrate beyond the site of infection, host physiological barriers such as the extracellular matrix, the basement membrane, and encapsulating fibrin network must be degraded. To circumvent these impediments, proteolytic enzymes facilitate the dissemination of the microorganism. Recruitment of host proteases to the bacterial surface represents a particularly effective mechanism for enhancing invasiveness. Plasmin is a broad spectrum serine protease that degrades fibrin, extracellular matrices, and connective tissue. A large number of pathogens express plasminogen receptors which immobilize plasmin(ogen) on the bacterial surface. Surface-bound plasminogen is then activated by plasminogen activators to plasmin through limited proteolysis thus triggering the development of a proteolytic surface on the bacteria and eventually assisting the spread of bacteria. The host hemostatic system plays an important role in systemic infection. The interplay between hemostatic processes such as coagulation and fibrinolysis and the inflammatory response constitutes essential components of host defense and bacterial invasion. The goal of this paper is to highlight mechanisms whereby pathogenic bacteria, by engaging surface receptors, utilize and exploit the host plasminogen and fibrinolytic system for the successful dissemination within the host.

  18. Tuberculosis extrapulmonar Extrapulmonary tuberculosis

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    P. Fanlo

    2007-01-01

    Full Text Available A pesar de que el pulmón es el órgano diana por excelencia de la tuberculosis, cualquier otro órgano y sistema puede verse afectado. En este trabajo se revisan las formas de tuberculosis extrapulmonar a excepción de la pleural que requieren del facultativo, en ocasiones, su más valiosa pericia diagnóstica. Desde la temida meningitis tuberculosa, pasando por la afectación insidiosa de la espondilodiscitis, la llamativa afectación ganglionar, la afectación genitourinaria, la pericarditis, para terminar las formas menos frecuentes como la ocular o la cutánea. En cada apartado indicaremos lo más característico con la finalidad de que pueda servir de orientación diagnóstica y terapéutica.In spite of the lung being the target organ par excellence of tuberculosis, any other organ and system can be affected. In this article we review the forms of extrapulmonary tuberculosis, with the exception of the pleural form that requires the use of good diagnostic skills. From the dreaded tuberculous meningitis, by way of the insidious affectation of the spondylodiscitis, the so-called ganglionary affectation , the genitourinary affectation, pericarditis, and ending with less frequent forms such as ocular and cutaneous tuberculosis. In each section we will indicate what is most characteristic with the aim of providing a diagnostic and therapeutic orientation.

  19. Nasal lymphatics as a novel invasion and dissemination route of bacterial meningitis.

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    Filippidis, Aristotelis; Fountas, Kostas N

    2009-06-01

    Bacterial meningitis constitutes an infectious disease with high morbidity and mortality, characterized by complex pathophysiology. Neisseria meningitis, Streptococcus pneumoniae, Haemophilus influenzae type b and other pathogens are capable of invading the CNS and infecting the meninges due to the incorporation of virulence factors. The pathophysiologic theories concerning the route of infection in bacterial meningitis consider a general cascade of events involving nasopharyngeal or middle ear colonization, pathogen bloodstream dissemination, blood-brain and blood-cerebrospinal fluid barriers crossing, and finally entrance of the implicated pathogen into the subarachnoid space, survival and subsequent infection. However, these theories cannot adequately explain the high percentage of negative blood cultures especially in cases of neonatal meningitis. Also, they cannot address with certainty the pathogens' entry site in to the cerebrospinal fluid, since the presence of barriers could act against bacterial infection of the meninges. In addition, experimental models of S. pneumoniae meningitis indicate that the route of infection may be independent of bacteraemia. The documented direct communication between the nasal lymphatics and the subarachnoid space could provide a hypothesis explaining the pathophysiologic mechanisms of meningeal infection and overcoming all the limitations of the current theories. It could also explain the presence of negative blood cultures while meningeal inflammation is present. Furthermore, it could also interpret the occasional fulminating evolution of bacterial meningitis since intense host defenses and central nervous system barriers could be bypassed. In our current communication we examine the role of the nasal lymphatic pathway in the development of meningitis. It is apparent that better understanding of the infection and dissemination route for bacterial meningitis can provide the opportunity for a more effective treatment.

  20. Extrapulmonary tuberculosis: tuberculous meningitis new developments.

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    Galimi, R

    2011-04-01

    Tuberculosis (TB) can involve any organ system in the body. Extrapulmonary involvement can occur in isolation or along with a pulmonary focus as in the case of patients with disseminated tuberculosis. Tuberculosis meningitis (TBM) is the most severe form of extrapulmonary tuberculosis. TBM a medical emergency, is still a major cause of serious illness in many parts of the world. TBM remains difficult to diagnose, and it is usually due to hematogenous dissemination of the tubercle bacillus. The exact incidence and prevalence are not known. The clinical spectrum is broad and may be non-specific making early diagnosis difficult. Improved outcome requires early recognition and treatment of these conditions. Clinical features included fever for more than 7 days, headache, or neck stiffness. While TBM is a disease of childhood, tuberculomas and spinal tuberculosis are invariably an adult manifestation. In HIV infection, TB is often atypical in presentation, frequently causing extrapulmonary disease, and patients have a high incidence of TBM. Clinical response to antituberculous therapy in all forms of neurotuberculosis is excellent if the diagnosis is made early before irreversible neurological deficit is established. Diagnosis is based on the characteristic clinical picture, neuroimaging abnormalities, cerebrospinal fluid changes and the response to anti-tuberculosis drugs. Diagnosis is best made with lumbar puncture and examination of the cerebrospinal fluid (CSF). Suspect TBM if there is a CSF leucocytosis (predominantly lymphocytes), the CSF protein is raised, and the CSF plasma glucose is meningeal inflammation, basal exudates, vasculitis and hydrocephalus. Treatment delay is strongly associated with death and empirical anti-tuberculosis therapy should be started promptly in all patients in whom the diagnosis of TBM is suspected. Corticosteroids reduce the number of deaths. Development of an effective vaccine against tuberculosis hinges on an improved understanding

  1. [Extrapulmonary pneumocystosis: a case report].

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    Valdebenito, Carlos; Bonacic, Macarena; Matamala, Jennifer; Wolff, Marcelo

    2015-06-01

    We report a case of a middle-age male patient, with newly HIV infection in AIDS stage diagnosis, no comorbitidies, who was hospitalized for subacute malaise, fever, self-limited unproductive cough and no bloody chronic diarrea. The diagnosis of Pneumocystis jiroveci pneumonia was performed by imagenological suspicion and stains of cysts of this pathogen with bronchoalveolar lavage samples. Treatment was initiated with oral cotrimoxazole and starting HAART with good clinical outcome. Concomitantly, an etiologic study was conducted for chronic diarrhea and through histopathological examination of colonic mucosa, numerous extracellular cystic structures Pneumocystis characteristics were observed, performing the diagnosis of extrapulmonary pneumocystosis. Extrapulmonary pneumocystosis is a rare cause of P. jiroveci infection, requires a high index of suspicion and should be approached in HIV patients with severe AIDS which is common in co-infection of various infections and is peremptory to make an etiologic diagnosis and early treatment.

  2. Vaccination with recombinant Mycobacterium tuberculosis PknD attenuates bacterial dissemination to the brain in guinea pigs.

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    Ciaran Skerry

    Full Text Available BACKGROUND: We have previously identified Mycobacterium tuberculosis PknD to be an important virulence factor required for the pathogenesis of central nervous system (CNS tuberculosis (TB. Specifically, PknD mediates bacillary invasion of the blood-brain barrier, which can be neutralized by specific antisera, suggesting its potential role as a therapeutic target against TB meningitis. METHODOLOGY/PRINCIPAL FINDINGS: We utilized an aerosol challenge guinea pig model of CNS TB and compared the protective efficacy of recombinant M. tuberculosis PknD subunit protein with that of M. bovis BCG against bacillary dissemination to the brain. BCG vaccination limited the pulmonary bacillary burden after aerosol challenge with virulent M. tuberculosis in guinea pigs and also reduced bacillary dissemination to the brain (P = 0.01. PknD vaccination also offered significant protection against bacterial dissemination to the brain, which was no different from BCG (P>0.24, even though PknD vaccinated animals had almost 100-fold higher pulmonary bacterial burdens. Higher levels of PknD-specific IgG were noted in animals immunized with PknD, but not in BCG-vaccinated or control animals. Furthermore, pre-incubation of M. tuberculosis with sera from PknD-vaccinated animals, but not with sera from BCG-vaccinated or control animals, significantly reduced bacterial invasion in a human blood-brain barrier model (P<0.01. CONCLUSION: Current recommendations for administering BCG at birth are based on protection gained against severe disease, such as TB meningitis, during infancy. We demonstrate that vaccination with recombinant M. tuberculosis PknD subunit offers a novel strategy to protect against TB meningitis, which is equivalent to BCG in a guinea pig model. Moreover, since BCG lacks the PknD sensor, BCG could also be boosted to develop a more effective vaccine against TB meningitis, a devastating disease that disproportionately affects young children.

  3. Extrapulmonary tuberculosis: are statistical reports accurate?

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    Kulchavenya, Ekaterina

    2014-01-01

    Before discussing the epidemiology of extrapulmonary tuberculosis (EPTB) and particularly urogenital tuberculosis (UGTB), unification of the terminology is necessary. The term ‘urogenital tuberculosis’ is preferable to ‘genitourinary tuberculosis’, as renal and urinary tract tuberculosis is more common than genital tuberculosis. Some understand the term ‘extrapulmonary tuberculosis’ as a specific tuberculosis (TB) lesion of all organs excluding the bronchus, lungs, pleura and intrathoracic br...

  4. Extrapulmonary tuberculosis: are statistical reports accurate?

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    Kulchavenya, Ekaterina

    2014-04-01

    Before discussing the epidemiology of extrapulmonary tuberculosis (EPTB) and particularly urogenital tuberculosis (UGTB), unification of the terminology is necessary. The term 'urogenital tuberculosis' is preferable to 'genitourinary tuberculosis', as renal and urinary tract tuberculosis is more common than genital tuberculosis. Some understand the term 'extrapulmonary tuberculosis' as a specific tuberculosis (TB) lesion of all organs excluding the bronchus, lungs, pleura and intrathoracic bronchopulmonary lymph nodes, but others consider pleural TB as one form of EPTB - and it is a reason for very different proportions in the spectrum of EPTB. Enigmatic tendencies have also been revealed in patients' distribution - in neighbouring regions the incidence rate may differ significantly. Although there is no clear explanation for these tendencies, careful study of the epidemiology of EPTB in different conditions will improve early diagnosis.

  5. Management of extrapulmonary sarcoidosis: challenges and solutions

    Science.gov (United States)

    Al-Kofahi, Khalid; Korsten, Peter; Ascoli, Christian; Virupannavar, Shanti; Mirsaeidi, Mehdi; Chang, Ian; Qaqish, Naim; Saketkoo, Lesley A; Baughman, Robert P; Sweiss, Nadera J

    2016-01-01

    Background Sarcoidosis is a chronic multisystem disease of unknown etiology characterized by noncaseating granulomas that most often involves the lungs, but frequently has extrapulmonary manifestations, which might be difficult to treat in individual patients. Objective To review different disease manifestations, focusing on extrapulmonary organ systems, and to provide treatment options for refractory cases. Materials and methods We performed a literature search using Medline and Google Scholar for individual or combined keywords of “sarcoidosis, extrapulmonary, treatment, kidney, neurosarcoidosis, cardiovascular, gastrointestinal, transplantation, musculoskeletal, rheumatology, arthritis, and skin”. Peer-reviewed articles, including review articles, clinical trials, observational trials, and case reports that were published in English were included. References from retrieved articles were also manually searched for relevant articles. Results and conclusion Isolated involvement of a single organ or organ system is rare in sarcoidosis, and thus all patients must be thoroughly evaluated for additional disease manifestations. Cardiac sarcoidosis and neurosarcoidosis may be life-threatening. Clinicians need to assess patients comprehensively using clinical, laboratory, imaging, and histopathological data to recommend competently the best and least toxic treatment option for the individual patient. PMID:27853374

  6. Gallium-67 citrate scan in extrapulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Lin Wanyu [Taichung Veterans General Hospital (Taiwan). Dept. of Nuclear Medicine; Hsieh Jihfang [Chi-Mei Foundation Hospital, Tainan (Taiwan)

    1999-07-01

    Aim: Whole-body gallium scan was performed to evaluate the usefulness of gallium scan for detecting extrapulmonary tuberculosis (TB) lesions. Methods: Thirty-seven patients with extrapulmonary TB were included in this study. Four patients were found to have two lesions. Totally, 41 lesions were identified, including 19 TB arthritis, 8 spinal TB, 5 TB meningitis, 3 TB lymphadenopathy, 2 TB pericarditis, 1 TB peritonitis, 1 intestinal TB, 1 skin TB and 1 renal TB. Results: Of the 41 extrapulmonary TB lesions, gallium scan detected 32 lesions with a sensitivity of 78%. All the patients with TB meningitis showed negative gallium scan. When the five cases of TB meningitis were excluded, the detection sensitivity of gallium scan increased to 88.9% (32/36). Conclusion: Our data revealed that gallium scan is a convenient and useful method for evaluating extrapulmonary TB lesions other than TB-meningitis. We suggest that gallium scan be included in the clinical routine for patients with suspected extrapulmonary TB. (orig.) [German] Ziel: Es wurden Ganzkoerper-Gallium-Szintigramme angefertigt, um den Nutzen der Gallium-Szintigraphie zur Erfassung von extrapulmonalen Tuberkuloseherden (TB) zu erfassen. Methoden: 37 Patienten mit extrapulmonaler TB wurden eingeschlossen. 4 Patienten hatten 2 Laesionen. Insgesamt wurden 41 Laesionen identifiziert, hierunter 19 TB-Arthritis, 8 spinale TB, 5 TB-Meningitis, 3 TB-Lymphadenopathie, 2 TB-Perikarditis, 1 TB-Peritonitis, 1 intestinale TB, 1 Haut-TB und eine Nieren-TB. Ergebnisse: Von den 41 extrapulmonalen TB-Herden erfasste die Gallium-Szintigraphie 32 Herde mit einer Sensitivitaet von 78%. Alle Patienten mit TB-Meningitis zeigten einen negativen Gallium-Scan. Wenn die 5 Faelle mit TB-Meningitis ausgeschlossen wurden, stieg die Sensitivititaet der Gallium-Szintigraphie auf 88,9% (32/36). Schlussfolgerung: Die Daten zeigen, dass die Gallium-Szintigraphie eine einfache und nuetzliche Methode zur Erfassung extrapulmonaler TB-Herde ist

  7. Successful Treatment of Osseous Blastomycosis without Pulmonary or Disseminated Disease and Review of the Literature

    Science.gov (United States)

    Day, Shandra R.; Weiss, David B.; Hazen, Kevin C.; Moore, Christopher C.

    2014-01-01

    Blastomycosis commonly occurs following inhalation of Blastomyces dermatitidis conidia causing a pulmonary infection and can disseminate to extrapulmonary sites. Osseous involvement primarily results from hematogenous spread but in rare cases direct inoculation can occur. We describe a case of osseous blastomycosis without pulmonary or disseminated disease successfully treated with posaconazole. PMID:24703876

  8. Disseminated Aspergillosis due to Aspergillus niger in Immunocompetent Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Ulku Ergene

    2013-01-01

    Full Text Available Invasive aspergillosis is a major cause of morbidity and mortality in immunocompromised patients. Many cases of pulmonary, cutaneous, cerebral, and paranasal sinus aspergillosis in immunocompetent patient were defined in literature but disseminated aspergillosis is very rare. Here we present an immunocompetent case with extrapulmonary disseminated aspergillosis due to Aspergillus niger, totally recovered after effective antifungal treatment with voriconazole.

  9. Aspects of the pathogenesis of extrapulmonary tuberculosis with special reference to tuberculous arthritis : an epidemiological case-analysis and a cohort-follow-up study

    NARCIS (Netherlands)

    C.A. Postema

    1994-01-01

    textabstractIn this thesis some aspects of bacterial especially tuberculous arthritis are discussed In connection with an outbreak of extrapulmonary tuberculosis in patients who were visiting an outpatient department for rheumatic diseases. An epidemiological analysis provides many details of the ex

  10. Molecular analysis of Mycobacterium isolates from extrapulmonary specimens obtained from patients in Mexico

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    Portillo-Gómez Leopoldo

    2009-03-01

    Full Text Available Abstract Background Little information is available on the molecular epidemiology in Mexico of Mycobacterium species infecting extrapulmonary sites in humans. This study used molecular methods to determine the Mycobacterium species present in tissues and body fluids in specimens obtained from patients in Mexico with extrapulmonary disease. Methods Bacterial or tissue specimens from patients with clinical or histological diagnosis of extrapulmonary tuberculosis were studied. DNA extracts from 30 bacterial cultures grown in Löwenstein Jensen medium and 42 paraffin-embedded tissues were prepared. Bacteria were cultured from urine, cerebrospinal fluid, pericardial fluid, gastric aspirate, or synovial fluid samples. Tissues samples were from lymph nodes, skin, brain, vagina, and peritoneum. The DNA extracts were analyzed by PCR and by line probe assay (INNO-LiPA MYCOBACTERIA v2. Innogenetics NV, Gent, Belgium in order to identify the Mycobacterium species present. DNA samples positive for M. tuberculosis complex were further analyzed by PCR and line probe assay (INNO-LiPA Rif.TB, Innogenetics NV, Gent, Belgium to detect mutations in the rpoB gene associated with rifampicin resistance. Results Of the 72 DNA extracts, 26 (36.1% and 23 (31.9% tested positive for Mycobacterium species by PCR or line probe assay, respectively. In tissues, M. tuberculosis complex and M. genus were found in lymph nodes, and M. genus was found in brain and vagina specimens. In body fluids, M. tuberculosis complex was found in synovial fluid. M. gordonae, M. smegmatis, M. kansasii, M. genus, M. fortuitum/M. peregrinum complex and M. tuberculosis complex were found in urine. M. chelonae/M. abscessus was found in pericardial fluid and M. kansasii was found in gastric aspirate. Two of M. tuberculosis complex isolates were also PCR and LiPA positive for the rpoB gene. These two isolates were from lymph nodes and were sensitive to rifampicin. Conclusion 1 We describe the

  11. Various pAQU plasmids possibly contribute to disseminate tetracycline resistance gene tet(M) among marine bacterial community.

    Science.gov (United States)

    Nonaka, Lisa; Maruyama, Fumito; Onishi, Yuki; Kobayashi, Takeshi; Ogura, Yoshitoshi; Hayashi, Tetsuya; Suzuki, Satoru; Masuda, Michiaki

    2014-01-01

    Emergence of antibiotic-resistant bacteria in the aquaculture environment is a significant problem for disease control of cultured fish as well as in human public health. Conjugative mobile genetic elements (MGEs) are involved in dissemination of antibiotic resistance genes (ARGs) among marine bacteria. In the present study, we first designed a PCR targeting traI gene encoding essential relaxase for conjugation. By this new PCR, we demonstrated that five of 83 strains isolated from a coastal aquaculture site had traI-positive MGEs. While one of the five strains that belonged to Shewanella sp. was shown to have an integrative conjugative element of the SXT/R391 family (ICEVchMex-like), the MGEs of the other four strains of Vibrio spp. were shown to have the backbone structure similar to that of previously described in pAQU1. The backbone structure shared by the pAQU1-like plasmids in the four strains corresponded to a ~100-kbp highly conserved region required for replication, partition and conjugative transfer, suggesting that these plasmids constituted "pAQU group." The pAQU group plasmids were shown to be capable of conjugative transfer of tet(M) and other ARGs from the Vibrio strains to E. coli. The pAQU group plasmid in one of the examined strains was designated as pAQU2, and its complete nucleotide sequence was determined and compared with that of pAQU1. The results revealed that pAQU2 contained fewer ARGs than pAQU1 did, and most of the ARGs in both of these plasmids were located in the similar region where multiple transposases were found, suggesting that the ARGs were introduced by several events of DNA transposition into an ancestral plasmid followed by drug selection in the aquaculture site. The results of the present study indicate that the "pAQU group" plasmids may play an important role in dissemination of ARGs in the marine environment.

  12. Various pAQU plasmids possibly contribute to disseminate tetracycline resistance gene tet(M among marine bacterial community

    Directory of Open Access Journals (Sweden)

    Lisa eNonaka

    2014-05-01

    Full Text Available Emergence of antibiotic-resistant bacteria in the aquaculture environment is a significant problem for disease control of cultured fish in as well as in human public health. Conjugative mobile genetic elements (MGEs are involved in dissemination of antibiotic resistance genes (ARGs among marine bacteria. In the present study, we first designed a PCR targeting traI gene encoding essential relaxase for conjugation. By this new PCR, we demonstrated that five of 83 strains isolated from a coastal aquaculture site had traI-positive MGEs. While one of the five strains that belonged to Shewanella sp. was shown to have an integrative conjugative element of the SXT/R391 family (ICEVchMex, the MGEs of the other four strains of Vibrio spp. were shown to have the backbone structure similar to that of previously described in pAQU1. The backbone structure shared by the pAQU1-like MGEs in the four strains corresponded to a ~100-kbp highly conserved region required for replication, partition and conjugative transfer, suggesting that these MGEs are plasmids that constitute pAQU group. The pAQU group plasmids were shown to be capable of conjugative transfer of tet(M and other ARGs from the Vibrio strains to E. coli. The pAQU group plasmid in one of the examined strains was designated as pAQU2, and its complete nucleotide sequence was determined and compared with that of pAQU1. The results revealed that pAQU2 contained fewer ARGs than pAQU1 did, and most of the ARGs in both of these plasmids were located in the similar region where multiple transposases were found, suggesting that the ARGs were introduced by several events of DNA transposition into an ancestral plasmid followed by drug selection in the aquaculture site. The results of the present study indicate that the pAQU group plasmids may play an important role in dissemination of ARGs in the marine environment.

  13. Hospital effluents are one of several sources of metal, antibiotic resistance genes and bacterial markers disseminated in Sub-Saharan urban rivers

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    Amandine Laffite

    2016-07-01

    Full Text Available Data concerning the occurrence of emerging biological contaminants such as antibiotic resistance genes (ARGs and fecal indicator bacteria (FIB in aquatic environments in Sub-Saharan African countries is limited. On the other hand, antibiotic resistance remains a worldwide problem which may pose serious potential risks to human and animal health. Consequently, there is a growing number of reports concerning the prevalence and dissemination of these contaminants into various environmental compartments. Sediments provide the opportunity to reconstruct the pollution history and evaluate impacts so this study investigates the abundance and distribution of toxic metals, FIB, and ARGs released from hospital effluent wastewaters and their presence in river sediments receiving systems. ARGs (blaTEM, blaCTX-M, blaSHV, and aadA, total bacterial load, and selected bacterial species FIB (E. coli, Enterococcus (ENT and Pseudomonas species (Psd were quantified by targeting species specific genes using quantitative PCR (qPCR in total DNA extracted from the sediments recovered from 4 hospital outlet pipes (HOP and their river receiving systems in the City of Kinshasa in the Democratic Republic of the Congo. The results highlight the great concentration of toxic metals in HOP, reaching the values (in mg kg-1 of 47.9 (Cr, 213.6 (Cu, 1434.4 (Zn, 2.6 (Cd, 281.5 (Pb, and 13.6 (Hg. The results also highlight the highest (P˂0.05 values of 16S rRNA, FIB, and ARGs copy numbers in all sampling sites including upstream (control site, discharge point, and downstream of receiving rivers, indicating that the hospital effluent water is not an exclusive source of the biological contaminants entering the urban rivers. Significant correlation were observed between (i all analyzed ARGs and total bacterial load (16S rRNA 0.51 to 0.72 (p<0.001, n=65; (ii ARGs (except blaTEM and FIB and Psd 0.57 < r < 0.82 (p<0.001, n=65; and (iii ARGs (except blaTEM and toxic metals (Cd, Cr, Cu

  14. Disseminated sporotrichosis.

    Science.gov (United States)

    Romero-Cabello, Raúl; Bonifaz, Alexandro; Romero-Feregrino, Raúl; Sánchez, Carlos Javier; Linares, Yancy; Zavala, Jorge Tay; Romero, Leticia Calderón; Romero-Feregrino, Rodrigo; Vega, José T Sánchez

    2011-03-25

    Sporotrichosis is a subacute or chronic infection caused by Sporothrix schenckii. It is a primary cutaneous infection and it has different clinical forms: disseminated by lymphatic vessels (75%), localised cutaneous form (20%), disseminated cutaneous and extracuteus rarely. The systemic disseminated sporotrichosis is considered a severe opportunistic infection. The best diagnostic test is the culture. The authors report a case of a 36-year-old man, originally from Puebla, Mexico, with a diagnosis of disseminated sporotrichosis. Differential diagnosis with other pathologies includes leishmaniasis, chromoblastomycosis, tuberculosis verrucose and lymphangitis. The development of unusual presentations in immunocompromised patients has been reported.

  15. Disseminated sporotrichosis

    Science.gov (United States)

    Romero-Cabello, Raúl; Bonifaz, Alexandro; Romero-Feregrino, Raúl; Sánchez, Carlos Javier; Linares, Yancy; Zavala, Jorge Tay; Romero, Leticia Calderón; Romero-Feregrino, Rodrigo; Vega, José T Sánchez

    2011-01-01

    Sporotrichosis is a subacute or chronic infection caused by Sporothrix schenckii. It is a primary cutaneous infection and it has different clinical forms: disseminated by lymphatic vessels (75%), localised cutaneous form (20%), disseminated cutaneous and extracuteus rarely. The systemic disseminated sporotrichosis is considered a severe opportunistic infection. The best diagnostic test is the culture. The authors report a case of a 36-year-old man, originally from Puebla, Mexico, with a diagnosis of disseminated sporotrichosis. Differential diagnosis with other pathologies includes leishmaniasis, chromoblastomycosis, tuberculosis verrucose and lymphangitis. The development of unusual presentations in immunocompromised patients has been reported. PMID:22700076

  16. Extrapulmonary Aspergillus infection in patients with CARD9 deficiency

    Science.gov (United States)

    Gazendam, Roel P.; Freeman, Alexandra F.; Hsu, Amy P.; Collar, Amanda L.; Sugui, Janyce A.; Drummond, Rebecca A.; Rongkavilit, Chokechai; Hoffman, Kevin; Henderson, Carolyn; Clark, Lily; Mezger, Markus; Swamydas, Muthulekha; Engeholm, Maik; Schüle, Rebecca; Neumayer, Bettina; Mikelis, Constantinos M.; Pittaluga, Stefania; Prasad, Vinod K.; Singh, Anurag; Milner, Joshua D.; Williams, Kelli W.; Lim, Jean K.; Kwon-Chung, Kyung J.; Holland, Steven M.; Hartl, Dominik; Kuijpers, Taco W.

    2016-01-01

    Invasive pulmonary aspergillosis is a life-threatening mycosis that only affects patients with immunosuppression, chemotherapy-induced neutropenia, transplantation, or congenital immunodeficiency. We studied the clinical, genetic, histological, and immunological features of 2 unrelated patients without known immunodeficiency who developed extrapulmonary invasive aspergillosis at the ages of 8 and 18. One patient died at age 12 with progressive intra-abdominal aspergillosis. The other patient had presented with intra-abdominal candidiasis at age 9, and developed central nervous system aspergillosis at age 18 and intra-abdominal aspergillosis at age 25. Neither patient developed Aspergillus infection of the lungs. One patient had homozygous M1I CARD9 (caspase recruitment domain family member 9) mutation, while the other had homozygous Q295X CARD9 mutation; both patients lacked CARD9 protein expression. The patients had normal monocyte and Th17 cell numbers in peripheral blood, but their mononuclear cells exhibited impaired production of proinflammatory cytokines upon fungus-specific stimulation. Neutrophil phagocytosis, killing, and oxidative burst against Aspergillus fumigatus were intact, but neither patient accumulated neutrophils in infected tissue despite normal neutrophil numbers in peripheral blood. The neutrophil tissue accumulation defect was not caused by defective neutrophil-intrinsic chemotaxis, indicating that production of neutrophil chemoattractants in extrapulmonary tissue is impaired in CARD9 deficiency. Taken together, our results show that CARD9 deficiency is the first known inherited or acquired condition that predisposes to extrapulmonary Aspergillus infection with sparing of the lungs, associated with impaired neutrophil recruitment to the site of infection. PMID:27777981

  17. Epidemiological Survey of Extrapulmonary Tuberculosis in Baghmalek City of Khuzestan Province in Iran (2007-2011

    Directory of Open Access Journals (Sweden)

    Yahyavi

    2015-04-01

    Full Text Available Background Mycobacterium tuberculosis is still an important cause of pulmonary and extrapulmonary tuberculosis (TB and a major cause of death in the world. Extrapulmonary TB is spread almost as much as one third of pulmonary TB. Objectives The aim of this study was to investigate the prevalence of TB and type of affected tissue in patients with extrapulmonary TB in Tuberculosis Center in Baghmalek City. Patients and Methods This retrospective cross-sectional study was performed on the medical records of patients with TB referred to Tuberculosis Center in Baghmalek City over a five-year period. Data included information about age, sex, location, and affected tissue or organ. Results Among 145 patients with TB, 67 patients (12.25% were diagnosed with extrapulmonary TB including 39 males and 28 females with the age range of 15 to 64 years. Most common organ involved in the extrapulmonary TB was the lymph nodes (29% followed by TB meningitis (17%, urinary tract TB (17% each, bone TB (13%, and pleural TB (13% each. Conclusions The findings suggest that the prevalence of extrapulmonary TB was significant. Therefore, it is necessary to perform tests for extrapulmonary TB besides tests for TB.

  18. Coexistent Nodal Diffuse Large B-Cell Lymphoma With Extrapulmonary Tuberculosis: A Rare Case.

    Science.gov (United States)

    Sachdev, Ritesh; Duggal, Rajan; Agrawal, Krati; Goel, Shalini

    2016-02-01

    Extrapulmonary tuberculosis coexistent with lymphomas in the same organ are rare and have been reported in the literature. The most common organs that are involved are small bowel, bronchus, kidney, and lymph nodes. Interestingly, the lymphoma that is commonly present with extrapulmonary tuberculosis is Hodgkin's lymphoma followed by low-grade non-Hodgkin's lymphoma. In the present study, we report a 60-year-old man with complaints of fever, loss of appetite, and generalized weakness. On investigation, generalized lymphadenopathy was noted, and the biopsy of cervical lymph node revealed coexistence of diffuse large B-cell lymphoma with extrapulmonary tuberculosis. This case is the second reported case of diffuse large B-cell lymphoma with extrapulmonary tuberculosis in the world and the first in India.

  19. Uterine sarcoidosis: a rare extrapulmonary site of sarcoidosis.

    Science.gov (United States)

    Marak, Creticus P; Alappan, Narendrakumar; Chopra, Amit; Dorokhova, Olena; Sinha, Sumita; Guddati, Achuta K

    2013-01-01

    Sarcoidosis is a multisystem disease which is most commonly manifested in the pulmonary system. However, extrapulmonary manifestations have also been frequently reported. Isolated occurrence of sarcoidosis in the genital system is rare and poses a diagnostic and therapeutic dilemma. Uterine sarcoidosis can present with cervical erosions, endometrial polypoid lesions, and recurrent serometra. In majority of cases, it is diagnosed by endometrial curettage, but it has also been detected by examination of hysterectomy, polypectomy, and autopsy specimens. Nonnecrotizing granulomas are the characteristic pathologic finding of sarcoidosis. However, many infectious and noninfectious etiologies including certain neoplasms can produce similar granulomatous reactions in the female genital tract. These conditions affect the female genital tract more commonly than sarcoidosis, and therefore it is important to rule out these conditions first before making a diagnosis of sarcoidosis. Treatment of sarcoidosis is different from treating these other conditions and the most commonly used systemic or local corticosteroids can be hazardous if the underlying cause is infection. In this case report, the clinical presentation, histopathology, clinical course, and treatment of a patient with isolated uterine sarcoidosis are described, and a brief literature review of sarcoidosis of the female genital tract is provided.

  20. Uterine Sarcoidosis: A Rare Extrapulmonary Site of Sarcoidosis

    Directory of Open Access Journals (Sweden)

    Creticus P. Marak

    2013-01-01

    Full Text Available Sarcoidosis is a multisystem disease which is most commonly manifested in the pulmonary system. However, extrapulmonary manifestations have also been frequently reported. Isolated occurrence of sarcoidosis in the genital system is rare and poses a diagnostic and therapeutic dilemma. Uterine sarcoidosis can present with cervical erosions, endometrial polypoid lesions, and recurrent serometra. In majority of cases, it is diagnosed by endometrial curettage, but it has also been detected by examination of hysterectomy, polypectomy, and autopsy specimens. Nonnecrotizing granulomas are the characteristic pathologic finding of sarcoidosis. However, many infectious and noninfectious etiologies including certain neoplasms can produce similar granulomatous reactions in the female genital tract. These conditions affect the female genital tract more commonly than sarcoidosis, and therefore it is important to rule out these conditions first before making a diagnosis of sarcoidosis. Treatment of sarcoidosis is different from treating these other conditions and the most commonly used systemic or local corticosteroids can be hazardous if the underlying cause is infection. In this case report, the clinical presentation, histopathology, clinical course, and treatment of a patient with isolated uterine sarcoidosis are described, and a brief literature review of sarcoidosis of the female genital tract is provided.

  1. Detection of Mycobacterium tuberculosis complex by nested polymerase chain reaction in pulmonary and extrapulmonary specimens

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    Adriana Antônia da Cruz Furini

    2013-12-01

    Full Text Available OBJECTIVE: To compare the performance of nested polymerase chain reaction (NPCR with that of cultures in the detection of the Mycobacterium tuberculosis complex in pulmonary and extrapulmonary specimens.METHODS: We analyzed 20 and 78 pulmonary and extrapulmonary specimens, respectively, of 67 hospitalized patients suspected of having tuberculosis. An automated microbial system was used for the identification of Mycobacterium spp. cultures, and M. tuberculosis IS6110 was used as the target sequence in the NPCR. The kappa statistic was used in order to assess the level of agreement among the results.RESULTS: Among the 67 patients, 6 and 5, respectively, were diagnosed with pulmonary and extrapulmonary tuberculosis, and the NPCR was positive in all of the cases. Among the 98 clinical specimens, smear microscopy, culture, and NPCR were positive in 6.00%, 8.16%, and 13.26%, respectively. Comparing the results of NPCR with those of cultures (the gold standard, we found that NPCR had a sensitivity and specificity of 100% and 83%, respectively, in pulmonary specimens, compared with 83% and 96%, respectively, in extrapulmonary specimens, with good concordance between the tests (kappa, 0.50 and 0.6867, respectively.CONCLUSIONS: Although NPCR proved to be a very useful tool for the detection of M. tuberculosis complex, clinical, epidemiological, and other laboratory data should also be considered in the diagnosis and treatment of pulmonary and extrapulmonary tuberculosis.

  2. AIDS-Related Extrapulmonary Pneumocystis carinii Infection Presenting as a Solitary Rectal Ulcer

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    Eric M Yoshida

    1996-01-01

    Full Text Available Extrapulmonary infection with Pneumocystis carinii, although uncommon, is increasingly recognized. Use of aerosolized pentamidine versus a systemic medication is thought to be a contributing factor due to the low concentrations of drug that are incapable of suppressing systemic infection. Infection with P carinii has been reported in every organ system including the gastrointestinal system. A 28-year-old acquired immunodeficiency syndrome patient receiving prophylaxis with aerosolized pentamidine who presented with a solitary rectal ulcer is reported. Initial biopsy was characteristic of extrapulmonary P carinii infection, with numerous organisms present. Occasional cytomegalovirus inclusion bodies were noted which may have been a copathogen but which were not treated. Treatment with intravenous pentamidine resulted in documented eradication of P carinii and complete resolution of the ulcer. Although lower gastrointestinal pneumocystosis has been described without ulceration, this is the first description of rectal ulceration presenting as the initial manifestation of extrapulmonary pneumocystosis.

  3. Should patients with extrapulmonary small-cell carcinoma receive prophylactic cranial irradiation?

    LENUS (Irish Health Repository)

    Naidoo, Jarushka

    2013-09-01

    Extrapulmonary small-cell carcinoma (EPSCC) is a rare disease. Management is based on small-cell lung carcinoma. Prophylactic cranial irradiation (PCI) is not routinely administered in EPSCC. This study investigates the role of PCI in EPSCC, by analyzing the incidence, treatment, and survival of patients with brain metastases in a national cohort. Disease biology and epidemiology are also investigated.

  4. Use of sirolimus in the treatment of lymphangioleiomyomatosis: favorable responses in patients with different extrapulmonary manifestations

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    Carolina Salim Gonçalves Freitas

    2015-06-01

    Full Text Available OBJECTIVE: Lymphangioleiomyomatosis (LAM is a rare disease that is currently considered a low-grade neoplasm with metastatic potential and variable progression. Mammalian target of rapamycin (mTOR inhibitors, such as sirolimus and everolimus, have recently become a treatment option for LAM patients, especially those with extrapulmonary manifestations. The objective of the present study was to describe a case series of four patients with LAM in Brazil who showed significant improvement, particularly in their extrapulmonary manifestations, after treatment with sirolimus (at 1-4 mg/day. METHODS: We describe four cases of LAM patients with different extrapulmonary manifestations who were treated with sirolimus. RESULTS: After treatment with sirolimus for 12 months, one patient presented resolution of severe chylothorax; one had a significant reduction in renal angiomyolipoma volume; and one showed significant regression of retroperitoneal lymphangioleiomyomas and abdominal lymph node enlargement. After treatment with sirolimus for 6 months, the remaining patient had a significant reduction in the volume of a massive retroperitoneal lymphangioleiomyoma. CONCLUSIONS: Our findings confirm that mTOR inhibitors are beneficial for patients with LAM, especially those with extrapulmonary manifestations, such as renal angiomyolipoma, lymphangioleiomyomas, and chylous effusions. However, certain aspects, such as the optimal dose, duration of treatment, and long-term adverse effects, have yet to be sufficiently clarified for mTOR inhibitors to be incorporated into LAM management protocols.

  5. Long-term mortality in patients with pulmonary and extrapulmonary tuberculosis

    DEFF Research Database (Denmark)

    Christensen, Anne-Sophie Halkjær; Roed, Casper; Andersen, Peter H

    2014-01-01

    BACKGROUND: Long-term mortality and causes of death in patients with pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) are poorly documented. In this study, long-term mortality and causes of death in PTB and EPTB patients were compared with the background population...

  6. Disseminated histoplasmosis (image)

    Science.gov (United States)

    Histoplasmosis is a fungal infection caused by inhaling dust from spore-infected bird droppings. In the disseminated ... fairly high for people with untreated widespread (disseminated) histoplasmosis, but is reduced significantly with treatment.

  7. Pulmonary involvement in patients presenting with extra-pulmonary tuberculosis: thinking beyond a normal chest x-ray

    Directory of Open Access Journals (Sweden)

    Herath S

    2014-03-01

    Full Text Available INTRODUCTION: Recognition of pulmonary involvement in extra-pulmonary tuberculosis (TB may be an important public health issue, as smear-negative pulmonary TB is responsible for about 17% of new infections. Pulmonary TB can be present despite a normal chest x-ray (CXR, even in human immunodeficiency virus (HIV–negative patients. In this retrospective clinical audit, we reviewed a case series of HIV-negative patients with extra-pulmonary tuberculosis to identify the proportion with concurrent pulmonary TB despite an unremarkable CXR. METHODS: Clinical notes, microbiology results and CXR reports were reviewed from consecutive patients treated at Auckland City Hospital for extra-pulmonary TB from January 2007 to July 2010. RESULTS: Of the sample of 103 patients with extra-pulmonary TB, the majority of patients were born in an Asian country (n=70; 68%. The commonest presentation of extra-pulmonary TB was lymphadenopathy (n=51; 50%, followed by pleural (n=24; 23% and bone (n=6; 6% disease. Extra-pulmonary TB was diagnosed by biopsy or excision of the extra-pulmonary site in the majority (n=74; 72%, and by sputum testing alone in 26 (25%. The majority had CXR abnormalities (n=76; 74%. In the group with a normal CXR (n=27, 55% (n=15 had sputum cultures performed. In total, 18% (n=5 of patients with extra-pulmonary TB and a normal CXR had pulmonary TB, of whom two were smear positive. DISCUSSION: In patients with extra-pulmonary TB, sputum testing should be considered to detect concurrent pulmonary TB even if a CXR is normal, especially in immunosuppressed or symptomatic patients. This may aid diagnosis and determine infectivity and consequent public health action.

  8. Limited dissemination of the wastewater treatment plant core resistome

    DEFF Research Database (Denmark)

    Munck, Christian; Albertsen, Mads; Telke, Amar;

    2015-01-01

    Horizontal gene transfer is a major contributor to the evolution of bacterial genomes and can facilitate the dissemination of antibiotic resistance genes between environmental reservoirs and potential pathogens. Wastewater treatment plants (WWTPs) are believed to play a central role...

  9. Visibility of Histoplasma within histiocytes on hematoxylin and eosin distinguishes disseminated histoplasmosis from other forms of pulmonary histoplasmosis.

    Science.gov (United States)

    Mukhopadhyay, Sanjay; Doxtader, Erika E

    2013-10-01

    The visibility of Histoplasma within histiocytes on hematoxylin and eosin is a well-known feature of disseminated histoplasmosis. However, it is unclear whether this finding can be used to differentiate disseminated histoplasmosis involving the lung from other forms of pulmonary histoplasmosis. The aim of this study was to determine whether the visibility of Histoplasma within histiocytes on hematoxylin and eosin in lung biopsies suggests disseminated disease. Lung biopsies in which Histoplasma was identified were re-examined to determine whether organisms were visible within histiocytes on hematoxylin and eosin. Clinical findings were reviewed retrospectively to determine the type of histoplasmosis. Histoplasma was visible within histiocytes on hematoxylin and eosin in lung biopsies from 4 patients (2 men, 2 women, 50-74 years) who presented with pulmonary manifestations without definite evidence of disseminated disease at the time of biopsy. Subsequently, all 4 manifested clinical and/or microbiologic features of disseminated disease (positive extrapulmonary cultures and fatal outcome in 2, positive extrapulmonary cultures in 1, and multiorgan failure and fatal outcome in 1). In contrast, organisms were identified on silver stains but could not be visualized on hematoxylin and eosin in 42 patients, none of whom showed clinical or microbiologic evidence of disseminated disease (pulmonary histoplasmoma, 38; acute pulmonary histoplasmosis, 4). In lung biopsies, the visibility of Histoplasma within histiocytes on hematoxylin and eosin suggests disseminated disease. Recognition of the significance of this finding is helpful in diagnosing disseminated disease in patients who present primarily with pulmonary manifestations without definite clinical evidence of dissemination at the time of biopsy.

  10. Dissemination Strategy Report

    DEFF Research Database (Denmark)

    Badger, Merete; Kjems, Jørgen; Farinetti, Laura;

    This report describes the dissemination and exploitation strategy for project Virtual Campus Hub (EU FP7 contract RI-283746). The project duration is October 2011-13 and the dissemination and exploitation plan will be revised continuously during the project’s lifecycle.......This report describes the dissemination and exploitation strategy for project Virtual Campus Hub (EU FP7 contract RI-283746). The project duration is October 2011-13 and the dissemination and exploitation plan will be revised continuously during the project’s lifecycle....

  11. Oncological outcome of unresectable lung metastases without extrapulmonary metastases in colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To explore the oncological outcomes of unresectable lung metastases without extrapulmonary metastases in colorectal cancer. METHODS: Patients with unresectable isolated lung metastases from colorectal cancer were prospectively collected in a single institution during a 5-year period. All patients received either the fluorouracil/leucovorin plus oxaliplatin, fluorouracil/leucovorin plus irinotecan or capecitabine plus oxaliplatin regimen as first-line treatment. The resectability after preoperative chem...

  12. Dissemination of tuberculosis after biopsy of primary tubercular prostate: a case report

    Directory of Open Access Journals (Sweden)

    Onkar Jha

    2015-01-01

    Full Text Available Only 15-20% of extrapulmonary tuberculosis (TB has been attributed to TB of the urogenital system and often Results from haematogenous spread from an active site of infection. Isolated involvement of prostate by TB is relatively less common. The incidence of primary prostatic TB is unknown and in its truest sense is a very rare entity. Here, we report the case of a patient with primary prostatic TB who was misdiagnosed as nonspecific granulomatous inflammation on transrectal ultrasound-guided biopsy of the prostate, who later presented to our centre after 4 months with disseminated TB. The rarity of the case prompted us to report this case.

  13. Radiological Appearance of Extrapulmonary Lesions in Rradiography (CT scan-MRI

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    A. Soltani Shirazi

    2005-08-01

    Full Text Available Introduction & Background: To make the diagnosis of chest lesions in chest radiography or CT scan easier, lesions are divided into three main groups: lesions of lung parenchyma, lesions of the heart and mediasti-num and lesions with origins of the protective tissues in the chest. Extrapulmonary lesions have various origins ranging from hard tissues like the bone, to soft tissues such as bone marrow or fatty tissue; they usu-ally present with diverse and sometimes misleading signs and symptoms. Knowledge about the radiologic semiolology of these instances helps to prevent mis-taking these lesions with lesions of pulmonary origin. Consequently timely and appropriate treatment can be provided. Here a study of five thousand chest radi-ographies of extrapulmonary lesions with primary diagnosis of pulmonary lesions is presented and the approach to diagnosis is discussed. According to the present study, 56% of extrapulmonary lesions are de-tectable by means of simple primary radiography and by considering radiologic semiology. We reached definite diagnosis by means of lung CT scan. Other lesions were diagnosed after performing biopsy or surgery.

  14. Concurrent evaluation of microscopic observation of drug susceptibility assay for pulmonary and extrapulmonary tuberculosis

    Science.gov (United States)

    Zadbuke, Sonali Sudhir; Set, Reena; Khan, Nishat; Shastri, Jayanthi

    2017-01-01

    BACKGROUND: Methods for detection and drug susceptibility of tuberculosis (TB) with solid media are inexpensive but slow and laborious. Rapid methods to diagnose TB and multidrug-resistant TB (MDR-TB) are a global priority for TB control. OBJECTIVES: A study was performed to compare the sensitivity of detection of mycobacterial growth and time of culture positivity by microscopic observation of drug susceptibility (MODS) assay with that of Lowenstein–Jensen (LJ) culture in pulmonary and extrapulmonary TB and to evaluate the concordance of the susceptibilities to isoniazid (INH) and rifampicin (RIF) by MODS and proportion method on LJ. MATERIALS AND METHODS: A prospective, laboratory-based study was conducted on a total of 300 samples from suspected cases of pulmonary and extrapulmonary TB. Samples were inoculated on LJ medium as per the standard guidelines and MODS assay was performed. RESULTS: Sensitivity of MODS assay was 80% and 83.3% and specificity was 92.9% and 83.3% for pulmonary and extrapulmonary samples, respectively. Difference between mean time to detection of Mycobacterium TB (MTB) by LJ medium and MODS was statistically significant, with MODS being faster. drug susceptibility testing (DST) by MODS when compared to economic variant of proportion method was 87.87% for RIF, 90.9% for INH, and 96.96% for MDR-TB detection. CONCLUSION: MODS assay provides rapid, safe, and sensitive detection of TB faster than the existing gold standard. It is extremely promising in effectively diagnosing MDR-TB.

  15. Polymerase chain reaction targeting insertion sequence for the diagnosis of extrapulmonary tuberculosis

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    V Makeshkumar

    2014-01-01

    Full Text Available Background & objectives: Diagnosis of extrapulmonary tuberculosis (EPTB is difficult using conventional diagnostic methods. This study was conducted to evaluate the use of polymerase chain reaction (PCR in diagnosis of definitive and probable extrapulmonary tuberculosis patients, and to assess the performance of insertion sequence (IS 6110 based PCR assay as compared to conventional culture by Lowenstein-Jensen (LJ method for the diagnosis of EPTB. Methods: A total of 178 non repeated clinical specimens were collected from clinically suspected extrapulmonary tuberculosis patients. The specimens included 59 ascitic fluid, 54 pleural fluid, 25 cerebrospinal fluid (CSF, 12 fine needle aspiration (FNA, 8 urine, 7 pus, 6 synovial fluid, 2 skin tissue, one pericardial fluid, one liver abscess, one pancreatic cyst fluid, one omental biopsy and one semen sample. All these clinical samples were subjected to Ziehl-Neelsen staining (ZN for acid fast bacilli (AFB and culture on LJ medium. PCR was performed by targeting 123bp fragment of insertion sequence IS6110 of Mycobacterium tuberculosis (MTB. Results: Of the 178 specimens, 10 (5.61% were ZN smear positive for AFB, six (3.37% were L-J culture positive from 10 AFB smear positive cases and 48 (26.96% were PCR IS 6110 positive for M. tuberculosis. Interpretation & conclusions: PCR using IS6110 primer was able to pick up more EPTB patients compared to conventional L-J culture method for detection of M. tuberculosis. False positive PCR IS6110 in three CSF samples may be due to latent TB infection which was limitation in this study.

  16. Classification of extrapulmonary manifestations due to Mycoplasma pneumoniae infection on the basis of possible pathogenesis

    Directory of Open Access Journals (Sweden)

    Mitsuo eNarita

    2016-01-01

    Full Text Available The list of extrapulmonary manifestations due to Mycoplasma pneumoniae infection can be classified according to the following three possible mechanisms derived from the established biological activity of M. pneumoniae; 1 a direct type in which the bacterium is present at the site of inflammation and local inflammatory cytokines induced by the bacterium play an important role 2 an indirect type in which the bacterium is not present at the site of inflammation and immune modulations, such as autoimmunity or formation of immune complexes, play an important role and 3 a vascular occlusion type in which obstruction of blood flow induced either directly or indirectly by the bacterium plays an important role. Recent studies concerning extrapulmonary manifestations have prompted the author to upgrade the list, including cardiac and aortic thrombi as cardiovascular manifestations; erythema nodosum, cutaneous leukocytoclastic vasculitis, and subcorneal pustular dermatosis as dermatological manifestations; acute cerebellar ataxia, opsoclonus-myoclonus syndrome, and thalamic necrosis as neurological manifestations; pulmonary embolism as a respiratory system manifestation; and renal artery embolism as a urogenital tract manifestation. Continuing nosological confusion on M. pneumoniae–induced mucositis (without skin lesions, which may be called M. pneumoniae-associated mucositis or M. pneumoniae-induced rash and mucositis separately from Stevens-Johnson syndrome, is argued in the dermatological manifestations. Serological methods are recommended for diagnosis because pneumonia or respiratory symptoms are often minimal or even absent in extrapulmonary manifestations due to M. pneumoniae infection. Concomitant use of immunomodulators, such as corticosteroids or immunoglobulins with antibiotics effective against M. pneumoniae, can be considered as treatment modalities for most severe cases, such as encephalitis. Further studies would be necessary to construct

  17. Mapping the epidemiology and trends of extra-pulmonary tuberculosis in Saudi Arabia.

    Science.gov (United States)

    Varghese, Bright; Al-Hajoj, Sahal

    2015-12-01

    An extra-pulmonary tuberculosis (EPTB) infection rate of 30% in Saudi Arabia remains above the global rate. A variable rate of infection in each province has been reported and the involvement of most organs has been cited. Nationwide collective data on the current trends of infection are scarce and the factors behind the increased rate of EPTB are perplexing. This review endeavors to shed light into the epidemiology of EPTB, various types of infections sites, geographical differences in the infection rate, known risk factors, and challenges in the diagnosis and management of EPTB in Saudi Arabia.

  18. DIFFERENCES BETWEEN PEDIATRIC PULMONARY AND EXTRA-PULMONARY TUBERCULOSIS: A WARNING SIGN FOR THE FUTURE

    Directory of Open Access Journals (Sweden)

    Ilker Devrim

    2014-08-01

    Full Text Available Introduction: Tuberculosis (TB remains a major global health problem affecting millions of people annually. Tuberculosis in children has unique features different from adults which makes the diagnosis to be more difficult. The spectrum of the symptoms of TB in children could vary from non-specific symptoms to severe clinical presentations.  In this study, we reviewed our experience at pediatric patients with active TB admitted in a tertiary hospital  and aimed to compare the epide­miological, clinical and microbiological features of  children with  the extra-pulmonary tuberculosis(EPTB and pulmonary tuberculosis(PTB. Material and methods: Patients under 14 years of age diagnosed with active TB in our unit between December 2008 and September 2013 were included in the study. Data including demographic characteristics, clinical history, microbiology, imaging studies, medications and outcomes of the patients were collected from medical records. Results: A total of 129 cases of active TB were identified.  Ninety-two (78.6% of the cases had Pulmonary Tuberculosis and 25 (21.4% of the cases had Extra-pulmonary tuberculosis. The most common signs and symptoms on admission were fever in 40 cases (34.2% and cough in 81 cases (69.2%. The number of patients without symptoms including fever, cough, malaise and weight loss were significantly higher in EXPTB (72.0% group when compared with patients in PTB group (13.0% (p 0.05. The detection rate of source in PTB group (42.4% was significantly higher than the rate in  EPTB group (20.0%( p=0.04. In the drug-resistant group, no source of infection could be established in 5 of 9 patients (55.5%. Conclusions: Extra-pulmonary tuberculosis diagnosis is more difficult than Pulmonary tuberculosis in children due to the various problems such as absence of associated pulmonary involvement,  lack of constitutional symptoms and negative tuberculosis exposure history compared to Pulmonary Tuberculosis. New

  19. Treatment pathways of extrapulmonary patients diagnosed at a tertiary care hospital in Delhi, India

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    Manoj Grover

    2014-01-01

    Full Text Available Background: In order to put extrapulmonary tuberculosis patients early on treatment, it is important to study pathways, which these patients adopt in for seeking treatment. Materials and Methods: In order to study the treatment pathways of extrapulmonary patients and assess appropriate points for intervention, a cross-sectional study was conducted in chest clinic of a tertiary care hospital in Delhi. Results: Factors associated with longer paths included reason for going to first health facility (nearness and known provider, availing more than one health facilities, presenting symptoms of fever, joint pain, nodular skin swelling and skin lesion. Self-referral to the chest clinic was associated with shorter paths. Lower level of education, occupation, non-serious perception of the disease and visiting five health facilities were significantly associated with patient delay of more than 3.5 weeks. Symptoms of fever, joint pain and skin lesion, visiting private health facility first, availing more than two health facilities and travelling distance of more than 100 km to reach chest clinic were significantly associated with the health facility delay of more than 4.5 weeks. Conclusions: Increasing public awareness, training of private practitioners and capacity building of government facilities will help in reducing delay.

  20. Dissemination and Exploitation Strategy

    DEFF Research Database (Denmark)

    Badger, Merete; Monaco, Lucio; Fransson, Torsten

    of Technology in Sweden, Politecnico di Torino in Italy, and Eindhoven University of Technology in the Netherlands. The project is partially funded by the European Commission under the 7th Framework Programme (project no. RI-283746). This report describes the final dissemination and exploitation strategy...

  1. Extra-pulmonary paragonimiasis with unusual arthritis and cutaneous features among a tourist returning from Gabon.

    Science.gov (United States)

    Malvy, D; Ezzedine, K H; Receveur, M C; Pistone, T; Mercié, P; Longy-Boursier, M

    2006-12-01

    Paragonimiasis is a helminthic disease that affect accidentally man after consumption of raw or poorly cooked crustacean dishes. The clinical feature is represented mainly by pulmonary signs. Extra-pulmonary manifestations including arthritic and skin attempt remain less frequent. The case is described of a young white French woman who become infected with Paragonimus while travelling to Gabon for a tourist trip. Clinical presentation accounted for extensive recurrent pruritic urticarian subcutaneous induration, permanent assymetrical pauciarthritis associated with joint swelling, and marked eosinophilia. Diagnosis was reached using serological testing showing seroconversion for specific antibodies. The patient was cured with a single oral dose of praziquantel. Even if the condition is rare among tourists to endemic zones, it must be considered when hypereosinophilia occurs in the returning traveller and migrant.

  2. Extrapulmonary tuberculosis in non-human immunodeficiency virus-infected adults in an endemic region

    Directory of Open Access Journals (Sweden)

    Ozvaran Mustafa

    2007-01-01

    Full Text Available Aims: Extrapulmonary tuberculosis (EPTB still constitutes an important clinical problem. We aimed to evaluate the incidence and features of extrapulmonary tuberculosis. Materials and Methods: We retrospectively evaluated 14,266 tuberculosis patients diagnosed between January 1999 and December 2003 in a tertiary care hospital in Istanbul. As many as 2,435 patients (17.1% with EPTB were evaluated for the incidence and features. Results: Of the 14,266 patients, 4,154 were female (29% and 10,112 were male (71% and were aged between 14 and 86 years with a mean age of 35 ± 14 years. As many as 660 (17.9% patients were diagnosed as EPTB in 1999, 568 (17.8% in 2000, 357 (13.7% in 2001, 462 (22% in 2002 and 388 (14.5% in 2003. EPTB presented most commonly as pleurisy (66%, followed by lymphadenitis (23%. Lymphadenitis and pleurisy were more commonly observed among female TB patients (60% and among male TB patients (59% respectively. EPTB showed a significant female predilection (26.8% compared to male patients (13.1%. Multi-organ involvement was observed in 37 (1.5% patients (two organs in 33 and three organs in 4. As many as 197 (8% EPTB cases had pulmonary tuberculosis simultaneously. Conclusions: EPTB still constitutes an important clinical problem. The rates of EPTB have remained constant despite the decline in pulmonary tuberculosis cases. In the current study, we present our experience of the incidence and features of EPTB patients without HIV infection. In this study, EPTB cases constituted one-fifth of all tuberculosis cases presented to our center in the study period.

  3. Clinical Study of Extrapulmonary Head and Neck Tuberculosis: A Single-Institute 10-year Experience

    Directory of Open Access Journals (Sweden)

    Oishi, Masahiro

    2015-10-01

    Full Text Available Introduction Although the incidence of tuberculosis (TB in Japan has been decreasing yearly, Japan remains ranked as an intermediate-burden country for TB. Objective This study aims to investigate the current situation of head and neck extrapulmonary TB (EPTB diagnosed in our department. Methods We retrospectively reviewed the clinical records of 47 patients diagnosed with EPTB in the head and neck in our department between January 2005 and December 2014. The extracted data included sex and age distribution, development site, chief complaint, presence or absence of concomitant active pulmonary TB (PTB or history of TB, tuberculin skin test (TST results, interferon-gamma release assay (IGRA results, and duration from the first visit to the final diagnosis of EPTB. Results The subjects consisted of 20 men and 27 women, and age ranged from 6 to 84 years. The most common site was the cervical lymph nodes (30 patients, with the supraclavicular nodes being the most commonly affected (60%. Histopathological examination was performed on 28 patients. TST was positive in 9 out of 9 patients and the IGRA was positive in 18 out of 19 patients. We observed concomitant PTB in 15 out of the 47 patients. Mean duration from the first visit to the final diagnosis of EPTB was 56 days. Conclusion The clinical symptoms of TB, especially those in the head and neck region, are varied. Otolaryngologists should be especially aware of the extrapulmonary manifestations of TB to ensure early diagnosis and treatment from the public health viewpoint.

  4. Immunocytochemistry versus nucleic acid amplification in fine needle aspirates and tissues of extrapulmonary tuberculosis

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    Madhu Mati Goel

    2012-01-01

    Full Text Available Background: Immunocytochemistry (ICC is an established routine diagnostic adjunct to cytology and histology for tumor diagnosis but has received little attention for diagnosis of tuberculosis. Aims: To have an objective method of direct visualization of mycobacteria or their products in clinical extrapulmonary tuberculosis (EPTB specimens, immunocytochemical localization of M. tuberculosis antigen by staining with species specific monoclonal antibody to 38-kDa antigen of Mycobacterium tuberculosis complex. Materials and Methods: Immunostaining with specific monoclonal antibody to 38-kDa antigen of Mycobacterium tuberculosis complex was done in fresh and archival fine needle aspirates and tissue granulomata of 302 cases of extrapulmonary tuberculosis and was compared with the molecular diagnostic i.e., nucleic amplification and conventional [Cytomorphology, Ziehl Neelsen (ZN staining and culture] tests and 386 controls. Results: Diagnostic indices by Bayesian analysis for all types of archival and fresh material varied from 64 to 76% in nucleic acid amplification (NAA and 96 to 98% in ICC. There was no significant difference in the diagnostic indices of ZN staining and/ or ICC in fresh or archival material whereas the sensitivity of NAA differed significantly in fresh versus archival material both in cytology (71.4% vs 52.1% and histology (51.1% vs 38.8%. ICC can be easily used on archival smears and formalin-fixed paraffin-embedded tissue sections with almost equal sensitivity and specificity as with fresh material, in contrast to NAA which showed significant difference in test results on archival and fresh material. Conclusions: Low detection sensitivity of MTB DNA in archival material from known tuberculous cases showed the limitation of in-house NAA-based molecular diagnosis. ICC was found to be sensitive, specific and a better technique than NAA and can be used as an adjunct to conventional morphology and ZN staining for the diagnosis of

  5. Developing an Effective Dissemination Plan.

    Science.gov (United States)

    Southwest Educational Development Laboratory, Austin, TX. National Center for the Dissemination of Disability Research.

    This booklet offers guidelines for the development of dissemination strategies, especially those concerned with research and programs. Individual sections address: the importance of including sound dissemination plans in grant proposals, factors found to be closely related to information utilization in the dissemination process, a philosophical…

  6. Disseminating Service Registry Records

    OpenAIRE

    A. Apps

    2006-01-01

    The JISC Information Environment Service Registry (IESR) contains descriptions of collections of resources available to researchers, learners and teachers in the UK, along with technical service access details. This paper describes the data model and metadata description schema of IESR, and the services IESR provides to disseminate its records. There is a particular focus on the Open Archives Initiative Protocol for Metadata Harvesting (OAI-PMH) interface, including a possible use scenario. I...

  7. DISSEMINATED HISTOPLASMOSIS IN IMMUNOCOMPETENT INDIVIDUALS- NOT A SO RARE ENTITY

    Directory of Open Access Journals (Sweden)

    Dibyendu De

    2015-04-01

    Full Text Available Introduction: Histoplasmosis is a rare fungal disease caused by dimorphic fungi Histoplasma capsulatum. The causative fungus is present in soil, infects through inhalation and manifests in three main types-acute primary, chronic cavitary and progressive disseminated Histoplasmosis. Disseminated Histoplasmosis (DH is defined as a clinical condition where fungus is present in more than one location. Among the forms of histoplasmosis, DH is the rarest and generally found in immune-compromised individual. Here we are presenting our experiences of the series of cases of Disseminated Histoplasmosis in immune-competent individuals who have been diagnosed in our institute in last 5 years. Materials and methods: This is a single centre retrospective observational study, from May 2009 to April 2014. Only cases with Disseminated Histoplasmosis in otherwise healthy immune-competent individuals were included in the study. The Histoplasmosis is confirmed by either presence of Histoplasma in biopsy specimen from extra-pulmonary organ or by positive growth in fungal culture Result: Total seven patients met the inclusion criteria. Five out of 7 patients were male. The mean age was 35 years. Five of the 7 patients presented with fever for long duration. Six patients complained of significant weight loss before diagnosis. On examination, one patient had skin nodules, five patients had hepato-splenomegaly, and two patients had lymphadenopathy. The laboratory investigation revealed anaemia in six out of 7 patients, and pancytopenia in 3 patients. Two patients had features of hemophagocytic syndrome in the bone marrow. All of the patient had undergone treatment with conventional amphotericine B  deoxy-cholate and azole antifungal. One patient with adrenal involvement died in hospital. The patient with skin nodule had recurrent relapses. The other patients had resolution of symptoms and clinically cured. Conclusion: Disseminated Histoplasmosis is not an uncommon

  8. Vimentin in Bacterial Infections

    DEFF Research Database (Denmark)

    Mak, Tim N; Brüggemann, Holger

    2016-01-01

    Despite well-studied bacterial strategies to target actin to subvert the host cell cytoskeleton, thus promoting bacterial survival, replication, and dissemination, relatively little is known about the bacterial interaction with other components of the host cell cytoskeleton, including intermediate...... filaments (IFs). IFs have not only roles in maintaining the structural integrity of the cell, but they are also involved in many cellular processes including cell adhesion, immune signaling, and autophagy, processes that are important in the context of bacterial infections. Here, we summarize the knowledge...... about the role of IFs in bacterial infections, focusing on the type III IF protein vimentin. Recent studies have revealed the involvement of vimentin in host cell defenses, acting as ligand for several pattern recognition receptors of the innate immune system. Two main aspects of bacteria...

  9. Delusions of Disseminated Fungosis

    Directory of Open Access Journals (Sweden)

    Ian Gassiep

    2014-01-01

    Full Text Available Introduction. Delusional infestation is a rare monosymptomatic hypochondriacal psychosis according to The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013. It can be a primary disorder or associated with an underlying psychological or physical disorder. It commonly presents as delusional parasitosis, and less than 1% may be fungi related. We present this case as it is a rare presentation of a rare condition. Case Presentation. Our patient is a 60-year-old Caucasian man who presented with a 7-year history of delusional infestation manifested as a disseminated fungal infection. He had previously been reviewed by multiple physicians for the same with no systemic illness diagnosed. After multiple reviews and thorough investigation we diagnosed him with a likely delusional disorder. As is common with this patient cohort he refused psychiatric review or antipsychotic medication. Conclusion. A delusion of a disseminated fungal infestation is a rare condition. It is exceedingly difficult to treat as these patients often refuse to believe the investigation results and diagnosis. Furthermore, they either refuse or are noncompliant with treatment. Multidisciplinary outpatient evaluation may be the best way to allay patient fears and improve treatment compliance.

  10. 肺炎支原体感染的肺外表现%Extrapulmonary manifestations of Mycoplasma pneumoniae infection

    Institute of Scientific and Technical Information of China (English)

    李呈媚

    2012-01-01

    The pathogenesis of Mycoplasma pneumoniae (MP) is inclined to the two mechanisms of epithelial cell adhesion and immunological, which immune dysregulation may play an important role in the pathogenicity of extra-pulmonary damage of MP. The manifestations of its extra-pulmonary usually involves multiple systems, including nervous system, cardiovascular system, urinary system, skin tissue, immune system damage, muscle and joint damage. Extra-pulmonary damage of MP should be paid attention in clinical work.%肺炎支原体的致病机理目前倾向于上皮细胞吸附及免疫学两种机制.其中免疫调节异常在肺炎支原体损害致病中可能起重要作用.肺炎支原体的肺外表现通常涉及多个系统,包括神经系统、心血管系统、泌尿系统、皮肤组织、相关免疫系统损害、相关肌肉及关节损害.临床工作中应重视MP肺外损害表现.

  11. AIDS defining disease: Disseminated cryptococcosis

    Directory of Open Access Journals (Sweden)

    Roshan Anupama

    2006-01-01

    Full Text Available Disseminated cryptococcosis is one of the acquired immune deficiency syndrome defining criteria and the most common cause of life threatening meningitis. Disseminated lesions in the skin manifest as papules or nodules that mimic molluscum contagiosum (MC. We report here a human immunodeficiency virus positive patient who presented with MC like lesions. Disseminated cryptococcosis was confirmed by India ink preparation and histopathology. The condition of the patient improved with amphotercin B.

  12. Dissemination of a highly virulent pathogen: tracking the early events that define infection.

    Directory of Open Access Journals (Sweden)

    Rodrigo J Gonzalez

    2015-01-01

    Full Text Available The series of events that occurs immediately after pathogen entrance into the body is largely speculative. Key aspects of these events are pathogen dissemination and pathogen interactions with the immune response as the invader moves into deeper tissues. We sought to define major events that occur early during infection of a highly virulent pathogen. To this end, we tracked early dissemination of Yersinia pestis, a highly pathogenic bacterium that causes bubonic plague in mammals. Specifically, we addressed two fundamental questions: (1 do the bacteria encounter barriers in disseminating to draining lymph nodes (LN, and (2 what mechanism does this nonmotile bacterium use to reach the LN compartment, as the prevailing model predicts trafficking in association with host cells. Infection was followed through microscopy imaging in addition to assessing bacterial population dynamics during dissemination from the skin. We found and characterized an unexpected bottleneck that severely restricts bacterial dissemination to LNs. The bacteria that do not pass through this bottleneck are confined to the skin, where large numbers of neutrophils arrive and efficiently control bacterial proliferation. Notably, bottleneck formation is route dependent, as it is abrogated after subcutaneous inoculation. Using a combination of approaches, including microscopy imaging, we tested the prevailing model of bacterial dissemination from the skin into LNs and found no evidence of involvement of migrating phagocytes in dissemination. Thus, early stages of infection are defined by a bottleneck that restricts bacterial dissemination and by neutrophil-dependent control of bacterial proliferation in the skin. Furthermore, and as opposed to current models, our data indicate an intracellular stage is not required by Y. pestis to disseminate from the skin to draining LNs. Because our findings address events that occur during early encounters of pathogen with the immune response

  13. Oncological outcome of unresectable lung metastases without extrapulmonary metastases in colorectal cancer

    Science.gov (United States)

    Li, Wen-Hua; Peng, Jun-Jie; Xiang, Jia-Qing; Chen, Wei; Cai, San-Jun; Zhang, Wen

    2010-01-01

    AIM: To explore the oncological outcomes of unresectable lung metastases without extrapulmonary metastases in colorectal cancer. METHODS: Patients with unresectable isolated lung metastases from colorectal cancer were prospectively collected in a single institution during a 5-year period. All patients received either the fluorouracil/leucovorin plus oxaliplatin, fluorouracil/leucovorin plus irinotecan or capecitabine plus oxaliplatin regimen as first-line treatment. The resectability after preoperative chemotherapy was evaluated. Patients’ outcome and predictive factors for overall survival were also investigated by univariate and multivariate analysis. RESULTS: A total of 70 patients were included in the study. After standardized first-line chemotherapy, only 4 patients (5.7%) were converted to resectable disease. The median overall survival time in all patients was 19 mo (95% CI: 12.6-25.4), with a 2-year overall survival rate of 38.8%. No survival difference was found among different first-line chemotherapeutic regimens. Prognostic analysis demonstrated that only the first response assessment for first-line treatment was the independent factor for predicting overall survival. The median survival time in partial response, stable disease and progressive disease patients were 27 mo, 16 mo and 8 mo (P = 0.00001). CONCLUSION: Pulmonary metastasectomy can only be performed in a small part of unresectable lung metastases patients after chemotherapy. Patients’ first response assessment is an important prognostic factor. PMID:20614489

  14. Extrapulmonary small cell carcinoma. An indication for prophylactic cranial irradiation? A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Frueh, Martin; Cerny, Thomas [Kantonsspital St. Gallen (Switzerland). Dept. of Oncology/Hematology; Kacsir, Bela; Plasswilm, Ludwig [Kantonsspital St. Gallen (Switzerland). Dept. of Radiation Oncology; Ess, Silvia [Cancer Registry, Canton of St. Gallen, Appenzell (Switzerland); Rodriguez, Regulo [Kantonsspital St. Gallen (Switzerland). Dept. of Pathology

    2011-09-15

    Information about extrapulmonary small cell carcinoma (EPSCC) is limited and the role of prophylactic cranial irradiation (PCI) is unknown. Disease presentation and outcome of all EPSCC at our hospital between 1990 and 2009 were retrospectively analyzed. Of 30 EPSCC, the male:female ratio was 58%:42%; 83% had a performance status of 0-2. Median age was 71 years (32-80). Seventeen (57%) had limited stage (LS), 13 (43%) extensive stage (ES). The location of the primary tumor was gastrointestinal (n = 8), unknown (6), gynecological (6), urogenital (5), and ear nose throat (5). Four (13%) developed brain metastases (2 ES, 2 LS). In ES, first line chemotherapy (CT) was given in 85%, mostly platinum-etoposide (64%). Response rate was 90%. In LS, CT and radiotherapy (RT) {+-} resection resulted in persistent remissions in 67% of patients. Median survival was 16 months (1-107 months), 18 months (1-107 months), and 9 months (0.4-25 months) for LS + ES, LS, and ES, respectively. Weight loss {>=}5 % and ECOG performance status 3 + 4 were associated with poorer survival (p < 0.001 and p < 0.01, respectively). The incidence of brain metastases was relatively low (13%). More studies are necessary, before routinely offering PCI to patients with EPSCC. Best survival outcomes in LS were achieved with multimodality treatment including CT and RT. Prognosis was poor in patients with ES. (orig.)

  15. Immune Reconstitution Inflammatory Syndrome Occurring in a Kidney Transplant Patient with Extrapulmonary Tuberculosis

    Science.gov (United States)

    Ledesma, Kandria Jumil; Liu, Jessie

    2017-01-01

    Tuberculosis (TB) occurring in solid organ transplantation (SOT) is associated with significant morbidity and mortality usually due to delays in diagnosis, drug toxicity encountered with antimycobacterial therapy, and drug-drug interactions. TB in SOT patients may mimic other infectious and noninfectious posttransplant complications such as posttransplant lymphoproliferative disorder (PTLD) and systemic cytomegalovirus infection. Immune reconstitution inflammatory syndrome (IRIS) is a host response resulting in paradoxical worsening of an infectious disease which occurs after the employment of effective therapy and reversal of an immunosuppressed state. We describe the development of immune reconstitution inflammatory syndrome (IRIS), a unique complication occurring during the treatment of extrapulmonary tuberculosis occurring after transplant which resulted from decreasing immunosuppression in a patient who received Alemtuzumab induction therapy. Although (IRIS) has been originally described in HIV/AIDS patients receiving highly active antiretroviral therapy (HAART), solid organ transplant recipients with diagnosed or occult TB whose immune system may undergo immune reconstitution during their posttransplant course represent a new high risk group.

  16. Evaluation of multiple laboratory methods in the diagnosis of extrapulmonary tuberculosis

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    Parimala Subramani

    2014-10-01

    Full Text Available Introduction: Tuberculosis remains a worldwide public health problem. The emergence of human immunodeficiency virus infections (HIV has further complicated the disease burden as it has rapidly increased the risk of pulmonary and extrapulmonary tuberculosis (EPTB. EPTB is an important clinical entity. The precise diagnosis is very important because early detection of cases and effective treatment if instituted at the right time completely cures the patients of the disease. Objectives: To find out sensitivity and specificity of Ziehl-Neelsens staining (ZN, Auramine staining, and rapid slide culture technique (RSC, comparing them with growth on Lowenstein-Jensens medium (ZN as the gold standard. Materials and Methods: The present study included 66 clinical specimens from patients suspected of EPTB inclusive of HIV-infected patients. They were subjected to ZN and Fluorescent method of staining, culturing by LJ and RSC method, and comparing growth on LJ medium as the gold standard. Results and Conclusion: Mycobacterium tuberculosis was isolated in 24.2%. Nontuberculosis Mycobacterium was isolated in 6% of the 66 samples processed. The highest number of isolation was from lymph node aspirates (83.3%. 2% of the samples were HIV seropositive.

  17. [Extrapulmonary tuberculosis in Denmark. A review of the incidence, localization and therapy].

    Science.gov (United States)

    Kok-Jensen, A; Viskum, K

    1994-09-12

    In Denmark, just under 20% of tuberculosis (TB) cases amongst Danes and 25-30% of cases amongst people of foreign nationalities are made up of isolated extrapulmonary (EP) TB. The incidence among Danes is falling, whereas an increasing amount of EP TB cases are found among foreigners due to continued immigration, and these now constitute 50% of all cases of EP TB. EP TB is found among older Danes and younger foreigners. The HIV/AIDS epidemic has not had any effect on the incidence of TB and EP TB in Denmark. EP TB is most frequently found in lymph nodes and the urogenital system. Since the disease is rare, it may be overlooked; it should be considered as a differential diagnosis in unresolved cases, particularly in immigrants from countries with a high prevalence of TB. Treatment is as for pulmonary TB, namely "four drug" therapy for six months. Surgical intervention is rarely required. Supplementation with oral steroids may be useful in very special cases.

  18. Successful treatment of cranial metastases of extrapulmonary small cell carcinoma with chemotherapy alone.

    Science.gov (United States)

    Orhan, B; Yalçin, S; Evrensel, T; Yerci, O; Manavoğlu, O

    1998-04-01

    Extrapulmonary small cell carcinoma (EPSCC) is a distinct clinical and pathological entity other than small cell carcinoma of the lung. We present a case with EPSCC, with neurologic impairment due to brain metastases at initial diagnosis, which showed a complete response to combination chemotherapy. A 55-year-old male patient was first admitted with a mass of 6 x 6 cm in diameter in the right cervical region. The diagnosis of small cell carcinoma was entertained with immunohistopathologic and light microscopic findings. During the period of investigation the tumor showed rapid progression and the patient had neurologic dysfunction with right hemiparesia, and papilla oedema in fundoscopy. Cranial CT showed supratentorial multiple cranial metastases and peritumoral oedema. Since the patient refused radiotherapy, combination chemotherapy was started (Etoposide 100 mg/sq m i.v., days 1,3,5 and cisplatin 80 mg/sq m i.v., day 1). A fast response to the chemotherapy was observed with rapid disappearance of the cervical mass. Following six cycles of the chemotherapy the patient recovered fully and all the lesions disappeared with CT.

  19. Selected Dissemination/Diffusion Strategies.

    Science.gov (United States)

    Schmitt, Marshall L.

    This analysis of selected diffusion and dissemination methods used by developer-demonstrator projects in the National Diffusion Network discusses strategies under the following headings: managing the project, developing materials, disseminating information, conducting awareness sessions, training personnel, using certified trainers, providing…

  20. Segmentation of Extrapulmonary Tuberculosis Infection Using Modified Automatic Seeded Region Growing

    Directory of Open Access Journals (Sweden)

    Nordin Abdul

    2009-01-01

    Full Text Available Abstract In the image segmentation process of positron emission tomography combined with computed tomography (PET/CT imaging, previous works used information in CT only for segmenting the image without utilizing the information that can be provided by PET. This paper proposes to utilize the hot spot values in PET to guide the segmentation in CT, in automatic image segmentation using seeded region growing (SRG technique. This automatic segmentation routine can be used as part of automatic diagnostic tools. In addition to the original initial seed selection using hot spot values in PET, this paper also introduces a new SRG growing criterion, the sliding windows. Fourteen images of patients having extrapulmonary tuberculosis have been examined using the above-mentioned method. To evaluate the performance of the modified SRG, three fidelity criteria are measured: percentage of under-segmentation area, percentage of over-segmentation area, and average time consumption. In terms of the under-segmentation percentage, SRG with average of the region growing criterion shows the least error percentage (51.85%. Meanwhile, SRG with local averaging and variance yielded the best results (2.67% for the over-segmentation percentage. In terms of the time complexity, the modified SRG with local averaging and variance growing criterion shows the best performance with 5.273 s average execution time. The results indicate that the proposed methods yield fairly good performance in terms of the over- and under-segmentation area. The results also demonstrated that the hot spot values in PET can be used to guide the automatic segmentation in CT image.

  1. Time trend and clinical pattern of extrapulmonary tuberculosis in Serbia, 1993-2007

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    Pešut Dragica P.

    2012-01-01

    Full Text Available Background/Aim. Increased incidence of extrapulmonary tuberculosis (XPTB is reported worldwide. Serbia is a country in socio-economic transition period with lowmiddle HIV prevalence and intermediate-to-low tuberculosis (TB incidence rate, 100% directly observed treatment (DOT coverage, and mandatory BCG vaccination at birth. The aim of the study was to examine the incidence trend and clinical features of XPTB in Serbia during a 15-year period. Methods. This retrospective observational study included XPTB cases diagnosed in the period between 1st January 1993 and 31st Decembre 2007, according to the reports of the National Referral Institute of Lung Diseases and Tuberculosis in Belgrade and Central Tuberculosis Register. Population estimates with extrapolations were based on 1991 and 2002 census data. Results. While the overall TB incidence rate showed a slight, not significant decreasing trend (p = 0.535, a significant increase was found for XPTB (y = 1.7996 + 0.089x; R2 = 0.4141; p = 0.01. A total of 2,858 XPTB cases (newly diagnosed and 10% relapses gave an average age specific incidence rate of 2.51/100,000 population (95% confidence interval, SD = 0.6182 with 8.9% annual increase. The male-to-female ratio was 0.54. Lymph nodes were most frequently affected site (48.5% followed by genitourinary (20.5%, pleural (12%, and osseo-arthicular (10.3% TB. Treatment outcome was successful in 88.29% of patients (cured and completed, 3.64% died, 5.18% interrupted, 0.57% displaced, and 2.3% unknown. Conclusion. Increasing trend of XPTB incidence rate may be a result of increased morbidity due to still present risk factors, possible higher detection rate in Serbia and better notification. A high coverage of newborns with BCG vaccination at birth might contribute to a decreased number and rare XPTB cases in children.

  2. Performativity: enrollments, contexts, dissemination

    Directory of Open Access Journals (Sweden)

    Miriam Soares Leite

    2014-04-01

    Full Text Available The term performativity and its inflexions have been applied to several concepts in the field of educational research. In this study, we trace the dissemination of the word performativity and its correlates, starting from the meanings attributed to the term by Stephen Ball, in his analysis of contemporary educational policies, but also using the theories of Jacques Derrida and Judith Butler, who used these terms to refer to social processes of signification and identification, and also references made to the term in studies of Anthropology, Arts, Political Science, Linguistics, Philosophy and Physics. On top of that, we researched studies in the field of academic education, examining articles from journals and other periodicals published over the last five years, in order to discuss the various meanings attributed to the term within the educational field. We present, in this paper, a synthesis of our investigations, highlighting the affirmations, negations and truth effects that can be construed from the use of these terms in educational research, in particular when approaching current educational policies.

  3. How Is Disseminated Intravascular Coagulation Treated?

    Science.gov (United States)

    ... the NHLBI on Twitter. How Is Disseminated Intravascular Coagulation Treated? Treatment for disseminated intravascular coagulation (DIC) depends ... and treat the underlying cause. Acute Disseminated Intravascular Coagulation People who have acute DIC may have severe ...

  4. Rapid differential diagnosis between extrapulmonary tuberculosis and focal complications of brucellosis using a multiplex real-time PCR assay.

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    María Isabel Queipo-Ortuño

    Full Text Available BACKGROUND: Arduous to differ clinically, extrapulmonary tuberculosis and focal complications of brucellosis remain important causes of morbidity and mortality in many countries. We developed and applied a multiplex real-time PCR assay (M RT-PCR for the simultaneous detection of Mycobacterium tuberculosis complex and Brucella spp. METHODOLOGY: Conventional microbiological techniques and M RT-PCR for M. tuberculosis complex and Brucella spp were performed on 45 clinical specimens from patients with focal complications of brucellosis or extrapulmonary tuberculosis and 26 control samples. Fragments of 207 bp and 164 bp from the conserved region of the genes coding for an immunogenic membrane protein of 31 kDa of B. abortus (BCSP31 and the intergenic region SenX3-RegX3 were used for the identification of Brucella and M. tuberculosis complex, respectively. CONCLUSIONS: The detection limit of the M RT-PCR was 2 genomes per reaction for both pathogens and the intra- and inter-assay coefficients of variation were 0.44% and 0.93% for Brucella and 0.58% and 1.12% for Mycobacterium. M RT-PCR correctly identified 42 of the 45 samples from patients with tuberculosis or brucellosis and was negative in all the controls. Thus, the overall sensitivity, specificity, PPV and NPV values of the M RT PCR assay were 93.3%, 100%, 100% and 89.7%, respectively, with an accuracy of 95.8% (95% CI, 91.1%-100%. Since M RT-PCR is highly reproducible and more rapid and sensitive than conventional microbiological tests, this technique could be a promising and practical approach for the differential diagnosis between extrapulmonary tuberculosis and focal complications of brucellosis.

  5. Isotopic and elemental composition of plutonium/americium oxides influence pulmonary and extra-pulmonary distribution after inhalation in rats.

    Science.gov (United States)

    Van der Meeren, A; Grémy, O

    2010-09-01

    The biodistribution of plutonium and americium has been studied in a rat model after inhalation of two PuO(2) powders in lungs and extra-pulmonary organs from 3 d to 3 mo. The main difference between the two powders was the content of americium (approximately 46% and 4.5% of total alpha activity). The PuO(2) with a higher proportion of americium shows an accelerated transfer of activity from lungs to blood as compared to PuO(2) with the lower americium content, illustrated by increased urinary excretion and higher bone and liver actinide retention. The total alpha activity measured reflects mostly the americium biological behavior. The activity contained in epithelial lining fluid, recovered in the acellular phase of broncho-alveolar lavages, mainly contains americium, whereas plutonium remains trapped in macrophages. Epithelial lining fluid could represent a transitional pulmonary compartment prior to translocation of actinides to the blood and subsequent deposition in extra-pulmonary retention organs. In addition, differential behaviors of plutonium and americium are also observed between the PuO(2) powders with a higher dissolution rate for both plutonium and americium being obtained for the PuO(2) with the highest americium content. Our results indicate that the biological behavior of plutonium and americium after translocation into blood differ two-fold: (1) for the two actinides for the same PuO(2) aerosol, and (2) for the same actinide from the two different aerosols. These results highlight the importance of considering the specific behavior of each contaminant after accidental pulmonary intake when assessing extra-pulmonary deposits from the level of activity excreted in urine or for therapeutic strategy decisions.

  6. Extra-pulmonary tuberculosis infection in the dialysis patients with end stage renal diseases: case reports and literature review

    Institute of Scientific and Technical Information of China (English)

    Wen-fang YANG; Fei HAN; Xiao-hui ZHANG; Ping ZHANG; Jiang-hua CHEN

    2013-01-01

    The diagnosis of extra-pulmonary tuberculosis (TB) seems relatively difficult due to the absence of specific symptoms and signs in patients on peritoneal dialysis or hemodialysis.We report four cases of extra-pulmonary tuberculosis on dialysis,with two cases on peritoneal dialysis and two cases on hemodialysis.The presentations,therapy,and outcomes of TB infection in these patients were reviewed.Otherwise,the English literature published in the PubMed database associating extra-pulmonary tuberculosis on dialysis over the last three decades is reviewed.A total of 61 studies containing 70 cases were included.The most common primary disease was diabetic nephropathy (22.86%,16/70).The peritoneum (31.42%,22/70),bone (21.42%,15/70),and lymph node (20%,14/70) were the most frequently infected.Single organ infection was common (90%,63/70).Fever (58.57%,41/70),pain (35.71%,25/70),and enlarged lymph node (20%,14/70) were the most common symptoms.Biopsy (67.14%,47/70) and culture (40%,28/70) provided most reliable methods for clear diagnosis of tuberculosis.The combined treatment of isoniazid,rifampicin,pyrazinamide,and ethambutol (44.29%,31/70) was the most common therapy.The majority of patients improved (82.86%,58/70); however,12 cases got worse (17.14%),with 10 of them dying (14.29%).Physicians should be aware of the non-specific symptoms and location of infection,and consider tuberculosis in their differential diagnoses in dialysis patients presenting with symptoms such as fever,pain,and weight loss.

  7. Hypothesis: Disseminated Intravascular Inflammation as the Inflammatory Counterpart to Disseminated Intravascular Coagulation

    Science.gov (United States)

    Bull, Brian S.; Bull, Maureen H.

    1994-08-01

    We have identified a leukocyte activation syndrome that is occasionally associated with the transfusion of intraoperatively recovered erythrocytes. This syndrome appears to result from intravascular damage caused by leukocytes activated during the erythrocyte salvage process. We hypothesize that this syndrome is part of a larger disease grouping: disseminated intravascular inflammation (DII). DII is the analog of the coagulation disorder disseminated intravascular coagulation. In disseminated intravascular coagulation, the organ damage results from uncontrolled activation of the clotting pathway; in DII the damage is caused by leukocytes that have become activated by direct contact with bacteria or in rare instances-such as erythrocyte salvage-in the absence of bacteria and bacterial products. Recent studies of the hazards associated with intraoperative blood salvage indicate that activation of leukocytes can be achieved by exposure to activated platelets alone. If such activated leukocytes are reinfused along with the washed erythrocytes, widespread organ damage may result. The lung is the organ most severely affected by activated leukocytes. Adult respiratory distress syndrome is one outcome. It is likely that DII is a presently unrecognized pathophysiological process that complicates a variety of primary disease states and increases their lethality.

  8. Herpes zoster (shingles) disseminated (image)

    Science.gov (United States)

    Herpes zoster (shingles) normally occurs in a limited area that follows a dermatome (see the "dermatome" picture). In individuals with damaged immune systems, herpes zoster may be widespread (disseminated), causing serious illness. Herpes ...

  9. National profile and treatment outcomes of patients with extrapulmonary tuberculosis in Benin.

    Directory of Open Access Journals (Sweden)

    Serge Ade

    Full Text Available BACKGROUND: In sub-Saharan Africa, there is a dearth of published literature on extrapulmonary tuberculosis (EPTB. OBJECTIVE: To describe demographic, diagnostic and HIV-status characteristics of patients with EPTB in Bénin, their treatment outcomes, and among those who completed their treatment in the Centre National Hospitalier de Pneumo-Phtisiologie (CNHP-P, the proportion whose bodyweight increased during treatment. MATERIAL AND FINDINGS: This was a retrospective cohort study with comparisons made between EPTB and new smear-positive pulmonary tuberculosis (NPTB patients diagnosed in the country from January to December 2011. There were 383 EPTB patients (9% of all TB cases with a mean age of 35 years, male/female ratio of 1.3 and important regional variation. There were significantly more females (p = 0.001, children <15 years (p<0.001 and HIV-positive patients (p = 0.005 with EPTB compared with NPTB. Pleural effusion, spinal and lymph node tuberculosis accounted for 66% of all EPTB. Children <15 years represented 16% of cases, with lymph node disease being most common among them (p<0.001. Of 130 EPTB patients registered in CNHP-P, 7% had a confirmed bacteriological/histological diagnosis. There were 331 (86% patients who successfully completed treatment. More patients with EPTB were lost-to-follow-up compared with NPTB (p<0.001 with all these patients from one region. The best treatment completion rates were in children <15 years (OR:3.5, 95%CI:1.0-14.8 while patients with pleural effusion and ascites had the worst outcomes. Of 72 HIV-coinfected patients, 88% were on antiretroviral therapy (ART. HIV-positive status was associated with poor outcomes while those on ART fared better. In the CNHP-P, more than 80% who completed their treatment showed an increase in bodyweight and this was more evident in HIV-positive compared with HIV-negative patients (p = 0.03. CONCLUSION: Patients with EPTB generally do well in Bénin, although

  10. Mycobacterium tuberculosis Complex and HIV Co-Infection among Extrapulmonary Tuberculosis Suspected Cases at the University of Gondar Hospital, Northwestern Ethiopia.

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    Alemu Fanosie

    Full Text Available Extrapulmonary Tuberculosis (EPTB and Human Immunodeficiency Virus (HIV infection are interrelated as a result of immune depression. The aim of this study was to determine the prevalence of Mycobacterium tuberculosis complex isolates and the burden of HIV co-infection among EPTB suspected patients.An institution based cross-sectional study was conducted among EPTB suspected patients at the University of Gondar Hospital. Socio-demographic characteristics and other clinical data were collected using a pretested questionnaire. GeneXpert MTB/RIF assay was performed to diagnosis Mycobacterium tuberculosis complex and Rifampicin resistance. All samples were also investigated by cytology and culture. The HIV statuses of all patients were screened initially by KHB, and all positive cases were further re-tested by STAT-pack. Data was analyzed using SPSS version 20 computer software and a P-value of < 0.05 was taken as statistically significant.A total of 141 extrapulmonary suspected patients were enrolled in this study. The overall prevalence of culture confirmed extrapulmonary tuberculosis infection was 29.8%, but the GeneXpert result showed a 26.2% prevalence of Mycobacterium tuberculosis complex infection. The 78.4% prevalence of extrapulmonary tuberculosis infection was found to be higher among the adult population. The prevalence of HIV infection among EPTB suspected patients was 14.1%, while it was 32.4% among GeneXpert-confirmed extrapulmonary TB cases (12/37. Tuberculosis lymphadenitis was the predominant (78.4% type of EPTB infection followed by tuberculosis cold abscess (10.7%. Adult hood, previous history of contact with known pulmonary tuberculosis patients, and HIV co-infection showed a statistically significant association with extrapulmonary tuberculosis infection (P<0.013.The prevalence of culture confirmed-EPTB infection was high, and a higher EPTB-HIV co-infection was also observed.

  11. Extrapulmonary tuberculosis. Radiological imaging of an almost forgotten transformation artist; Extrapulmonale Tuberkulose. Die radiologische Bildgebung eines fast vergessenen Verwandlungskuenstlers

    Energy Technology Data Exchange (ETDEWEB)

    Heye, T.; Kauczor, H.U.; Horsch, W. [Universitaetsklinikum Heidelberg (Germany). Diagnostische und Interventionelle Radiologie; Stoijkovic, M.; Junghanss, T. [Universitaetsklinikum Heidelberg (Germany). Sektion Klinische Tropenmedizin

    2011-11-15

    Tuberculosis (TB) continues to be one of the infectious diseases with the world's highest rates of avoidable morbidity and mortality. A continuing downward trend has only been observed in highly industrialized countries, including Germany with 4,400 cases in the year 2009 representing an incidence of 5.5 per 100,000 persons. At the same time, the exposure to this patient group and the clinical experience are decreasing. Tuberculosis may affect any organ. The lung was the manifestation site in 80 % of cases, and extrapulmonary manifestations were recorded in 20 % of cases in Germany in the year 2008. Lymph node involvement is most common with a rate of approximately 50 % of all extrapulmonary cases followed by the pleura in 18 % of cases, genitourinary tract in 13 % of cases, bones and joints in 6 % of cases, gastrointestinal tract in 6 % of cases, the central nervous system in 3 % of cases and the spine in 3 % of cases. Symptoms like fever, night sweats and weight loss are non-specific and may be absent. The aim of the review is to raise awareness of this disease, which is increasingly falling into oblivion, with its various radiological manifestations and to point out clinical-epidemiological and demographic factors that raise suspicion of tuberculosis. (orig.)

  12. Relationship between human LTA4H polymorphisms and extra-pulmonary tuberculosis in an ethnic Han Chinese population in Eastern China.

    Science.gov (United States)

    Yang, Jinghui; Chen, Jin; Yue, Jun; Liu, Lirong; Han, Min; Wang, Hongxiu

    2014-12-01

    Two single nucleotide polymorphisms in Leukotriene A4 hydrolase (LTA4H) gene were reported to be associated with protection from pulmonary tuberculosis in Vietnamese population. But these associations were not found in the Russians. To investigate the association of LTA4H polymorphisms with tuberculosis in a Han Chinese population in Eastern China, we genotyped 5 SNPs of LTA4H gene in 743 of pulmonary tuberculosis patients, 372 of extra-pulmonary tuberculosis patients and 888 of healthy controls individuals. The CC and TT homozygotes of rs1978331 and rs2540474 were identified to have higher rates (P tuberculosis (OR = 1.412; 95% CI = 1.104-1.804 and(OR = 1.380; 95% CI = 1.080-1.764). However, no significant association was found between any of the SNPs and pulmonary tuberculosis. In the extra-pulmonary tuberculosis subgroups. LTA4H gene were significantly associated with tuberculous meningitis, lymph node tuberculosis, bone tuberculosis and other extra-pulmonary tuberculosis except for pleural tuberculosis. The present findings suggest that polymorphisms in the LTA4H gene may affect susceptibility to extra-pulmonary tuberculosis and change the risk of developing the disease in the Han nationality in the East China.

  13. Disseminating an Effective Educational Technology.

    Science.gov (United States)

    Axelrod, Saul

    1992-01-01

    Reasons for the failure to adopt behavior-analytic teaching strategies include the perception that behavior analysis is coercive and controlling, difficulties in implementation, university factors, and marketing problems. The goal of dissemination of these strategies could be met through creating motivational conditions and devising marketing…

  14. The burden of extrapulmonary and meningitis tuberculosis: an investigation of national surveillance data, Germany, 2002 to 2009.

    Science.gov (United States)

    Ducomble, T; Tolksdorf, K; Karagiannis, I; Hauer, B; Brodhun, B; Haas, W; Fiebig, L

    2013-03-21

    Tuberculosis (TB) surveillance commonly focuses on pulmonary (PTB) where the main organ affected is the lung. This might lead to underestimate extrapulmonary TB (EPTB) forms, where in addition to the lung other sites are affected by TB. In Germany, TB notification data provide the main site and the secondary site of disease. To gain an overview of all the different EPTB forms, we analysed German TB notification data between 2002 and 2009 using information on both main and secondary disease site to describe all individual EPTB forms. Further, we assessed factors associated with meningitis using multivariable logistic regression. Solely analysing the main site of disease, lead to one third of EPTB manifestations being overlooked. Case characteristics varied substantially across individual extrapulmonary forms. Of 46,349 TB patients, 422 (0.9%) had meningitis as main or secondary site. Of those, 105 (25%) of the 415 with available information had died. Multivariable analysis showed that meningitis was more likely in children younger than five years and between five and nine years-old (odds ratio (OR): 4.90; 95% confidence interval (CI): 3.40–7.07 and OR: 2.65; 95% CI: 1.40–5.00), in females (OR: 1.42; 95% CI: 1.17–1.73), and in those born in the World Health Organization (WHO) regions of south-east Asia (OR: 2.38; 95% CI: 1.66–3.43) and eastern Mediterranean (OR: 1.51; 95% CI: 1.02–2.23). Overall, EPTB manifestations, including meningitis, which is often fatal, were underestimated by routine analysis. We thus recommend using all information on disease manifestation generated by surveillance to monitor severe forms and to transfer the gained knowledge to TB case management where awareness of EPTB is most important.

  15. The bacterial lipocalins.

    Science.gov (United States)

    Bishop, R E

    2000-10-18

    The lipocalins were once regarded as a eukaryotic protein family, but new members have been recently discovered in bacteria. The first bacterial lipocalin (Blc) was identified in Escherichia coli as an outer membrane lipoprotein expressed under conditions of environmental stress. Blc is distinguished from most lipocalins by the absence of intramolecular disulfide bonds, but the presence of a membrane anchor is shared with two of its closest homologues, apolipoprotein D and lazarillo. Several common features of the membrane-anchored lipocalins suggest that each may play an important role in membrane biogenesis and repair. Additionally, Blc proteins are implicated in the dissemination of antibiotic resistance genes and in the activation of immunity. Recent genome sequencing efforts reveal the existence of at least 20 bacterial lipocalins. The lipocalins appear to have originated in Gram-negative bacteria and were probably transferred horizontally to eukaryotes from the endosymbiotic alpha-proteobacterial ancestor of the mitochondrion. The genome sequences also reveal that some bacterial lipocalins exhibit disulfide bonds and alternative modes of subcellular localization, which include targeting to the periplasmic space, the cytoplasmic membrane, and the cytosol. The relationships between bacterial lipocalin structure and function further illuminate the common biochemistry of bacterial and eukaryotic cells.

  16. Acute disseminated histoplasmosis and endocarditis

    Directory of Open Access Journals (Sweden)

    SCAPELLATO Pablo G.

    1998-01-01

    Full Text Available Acute disseminated histoplasmosis is a frequent condition in HIV carriers. Thirty-five cases of endocarditis caused by Histoplasma capsulatum have been reported in international literature, and all these descriptions correspond to a context of subacute disseminated histoplasmosis. This paper presents the case of a HIV-positive patient with fever, dyspnea, weight loss, vomiting and polyadenopathies to whom histoplasmosis was diagnosed following blood-cultures and isolation of the agent responsible for cutaneous lesions, and in whom aortic-valve vegetations were found during an echocardiogram. The patient was treated with amphotericin B and had a good outcome; subsequent echocardiograms showed no vegetations. Literature on the subject is reviewed, with special emphasis on diagnosis and treatment of previously described cases.

  17. Knowledge dissemination: a core mission

    CERN Multimedia

    2011-01-01

    It’s been a year since the CERN Council approved our policy on intellectual property management, so I’d like to take a look at what we’ve achieved since then. In short, a great deal. We’ve moved away from a fairly unregulated approach towards a well balanced and clearly defined system built around sound intellectual property management designed to deliver maximum dissemination and benefit for society from CERN innovation. It’s a move that I celebrate and fully support.   In 2009, CERN signed two partnership agreements to develop CERN technologies, two commercial licenses and eleven R&D licenses. Last year, the figures were six partnership agreements, five commercial licenses and twenty R&D licenses, indicating a real increase in dissemination efforts. From 2009 to 2010, however, the number of new technologies that were identified and disclosed hardly changed: nine in 2009, ten in 2010. These numbers are good, but we must improve, particu...

  18. Disseminated sporotrichosis in an immunocompetent patient

    Science.gov (United States)

    Hassan, Kareem; Turker, Tolga; Zangeneh, Tirdad

    2016-01-01

    Abstract Sporothrix schenckii, the causative agent of sporotrichosis, is a relatively rare infection. Local infection usually occurs through direct inoculation of the organism through the skin; disseminated disease is rarely seen. This article describes a case of disseminated sporotrichosis in a middle-aged man without the commonly seen risk factors for dissemination. PMID:27583270

  19. MRI in acute disseminated encephalomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Caldemeyer, K.S. (Div. of Neuroradiology, Dept. of Radiology, Indiana Univ. School of Medicine, Indianapolis, IN (United States)); Smith, R.R. (Div. of Neuroradiology, Dept. of Radiology, Indiana Univ. School of Medicine, Indianapolis, IN (United States)); Harris, T.M. (Div. of Neuroradiology, Dept. of Radiology, Indiana Univ. School of Medicine, Indianapolis, IN (United States)); Edwards, M.K. (Div. of Neuroradiology, Dept. of Radiology, Indiana Univ. School of Medicine, Indianapolis, IN (United States))

    1994-04-01

    A retrospective analysis of CT and MRI studies in 12 patients with a clinical diagnosis of acute disseminated encephalomyelitis (ADEM) was performed. MRI was the definitive modality for the assessment of the lesions of ADEM: all patients had abnormalities consistent with the clinical diagnosis. Ten had abnormalities in the brain, three spinal cord lesions, and three showed evidence of optic neuritis. CT was normal in 6 of the 7 patients in which it was performed. (orig.)

  20. Perforating Disseminated Necrobiosis Lipoidica Diabeticorum

    OpenAIRE

    Paula Lozanova; Lyubomir Dourmishev; Snejina Vassileva; Ljubka Miteva; Maria Balabanova

    2013-01-01

    Perforating necrobiosis lipoidica is a very rare clinical variant which consists of degeneration and transepidermal elimination of the collagen with few cases reported in the literature. In two-thirds of the patients it associates with diabetes, with no relation with the glucose control. We present a 42-year-old female patient with a 7-year history of diabetes on insulin therapy, referred to our clinic with a 3-year history of multiple asymptomatic firm plaques disseminated on the upper and l...

  1. Myeloma multiplex with pulmonary dissemination

    OpenAIRE

    Terzić Brankica; Maksić Đoko; Škuletić Vesna; Pilčević Dejan; Mijušković Mirjana; Čukić Zoran; Obrenčević Katarina; Petrović Marijana; Tadić-Pilčević Jelena; Petrović Milica

    2014-01-01

    Introduction. Multiple myeloma is a hemathological malignancy characterized by the clonal proliferation of plasma cells in the bone the marrow. Extramedullary dissemination of multiple myeloma is uncommon. In several cases only, the multiple myeloma malignant plasma cells had diseminated to the lung parenchyma. Case report. We presented a case of multiple myeloma with lung plasmacytoma, in a 79-year-old patient, hospitalized for febrility and infiltrative m...

  2. A Long-term Co-perfused Disseminated Tuberculosis-3D Liver Hollow Fiber Model for Both Drug Efficacy and Hepatotoxicity in Babies.

    Science.gov (United States)

    Srivastava, Shashikant; Pasipanodya, Jotam G; Ramachandran, Geetha; Deshpande, Devyani; Shuford, Stephen; Crosswell, Howland E; Cirrincione, Kayle N; Sherman, Carleton M; Swaminathan, Soumya; Gumbo, Tawanda

    2016-04-01

    Treatment of disseminated tuberculosis in children≤6years has not been optimized. The pyrazinamide-containing combination regimen used to treat disseminated tuberculosis in babies and toddlers was extrapolated from adult pulmonary tuberculosis. Due to hepatotoxicity worries, there are no dose-response studies in children. We designed a hollow fiber system model of disseminated intracellular tuberculosis with co-perfused three-dimensional organotypic liver modules to simultaneously test for efficacy and toxicity. We utilized pediatric pharmacokinetics of pyrazinamide and acetaminophen to determine dose-dependent pyrazinamide efficacy and hepatotoxicity. Acetaminophen concentrations that cause hepatotoxicity in children led to elevated liver function tests, while 100mg/kg pyrazinamide did not. Surprisingly, pyrazinamide did not kill intracellular Mycobacterium tuberculosis up to fourfold the standard dose as monotherapy or as combination therapy, despite achieving high intracellular concentrations. Host-pathogen RNA-sequencing revealed lack of a pyrazinamide exposure transcript signature in intracellular bacteria or of phagolysosome acidification on pH imaging. Artificial intelligence algorithms confirmed that pyrazinamide was not predictive of good clinical outcomes in children≤6years who had extrapulmonary tuberculosis. Thus, adding a drug that works inside macrophages could benefit children with disseminated tuberculosis. Our in vitro model can be used to identify such new regimens that could accelerate cure while minimizing toxicity.

  3. IL-10R1 S138G loss-of-function polymorphism is associated with extrapulmonary tuberculosis risk development in Tunisia.

    Science.gov (United States)

    Ben-Selma, Walid; Ben-Abderrahmen, Yosra; Boukadida, Jalel; Harizi, Hedi

    2012-01-01

    There is considerable evidence that host genetic factors are important in determining susceptibility to mycobacterial infections. More recently, functional genetic mutations affecting IL-10 receptor 1 (IL-10R1) were described. In this study, we investigated the relationship of IL-10R1 S138G loss-of-function polymorphism (A536G: rs3135932) with susceptibility to active tuberculosis (TB) in Tunisian patients. A total of 168 patients with pulmonary TB, 55 with extrapulmonary TB, and 150 control subjects were studied. Genomic DNA samples were extracted from leukocytes and used to investigate S138G polymorphism in IL-10R1 gene by multiplex allele-specific polymerase chain reaction. Associations between G allele [odds ratio OR=5.01; 95% confidence intervals CI=2.58-9.77; P=10(-7)], GG genotypes [OR=9.06; 95% CI (1.58-67.33); correcting P-values using the Bonferroni method for multiple tests Pc=0.015] and AG genotype [OR=3.75; 95% CI (1.62-8.7); Pc=0.0012] with the risk development of active extrapulmonary TB were found. In contrast, the AA genotype was found to be associated with resistance to extrapulmonary TB [OR=0.19; 95% CI (0.09-0.42); Pc=6.10(-6)]. No association was found between S138G SNP and pulmonary TB. In conclusion, our study suggested the possible role of IL-10R1 S138G loss-of-function polymorphism in extrapulmonary TB susceptibility-resistance in Tunisia.

  4. Role of multiplex polymerase chain reaction using IS6110 and Protein b for the diagnosis of extra-pulmonary tuberculosis: North India

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    Kusum Sharma

    2015-01-01

    Full Text Available Background: Prompt and accurate diagnosis of extra-pulmonary tuberculosis (TB is highly challenging. Current conventional techniques lack sensitivity and are time-consuming. Here, we report our experience with multiplex polymerase chain reaction (MPCR using two targets namely IS6110 and protein antigen b in the diagnosis of extra-pulmonary TB. Materials and Methods: A total of 150 patients of extra-pulmonary TB visiting tertiary care center in north India between September 2008 and December 2009 were included in the study. Sixty-six biopsy samples and 84 were body fluids from these patients were subjected for microscopy (Ziehl-Neelsen, culture on LJ medium and for Multiplex PCR using IS6110 and Protein b antigen. Results: Smear positivity was noted in 11 samples (7.33%, and LJ culture yielded Mycobacterium tuberculosis in 8 biopsies and 9 body fluids with overall positivity of 11.3%. The multi-targeted PCR could detect M. tuberculosis in a total of 112 samples. Of 112 positive samples, only Protein b band was detected in 7 samples and only IS6110 was detected in 5 samples. Overall Protein b, PCR could detect 71.33% of the cases, whereas IS6110 was positive in 66.6% of the cases. Overall the sensitivities of microscopy, culture, IS6110 PCR, Protein b PCR and MPCR were 7.33%, 11.3%, 66.67%, 71.3% and 74.6%, respectively. Thus by using more than two targets the sensitivity increased from 66.67% of IS6110 to 74.6% in MPCR. Conclusion: Multiplex polymerase chain reaction using IS6110 and Protein b antigen is a highly sensitive and specific tool in the diagnosis of pauci-bacillary conditions like extra-pulmonary TB.

  5. Perforating Disseminated Necrobiosis Lipoidica Diabeticorum

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    Paula Lozanova

    2013-01-01

    Full Text Available Perforating necrobiosis lipoidica is a very rare clinical variant which consists of degeneration and transepidermal elimination of the collagen with few cases reported in the literature. In two-thirds of the patients it associates with diabetes, with no relation with the glucose control. We present a 42-year-old female patient with a 7-year history of diabetes on insulin therapy, referred to our clinic with a 3-year history of multiple asymptomatic firm plaques disseminated on the upper and lower extremities. The clinical and histological findings proved the diagnosis of perforating necrobiosis lipoidica.

  6. Data Dissemination in the Wild

    DEFF Research Database (Denmark)

    Vingelmann, Peter; Pedersen, Morten Videbæk; Heide, Janus;

    2012-01-01

    This paper investigates the problem of efficient data dissemination in Mobile Ad hoc NETworks (MANETs) with high mobility. A testbed is presented; which provides a high degree of mobility in experiments. The testbed consists of 10 autonomous robots with mobile phones mounted on them. The mobile...... phones form an IEEE 802.11g ad hoc network to communicate with each other. A dynamic network topology is assumed, where the mobile devices form a cooperative cluster in order to exchange data packets among each other. In our multimedia exchange scenario, the initial state is that one device carries all...

  7. Disseminated Tuberculosis Mimicking Ankylosing Spondylitis

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    Valérie Huyge

    2011-01-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory disorder affecting mainly the axial skeleton. Here we report a case of a man with a clinical suspicion of ankylosing spondylitis but with a persistence of increased inflammatory markers. In this case, 18F-FDG-PET/CT revealed multiple hypermetabolic lesions in axial skeleton, lymph nodes, and the lung, suggestive of either disseminated tuberculosis or lymphoma. Histological analysis of the pulmonary lesion revealed mycobacterium tuberculosis. This case highlights, firstly, the importance of excluding other diagnoses in the presence of clinical picture of ankylosing spondylitis and high inflammatory markers and, secondly, the determining role of PET/CT.

  8. Bacterial Vaginosis

    Science.gov (United States)

    ... Issues > Conditions > Sexually Transmitted > Bacterial Vaginosis Health Issues Listen Español Text Size Email Print Share Bacterial Vaginosis Page Content Bacterial vaginosis (BV) is the most common vaginal infection in sexually active teenaged girls . It appears to be caused by ...

  9. Disseminated rhodococcus equi infection in HIV infection despite highly active antiretroviral therapy

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    Ferretti Francesca

    2011-12-01

    Full Text Available Abstract Background Rhodococcus equi (R.equi is an acid fast, GRAM + coccobacillus, which is widespread in the soil and causes pulmonary and extrapulmonary infections in immunocompromised people. In the context of HIV infection, R.equi infection (rhodococcosis is regarded as an opportunistic disease, and its outcome is influenced by highly active antiretroviral therapy (HAART. Case presentation We report two cases of HIV-related rhodococcosis that disseminated despite suppressive HAART and anti-rhodococcal treatment; in both cases there was no immunological recovery, with CD4+ cells count below 200/μL. In the first case, pulmonary rhodococcosis presented 6 months after initiation of HAART, and was followed by an extracerebral intracranial and a cerebral rhodococcal abscess 1 and 8 months, respectively, after onset of pulmonary infection. The second case was characterized by a protracted course with spread of infection to various organs, including subcutaneous tissue, skin, colon and other intra-abdominal tissues, and central nervous system; the spread started 4 years after clinical resolution of a first pulmonary manifestation and progressed over a period of 2 years. Conclusions Our report highlights the importance of an effective immune recovery, despite fully suppressive HAART, along with anti-rhodococcal therapy, in order to clear rhodococcal infection.

  10. Myeloma multiplex with pulmonary dissemination

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    Terzić Brankica

    2014-01-01

    Full Text Available Introduction. Multiple myeloma is a hemathological malignancy characterized by the clonal proliferation of plasma cells in the bone the marrow. Extramedullary dissemination of multiple myeloma is uncommon. In several cases only, the multiple myeloma malignant plasma cells had diseminated to the lung parenchyma. Case report. We presented a case of multiple myeloma with lung plasmacytoma, in a 79-year-old patient, hospitalized for febrility and infiltrative mass in the right lung. Two months before the patient was admitted, because of developing terminal renal failure, hemodialysis treatment had started three times a week. Since then, the patient was oliguric, but because of febrility and hemoptysis that appeared, at first he was treated with dual antibiotic therapy which resulted in temporary improvement of his general condition, but pleural effusion remained. After thoracocentesis, followed by myelogram, the multiple myeloma diagnosis was established. Conclusion. In patients of middle and older age, with general weakness, exhaustion, loss of weight, renal failure which progresses to the end stage rapidly, if symptoms of respiratory tract occur, consider this uncommon disease - extramedullary dissemination of multiple myeloma.

  11. Metastatic Extrapulmonary Small Cell Carcinoma to the Cerebellopontine Angle: A Case Report and Review of the Literature

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    Debebe Theodros

    2015-01-01

    Full Text Available Extrapulmonary small cell carcinomas (EPSCC are rare malignancies with poor patient prognoses. We present the case of a 63-year-old male who underwent surgical resection of a poorly differentiated small cell carcinoma, likely from a small intestinal primary tumor that metastasized to the cerebellopontine angle (CPA. A 63-year-old male presented with mild left facial paralysis, hearing loss, and balance instability. MRI revealed a 15 mm mass in the left CPA involving the internal auditory canal consistent with a vestibular schwannoma. Preoperative MRI eight weeks later demonstrated marked enlargement to 35 mm. The patient underwent a suboccipital craniectomy and the mass was grossly different visually and in consistency from a standard vestibular schwannoma. The final pathology revealed a poorly differentiated small cell carcinoma. Postoperative PET scan identified avid uptake in the small intestine suggestive of either a small intestinal primary tumor or additional metastatic disease. The patient underwent whole brain radiation therapy and chemotherapy and at last follow-up demonstrated improvement in his symptoms. Surgical resection and radiotherapy are potential treatment options to improve survival in patients diagnosed with NET brain metastases. We present the first documented case of skull base metastasis of a poorly differentiated small cell carcinoma involving the CPA.

  12. Intravascular clearance of disseminating Cryptococcus neoformans in the brain can be improved by enhancing neutrophil recruitment in mice.

    Science.gov (United States)

    Sun, Donglei; Zhang, Mingshun; Liu, Gongguan; Wu, Hui; Li, Chang; Zhou, Hong; Zhang, Xiquan; Shi, Meiqing

    2016-07-01

    Extrapulmonary dissemination of Cryptococcus neoformans (C. neoformans) is one of the most critical steps in the development of meningoencephalitis. Here, we report that clearance of the disseminating C. neoformans occurs within the brain microvasculature. Interestingly, the efficiency of the intravascular clearance in the brain is reduced compared to that in the lung. Intravascular clearance is mainly mediated by neutrophils, and complement C5a receptor signaling is crucial for mediating neutrophil recruitment in the vasculature. C. neoformans stimulated actin polymerization of neutrophils is critically involved in their recruitment to the lung, which is associated with the unique vascular structure detected in the lung. The relatively lower efficiency of fungal clearance in the brain vasculature correlates with less efficient recruitment of neutrophils. Accordingly, intravascular clearance of C. neoformans in the brain could be remarkably improved by increasing the recruitment of neutrophils. We conclude that neutrophils have the ability to eliminate C. neoformans arrested in the vasculature. However, insufficient recruitment of neutrophils limited the optimal clearance of this microorganism in the brain. These results imply that a therapeutic strategy aimed at enhancing the accumulation of neutrophils could help prevent cryptococcal meningoencephalitis.

  13. Imunofenotipagem e remodelamento da matriz extracelular na sarcoidose pulmonar e extrapulmonar Immunophenotyping and extracellular matrix remodeling in pulmonary and extrapulmonary sarcoidosis

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    Pedro Henrique Ramos Quintino da Silva

    2012-06-01

    Full Text Available OBJETIVO: Investigar o significado de marcadores de imunidade celular e de componentes elásticos/colágeno da matriz extracelular em estruturas granulomatosas em biópsias de pacientes com sarcoidose pulmonar ou extrapulmonar. MÉTODOS: Determinações qualitativas e quantitativas de células inflamatórias, de fibras de colágeno e de fibras elásticas em estruturas granulomatosas em biópsias cirúrgicas de 40 pacientes com sarcoidose pulmonar e extrapulmonar foram realizadas por histomorfometria, imuno-histoquímica, e técnicas de coloração com picrosirius e resorcina-fucsina de Weigert. RESULTADOS: A densidade de linfócitos, macrófagos e neutrófilos nas biópsias extrapulmonares foi significativamente maior do que nas biópsias pulmonares. Os granulomas pulmonares apresentaram uma quantidade significativamente maior de fibras de colágeno e menor densidade de fibras elásticas que os granulomas extrapulmonares. A quantidade de macrófagos nos granulomas pulmonares correlacionou-se com CVF (p OBJECTIVE: To investigate the significance of cellular immune markers, as well as that of collagen and elastic components of the extracellular matrix, within granulomatous structures in biopsies of patients with pulmonary or extrapulmonary sarcoidosis. METHODS: We carried out qualitative and quantitative evaluations of inflammatory cells, collagen fibers, and elastic fibers in granulomatous structures in surgical biopsies of 40 patients with pulmonary and extrapulmonary sarcoidosis using histomorphometry, immunohistochemistry, picrosirius red staining, and Weigert's resorcin-fuchsin staining. RESULTS: The extrapulmonary tissue biopsies presented significantly higher densities of lymphocytes, macrophages, and neutrophils than did the lung tissue biopsies. Pulmonary granulomas showed a significantly higher number of collagen fibers and a lower density of elastic fibers than did extrapulmonary granulomas. The amount of macrophages in the lung samples

  14. Obstetrical disseminated intravascular coagulation score.

    Science.gov (United States)

    Kobayashi, Takao

    2014-06-01

    Obstetrical disseminated intravascular coagulation (DIC) is usually a very acute, serious complication of pregnancy. The obstetrical DIC score helps with making a prompt diagnosis and starting treatment early. This DIC score, in which higher scores are given for clinical parameters rather than for laboratory parameters, has three components: (i) the underlying diseases; (ii) the clinical symptoms; and (iii) the laboratory findings (coagulation tests). It is justifiably appropriate to initiate therapy for DIC when the obstetrical DIC score reaches 8 points or more before obtaining the results of coagulation tests. Improvement of blood coagulation tests and clinical symptoms are essential to the efficacy evaluation for treatment after a diagnosis of obstetrical DIC. Therefore, the efficacy evaluation criteria for obstetrical DIC are also defined to enable follow-up of the clinical efficacy of DIC therapy.

  15. Treatment of Disseminated Intravascular Coagulation.

    Science.gov (United States)

    Makruasi, Nisa

    2015-11-01

    Disseminated intravascular coagulation (DIC) is a syndrome characterized by systemic activation of blood coagulation, generation of thrombin, and leading to disturbance of the microvasculature. In this article, definition and diagnostic criteria of DIC depend on the International Society of Thrombosis and Haemostasis (ISTH). There is no gold standard for diagnosis of DIC, only low quality evidence is used in general practice. Many diagnostic tests and repeated measurement are required. For the treatment of DIC, there is no good quality evidence. The most important treatment for DIC is the specific treatment of the conditions associated DIC. Platelets and/or plasma transfusion may be also necessary if indicated. Nevertheless, there is no gold standard for diagnosis and treatment of DIC, we use only low quality evidence in general practice.

  16. A Case of Probable MHC Class II Deficiency with Disseminated BCGitis.

    Science.gov (United States)

    Alyasin, Soheyla; Abolnezhadian, Farhad; Khoshkhui, Maryam

    2015-09-01

    Major histocompatibility complex (MHC) class II deficiency is a primary immunodeficiency disease characterized by abnormality of MHC class II molecules surface expression on peripheral blood lymphocytes and monocytes. Clinical manifestations include extreme susceptibility to viral, bacterial, and fungal infections but the immunodeficiency is not as severe as SCID (severe combined immunodeficiency), as evidenced by failure to develop disseminated infection after BCG vaccination. Therefore, MHC II deficiency with BCGosis, that is disseminated BCGitis, is not reported commonly. We report an interesting case of BCGosis after vaccination that was diagnosed to have probable MHC II deficiency.

  17. Insight to the Epidemiology and Risk Factors of Extrapulmonary Tuberculosis in Tianjin, China during 2006-2011.

    Directory of Open Access Journals (Sweden)

    Xiaoqing Wang

    Full Text Available The proportion of extrapulmonary tuberculosis (EPTB among all the reported tuberculosis (TB cases has increased in different populations. Despite the large burden of TB in China, the epidemiology of EPTB in China remains largely understudied and the risk factors for having EPTB diagnosis in China have not been identified.To gain insight to EPTB epidemiology in China, we analyzed TB surveillance data collected in Tianjin, China, during 2006 to 2011. The frequency of EPTB among all TB cases and within different socio-demographic groups of the study patients aged 15 years and older was determined for EPTB in general and by specific types. The distribution of socio-demographic characteristics was compared between pulmonary TB (PTB group and EPTB group by chi-square test. Crude and multiple logistic regression-derived adjusted odds ratios (aOR and 95% confidence intervals (CI were determined to assess the associations between having EPTB diagnosis and each individual explanatory variable in question.About one-tenth (1,512/14,561 of the patients investigated in this study had EPTB. Of these 1,512 EPTB cases, about two thirds were pleural TB. Significant difference in age, occupation, and urbanity of residence were found between PTB and EPTB groups (p<0.05. Patients with EPTB diagnosis were more likely to be 65 years or older (aOR = 1.22, 95% CI: 1.02, 1.46, to be retired (aOR = 1.37, 95% CI: 1.08, 1.75, and to live in urban areas (aOR = 1 38, 95% CI: 1.22, 1.55.The findings of this study extends the knowledgebase of EPTB epidemiology in developing countries and highlight the need for improved EPTB detection in China, especially in subpopulations with high risk for EPTB or having limited access to medical facilities with adequate capacity for EPTB diagnosis.

  18. Insight to the Epidemiology and Risk Factors of Extrapulmonary Tuberculosis in Tianjin, China during 2006-2011

    Science.gov (United States)

    Wang, Xiaoqing; Yang, Zhenhua; Fu, Yanyong; Zhang, Guoqin; Wang, Xu; Zhang, Yuhua; Wang, Xiexiu

    2014-01-01

    Background The proportion of extrapulmonary tuberculosis (EPTB) among all the reported tuberculosis (TB) cases has increased in different populations. Despite the large burden of TB in China, the epidemiology of EPTB in China remains largely understudied and the risk factors for having EPTB diagnosis in China have not been identified. Methods To gain insight to EPTB epidemiology in China, we analyzed TB surveillance data collected in Tianjin, China, during 2006 to 2011. The frequency of EPTB among all TB cases and within different socio-demographic groups of the study patients aged 15 years and older was determined for EPTB in general and by specific types. The distribution of socio-demographic characteristics was compared between pulmonary TB (PTB) group and EPTB group by chi-square test. Crude and multiple logistic regression-derived adjusted odds ratios (aOR) and 95% confidence intervals (CI) were determined to assess the associations between having EPTB diagnosis and each individual explanatory variable in question. Results About one-tenth (1,512/14,561) of the patients investigated in this study had EPTB. Of these 1,512 EPTB cases, about two thirds were pleural TB. Significant difference in age, occupation, and urbanity of residence were found between PTB and EPTB groups (p<0.05). Patients with EPTB diagnosis were more likely to be 65 years or older (aOR = 1.22, 95% CI: 1.02, 1.46), to be retired (aOR = 1.37, 95% CI: 1.08, 1.75), and to live in urban areas (aOR = 1 38, 95% CI: 1.22, 1.55). Conclusions The findings of this study extends the knowledgebase of EPTB epidemiology in developing countries and highlight the need for improved EPTB detection in China, especially in subpopulations with high risk for EPTB or having limited access to medical facilities with adequate capacity for EPTB diagnosis. PMID:25494360

  19. Tissue sensitivity of the rat upper and lower extrapulmonary airways to the inhaled electrophilic air pollutants diacetyl and acrolein.

    Science.gov (United States)

    Cichocki, Joseph A; Smith, Gregory J; Morris, John B

    2014-11-01

    The target site for inhaled vapor-induced injury often differs in mouth-breathing humans compared with nose-breathing rats, thus complicating the use of rat inhalation toxicity data for assessment of human risk. We sought to examine sensitivity of respiratory/transitional nasal (RTM) and tracheobronchial (TBM) mucosa to two electrophilic irritant vapors: diacetyl and acrolein. Computational fluid dynamic physiologically based pharmacokinetic modeling was coupled with biomarker assessment to establish delivered dose-response relationships in RTM and TBM in male F344 rats following 6 h exposure to diacetyl or acrolein. Biomarkers included glutathione status, proinflammatory and antioxidant gene mRNA levels, and nuclear translocation of nuclear factor (erythroid-derived 2)-like 2 (Nrf2). Modeling revealed that 0.0094-0.1653 μg acrolein/min-cm(2) and 3.9-21.6 μg diacetyl/min-cm(2) were deposited into RTM/TBM. Results indicate RTM and TBM were generally of similar sensitivity to diacetyl and acrolein. For instance, both tissues displayed induction of antioxidant and proinflammatory genes, and nuclear accumulation of Nrf2 after electrophile exposure. Hierarchical cellular response patterns were similar in RTM and TBM but differed between vapors. Specifically, diacetyl exposure induced proinflammatory and antioxidant genes concomitantly at low exposure levels, whereas acrolein induced antioxidant genes at much lower exposure levels than that required to induce proinflammatory genes. Generally, diacetyl was less potent than acrolein, as measured by maximal induction of transcripts. In conclusion, the upper and lower extrapulmonary airways are of similar sensitivity to inhaled electrophilic vapors. Dosimetrically based extrapolation of nasal responses in nose-breathing rodents may provide an approach to predict risk to the lower airways of humans during mouth-breathing.

  20. Federal Mechanisms to Support Intervention Dissemination

    Science.gov (United States)

    Diana, Augusto; Bennett, Nicole

    2015-01-01

    This paper examines federal mechanisms that support program developers and researchers in disseminating effective interventions for public benefit. The purpose of this paper is not to discuss the dissemination of intervention research (i.e., how to inform stakeholders about research findings), nor is it intended to discuss the research of…

  1. The Tenth National Dissemination Conference. A Report.

    Science.gov (United States)

    Herlig, Richard K.

    This report on the Tenth National Dissemination Conference of 1977 outlines the purposes of the conference and summarizes the present state of educational information dissemination. National programs are described, including the National Institute of Education State Capacity Building Program, the National Diffusion Network, the Dissemination…

  2. Curriculum Dissemination as Planned Cultural Diffusion.

    Science.gov (United States)

    Rudduck, Jean

    The author traces the change from the use of the term "diffusion" to the term "dissemination" with reference to curriculum projects in Britain and discusses implications of the change. Although at one time the two terms were used interchangeably, the term "dissemination" now emphasizes techniques of effective management rather than the educational…

  3. D5.1 Dissemination Plan

    DEFF Research Database (Denmark)

    Buus, Lillian; Ryberg, Thomas; Eleftheriou, Paraskevi

    2009-01-01

    at defining the dissemination goals as well as the project’s target audience and channels through which the EATrain2 solution is going to be promoted. It also includes partners competences in the dissemination area and detailed schedule of events thematically related to the project’s scope. The deliverable...

  4. Effectiveness of an integrated real-time PCR method for detection of the Mycobacterium tuberculosis complex in smear-negative extrapulmonary samples in an area of low tuberculosis prevalence.

    Science.gov (United States)

    Moure, Raquel; Martín, Rogelio; Alcaide, Fernando

    2012-02-01

    Early extrapulmonary tuberculosis (EPTB) diagnosis is particularly difficult. Among 108 smear-negative extrapulmonary samples showing a positive culture for Mycobacterium tuberculosis complex (43 body fluids and 65 nonliquid specimens), 63 (58.3%) were positive with the Xpert MTB/RIF assay (GX). GX sensitivity was quite low for samples from sterile locations (especially for pleural fluids: 26.9%) but high for some nonliquid samples, like abscess aspirates (76.5%). In summary, GX may be a useful tool to be considered for EPTB diagnosis.

  5. An Arthrobacter spp. bacteremia leading to fetal death and maternal disseminated intravascular coagulation.

    Science.gov (United States)

    Shigeta, Naoya; Ozaki, Kimiaki; Hori, Kensuke; Ito, Kimihiko; Nakayama, Masahiro; Nakahira, Kumiko; Yanagihara, Itaru

    2013-02-01

    A 34-year-old parous woman developed high fever and threatened preterm labor after a 1-day trip, for which she was receiving prenatal care at a hospital. Three days after onset, at 24 4/7 weeks of gestation, she was transferred to our hospital in an emergency. Soon after the woman's arrival at our hospital, the infant was spontaneously stillborn via a transvaginal delivery. Laboratory tests revealed severe maternal disseminated intravascular coagulation with renal and liver insufficiency. Histopathologic examination of the placenta revealed vast fibrin deposition and remarkable neutrophilic infiltration in the intervillous space, suggesting a rare bacterial infection caused by Arthrobacter spp. The bacteria were predominantly detected in the placenta and maternal blood serum by common bacterial 16S rRNA sequencing after polymerase chain reaction amplification. We report the first case, to our knowledge, of bacteremia with Arthrobacter spp., which may lead to maternal disseminated intravascular coagulation and intrauterine fetal death.

  6. Disseminated Herpes Zoster in Association with HIV

    Directory of Open Access Journals (Sweden)

    Kuchabal D

    2000-01-01

    Full Text Available HIV infected individuals are susceptible to a wide variety of skin manifestations due to profound defect in cell-mediated immunity. We describe 2 patients with Disseminated Herpes Zoster, both the patients has associated HIV infection.

  7. Disseminated intravascular coagulation in cancer patients

    NARCIS (Netherlands)

    M. Levi

    2009-01-01

    Disseminated intravascular coagulation (DIC) is a syndrome that may complicate a variety of diseases, including malignant disease. DIC is characterized by widespread, intravascular activation of coagulation (leading to intravascular fibrin deposition) and simultaneous consumption of coagulation fact

  8. Smart-tag Based Data Dissemination

    DEFF Research Database (Denmark)

    Bonnet, Philippe; Beaufour, Allan; Leopold, Martin

    2002-01-01

    Monitoring wide, hostile areas requires disseminating data between fixed, disconnected clusters of sensor nodes. It is not always possible to install long-range radios in order to cover the whole area. We propose to leverage the movement of mobile individuals, equipped with smart......-tags, to disseminate data across disconnected static nodes spread across a wide area. Static nodes and mobile smart-tags exchange data when they are in the vicinity of each other; smart-tags disseminate data as they move around. In this paper, we propose an algorithm for update propagation and a model for smart......-tag based data dissemination. We use simulation to study the characteristics of the model we propose. Finally, we present an implementation based on Bluetooth smart-tags....

  9. Bacterial gastroenteritis

    Science.gov (United States)

    Bacterial gastroenteritis is present when bacteria cause an infection of the stomach and intestines ... has not been treated Many different types of bacteria can cause ... Campylobacter jejuni E coli Salmonella Shigella Staphylococcus ...

  10. Biopersistence and translocation to extrapulmonary organs of titanium dioxide nanoparticles after subacute inhalation exposure to aerosol in adult and elderly rats.

    Science.gov (United States)

    Gaté, Laurent; Disdier, Clémence; Cosnier, Frédéric; Gagnaire, François; Devoy, Jérôme; Saba, Wadad; Brun, Emilie; Chalansonnet, Monique; Mabondzo, Aloise

    2017-01-04

    The increasing industrial use of nanoparticles (NPs) has raised concerns about their impact on human health. Since aging and exposure to environmental factors are linked to the risk for developing pathologies, we address the question of TiO2 NPs toxicokinetics in the context of a realistic occupational exposure. We report the biodistribution of titanium in healthy young adults (12-13-week-old) and in elderly rats (19-month-old) exposed to 10mg/m(3) of a TiO2 nanostructured aerosol 6h/day, 5days/week for 4 weeks. We measured Ti content in major organs using inductively coupled plasma mass spectrometry immediately and up to 180days after the end of exposure. Large amounts of titanium were initially found in lung which were slowly cleared during the post-exposure period. From day 28, a small increase of Ti was found in the spleen and liver of exposed young adult rats. Such an increase was however never found in their blood, kidneys or brain. In the elderly group, translocation to extra-pulmonary organs was significant at day 90. Ti recovered from the spleen and liver of exposed elderly rats was higher than in exposed young adults. These data suggest that TiO2 NPs may translocate from the lung to extra-pulmonary organs where they could possibly promote systemic health effects.

  11. Disseminated Rhodococcus equi infection in dromedary camels (Camelus dromedarius).

    Science.gov (United States)

    Kinne, J; Madarame, H; Takai, S; Jose, S; Wernery, U

    2011-04-21

    Rhodococcus (R). equi, a recognized pathogen in horses, is emerging as a human opportunistic pathogen, especially in immunocompromized people. It affects also New World camelids, but there are no reports of R. equi infection in Old World camelids yet. Four cases of disseminated R. equi infection in adult breeding dromedaries occurred at one camel farm near Dubai within 16 months of each other. At necropsy the lungs were diffusely consolidated with large caseous areas. Histology revealed severe suppurative to necrotising pneumonia with multiple encapsulated abscesses. Immunohistochemistry enabled the detection of 15- to 17-kDa antigens (VapA) of R. equi in the lung sections. High numbers of R. equi were isolated from the lung lesions as well as from liver, spleen and mediastinal lymph nodes, indicative of septicaemia. The isolated strains were PCR-positive for the specific virulence plasmid (VapA-Gen) of R. equi, indicating virulent strains and containing an 85-kb type I plasmid. This is the first report of disseminated R. equi infection in Old World camelids. Since adult camels in general do not suffer from bacterial caused pneumonia (except tuberculosis), this is a new emerging disease for camels.

  12. Disseminated cryptococcosis presenting as cutaneous cellulitis in an adolescent with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Ellen Simionato Valente

    2015-06-01

    Full Text Available We report here the case of a 17-year-old girl from Pelotas, Brazil, with systemic lupus erythematosus and disseminated cryptococcal infection. Prior to diagnosis, she was a chronic user of corticosteroids and other immunosuppressive drugs. Her first symptoms were skin lesions that simulated bacterial cellulitis. Upon suspicion, we performed a biopsy and fungal infection was confirmed. Appropriate therapy was established, and the patient was discharged after 42 days of treatment in complete remission.

  13. Disseminated Cryptococcosis Presenting as Cutaneous Cellulitis in an Adolescent With Systemic Lupus Erythematosus.

    Science.gov (United States)

    Valente, Ellen Simionato; Lazzarin, Mauricio Costa; Koech, Bruno Lopes; da Rosa, Ralph Vighi; de Almeida, Rafael; de Oliveira, Umberto Lopes; Neugebauer, Maria Gertrudes Fernandes Pereira; Sacco, Alexander Gonüalves

    2015-04-15

    We report here the case of a 17-year-old girl from Pelotas, Brazil, with systemic lupus erythematosus and disseminated cryptococcal infection. Prior to diagnosis, she was a chronic user of corticosteroids and other immunosuppressive drugs. Her first symptoms were skin lesions that simulated bacterial cellulitis. Upon suspicion, we performed a biopsy and fungal infection was confirmed. Appropriate therapy was established, and the patient was discharged after 42 days of treatment in complete remission.

  14. Agricultural information dissemination using ICTs: A review and analysis of information dissemination models in China

    Directory of Open Access Journals (Sweden)

    Yun Zhang

    2016-03-01

    Full Text Available Over the last three decades, China’s agriculture sector has been transformed from the traditional to modern practice through the effective deployment of Information and Communication Technologies (ICTs. Information processing and dissemination have played a critical role in this transformation process. Many studies in relation to agriculture information services have been conducted in China, but few of them have attempted to provide a comprehensive review and analysis of different information dissemination models and their applications. This paper aims to review and identify the ICT based information dissemination models in China and to share the knowledge and experience in applying emerging ICTs in disseminating agriculture information to farmers and farm communities to improve productivity and economic, social and environmental sustainability. The paper reviews and analyzes the development stages of China’s agricultural information dissemination systems and different mechanisms for agricultural information service development and operations. Seven ICT-based information dissemination models are identified and discussed. Success cases are presented. The findings provide a useful direction for researchers and practitioners in developing future ICT based information dissemination systems. It is hoped that this paper will also help other developing countries to learn from China’s experience and best practice in their endeavor of applying emerging ICTs in agriculture information dissemination and knowledge transfer.

  15. Spontaneous bacterial peritonitis: Few additional points

    Institute of Scientific and Technical Information of China (English)

    Pankaj Jain

    2009-01-01

    Spontaneous bacterial peritonitis (SBP) is a treatable complication of decompensated cirrhosis. Coagulopathy with evidence of hyperfibrinolysis or clinically evident disseminated intravascular coagulation precludes paracentesis. Alcoholic hepatitis with fever, leucocytosis and abdominal pain should be evaluated for SBP. Oral ofloxacin is as effective as parenteral cefotaxime in treatment of SBP except for inpatients with vomiting,encephalopathy, or renal failure. Albumin is superior to hydroxyethyl starch in treatment of SBP.

  16. Postoperative systemic dissemination of injected elemental mercury.

    Science.gov (United States)

    Kang, Suk-Hyung; Park, Seung Won; Moon, Kyung-Yoon

    2011-04-01

    There were only a few reports of mercury on pulmonary artery. However, there is no data on surgery related mercury dissemination. The objective of the present article is to describe one case of postoperative injected mercury dissemination. A 19-year-old man presented severe neck pain including meningeal irritation sign and abdominal pain after injection of mercury for the purpose of suicide. Radiologic study showed injected mercury in the neck involving high cervical epidural space and subcutaneous layer of abdomen. Partial hemilaminectomy and open mercury evacuation of spinal canal was performed. For the removal of abdominal subcutaneous mercury, C-arm guided needle aspiration was done. After surgery, radiologic study showed disseminated mercury in the lung, heart, skull base and low spinal canal. Neck pain and abdominal pain were improved after surgery. During 1 month after surgery, there was no symptom of mercury intoxication except increased mercury concentration of urine, blood and hair. We assumed the bone work during surgery might have caused mercury dissemination. Therefore, we recommend minimal invasive surgical technique for removal of injected mercury. If open exposures are needed, cautious surgical technique to prohibit mercury dissemination is necessary and normal barrier should be protected to prevent the migration of mercury.

  17. Comprehensive analysis of information dissemination in disasters

    Science.gov (United States)

    Zhang, N.; Huang, H.; Su, Boni

    2016-11-01

    China is a country that experiences a large number of disasters. The number of deaths caused by large-scale disasters and accidents in past 10 years is around 900,000. More than 92.8 percent of these deaths could be avoided if there were an effective pre-warning system deployed. Knowledge of the information dissemination characteristics of different information media taking into consideration governmental assistance (information published by a government) in disasters in urban areas, plays a critical role in increasing response time and reducing the number of deaths and economic losses. In this paper we have developed a comprehensive information dissemination model to optimize efficiency of pre-warning mechanics. This model also can be used for disseminating information for evacuees making real-time evacuation plans. We analyzed every single information dissemination models for pre-warning in disasters by considering 14 media: short message service (SMS), phone, television, radio, news portals, Wechat, microblogs, email, newspapers, loudspeaker vehicles, loudspeakers, oral communication, and passive information acquisition via visual and auditory senses. Since governmental assistance is very useful in a disaster, we calculated the sensitivity of governmental assistance ratio. The results provide useful references for information dissemination during disasters in urban areas.

  18. Smart-tag Based Data Dissemination

    DEFF Research Database (Denmark)

    Bonnet, Philippe; Beaufour, Allan; Leopold, Martin

    2002-01-01

    Monitoring wide, hostile areas requires disseminating data between fixed, disconnected clusters of sensor nodes. It is not always possible to install long-range radios in order to cover the whole area. We propose to leverage the movement of mobile individuals, equipped with smart-tags, to dissemi......-tag based data dissemination. We use simulation to study the characteristics of the model we propose. Finally, we present an implementation based on Bluetooth smart-tags.......Monitoring wide, hostile areas requires disseminating data between fixed, disconnected clusters of sensor nodes. It is not always possible to install long-range radios in order to cover the whole area. We propose to leverage the movement of mobile individuals, equipped with smart......-tags, to disseminate data across disconnected static nodes spread across a wide area. Static nodes and mobile smart-tags exchange data when they are in the vicinity of each other; smart-tags disseminate data as they move around. In this paper, we propose an algorithm for update propagation and a model for smart...

  19. Comparative clinical study of different multiplex real time PCR strategies for the simultaneous differential diagnosis between extrapulmonary tuberculosis and focal complications of brucellosis.

    Directory of Open Access Journals (Sweden)

    Rocio Sanjuan-Jimenez

    Full Text Available BACKGROUND: Both brucellosis and tuberculosis are chronic-debilitating systemic granulomatous diseases with a high incidence in many countries in Africa, Central and South America, the Middle East and the Indian subcontinent. Certain focal complications of brucellosis and extrapulmonary tuberculosis are very difficult to differentiate clinically, biologically and radiologically. As the conventional microbiological methods for the diagnosis of the two diseases have many limitations, as well as being time-consuming, multiplex real time PCR (M RT-PCR could be a promising and practical approach to hasten the differential diagnosis and improve prognosis. METHODOLOGY/PRINCIPAL FINDINGS: We designed a SYBR Green single-tube multiplex real-time PCR protocol targeting bcsp31 and the IS711 sequence detecting all pathogenic species and biovars of Brucella genus, the IS6110 sequence detecting Mycobacterium genus, and the intergenic region senX3-regX3 specifically detecting Mycobacterium tuberculosis complex. The diagnostic yield of the M RT-PCR with the three pairs of resultant amplicons was then analyzed in 91 clinical samples corresponding to 30 patients with focal complications of brucellosis, 24 patients with extrapulmonary tuberculosis, and 36 patients (Control Group with different infectious, autoimmune or neoplastic diseases. Thirty-five patients had vertebral osteomyelitis, 21 subacute or chronic meningitis or meningoencephalitis, 13 liver or splenic abscess, eight orchiepididymitis, seven subacute or chronic arthritis, and the remaining seven samples were from different locations. Of the three pairs of amplicons (senX3-regX3+ bcsp3, senX3-regX3+ IS711 and IS6110+ IS711 only senX3-regX3+ IS711 was 100% specific for both the Brucella genus and M. tuberculosis complex. For all the clinical samples studied, the overall sensitivity, specificity, and positive and negative predictive values of the M RT-PCR assay were 89.1%, 100%, 85.7% and 100

  20. Tracking Users for a Targeted Dissemination

    Directory of Open Access Journals (Sweden)

    Philippe Bautier

    2015-12-01

    Full Text Available How to build a dissemination and communication strategy in a world where users have easy access to a deluge of data and information from various origins and where IT tools and design standards change so quickly that users behaviour and their expectations are continuously modified? The first challenge of Eurostat is clearly to know what users want: we know our different types of users but we have to identify how they get our data, what they do with our data, how they react to our outputs and which sort of new service they would like us to propose. Translating these needs into a visual dissemination is a new challenge undertaken by Eurostat through a new portal, new mobile apps and new info graphs and basic application as well as increasing the visibility on Google. The objective of this paper is to share Eurostat's experience in identifying user Leeds and to show how concretely this information has been visually disseminated.

  1. A rare case of disseminated cysticercosis

    Directory of Open Access Journals (Sweden)

    Debananda Gonjhu

    2015-01-01

    Full Text Available Cysticercosis is a common tropical disease and a common cause of seizures and neurological morbidity. Neurocysticercosis (NCC is the most common manifestation of the disease involving the central nervous system (CNS. One of the uncommon manifestations of cysticercosis is its disseminated form. The most commonly affected organs are the subcutaneous tissues, skeletal muscles, lungs, brain, eyes, liver, and occasionally the heart, thyroid, and pancreas but in widespread dissemination it can involve any organ in the body. We report here a case of a 35-year-old-female with disseminated cysticercosis (DCC. She attended our hospital with headache, fever, and symptoms of multiple palpable nodules. After the investigations, she was diagnosed with DCC involving the brain and subcutaneous tissues all over the body. Then she was successfully treated with albendazole and steroids.

  2. Pineocytoma with diffuse dissemination to the leptomeninges

    Directory of Open Access Journals (Sweden)

    Michael Selch

    2011-10-01

    Full Text Available Pineal parenchymal tumors are rare. Of the three types of pineal parenchymal tumors, pineocytomas are the least aggressive and are not known to diffusely disseminate. In this paper, we report the successful treatment of a case of pineocytoma with diffuse leptomeningeal relapse following initial stereotactic radiotherapy. A 39-year-old female presented with headaches, balance impairment, urinary incontinence, and blunted affect. A pineal mass was discovered on magnetic resonance imaging (MRI. A diagnosis of pineocytoma was established with an endoscopic pineal gland biopsy, and the patient received stereotactic radiotherapy. Ten years later, she developed diffuse leptomeningeal dissemination. The patient was then successfully treated with craniospinal radiation therapy. Leptomeningeal spread may develop as late as 10 years after initial presentation of pineocytoma. Our case demonstrates the importance of long-term follow-up of patients with pineal parenchymal tumors following radiation therapy, and the efficacy of craniospinal radiation in the treatment of leptomeningeal dissemination.

  3. Bacterial Adhesion & Blocking Bacterial Adhesion

    DEFF Research Database (Denmark)

    Vejborg, Rebecca Munk

    2008-01-01

    tract to the microbial flocs in waste water treatment facilities. Microbial biofilms may however also cause a wide range of industrial and medical problems, and have been implicated in a wide range of persistent infectious diseases, including implantassociated microbial infections. Bacterial adhesion...... is the first committing step in biofilm formation, and has therefore been intensely scrutinized. Much however, still remains elusive. Bacterial adhesion is a highly complex process, which is influenced by a variety of factors. In this thesis, a range of physico-chemical, molecular and environmental parameters......, which influence the transition from a planktonic lifestyle to a sessile lifestyle, have been studied. Protein conditioning film formation was found to influence bacterial adhesion and subsequent biofilm formation considerable, and an aqueous extract of fish muscle tissue was shown to significantly...

  4. Bacterial lipases

    NARCIS (Netherlands)

    Jaeger, Karl-Erich; Ransac, Stéphane; Dijkstra, Bauke W.; Colson, Charles; Heuvel, Margreet van; Misset, Onno

    1994-01-01

    Many different bacterial species produce lipases which hydrolyze esters of glycerol with preferably long-chain fatty acids. They act at the interface generated by a hydrophobic lipid substrate in a hydrophilic aqueous medium. A characteristic property of lipases is called interfacial activation, mea

  5. Bacterial Ecology

    DEFF Research Database (Denmark)

    Fenchel, Tom

    2011-01-01

    Bacterial ecology is concerned with the interactions between bacteria and their biological and nonbiological environments and with the role of bacteria in biogeochemical element cycling. Many fundamental properties of bacteria are consequences of their small size. Thus, they can efficiently exploit...

  6. Multicenter Evaluation of Anyplex Plus MTB/NTM MDR-TB Assay for Rapid Detection of Mycobacterium tuberculosis Complex and Multidrug-Resistant Isolates in Pulmonary and Extrapulmonary Specimens.

    Science.gov (United States)

    Sali, Michela; De Maio, Flavio; Caccuri, Francesca; Campilongo, Federica; Sanguinetti, Maurizio; Fiorentini, Simona; Delogu, Giovanni; Giagulli, Cinzia

    2016-01-01

    The rapid diagnosis of tuberculosis (TB) and the detection of drug-resistant Mycobacterium tuberculosis strains are critical for successful public health interventions. Therefore, TB diagnosis requires the availability of diagnostic tools that allow the rapid detection of M. tuberculosis and drug resistance in clinical samples. Here, we performed a multicenter study to evaluate the performance of the Seegene Anyplex MTB/NTM MDR-TB assay, a new molecular method based on a multiplex real-time PCR system, for detection of Mycobacterium tuberculosis complex (MTBC), nontuberculous mycobacteria (NTM), and genetic determinants of drug resistance. In total, the results for 755 samples (534 pulmonary and 221 extrapulmonary samples) were compared with the results of smears and cultures. For pulmonary specimens, the sensitivities of the Anyplex assay and acid-fast bacillus smear testing were 86.4% and 75.0%, respectively, and the specificities were 99% and 99.4%. For extrapulmonary specimens, the sensitivities of the Anyplex assay and acid-fast bacillus smear testing were 83.3% and 50.0%, respectively, and the specificities of both were 100%. The negative and positive predictive values of the Anyplex assay for pulmonary specimens were 97% and 100%, respectively, and those for extrapulmonary specimens were 84.6% and 100%. The sensitivities of the Anyplex assay for detecting isoniazid resistance in MTBC strains from pulmonary and extrapulmonary specimens were 83.3% and 50%, respectively, while the specificities were 100% for both specimen types. These results demonstrate that the Anyplex MTB/NTM MDR-TB assay is an efficient and rapid method for the diagnosis of pulmonary and extrapulmonary TB and the detection of isoniazid resistance.

  7. Extrapulmonary Small Cell Carcinoma of the Seminal Vesicles and Prostate Demonstrated on 18F-FDG Positron Emission Tomography/Computed Tomography.

    Science.gov (United States)

    Tabrizipour, Amir Iravani; Shen, Lily; Mansberg, Robert; Chuong, Bui

    2016-02-01

    Extrapulmonary primary small cell carcinomas arising from the urogenital tract is infrequent. It can rarely arise from the prostate and even more rarely from the seminal vesicles. We present a 79-year-old male who was admitted due to acute renal failure with a history of radical radiotherapy for prostate adenocarcinoma 13 years ago. The prostate specific antigen level was not elevated. An abdominopelvic computed tomography (CT) scan showed markedly enlarged seminal vesicles causing bilateral ureteral obstruction and a mildly enlarged prostate. Further evaluation with fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/CT demonstrated extensive 18F-FDG uptake in the pelvis with diffuse involvement of both seminal vesicles and the prostate without pathologic uptake in the lungs or elsewhere in the body. Core biopsies of the prostate and both seminal vesicles revealed diffuse involvement by small cell carcinoma. Therapy could not be instituted due to a rapid deterioration in the patient's clinical condition.

  8. Síndrome do desconforto respiratório agudo pulmonar e extrapulmonar: existem diferenças? Pulmonary and extrapulmonary acute respiratory distress syndrome: are they different?

    Directory of Open Access Journals (Sweden)

    Cristiane S. N. Baez Garcia

    2008-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A patogênese da síndrome do desconforto respiratório agudo (SDRA tem sido explicada pela presença de uma agressão direta (SDRA pulmonar e/ou indireta (SDRA extrapulmonar ao parênquima pulmonar. Evidências indicam que a fisiopatologia da doença pode diferir com o tipo de lesão. O objetivo deste estudo foi apresentar breve revisão das diferenças entre a SDRA pulmonar e a SDRA extrapulmonar e discutir as interações entre os aspectos morfofuncionais e a resposta aos diferentes tratamentos. CONTEÚDO: Esta revisão bibliográfica baseou-se em uma pesquisa sistemática de artigos experimentais e clínicos sobre SDRA incluídos nas bases de dados MedLine e SciElo nos últimos 20 anos. Muitos pesquisadores concordam, com base em estudos experimentais, que a SDRA pulmonar e a SDRA extrapulmonar não são idênticas no que diz respeito aos aspectos morfofuncionais, a resposta à pressão positiva ao final da expiração (PEEP, manobra de recrutamento alveolar, posição prona e outras terapias farmacológicas. Entretanto, os estudos clínicos têm descrito resultados contraditórios, os quais podem ser atribuídos à dificuldade de se classificar a SDRA em uma ou outra etiologia, e de se precisar o início, a fase e a gravidade da SDRA nos pacientes. CONCLUSÕES: Pacientes com SDRA de etiologias distintas perduram sendo considerados como pertencendo a uma mesma síndrome e, assim, são tratados da mesma forma. Logo, é fundamental entender as diferenças fisiopatológicas entre a SDRA pulmonar e extrapulmonar para que a terapia seja mais bem direcionada.BACKGROUND AND OBJECTIVES: The pathogenesis of acute respiratory distress syndrome (ARDS has been described by the presence of direct (pulmonary and/or indirect (extrapulmonary insult to the lung parenchyma. Evidence indicates that the pathophysiology of ARDS may differ according to the type of primary insult. This article presents a brief overview of differences

  9. CHRONIC DISSEMINATED HISTOPLASMOSIS WITH PROLONGED LATENCY

    Science.gov (United States)

    A case of chronic disseminated histoplasmosis in an ex-serviceman is described. Evidence is presented to support a latency period of over sixty years between acquisition of infection and clinical manifestation. This is the longest latency period for histoplasmosis described in the medical literature...

  10. Data Dissemination in Mobile Phone Sensor Networks

    NARCIS (Netherlands)

    Le, Viet-Duc; Le, Viet-Duc

    2012-01-01

    Deploying sensors over large areas is costly in terms of configuration, hardware, and maintenance. Using onboard sensors of today mobile phones can significantly reduce the expenses in monitoring areas and disseminating events or data. Via the available short-range Bluetooth and/or WiFi interfaces,

  11. Disseminated Gastrointestinal Mucormycosis in Immunocompromised Disease

    Directory of Open Access Journals (Sweden)

    Tae Sun Ha

    2015-11-01

    Full Text Available Mucormycosis is an uncommon opportunistic fungal infection mostly affecting immunocompromised patients and gastrointestinal mucormycosis is a rare and life-threatening. We describe a 31-year-old man with a history of idiopathic cyclic neutropenia who developed perforations of the stomach and intestine and intra-abdominal bleeding due to disseminated gastrointestinal mucormycosis after the initial operation.

  12. Disseminated Enteroviral Infection Associated with Obinutuzumab.

    Science.gov (United States)

    Dendle, Claire; Gilbertson, Michael; Korman, Tony M; Golder, Vera; Morand, Eric; Opat, Stephen

    2015-09-01

    Two cases of disseminated enteroviral infection occurred in patients who received the CD20 monoclonal antibody obinutuzumab. Clinical features included hepatitis, edema, and a dermatomyositis-like syndrome. These manifestations may be unfamiliar to clinicians and are possibly responsive to intravenous immunoglobulin. Clinicians should remain vigilant for enteroviral infections in patients receiving obinutuzumab.

  13. Disseminated Enteroviral Infection Associated with Obinutuzumab

    OpenAIRE

    Dendle, Claire; Gilbertson, Michael; Korman, Tony M; Golder, Vera; Morand, Eric; Opat, Stephen

    2015-01-01

    Two cases of disseminated enteroviral infection occurred in patients who received the CD20 monoclonal antibody obinutuzumab. Clinical features included hepatitis, edema, and a dermatomyositis-like syndrome. These manifestations may be unfamiliar to clinicians and are possibly responsive to intravenous immunoglobulin. Clinicians should remain vigilant for enteroviral infections in patients receiving obinutuzumab.

  14. Strategies for Production and Dissemination of CAI.

    Science.gov (United States)

    Olivier, W. P.; Scott, G. F.

    The Individualization Project at the Ontario Institute for Studies in Education (OISE) was organized on a cooperative basis with a federal agency and several community colleges. The main design goals were to produce needed courseware, move smoothly from research and development to a production mode of operation, and to emphasize dissemination of…

  15. Disseminating Traffic Information in Vehicular Networks

    Directory of Open Access Journals (Sweden)

    Muhammad Alyas Shahid

    2015-11-01

    Full Text Available In this paper Wifi based system is described for disseminating traffic information in vehicular networks. Basic aim of this approach is to distribute information regarding the traffic conditions such as traffic congestions or safety warnings to vehicles in an effective way.

  16. The FAIR-INNOVATION dissemination project.

    Science.gov (United States)

    Gormley, R

    2001-08-01

    The goal of the FAIR-INNOVATION dissemination project (FLAIR-FLOW 3) (1997-2000) was to disseminate R&D results from the EU FAIR programme to small and medium-sized food enterprises (SMEs), health professionals (HPs) and consumer groups (CGs) in 19 European countries. The dissemination routes were: (i) one-page technical documents on research results; (ii) their reproduction on the internet; (iii) their reproduction in journals Europe-wide; (iv) workshops on results from EU-supported food research programmes; and (v) lectures and poster presentations by FLAIR-FLOW network personnel. Of the 135 one-pagers produced, 62% were targeted at SMEs, 18% at HPs and 5% at CGs. The remaining 15% were on food safety and were common to the three target groups. There were 1047 publications arising from one-pages in trade journals, and over 8000 requests (paper route) were received for follow-up information. These were in addition to 240 k downloads from the FLAIR-FLOW 3 web site (www.flair-flow.com). Initiatives for HPs included specially collated versions of the one-pagers for major conferences, 20 focused workshops, and interaction with the European Federation of Associations of Dieticians. Currently, dissemination is continuing through FLAIR-FLOW 4 (2001-2003) in 24 countries. FLAIR-FLOW 4 is co-ordinated by M. Jean François Quillien from INRA-CRIAA (FR) at criaa@rennes.inra.fr.

  17. Evolution of diffusion and dissemination theory.

    Science.gov (United States)

    Dearing, James W

    2008-01-01

    The article provides a review and considers how the diffusion of innovations Research paradigm has changed, and offers suggestions for the further development of this theory of social change. Main emphases of diffusion Research studies are compared over time, with special attention to applications of diffusion theory-based concepts as types of dissemination science. A considerable degree of paradigmatic evolution is observed. The classical diffusion model focused on adopter innovativeness, individuals as the locus of decision, communication channels, and adoption as the primary outcome measures in post hoc observational study designs. The diffusion systems in question were centralized, with fidelity of implementation often assumed. Current dissemination Research and practice is better characterized by tests of interventions that operationalize one or more diffusion theory-based concepts and concepts from other change approaches, involve complex organizations as the units of adoption, and focus on implementation issues. Foment characterizes dissemination and implementation Research, Reflecting both its interdisciplinary Roots and the imperative of spreading evidence-based innovations as a basis for a new paradigm of translational studies of dissemination science.

  18. ESEA III Evaluation and Dissemination: An Assessment.

    Science.gov (United States)

    Balyeat, Ralph R.; Norman, C. Douglas

    This study surveyed evaluation and dissemination/diffusion practices of ESEA III projects funded in the 1969 fiscal year, which projects are nearing the end of their operations as federally supported programs. The study attempted to discover if (1) the projects were evaluated in accordance with generally accepted procedures, (2) the project…

  19. The Hawaii Educational Dissemination Diffusion System Plan.

    Science.gov (United States)

    Min, Kellet; And Others

    Hawaii's endeavor to use information technology to improve educational practices within the state is described in four major sections: (1) the framework of the plan, including a brief history of dissemination, the goals of the plan, and philosophic statements on resources, linkages, and leadership; (2) the resource component, including an…

  20. Building State Capacity in Dissemination: Literature Review.

    Science.gov (United States)

    Strang, Ernest W.

    This review was developed by and principally for the National Testing Service (NTS) Dissemination Project Staff. It is one of eight activities being used by NTS to develop a design for an evaluation of the State Capacity Building Program. The review is in two parts. The first part provides background information, evaluation methodologies and…

  1. A Proposed Framework for Educational Innovation Dissemination

    Science.gov (United States)

    Hazen, Benjamin T.; Wu, Yun; Sankar, Chetan S.; Jones-Farmer, L. Allison

    2012-01-01

    Although the need for new educational technologies is increasing, the process for disseminating these innovations remains a challenge. A literature review shows that few studies have thoroughly investigated this area. Furthermore, there is no comprehensive framework or coordinated research agenda that may be used to guide such investigation. This…

  2. Differential diagnosis of disseminated periventricular calcifications

    Energy Technology Data Exchange (ETDEWEB)

    Rieger, P.; Piepgras, U.

    1986-08-01

    Juvenile disseminated periventricular calcifications may occur in tuberous sclerosis, toxoplasmosis, cytomegaly, and in tuberculous meningitis. Cysticercosis, by contrast, does not result in corresponding intracerebral foci until an older age. Differential diagnosis is no problem if clinical findings are typical (tuberous sclerosis) or if serological verification is positive. However, any unclear clinical diagnosis can often be secured by CT.

  3. Computer software management, evaluation, and dissemination

    Science.gov (United States)

    1983-01-01

    The activities of the Computer Software Management and Information Center involving the collection, processing, and distribution of software developed under the auspices of NASA and certain other federal agencies are reported. Program checkout and evaluation, inventory control, customer services and marketing, dissemination, program maintenance, and special development tasks are discussed.

  4. Knowledge Management and Global Information Dissemination

    Science.gov (United States)

    Umunadi, Ejiwoke Kennedy

    2014-01-01

    The paper looked at knowledge management and global information dissemination. Knowledge is a very powerful tool for survival, growth and development. It can be seen as the information, understanding and skills that you gain through education or experience. The paper was addressed under the following sub-headings: Knowledge management knowledge…

  5. A Primer on Disseminating Applied Quantitative Research

    Science.gov (United States)

    Bell, Bethany A.; DiStefano, Christine; Morgan, Grant B.

    2010-01-01

    Transparency and replication are essential features of scientific inquiry, yet scientific communications of applied quantitative research are often lacking in much-needed procedural information. In an effort to promote researchers dissemination of their quantitative studies in a cohesive, detailed, and informative manner, the authors delineate…

  6. [Bacterial vaginosis].

    Science.gov (United States)

    Romero Herrero, Daniel; Andreu Domingo, Antonia

    2016-07-01

    Bacterial vaginosis (BV) is the main cause of vaginal dysbacteriosis in the women during the reproductive age. It is an entity in which many studies have focused for years and which is still open for discussion topics. This is due to the diversity of microorganisms that cause it and therefore, its difficult treatment. Bacterial vaginosis is probably the result of vaginal colonization by complex bacterial communities, many of them non-cultivable and with interdependent metabolism where anaerobic populations most likely play an important role in its pathogenesis. The main symptoms are an increase of vaginal discharge and the unpleasant smell of it. It can lead to serious consequences for women, such as an increased risk of contracting sexually transmitted infections including human immunodeficiency virus and upper genital tract and pregnancy complications. Gram stain is the gold standard for microbiological diagnosis of BV, but can also be diagnosed using the Amsel clinical criteria. It should not be considered a sexually transmitted disease but it is highly related to sex. Recurrence is the main problem of medical treatment. Apart from BV, there are other dysbacteriosis less characterized like aerobic vaginitis of which further studies are coming slowly but are achieving more attention and consensus among specialists.

  7. Dissemination Matters: Influences of Dissemination Activities on User Types in an Online Educational Community

    Directory of Open Access Journals (Sweden)

    Min Yuan

    2014-09-01

    Full Text Available Emerging online educational communities provide spaces for teachers to find resources, create instructional activities, and share these activities with others. Within these online communities, individual users’ activities may vary widely, and thus different user types can be identified. In addition, users’ patterns of activities in online communities are dynamic, and further can be affected by dissemination activities. Through analyzing usage analytics in an online teacher community called the Instructional Architect, this study explores the influences of dissemination activities on the usage patterns of different user types. Results show that dissemination activities can play an important role in encouraging users’ active participation, while the absence of dissemination activities can further increase participation inequality.

  8. 小儿肺炎支原体感染肺外器官损害210例临床分析%Clinical analysis on 210 infants with Mycoplasna pneumonia infection and extrapulmonary organ damage

    Institute of Scientific and Technical Information of China (English)

    庞学问

    2012-01-01

    Objective; To explore the clinical manifestations of the infants with Mycoplasma pneumonia infection and extrapulmo-nary organ damage, improve the diagnostic and treatment level. Methods; The clinical data of 210 infants with Mycoplasma pneumonia infection and extrapulmonary organ damage were analyzed retrospectively. Results: Among 534 infants with Mycoplasma pneumonia infection, 210 infants were found with extrapulmonary organ damage, accounting for 3^. 3% , the main organs involved included cardiovascular system (69 infants, 32.9%), digestive system (86 infants, 41.0%), hematologic system (48 infants, 22.9%), urinary system (46 infants, 21. 9% ) , nervous system (8 infants, 3. 8% ) , skin lesion (37 infants, 17. 6% ) , and muscular and joint damage (18 infants, 8. 6% ) . Conclusion: Mycoplasma pneumonia infection can induce pulmonary lesion and one or more than one extrapulmonary organ damage. The infants with Mycoplasma pneumonia infection who have extrapulmonary features or extrapulmonary features as main clinical manifestations should be diagnosed and treated timely, than they will get favorable prognosis.%目的:探讨小儿肺炎支原体(MP)感染肺外器官损害的临床表现,提高诊治水平.方法:回顾分析有肺外器官损害的210例MP感染患儿临床资料.结果:肺炎支原体肺炎(MPP) 534例中210例有肺外器官损害(39.3%),累及的主要器官有心血管系统69例(32.9%)、消化系统86例(41.0%)、血液系统48例(22.9%)、泌尿系统46例(21.9%)、神经系统8例(3.8%)、皮肤损害37例(17.6%)、肌肉关节损害18例(8.6%).结论:MP感染除引起肺部病变外,可同时有1个或1个以上肺外器官受累.对出现肺外表现或以肺外表现为主要临床症状的MPP患儿应及早确诊,及时治疗,预后良好.

  9. EMPOWER. Deliverable no 7.1 Dissemination Plan

    NARCIS (Netherlands)

    Meeuwissen, M.; Fioreze, T.; Thomas, T.; Pickerden, C.; Hof, T.

    2015-01-01

    This deliverable describes the general plan regarding all dissemination activities of the consortium partners and work packages during the project. This links directly to D7.4 where the realization of different dissemination activities will be reported.

  10. Analysis of Misdiagnosis in Extrapulmonary Tuberculosis By 18F-FDG-PET/CT%肺外结核18F-FDG-PET/CT误诊分析

    Institute of Scientific and Technical Information of China (English)

    邱大胜; 胡晓燕; 彭辽河; 李杰; 朱佳; 周静; 丁九荣

    2012-01-01

    Objective To investigate the 18F-FDG-PET/CT findings of extrapulmonary tuberculosis and to analyze the reasons of misdiagnosis in extrapulmonary tuberculosis. Methods The F-FDG-PET/CT imaging findings of 25 cases misdiagnosed as malignant tumors were retrospectively analyzed. Results In 25 cases, 23 cases of tuberculosis were con firmed by pathology, 2 cases of tuberculosis were confirmed by clinical therapy. 25 cases of extrapulmonary tuberculosis in cluded bone and joint tuberculosis in 8 cases (tuberculosis of thoracic vertebra in 4 cases, widespread tuberculosis of whole body skeleton in 2 cases, joint and soft tissue tuberculosis in 2 cases) , pleural or peritoneal tuberculosis in 10 cases, lymphnode tuberculosis in 7 cases. Tuberculosis of thoracic vertebra in 4 cases showed destruction of osteolysis with soft tis sue mass or swelling. ' F-FDG-PET demonstrated high metabolic activity lesions in these thoracic vertebra, the maximum standard uptake values( SUVmax) of these lesions were ranged 3. 56 to 12. 580 CT showed multiple destruction of bone all over the body without obvious soft tissue mass in 2 cases, and PET demonstrated high metabolic activity lesions widespread in bones of whole body. In 2 cases of joint and soft tissue tuberculosis, CT showed psoas abscess, which downward to the left hip join and left pelvis, and soft tissue mass surrounding the hip joint. PET demonstrated high metabolic activity lesions (SUVmax =4. 36 -8. 23). In 10 cases of pleural or peritoneal tuberculosis, pleura and peritoneum were both involved in 1 case, and only peritoneum was involved in 9 cases. CT showed pleura or peritoneum was thickened with pleural effusion or ascites. PET demonstrated strip like lesions with high metabolic activity (SUVmax =2.56 -6.23) in the thickened pleura or peritoneum. In 7 cases of lymph node tuberculosis, CT showed multiple lymphadenectasis in both hilums and mediastinum which diameter was 1. 5 - 8. 0 cm, and SUVm!1 on the PET were about 10. 5

  11. Dissemination of CERN Technologies Through External Entrepreneurs

    CERN Document Server

    Lande, Bjørnulf Visdal; Huuse, Henning

    2008-01-01

    This study focuses on dissemination of innovations through external entrepreneurs. The innovations studied are developed at the European Organization for Nuclear Research (CERN) and commercialized by entrepreneurs establishing spin-off companies on the outside of the Organization. The objective of this study is to provide knowledge to facilitate future external entrepreneurs to increase dissemination of CERN technologies. The research questions looks at the timeline from preparations for creating the spin-off company, until having a product for commercialization in the market. A qualitative cross case investigation was conducted to assess the experiences of four spin-off companies. A framework was created to structure the discussion by finding and categorizing impeding- and success factors seen from the entrepreneurs point of view. The findings where structured in three phases respectively, the time before starting the company, the beginning of the company and the final development before selling products. Th...

  12. Dissemination of Educational Tools and Programs

    Science.gov (United States)

    Christian, C.

    1998-05-01

    The IDEAS program is oriented towards innovative approaches to education and therefore result in a wide range of programs including Astro Capella (the creation of a capella astronomy songs written and performed by a group from NASA/GSFC, Smale, Boyd, and Granger), video kiosks in the Air and Space Museum (SAO, Dow), teaching astronomy in the parks (U of Wisconsin, Bjorkman, Wilcots), as well as the more bread and butter programs of teacher training and curriculum development. In addition to describing some of the diverse programs to come out of the IDEAS programs, I will discuss the dissemination of the results of those programs, and especially the role of the broker/facilitator in that dissemination. The audience is invited to participate in this discussion.

  13. Disseminated histoplasmosis with oral and cutaneous manifestations

    Directory of Open Access Journals (Sweden)

    S Vidyanath

    2013-01-01

    Full Text Available Histoplasmosis is a systemic mycotic infection caused by the dimorphic fungus, Histoplasma capsulatum. Systemic histoplasmosis has emerged as an important opportunistic infection in human immunodeficiency virus (HIV patients and those in endemic areas. Reported cases of histoplasmosis have been low in India with less than 50 cases being reported. We are reporting a case of disseminated histoplasmosis with oral and cutaneous involvement in an HIV seronegative patient.

  14. Tension Hydrothorax Related to Disseminated Endometriosis

    Directory of Open Access Journals (Sweden)

    AnnaKate Deal, MD

    2016-01-01

    Full Text Available We present the case of a 34-year-old woman presenting to the emergency department (ED with dyspnea, cough, and fever. She was found to have a tension hydrothorax and was treated with ultrasound-guided thoracentesis in the ED. Subsequent inpatient evaluation showed the patient had disseminated endometriosis. Tension hydrothorax has not been previously described in the literature as a complication of this disease.

  15. [Disseminated intravascular coagulation in solid tumours].

    Science.gov (United States)

    Ferrand, François Régis; Garcia-Hejl, Carine; Moussaid, Yassine; Schernberg, Antoine; Bidard, François-Clément; Pavic, Michel; Khenifer, Safia; Stoclin, Annabelle

    2014-06-01

    Disseminated intravascular coagulation (DIC) is a complex abnormality of hemostasis with dramatic consequences and long described as associated with tumors. Yet the diagnosis and management of paraneoplastic DIC are poorly defined. The purpose of this paper is to review DIC associated with solid tumors, at the pathophysiological and therapeutic levels in particular. We also report data from a recent retrospective series of patients with DIC in the context of a solid tumor, to illustrate the epidemiological, clinical and prognostic.

  16. Disseminated cutaneous histoplasmosis in an immunocompetent adult

    Directory of Open Access Journals (Sweden)

    Manoj Harnalikar

    2012-01-01

    Full Text Available Histoplasmosis, a systemic mycosis caused by the dimorphic fungus Histoplasma capsulatum var capsulatum and Histoplasma capsulatum var duboisii is endemic to many parts of the world. The clinical manifestations range from acute or chronic pulmonary infection to a progressive disseminated disease. After initial exposure to the fungus, the infection is self-limited and restricted to the lungs in 99% of healthy individuals. The remaining 1%, however, progress to either disseminated or chronic disease involving the lungs, liver, spleen, lymph nodes, bone marrow or rarely, the skin and mucous membranes. Mucocutaneous histoplasmosis is frequently reported in patients with acquired immune deficiency syndrome (AIDS, but it is rare in immunocompetent hosts. A 60-year-old male presented with asymptomatic swelling of the hard palate and crusted papules and nodules over the extremities, face and trunk. Clinically, the diagnoses of cutaneous cryptococcosis versus histoplasmosis was considered in this patient. A chest X-ray revealed hilar lymphadenopathy. Enzyme-linked immunosorbent assay (ELISA for human immunodeficiency virus (HIV was nonreactive. Skin biopsy revealed multiple tiny intracellular round yeast forms with a halo in the mid-dermis. Culture of the skin biopsy in Sabouraud′s dextrose agar showed colonies of Histoplasma capsulatum. Despite an investigation including no evidence of underlying immunosuppression was found, he was started on IV amphotericin-B (0.5 mg/kg/day. However, the patient succumbed to his disease 2 days after presentation. We report a rare case of disseminated cutaneous histoplasmosis in an immunocompetent individual.

  17. Use of UDP for efficient imagery dissemination

    Science.gov (United States)

    Prandolini, Robert; Au, T. A.; Lui, Andrew K.; Owen, Michael J.; Grigg, Mark W.

    2000-05-01

    In the defence organization, imagery represents an important information source for users in the tactical, operational and strategic environments. Its wider dissemination may rely on deployed communication networks that are often unstable with high bit error rates and outages. This paper presents efficient techniques for imagery dissemination using the user datagram protocol (UDP). The use of UDP is compared with the popular transmission control protocol and shown to be superior in performance for error prone IP networks. We have employed a wavelet based coder producing an embedded bit-stream. The packetization of the bit-stream is investigated and we show that it is better to tile an image into independent embedded bit-streams when the network performance is poor. Variable-size tiling is compared with, and shown to be superior to, a fixed-size tiling approach. Selective re-transmission of lost packets is implemented for efficient imagery dissemination using UDP. The selective re- transmission scheme is a function of network bandwidth, delay times, error rates and the significance of the packet.

  18. Airborne dissemination of Escherichia coli in a dairy cattle farm and its environment.

    Science.gov (United States)

    Sanz, Susana; Olarte, Carmen; Martínez-Olarte, Roberto; Navajas-Benito, Enrique V; Alonso, C Andrea; Hidalgo-Sanz, Sara; Somalo, Sergio; Torres, Carmen

    2015-03-16

    There are multiple ways bacteria can be transported from its origin to another area or substrate. Water, food handlers, insects and other animals are known to serve as a vehicle for bacterial dispersion. However, the importance of the air in open areas as a possible way of bacterial dissemination has not been so well analyzed. In this study, we investigated the airborne dissemination of Escherichia coli from the inside of a dairy cattle farm to the immediate environment. The air samples were taken inside the farm (area 0) and from the immediate outside farm surroundings at distance of 50, 100 and 150m in four directions (north, south, east, and west). At each point, the air was collected at different heights: 40cm, 70cm and 1m. The sampling was carried out in two weather seasons (November and July). E. coli was isolated in both inside and outside air, even in samples taken 150m from the farm. A seasonal effect was observed with more bacterial isolates when temperature was higher. Regarding the distribution of the isolates, wind direction appeared as a determining factor. In order to verify that E. coli strains isolated from animal housing facilities were identical to those isolated from the air of the immediate farm environment, their genomic DNA profiles were analyzed by pulsed-field gel electrophoresis (PFGE) after digestion with the endonuclease XbaI. The comparison of genetic profiles suggested that the strains isolated from inside and outside the farm were related, leading to the conclusion that the air is an important vehicle for E. coli dissemination.

  19. Bacterial hydrodynamics

    CERN Document Server

    Lauga, Eric

    2015-01-01

    Bacteria predate plants and animals by billions of years. Today, they are the world's smallest cells yet they represent the bulk of the world's biomass, and the main reservoir of nutrients for higher organisms. Most bacteria can move on their own, and the majority of motile bacteria are able to swim in viscous fluids using slender helical appendages called flagella. Low-Reynolds-number hydrodynamics is at the heart of the ability of flagella to generate propulsion at the micron scale. In fact, fluid dynamic forces impact many aspects of bacteriology, ranging from the ability of cells to reorient and search their surroundings to their interactions within mechanically and chemically-complex environments. Using hydrodynamics as an organizing framework, we review the biomechanics of bacterial motility and look ahead to future challenges.

  20. Palatal Actinomycosis and Kaposi Sarcoma in an HIV-Infected Subject with Disseminated Mycobacterium avium-intracellulare Infection

    Directory of Open Access Journals (Sweden)

    Yuria Ablanedo-Terrazas

    2012-01-01

    Full Text Available Actinomyces and Mycobacterium avium-intracellulare are facultative intracellular organisms, members of the bacterial order actinomycetales. Although Actinomyces can behave as copathogen when anatomic barriers are compromised, its coinfection with Mycobacterium avium-intracellulare has not previously been reported. We present the first reported case of palatal actinomycosis co-infection with disseminated MAC, in an HIV-infected subject with Kaposi sarcoma and diabetes. We discuss the pathogenesis of the complex condition of this subject.

  1. Contribution of the P2X7 1513A/C loss-of-function polymorphism to extrapulmonary tuberculosis susceptibility in Tunisian populations.

    Science.gov (United States)

    Ben-Selma, Walid; Ben-Kahla, Imen; Boukadida, Jalel; Harizi, Hedi

    2011-10-01

    The P2X7 receptor has been found to be linked to an increased risk for tuberculosis in some populations. In this study, we investigate whether the P2X7 receptor plays a role in increasing susceptibility to tuberculosis in Tunisia. We examined two 1513A/C and -762T/C polymorphisms at the P2X7 receptor in 168 patients with pulmonary TB (pTB), 55 patients with extrapulmonary TB (epTB) and 150 blood donors from Tunisia. Genotyping of 1513A/C and -762T/C polymorphisms was performed in purified genomic DNA using PCR-restriction fragment length polymorphism and allele-specific PCR, respectively. The 1513C, CC and AC loss-of-function allele and genotypes were overrepresented in the epTB group compared with the control group (45% vs. 17%, P=10(-8) ; 24% vs. 4%, P=3 × 10(-7) ; 42% vs. 27%, P=10(-3) , respectively). Additionally, they were associated with 3.83-, 11.86- and 3.15-fold risks of developing this clinical tuberculosis form, respectively. No associations between the -762T/C polymorphism and tuberculosis disease, as well as disease anatomic location were observed. Collectively, our results suggest that the P2X7 1513A/C loss-of-function polymorphism may contribute to susceptibility to epTB in Tunisian populations.

  2. Bacterial vaginosis -- aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000687.htm Bacterial vaginosis - aftercare To use the sharing features on this ... to back after you use the bathroom. Preventing Bacterial Vaginosis You can help prevent bacterial vaginosis by: Not ...

  3. Pregnancy Complications: Bacterial Vaginosis

    Science.gov (United States)

    ... Complications & Loss > Pregnancy complications > Bacterial vaginosis and pregnancy Bacterial vaginosis and pregnancy E-mail to a friend Please ... this page It's been added to your dashboard . Bacterial vaginosis (also called BV or vaginitis) is an infection ...

  4. The Diagnosis and Man Disseminated Intravascular Coagulation

    Institute of Scientific and Technical Information of China (English)

    Flelcher B.; Taylor.Jr

    2003-01-01

    @@ This review describes disseminated intravascular coagulation(DIC) as a syndrome in which hemostatic factors are activated and products are generated. This syndrome ranges in severity from an obvious decompensated coagulopathy (overt-DIC) to the subclinical compensated activation of hemostatic factors(non-overt DIC). Ths first part of this review emphasizes two points: First, activation of the hemostatic system is controlled by a vast network of capillaries and venules through anticoagulant and antiinflammatory regulatory factors that operate from the endothelium( e. G. , protein C and thrombomodulin, tissue factor pathway inhibitor).

  5. Disseminated lupus vulgaris: a case report.

    Science.gov (United States)

    Can, Burce; Zindanci, Ilkin; Turkoglu, Zafer; Kavala, Mukaddes; Ulucay, Vasfiye; Demir, Filiz Topaloglu

    2014-01-01

    Lupus vulgaris is a secondary form of cutaneous tuberculosis which persists for years if not treated. The head and neck are the most commonly affected sites. While less frequently arms and legs, and rarely the trunk and the scalp are involved. Herein, we describe a 73-year-old man with a 5-year history of slowly growing, atrophic, some eroded and ulcerated, red-brown plaques on his forehead, nose, cheeks, ear lobes, trunk and extremites. All of his disseminated lesions healed after antituberculosis therapy.

  6. Thinking of modern wushu dissemination method

    Institute of Scientific and Technical Information of China (English)

    Li ping Wang

    2015-01-01

    martial arts in China for thousands of years culture heritage plays an important role, today has become a symbol of Chinese national culture. Martial arts in the long history of several thousand years, continuous development and fusion, formed a unique mode of transmission, and under the changing trend of the development of modern science and technology, not according to the traditional Chinese wushu dissemination, combined with the contemporary science and technology, network promotion, development of martial arts school, strengthen the cultural background, is the best way out for the spread of Chinese martial arts.

  7. Disseminated toxocariasis in an immunocompetent host

    Institute of Scientific and Technical Information of China (English)

    Madan; Raj; Aryal; Paras; Karmacharya; Amrit; Pokharel; Smith; Giri; Ranjan; Pathak; Richard; Alweis

    2014-01-01

    Toxocariasis is a zoonotic infection caused by Toxocara canis,or less commonly,Toxocara cati,which is one of the most common zoonotic infections worldwide.It commonly affects the pediatric and immunocompromised population;however,it has rarely been reported in the immunocompetent adults.Two of the well-recognized syndromes in children are visceral larva migrans and ocular larva migrans.Infection in adults usually ranges from asymptomatic to nonspecific symptoms which makes the diagnosis challenging.A case of 36 year-old male was presented with disseminated toxocariasis with pulmonary and hepatic involvement and striking peripheral eosinophilia.

  8. Disseminated toxocariasis in an immunocompetent host

    Institute of Scientific and Technical Information of China (English)

    Madan Raj Aryal; Paras Karmacharya; Amrit Pokharel; Smith Giri; Ranjan Pathak; Richard Alweis

    2014-01-01

    Toxocariasis is a zoonotic infection caused by Toxocara canis, or less commonly, Toxocara cati, which is one of the most common zoonotic infections worldwide. It commonly affects the pediatric and immunocompromised population; however, it has rarely been reported in the immunocompetent adults. Two of the well-recognized syndromes in children are visceral larva migrans and ocular larva migrans. Infection in adults usually ranges from asymptomatic to non-specific symptoms which makes the diagnosis challenging. A case of 36 year-old male was presented with disseminated toxocariasis with pulmonary and hepatic involvement and striking peripheral eosinophilia.

  9. [Disseminated histoplasmosis treated by boluses of fluconazole].

    Science.gov (United States)

    Mandengue Ebenye, C; Takuefou Mfangam, B; Nouédoui, C; Atangana, P J A

    2015-01-01

    We report a case in which an HIV-infected man was cured of disseminated histoplasmosis (Histoplasma capsulatum var duboisii) after treatment by high-dose fluconazole (1,600 mg taken four times daily) for 2 months, combined with active antiretroviral therapy. The choice of fluconazole at this dosage was motivated by its availability as a generic and thus inexpensive medication, the patient's precarious status, and his critical clinical condition. At the end of the second month of treatment, the patient chose to stop the fluconazole, which he could no longer afford, while continuing the antiretroviral treatment, which was free. The clinical and laboratory improvement observed from the first week has continued to progress for more than 8 months after fluconazole treatment stopped. This single case needs - and deserves - to be confirmed in a series of patients. Nonetheless it makes it possible to envision fluconazole as a low-cost and efficacious antifungal agent for the treatment of disseminated histoplasmosis in AIDS patients in sub-Saharan Africa.

  10. Disseminated Cerebrospinal Embryonal Tumor in the Adult

    Science.gov (United States)

    Armocida, Daniele; Caporlingua, Federico; Lapadula, Gennaro; Elefante, Grazia Maria; Antonelli, Manila; Salvati, Maurizio

    2016-01-01

    Introduction. According to the 2016 World Health Organization classification of Tumors of the Central Nervous System, the term Primitive Neuroectodermal Tumor has been replaced by the term Embryonal Tumor (ET). We present a case of disseminated cerebrospinal ET presenting in an adult patient. Illustrative Case. A 49-year-old male presenting with low back pain, dysuria, and hypoesthesia of the lower extremities referred to our emergency department. Brain and whole spine contrast-enhanced MRI documented a diffusively disseminated heterogeneous neoplasm with intradural extra- and intramedullary involvement of the cervicothoracic tract and cauda equina. A primary biopsy of the lumbosacral localization was performed through L5 bilateral laminectomy. Histologic diagnosis was Embryonal Tumor Not Otherwise Specified. The patient underwent chemotherapy with postoperative adjuvant alternating Vincristine-Doxorubicin-Ifosfamide (VAI) and Ifosfamide-Etoposide (IE). Discussion. Spinal ETs are exceedingly rare especially when presenting in the adult patient. Neurosurgical and oncologic management is still unclear. When feasible, surgical removal should always be performed to obtain a histologic diagnosis. Postoperative adjuvant therapy might entail both chemo- and radiotherapy; however a consensus on this matter is still lacking. PMID:27818821

  11. Clean coal technology promotion and dissemination

    Energy Technology Data Exchange (ETDEWEB)

    Minchener, A.J.; McMullan, J.T.; Kubica, K. (and others) [IEA Coal Research Ltd, London (United Kingdom)

    2008-07-01

    This project has provided a means to valorise the technical achievements of the CCT power generation RD&D activities arising from the ECSC and RFCS coal utilisation programmes. The focus has been on promotion and dissemination of such results to major coal-using Member States that have recently joined the European Union, namely Poland, the Czech Republic and Romania. A comprehensive review of the scope and achievements of the ECSC and RFCS projects on coal-fired power generation RD&D has been prepared and posted on the IEACCC website. This document has been translated by the partners in the three designated States and disseminated to their respective national stakeholders. Workshops have been held successfully in each country to promote the findings of the review and to determine their respective primary interests in future RD&D. The attendees have included representatives of major power plant operators, equipment manufacturers and developers, research institutes and universities. Very positive feedback was received from those stakeholders. The project has been completed with the circulation of the report and associated information to comparable stakeholders in the EU-15 countries and other newer members of the European Union via various networks and associations. 2 tabs., 3 apps.

  12. New trends in knowledge dissemination: TED Talks

    Directory of Open Access Journals (Sweden)

    Giuseppina Scotto di Carlo

    2014-05-01

    Full Text Available This paper investigates the key elements of ethos, pathos and logos linguistic strategies as some main features of TED (Technology, Entertainment, Design Talks, popularizing speeches aiming at Knowledge Dissemination. Through a comparison between the TED Talk ‘HIV - How to fight an epidemic of bad laws’, by Shereen El-Feki (2012a, and another speech held by the same author at the  2012 Symposia The Global Commission on HIV and the Law, addressed to specialists, the paper analyses TED Talks as an innovative tool of popularization, which breaches the typical triangularisation ‘scientist-mediator-audience’, bringing scientists directly into contact with their audiences. Drawing upon Aristotle’s three pillars of rhetoric, the paper analyses the strategies used to establish the ethos of the speech, by proposing a topic as morally worth of spreading; pathos, by creating a direct contact with the public; and logos, investigated through an analysis of the elements used to recontextualise scientific discourses into popularized speeches. The analysis suggests that TED Talks are a recodification, not a mere translation of texts; they are a means to disseminate knowledge reducing the asymmetry between audiences and scientists.

  13. Diagnosis and treatment of disseminated intravascular coagulation.

    Science.gov (United States)

    Levi, M

    2014-06-01

    Disseminated intravascular coagulation (DIC) is a condition in which systemic activation of coagulation without a specific localization occurs, resulting in extensive formation of intravascular fibrin, particularly in small and midsize vessels. Disseminated intravascular coagulation may lead to several altered coagulation parameters, including a low platelet count, abnormal global clotting assays, low levels of physiological anticoagulant proteases, or increased fibrin degradation products. Also, more complex assays for activation of coagulation factors or pathways may indicate involvement of these molecules in DIC. None of these tests alone, however, can accurately ascertain or rebuff a diagnosis of DIC. Nonetheless, a combination of readily available routine assays may be instrumental in establishing a diagnosis of DIC and can also be useful to point to a subset of patients with DIC that may need definite, often costly, interventions in the hemostatic system. Current insights on relevant etiological pathways that may contribute to the occurrence of DIC have led to innovative therapeutic and adjunctive approaches to patient with DIC. Management options directed at the amelioration of hemostatic activation may tentatively be indicated and were found to be advantageous in experimental and clinical investigations. These treatments encompass elimination of tissue factor-mediated thrombin generation or restitution of normal anticoagulant function.

  14. Hydrogen Technical Analysis -- Dissemination of Information

    Energy Technology Data Exchange (ETDEWEB)

    George Kervitsky, Jr.

    2006-03-20

    SENTECH is a small energy and environmental consulting firm providing technical, analytical, and communications solutions to technology management issues. The activities proposed by SENTECH focused on gathering and developing communications materials and information, and various dissemination activities to present the benefits of hydrogen energy to a broad audience while at the same time establishing permanent communications channels to enable continued two-way dialog with these audiences in future years. Effective communications and information dissemination is critical to the acceptance of new technology. Hydrogen technologies face the additional challenge of safety preconceptions formed primarily as a result of the crash of the Hindenburg. Effective communications play a key role in all aspects of human interaction, and will help to overcome the perceptual barriers, whether of safety, economics, or benefits. As originally proposed SENTECH identified three distinct information dissemination activities to address three distinct but important audiences; these formed the basis for the task structure used in phases 1 and 2. The tasks were: (1) Print information--Brochures that target the certain segment of the population and will be distributed via relevant technical conferences and traditional distribution channels. (2) Face-to-face meetings--With industries identified to have a stake in hydrogen energy. The three industry audiences are architect/engineering firms, renewable energy firms, and energy companies that have not made a commitment to hydrogen (3) Educational Forums--The final audience is students--the future engineers, technicians, and energy consumers. SENTECH will expand on its previous educational work in this area. The communications activities proposed by SENTECH and completed as a result of this cooperative agreement was designed to compliment the research and development work funded by the DOE by presenting the technical achievements and validations

  15. Calpains promote neutrophil recruitment and bacterial clearance in an acute bacterial peritonitis model.

    Science.gov (United States)

    Kumar, Vijay; Everingham, Stephanie; Hall, Christine; Greer, Peter A; Craig, Andrew W B

    2014-03-01

    Activation of the innate immune system is critical for clearance of bacterial pathogens to limit systemic infections and host tissue damage. Here, we report a key role for calpain proteases in bacterial clearance in mice with acute peritonitis. Using transgenic mice expressing Cre recombinase primarily in innate immune cells (fes-Cre), we generated conditional capns1 knockout mice. Consistent with capns1 being essential for stability and function of the ubiquitous calpains (calpain-1, calpain-2), peritoneal cells from these mice had reduced levels of calpain-2/capns1, and reduced proteolysis of their substrate selenoprotein K. Using an acute bacterial peritonitis model, we observed impaired bacterial killing within the peritoneum and development of bacteremia in calpain knockout mice. These defects correlated with significant reductions in IL-1α release, neutrophil recruitment, and generation of reactive oxygen species in calpain knockout mice with acute bacterial peritonitis. Peritoneal macrophages from calpain knockout mice infected with enterobacteria ex vivo, were competent in phagocytosis of bacteria, but showed impaired clearance of intracellular bacteria compared with control macrophages. Together, these results implicate calpains as key mediators of effective innate immune responses to acute bacterial infections, to prevent systemic dissemination of bacteria that can lead to sepsis.

  16. Bacterial Toxins as Pathogen Weapons Against Phagocytes.

    Science.gov (United States)

    do Vale, Ana; Cabanes, Didier; Sousa, Sandra

    2016-01-01

    Bacterial toxins are virulence factors that manipulate host cell functions and take over the control of vital processes of living organisms to favor microbial infection. Some toxins directly target innate immune cells, thereby annihilating a major branch of the host immune response. In this review we will focus on bacterial toxins that act from the extracellular milieu and hinder the function of macrophages and neutrophils. In particular, we will concentrate on toxins from Gram-positive and Gram-negative bacteria that manipulate cell signaling or induce cell death by either imposing direct damage to the host cells cytoplasmic membrane or enzymatically modifying key eukaryotic targets. Outcomes regarding pathogen dissemination, host damage and disease progression will be discussed.

  17. Bacterial toxins as pathogen weapons against phagocytes

    Directory of Open Access Journals (Sweden)

    Ana edo Vale

    2016-02-01

    Full Text Available Bacterial toxins are virulence factors that manipulate host cell functions and take over the control of vital processes of living organisms to favour microbial infection. Some toxins directly target innate immune cells, thereby annihilating a major branch of the host immune response. In this review we will focus on bacterial toxins that act from the extracellular milieu and hinder the function of macrophages and neutrophils. In particular, we will concentrate on toxins from Gram-positive and Gram-negative bacteria that manipulate cell signalling or induce cell death by either imposing direct damage to the host cells cytoplasmic membrane or enzymatically modifying key eukaryotic targets. Outcomes regarding pathogen dissemination, host damage and disease progression will be discussed.

  18. Mononuclear phagocytes contribute to intestinal invasion and dissemination of Yersinia enterocolitica.

    Science.gov (United States)

    Drechsler-Hake, Doreen; Alamir, Hanin; Hahn, Julia; Günter, Manina; Wagner, Samuel; Schütz, Monika; Bohn, Erwin; Schenke-Layland, Katja; Pisano, Fabio; Dersch, Petra; Autenrieth, Ingo B; Autenrieth, Stella E

    2016-09-01

    Enteropathogenic Yersinia enterocolitica (Ye) enters the host via contaminated food. After colonisation of the small intestine Ye invades the Peyer's patches (PPs) via M cells and disseminates to the mesenteric lymph nodes (MLNs), spleen and liver. Whether Ye uses other invasion routes and which pathogenicity factors are required remains elusive. Oral infection of lymphotoxin-β-receptor deficient mice lacking PPs and MLNs with Ye revealed similar bacterial load in the spleen 1h post infection as wild-type mice, demonstrating a PP-independent dissemination route for Ye. Immunohistological analysis of the small intestine revealed Ye in close contact with mononuclear phagocytes (MPs), specifically CX3CR1(+) monocyte-derived cells (MCs) as well as CD103(+) dendritic cells (DCs). This finding was confirmed by flow cytometry and imaging flow cytometry analysis of lamina propria (LP) leukocytes showing CD103(+) DCs and MCs with intracellular Ye. Uptake of Ye by LP CD103(+) DCs and MCs was dependent on the pathogenicity factor invasin, whereas the adhesin YadA was dispensable as demonstrated by Ye deletion mutants. Furthermore, Ye were found exclusively associated with CD103(+) DCs in the MLNs from wild-type mice, but not from CCR7(-/-) mice, demonstrating a CCR7 dependent transport of Ye by CD103(+) DCs from LP to the MLNs. In contrast, dissemination of Ye to the spleen was dependent on MCs as significantly less Ye could be recovered from the spleen of CX3CR1(GFP/GFP) mice compared to wild-type mice. Altogether, MCs and CD103(+) DCs contribute to immediate invasion and dissemination of Ye. This together with data from other bacteria suggests MPs as general pathogenic entry site in the intestine.

  19. An uncommon presentation of progressive disseminated histoplasmosis

    Directory of Open Access Journals (Sweden)

    Vijay Kumar Agarwal

    2016-01-01

    Full Text Available Progressive disseminated histoplasmosis (PDH caused by Histoplasma capsulatum generally develops in immunocompromised patients or those on long-term systemic corticosteroid therapy. Here, we report a case of PDH in an immunocompetent patient, which is a rare occurrence. A 56- year-old male patient, whose work often led him to caves, now reported with a low-grade fever and altered sensorium. Investigations revealed hyponatremia, bilateral adrenal enlargement, and mediastinal lymphadenopathy. A rare complication of the manifestations of histoplasmosis in an immunocompetent patient, in the form of ring lesions in the brain, came to light during the clinical investigations. The patient developed generalized tonic–clonic convulsions and needed care for the critical condition 2 weeks into treatment. This case report traces the clinical course, histological and serological findings, and response to amphotericin B therapy in the patient.

  20. Quinine-Induced Disseminated Intravascular Coagulation

    Directory of Open Access Journals (Sweden)

    Firas Abed

    2016-01-01

    Full Text Available Every drug comes with some side effect. It is the benefit/risk ratio that determines the medical use of the drug. Quinine, a known antimalarial drug, has been used for nocturnal leg cramps since the 1930s; it is associated with severe life-threatening hematological and cardiovascular side effects. Disseminated intravascular coagulation (DIC, albeit rare, is a known coagulopathy associated with Quinine. It is imperative to inquire about the Quinine intake in medication history in patients with coagulopathy, as most patients still consider it a harmless home remedy for nocturnal leg cramps. In this report, we present a case of coagulopathy in a middle-aged woman, who gave a history of taking Quinine for nocturnal leg cramps, as her home remedy. Early identification of the offending agent led to the diagnosis, prompt discontinuation of the medication, and complete recovery and prevented the future possibility of recurrence.

  1. Alpha particles for treatment of disseminated melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Link, E.M. [London Univ. (United Kingdom)

    2010-11-15

    Invading melanoma spreads to local and unpredictable distant location at the early stages of its development. It is justifiable, therefore to classify the disease as a systemic disorder. This requires a systemic treatment that reaches all melanoma cells irrespective of whether they are singly dispersed and in circulation or already forming solid tumours of various sizes. Targeted radiotherapy affects directly and selectively cancer cells provided an appropriate radionuclide and its carrier are chosen. Melanoma is a pigmented tumour. Methylene blue (MTB) accumulates selectively in melanoma cells due to its exceptionally high affinity to melanin. MTB serves, therefore, as a carrier for radionuclides. {sup 211}At-MTB has proved to be particularly effective in treating disseminated melanoma when administered systemically and, at the same time, non-toxic to normal non-pigmented and pigmented organs. (author)

  2. Alpha particles for treatment of disseminated melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Link, E.M. [London University (United Kingdom)

    2010-07-01

    Invading melanoma spreads to local and unpredictable distant location at the early stages of its development. It is justifiable, therefore, to classify the disease as a systemic disorder. This requires a systemic treatment that reaches all melanoma cells irrespective of whether they are singly dispersed and in circulation or already forming solid tumours of various sizes. Targeted radiotherapy affects directly and selectively cancer cells provided an appropriate radionuclide and its carrier are chosen. Melanoma is a pigmented tumour. Methylene blue (MTB)) accumulates selectively in melanoma cells due to its exceptionally high affinity to melanin. MTB serves, therefore, as a carrier for radionuclides. {sup 211}At-MTB has proved to be particularly effective in treating disseminated melanoma when administered systemically and, at the same time, non-toxic to normal non-pigmented and pigmented organs. (authors)

  3. Multilocular disseminated tarlov cysts: importance of imaging.

    Science.gov (United States)

    Padma, Subramanyam; Sundaram, P Shanmuga

    2014-01-01

    With technological advancements and wider availability of multimodality imaging, incidental lesions are frequently identified in patients undergoing various imaging studies. We report here a case of multiloculated disseminated perineural or Tarlov cysts (TCs). The primary aim of our study was to (1) provide a comprehensive review of the clinical, imaging and histopathological features of TCs (2) to draw attention to the fact that multiple lumbo-sacral and dorsal TCs can produce nerve injuries and serious movement disturbances (3) to document the usefulness of the magnetic resonance imaging (MRI) and bone scan in noninvasive diagnosis and guiding management in such cases. These cysts are clearly identified by MR and computerized tomography imaging of the lumbosacral spine. However, there are no reports on the scintigraphic findings of TCs in literature. TCs are typically benign, asymptomatic lesions that can simply be monitored. Until date, no consensus exists about the best surgical strategy to be followed for their management.

  4. Telemedicine: challenges to dissemination in Brazil

    Directory of Open Access Journals (Sweden)

    Jose Manuel Santos de Varge Maldonado

    Full Text Available Abstract: Telemedicine has been seen as an important tool for facing the challenges of universal health systems. The goal of this article is to discuss the main challenges to its full dissemination in Brazil. Being a somewhat new area, there are not many scientific papers that systematize it. This article is an exploratory paper, as it aims to provide an overall perspective on the subject. From an economic point of view, telemedicine is a strategic area due to its an intrinsic potential of being a source for generating innovation, for requiring and incorporating technological breakthroughs from other areas, and for its interdisciplinary nature and dynamic inter-relations that drive different industries. From the social perspective, it has the potential to make access to health services democratic, by connecting remote regions with health services located in hospitals and centers of reference for prevention, diagnosis and treatment.

  5. Ventricular metastasis resulting in disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Davis Ian D

    2005-05-01

    Full Text Available Abstract Background Disseminated Intravascular Coagulation (DIC complicates up to 7% of malignancies, the commonest solid organ association being adenocarcinoma. Transitional Cell Carcinoma (TCC has rarely been associated with DIC. Case presentation A 74-year-old woman with TCC bladder and DIC was found to have a cardiac lesion suspicious for metastatic disease. The DIC improved with infusion of plasma and administration of Vitamin K, however the cardiac lesion was deemed inoperable and chemotherapy inappropriate; given the patients functional status. We postulate that direct activation of the coagulation cascade by the intraventricular metastasis probably triggered the coagulopathy in this patient. Conclusion Cardiac metastases should be considered in cancer patients with otherwise unexplained DIC. This may influence treatment choices.

  6. [Disseminated intravascular coagulation: clinical and biological diagnosis].

    Science.gov (United States)

    Touaoussa, Aziz; El Youssi, Hind; El Hassani, Imane; Hanouf, Daham; El Bergui, Imane; Zoulati, Ghizlane; Amrani Hassani, Moncef

    2015-01-01

    Disseminated intravascular coagulation (DIC) is a syndrome characterized by the systemic activation of blood coagulation. Its pathophysiological mechanisms are complex and dependent on the underlying pathology, making the clinical and biological expression of quite variable DIC. Among the various biological parameters disrupted, most are not specific, and none of them allows in itself to make the diagnosis. All this does not facilitate the task of the practitioner for diagnosis of overt DIC, much less that of the non-overt DIC, early stage whose treatment would improve the prognosis. These considerations have led to develop scores, combining several parameters depending on their availability in daily practice, as well as their diagnostic relevance. Of all the scores, the ISTH (International society of thrombosis and hemostasis) remains the most used.

  7. Subcapsular sinus macrophages limit acute gammaherpesvirus dissemination.

    Science.gov (United States)

    Frederico, Bruno; Chao, Brittany; Lawler, Clara; May, Janet S; Stevenson, Philip G

    2015-08-01

    Lymphocyte proliferation, mobility and longevity make them prime targets for virus infection. Myeloid cells that process and present environmental antigens to lymphocytes are consequently an important line of defence. Subcapsular sinus macrophages (SSMs) filter the afferent lymph and communicate with B-cells. How they interact with B-cell-tropic viruses is unknown. We analysed their encounter with murid herpesvirus-4 (MuHV-4), an experimentally accessible gammaherpesvirus related to Kaposi's sarcoma-associated herpesvirus. MuHV-4 disseminated via lymph nodes, and intranasally or subcutaneously inoculated virions readily infected SSMs. However, this infection was poorly productive. SSM depletion with clodronate-loaded liposomes or with diphtheria toxin in CD169-diphtheria toxin receptor transgenic mice increased B-cell infection and hastened virus spread to the spleen. Dendritic cells provided the main route to B-cells, and SSMs slowed host colonization, apparently by absorbing virions non-productively from the afferent lymph.

  8. Data Dissemination in Mobile Computing Environment

    Directory of Open Access Journals (Sweden)

    Dr A. Venugopal Reddy

    2009-07-01

    Full Text Available Data dissemination in asymmetrical communicationenvironment, where the downlink communication capacity ismuch greater than the uplink communication capacity, is bestsuited for mobile environment. In this architecture there will bea stationary server continuously broadcasting different dataitems over the air. The mobile clients continuously listen to thechannel and access the data of their interest whenever itappears on the channel and download the same. The typicalapplications of such architecture are stock market information,weather information, traffic information etc. The importantissue that is to be addressed in this type of data disseminationis – how quickly the mobile clients access the data item of theirinterest i.e. minimum access time so that the mobile clients savethe precious battery power while they are on mobile. Thispaper reviews the various techniques for achieving theminimum access time. The advantages and disadvantages arediscussed and explored different research areas for achievingthe minimum access time.

  9. [Analysis of dissemination pathways for poliovirus].

    Science.gov (United States)

    Ohka, Seii

    2009-06-01

    Poliomyelitis is an acute disease of the central nervous system (CNS) caused by poliovirus (PV). In humans, an infection is initiated by oral ingestion of the virus, followed by multiplication in the alimentary mucosa, from which the virus spreads through the bloodstream. Paralytic poliomyelitis initiates from the invasion of the central nervous system by circulating poliovirus, probably via the blood-brain barrier. After the virus enters the central nervous system, it replicates in neurons, especially in motor neurons, inducing the cell death that causes paralytic poliomyelitis. Along with this route of dissemination, a neuron-specific pathway has been reported in humans, monkeys, and PV-sensitive transgenic (Tg) mice carrying the PV receptor (hPVR/CD155) gene. It is important for the efficient virus dissemination to overcome the barriers as follows; i) to access the target tissue, ii) to enter the cells, iii) to reach the place for the replication, iv) to replicate efficiently. PV is easily transferred to humans orally; however, no rodent model for oral infections has been developed. We analyzed the each barrier above, and showed that PV is inactivated by the low pH of the gastric contents in mice. We also demonstrated that type 1 interferon signaling plays an important role in determining permissivity in the alimentary tract. As for the neural pathway, we demonstrated that direct efficient interaction between the cytoplasmic domain and cytoplasmic dynein is essential for the efficient retrograde transport of PV-containing vesicles along microtubules for the hPVR-dependent PV transport. On the other hand, we found that hPVR-independent axonal transport of PV was also observed in hPVR-Tg and non-Tg mice, indicating that several different pathways for PV axonal transport exist.

  10. Intracranial germinoma with ventricular system dissemination

    Directory of Open Access Journals (Sweden)

    Shi-yun CHEN

    2014-05-01

    Full Text Available Objective To study the clinical, neuroimaging and histopathological features of intracranial germinoma.  Methods One case of intracranial germinoma with ventricular system dissemination was reported, and related literatures were reviewed.  Results A 34-year-old male complained of progressive dizziness for 30 d and manifested unsteady gait for 45 d. Radiological examinations revealed low signal intensity on T1WI and hyperintense on T2WI in the corpus callosum, left cerebellum, around the fourth ventricle, aqueduct mesencephalon, the ventral pons and pineal region, with even or uneven enhancement after contrast. The clinical initial diagnosis was "intracranial multiple focal lesions and high possibility of multiple sclerosis". After well response to glucocorticoid impact and dehydration, the patient stopped taking drugs but presented relapse and exacerbation. Later, he underwent biopsy on pineal region and was diagnosed as intracranial germinoma. Microscopically, the big germ cells and lymphocytes coexisted. Tumor cells were epithelioid cells with transparent cytoplasm, prominent nuclei and mitotic activity. Lymphocytes were distributed along interstitial substance of vessel and fiber, and individual syncytiotrophoblasts were sprasely distributed. Immunohistochemical staining showed tumor cells were positive for CD117 and OCT3/4, and the syncytiotrophoblasts were positive for β-human chorionic gonadotropin ( β-hCG. The clinical symptoms were completely alleviated after radiotherapy and chemotherapy.  Conclusions Because of the sensitivity for radiotherapy and chemotherapy, intracranial germinoma can be diagnosed and treated early to improve its prognosis. However, it is very easy to disseminate along with ventricular system and form multiple lesions, leading to atypical clinical and imaging manifestations, which is a big challenge for clinical diagnosis. doi: 10.3969/j.issn.1672-6731.2014.05.010

  11. Photoletter to the editor: Disseminated histoplasmosis with initial oral manifestations

    OpenAIRE

    Sinha, Surabhi; Sardana, Kabir; Vijay K Garg

    2013-01-01

    Histoplasmosis is a systemic fungal disease that may present in a variety of clinical manifestations. Involvment of the oral mucosa is very rare and may occur as part of disseminated histoplasmosis or as isolated involvement. We present a patient with disseminated histoplasmosis, in whom oral lesions were the initial manifestation of the disease.

  12. Disseminated histoplasmosis in a Danish patient with AIDS

    DEFF Research Database (Denmark)

    Smith, E; Franzmann, M; Mathiesen, Lars Reinhardt

    1989-01-01

    We present the first case of disseminated histoplasmosis in an AIDS patient in Europe, a 33-year-old Danish homosexual man, and recommend a detailed travel history in HIV-positive patients presenting with fever, weight loss and organomegaly. In Scandinavia disseminated histoplasmosis is rare...

  13. A directional data dissemination protocol for vehicular environments

    NARCIS (Netherlands)

    Schwartz, Ramon S.; Barbosa, Rafael R.R.; Meratnia, Nirvana; Heijenk, Geert; Scholten, Hans

    2011-01-01

    This paper presents a simple and robust dissemination protocol that efficiently deals with data dissemination in both dense and sparse vehicular networks. Our goal is to address highway scenarios where vehicles equipped with sensors detect an event, e.g., a hazard and broadcast an event message to a

  14. Cultivating Change: Disseminating Innovation in Higher Education Teaching and Learning

    Science.gov (United States)

    Gannaway, Deanne; Hinton, Tilly; Berry, Bianca; Moore, Kaitlin

    2013-01-01

    Effective dissemination is crucial if innovation and development in teaching and learning in higher education are to lead to sustainable changes in practice. In 2003, King used an agricultural metaphor to challenge innovators to understand the purposes behind their dissemination aims. Similar to the way that seed can be spread, one could choose to…

  15. Fair and adaptive data dissemination for traffic information systems

    NARCIS (Netherlands)

    Schwartz, Ramon S.; Ohazulike, Anthony E.; Sommer, Christoph; Scholten, Hans; Dressler, Falko; Havinga, Paul

    2012-01-01

    Vehicular Ad-hoc Networks (VANETs) are expected to serve as support to the development of not only safety applications but also information-rich applications that disseminate relevant data to vehicles. Due to the continuous collection, processing, and dissemination of data, one crucial requirement i

  16. Host defence against disseminated and invasive Candida albicans infections

    NARCIS (Netherlands)

    Vonk, Alouise Gabrielle

    2004-01-01

    The yeast Candida albicans is the primary etiologic agent of disseminated and invasive candidiasis. The incidence of disseminated and invasive candidiasis has paralleled the use of modern medical procedures that adversely affect the immune system, and highlights the difficulty of treating disseminat

  17. Disseminated Fusariosis Occurring in Two Patients Despite Posaconazole Prophylaxis▿

    OpenAIRE

    Bose, Prithviraj; Parekh, Hiral D.; Holter, Jennifer L.; Greenfield, Ronald A.

    2011-01-01

    Posaconazole is widely used for prophylaxis against invasive fungal infections in patients undergoing myeloablative therapy. Disseminated fusariosis is a serious invasive mold infection in such patients. Preclinical and clinical studies indicate activity of posaconazole against Fusarium. We describe two cases of disseminated fusariosis that occurred despite posaconazole prophylaxis.

  18. DDDRC: decentralised data dissemination in VANET using raptor codes

    Science.gov (United States)

    Kumar, Rakesh; Dave, Mayank

    2015-06-01

    The design of data dissemination protocol has been a great challenge due to the highly dynamic and unreliable wireless channel in vehicular ad hoc networks (VANET). In literature, several interesting solutions are proposed to perform data dissemination for this environment. But these solutions either use architectures requiring centralised coordination or global network knowledge or large intermediate buffers. In this paper, we propose a decentralised technique that overcomes above requirements and provides reliable and scalable communication in both dense and sparse traffic for VANET. Random walks are used in the proposed technique to disseminate data from one vehicle to other vehicles in the network. We use raptor codes to provide low decoding complexity and more scalability for data dissemination. Simulation results demonstrate that the proposed technique has better fault tolerance with lower complexity than general random-walk-based dissemination process and more scalability as compared to the other protocols.

  19. DISSEMINATING MULTICULTURALISM THROUGH THE TEACHING OF TRANSLATION

    Directory of Open Access Journals (Sweden)

    Arido Laksono

    2013-12-01

    Full Text Available 800x600 ABSTRACT Students are expected to change the world. Their perspectives represent the way they view the world and its phenomena. The broader knowledge they possess, the more tolerance they have in interpreting life. In the global era, students should understand the importance of having good knowledge in multiculturalism. They will involve in an inter-cultural encounter since sources of information are widely offered. The willingness to have such an open mind is required in order to develop a better place to live and work. One way to disseminate multiculturalism values is using text containing information about culture and social values. The text written in English or Bahasa Indonesia for the class designed in disseminating multiculturalism is Translation. Here, students are taught to interpret the messages conveyed and translate the information from the source language to the target language correctly. Teacher must have good and creative technique in delivering the material so that students really enjoy the class and deeply understand the topic. The teaching and learning process in Translation class, therefore, is an effective medium to achieve the expected purpose as stated above. Theory of translation will not be the one and only theory to do the translation job, but it also needs comprehensive knowledge on other social sciences. Hence, translation class will not only discuss lines of words in a paragraph, but also reciprocal discussion among the members of the class. At the end, students will have the ability to translate such information in a text correctly and to establish civic society with more open comprehension over society and its culture. Keywords: theory of translation, multiculturalism, teaching-learning process, globalization. Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0

  20. The importance of serological tests implementation in disseminated candidiasis diagnose.

    Science.gov (United States)

    Gegić, Merima; Numanović, Fatima; Delibegović, Zineta; Tihić, Nijaz; Nurkić, Mahmut; Hukić, Mirsada

    2013-03-01

    Candidiasis is defined as an infection or disease caused by a fungus of the genus Candida. Rate of disseminated candidiasis increases with the growth of the number of immunocompromised patients. In the the last few decades the incidence of disseminated candidiasis is in growth as well as the mortality rate. The aim of this survey is to show the importance of serological tests implementation in disseminated candidiasis diagnose. This is a prospective study involving 60 patients with malign diseases with and without clinical signs of disseminated candidiasis and 30 healthy people who represent the control group. Apart from hemoculture, detection of circulating mannan antigen and adequate antibodies of Candida species applying comercial ELISA test was determined in each patient. This survey deals with relevant factors causing disseminated candidiasis. This survey showed that the group of patients with clinical signs of disseminated candidiasis had more patients with positive hemoculture to Candida species, then the group of patients without clinical signs of disseminated candidiasis. The number of patients being examined and positive to antigens and antibodies was higher (p candidiasis (7/30; 23.3%), then in the group of patients without clinical signs of disseminated candidiasis (0/30; 0%): Average value of titra antigen was statistically higher (p candidiasis 6/30 (20%) of patients had Candida spp.positive hemocultures while in the group of patients without clinical signs of disseminated candidiasis 1/30 (3.3%) of patients had Candida spp. positive hemocultures, which was considerably higher (p candidiasis were statistically significant, while correlation of results of hemoculture and antibodies was insignificant. Because of low sensitivity of hemoculture and time needed for isolation of Candida spp., introducing serological tests in regular procedures would speed disseminated candidiasis diagnose.

  1. Hawaii Educational Dissemination Diffusion System: An Action Report. Hawaii State Dissemination Conference, Hawaii Department of Education (Honolulu, Hawaii, October 1979).

    Science.gov (United States)

    Northwest Regional Educational Lab., Portland, OR.

    The first intensive exposure to organized dissemination at the state, regional, and national level for many of the participants, this 2-day conference consisted of a series of sessions held in Honolulu and neighboring islands. Explanations of how these dissemination efforts are organized and operated were followed by detailed information on the…

  2. Imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome%艾滋病并发肺结核播散的影像表现

    Institute of Scientific and Technical Information of China (English)

    宋文艳; 赵祖琦; 赵大伟; 刘晋新; 官宛华; 梁艺; 贾翠宇; 张瑞池

    2013-01-01

    Objective To study the imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS).Methods X-ray and multi-slice CT (MSCT)data from 33 AIDS patients with disseminated pulnonary tuberculosis confirmed by clinical manifestations and laboratory tests were analyzed retrospectively.Results Thirty patients underwent initial chest radiography examination,29 patients showed abnormal appearances,including bilateral disseminations in 21 patients and unilateral multiple disseminations in 8 patients.All patients underwent MSCT examination,26 patients showed bilateral disseminations and 7 patients showed unilateral multiple disseminations.The abnormal pulmonary appearances included nodule (n =25),miliary nodule (n =22),air-space consolidation (n =22),cavity (n =11),fibrosis (n =7),ground-glass opacity (n =7),pneumatocele (n =4),calcification (n =2).There were 20 patients with more than 3 abnormal appearances and 13 patients with one or two abnormal appearances.The extra-pulmonary tuberculosis included pleural effusion (n =33),lymphadenopathy (n =30),intestinal tuberculosis (n =3),splenic tuberculosis (n =1) and cerebral tuberculosis (n =1).Conclusion Disseminated pulmonary tuberculosis should be highly suspected in AIDS patients with diffused nodules,miliary nodules,air-space consolidations or multiple cavities,accompanied with pleural effusion and lymphadenopathy.%目的 探讨艾滋病(AIDS)并发肺结核肺内播散的影像特点.方法 回顾性分析经临床及实验室检查证实的33例AIDS并发肺结核肺内播散的X线胸片及MSCT影像资料,总结其影像表现特征.结果 首诊X线胸片检查30例,29例表现异常,包括病灶呈双侧播散性分布21例,单侧多发病变8例.所有患者均行MSCT扫描,病变呈单侧和双侧肺内多发分布分别为7例和26例;病变形态包括结节(25例)、粟粒(22例)、气腔实变(22例)、空洞(11例)、纤维索条(7例)、磨玻璃影(7

  3. Local and disseminated acute phase response during bacterial respiratory infection in pigs

    DEFF Research Database (Denmark)

    Skovgaard, Kerstin; Mortensen, Shila; Heegaard, Peter M. H.

    2010-01-01

    The acute phase response is playing an important role, aiming to restore the healthy state after tissue injury, inflammation and infection. The biological function of this response and its interplay with other parts of innate defense reactions remain somewhat elusive. Expression of acute phase pr......-types in the organism are involved in production of APP and further supports that extrahepatic APP might be important players of the innate defence system....

  4. Acute disseminated encephalomyelitis: a comprehensive review

    Directory of Open Access Journals (Sweden)

    LIU Zheng

    2013-09-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM is a disease that is characterized by an immune-mediated inflammatory reaction and demyelination in the central nervous system, including optic nerve, brain and spinal cord, which is common in children, but also appears in adults. ADEM happens probably with a causative relationship to viral diseases or prior vaccinations. It can also occur without any cause. The clinical symptoms of ADEM can begin with fever, headache and meningeal signs, followed by abnormal mental status, seizures and focal neurological signs, such as limb pareses, visual decline and speech disturbances. And their clinical courses may be monophasic, recurrent or multiphasic, mild but also very aggressive. Neuroimaging may be characterized by large demyelinating lesions in the brain involving both the white and the grey matter, and spinal cord. Lesions in ADEM are typically large globular lesions, multiple, and asymmetric, partially with diffuse or ring-like gadolinium enhancement. The diagnosis of ADEM requires both multifocal involvement and encephalopathy by consensus criteria. The differential diagnoses of ADEM include a variety of disorders, such as viral encephalitis, multiple sclerosis, neuromyelitis optica spectrum disorders and primary central nervous system vasculitis, etc. Treatments of ADEM include corticosteroids, intravenous immunoglobulin, plasmapheresis and other immunosuppressive agents.

  5. Laboratory testing in disseminated intravascular coagulation.

    Science.gov (United States)

    Favaloro, Emmanuel J

    2010-06-01

    The diagnosis of disseminated intravascular coagulation (DIC) relies on clinical signs and symptoms, identification of the underlying disease, the results of laboratory testing, and differentiation from other pathologies. The clinical features mainly depend on the underlying cause of the DIC. The laboratory diagnosis of DIC uses a combination of tests because no single test result alone can firmly establish or rule out the diagnosis. Global tests of hemostasis may initially provide evidence of coagulation activation and later in the process provide evidence of consumption of coagulation factors, but their individual diagnostic efficiency is limited. Fibrinolytic markers, in particular D-dimer, are reflective of activation of both coagulation and fibrinolysis, so that a normal finding can be useful for ruling-out DIC. Decreased levels of the natural anticoagulants (in particular, antithrombin and protein C) are frequently observed in patients with DIC, but their measurement is not normally incorporated into standard diagnostic algorithms. New tests are being explored for utility in DIC, and some additional tests may be useful on a case-by-case basis, depending on the proposed cause of the DIC or their local availability. For example, clot waveform analysis is useful but currently limited to a single instrument. Also, procalcitonin is an inflammatory biomarker that may be useful within the context of septic DIC, and activated factor X clotting time is an emerging test of procoagulant phospholipids that also seems to hold promise in DIC.

  6. Acute disseminated encephalomyelitis; Akute disseminierte Enzephalomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Politi, M.; Papanagiotou, P.; Grunwald, I.Q.; Roth, C.; Reith, W. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2008-06-15

    Acute disseminated encephalomyelitis (ADEM) is an acute widespread autoimmune demyelinating condition, which principally affects the white matter of the brain and spinal cord. It usually follows an infection or vaccination. The typical presentation is that of multifocal neurologic disturbances accompanied by change in mental status. CSF analysis reveals lymphocytic pleocytosis and elevated protein content, but may also yield normal results. MRI is regarded as the diagnostic imaging modality of choice and typically demonstrates involvement of deep cerebral hemispheric and subcortical white matter as well as lesions in the basal ganglia, gray-white junction, diencephalon, brainstem, cerebellum and spinal cord. Unlike multiple sclerosis (MS), ADEM has a monophasic course and a favorable long-term prognosis. (orig.) [German] Die akute disseminierte Enzephalomyelitis (ADEM) ist eine akut auftretende autoimmune demylinisierende Erkrankung der weissen Substanz, die hauptsaechlich Gehirn und Rueckenmark befaellt. Ueblicherweise tritt sie nach einer Infektion oder Impfung auf. Die Entwicklung einer fokalen oder multifokalen neurologischen Funktionsstoerung ist das Kennzeichen der klinischen Praesentation der ADEM. Lymphozytaere Pleozytose und Eiweisserhoehung sind typische Befunde in der Liquoruntersuchung. Die Magnetresonanztomographie (MRT) ist die Untersuchungsmethode der Wahl. Die ADEM-Laesionen sind typischerweise gross, multipel und asymmetrisch. Sie koennen in den Gross- und Kleinhirnhemisphaeren, im Hirnstamm und im Rueckenmark lokalisiert sein. Die subkortikale und die zentrale weisse Substanz sind am haeufigsten befallen. Weniger haeufig ist die graue Substanz der Thalami und der Basalganglien betroffen. Im Gegensatz zur Multiplen Sklerose (MS) ist die Prognose der ADEM im Allgemeinen guenstig. (orig.)

  7. Modeling news dissemination on nuclear issues

    Energy Technology Data Exchange (ETDEWEB)

    Reis Junior, Jose S.B.; Barroso, Antonio C.O.; Menezes, Mario O., E-mail: jsbrj@ime.usp.b, E-mail: barroso@ipen.b, E-mail: mario@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-07-01

    Using a modified epidemiological model, the dissemination of news by media agents after the occurrence of large scale disasters was studied. A modified compartmented model was developed in a previous paper presented at INAC 2007. There it used to study to the Chernobyl's nuclear accident (1986) and the Concorde airplane crash (2000). Now the model has been applied to a larger and more diverse group of events - nuclear, non-nuclear and naturally caused disasters. To be comprehensive, old and recent events from various regions of the world were selected. A more robust news repository was used, and improved search techniques were developed to ensure that the scripts would not count false positive news. The same model was used but with improved non-linear embedded simulation optimization algorithms to generate the parameters of interest for our model. Individual parameters and some specific combination of them allow some interesting perceptions on how the nature of the accident / disaster gives rise to different profiles of growth and decay of the news. In our studies events involving nuclear causes generate news repercussion with more explosive / robust surge profiles and longer decaying tails than those of other natures. As a consequence of these differences, public opinion and policy makers are also much more sensitive to some issues than to others. The model, through its epidemiological parameters, shows in quantitative manner how 'nervous' the media content generators are with respect to nuclear installations and how resilient this negative feelings about nuclear is. (author)

  8. Dissemination and experience with cognitive processing therapy

    Directory of Open Access Journals (Sweden)

    Kathleen M. Chard, PhD

    Full Text Available Clinical practice guidelines suggest that cognitive behavioral therapies are recommended for the treatment of posttraumatic stress disorder (PTSD. One of these treatments, cognitive processing therapy (CPT, is an evidence-based treatment that has been shown to be effective at treating combat, assault, and interpersonal violence trauma in randomized controlled trials. The Department of Veterans Affairs (VA Office of Mental Health Services has implemented an initiative to disseminate CPT as part of a broad effort to make evidence-based psychotherapies widely available throughout the VA healthcare system. This article provides an overview of CPT and reviews the efficacy and program evaluation data supporting its use in a variety of settings. In addition, we report on survey data from individuals who have participated in the VA initiative and on outcome data from patients treated by rollout-trained therapists. Our data suggest that many clinicians trained in the rollout show good adoption of the CPT model and demonstrate solid improvements in their patients’ PTSD and depressive symptomotology. Finally, we offer recommendations for using CPT in clinical settings.

  9. Vasogenic edema characterizes pediatric acute disseminated encephalomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Zuccoli, Giulio; Panigrahy, Ashok; Sreedher, Gayathri; Bailey, Ariel [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Section of Neuroradiology, Pittsburgh, PA (United States); Laney, Ernest John [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Section of Neuroradiology, Pittsburgh, PA (United States); Rush University Medical Center, Department of Diagnostic Radiology, Chicago, IL (United States); La Colla, Luca [University of Parma, Department of Anesthesiology, Parma (Italy); UPMC Shadyside Hospital, Department of Emergency Medicine, Pittsburgh, PA (United States); Alper, Gulay [Children' s Hospital of Pittsburgh of UPMC, Department of Pediatric Neurology, Neuroimmunology Clinic, Pittsburgh, PA (United States)

    2014-08-15

    MR imaging criteria for diagnosing acute disseminated encephalomyelitis (ADEM) have not been clearly established. Due to the wide spectrum of differential considerations, new imaging features allowing early and accurate diagnosis for ADEM are needed. We hypothesized that ADEM lesions would be characterized by vasogenic edema due to the potential reversibility of the disease. Sixteen patients who met the diagnostic criteria for ADEM proposed by the International Pediatric Multiple Sclerosis Study Group (IPMSSG) and had complete MR imaging studies performed at our institution during the acute phase of the disease were identified retrospectively and evaluated by experienced pediatric neuroradiologists. Vasogenic edema was demonstrated on diffusion-weighted imaging (DWI) and corresponding apparent diffusion coefficient (ADC) maps in 12 out of 16 patients; cytotoxic edema was identified in two patients while the other two patients displayed no changes on DWI/ADC. ADC values for lesions and normal-appearing brain tissue were 1.39 ± 0.45 x 10{sup -3} and 0.81 ± 0.09 x 10{sup -3} mm/s{sup 2}, respectively (p = 0.002). When considering a cutoff of 5 days between acute and subacute disease, no difference between ADC values in acute vs. subacute phase was depicted. However, we found a significant correlation and an inverse and significant relationship between time and ADC value. We propose that vasogenic edema is a reliable diagnostic sign of acute neuroinflammation in ADEM. (orig.)

  10. Identification of Mycobacterium tuberculosis in Clinical Specimens of Patients Suspected of Having Extrapulmonary Tuberculosis by Application of Nested PCR on Five Different Genes.

    Science.gov (United States)

    Khosravi, Azar D; Alami, Ameneh; Meghdadi, Hossein; Hosseini, Atta A

    2017-01-01

    Definitive and rapid diagnosis of extrapulmonary tuberculosis (EPTB) is challenging since conventional techniques have limitations due to the paucibacillary nature of the disease. To increase the sensitivity of detection of Mycobacterium tuberculosis (MTB) in EPTB specimens, we performed a nested PCR assay targeting several genes of MTB on EPTB specimens. A total of 100 clinical specimens from suspected cases of EPTB were processed. Standard staining for acid fast bacilli (AFB) was performed as the preliminary screening test. Extracted DNAs from specimens were subjected to Nested PCR technique for the detection of five different MTB target genes of IS6110, IS1081, hsp65kd, mbp64, and mtp40. On performing AFB staining, only 13% of specimens were positive, of which ascites fluid (33.3%), followed by pleural effusion (30.8%) showed the greatest AFB positivity rate. We demonstrated slight improvement in yields in lymph node which comprised the majority of specimens in this study, by employing PCR targeted to IS6110- and hsp65-genes in comparison to AFB staining. However, the yields in ascites fluid and pleural effusion were not substantially improved by PCR, but those from bone and wound were, as in nested PCR employing either gene, the same positivity rate were obtained for ascites fluid (33.3%), while for pleural effusion specimens only IS1081 based PCR showed identical positivity rate with AFB stain (30.8%). The results for bone and wound specimens, however, demonstrated an improved yield mainly by employing IS1081 gene. Here, we report higher detection rate of EPTB in clinical specimens using five different targeted MTB genes. This nested PCR approach facilitates the comparison and the selection of the most frequently detected genes. Of course this study demonstrated the priority of IS1081 followed by mtp40 and IS6110, among the five tested genes and indicates the effectiveness of any of the three genes in the design of an efficient nested-PCR test that facilitates

  11. Identification of Mycobacterium tuberculosis in Clinical Specimens of Patients Suspected of Having Extrapulmonary Tuberculosis by Application of Nested PCR on Five Different Genes

    Science.gov (United States)

    Khosravi, Azar D.; Alami, Ameneh; Meghdadi, Hossein; Hosseini, Atta A.

    2017-01-01

    Definitive and rapid diagnosis of extrapulmonary tuberculosis (EPTB) is challenging since conventional techniques have limitations due to the paucibacillary nature of the disease. To increase the sensitivity of detection of Mycobacterium tuberculosis (MTB) in EPTB specimens, we performed a nested PCR assay targeting several genes of MTB on EPTB specimens. A total of 100 clinical specimens from suspected cases of EPTB were processed. Standard staining for acid fast bacilli (AFB) was performed as the preliminary screening test. Extracted DNAs from specimens were subjected to Nested PCR technique for the detection of five different MTB target genes of IS6110, IS1081, hsp65kd, mbp64, and mtp40. On performing AFB staining, only 13% of specimens were positive, of which ascites fluid (33.3%), followed by pleural effusion (30.8%) showed the greatest AFB positivity rate. We demonstrated slight improvement in yields in lymph node which comprised the majority of specimens in this study, by employing PCR targeted to IS6110- and hsp65-genes in comparison to AFB staining. However, the yields in ascites fluid and pleural effusion were not substantially improved by PCR, but those from bone and wound were, as in nested PCR employing either gene, the same positivity rate were obtained for ascites fluid (33.3%), while for pleural effusion specimens only IS1081 based PCR showed identical positivity rate with AFB stain (30.8%). The results for bone and wound specimens, however, demonstrated an improved yield mainly by employing IS1081 gene. Here, we report higher detection rate of EPTB in clinical specimens using five different targeted MTB genes. This nested PCR approach facilitates the comparison and the selection of the most frequently detected genes. Of course this study demonstrated the priority of IS1081 followed by mtp40 and IS6110, among the five tested genes and indicates the effectiveness of any of the three genes in the design of an efficient nested-PCR test that facilitates

  12. Strategies for Disseminating Qualitative Research Findings: Three Exemplars

    Directory of Open Access Journals (Sweden)

    Steven Keen

    2007-09-01

    Full Text Available Assuming there are those who do pay attention to the dissemination of qualitative research findings, what can we learn from them? For this article, we searched for examples of qualitative research where findings have been disseminated beyond the journal article and/or conference presentation. The rationale for pursuing examples of how good qualitative research has been disseminated is that we pay attention to both scientific and communicative concerns. All three exemplars in this article go beyond the forms of dissemination that traditionally serve academic communities and attempt to address the communicative concern of qualitative research findings. This is not to say that these modes of dissemination replace the scholarship of qualitative research and/or the peer-reviewed journal manuscript—far from it. In disseminating qualitative data, researchers have an array of presentational styles and formats to choose from that best fit their research purposes, such as drama, dance, poetry, websites, video and evocative forms of writing. We conclude by considering the ethical issues that may be involved in these forms of disseminating qualitative research, as well as the challenges for evaluating the impact of such strategies. URN: urn:nbn:de:0114-fqs0703174

  13. A Spread Willingness Computing-Based Information Dissemination Model

    Directory of Open Access Journals (Sweden)

    Haojing Huang

    2014-01-01

    Full Text Available This paper constructs a kind of spread willingness computing based on information dissemination model for social network. The model takes into account the impact of node degree and dissemination mechanism, combined with the complex network theory and dynamics of infectious diseases, and further establishes the dynamical evolution equations. Equations characterize the evolutionary relationship between different types of nodes with time. The spread willingness computing contains three factors which have impact on user’s spread behavior: strength of the relationship between the nodes, views identity, and frequency of contact. Simulation results show that different degrees of nodes show the same trend in the network, and even if the degree of node is very small, there is likelihood of a large area of information dissemination. The weaker the relationship between nodes, the higher probability of views selection and the higher the frequency of contact with information so that information spreads rapidly and leads to a wide range of dissemination. As the dissemination probability and immune probability change, the speed of information dissemination is also changing accordingly. The studies meet social networking features and can help to master the behavior of users and understand and analyze characteristics of information dissemination in social network.

  14. Cacades: A reliable dissemination protocol for data collection sensor network

    Science.gov (United States)

    Peng, Y.; Song, W.; Huang, R.; Xu, M.; Shirazi, B.; LaHusen, R.; Pei, G.

    2009-01-01

    In this paper, we propose a fast and reliable data dissemination protocol Cascades to disseminate data from the sink(base station) to all or a subset of nodes in a data collection sensor network. Cascades makes use of the parentmonitor-children analogy to ensure reliable dissemination. Each node monitors whether or not its children have received the broadcast messages through snooping children's rebroadcasts or waiting for explicit ACKs. If a node detects a gap in its message sequences, it can fetch the missing messages from its neighbours reactively. Cascades also considers many practical issues for field deployment, such as dynamic topology, link/node failure, etc.. It therefore guarantees that a disseminated message from the sink will reach all intended receivers and the dissemination is terminated in a short time period. Notice that, all existing dissemination protocols either do not guarantee reliability or do not terminate [1, 2], which does not meet the requirement of real-time command control. We conducted experiment evaluations in both TOSSIM simulator and a sensor network testbed to compare Cascades with those existing dissemination protocols in TinyOS sensor networks, which show that Cascades achieves a higher degree of reliability, lower communication cost, and less delivery delay. ??2009 IEEE.

  15. Metagenomic analysis of bacterial community composition and antibiotic resistance genes in a wastewater treatment plant and its receiving surface water.

    Science.gov (United States)

    Tang, Junying; Bu, Yuanqing; Zhang, Xu-Xiang; Huang, Kailong; He, Xiwei; Ye, Lin; Shan, Zhengjun; Ren, Hongqiang

    2016-10-01

    The presence of pathogenic bacteria and the dissemination of antibiotic resistance genes (ARGs) may pose big risks to the rivers that receive the effluent from municipal wastewater treatment plants (WWTPs). In this study, we investigated the changes of bacterial community and ARGs along treatment processes of one WWTP, and examined the effects of the effluent discharge on the bacterial community and ARGs in the receiving river. Pyrosequencing was applied to reveal bacterial community composition including potential bacterial pathogen, and Illumina high-throughput sequencing was used for profiling ARGs. The results showed that the WWTP had good removal efficiency on potential pathogenic bacteria (especially Arcobacter butzleri) and ARGs. Moreover, the bacterial communities of downstream and upstream of the river showed no significant difference. However, the increase in the abundance of potential pathogens and ARGs at effluent outfall was observed, indicating that WWTP effluent might contribute to the dissemination of potential pathogenic bacteria and ARGs in the receiving river.

  16. A CASE OF DISSEMINATED HISTOPLASMOSIS IN AN IMMUNOCOMPETENT PERSON

    Directory of Open Access Journals (Sweden)

    Debkumar

    2014-06-01

    Full Text Available Histoplasmosis is a fungal disease caused by Histoplasma capsulatum. Most infections are asymptomatic or self-limiting but some may develop acute pulmonary infections or severe and progressive disseminated infection. Disseminated histoplasmosis frequently affects the adrenal gland; however, unilateral involvement in immunosuppressed patients is the usual presentation. We report a case of a middle aged immunocompetent male with history of weight loss, fever, hepatomegaly and bilateral adrenal mass who was diagnosed to be suffering from disseminated histoplasmosis and successfully treated with Itraconazole

  17. Coexistence of disseminated granuloma annulare and asymptomatic multiple myeloma

    Directory of Open Access Journals (Sweden)

    Şebnem Aktan

    2013-09-01

    Full Text Available Granuloma annulare (GA is a benign inflammatory dermatosis of unknown cause, characterized by necrobiotic dermal papules. Several morphologic forms of GA including localized, disseminated, linear, nodular, perforating, subcutaneous, pustular and arcuate dermal erythema have been reported in the literature. Disseminated GA, a rarely seen form, has been reported in association with some hematopoietic and solid malignancies; however, it has been suggested that the exact causative relationship between malignancy and GA is unclear. We present here a 66-year-old female patient with disseminated GA associated with asymptomatic multipl myeloma.

  18. Disseminated encephalomyelitis-like central nervous system neoplasm in childhood.

    Science.gov (United States)

    Zhao, Jianhui; Bao, Xinhua; Fu, Na; Ye, Jintang; Li, Ting; Yuan, Yun; Zhang, Chunyu; Zhang, Yao; Zhang, Yuehua; Qin, Jiong; Wu, Xiru

    2014-08-01

    A malignant neoplasm in the central nervous system with diffuse white matter changes on magnetic resonance imaging (MRI) is rare in children. It could be misdiagnosed as acute disseminated encephalomyelitis. This report presents our experience based on 4 patients (3 male, 1 female; aged 7-13 years) whose MRI showed diffuse lesions in white matter and who were initially diagnosed with acute disseminated encephalomyelitis. All of the patients received corticosteroid therapy. After brain biopsy, the patients were diagnosed with gliomatosis cerebri, primitive neuroectodermal tumor and central nervous system lymphoma. We also provide literature reviews and discuss the differentiation of central nervous system neoplasm from acute disseminated encephalomyelitis.

  19. Multi-Scale Dissemination of Time Series Data

    DEFF Research Database (Denmark)

    Guo, Qingsong; Zhou, Yongluan; Su, Li

    2013-01-01

    , which is an abstract indicator for both the physical limits and the amount of data that the subscriber would like to handle. To handle this problem, we propose a system framework for multi-scale time series data dissemination that employs a typical tree-based dissemination network and existing time......-series compression models. Due to the bandwidth limits regarding to potentially sheer speed of data, it is inevitable to compress and re-compress data along the dissemination paths according to the subscription level of each node. Compression would caused the accuracy loss of data, thus we devise several algorithms...

  20. Disseminated intravascular coagulation in burn injury.

    Science.gov (United States)

    Lippi, Giuseppe; Ippolito, Luigi; Cervellin, Gianfranco

    2010-06-01

    Disseminated intravascular coagulation (DIC) is a complex and multifaceted disorder characterized by the activation of coagulation and fibrinolytic pathways, consumption of coagulation factors, and depletion of coagulation regulatory proteins. The introduction into the circulation of cellular debris characterized by strong thromboplastic activity due to tissue factor exposition or release (in or from burned tissues), which can thereby activate extrinsic pathway of coagulation system and trigger massive thrombin generation when present in sufficient concentration, represents the most plausible biological explanation to support the development of intravascular coagulation in patients with burn injury. Severe burns left untreated might also lead to an immunological and inflammatory response (activation of the complement cascade), which can amplify fibrinolysis and blood clotting. Overall, the real prevalence of DIC in patients with burns is as yet unclear. Postmortem, retrospective, and even longitudinal investigations are in fact biased by several factors, such as the objective difficulty to establish whether DIC might have occurred as a primary complication of burns or rather as a consequence of other superimposed pathologies (e.g., sepsis, multiple organ failure), the different diagnostic criteria for assessing DIC, and the heterogeneity of the patient samples studied. Nevertheless, the current scientific evidence is consistent with the hypothesis that biochemical changes suggestive for DIC (hypercoagulability, hypo- and hyperfibrinolysis) are commonplace in patients with burn trauma, and their severity increases exponentially with the severity of injury. Overt DIC seems to occur especially in critically ill burn patients or in those with severe burns (up to third degree) and large involvement of body surface area, in whom an appropriate therapy might be effective to prevent the otherwise fulminant course. Although early prophylaxis with antithrombin concentrates

  1. Fatal disseminated toxoplasmosis in an immunocompetent cat

    Directory of Open Access Journals (Sweden)

    Susanna S. Nagel

    2013-02-01

    Full Text Available A 10-year-old domestic short hair cat was referred for investigation of anorexia and polydipsia of 3 days’ duration. Clinically the cat was obese, pyrexic (39.8 °C, had acute abdominal pain and severe bilirubinuria. Haematology and serum biochemistry revealed severe panleukopenia, thrombocytopenia, markedly elevated alanine aminotransferase (ALT and five-fold increased pre-prandial bile acids. Ultrasonographic evaluation of the abdomen did not identify any abnormalities. Serum tests for feline immunodeficiency virus (FIV and feline leukaemia virus (FeLV were negative. Broad-spectrum antibiotic treatment for infectious hepatitis was to no avail; the cat deteriorated and died 72 h after admission. Necropsy revealed mild icterus and anaemia, severe multifocal hepatic necrosis, serofibrinous hydrothorax, pulmonary oedema and interstitial pneumonia. Histopathology confirmed the macroscopic findings and revealed multifocal microgranulomata in the brain and myocardium, as well as areas of necrosis in lymph nodes and multifocally in splenic red pulp. Long bone shaft marrow was hyperplastic with a predominance of leukocyte precursors and megakaryocytes and splenic red pulp showed mild extramedullary haemopoiesis. Immunohistochemical staining for Toxoplasma gondii was strongly positive, with scattered cysts and tachyzoites in the liver, lymph nodes, spleen, lungs, brain, salivary glands and intracellularly in round cells in occasional blood vessels. Immunohistochemical staining for corona virus on the same tissues was negative, ruling out feline infectious peritonitis (FIP. Polymerase chain reaction (PCR on formalin-fixed paraffin-wax embedded tissues was positive for Toxoplasma sp., but attempts at sequencing were unsuccessful. This was the first case report of fulminant disseminated toxoplasmosis in South Africa, in which detailed histopathology in an apparently immunocompetent cat was described.

  2. VALUE OF INTERFERON-GAMMA RELEASE TEST IN DIAGNOSING EXTRAPULMONARY TUBERCULOSIS%干扰素γ释放试验诊断肺外结核的应用价值

    Institute of Scientific and Technical Information of China (English)

    贾晨光; 李秀武; 姚黎明; 刘建强; 黄俊; 陈银芳; 张雷

    2014-01-01

    Objective To compare the sensitivity of interferon gamma release test (IGRA) with suptum smear,sputum culture and tuberculin slcintest (TST ) in the diagnosis of extrapulmonary tuberculosis.To investigate the value of IGRA method in extrapulmonary tuberculosis.Methods Fresh peripheral blood samples were collected from 75 patients of clinically diagnosed extrapulmonary tuberculosis.The result was compared with those of traditional gold standard test methods (sputum smear and sputum culture,TST ),and their clinical application value further were analyzed.Results In 75 cases of extrapulmonary tuberculosis,the positive rate by IGRA reagent test was 84.0%,sputum smear 8.0%,sputum culture 5.3%,TST test 52.0%.The positive rate of IGRA was significantly higher than those of other common methods,and the differences were statistically significant (P<0.01).Conclusion In the diagnosis of extrapulmonary tuberculosis,the sensitivity of IGRA reagent is significantly higher than those of the traditional test methods,IGRA has a good clinical value.%目的:比较干扰素γ释放试验(interferon gamma release assay,IGRA)与结核菌染色涂片、结核菌培养、结核菌素试验(tuberculin skin test,TST)在肺外结核诊断中的敏感性,探讨 IGRA方法在肺外结核中的应用价值。方法采集75例经临床诊断为肺外结核病患者的新鲜外周血,将 IGRA检测结果与传统的检测方法(结核菌染色涂片、结核菌染色涂片培养、TST)的检测结果进行比较。结果75例肺外结核患者中,IGRA检测阳性率为84.0%,结核菌染色涂片(8.0%),结核菌培养(5.3%),TST检测(52.0%),IGRA检测阳性率均明显高于其他临床常用检测方法,差异有统计学意义(P<0.01)。结论 IGRA试剂检测法诊断肺外结核,敏感性明显高于传统的检测方法,有很好的临床应用价值。

  3. Bacterial selection by mycospheres of Atlantic Rainforest mushrooms.

    Science.gov (United States)

    Halsey, Joshua Andrew; de Cássia Pereira E Silva, Michele; Andreote, Fernando Dini

    2016-10-01

    This study focuses on the selection exerted on bacterial communities in the mycospheres of mushrooms collected in the Brazilian Atlantic Rainforest. A total of 24 paired samples (bulk soil vs. mycosphere) were assessed to investigate potential interactions between fungi and bacteria present in fungal mycospheres. Prevalent fungal families were identified as Marasmiaceae and Lepiotaceae (both Basidiomycota) based on ITS partial sequencing. We used culture-independent techniques to analyze bacterial DNA from soil and mycosphere samples. Bacterial communities in the samples were distinguished based on overall bacterial, alphaproteobacterial, and betaproteobacterial PCR-DGGE patterns, which were different in fungi belonging to different taxa. These results were confirmed by pyrosequencing the V4 region of the 16S rRNA gene (based on five bulk soil vs. mycosphere pairs), which revealed the most responsive bacterial families in the different conditions generated beneath the mushrooms, identified as Bradyrhizobiaceae, Burkholderiaceae, and Pseudomonadaceae. The bacterial families Acetobacteraceae, Chrhoniobacteraceae, Planctomycetaceae, Conexibacteraceae, and Burkholderiaceae were found in all mycosphere samples, composing the core mycosphere microbiome. Similarly, some bacterial groups identified as Koribacteriaceae, Acidobacteria (Solibacteriaceae) and an unclassified group of Acidobacteria were preferentially present in the bulk soil samples (found in all of them). In this study we depict the mycosphere effect exerted by mushrooms inhabiting the Brazilian Atlantic Rainforest, and identify the bacteria with highest response to such a specific niche, possibly indicating the role bacteria play in mushroom development and dissemination within this yet-unexplored environment.

  4. Prevention of bacterial adhesion

    DEFF Research Database (Denmark)

    Klemm, Per; Vejborg, Rebecca Munk; Hancock, Viktoria

    2010-01-01

    Management of bacterial infections is becoming increasingly difficult due to the emergence and increasing prevalence of bacterial pathogens that are resistant to available antibiotics. Conventional antibiotics generally kill bacteria by interfering with vital cellular functions, an approach...... that imposes selection pressure for resistant bacteria. New approaches are urgently needed. Targeting bacterial virulence functions directly is an attractive alternative. An obvious target is bacterial adhesion. Bacterial adhesion to surfaces is the first step in colonization, invasion, and biofilm formation....... As such, adhesion represents the Achilles heel of crucial pathogenic functions. It follows that interference with adhesion can reduce bacterial virulence. Here, we illustrate this important topic with examples of techniques being developed that can inhibit bacterial adhesion. Some of these will become...

  5. Data Dissemination in Wireless Networks with Network Coding

    CERN Document Server

    Firooz, Mohammad H

    2012-01-01

    We investigate the use of network coding for information dissemination over a wireless network. Using network coding allows for a simple, distributed and robust algorithm where nodes do not need any information from their neighbors. In this paper, we analyze the time needed to diffuse information throughout a network when network coding is implemented at all nodes. We then provide an upper bound for the dissemination time for ad-hoc networks with general topology. Moreover, we derive a relation between dissemination time and the size of the wireless network. It is shown that for a wireless network with N nodes, the dissemination latency is between O(N) and O(N^2), depending on the reception probabilities of the nodes. These observations are validated by the simulation results.

  6. Activity of posaconazole in treatment of experimental disseminated zygomycosis

    NARCIS (Netherlands)

    Dannaoui, E; Meis, JFGM; Loebenberg, D; Verweij, PE

    2003-01-01

    Three isolates of zygomycetes were used to produce a disseminated infection in nonimmunocompromised mice. Against all zygomycete strains, amphotericin B significantly prolonged survival. Itraconazole was inactive against Rhizopus microsporus and Rhizopus oryzae but was partially active against Absid

  7. Activity of posaconazole in treatment of experimental disseminated zygomycosis.

    NARCIS (Netherlands)

    Danaoui, E.; Meis, J.F.G.M.; Loebenberg, D.; Verweij, P.E.

    2003-01-01

    Three isolates of zygomycetes were used to produce a disseminated infection in nonimmunocompromised mice. Against all zygomycete strains, amphotericin B significantly prolonged survival. Itraconazole was inactive against Rhizopus microsporus and Rhizopus oryzae but was partially active against Absid

  8. Acute disseminated toxoplasmosis in a juvenile cheetah (Acinonyx jubatus).

    Science.gov (United States)

    Lloyd, Christopher; Stidworthy, Mark F

    2007-09-01

    A juvenile cheetah (Acinonyx jubatus) died with rapidly progressive pyrexia, tachypnea, abdominal effusion, and hepatomegaly. Postmortem examination revealed lesions consistent with acute disseminated infection with Toxoplasma gondii. The presence of this organism was confirmed in multiple organs by immunohistochemistry and polymerase chain reaction. To the best of our knowledge, we propose this to be the first reported case of primary acute disseminated toxoplasmosis in a cheetah.

  9. A Powerful Optimization Approach for the Multi Channel Dissemination Networks

    CERN Document Server

    Al-Mogren, Ahmad Saad

    2010-01-01

    In the wireless environment, dissemination techniques may improve data access for the users. In this paper, we show a description of dissemination architecture that fits the overall telecommunication network. This architecture is designed to provide efficient data access and power saving for the mobile units. A concurrency control approach, MCD, is suggested for data consistency and conflict checking. A performance study shows that the power consumption, space overhead, and response time associated with MCD is far less than other previous techniques.

  10. Disseminated BCG infection in a patient with severe combined immunodeficiency

    Energy Technology Data Exchange (ETDEWEB)

    Han, Tae Il [Eulji University School of Medicine, Taejon (Korea, Republic of); Kim, In One; Kim, Woo Sun; Yeon, Kyung Mo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2000-06-01

    Disseminated mycobacterial infection after bacillus Calmette-Guerin (BCG) accination is a very rare disorder, occurring mostly in patients with immunologic eficiency. We report a case of disseminated BCG infection in a 16-month-old girl with severe combined immunodeficiency. Plain radiographs showed multiple osteolytic lesions in the femora, tibiae, humerus, and phalanges. Abdominal sonography and CT scanning revealed multiple nodules in the spleen, and portocaval lymphadenopathy.

  11. Disseminated BCG Infection in a patient with Severe Combined Immunodeficiency

    OpenAIRE

    Han, Tae Il; Kim, In-One; Kim, Woo Sun; Yeon, Kyung Mo

    2000-01-01

    Disseminated mycobacterial infection after bacillus Calmette-Guerin (BCG) vaccination is a very rare disorder, occurring mostly in patients with immunologic deficiency. We report a case of disseminated BCG infection in a 16-month-old girl with severe combined immunodeficiency. Plain radiographs showed multiple osteolytic lesions in the femora, tibiae, humerus, and phalanges. Abdominal sonography and CT scanning revealed multiple nodules in the spleen, and portocaval lymphadenopathy.

  12. Utility of in vivo transcription profiling for identifying Pseudomonas aeruginosa genes needed for gastrointestinal colonization and dissemination

    DEFF Research Database (Denmark)

    Koh, Andrew Y; Mikkelsen, Per J; Smith, Roger S;

    2010-01-01

    Microarray analysis of Pseudomonas aeruginosa mRNA transcripts expressed in vivo during animal infection has not been previously used to investigate potential virulence factors needed in this setting. We compared mRNA expression in bacterial cells recovered from the gastrointestinal (GI) tracts...... to test mutants in genes identified as having increased transcription during in vivo colonization. All of the Tn-library mutants in biofilm-associated genes had an attenuated ability to form biofilms in vitro, but there were no significant differences in GI colonization and dissemination between...

  13. A Survey on Data Dissemination in Wireless Sensor Networks

    Institute of Scientific and Technical Information of China (English)

    郑霄龙; 万猛

    2014-01-01

    Wireless sensor networks (WSNs) have been applied in a variety of application areas. Most WSN systems, once deployed, are intended to operate unattended for a long period. During the lifetime, it is necessary to fix bugs, reconfigure system parameters, and upgrade the software in order to achieve reliable system performance. However, manually collecting all nodes back and reconfiguring through serial connections with computer is infeasible since it is labor-intensive and inconvenient due to the harsh deploying environments. Hence, data dissemination over multi-hop is desired to facilitate such tasks. This survey discusses the requirements and challenges of data dissemination in WSNs, reviews existing work, introduces some relevant techniques, presents the metrics of the performance and comparisons of the state-of-the-art work, and finally suggests the possible future directions in data dissemination studies. This survey elaborates and compares existing approaches of two categories: structure-less schemes and structure-based schemes, classified by whether or not the network structure information is used during the disseminating process. In existing literatures, different categories have definite boundary and limited analysis on the trade-off between different categories. Besides, there is no survey that discusses the emerging techniques such as Constructive Interference (CI) while these techniques have the chance to change the framework of data dissemination. In a word, even though many efforts have been made, data dissemination in WSNs still needs some more work to embrace the new techniques and improve the efficiency and practicability further.

  14. 肺源性与肺外源性急性呼吸窘迫综合征呼吸力学的异同及机械通气策略%Respiratory mechanic differences and mechanical ventilation strategy for acute respiratory distress syndrome caused by pulmonary and extrapulmonary Injury

    Institute of Scientific and Technical Information of China (English)

    喻文亮

    2010-01-01

    Acute respiratory distress syndrome(ARDS) can be divided into pulmonary ARDS and extrapulmonary ARDS according to its origin.The prevalent damage in early stages of pulmonary ARDS is intra-alveolar,whereas in extra-pulmonary ARDS it is the interstitial edema.In pulmonary ARDS,lung compliance is worse than in extrapulmonary ARDS,whereas the main abnormality is the decrease in chest Wall compliance.due to abnormally high intra-abdominal pressure.Positive end expiratory pressure,recruitment maneuver and prone position ventilation are more effective in extrapulmonary ARDS,whereas low tidal volume ventilation play equal role in rescuing the two types of ARDS.%急性呼吸窘迫综合征(ARDS)按其病因可分为肺源性ARDS和肺外源性ARDS.肺源性ARDS早期多为肺泡损害,而肺外源性ARDS多为间质性肺水肿.肺源性ARDS患儿肺顺应性降低,而肺外源性ARDS由于腹腔内压增高其胸壁顺应性更低.肺外源性ARDS中应用呼气末正压、肺复张手法及俯卧位通气效果更好,而两者的小潮气量通气效果相似.

  15. Amplicon DNA melting analysis for the simultaneous detection of Brucella spp and Mycobacterium tuberculosis complex. Potential use in rapid differential diagnosis between extrapulmonary tuberculosis and focal complications of brucellosis.

    Science.gov (United States)

    Sanjuan-Jimenez, Rocio; Colmenero, Juan D; Bermúdez, Pilar; Alonso, Antonio; Morata, Pilar

    2013-01-01

    Some sites of extrapulmonary tuberculosis and focal complications of brucellosis are very difficult to differentiate clinically, radiologically, and even histopathologically. Conventional microbiological methods for the diagnosis of extrapulmonary tuberculosis and complicated brucellosis not only lack adequate sensitivity, they are also time consuming, which could lead to an unfavourable prognosis. The aim of this work was to develop a multiplex real-time PCR assay based on SYBR Green I to simultaneously detect Brucella spp and Mycobacterium tuberculosis complex and evaluate the efficacy of the technique with different candidate genes. The IS711, bcsp31 and omp2a genes were used for the identification of Brucella spp and the IS6110, senX3-regX3 and cfp31 genes were targeted for the detection of the M. tuberculosis complex. As a result of the different combinations of primers, nine different reactions were evaluated. A test was defined as positive only when the gene combinations were capable of co-amplifying both pathogens in a single reaction tube and showed distinguishable melting temperatures for each microorganism. According to the melting analysis, only three combinations of amplicons (senX3-regX3+bcsp31, senX3-regX3+IS711 and IS6110+IS711) were visible. Detection limits of senX3-regX3+bcsp31 and senX3-regX3+IS711 were of 2 and 3 genome equivalents for M. tuberculosis complex and Brucella while for IS6110+IS711 they were of 200 and 300 genome equivalents, respectively. The three assays correctly identified all the samples, showing negative results for the control patients. The presence of multicopy elements and GC content were the components most influencing the efficiency of the test; this should be taken into account when designing a multiplex-based SYBR Green I assay. In conclusion, multiplex real time PCR assays based on the targets senX3-regX3+bcsp31 and senX3-regX3+IS711 using SYBR Green I are highly sensitive and reproducible. This may therefore be a

  16. Amplicon DNA melting analysis for the simultaneous detection of Brucella spp and Mycobacterium tuberculosis complex. Potential use in rapid differential diagnosis between extrapulmonary tuberculosis and focal complications of brucellosis.

    Directory of Open Access Journals (Sweden)

    Rocio Sanjuan-Jimenez

    Full Text Available Some sites of extrapulmonary tuberculosis and focal complications of brucellosis are very difficult to differentiate clinically, radiologically, and even histopathologically. Conventional microbiological methods for the diagnosis of extrapulmonary tuberculosis and complicated brucellosis not only lack adequate sensitivity, they are also time consuming, which could lead to an unfavourable prognosis. The aim of this work was to develop a multiplex real-time PCR assay based on SYBR Green I to simultaneously detect Brucella spp and Mycobacterium tuberculosis complex and evaluate the efficacy of the technique with different candidate genes. The IS711, bcsp31 and omp2a genes were used for the identification of Brucella spp and the IS6110, senX3-regX3 and cfp31 genes were targeted for the detection of the M. tuberculosis complex. As a result of the different combinations of primers, nine different reactions were evaluated. A test was defined as positive only when the gene combinations were capable of co-amplifying both pathogens in a single reaction tube and showed distinguishable melting temperatures for each microorganism. According to the melting analysis, only three combinations of amplicons (senX3-regX3+bcsp31, senX3-regX3+IS711 and IS6110+IS711 were visible. Detection limits of senX3-regX3+bcsp31 and senX3-regX3+IS711 were of 2 and 3 genome equivalents for M. tuberculosis complex and Brucella while for IS6110+IS711 they were of 200 and 300 genome equivalents, respectively. The three assays correctly identified all the samples, showing negative results for the control patients. The presence of multicopy elements and GC content were the components most influencing the efficiency of the test; this should be taken into account when designing a multiplex-based SYBR Green I assay. In conclusion, multiplex real time PCR assays based on the targets senX3-regX3+bcsp31 and senX3-regX3+IS711 using SYBR Green I are highly sensitive and reproducible. This may

  17. Peritonitis - spontaneous bacterial

    Science.gov (United States)

    Spontaneous bacterial peritonitis (SBP); Ascites - peritonitis; Cirrhosis - peritonitis ... who are on peritoneal dialysis for kidney failure. Peritonitis may have other causes . These include infection from ...

  18. Do the Hydatid Cysts Have Unusual Localization and Dissemination Ways in the Chest Cavity?

    Directory of Open Access Journals (Sweden)

    Yucel Akkas

    2016-01-01

    Full Text Available We wanted to report our two cases of intrathoracic extrapulmonary hydatid cyst in pleural cavity due to its rarity. Our first case is a 24-year-old male patient who was admitted with a cystic mass lesion consistent with hydatid cyst which was incidentally detected in inferior lobe of the right lung neighboring to thoracic wall and diaphragm. Our second case is a 32-year-old male patient who was admitted with chest pain and a cystic lesion in apex of the right hemithorax and intercostal field in basal after he had been medically treated due to hydatid cyst of the dome of the liver for two years. The cysts were removed with thoracotomy. Extrapulmonary intrathoracic hydatid cysts were evaluated with regard to invasion ways and treatment indications and methods.

  19. Dissemination of tuberculosis after biopsy of primary tubercular prostate: a case report

    OpenAIRE

    Onkar Jha; Vidya Nair; Deepak Talwar

    2015-01-01

    Only 15-20% of extrapulmonary tuberculosis (TB) has been attributed to TB of the urogenital system and often Results from haematogenous spread from an active site of infection. Isolated involvement of prostate by TB is relatively less common. The incidence of primary prostatic TB is unknown and in its truest sense is a very rare entity. Here, we report the case of a patient with primary prostatic TB who was misdiagnosed as nonspecific granulomatous inflammation on transrectal ultrasound-guid...

  20. Selective dissemination and indexing of scientific information.

    Science.gov (United States)

    Schneider, J H

    1971-07-23

    Selective dissemination of information to individuals provides a new and promising method for keeping abreast of current scientific information. Since SDI services are directed to the information needs of each individual, they are a significant step beyond grouporiented services and products, which require considerable expenditure of effort by each user as he sorts useful information from trash. However, SDI systems do require a high degree of precision in matching scientists against documents. They must operate more efficiently and economically than many current systems which occasionally provide a useful item of information to users. To meet these stringent requirements for quality, precision, efficiency, and economy, more research must be devoted to comparing and improving indexing methods, which are the basic component of all information storage and retrieval systems. It is incredible that so much money has been spent on the development and operation of scientific information systems before basic data on the comparative performance of various indexing methods have been gathered, analyzed, and confirmed by multiple investigators. The design of an effective information system would seem to require this type of basic knowledge, just as basic properties of alternative materials must be known before an engineer can design a building, bridge, or factory. Yet, except for the few studies mentioned in the previous section, research on indexing methods has been greatly neglected. Bourne's comment about studies of indexing languages is still an appropriate description of the situation: "In almost all the experimental reports, the investigator worked with an indexing language different than that of other experimenters. Consequently, no one has ever had his test results verified, or expanded, or made more precise by another experimenter" (47). Most existing information systems are based on keyword indexing, with concepts broken into isolated terms during input operations

  1. Prevention of bacterial adhesion

    DEFF Research Database (Denmark)

    Klemm, Per; Vejborg, Rebecca Munk; Hancock, Viktoria

    2010-01-01

    Management of bacterial infections is becoming increasingly difficult due to the emergence and increasing prevalence of bacterial pathogens that are resistant to available antibiotics. Conventional antibiotics generally kill bacteria by interfering with vital cellular functions, an approach that ...... valuable weapons for preventing pathogen contamination and fighting infectious diseases in the future....

  2. Diagnosis of bacterial hepatic abscess by CT

    Institute of Scientific and Technical Information of China (English)

    Cheng-Lin Wang; Xue-Jun Guo; Shui-Bo Qiu; Yi Lei; Zhi-Dong Yuan; Han-Bin Dong; Hui-An Liu

    2007-01-01

    BACKGROUND: Bacterial hepatic abscess usually is acute and progressive, often resulting in sepsis, impairment of liver function and disseminated intravascular coagulation. The mortality rate was as high as 80%in the past. For the purpose of early diagnosis and differential diagnosis of this disease, we probed the imaging manifestations and their characteristics in bacterial hepatic abscesses by CT scan. METHODS:Twenty-four lesions from 21 patients with bacterial hepatic abscesses that were conifrmed by clinical features, puncture and culture were reviewed for CT manifestations. Fourteen patients were male and 7 were female, with an average age of 56.2 years. All lesions underwent CT plain scan and three-phase enhanced scan and 15 patients underwent delayed-phase imaging. Three senior radiologists read the iflms in accordance with a standard. RESULTS: Among 24 lesions, 18 (75%) were situated in the right liver with diameters of 1.4-9.3 cm (average 4.5 cm). Nineteen (79.2%) lesions were round or sub-round in shape, and 22 (91.7%) had smooth, uninterrupted and sharp edges. All lesions showed low attenuation of less than 20 Hu. Twenty-two enhanced lesions (91.7%) had rim-shaped enhancement in the abscess wall, and 13 (54.2%) showed single or double-ring signs. Eighteen (75%) displayed honeycomb-like, grid-like or strip-like enhancement. Eighteen (75%) were regionally enhanced in the surroundings or upper or lower layers. Only 2 (8.3%) displayed a gas-liquid surface sign. CONCLUSIONS:  The CT ifndings of bacterial hepatic abscess are usually typical, and the diagnosis of the abscess is not dififcult. To precisely diagnose atypical cases, it is necessary to combine CT with clinical observations and follow-up.

  3. Acute Myopericarditis Likely Secondary to Disseminated Gonococcal Infection

    Directory of Open Access Journals (Sweden)

    Daniel Bunker

    2015-01-01

    Full Text Available Disseminated gonococcal infection (DGI is a rare complication of primary infection with Neisseria gonorrhoeae. Cardiac involvement in this condition is rare, and is usually limited to endocarditis. However, there are a number of older reports suggestive of direct myocardial involvement. We report a case of a 38-year-old male with HIV who presented with chest pain, pharyngitis, tenosynovitis, and purpuric skin lesions. Transthoracic echocardiogram showed acute biventricular dysfunction. Skin biopsy showed diplococci consistent with disseminated gonococcal infection, and treatment with ceftriaxone improved his symptoms and ejection fraction. Though gonococcal infection was never proven with culture or nucleic acid amplification testing, the clinical picture and histologic findings were highly suggestive of DGI. Clinicians should consider disseminated gonococcal infection when a patient presents with acute myocarditis, especially if there are concurrent skin and joint lesions.

  4. Achieving Timeliness and High Throughput Metrics in Dissemination Systems

    Directory of Open Access Journals (Sweden)

    MANNE ANUSHA

    2012-09-01

    Full Text Available Existing systems for information dissemination is inadequate and typically results in information gaps. The lack of a clear concise system for information dissemination makes it difficult to determine the most efficient and effective way to pass information especially in the fields of ecommerce and security alerting systems to the appropriate parties. These systems usually require that the desired information be matched between numerous sources and sinks based on established subscriptions. Timeliness and Throughput are performance metrics used for evaluation. And these existing systems fail to achieve a balance between the two. So a much better system termed INFOD (INFOrmation Dissemination was proposed earlier that achieves a balance between performance metrics. We observed that an Integrated Control Loop used by admission control scheme of INFOD employs PL/SQL stored procedures that are huge computation overhead. We propose to replace them with Java stored procedures that can tremendously increase the performance.

  5. Acute Myopericarditis Likely Secondary to Disseminated Gonococcal Infection

    Science.gov (United States)

    Bunker, Daniel; Kerr, Leslie Dubin

    2015-01-01

    Disseminated gonococcal infection (DGI) is a rare complication of primary infection with Neisseria gonorrhoeae. Cardiac involvement in this condition is rare, and is usually limited to endocarditis. However, there are a number of older reports suggestive of direct myocardial involvement. We report a case of a 38-year-old male with HIV who presented with chest pain, pharyngitis, tenosynovitis, and purpuric skin lesions. Transthoracic echocardiogram showed acute biventricular dysfunction. Skin biopsy showed diplococci consistent with disseminated gonococcal infection, and treatment with ceftriaxone improved his symptoms and ejection fraction. Though gonococcal infection was never proven with culture or nucleic acid amplification testing, the clinical picture and histologic findings were highly suggestive of DGI. Clinicians should consider disseminated gonococcal infection when a patient presents with acute myocarditis, especially if there are concurrent skin and joint lesions. PMID:26246922

  6. Disseminated cryptococcosis with cutaneous involvement in an immunocompetent patient*

    Science.gov (United States)

    Sacht, Gabriely Lessa; de Lima, Alexandre Moretti; Perdomo, Yuri Chiarelli; Boigues, Rafaela Suguimoto; Takita, Luiz Carlos; Hans Filho, Günter

    2016-01-01

    Cryptococcosis is a fungal infection of opportunistic behavior that is unusual in immunocompetent patients. We report a rare case of disseminated cryptococcosis with cutaneous involvement in an immunocompetent individual. During hospitalization, Cryptococcus gattii was isolated from skin lesions, lung and spinal fluid. The diagnosis of disseminated cryptococcosis was confirmed and treatment was established. The patient showed improvement. Due to the probable clinical severity of the disease and the possibility that skin lesions may be the first manifestation of this illness, prompt diagnosis must be established and treatment provided. PMID:28099613

  7. Extremely refractory Kawasaki disease with disseminated intravascular coagulation.

    Science.gov (United States)

    Koh, Young Kwon; Lee, Jae Hee; Park, Yeong Bong

    2017-03-07

    Disseminated intravascular coagulation is a rare complication of Kawasaki disease and appears in Kawasaki disease patients. We report a case of refractory Kawasaki disease complicated with disseminated intravascular coagulation and giant coronary aneurysm. A 5-month-old boy presented with Kawasaki disease with coagulopathy. Although the coagulopathy improved after fresh-frozen plasma and antithrombin-III administration, the fever persisted despite two rounds of intravenous immunoglobulin, along with intravenous methylprednisolone pulse therapy and infliximab administration. Despite all efforts to treatment, the patient had giant coronary aneurysms and died suddenly.

  8. Multiphasic acute disseminated encephalomyelitis associated with atypical rubella virus infection.

    Science.gov (United States)

    Shinoda, Koji; Asahara, Hideaki; Uehara, Taira; Miyoshi, Katsue; Suzuki, Satoshi O; Iwaki, Toru; Kira, Jun-ichi

    2015-02-01

    We report the first case of an occurrence of multiphasic acute disseminated encephalomyelitis (ADEM) associated with atypical rubella virus infection with no rash and long-term increased titers of serum anti-rubella IgM in a 17-year-old male who had no history of rubella vaccination. He suffered from at least six clinical exacerbations with disseminated hyperintense lesions on FLAIR MR images during the course of 18 months. Repeated methylprednisolone pulse therapy and intravenous immunoglobulin therapy resolved the exacerbations. In patients with multiphasic ADEM of unknown etiology, clinicians should also consider the possibility of preceding infection with rubella virus.

  9. Abdominal alterations in disseminated paracoccidioidomycosis: computed tomography findings

    Energy Technology Data Exchange (ETDEWEB)

    Vermelho, Marli Batista Fernandes; Correia, Ademir Silva; Michailowsky, Tania Cibele de Almeida; Suzart, Elizete Kazumi Kuniyoshi; Ibanes, Aline Santos; Almeida, Lanamar Aparecida; Khoury, Zarifa; Barba, Mario Flores, E-mail: marlivermelho@globo.com [Instituto de Infectologia Emilio Ribas (IIER), Sao Paulo, SP (Brazil)

    2015-03-15

    Objective: to evaluate the incidence and spectrum of abdominal computed tomography imaging findings in patients with paracoccidioidomycosis. Materials and methods: retrospective analysis of abdominal computed tomography images of 26 patients with disseminated paracoccidioidomycosis. Results: abnormal abdominal tomographic findings were observed in 18 patients (69.2%), while no significant finding was observed in the other 8 (30.8%) patients. Conclusion: computed tomography has demonstrated to play a relevant role in the screening and detection of abdominal abnormalities in patients with disseminated paracoccidioidomycosis. (author)

  10. Dissemination of Orientia tsutsugamushi and inflammatory responses in a murine model of scrub typhus.

    Directory of Open Access Journals (Sweden)

    Christian A Keller

    2014-08-01

    Full Text Available Central aspects in the pathogenesis of scrub typhus, an infection caused by Orientia (O. tsutsugamushi, have remained obscure. Its organ and cellular tropism are poorly understood. The purpose of this study was to analyze the kinetics of bacterial dissemination and associated inflammatory responses in infected tissues in an experimental scrub typhus mouse model, following infection with the human pathogenic strain Karp. We provide a thorough analysis of O. tsutsugamushi infection in inbred Balb/c mice using footpad inoculation, which is close to the natural way of infection. By a novel, highly sensitive qPCR targeting the multi copy traD genes, we quantitatively monitored the spread of O. tsutsugamushi Karp from the skin inoculation site via the regional lymph node to the internal target organs. The highest bacterial loads were measured in the lung. Using confocal imaging, we also detected O. tsutsugamushi at the single cell level in the lung and found a predominant macrophage rather than endothelial localization. Immunohistochemical analysis of infiltrates in lung and brain revealed differently composed lesions with specific localizations: iNOS-expressing macrophages were frequent in infiltrative parenchymal noduli, but uncommon in perivascular lesions within these organs. Quantitative analysis of the macrophage response by immunohistochemistry in liver, heart, lung and brain demonstrated an early onset of macrophage activation in the liver. Serum levels of interferon (IFN-γ were increased during the acute infection, and we showed that IFN-γ contributed to iNOS-dependent bacterial growth control. Our data show that upon inoculation to the skin, O. tsutsugamushi spreads systemically to a large number of organs and gives rise to organ-specific inflammation patterns. The findings suggest an essential role for the lung in the pathogenesis of scrub typhus. The model will allow detailed studies on host-pathogen interaction and provide further

  11. Interfering with bacterial gossip

    DEFF Research Database (Denmark)

    Bjarnsholt, Thomas; Tolker-Nielsen, Tim; Givskov, Michael

    2011-01-01

    defense. Antibiotics exhibit a rather limited effect on biofilms. Furthermore, antibiotics have an ‘inherent obsolescence’ because they select for development of resistance. Bacterial infections with origin in bacterial biofilms have become a serious threat in developed countries. Pseudomonas aeruginosa...... that appropriately target bacteria in their relevant habitat with the aim of mitigating their destructive impact on patients. In this review we describe molecular mechanisms involved in “bacterial gossip” (more scientifically referred to as quorum sensing (QS) and c-di-GMP signaling), virulence, biofilm formation......, resistance and QS inhibition as future antimicrobial targets, in particular those that would work to minimize selection pressures for the development of resistant bacteria....

  12. Hijacking host cell highways: manipulation of the host actin cytoskeleton by obligate intracellular bacterial pathogens

    Directory of Open Access Journals (Sweden)

    Punsiri M Colonne

    2016-09-01

    Full Text Available Intracellular bacterial pathogens replicate within eukaryotic cells and display unique adaptations that support key infection events including invasion, replication, immune evasion, and dissemination. From invasion to dissemination, all stages of the intracellular bacterial life cycle share the same three-dimensional cytosolic space containing the host cytoskeleton. For successful infection and replication, many pathogens hijack the cytoskeleton using effector proteins introduced into the host cytosol by specialized secretion systems. A subset of effectors contains eukaryotic-like motifs that mimic host proteins to exploit signaling and modify specific cytoskeletal components such as actin and microtubules. Cytoskeletal rearrangement promotes numerous events that are beneficial to the pathogen, including internalization of bacteria, subversion of cell intrinsic immunity, structural support for bacteria-containing vacuoles, altered vesicular trafficking, actin-dependent bacterial movement, and pathogen dissemination. This review highlights a diverse group of obligate intracellular bacterial pathogens that manipulate the host cytoskeleton to thrive within eukaryotic cells and discusses underlying molecular mechanisms that promote these dynamic host-pathogen interactions.

  13. Progressive disseminated histoplasmosis presenting with cachexia and hypercalcemia

    Directory of Open Access Journals (Sweden)

    Khasawneh FA

    2013-02-01

    Full Text Available Faisal A Khasawneh,1 Subhan Ahmed,2 Ruba A Halloush31Section of Infectious Diseases, Department of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo, TX, 2Section of Nephrology, Department of Internal Medicine, University of Oklahoma, Tulsa, OK, 3Amarillo Pathology Group, Amarillo, TX, USAAbstract: Histoplasmosis is a common endemic mycosis. The majority of infections involving this dimorphic fungus are asymptomatic. Manifestations in symptomatic patients are diverse, ranging from flu-like illness to a more serious disseminated disease. We present here a case of chronic disseminated histoplasmosis mimicking a metastatic cancer. We reviewed the literature for cases of disseminated histoplasmosis presenting with hypercalcemia, focusing particularly on clinical presentation, risk factors predisposing for fungal infection, and outcome. We report a case of a 65-year-old diabetic male who presented with unexplained weight loss and hypercalcemia. Multiple brain space-occupying lesions and bilateral adrenal enlargement were evident on imaging studies. Biopsies showed caseating granulomas with budding yeast, consistent with histoplasmosis. The patient's symptoms resolved after liposomal amphotericin B and itraconazole therapy. Granulomatous diseases, including fungal infections, should be considered alongside malignancies, in patients with similar presentation.Keywords: disseminated histoplasmosis, hypercalcemia

  14. DISSEMINATE CYSTICERCOSIS. One-day treatment in a case

    Directory of Open Access Journals (Sweden)

    Mashiyi MK

    2004-01-01

    Full Text Available We report a patient presenting disseminated cysticercosis characterized by neurocysticercosis, subcutaneous, muscular, and cardiac cysticercosis treated with praziquantel during one day RESUMEN: Se comenta el caso de un paciente que presentó cisticercosis diseminada, caracterizada por neurocisticercosis, y cisticercosis subcutánea, muscular y cardiaca, tratada con praziquantel durante un dia.

  15. Integrity and dissemination control in administrative applications through information designators

    NARCIS (Netherlands)

    Teepe, W.G.

    2005-01-01

    When more and more information sources are being linked, it seems that it becomes ever more easy to track individuals in ways that are not deemed appropriate. However, increased linking of information does not need to imply increased dissemination of privacy-sensitive information. We present a new a

  16. Disseminated peritoneal leiomyomatosis with malignant change, in a male

    DEFF Research Database (Denmark)

    Lausen, I; Jensen, O J; Andersen, E

    1990-01-01

    Disseminated peritoneal leiomyomatosis (DPL) is a rare disorder, characterized by the occurrence of multiple leiomyomas scattered throughout the peritoneal cavity. Until this report DPL had been observed only in women and there is only one previous case with malignant change. A case of DPL...

  17. Disseminated intravascular coagulopathy in dengue:a brief review

    Institute of Scientific and Technical Information of China (English)

    Viroj Wiwanitkit

    2009-01-01

    Dengue infection is an arboviral infection with a very high prevalence in tropical Southeast Asia.This infection presents as a clinical illness comprising of very high fever with several hematologic aberrations.In this article, the author briefly reviewed the report on disseminated intravascular coagulopathy (DIC),a severe complica-tion,in dengue.

  18. 45 CFR 1388.7 - Program criteria-dissemination.

    Science.gov (United States)

    2010-10-01

    ... disabilities and their families. (f) The values of the UAP must be reflected in the language and images used in UAP products. (g) Dissemination products must reflect the cultural diversity of the community. (h... variety of products to promote public awareness and visibility of the UAP, and facilitate replication...

  19. Disseminated tuberculosis with rare involvements; Tuberculose floride avec localisations rares

    Energy Technology Data Exchange (ETDEWEB)

    Goasdoue, P.; Dubayle, P.; Boyer, B.; Le Clainche, P.; Pharaboz, C.; Debord, T. [Hopital d`Instruction des Armees Begin, 94 - Saint-Mande (France)

    1997-09-01

    We report a case of disseminated tuberculosis involving the middle ear, the central nervous system, the spine and the lung. The tuberculous epidural abscess and otomastoiditis don`t have any specific imaging features. But their coexistence with an other tuberculous involvement might suggest their tuberculous nature. The epidural abscess may result from direct extension from otomastoiditis. (authors).

  20. Packaging for Dissemination. Diffusion of Innovations Handbook Series.

    Science.gov (United States)

    Abbott, Andrew D.; And Others

    This handbook reviews some of the forms that can be used to package educational projects for dissemination to other schools, such as written reports, slide tape presentations, news releases, conference presentations, and workshops. Guidelines and suggestions in the essays on each format are supplemented by the appendices, which include a report…

  1. Evaluation Designs for the Improving Teaching Competencies Program Dissemination Strategies.

    Science.gov (United States)

    Reinhard, Diane L.; And Others

    Evaluation designs are presented for these work components of the Improving Teaching Competencies Program (ITCP): (1) developing, implementing, and evaluating a strategy for disseminating selected ITCP instructional systems in Individually Guided Education (IGE) schools; (2) developing, implementing, and evaluating a strategy for disseminating…

  2. Exploiting beacons for scalable broadcast data dissemination in VANETs

    NARCIS (Netherlands)

    Schwartz, Ramon S.; Das, Kallol; Scholten, Hans; Havinga, Paul

    2012-01-01

    Vehicular Ad-hoc Networks (VANETs) enable the timely broadcast dissemination of event-driven messages to interested vehicles. However, when dealing with broadcast communication, suppression techniques must be designed to prevent the so-called broadcast storm problem. Numerous suppression schemes aim

  3. CT of disseminated plasmacytoma - in an AIDS patient

    Energy Technology Data Exchange (ETDEWEB)

    Leder, D.S.; Nazarian, L.N.; Burke, M. [Thomas Jefferson Univ., Philadelphia, PA (United States)

    1996-05-01

    It is well known that acquired immunodeficiency syndrome (AIDS) is associated with increased risk of neoplasms, particularly Kaposi sarcoma and non-Hodgkin lymphoma. There have been several recent reports in the literature describing plasma cell tumors in AIDS patients. We report the imaging findings in a case of widely disseminated plasmacytoma in a patient with known AIDS. 7 refs., 3 figs.

  4. Opportunistic Beacon Networks: Information Dissemination via Wireless Network Identifiers

    NARCIS (Netherlands)

    Türkes, Okan; Scholten, Hans; Havinga, Paul J.M.

    2016-01-01

    This paper presents OBN, a universal opportunistic ad hoc networking model particularly intended for smart mobile devices. It enables fast and lightweight data dissemination in wireless community networks through the utilization of universally-available wireless network identifiers. As a ubiquitous

  5. Use micro letter school education information dissemination of innovation

    Institute of Scientific and Technical Information of China (English)

    张弟龙

    2014-01-01

    Discussing the content spread on wechat during the process of school education is of great signiifcance. The main bodies of the spread of the school education can be summarized as: in the ofifcial institutions with the participation of school organizations, non-governmental organizations committed to the school education dissemination activities, and pedagogical authors, the scientiifc researchers, as wel as the general public.

  6. Disseminated intravascular coagulation in malaria: A case report

    Directory of Open Access Journals (Sweden)

    Laltanpuii Sailo

    2014-01-01

    Full Text Available Disseminated intravascular coagulation (DIC is seen in <5% of patients with severe Plasmodium falciparum malaria and is more common in cerebral malaria. Here, we report the diagnosis and management of a case of severe P. falciparum malaria with DIC.

  7. Using scenarios for dissemination - Experiences from the IMS GLOBEMEN project

    DEFF Research Database (Denmark)

    Ollus, Martin; Hartel, Ingo; Tølle, Martin;

    2002-01-01

    due to the complexities of the interdisciplinary field addressed. As an instrument for communication to the non-specialist public the IMS GLOBEMEN project produces a web-based scenario as part of its dissemination activities. It is aimed at giving a practical overview of specific challenges...

  8. Proceedings: panel on information dissemination for wind energy

    Energy Technology Data Exchange (ETDEWEB)

    Weis, P. [ed.

    1980-04-01

    This meeting was called as part of a multi-year planning effort. Groups involved in the production and/or dissemination of information on wind energy were invited to describe their current activities and their perceptions of the needs of the 80's in this area. Participants exchanged copies of materials they distribute regularly and discussed frequently asked questions.

  9. An unusual cystic appearance of disseminated low-grade gliomas

    Energy Technology Data Exchange (ETDEWEB)

    Huang, T.; Zimmerman, R.A. [Dept. of Radiology, Children' s Hospital of Philadelphia, PA (United States); Perilongo, G. [Dipt. di Pediatria, Univ. di Padova (Italy); Kaufman, B.A. [Dept. of Neurosurgery, St Louis Children' s Hospital, St Louis, MO (United States); Holden, K.R. [Division of Pediatric Neurology, Room 511, Children' s Hospital, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425-2232 (United States); Carollo, C. [Division of Neuroradiology, Regione Veneto, Azienda Ospedalieri di Padova, Universita di Padova, Via Giustiniani 3, 35 128 Padua (Italy); Kling Chong, W.K. [Dept. of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom)

    2001-10-01

    We report five cases of pediatric disseminated low-grade gliomas of the brainstem or spinal cord that exhibited an unusual, cystic pattern. Leptomeningeal disease was present in three of these at diagnosis, and was detected shortly afterwards in the other two. Four patients are alive up to 5 years later, following minimal to no intervention, while one is dead. (orig.)

  10. Deliverable 9.7 - GALA Dissemination Report 4

    NARCIS (Netherlands)

    Westera, Wim; Berta, Riccardo; Moreno-Ger, Pablo; Bellotti, Francesco; Nadolski, Rob; Padrón-Nápoles, Carmen; Boyle, Liz; Beligan, Daniel; Baalsrud Hauge, Jannicke

    2014-01-01

    We have created and executed a separate plan for the transition of GALA to the Serious Games Society for securing the conditions in the post-project phase. For assessing the effectiveness of the dissemination efforts we have devised 5 outward- looking KPIs. All KPI requirements were met. Also, addi

  11. RMD: Reliable Multicast Data Dissemination within Groups of Collaborating Objects

    NARCIS (Netherlands)

    Marin-Perianu, M.; Havinga, P.J.M.

    2006-01-01

    Factory and industrial automation systems gradually start to incorporate wireless networks of smart objects and sensor nodes. In this context, one fundamental problem is the reliability of data dissemination, particularly in the case of total or partial network reconfiguration. We propose RMD, a rel

  12. Disseminated aspergillosis attributable to Aspergillus deflectus in a springer spaniel.

    Science.gov (United States)

    Kahler, J S; Leach, M W; Jang, S; Wong, A

    1990-10-01

    Disseminated aspergillosis attributable to Aspergillus deflectus was diagnosed in a Springer Spaniel with lethargy, lameness, anorexia, weight loss, pyrexia, lymphadenopathy, hematuria, and urinary incontinence. Necropsy revealed granulomatous inflammation and numerous fungal hyphae in many organs. The conidial heads of the fungus have a characteristic briar-pipe appearance in culture.

  13. Disseminating Improved Practices: Are Volunteer Farmer Trainers Effective?

    Science.gov (United States)

    Lukuyu, B.; Place, F.; Franzel, S.; Kiptot, E.

    2012-01-01

    Purpose: This paper assesses the effectiveness of volunteer farmer trainers in promoting adoption of agricultural technologies in western Kenya. Specifically, the purpose was to assess the type of information they disseminated, farmer trainers' characteristics desirable to farmer trainees, and how trainees evaluate farmer trainers.…

  14. Data Model of the BNL Archive and Dissemination System

    Energy Technology Data Exchange (ETDEWEB)

    Heller, J; Osterer, L

    1977-02-01

    The Data Model, i.e., the information content of the data base as it is viewed by the users, of the BNL Archive and Dissemination System is presented. The syntax of the data model is stated in BNF form, and the semantic meaning is discussed. Examples of the use of the data model are given. 3 figs.

  15. 48 CFR 2905.101 - Methods of disseminating information.

    Science.gov (United States)

    2010-10-01

    ... information. Contracting officers may only use the Government Point of Entry (GPE) for synopsis and dissemination of information concerning procurement actions. The Division of Acquisition Management Services... information. 2905.101 Section 2905.101 Federal Acquisition Regulations System DEPARTMENT OF LABOR...

  16. Mucosal damage and neutropenia are required for Candida albicans dissemination.

    Directory of Open Access Journals (Sweden)

    Andrew Y Koh

    2008-02-01

    Full Text Available Candida albicans fungemia in cancer patients is thought to develop from initial gastrointestinal (GI colonization with subsequent translocation into the bloodstream after administration of chemotherapy. It is unclear what components of the innate immune system are necessary for preventing C. albicans dissemination from the GI tract, but we have hypothesized that both neutropenia and GI mucosal damage are critical for allowing widespread invasive C. albicans disease. We investigated these parameters in a mouse model of C. albicans GI colonization that led to systemic spread after administration of immunosuppression and mucosal damage. After depleting resident GI intestinal flora with antibiotic treatment and achieving stable GI colonization levels of C. albicans, it was determined that systemic chemotherapy with cyclophosphamide led to 100% mortality, whereas selective neutrophil depletion, macrophage depletion, lymphopenia or GI mucosal disruption alone resulted in no mortality. Selective neutrophil depletion combined with GI mucosal disruption led to disseminated fungal infection and 100% mortality ensued. GI translocation and dissemination by C. albicans was also dependent on the organism's ability to transform from the yeast to the hyphal form. This mouse model of GI colonization and fungemia is useful for studying factors of innate host immunity needed to prevent invasive C. albicans disease as well as identifying virulence factors that are necessary for fungal GI colonization and dissemination. The model may also prove valuable for evaluating therapies to control C. albicans infections.

  17. 10 CFR 602.18 - Dissemination of results.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Dissemination of results. 602.18 Section 602.18 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL... that is published or accepted for publication in a recognized scientific or technical journal and...

  18. 10 CFR 605.20 - Dissemination of results.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Dissemination of results. 605.20 Section 605.20 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS THE OFFICE OF ENERGY RESEARCH FINANCIAL ASSISTANCE... publication in a recognized scientific or technical journal and which satisfies the information...

  19. Marketing: Exploring Applications for Educational Dissemination. Literature Synthesis.

    Science.gov (United States)

    Reed, Linda

    This synthesis of information about marketing and information dissemination of education-related products is divided into three parts: an overview of major writings, specific marketing strategies, and resources for further study. The first part opens with a definition of marketing as it relates to education. A review of the literature provides…

  20. Bacterial intermediate filaments

    DEFF Research Database (Denmark)

    Charbon, Godefroid; Cabeen, M.; Jacobs-Wagner, C.

    2009-01-01

    Crescentin, which is the founding member of a rapidly growing family of bacterial cytoskeletal proteins, was previously proposed to resemble eukaryotic intermediate filament (IF) proteins based on structural prediction and in vitro polymerization properties. Here, we demonstrate that crescentin...

  1. Bacterial Wound Culture

    Science.gov (United States)

    ... Home Visit Global Sites Search Help? Bacterial Wound Culture Share this page: Was this page helpful? Also known as: Aerobic Wound Culture; Anaerobic Wound Culture Formal name: Culture, wound Related ...

  2. Bacterial surface adaptation

    Science.gov (United States)

    Utada, Andrew

    2014-03-01

    Biofilms are structured multi-cellular communities that are fundamental to the biology and ecology of bacteria. Parasitic bacterial biofilms can cause lethal infections and biofouling, but commensal bacterial biofilms, such as those found in the gut, can break down otherwise indigestible plant polysaccharides and allow us to enjoy vegetables. The first step in biofilm formation, adaptation to life on a surface, requires a working knowledge of low Reynolds number fluid physics, and the coordination of biochemical signaling, polysaccharide production, and molecular motility motors. These crucial early stages of biofilm formation are at present poorly understood. By adapting methods from soft matter physics, we dissect bacterial social behavior at the single cell level for several prototypical bacterial species, including Pseudomonas aeruginosa and Vibrio cholerae.

  3. Bacterial Meningitis in Infants

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2004-04-01

    Full Text Available A retrospective study of 80 infantile patients (ages 30-365 days; 47 male, 33 female with culture-proven bacterial meningitis seen over a 16 year period (1986-2001 is reported from Taiwan.

  4. Bacterial proteases and virulence

    DEFF Research Database (Denmark)

    Frees, Dorte; Brøndsted, Lone; Ingmer, Hanne

    2013-01-01

    Bacterial pathogens rely on proteolysis for variety of purposes during the infection process. In the cytosol, the main proteolytic players are the conserved Clp and Lon proteases that directly contribute to virulence through the timely degradation of virulence regulators and indirectly by providing....... These extracellular proteases are activated in complex cascades involving auto-processing and proteolytic maturation. Thus, proteolysis has been adopted by bacterial pathogens at multiple levels to ensure the success of the pathogen in contact with the human host....

  5. [Diagnosis of bacterial vaginosis].

    Science.gov (United States)

    Djukić, Slobodanka; Ćirković, Ivana; Arsić, Biljana; Garalejić, Eliana

    2013-01-01

    Bacterial vaginosis is a common, complex clinical syndrome characterized by alterations in the normal vaginal flora. When symptomatic, it is associated with a malodorous vaginal discharge and on occasion vaginal burning or itching. Under normal conditions, lactobacilli constitute 95% of the bacteria in the vagina. Bacterial vaginosis is associated with severe reduction or absence of the normal H2O2-producing lactobacilli and overgrowth of anaerobic bacteria and Gardnerella vaginalis, Atopobium vaginae, Mycoplasma hominis and Mobiluncus species. Most types of infectious disease are diagnosed by culture, by isolating an antigen or RNA/DNA from the microbe, or by serodiagnosis to determine the presence of antibodies to the microbe. Therefore, demonstration of the presence of an infectious agent is often a necessary criterion for the diagnosis of the disease. This is not the case for bacterial vaginosis, since the ultimate cause of the disease is not yet known. There are a variety of methods for the diagnosis of bacterial vaginosis but no method can at present be regarded as the best. Diagnosing bacterial vaginosis has long been based on the clinical criteria of Amsel, whereby three of four defined criteria must be satisfied. Nugent's scoring system has been further developed and includes validation of the categories of observable bacteria structures. Up-to-date molecular tests are introduced, and better understanding of vaginal microbiome, a clear definition for bacterial vaginosis, and short-term and long-term fluctuations in vaginal microflora will help to better define molecular tests within the broader clinical context.

  6. B cells enhance antigen-specific CD4 T cell priming and prevent bacteria dissemination following Chlamydia muridarum genital tract infection.

    Science.gov (United States)

    Li, Lin-Xi; McSorley, Stephen J

    2013-10-01

    B cells can contribute to acquired immunity against intracellular bacteria, but do not usually participate in primary clearance. Here, we examined the endogenous CD4 T cell response to genital infection with Chlamydia muridarum using MHC class-II tetramers. Chlamydia-specific CD4 T cells expanded rapidly and persisted as a stable memory pool for several months after infection. While most lymph node Chlamydia-specific CD4 T cells expressed T-bet, a small percentage co-expressed Foxp3, and RORγt-expressing T cells were enriched within the reproductive tract. Local Chlamydia-specific CD4 T cell priming was markedly reduced in mice lacking B cells, and bacteria were able to disseminate to the peritoneal cavity, initiating a cellular infiltrate and ascites. However, bacterial dissemination also coincided with elevated systemic Chlamydia-specific CD4 T cell responses and resolution of primary infection. Together, these data reveal heterogeneity in pathogen-specific CD4 T cell responses within the genital tract and an unexpected requirement for B cells in regulating local T cell activation and bacterial dissemination during genital infection.

  7. Acute Disseminated Encephalomyelitis: A Review of Eleven Cases in Childhood in North of Iran

    Directory of Open Access Journals (Sweden)

    Ali Nikkhah

    2016-01-01

    Full Text Available Background: Acute disseminated encephalomyelitis (ADEM is an inflammatory demyelinating disorder. The pathogenesis is unclear, but it is thought to be immune-mediated. The prognosis is favorable, with most children making a full recovery. Objectives: The present report analyzed different clinical presentations, response to treatment and outcome in a series of 11 patients with ADEM who referred to our tertiary center in north of Iran from 2010 to 2014. Materials and Methods: In this retrospective simple descriptive review, eleven cases with ADEM admitted in the neurology ward from 2010 to 2014 were enrolled. The clinical findings and laboratory and imaging results of patients were reviewed. All of these cases were evaluated with neurological examination, serologic tests for bacterial meningitis and viral encephalitis (especially, herpes simplex virus and brain MRI without contrast. After discharge, patients were followed for at least six months (6 to 12 months clinically and radiologically. Results: Of 11 children, 8 were male and 3 female. Their ages ranged between 4 and 10 years. The mean interval between the preceding infection and symptoms of encephalomyelitis was nine days. The most common presenting symptoms were ataxia in 45.4%, fever and headache in 36.4% and altered consciousness in 18.2% of patients. Neurological examination revealed pyramidal motor signs such as brisk deep tendon reflexes (hyperreflexia (81.8%, cranial nerve involvement (18.2%, dysarthria (9.1% and abnormal movements (9.1%. We followed up these patients in long-term for 6 to 12 months. Only in 1 child who received IVIG, mild ataxia had reminded. Conclusions: The prognosis of acute disseminated encephalomyelitis (ADEM is favorable. Early diagnosis and prompt treatment of ADEM would probably reduce morbidity.

  8. Antibiotic innovation may contribute to slowing the dissemination of multiresistant Streptococcus pneumoniae: the example of ketolides.

    Directory of Open Access Journals (Sweden)

    Lulla Opatowski

    Full Text Available BACKGROUND: Despite increasingly frequent bacterial resistance to antibiotics, antibacterial innovation is rare. Ketolides constitute one of the very few new antibiotic classes active against Streptococcus pneumoniae developed during the last 25 years. Their mechanism of action resembles that of macrolides, but they are unaffected by common resistance mechanisms. However, cross-resistance to ketolides has been observed in some macrolide-resistant strains. We examined how new antibiotic exposure may affect overall pneumococcal resistance patterns in the population. The aims of this study were to assess the potential dissemination of newly emerged resistances and to control the selection of strains already multiresistant to existing antimicrobials. METHODOLOGY/PRINCIPAL FINDINGS: We developed an age-structured population model for S. pneumoniae transmission in a human community exposed to heptavalent vaccine, and beta-lactams, macrolides and ketolides. The dynamics of intra-individual selection of resistant strains under antibiotic exposure and interindividual transmission were simulated, with antibiotic-specific resistance mechanisms defining the path to co-resistances and cross-resistances, and parameters concerning the French situation. Results of this simulation study suggest that new antibiotic consumption could markedly slow the diffusion of multiresistant strains. Wider use was associated with slower progression of multiresistance. When ketolides were prescribed to all ages, resistance to them reached 10% after >15 years, while it took >40 years when they were prescribed only to adults. In the scenario according to which new antibiotics totally replaced former antimicrobials, the beta-lactam resistance rate was limited at 70%. CONCLUSIONS: In a context of widespread vaccination and rational use of antibiotics, innovative antibiotic, prescribed to all age groups, may have an added impact on multiresistant-strain dissemination in the

  9. Influenza virus induces bacterial and nonbacterial otitis media.

    Science.gov (United States)

    Short, Kirsty R; Diavatopoulos, Dimitri A; Thornton, Ruth; Pedersen, John; Strugnell, Richard A; Wise, Andrew K; Reading, Patrick C; Wijburg, Odilia L

    2011-12-15

    Otitis media (OM) is one of the most common childhood diseases. OM can arise when a viral infection enables bacteria to disseminate from the nasopharynx to the middle ear. Here, we provide the first infant murine model for disease. Mice coinfected with Streptococcus pneumoniae and influenza virus had high bacterial load in the middle ear, middle ear inflammation, and hearing loss. In contrast, mice colonized with S. pneumoniae alone had significantly less bacteria in the ear, minimal hearing loss, and no inflammation. Of interest, infection with influenza virus alone also caused some middle ear inflammation and hearing loss. Overall, this study provides a clinically relevant and easily accessible animal model to study the pathogenesis and prevention of OM. Moreover, we provide, to our knowledge, the first evidence that influenza virus alone causes middle ear inflammation in infant mice. This inflammation may then play an important role in the development of bacterial OM.

  10. [Bacterial genomics and metagenomics: clinical applications and medical relevance].

    Science.gov (United States)

    Diene, S M; Bertelli, C; Pillonel, T; Schrenzel, J; Greub, G

    2014-11-12

    New sequencing technologies provide in a short time and at low cost high amount of genomic sequences useful for applications such as: a) development of diagnostic PCRs and/or serological tests; b) detection of virulence factors (virulome) or genes/SNPs associated with resistance to antibiotics (resistome) and c) investigation of transmission and dissemination of bacterial pathogens. Thus, bacterial genomics of medical importance is useful to clinical microbiologists, to infectious diseases specialists as well as to epidemiologists. Determining the microbial composition of a sample by metagenomics is another application of new sequencing technologies, useful to understand the impact of bacteria on various non-infectious diseases such as obesity, asthma, or diabetes. Genomics and metagenomics will likely become a specialized diagnostic analysis.

  11. Clinical analysis on children with extrapulmonary damage as the first symptoms of Mycoplasma pneumoniae infection%小儿以肺外损害为首发症状的肺炎支原体感染临床分析

    Institute of Scientific and Technical Information of China (English)

    吴国媛; 卓俊瑞

    2015-01-01

    Objective:to investigate the clinical manifestations of pediatric extrapulmonary organ damage as first symp-toms of Mycoplasma pneumonia(MP)infection,improve the diagnostic and treatment level. Methods:The clinical data of 79 children with Mycoplasma pneumonia infection of extrapulmonary organ damage as first symptoms were analyzed retro-spectively. Results:Among 578 children with Mycoplasma pneumoniae infection,79 children were found with extrapulmo-nary organ damage as starting symptoms(13. 7% ),79 children involving the main organs included hematologic system (28children,35. 4% ),nervous system( 19children,24. 1% ),skin lesion( 11 children,13. 9% ),digestive system( 7children,8. 9% ),cardiovascular system( 6children,7. 6% ),connective tissue(5children,6. 3% ),muscular and joint damage(2children,2. 5% ),and urinary system( 1children,1. 3% ). Conclusion:Damage of other visceral organs is fre-quently observed in children with Mycoplasma infection . Children with respiratory infection and multi - organs disfunction should not overlook the complications caused by Mycoplasma pneumoniae infection ,especially when the symptoms of respir-atory tract infection appear.%目的:分析小儿以肺外脏器损害为首发症状的肺炎支原体(Mycoplasma pneumoniae ,MP)感染的临床表现,提高诊治水平。方法回顾分析以肺外脏器损害为首发症状的79例 MP 感染患儿临床资料。结果肺炎支原体(MP)感染578例中79例以肺外器官损害为首发症状(13.7%),累及的主要器官有血液系统28例(35.4%)、神经系统19例(24.1%)、皮肤损害11例(13.9%)、消化系统7例(8.9%)、心血管系统6例(7.6%)、结缔组织5例(6.3%)、肌肉关节损害2例(2.5%)、泌尿系统1例(1.3%)。结论小儿肺炎支原体易引起肺外脏器损害,对于常规治疗不理想及诊断不明确患儿,应注意支原体感染,尤其是以肺外脏器损害为首发症状者。

  12. Clinical usefulness of the nested polymerase chain reaction in the diagnosis of extrapulmonary tuberculosis Utilidad clínica de la reacción en cadena de la polimerasa anidada para el diagnóstico de tuberculosis extrapulmonar

    Directory of Open Access Journals (Sweden)

    Guadalupe García-Elorriaga

    2009-06-01

    Full Text Available OBJECTIVE:To evaluate the effectiveness of nested polymerase chain reaction (PCR for diagnosis of extrapulmonary tuberculosis (ETB, as well as the impact of PCR results on clinical management. MATERIALS AND METHODS:We conducted a study of nested PCR tests in 45 patients and a review of patient hospital files, calculating sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV. RESULTS:PCR was positive in 51% of cases; PCR sensitivity for diagnosing TB was 86%, specificity was 79%, PPV was 76%, and NPV was 88%. When solely analyzing urine samples, sensitivity and NPV increased to 100%. PCR exerted an influence on management in 27% of patients. CONCLUSIONS:PCR for rapid diagnosis of extrapulmonary TB has an adequate effect, which improves when performed on urine. The results of PCR exerted an acceptable impact on the clinical management of these patients.OBJETIVO:Evaluar la eficacia de la reacción en cadena de la polimerasa (PCR anidada para el diagnóstico de tuberculosis extrapulmonar, así como el impacto de sus resultados en el manejo clínico. MATERIAL Y MÉTODOS: Se realizó PCR anidada en 45 pacientes y se llevó a cabo la revisión de expedientes. Se calculó sensibilidad, especificidad, valor predictivo positivo (VPP y valor predictivo negativo (VPN. RESULTADOS:La PCR fue positiva en 51% de los casos, la sensibilidad fue de 86%, la especificidad de 79%, el VPP de 76% y el VPN de 88%. Al analizar solamente las muestras de orina, la sensibilidad y VPN se incrementaron a 100%. La PCR influyó en el manejo de 27% de los pacientes. CONCLUSIONES:La PCR para el diagnóstico rápido de TB extrapulmonar tiene una eficacia adecuada, la cual mejora cuando se realiza en orina. El resultado de la PCR tuvo un impacto aceptable en el manejo clínico de estos pacientes.

  13. Disseminated cryptococcal lymphadenitis with negative latex agglutination test

    Institute of Scientific and Technical Information of China (English)

    XU Xiao-guang; BI Xin-ling; WU Jian-hua; XU Hong; LIAO Wan-qing

    2012-01-01

    We reported an unusual case of disseminated cryptococcal lymphadenitis in an immunocompetent host who presented with fever and lymphadenopathy,which were the only two symptoms and signs.Latex agglutination test of serum and cerebrospinal fluid (CSF) were negative,while lymph node biopsy showed Cryptococcus neoformans.A diagnosis of disseminated cryptococcal lymphadenitis was made.Then the patient was treated with amphotericin B for 15 days as initial therapy and itraconazole for 6 months as maintenance therapy respectively.The patient received re-examination per 6 months and was followed up for 2 years.Swollen lymph nodes diminished gradually,and no fever or other symptoms were found.Latex agglutination test of serum and CSF were negative throughout the follow-up period,and anti-HIV,syphilis and tuberculosis antibody were all negative.

  14. Editorial opinion: public dissemination of raw turbulence data

    Science.gov (United States)

    Sillero, Juan A.; Jiménez, Javier

    2016-04-01

    Many of the papers in this issue deal with processing of pre-existing large-scale turbulence data. We argue here that there is a certain urgency to the discussion of whether raw data should be made publicly available within the turbulence community, and of which are the best procedures, technology and rules for possible dissemination. Besides expressing the personal opinion that such sharing would be advantageous for the field, the urgency mostly arises from the danger that funding agencies and other institutions would otherwise set standards without proper community input. The experience of the Madrid School of Aeronautics with the dissemination of numerical simulation results is briefly reviewed, including the present technological solutions and usage statistics.

  15. Scientific knowledge dissemination in Danish seed communities of practice

    DEFF Research Database (Denmark)

    Tveden-Nyborg, Svend; Misfeldt, Morten; Boelt, Birte

    2012-01-01

    scientific knowledge communication. Theoretically, we consider these actors participants in different communities of practice relating to the production of seeds (Seed-CoP), and we conclude that strong network collaboration is present among Danish seed-CoP effectuated by the valuable work undertaken...... by the consultants. We discovered a divergence in knowledge dissemination among the growers – an innovative group of growers with a high demand for new scientific knowledge versus a majority of growers content with the level of knowledge provided by the consultants. ‘Time’ was recognized as an important parameter......, as only the innovative growers prioritized time allocation for additional knowledge search. To improve scientific knowledge dissemination and interdisciplinary collaboration among Danish seed-CoP we recommend a combination of face-to-face and online communication processes....

  16. [A case of disseminated gonococcal infection without typical skin rash].

    Science.gov (United States)

    Yokota, Kazuhisa; Gomi, Harumi; Morisawa, Yuji

    2011-07-01

    Few case reports have been published on disseminated gonococcal infection in Japan. We report such a non-HIV case without typical skin rash. A 49-year-old Japanese man living in Thailand on business was seen for fever and multiple arthralgia after returning to Japan. Given the travel history, differential diagnoses included endemic viral infection such as human immunodeficiency virus (HIV), dengue fever, and chikungunya. Diagnosis was based on right-knee arthrocentesis, and synovial fluid culture followed by Neisseria gonorrhoeae polymerase chain reaction (PCR). The isolated strain was sensitive to penicillin. The man was treated with intravenous ceftriaxone and oral levofloxacin. Disseminated gonococcal infection should thus be considered when examining those with classical polyarthralgia symptoms even without a typical skin rash.

  17. Multiagent Based Information Dissemination in Vehicular Ad Hoc Networks

    Directory of Open Access Journals (Sweden)

    S.S. Manvi

    2009-01-01

    Full Text Available Vehicular Ad hoc Networks (VANETs are a compelling application of ad hoc networks, because of the potential to access specific context information (e.g. traffic conditions, service updates, route planning and deliver multimedia services (Voice over IP, in-car entertainment, instant messaging, etc.. This paper proposes an agent based information dissemination model for VANETs. A two-tier agent architecture is employed comprising of the following: 1 'lightweight', network-facing, mobile agents; 2 'heavyweight', application-facing, norm-aware agents. The limitations of VANETs lead us to consider a hybrid wireless network architecture that includes Wireless LAN/Cellular and ad hoc networking for analyzing the proposed model. The proposed model provides flexibility, adaptability and maintainability for traffic information dissemination in VANETs as well as supports robust and agile network management. The proposed model has been simulated in various network scenarios to evaluate the effectiveness of the approach.

  18. Congestion Reduction Using Ad hoc Message Dissemination in Vehicular Networks

    CERN Document Server

    Hewer, Thomas D

    2008-01-01

    Vehicle-to-vehicle communications can be used effectively for intelligent transport systems (ITS) and location-aware services. The ability to disseminate information in an ad-hoc fashion allows pertinent information to propagate faster through the network. In the realm of ITS, the ability to spread warning information faster and further is of great advantage to the receivers of this information. In this paper we propose and present a message-dissemination procedure that uses vehicular wireless protocols for influencing traffic flow, reducing congestion in road networks. The computational experiments presented in this paper show how an intelligent driver model (IDM) and car-following model can be adapted to 'react' to the reception of information. This model also presents the advantages of coupling together traffic modelling tools and network simulation tools.

  19. Modelling information dissemination under privacy concerns in social media

    Science.gov (United States)

    Zhu, Hui; Huang, Cheng; Lu, Rongxing; Li, Hui

    2016-05-01

    Social media has recently become an important platform for users to share news, express views, and post messages. However, due to user privacy preservation in social media, many privacy setting tools are employed, which inevitably change the patterns and dynamics of information dissemination. In this study, a general stochastic model using dynamic evolution equations was introduced to illustrate how privacy concerns impact the process of information dissemination. Extensive simulations and analyzes involving the privacy settings of general users, privileged users, and pure observers were conducted on real-world networks, and the results demonstrated that user privacy settings affect information differently. Finally, we also studied the process of information diffusion analytically and numerically with different privacy settings using two classic networks.

  20. Multilocular disseminated Tarlov cysts: Importance of imaging and management options.

    Science.gov (United States)

    Padma, Subramanyam; Palaniswamy, Shanmuga Sundaram

    2012-04-01

    With technological advancements and wider availability of multimodality imaging, incidental lesions are frequently identified in patients undergoing various imaging studies. We report here a case of multiloculated disseminated perineural or Tarlov cysts (TCs). The primary aim of this case study was to (1) provide a comprehensive review of the clinical, imaging, and histopathological features of TCs (2) to draw attention to the fact that multiple lumbosacral and dorsal TCs can produce nerve injuries and serious movement disturbances, and (3) to document the usefulness of the magnetic resonance imaging and bone scan in non-invasive diagnosis and guiding management in such cases. These cysts are clearly identified by magnetic resonance imaging (MRI) and computerized tomography imaging of the lumbosacral spine. However, there are no reports on the scintigraphic findings of multilocular disseminated TC in literature. TCs are typically benign, asymptomatic lesions that can simply be monitored. To date, no consensus exists about the best surgical strategy to use when indicated.

  1. GigaDB: promoting data dissemination and reproducibility.

    Science.gov (United States)

    Sneddon, Tam P; Zhe, Xiao Si; Edmunds, Scott C; Li, Peter; Goodman, Laurie; Hunter, Christopher I

    2014-01-01

    Often papers are published where the underlying data supporting the research are not made available because of the limitations of making such large data sets publicly and permanently accessible. Even if the raw data are deposited in public archives, the essential analysis intermediaries, scripts or software are frequently not made available, meaning the science is not reproducible. The GigaScience journal is attempting to address this issue with the associated data storage and dissemination portal, the GigaScience database (GigaDB). Here we present the current version of GigaDB and reveal plans for the next generation of improvements. However, most importantly, we are soliciting responses from you, the users, to ensure that future developments are focused on the data storage and dissemination issues that still need resolving. Database URL: http://www.gigadb.org.

  2. Disseminated Mycobacterium avium complex infection in an immunocompetent pregnant woman

    Directory of Open Access Journals (Sweden)

    Kim Woo

    2006-10-01

    Full Text Available Abstract Background Disseminated mycobacterium avium complex (MAC occurs mainly in immunocompromised hosts, which is associated with abnormal cellular immunity. Case presentation A 26-year-old pregnant woman presented with fever and general weakness. Miliary lung nodules were noted on chest X-ray. Under the impression of miliary tuberculosis, anti-tuberculosis medication was administered. However, the patient was not improved. Further work-up demonstrated MAC in the sputum and placenta. The patient was treated successfully with clarithromycin-based combination regimen. Conclusion This appears to be the first case of disseminated MAC in an otherwise healthy pregnant woman. Clinicians should be alert for the diagnosis of MAC infection in diverse clinical conditions.

  3. A case of adult onset disseminated juvenile xanthogranuloma

    Directory of Open Access Journals (Sweden)

    Havva Hilal Ayvaz

    2016-01-01

    Full Text Available Juvenile xanthogranuloma (JX is a rare, benign, non-Langerhans histiocytic proliferative disease that etiology is unknown. It is usually seen in children and infants. JX in adult is very rare. A 41-year-old female patient was admitted to our clinic with papules on her face, torso and extremities. A few lesions had occured 3 years ago on her face, they disseminated all over her body after having a traffic accident one year ago which for she had operations and she also concurrently was diagnosed asdiabetes mellitus (DM. Based on clinical and histopathological findings, the diagnosis of JX was made. There is no systemic involvement of JX detected. JX seen in adults are very rare and usually associated with hematological malignancy. The present case is a rare adult onset disseminated JX case without malignancy

  4. Reframing the dissemination challenge: a marketing and distribution perspective.

    Science.gov (United States)

    Kreuter, Matthew W; Bernhardt, Jay M

    2009-12-01

    A fundamental obstacle to successful dissemination and implementation of evidence-based public health programs is the near-total absence of systems and infrastructure for marketing and distribution. We describe the functions of a marketing and distribution system, and we explain how it would help move effective public health programs from research to practice. Then we critically evaluate the 4 dominant strategies now used to promote dissemination and implementation, and we explain how each would be enhanced by marketing and distribution systems. Finally, we make 6 recommendations for building the needed system infrastructure and discuss the responsibility within the public health community for implementation of these recommendations. Without serious investment in such infrastructure, application of proven solutions in public health practice will continue to occur slowly and rarely.

  5. [Disseminated mucormycosis in immunocompetent patients: A disease that also exists].

    Science.gov (United States)

    Pozo Laderas, Juan Carlos; Pontes Moreno, Antonio; Pozo Salido, Carmen; Robles Arista, Juan Carlos; Linares Sicilia, María José

    2015-01-01

    Mucormycosis is usually an acute angioinvasive infections, which leads to non-suppurative necrosis and significant tissue damage. It represents 1.6% of all the invasive fungal infections and predominates in immunosuppressed patients with risk factors. Incidence has been significantly increased even in immunocompetent patients. Due to finding a case of disseminated mucormycosis caused by Rhizomucor pusillus in a young immunocompetent patient, a systematic review was carried out of reported cases in PubMed of mucormycosis in immunocompetent adults according to the main anatomic locations, and especially in disseminated cases. A review of the main risk factors and pathogenicity, clinical manifestations, techniques of early diagnosis, current treatment options, and prognosis is presented. Taxonomy and classification of the genus Mucor has also been reviewed.

  6. Concept of scientific wildlife conservation and its dissemination.

    Science.gov (United States)

    Zhou, Xue-Hong; Wan, Xiao-Tong; Jin, Yu-Hui; Zhang, Wei

    2016-09-18

    In recent years, wildlife conservation has attracted great public attention. However, substantial distinctions can be found in the prevailing concepts of wildlife conservation, particularly with the recent notion that emphasizes animal rights. Wildlife welfare and wildlife rights are not synonymous, with welfare more compatible with the reasonable and legal utilization of wildlife. The key to scientific wildlife conservation is the appropriate awareness and appreciation of the relationship between wildlife conservation and utilization and the theoretical basis of holism. Nevertheless, rational biases regarding the public's understanding of wildlife conservation and the spread of information via social media still exist. As such, expansion of the concept of scientific wildlife conservation requires the application of several measures. Wildlife conservation researchers should be regarded as the most important disseminators of scientifically-based information, with education in schools and universities of growing importance. Furthermore, the media should shoulder the social responsibility for the accurate dissemination of conservation information.

  7. Mexican journals of educational research towards mainstream dissemination of science

    Directory of Open Access Journals (Sweden)

    Cabrera-Flores, Mayer

    2014-08-01

    Full Text Available The purpose of this study is to analyze the Electronic Journal of Educational Research (REDIE on its path towards the common manner of scientific dissemination. This research presents the evolution of Mexican policy with regards to the journals, the situation of the Educational Research Mexican journals, and its profundity relating to REDIE. In its evolution, there were three moments that stood out the most: the standardization of quality criteria, the digitalization and open access of the scientific journals, those that came together with REDIE like REDALYC and LATINDEX , and the individual initiatives of those journals that motivated the development of the scientific dissemination in Mexico. The investigation concludes with the realization of the necessity of achieving agreement on the efforts of various principal actors: governmental bodies, institutions, and academic communities.

  8. Overcoming Legal Limitations in Disseminating Slovene Web Corpora

    Directory of Open Access Journals (Sweden)

    Tomaž Erjavec

    2016-09-01

    Full Text Available Web texts are becoming increasingly relevant sources of information, with web corpora useful for corpus linguistic studies and development of language technologies. Even though web texts are directly accessable, which substantially simplifies the collection procedure compilation of web corpora is still complex, time consuming and expensive. It is crucial that similar endeavours are not repeated, which is why it is necessary to make the created corpora easily and widely accessible both to researchers and a wider audience. While this is logistically and technically a straightforward procedure, legal constraints, such as copyright, privacy and terms of use severely hinder the dissemination of web corpora. This paper discusses legal conditions and actual practice in this area, gives an overview of current practices and proposes a range of mitigation measures on the example of the Janes corpus of Slovene user-generated content in order to ensure free and open dissemination of Slovene web corpora.

  9. Topology for efficient information dissemination in ad-hoc networking

    Science.gov (United States)

    Jennings, E.; Okino, C. M.

    2002-01-01

    In this paper, we explore the information dissemination problem in ad-hoc wirless networks. First, we analyze the probability of successful broadcast, assuming: the nodes are uniformly distributed, the available area has a lower bould relative to the total number of nodes, and there is zero knowledge of the overall topology of the network. By showing that the probability of such events is small, we are motivated to extract good graph topologies to minimize the overall transmissions. Three algorithms are used to generate topologies of the network with guaranteed connectivity. These are the minimum radius graph, the relative neighborhood graph and the minimum spanning tree. Our simulation shows that the relative neighborhood graph has certain good graph properties, which makes it suitable for efficient information dissemination.

  10. JPEG2000 and dissemination of cultural heritage over the Internet.

    Science.gov (United States)

    Politou, Eugenia A; Pavlidis, George P; Chamzas, Christodoulos

    2004-03-01

    By applying the latest technologies in image compression for managing the storage of massive image data within cultural heritage databases and by exploiting the universality of the Internet we are now able not only to effectively digitize, record and preserve, but also to promote the dissemination of cultural heritage. In this work we present an application of the latest image compression standard JPEG2000 in managing and browsing image databases, focusing on the image transmission aspect rather than database management and indexing. We combine the technologies of JPEG2000 image compression with client-server socket connections and client browser plug-in, as to provide with an all-in-one package for remote browsing of JPEG2000 compressed image databases, suitable for the effective dissemination of cultural heritage.

  11. Disseminated histoplasmosis causing reversible gaze palsy and optic neuropathy.

    Science.gov (United States)

    Perry, J D; Girkin, C A; Miller, N R; Mann, R B

    1999-06-01

    Subacute disseminated histoplasmosis is an uncommon entity. Typical neuro-ophthalmologic manifestations are usually secondary to histoplasmomas or encephalitis. A 45-year-old man noted blurred vision while receiving empiric antituberculosis therapy for fever and diffuse granulomatous disease of unknown origin. Vertical-gaze palsy, right horizontal-gaze paresis, and mild right optic neuropathy were found on neuro-ophthalmologic examination. Further questioning revealed a history of frequent contact with fighting cocks from South America. Magnetic resonance images were consistent with multiple hemorrhagic infarcts, areas of inflammation, or both, and cerebral angiography showed changes consistent with vasculitis. A previously obtained biopsy specimen from the duodenum was restained and found to be positive for fungal elements. Serum antigen titers for Histoplasma capsulatum demonstrated evidence of active infection. This case is a rare example of a supranuclear ocular motility disturbance and optic neuropathy secondary to an occlusive vascular process in a patient with subacute disseminated histoplasmosis.

  12. Promising Website Practices for Disseminating Research on Family-School Partnerships to the Community

    Science.gov (United States)

    Chavkin, Nancy Feyl; Chavkin, Allan

    2008-01-01

    The issue of research dissemination via websites is part of the larger research utilization question, and the authors begin with a review of literature on the theory and best practices in dissemination. The second part of the study involves an exploratory examination of the websites and dissemination practices of 30 research centers focusing on…

  13. National Dissemination Conference. Proceedings. (9th, Kansas City, Missouri, June 22-24, 1976).

    Science.gov (United States)

    Herlig, Richard K.

    The objectives of this conference included (1) bringing conferees in contact with leaders of recent national dissemination endeavors, (2) allowing them to interact in voicing dissemination problems and posing possible solutions, and (3) eliciting concerns related to dissemination/diffusion efforts. The proceedings include lists of the…

  14. 34 CFR 412.31 - What existing dissemination systems must be used?

    Science.gov (United States)

    2010-07-01

    ... existing dissemination systems must be used? In carrying out its activities, each CCC must use existing dissemination systems, including the National Diffusion Network and the National Center or Centers for Research... 34 Education 3 2010-07-01 2010-07-01 false What existing dissemination systems must be used?...

  15. Disseminating Chronic Disease Prevention "to or with" Canadian Public Health Systems

    Science.gov (United States)

    Masuda, Jeffrey R.; Robinson, Kerry; Elliott, Susan; Eyles, John

    2009-01-01

    This article follows a conceptual article published in this journal by Elliott et al. and provides an empirical evaluation of the Canadian Heart Health Initiative-Dissemination Phase. Between 1994 and 2005, seven provincial research teams of the Canadian Heart Health Initiative-Dissemination Phase undertook projects to disseminate and evaluate the…

  16. Disseminated lymphoma presenting as acute thigh pain and renal failure.

    LENUS (Irish Health Repository)

    Brown, Catherine

    2009-01-01

    A 66-year-old diabetic man presented with severe right thigh swelling and pain together with acute renal failure. At autopsy, this was found to be due to disseminated high grade B cell lymphoma invading the psoas muscle and multiple organs, including the kidneys. The unique presentation of this case emphasizes the need for increased awareness of the variety of ways in which lymphoma can manifest itself.

  17. Visualization and dissemination of global crustal models on virtual globes

    Science.gov (United States)

    Zhu, Liang-feng; Pan, Xin; Sun, Jian-zhong

    2016-05-01

    Global crustal models, such as CRUST 5.1 and its descendants, are very useful in a broad range of geoscience applications. The current method for representing the existing global crustal models relies heavily on dedicated computer programs to read and work with those models. Therefore, it is not suited to visualize and disseminate global crustal information to non-geological users. This shortcoming is becoming obvious as more and more people from both academic and non-academic institutions are interested in understanding the structure and composition of the crust. There is a pressing need to provide a modern, universal and user-friendly method to represent and visualize the existing global crustal models. In this paper, we present a systematic framework to easily visualize and disseminate the global crustal structure on virtual globes. Based on crustal information exported from the existing global crustal models, we first create a variety of KML-formatted crustal models with different levels of detail (LODs). And then the KML-formatted models can be loaded into a virtual globe for 3D visualization and model dissemination. A Keyhole Markup Language (KML) generator (Crust2KML) is developed to automatically convert crustal information obtained from the CRUST 1.0 model into KML-formatted global crustal models, and a web application (VisualCrust) is designed to disseminate and visualize those models over the Internet. The presented framework and associated implementations can be conveniently exported to other applications to support visualizing and analyzing the Earth's internal structure on both regional and global scales in a 3D virtual-globe environment.

  18. First case of disseminated cryptococcosis in a Gorilla gorilla.

    Science.gov (United States)

    Mischnik, Alexander; Stockklausner, Julia; Hohneder, Nicole; Jensen, Henrik E; Zimmermann, Stefan; Reuss, David E; Rickerts, Volker; Tintelnot, Kathrin; Stockklausner, Clemens

    2014-11-01

    In humans, Cryptococcus mainly infects individuals with HIV infection or other types of immunosuppression. Here, we report the first case of disseminated cryptococcosis in a simian immunodeficiency virus-negative 27-year-old female Gorilla gorilla presenting with lethargy, progressive weight loss and productive cough. The diagnosis was confirmed by positive lung biopsy culture, serum cryptococcal antigen, and cerebral histopathology demonstrating encapsulated yeasts. Molecular characterisation of lung culture isolate yielded Cryptococcus neoformans var. grubii. An immune-deficiency could not be demonstrated.

  19. Disseminated Streptococcus pneumoniae infection involving a ventricular assist device.

    Science.gov (United States)

    Reeves, J S; Rajagopalan, N; Huaman, M A

    2015-08-01

    We describe the first reported case, to our knowledge, of disseminated pneumococcal infection involving a left ventricular assist device (LVAD). The management of this infection was extremely challenging, requiring multiple surgical debridements, LVAD removal, and prolonged courses of antibiotics. The Streptococcus pneumoniae isolate was found to be serotype 19F, which is included in both the pneumococcal polysaccharide and conjugate vaccines. This report highlights the importance of routine screening for up-to-date vaccination in patients who undergo LVAD implantation.

  20. Macrophage Function in Early Dissemination and Dormancy of Breast Cancer

    Science.gov (United States)

    2015-09-01

    of Oncological Sciences, The Immunology Institute, Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, USA 3Department of...cell 13, 58-68. Joyce, J. A., and Pollard, J. W. (2009). Microenvironmental regulation of metastasis. Nature reviews Cancer 9, 239-252. Kaplan, R. N...AWARD NUMBER: W81XWH-14-1-0365 TITLE: Macrophage Functions in Early Dissemination and Dormancy of Breast Cancer PRINCIPAL INVESTIGATOR: Nina

  1. Efficient Information Dissemination in Wireless Sensor Networks using Mobile Sinks

    Science.gov (United States)

    2006-10-01

    a large number of mobile sinks. They describe the SEAD (Scalable Energy-efficient Asynchronous Dissemination) protocol to build and maintain an...the most loaded sensor node ( Emax ) can be approximated as follows. Sensors that are only one hop away from the sink towards the event location (i.e...is proportional to the ratio of A1/A0, i.e., (12) where (13) (14) Thus, Emax is a linear function of the distance d between the sink

  2. Survey Study of Moso Bamboo Management Techniques Dissemination in Zhejiang

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    By PRA survey to 1 245 farmer households of 10 key Moso bamboo (Phyllostachys pubescens) production counties, the source and demand of the management techniques in Zhejiang were studied. The conducted principal factor analysis revealed that experience and traditional knowledge are currently major technical sources of farmer households' Moso bamboo forest management techniques and that the demonstrative household is a highly expected technical source, in which the prime factor is interpersonal dissemination ...

  3. Ultrasound, CT and MRI of ruptured and disseminated hydatid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Sinner, W.N. von (King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia). Department of Radiology)

    Three cases of echinococcus granulosus with rupture of hydatid cysts and widespread abdominal, pelvic of pleural dissemination are described. Ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) allowed recognition of ruptured hydatid cysts. This assisted to come to an appropriate therapy and exclusion or confirmation of hydatid cysts elsewhere in the body. Ultrasound, CT and MRI are also important for follow-up, evaluation of therapeutic response and/or early diagnosis of recurrence. (author). 22 refs.; 3 figs.

  4. Disseminated Histoplasmosis with Oral Manifestation in an Immunocompetent Patient

    Science.gov (United States)

    Chatterjee, Aishwarya; Agarwal, Manoj; Mathur, Meetu; Mathur, Setu; Mallikarjun, R.; Banerjee, Subrata

    2017-01-01

    A case of disseminated histoplasmosis (DH) in a 60-year-old female patient is reported from Jaipur, Rajasthan, India. The patient presented with multiple papules on the skin surrounding the lips, face, torso, trunk, and back. She also complained of growth in the palate. Histoplasmosis was confirmed by biopsy and histopathology of skin and palatal lesions. This case report highlights the presenting features and occurrence of histoplasmosis in nonendemic region in India. PMID:28255468

  5. Disseminated Chrysosporium infection in a German shepherd dog

    Directory of Open Access Journals (Sweden)

    Emily Cook

    2015-12-01

    Full Text Available Disseminated Chrysosporium spp. infection was diagnosed in a German shepherd dog based on a positive fungal culture and cytological findings of intralesional fungi associated with granulomatous splenitis and neutrophilic lymphadenitis. The clinical presentation that could mimic a multicentric lymphoma, including markedly enlarged lymph nodes and a very abnormal splenic appearance on ultrasound makes this case even more atypical. The patient showed rapid clinical improvement on oral posaconazole and remains clinically stable ten months after diagnosis.

  6. Dissemination of information to General Practitioners: a questionnaire survey

    Directory of Open Access Journals (Sweden)

    Fortnum Heather

    2004-11-01

    Full Text Available Abstract Background Early identification of permanent hearing impairment in children enables appropriate intervention which reduces adverse developmental outcomes. The UK Government has introduced a universal hearing screening programme for neonates. All involved health professionals, including those in Primary Care, need to be aware of the service to enable them to offer appropriate support to their patients. A programme of information dissemination within Primary Care was therefore undertaken. The aim of the current study was to determine the extent to which the information had reached General Practitioners (GPs, the GPs' preferred mode of dissemination and the sources from which GPs accessed information Methods Postal questionnaire survey of a randomised sample of 1000 GPs in the Phase I pilot sites of the Neonatal Hearing Screening Programme (NHSP. Results Responses were received from 54.2% of the sample. Just under 50% of those responding had received information, 62.2% of respondents said they would like to receive more information and the preferred methods of dissemination were the written word and web-sites to allow access when needed. Few GPs perceive themselves to have a core role in the delivery of the NHSP and thence a need for knowledge in the subject. Many are keen to delegate detail to a third party, usually the health visitor, who has traditionally had responsibility for hearing screening. Conclusions Dissemination efforts for service developments of relevance to GPs should concentrate on advertising a website address via brief but memorable posted literature and/or articles in relevant journals and magazines. The website should be GP-friendly, and have a dedicated area for GPs including information of specific relevance and downloadable information sheets.

  7. Enterobacter aerogenes and Enterobacter cloacae; versatile bacterial pathogens confronting antibiotic treatment

    OpenAIRE

    Davin-Regli, Anne,; Pagès, Jean-Marie

    2015-01-01

    International audience; Enterobacter aerogenes and E. cloacae have been reported as important opportunistic and multiresistant bacterial pathogens for humans during the last three decades in hospital wards. These Gram-negative bacteria have been largely described during several outbreaks of hospital-acquired infections in Europe and particularly in France. The dissemination of Enterobacter sp. is associated with the presence of redundant regulatory cascades that efficiently control the membra...

  8. Bacterial glycosyltransferase toxins.

    Science.gov (United States)

    Jank, Thomas; Belyi, Yury; Aktories, Klaus

    2015-12-01

    Mono-glycosylation of host proteins is a common mechanism by which bacterial protein toxins manipulate cellular functions of eukaryotic target host cells. Prototypic for this group of glycosyltransferase toxins are Clostridium difficile toxins A and B, which modify guanine nucleotide-binding proteins of the Rho family. However, toxin-induced glycosylation is not restricted to the Clostridia. Various types of bacterial pathogens including Escherichia coli, Yersinia, Photorhabdus and Legionella species produce glycosyltransferase toxins. Recent studies discovered novel unexpected variations in host protein targets and amino acid acceptors of toxin-catalysed glycosylation. These findings open new perspectives in toxin as well as in carbohydrate research.

  9. Endothelial JAM-A promotes reovirus viremia and bloodstream dissemination.

    Science.gov (United States)

    Lai, Caroline M; Boehme, Karl W; Pruijssers, Andrea J; Parekh, Vrajesh V; Van Kaer, Luc; Parkos, Charles A; Dermody, Terence S

    2015-02-01

    Viruses that cause systemic disease often spread through the bloodstream to infect target tissues. Although viremia is an important step in the pathogenesis of many viruses, how viremia is established is not well understood. Reovirus has been used to dissect mechanisms of viral pathogenesis and is being evaluated in clinical trials as an oncolytic agent. After peroral entry into mice, reovirus replicates within the gastrointestinal tract and disseminates systemically via hematogenous or neural routes. Junctional adhesion molecule-A (JAM-A) is a tight junction protein that serves as a receptor for reovirus. JAM-A is required for establishment of viremia and viral spread to sites of secondary replication. JAM-A also is expressed on the surface of circulating hematopoietic cells. To determine contributions of endothelial and hematopoietic JAM-A to reovirus dissemination and pathogenesis, we generated strains of mice with altered JAM-A expression in these cell types and assessed bloodstream spread of reovirus strain type 1 Lang (T1L), which disseminates solely by hematogenous routes. We found that endothelial JAM-A but not hematopoietic JAM-A facilitates reovirus T1L bloodstream entry and egress. Understanding how viruses establish viremia may aid in development of inhibitors of this critical step in viral pathogenesis and foster engineering of improved oncolytic viral vectors.

  10. A Personalized Information Dissemination System Based on How-Net

    Institute of Scientific and Technical Information of China (English)

    张磊; 杜小勇; 王珊

    2002-01-01

    The information dissemination model is becoming increasingly important inwide-area information systems. In this model, a user subscribes to an information disseminationservice by submitting profiles that describe his interests. There have been several simple kindsof information dissemination services on the Internet such as mailing list, but the problemis that it provides a crude granularity of interest matching. A user whose information needdoes not exactly match certain lists will either receive too many irrelevant or too few relevantmessages. This paper presents a personalized information dissemination model based on How-Net, which uses a Concept Network-Views (CN-V) model to support information filtering, user'sinterests modeling and information recommendation. A Concept Network is constructed uponthe user's profiles and the content of documents, which describes concepts and their relationsin the content and assigns different weights to these concepts. Usually the Concept Network isnot well arranged, from which it is hard to find some useful relations, so several views from areextracted it to represent the important relations explicitly.

  11. Disseminated Mycobacterium genavense infection in a FIV-positive cat.

    Science.gov (United States)

    Hughes, M S; Ball, N W; Love, D N; Canfield, P J; Wigney, D I; Dawson, D; Davis, P E; Malik, R

    1999-03-01

    An 8-year-old FIV-positive Australian cat was presented with coughing, periocular alopecia, pyrexia and inappetence. Skin scrapings demonstrated Demodex cati mites. Antibiotics were administered and it was treated successfully for periocular demodectic mange, but the cat continued to exhibit respiratory signs and lose weight. Further investigation revealed an ascarid infection and active chronic inflammation of undetected cause affecting the lower airways. Repetitive treatment with pyrantel failed to eradicate the ascarid infection. The cat became cachectic and developed moist ulcerative dermatitis of the neck, severe non-regenerative anaemia, leucopenia and thrombocytopenia. Necropsy and histopathology revealed mycobacteriosis affecting skin, lungs, spleen, lymph nodes, liver and kidney. Attempted culture of frozen tissues at a mycobacteria reference laboratory was unsuccessful. Paraffin-embedded, formalin-fixed tissue was retrieved and examined using PCR to amplify part of the 16S rRNA gene. A diagnosis of disseminated Mycobacterium genavense infection was made based on the presence of acid fast bacteria in many tissues and partial sequence of the 16S rRNA gene. Although M genavense has been identified previously as a cause of disseminated disease in AIDS patients, this is the first report of infection in a cat. It was suspected that the demodecosis, recurrent ascarid infections and disseminated M genavense infection resulted from an immune deficiency syndrome consequent to longstanding FIV infection.

  12. Predicting links based on knowledge dissemination in complex network

    Science.gov (United States)

    Zhou, Wen; Jia, Yifan

    2017-04-01

    Link prediction is the task of mining the missing links in networks or predicting the next vertex pair to be connected by a link. A lot of link prediction methods were inspired by evolutionary processes of networks. In this paper, a new mechanism for the formation of complex networks called knowledge dissemination (KD) is proposed with the assumption of knowledge disseminating through the paths of a network. Accordingly, a new link prediction method-knowledge dissemination based link prediction (KDLP)-is proposed to test KD. KDLP characterizes vertex similarity based on knowledge quantity (KQ) which measures the importance of a vertex through H-index. Extensive numerical simulations on six real-world networks demonstrate that KDLP is a strong link prediction method which performs at a higher prediction accuracy than four well-known similarity measures including common neighbors, local path index, average commute time and matrix forest index. Furthermore, based on the common conclusion that an excellent link prediction method reveals a good evolving mechanism, the experiment results suggest that KD is a considerable network evolving mechanism for the formation of complex networks.

  13. Disseminating Comparative Effectiveness Research Through Community-based Experiential Learning

    Science.gov (United States)

    Williamson, Margaret; Stevenson, Lynn; Davis, Brandy R.; Evans, R. Lee

    2017-01-01

    Objectives. To launch and evaluate a comparative effectiveness research education and dissemination program as part of an introductory pharmacy practice experience (IPPE). Methods. First- through third-year PharmD students received training on comparative effectiveness research and disseminated printed educational materials to patients in the community who they were monitoring longitudinally (n=314). Students completed an assessment and initial visit documentation form at the first visit, and a follow-up assessment and documentation form at a subsequent visit. Results. Twenty-three diabetes patients, 29 acid-reflux patients, 30 osteoarthritis patients, and 50 hypertension patients received materials. Aside from the patient asking questions, which was the most common outcome (n=44), the program resulted in 38 additional actions, which included stopping, starting, or changing treatments or health behaviors, or having additional follow-up or diagnostic testing. Small but positive improvements in patient understanding, confidence, and self-efficacy were observed. Conclusions. Dissemination of comparative effectiveness research materials in an IPPE program demonstrated a positive trend in markers of informed decision-making. PMID:28289299

  14. A privileged intraphagocyte niche is responsible for disseminated infection of Staphylococcus aureus in a zebrafish model.

    Science.gov (United States)

    Prajsnar, Tomasz K; Hamilton, Ruth; Garcia-Lara, Jorge; McVicker, Gareth; Williams, Alexander; Boots, Michael; Foster, Simon J; Renshaw, Stephen A

    2012-10-01

    The innate immune system is the primary defence against the versatile pathogen, Staphylococcus aureus. How this organism is able to avoid immune killing and cause infections is poorly understood. Using an established larval zebrafish infection model, we have shown that overwhelming infection is due to subversion of phagocytes by staphylococci, allowing bacteria to evade killing and found foci of disease. Larval zebrafish coinfected with two S. aureus strains carrying different fluorescent reporter gene fusions (but otherwise isogenic) had bacterial lesions, at the time of host death, containing predominantly one strain. Quantitative data using two marked strains revealed that the strain ratios, during overwhelming infection, were often skewed towards the extremes, with one strain predominating. Infection with passaged bacterial clones revealed the phenomenon not to bedue to adventitious mutations acquired by the pathogen. After infection of the host, all bacteria are internalized by phagocytes and the skewing of population ratios is absolutely dependent on the presence of phagocytes. Mathematical modelling of pathogen population dynamics revealed the data patterns are consistent with the hypothesis that a small number of infected phagocytes serve as an intracellular reservoir for S. aureus, which upon release leads to disseminated infection. Strategies to specifically alter neutrophil/macrophage numbers were used to map the potential subpopulation of phagocytes acting as a pathogen reservoir, revealing neutrophils as the likely 'niche'. Subsequently in a murine sepsis model, S. aureus abscesses in kidneys were also found to be predominantly clonal, therefore likely founded by an individual cell, suggesting a potential mechanism analogous to the zebrafish model with few protected niches. These findings add credence to the argument that S. aureus control regimes should recognize both the intracellular as well as extracellular facets of the S. aureus life

  15. Seizures Complicating Bacterial Meningitis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2004-09-01

    Full Text Available The clinical data of 116 patients, 1 month to <5 years of age, admitted for bacterial meningitis, and grouped according to those with and without seizures during hospitalization, were compared in a study at Buddhist Dalin Tzu Chi General Hospital, Chang Gung Memorial Hospital and other centers in Taiwan.

  16. The dissemination of C10 cysteine protease genes in Bacteroides fragilis by mobile genetic elements

    LENUS (Irish Health Repository)

    Thornton, Roibeard F

    2010-04-23

    Abstract Background The C10 family of cysteine proteases includes enzymes that contribute to the virulence of bacterial pathogens, such as SpeB in Streptococcus pyogenes. The presence of homologues of cysteine protease genes in human commensal organisms has not been examined. Bacteroides fragilis is a member of the dominant Bacteroidetes phylum of the human intestinal microbiota, and is a significant opportunistic pathogen. Results Four homologues of the streptococcal virulence factor SpeB were identified in the B. fragilis genome. These four protease genes, two were directly contiguous to open reading frames predicted to encode staphostatin-like inhibitors, with which the protease genes were co-transcribed. Two of these protease genes are unique to B. fragilis 638R and are associated with two large genomic insertions. Gene annotation indicated that one of these insertions was a conjugative Tn-like element and the other was a prophage-like element, which was shown to be capable of excision. Homologues of the B. fragilis C10 protease genes were present in a panel of clinical isolates, and in DNA extracted from normal human faecal microbiota. Conclusions This study suggests a mechanism for the evolution and dissemination of an important class of protease in major members of the normal human microbiota.

  17. The dissemination of C10 cysteine protease genes in Bacteroides fragilis by mobile genetic elements

    Directory of Open Access Journals (Sweden)

    Kagawa Todd F

    2010-04-01

    Full Text Available Abstract Background The C10 family of cysteine proteases includes enzymes that contribute to the virulence of bacterial pathogens, such as SpeB in Streptococcus pyogenes. The presence of homologues of cysteine protease genes in human commensal organisms has not been examined. Bacteroides fragilis is a member of the dominant Bacteroidetes phylum of the human intestinal microbiota, and is a significant opportunistic pathogen. Results Four homologues of the streptococcal virulence factor SpeB were identified in the B. fragilis genome. These four protease genes, two were directly contiguous to open reading frames predicted to encode staphostatin-like inhibitors, with which the protease genes were co-transcribed. Two of these protease genes are unique to B. fragilis 638R and are associated with two large genomic insertions. Gene annotation indicated that one of these insertions was a conjugative Tn-like element and the other was a prophage-like element, which was shown to be capable of excision. Homologues of the B. fragilis C10 protease genes were present in a panel of clinical isolates, and in DNA extracted from normal human faecal microbiota. Conclusions This study suggests a mechanism for the evolution and dissemination of an important class of protease in major members of the normal human microbiota.

  18. Clinical profile of disseminated cryptococcal infection-a case series

    Institute of Scientific and Technical Information of China (English)

    Vishwanath Sathyanarayanan; Ragini Bekur; Abdul Razak; Joydeep Chakraborty

    2010-01-01

    Objective:To study disseminated cryptococcal infection in a tertiary care hospital in Southern India.Methods:The clinical profile of 12 disseminated cryptococcosis patients with the age group of28-52years was retrospectively analyzed.Results:7(58.3%) presented with fever 30 days whereas2(16.7%)did not have fever. All the12(100%) had headache, 2(16.7%)had altered sensorium, one(8%)seizure.5(41.7%) had diarrhea and vomiting.6(50%) had oral candidiasis, and anemia.9(75%)had elevated erythrocyte sedimentation rate (ESR). 6(50%) had neck stiffness. Cerebrospinal fluid (CSF) pressure was elevated in all12(100%) patients. Blood culture positive for Cryptococcus neoformans(C. neoformans) in11(91.7%) andCSF culture positive in all12 (100%), one(8%)had urine culture positive. India ink preparation was positive in 10(83.3%). CD4 count was less than50/microl in 4 (33.3%), between 50-100 in6(50%)and2(16.7%) in the range of100-200. 6(50%) were treated with parenteral amphotericin B (0.7 mg/kg/d) during intensive phase followed by oral fluconazole400 mg/d for8 weeks then maintenance oral fluconazole 200 mg/d.5(41.6%) were treated with fluconazole alone.8(66.7%) improved and4(33.3%) patients died. Among those who succumbed to the illness,2(16.7%) received amphotericin and fluconazole,2(16.7%) patients received fluconazole alone.Conclusions: Disseminated cryptococcosis can cause considerable mortality inHIV patients and immunocompromised non-HIV individuals. At times, its presentation closely mimics that of Tuberculosis. Early diagnosis and appropriate treatment should be started as early as possible.

  19. Serum hyaluronic acid in patients with disseminated neoplasm.

    OpenAIRE

    Manley, G.; Warren, C

    1987-01-01

    Hyaluronic acid concentrations were measured by a laser nephelometric assay in serum samples from 50 patients with advanced disseminated neoplasm and 50 healthy controls matched for age and sex. The identity of hyaluronic acid was confirmed by a combination of electrophoretic and enzymatic techniques. The mean serum hyaluronic acid concentration for the control group was 1.09 mg/l, with a range of 0-4 mg/l. The mean concentration for patients with neoplastic disease was 10.38 mg/l, with a ran...

  20. Disseminated tuberculosis in a patient with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    J. Harikrishna

    2012-10-01

    Full Text Available Systemic lupus erythematosus (SLE is a systemic autoimmune disorder. Intercurrent infections and nephritis are important causes of mortality in SLE. Among infections, tuberculosis (TB is of particular importance as SLE patients are more susceptible to develop active TB, prior TB can precipitate SLE in genetically susceptible individuals and similar clinical presentations of SLE flare and TB may lead to delayed diagnosis. We report a patient with SLE, who developed disseminated TB. The present case highlights the importance of a high index of suspicion and focussed evaluation in the diagnosis of intercurrent infections, particularly TB in patients with SLE.

  1. Current concepts in the management of disseminated intravascular coagulation.

    Science.gov (United States)

    Thachil, Jecko; Toh, Cheng Hock

    2012-04-01

    Disseminated Intravascular Coagulation is a clinicopathological syndrome where widespread intravascular coagulation occurs in response to an inciting process. The pathophysiology for this disorder is complex with an important role for thrombin, the central regulator of the coagulation process. Since the clinical spectrum of DIC is variable due to its dynamic nature, the laboratory diagnosis should ideally be not based on a single marker or an isolated set of results. The treatment should primary focus on the management of the underlying triggering condition with blood products used as resuscitative measures. Newer therapeutic modalities have been recently tried with success although the management of DIC still remains a major challenge.

  2. Study of Disseminating Landslide Early Warning Information in Malaysia

    Science.gov (United States)

    Koay, Swee Peng; Lateh, Habibah; Tien Tay, Lea; Ahamd, Jamilah; Chan, Huah Yong; Sakai, Naoki; Jamaludin, Suhaimi

    2015-04-01

    In Malaysia, rain induced landslides are occurring more often than before. The Malaysian Government allocates millions of Malaysian Ringgit for slope monitoring and slope failure remedial measures in the budget every year. In rural areas, local authorities also play a major role in monitoring the slope to prevent casualty by giving information to the residents who are staying near to the slopes. However, there are thousands of slopes which are classified as high risk slopes in Malaysia. Implementing site monitoring system in these slopes to monitor the movement of the soil in the slopes, predicting the occurrence of slopes failure and establishing early warning system are too costly and almost impossible. In our study, we propose Accumulated Rainfall vs. Rainfall Intensity prediction method to predict the slope failure by referring to the predicted rainfall data from radar and the rain volume from rain gauges. The critical line which determines if the slope is in danger, is generated by simulator with well-surveyed the soil property in the slope and compared with historical data. By establishing such predicting system, the slope failure warning information can be obtained and disseminated to the surroundings via SMS, internet and siren. However, establishing the early warning dissemination system is not enough in disaster prevention, educating school children and the community by giving knowledge on landslides, such as landslide's definition, how and why does the slope failure happen and when will it fail, to raise the risk awareness on landslides will reduce landslides casualty, especially in rural area. Moreover, showing video on the risk and symptom of landslides in school will also help the school children gaining the knowledge of landslides. Generating hazard map and landslides historical data provides further information on the occurrence of the slope failure. In future, further study on fine tuning of landslides prediction method, applying IT technology to

  3. [Disseminated fusariosis in a patient with acute lymphoblastic leukaemia

    DEFF Research Database (Denmark)

    Hermansen, N.E.; Ralfkiaer, E.M.; Kjeldsen, L.

    2008-01-01

    Invasive mould infections are a major cause of infectious mortality in highly immunosuppressed patients. Incidence in this high risk group is 10-20% with a death rate in excess of 50%. Most invasive moulds are Aspergillus spp. We present a case of a 74-year-old woman with acute lymphoblastic...... leukaemia who developed a rare disseminated mould infection with Fusarium solani during induction chemotherapy. We present the case story and discuss the pathogenesis, clinical characteristics and treatment of invasive fusariosis Udgivelsesdato: 2008/9/8...

  4. Rare Dysuria: Prostatic Abscess due to Disseminated Coccidioidomycosis

    Directory of Open Access Journals (Sweden)

    Pedram Ansari Pirsaraei

    2016-11-01

    Full Text Available We present a case of disseminated coccidioidomycosis with formation of a prostatic abscess in a 28-year-old diabetic male. Though rare, Coccidiodes prostatitis should be included in the differential for patients who have spent time in endemic areas and present with prostatitis or other genitourinary tract symptoms, especially in the setting of immunocompromise. The small number of Coccidiodes prostatitis cases described in the literature previously are reviewed, along with a wider discussion of coccidioidomycosis. Treatment modalities for this challenging fungal disease are also discussed.

  5. Prostate Biopsy Sampling Causes Hematogenous Dissemination of Epithelial Cellular Material

    Directory of Open Access Journals (Sweden)

    Sam Ladjevardi

    2014-01-01

    Full Text Available The extent of epithelial cellular material (ECM occurring in venous blood samples after diagnostic core needle biopsy (CNB was studied in 23 patients with CNB diagnosed prostate cancer without provable metastases and 15 patients without cancer. The data show a significant increase of ECM in the peripheral blood sampled 20 seconds or 30 minutes after the last of 10 CNB procedures compared to the number of ECM detectable in the blood samples taken before the performance of CNB. The data indicate that diagnostic CNB of prostate cancer causes an extensive tissue trauma with a potential risk of cancer cell dissemination.

  6. Modeling infectious diseases dissemination through online role-playing games.

    Science.gov (United States)

    Balicer, Ran D

    2007-03-01

    As mathematical modeling of infectious diseases becomes increasingly important for developing public health policies, a novel platform for such studies might be considered. Millions of people worldwide play interactive online role-playing games, forming complex and rich networks among their virtual characters. An unexpected outbreak of an infective communicable disease (unplanned by the game creators) recently occurred in this virtual world. This outbreak holds surprising similarities to real-world epidemics. It is possible that these virtual environments could serve as a platform for studying the dissemination of infectious diseases, and as a testing ground for novel interventions to control emerging communicable diseases.

  7. International Journal of Information Dissemination and Technology (IJIDT)

    OpenAIRE

    Kuri , Ramesh; Adin, Tayappa

    2016-01-01

    The paper brings out the results of a Bibliomatrics analysis of the journal titled "International Journal of Information Dissemination and Technology (IJIDT)” for the period of 2011-2015. The result showed that there are 254 articles are published during in study period. Among 254 articles the study found that 93.69% of papers are multi-authored. The degree of collaboration is found to be 0.59%. The average author productivity is 1.86%. More than 26% of articles appeared on dom...

  8. Heterogeneous Epidemic Model for Assessing Data Dissemination in Opportunistic Networks

    DEFF Research Database (Denmark)

    Rozanova, Liudmila; Alekseev, Vadim; Temerev, Alexander

    2014-01-01

    In this paper we apply a susceptible-infected-susceptible (SIS) epidemic model to analyse data dissemination in opportunistic networks with heterogeneous setting of transmission parameters, as established in author's previous paper? . We obtained the estimation of the final epidemic size assuming...... that amount of data transferred between network nodes possesses a Pareto distribution, implying scale-free properties. In this context, more heterogeneity in susceptibility means the less severe epidemic progression, and, on the contrary, more heterogeneity in infectivity leads to more severe epidemics...

  9. Cooperative Bacterial Foraging Optimization

    Directory of Open Access Journals (Sweden)

    Hanning Chen

    2009-01-01

    Full Text Available Bacterial Foraging Optimization (BFO is a novel optimization algorithm based on the social foraging behavior of E. coli bacteria. This paper presents a variation on the original BFO algorithm, namely, the Cooperative Bacterial Foraging Optimization (CBFO, which significantly improve the original BFO in solving complex optimization problems. This significant improvement is achieved by applying two cooperative approaches to the original BFO, namely, the serial heterogeneous cooperation on the implicit space decomposition level and the serial heterogeneous cooperation on the hybrid space decomposition level. The experiments compare the performance of two CBFO variants with the original BFO, the standard PSO and a real-coded GA on four widely used benchmark functions. The new method shows a marked improvement in performance over the original BFO and appears to be comparable with the PSO and GA.

  10. Bacterial Colony Optimization

    Directory of Open Access Journals (Sweden)

    Ben Niu

    2012-01-01

    Full Text Available This paper investigates the behaviors at different developmental stages in Escherichia coli (E. coli lifecycle and developing a new biologically inspired optimization algorithm named bacterial colony optimization (BCO. BCO is based on a lifecycle model that simulates some typical behaviors of E. coli bacteria during their whole lifecycle, including chemotaxis, communication, elimination, reproduction, and migration. A newly created chemotaxis strategy combined with communication mechanism is developed to simplify the bacterial optimization, which is spread over the whole optimization process. However, the other behaviors such as elimination, reproduction, and migration are implemented only when the given conditions are satisfied. Two types of interactive communication schemas: individuals exchange schema and group exchange schema are designed to improve the optimization efficiency. In the simulation studies, a set of 12 benchmark functions belonging to three classes (unimodal, multimodal, and rotated problems are performed, and the performances of the proposed algorithms are compared with five recent evolutionary algorithms to demonstrate the superiority of BCO.

  11. Bacterial assays for recombinagens.

    Science.gov (United States)

    Hoffmann, G R

    1992-12-01

    Two principal strategies have been used for studying recombinagenic effects of chemicals and radiation in bacteria: (1) measurement of homologous recombination involving defined alleles in a partially diploid strain, and (2) measurement of the formation and loss of genetic duplications in the bacterial chromosome. In the former category, most methods involve one allele in the bacterial chromosome and another in a plasmid, but it is also possible to detect recombination between two chromosomal alleles or between two extrachromosomal alleles. This review summarizes methods that use each of these approaches for detecting recombination and tabulates data on agents that have been found to be recombinagenic in bacteria. The assays are discussed with respect to their effectiveness in testing for recombinagens and their potential for elucidating mechanisms underlying recombinagenic effects.

  12. Bacterial transformation of terpenoids

    Science.gov (United States)

    Grishko, V. V.; Nogovitsina, Y. M.; Ivshina, I. B.

    2014-04-01

    Data on the bacterial transformation of terpenoids published in the literature in the past decade are analyzed. Possible pathways for chemo-, regio- and stereoselective modifications of terpenoids are discussed. Considerable attention is given to new technological approaches to the synthesis of terpenoid derivatives suitable for the use in the perfume and food industry and promising as drugs and chiral intermediates for fine organic synthesis. The bibliography includes 246 references.

  13. Spontaneous bacterial peritonitis

    OpenAIRE

    Al Amri Saleh

    1995-01-01

    Spontaneous bacterial peritonitis (SBP) is an infection of the ascitic fluid without obvious intra-abdominal source of sepsis; usually complicates advanced liver disease. The pathogenesis of the disease is multifactorial: low ascitic protein-content, which reflects defi-cient ascitic fluid complement and hence, reduced opsonic activity is thought to be the most important pathogenic factor. Frequent and prolonged bacteremia has been considered as another pertinent cause of SBP. This disease is...

  14. Modelling bacterial speciation

    OpenAIRE

    2006-01-01

    A central problem in understanding bacterial speciation is how clusters of closely related strains emerge and persist in the face of recombination. We use a neutral Fisher–Wright model in which genotypes, defined by the alleles at 140 house-keeping loci, change in each generation by mutation or recombination, and examine conditions in which an initially uniform population gives rise to resolved clusters. Where recombination occurs at equal frequency between all members of the population, we o...

  15. Adaptive Bacterial Foraging Optimization

    Directory of Open Access Journals (Sweden)

    Hanning Chen

    2011-01-01

    Full Text Available Bacterial Foraging Optimization (BFO is a recently developed nature-inspired optimization algorithm, which is based on the foraging behavior of E. coli bacteria. Up to now, BFO has been applied successfully to some engineering problems due to its simplicity and ease of implementation. However, BFO possesses a poor convergence behavior over complex optimization problems as compared to other nature-inspired optimization techniques. This paper first analyzes how the run-length unit parameter of BFO controls the exploration of the whole search space and the exploitation of the promising areas. Then it presents a variation on the original BFO, called the adaptive bacterial foraging optimization (ABFO, employing the adaptive foraging strategies to improve the performance of the original BFO. This improvement is achieved by enabling the bacterial foraging algorithm to adjust the run-length unit parameter dynamically during algorithm execution in order to balance the exploration/exploitation tradeoff. The experiments compare the performance of two versions of ABFO with the original BFO, the standard particle swarm optimization (PSO and a real-coded genetic algorithm (GA on four widely-used benchmark functions. The proposed ABFO shows a marked improvement in performance over the original BFO and appears to be comparable with the PSO and GA.

  16. Neglected bacterial zoonoses.

    Science.gov (United States)

    Chikeka, I; Dumler, J S

    2015-05-01

    Bacterial zoonoses comprise a group of diseases in humans or animals acquired by direct contact with or by oral consumption of contaminated animal materials, or via arthropod vectors. Among neglected infections, bacterial zoonoses are among the most neglected given emerging data on incidence and prevalence as causes of acute febrile illness, even in areas where recognized neglected tropical diseases occur frequently. Although many other bacterial infections could also be considered in this neglected category, five distinct infections stand out because they are globally distributed, are acute febrile diseases, have high rates of morbidity and case fatality, and are reported as commonly as malaria, typhoid or dengue virus infections in carefully designed studies in which broad-spectrum diagnoses are actively sought. This review will focus attention on leptospirosis, relapsing fever borreliosis and rickettsioses, including scrub typhus, murine typhus and spotted fever group rickettsiosis. Of greatest interest is the lack of distinguishing clinical features among these infections when in humans, which confounds diagnosis where laboratory confirmation is lacking, and in regions where clinical diagnosis is often attributed to one of several perceived more common threats. As diseases such as malaria come under improved control, the real impact of these common and under-recognized infections will become evident, as will the requirement for the strategies and allocation of resources for their control.

  17. Bacterial infections of pulp and periodontal origin.

    Science.gov (United States)

    González-Moles, Miguel Angel; González, Nabila M

    2004-01-01

    The anatomical and structural characteristics of the pulp make this structure prone to altering as a result of, for instance, periodontal conditions (proximity), iatrogenic alterations, infections and involvement of vascular and nerve structures (it is surrounded by hard tissues that prevent expansion), to name just a few. Pulpitis is a process that courses with pain of varying intensity that allows us to determine the location of the lesion in clinical terms. Its evolution varies and may even progress to pulpar necrosis that in turn, produces neuritis-like pain. Diagnosis is established by means of clinical symptomatology and supported by X-rays, palpation of tissues at painful sites, application of electrical stimuli, heat, etc. Periodontitis is a bacterial infection originating in the apex. The most important form is the so-called acute apical periodontitis that arises as a result of a prior episode of pulpitis. It is characterized by acute pain located in the tooth, accompanied by the feeling of having a long-tooth. The patient refers being unable to chew on that side; there may be painful mobility of the tooth and an outflow of pus that alleviates symptoms. X-rays do not provide a lot of information, but may attest to a widening of the apical space. This pathology may disseminate to surrounding tissues, leading to conditions of considerable severity.

  18. Thyroid Storm Complicated by Bicytopenia and Disseminated Intravascular Coagulation

    Science.gov (United States)

    Tokushima, Yoshinori; Sakanishi, Yuta; Nagae, Kou; Tokushima, Midori; Tago, Masaki; Tomonaga, Motosuke; Yoshioka, Tsuneaki; Hyakutake, Masaki; Sugioka, Takashi; Yamashita, Shu-ichi

    2014-01-01

    Patient: Male, 23 Final Diagnosis: Thyroid storm Symptoms: Delirium • diarrhea • fever • hypertension • hyperventilation • tachycardia • weight loss Medication: — Clinical Procedure: — Specialty: Endocrinology and Metabolic Objective: Unusual clinical course Background: The clinical presentation of thyroid storm includes fever, tachycardia, hypertension, and neurological abnormalities. It is a serious condition with a high mortality rate. Furthermore, some other complications affect the clinical course of thyroid storm. Although it is reported that prognosis is poor when thyroid storm is complicated by disseminated intravascular coagulation syndrome (DIC) and leukopenia, reports of such cases are rare. Case Report: A 23-year-old man presented with delirium, high pyrexia, diarrhea, and weight loss of 18 kg over 2 months. According to the criteria of Burch and Wartofsky, he was diagnosed with thyroid storm on the basis of his symptom-complex and laboratory data that confirmed the presence of hyperthyroidism. Investigations also found leukopenia, thrombocytopenia, and disseminated intravascular coagulation, all of which are very rare complications of thyroid storm. We successfully treated him with combined therapy including anti-thyroid medication, despite leukopenia. Conclusions: Early diagnosis and treatment are essential in ensuring a good outcome for patients with this rare combination of medical problems. PMID:25072662

  19. The role of networks in the dissemination of clean technologies

    Energy Technology Data Exchange (ETDEWEB)

    Janssen, M. [KEMA, Arnhem (Netherlands)

    2003-07-01

    Information from scientific research projects is generally disseminated to potential users (Small Medium Enterprises (SME) and industries) through scientific papers and conferences. The author presents a more effective way to disseminate this valuable information to SMEs. The proposed approach was introduced by Thematic Networks within the Fifth Frame Programme of the European Commission (EC). The Network was created to provide a smooth transmission of knowledge from those who generate the information to those who use it. The author discussed the role of Thematic Network in relation to the Consortium entitled Production of Novel Products from Glassy Combustion Residues (PROGRES). The Network resulted in a pan-European discussion platform to study issues associated with advanced uses for combustion residues as secondary raw materials. Emphasis was placed on new advanced technologies for fly ash based products under practical conditions. This topic will be discussed in a book being completed by an International PROGRES Consortium. It will describe new technologies for coal fly ash based products. When launching new products, consideration will be given to all stakeholders, from producers of residues to potential users. 2 figs.

  20. TOWARDS A NEW APPROACH OF DATA DISSEMINATION IN VANETS NETWORKS

    Directory of Open Access Journals (Sweden)

    Ouafa Mahma

    2016-01-01

    Full Text Available In the 2000s, ad hoc networks was developed and highly used in dynamic environment, particularly for inter- vehicular communication (VANETs : Vehicular Ad hoc Networks. Since that time, many researches and developments process was dedicated to VANET networks. This was motivated by the current vehicular industry trend that is leading to a new transport system generation based on the use of new communication technologies in order to provide many services to passengers, the fact that improves the driving and travel’s experience. These systems require traffic information sharing and dissemination the example as the case alert message emitting allowing the driver to minimize driving risks. Sharing such information between vehicles helps to anticipate potentially dangerous situations, as well as planning better routes during congestion situations. In this context, we are trying in this paper to model and simulate VANET Networks in order to analyze and evaluate security information dissemination approaches and mechanisms used in this type of networks in several exchanges conditions.This in order to identify their limitations and suggest a new improved approach. This study was conducted as part of our research project entitled “Simulation & VANETs”, where we justify and validate our approach using modeling and simulation techniques and tools used in this domain.

  1. Lupus Flare: An Uncommon Presentation of Disseminated Gonorrhea

    Directory of Open Access Journals (Sweden)

    Uyen To

    2014-01-01

    Full Text Available Gonorrhea is one of the most common sexually transmitted diseases in the US with 700,000 annual cases. Although most cases of gonorrhea are localized, approximately 0.5–3% become disseminated. Here we discuss a rare case of a patient with systemic lupus erythematosus (SLE who developed septic shock from disseminated gonorrhea infection (DGI. Our patient is a 24-year-old woman with SLE, mixed connective tissue disease with cutaneous vasculitis, and lupus nephritis who presented with several weeks of malaise and generalized body aches associated with a diffuse rash along her fingers, palms, and trunk. Infectious workup was unrevealing with the exception of a positive gonorrhea test obtained from a cervical swab. Given her symptoms of tenosynovitis, the appearance of her skin lesions, and her positive gonorrhea test, she was diagnosed with septic shock secondary to DGI. With antibiotic treatment, the patient reported a dramatic improvement of the pain in her swollen joints and her rash receded. Patients diagnosed with SLE carry an increased risk of gonorrhea regardless of whether or not they are being treated for their SLE. Although it is well-documented that SLE is associated with severe DGI, few describe it resulting in overt septic shock.

  2. Hepatitis in Disseminated Bacillus Calmette-Guérin Infection

    Directory of Open Access Journals (Sweden)

    Markus U Göttke

    2000-01-01

    Full Text Available Local immunotherapy with an attenuated live strain of Mycobacterium bovis, bacillus Calmette-Guérin (BCG, is an effective and frequently used treatment for in situ transitional cell carcinoma (TCC of the bladder. Success rates are high, and serious side effects are infrequent but can affect every organ system. A 79-year-old patient with recently diagnosed TCC who was treated with intravesical BCG for a recurrence after initial surgical treatment is reported. After unsuccessful attempts at bladder catheterization with the creation of a false passage for his third treatment, BCG was instilled via a suprapubic catheter the same day and again a week later. Two weeks after the third BCG instillation, the patient presented with profound lethargy and weakness to the point of not being able to get up out of a chair. He was febrile, anorexic, icteric and had hepatosplenomegaly. Disseminated BCG infection was suspected on the basis of history, clinical examination and a liver biopsy that showed noncaseating granulomatous hepatitis. Empirical treatment was started with antituberculous combination therapy. A short course of an oral corticosteroid was given. Clinical improvement was marked and sustained so that the patient could be discharged home for the full six-month course of his treatment. Disseminated BCG infection with granulomatous hepatitis can be severe and life-threatening in cases where a large intravascular inoculum of BCG may have been given inadvertently.

  3. The influence of Iranian scientific journals in disseminating medical information

    Directory of Open Access Journals (Sweden)

    Farzaneh Aminpour

    2012-01-01

    Full Text Available Background: Scientific journals are the most credible and updated information resources for valid information in the various fields of science and technology. The present study investigates the status of Iranian scientific journals in disseminating medical information to the world of science. Materials and Methods: Total 163 Iranian medical journals accredited by national medical journals commission of Iranian ministry of health and medical education were evaluated through a cross-sectional study. The results were represented in descriptive statistics in the form of table and chart. Results: The study showed that 89.6% of Iranian medical journals were covered by regional information databases. Web of Science database indexed 22 (13.5% Iranian journals in the field of medical science. Only six (6.7% journals were indexed by Medline. Fifty-eight (35.6% journals were in English, 102 (62.6% in Persian, and three (1.8% were bilingual which published their articles both in Persian and English languages. The highest Impact factor belonged to Iranian Journal of Allergy Asthma and Immunology. Conclusions: Improving scientific credibility of Iranian scholarly journals and their influence in disseminating medical information calls for a precise scientific and executive administration in publishing standards and also in the quality of content.

  4. IMPORTANCE OF LYMPHATIC’S IN DISSEMINATION OF BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Zahida Rasool

    2013-09-01

    Full Text Available The Breast cancer is one of the most common cancers in females with many subtypes. Breast cancer can spread via hematogenous route as well as lymphatic routes. Knowledge of the lymphatic drainage of breast is required not only for the performance of surgical procedures but also in planning therapeutic radiation, predicting sites of locally recurrent disease.The lymphatic drainage of the breast is considered rich, and identification of the major pathways allows a surgeon to predict the sites most commonly containing lymph-borne metastases. Careful inspection and palpation of Axillary, supraclavicular and parasternal sites for nodal involvement is thoroughly performed for recording location, size, consistency, shape, mobility, fixation, and other characteristics of any palpable lymphadenopathy. Local implications of lymphatic obstruction can be Preau D orange appearance and edema while as distant manifestations can be involvement of Nodes along with dissemination to other organs.The further the lymphatic dissemination , the lesser the favourable prognosis . Pathologic stage combines the findings from pathologic examination of the resected primary breast cancer and axillary or other regional lymph nodes.This connotes the importance of Status of Lymphatics in Breast Cancer.

  5. 235例肺外结核性创面患者流行病学调查%Epidemiological investigation of 235 patients with extra-pulmonary tuberculosis wounds

    Institute of Scientific and Technical Information of China (English)

    常娜; 贾赤宇; 刘真; 张亚洁; 李文婷; 田甜

    2015-01-01

    目的 初步探讨肺外结核性创面流行病学特点和规律,为临床研究提供可靠数据.方法 对笔者单位2010年1月-2012年12月收治的肺外结核性创面患者的性别、年龄、民族、家庭背景、卡介苗接种情况、原发病灶、外伤史这几项资料进行回顾性分析,总结其规律及特点. 结果 5 863例肺外结核病患者中,235例出现结核性创面,占4.0%.其中男139例、女96例,男女之比为1.4∶1.0.年龄1~87(37±18)岁,其中大于15岁且小于或等于30岁青壮年患者构成比最大(100例,42.6%).多数患者为汉族;仅有11例患者为少数民族,占4.7%.患者中163例来自农村,占69.4%;72例来自城镇,占30.6%.卡介苗接种率为13.6%(32例).原发病灶中,以周围淋巴结结核为主,共112例,占47.7%,其中又以颈部淋巴结结核为主(99例,88.4%).21例(男19例、女2例)患者近期有车祸等外伤史. 结论 结核性创面有一定的发病率,并非罕见,以农村地区青壮年人群多发,患者的卡介苗接种率较低,颈部淋巴结结核为主要原发病灶.%Objective To investigate the epidemiological characteristics and patterns of extra-pulmonary tuberculosis wounds in order to provide reliable data for further clinical research.Methods Records of patients with extra-pulmonary tuberculosis wounds hospitalized from January 2010 to December 2012 were retrospectively analyzed,including gender,age,nationality,family background,Bacille CalmetteGuerin (BCG) vaccination,primary lesion,and history of injury.Results Tuberculosis wounds were found in 235 patients among 5 863 patients with extra-pulmonary tuberculosis,accounting for 4.0%.Among the patients with tuberculosis wounds,there were 139 male and 96 female,and the ratio of male to female was 1.4∶ 1.0.The age of patients ranged from 1 to 87 (37 ± 18) years old,and the highest incidence occurred in patients older than 15 and younger than or equal to 30 years old (100 cases

  6. Portable Microwave Frequency Dissemination in Free Space and Implications on Ground-Satellite Synchronization

    CERN Document Server

    Wang, Bo; Bai, Yu; Yuan, Yibo; Gao, Chao; Wang, Lijun

    2015-01-01

    Frequency dissemination and synchronization in free space plays an important role in global navigation satellite system (GNSS), radio astronomy and synthetic aperture radar (SAR). In this paper, we demonstrate a portable radio frequency (RF) dissemination scheme via free space using microwave antennas. The setup has a good environment adaptability and high dissemination stability. The frequency signal is disseminated at different distances ranging from 10 to 640 m with a fixed 10 Hz locking bandwidth, and the scaling law of dissemination stability on distance and averaging time is discussed. The preliminary extrapolation shows that the dissemination stability may reach $1\\times10^{-12}/s$ in ground-to-satellite synchronization, which far exceeds all present methods, and is worthy for further study.

  7. A dissemination research agenda to strengthen health promotion and disease prevention.

    Science.gov (United States)

    Johnson, J L; Green, L W; Frankish, C J; MacLean, D R; Stachenko, S

    1996-01-01

    The question of how to enhance the dissemination of knowledge and the use of innovations related to disease prevention and health promotion was posed to an international group of experts at an invitational research conference held in Vancouver, British Columbia in March 1995. The Canadian Conference on Dissemination Research Strengthening Health Promotion and Disease Prevention was co-sponsored by 15 voluntary organizations, government agencies and industries. It examined advances and gaps in the study of diffusion and adoption of preventive knowledge and practices among health professionals and the public. It was the first national conference of its kind devoted to dissemination research and dissemination of research specifically in health promotion and disease prevention. This paper summarizes the major issues raised in the papers presented at this conference. Policies and strategies for strengthening dissemination research and the dissemination of health promotion knowledge and practices are suggested.

  8. The use of molecular typing to evaluate the dissemination of antimicrobial resistance among gram-negative rods in Brazilian hospitals

    Directory of Open Access Journals (Sweden)

    Iraci Tosin

    2003-12-01

    Full Text Available Antimicrobial resistance has increased rapidly in Brazil and worldwide during the past few years, giving rise to a growing necessity for antimicrobial resistance surveillance programs. These programs have been instituted in order to monitor bacterial resistance in various regions, and to guide empirical antimicrobial therapy. We evaluated the use of molecular typing in multicenter surveillance programs. We also studied the dissemination modes of selected resistance profiles. Antimicrobial susceptibility to various antimicrobial agents was evaluated by the reference broth microdilution method. Bacterial isolates with selected susceptibility patterns were characterized by pulsed field-gel electrophoresis (PFGE. A total of 119 Gram-negative bacteria were molecularly typed, including 22 imipenem-resistant Pseudomonas aeruginosa, 26 ESBL-producing Escherichia coli, 27 cefoxitin-resistant-ESBL-producing Klebsiella pneumoniae, 33 Enterobacter spp., 8 Citrobacter spp., and 3 S. marcescens isolates resistant to ceftazidime. The isolates were from clinically apparent bacteremia of patients hospitalized in medical centers located in 13 cities of 11 Brazilian states. Our molecular typing results revealed a great genetic diversity among isolates of the same species. However, some major PFGE patterns were found in more than one isolate. All repeated PFGE patterns were detected in only 2 isolates, which were isolated within the same institutions or in different medical centers. We conclude that the ability to characterize organisms phenotypically and genotypically is a powerful epidemiologic tool and it provides unique information that is very important for multicenter surveillance programs.

  9. Disseminated cryptococcosis with extensive subcutaneous nodules in a renal transplant recipient

    Institute of Scientific and Technical Information of China (English)

    桑红; 周文泉; 石群立; 张新华; 倪容之

    2004-01-01

    @@ Patients with disseminated cryptococcosis infrequently present with cutaneous involvement. A 34-year-old woman who had a renal transplant developed disseminated cryptococcosis with an unusual cutaneous presentation. Extensive subcutaneous nodules are rare in disseminated cryptococcosis, but the patient belonged to a high-risk group. Fluconazole 200 mg/d was administered intravenously. After a total dose of 1800 mg of fluconazole was given, the patient ' s situation improved.

  10. Bacterial chromosome segregation.

    Science.gov (United States)

    Possoz, Christophe; Junier, Ivan; Espeli, Olivier

    2012-01-01

    Dividing cells have mechanisms to ensure that their genomes are faithfully segregated into daughter cells. In bacteria, the description of these mechanisms has been considerably improved in the recent years. This review focuses on the different aspects of bacterial chromosome segregation that can be understood thanks to the studies performed with model organisms: Escherichia coli, Bacillus subtilis, Caulobacter crescentus and Vibrio cholerae. We describe the global positionning of the nucleoid in the cell and the specific localization and dynamics of different chromosomal loci, kinetic and biophysic aspects of chromosome segregation are presented. Finally, a presentation of the key proteins involved in the chromosome segregation is made.

  11. Bacterial Degradation of Pesticides

    DEFF Research Database (Denmark)

    Knudsen, Berith Elkær

    This PhD project was carried out as part of the Microbial Remediation of Contaminated Soil and Water Resources (MIRESOWA) project, funded by the Danish Council for Strategic Research (grant number 2104-08-0012). The environment is contaminated with various xenobiotic compounds e.g. pesticides......D student, to construct fungal-bacterial consortia in order to potentially stimulate pesticide degradation thereby increasing the chance of successful bioaugmentation. The results of the project are reported in three article manuscripts, included in this thesis. In manuscript I, the mineralization of 2...

  12. Spontaneous bacterial peritonitis

    Directory of Open Access Journals (Sweden)

    Al Amri Saleh

    1995-01-01

    Full Text Available Spontaneous bacterial peritonitis (SBP is an infection of the ascitic fluid without obvious intra-abdominal source of sepsis; usually complicates advanced liver disease. The pathogenesis of the disease is multifactorial: low ascitic protein-content, which reflects defi-cient ascitic fluid complement and hence, reduced opsonic activity is thought to be the most important pathogenic factor. Frequent and prolonged bacteremia has been considered as another pertinent cause of SBP. This disease is associated with high mortality and recurrence. Therefore, orompt recognition and institution of therapy and plan of prophylaxis is vital.

  13. Bacterial mitotic machineries

    DEFF Research Database (Denmark)

    Gerdes, Kenn; Møller-Jensen, Jakob; Ebersbach, Gitte;

    2004-01-01

    Here, we review recent progress that yields fundamental new insight into the molecular mechanisms behind plasmid and chromosome segregation in prokaryotic cells. In particular, we describe how prokaryotic actin homologs form mitotic machineries that segregate DNA before cell division. Thus, the Par......M protein of plasmid R1 forms F actin-like filaments that separate and move plasmid DNA from mid-cell to the cell poles. Evidence from three different laboratories indicate that the morphogenetic MreB protein may be involved in segregation of the bacterial chromosome....

  14. Disseminated histoplasmosis presenting as diabetic keto-acidosis in an immunocompetent patient.

    Science.gov (United States)

    Niknam, Negin; Malhotra, Prashant; Kim, Angela; Koenig, Seth

    2017-01-06

    Histoplasma capsulatum causes a spectrum of manifestations from asymptomatic to fatal disseminated disease. Disseminated histoplasmosis is mostly seen in endemic areas among immunocompromised patients such as those with AIDS. Here, we present a patient living in a non-endemic area with previously undiagnosed diabetes mellitus, who presented with septic shock and diabetic ketoacidosis (DKA), and was ultimately diagnosed with disseminated histoplasmosis. The patient rapidly recovered on administration of intravenous liposomal amphotericin followed by oral itraconazole. Uncontrolled diabetes may be a risk factor for disseminated or severe histoplasmosis in otherwise immunocompetent patients.

  15. The Pathological Features of Dissemination of Lymphoma in the Heart in 42 Autopsy Cases

    Institute of Scientific and Technical Information of China (English)

    Siqing Feng; Wenchen Huang; Limei Liu; Yanqin Liu; Fan Zhou; Xuemei Zhang

    2005-01-01

    OBJECTIVE To study the pathological features of dissemination of lymphoma in the heart and understand its influence on cardiac function.METHODS Forty-two patients who died of lymphoma were autoposied and the gross and microscopic pathological changes of the heart observed.RESULTS Eight (19.05%) out of 42 cases had heart dissemination in the pericardium and heart wall. The dissemination features noted were of a nodular type, diffuse type and mixed type, leading to neoplastic myocarditis.CONCLUSION The pathological features of dissemination of lymphoma in the heart are varied, and the different types can produce dissimilar influences in heart function.

  16. Cutaneous Cryptococcosis: a marker of life threatening disseminated cryptococcosis in HIV AIDS

    Directory of Open Access Journals (Sweden)

    Hari Kishan Kumar Yadalla

    2011-10-01

    Full Text Available Cryptococcosis is an opportunistic infection caused by a ubiquitous encapsulated yeast, Cryptococcus neoformans. Affects 5 – 10 % of patients with HIV worldwide. Disseminated cryptococcosis is one of the AIDS defining criteria and the most common cause of life threatening meningitis. Upto 20% of patients with disseminated disease can have skin involvement. Cutaneous lesions in disseminated cryptococcosis are seldom pathognomonic and portent neurological involvement. The significance of skin lesions may provide the first evidence of dissemination and indicate a poor prognosis, however, earlier recognition and treatment would improve survival. Herein we report a case of cryptococcal meningitis with skin lesions in a HIV seropositive patient.

  17. Spontaneous bacterial peritonitis

    Institute of Scientific and Technical Information of China (English)

    Anastasios Koulaouzidis; Shivaram Bhat; Athar A Saeed

    2009-01-01

    Since its initial description in 1964, research has transformed spontaneous bacterial peritonitis (SBP) from a feared disease (with reported mortality of 90%) to a treatable complication of decompensated cirrhosis,albeit with steady prevalence and a high recurrence rate. Bacterial translocation, the key mechanism in the pathogenesis of SBP, is only possible because of the concurrent failure of defensive mechanisms in cirrhosis.Variants of SBP should be treated. Leucocyte esterase reagent strips have managed to shorten the 'tap-toshot' time, while future studies should look into their combined use with ascitic fluid pH. Third generation cephalosporins are the antibiotic of choice because they have a number of advantages. Renal dysfunction has been shown to be an independent predictor of mortality in patients with SBP. Albumin is felt to reduce the risk of renal impairment by improving effective intravascular volume, and by helping to bind proinflammatory molecules. Following a single episode of SBP, patients should have long-term antibiotic prophylaxis and be considered for liver transplantation.

  18. Origin in Acinetobacter guillouiae and dissemination of the aminoglycoside-modifying enzyme Aph(3')-VI.

    Science.gov (United States)

    Yoon, Eun-Jeong; Goussard, Sylvie; Touchon, Marie; Krizova, Lenka; Cerqueira, Gustavo; Murphy, Cheryl; Lambert, Thierry; Grillot-Courvalin, Catherine; Nemec, Alexandr; Courvalin, Patrice

    2014-10-21

    disseminating to phylogenetically distant genera pathogenic for humans. Using a combination of whole-genome sequencing of a collection of Acinetobacter spp. covering the breadth of the known taxonomic diversity of the genus, gene cloning, detailed promoter analysis, study of heterologous gene expression, and comparative analysis of the phylogenetic trees of aphA6 and of the bacterial hosts, we found that aphA6 originated in Acinetobacter guillouiae, an amikacin-susceptible environmental species. The gene conferred, upon mobilization, high-level resistance to the new hosts. This work stresses that nonpathogenic bacteria can act as reservoirs of resistance determinants, and it provides an example of the use of a genomic library to study the origin and dissemination of an antibiotic resistance gene to human pathogens.

  19. Disseminated pleomorphic myofibrosarcoma in a grizzly bear (Ursus arctos horribilis).

    Science.gov (United States)

    Mete, A; Woods, L; Famini, D; Anderson, M

    2012-01-01

    The pathological and diagnostic features of a widely disseminated pleomorphic high-grade myofibroblastic sarcoma are described in a 23-year-old male brown bear (Ursus arctos horribilis). Firm, solid, white to tan neoplastic nodules, often with cavitated or soft grey-red necrotic centres, were observed throughout most internal organs, subcutaneous tissues and skeletal muscles on gross examination. Microscopically, the tumour consisted of pleomorphic spindle cells forming interlacing fascicles with a focal storiform pattern with large numbers of bizarre polygonal multinucleate cells, frequently within a collagenous stroma. Immunohistochemistry, Masson's trichrome stain and transmission electron microscopy designated the myofibroblast as the cell of origin. This is the first case of a high-grade myofibrosarcoma in a grizzly bear.

  20. Neuroleptic Malignant Syndrome Associated with Refractory Acute Disseminated Encephalomyelitis

    Directory of Open Access Journals (Sweden)

    Silvia R. Delgado

    2016-04-01

    Full Text Available We present the case of a young man who was transferred to our hospital with worsening acute disseminated encephalomyelitis (ADEM despite treatment with intravenous methylprednisolone, intravenous immunoglobulin and plasma exchange. He developed neuroleptic malignant syndrome (NMS without the use of dopamine-modulating drugs. His progressive clinical improvement started after treatment with intravenous cyclophosphamide and methylprednisolone. In our patient, acute demyelination with severe bilateral inflammation of the basal ganglia could have caused a state of central dopamine depletion, creating proper conditions for the development of NMS. Significant clinical improvement of our case after treatment with intravenous cyclophosphamide and steroids provides further evidence for a possible role of the inflammatory lesions in the pathogenesis of NMS in association with ADEM.

  1. Generalized calcinosis cutis associated with disseminated paecilomycosis in a dog.

    Science.gov (United States)

    Holahan, Melissa L; Loft, K Earl; Swenson, Cheryl L; Martinez-Ruzafa, Ivan

    2008-12-01

    A 4-year-old spayed female mixed breed dog was referred to the Michigan State University, Veterinary Teaching Hospital (MSU-VTH) with vomiting, lethargy and anorexia of 2 weeks duration. Abdominal radiographs and ultrasonography showed hepatosplenomegaly. Cytological evaluation of ultrasound-guided fine needle aspirates of the liver and spleen revealed fungal organisms and pyogranulomatous inflammation; fungal culture documented Paecilomyces variotii infection. The dog received antifungal therapy and supportive care. Multiple firm plaque-like skin lesions, predominantly involving the inguinal region, developed 18 days after initial presentation and were diagnosed histopathologically as calcinosis cutis. While generalized calcinosis cutis has been reported in three dogs with blastomycosis and one dog with leptospirosis, the association with disseminated Paecilomyces spp. infection is novel.

  2. Adapting Axelrod's cultural dissemination model for simulating peer effects.

    Science.gov (United States)

    Hofer, Christian; Lechner, Gernot; Brudermann, Thomas; Füllsack, Manfred

    2017-01-01

    We present a generic method for considering incomplete but gradually expandable sociological data in agent-based modeling based on the classic model of cultural dissemination by Axelrod. Our method extension was inspired by research on the diffusion of citizen photovoltaic initiatives, i.e. by initiatives in which citizens collectively invest in photovoltaic plants and share the profits. Owing to the absence of empirical interaction parameters, the Axelrod model was used as basis for considering peer effects with contrived interaction data that can be updated from empirical surveys later on. The Axelrod model was extended to cover the following additional features: •Consideration of empirical social science data for concrete social interaction.•Development of a variable and fine-tunable interaction function for agents.•Deployment of a generic procedure for modeling peer effects in agent-based models.

  3. Handicrafts production: documentation and audiovisual dissemination as sociocultural appreciation technology

    Directory of Open Access Journals (Sweden)

    Luciana Alvarenga

    2016-01-01

    Full Text Available The paper presents the results of scientific research, technology and innovation project in the creative economy sector, conducted from January 2014 to January 2015 that aimed to document and disclose the artisans and handicraft production of Vila de Itaúnas, ES, Brasil. The process was developed from initial conversations, followed by planning and conducting participatory workshops for documentation and audiovisual dissemination around the production of handicrafts and its relation to biodiversity and local culture. The initial objective was to promote expression and diffusion spaces of knowledge among and for the local population, also reaching a regional, state and national public. Throughout the process, it was found that the participatory workshops and the collective production of a virtual site for disclosure of practices and products contributed to the development and socio-cultural recognition of artisan and craft in the region.

  4. Residential segregation and cultural dissemination: An Axelrod-Schelling model

    Science.gov (United States)

    Gracia-Lázaro, C.; Lafuerza, L. F.; Floría, L. M.; Moreno, Y.

    2009-10-01

    In the Axelrod’s model of cultural dissemination, we consider the mobility of cultural agents through the introduction of a density of empty sites and the possibility that agents in a dissimilar neighborhood can move to them if their mean cultural similarity with the neighborhood is below some threshold. While for low values of the density of empty sites, the mobility enhances the convergence to a global culture, for high enough values of it, the dynamics can lead to the coexistence of disconnected domains of different cultures. In this regime, the increase in initial cultural diversity paradoxically increases the convergence to a dominant culture. Further increase in diversity leads to the fragmentation of the dominant culture into domains, forever changing in shape and number, as an effect of the never ending eroding activity of cultural minorities.

  5. [Traumatic abruption of the placenta with disseminated intravascular coagulation].

    Science.gov (United States)

    Benz, R; Malär, A-U; Benz-Wörner, J; Scherer, M; Hodel, M; Gähler, A; Haberthür, C; Konrad, C

    2012-10-01

    Trauma in pregnancy is infrequent and a systematic primary strategy constitutes a real challenge for the interdisciplinary team. With a high fetal mortality rate and a substantial maternal mortality rate traumatic placental abruption is a severe emergency which every anesthetist should be aware of. After hemodynamic stabilization of the mother and control of the viability of the fetus the therapy of traumatic placental abruption consists mostly of an immediate caesarean section. Coagulopathy by depletion of coagulation factors as well as disseminated intravascular coagulation (DIC) have to be expected and consequently a massive blood loss must be anticipated. Thrombelastography provides assistance for fast differential diagnosis and goal-directed treatment of the disturbed sections of the coagulation cascade.

  6. Disseminated intravascular coagulation in obstetric and gynecologic disorders.

    Science.gov (United States)

    Montagnana, Martina; Franchi, Massimo; Danese, Elisa; Gotsch, Francesca; Guidi, Gian Cesare

    2010-06-01

    Disseminated intravascular coagulation (DIC) is a syndrome characterized by a massive, widespread, and ongoing activation of the coagulation system, secondary to a variety of clinical conditions. Many obstetric complications, such as abruptio placentae, amniotic fluid embolism, endotoxin sepsis, retained dead fetus, post-hemorrhagic shock, hydatidiform mole, and gynecologic malignancies, might trigger DIC. In these gynecologic and obstetric settings, DIC is usually associated with high mortality and morbidity rates. No single laboratory test is sensitive or specific enough to diagnose DIC definitively, but it can be diagnosed by using a combination of multiple clinical and laboratory tests that reflect the pathophysiology of the syndrome. At present, the therapeutical approach to pregnancy- and gynecologic-related DIC comprises the specific and aggressive treatment of the underlying disease, eventually followed by a supportive blood product replacement therapy and restoration of physiological anticoagulant pathways. This article reviews the etiopathogenesis, clinical manifestations, laboratory diagnosis, and therapy of pregnancy- and gynecologic-related DIC.

  7. Potential diagnostic markers for disseminated intravascular coagulation of sepsis.

    Science.gov (United States)

    Iba, Toshiaki; Ito, Takashi; Maruyama, Ikuro; Jilma, Bernd; Brenner, Thorsten; Müller, Marcella C A; Juffermans, Nicole P; Thachil, Jecko

    2016-03-01

    Disseminated intravascular coagulation (DIC) is an acquired thrombo-haemorrhagic disorder which arises in clinical scenarios like sepsis, trauma and malignancies. The clinic-laboratory diagnosis of DIC is made in a patient who develops the combination of laboratory abnormalities in the appropriate clinical scenario. The most common laboratory parameters in this setting have been the clotting profile, platelet count, serum fibrinogen and fibrin degradation markers. These tests had the advantage that they could be performed easily and in most laboratories. However, with the better understanding of the pathophysiology of DIC, in recent years, more specific tests have been suggested to be useful in this setting. The newer tests can also prove to be useful in prognostication in DIC. In addition, they may provide assistance in the selection and monitoring of patients diagnosed with DIC.

  8. Thrombocytopenia and thrombosis in disseminated intravascular coagulation (DIC).

    Science.gov (United States)

    Kitchens, Craig S

    2009-01-01

    Disseminated intravascular coagulation (DIC) is the physiologic result of pathologic overstimulation of the coagulation system. Despite multiple triggers, a myriad of laboratory abnormalities, and a clinical presentation ranging from gross hemostatic failure to life-threatening thrombosis, or even both simultaneously, a simplified clinical approach augmented by a few readily available tests allows prompt identification of the process and elucidation of treatment opportunities. Platelet counts in DIC may be low, especially in acute sepsis-associated DIC, yet increased in malignancy-associated chronic DIC. Thrombotic risk is not a function of the platelet count, and thrombocytopenia does not protect the patient from thrombosis. The stratification of both thrombotic risk and hemorrhagic risk will be addressed.

  9. Disseminated intravascular coagulation in term and preterm neonates.

    Science.gov (United States)

    Veldman, Alex; Fischer, Doris; Nold, Marcel F; Wong, Flora Y

    2010-06-01

    Among critically ill patients, the risk of developing disseminated intravascular coagulation (DIC) is probably highest in neonates. Low plasma reserves in pro- and anticoagulant coagulation factors, intravascular volume contraction after birth, and a high incidence of hypoxia and sepsis in critically ill newborns rapidly lead to a decompensation of the coagulation system in this population. Global coagulation tests and single-factor plasma levels have to be interpreted in the context of age-corrected normal ranges. Platelet consumption and reduced protein C plasma levels have diagnostic value; the latter also has prognostic potential in neonates with DIC and sepsis. Therapeutic success relies heavily on reversal of the underlying condition. Some coagulation-specific therapies have been explored in small studies and case series with varying success and sometimes conflicting results. Therefore, larger controlled trials in this common and serious condition are urgently needed.

  10. Advanced Congestive Heart Failure Associated With Disseminated Intravascular Coagulopathy.

    Science.gov (United States)

    Sarcon, Annahita; Liu, Xiaoli; Ton, David; Haywood, James; Hitchcock, Todd

    2015-01-01

    Background. Disseminated intravascular coagulopathy (DIC) is a complication of an underlying disease and not a primary illness. It is most commonly associated with sepsis, trauma, obstetrical complications, and malignancies. There are very few cases in the literature illustrating the association between DIC and congestive heart failure. Findings. In this report, we present a case of severe congestive heart failure, leading to biventricular thrombi and subsequently DIC. Conclusion. We suggest that the association between congestive heart failure and DIC is an underrecognized one. Congestive heart failure continues to remain a major cause of morbidity and mortality despite advances in medical therapies. Thus far, the precise role of coagulation factors in congestive heart failure is unknown. Further investigations are needed to elucidate the pathophysiology of congestive heart failure and coagulation factors.

  11. A RELIABILITY ENHANCED DENSITY ADAPTIVE DATA DISSEMINATION SCHEME FOR VANETS

    Institute of Scientific and Technical Information of China (English)

    Zhou Lianke; Cui Gang; Luo Danyan; Liu Hongwei

    2011-01-01

    In this paper,a reliability enhanced and density adaptive data disseminating scheme is proposed for Vehicular Ad hoc NETworks (VANETs).The distributed on demand inquiring and responding mechanism is employed to get nodes' connectivity information.The announcing-listening process is also designed to find the nodes with bigger additional degree to rebroadcast,by which the relaying node is selected freely from density's influence.Simultaneously,a reliability parameter is designed to choose redundant relays for each hop.According to the importance of the broadcast,the parameter is set by the source node properly.Simulation results show that the scheme has achieved good performances such as low forwarding ratio,short latency and low load.The broadcast coverage ratio is ensured against the influence of key link errors and relaying nodes failure by paying suitable additional communication.

  12. Influence and Dissemination Of Sentiments in Social Network Communication Patterns

    DEFF Research Database (Denmark)

    Hillmann, Robert; Trier, Matthias

    2013-01-01

    of sentiments in a quantitative analysis that is based on retrieved textual messages of communication patterns in over 12000 online social networks. Our empirical results suggest a general influence of sentiments on node communication patterns that is evidenced by increased occurrences of subsequent messages......Previous research suggests the existence of sentiments in online social networks. In comparison to real life human interaction, in which sentiments have been shown to have an influence on human behaviour, it is not yet completely understood which mechanisms explain how sentiments influence users...... in online environments. We develop a theoretical framework that tries to bridge the gap between social influence theories that focus on offline interactions on one hand and online interaction in social networks on the other hand. We then test our hypothesis about the influence and dissemination...

  13. Scientific knowledge dissemination in Danish seed communities of practice

    DEFF Research Database (Denmark)

    Tveden-Nyborg, Svend; Misfeldt, Morten; Boelt, Birte

    2012-01-01

    scientific knowledge communication. Theoretically, we consider these actors participants in different communities of practice relating to the production of seeds (Seed-CoP), and we conclude that strong network collaboration is present among Danish seed-CoP effectuated by the valuable work undertaken......Danish agriculture and seed science have a history of successful collaboration spanning more than a hundred years. In this study, we interviewed 26 growers, consultants, and scientists from the Danish seed community focusing on their current knowledge status and on their views on improving......, as only the innovative growers prioritized time allocation for additional knowledge search. To improve scientific knowledge dissemination and interdisciplinary collaboration among Danish seed-CoP we recommend a combination of face-to-face and online communication processes....

  14. Dissemination of spatial data infrastructure in Panamá

    Directory of Open Access Journals (Sweden)

    Sandra Yanet Velazco Florez

    2016-06-01

    Full Text Available Spatial Data Infrastructure deployed today, allow the dissemination of information that comes to an individual in a simple and accessible way for any organization whether it be public, private or citizens. The means by which messages arrive from one individual to another are called communication channels. Theories of diffusion of innovation can provide a very useful for the study and development of national and regional IDE framework. The diffusion model of innovation of Rogers, emphasizes the importance of interpersonal end communication and the role of social networks, through processes of disclosure to different societies, considering also that the media does not are the only channels of diffusion of innovations, most however, this communication need of leadership within the group to manage communication processes for the new product offered is recognized and accepted by the stakeholders to whom it is addressed.

  15. Evaluation of Disseminated Intravascular Coagulation in the Craniocerebral Traumas

    Directory of Open Access Journals (Sweden)

    Faruk Altinel

    2014-06-01

    Full Text Available Traumatic injury is one of the most important cause of disseminated intravascular coagulation (DIC. It occurs because of blood loss and hemodilution due to fluid resuscitation. The incidence of trauma associated DIC is mainly higher in the craniocerebral traumas. Even though craniocerebral trauma related DIC is well defined, the pathophysiology has been poorly characterized in the literature. Due to the fact that brain tissue is highly significant for procoagulant molecules, craniocerebral traumas are closely related to DIC. In the current study, 30 patients admitted to emergency room have been considered on the first and fifth day of admission to the hospital for the coagulation tests to evaluate DIC in both two groups. [Cukurova Med J 2014; 39(3.000: 488-495

  16. Antimicrobials for bacterial bioterrorism agents.

    Science.gov (United States)

    Sarkar-Tyson, Mitali; Atkins, Helen S

    2011-06-01

    The limitations of current antimicrobials for highly virulent pathogens considered as potential bioterrorism agents drives the requirement for new antimicrobials that are suitable for use in populations in the event of a deliberate release. Strategies targeting bacterial virulence offer the potential for new countermeasures to combat bacterial bioterrorism agents, including those active against a broad spectrum of pathogens. Although early in the development of antivirulence approaches, inhibitors of bacterial type III secretion systems and cell division mechanisms show promise for the future.

  17. Outcome of Patients With Pilocytic Astrocytoma and Leptomeningeal Dissemination

    Energy Technology Data Exchange (ETDEWEB)

    Mazloom, Ali; Hodges, Joseph C.; Teh, Bin S. [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States); Chintagumpala, Murali [Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States); Paulino, Arnold C., E-mail: apaulino@tmhs.org [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States); Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States)

    2012-10-01

    Purpose: To determine the patient, tumor, and treatment characteristics of patients with pilocytic astrocytoma (PA) and leptomeningeal dissemination (LMD). Methods and Materials: A PubMed search of English-language studies pertaining to PA with LMD was performed using a combination of keywords that included juvenile pilocytic astrocytoma, low-grade astrocytoma, low-grade glioma, leptomeningeal dissemination, neuraxis spread, and radiotherapy. We found 26 studies with 58 patients between 1976 and 2005 that met these criteria. Results: The median survival for PA patients with LMD was 65 months. The 1-, 2-, and 5-year overall survival (OS) rate after the diagnosis of LMD was 81.1%, 75.7%, and 55.5%. The 1-, 2-, and 5-year progression-free survival (PFS) rate after the diagnosis of LMD was 69.3%, 66.5%, and 34.6%, respectively. Age, gender, primary site location, timing of LMD presentation (synchronous vs. metachronous), and LMD location did not significantly influence OS or PFS. No statistically significant difference was found in OS or PFS between the chemotherapy and radiotherapy groups. Likewise, no difference was found in OS or PFS according to the use of craniospinal irradiation vs. less extensive RT fields. Conclusions: Approximately one-half of PA patients were alive 5 years after the diagnosis of LMD. Both chemotherapy and radiotherapy have efficacy against LMD. Although the use of craniospinal irradiation did not have an effect on PFS, the patient numbers were small and a larger number treated with craniospinal irradiation is needed to determine its efficacy.

  18. Dissemination and Implementation of Function Focused Care for Assisted Living.

    Science.gov (United States)

    Resnick, Barbara; Galik, Elizabeth; Vigne, Erin; Carew, Allison Payne

    2016-06-01

    Assisted living (AL) settings are residential settings that provide housing and supportive services for older and disabled adults. Although individuals in AL are less functionally impaired than those in nursing home settings, they engage in limited amounts of physical activity and experience more rapid functional decline than their peers in nursing homes. Function Focused Care for Assisted Living (FFC-AL) was developed to prevent decline, improve function, and increase physical activity among residents living in these settings. The purpose of this study was to disseminate and implement the previously established, effective FFC-AL approach to 100 AL settings. Evidence of our ability to successfully disseminate and implement FFC-AL across these settings was established using the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance model. Settings were eligible to participate if they had more than eight beds and identified a nurse (i.e., registered nurse, licensed practical nurse, or direct care worker) champion to facilitate the implementation process. Setting recruitment was done via mailed invitations to 300 eligible ALs and e-mails to relevant AL organizations. Evidence of reach was based on our ability to recruit 99 ALs with adoption of the intervention in 78 (78%). There was a significant improvement in policies supporting function-focused care and in establishing environments that supported function-focused care, and there was evidence of enduring changes in settings indicative of maintenance. We were able to implement all aspects of the intervention although challenges were identified. Future work should focus on using more face-to-face interactions with champions along with identified stakeholders, evaluating characteristics of champions to establish those who are most successful, and recruiting residents to obtain resident-specific outcomes.

  19. CD47 Promotes Protective Innate and Adaptive Immunity in a Mouse Model of Disseminated Candidiasis.

    Science.gov (United States)

    Navarathna, Dhammika H M L P; Stein, Erica V; Lessey-Morillon, Elizabeth C; Nayak, Debasis; Martin-Manso, Gema; Roberts, David D

    2015-01-01

    CD47 is a widely expressed receptor that regulates immunity by engaging its counter-receptor SIRPα on phagocytes and its secreted ligand thrombospondin-1. Mice lacking CD47 can exhibit enhanced or impaired host responses to bacterial pathogens, but its role in fungal immunity has not been examined. cd47-/- mice on a C57BL/6 background showed significantly increased morbidity and mortality following Candida albicans infection when compared with wild-type mice. Despite normal fungal colonization at earlier times, cd47-/- mice at four days post-infection had increased colonization of brain and kidneys accompanied by stronger inflammatory reactions. Neutrophil and macrophage numbers were significantly elevated in kidneys and neutrophils in the brains of infected cd47-/- mice. However, no defect in phagocytic activity towards C. albicans was observed in cd47-/- bone-marrow-derived macrophages, and neutrophil and macrophage killing of C. albicans was not impaired. CD47-deficiency did not alter the early humoral immune response to C. albicans. Th1, Th2, and Th17 population of CD4+ T cells were expanded in the spleen, and gene expression profiles of spleen and kidney showed stronger pro-inflammatory signaling in infected cd47-/- mice. The chemoattractant chemokines MIP-2α and MIP-2β were highly expressed in infected spleens of cd47-/- mice. G-CSF, GM-CSF, and the inflammasome component NLRP3 were more highly expressed in infected cd47-/- kidneys than in infected wild-type controls. Circulating pro- (TNF-α, IL-6) and anti-inflammatory cytokines (IL-10) were significantly elevated, but IL-17 was decreased. These data indicate that CD47 plays protective roles against disseminated candidiasis and alters pro-inflammatory and immunosuppressive pathways known to regulate innate and T cell immunity.

  20. Acute disseminated encephalomyelitis in children: differential diagnosis from multiple sclerosis on the basis of clinical course

    Directory of Open Access Journals (Sweden)

    Yun Jin Lee

    2011-06-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM is a demyelinating disease of the central nervous system (CNS that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS. Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.

  1. The balance of apoptotic and necrotic cell death in Mycobacterium tuberculosis infected macrophages is not dependent on bacterial virulence.

    OpenAIRE

    2012-01-01

    BACKGROUND: An important mechanism of Mycobacterium tuberculosis pathogenesis is the ability to control cell death pathways in infected macrophages: apoptotic cell death is bactericidal, whereas necrotic cell death may facilitate bacterial dissemination and transmission. METHODS: We examine M.tuberculosis control of spontaneous and chemically induced macrophage cell death using automated confocal fluorescence microscopy, image analysis, flow cytometry, plate-reader based vitality assays, and ...

  2. Epigenetics and bacterial infections.

    Science.gov (United States)

    Bierne, Hélène; Hamon, Mélanie; Cossart, Pascale

    2012-12-01

    Epigenetic mechanisms regulate expression of the genome to generate various cell types during development or orchestrate cellular responses to external stimuli. Recent studies highlight that bacteria can affect the chromatin structure and transcriptional program of host cells by influencing diverse epigenetic factors (i.e., histone modifications, DNA methylation, chromatin-associated complexes, noncoding RNAs, and RNA splicing factors). In this article, we first review the molecular bases of the epigenetic language and then describe the current state of research regarding how bacteria can alter epigenetic marks and machineries. Bacterial-induced epigenetic deregulations may affect host cell function either to promote host defense or to allow pathogen persistence. Thus, pathogenic bacteria can be considered as potential epimutagens able to reshape the epigenome. Their effects might generate specific, long-lasting imprints on host cells, leading to a memory of infection that influences immunity and might be at the origin of unexplained diseases.

  3. Bacterial polyhydroxyalkanoates: Still fabulous?

    Science.gov (United States)

    Możejko-Ciesielska, Justyna; Kiewisz, Robert

    2016-11-01

    Bacterial polyhydroxyalkanoates (PHA) are polyesters accumulated as carbon and energy storage materials under limited growth conditions in the presence of excess carbon sources. They have been developed as biomaterials with unique properties for the past many years being considered as a potential substitute for conventional non-degradable plastics. Due to the increasing concern towards global climate change, depleting petroleum resource and problems with an utilization of a growing number of synthetic plastics, PHAs have gained much more attention from industry and research. These environmentally friendly microbial polymers have great potential in biomedical, agricultural, and industrial applications. However, their production on a large scale is still limited. This paper describes the backgrounds of PHAs and discussed the current state of knowledge on the polyhydroxyalkanoates. Ability of bacteria to convert different carbon sources to PHAs, the opportunities and challenges of their introduction to global market as valuable renewable products have been also discussed.

  4. Disseminated tuberculosis presenting with finger swelling in a patient with tuberculous osteomyelitis: a case report

    Directory of Open Access Journals (Sweden)

    Caplivski Daniel

    2005-11-01

    Full Text Available Abstract Background Extrapulmonary manifestations of tuberculosis have become increasingly important in the era of HIV/AIDS. Case presentation We describe a case of tuberculosis (TB dactylitis in a patient with AIDS who originated from the Ivory Coast. The diagnosis was established by direct visualization of acid-fast bacilli on joint fluid and bone biopsy of the proximal phalanx. Imaging of the chest revealed multiple bilateral nodules. Confirmation of the diagnosis was made by isolation of Mycobacterium tuberculosis from sputum and bone cultures. Conclusion Tuberculosis should be considered in patients with unusual soft tissue or skeletal lesions, especially when an immunosuppressive condition is present. Ziehl-Neelsen staining and culture of tissue obtained via surgical biopsy offer the most direct approach to diagnosis.

  5. Disseminated histoplasmosis in allogeneic bone marrow transplant: a diagnosis not to be missed.

    Science.gov (United States)

    Haydoura, S; Wallentine, J; Lopansri, B; Ford, C D; Saad, D; Burke, J P

    2014-10-01

    Immunosuppressed patients are at highest risk for disseminated histoplasmosis, but only a few cases have been reported in hematopoietic stem cell transplant recipients. We report a case of disseminated histoplasmosis in an allogeneic bone marrow transplant recipient residing in a non-endemic area. Diagnosis was first suspected based on a peripheral blood smear.

  6. In search of the quickest way to disseminate health care innovations

    NARCIS (Netherlands)

    Schrijvers, G.; Oudendijk, Nico; Vries, Pety de

    2003-01-01

    Research Question: Innovations in health care are slowly disseminated in The Netherlands and elsewhere. That's why the researchers defined their research question: What is the quickest way of disseminating health care innovations? Research method: The design was a comparative, qualitative case study

  7. 48 CFR 1252.242-70 - Dissemination of information-educational institutions.

    Science.gov (United States)

    2010-10-01

    ... information-educational institutions. 1252.242-70 Section 1252.242-70 Federal Acquisition Regulations System... Provisions and Clauses 1252.242-70 Dissemination of information—educational institutions. As prescribed in (TAR) 48 CFR 1242.7000(a), insert the following clause: Dissemination of...

  8. 29 CFR 90.22 - Dissemination of program knowledge and assistance to workers.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Dissemination of program knowledge and assistance to workers. 90.22 Section 90.22 Labor Office of the Secretary of Labor CERTIFICATION OF ELIGIBILITY TO APPLY FOR... the Subject of an Investigation for Industry Import Relief § 90.22 Dissemination of program...

  9. 29 CFR 1960.12 - Dissemination of occupational safety and health program information.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Dissemination of occupational safety and health program information. 1960.12 Section 1960.12 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND... OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Administration § 1960.12 Dissemination...

  10. Fatal cases of disseminated nocardiosis: challenges to physicians and clinical microbiologists - Case report.

    Science.gov (United States)

    Piukovics, Klára; Bertalan, Viktória; Terhes, Gabriella; Báthori, Ágnes; Hajdú, Edit; Pokorny, Gyula; Kovács, László; Urbán, Edit

    2016-12-01

    Despite the development in the identification of Nocardia spp., common challenges exist in the laboratory diagnosis and management of nocardiosis. We report two cases of disseminated nocardiosis in a patient with hematologic disorder and in a patient with systemic lupus erythematosus, where the cooperation between various specialists was essential to set up the adequate diagnosis of disseminated nocardiosis.

  11. The Use of Online Strategies and Social Media for Research Dissemination in Education

    Science.gov (United States)

    Cooper, Amanda

    2014-01-01

    Alongside a growing interest in knowledge mobilization (trying to increase the connection between research, policy and practice) there has been a transformation of how knowledge is produced, accessed and disseminated in light of the internet and social media strategies. Few studies have explored the use of social media for research dissemination.…

  12. D3: Data-centric Data Dissemination in Wireless Sensor Networks

    NARCIS (Netherlands)

    Ditzel, M.; Langendoen, K.

    2005-01-01

    This paper presents a novel method to disseminate sensor data in a wireless sensor network, called D3 (Data-centric Data Dissemination). The method combines the advantages of data-centric routing like SPIN and directed diffusion and energy-efficient MAC protocols such as S-MAC and T-MAC. The protoco

  13. [Florida State Department of Education] Division of Vocational Education Dissemination and Diffusion Handbook.

    Science.gov (United States)

    Florida State Dept. of Education, Tallahassee. Div. of Vocational Education.

    This dissemination and diffusion handbook for the Florida State Department Division of Vocational Education is divided into ten chapters. Chapter 1 describes the functions of the dissemination and diffusion (D&D) section of the division of vocational education. Identifying the procedures and processes to be followed, chapter 2 focuses on the…

  14. Approaches to Mixed Methods Dissemination and Implementation Research: Methods, Strengths, Caveats, and Opportunities

    OpenAIRE

    Green, Carla A.; Duan, Naihua; Gibbons, Robert D.; Hoagwood, Kimberly E; Palinkas, Lawrence A.; Wisdom, Jennifer P.

    2015-01-01

    Limited translation of research into practice has prompted study of diffusion and implementation, and development of effective methods of encouraging adoption, dissemination and implementation. Mixed methods techniques offer approaches for assessing and addressing processes affecting implementation of evidence-based interventions. We describe common mixed methods approaches used in dissemination and implementation research, discuss strengths and limitations of mixed methods approaches to data...

  15. Diffusing (let it happen) or disseminating (make it happen) innovations in health care

    NARCIS (Netherlands)

    Jippes, Erik; Achterkamp, Marjolein C.; Pols, Jan; Brand, Paul L. P.; van Engelen, Jo M. L.

    2013-01-01

    Management has different options for spreading new products. Our study empirically assessed the integral effects of both diffusion and dissemination on innovation adoption. Data on diffusion (as measured by social network density) and on dissemination (as measured by formulating objectives and execu

  16. On the applicability of fair and adaptive data dissemination in traffic information systems

    NARCIS (Netherlands)

    Schwartz, Ramon S.; Ohazulike, Anthony E.; Sommer, Christoph; Scholten, Hans; Dressler, Falko; Havinga, Paul

    2014-01-01

    Vehicular Ad hoc Networks (VANETs) are expected to serve as support to the development of not only safety applications but also information-rich applications that disseminate relevant data to vehicles. Due to the continuous collection, processing, and dissemination of data, one crucial requirement i

  17. Profound peripheral T-lymphocyte depletion and activation in disseminated tuberculosis

    Directory of Open Access Journals (Sweden)

    Denise Silva Rodrigues

    2006-02-01

    Full Text Available Three HIV-1-seronegative patients with disseminated tuberculosis presented significant depletion of T-cell counts, in CD4+ and/or CD8+ cells, associated with increased expression of activation marker CD38 on CD8+ T-lymphocytes. This finding raises the question of potential mechanisms involved in the activation or loss of T-cells in disseminated tuberculosis.

  18. Allograft and prostatic involvement in a renal transplant recipient with disseminated tuberculosis.

    Science.gov (United States)

    Sreejith, P; Jha, V; Kohli, H S; Rathi, M; Gupta, K L; Sakhuja, V

    2010-01-01

    Tuberculosis is a serious opportunistic infection in renal transplant recipients and is disseminated in nature in one-third of patients. Genito urinary tuberculosis is rare in renal transplant recipients. We report a patient presenting 5 years after renal transplantation with disseminated tuberculosis and allograft and prostatic involvement.

  19. The Microelectronics Education Programme--Dissemination and Diffusion of Microelectronics Technology in Education.

    Science.gov (United States)

    Milne, J. A.; Anderson, J. S. A.

    1984-01-01

    Describes the Microelectronics Education Programme, a development program which embodies the building of a springboard for the dissemination of microelectronic innovations that will benefit education. Springboard activities discussed in detail include information dissemination through regional information centers, inservice teacher training, and…

  20. Delay-Aware Program Codes Dissemination Scheme in Internet of Everything

    Directory of Open Access Journals (Sweden)

    Yixuan Xu

    2016-01-01

    Full Text Available Due to recent advancements in big data, connection technologies, and smart devices, our environment is transforming into an “Internet of Everything” (IoE environment. These smart devices can obtain new or special functions by reprogramming: upgrade their soft systems through receiving new version of program codes. However, bulk codes dissemination suffers from large delay, energy consumption, and number of retransmissions because of the unreliability of wireless links. In this paper, a delay-aware program dissemination (DAPD scheme is proposed to disseminate program codes with fast, reliable, and energy-efficient style. We observe that although total energy is limited in wireless sensor network, there exists residual energy in nodes deployed far from the base station. Therefore, DAPD scheme improves the performance of bulk codes dissemination through the following two aspects. (1 Due to the fact that a high transmitting power can significantly improve the quality of wireless links, transmitting power of sensors with more residual energy is enhanced to improve link quality. (2 Due to the fact that performance of correlated dissemination tends to degrade in a highly dynamic environment, link correlation is autonomously updated in DAPD during codes dissemination to maintain improvements brought by correlated dissemination. Theoretical analysis and experimental results show that, compared with previous work, DAPD scheme improves the dissemination performance in terms of completion time, transmission cost, and the efficiency of energy utilization.

  1. Disseminated Neonatal Herpes Caused by Herpes Simplex Virus Types 1 and 2

    Science.gov (United States)

    Martic, Jelena; Stanojevic, Maja; Jankovic, Sasa; Nedeljkovic, Jasminka; Nikolic, Ljubica; Pasic, Srdjan; Jankovic, Borisav; Jovanovic, Tanja

    2007-01-01

    Disseminated neonatal herpes simplex virus (HSV) infection is characterized by progressive multiple organ failure and high mortality rates. It can result from infection with either HSV-1 or HSV-2. We report a case of disseminated neonatal herpes that was caused by HSV-1 and HSV-2. PMID:17479897

  2. A scalable data dissemination protocol for both highway and urban vehicular environments

    NARCIS (Netherlands)

    Schwartz, Ramon S.; Scholten, Hans; Havinga, Paul

    2013-01-01

    Vehicular ad hoc networks (VANETs) enable the timely broadcast dissemination of event-driven messages to interested vehicles. Especially when dealing with broadcast communication, data dissemination protocols must achieve a high degree of scalability due to frequent deviations in the network density

  3. 7 CFR 612.5 - Dissemination of water supply forecasts and basic data.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Dissemination of water supply forecasts and basic data... SUPPLY FORECASTS § 612.5 Dissemination of water supply forecasts and basic data. Water supply outlook reports prepared by NRCS and its cooperators containing water supply forecasts and basic data are...

  4. 47 CFR 64.707 - Public dissemination of information by providers of operator services.

    Science.gov (United States)

    2010-10-01

    ... § 64.707 Public dissemination of information by providers of operator services. Providers of operator... 47 Telecommunication 3 2010-10-01 2010-10-01 false Public dissemination of information by providers of operator services. 64.707 Section 64.707 Telecommunication FEDERAL COMMUNICATIONS...

  5. Survival and evolution of a large multidrug resistance plasmid in new clinical bacterial hosts

    DEFF Research Database (Denmark)

    Porse, Andreas; Schønning, Kristian; Munck, Christian;

    2016-01-01

    Large conjugative plasmids are important drivers of bacterial evolution and contribute significantly to the dissemination of antibiotic resistance. Although plasmid borne multidrug resistance is recognized as one of the main challenges in modern medicine, the adaptive forces shaping the evolution...... sequencing to show that the long-term persistence and molecular integrity of the plasmid is highly influenced by multiple factors within a 25 kb plasmid region constituting a host-dependent burden. In the E. coli hosts investigated here, improved plasmid stability readily evolves via IS26 mediated deletions...... consistently followed by all evolved E. coli lineages exposes a trade-off between horizontal and vertical transmission that may ultimately limit the dissemination potential of clinical multidrug resistance plasmids in these hosts....

  6. Scintigraphic visualization of bacterial translocation in experimental strangulated intestinal obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Galeev, Yu.M.; Popov, M.V.; Salato, O.V. [Siberian Branch of Russian Academy of Medical Science, Research Centre of Reparative and Restorative Surgery, East Siberian Research Centre, 100 Yubileyniy, P.O. Box 23, Irkutsk (Russian Federation); Lishmanov, Yu.B. [Siberian Branch of Russian Academy of Medical Science, Research and Development Institute of Cardiology, Tomsk Research Centre, Tomsk (Russian Federation); Grigorev, E.G.; Aparcin, K.A. [Siberian Branch of Russian Academy of Medical Science, Research Centre of Reparative and Restorative Surgery, East Siberian Research Centre, 100 Yubileyniy, P.O. Box 23, Irkutsk (Russian Federation); Irkutsk State Medical University, Department of Hospital Surgery, Irkutsk (Russian Federation)

    2009-11-15

    The purpose of this study was to obtain scintigraphic images depicting translocation of {sup 99m}Tc-labelled Escherichia coli bacteria through the intestinal barrier and to quantify this process using methods of nuclear medicine. Thirty male Wistar rats (including 20 rats with modelled strangulated intestinal obstruction and 10 healthy rats) were used for bacterial scintigraphy. {sup 99m}Tc-labelled E. coli bacteria ({sup 99m}Ts-E. coli) with an activity of 7.4-11.1 MBq were administered into a section of the small intestine. Scintigraphic visualization of bacterial translocation into organs and tissues of laboratory animals was recorded in dynamic (240 min) and static (15 min) modes. The number of labelled bacteria, which migrated through the intestinal barrier, was quantified by calculating the translocation index (TI). Control indicated no translocation of {sup 99m}Ts-E. coli administered into the intestine through the parietes of the small intestine's distal part in healthy animals. Animals with strangulated obstruction demonstrated different migration strength and routes of labelled bacteria from strangulated and superior to strangulation sections of the small intestine. {sup 99m}Ts-E. coli migrated from the strangulated loop into the peritoneal cavity later causing systemic bacteraemia through peritoneal resorption. The section of the small intestine, which was superior to the strangulation, demonstrated migration of labelled bacteria first into the portal and then into the systemic circulation. The strangulated section of the small intestine was the main source of bacteria dissemination since the number of labelled bacteria, which migrated from this section significantly, exceeded that of the area superior to the strangulation section of the small intestine (p = 0.0003). Bacterial scintigraphy demonstrated the possibility of visualizing migration routes of labelled bacteria and quantifying their translocation through the intestinal barrier. This

  7. The master activator of IncA/C conjugative plasmids stimulates genomic islands and multidrug resistance dissemination.

    Science.gov (United States)

    Carraro, Nicolas; Matteau, Dominick; Luo, Peng; Rodrigue, Sébastien; Burrus, Vincent

    2014-10-01

    Dissemination of antibiotic resistance genes occurs mostly by conjugation, which mediates DNA transfer between cells in direct contact. Conjugative plasmids of the IncA/C incompatibility group have become a substantial threat due to their broad host-range, the extended spectrum of antimicrobial resistance they confer, their prevalence in enteric bacteria and their very efficient spread by conjugation. However, their biology remains largely unexplored. Using the IncA/C conjugative plasmid pVCR94ΔX as a prototype, we have investigated the regulatory circuitry that governs IncA/C plasmids dissemination and found that the transcriptional activator complex AcaCD is essential for the expression of plasmid transfer genes. Using chromatin immunoprecipitation coupled with exonuclease digestion (ChIP-exo) and RNA sequencing (RNA-seq) approaches, we have identified the sequences recognized by AcaCD and characterized the AcaCD regulon. Data mining using the DNA motif recognized by AcaCD revealed potential AcaCD-binding sites upstream of genes involved in the intracellular mobility functions (recombination directionality factor and mobilization genes) in two widespread classes of genomic islands (GIs) phylogenetically unrelated to IncA/C plasmids. The first class, SGI1, confers and propagates multidrug resistance in Salmonella enterica and Proteus mirabilis, whereas MGIVmi1 in Vibrio mimicus belongs to a previously uncharacterized class of GIs. We have demonstrated that through expression of AcaCD, IncA/C plasmids specifically trigger the excision and mobilization of the GIs at high frequencies. This study provides new evidence of the considerable impact of IncA/C plasmids on bacterial genome plasticity through their own mobility and the mobilization of genomic islands.

  8. Value of immunodiagnostic techniques on diagnosis of pulmonary and extrapulmonary tuberculosis%免疫诊断技术在肺结核及肺外结核诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    程小星; 蒋静

    2011-01-01

    Serological diagnostic techniques and T-cell interferon gamma release assays (IGRAs)are main immunodiagnostic techniques for tuberculosis. Serological tests are simple and fast, however,they have low specificity and sensitivity in the diagnosis of tuberculosis. Based on cellular immune responses, IGRAs are important breakthrough of immunodiagnostic techniques for tuberculosis. The value of IGRAs in the diagnosis of latent tuberculosis infection has been widely recognized. The diagnostic specificity is 89% in IGRAs, which is significantly higher than that in tuberculin test. However,peripheral blood monouclear cell IGRAs could not be used to differentiate active tuberculosis, latent infection and previous infection, so the poor specificity of diagnosis of active tuberculosis is the main problem. Tuberculosis local immune cell IGRAs has better specificity and sensitivity in the diagnosis of pulmonary and extrapulmonary tuberculosis, so it is worth further study.%目前结核病免疫学诊断技术的研究热点是血清学诊断技术和基于细胞免疫反应的干扰素-γ释放试验.血清学诊断方法具有简单快速的优点,易于推广应用,是研究比较多的结核病诊断方法之一,但现有血清学试验试剂在结核病诊断的特异性和敏感性方面还有待提高.基于细胞免疫反应的干扰素-γ释放试验是结核免疫诊断技术的重要突破,在诊断结核潜伏感染中的价值已经得到广泛的认可,诊断的特异性可达89%,显著高于结核菌素试验.但基于外周血单个核细胞的干扰素-γ释放试验不能区分活动性肺结核、潜伏感染及以往感染,因此诊断活动性结核病的特异性差是其主要问题.基于结核病变局部免疫细胞的干扰素-γ释放试验在肺结核及肺外结核的诊断中具有更好的特异性和敏感性,值得进一步研究.

  9. Evidence-based approaches to dissemination and diffusion of physical activity interventions.

    Science.gov (United States)

    Owen, Neville; Glanz, Karen; Sallis, James F; Kelder, Steven H

    2006-10-01

    With the increasing availability of effective, evidence-based physical activity interventions, widespread diffusion is needed. We examine conceptual foundations for research on dissemination and diffusion of physical activity interventions; describe two school-based program examples; review examples of dissemination and diffusion research on other health behaviors; and examine policies that may accelerate the diffusion process. Lack of dissemination and diffusion evaluation research and policy advocacy is one of the factors limiting the impact of evidence-based physical activity interventions on public health. There is the need to collaborate with policy experts from other fields to improve the interdisciplinary science base for dissemination and diffusion. The promise of widespread adoption of evidence-based physical activity interventions to improve public health is sufficient to justify devotion of substantial resources to the relevant research on dissemination and diffusion.

  10. A systematic review of studies evaluating diffusion and dissemination of selected cancer control interventions.

    Science.gov (United States)

    Ellis, Peter; Robinson, Paula; Ciliska, Donna; Armour, Tanya; Brouwers, Melissa; O'Brien, Mary Ann; Sussman, Jonathan; Raina, Parminder

    2005-09-01

    With this review, the authors sought to determine what strategies have been evaluated (including the outcomes assessed) to disseminate cancer control interventions that promote the uptake of behavior change. Five topic areas along the cancer care continuum (smoking cessation, healthy diet, mammography, cervical cancer screening, and control of cancer pain) were selected to be representative. A systematic review was conducted of primary studies evaluating dissemination of a cancer control intervention. Thirty-one studies were identified that evaluated dissemination strategies in the 5 topic areas. No strong evidence currently exists to recommend any one dissemination strategy as effective in promoting the uptake of cancer control interventions. The authors conclude that there is a strong need for more research into dissemination of cancer control interventions. Future research should consider methodological issues such as the most appropriate study design and outcomes to be evaluated.

  11. Partnerships for Creating Learning Resources Fostering Discovery and Dissemination

    Science.gov (United States)

    Ruzek, M.; Johnson, D. R.

    2001-12-01

    Partnerships among educators and between educators and researchers within and among universities are especially important for fostering discovery, creating learning resources, and sharing materials for Earth system science education. Partners with diverse expertise motivate one another by contributing ideas and resources to the collaborative group, thus enabling discovery in the creation and enrichment of content being developed for the classroom or laboratory and also for informal education. The key to discovery in the interdisciplinary dimension of Earth system science requires knowledge and background experiences from many disciplines. Through sharing their expertise within collaborations, scientists and educators extend the usefulness of their work to others for use in their own classrooms, with perhaps modification of the resource to meet their specific needs. The new resource may be refined and redirected, and once again shared with other colleagues to extend the spiral of increasing utility and foster the broader use of the original resource. Collaborations enabling discovery become especially powerful when partnerships cross disciplines and extend horizons between fields of expertise in scientific research and professional education. Product dissemination and user community growth are natural results of a functioning collaborative of educators and researchers with common interests. This collaborative community-building concept forms the core of successful education endeavors within the NASA/USRA Earth System Science Education Program (ESSE) which supported forty-five interdisciplinary teams between 1991 and 2000 to develop and offer courses on Earth system topics. Throughout this effort, ESSE recognized the value of partnerships, communication, and venues which promoted team building, and engaged in collaborations with the Inter-American Institute, the Woodrow Wilson Foundation and Project ALERT aimed to foster discovery in the creation, review and

  12. Does surgical resection of hepatocellular carcinoma accelerate cancer dissemination?

    Institute of Scientific and Technical Information of China (English)

    I-Shyan Sheen; Yi-Chun Tsai; Tsu-Yen Wu; Kuo-Shyang Jeng; Shou-Chuan Shih; Po-Chuan Wang; Wen-Hsiung Chang; Horng-Yuan Wang; Li-Rung Shyung; Shee-Chan Lin; Chin-Roa Kao

    2004-01-01

    AIM: This study was to investigate whether surgery could increase cancer dissemination and postoperative recurrence in patients with hepatocellular carcinoma (HCC) by detection of human α-fetoprotein messenger RNA (hAFP mRNA), hAFP mRNA in the peripheral blood of patients with HCC has been considered as a surrogate marker for circulating tumor cells.METHODS: Eighty-one consecutive patients who underwent curative resection for HCC entered this prospective cohort study. We examined hAFP mRNA from the peripheral blood obtained preoperatively, perioperatively, and postoperatively to correlate the prognosis after curative resections from HCC patients and from the control subjects. Detection of hAFP mRNA by reverse transcriptase and polymerase chain reaction amplification (RT-PCR) was performed with primers specifically. The relations between the clinical variables (age,sex, associated liver cirrhosis, hepatitis B virus infection,hepatitis C virus infection, serum α-fetoprotein and ChildPugh class), the histological variables (size, capsule, vascular permeation, grade of differentiation, and daughter nodules),hAFP mRNA in peripheral blood of 3 different sessions, and postoperative course (recurrence, and recurrence related death) were analysed.RESULTS: No hAFP mRNA was detected in control group subjects. Twenty-two (27%), 24 (30%) and 19 (23%) of 81 HCC patients had hAFP mRNA positivity in the preoperative,perioperative and postoperative peripheral blood. The preoperative presence did not influence the risk of HCC recurrence (55% vs41%, P=0.280). In contrast, patients with postoperative presence had a significantly higher recurrence (90% vs 31%, P<0.001; odds ratio 19.2; 95% confidence interval: 4.0-91.7). In the multivariate analysis by COX proportional hazards model, postoperative positivity had a significant influence on recurrence (P=0.067) and recurrence related mortality (P=0.017). Whereas, the perioperative positivity of hAFP mRNA did not increase HCC

  13. Acute Disseminated Histoplasmosis with Atypical Lymphocytosis in an Immunocompetent Host

    Directory of Open Access Journals (Sweden)

    Ayman Elbadawi, MD

    2017-01-01

    Full Text Available 65 year-old-male presented with a one-week history of high grade fever, fatigue and confusion which began abruptly two days after a cystoscopy procedure. Past medical history included pulmonary sarcoidosis diagnosed by mediastinal lymph biopsy, diabetes and hypertension. On admission he was febrile and confused with stable vital signs. Initial workup included negative Head CT and lumbar puncture. Blood work revealed normal metabolic and liver function tests with progressive anemia, thrombocytopenia and atypical lymphocytosis of 15–20%. Blood, urine and respiratory cultures all were negative for bacteria and. A bone marrow biopsy was done given the abnormal lymphocytes in peripheral smear, revealing budding yeast consistent with Histoplasma capsulatum. Histoplasma antigen was positive in urine and eventually blood and bone marrow grew H. capsulatum. Patient was started on amphotericin-B for diagnosis of disseminated histoplasmosis. After a 2 week period of amphotericin B, patient was switched to oral Itraconazole to complete 12 months course of treatment.

  14. NIST Gas Hydrate Research Database and Web Dissemination Channel.

    Science.gov (United States)

    Kroenlein, K; Muzny, C D; Kazakov, A; Diky, V V; Chirico, R D; Frenkel, M; Sloan, E D

    2010-01-01

    To facilitate advances in application of technologies pertaining to gas hydrates, a freely available data resource containing experimentally derived information about those materials was developed. This work was performed by the Thermodynamic Research Center (TRC) paralleling a highly successful database of thermodynamic and transport properties of molecular pure compounds and their mixtures. Population of the gas-hydrates database required development of guided data capture (GDC) software designed to convert experimental data and metadata into a well organized electronic format, as well as a relational database schema to accommodate all types of numerical and metadata within the scope of the project. To guarantee utility for the broad gas hydrate research community, TRC worked closely with the Committee on Data for Science and Technology (CODATA) task group for Data on Natural Gas Hydrates, an international data sharing effort, in developing a gas hydrate markup language (GHML). The fruits of these efforts are disseminated through the NIST Sandard Reference Data Program [1] as the Clathrate Hydrate Physical Property Database (SRD #156). A web-based interface for this database, as well as scientific results from the Mallik 2002 Gas Hydrate Production Research Well Program [2], is deployed at http://gashydrates.nist.gov.

  15. Tight Bounds on Information Dissemination in Sparse Mobile Networks

    CERN Document Server

    Pettarin, Alberto; Pucci, Geppino; Upfal, Eli

    2011-01-01

    Motivated by the growing interest in mobile systems, we study the dynamics of information dissemination between agents moving independently on a plane. Formally, we consider $k$ mobile agents performing independent random walks on an $n$-node grid. At time $0$, each agent is located at a random node of the grid and one agent has a rumor. The spread of the rumor is governed by a dynamic communication graph process ${G_t(r) | t \\geq 0}$, where two agents are connected by an edge in $G_t(r)$ iff their distance at time $t$ is within their transmission radius $r$. Modeling the physical reality that the speed of radio transmission is much faster than the motion of the agents, we assume that the rumor can travel throughout a connected component of $G_t$ before the graph is altered by the motion. We study the broadcast time $T_B$ of the system, which is the time it takes for all agents to know the rumor. We focus on the sparse case (below the percolation point $r_c \\approx \\sqrt{n/k}$) where, with high probability, n...

  16. Simultaneous Resection of Disseminated Hepatocellular Carcinoma and Colon Cancer

    Directory of Open Access Journals (Sweden)

    Yuki Haga

    2013-01-01

    Full Text Available A 75-year-old woman with abdominal pain and vomiting was admitted to our hospital. Colonoscopy showed an advanced colon cancer that encompassed the entire circumference of the descending colon’s lumen. The patient was diagnosed with occlusive ileus associated with the colon cancer. She had been watched for liver cirrhosis due to the hepatitis C virus and received radiofrequency ablation therapy for hepatocellular carcinoma (HCC 6 years previously. Although she exhibited a gradual increase in serum levels of α-fetoprotein and PIVKA-II starting 2 years before admission, no tumors were detected in the liver by abdominal ultrasonography and computed tomography. On admission, contrast-enhanced computed tomography revealed not only the colon cancer but also a tumor adjacent to the cecum. Both tumors were successfully removed by surgery and a pathological analysis revealed that the cecum tumor was poorly-differentiated HCC. The serum levels of α-fetoprotein and PIVKA-II declined markedly after the operation and no masses considered as peritoneal metastasis have been detected to date. This is the first report of the simultaneous resection of disseminated HCC and colon cancer.

  17. Whole abdominal irradiation for peritoneal dissemination of alimentary tract cancers

    Energy Technology Data Exchange (ETDEWEB)

    Sugahara, Shinji; Ohara, Kiyoshi; Todoroki, Takeshi; Tatsuzaki, Hideo; Fuji, Hiroshi; Kawashima, Mitsuhiko; Fukao, Katsushi; Itai, Yuji [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine

    1995-09-01

    Between January 1986 and August 1991, 19 patients with alimentary tract cancers complicated by peritoneal dissemination received whole abdominal irradiation combined with intraperitoneal chemotherapy postoperatively. Using a moving-strip technique of irradiation, 12.0 Gy was delivered in three fractions to the entire abdominal contents with partial liver and kidney shielding. The primary tumor sites were the stomach in 12 patients, the colorectum in five, and the gall bladder in two. Nine patients with gross residual disease also received a limited field boost of 30.6 Gy in 17 fractions after completion of treatment to the whole abdomen. None of the patients failed to complete the planned dose despite acute gastrointestinal toxicity (nausea and vomiting, 84%, diarrhea and cramping, 78%) and acute hematologic toxicity (leukocytopenia, 84%, thrombocytopenia, 68%). Our follow-up study revealed that the actuarial one-year survival rate was 28.4% and the median survival time was 9.0 months. Survival rates at one-year for patients with colorectal and gastric cancer were 75.0% and 16.7%, respectively. Patients with gastric cancer (n=12) had a poorer outcome than those with colorectal cancer (n=5) in the present study. One reason for this difference may have been the presence of cancerous pleuritis, which was frequently observed in patients with gastric cancer. Therefore, more intensive treatment to prevent cancerous pleuritis seems to be necessary to improve the efficacy of whole abdominal irradiation. (author).

  18. Familial disseminated cutaneous glomuvenous malformation: Treatment with polidocanol sclerotherapy

    Directory of Open Access Journals (Sweden)

    Aditi Jha

    2016-01-01

    Full Text Available Glomuvenous malformations (GVMs present as asymptomatic multiple pink-to-blue nodules or plaques. Disseminated lesions are rare, representing 10% of all the cases. Familial cases are caused by mutations in the glomulin gene. A young male presented with multiple bluish-to-dusky red-coloured nodules 10-15 in numbers over the trunk, limbs and buttocks since 12 years of age. They ranged in size from 1 to 3 cm, partially to non-compressible and tender on palpation. There was no history of any systemic complaint. His sister and mother had similar lesions but in a limited distribution. Biopsy showed multiple ectatic dilated vascular channels lined by multiple layers of glomus cells consistent with the diagnosis of GVM. The biopsy of the lesions from the mother and sister also showed similar features. Mutation analysis for glomulin gene could not be done because of the unavailability of the facility at our setting. He underwent sclerotherapy with 3% polidocanol every 2 weeks, and there was significant improvement in the lesions after six sessions of sclerotherapy. The patient is under follow-up and there is no recurrence of the lesions over treated sites after 6 months.

  19. Diffusion theory and knowledge dissemination, utilization and integration.

    Science.gov (United States)

    Green, Lawrence W; Ottoson, Judith M; García, César; Hiatt, Robert A; Roditis, Maria L

    Part of the Community Health and Preventive Medicine Commons, Health and Medical Administration Commons, Health Policy Commons, Health Services Administration Commons, Health Services Research Commons, and the Public Health Education and Promotion Commons. Many accomplishments of public health have been distributed unevenly among populations. This article reviews the concepts of applying evidence-based practice in public health in the face of the varied cultures and circumstances of practice in these varied populations. Key components of EBPH include: making decisions based on the best available scientific evidence, using data and information systems systematically, applying program planning frameworks, engaging the community and practitioners in decision making, conducting sound evaluation, and disseminating what is learned. The usual application of these principles has overemphasized the scientific evidence as the starting point, whereas this review suggests engaging the community and practitioners as an equally important starting point to assess their needs, assets and circumstances, which can be facilitated with program planning frameworks and use of local assessment and surveillance data.

  20. Fast Program Codes Dissemination for Smart Wireless Software Defined Networks

    Directory of Open Access Journals (Sweden)

    Xiao Liu

    2016-01-01

    Full Text Available In smart wireless software defined networks (WSDNs, sensor nodes are deployed in the monitored area to sense data. In order to increase the flexibility of WSDNs configuration, sensor nodes use programmable technology. Thus, programming and software engineering that integrate Internet of Things (IoT lead to a smart world. Due to the large capacity of program codes and the limited energy of wireless network, only a subset of nodes is selected to spread program codes, and the remaining nodes are in sleep status to save energy. In this paper, a fast program codes dissemination (FPCD scheme for smart wireless software defined networking is proposed; many nodes in the area far from the sink will be selected to spread program codes; those areas have much energy left, while the area near the sink chooses less number of active nodes to spread program codes to save energy. Thus, FPCD scheme can reduce delay for spreading program codes while retaining network lifetime. The theoretical analysis and experimental results show that our approach can reduce transmission delay by 10.76%–105.791% while retaining network lifetime compares with previous broadcast schemes.

  1. A short contemporary history of disseminated intravascular coagulation.

    Science.gov (United States)

    Levi, Marcel; van der Poll, Tom

    2014-11-01

    Disseminated intravascular coagulation (DIC) is a syndrome characterized by systemic intravascular activation of coagulation, leading to a widespread deposition of fibrin in the circulation. There is ample experimental and pathological evidence that the fibrin deposition contributes to multiple organ failure. The massive and ongoing activation of coagulation may result in depletion of platelets and coagulation factors, which may cause bleeding (consumption coagulopathy). The syndrome of DIC is well known in the medical literature for centuries, although a more precise description of the underlying mechanisms had to await the 20th century. Initial ideas on a role of the contact activation system as the primary trigger for the systemic activation of coagulation as well as a presumed hyperfibrinolytic response in DIC have been found to be misconceptions. Experimental and clinical evidence now indicate that the initiation of coagulation in DIC is caused by tissue factor expression, which in combination with downregulated physiological anticoagulant pathways and impaired fibrinolysis leads to widespread fibrin deposition. In addition, an extensive bidirectional interaction between coagulation and inflammation may further contribute to the pathogenesis of DIC.

  2. [Progress in diagnosis and treatment for disseminated intravascular coagulation].

    Science.gov (United States)

    Wada, Hideo; Matsumoto, Takeshi; Aota, Takumi; Yamashita, Yoshiki

    2015-02-01

    As the development of a hypercoagulable state in the setting of disseminated intravascular coagulation (DIC) induces localized infection, therapy for DIC should be evaluated according to the findings of examinations for both severe sepsis and DIC. DIC is classified into the following types: "bleeding type," "organ failure type," "asymptomatic type," and "complication type." The "bleeding type" and "organ failure type" are considered to reflect the "plasmin inhibitor (PI) deficiency type" and "antithrombin (AT) deficiency type," respectively. In order to improve the diagnosis of DIC, in particular limitations in global coagulation tests, the Japanese Society of Thrombosis and Hemostasis recently proposed tentative diagnostic criteria for DIC using hemostatic molecular markers and AT. The recommendations for treatment of DIC, especially the use of AT concentrates, recombinant activated protein C and thrombomodulin, vary among several guidelines for the management of DIC. These agents inhibit the effects of key proteases in activating coagulation and consequently exert an anti-inflammatory effect on DIC. Hence, it is necessary to extensively evaluate these agents in well-conducted clinical trials.

  3. Diagnostic criteria and laboratory tests for disseminated intravascular coagulation.

    Science.gov (United States)

    Wada, Hideo; Matsumoto, Takeshi; Hatada, Tuyoshi

    2012-12-01

    Three diagnostic criteria for disseminated intravascular coagulation (DIC) have been established by the Japanese Ministry of Health, Labor and Welfare, the International Society on Thrombosis and Hemostasis (ISTH) and the Japanese Association for Acute Medicine. The diagnostic criteria involving global coagulation tests, such as the Japanese Ministry of Health, Labor and Welfare criteria and the ISTH overt diagnostic criteria, are first-generation DIC diagnostic criteria, those involving global coagulation tests and changes in these tests such as the Japanese Association for Acute Medicine criteria, are second-generation DIC diagnostic criteria, and those including non-overt DIC diagnostic criteria involving global coagulation tests, changes in these tests and hemostatic molecular markers will be the future (third-generation) DIC diagnostic criteria. There are no significant differences in the three diagnostic criteria with respect to predicting poor outcomes. Therefore, the third generation of diagnostic criteria including hemostatic molecular markers is expected to be established. Standardization and the determination of adequate cutoff values should be required for each laboratory test.

  4. Back to the future: testing in disseminated intravascular coagulation.

    Science.gov (United States)

    Toh, Cheng-Hock; Downey, Colin

    2005-11-01

    Following on from the first clinical observations on disseminated intravascular coagulation (DIC) in the nineteenth century, the dawn of laboratory testing for DIC began with the availability of assays that characterized the extrinsic and intrinsic pathways of coagulation. Markedly increased clotting times were the hallmark of DIC. As the understanding of the biochemistry of haemostasis and thrombosis improved, new tests were developed based on the molecular players that participate in the process. However, many are non-specific for DIC and/or are unwieldy in performance to keep apace with the demands of the acute clinical setting. The renewed emphasis in DIC for the modern laboratory of the twenty-first century has seen a return to the simple, rapid and practical global tests of coagulation within scoring systems that also capture the pathophysiological continuum by trend analysis. Additionally, new technologies based on these simple tests of coagulation hold promise in also indicating the in vivo interplay between coagulation and inflammation during DIC.

  5. Thromboelastometry in patients with severe sepsis and disseminated intravascular coagulation.

    Science.gov (United States)

    Sivula, Mirka; Pettilä, Ville; Niemi, Tomi T; Varpula, Marjut; Kuitunen, Anne H

    2009-09-01

    Severe sepsis induces coagulopathy, which may lead to disseminated intravascular coagulation (DIC). Thromboelastometry is a point-of-care whole blood coagulation monitor, which has been validated in human endotoxemia model. We assessed thromboelastometry in severe sepsis and overt DIC and investigated its applicability in differentiating sepsis-related coagulation disturbances. Thromboelastometry (EXTEM and FIBTEM tests) and traditional coagulation assays were analyzed in 28 patients with severe sepsis, 12 of who fulfilled the criteria of overt DIC on admission. Ten healthy persons served as controls. Coagulation parameters, clotting time, clot formation time (CFT), alpha angle, maximal clot firmness (MCF) and lysis index at 60 min, were registered. In patients with overt DIC, EXTEM MCF, CFT and alpha angle differed from that in both healthy controls and patients without DIC, indicating hypocoagulation (MCF 52, 63 and 68 mm; CFT 184, 88 and 73 s; and alpha angle 58, 72 and 76 degrees , respectively, P coagulation assays showed progressively worsening coagulopathy from controls to septic patients without DIC and further to those with overt DIC. We conclude that thromboelastometry may be a valuable tool in assessing whole blood coagulation capacity in patients with severe sepsis with and without overt DIC.

  6. Equine pulmonary aspergillosis with encephalitic, myocardial, and renal dissemination.

    Science.gov (United States)

    Headley, Selwyn Arlington; de Carvalho, Pedro Henrique; Cunha Filho, Luiz Fernando C; Yamamura, Aline Artioli Machado; Okano, Werner

    2014-02-01

    The cause of the death of a 16-month-old Brasileiro-de-Hipismo filly and a 3-year-old male Paint Horse with clinical manifestations of anemia and apathy from southern Brazil was investigated. These horses were maintained at the same stable; received hay as part of their diet and were submitted for routine necropsy evaluations. Significant gross findings included several nodules randomly distributed throughout the pulmonary lobes of both horses, and the kidneys, myocardium, and the frontal lobes of the cerebrum of the filly. Histopathological evaluation revealed pyogranulomatous bronchopneumonia in both horses; granulomatous interstitial nephritis, myocarditis, and encephalitis were observed in the filly. All lesions contained vasculitis and thrombosis associated with myriads of intralesional, branching, septate fungi consistent with Aspergillus spp.; intralesional fungi were more easily identified by the Grocott methenamine silver stain. Mycological culture of fresh pulmonary sections from both horses and the brain of the filly revealed pure growths of A. fumigatus. These findings confirmed the participation of A. fumigatus in the etiopathogenesis of the lesions observed in the lungs of both horses, and the cerebrum, myocardium and kidneys of the filly and might represent the first description of A. fumigatus-induced encephalitis in horses. Additionally, we believe that infection occurred during the ingestion of contaminated hay or by inhalation of spores within contaminated bedding that resulted in transient nasal mycosis, which progressed to pyogranulomatous bronchopneumonia in both horses with embolic encephalitic, myocardial, and renal dissemination of A. fumigatus occurring only in the filly.

  7. A Community Publication and Dissemination System for Hydrology Education Materials

    Science.gov (United States)

    Ruddell, B. L.

    2015-12-01

    Hosted by CUAHSI and the Science Education Resource Center (SERC), federated by the National Science Digital Library (NSDL), and allied with the Water Data Center (WDC), Hydrologic Information System (HIS), and HydroShare projects, a simple cyberinfrastructure has been launched for the publication and dissemination of data and model driven university hydrology education materials. This lightweight system's metadata describes learning content as a data-driven module with defined data inputs and outputs. This structure allows a user to mix and match modules to create sequences of content that teach both hydrology and computer learning outcomes. Importantly, this modular infrastructure allows an instructor to substitute a module based on updated computer methods for one based on outdated computer methods, hopefully solving the problem of rapid obsolescence that has hampered previous community efforts. The prototype system is now available from CUAHSI and SERC, with some example content. The system is designed to catalog, link to, make visible, and make accessible the existing and future contributions of the community; this system does not create content. Submissions from hydrology educators are eagerly solicited, especially for existing content.

  8. Disseminated mycobacteriosis in a stranded loggerhead sea turtle (Caretta caretta).

    Science.gov (United States)

    Nardini, Giordano; Florio, Daniela; Di Girolamo, Nicola; Gustinelli, Andrea; Quaglio, Francesco; Fiorentini, Laura; Leopardi, Stefania; Fioravanti, Maria Letizia

    2014-06-01

    A loggerhead sea turtle (Caretta caretta) was found stranded alive along the Adriatic coast close to Ancona, Italy, displaying obtundation, tachypnea, and increased respiratory effort. It died a few hours after admission, and a postmortem examination was immediately performed. Miliary yellowish nodules were evident in the liver, and a lower number in the heart, stomach, and gut wall. Hundreds of whitish nodules were scattered in the lungs, with the majority of the pulmonary parenchyma being replaced by the lesions. Histologically, all nodular lesions consisted of a small central area of necrosis with acid-fast bacilli surrounded by epithelioid cells, macrophages, and lymphocytes. Giant cells were found in the spleen and the liver. Kidneys, lungs, liver, spleen, brain, and skin lesions were inoculated aseptically onto general isolation media and selective isolation media for mycobacteria. The isolate showed a restriction pattern identical to Mycobacterium chelonae by polymerase chain reaction-restriction fragment length polymorphism. To the best of the authors' knowledge, this is the first description of a disseminated infection caused by a potentially pathogenic mycobacteria in a stranded, free-ranging loggerhead sea turtle. Veterinary staff and biologists who handle sea turtles with suspected mycobacterial disease should protect themselves appropriately.

  9. Review: Biological relevance of disseminated tumor cells in cancer patients.

    Science.gov (United States)

    Riethdorf, Sabine; Wikman, Harriet; Pantel, Klaus

    2008-11-01

    The prognosis of cancer patients is largely determined by the occurrence of distant metastases. In patients with primary tumors, this relapse is mainly due to clinically occult micrometastasis present in secondary organs at primary diagnosis but not detectable even with high resolution imaging procedures. Sensitive and specific immunocytochemical and molecular assays enable the detection and characterization of disseminated tumor cells (DTC) at the single cell level in bone marrow (BM) as the common homing site of DTC and circulating tumor cells (CTC) in peripheral blood. Because of the high variability of results in DTC and CTC detection, there is an urgent need for standardized methods. In this review, we will focus on BM and present currently available methods for the detection and characterization of DTC. Furthermore, we will discuss data on the biology of DTC and the clinical relevance of DTC detection. While the prognostic impact of DTC in BM has clearly been shown for primary breast cancer patients, less is known about the clinical relevance of DTC in patients with other carcinomas. Current findings suggest that DTC are capable to survive chemotherapy and persist in a dormant nonproliferating state over years. To what extent these DTC have stem cell properties is subject of ongoing investigations. Further characterization is required to understand the biology of DTC and to identify new targets for improved risk prevention and tailoring of therapy. Our review will focus on breast, colon, lung, and prostate cancer as the main tumor entities in Europe and the United States.

  10. Intelligent Information Dissemination Scheme for Urban Vehicular Ad Hoc Networks

    Directory of Open Access Journals (Sweden)

    Jinsheng Yang

    2015-01-01

    Full Text Available In vehicular ad hoc networks (VANETs, a hotspot, such as a parking lot, is an information source and will receive inquiries from many vehicles for seeking any possible free parking space. According to the routing protocols in literature, each of the vehicles needs to flood its route discovery (RD packets to discover a route to the hotspot before sending inquiring packets to the parking lot. As a result, the VANET nearby an urban area or city center may incur the problem of broadcast storm due to so many flooding RD packets during rush hours. To avoid the broadcast storm problem, this paper presents a hotspot-enabled routing-tree based data forwarding method, called the intelligent information dissemination scheme (IID. Our method can let the hotspot automatically decide when to build the routing-tree for proactive information transmissions under the condition that the number of vehicle routing discoveries during a given period exceeds a certain threshold which is calculated through our developed analytical packet delivery model. The routing information will be dynamically maintained by vehicles located at each intersection near the hotspot if the maintaining cost is less than that of allowing vehicles to discover routes themselves. Simulation results show that this method can minimize routing delays for vehicles with lower packets delivery overheads.

  11. Disseminating the unit of mass from multiple primary realisations

    Science.gov (United States)

    Nielsen, Lars

    2016-12-01

    When a new definition of the kilogram has been adopted in 2018 as expected, the unit of mass will be realised by the watt balance method, the x-ray crystal density method or perhaps other primary methods still to be developed. So far, the standard uncertainties associated with the available primary methods are at least one order of magnitude larger than the standard uncertainty associated with mass comparisons using mass comparators, so differences in primary realisations of the kilogram are easily detected, whereas many National Metrology Institutes would have to increase their calibration and measurement capabilities (CMCs) if they were traceable to a single primary realisation. This paper presents a scheme for obtaining traceability to multiple primary realisations of the kilogram using a small group of stainless steel 1 kg weights, which are allowed to change their masses over time in a way known to be realistic, and which are calibrated and stored in air. An analysis of the scheme shows that if the relative standard uncertainties of future primary realisations are equal to the relative standard uncertainties of the present methods used to measure the Planck constant, the unit of mass can be disseminated with a standard uncertainty less than 0.015 mg, which matches the smallest CMCs currently claimed for the calibration of 1 kg weights.

  12. Selective Flocculation Enhanced Magnetic Separation of Ultrafine Disseminated Magnetite Ores

    Directory of Open Access Journals (Sweden)

    Tao Su

    2016-08-01

    Full Text Available Simple magnetic separation for a certain magnetite mine with ultrafine disseminated lean ores has resulted in low performance, as the fine sizes and aggregation of ground mineral particles have caused inefficient recovery of the ultrafine minerals. In this study, we attempt to increase the apparent sizes of target mineral particles, and improve the separation indices, by using a multi-stage grinding-dispersion-selective flocculation-weak magnetic separation process. The results showed that under the conditions of 500 g/t sodium hexametaphospate (SHMP as dispersant, 750 g/t carboxymethyl starch (CMS as flocculant, agitating at 400 rpm for 10 min, with slurry pH 11, and final grinding fineness of 93.5% less than 0.03 mm, the obtained concentrate contained 62.82% iron, with recovery of 79.12% after multi-stage magnetic separation. Compared to simple magnetic separation, the concentrate’s iron grade increased by 1.26%, and a recovery rate by 5.08%. Fundamental analysis indicated that, in a dispersed state of dispersion, magnetite particles had weaker negative surface charges than quartz, allowing the adsorption of negative CMS ions via hydrogen bonding. Consequently, the aggregate size of the initial concentrate increased from 24.30 to 38.37 μm, accomplishing the goal of selective flocculation, and increasing the indices of separation.

  13. An Acute Disseminated Encephalomyelitis Case due to Mycobacterium tuberculosis

    Directory of Open Access Journals (Sweden)

    Hale Turan Özden

    2016-03-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM is an inflammatory and demyelinating disorder of the central nervous system that is characterized by multifocal involvement of the white matter. Our patient was a 27-year-old female patient who had given birth to a baby with caesarean in another hospital. After four days upon the parturition, she was admitted to our hospital’s general intensive care unit with a poor general status, confusion and a fever. She was diagnosed with ADEM according to the clinical, laboratory and radiological findings. In addition to her antibiotic treatment (meropenem that had been given in the previous health care facility, corticosteroid therapy was also started. The patient passed away due to the ventilator-associated pneumonia infection on the 10th day of her admission. Mycobacterium tuberculosis proliferation was observed in the cerebrospinal fluid after her death. As it is reported in literature, tuberculosis is a rare cause of ADEM. In conclusion, it should be noted that M. tuberculosis can be a rare cause of ADEM in regions where the disease is endemic. J Microbiol Infect Dis 2016;6(1: 28-31

  14. Disseminated Langerhans' cell histiocytosis and massive protein-losing enteropathy

    Directory of Open Access Journals (Sweden)

    Santos-Machado T.M.

    1999-01-01

    Full Text Available Symptomatic involvement of the gastrointestinal (GI tract as a prominent symptom in Langerhans' cell histiocytosis (LCH is uncommon, occurring in less than 1 to 5% of all cases, even when the disease is in its disseminated form. Up to now, there have been reports of 18 cases of LCH with GI manifestations, including our 2 cases, with diarrhea (77.7%, protein-losing enteropathy (33.3% and bloody stool being the most frequent findings. The authors present two patients with severe diarrhea and refractory hypoalbuminemia, and with the protein-losing enteropathy documented by Cr51-labeled albumin studies. A review of the literature indicated that the presence of GI symptoms is often associated with systemic disease as well as with poor prognosis, mainly under 2 years of age. Radioisotopes are useful for documenting protein loss in several diseases with high specificity and sensitivity, and their utilization in the cases reviewed here permitted diagnoses in 6 children, as well as improved therapeutic management.

  15. Disseminating knowledge about 'Local Food Plants' and 'Local Plant Foods'.

    Science.gov (United States)

    Rivera, Diego; Heinrich, Michael; Obón, Concepción; Inocencio, Cristina; Nebel, Sabine; Verde, Alonso; Fajardo, José

    2006-01-01

    Ethnobotanical approaches to the study of Mediterranean food plants offer novel ways for analyzing and preserving traditional knowledge and agrobiodiversity in the Mediterranean area. This article highlights our strategy to increase the awareness within traditional knowledge systems and encourage the continuous evolution of it, avoiding the loss of substantial parts of the local cultural and biological diversity. The strategy is part of a broader stream of thought, which does attempt to disseminate information locally in a multitude of ways, e.g. through a range of publications in rural or urban zones, to people with or without formal education, to children or the elderly. This article is a very personal account of the experience of the authors, but there is an urgent need to assess the impact of such activities on a broader level, and, also, to reassess the impact researchers have on the communities. Our clear impression in all field sites has been that the simple fact that such traditional knowledge systems are the focus of scientific investigation are an essential element of giving renewed sociocultural value to such knowledge and that activities like the ones described here are of great interest to the communities we worked in.

  16. The role of information dissemination in sustainability of international partnerships.

    Science.gov (United States)

    Delclos, G L; Felknor, S A; Morandi, M T; Schulze, L J; Tovar, L S; Yanes, L

    1999-01-01

    The Fogarty-supported International Training Program of the Southwest Center for Occupational and Environmental Health (SWCOEH) at the University of Texas School of Public Health was initiated in 1995, with its activities focused primarily on Latin America. As this program has matured, its participants have been concerned about including elements that increase the likelihood that its trainees and projects will have a sustainable impact on occupational and environmental health in collaborating countries. The Center recently reviewed the experiences of various international organizations and national development agencies with established track records involving donor-supported projects. The authors summarize factors associated with project sustainability and describe how some of them are being incorporated into the SWCOEH program. Particular mention is made of the importance of supporting an infrastructure for broad information dissemination in the language of the intended audience. An example of a project to support a peer-reviewed Spanish-language journal devoted to occupational and environmental health, Salud de los Trabajadores, is presented.

  17. Digital game for education and dissemination of nuclear energy applications

    Energy Technology Data Exchange (ETDEWEB)

    Legey, Ana Paula; Silva, Marcio H.; Machado, Daniel M.; Santo, Andre Cotelli E.; Lapa, Celso M.F.; Mol, Antonio C.A., E-mail: analegey@hotmail.com, E-mail: machado.mol@gmail.com [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Lab. de Realidade Virtual; Lima, Tiago Rocha; Paula, Vanessa M.; Junior, Israel L.; Augusto, Haline F., E-mail: tlrtiago@gmail.com, E-mail: vnspaula@hotmail.com, E-mail: halineffa@hotmail.com, E-mail: israel_plj@hotmail.com [Centro Universitario Carioca (UniCarioca), Rio de Janeiro, RJ (Brazil)

    2015-07-01

    Students are immersed in a society with many possibilities of interaction, either computer or smart phones. In addition, students demand more innovation, dynamism and interactivity in classrooms. The form of education that can motivate students to engage in the learning process can get them to be interested in the lessons and not prematurely abandon schools. On the other hand, educational materials based on Virtual Reality (VR), as computer games, have been considered an important educational tool for making dynamic, motivating, innovative, in addition to achieving those areas where traditional methods are not reaching its goal. Motivated by the above, and given the competence developed by the Virtual Reality Laboratory of the Instituto de Engenharia Nuclear / CNEN and the collaboration of the University Center UniCarioca, was developed a digital game based on virtual reality tools for the teaching of a subject of area of science that needs to be addressed to society more contextualized way: the different applications of nuclear energy. It is expected that this digital game is an important tool for the dissemination, teaching and learning the benefits of nuclear energy. (author)

  18. NEOLOGISMS IN CHILD'S SPEECH CAUSED BY THE DISSEMINATION OF VIDEOS

    Directory of Open Access Journals (Sweden)

    Sidorenko A. V.

    2015-11-01

    Full Text Available The article studies words and set expressions of children's speech appearance of which are directly linked to the dissemination of movies in the late 1980s in the Soviet Union. These words and set expressions are analyzed on the basis of the material collected by the author for «The Dictionary of Soviet Childhood» being prepared for printing. As a result of exposure to foreign video products, some new expressions and words entered children's speech and have become an important part of the linguistic landscape of the Soviet childhood. Many of them have been stored in conversations so far: invective vocabulary, translation loanwords, barbarisms, exotic vocabulary, proper names. Many words have developed new meanings and become part of new Russian lexical sets. These neologisms in vocabulary are reflected in children's folklore; some of them have become part of the literary language and have been fixed in modern dictionaries of the Russian language. Many of them are still used in Russian informal speech. The author gives examples of the use of these lexical units in fiction and publicist texts paying attention to their semantic, phonetic, spelling and grammatical features

  19. γ-干扰素释放试验在肺外结核诊断中的应用与评价%Evaluation of interferon-gamma release technique in extra-pulmonary tuberculosis detection

    Institute of Scientific and Technical Information of China (English)

    鲁曦; 李王平; 谢永宏; 孙瑞琳; 刘伟; 金发光

    2016-01-01

    目的:探讨γ-干扰素释放试验(T细胞斑点试验)在肺外结核诊断中的使用效能。方法通过对265例入组的肺外结核疑似患者进行T细胞斑点试验检测,分析该技术在肺外结核中的诊断效能和影响该检测结果的风险因素。结果265例患者中,确诊肺外结核147例、可疑肺外结核32例、排除结核感染86例。在去除可疑样本之后,T细胞斑点试验灵敏度和特异性分别为81%和53%。其中,T细胞斑点试验对淋巴结核与结核性腹膜炎检测灵敏度最高,均为88%;结核性胸膜炎检测的灵敏度最低,为75%;T细胞斑点试验对淋巴结核检测的特异性最高,为67%;而肠结核检测的特异性最低,仅为44%。在免疫功能低下人群中,其灵敏度较免疫功能正常人群显著降低(P<0.05)。此外,年龄(≥65岁)对T细胞斑点试验灵敏度及对阳性预测值和阴性预测值的影响具有统计学意义( P<0.05)。结论 T细胞斑点试验能够作为疑似肺外结核鉴别的辅助诊断工具,具有较高的灵敏度,但在不同感染部位的检测效能不同。 T细胞斑点试验检测结果受到患者免疫功能状态与年龄的影响,因此在进行该项检测之前有必要对患者免疫状态等相关因素进行评估。%Objective To evaluate the clinic presentation of interferon-gamma release method ( T cell spot test) in extra-pulmonary tuberculosis ( E-TB) diagnosis. Methods Totally 265 suspect E-TB patients were included in the study. The clinic practice and risk factors were analyzed. Results Among the 265 cases, there were 147 were diagnosed as E-TB infection that confirmed by bacteriology or histology. E-TB was excluded in 86 patients, and the rest of 32 cases still cannot be diagnosed. After the suspicious cases removed, the sensitivity and specificity of T cell spot test assay were 81% and 53%. Among them, the sensitivity in crewels and tuberculous peritonitis detection was higher than others ( both 88

  20. Bacterial degradation of aminopyrine.

    Science.gov (United States)

    Blecher, H; Blecher, R; Wegst, W; Eberspaecher, J; Lingens, F

    1981-11-01

    1. Four strains of bacteria growing with aminopyrine as sole source of carbon were isolated from soil and were identified as strains of Phenylobacterium immobilis. 2. Strain M13 and strain E, the type species of Phenylobacterium immobilis (DSM 1986), which had been isolated by enrichment with chloridazon (5-amino-4-chloro-2-phenyl-2H-pyridazin-3-one) were used to investigate the bacterial degradation of aminopyrine. 3. Three metabolites were isolated and identified as: 4-(dimethylamino)-1,2-dihydro-1,5-dimethyl-2-(2,3-dihydro-2,3-dihydroxy-4,6-cyc lohexadien-1-yl)-3H-pyrazol-3-one, 4-(dimethylamino)-1,2-dihydro-1,5-dimethyl-2-(2,3-dihydroxyphenyl)-3H-pyrazol-3 -one and 4-(dimethylamino)-1,2-dihydro-1,5-dimethyl-3H-pyrazol-3-one. 4. An enzyme extract from cells of strain m13 was shown to further metabolize the catechol derivative of aminopyrine, with the formation of 2-pyrone-6-carboxylic acid. 5. Results indicate that the benzene ring of aminopyrine is the principal site of microbial metabolism.

  1. Electromagnetism of Bacterial Growth

    Science.gov (United States)

    Ainiwaer, Ailiyasi

    2011-10-01

    There has been increasing concern from the public about personal health due to the significant rise in the daily use of electrical devices such as cell phones, radios, computers, GPS, video games and television. All of these devices create electromagnetic (EM) fields, which are simply magnetic and electric fields surrounding the appliances that simultaneously affect the human bio-system. Although these can affect the human system, obstacles can easily shield or weaken the electrical fields; however, magnetic fields cannot be weakened and can pass through walls, human bodies and most other objects. The present study was conducted to examine the possible effects of bacteria when exposed to magnetic fields. The results indicate that a strong causal relationship is not clear, since different magnetic fields affect the bacteria differently, with some causing an increase in bacterial cells, and others causing a decrease in the same cells. This phenomenon has yet to be explained, but the current study attempts to offer a mathematical explanation for this occurrence. The researchers added cultures to the magnetic fields to examine any effects to ion transportation. Researchers discovered ions such as potassium and sodium are affected by the magnetic field. A formula is presented in the analysis section to explain this effect.

  2. Evolution of Bacterial Suicide

    Science.gov (United States)

    Tchernookov, Martin; Nemenman, Ilya

    2013-03-01

    While active, controlled cellular suicide (autolysis) in bacteria is commonly observed, it has been hard to argue that autolysis can be beneficial to an individual who commits it. We propose a theoretical model that predicts that bacterial autolysis is evolutionarily advantageous to an individualand would fixate in physically structured environments for stationary phase colonies. We perform spatially resolved agent-based simulations of the model, which predict that lower mixing in the environment results in fixation of a higher autolysis rate from a single mutated cell, regardless of the colony's genetic diversity. We argue that quorum sensing will fixate as well, even if initially rare, if it is coupled to controlling the autolysis rate. The model does not predict a strong additional competitive advantage for cells where autolysis is controlled by quorum sensing systems that distinguish self from nonself. These predictions are broadly supported by recent experimental results in B. subtilisand S. pneumoniae. Research partially supported by the James S McDonnell Foundation grant No. 220020321 and by HFSP grant No. RGY0084/2011.

  3. Bacterial endocarditis prophylaxis.

    Science.gov (United States)

    Blanco-Carrión, Andrés

    2004-01-01

    Bacterial endocarditis (BE) is a disease resulting from the association of morphological alterations of the heart and bacteraemia originating from different sources that at times can be indiscernible (infectious endocarditis). It is classified on the basis of the morphological alteration involved, depending on the clinical manifestations and course of illness, which varies according to the causative microorganism and host conditions (for example, it is characteristic in I.V. drug users). The most common microorganisms involved are: Streptococcus viridans (55%), Staphylococcus aureus (30%), Enterococcus (6%) and HACEK bacteria (corresponding to the initials: Haemophilus, Actinobacillus, Cardiobacterium, Eikenella and Kingella), although on occasions it can also be caused by fungi. The oral microbiological flora plays a very important role in the aetiopathogenesis of BE, given that the condition may be of oral or dental origin. This paper will deal with the prevention of said bacteraemia. Prophylaxis will be undertaken using amoxicillin or clindamycin according to action protocols, with special emphasis placed on oral hygiene in patients with structural defects of the heart.

  4. Control of favorable lithology on Jinlongshan micro-fine disseminated gold deposits, southern Qinling Mountains

    Institute of Scientific and Technical Information of China (English)

    ZHAO; Liqing

    2002-01-01

    Tectonics of Lithosphere and Metallogenic Regularity in Qinling-Dabashan Mountains (in Chinese with English abstr.), Wuhan: China University of Geology Press, 1994, 192.[13]Xu, Q., Liu, B., Xu, X. et al., Evolution of Sedimentary Basin of South Belt in Eastern Qinling Mountains and Metallo-genic Conditions of Multiple Metal (in Chinese with English abstr.), Chengdu: Southwest Jiaotong University Press, 1994,6.[14]Yang, Z., Tectonic Lithofacies of Margin Transform Basin and Metallogenic Process (in Chinese with English abstr.), Bei-jing: Science Press, 1991, 87-97.[15]Kuang, Y., Zhang, B., Ouyang, J., The regional crustal mobility reflected by the geochemmistry of Paleozoic sedimentary rocks in south Qinling, Acta Petrologica Sinica (in Chinese with English abstr.), 1995, 11(2): 203-212.[16]Shen, P., The geochemical features of minor elements and rare-earth elements of the Qiuling micro-disseminated gold de-posit in Zhen'an County, Shangxi Province, Geological Exploration (in Chinese with English abstr.), 1996, 11(3): 45-53.[17]Zhang, J., Lu, J., Yang, F., Experiment of bacterial enriching gold and geochemical significance, Geological Review (in Chinese with English abstr.), 1996, 42(5): 434-437.[18]Li, J., Qi, F., Xu, Q., The role of carbon and organic matter during metallogenic process of micro disseminated type (Car-lin-type), Mineral Deposits (in Chinese with English abstr.), 1996, 15(3): 193-205.[19]Hu, K., Zhai, J., Liu, Y., Genesis and organic geochemical characteristics of the carbonaceous rock stratabound gold de-posits, South China, Science in China, Ser. D, 2000, 43(5): 507-520.[20]Zeng, Y., Jiang, S., Experiment of mechanism of precipitation of gold on the surface of pyrites, Scientia Geologica Sinica (in Chinese with English abstr.), 1996, 31(1): 90-95.[21]Presnell, R. D., Parry, W. T., Geology and geochemistry of the Barneys Canyon gold deposits, Utah, Econ. Geol., 1996, 91: 273-288.

  5. Phenol-Soluble Modulins Contribute to Early Sepsis Dissemination Not Late Local USA300-Osteomyelitis Severity in Rabbits.

    Directory of Open Access Journals (Sweden)

    Benjamin Davido

    Full Text Available In bone and joint infections (BJIs, bacterial toxins are major virulence factors: Panton-Valentine leukocidin (PVL expression leads to severe local damage, including bone distortion and abscesses, while α-hemolysin (Hla production is associated with severe sepsis-related mortality. Recently, other toxins, namely phenol-soluble modulins (PSMs expressed by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA strain USA300 (LAC WT were shown to have ex vivo intracellular cytotoxic activity after S. aureus invasion of osteoblasts, but their in vivo contribution in a relatively PVL-sensitive osteomyelitis model remains poorly elucidated.We compared the outcomes of experimental rabbit osteomyelitises induced with pvl+hla+psms+ LAC WT and its isogenic Δpsm derivatives (LAC Δpsmα and LAC Δpsmαβhld using an inoculum of 3 × 108 CFUs. Mortality, hematogenous spread (blood culture, spleen and kidney, lung and bone involvements were assessed in two groups (non-survivors of severe sepsis and survivors sacrificed on day (D 14.Severe sepsis-related mortality tended to be lower for Δpsm derivatives (Kaplan-Meier curves, P = .06. Non-survivors' bone LAC-Δpsmα (6.9 log10 CFUs/g of bone, P = .04 or -Δpsmαβhld (6.86 log10 CFUs/g of bone, P = .014 densities were significantly higher than LAC WT (6.43 log10 CFUs/g of bone. Conversely, lung Δpsmαβhld CFUs were significantly lower than LAC WT (P = .04. LAC Δpsmα, Δpsmαβhld and WT induced similar bone damage in D14 survivors, with comparable bacterial densities (respectively: 5.89, 5.91, and 6.15 log10 CFUs/g of bone. Meanwhile, pulmonary histological scores of inflammation were significantly higher for LAC Δpsmα- and Δpsmαβhld-infected rabbits compared to LAC WT (P = .04 and .01, respectively but with comparable lung bacterial densities.Our experimental results showed that deactivating PSM peptides significantly limited bacterial dissemination from bone during the early

  6. Dissemination of an innovative mastery learning curriculum grounded in implementation science principles: a case study.

    Science.gov (United States)

    McGaghie, William C; Barsuk, Jeffrey H; Cohen, Elaine R; Kristopaitis, Theresa; Wayne, Diane B

    2015-11-01

    Dissemination of a medical education innovation, such as mastery learning, from a setting where it has been used successfully to a new and different medical education environment is not easy. This article describes the uneven yet successful dissemination of a simulation-based mastery learning (SBML) curriculum on central venous catheter (CVC) insertion for internal medicine and emergency medicine residents across medical education settings. The dissemination program was grounded in implementation science principles. The article begins by describing implementation science which addresses the mechanisms of medical education and health care delivery. The authors then present a mastery learning case study in two phases: (1) the development, implementation, and evaluation of the SBML CVC curriculum at a tertiary care academic medical center; and (2) the dissemination of the SBML CVC curriculum to an academic community hospital setting. Contextual information about the drivers and barriers that affected the SBML CVC curriculum dissemination is presented. This work demonstrates that dissemination of mastery learning curricula, like all other medical education innovations, will fail without active educational leadership, personal contacts, dedication, hard work, rigorous measurement, and attention to implementation science principles. The article concludes by presenting a set of lessons learned about disseminating an SBML CVC curriculum across different medical education settings.

  7. Lessons Learned From Dissemination of Evidence-Based Interventions for HIV Prevention.

    Science.gov (United States)

    Collins, Charles B; Sapiano, Tobey N

    2016-10-01

    In 1999, IOM issued a report that recommended that the Centers for Disease Control and Prevention should disseminate evidence-based HIV prevention interventions (EBIs) to be implemented by health departments, community-based organizations, drug treatment centers, and clinics. Based on these recommendations, the Diffusion of Effective Behavioral Interventions Project was initiated in 2000 and began disseminating interventions into public health practice. For 15 years, the Centers for Disease Control and Prevention has disseminated 29 EBIs to more than 11,300 agencies. Lessons were identified during the 15 years of implementation regarding successful methods of dissemination of EBIs. Lessons around selecting interventions for dissemination, developing a dissemination infrastructure including a resource website (https://effectiveinterventions.cdc.gov), and engagement with stakeholders are discussed. A continuous development approach ensured that intervention implementation materials, instructions, and technical assistance were all tailored to the needs of end users, focus populations, and agency capacities. Six follow-up studies demonstrated that adopters of EBIs were able to obtain comparable outcomes to those of the original efficacy research. The Diffusion of Effective Behavioral Interventions Project may offer guidance for other large, national, evidence-based public health dissemination projects.

  8. Twist1-positive epithelial cells retain adhesive and proliferative capacity throughout dissemination

    Directory of Open Access Journals (Sweden)

    Eliah R. Shamir

    2016-09-01

    Full Text Available Dissemination is the process by which cells detach and migrate away from a multicellular tissue. The epithelial-to-mesenchymal transition (EMT conceptualizes dissemination in a stepwise fashion, with downregulation of E-cadherin leading to loss of intercellular junctions, induction of motility, and then escape from the epithelium. This gain of migratory activity is proposed to be mutually exclusive with proliferation. We previously developed a dissemination assay based on inducible expression of the transcription factor Twist1 and here utilize it to characterize the timing and dynamics of intercellular adhesion, proliferation and migration during dissemination. Surprisingly, Twist1+ epithelium displayed extensive intercellular junctions, and Twist1– luminal epithelial cells could still adhere to disseminating Twist1+ cells. Although proteolysis and proliferation were both observed throughout dissemination, neither was absolutely required. Finally, Twist1+ cells exhibited a hybrid migration mode; their morphology and nuclear deformation were characteristic of amoeboid cells, whereas their dynamic protrusive activity, pericellular proteolysis and migration speeds were more typical of mesenchymal cells. Our data reveal that epithelial cells can disseminate while retaining competence to adhere and proliferate.

  9. Borrelia burgdorferi genetic markers and disseminated disease in patients with early Lyme disease.

    Science.gov (United States)

    Jones, Kathryn L; Glickstein, Lisa J; Damle, Nitin; Sikand, Vijay K; McHugh, Gail; Steere, Allen C

    2006-12-01

    Three genetic markers of Borrelia burgdorferi have been associated with disseminated disease: the OspC type, the 16S-23S rRNA intergenic spacer type (RST), and vlsE. Here, we modified previous methods so as to identify the three markers by PCR and restriction fragment length polymorphism in parallel, analyzed B. burgdorferi isolates from erythema migrans (EM) skin lesions in 91 patients, and correlated the results with evidence of dissemination. OspC type A was found approximately twice as frequently in patients with disseminated disease, whereas type K was identified approximately twice as often in those without evidence of dissemination, but these trends were not statistically significant. The remaining seven types identified were found nearly equally in patients with or without evidence of dissemination. RST 1 strains were significantly associated with dissemination (P=0.03), whereas RST 2 and RST 3 strains tended to have an inverse association with this outcome. The vlsE gene was identified in all 91 cases, using primer sets specific for an N-terminal sequence of B. burgdorferi strain B31 (vlsEB31) or strain 297 (vlsE297), but neither marker was associated with dissemination. Specific combinations of the three genetic markers usually occurred together. OspC type A was always found with RST 1 and vlsEB31, type K was always identified with RST 2 and more often with vlsE297, and types E and I were almost always found with RST 3 and equally often with vlsEB31 and vlsE297. We conclude that B. burgdorferi strains vary in their capacity to disseminate, but almost all strains isolated from EM lesions sometimes caused disseminated disease.

  10. Borrelia burgdorferi Genetic Markers and Disseminated Disease in Patients with Early Lyme Disease▿

    Science.gov (United States)

    Jones, Kathryn L.; Glickstein, Lisa J.; Damle, Nitin; Sikand, Vijay K.; McHugh, Gail; Steere, Allen C.

    2006-01-01

    Three genetic markers of Borrelia burgdorferi have been associated with disseminated disease: the OspC type, the 16S-23S rRNA intergenic spacer type (RST), and vlsE. Here, we modified previous methods so as to identify the three markers by PCR and restriction fragment length polymorphism in parallel, analyzed B. burgdorferi isolates from erythema migrans (EM) skin lesions in 91 patients, and correlated the results with evidence of dissemination. OspC type A was found approximately twice as frequently in patients with disseminated disease, whereas type K was identified approximately twice as often in those without evidence of dissemination, but these trends were not statistically significant. The remaining seven types identified were found nearly equally in patients with or without evidence of dissemination. RST 1 strains were significantly associated with dissemination (P = 0.03), whereas RST 2 and RST 3 strains tended to have an inverse association with this outcome. The vlsE gene was identified in all 91 cases, using primer sets specific for an N-terminal sequence of B. burgdorferi strain B31 (vlsEB31) or strain 297 (vlsE297), but neither marker was associated with dissemination. Specific combinations of the three genetic markers usually occurred together. OspC type A was always found with RST 1 and vlsEB31, type K was always identified with RST 2 and more often with vlsE297, and types E and I were almost always found with RST 3 and equally often with vlsEB31 and vlsE297. We conclude that B. burgdorferi strains vary in their capacity to disseminate, but almost all strains isolated from EM lesions sometimes caused disseminated disease. PMID:17035489

  11. [DISSEMINATION BY H. PYLORI IN PATIENTS, SUFFERING VARIOUS FORMS OF CHOLECYSTITIS].

    Science.gov (United States)

    Kyazimov, I L; Takhmazova, Ch T

    2015-05-01

    Comparative analysis of dissemination by H. pylori of the bile portions in patients of a control group, suffering an acute calculous cholecystitis (ACCH), was performed. Dissemination of H. pylori in a control group was significantly less, than in a bile portions of patients, suffering ACCH. While analyzing the rate and degree of dissemination by H. pylori of the gastic and gallbladder mucosa biopsies of patients, suffering chronic non-calculous cholecystitis, associated with duodenogastric reflux and gastroduodenitis, bacteria were revealed trustworthy more often and in more number, than in a gallbladder mucosa in patients, suffering ACCH.

  12. Approaches to Mixed Methods Dissemination and Implementation Research: Methods, Strengths, Caveats, and Opportunities.

    Science.gov (United States)

    Green, Carla A; Duan, Naihua; Gibbons, Robert D; Hoagwood, Kimberly E; Palinkas, Lawrence A; Wisdom, Jennifer P

    2015-09-01

    Limited translation of research into practice has prompted study of diffusion and implementation, and development of effective methods of encouraging adoption, dissemination and implementation. Mixed methods techniques offer approaches for assessing and addressing processes affecting implementation of evidence-based interventions. We describe common mixed methods approaches used in dissemination and implementation research, discuss strengths and limitations of mixed methods approaches to data collection, and suggest promising methods not yet widely used in implementation research. We review qualitative, quantitative, and hybrid approaches to mixed methods dissemination and implementation studies, and describe methods for integrating multiple methods to increase depth of understanding while improving reliability and validity of findings.

  13. A mixed-methods study of research dissemination across practice-based research networks.

    Science.gov (United States)

    Lipman, Paula Darby; Lange, Carol J; Cohen, Rachel A; Peterson, Kevin A

    2014-01-01

    Practice-based research networks may be expanding beyond research into rapid learning systems. This mixed-methods study uses Agency for Healthcare Research and Quality registry data to identify networks currently engaged in dissemination of research findings and to select a sample to participate in qualitative semistructured interviews. An adapted Diffusion of Innovations framework was used to organize concepts by characteristics of networks, dissemination activities, and mechanisms for rapid learning. Six regional networks provided detailed information about dissemination strategies, organizational context, role of practice-based research network, member involvement, and practice incentives. Strategies compatible with current practices and learning innovations that generate observable improvements may increase effectiveness of rapid learning approaches.

  14. Disseminated Acanthamoeba sinusitis in a patient with AIDS: a possible role for early antiretroviral therapy.

    Science.gov (United States)

    Carter, Wendy W; Gompf, Sandra G; Toney, John F; Greene, John N; Cutolo, Edward P

    2004-01-01

    Acanthamoeba, a free-living ameba, has been reported to infect humans with subacute encephalitis, sinusitis, or keratitis. Multiple cases of Acanthamoeba sinusitis with dissemination have been reported in association with AIDS, with high mortality. We report successful treatment of a 35-year-old woman who presented with sinusitis that progressed to disseminated acanthamebiasis as her initial manifestation of AIDS. To our knowledge, our patient was one of the few and longest-lived survivors of disseminated Acanthamoeba infection with AIDS. As with other opportunistic infections, early aggressive therapy including HAART may alter the outcome in this almost uniformly fatal disease.

  15. Meningitis bacteriana Bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Ana Teresa Alvarado Guevara

    2006-03-01

    causales son virales lo cual conlleva a las diferentes sub-clasificaciones. También en ciertos casos puede ser ocasionada por hongos, bacterias atípicas, micobacterias y parásitos.In Costa Rica the bacterial meningitis had turn into a high-priority subject in which to monitoring epidemiologist. It had been talked about in the last months, to dice an increase in the attention is published of this subject, due to this phenomenon it becomes necessary to make a revision of topic. Meningitis is an inflammation of leptomeninges and colonization of the subarachnoid cerebrospinal fluid (LCR due to different agents, which produces meningeal symptoms (ex. migraine, neck rigidity, and photophobia and pleocytosis in LCR. De pending on the variables to take into account is possible to group it in different classifications, taking into account the time of evolution are possible to be divided in acute or chronic, to first with few hours or days of beginning of the symptoms, whereas the chronicle also presents a silence course but of the disease of approximately 4 weeks of instauration. There is a difference according to its etiologic agent; they can be infectious and non-infectious. Examples of common non-infectious causes include medications (ex, nonsteroidal anti-inflammatory drugs, and antibiotics and carcinomatosis. A classification exists as well according to the causal agent. The acute bacterial meningitis remarks a bacterial origin of the syndrome, which characterizes by the by an acute onset of meningeal symptoms and neutrophilic pleocytosis. Each one of the bacteriological agents, parasitic or fungus finishes by characterizing the different presentations of the clinical features (ex, meningocóccica meningitis, Cryptococcus meningitis. Finally, there is also the aseptic meningitis, denominated in this form because it’s nonpyogenic cellular response caused by many types of agents. The patients show an acute beginning of symptoms, fever and lymphocytic pleocytosis. After

  16. Bacterial Communities: Interactions to Scale

    Directory of Open Access Journals (Sweden)

    Reed M. Stubbendieck

    2016-08-01

    Full Text Available In the environment, bacteria live in complex multispecies communities. These communities span in scale from small, multicellular aggregates to billions or trillions of cells within the gastrointestinal tract of animals. The dynamics of bacterial communities are determined by pairwise interactions that occur between different species in the community. Though interactions occur between a few cells at a time, the outcomes of these interchanges have ramifications that ripple through many orders of magnitude, and ultimately affect the macroscopic world including the health of host organisms. In this review we cover how bacterial competition influences the structures of bacterial communities. We also emphasize methods and insights garnered from culture-dependent pairwise interaction studies, metagenomic analyses, and modeling experiments. Finally, we argue that the integration of multiple approaches will be instrumental to future understanding of the underlying dynamics of bacterial communities.

  17. Research and dissemination: an ethical way to prevention

    Science.gov (United States)

    Lugeri, Francesca; Farabollini, Piero

    2015-04-01

    The Italian landscape is well representative of the dualism risk / resource which, along with its contradictions, characterizes the whole country. In fact, it also poses continuous questions to the further parallel duality defense / management, as we think to those cases where the natural environment is a high source of hazard to the population living in the concerned territory, being at the same time a resource thanks to the beauty expressed by the shapes of the landscape. The knowledge of the environment where we live is an essential process, even for the survival itself; the difficult journey towards science and knowledge, has been characterized, in the various ages, from different approaches, conditioned by the availability of tools and resources, as well as by the particular historical social, political phases. Research on the evolution of phenomena in time and space; their description, representation and analysis; the interaction between mankind and the physical environment, are a priority for geologists. More than 50 years after the tragedy of Vajont, the issues of shared knowledge, awareness, perception of risk, are still pending and the prevention practices are still a dramatically distant goal. It is essential to disseminate scientific heritage, by implementing processes of communication, using new codes and strategies, able to make individuals / communities / society aware of the local context, in order to trigger a consistent and shared virtuous behaviour,. The strategies of participatory democracy are based on this indispensable assumption, aiming at involving the public in policy management, as well as in prevention practices, towards the sustainable development of the territory. A shared ethics, for the world of research as well as for the society, must aim at overcoming the usual and sterile actions of a mere repairing of the damage, in order to reach a shared behaviour, based on a conscious knowledge, which is the essential foundation to start

  18. Mycobacteriophages as Incubators for Intein Dissemination and Evolution

    Science.gov (United States)

    Kelley, Danielle S.; Lennon, Christopher W.; Novikova, Olga

    2016-01-01

    ABSTRACT Inteins are self-splicing protein elements that are mobile at the DNA level and are sporadically distributed across microbial genomes. Inteins appear to be horizontally transferred, and it has been speculated that phages may play a role in intein distribution. Our attention turns to mycobacteriophages, which infect mycobacteria, where both phage and host harbor inteins. Using bioinformatics, mycobacteriophage genomes were mined for inteins. This study reveals that these mobile elements are present across multiple mycobacteriophage clusters and are pervasive in certain genes, like the large terminase subunit TerL and a RecB-like nuclease, with the majority of intein-containing genes being phage specific. Strikingly, despite this phage specificity, inteins localize to functional motifs shared with bacteria, such that intein-containing genes have similar roles, like hydrolase activity and nucleic acid binding, indicating a global commonality among intein-hosting proteins. Additionally, there are multiple insertion points within active centers, implying independent invasion events, with regulatory implications. Several phage inteins were shown to be splicing competent and to encode functional homing endonucleases, important for mobility. Further, bioinformatic analysis supports the potential for phages as facilitators of intein movement among mycobacteria and related genera. Analysis of catalytic intein residues finds the highly conserved penultimate histidine inconsistently maintained among mycobacteriophages. Biochemical characterization of a noncanonical phage intein shows that this residue influences precursor accumulation, suggesting that splicing has been tuned in phages to modulate generation of important proteins. Together, this work expands our understanding of phage-based intein dissemination and evolution and implies that phages provide a context for evolution of splicing-based regulation. PMID:27703073

  19. Inadequate dissemination of phase I trials: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Evelyne Decullier

    2009-02-01

    Full Text Available BACKGROUND: Drug development is ideally a logical sequence in which information from small early studies (Phase I is subsequently used to inform and plan larger, more definitive studies (Phases II-IV. Phase I trials are unique because they generally provide the first evaluation of new drugs in humans. The conduct and dissemination of Phase I trials have not previously been empirically evaluated. Our objective was to describe the initiation, completion, and publication of Phase I trials in comparison with Phase II-IV trials. METHODS AND FINDINGS: We reviewed a cohort of all protocols approved by a sample of ethics committees in France from January 1, 1994 to December 31, 1994. The comparison of 140 Phase I trials with 304 Phase II-IV trials, showed that Phase I studies were more likely to be initiated (133/140 [95%] versus 269/304 [88%], more likely to be completed (127/133 [95%] versus 218/269 [81%], and more likely to produce confirmatory results (71/83 [86%] versus 125/175 [71%] than Phase II-IV trials. Publication was less frequent for Phase I studies (21/127 [17%] versus 93/218 [43%], even if only accounting for studies providing confirmatory results (18/71 [25%] versus 79/125 [63%]. CONCLUSIONS: The initiation, completion, and publications of Phase I trials are different from those of other studies. Moreover, the results of these trials should be published in order to ensure the integrity of the overall body of scientific knowledge, and ultimately the safety of future trial participants and patients.

  20. Strongyloides stercoralis disseminated infection and schistosomiasis in an AIDS patient

    Directory of Open Access Journals (Sweden)

    Rodrigo Martins Brandão

    2012-12-01

    Full Text Available Strongyloides stercoralis hyperinfection syndrome is classically associated with impaired host response and implies in an overburden of larvae in its usual cycle. It has been recognized as a severe and potentially fatal condition in immunocompromised individuals, especially those using oral corticosteroids. Infection with Schistosoma mansoni not only increases the susceptibility to HIV infection, but also promotes progression to disease. The association of the most severe forms of strongyloidiasis and AIDS is scarcely described, even more when S. mansoni is also associated. The authors describe a case of a 34-year-old previously healthy male, admitted to the emergency department with a history of hematemesis associated with dyspnea, hemoptysis, and fever. He referred homosexual relations for 6 years. Physical examination showed an ill-looking patient, and was remarkable for tachycardia, tachypnea, diaphoresis, and pulse oximetry of 70% in room air. Lungs examination revealed the presence of rales in the left base. Chest radiography showed a diffuse and bilateral reticulo-nodular pattern. HIV serology was positive. Empirical antimicrobial therapy and corticosteroids were initiated. On the third day of hospitalization, petechiae appeared over the periumbilical area, but no further investigation was undertaken because the patient died soon after. The autopsy findings were compatible with S. stercoralis disseminated infection, a hepatic intestinal chronic form of schistosomiasis, and septic shock as the primary cause of death. The authors call attention to this infrequent association.