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Sample records for causing epidemic nephritis

  1. Radiation nephritis causing nephrotic syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Jennette, J.C.; Ordonez, N.G.

    1983-12-01

    Clinical symptoms of acute radiation nephritis with nephrotic syndrome developed in a fifty-six-year-old woman after abdominal radiation therapy for an astrocytoma of the spinal cord. The diagnosis of radiation nephritis was confirmed by renal biopsy. To our knowledge, this is the first documented case of radiation nephritis associated with nephrotic syndrome.

  2. 75 FR 35492 - Guidance for Industry on Lupus Nephritis Caused By Systemic Lupus Erythematosus-Developing...

    Science.gov (United States)

    2010-06-22

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Lupus Nephritis Caused By Systemic... availability of a guidance for industry entitled ``Lupus Nephritis Caused By Systemic Lupus Erythematosus... nephritis (LN) caused by systemic lupus erythematosus (SLE). This guidance finalizes the parts of the...

  3. 77 FR 38305 - Guidance for Industry on Lupus Nephritis Caused by Systemic Lupus Erythematosus-Developing...

    Science.gov (United States)

    2012-06-27

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Lupus Nephritis Caused by Systemic... a notice published in the Federal Register of June 22, 2010 (75 FR 35492), FDA announced the availability of a guidance entitled ``Lupus Nephritis Caused By Systemic Lupus...

  4. Lupus Nephritis

    Science.gov (United States)

    ... Disease Organizations​​ . (PDF, 345 KB)​​​​​ Alternate Language URL Lupus Nephritis Page Content On this page: What is lupus ... Nutrition Points to Remember Clinical Trials What is lupus nephritis? Lupus nephritis is kidney inflammation caused by systemic ...

  5. Lupus nephritis: current update

    OpenAIRE

    Saxena, Ramesh; Mahajan, Tina; Mohan, Chandra

    2011-01-01

    Lupus nephritis is a major cause of morbidity and mortality in patients with systemic lupus erythematosus. The general consensus is that 60% of lupus patients will develop clinically relevant nephritis at some time in the course of their illness. Prompt recognition and treatment of renal disease is important, as early response to therapy is correlated with better outcome. The present review summarizes our current understanding of the pathogenic mechanisms underlying lupus nephritis and how th...

  6. Epidemic of Postsurgical Infections Caused by Mycobacterium massiliense▿

    Science.gov (United States)

    Duarte, Rafael Silva; Lourenço, Maria Cristina Silva; Fonseca, Leila de Souza; Leão, Sylvia Cardoso; Amorim, Efigenia de Lourdes T.; Rocha, Ingrid L. L.; Coelho, Fabrice Santana; Viana-Niero, Cristina; Gomes, Karen Machado; da Silva, Marlei Gomes; de Oliveira Lorena, Nádia Suely; Pitombo, Marcos Bettini; Ferreira, Rosa M. C.; de Oliveira Garcia, Márcio Henrique; de Oliveira, Gisele Pinto; Lupi, Otilia; Vilaça, Bruno Rios; Serradas, Lúcia Rodrigues; Chebabo, Alberto; Marques, Elizabeth Andrade; Teixeira, Lúcia Martins; Dalcolmo, Margareth; Senna, Simone Gonçalves; Sampaio, Jorge Luiz Mello

    2009-01-01

    An epidemic of infections after video-assisted surgery (1,051 possible cases) caused by rapidly growing mycobacteria (RGM) and involving 63 hospitals in the state of Rio de Janeiro, Brazil, occurred between August 2006 and July 2007. One hundred ninety-seven cases were confirmed by positive acid-fast staining and/or culture techniques. Thirty-eight hospitals had cases confirmed by mycobacterial culture, with a total of 148 available isolates recovered from 146 patients. Most (n = 144; 97.2%) isolates presented a PRA-hsp65 restriction pattern suggestive of Mycobacterium bolletii or Mycobacterium massiliense. Seventy-four of these isolates were further identified by hsp65 or rpoB partial sequencing, confirming the species identification as M. massiliense. Epidemic isolates showed susceptibility to amikacin (MIC at which 90% of the tested isolates are inhibited [MIC90], 8 μg/ml) and clarithromycin (MIC90, 0.25 μg/ml) but resistance to ciprofloxacin (MIC90, ≥32 μg/ml), cefoxitin (MIC90, 128 μg/ml), and doxycycline (MIC90, ≥64 μg/ml). Representative epidemic M. massiliense isolates that were randomly selected, including at least one isolate from each hospital where confirmed cases were detected, belonged to a single clone, as indicated by the analysis of pulsed-field gel electrophoresis (PFGE) patterns. They also had the same PFGE pattern as that previously observed in two outbreaks that occurred in other Brazilian cities; we designated this clone BRA100. All five BRA100 M. massiliense isolates tested presented consistent tolerance to 2% glutaraldehyde. This is the largest epidemic of postsurgical infections caused by RGM reported in the literature to date in Brazil. PMID:19403765

  7. Lupus and Kidney Disease (Lupus Nephritis)

    Science.gov (United States)

    ... NKF Newsroom Contact Us You are here Home » Lupus and Kidney Disease (Lupus Nephritis) Lupus is a short name for a ... affects only your skin. A Personal Look at Lupus Nephritis What causes lupus? No one knows what ...

  8. Lupus nephritis

    Science.gov (United States)

    ... American College of Rheumatology Guidelines for Screening, Case Definition, Treatment and Management of Lupus Nephritis. Arthritis Care ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  9. The Clinicopathological Study of Lupus Nephritis

    OpenAIRE

    Raouf Rahim Merza; Ayar Omer Ali; Hawar Ali Ehsan Kaka Khan

    2014-01-01

    Purpose: Lupus nephritis is one of the most serious manifestations of Systemic lupus erythematosis and it is a major cause of morbidity and mortality. The aim of this study is to compare males and females in lupus nephritis presentations. Material and Methods: A cross-sectional study performed on forty five patients with biopsy proven Lupus Nephritis including 32 females and 13 males. All patients assessed by questionnaire form and investigated for hematological, biochemical, immunologica...

  10. Suspected ciprofloxacin-induced interstitial nephritis.

    Science.gov (United States)

    Murray, K M; Wilson, M G

    1990-04-01

    Interstitial nephritis is a rare but serious adverse effect of many drugs and usually is diagnosed by clinical signs and symptoms of hematuria, proteinuria, eosinophilia, fever, azotemia, and rash. Ciprofloxacin is one drug that has been reported to cause interstitial nephritis. Renal toxicities have been reported in less than one percent of the patients receiving ciprofloxacin therapy. Limited documentation of this adverse effect exists in the literature. This article describes a patient with suspected ciprofloxacin-induced interstitial nephritis. PMID:2327115

  11. Did Wired and Wireless Telegraphy and Telephony cause the emergence of epidemic Poliomyelitis ?

    OpenAIRE

    Lauer, Vincent

    2015-01-01

    Epidemic Poliomyelitis is one of the diseases that emerged as major public health problems during the 20 th century, and can thus be suspected of being caused by artificial electromagnetic waves. Detailed examination reveals that early epidemic outbreaks coincided with changes in emissions of artificial electromagnetic waves, including the intentional emissions of wireless telegraphy and the unintentional emissions of wire telephony. The fundamental change from irregular outbreaks to yearly e...

  12. Root Cause Analysis of the Fusarium Keratitis Epidemic of 2004–2006 and Prescriptions for Preventing Future Epidemics

    Science.gov (United States)

    Bullock, John D.

    2009-01-01

    Purpose: A root cause analysis of the Fusarium keratitis epidemic of 2004–2006 was performed. Methods: Three US Food and Drug Administration (FDA) documents were analyzed. Poisson and case-control studies were performed on outbreak data from Singapore. Irreversible thermochromic labels were applied to cartons of contact lens solution bottles, which were then subjected to elevated temperatures. Results: The 1997 FDA guidance document concerning storage temperatures of contact lens care products predicted temperature-related solution instability. Bausch & Lomb (B&L) requested FDA approval for ReNu with MoistureLoc, claiming that it was substantially equivalent to other products. FDA Form 483 stated that cases of ReNu-related Fusarium keratitis from Asia had not been reported, the removal of the product from the Asian markets was unreported, and B&L had not performed biocidal testing on samples associated with Asian cases. The outbreak in Singapore could have been recognized after only 3 cases (Pr = .0067). The cause of the Singapore outbreak could have been determined after the recognition of only 3 (P = .0429), 5 (95% confidence interval [CI], 1.15–126.0), or 15 cases (95% CI, 1.60–14.1). Thermochromic labels can irreversibly change color when exposed to elevated temperatures, thus warning of potential antimicrobial failure. Conclusions: The worldwide Fusarium keratitis epidemic of 2004–2006 could, theoretically, have been prevented entirely, recognized much earlier, or mitigated by much more rigorous oversight by the FDA, by strict adherence by B&L to FDA guidelines and requirements, by the application of basic statistical methods, and/or by the use of temperature indication technology. The lessons learned from a root cause analysis of this pharmacologic catastrophy may help avert or mitigate future epidemics. PMID:20126495

  13. A Universal Model for Predicting Dynamics of the Epidemics Caused by Special Pathogens

    Directory of Open Access Journals (Sweden)

    Alexander G. Bachinsky

    2013-01-01

    Full Text Available A universal model intended primarily for predicting dynamics of the mass epidemics (outbreaks caused by special pathogens is being developed at the State Research Center of Virology and Biotechnology Vector. The model includes the range of major countermeasures: preventive and emergency mass vaccination, vaccination of risk groups as well as search for and isolation/observation of infected cases, contacts, and suspects, and quarantine. The intensity of interventions depends on the availability of the relevant resources. The effect of resource limitations on the development of a putative epidemic of Ebola hemorrhagic fever is demonstrated. The modeling results allow for estimation of the material and human resources necessary for eradication of an epidemic.

  14. Granulomatous interstitial nephritis.

    Science.gov (United States)

    Shah, Shivani; Carter-Monroe, Naima; Atta, Mohamed G

    2015-10-01

    Granulomatous interstitial nephritis (GIN) is a rare entity detected in ∼0.5-0.9% of all renal biopsies. GIN has been linked to several antibiotics such as cephalosporins, vancomycin, nitrofurantoin and ciprofloxacin. It is also associated with NSAIDs and granulomatous disorders such as sarcoidosis, tuberculosis, fungal infections, and granulomatosis with polyangiitis. Renal biopsy is critical in establishing this diagnosis, and the extent of tubular atrophy and interstitial fibrosis may aid in determining prognosis. Retrospective data and clinical experience suggest that removal of the offending agent in conjunction with corticosteroid therapy often results in improvement in renal function. We describe a patient with a history of multiple spinal surgeries complicated by wound infection who presented with confusion and rash with subsequent development of acute kidney injury. Urinalysis demonstrated pyuria and eosinophiluria, and renal biopsy revealed acute interstitial nephritis with granulomas. These findings were attributed to doxycycline treatment of his wound infection. This review explores the clinical associations, presentation, diagnosis, and treatment of this uncommon cause of acute kidney injury. PMID:26413275

  15. A Universal Model for Predicting Dynamics of the Epidemics Caused by Special Pathogens

    OpenAIRE

    Bachinsky, Alexander G.; Lily Ph. Nizolenko

    2013-01-01

    A universal model intended primarily for predicting dynamics of the mass epidemics (outbreaks) caused by special pathogens is being developed at the State Research Center of Virology and Biotechnology Vector. The model includes the range of major countermeasures: preventive and emergency mass vaccination, vaccination of risk groups as well as search for and isolation/observation of infected cases, contacts, and suspects, and quarantine. The intensity of interventions depends on the availabili...

  16. Cause and effect in childhood obesity: solutions for a national epidemic.

    Science.gov (United States)

    Wieting, J Michael

    2008-10-01

    Childhood obesity has reached epidemic proportions in the United States. As a result, children are at increased risk for myriad preventable acute and chronic medical problems--many of which are associated with increased morbidity and mortality. In addition, childhood obesity has serious psychosocial consequences, such as low self-esteem, lower quality of life, and depression. The multifaceted causes and solutions to this pervasive health issue are discussed in the present review, as are pertinent health policy issues. Osteopathic physicians and other healthcare providers can play an important role in patient and family education, direct care, and advocacy. PMID:18948638

  17. Tropheryma whipplei as a Cause of Epidemic Fever, Senegal, 2010-2012.

    Science.gov (United States)

    Bassene, Hubert; Mediannikov, Oleg; Socolovschi, Cristina; Ratmanov, Pavel; Keita, Alpha K; Sokhna, Cheikh; Raoult, Didier; Fenollar, Florence

    2016-07-01

    The bacterium Tropheryma whipplei, which causes Whipple disease in humans, is commonly detected in the feces of persons in Africa. It is also associated with acute infections. We investigated the role of T. whipplei in febrile patients from 2 rural villages in Senegal. During June 2010-March 2012, we collected whole-blood finger-prick samples from 786 febrile and 385 healthy villagers. T. whipplei was detected in blood specimens from 36 (4.6%) of the 786 febrile patients and in 1 (0.25%) of the 385 apparently healthy persons. Of the 37 T. whipplei cases, 26 (70.2%) were detected in August 2010. Familial cases and a potential new genotype were observed. The patients' symptoms were mainly headache (68.9%) and cough (36.1%). Our findings suggest that T. whipplei is a cause of epidemic fever in Senegal. PMID:27314980

  18. Treatment of lupus nephritis

    NARCIS (Netherlands)

    Dolff, Sebastian; Berden, Jo H. M.; Bijl, Marc

    2010-01-01

    Renal involvement in systemic lupus erythematosus patients is a severe disease manifestation characterized by various clinical and histopathological alterations The revised International Society of Nephrology/Renal Pathology Society 2003 classification defines the subclasses of lupus nephritis (LN)

  19. What is really causing the obesity epidemic? A review of reviews in children and adults.

    Science.gov (United States)

    Ross, Sharon E; Flynn, Jennifer I; Pate, Russell R

    2016-06-01

    Obesity prevention is a public health priority and intervention strategies have focused primarily on healthy eating and physical activity in children and adults. To date, no review has systematically compiled and synthesised the scientific evidence from published review articles to determine whether there is clear consensus on the causes of obesity. A systematic review of the literature was conducted searching PubMed/Medline for narrative and systematic review articles published between January 1990 and October 2014 that examined the causes of obesity. In total, 12 of 65 articles met the inclusion criteria; 7 reviews focused on adults (1 systematic, 6 narrative) and 5 reviews on children (2 systematic, 3 narrative). The most popular cause of obesity identified in reviews of adult studies was "combined physical activity and diet" (3 of 7 studies), whereas the most popular cause specified in reviews of child studies was deemed "inconclusive" (2 of 5 studies). While a number of reviews have examined the causes of obesity, the methodology and conclusions varied widely, and few were conducted systematically. Currently, no consensus exists across published literature reviews regarding the primary cause of the obesity epidemic, and more research, particularly prospective studies using state-of-the-art measures, is warranted. PMID:26400631

  20. Acute tubulointerstitial nephritis.

    Science.gov (United States)

    Ulinski, Tim; Sellier-Leclerc, Anne-Laure; Tudorache, Elena; Bensman, Albert; Aoun, Bilal

    2012-07-01

    Acute tubulointerstitial nephritis (TIN) is a frequent cause of acute renal failure, characterised by the presence of inflammatory cell infiltrate in the interstitium of the kidney. Immuno-allergic reaction to certain medications, mainly non-steroidal anti-inflammatory drugs and antibiotics are by far the most important etiology for TIN today, but other situations such as infections, toxins, and vasculitis are known to induce TIN. Incidence of TIN is increasing, probably due to prescription habits and NSAID overuse, representing 3-7% of acute kidney injury in biopsies in children. Avoidance of the causal substance and rapid steroid therapy are hallmarks for patient care, but spontaneous initial recovery is very frequent and the general prognosis seems satisfactory. However, development of chronic TIN, without response to steroid or other immunosuppressive treatment, is possible. As the largest part of TIN is secondary to certain drugs, clear indications in particular for NSAID or antibiotics should be respected to reduce the number of TIN cases. PMID:21638156

  1. Clostridium difficile infection caused by the epidemic BI/NAP1/027 strain.

    Science.gov (United States)

    O'Connor, Jennifer R; Johnson, Stuart; Gerding, Dale N

    2009-05-01

    Rates and severity of Clostridium difficile infection (CDI) in hospitals in North America and Europe have increased since 2000 and correlate with dissemination of an epidemic strain characterized by higher than usual toxin A and B production, the presence of a third toxin, binary toxin, and high-level resistance to fluoroquinolone antibiotics. The strain, which is restriction endonuclease analysis group BI, pulse-field gel electrophoresis type NAP1, and polymerase chain reaction ribotype 027, is designated BI/NAP1/027. How this strain has become so widely distributed geographically and produces such severe CDI is the subject of active investigation. The deletion at position 117 of the tcdC gene, a repressor of toxin A and B production, is one possible contributor to increased levels of the toxins. The role of binary toxin is unknown. Recent isolates of BI/NAP1/027 were found to be resistant to fluoroquinolones, which is likely to contribute to the dissemination of this strain. Other virulence factors such as increased sporulation and surface layer protein adherence are also under investigation. Infections caused by this organism are particularly frequent among elderly hospitalized patients, in whom the attributable 30-day mortality is greater than 5%. Major risk factors for BI/NAP1/027 infection include advanced age, hospitalization, and exposure to specific antimicrobials, especially fluoroquinolones and cephalosporins. When CDI is severe, vancomycin treatment is more effective than metronidazole; for mild disease either agent can be used. Control of hospital outbreaks caused by BI/NAP1/027 is difficult but possible through a combination of barrier precautions, environmental cleaning, and antimicrobial stewardship. PMID:19457419

  2. The Persistent Circulation of Enterovirus 71 in People's Republic of China: Causing Emerging Nationwide Epidemics Since 2008

    OpenAIRE

    Xiaojuan Tan; Xueyong Huang; Shuangli Zhu; Hui Chen; Qiuli Yu; Haiyan Wang; Xixiang Huo; Jianhui Zhou; Yan Wu; Dongmei Yan; Yong Zhang; Dongyan Wang; Aili Cui; Hongqiu An; Wenbo Xu

    2011-01-01

    Emerging epidemics of hand-foot-and-mouth disease (HFMD) associated with enterovirus 71 (EV71) has become a serious concern in mainland China. It caused 126 and 353 fatalities in 2008 and 2009, respectively. The epidemiologic and pathogenic data of the outbreak collected from national laboratory network and notifiable disease surveillance system. To understand the virological evolution of this emerging outbreak, 326 VP1 gene sequences of EV71 detected in China from 1987 to 2009 were collected...

  3. Epidemic Keratoconjunctivitis-Causing Adenoviruses Induce MUC16 Ectodomain Release To Infect Ocular Surface Epithelial Cells.

    Science.gov (United States)

    Menon, Balaraj B; Zhou, Xiaohong; Spurr-Michaud, Sandra; Rajaiya, Jaya; Chodosh, James; Gipson, Ilene K

    2016-01-01

    Human adenoviruses (HAdV), species D in particular (HAdV-D), are frequently associated with epidemic keratoconjunctivitis (EKC). Although the infection originates at the ocular surface epithelium, the mechanisms by which HAdV-Ds bypass the membrane-associated mucin (MAM)-rich glycocalyx of the ocular surface epithelium to trigger infection and inflammation remain unknown. Here, we report that an EKC-causing adenovirus (HAdV-D37), but not a non-EKC-causing one (HAdV-D19p), induces ectodomain release of MUC16-a MAM with barrier functions at the ocular surface-from cultured human corneal and conjunctival epithelial cells. HAdV-D37, but not HAdV-D19p, is also found to decrease the glycocalyx barrier function of corneal epithelial cells, as determined by rose bengal dye penetrance assays. Furthermore, results from quantitative PCR (qPCR) amplification of viral genomic DNA using primers specific to a conserved region of the E1B gene show that, in comparison to infection by HAdV-D19p, infection by HAdV-D37 is significantly increased in corneal epithelial cells. Collectively, these results point to a MUC16 ectodomain release-dependent mechanism utilized by the EKC-causing HAdV-D37 to initiate infection at the ocular surface. These findings are important in terms of understanding the pathogenesis of adenoviral keratoconjunctivitis. Similar MAM ectodomain release mechanisms may be prevalent across other mucosal epithelia in the body (e.g., the airway epithelium) that are prone to adenoviral infection. IMPORTANCE Human adenoviruses (HAdVs) are double-stranded DNA viruses that cause infections across all mucosal tissues in the body. At the ocular surface, HAdVs cause keratoconjunctivitis (E. Ford, K. E. Nelson, and D. Warren, Epidemiol Rev 9:244-261, 1987, and C. M. Robinson, D. Seto, M. S. Jones, D. W. Dyer, and J. Chodosh, Infect Genet Evol 11:1208-1217, 2011, doi:10.1016/j.meegid.2011.04.031)-a highly contagious infection that accounts for nearly 60% of conjunctivitis cases

  4. Granulomatous interstitial nephritis

    OpenAIRE

    Shah, Shivani; Carter-Monroe, Naima; Atta, Mohamed G.

    2015-01-01

    Granulomatous interstitial nephritis (GIN) is a rare entity detected in ∼0.5–0.9% of all renal biopsies. GIN has been linked to several antibiotics such as cephalosporins, vancomycin, nitrofurantoin and ciprofloxacin. It is also associated with NSAIDs and granulomatous disorders such as sarcoidosis, tuberculosis, fungal infections, and granulomatosis with polyangiitis. Renal biopsy is critical in establishing this diagnosis, and the extent of tubular atrophy and interstitial fibrosis may aid ...

  5. Norovirus epidemics caused by new GII.2 chimera viruses in 2012-2014 in Japan.

    Science.gov (United States)

    Motomura, Kazushi; Boonchan, Michittra; Noda, Mamoru; Tanaka, Tomoyuki; Takeda, Naokazu

    2016-08-01

    The new GII.2 variant collected from May 2012-March 2014 consisted of GII.15 and GII.2 genomes, in which the putative recombination points found in the boundary region between ORF1 and ORF2. These findings suggested that the swapping of structural and non-structural proteins is a common mechanism for generating new epidemic variants in nature. PMID:27112386

  6. Mechanisms of tissue injury in lupus nephritis

    OpenAIRE

    Tamara K Nowling; Gilkeson, Gary S.

    2011-01-01

    Systemic lupus erythematosus is a prototypic autoimmune disease characterized by autoantibody production and immune complex formation/deposition in target organs such as the kidney. Resultant local inflammation then leads to organ damage. Nephritis, a major cause of morbidity and mortality in patients with lupus, occurs in approximately 50% of lupus patients. In the present review, we provide an overview of the current research and knowledge concerning mechanisms of renal injury in both lupus...

  7. Prognostic factors in lupus nephritis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Starklint, Henrik; Halberg, Poul;

    2006-01-01

    To evaluate the prognostic significance of clinical and renal biopsy findings in an unselected cohort of patients with systemic lupus erythematosus (SLE) and nephritis.......To evaluate the prognostic significance of clinical and renal biopsy findings in an unselected cohort of patients with systemic lupus erythematosus (SLE) and nephritis....

  8. Radiation nephritis. Clinical manifestations and pathophysiologic mechanisms

    International Nuclear Information System (INIS)

    Radiation nephritis is both volume and dose related. Clinical experience would indicate that a minimum of one third of the renal volume needs to be excluded from nephrotoxic doses which appears to have a threshold of 2,000 cGy. The site of damage leading to renal failure appears to be the microvasculature ultimately expressed as glomerulosclerosis. How much direct damage to the tubular system contributes to this process is unclear, but undoubtedly the resultant systemic physiologic effects potentiate the expression of damage in the irradiated kidney. The acute syndrome, with all the potential manifestations of renal failure, rarely presents sooner than six months and appears to have no clear prodrome, although it would seem reasonable that a subclinical syndrome consisting of abnormalities detectable by urinalysis may occur. Treatment of radiation-induced nephritis or hypertension is no different from treatment for nephritis from any other cause and should be aggressive with lifelong follow-up. Carcinogenesis is a rare late expression of radiation-induced kidney damage. 25 references

  9. Pediatric lupus nephritis: Management update

    OpenAIRE

    SINHA, Rajiv; Raut, Sumantra

    2014-01-01

    Childhood-onset systemic lupus erythematosus (cSLE) is a severe multisystem autoimmune disease. Renal involvement occurs in the majority of cSLE patients and is often fatal. Renal biopsy is an important investigation in the management of lupus nephritis. Treatment of renal lupus consists of an induction phase and maintenance phase. Treatment of childhood lupus nephritis using steroids is associated with poor outcome and excess side-effects. The addition of cyclophosphamide to the treatment sc...

  10. [Epidemic outbreaks of dermatitis caused by butterflies of the genus Hylesia (Lepidoptera: Hemileucidae) in São Paulo State, Brazil].

    Science.gov (United States)

    Glasser, C M; Cardoso, J L; Bruno, G C; Domingos, M de F; Moraes, R H; Ciaravolo, R M

    1993-06-01

    Epidemic outbreaks of dermatitis caused by Hylesia sp which occurred in the coastal region of the State of S. Paulo during the period of December 1989 to December 1991 are confirmed. The incident assumed its greatest intensity in Bertioga, in Santos County, where 612 cases were registered. The outbreak also affected 12 other counties in that region and it was estimated that hundred of affected persons sought the Local Health Service Care. The majority presented with erythematous and prutiginous lesions and papula which lasted 7 to 14 days on average. Treatment consisted of systemic administration of antihistamines, and the use of topic corticosteroids and cold compresses. During the above-mentioned period, three epidemic episodes, coinciding with the rainy season (November to January), occurred. They were first observed in the northern part of the coastal area and then spread to the south. Information as to how avoid contact with the moth was the main prophylactic measure. In highly infested buildings the effectiveness of residual insecticide procedure was used in the attempt to reduce the level of moth infestation. Satisfactory results were obtained with deltametrin applied in a dosage of 50 mg/m2 of wall. PMID:8115837

  11. Childhood cardiovascular risk factors in South Asians: A cause of concern for adult cardiovascular disease epidemic

    International Nuclear Information System (INIS)

    Cardiovascular risk factors in children are increasing at an alarming rate in the western world. However, there is limited information regarding these in the South Asian children. This review attempts at summarizing such evidence. South Asians are remarkable for the earlier onset of adult cardiovascular disease (CVD) by almost a decade compared to the Caucasians. We identified published literature, mainly on PubMed, Embase and Cochrane library using specific search terms such as lipid abnormalities, high blood pressure, hyperglycemia, tobacco use, obesity, physical inactivity, and unhealthy dietary practices. Atherosclerotic CVD processes begin early in childhood and are influenced over the life course by genetic and potentially modifiable risk factors and environmental exposure. 80% of adult CVD burden will fall on the developing nations by 2020. The concept of primordial prevention is fast emerging as a necessary prevention tool to curb adult CVD epidemic. Established guidelines and proven preventive strategies on cardiovascular health exist; however, are always implemented half-heartedly. Composite screening and prediction tools for adults can be adapted and validated in children tailored to South Asian population. South Asian children could be at a greater risk of developing cardiovascular risk factors at an earlier stage, thus, timely interventions are imperative

  12. The persistent circulation of enterovirus 71 in People's Republic of China: causing emerging nationwide epidemics since 2008.

    Directory of Open Access Journals (Sweden)

    Xiaojuan Tan

    Full Text Available Emerging epidemics of hand-foot-and-mouth disease (HFMD associated with enterovirus 71 (EV71 has become a serious concern in mainland China. It caused 126 and 353 fatalities in 2008 and 2009, respectively. The epidemiologic and pathogenic data of the outbreak collected from national laboratory network and notifiable disease surveillance system. To understand the virological evolution of this emerging outbreak, 326 VP1 gene sequences of EV71 detected in China from 1987 to 2009 were collected for genetic analyses. Evidence from both traditional and molecular epidemiology confirmed that the recent HFMD outbreak was an emerging one caused by EV71 of subgenotype C4. This emerging HFMD outbreak is associated with EV71 of subgenotype C4, circulating persistently in mainland China since 1998, but not attributed to the importation of new genotype. Originating from 1992, subgenotype C4 has been the predominant genotype since 1998 in mainland China, with an evolutionary rate of 4.6∼4.8×10⁻³ nucleotide substitutions/site/year. The phylogenetic analysis revealed that the majority of the virus during this epidemic was the most recent descendant of subgenotype C4 (clade C4a. It suggests that the evolution might be one of the potential reasons for this native virus to cause the emerging outbreak in China. However, strong negative selective pressure on VP1 protein of EV71 suggested that immune escape might not be the evolving strategy of EV71, predicting a light future for vaccine development. Nonetheless, long-term antigenic and genetic surveillance is still necessary for further understanding.

  13. Radionuclide scintigraphy of bacterial nephritis

    International Nuclear Information System (INIS)

    Pyelonephritis is a leading cause of renal failure and is expected to cost as much as three billion dollars in 1984. The diagnosis of urinary tract infection is usually not difficult. However, localization of the infection within the renal parenchyma as opposed to the collecting system is much more difficult. Flank pain, fever, bacteiuria and evidence of parenchymal involvement by intravenous urography may be absent or unrecognized particularly in the infant. Ultrasound and Nuclear Medicine are advocated as better methods to define parenchymal involvement. Such definition is important in the consideration of treatment since parenchymal involvement of the kidney carries a much more ominous potential outcome than infection restricted to within the collecting system. 38 children with a clinical diagnosis of urinary tract infection were studied. 26 of the patients demonstrated abnormal renal parenchymal findings with Gallium-67 Citrate or Tc-99m Glucoheptonate scintigraphy. Intravenous urography was notably ineffective with only 5 of the 20 interpreted as abnormal due to parenchymal disease or decreased function. 11 were entirely normal while only 5 demonstrated scars or hydronephrosis. Only 10 of 17 patients demonstrated intranvesicoureteral reflux on x-ray or nuclear cystography. Ultrasound depicted 6 of 20 patients as having parenchymal abnormalities. Seven were normal. Nonspecific findings such as dilitation of the renal pelvis or renal enlargement was noted in 11 of the 20 patients. Radionuclide Scintigraphy is the most efficacious modality to detect since acute bacterial nephritis

  14. A rare case of transition to membranous lupus nephritis from diffuse proliferative lupus nephritis

    OpenAIRE

    Nishi, Hitomi; Sugimoto, Keisuke; FUJITA, Shinsuke; Miyazawa, Tomoki; Enya, Takuji; Izu, Akane; Wada, Norihisa; Okada, Mitsuru; Takemura, Tsukasa

    2014-01-01

    [Abstract] Lupus nephritis is an important complication of systemic lupus erythematosus (SLE) that affects the prognosis. A rare type of lupus nephritis, class V, shows histological findings resembling those of membranous nephropathy. While most diffuse proliferative lupus nephritis is associated with other SLE disease activity, class V lupus nephritis can occur without systemic activity. Furthermore, Class V is less responsive to steroid therapy than other forms of lupus nephritis. We treate...

  15. [Interstitial nephritis in rheumatic diseases].

    Science.gov (United States)

    Korsten, P; Müller, G A

    2015-05-01

    Interstitial nephritis is responsible for about 12 % of end-stage renal disease in Germany. It comprises an etiologically heterogenous group of inflammatory renal disorders which primarily affect the renal interstitium and tubuli. Drugs, predominantly antibiotics, nonsteroidal anti-inflammatory drugs and proton pump inhibitors are causative in the majority of cases. Rheumatic diseases frequently affect the kidneys, either the glomeruli or the interstitial tissues. Inflammatory interstitial processes can be accompanied by complex functional tubular disorders. This review gives an overview about clinical and laboratory findings of interstitial nephritis in the context of rheumatic diseases. Sarcoidosis, tubulointerstitial nephritis and uveitis (TINU) syndrome, primary Sjogren's syndrome, and IgG4-related disease often show an interstitial nephritis when the kidneys are affected. Other diseases, such as systemic lupus erythematosus, systemic sclerosis, drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, and granulomatosis with polyangiitis are more rarely associated with predominant interstitial nephritis. Glucocorticoids are the mainstay of therapy for most cases; in refractory cases or when side effects occur, second-line immunosuppressants such as mycophenolate mofetil, azathioprine and others, rarely biologics, can be used. PMID:25962450

  16. Lupus nephritis in children

    International Nuclear Information System (INIS)

    To determine the clinicopathological pattern of lupus nephritis in paediatric nephrology patients. Twenty six patients upto the age 16 years of either gender, with a mean age of 12.4 +- 1.90 years having primary SLE with renal involvement in the form of oedema, hypertension, haematuria and proteinuria were included. Twenty one were females. Percutaneous renal biopsy was performed. Histological lesion was classified according to WHO classification. Patients were treated with immunosuppressive therapy and their clinical course was followed for at least one year. The mean duration of follow up was 1.77 years. Renal involvement was seen in 92.30% within 2 years of the onset of primary disease. Diffuse proliferative glomerulonephritis was the commonest histological lesion (n=14) followed by membranous nephropathy (n=6). The commonest clinical manifestation was oedema (80.76%) followed by hypertension (46.15%). Proteinuria was present in 100% of cases, haematuria in 38.46% and azotemia in 19.33% of patients. Nephrotic range proteinuria was more common in class III and IV, while azotemia was observed only in class IV. The disease was well controlled in 73.07% , relapse was seen in 3.8% of patients, 15.38% died of infections and uremic encephalopathy while 7.69% were lost to follow-up. Diffuse proliferative glomerulonephritis is the commonest histological lesion in our set-up. Renal involvement is mostly seen within first two years of the primary disease which can be controlled satisfactorily with immunosuppressive therapy. (author)

  17. Unrecognized ingestion of Toxoplasma gondii oocysts causes congenital toxoplasmosis and epidemics in North America

    Science.gov (United States)

    Undetected contamination of food and water by T. gondii oocysts frequently causes infection of humans in North America.Risks are often unrecognized by those infected. Demographic factors did not identify those with oocysts infections. Thus, although education programs describing hygienic measures ma...

  18. Lead Exposure: A Contributing Cause of the Current Breast Cancer Epidemic in Nigerian Women

    OpenAIRE

    Alatise, Olusegun I.; Schrauzer, Gerhard N.

    2010-01-01

    Breast cancer incidence in Nigerian women has significantly increased during the past three decades in parallel with the rapid industrialization of that country. This suggested that the associated widespread contamination of the soil and of the water supplies by lead (Pb) and other industrial metals was a major contributing cause. Because of its many domestic, industrial, and automotive uses, Pb is of particular concern as it has been shown to promote the development of mammary tumors in muri...

  19. Genetic predisposition to fiber carcinogenesis causes a mesothelioma epidemic in Turkey.

    OpenAIRE

    Dogan, A. Umran; Baris, Y. Izzettin; Dogan, Meral; Emri, Salih; Steele, Ian; Elmishad, Amira G.; Carbone, Michele

    2006-01-01

    Cancer type: Malignant mesotheliomaStudy design: cohort studyStudy size: 24 family pedigreesDescription of cohort(s) studied: people born in three villages in Cappadocia (Turkey): villages of Tuzkoy, Karain, and 'Old' Sarihidir, where approximately 50% of deaths are caused by malignant mesotheliomaExposure(s) evaluated: erioniteImpact on risk: The X-ray diffraction pattern and the crystal structure of erionite from malignant mesothelioma villages were determined and compared the results with ...

  20. Scrum kidney: epidemic pyoderma caused by a nephritogenic Streptococcus pyogenes in a rugby team.

    Science.gov (United States)

    Ludlam, H; Cookson, B

    1986-08-01

    In December, 1984, an outbreak of pyoderma affected five scrum players in the St Thomas' Hospital rugby team. The causative organism, Streptococcus pyogenes, was acquired during a match against a team experiencing an outbreak of impetigo, and was transmitted to two front row players of another team a week later, and to two girlfriends of affected St Thomas' players a month later. The strain was M-type 49, tetracycline-resistant, and virulent. It caused salpingitis in a girlfriend and acute glomerulonephritis in one rugby player. No case of subclinical glomerulonephritis was detected in eight patients with pyoderma. Screening of the St Thomas' Hospital team revealed four further cases of non-streptococcal skin infection, with evidence for contemporaneous spread of Staphylococcus aureus. Teams should not field players with sepsis, and it may be advisable to apply a skin antiseptic to traumatised skin after the match. PMID:2874337

  1. Searching of Main Cause Leading to Severe Influenza A Virus Mutations and Consequently to Influenza Pandemics/Epidemics

    Directory of Open Access Journals (Sweden)

    Guang Wu

    2005-01-01

    Full Text Available The unpredictable mutations in the proteins from influenza A virus lead to the great difficulty in prevention of possible outbreak of bird flu and pandemic/epidemic of influenza. This unpredictability is due to the fact that we know little about the causes that lead to the mutations. In three of our recent studies on the hemagglutinins from influenza A virus, we unintentionally noticed the periodicity of mutations in hemagglutinins similar to the periodicity of sunspot. We calculated the amino-acid pair predictability and amino-acid distribution rank, which are developed by us over last several years and can numerically present the evolution of proteins in question, of 1217 full-length hemagglutinins from influenza A viruses. We then used the fast Fourier transform to determine the periodicity of mutations in the hemagglutinins. We compare the periodicities of mutations in influenza A virus hemagglutinins with those of solar and galactic cosmic rays and find a main periodicity of the mutations identical to that of sunspot and neutron rate (11 years/circle. Then we plot the sunspot number with respect to the historical pandemics/epidemics/non-pandemic new strains over last three centuries and compare the recorded sunspots with the historical pandemics before 1700. Both show a good agreement between sunspot activity and influenza related events. As the histories of Sun and galaxy are incomparably much longer than the history of influenza virus, the only logical deduction is that the hemagglutinin periodicities, which are identical to the periodicities of solar and galactic cosmic rays, are attribute to the solar and galactic activity. As the hemagglutinin is a sample of influenza A virus, we can logically deduce the role of migratory wild birds on the outbreak of bird flu and influenza, that is, cosmic rays are heading towards the polar regions, where more mutations occur in influenza A virus either within the wild birds or in their living

  2. Association of STAT4 Polymorphism with Severe Renal Insufficiency in Lupus Nephritis

    Science.gov (United States)

    Bolin, Karin; Sandling, Johanna K.; Zickert, Agneta; Jönsen, Andreas; Sjöwall, Christopher; Svenungsson, Elisabet; Bengtsson, Anders A.; Eloranta, Maija-Leena; Rönnblom, Lars; Syvänen, Ann-Christine; Gunnarsson, Iva; Nordmark, Gunnel

    2013-01-01

    Lupus nephritis is a cause of significant morbidity in systemic lupus erythematosus (SLE) and its genetic background has not been completely clarified. The aim of this investigation was to analyze single nucleotide polymorphisms (SNPs) for association with lupus nephritis, its severe form proliferative nephritis and renal outcome, in two Swedish cohorts. Cohort I (n = 567 SLE cases, n =  512 controls) was previously genotyped for 5676 SNPs and cohort II (n = 145 SLE cases, n = 619 controls) was genotyped for SNPs in STAT4, IRF5, TNIP1 and BLK. Case-control and case-only association analyses for patients with lupus nephritis, proliferative nephritis and severe renal insufficiency were performed. In the case-control analysis of cohort I, four highly linked SNPs in STAT4 were associated with lupus nephritis with genome wide significance with p = 3.7×10−9, OR 2.20 for the best SNP rs11889341. Strong signals of association between IRF5 and an HLA-DR3 SNP marker were also detected in the lupus nephritis case versus healthy control analysis (p <0.0001). An additional six genes showed an association with lupus nephritis with p <0.001 (PMS2, TNIP1, CARD11, ITGAM, BLK and IRAK1). In the case-only meta-analysis of the two cohorts, the STAT4 SNP rs7582694 was associated with severe renal insufficiency with p  = 1.6×10−3 and OR 2.22. We conclude that genetic variations in STAT4 predispose to lupus nephritis and a worse outcome with severe renal insufficiency. PMID:24386384

  3. Clinical profile of patients with lupus nephritis

    OpenAIRE

    A.C. Schönrock; T.L. Skare

    2011-01-01

    To the Editor Lupus nephritis is the strongest predictor of systemic lupus erythematosus (SLE) patient’s morbidity and mortality with a prevalence varying from 31 to 65% according to the studied population (1). As the onset of lupus nephritis is usually silent, knowing possible association with others symptoms is useful in order to keep of better vigilance on patients with higher possibility to develop it. Pistiner et al described that lupus patients with nephritis also have an increased freq...

  4. Th Subset Balance in Lupus Nephritis

    OpenAIRE

    Katsuhisa Miyake; Mitsuteru Akahoshi; Hitoshi Nakashima

    2011-01-01

    Lupus nephritis, which has various histological patterns and variable clinical outcomes, is one of the most important complications of systemic lupus nephritis (SLE). This pathogenetic mechanism in each histologically different type of lupus nephritis (LN) remains unclear. Although SLE is suggested to be a Th2-driven disease, elevation of both Th1 and Th2 cytokines occurs in both humans and mice, suggesting that SLE is a complex disease driven by different lymphocyte subsets with high heterog...

  5. Pro: Cyclophosphamide in lupus nephritis.

    Science.gov (United States)

    Kallenberg, Cees G M

    2016-07-01

    Based on efficacy and toxicity considerations, both low-dose pulse cyclophosphamide as part of the Euro-Lupus Nephritis protocol and mycophenolate mofetil (MMF) with corticosteroids may be considered for induction of remission in patients with proliferative lupus nephritis. The long-term follow-up data available for low-dose pulse cyclophosphamide, the fact that compliance is guaranteed with this regimen and economic issues all favour the Euro-Lupus regimen in this author's opinion. For maintenance treatment, either azathioprine (AZA) or MMF may be used; AZA is preferred in case pregnancy is planned, while MMF is preferred when the disease relapses during use of AZA and, possibly, after successful induction of remission with MMF. PMID:27190359

  6. Kinin system in lupus nephritis.

    Science.gov (United States)

    Dellalibera-Joviliano, R; Reis, M L; Donadi, E A

    2001-09-01

    There are few studies regarding the evaluation of the kinin system in patients with systemic lupus erythematosus (SLE). In this study, we evaluated the plasma levels of high-molecular weight kininogen (HKg), low-molecular weight kininogen (LKg) and plasma kallikrein; the plasma activity of tissue kallikrein and kininase II, and urinary kallikrein and kininase II activities in patients presenting with active lupus nephritis. A total of 30 patients (29 women) aged 21-62 years (median = 39) and 30 controls matched to the patients for sex and age were studied. Patients presenting with other underlying diseases or using drugs, which could interfere with the kinin system, were excluded. HKg and LKg levels were indirectly evaluated by ELISA. Plasma kallikrein, tissue kallikrein, and kininase II were evaluated by their enzymatic activity on selective substrates. The Mann-Whitney test was used for statistical analysis. HKg, LKg and plasma kallikrein levels were significantly increased in patients (p < 0.001, for each comparison). Similarly, tissue kallikrein and kininase II activities were significantly increased in plasma and urine of patients (p <0.001, for each comparison). In urine, the activities of tissue kallikrein and kininase II were at least seven times higher than those seen in the plasma of patients. These results indicate that the kinin system is involved in the acute manifestations of lupus nephritis. Kinins may facilitate immunecomplex deposition and may induce the release of other pro-inflammatory mediators, including cytokines actively involved in the pathogenesis of lupus nephritis. PMID:11562080

  7. Kidney disease in lupus is not always 'lupus nephritis'

    OpenAIRE

    Anders, Hans-Joachim; Weening, Jan

    2013-01-01

    textabstractIn lupus erythematosus, elevated serum creatinine levels and urinary abnormalities implicate a kidney disorder, which may not always be lupus nephritis as defined by the current classification of the International Society of Nephrology/Renal Pathology Society. The signs of renal dysfunction may be caused by lupusunrelated renal injury such as drug toxicity or infection or by lupus-associated mechanisms that are not part of the classification, such as minimal change nephrotic syndr...

  8. Acute interstitial nephritis with acetaminophen and alcohol intoxication

    OpenAIRE

    Alexopoulou Iakovina; Fruchter Lauren L; Lau Keith K

    2011-01-01

    Abstract Drug-induced acute interstitial nephritis (AIN) represents a growing cause of renal failure in current medical practice. While antimicrobials and non-steroidal anti-inflammatory drugs are typically associated with drug-induced AIN, few reports have been made on the involvement of other analgesics. We report our experience in managing a 17-year-old female with AIN and subsequent renal injury following an acetaminophen overdose in conjunction with acute alcohol intoxication. It is well...

  9. Th Subset Balance in Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Katsuhisa Miyake

    2011-01-01

    Full Text Available Lupus nephritis, which has various histological patterns and variable clinical outcomes, is one of the most important complications of systemic lupus nephritis (SLE. This pathogenetic mechanism in each histologically different type of lupus nephritis (LN remains unclear. Although SLE is suggested to be a Th2-driven disease, elevation of both Th1 and Th2 cytokines occurs in both humans and mice, suggesting that SLE is a complex disease driven by different lymphocyte subsets with high heterogeneity of clinical manifestations and organ involvement. Recent findings in LN elucidate an essential role for the Th1, IL-17 producing T cells and Th17 cells in the development of diffuse proliferative lupus nephritis (DPLN, and Th2 cytokine in that of membranous lupus nephritis (MLN. These data support the hypothesis that individual Th1/Th2 balance is one of the critical determinants for histopathology of LN.

  10. Levetiracetam-induced severe acute granulomatous interstitial nephritis.

    Science.gov (United States)

    Chau, Katrina; Yong, Jim; Ismail, Kasim; Griffith, Neil; Liu, Michael; Makris, Angela

    2012-06-01

    Granulomatous interstitial nephritis (GIN) is an uncommon cause of renal failure, which may be caused by drugs. Levetiracetam is an increasingly used anti-epileptic medication that is not known to cause renal toxicity in adults. To our knowledge, levetiracetam has not previously been reported as a cause of GIN. We report the case of a 69-year-old woman who developed haemodialysis-requiring acute renal failure after commencement of treatment with levetiracetam, which was shown to be GIN by renal biopsy. She made a complete recovery with cessation of levetiracetam and treatment with steroids. PMID:26069773

  11. Rethinking biologics in lupus nephritis.

    Science.gov (United States)

    Venuturupalli, S

    2016-09-01

    Lupus nephritis (LN) is a chronic and devastating complication of systemic lupus erythematosus. Despite advances in our understanding of LN and the availability of effective therapies, LN remains a difficult clinical problem, and progression to end stage renal disease remains a significant challenge. Though the advent of biologics has revolutionized the treatment of many rheumatological conditions, and several clinical trials of biologics have been conducted in LN, the promise of biologics remains unfulfilled. The experience gained from these initial clinical trials can help tailor approaches in future clinical trials, and the lessons learned can be applied to find a cure for this condition. PMID:27497255

  12. Phenotypic and Genotypic Characterization of Race TKTTF of Puccinia graminis f. sp. tritici that Caused a Wheat Stem Rust Epidemic in Southern Ethiopia in 2013-14.

    Science.gov (United States)

    Olivera, Pablo; Newcomb, Maria; Szabo, Les J; Rouse, Matthew; Johnson, Jerry; Gale, Samuel; Luster, Douglas G; Hodson, David; Cox, James A; Burgin, Laura; Hort, Matt; Gilligan, Christopher A; Patpour, Mehran; Justesen, Annemarie F; Hovmøller, Mogens S; Woldeab, Getaneh; Hailu, Endale; Hundie, Bekele; Tadesse, Kebede; Pumphrey, Michael; Singh, Ravi P; Jin, Yue

    2015-07-01

    A severe stem rust epidemic occurred in southern Ethiopia during November 2013 to January 2014, with yield losses close to 100% on the most widely grown wheat cultivar, 'Digalu'. Sixty-four stem rust samples collected from the regions were analyzed. A meteorological model for airborne spore dispersal was used to identify which regions were most likely to have been infected from postulated sites of initial infection. Based on the analyses of 106 single-pustule isolates derived from these samples, four races of Puccinia graminis f. sp. tritici were identified: TKTTF, TTKSK, RRTTF, and JRCQC. Race TKTTF was found to be the primary cause of the epidemic in the southeastern zones of Bale and Arsi. Isolates of race TKTTF were first identified in samples collected in early October 2013 from West Arsi. It was the sole or predominant race in 31 samples collected from Bale and Arsi zones after the stem rust epidemic was established. Race TTKSK was recovered from 15 samples from Bale and Arsi zones at low frequencies. Genotyping indicated that isolates of race TKTTF belongs to a genetic lineage that is different from the Ug99 race group and is composed of two distinct genetic types. Results from evaluation of selected germplasm indicated that some cultivars and breeding lines resistant to the Ug99 race group are susceptible to race TKTTF. Appearance of race TKTTF and the ensuing epidemic underlines the continuing threats and challenges posed by stem rust not only in East Africa but also to wider-scale wheat production. PMID:25775107

  13. The Clinicopathological Study of Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Raouf Rahim Merza

    2014-08-01

    Results: The current study shows female predominance 32(71.1% compared with 13(28.9% male. Class IV 15(33.3% nephritis was the most common type followed by class III 9(20.9%.The male patients develop nephritis early in the course of Systemic lupus erythematosis than females, and they were more commonly had hypertension and edema, and the hematological, cardiovascular, pulmonary, and central nervous system were the most common extra renal manifestation in males while mucocutaneous manifestations were the commonest in females, and further more males had more proliferative type of Lupus nephritis than females. Conclusion: Males had more severe type of lupus nephritis than females. [Cukurova Med J 2014; 39(4.000: 679-688

  14. Drought, epidemic disease, and the fall of classic period cultures in Mesoamerica (AD 750-950). Hemorrhagic fevers as a cause of massive population loss.

    Science.gov (United States)

    Acuna-Soto, Rodolfo; Stahle, David W; Therrell, Matthew D; Gomez Chavez, Sergio; Cleaveland, Malcolm K

    2005-01-01

    The classical period in Mexico (AD 250-750) was an era of splendor. The city of Teotihuacan was one of the largest and most sophisticated human conglomerates of the pre-industrial world. The Mayan civilization in southeastern Mexico and the Yucatan peninsula reached an impressive degree of development at the same time. This time of prosperity came to an end during the Terminal Classic Period (AD 750-950) a time of massive population loss throughout Mesoamerica. A second episode of massive depopulation in the same area was experienced during the sixteenth century when, in less than one century, between 80% and 90% of the entire indigenous population was lost. The 16th century depopulation of Mexico constitutes one of the worst demographic catastrophes in human history. Although newly imported European and African diseases caused high mortality among the native population, the major 16th century population losses were caused by a series of epidemics of a hemorrhagic fever called Cocoliztli, a highly lethal disease unknown to both Aztec and European physicians during the colonial era. The cocoliztli epidemics occurred during the 16th century megadrought, when severe drought extended at times from central Mexico to the boreal forest of Canada, and from the Pacific to the Atlantic coast. The collapse of the cultures of the Classic Period seems also to have occurred during a time of severe drought. Tree ring and lake sediment records indicate that some of the most severe and prolonged droughts to impact North America-Mesoamerica in the past 1000-4000 years occurred between AD 650 and 1000, particularly during the 8th and 9th centuries, a period of time that coincides with the Terminal Classic Period. Based on the similarities of the climatic (severe drought) and demographic (massive population loss) events in Mesoamerica during the sixteenth century, we propose that drought-associated epidemics of hemorrhagic fever may have contributed to the massive population loss

  15. The Role of Autophagy in Lupus Nephritis

    OpenAIRE

    Linlin Wang; Helen Ka Wai Law

    2015-01-01

    Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease characterized by the generation of immune responses to self-antigens. Lupus nephritis is one of the most common and severe complications in SLE patients. Though the pathogenesis of lupus nephritis has been studied extensively, unresolved questions are still left and new therapeutic methods are needed for disease control. Autophagy is a conserved catabolic process through which cytoplasmic constituents can be degraded in...

  16. Lupus nephritis and lupus band test.

    OpenAIRE

    Adam, B. A.; Wang, F; Looi, L. M.; Prathap, K.

    1981-01-01

    Twenty-seven patients with histologically confirmed lupus nephritis were studied to identify the incidence of lupus band and its significance to histological patterns of nephritis and complement levels. It was found that the kidney involvement is 2.5 times more frequent in lupus band positive patients. The association of a positive lupus and low C3 level signifies the presence of diffuse proliferative glomerulonephritis rather than membranous glomerulonephritis. The results, together with ear...

  17. 补肾养血法治疗狼疮肾炎环磷酰胺冲击疗法后引起的白细胞减少症临床研究%Clinical Study on the Reinforcing Kidney and Nourishing Blood Method in Treating Leukopenia Caused by Cyclophosphamide Pulse Therapy for Lupus Nephritis

    Institute of Scientific and Technical Information of China (English)

    程淑红; 宋纯东

    2011-01-01

    Objective:To observe the clinical effects of reinforcing kidney and nourishing blood method in treating leukopenia caused by cyclophosphamide pulse therapy for lupus nephritis. Methods: 30 cases of lupus nephritis were randomly divided into treatment group with 16 cases and control group with 14 cases. The treatment group was treated with kidney reinforcing and blood nourishing herbs and the control group was treated with Leucogen,Vitamin B4 tablets and inosine tablets. Both groups were treated for two weeks as a course of treatment. Results:The total effective rate of the treatment group was 93. 7% and that of the control group was 71% ,so the curative effect of the treatment group was superior to that of the control group( P < 0. 01). Conclusion; Kidney reinforcing and blood nourishing herbs have excellent therapeutic effect in treating leukopenia caused by cyclophosphamide pulse therapy for lupus nephritis.%目的:观察补肾养血法治疗狼疮肾炎环磷酰胺冲击疗法后引起的白细胞减少症的临床疗效.方法:将30例患者随机分为治疗组16例与对照组14例,治疗组给予补肾养血中药治疗,对照组口服刺可君、维生素B4片、肌苷片,两组均以14 d为1疗程.结果:治疗组有效率93.7%,对照组有效率71.0%,治疗组疗效明显优于对照组(P<0.01).结论:补肾养血中药治疗狼疮肾炎环磷酰胺冲击疗法后引起的白细胞减少症有较好的临床疗效.

  18. Dynamics of beneficial epidemics

    CERN Document Server

    Berdahl, Andrew; De Bacco, Caterina; Dumas, Marion; Ferdinand, Vanessa; Grochow, Joshua A; Hébert-Dufresne, Laurent; Kallus, Yoav; Kempes, Christopher P; Kolchinsky, Artemy; Larremore, Daniel B; Libby, Eric; Power, Eleanor A; Stern, Caitlin A; Tracey, Brendan

    2016-01-01

    Pathogens can spread epidemically through populations. Beneficial contagions, such as viruses that enhance host survival or technological innovations that improve quality of life, also have the potential to spread epidemically. How do the dynamics of beneficial biological and social epidemics differ from those of detrimental epidemics? We investigate this question using three theoretical approaches as well as an empirical analysis of concept propagation. First, in evolutionary models, we show that a beneficial horizontally-transmissible element, such as viral DNA, spreads super-exponentially through a population, substantially more quickly than a beneficial mutation. Second, in an epidemiological social network approach, we show that infections that cause increased connectivity lead to faster-than-exponential fixation in the population. Third, in a sociological model with strategic rewiring, we find that preferences for increased global infection accelerate spread and produce super-exponential fixation rates,...

  19. Acute interstitial nephritis - a reappraisal and update.

    Science.gov (United States)

    Raghavan, Rajeev; Eknoyan, Garabed

    2014-09-01

    Acute interstitial nephritis (AIN) is an under recognized and under diagnosed cause of acute kidney injury (AKI). It is estimated to account for 15 - 20% of cases of AKI; it is the reported diagnosis in 2.8% of all kidney biopsies, and 13.5% of biopsies done specifically for acute renal failure. Considerable evidence implicates antigen initiated cell-mediated injury in the pathogenesis of AIN. Drugs account for 70% of all cases, with over 150 different agents incriminated. The remaining cases are due to infections, autoimmune diseases, and rarely idiopathic. The central component of renal injury in AIN is altered tubular function, which usually precedes decrements in filtration rate. The key to early diagnosis is vigilance for the presence of tubular dysfunction in non-oliguric individuals, especially in patients with modest but gradual increments in creatinine level. The utility of urinary biomarkers to diagnose AIN in its early nascent and potentially reversible stage remains to be determined. Prompt recognition, elimination of the offending source of antigen, and use of a limited course of steroid therapy where indicated, will result in complete resolution in ~ 65% of cases, partial resolution in up to 20%, and irreversible damage in the rest. PMID:25079860

  20. Treatment of severe henoch-schonlein purpura nephritis with mycophenolate mofetil

    Directory of Open Access Journals (Sweden)

    Ahmad Ali Nikibakhsh

    2014-01-01

    Full Text Available Henoch-Schonlein purpura (HSP is the most common childhood vasculitis. Renal involvement in HSP is one of the major causes of chronic renal failure in children. It is important to start effective and relatively safe medication to prevent end-stage renal disease (ESRD. Mycophenolate mofetil (MMF appears to be a promising therapeutic agent in many autoimmune diseases such as lupus nephritis and vasculitis. Herein, we describe the treatment with MMF of three patients with HSP nephritis. In two cases with rapidly progressive glomerulonephritis without response to steroid, after treatment with MMF, significant improvement in kidney function and proteinuria were observed. In another patient with HSP nephritic-nephrotic syn-drome who showed resistance to steroid, MMF offered a favorable effect. MMF seems to be a promising therapeutic agent in the treatment of the severe HSP nephritis.

  1. Granulomatous Interstitial Nephritis Presenting as Hypercalcemia and Nephrolithiasis

    Directory of Open Access Journals (Sweden)

    Saika Sharmeen

    2016-01-01

    Full Text Available We report a case of acute kidney injury as the initial manifestation of sarcoidosis. A 55-year-old male was sent from his primary care physician’s office with incidental lab findings significant for hypercalcemia and acute kidney injury with past medical history significant for nephrolithiasis. Initial treatment with intravenous hydration did not improve his condition. The renal biopsy subsequently revealed granulomatous interstitial nephritis (GIN. Treatment with the appropriate dose of glucocorticoids improved both the hypercalcemia and renal function. Our case demonstrates that renal limited GIN due to sarcoidosis, although a rare entity, can cause severe acute kidney injury and progressive renal failure unless promptly diagnosed and treated.

  2. Chemokines and Chemokine Receptors in the Development of Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Xiaofeng Liao

    2016-01-01

    Full Text Available Lupus nephritis (LN is a major cause of morbidity and mortality in the patients with systemic lupus erythematosus (SLE, an autoimmune disease with damage to multiple organs. Leukocyte recruitment into the inflamed kidney is a critical step to promote LN progression, and the chemokine/chemokine receptor system is necessary for leukocyte recruitment. In this review, we summarize recent studies on the roles of chemokines and chemokine receptors in the development of LN and discuss the potential and hurdles of developing novel, chemokine-based drugs to treat LN.

  3. Chemokines and Chemokine Receptors in the Development of Lupus Nephritis.

    Science.gov (United States)

    Liao, Xiaofeng; Pirapakaran, Tharshikha; Luo, Xin M

    2016-01-01

    Lupus nephritis (LN) is a major cause of morbidity and mortality in the patients with systemic lupus erythematosus (SLE), an autoimmune disease with damage to multiple organs. Leukocyte recruitment into the inflamed kidney is a critical step to promote LN progression, and the chemokine/chemokine receptor system is necessary for leukocyte recruitment. In this review, we summarize recent studies on the roles of chemokines and chemokine receptors in the development of LN and discuss the potential and hurdles of developing novel, chemokine-based drugs to treat LN. PMID:27403037

  4. Biomarkers for Lupus Nephritis: A Critical Appraisal

    Directory of Open Access Journals (Sweden)

    Chi Chiu Mok

    2010-01-01

    Full Text Available Kidney disease is one of the most serious manifestations of systemic lupus erythematosus (SLE. Despite the improvement in the medical care of SLE in the past two decades, the prognosis of lupus nephritis remains unsatisfactory. Besides exploring more effective but less toxic treatment modalities that will further improve the remission rate, early detection and treatment of renal activity may spare patients from intensive immunosuppressive therapies and reduce renal damage. Conventional clinical parameters such as creatinine clearance, proteinuria, urine sediments, anti-dsDNA, and complement levels are not sensitive or specific enough for detecting ongoing disease activity in the lupus kidneys and early relapse of nephritis. Thus, novel biomarkers are necessary to enhance the diagnostic accuracy and sensitivity of lupus renal disease, prognostic stratification, monitoring of treatment response, and detection of early renal flares. This paper reviews promising biomarkers that have recently been evaluated in longitudinal studies of lupus nephritis.

  5. Natural history of "silent" lupus nephritis.

    Science.gov (United States)

    Bennett, W M; Bardana, E J; Norman, D J; Houghton, D C

    1982-05-01

    Twenty patients with systemic lupus erythematosus but without evident renal involvement previously underwent percutaneous renal biopsy. Findings revealed almost universal pathologic evidence of nephritis. Included were three patients who had diffuse proliferative changes and five who had subendothelial electron dense deposits. Only four patients developed clinical renal disease during the follow-up period while no patient died or required dialysis. Using the Life Table Method, the cumulative percentage of patients free from any clinical renal disease was over 60% at 10 yr from the time of diagnosis of systemic lupus, and at 8 yr from the time of the original biopsy. It is concluded that silent lupus nephritis, regardless of histologic subtype, has a favorable prognosis. These data may not be applicable to patients with similar biopsies who have evidence of clinical lupus nephritis. PMID:7091151

  6. The persistent challenge of lupus nephritis.

    Science.gov (United States)

    Valesini, Guido; Conti, Fabrizio

    2011-06-01

    Systemic lupus erythematosus has long been considered the prototypic autoimmune disease. Although the etiology remains enigmatic, there has been vigorous definition of the clinical features and the natural history. In this issue, we review the persistent challenge of lupus nephritis and, in particular, features of diagnosis as well as treatment options. It is clear that major therapeutic advances have occurred but there is still a considerable unmet need in the population. This issue does not review all the clinical problems of lupus nephritis, but rather attempts to place the most recent data in perspective for the clinician. PMID:20811786

  7. Karyomegalic Interstitial Nephritis: A Case Report and Review of the Literature.

    Science.gov (United States)

    Isnard, Pierre; Rabant, Marion; Labaye, Jacques; Antignac, Corinne; Knebelmann, Bertrand; Zaidan, Mohamad

    2016-05-01

    Karyomegalic interstitial nephritis is a rare cause of hereditary chronic interstitial nephritis, described for the first time over 40 years ago.A 36-year-old woman, of Turkish origin, presented with chronic kidney disease and high blood pressure. She had a history of recurrent upper respiratory tract infections but no familial history of nephropathy. Physical examination was unremarkable. Laboratory tests showed serum creatinine at 2.3 mg/dL with an estimated glomerular filtration rate of 26 mL/min/1.73m, and gamma-glutamyl transpeptidase and alkaline phosphatase at 3 and 1.5 times the upper normal limit. Urinalysis showed 0.8 g/day of nonselective proteinuria, microscopic hematuria, and aseptic leukocyturia. Immunological tests and tests for human immunodeficiency and hepatitis B and C viruses were negative. Complement level and serum proteins electrophoresis were normal. Analysis of the renal biopsy showed severe interstitial fibrosis and tubular atrophy. Numerous tubular cells had nuclear enlargement with irregular outlines, hyperchromatic aspect, and prominent nucleoli. These findings were highly suggestive of karyomegalic interstitial nephritis, which was further confirmed by exome sequencing of FAN1 gene showing an identified homozygous frameshift mutation due to a one-base-pair deletion in exon 12 (c.2616delA).The present case illustrates a rare but severe cause of hereditary interstitial nephritis, sometimes accompanied by subtle extrarenal manifestations. Identification of mutations in FAN1 gene underscores recent insights linking inadequate DNA repair and susceptibility to chronic kidney disease. PMID:27196444

  8. The frequency and outcome of lupus nephritis

    DEFF Research Database (Denmark)

    Hanly, John G; O'Keeffe, Aidan G; Su, Li;

    2016-01-01

    OBJECTIVE: To determine nephritis outcomes in a prospective multi-ethnic/racial SLE inception cohort. METHODS: Patients in the Systemic Lupus International Collaborating Clinics inception cohort (≤15 months of SLE diagnosis) were assessed annually for estimated glomerular filtration rate (e...

  9. Antiphospholipid Antibodies in Lupus Nephritis.

    Science.gov (United States)

    Parodis, Ioannis; Arnaud, Laurent; Gerhardsson, Jakob; Zickert, Agneta; Sundelin, Birgitta; Malmström, Vivianne; Svenungsson, Elisabet; Gunnarsson, Iva

    2016-01-01

    Lupus nephritis (LN) is a major manifestation of systemic lupus erythematosus (SLE). It remains unclear whether antiphospholipid antibodies (aPL) alter the course of LN. We thus investigated the impact of aPL on short-term and long-term renal outcomes in patients with LN. We assessed levels of aPL cross-sectionally in SLE patients diagnosed with (n = 204) or without (n = 294) LN, and prospectively in 64 patients with active biopsy-proven LN (52 proliferative, 12 membranous), before and after induction treatment (short-term outcomes). Long-term renal outcome in the prospective LN cohort was determined by the estimated glomerular filtration rate (eGFR) and the Chronic Kidney Disease (CKD) stage, after a median follow-up of 11.3 years (range: 3.3-18.8). Cross-sectional analysis revealed no association between LN and IgG/IgM anticardiolipin or anti-β2-glycoprotein I antibodies, or lupus anticoagulant. Both aPL positivity and levels were similar in patients with active LN and non-renal SLE. Following induction treatment for LN, serum IgG/IgM aPL levels decreased in responders (p<0.005 for all), but not in non-responders. Both at active LN and post-treatment, patients with IgG, but not IgM, aPL had higher creatinine levels compared with patients without IgG aPL. Neither aPL positivity nor levels were associated with changes in eGFR from either baseline or post-treatment through long-term follow-up. Moreover, aPL positivity and levels both at baseline and post-treatment were similar in patients with a CKD stage ≥3 versus 1-2 at the last follow-up. In conclusion, neither aPL positivity nor levels were found to be associated with the occurrence of LN in SLE patients. However, IgG aPL positivity in LN patients was associated with a short-term impairment of the renal function while no effect on long-term renal outcome was observed. Furthermore, IgG and IgM aPL levels decreased following induction treatment only in responders, indicating that aPL levels are affected by

  10. Antiphospholipid Antibodies in Lupus Nephritis.

    Directory of Open Access Journals (Sweden)

    Ioannis Parodis

    Full Text Available Lupus nephritis (LN is a major manifestation of systemic lupus erythematosus (SLE. It remains unclear whether antiphospholipid antibodies (aPL alter the course of LN. We thus investigated the impact of aPL on short-term and long-term renal outcomes in patients with LN. We assessed levels of aPL cross-sectionally in SLE patients diagnosed with (n = 204 or without (n = 294 LN, and prospectively in 64 patients with active biopsy-proven LN (52 proliferative, 12 membranous, before and after induction treatment (short-term outcomes. Long-term renal outcome in the prospective LN cohort was determined by the estimated glomerular filtration rate (eGFR and the Chronic Kidney Disease (CKD stage, after a median follow-up of 11.3 years (range: 3.3-18.8. Cross-sectional analysis revealed no association between LN and IgG/IgM anticardiolipin or anti-β2-glycoprotein I antibodies, or lupus anticoagulant. Both aPL positivity and levels were similar in patients with active LN and non-renal SLE. Following induction treatment for LN, serum IgG/IgM aPL levels decreased in responders (p<0.005 for all, but not in non-responders. Both at active LN and post-treatment, patients with IgG, but not IgM, aPL had higher creatinine levels compared with patients without IgG aPL. Neither aPL positivity nor levels were associated with changes in eGFR from either baseline or post-treatment through long-term follow-up. Moreover, aPL positivity and levels both at baseline and post-treatment were similar in patients with a CKD stage ≥3 versus 1-2 at the last follow-up. In conclusion, neither aPL positivity nor levels were found to be associated with the occurrence of LN in SLE patients. However, IgG aPL positivity in LN patients was associated with a short-term impairment of the renal function while no effect on long-term renal outcome was observed. Furthermore, IgG and IgM aPL levels decreased following induction treatment only in responders, indicating that aPL levels are

  11. Environmental injury to the kidney: Interstitial nephritis

    Directory of Open Access Journals (Sweden)

    James C. Chan

    2014-10-01

    Full Text Available The First Emperor of China (Qin Shi Huang: 259–210 BCE would have been interested in interstitial nephritis. He might conceivably be fascinated to know that consumption of mercury elixir, instead of giving him immortality, might have shortened his life by giving him interstitial nephritis. In the Balkan region of Eastern Europe, clustering of a peculiar interstitial nephritis is prevalent. One environmental risk contributing to Balkan endemic nephritis is aristolochic acid contamination of cooking flour, drinking water, and herbal medicine. In addition, the popular use of nonprescription Chinese weight reduction herbs and public unawareness of the consequential aristolochic acid nephropathy has become a worldwide problem. Finally, the mighty Romans of antiquity lost their empire, arguably due to lead in their wine containers, lead water pipes, and lead cooking utensils. In modern times, lead paint has become universally banned, which has resulted in a reduction of lead-induced interstitial nephritis. In recent decades, bisphenol A (BPA has been identified as a new environmental risk. BPA is in the plastic coating of food and beverage containers to prevent corrosion. BPA is so ubiquitous that urinary BPA and proteinuria are present in a high percentage of the population. BPA-induced kidney injury and other health concerns have led certain countries to ban BPA. Now, BPA-free containers are being introduced with great fanfare by manufacturers, but safety issues on all plastic products remain. It begs the question whether “plastics” of today take the place of “lead” in ancient Rome. This is a challenging question without an answer at this point.

  12. Urinary CXCL10: a marker of nephritis in lupus patients

    Directory of Open Access Journals (Sweden)

    M. A. Marie

    2014-03-01

    Full Text Available Systemic lupus erythematosus (SLE is a connective tissue disease characterized by the formation of autoantibodies and immune complexes. Lupus nephritis is one of the hallmark features of SLE. CXCL10 is a chemokine secreted by IFNg- stimulated endothelial cells and has been shown to be involved in the pathological processes of autoimmune diseases. The objective was to measure urinary CXCL10 in SLE patients, to compare levels between nephritis and non-nephritis groups and to study its correlation with other variables. Sixty lupus patients were enrolled in our trial. Thirty patients had lupus nephritis and the other 30 were without evidence of lupus nephritis. Thirty healthy subjects were willing to participate as a healthy control group. Renal biopsy was performed for lupus nephritis group. Urinary CXCL10 was measured using the ELISA technique. Serum creatinine, C3, C4 and 24 h urinary proteins were measured. Lupus activity was assessed using systemic lupus erythematosus disease activity index (SLEDAI scoring system. Renal activity was measured using renal activity scoring system. CXCL10 was significantly higher in lupus nephritis patients than in lupus patients without nephritis. CXCL10 was significantly correlated with renal activity score, 24 hours urinary proteins and the SLEDAI score. It is highly valid predictor of SLE nephritis with high sensitivity and specificity. CXCL 10 a highly sensitive and specific non-invasive diagnostic tool for lupus nephritis patients.

  13. The politics of underdevelopment: metered to death-how a water experiment caused riots and a cholera epidemic.

    Science.gov (United States)

    Pauw, Jacques

    2003-01-01

    Water privatization programs in South Africa, part of a government policy aimed at making people pay for the full cost of running water ("total cost recovery"), was developed by private water companies and the World Bank to finance improved water supplies and build the country's economy. Instead the programs are causing more misery than development. Millions of poor people have had their water supply cut off because of inability to pay, forcing them to get their water from polluted rivers and lakes and leading to South Africa's worst cholera outbreak--which the government paid millions of dollars to control. Residents in some townships are rebelling, and many of the private multinational water companies are reassessing their involvement in South Africa. PMID:14758861

  14. Trap gun: an unusual firearm, aimed at wild animals but causing a silent epidemic of human fatalities.

    Science.gov (United States)

    Kodikara, Sarathchandra; Kudagama, Muditha

    2014-03-01

    Among a variety of uncommon firearms of different origin used worldwide, the trap gun used in Sri Lanka is underreported. This is an illegal, locally made, smooth-bore, long-barreled, muzzle-loading firearm with a victim-activated simple trigger mechanism. It is mainly used to protect crops and livestock from the potential harm by wild animals. Trap gun is mounted horizontally on pegs of sticks fixed to the ground. Miscellaneous metal pieces are used as ammunition. A small metal container filled with powdered matchstick heads/firecrackers covered by the striker surface of the matchstick box is used as the percussion cap. A metal hammer is set to hit the percussion cap. Through a lever mechanism, the hammer is kept under tension. The lever mechanism is connected to a trigger cord, which runs across the animal path. The first passerby, a human being or a wild animal, who accidentally trips the trigger cord and activates the trigger mechanism is critically injured. This characteristically damages the lower limbs of the human being. This communication highlights a death due to trap gun injury. The injury pattern caused by trap gun could overlap with that of shotgun and rifled firearm. A meticulous autopsy could sort it out. PMID:24457573

  15. Herpes virus infection associated with interstitial nephritis in a beaked whale (Mesoplodon densirostris

    Directory of Open Access Journals (Sweden)

    Arbelo Manuel

    2012-12-01

    Full Text Available Abstract Background The capacity for herpesvirus to cause disease in cetaceans is unclear and may be varied depending on the different conditions of individuals and between different species. Kidney pathology and intralesional virus-associated infection have been rarely reported in cetaceans. Result On April 2004, an old adult male Blainville’s beaked whale (Mesoplodon densirostris 420 cm long with a poor body condition was stranded on Tenerife Island. During necropsy, no gross lesions were observed in the kidneys. However, membranous glomerulonephritis, multifocal interstitial lymphoplasmacytic nephritis and acute multifocal necrotizing tubulointerstitial nephritis with intranuclear inclusion bodies was diagnosed by histological analysis. Tissue samples were submitted for bacteriological analysis and molecular viral screening. Conclusion A novel alpha herpesvirus associated with interstitial nephritis was identified in an old adult male Blainville's beaked whale (M. densirostris with a poor body condition stranded in the Canary Islands. This report suggests that identification of herpesvirus infection could be used as a differential diagnosis for interstitial nephritis in cetaceans.

  16. Development of tertiary lymphoid structures in the kidneys of pigs with chronic leptospiral nephritis.

    Science.gov (United States)

    Pezzolato, M; Maina, E; Lonardi, S; Bozzetta, E; Grassi, F; Scanziani, E; Radaelli, E

    2012-01-15

    Tertiary lymphoid organs (TLOs) are structures that are morphologically and functionally similar to secondary lymphoid organs. TLOs usually arise in a background of chronic inflammation. Several histological patterns of interstitial nephritis have been documented in porcine leptospirosis. Among them the lympho-follicular pattern is characterized by infiltrates of mononuclear cells organized in lymphoid follicle-like structures. Immunohistological analysis of 5 cases of porcine lympho-follicular nephritis associated with Leptospira Pomona infection demonstrated the presence of inflammatory cell populations, including B cells, T cells, macrophages and follicular dendritic cells (FDCs), which were compartmentalized as in TLOs. Immunohistochemistry for Leptospira Pomona revealed an intimate association between leptospiral antigen and FDCs. Overexpression of MHCII in different populations of both professional and non-professional antigen presenting cells was also demonstrated. FDCs play role during TLOs induction for their ability to retain non-self antigens in the form of immune complexes, thus causing persistent T cell activation, generation of a complex cytokine network and stimulation of humoral immunity. Sustained bacterial antigen presentation in the context of chronic leptospiral nephritis, may also lead to autoimmune mechanisms involved in the generation of TLOs. Whether lymphoid neogenesis and TLOs play a protective role in porcine leptospiral nephritis is still unclear. PMID:22227076

  17. Lupus Nephritis Susceptibility Loci in Women with Systemic Lupus Erythematosus

    OpenAIRE

    Chung, Sharon A.; Brown, Elizabeth E; Williams, Adrienne H; Ramos, Paula S.; Berthier, Celine C.; Bhangale, Tushar; Alarcon-Riquelme, Marta E; Behrens, Timothy W.; Criswell, Lindsey A.; Graham, Deborah Cunninghame; Demirci, F. Yesim; Jeffrey C Edberg; Gaffney, Patrick M.; Harley, John B.; Jacob, Chaim O.

    2014-01-01

    Lupus nephritis is a manifestation of SLE resulting from glomerular immune complex deposition and inflammation. Lupus nephritis demonstrates familial aggregation and accounts for significant morbidity and mortality. We completed a meta-analysis of three genome-wide association studies of SLE to identify lupus nephritis–predisposing loci. Through genotyping and imputation, >1.6 million markers were assessed in 2000 unrelated women of European descent with SLE (588 patients with lupus nephritis...

  18. Urinary CXCL10: a marker of nephritis in lupus patients

    OpenAIRE

    M. A. Marie; R. E. Abu Khalil; H. M. Habib

    2014-01-01

    Systemic lupus erythematosus (SLE) is a connective tissue disease characterized by the formation of autoantibodies and immune complexes. Lupus nephritis is one of the hallmark features of SLE. CXCL10 is a chemokine secreted by IFNg- stimulated endothelial cells and has been shown to be involved in the pathological processes of autoimmune diseases. The objective was to measure urinary CXCL10 in SLE patients, to compare levels between nephritis and non-nephritis groups and to study its correlat...

  19. Lupus Nephritis: The Evolving Role of Novel Therapeutics

    OpenAIRE

    Rovin, Brad H; Parikh, Samir V

    2014-01-01

    Immune complex accumulation in the kidney is the hallmark of lupus nephritis and triggers a series of events that result in kidney inflammation and injury. Cytotoxic agents and corticosteroids are standard of care for lupus nephritis treatment, but are associated with considerable morbidity and suboptimal outcomes. Recently, there has been interest in using novel biologic agents and small molecules to treat lupus nephritis. These therapies can be broadly categorized as anti-inflammatory (laqu...

  20. Intravenous Immunoglobulin in the Management of Lupus Nephritis

    OpenAIRE

    Wenderfer, Scott E.; Trisha Thacker

    2012-01-01

    The occurrence of nephritis in patients with systemic lupus erythematosus is associated with increased morbidity and mortality. The pathogenesis of lupus nephritis is complex, involving innate and adaptive cellular and humoral immune responses. Autoantibodies in particular have been shown to be critical in the initiation and progression of renal injury, via interactions with both Fc-receptors and complement. One approach in the management of patients with lupus nephritis has been the use of i...

  1. An unusual presentation of juvenile lupus nephritis

    OpenAIRE

    Malleshwar Bottu; Manjusha Yadla; Srikanth Burri; Megha Uppin

    2016-01-01

    The incidence of juvenile lupus varies widely ranging between 4 and 250 per 100,000 population. Most common organ involvement in juvenile lupus is kidney. Neurological, cutaneous and hematological involvements are also involved. Skeletal muscle involvement in the form of myositis is rare. Myositis as presenting manifestation in juvenile lupus is also unusual. Herein, we report one such case wherein myositis preceded the onset of lupus nephritis

  2. An unusual presentation of juvenile lupus nephritis

    Directory of Open Access Journals (Sweden)

    Malleshwar Bottu

    2016-01-01

    Full Text Available The incidence of juvenile lupus varies widely ranging between 4 and 250 per 100,000 population. Most common organ involvement in juvenile lupus is kidney. Neurological, cutaneous and hematological involvements are also involved. Skeletal muscle involvement in the form of myositis is rare. Myositis as presenting manifestation in juvenile lupus is also unusual. Herein, we report one such case wherein myositis preceded the onset of lupus nephritis

  3. Biomarkers for Lupus Nephritis: A Critical Appraisal

    OpenAIRE

    Chi Chiu Mok

    2010-01-01

    Kidney disease is one of the most serious manifestations of systemic lupus erythematosus (SLE). Despite the improvement in the medical care of SLE in the past two decades, the prognosis of lupus nephritis remains unsatisfactory. Besides exploring more effective but less toxic treatment modalities that will further improve the remission rate, early detection and treatment of renal activity may spare patients from intensive immunosuppressive therapies and reduce renal damage. Conventional clini...

  4. Recurrence of Lupus Nephritis after Kidney Transplantation

    OpenAIRE

    Contreras, Gabriel; Mattiazzi, Adela; Guerra, Giselle; Ortega, Luis M.; Tozman, Elaine C.; Li, Hua; Tamariz, Leonardo; Carvalho, Cristiane; Kupin, Warren; Ladino, Marco; Leclercq, Baudouin; Jaraba, Isabel; Carvalho, Decio; Carles, Efrain; Roth, David

    2010-01-01

    The frequency and outcome of recurrent lupus nephritis (RLN) among recipients of a kidney allograft vary among single-center reports. From the United Network for Organ Sharing files, we estimated the period prevalence and predictors of RLN in recipients who received a transplant between 1987 and 2006 and assessed the effects of RLN on allograft failure and recipients' survival. Among 6850 recipients of a kidney allograft with systemic lupus erythematosus, 167 recipients had RLN, 1770 experien...

  5. Classifying Lupus Nephritis: An Ongoing Story

    Directory of Open Access Journals (Sweden)

    Saba Kiremitci

    2014-01-01

    Full Text Available The role of the renal biopsy in lupus nephritis is to provide the diagnosis and to define the parameters of prognostic and therapeutic significance for an effective clinicopathological correlation. Various classification schemas initiated by World Health Organization in 1974 have been proposed until the most recent update by International Society of Nephrology/Renal Pathology Society in 2004. In this paper, we reviewed the new classification system with the associated literature to highlight the benefits and the weak points that emerged so far. The great advantage of the classification emerged to provide a uniform reporting for lupus nephritis all over the world. It has provided more reproducible results from different centers. However, the studies indicated that the presence of glomerular necrotizing lesion was no longer significant to determine the classes of lupus nephritis leading to loss of pathogenetic diversity of the classes. Another weakness of the classification that also emerged in time was the lack of discussions related to the prognostic significance of tubulointerstitial involvement which was not included in the classification. Therefore, the pathogenetic diversity of the classification still needs to be clarified by additional studies, and it needs to be improved by the inclusion of the tubulointerstitial lesions related to prognosis.

  6. Influenza: Epidemics and Pandemics

    OpenAIRE

    Markovski, Velo

    2013-01-01

    Influenza is a viral, pandemic and respiratory disease with high morbidity particular and significant mortality rate amongst humans. WHO has counted that each outbreak of epidemic is costing between 10-60 million dollars to one million citizens and each year there are between 250.000 to 500.000 deaths caused by flu. Eight RNA segments of influenza A and B viruses and seven segments of the C viruses are independently encapsulated by viral nucleoprotein. The heamagglutinin is the most important...

  7. IgG4-related tubulointerstitial nephritis accompanied with cystic formation

    OpenAIRE

    Fukuhara, Hideo; Taniguchi, Yoshinori; Matsumoto, Manabu; Kuroda, Naoto; Fukata, Satoshi; Inoue, Keiji; Fujimoto, Shimpei; Terada, Yoshio; Shuin, Taro

    2014-01-01

    Background An immunoglobulin G4 (IgG4)-related disease is important disease in differential diagnosis of tumors in kidney, pancreas, lung and other organs. The imaging findings of IgG4-related kidney diseases are usually expressed as defect contrast region, while cystic formation in kidney is extremely rare. Here, we report a case of IgG4-related tubulointerstitial nephritis with renal cystic change caused by the narrowing or obstruction of collecting duct in renal medulla. Case presentation ...

  8. Pregnancy in Systemic Lupus Erythematosus Patients with Nephritis

    OpenAIRE

    Panagiotis Pateinakis; Athina Pyrpasopoulou

    2014-01-01

    Pregnancy in patients with lupus nephritis is a challenging clinical situation. Although not absolutely contraindicated, it is associated with increased risk for foetal and maternal complications, including foetal loss, preterm delivery, intrauterine growth retardation, hypertension, pre-eclampsia, nephritis flare, and, rarely, maternal death. The complication rate is further increased in the presence of antiphospholipid antibodies or the antiphospholipid syndrome. Proliferative classes of ne...

  9. Necrotizing and Crescentic Lupus Nephritis with Antineutrophil Cytoplasmic Antibody Seropositivity

    OpenAIRE

    Nasr, Samih H.; D'Agati, Vivette D; Park, Hye-Ran; Sterman, Paul L.; Goyzueta, Juan D.; Dressler, Robert M.; Hazlett, Shawn M.; Pursell, Robert N.; Caputo, Christopher; Markowitz, Glen S.

    2008-01-01

    Background and objectives: Lupus nephritis is a classic immune complex glomerulonephritis. In contrast, antineutrophil cytoplasmic antibodies are associated with necrotizing and crescentic glomerulonephritis, in the absence of significant immune deposits. Antineutrophil cytoplasmic antibodies are detected by indirect immunofluorescence in 20% of patients with systemic lupus erythematosus. We report 10 cases of necrotizing and crescentic lupus nephritis with antineutrophil cytoplasmic antibody...

  10. Dutch guidelines for diagnosis and therapy of proliferative lupus nephritis.

    NARCIS (Netherlands)

    Tellingen, A. van; Voskuyl, A.E.; Vervloet, M.G.; Bijl, M. van der; Sevaux, R.G.L. de; Berger, S.P.; Derksen, R.H.W.M.; Berden, J.H.M.

    2012-01-01

    Proliferative lupus nephritis is a strong predictor of morbidity and mortality in patients with systemic lupus erythematosus. Despite improvements in the management of lupus nephritis, a significant number of the patients do not respond to immunosuppressive therapy and progress to end-stage renal fa

  11. Dutch guidelines for diagnosis and therapy of proliferative lupus nephritis

    NARCIS (Netherlands)

    van Tellingen, A.; Voskuyl, A. E.; Vervloet, M. G.; Bijl, M.; de Sevaux, R. G. L.; Berger, S. P.; Derksen, R. H. W. M.; Berden, J. H. M.

    2012-01-01

    Proliferative lupus nephritis is a strong predictor of morbidity and mortality in patients with systemic lupus erythematosus. Despite improvements in the management of lupus nephritis, a significant number of the patients do not respond to immunosuppressive therapy and progress to end-stage renal fa

  12. The Explosive Human Immunodeficiency Virus Type 1 Epidemic among Injecting Drug Users of Kathmandu, Nepal, Is Caused by a Subtype C Virus of Restricted Genetic Diversity

    OpenAIRE

    Oelrichs, Robert B.; Shrestha, Iswar L.; Anderson, David A.; Deacon, Nicholas J.

    2000-01-01

    An explosive epidemic of human immunodeficiency virus type 1 (HIV-1) has been documented among the injecting drug user population of Kathmandu, Nepal, whose seropositivity rate has risen from 0 to 40% between 1995 and 1997. By using Catrimox to preserve whole-blood RNA at ambient temperature for transportation, HIV-1 envelope V3–V4 sequences were obtained from 36 patients in this group. Analysis of the sequences indicated a homogenous epidemic of subtype C virus, with at least two independent...

  13. Prognosis and predictors of convulsion among pediatric lupus nephritis patients

    International Nuclear Information System (INIS)

    In this study, we aimed to analyze features and outcome of convulsion in pediatric lupus nephritis patients. We retrospectively reviewed data of 14 Iranian children with lupus nephritis who developed seizures and compared them with a group of the same number of well matched pediatric lupus nephritis patients. Higher serum creatinine levels and higher frequencies of anemia and lymphopenia were observed in the convulsion group. Multivariable logistic regression analysis revealed that the only risk factor for development of convulsion in pediatric lupus patients with nephritis was lymphopenia. Survival analysis showed that convulsion had no impact on patient and renal function outcomes in our pediatric lupus nephritis subjects. In conclusion, we found that lymphopenia is a predictive factor for convulsion occurrence in our patients and special attention to neurological status assessment may be needed in this situation. (author)

  14. Prognosis and predictors of convulsion among pediatric lupus nephritis patients

    Directory of Open Access Journals (Sweden)

    Beiraghdar Fatemeh

    2009-01-01

    Full Text Available In this study, we aimed to analyze features and outcome of convulsion in pediatric lupus nephritis patients. We retrospectively reviewed data of 14 Iranian children with lupus nephritis who developed seizures and compared them with a group of the same number of well matched pe-diatric lupus nephritis patients. Higher serum creatinine levels and higher frequencies of anemia and lymphopenia were observed in the convulsion group. Multivariable logistic regression analysis re-vealed that the only risk factor for development of convulsion in pediatric lupus patients with ne-phritis was lymphopenia. Survival analysis showed that convulsion had no impact on patient and renal function outcomes in our pediatric lupus nephritis subjects. In conclusion, we found that lympho-penia is a predictive factor for convulsion occurrence in our patients and special attention to neuro-logical status assessment may be needed in this situation.

  15. 狼疮肾炎的药物治疗进展%Lupus Nephritis of Existing and New Drug Treatment

    Institute of Scientific and Technical Information of China (English)

    李海端(综述); 李建华(审校)

    2014-01-01

    Lupus nephritis is involved by SLE and caused by immune complexes,is one of the most often involving organs of systemic lupus erythematosus,also is the most common secondery glomerular disease. In recent years,as the study of pathogenesis of lupus nephritis and the application of the renal biopsy, lupus ne-phritis patients' survival rate has improved significantly,but given recurrence of lupus nephritis and side effects in the process of application of various immune suppression,the treatment of lupus nephritis there is still a challenge. The purpose of this paper is to review existing and new drug treatment of lupus nephritis.%狼疮肾炎是系统性红斑狼疮累及肾脏所引起的一种免疫复合物性肾炎,是最常见的继发性肾小球疾病。近年来,随着对狼疮肾炎发病机制的研究及肾活检的应用,狼疮肾炎的治疗已取得了可观的效果,狼疮肾炎患者的生存率已显著提高,但是由于狼疮肾炎存在复发及治疗过程中应用各种免疫抑制剂所引起的不良反应,狼疮肾炎的治疗仍存在挑战。该文就狼疮肾炎的药物治疗进展予以综述。

  16. Unusual manifestations of acute Q fever: autoimmune hemolytic anemia and tubulointerstitial nephritis

    Directory of Open Access Journals (Sweden)

    Korkmaz Serdal

    2012-05-01

    Full Text Available Abstract Q fever is a worldwide zoonotic infection that caused by Coxiella burnetii, a strict intracellular bacterium. It may be manifested by some of the autoimmune events and is classified into acute and chronic forms. The most frequent clinical manifestation of acute form is a self-limited febrile illness which is associated with severe headache, muscle ache, arthralgia and cough. Meningoencephalitis, thyroiditis, pericarditis, myocarditis, mesenteric lymphadenopathy, hemolytic anemia, and nephritis are rare manifestations. Here we present a case of acute Q fever together with Coombs’ positive autoimmune hemolytic anemia (AIHA and tubulointerstitial nephritis treated with chlarithromycin, steroids and hemodialysis. Clinicians should be aware of such rare manifestations of the disease.

  17. Ofatumumab treatment in lupus nephritis patients.

    Science.gov (United States)

    Haarhaus, Malena Loberg; Svenungsson, Elisabet; Gunnarsson, Iva

    2016-08-01

    Rituximab is frequently used in systemic lupus erythematosus; however, side effects such as infusion-related reactions limit its use. In this case report, we describe, for the first time, treatment with ofatumumab in four patients with lupus nephritis. The treatment was well tolerated in three of the patients, and a reduction of proteinuria was seen in all cases. This emphasizes the importance of alternative B-cell-depleting therapies in patients with an initial good response to rituximab, but who develop side effects. PMID:27478595

  18. Partial Lipodystrophy and Rapidly Progressive Nephritis

    Directory of Open Access Journals (Sweden)

    Hasan Mjalli

    2001-01-01

    Full Text Available We report the association of partial lipodystrophy (PL and nephritis in an 11-year-old boy. He had symmetric absence of facial fat with retention of adipose tissue in the arms, chest, abdomen and hips associated with macroscopic hematuria, proteinuria combined with depression of the complement C3 level. The patient had rapidly progressive glomerulonephritis (RPGN and the histopathological study showed findings of mesangio-capillary glomerulonephritis (MCGN and crescents. We managed and followed up this patient for three years. At the last follow-up visit, he still has mild proteinuria and microscopic hematuria and stable renal function.

  19. A Twenty-First Century Cancer Epidemic Caused by Obesity: The Involvement of Insulin, Diabetes, and Insulin-Like Growth Factors

    OpenAIRE

    Westley, Rosalyne L.; May, Felicity E. B.

    2013-01-01

    Obesity has reached epidemic proportions in the developed world. The progression from obesity to diabetes mellitus type 2, via metabolic syndrome, is recognised, and the significant associated increase in the risk of major human cancers acknowledged. We review the molecular basis of the involvement of morbidly high concentrations of endogenous or therapeutic insulin and of insulin-like growth factors in the progression from obesity to diabetes and finally to cancer. Epidemiological and bioche...

  20. Intravenous Immunoglobulin in the Management of Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Scott E. Wenderfer

    2012-01-01

    Full Text Available The occurrence of nephritis in patients with systemic lupus erythematosus is associated with increased morbidity and mortality. The pathogenesis of lupus nephritis is complex, involving innate and adaptive cellular and humoral immune responses. Autoantibodies in particular have been shown to be critical in the initiation and progression of renal injury, via interactions with both Fc-receptors and complement. One approach in the management of patients with lupus nephritis has been the use of intravenous immunoglobulin. This therapy has shown benefit in the setting of many forms of autoantibody-mediated injury; however, the mechanisms of efficacy are not fully understood. In this paper, the data supporting the use of immunoglobulin therapy in lupus nephritis will be evaluated. In addition, the potential mechanisms of action will be discussed with respect to the known involvement of complement and Fc-receptors in the kidney parenchyma. Results are provocative and warrant additional clinical trials.

  1. TUBULORETICULAR STRUCTURE AND CYLINDRICAL CONFRONTING CISTERNAE IN LUPUS NEPHRITIS

    Institute of Scientific and Technical Information of China (English)

    陈振斌; 梁平; 余英豪; 谢福安; 陈莲云

    1998-01-01

    Objective. To investigate the pathological significance of tubuloreticular structure(TRS) and cyhndricol confronting cisternae(CCC) in patients with lupus nephritis. Methods. An electron microscopical study of 24 renal biopsy specimens from patients with lupus nephritis was carried out, with particular emphasis on two endoplasmie reticulum(ER)-related structures. Result. TRS was found in 18 cases, and CCC in 10 of them. TRS often oppeared in the capillary endothelium, and did not correlate well with the activity index of lupus nephritis, CCC appeared frequently in monoeyte/macrophage and lymphocyte, and correlated well with hoth the activity index nod the amount of interstitial immune deposits. Conclusion. TRS and CCC derived from inward "budding" of ER membrane were suggested and the morphogenesis and morphologic variations of CCC were discussed. Both TRS and CCC are pathognomonic,though not specific changes. They may be helpful in pathologic diagnosis of lupus nephritis, when properly combined with certain clinical and pathological features.

  2. Could we abandon cyclophosphamide in systemic vasculitis and lupus nephritis?

    NARCIS (Netherlands)

    Kallenberg, Cees G. M.

    2013-01-01

    Cyclophosphamide has greatly improved prognosis in antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV) and proliferative lupus nephritis (LN). However, the side effects of long-term cyclophosphamide treatment are considerable prompting a search for alternatives to cyclophosphamide. F

  3. Epidemic Percolation Networks, Epidemic Outcomes, and Interventions

    OpenAIRE

    Eben Kenah; Miller, Joel C.

    2011-01-01

    Epidemic percolation networks (EPNs) are directed random networks that can be used to analyze stochastic “Susceptible-Infectious-Removed” (SIR) and “Susceptible-Exposed-Infectious-Removed” (SEIR) epidemic models, unifying and generalizing previous uses of networks and branching processes to analyze mass-action and network-based S(E)IR models. This paper explains the fundamental concepts underlying the definition and use of EPNs, using them to build intuition about the final outcomes of epidem...

  4. Acute radiation nephritis. Its evolution on sequential bone imaging

    International Nuclear Information System (INIS)

    Acute radiation nephritis typically affects the kidneys 3-12 months after radiation exposure and may occur with doses as low as 2500 rads. After an initial latent period, the affected portions of the kidneys become swollen and edematous, and develop multiple petechiae. Necrotizing vasculitis and interstitial hemorrhage occur, and the end stage is that of scarring. Two patients are presented in whom localized acute radiation nephritis developed, and whose kidneys demonstrated the characteristic sequential changes of this entity on serial bone imaging

  5. Environmental factors predicting nephritis in systemic lupus erythematosus.

    OpenAIRE

    McAlindon, T; Giannotta, L; Taub, N.; D'Cruz, D; Hughes, G.

    1993-01-01

    OBJECTIVES--To evaluate social class, ethnic origin, and various endocrine variables as potential risk factors in the development of nephritis in patients with systemic lupus erythematosus (SLE). METHODS--A cross-sectional survey was carried out of all outpatients with SLE attending the lupus Clinic of St Thomas's Hospital from March to October 1992 using retrospective survival data. The main outcome measure was the duration of SLE before the onset of nephritis. RESULTS--Two hundred and ninet...

  6. Mycophenolate mofetil in the treatment of lupus nephritis

    OpenAIRE

    Patrick FK Yong; David P D’Cruz

    2008-01-01

    Patrick FK Yong1,2, David P D’Cruz21Department of Clinical Immunology, Kings College Hospital; 2The Lupus Research Unit, St Thomas’ Hospital, London, UKAbstract: Lupus nephritis is a complication of systemic lupus erythematosus, which has significant morbidity and mortality. The accepted standard of treatment for severe lupus nephritis is cyclophosphamide for induction of remission. This has significant adverse effects including severe infection and amenorrhea. In addition...

  7. Renal Glycosphingolipid Metabolism Is Dysfunctional in Lupus Nephritis

    OpenAIRE

    Tamara K Nowling; Mather, Andrew R.; Thiyagarajan, Thirumagal; Hernández-Corbacho, María José; Powers, Thomas W.; Jones, E. Ellen; Snider, Ashley J.; Oates, Jim C.; Drake, Richard R.; Siskind, Leah J.

    2014-01-01

    Nearly one half of patients with lupus develop glomerulonephritis (GN), which often leads to renal failure. Although nephritis is diagnosed by the presence of proteinuria, the pathology of nephritis can fall into one of five classes defined by different forms of tissue injury, and the mechanisms involved in pathogenesis are not completely understood. Glycosphingolipids are abundant in the kidney, have roles in many cellular functions, and were shown to be involved in other renal diseases. Her...

  8. Trimethoprim-sulfamethoxazole induced acute interstitial nephritis in renal allografts; clinical course and outcome.

    LENUS (Irish Health Repository)

    Garvey, J P

    2009-11-01

    Acute interstitial nephritis (AIN) secondary to trimethoprim-sulfamethoxazole (TMP-SMX) is well documented as a cause of acute renal failure in native kidneys. TMP-SMX is the standard prophylactic agent against pneumocystis carinii (PCP) used in the early post-transplant period, however, it has to date only been indirectly associated with AIN in renal allografts. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: We describe eleven renal transplant patients with acute allograft dysfunction in whom a transplant biopsy demonstrated primary histopathologic features of allergic AIN, all of whom were receiving TMP-SMX in addition to other medications known to cause AIN.

  9. [Acute tubulointerstitial nephritis following adenovirus and respiratory syncytial virus infection].

    Science.gov (United States)

    de Suremain, A; Somrani, R; Bourdat-Michel, G; Pinel, N; Morel-Baccard, C; Payen, V

    2015-05-01

    Acute tubulointerstitial nephritis (TIN) is responsible for nearly 10% of acute renal failure (ARF) cases in children. It is mostly drug-induced, but in a few cases viruses are involved, probably by an indirect mechanism. An immune-competent 13-month-old boy was admitted to the intensive care unit for severe ARF with anuria in a context of fever, cough, and rhinorrhea lasting 1 week. The kidney biopsy performed early brought out tubulointerstitial damage with mild infiltrate of lymphocytes, without any signs of necrosis. There were no virus inclusion bodies, no interstitial hemorrhage, and no glomerular or vascular damage. Other causes of TIN were excluded: there was no biological argument for an immunological, immune, or drug-induced cause. Adenovirus (ADV) and respiratory syncytial virus (RSV) were positive in respiratory multiplex polymerase chain reaction (PCR) in nasal aspirate but not in blood, urine, and renal tissue. The patient underwent dialysis for 10 days but the response to corticosteroid therapy was quickly observed within 48 h. The mechanism of TIN associated with virus infection is unknown. However, it may be immune-mediated to be able to link severe renal dysfunction and ADV and/or RSV invasion of the respiratory tract. PMID:25842199

  10. Dengue 3 Epidemic, Havana, 2001

    OpenAIRE

    Peláez, Otto; Guzmán, María G.; Kourí, Gustavo; Pérez, Raúl; San Martín, José L.; Vázquez, Susana; Rosario, Delfina; Mora, Regla; Quintana, Ibrahim; Bisset, Juan; Cancio, Reynel; Masa, Ana M; Castro, Osvaldo; González, Daniel; Avila, Luis C.

    2004-01-01

    In June 2001, dengue transmission was detected in Havana, Cuba; 12,889 cases were reported. Dengue 3, the etiologic agent of the epidemic, caused the dengue hemorrhagic fever only in adults, with 78 cases and 3 deaths. After intensive vector control efforts, no new cases have been detected.

  11. The peculiar epidemic, part I: social response to AIDS in Alameda county

    OpenAIRE

    M Garcia-Soto; Fullilove, R E; Fullilove, M. T.; K Haynes-Sanstad

    1998-01-01

    The morbidity and mortality caused by epidemics threaten social functioning of complex societies. Societies mount a social response to epidemics in order to contain the potential damage from uncontrolled disease. Despite the threat posed by epidemics, social and contextual 'vulnerabilities' often impede efforts to contain epidemics. The AIDS epidemic provides an example of a 'peculiar' epidemic, in which threat to social welfare failed to provoke adequate social efforts at containment. In ord...

  12. Acute interstitial nephritis with acetaminophen and alcohol intoxication

    Directory of Open Access Journals (Sweden)

    Alexopoulou Iakovina

    2011-04-01

    Full Text Available Abstract Drug-induced acute interstitial nephritis (AIN represents a growing cause of renal failure in current medical practice. While antimicrobials and non-steroidal anti-inflammatory drugs are typically associated with drug-induced AIN, few reports have been made on the involvement of other analgesics. We report our experience in managing a 17-year-old female with AIN and subsequent renal injury following an acetaminophen overdose in conjunction with acute alcohol intoxication. It is well established that acetaminophen metabolism, particularly at high doses, produces reactive metabolites that may induce renal and hepatic toxicity. It is also plausible however, that such reactive species could instead alter renal peptide immunogenicity, thereby inducing AIN. In the following report, we review a possible mechanism for the acetaminophen-induced AIN observed in our patient and also discuss the potential involvement of acute alcohol ingestion in disease onset. The objective of our report is to increase awareness of healthcare professionals to the potential involvement of these commonly used agents in AIN pathogenesis.

  13. Phenazopyridine associated acute interstitial nephritis and review of literature.

    Science.gov (United States)

    Singh, Manisha; Shailesh, Fnu; Tiwari, Upasana; Sharma, Shree G; Malik, Bilal

    2014-06-01

    Phenazopyridine is a urinary analgesic; commonly seen side-effects of this drug include, orange discoloration of urine, methemoglobinemia, yellowish skin discoloration, hepatitis and acute renal failure. Various case reports with phenazopyridine associated acute renal failure secondary to acute tubular necrosis have been reported in the literature. Acute kidney injury in these patients is caused by either direct injury to renal tubular epithelial cells or secondary to pigment induced nephropathy from hemolytic anemia. Hypoxic injury from phenazopyridine-induced methemoglobinemia has been well documented. We report a case of biopsy proven acute interstitial nephritis, associated with therapeutic doses of phenazopyridine without any evidence of methemoglobinemia or other mechanism of renal injury. Clinicians should be aware of the toxicity of this commonly used drug and should look closely for signs of renal insufficiency. Identifying and stopping the offending medication stays as the first step, but recent studies indicate that early steroid administration improves renal recovery, as well as decreasing the risk of progression to chronic kidney disease with fibrosis and consequent permanent renal damage. PMID:24575779

  14. MicroRNAs Implicated in the Immunopathogenesis of Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Cristen B. Chafin

    2013-01-01

    Full Text Available Systemic lupus erythematosus (SLE is an autoimmune disease characterized by the deposition of immune complexes due to widespread loss of immune tolerance to nuclear self-antigens. Deposition in the renal glomeruli results in the development of lupus nephritis (LN, the leading cause of morbidity and mortality in SLE. In addition to the well-recognized genetic susceptibility to SLE, disease pathogenesis is influenced by epigenetic regulators such as microRNAs (miRNAs. miRNAs are small, noncoding RNAs that bind to the 3′ untranslated region of target mRNAs resulting in posttranscriptional gene modulation. miRNAs play an important and dynamic role in the activation of innate immune cells and are critical in regulating the adaptive immune response. Immune stimulation and the resulting cytokine milieu alter miRNA expression while miRNAs themselves modify cellular responses to stimulation. Here we examine dysregulated miRNAs implicated in LN pathogenesis from human SLE patients and murine lupus models. The effects of LN-associated miRNAs in the kidney, peripheral blood mononuclear cells, macrophages, mesangial cells, dendritic cells, and splenocytes are discussed. As the role of miRNAs in immunopathogenesis becomes delineated, it is likely that specific miRNAs may serve as targets for therapeutic intervention in the treatment of LN and other pathologies.

  15. Acute interstitial nephritis with acetaminophen and alcohol intoxication.

    Science.gov (United States)

    Fruchter, Lauren L; Alexopoulou, Iakovina; Lau, Keith K

    2011-01-01

    Drug-induced acute interstitial nephritis (AIN) represents a growing cause of renal failure in current medical practice. While antimicrobials and non-steroidal anti-inflammatory drugs are typically associated with drug-induced AIN, few reports have been made on the involvement of other analgesics. We report our experience in managing a 17-year-old female with AIN and subsequent renal injury following an acetaminophen overdose in conjunction with acute alcohol intoxication. It is well established that acetaminophen metabolism, particularly at high doses, produces reactive metabolites that may induce renal and hepatic toxicity. It is also plausible however, that such reactive species could instead alter renal peptide immunogenicity, thereby inducing AIN. In the following report, we review a possible mechanism for the acetaminophen-induced AIN observed in our patient and also discuss the potential involvement of acute alcohol ingestion in disease onset. The objective of our report is to increase awareness of healthcare professionals to the potential involvement of these commonly used agents in AIN pathogenesis. PMID:21496243

  16. Epidemic Trade

    DEFF Research Database (Denmark)

    Boerner, Lars; Severgnini, Battista

    This paper studies the spread of the Black Death as a proxy for the intensity of medieval trade flows between 1346 and 1351. The Black Death struck most areas of Europe and the wider Mediterranean. Based on a modied version of the gravity model, we estimate the speed (in kilometers per day) of...... geographical position are of substantial signicance. These results are the first to enable us to identify and quantify key variables of medieval trade flows based on an empirical trade model. These results shed new light on many qualitative debates on the importance and causes of medieval trade....

  17. Epidemic percolation networks, epidemic outcomes, and interventions.

    Science.gov (United States)

    Kenah, Eben; Miller, Joel C

    2011-01-01

    Epidemic percolation networks (EPNs) are directed random networks that can be used to analyze stochastic "Susceptible-Infectious-Removed" (SIR) and "Susceptible-Exposed-Infectious-Removed" (SEIR) epidemic models, unifying and generalizing previous uses of networks and branching processes to analyze mass-action and network-based S(E)IR models. This paper explains the fundamental concepts underlying the definition and use of EPNs, using them to build intuition about the final outcomes of epidemics. We then show how EPNs provide a novel and useful perspective on the design of vaccination strategies. PMID:21437002

  18. B-cell depletion in the treatment of lupus nephritis.

    Science.gov (United States)

    Gregersen, Jon W; Jayne, David R W

    2012-09-01

    Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that is clinically heterogeneous and affects multiple organs. Lupus nephritis is the most frequent severe manifestation of SLE. Conventional immunosuppressive therapy has increased the life expectancy of patients diagnosed with lupus nephritis, but only 70-80% of patients respond to this treatment and its adverse effects are considerable. B cells are central to the pathogenesis of SLE and are, therefore, an attractive therapeutic target. B-cell depletion has been used successfully to treat other autoimmune diseases, such as rheumatoid arthritis and antineutrophil cytoplasmic antibody-associated vasculitis, and many case reports and small nonrandomized trials of B-cell-depleting agents in patients with lupus nephritis have reported positive results. By contrast, two large placebo-controlled trials designed to investigate the efficacy of the B-cell-depleting agents rituximab and ocrelizumab as a treatment for lupus nephritis, failed to meet their primary efficacy end points (LUNAR and BELONG, respectively). This Review discusses the current evidence on the use of B-cell depletion in the treatment of lupus nephritis, which is derived from case studies and clinical trials including a total of over 800 patients. PMID:22801948

  19. Immune profile and Epstein-Barr virus infection in acute interstitial nephritis: an immunohistochemical study in 78 patients.

    LENUS (Irish Health Repository)

    Mansur, Abdurrezagh

    2011-01-01

    Acute interstitial nephritis (AIN) is a common cause of acute kidney injury and is characterised by a dense interstitial cellular infiltrate, which has not been well defined. Previous studies have demonstrated a correlation between Epstein-Barr virus (EBV) infection and AIN. The purpose of our study was to define the nature of the interstitial immune infiltrate and to investigate the possibility of renal infection with EBV.

  20. Renal cell apoptosis in human lupus nephritis: a histological study

    DEFF Research Database (Denmark)

    Faurschou, M; Penkowa, Milena; Andersen, C B;

    2009-01-01

    Nuclear autoantigens from apoptotic cells are believed to drive the immunological response in systemic lupus erythematosus (SLE). Conflicting data exist as to the possible renal origin of apoptotic cells in SLE patients with nephritis. We assessed the level of renal cell apoptosis in kidney...... biopsies from 35 patients with lupus nephritis by means of terminal deoxynucleotidyl-transferase (TdT)-mediated deoxyuridine triphosphate (dUTP)-digoxigenin nick end labeling (TUNEL). Five samples of normal kidney tissue served as control specimens. We did not observe apoptotic glomerular cells in any of...... that apoptotic renal cells constitute a quantitatively important source of auto-antibody-inducing nuclear auto-antigens in human lupus nephritis....

  1. History of Nephritis%肾炎的历史

    Institute of Scientific and Technical Information of China (English)

    张前进; 甄橙

    2001-01-01

    The nephritis is one of the common and detrimental diseases.This paper reviews the history of knowledge of nephritis,ancient and modern,and western and Chinese medicine,demonstrating that the continuous development of treatment of TCM and western medicine are all effective measures to combat nephritis.%肾炎是一种常见的危害人类健康的疾病。从古今中外对肾炎的认识历史来看,人类在征服肾炎的历程中,传统的中医中药治疗和不断发展的西医学都是战胜疾病的有效治疗手段。

  2. Do we still need renal biopsy in lupus nephritis?

    Science.gov (United States)

    Haładyj, Ewa; Cervera, Ricard

    2016-01-01

    The natural course of systemic lupus erythematosus (SLE) is characterized by periods of disease activity and remissions. Prolonged disease activity results in cumulative organ damage. Lupus nephritis is one of the most common and devastating manifestations of SLE. In the era of changing therapy to less toxic regimens, some authors have stated that if mycophenolate mofetil can be used for the induction and maintenance treatment in all histological classes of lupus nephritis, renal biopsy can be omitted. This article aims to answer the question of what brings the bigger risk: renal biopsy or its abandonment. PMID:27407281

  3. Modeling and simulation of epidemic spread

    DEFF Research Database (Denmark)

    Shatnawi, Maad; Lazarova-Molnar, Sanja; Zaki, Nazar

    Epidemics have disturbed human lives for centuries causing massive numbers of deaths and illnesses among people and animals. As the number of urbanized and mobile population has increased, the possibility of a worldwide pandemic has grown too. The latest advances in high-performance computing and...... computational network science can help computational epidemiologists to develop large-scale high-fidelity models of epidemic spread. These models can help to characterize the large-scale patterns of epidemics and guide public health officials and policy makers in taking appropriate decisions to prevent and...

  4. Features and outcomes of lupus nephritis in Morocco: analysis of 114 patients

    Directory of Open Access Journals (Sweden)

    Haddiya I

    2013-11-01

    Full Text Available Intissar Haddiya,1 Hakim Hamzaoui,1 Nabil Tachfouti,2 Zitouna Al Hamany,3 Aicha Radoui,1 Najoua Zbiti,1 Yamama Amar,1 Hakima Rhou,1 Loubna Benamar,1 Naima Ouzeddoun,1 Rabea Bayahia1 1Department of Nephrology, Dialysis, and Renal Transplantation, Ibn Sina University Hospital, Rabat, Morocco; 2Department of Epidemiology, Fez, Morocco; 3Department of Pathology, Rabat Children's Hospital, Rabat, Morocco Background: There is wide variation in clinical presentation and outcome of lupus nephritis (LN among different ethnic groups. Few data for LN exist on North Africans, especially those from Morocco. The aim of our study was to review retrospectively the features and outcome of LN in Moroccan patients. Patients and methods: We performed a single-center retrospective study. A total of 114 patients with LN were included. All patients met American Rheumatism Association criteria. LN was classified according to the International Society of Nephrology/Renal Pathology Society classification. We adopted previously defined outcome criteria for LN. Results: There were 101 females and 13 males, with a mean age of 29.9 years. At first presentation, we noted hypertension in 33%, hematuria in 76%, nephrotic syndrome in 53%, and renal failure in 60% of cases. Renal biopsy revealed predominant proliferative classes in more than 80% of patients. Patients received different regimens mainly based on intravenous cyclophosphamide. After a mean follow-up of 22 months, remission occurred in 45.5%, relapses in 82%, end-stage renal failure in 21%, and death in 16% of cases. Infection and neurological and cardiovascular diseases were the most frequent causes of death. Conclusion: LN seems to be severe in our study, with a predominance of proliferative forms, severe renal manifestations, and poor renal and overall survival. Keywords: lupus nephritis, systemic lupus erythematosus, nephritis

  5. Actinobacillus suis and Actinobacillus equuli, emergent pathogens of septic embolic nephritis, a new challenge for the swine industry Actinobacillus suis y Actinobacillus equuli, patógenos emergentes de nefritis embólica séptica, un nuevo desafío para la industria porcina

    OpenAIRE

    CE Benavente; IC Fuentealba

    2012-01-01

    Kidney lesions are an important cause of tissue condemnation in slaughterhouses. In addition to the potential public health implications, organ condemnations have a significant economic impact on the food animal industry. The condition classified broadly as "nephritis" is one of the main causes of tissue condemnation. Embolic nephritis resembling Actinobacillus equuli infection in foals has been recently detected in sows and market hogs. Actinobacillus suis is phenotypically and phylogenetica...

  6. Leptospirosis: A Silent Epidemic Disease

    OpenAIRE

    Maria Cristina Schneider; Michel Jancloes; Daniel F. Buss; Sylvain Aldighieri; Eric Bertherat; Patricia Najera; Galan, Deise I.; Kara Durski; Marcos A. Espinal

    2013-01-01

    This special issue of International Journal of Environmental Research and Public Health is dedicated to leptospirosis, an endemic zoonotic disease that is a cause of many acute undifferentiated fevers, especially in tropical countries [1,2]. While it can be debated whether leptospirosis is an emerging disease, it is evident that it is becoming an emerging public health problem. It is recognized as a disease of epidemic potential that has a significant health impact in many parts of the world.

  7. Modeling Epidemic Network Failures

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Fagertun, Anna Manolova

    2013-01-01

    This paper presents the implementation of a failure propagation model for transport networks when multiple failures occur resulting in an epidemic. We model the Susceptible Infected Disabled (SID) epidemic model and validate it by comparing it to analytical solutions. Furthermore, we evaluate...... the SID model’s behavior and impact on the network performance, as well as the severity of the infection spreading. The simulations are carried out in OPNET Modeler. The model provides an important input to epidemic connection recovery mechanisms, and can due to its flexibility and versatility be used...... to evaluate multiple epidemic scenarios in various network types....

  8. Serum Renalase Levels Correlate with Disease Activity in Lupus Nephritis.

    Directory of Open Access Journals (Sweden)

    Chaojun Qi

    Full Text Available Lupus nephritis (LN is among the most serious complications of systemic lupus erythematosus (SLE, which causes significant morbidity and mortality. Renalase is a novel, kidney-secreted cytokine-like protein that promotes cell survival. Here, we aimed to investigate the relationship of serum renalase levels with LN and its role in the disease progression of LN.For this cross-sectional study, 67 LN patients and 35 healthy controls were enrolled. Seventeen active LN patients who received standard therapies were followed up for six months. Disease activity was determined by the SLE Disease Activity-2000 (SLEDAI-2K scoring system and serum renalase amounts were determined by ELISA. Predictive value of renalase for disease activity was assessed. Furthermore, the expression of renalase in the kidneys of patients and macrophage infiltration was assessed by immunohistochemistry.Serum renalase amounts were significantly higher in LN patients than in healthy controls. Moreover, patients with proliferative LN had more elevated serum renalase levels than Class V LN patients. In proliferative LN patients, serum renalase levels were significantly higher in patients with active LN than those with inactive LN. Serum renalase levels were positively correlated with SLEDAI-2K, 24-h urine protein excretion, ds-DNA and ESR but inversely correlated with serum albumin and C3. Renalase amounts decreased significantly after six-months of standard therapy. The performance of renalase as a marker for diagnosis of active LN was 0.906 with a cutoff value of 66.67 μg/ml. We also observed that the amount of renalase was significantly higher in glomerular of proliferative LN along with the co-expression of macrophages.Serum renalase levels were correlated with disease activity in LN. Serum renalase might serve as a potential indicator for disease activity in LN. The marked increase of glomerular renalase and its association with macrophages suggest that it might play an

  9. Understanding lupus nephritis: diagnosis, management, and treatment options

    Directory of Open Access Journals (Sweden)

    Mok CC

    2012-05-01

    Full Text Available Chi Chiu MokDepartment of Medicine, Tuen Mun Hospital and Center for Assessment and Treatment of Rheumatic Diseases, Pok Oi Hospital, Hong Kong, ChinaAbstract: Systemic lupus erythematosus (SLE predominantly affects women in their reproductive years. Renal disease (glomerulonephritis is one of the most frequent and serious manifestations of SLE. Of the various histological types of lupus glomerulonephritis, diffuse proliferative nephritis carries the worst prognosis. Combined with high-dose prednisone, mycophenolate mofetil (MMF has emerged as a first-line immunosuppressive treatment, although data regarding the efficacy of MMF on the long-term preservation of renal function are forthcoming. Cyclophosphamide is reserved for more severe forms of lupus nephritis, such as crescentic glomerulonephritis with rapidly deteriorating renal function, patients with significant renal function impairment at presentation, and refractory renal disease. Evidence for the calcineurin inhibitors in the treatment of lupus nephritis is weaker, and it concerns patients who are intolerant or recalcitrant to other agents. While further controlled trials are mandatory, B cell modulation therapies, such as rituximab, belimumab and epratuzumab are confined to refractory disease. Non-immunosuppressive measures, such as angiotensin-converting enzyme inhibitors, vigorous blood pressure control, prevention and treatment of hyperlipidemia and osteoporosis, are equally important.Keywords: lupus, nephritis, nephropathy, glomerulonephritis, treatment, therapy, women

  10. Kidney disease in lupus is not always 'lupus nephritis'

    NARCIS (Netherlands)

    H.J. Anders (Hans-Joachim); J.J. Weening (Jan)

    2013-01-01

    textabstractIn lupus erythematosus, elevated serum creatinine levels and urinary abnormalities implicate a kidney disorder, which may not always be lupus nephritis as defined by the current classification of the International Society of Nephrology/Renal Pathology Society. The signs of renal dysfunct

  11. Incidence of systemic lupus erythematosus and lupus nephritis in Denmark

    DEFF Research Database (Denmark)

    Hermansen, Marie-Louise F.; Lindhardsen, Jesper; Torp-Pedersen, Christian;

    2016-01-01

    OBJECTIVE: To determine the incidence of systemic lupus erythematosus (SLE) and SLE with concomitant or subsequent lupus nephritis (LN) in Denmark during 1995-2011, using data from the Danish National Patient Registry (NPR). METHODS: To assess the incidence of SLE, we identified all persons aged...

  12. Ergotamine-induced acute tubulo-interstitial nephritis

    OpenAIRE

    Maryam Pakfetrat; Akbar Rasekhi; Fatemeh Eftekhari; Nahid Hashemi; Jamshid Roozbeh; Simin Torabineghad; Leila Malekmakan

    2013-01-01

    Ergotamine has been used for the treatment of migraine for many years, and its use in adults is considered to be safe and effective. In this report, we present a 22-year-old female patient, a known case of migraine, who was on ergotamine tartrate and presented with hypertension and renal failure. Renal biopsy indicated features of acute tubulo-interstitital nephritis.

  13. Treatment of severe proliferative lupus nephritis: The current state

    OpenAIRE

    Mok, C; Wong, R; Lai, K.

    2003-01-01

    Despite the development of new modalities, cyclophosphamide (CYC) remains the preferred initial treatment for severe proliferative lupus nephritis. Controversies continue about the best route, dosage, and duration of CYC treatment. For recalcitrant disease, new immunosuppressive and immunomodulating agents, immunoablative high dose CYC, nucleoside analogues, apheresis, and the biological response modifiers can be considered.

  14. Pregnancy in Systemic Lupus Erythematosus Patients with Nephritis

    Directory of Open Access Journals (Sweden)

    Panagiotis Pateinakis

    2014-07-01

    Full Text Available Pregnancy in patients with lupus nephritis is a challenging clinical situation. Although not absolutely contraindicated, it is associated with increased risk for foetal and maternal complications, including foetal loss, preterm delivery, intrauterine growth retardation, hypertension, pre-eclampsia, nephritis flare, and, rarely, maternal death. The complication rate is further increased in the presence of antiphospholipid antibodies or the antiphospholipid syndrome. Proliferative classes of nephritis (III and IV also appear to confer excess risk for complications. Immunosuppressives such as cyclophosphamide and mycophenolate, and antihypertensives such as angiotensin-converting-enzyme (ACE inhibitors and angiotensin receptor blockers need to be stopped due to teratogenic effects. Agents like corticosteroids, azathioprine, and probably calcineurin inhibitors are considered compatible with gestation. Lupus activity needs to be assessed and carefully monitored. Thrombotic risk due to antiphospholipid antibodies, thrombotic events, or nephrosis needs to be evaluated and managed accordingly, with the use of aspirin and/or unfractioned or low molecular weight heparin. Differentiating between severe pre-eclampsia and lupus nephritis flare might require a renal biopsy, which might not always be feasible, for example after the 32nd gestational week or in a setting of uncontrolled hypertension or thrombocytopaenia. A 6-month history of quiescent disease on non-teratogenic agents seems to be associated with best chance for favourable outcomes. Pregnancy is optimally managed by a multidisciplinary team of experienced specialists, and close monitoring for disease activity during gestation; additionally, follow-up for maternal flare postpartum is also advised.

  15. Renal cell apoptosis in human lupus nephritis: a histological study

    DEFF Research Database (Denmark)

    Faurschou, M; Penkowa, Milena; Andersen, C B; Starklint, H; Jacobsen, S

    2009-01-01

    Nuclear autoantigens from apoptotic cells are believed to drive the immunological response in systemic lupus erythematosus (SLE). Conflicting data exist as to the possible renal origin of apoptotic cells in SLE patients with nephritis. We assessed the level of renal cell apoptosis in kidney biops...

  16. Traffic-driven SIR epidemic model on networks

    CERN Document Server

    Pu, Cunlai; Yang, Jian

    2015-01-01

    We propose a novel SIR epidemic model which is driven by the transmission of infection packets in networks. Specifically, infected nodes generate and deliver infection packets causing the spread of the epidemic, while recovered nodes block the delivery of infection packets, and this inhibits the epidemic spreading. The efficient routing protocol governed by a control parameter $\\alpha$ is used in the packet transmission. We obtain the maximum instantaneous population of infected nodes, the maximum population of ever infected nodes, as well as the corresponding optimal $\\alpha$ through simulation. We find that generally more balanced load distribution leads to more intense and wide spread of an epidemic in networks. Increasing either average node degree or homogeneity of degree distribution will facilitate epidemic spreading. When packet generation rate $\\rho$ is small, increasing $\\rho$ favors epidemic spreading. However, when $\\rho$ is large enough, traffic congestion appears which inhibits epidemic spreadin...

  17. The Zika epidemics and transplantation.

    Science.gov (United States)

    Silveira, Fernanda P; Campos, Silvia V

    2016-05-01

    In the last few months an epidemic of Zika virus (ZIKV) has affected several countries, and it continues to spread rapidly. This virus was initially thought to cause only a mild febrile illness; however, the current epidemic has shown that it is associated with serious complications. Increasing reports are linking ZIKV to devastating conditions such as microcephaly in newborns and important neurologic syndromes. Although ZIKV infection has not yet been reported in transplant recipients, it is likely that it will be reported soon because of the number of transplants performed in affected areas and global travel. We discuss the effect of ZIKV in transplantation and propose recommendations to prevent donor-derived infections. PMID:27197772

  18. Hepatocellular carcinoma and industrial epidemics

    Institute of Scientific and Technical Information of China (English)

    Alain Braillon; Gérard Dubois

    2011-01-01

    Worldwide, the burden of the non viral causes of hepatocellular carcinoma (HCC) is usually underestimated. Clearly industrial goods, tobacco, alcohol and processed foods are the agents of new epidemics in modern times which far outscore the burden of infectious agents on morbidity and mortality. Smoking, a dose-related contributing factor for HCC, receives too little attention in clinical practice. In France, tobacco, hepatitis B and C virus and alcohol are the main risk factors for HCC mortality (33%, 31% and 26%, respectively). In developing countries, where tobacco consumption is dramatically increasing, this epidemic may soon surpass hepatitis B. Obesity and diabetes are the contributing factors too. The role of industrial processed foods in the increase of the prevalence of obesity and diabetes cannot be ignored.

  19. Generation interval contraction and epidemic data analysis

    CERN Document Server

    Kenah, Eben; Robins, James M

    2008-01-01

    The generation interval is the time between the infection time of an infected person and the infection time of his or her infector. Probability density functions for generation intervals have been an important input for epidemic models and epidemic data analysis. In this paper, we specify a general stochastic SIR epidemic model and prove that the mean generation interval decreases when susceptible persons are at risk of infectious contact from multiple sources. The intuition behind this is that when a susceptible person has multiple potential infectors, there is a ``race'' to infect him or her in which only the first infectious contact leads to infection. In an epidemic, the mean generation interval contracts as the prevalence of infection increases. We call this global competition among potential infectors. When there is rapid transmission within clusters of contacts, generation interval contraction can be caused by a high local prevalence of infection even when the global prevalence is low. We call this loc...

  20. Comparative analysis of clinical characters between acute focal bacterial nephritis and acute pylonephritis

    Institute of Scientific and Technical Information of China (English)

    李湛

    2013-01-01

    Objective To improve standards of diagnosis and therapy for acute focal bacterial nephritis by comparing the characters of acute focal bacterial nephritis and acute pylonephritis.Methods Thirty-five patients of upper urinary tract infection whoever accepted ultrasongraphic and computed tomographic (CT) examinations in Beijing Hospital from January 2007 to January 2013 were studied retrospectively.Eighteen patients were diagnosed as acute focal bacterial nephritis (AFBN) according to CT imaging features,the other 17 patients were diagnosed as acute

  1. Geographical distribution, a risk factor for the incidence of lupus nephritis in China

    OpenAIRE

    Pan, Qingjun; Li, Yaning; Ye, Ling; Deng, Zhenzhen; Li, Lu; Feng, Yongmin; Liu, Weijing; LIU, HUAFENG

    2014-01-01

    Background Geographical variation in lupus nephritis epidemiology may indicate important environmental factors contributions to the etiology of lupus nephritis. This paper first describes the epidemiology of biopsy-proven lupus nephritis in China by performing a systematic literature review and the possible social-environmental influential factors. Methods The keywords “lupus nephritis”, “renal biopsy” and “systemic lupus erythematous” were searched in the three largest Chinese electronic dat...

  2. PTSD: A Growing Epidemic

    Science.gov (United States)

    ... plane crashes, bombings, or natural disasters such as floods or earthquakes. The majority of people exposed to ... tell? Read More "Post Traumatic Stress Disorder (PTSD)" Articles PTSD: A Growing Epidemic / Symptoms, Diagnosis, Treatment / NIH ...

  3. Renal expression of polyomavirus large T antigen is associated with nephritis in human systemic lupus erythematosus

    DEFF Research Database (Denmark)

    Fenton, Kristin Andreassen; Mjelle, Janne Erikke; Jacobsen, Søren;

    2008-01-01

    these complexes bound induced anti-nucleosome antibodies and finally (iv) that they associated with glomerular membranes as immune complexes. This process may be relevant for human lupus nephritis, since productive polyomavirus infection is associated with this organ manifestation. Here, we compare...... membranes and contribute to the evolution of lupus nephritis in human SLE....... nephritis in the T-ag transgenic mouse with nephritis in human SLE. Glomerular sections were analysed by transmission electron microscopy, immune electron microscopy (IEM) and by co-localization IEM and TUNEL IEM assays to compare morphological changes, composition of immune complexes and formation of...

  4. A pathophysiology-based approach to the diagnosis and treatment of lupus nephritis.

    Science.gov (United States)

    Anders, Hans-Joachim; Rovin, Brad

    2016-09-01

    Lupus is no longer an unknown chameleon of medicine. Significant progress has been made on unraveling the pathogenesis of lupus and lupus nephritis, and how to treat the disease. Here we provide an update on the pathophysiology of lupus and its related kidney disease, consider areas of controversy in disease management, and discuss the unmet needs of lupus nephritis and how to address these needs. We focus on rethinking how innovative therapies for lupus nephritis should be evaluated and evolving strategies to more efficiently mitigate irreversible nephron loss in patients with lupus nephritis. PMID:27378475

  5. A Case of Classic Polyarteritis Nodosa Resembling Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Ali BAKAN

    2014-05-01

    Full Text Available Classic polyarteritis nodosa (cPAN is a systemic necrotizing vasculitis of medium-sized muscular arteries. Glomerular involvement is not expected in the course of cPAN. Herein, we describe a case of cPAN with glomerular and multiple arterial involvement. The patient presented with severe abdominal pain and high fever. Urine analysis showed hematuria and 1g/day proteinuria. Kidney biopsy showed fibrinoid necrosis of arterioles and IgG, IgA and C1q positivity raising a suspicion of lupus nephritis. However digital subtraction angiography revealed typical multiple micro-aneurysms in the coronary, mesenteric, splenic and renal arteries establishing the diagnosis of cPAN. Kidney biopsy in cPAN may reveal non-specific immune-deposits and fibrinoid necrosis of arterioles mimicking lupus nephritis and microscopic polyangiitis. c-PAN should be carefully differentiated from these entities.

  6. Ergotamine-induced acute tubulo-interstitial nephritis

    Directory of Open Access Journals (Sweden)

    Maryam Pakfetrat

    2013-01-01

    Full Text Available Ergotamine has been used for the treatment of migraine for many years, and its use in adults is considered to be safe and effective. In this report, we present a 22-year-old female patient, a known case of migraine, who was on ergotamine tartrate and presented with hypertension and renal failure. Renal biopsy indicated features of acute tubulo-interstitital nephritis.

  7. Ergotamine-induced acute tubulo-interstitial nephritis.

    Science.gov (United States)

    Pakfetrat, Maryam; Rasekhi, Akbar; Eftekhari, Fatemeh; Hashemi, Nahid; Roozbeh, Jamshid; Torabineghad, Simin; Malekmakan, Leila

    2013-09-01

    Ergotamine has been used for the treatment of migraine for many years, and its use in adults is considered to be safe and effective. In this report, we present a 22-year-old female patient, a known case of migraine, who was on ergotamine tartrate and presented with hypertension and renal failure. Renal biopsy indicated features of acute tubulo-interstitital nephritis. PMID:24029265

  8. Understanding lupus nephritis: diagnosis, management, and treatment options

    OpenAIRE

    Mok CC

    2012-01-01

    Chi Chiu MokDepartment of Medicine, Tuen Mun Hospital and Center for Assessment and Treatment of Rheumatic Diseases, Pok Oi Hospital, Hong Kong, ChinaAbstract: Systemic lupus erythematosus (SLE) predominantly affects women in their reproductive years. Renal disease (glomerulonephritis) is one of the most frequent and serious manifestations of SLE. Of the various histological types of lupus glomerulonephritis, diffuse proliferative nephritis carries the worst prognosis. Combined with high-dose...

  9. Case of chronic nephritis%慢性肾炎案

    Institute of Scientific and Technical Information of China (English)

    尚军; 孟苏华; 尚兆奎; ZHANG Nan

    2011-01-01

    @@ Patient, female, 46 years old.Date of first visit: February 17, 1996.Complaint: chronic nephritis for 3 years.The patient suddenly got dizziness of head, depression of chest, palpitation, abdominal distension, weakness and soreness of lumbus and knee, weakness of whole body, frequent low fever, edema of eyelid and low limbs, with high temperature ranged from 37-38℃ 3 years ago.It was controlled by Chinese medicine and diuretics.

  10. Appraisal of lupus nephritis by renal imaging with gallium-67

    International Nuclear Information System (INIS)

    To assess the activity of lupus nephritis, 43 patients with systemic lupus erythematosus (SLE) were studied by gallium imaging. Delayed renal visualization 48 hours after the gallium injection, a positive result, was noted in 25 of 48 scans. Active renal disease was defined by the presence of hematuria, pyuria (10 or more red blood cells or white blood cells per high-power field), proteinuria (1 g or more per 24 hours), a rising serum creatinine level, or a recent biopsy specimen showing proliferative and/or necrotizing lesions involving more than 20 percent of glomeruli. Renal disease was active in 18 instances, inactive in 23, and undetermined in seven (a total of 48 scans). Sixteen of the 18 scans (89 percent) in patients with active renal disease showed positive findings, as compared with only four of 23 scans (17 percent) in patients with inactive renal disease (p less than 0.001). Patients with positive scanning results had a higher rate of hypertension (p = 0.02), nephrotic proteinuria (p = 0.01), and progressive renal failure (p = 0.02). Mild mesangial nephritis (World Health Organization classes I and II) was noted only in the patients with negative scanning results (p = 0.02) who, however, showed a higher incidence of severe extrarenal SLE (p = 0.04). It is concluded that gallium imaging is a useful tool in evaluating the activity of lupus nephritis

  11. Appraisal of lupus nephritis by renal imaging with gallium-67

    Energy Technology Data Exchange (ETDEWEB)

    Bakir, A.A.; Lopez-Majano, V.; Hryhorczuk, D.O.; Rhee, H.L.; Dunea, G.

    1985-08-01

    To assess the activity of lupus nephritis, 43 patients with systemic lupus erythematosus (SLE) were studied by gallium imaging. Delayed renal visualization 48 hours after the gallium injection, a positive result, was noted in 25 of 48 scans. Active renal disease was defined by the presence of hematuria, pyuria (10 or more red blood cells or white blood cells per high-power field), proteinuria (1 g or more per 24 hours), a rising serum creatinine level, or a recent biopsy specimen showing proliferative and/or necrotizing lesions involving more than 20 percent of glomeruli. Renal disease was active in 18 instances, inactive in 23, and undetermined in seven (a total of 48 scans). Sixteen of the 18 scans (89 percent) in patients with active renal disease showed positive findings, as compared with only four of 23 scans (17 percent) in patients with inactive renal disease (p less than 0.001). Patients with positive scanning results had a higher rate of hypertension (p = 0.02), nephrotic proteinuria (p = 0.01), and progressive renal failure (p = 0.02). Mild mesangial nephritis (World Health Organization classes I and II) was noted only in the patients with negative scanning results (p = 0.02) who, however, showed a higher incidence of severe extrarenal SLE (p = 0.04). It is concluded that gallium imaging is a useful tool in evaluating the activity of lupus nephritis.

  12. [Thalidomide epidemics: 50 years after].

    Science.gov (United States)

    Sípek, Antonín; Sípek, Antonín; Maňáková, Eva

    2012-01-01

    Thalidomide tragedy and the subsequent epidemics of congenital anomalies is one of the most tragic but also enlightening chapters in the history of modern medicine. Many thousands of children were born with various anomalies - especially with limb deformities - because of the mass usage of thalidomide by pregnant women. The numbers of the spontaneous abortions and fetal deaths will remain unknown forever. In year 2012 we have a sad 50th anniversary of final recognition of thalidomide teratogenous potential. The causes of this tragedy and subsequent actions are summarized in our text.Key words: thalidomide, teratogenesis, congenital anomalies. PMID:23387816

  13. Epidemics of infectious diseases in newborn nurseries.

    Science.gov (United States)

    Smith, D H

    1979-06-01

    The newborn nursery is a frequent site of epidemics of infectious disease. The unique susceptibility of neonates to colonization, their intimate exposure to hospital personnel, and their frquent contact with possibly contaminated inanimate objects are major factors contributing to the risk of nursery epidemics. Most of the epidemics described have been caused by bacteria; the role of viruses in nosocomial infections is not well defined but is undoubtedly greater than presently appreciated. All bacteria implicated in nursery epidemics have the capacity to survive or even multiply in the environment or on human skin or to cause gastrointestinal disease. Analysis of the etiologic bacteria, the epidemiology of outbreaks studied, and extensive clinical research indicate that bacterial transmission in this setting occurs primarily by manual contact and very infrequently by the respiratory route. The cornerstone of a program to prevent infectious diseases in the nursery consists of active, disease-oriented surveillance by specially trained personnel; microbiologic surveillance is important only when specifically indicated. Practical technical considerations for prevention of infectious diseases in nurseries are available. Programs to eradicate an ongoing epidemic must be individualized. PMID:380862

  14. A Rare Presentation of Lupus Nephritis Flare up with Posterior Reversible Leucoencephalopathy.

    Science.gov (United States)

    Mani, S Hima; Shivaprasad, S M; Umesh, L

    2016-01-01

    Systemic lupus erythematosus (SLE) is associated with various neurologic or psychiatric abnormalities and Posterior Reversible Leuco Encephalopathy Syndrome (PRES) is very rare neurological manifestation in SLE. PRES is associated with various clinical manifestations, like, seizures, visual loss, headaches, vomiting altered mental status and rarely focal neurological deficits. Other predisposing condition associated with PRES is eclampsia, accelerated hypertension, uraemia, transplantation, autoimmune diseases and/or use of immunosuppressive drugs. It is important to recognise PRES since it is a potentially reversible. We describe an unusual case of PRES caused by uraemia during lupus flare up in a patient with biopsy proven class IV lupus nephritis who presented with features of asymmetrical quadriparesis which completely reversed after haemodialysis sessions and treating lupus flare up. In our case she presented with quadriparesis which is a rare presentation and hypertensive encephalopathy was not present. PMID:26894110

  15. Epidemiological investigation on causes of the decline in the epidemic situation of human brucellosis%人间布鲁杆菌病疫情下降原因的流行病学调查

    Institute of Scientific and Technical Information of China (English)

    刘晓丽; 赵会生; 陈素良; 孙印旗; 赵旭春; 姜霞; 韩国毅; 李月平; 吴建明; 钱振宇; 刘俊平

    2012-01-01

    目的 探讨人间布鲁杆菌病(以下简称布病)疫情下降原因,为制定防控措施积累科学依据.方法 选择人间布病疫情严重且2010年病例数较2009年大幅度下降的市、县、村作为调查点,收集并调查居民畜牧养殖、畜间疫情、人间布病疫情、防疫措施的变化情况,分析人间布病疫情下降原因.结果 2010年人间布病疫情下降与畜牧存栏量减少、户养殖率下降、养殖人口率下降、畜间布病疫情下降和畜疫户率降低等因素有关.畜牧存栏量大幅度减少的原因是2009年11月实施了严厉的禁牧政策,养殖成本增加,居民弃养或减少了家畜存栏数;由于禁牧导致圈养增多,减少了羊群间布病传播的机会,畜间布病疫情减轻.还发现羊是当地布病的主要传染源.当地居民畜牧养殖行为习惯和健康行为形成不是影响2010年人间布病疫情下降的因素.结论 当地人间布病疫情下降主要原因是当地政府禁牧导致了羊存栏量减少,羊群布病疫情减轻所致.%Objectives To explore the causes of the decline of human brucellosis and provide scientific evidence to develop the measures for the prevention and control of the disease. Methods Survey areas were selected, in which the epidemic situation of human brucellosis was serious and the epidemic situation was significantly declined in 2010 compared with 2009. Materials of resident livestock, livestock brucellosis, human brucellosis and preventive measure changed from 2009 to 2010 were collected and investigated in the villages and the counties. The causes of the decline in human brucellosis were analyzed. Results The decline in human brucellosis in 2010 was related with the decline in livestock breeding stock, farming households rate, population of farming,livestock brucellosis and the number of households with livestock brucellosis. Conclusion The decline in sheep breeding stock and the decrease in sheep brucellosis which were

  16. Association of Acute Interstitial Nephritis with Carnivora, a Venus Flytrap Extract, in a 30-Year-Old Man with Hodgkin’s Lymphoma

    Directory of Open Access Journals (Sweden)

    Susan Ziolkowski

    2014-01-01

    Full Text Available Acute interstitial nephritis (AIN is a common cause of acute kidney injury and has been associated with a variety of medications. This is the case of 30-year-old man with Hodgkin’s lymphoma who on routine labs before chemotherapy was found to have acute nonoliguric renal failure. A kidney biopsy was performed and confirmed the diagnosis of acute interstitial nephritis. The patient had taken several medications including a higher dose of Carnivora, a Venus flytrap extract, composed of numerous amino acids. The medication was discontinued and kidney function improved towards the patient’s baseline indicating that this may be the possible cause of his AIN. Proximal tubular cell uptake of amino acids increasing transcription of nuclear factor-kappaB is a proposed mechanism of AIN from this compound.

  17. The Epidemics of Corruption

    CERN Document Server

    Blanchard, P; Krüger, T; Martin, P; Blanchard, Ph.

    2005-01-01

    We study corruption as a generalized epidemic process on the graph of social relationships. The main difference to classical epidemic processes is the strong nonlinear dependence of the transmission probability on the local density of corruption and the mean field influence of the overall corruption in the society. Network clustering and the degree-degree correlation play an essential role in corruption dynamics. We discuss phase transitions, the influence of the graph structure and the implications for epidemic control. Structural and dynamical arguments are given why strongly hierarchically organized societies like systems with dictatorial tendency are more vulnerable to corruption than democracies. A similar type of modelling can be applied to other social contagion spreading processes like opinion formation, doping usage, social disorders or innovation dynamics.

  18. Dr. Lu Renhe's Experience in Treating Latent Nephritis with Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    Chen Jie

    2005-01-01

    @@ Dr. Lu Renhe of the First Clinical Medical College affiliated to Beijing University of Traditional Chinese Medicine has engaged in clinical practice,teaching and research for more than 40 years and accumulated rich experience of treating various kinds of nephritis, diabetes and their complications.The following is an introduction to his experience of treating latent nephritis.

  19. Lupus nephritis associated with placental site trophoblastic tumor: A case report and review of the literature

    OpenAIRE

    Xiao, Changji; Zhao, Jing; Li, Mengtao; Zhao, Dachun; Xiang, Yang

    2014-01-01

    Highlights • The present case is the first case report of PSTT associated with lupus nephritis. • The patient presented with lupus nephritis as paraneoplastic nephropathy before PSTT discovered, and rapidly achieved complete remission after hysterectomy. • This unusual findings must be interpreted appropriately to achieve the correct diagnosis.

  20. Urinary neutrophil gelatinase-associated lipocalin as a novel biomarker for disease activity in lupus nephritis

    OpenAIRE

    Rubinstein, Tamar; Pitashny, Milena; Levine, Benjamin; Schwartz, Noa; Schwartzman, Julie; Weinstein, Elena; Pego-Reigosa, Jose M.; Lu, Tim Y.-T.; Isenberg, David; Rahman, Anisur; Putterman, Chaim

    2010-01-01

    Objectives. Clinical and laboratory markers in current use have limited specificity and sensitivity for predicting the development of renal disease in lupus patients. In this longitudinal study, we investigated whether urinary neutrophil gelatinase-associated lipocalin (uNGAL) predicts active nephritis and renal flares in lupus patients with and without a history of biopsy-proven lupus nephritis.

  1. High risk of ischemic heart disease in patients with lupus nephritis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Mellemkjaer, Lene; Starklint, Henrik;

    2011-01-01

    To investigate the occurrence of ischemic heart disease (IHD) in a cohort of 104 Danish patients with biopsy-proven lupus nephritis (LN).......To investigate the occurrence of ischemic heart disease (IHD) in a cohort of 104 Danish patients with biopsy-proven lupus nephritis (LN)....

  2. Evaluating Subcriticality during the Ebola Epidemic in West Africa.

    Directory of Open Access Journals (Sweden)

    Wayne T A Enanoria

    Full Text Available The 2014-2015 Ebola outbreak is the largest and most widespread to date. In order to estimate ongoing transmission in the affected countries, we estimated the weekly average number of secondary cases caused by one individual infected with Ebola throughout the infectious period for each affected West African country using a stochastic hidden Markov model fitted to case data from the World Health Organization. If the average number of infections caused by one Ebola infection is less than 1.0, the epidemic is subcritical and cannot sustain itself. The epidemics in Liberia and Sierra Leone have approached subcriticality at some point during the epidemic; the epidemic in Guinea is ongoing with no evidence that it is subcritical. Response efforts to control the epidemic should continue in order to eliminate Ebola cases in West Africa.

  3. Epidemics: Lessons from the past and current patterns of response

    Science.gov (United States)

    Martin, Paul

    2008-09-01

    Hippocrates gave the term 'epidemic' its medical meaning. From antiquity to modern times, the meaning of the word epidemic has continued to evolve. Over the centuries, researchers have reached an understanding of the varying aspects of epidemics and have tried to combat them. The role played by travel, trade, and human exchanges in the propagation of epidemic infectious diseases has been understood. In 1948, the World Health Organization was created and given the task of advancing ways of combating epidemics. An early warning system to combat epidemics has been implemented by the WHO. The Global Outbreak Alert and Response Network (GOARN) is collaboration between existing institutions and networks that pool their human and technical resources to fight outbreaks. Avian influenza constitutes currently the most deadly epidemic threat, with fears that it could rapidly reach pandemic proportions and put several thousands of lives in jeopardy. Thanks to the WHO's support, most of the world's countries have mobilised and implemented an 'Action Plan for Pandemic Influenza'. As a result, most outbreaks of the H5N1 avian flu virus have so far been speedily contained. Cases of dengue virus introduction in countries possessing every circumstance required for its epidemic spread provide another example pertinent to the prevention of epidemics caused by vector-borne pathogens.

  4. Renal Biopsy in Patients Developing Severe Pre-eclampsia: Crescentic IgA Nephritis

    Directory of Open Access Journals (Sweden)

    Dilek GİBYELİ GENEK

    2011-09-01

    Full Text Available IgA nephritis is known as the most common glomerulonephritis and a disease with good prognosis. Acute renal failure, nephrotic syndrome and malignant hypertension can be seen less than 10% of patients with IgA nephritis. Acute renal failure occurs due to crescentic IgA nephritis or tubular occlusion or tubuler injury due to severe glomerular hematuria. IgA nephritis in pregnancy have a good prognosis. On the other hand; the most common renal complication during pregnancy is development of preeclampsia. Preeclampsia occurs in approximately 5% of all pregnancies. Underlying renal pathology increases the risk of preeclampsia. We presented this case with cresentic IgA nephritis with severe preeclampsia to emphasize this issue.

  5. The Obesity Epidemic

    Centers for Disease Control (CDC) Podcasts

    2011-07-18

    Learn about obesity and the community initiatives taking place to prevent and reduce this epidemic.  Created: 7/18/2011 by National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity and Obesity.   Date Released: 7/18/2011.

  6. Pulse cyclophospamide in severe lupus nephritis: Southern Indian experience

    Directory of Open Access Journals (Sweden)

    Das Uttara

    2010-01-01

    Full Text Available To evaluate the efficacy and safety of the monthly pulse IV cyclophosphamide (IVC therapy in patients with severe lupus nephritis, we studied 39 patients of lupus nephritis on IVC therapy between 1998 to 2002. Single monthly cyclophosphamide (0.75-1 g/m² was infused intravenously with oral prednisolone (0.5 mg/kg per day and appropriate hydration. Of the 39 pa-tients 25 (86.2% patients were females and 4 (13.8% were males. Six (2% cases had irregular follow-up and 3 patients had expired during the initial cycles and were excluded from the study. The mean age was 25.6 + 6.72 years (range 10-40 years. The mean duration of the disease from the onset to renal biopsy was 24.2 + 18.5 months. The clinical presentations included nephrotic syndrome (34.5%, acute glomerulonephritis (31.0%, Pyrexia of unknown origin (PUO (10.3%, and rapidly progressive renal failure (6.7%. Renal insufficiency was present in 47.2% cases. Twenty-two (75.9% patients had diffuse proliferative glomerulonephritis (class IV, 6 (20.7% focal proliferative glomerulonephritis (class III, and one (3.4% class Vd. After a mean follow-up of 15.8 months, out of 29 patients, 13 (44.8% had achieved complete remission, 7 (24.1% partial remission and 9 (31.0% cases did not respond to the therapy. Side effects of the therapy included vomiting and nausea (100% and hair loss during the first few doses of IVC. In addition, one case had dysfunctional uterine bleeding and two patients had avascular necrosis of femoral head. We conclude that our data indicate that IVC in severe lupus nephritis is effective in Indian patients though longer follow-up is required.

  7. Diagnosis of IgG4-Related Tubulointerstitial Nephritis

    OpenAIRE

    Raissian, Yassaman; Nasr, Samih H.; Larsen, Christopher P.; Colvin, Robert B.; Smyrk, Thomas C.; Takahashi, Naoki; Bhalodia, Ami; Sohani, Aliyah R.; ZHANG, LIZHI; Chari, Suresh; Sethi, Sanjeev; Fidler, Mary E.; Cornell, Lynn D

    2011-01-01

    IgG4-related systemic disease is an autoimmune disease that was first recognized in the pancreas but also affects other organs. This disease may manifest as tubulointerstitial nephritis (IgG4-TIN), but its clinicopathologic features in the kidney are not well described. Of the 35 patients with IgG4-TIN whose renal tissue specimens we examined, 27 (77%) had acute or progressive chronic renal failure, 29 (83%) had involvement of other organ systems, and 18 of 23 (78%) had radiographic abnormali...

  8. Expression of major histocompatibility complex class II antigens in porcine leptospiral nephritis.

    Science.gov (United States)

    Radaelli, E; Del Piero, F; Aresu, L; Sciarrone, F; Vicari, N; Mattiello, S; Tagliabue, S; Fabbi, M; Scanziani, E

    2009-09-01

    Class II major histocompatibility complex (MHCII) is required for the presentation of antigens to CD4 helper T cells. During nephritis, not only primary antigen presenting cells such as histiocytes and lymphocytes, but also cytokine-stimulated tubular epithelial cells express MHCII. Leptospirosis in fattening pigs is characterized by several degrees of nephritis, from absence of lesions to severe multifocal tubulo-interstitial inflammation. Renal tissue from 20 8-month-old pigs with spontaneous nephritis and 6 control pigs without renal lesions were investigated for leptospirosis by indirect immunohistochemistry (IHC) and polymerase chain reaction (PCR). IHC for MHCII also was performed on renal samples. Serum samples were tested for different serovars of Leptospira interrogans. Control pigs were free of interstitial nephritis and negative for leptospirosis by all tests. In pigs with nephritis, serology was positive for serovar Pomona in 19/20 pigs. In 16 of these 19 pigs, leptospiral renal infection was confirmed by PCR and/or indirect IHC. Nephritic lesions were classified histologically into perivascular lymphocytic (4 pigs), lymphofollicular (6 pigs), lymphohistiocytic (8 pigs), and neutrophilic (2 pigs) pattern. MHCII expression by histiocytes and lymphocytes was observed in all lesions. Prominent MHCII expression in regenerating tubular epithelium was observed in lymphofollicular and lymphohistiocytic nephritis. No tubular colocalization between leptospiral and MHCII antigen was observed. Results suggest that during leptospiral nephritis, MHCII contributes to the intensity of the inflammatory response. Furthermore de novo MHCII expression in regenerating tubules may play a role in the defence mechanism against leptospiral tubular colonization. PMID:19179617

  9. Epidemic outbreaks on structured populations

    CERN Document Server

    Vazquez, Alexei

    2007-01-01

    Our chances to halt epidemic outbreaks rely on how accurately we represent the population structure underlying the disease spread. When analyzing global epidemics this force us to consider metapopulation models taking into account intra- and inter-community interactions. Recently Watts et al introduced a metapopulation model which accounts for several features observed in real outbreaks [Watts et al, PNAS 102, 11157 (2005)]. In this work I provide an analytical solution to this model, enhancing our understanding of the model and the epidemic outbreaks it represents. First, I demonstrate that depending on the intra-community expected outbreak size and the fraction of social bridges the epidemic outbreaks die out or there is a finite probability to observe a global epidemics. Second, I show that the global scenario is characterized by resurgent epidemics, their number increasing with increasing the intra-community average distance between individuals. Finally, I present empirical data for the AIDS epidemics sup...

  10. Treatment of intractable lupus nephritis with total lymphoid irradiation

    International Nuclear Information System (INIS)

    Ten patients with lupus nephritis and marked proteinuria (3.9 g or more/d) that did not respond adequately to treatment with prednisone alone or prednisone in combination with azathioprine were treated with total lymphoid irradiation in an uncontrolled feasibility study. Within 6 weeks after the start of total lymphoid irradiation, the serum albumin level rose in all patients in association with a reduction in the serum level of anti-DNA antibodies, an increase in the serum complement level, or both. Improvement in these variables persisted in eight patients followed for more than 1 year, with the stabilization or reduction of the serum creatinine level. Urinary leakage of albumin was substantially reduced in all patients. Side effects associated with radiotherapy included transient constitutional complaints in ten patients, transient blood element depressions in three, localized viral and bacterial infections in four, and ovarian failure in one. The results suggest that total lymphoid irradiation may provide an alternative to cytotoxic drugs in the treatment of lupus nephritis

  11. Treatment of intractable lupus nephritis with total lymphoid irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Strober, S.; Field, E.; Hoppe, R.T.; Kotzin, B.L.; Shemesh, O.; Engleman, E.; Ross, J.C.; Myers, B.D.

    1985-04-01

    Ten patients with lupus nephritis and marked proteinuria (3.9 g or more/d) that did not respond adequately to treatment with prednisone alone or prednisone in combination with azathioprine were treated with total lymphoid irradiation in an uncontrolled feasibility study. Within 6 weeks after the start of total lymphoid irradiation, the serum albumin level rose in all patients in association with a reduction in the serum level of anti-DNA antibodies, an increase in the serum complement level, or both. Improvement in these variables persisted in eight patients followed for more than 1 year, with the stabilization or reduction of the serum creatinine level. Urinary leakage of albumin was substantially reduced in all patients. Side effects associated with radiotherapy included transient constitutional complaints in ten patients, transient blood element depressions in three, localized viral and bacterial infections in four, and ovarian failure in one. The results suggest that total lymphoid irradiation may provide an alternative to cytotoxic drugs in the treatment of lupus nephritis.

  12. Renal flare prediction and prognosis in lupus nephritis Hispanic patients.

    Science.gov (United States)

    Mejía-Vilet, J M; Córdova-Sánchez, B M; Arreola-Guerra, J M; Morales-Buenrostro, L E; Uribe-Uribe, N O; Correa-Rotter, R

    2016-03-01

    We performed a retrospective cohort analysis focusing on lupus nephritis renal flare incidence and outcome predictors. One hundred and eighteen patients with biopsy-proven lupus nephritis were segregated by induction/maintenance regimes. The primary outcome was the proportion of patients experiencing renal flare. Secondary assessment included doubling of serum creatinine and development of end-stage renal disease. After a median follow-up of 31 months (interquartile range 21-46) from the date of response to induction therapy, 47 patients (39.8%) developed a renal flare. Azathioprine-maintained patients had a higher risk of renal flare compared with mycophenolate mofetil-maintained patients (hazard ratio 2.53, 95% confidence interval 1.39-4.59, p flare on multivariate analysis. Ten patients progressed to end-stage renal disease (8.5%) by a median 32.5 months. Age (hazard ratio 0.88, 0.77-0.99, p = 0.05), complete remission after induction therapy (hazard ratio 0.08, 0.01-0.94, p = 0.04) and severe nephritic flare (hazard ratio 13.6, 1.72-107.7, p = 0.01) were associated with end-stage renal disease development. Azathioprine maintenance therapy is associated with a higher incidence of relapse in the Mexican-mestizo population. Younger age and nephritic flares predict development of end-stage renal disease. PMID:26405028

  13. Proximity Networks and Epidemics

    CERN Document Server

    Toroczkai, Z

    2007-01-01

    Disease spread in most biological populations requires the proximity of agents. In populations where the individuals have spatial mobility, the contact graph is generated by the "collision dynamics" of the agents, and thus the evolution of epidemics couples directly to the spatial dynamics of the population. We first briefly review the properties and the methodology of an agent-based simulation (EPISIMS) to model disease spread in realistic urban dynamic contact networks. Using the data generated by this simulation, we introduce the notion of dynamic proximity networks which takes into account the relevant time scales for disease spread: contact duration, infectivity period and rate of contact creation. This approach promises to be a good candidate for a unified treatment of epidemic types that are driven by agent collision dynamics. In particular, using a simple model, we show that it can can account for the observed qualitative differences between the degree distributions of contact graphs of diseases with ...

  14. Epidemics on Interconnected Networks

    CERN Document Server

    Dickison, M; Stanley, H E

    2012-01-01

    Populations are seldom completely isolated from their environment. Individuals in a particular geographic or social region may be considered a distinct network due to strong local ties, but will also interact with individuals in other networks. We study the susceptible-infected-recovered (SIR) process on interconnected network systems, and find two distinct regimes. In strongly-coupled network systems, epidemics occur simultaneously across the entire system at a critical infection strength $\\beta_c$, below which the disease does not spread. In contrast, in weakly-coupled network systems, a mixed phase exists below $\\beta_c$ of the coupled network system, where an epidemic occurs in one network but does not spread to the coupled network. We derive an expression for the network and disease parameters that allow this mixed phase and verify it numerically. Public health implications of communities comprising these two classes of network systems are also mentioned.

  15. Critical care during epidemics

    OpenAIRE

    Rubinson, Lewis; O'Toole, Tara

    2005-01-01

    We recommend several actions that could improve hospitals' abilities to deliver critical care during epidemics involving large numbers of victims. In the absence of careful pre-event planning, demand for critical care services may quickly exceed available intensive care unit (ICU) staff, beds and equipment, leaving the bulk of the infected populace without benefit of potentially lifesaving critical care. The toll of death may be inversely proportional to the ability to augment critical care c...

  16. Chikungunya: a potentially emerging epidemic?

    Directory of Open Access Journals (Sweden)

    Michelle M Thiboutot

    Full Text Available Chikungunya virus is a mosquito-borne emerging pathogen that has a major health impact in humans and causes fever disease, headache, rash, nausea, vomiting, myalgia, and arthralgia. Indigenous to tropical Africa, recent large outbreaks have been reported in parts of South East Asia and several of its neighboring islands in 2005-07 and in Europe in 2007. Furthermore, positive cases have been confirmed in the United States in travelers returning from known outbreak areas. Currently, there is no vaccine or antiviral treatment. With the threat of an emerging global pandemic, the peculiar problems associated with the more immediate and seasonal epidemics warrant the development of an effective vaccine. In this review, we summarize the evidence supporting these concepts.

  17. Clinical Observations on Treatment of Lupus Nephritis with Kidney-nourishing and Toxin-removing Method——A Report of 60 Cases

    Institute of Scientific and Technical Information of China (English)

    Qi Airong; Yi Tiegang; Liu Xueyao; Hong Qinguo; Duan Shumin

    2006-01-01

    Objective:To observe the therapeutic effect of Si Cao Tang (四草汤), a TCM decoction for nourishing kidney and removing toxin, on lupus nephritis. Method: 60 patients with lupus nephritis were divided into a treatment group and a control group with 30 cases in each group. Hormonotherapy with standard course of treatment plus CTX shock was used not only in the control group, but also in the treatment group. However, Si Cao Tang was added in the treatment group. Result: Edema, swelling pain in the joints, skin rash and hematuria were obviously alleviated in the treatment group as compared to the control group with significant difference (P<0.05). Complement C3 level was very obviously enhanced,and blood sedimentation, antinuclear antibody, ds-DNA antibody and IgG were very obviously reduced in the treatment group as compared to the control group with very significant difference (P<0.01).Furthermore, the incidences of hepatic damage, baldness, menstrual disorder and secondary infection in the treatment group were lower than those in the control group with significant difference (P<0.05).However, there was no significant difference (P>0.05) between the two groups in reducing proteinufia,blood creatinine, urea nitrogen and antinuclear antibody titer as well as enhancing albumin. Conclusion:Si Cao Tang can effectively treat lupus nephritis with its therapeutic effect being better than that of hormonotherapy with standard course of treatment plus CTX shock and the incidence of its side effects obviously reduced. The decoction can effectively control lupus activity and treat and prevent glomerulosclerosis caused by lupus nephritis.

  18. The renal metallothionein expression profile is altered in human lupus nephritis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Penkowa, Milena; Andersen, Claus Bøgelund;

    2008-01-01

    -I+II expression profile is altered during lupus nephritis. METHODS: Immunohistochemistry was performed on renal biopsies from 37 patients with lupus nephritis. Four specimens of healthy renal tissue served as controls. Clinicopathological correlation studies and renal survival analyses were performed by means of...... standard statistical methods. RESULTS: Proximal tubules displaying epithelial cell MT-I+II depletion in combination with luminal MT-I+II expression were observed in 31 out of 37 of the lupus nephritis specimens, but not in any of the control sections (P = 0.006). The tubular MT score, defined as the median...... number of proximal tubules displaying this MT expression pattern per high-power microscope field (40x magnification), was positively correlated to the creatinine clearance in the lupus nephritis cohort (P = 0.01). Furthermore, a tubular MT score below the median value of the cohort emerged as a...

  19. [Cholera++ epidemic in Kenya].

    Science.gov (United States)

    Paugam, H

    1999-03-01

    A cholera epidemic in 1997 followed on the heels of the 1992 epidemic that claimed thousands of victims in Kenya. This time, it emerged in the Migori district near the Tanzanian border, when a woman who had married in Tanzania brought her five-month-old baby to visit her parents. The infant, who contracted serious diarrhea and vomiting, died before the mother could reach a dispensary. During the funeral, a perfect opportunity for the disease to spread, those attending observed the traditional ritual of touching the corpse, and then ate and drank with the next of kin. Many developed symptoms of cholera, and several died in the next few days, even before first aid could be administered. At the Public Health Laboratory in Nairobi, analyses confirmed the presence of the Ogawa strain of Vibrio cholerae. Given the global reputation of Médecins Sans Frontières [Doctors Without Borders] in the field of cholera, the head of public health for Homa Bay District issued a call for help in August 1997, asking the team to provide preventive solutions and assess the gravity of the situation. Despite intense logistical, technical and health initiatives, the epidemic spread like wildfire. Five months after the initial outbreak, in February 1998, two Canadian nurses working for MSF in Homa Bay hurriedly surveyed the situation in Nyanza Province, which has a population of three million. The author accompanied one of these nurses, Joceline Roy, a Quebecer in her forties, on a tour that lasted more than 15 hours. Roy worked conscientiously, with great precision and energy. This narrative conveys much more than the fatigue and hazards of travel in the developing world; it tells the story of an important, but little publicized, aspect of nursing. PMID:10362941

  20. Erythema Infectiosum: An Epidemic That Mimics Rubeola

    OpenAIRE

    Galvon, Fran A. C.

    1982-01-01

    Erythema infectiosum occurs mainly in epidemics among school children and is often misdiagnosed as rubella, rubeola, or another exanthem. This may cause unnecessary treatment and prolonged absence from school. Etiology is presumably viral, and mode of transmission presumably droplet nuclei, but neither of these factors are proven. Diagnosis at present is based on clinical information only. This paper reports the investigation of 80 cases within a school, through the cooperation of community p...

  1. Human enterovirus 71 epidemics: what's next?

    OpenAIRE

    Yip, Cyril C. Y.; Lau, Susanna K. P.; Woo, Patrick C. Y.; Yuen, Kwok-Yung

    2013-01-01

    Human enterovirus 71 (EV71) epidemics have affected various countries in the past 40 years. EV71 commonly causes hand, foot and mouth disease (HFMD) in children, but can result in neurological and cardiorespiratory complications in severe cases. Genotypic changes of EV71 have been observed in different places over time, with the emergence of novel genotypes or subgenotypes giving rise to serious outbreaks. Since the late 1990s, intra- and inter-typic recombination events in EV71 have been inc...

  2. Acute Interstitial Nephritis and Membranous Nephropathy in the Context of IgG4-Related Disease

    OpenAIRE

    Stylianou, Kostas; Maragkaki, Eleftheria; Tzanakakis, Michael; Stratakis, Stavros; Gakiopoulou, Hariklia; Daphnis, Eugene

    2014-01-01

    We present the case of a patient with IgG4-related disease, which manifested in an asynchronous manner as vitiligo, cholecystitis, sialadenitis, lymphadenopathy, facial palsy and kidney dysfunction. The patient underwent a renal biopsy, and a presumptive diagnosis of lupus nephritis was made due to compatible clinical and immunological findings. The biopsy revealed IgG4-related kidney disease with severe interstitial nephritis and membranous nephropathy. Corticosteroids treatment restored all...

  3. Measuring eosinophiluria, urinary eosinophil cationic protein and urinary interleukin-5 in patients with Lupus Nephritis

    OpenAIRE

    Brito, Tereza Neuma Souza; Vilar, Maria José; Almeida, José Bruno; Faria, Ana Luiza Souza Brito; Medeiros, Sarah Dantas Viana; Medeiros, Maria Carmo Cardoso; Silva, Edna Marques Araújo; Silva, Vanessa Marques Araújo; Souza, Luanda Bárbara F Canário; Arruda, Luisa Karla P; Costa, Tatiana Xavier; Junior, Geraldo Barroso Cavalcanti; Oliveira, Antonio G; Sales, Valéria Soraya Farias

    2014-01-01

    Background Urine is increasingly becoming an attractive biological fluid in clinical practice due to being an easily obtained, non-invasive sampling method, containing proteins and peptides. The aim of this study was to investigate eosinophiluria, urinary eosinophil cationic protein (uECP) and urinary IL-5 (uIL-5) in patients with Lupus Nephritis. Methods Seventy-four patients with SLE—20 with clinical and laboratory evidence of lupus nephritis (LN group) and 54 without evidence of renal invo...

  4. Association of mannan-binding lectin gene polymorphisms with progression of severe lupus nephritis

    Institute of Scientific and Technical Information of China (English)

    常欣蓓

    2014-01-01

    Objective To investigate the association of single nucleotide polymorphisms(SNPs)of the mannan-binding lectin(MBL)gene with serum levels,development,progression and prognosis of severe lupus nephritis(LN).Methods A total of 107 severe lupus nephritis patients were enrolled in the study from January 2003 to October2013.Integrated capillary electrophoresis was used to detect MBL gene polymorphism in peripheral blood

  5. Long-term mortality and renal outcome in a cohort of 100 patients with lupus nephritis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Dreyer, Lene; Kamper, Anne-Lise;

    2010-01-01

    To evaluate the long-term mortality and renal outcome in a cohort of Danish patients with lupus nephritis (LN) and to identify outcome predictors among findings registered at the time of the first renal biopsy.......To evaluate the long-term mortality and renal outcome in a cohort of Danish patients with lupus nephritis (LN) and to identify outcome predictors among findings registered at the time of the first renal biopsy....

  6. Effects of aspirin, prednisolone and indomethacin on nephrotoxic serum nephritis in the rat.

    OpenAIRE

    Kurokawa, H; Sakamoto, K.

    1982-01-01

    1 The effects of aspirin, prednisolone, and indomethacin on nephrotoxic serum nephritis in rats was studied. The nephritis was induced by a single intravenous injection of nephrotoxic serum (NTS, rabbit anti-serum against the water-soluble renal antigen of the rat). The injection of NTS induced the heterologous phase of proteinuria (within a day after NTS injection) and then the autologous phase (5 to 7 days after NTS injection). The effect of drugs given before the NTS (i.e. prophylactically...

  7. Lupus cystitis with hydroureteronephrosis in a young female with lupus nephritis

    OpenAIRE

    Tony Ete; Sumantro Mondal; Debanjali Sinha; Soumik Sarkar; Abhirup Bhunia; Shingamlung Kamei; Jyotirmoy Pal; Alakendu Ghosh

    2014-01-01

    Systemic lupus erythematosus is an autoimmune, multisystem disorder. Lupus nephritis is a common manifestation of SLE. Though rare, SLE may also involve lower urinary tract in the form of lupus cystitis with associated complications like hydroureteronephrosis. Lupus cystitis may present with gastro intestinal (GI) symptoms as the initial manifestation. The case reported herein is concerned with concomitant lupus nephritis and cystitis in a young female who also had associated GI symptoms and ...

  8. An Unusual Initial Presentation of Lupus Nephritis as a Renal Mass

    OpenAIRE

    Remi Goupil; Annie-Claire Nadeau-Fredette; Virginie Royal; Alexandre Dugas; Jean-Philippe Lafrance

    2015-01-01

    Lupus nephritis is a frequent manifestation of systemic lupus erythematous. Lupus nephritis usually presents with abnormal urinalysis, proteinuria, and/or renal insufficiency. We report a case of a 48-year-old woman who underwent partial nephrectomy for a fortuitously discovered solid enhancing left kidney mass. No neoplastic cells were found in the biopsy specimen; however, the pathology findings were compatible with immune complex glomerulonephritis with a predominantly membranous distribut...

  9. Development of FET-type albumin sensor for diagnosing nephritis.

    Science.gov (United States)

    Park, Keun-Yong; Sohn, Young-Soo; Kim, Chang-Kyu; Kim, Hong-Seok; Bae, Young-Seuk; Choi, Sie-Young

    2008-07-15

    An albumin biosensor based on a potentiometric measurement using Biofield-effect-transistor (BioFET) has been designed and fabricated, and its characteristics were investigated. The BioFET was fabricated using semiconductor integrated circuit (IC) technology. The gate surface of the BioFET was chemically modified by newly developed self-assembled monolayer (SAM) synthesized by a thiazole benzo crown ether ethylamine (TBCEA)-thioctic acid to immobilize anti-albumin. SAM formation, antibody immobilization, and antigen-antibody interaction were verified using surface plasmon resonance (SPR). The output voltage changes of the BioFET with respect to various albumin concentrations were obtained. Quasi-reference electrode (QRE) and reference FET (ReFET) has been integrated with the BioFET, and its output characteristic was investigated. The results demonstrate the feasibility of the BioFET as the albumin sensor for diagnosing nephritis. PMID:18440216

  10. The Obesity Epidemic: Why and How the Government Must Act

    OpenAIRE

    Wolf, Emily

    2004-01-01

    This paper calls for the United States government – including, but not limited to, the Food and Drug Administration, the Federal Trade Commission, and Health and Human Services – to take definitive and aggressive steps to combat the nationwide obesity epidemic. After providing a history of how and why we now find ourselves in the midst of an obesity epidemic, and highlighting the specifics of our current dilemma, the paper details the devastating causes a...

  11. Renal Localization of {sup 67}Ga Citrate in Noninfectious Nephritis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Wook; Jeong, Min Soo; Rhee, Sunn Kgoo; Kim, Sam Yong; Shin, Young Tai; Ro, Heung Kyu [Chungnam University College of Medicine, Deajeon (Korea, Republic of)

    1992-07-15

    {sup 67}Ga citrate scan has been requested for detection or follow-up of inflammatory or neoplastic disease. Visualization of {sup 67}Ga citrate in the kidneys at 48 and 72 hr post injection is usually interpreted as evidence of renal pathology. But precise mechanisms of abnormal {sup 67}Ga uptake in kidneys were unknown. We undertook a study to determine the clinical value of {sup 67}Ga citrate imaging of the kidneys in 68 patients with primary or secondary nephropathy confirmed by renal biopsy and 66 control patients without renal disease. Renal uptake in 48 to 72 hr images was graded as follows: Grade 0=background activity;1=faint uptake greater than background; 2=definite uptake, but less than lumbar vertebrae;3 same uptake as lumbar vertebrae, but less than liver; 4=same or higher uptake than liver. The results were as follows. 1) 42 of 68(62%) patients with noninfectious nephritis showed grade 2 or higher {sup 67}Ga renal uptake but only 10 percent of control patients showed similar uptake. 2) In 14 patients with systemic lupus erythematosus, 8 of 9 (89%) patients with lupus nephritis exhibited marked renal uptake. 3) 36 of 41 patients (88%) with combined nephrotic syndrome showed Grade 2 or higher renal uptake. 4) Renal {sup 67}Ga uptake was correlated with clinical severity of nephrotic syndrome determined by serum albumin level, 24 hr urine protein excretion and serum lipid levels. 5) After complete remission of nephrotic syndrome, renal uptake in all 8 patients who were initially Grade 3 or 4, decreased to Grade 1 or 0. In conclusion, we think that the mechanism of renal {sup 67}Ga uptake in nephrotic syndrome might be related to the pathogenesis of nephrotic syndrome. In systemic lupus erythematosus, {sup 67}Ga citrate scan is useful in predicting renal involvement.

  12. Drug-induced acute tubulointerstitial nephritis: a case with elevated urinary cadmium.

    Science.gov (United States)

    Subat-Dezulović, Mirna; Slavić, Irena; Rozmanić, Vojko; Persić, Mladen; Medjimurec, Branka; Sćukanec-Spoljar, Mira

    2002-05-01

    Acute tubulointerstitial nephritis (ATIN) has many different causes, but is most frequently caused by drugs. We report a 13-year-old vegetarian girl with drug-induced ATIN, confirmed by renal biopsy, and simultaneous occurrence of elevated urinary cadmium. Four weeks prior to admission she had been treated with antibiotics and acetaminophen for respiratory infection, and remaining febrile, was treated with different "home-made" herbal mixtures. She presented with acute non-oliguric renal failure, tubular dysfunction, and sterile pyuria, but without skin rash or edema. Laboratory data showed a raised erythrocyte sedimentation rate, normal white blood count with eosinophilia, and a serum creatinine of 245 micromol/l. Urinalysis was remarkable for glycosuria, tubular proteinuria, and elevated beta(2)-microglobulin and N-acetyl-beta-D-glucosaminidase excretion. Immunoserological tests characteristic of acute glomerulonephritis and systemic diseases were negative. She was treated with steroids and her renal function improved. Follow-up analyses disclosed normal urinary cadmium and enzyme excretion within 6 months. Heavy metal analysis of herbal preparations that she had taken confirmed the presence of cadmium, but within approved concentrations. In conclusion, elevated urinary cadmium in the case of drug-induced ATIN may be assumed to be an accidental finding. However, consumption of different herbs containing cadmium and cadmium-induced nephro-toxicity could be the reason for such serious renal damage. PMID:12042900

  13. Prostaglandin E2 promotes cellular recovery from established nephrotoxic serum nephritis in mice, prosurvival, and regenerative effects on glomerular cells

    OpenAIRE

    Kvirkvelia, Nino; McMenamin, Malgorzata; Chaudhary, Kapil; Bartoli, Manuela; Madaio, Michael P.

    2013-01-01

    We postulated that prostaglandin E2 (PGE2), which exhibits regulatory functions to control immune-mediated inflammation, fibrosis, oxidative stress, and tissue/cellular regeneration, has the potential to improve the course of nephritis. Therefore, the therapeutic potential of prostanoid on established nephritis in mice was evaluated focusing on its role on renal cellular recovery, with emphasis on its cytoprotecting and growth-promoting effects. Acute nephritis was induced in mice by single i...

  14. Psychogenic epidemics and work.

    Science.gov (United States)

    Olkinuora, M

    1984-12-01

    Psychogenic epidemics cover various forms of collective behavior and include mass hysteria, mass psychogenic illness, and hysterical contagion for which no physical explanation can be found. The typical course of a psychogenic epidemic at a workplace progresses from sudden onset, often with dramatic symptoms, to a rapidly attained peak that draws much publicity and is followed by quick disappearance of the symptoms. Over 90% of the affected persons are women, and the symptoms range from dizziness, vomiting, nausea, and fainting to epileptic-type seizures, hyperventilation, and skin disorders. The background mechanisms are thought to be generalized beliefs and triggering events which create a sense of threat that leads to a physiological state of arousal. This state, in turn, creates new beliefs which give meaning to the sense of arousal. The new belief spreads through sociometric channels. Predisposing factors include boredom, pressure to produce, physical stressors, poor labor-management relations, and impaired interpersonal communications, and lack of social support. It is important that a thorough investigation be carried out in all instances. Investigation is not only necessary for diagnosis, but it also reassures the management, the employees, and the press that physical factors are unlikely to be responsible for the disease. PMID:6535252

  15. Anti-dsDNA, anti-Sm antibodies, and the lupus anticoagulant: significant factors associated with lupus nephritis

    OpenAIRE

    Alba, P.; L. Bento; Cuadrado, M; Karim, Y; Tungekar, M; Abbs, I; Khamashta, M; D'Cruz, D; Hughes, G.

    2003-01-01

    Background: Lupus nephritis (LN) is a common manifestation in patients with systemic lupus erythematosus (SLE). Autoantibodies and ethnicity have been associated with LN, but the results are controversial.

  16. Insights into the epidemiology and management of lupus nephritis from the US rheumatologist's perspective.

    Science.gov (United States)

    Hoover, Paul J; Costenbader, Karen H

    2016-09-01

    Lupus nephritis is a common and severe manifestation of systemic lupus erythematosus that disproportionately affects nonwhites and those in lower socioeconomic groups. This review discusses recent data on the incidence, prevalence, and outcomes of patients with lupus nephritis with a focus on low-income US Medicaid patients. We also review recent guidelines on diagnosis, treatment, and screening for new onset and relapses of lupus nephritis. Finally, we discuss the management of lupus nephritis from a rheumatologist's perspective, including vigilance for the common adverse events related to disease and treatment, and we review prevention and new treatment strategies. PMID:27344205

  17. Flu pandemics: homeopathic prophylaxis and definition of the epidemic genius

    Directory of Open Access Journals (Sweden)

    Renan Marino

    2009-09-01

    Full Text Available Recent studies on viral genetics establish swine-H1N1 – responsible for the ongoing pandemics – as a remainder or continuation of the agent causing the flu epidemics of 1918. This study aimed at analyzing whether this common etiology also result in significant correlations of clinical manifestations. To do so, data were collected to compare the clinical evolution of cases in the 1918 and 2009 epidemics.  This historical revision was the ground for evaluating the response to treatment including homeopathy in the former epidemics. It is discussed the convenience of including homeopathic prophylaxis grounded on the diagnosis of the epidemic genius among public health actions.

  18. Granulomatous interstitial nephritis secondary to chronic lymphocytic leukemia/small lymphocytic lymphoma.

    Science.gov (United States)

    Nasr, Samih H; Shanafelt, Tait D; Hanson, Curtis A; Fidler, Mary E; Cornell, Lynn D; Sethi, Sanjeev; Chaffee, Kari G; Morris, Joseph; Leung, Nelson

    2015-06-01

    Granulomatous interstitial nephritis (GIN) is an uncommon pathologic lesion encountered in 0.5% to 5.9% of renal biopsies. Drugs, sarcoidosis, and infections are responsible for most cases of GIN. Malignancy is not an established cause of GIN. Here, we report a series of 5 patients with GIN secondary to chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Patients were mostly elderly white males with an established history of CLL/SLL who presented with severe renal impairment (median peak serum creatinine, 7.3 mg/dL), leukocyturia, and mild proteinuria. One had nephromegaly. In 2 patients, the development and relapse of renal insufficiency closely paralleled the level of lymphocytosis. Kidney biopsy in all patients showed GIN concomitant with CLL/SLL leukemic interstitial infiltration. Granulomas were nonnecrotizing and epithelioid and were associated with giant cells. One biopsy showed granulomatous arteritis. One patient had a granulomatous reaction in lymph nodes and skin. Steroids with/without CLL/SLL-directed chemotherapy led to partial improvement of kidney function in all patients except 1 who had advanced cortical scarring on biopsy. In conclusion, we report an association between CLL/SLL and GIN. Patients typically present with severe renal failure due to both GIN and leukemic interstitial infiltration, which tends to respond to steroids with/without CLL/SLL-directed chemotherapy. The pathogenesis of GIN in this clinical setting is unknown but may represent a local hypersensitivity reaction to the CLL/SLL tumor cells. PMID:25795422

  19. Intractable membranous lupus nephritis showing selective improvement of subepithelial deposits with tacrolimus therapy: a case report.

    Science.gov (United States)

    Nonaka, Kanae; Ubara, Yoshifumi; Suwabe, Tatsuya; Takaichi, Kenmei; Oohashi, Kenichi

    2013-08-01

    A 37-year-old female patient was admitted for evaluation of nephrotic proteinuria refractory to prednisolone and other immunosuppressants in 2004. On admission, urinary protein loss was 16 g/d. Anti-ds DNA antibody was positive and hypocomplementemia was detected. Renal biopsy revealed membranous lupus nephritis. Because 5 cyclophosphamide pulse therapies did not have an effect, tacrolimus was started at 3 mg daily. Proteinuria decreased to 4.8 g/d after 5 months and was antids DNA antibody remained positive and hypocomplementemia persisted. Repeat renal biopsy revealed thinning of the glomerular capillary walls and disappearance of subepithelial electron-dense deposits. However, the subendothelial and mesangial deposits were unchanged. In this patient, proteinuria refractory to various immunosuppressants including cyclosporine A improved after administration of tacrolimus, and selective disappearance of subepithelial deposits was seen histologically. This is the first histological evidence that tacrolimus therapy may cause removal of subepithelial deposits, which are separated from the circulation by the glomerular basement membrane. This finding is supported by experimental data that tacrolimus selectively block the binding of FK-binding protein 12 to transient receptor potential-cation channel 6, resulting in normalization of affected podocytes. PMID:22541676

  20. Renal Dnase1 enzyme activity and protein expression is selectively shut down in murine and human membranoproliferative lupus nephritis.

    Directory of Open Access Journals (Sweden)

    Svetlana N Zykova

    Full Text Available BACKGROUND: Deposition of chromatin-IgG complexes within glomerular membranes is a key event in the pathogenesis of lupus nephritis. We recently reported an acquired loss of renal Dnase1 expression linked to transformation from mild to severe membranoproliferative lupus nephritis in (NZBxNZWF1 mice. As this may represent a basic mechanism in the progression of lupus nephritis, several aspects of Dnase1 expression in lupus nephritis were analyzed. METHODOLOGY/PRINCIPAL FINDINGS: Total nuclease activity and Dnase1 expression and activity was evaluated using in situ and in vitro analyses of kidneys and sera from (NZBxNZWF1 mice of different ages, and from age-matched healthy controls. Immunofluorescence staining for Dnase1 was performed on kidney biopsies from (NZBxNZWF1 mice as well as from human SLE patients and controls. Reduced serum Dnase1 activity was observed in both mesangial and end-stage lupus nephritis. A selective reduction in renal Dnase1 activity was seen in mice with massive deposition of chromatin-containing immune complexes in glomerular capillary walls. Mice with mild mesangial nephritis showed normal renal Dnase1 activity. Similar differences were seen when comparing human kidneys with severe and mild lupus nephritis. Dnase1 was diffusely expressed within the kidney in normal and mildly affected kidneys, whereas upon progression towards end-stage renal disease, Dnase1 was down-regulated in all renal compartments. This demonstrates that the changes associated with development of severe nephritis in the murine model are also relevant to human lupus nephritis. CONCLUSIONS/SIGNIFICANCE: Reduction in renal Dnase1 expression and activity is limited to mice and SLE patients with signs of membranoproliferative nephritis, and may be a critical event in the development of severe forms of lupus nephritis. Reduced Dnase1 activity reflects loss in the expression of the protein and not inhibition of enzyme activity.

  1. Porcine epidemic diarrhea virus infection: Etiology, epidemiology, pathogenesis and immunoprophylaxis.

    Science.gov (United States)

    Jung, Kwonil; Saif, Linda J

    2015-05-01

    Porcine epidemic diarrhea virus (PEDV), a member of the genera Alphacoronavirus in the family Coronaviridae, causes acute diarrhea/vomiting, dehydration and high mortality in seronegative neonatal piglets. For the last three decades, PEDV infection has resulted in significant economic losses in the European and Asian pig industries, but in 2013-2014 the disease was also reported in the US, Canada and Mexico. The PED epidemic in the US, from April 2013 to the present, has led to the loss of more than 10% of the US pig population. The disappearance and re-emergence of epidemic PED indicates that the virus is able to escape from current vaccination protocols, biosecurity and control systems. Endemic PED is a significant problem, which is exacerbated by the emergence (or potential importation) of multiple PEDV variants. Epidemic PEDV strains spread rapidly and cause a high number of pig deaths. These strains are highly enteropathogenic and acutely infect villous epithelial cells of the entire small and large intestines although the jejunum and ileum are the primary sites. PEDV infections cause acute, severe atrophic enteritis accompanied by viremia that leads to profound diarrhea and vomiting, followed by extensive dehydration, which is the major cause of death in nursing piglets. A comprehensive understanding of the pathogenic characteristics of epidemic or endemic PEDV strains is needed to prevent and control the disease in affected regions and to develop an effective vaccine. This review focuses on the etiology, epidemiology, disease mechanisms and pathogenesis as well as immunoprophylaxis against PEDV infection. PMID:25841898

  2. Predictors of mortality in children with lupus nephritis

    Directory of Open Access Journals (Sweden)

    Lukman Oktadianto

    2014-11-01

    Full Text Available Background Renal involvement during the clinical course of systemic lupus erythematosus (SLE is generally considered to be the most important factor influencing disease prognosis in terms of morbidity and mortality. Various factors have been reported to influence the prognosis of lupus nephritis (LN. Objective To analyze clinical signs and laboratory parameters that might serve as predictors associated with mortality in pediatric LN. Methods Retrospectively, medical records of children with LN at Soetomo Hospital from 1998 to 2011 were studied. Diagnosis of SLE was based on Revised American Rheumatism Association critera, while patients with clinical manifestations of hypertension, abnormal urinalysis, and serum creatinin > 1 mg/dL were considered as lupus nephritis. Cox proportional hazard modeling was used to assess for associations of clinical signs and laboratory parameters with mortality. Kaplan-Meier survival analysis was used to assess the cumulative survival from the time of diagnosis to the outcome. Results There were 57 children with LN of whom 43 (75% were girls. The female-to-male ratio was 3:1. Subjects’ mean age was 10.6 (SD 6.87 years. The mean time of observation was 51 (SD 74.54 months and 23 (40% children died. Age, gender, hypertension, hematuria, proteinuria, and anemia were not significant as predictors for mortality. However, hypertensive crisis (HR=2.79; 95%CI 1.16 to 6.75; P=0.02 and initial glomerular filtration rate (GFR of <75 mL/min/1.73m2 (HR=3.01; 95%CI 1.23 to 7.34; P=0.01 were significant predictors of mortality in children with LN. The mean survival time of LN with hypertensive crisis and initial GFR <75 mL/min/1.73m2 was 36.9 (SD 12.17 months. Conclusion Hypertensive crisis and GFR <75 mL/min/1.73m2 are significant predictors of mortality in children with LN. [Paediatr Indones. 2014;54:338-43.].

  3. Stochastic epidemic models: a survey

    CERN Document Server

    Britton, Tom

    2009-01-01

    This paper is a survey paper on stochastic epidemic models. A simple stochastic epidemic model is defined and exact and asymptotic model properties (relying on a large community) are presented. The purpose of modelling is illustrated by studying effects of vaccination and also in terms of inference procedures for important parameters, such as the basic reproduction number and the critical vaccination coverage. Several generalizations towards realism, e.g. multitype and household epidemic models, are also presented, as is a model for endemic diseases.

  4. Virus-Specific Differences in Rates of Disease during the 2010 Dengue Epidemic in Puerto Rico

    OpenAIRE

    Sharp, Tyler M.; Elizabeth Hunsperger; Santiago, Gilberto A.; Jorge L Muñoz-Jordan; Santiago, Luis M.; Aidsa Rivera; Rodríguez-Acosta, Rosa L.; Lorenzo Gonzalez Feliciano; Margolis, Harold S; Tomashek, Kay M.

    2013-01-01

    BACKGROUND: Dengue is a potentially fatal acute febrile illness (AFI) caused by four mosquito-transmitted dengue viruses (DENV-1-4) that are endemic in Puerto Rico. In January 2010, the number of suspected dengue cases reported to the passive dengue surveillance system exceeded the epidemic threshold and an epidemic was declared soon after. METHODOLOGY/PRINCIPAL FINDINGS: To characterize the epidemic, surveillance and laboratory diagnostic data were compiled. A suspected case was a dengue-lik...

  5. Diarrheal Epidemics in Dhaka, Bangladesh, During Three Consecutive Floods: 1988, 1998, and 2004

    OpenAIRE

    Schwartz, Brian S.; Harris, Jason B.; Khan, Ashraful I.; LaRocque, Regina C.; Sack, David A.; Malek, Mohammad A.; Faruque, Abu S.G.; Qadri, Firdausi; Calderwood, Stephen B.; Luby, Stephen P; Ryan, Edward T.

    2006-01-01

    We examined demographic, microbiologic, and clinical data from patients presenting during 1988, 1998, and 2004 flood-associated diarrheal epidemics at a diarrhea treatment hospital in Dhaka, Bangladesh. Compared with non-flood periods, individuals presenting during flood-associated epidemics were older, more severely dehydrated, and of lower socioeconomic status. During flood-associated epidemics, Vibrio cholerae was the most commonly identified cause of diarrhea, and the only diarrheal patho...

  6. Efficacy of novel monoclonal antibody belimumab in the treatment of lupus nephritis

    Directory of Open Access Journals (Sweden)

    Marianne Frieri

    2015-01-01

    Full Text Available Recently introduced into the market, belimumab (Benlysta is a monoclonal antibody that has potential clinically efficacious applications for the treatment of lupus nephritis. Lupus nephritis is a major complication of systemic lupus erythematosus (SLE that can lead to significant illness or even death without proper intervention and treatment. With vast implications through a novel mechanism, belimumab offers a new standard of treatment for physicians in the complications associated with SLE, specifically lupus nephritis. By targeting B cell signaling and maturation, belimumab is able to mitigate the underlying pathological complications surrounding SLE. Phase 3 clinical trials with belimumab have depicted clinically efficacious applications, suggesting belimumab as a revolutionary breakthrough in the treatment armamentarium for practicing clinicians. This article explains the precise mechanism of action of belimumab on the soluble protein BlyS that plays a major role in the pathogenesis of lupus nephritis. In addition, the extensive pharmacokinetics and clinical implications are exemplified in this review with belimumab′s comparison with standard therapeutic guidelines for the treatment of lupus nephritis.

  7. Prognostic value of renal biopsy and clinical variables in patients with lupus nephritis and normal serum creatinine

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Starklint, Henrik; Petersen, J;

    1999-01-01

    To evaluate factors with possible influence on the renal outcome in patients with lupus nephritis but without chronic renal insufficiency (CRI).......To evaluate factors with possible influence on the renal outcome in patients with lupus nephritis but without chronic renal insufficiency (CRI)....

  8. NO EVIDENCE FOR AN INDEPENDENT ROLE OF ANTI-HEPARAN SULFATE REACTIVITY APART FROM ANTI-DNA IN LUPUS NEPHRITIS

    NARCIS (Netherlands)

    HYLKEMA, MN; ZWET, IVD; KRAMERS, C; VANBRUGGEN, MCJ; SWAAK, AJG; BERDEN, JHM; SMEENK, RJT; Hylkema, Machteld

    1995-01-01

    The presence of anti-heparan sulphate (HS) reactivity in serum is closely related to the occurrence of nephritis in patients with systemic lupus erythematosus (SLE). Since patients with lupus nephritis in general also have high titres of anti-DNA antibodies, we wanted to clarify the relationship bet

  9. Lupus Nephritis in Senegal: A Study of 42 Cases

    Directory of Open Access Journals (Sweden)

    Niang A

    2008-01-01

    Full Text Available Renal involvement determines the prognosis of systemic lupus erythematosus (SLE. The aims of this study were to assess the clinical, laboratory and therapeutic aspects of lupus nephritis (LN in Senegal in order to improve its management. We included all patients presenting with SLE followed-up in the Internal Medicine and Dermatology Clinics of the Aristide Le Dantec University Teaching Hospital of Dakar, from January 1993 to December 2002. Patients with SLE without evidence of LN (defined by proteinuria more than 0.5 g/24 hours and/or hematuria were excluded. A total of 74 patients with a diagnosis of SLE were studied, 42 of whom (56.75% had features of LN. Their mean age was 29.6 years and male-female ratio was 0.13. The nephrotic syndrome was seen in 45.23% of the cases and renal insufficiency in 37.71%. Renal biopsy was performed in 52.38% of the cases, which showed predominantly WHO classes IV and V lesions. The main treatment modality employed was corticoste-roids, while immunosuppressive drugs in addition were used in 35.71% of the patients. The short-term prognosis was favorable but in the middle-term, many patients were lost to follow-up. We conclude that early diagnosis by systematic urine screening, good patient information, percutaneous renal biopsy and use of appropriate immunosuppressive therapy will help improving the prognosis of LN in Senegal.

  10. Outcome of the acute glomerular injury in proliferative lupus nephritis

    International Nuclear Information System (INIS)

    Treatment with total lymphoid irradiation (TLI) and corticosteroids markedly reduced activity of systemic lupus erythematosis in 10 patients with diffuse proliferative lupus nephritis (DPLN) complicated by a nephrotic syndrome. Physiologic and morphometric techniques were used serially before, and 12 and 36 mo post-TLI to characterize the course of glomerular injury. Judged by a progressive reduction in the density of glomerular cells and immune deposits, glomerular inflammation subsided. A sustained reduction in the fractional clearance of albumin, IgG and uncharged dextrans of radius greater than 50 A, pointed to a parallel improvement in glomerular barrier size-selectivity. Corresponding changes in GFR were modest, however. A trend towards higher GFR at 12 mo was associated with a marked increase in the fraction of glomerular tuft area occupied by patent capillary loops as inflammatory changes receded. A late trend toward declining GFR beyond 12 mo was associated with progressive glomerulosclerosis, which affected 57% of all glomeruli globally by 36 mo post-TLI. Judged by a parallel increase in volume by 59%, remaining, patent glomeruli had undergone a process of adaptive enlargement. We propose that an increasing fraction of glomeruli continues to undergo progressive sclerosis after DPLN has become quiescent, and that the prevailing GFR depends on the extent to which hypertrophied remnant glomeruli can compensate for the ensuing loss of filtration surface area

  11. Outcome of the acute glomerular injury in proliferative lupus nephritis

    Energy Technology Data Exchange (ETDEWEB)

    Chagnac, A.; Kiberd, B.A.; Farinas, M.C.; Strober, S.; Sibley, R.K.; Hoppe, R.; Myers, B.D. (Stanford Univ. Medical Center, CA (USA))

    1989-09-01

    Treatment with total lymphoid irradiation (TLI) and corticosteroids markedly reduced activity of systemic lupus erythematosis in 10 patients with diffuse proliferative lupus nephritis (DPLN) complicated by a nephrotic syndrome. Physiologic and morphometric techniques were used serially before, and 12 and 36 mo post-TLI to characterize the course of glomerular injury. Judged by a progressive reduction in the density of glomerular cells and immune deposits, glomerular inflammation subsided. A sustained reduction in the fractional clearance of albumin, IgG and uncharged dextrans of radius greater than 50 A, pointed to a parallel improvement in glomerular barrier size-selectivity. Corresponding changes in GFR were modest, however. A trend towards higher GFR at 12 mo was associated with a marked increase in the fraction of glomerular tuft area occupied by patent capillary loops as inflammatory changes receded. A late trend toward declining GFR beyond 12 mo was associated with progressive glomerulosclerosis, which affected 57% of all glomeruli globally by 36 mo post-TLI. Judged by a parallel increase in volume by 59%, remaining, patent glomeruli had undergone a process of adaptive enlargement. We propose that an increasing fraction of glomeruli continues to undergo progressive sclerosis after DPLN has become quiescent, and that the prevailing GFR depends on the extent to which hypertrophied remnant glomeruli can compensate for the ensuing loss of filtration surface area.

  12. Epidemic processes in complex networks

    CERN Document Server

    Pastor-Satorras, Romualdo; Van Mieghem, Piet; Vespignani, Alessandro

    2014-01-01

    In recent years the research community has accumulated overwhelming evidence for the emergence of complex and heterogeneous connectivity patterns in a wide range of biological and socio-technical systems. The complex properties of real world networks have a profound impact on the behavior of equilibrium and non-equilibrium phenomena occurring in various systems, and the study of epidemic spreading is central to our understanding of the unfolding of dynamical processes in complex networks. The theoretical analysis of epidemic spreading in heterogeneous networks requires the development of novel analytical frameworks, and it has produced results of conceptual and practical relevance. Here we present a coherent and comprehensive review of the vast research activity concerning epidemic processes, detailing the successful theoretical approaches as well as making their limits and assumptions clear. Physicists, epidemiologists, computer and social scientists share a common interest in studying epidemic spreading and...

  13. Epidemic spreading in complex networks

    Institute of Scientific and Technical Information of China (English)

    Jie ZHOU; Zong-hua LIU

    2008-01-01

    The study of epidemic spreading in complex networks is currently a hot topic and a large body of results have been achieved.In this paper,we briefly review our contributions to this field,which includes the underlying mechanism of rumor propagation,the epidemic spreading in community networks,the influence of varying topology,and the influence of mobility of agents.Also,some future directions are pointed out.

  14. Epidemic Increase in Methicillin-resistant Staphylococcus aureus in Copenhagen

    DEFF Research Database (Denmark)

    Westh, Henrik; Boye, Kit; Bartels, Mette Damkjær;

    2006-01-01

    INTRODUCTION: We have found an epidemic increase in methicillin-resistant Staphylococcus aureus (MRSA) in Copenhagen. The increase has a complex background and involves hospitals, nursing homes and persons nursed in their own home. MATERIAL AND METHODS: We found 33 MRSA patients in 2003 and 121 in...... 2004. All isolates have been spa-typed and epidemiologic information collected. RESULTS: The number of MRSA cases has a doubling time of about six months. The epidemic has been caused by many different MRSA types and 31 staphylococcus protein A genotypes (spa types). MRSA has caused several hospital...

  15. Epidemic Increase in Methicillin-resistant Staphylococcus aureus in Copenhagen

    DEFF Research Database (Denmark)

    Westh, Henrik; Boye, Kit; Bartels, Mette Damkjær;

    2006-01-01

    INTRODUCTION: We have found an epidemic increase in methicillin-resistant Staphylococcus aureus (MRSA) in Copenhagen. The increase has a complex background and involves hospitals, nursing homes and persons nursed in their own home. MATERIAL AND METHODS: We found 33 MRSA patients in 2003 and 121...... in 2004. All isolates have been spa-typed and epidemiologic information collected. RESULTS: The number of MRSA cases has a doubling time of about six months. The epidemic has been caused by many different MRSA types and 31 staphylococcus protein A genotypes (spa types). MRSA has caused several hospital...

  16. Relapsing tubulointerstitial nephritis in an adolescent with inflammatory bowel disease without aminosalicylate exposure.

    LENUS (Irish Health Repository)

    Shahrani Muhammad, H S

    2012-01-31

    A 14-year-old boy presented with ongoing constipation as a manifestation of newly diagnosed Crohn\\'s disease (CD) and a concomitant decline in renal function with biopsy-proven interstitial nephritis. Initiation of steroid therapy and mesalazine was associated with an improvement in symptoms and renal function. We describe a rare case of a 5-aminosalicylic acid (5-ASA)-naive patient who developed interstitial nephritis in association with CD with no evidence of other primary glomerulopathy. A unique feature of the case being a profound systemic inflammatory response at the time of diagnosis and a relapse in nephritis 2 months after cessation of mesalazine in the absence of any macroscopic colitis.

  17. Autoantibodies and Resident Renal Cells in the Pathogenesis of Lupus Nephritis: Getting to Know the Unknown

    Directory of Open Access Journals (Sweden)

    Susan Yung

    2012-01-01

    Full Text Available Systemic lupus erythematosus is characterized by a breakdown of self-tolerance and production of autoantibodies. Kidney involvement (i.e., lupus nephritis is both common and severe and can result in permanent damage within the glomerular, vascular, and tubulo-interstitial compartments of the kidney, leading to acute or chronic renal failure. Accumulating evidence shows that anti-dsDNA antibodies play a critical role in the pathogenesis of lupus nephritis through their binding to cell surface proteins of resident kidney cells, thereby triggering the downstream activation of signaling pathways and the release of mediators of inflammation and fibrosis. This paper describes the mechanisms through which autoantibodies interact with resident renal cells and how this interaction plays a part in disease pathogenesis that ultimately leads to structural and functional alterations in lupus nephritis.

  18. Hypothesis: dynamics of classical malaria epidemics show Plasmodium falciparum's survival strategy.

    Science.gov (United States)

    Shanks, G Dennis

    2015-03-01

    Areas of marginal transmission can generate enormous lethal falciparum malaria epidemics when factors favoring the parasite shift only slightly. Although usually described in terms of vectorial capacity, medical scientists working in India in the early 20th century came to the conclusion that "an epidemic of relapses" was the key triggering event of malaria epidemics. This explanation has been largely discarded, because the biology of Plasmodium falciparum recrudescence has since been differentiated from P. vivax relapse. Using data from the Punjab in 1908 and Ceylon in 1934-1935, the genesis of malaria epidemics has been re-examined to inform current control efforts. The epidemics were focused geographically depending on recent rainfall or drought. Epidemics arose very suddenly and simultaneously in several places. Malaria spleen surveys indicated very little recent malaria transmission, and blood smears showed very few gametocytes just before the epidemic. Population stress as indicated by high grain prices because of a poor harvest caused by drought the previous year was a risk factor for malaria epidemics. Although increased female Anopheline survival because of increased humidity played an important part in the magnification of the epidemic, it does not explain its genesis. Human population stress triggering a shift toward gametocytogenesis is hypothesized as the key initiation factor for malaria epidemics. Its evolutionary significance may be that it allows the parasite to match the tropical agricultural cycle. PMID:25624407

  19. [Epidemics return and new ones are added].

    Science.gov (United States)

    Witte, A

    1991-12-01

    Cholera asiatic is an acute infection of the intestinal tract through Vibrio cholerae bacteria causing diarrhea, dehydration, and kidney failure. It was discovered by Robert Koch in 1883 on his study trip in Egypt. Transmission is mostly through drinking of contaminated water and sometimes by consumption of infected food such as seafood. Cholera originates from southeast Asia, mainly India where it already appeared in ancient times. It spread from India in pandemic waves in the last few centuries throughout the world up to 1923 in Europe. Epidemics were nonetheless registered in India, China, Japan, Iran, and Egypt (1947). There was a pandemic in Peru in 1991 (caused by hyperinflation-induced malnutrition, contaminated water, and untreated sewage pouring into the sea) that also affected the neighboring countries, and small epidemics among Kurdish refugees and Bangladeshi catastrophe victims. On June 5, 1981 the deaths by atypical pneumonia of 5 homosexual men were reported to the Centers for Disease Control in Atlanta, Georgia, which was the beginning of the acquired immunodeficiency syndrome (AIDS) epidemic caused by HIV. WHO's latest figures indicated a total of 366,455 AIDS patients in 162 countries, but a higher estimate of 1.4 million was more likely. As of April 1991 and estimated 8-10 million adults were infected with HIV, 6 million of them in Africa, south of the Sahel. In the next century 15-20% of the working population will die of AIDS leaving behind 10 million orphans. Tuberculosis has also been activated as an opportunistic disease of HIV infection. Up to 55% of African TB patients were also infected with HIV. Some predict that the AIDS pandemic will equalize the population growth by an average of 300,000 deaths/year. PMID:1786218

  20. Changes in pathological pattern and treatment regimens based on repeat renal biopsy in lupus nephritis

    Institute of Scientific and Technical Information of China (English)

    WANG Guo-bao; XU Zheng-jin; LIU Hong-fa; ZHOU Qiu-gen; ZHOU Zhan-mei; JIA Nan

    2012-01-01

    Background Relapses occur frequently in patients with lupus nephritis.Renal biopsy is the gold standard for assessing renal activity and hence guiding the treatment.Whether repeat renal biopsy is helpful during flares of lupus nephritis remains inconclusive.In the present study,we retrospectively reviewed the patients with lupus nephritis who had more than one renal biopsy with the hope to find the clinical value of repeat biopsy.Methods Patients who had a diagnosis of lupus nephritis and two or more renal biopsies were selected from the database of the patient pathology registration at this renal division.Renal biopsy was evaluated according to the International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification of lupus nephritis.The pathological patterns and treatment regimens were analyzed after a repeat biopsy.Results We identified 44 systemic lupus erythematosus patients with serial renal biopsies.In total,there were 94 renal biopsies.Overall,the pathological transition occurred in 64% instances according to the ISN/RPS class.When the transition was analyzed according to proliferative,membranous or mix lesions,it showed different profile:35% in patients with proliferative lesion,23.5% patients with mix lesions,100% in patients with pure membranous lesion.The pathological transition could not be predicted by any clinical characteristics.After the repeat renal biopsy,34% of patients had a change in their treatment regimens.Conclusions The pathological conversion was very prevalent in patients with lupus nephritis.However,the transitions became less prevalent when they were analyzed according to pure membranous,proliferative,and mix lesion.Repeat biopsy might be helpful to avoid unnecessary increased immunosuppression therapy.

  1. [On the epidemic of cholera and its prevention and control by the railway authorities in 1932].

    Science.gov (United States)

    Huang, H P; Song, M H

    2016-01-28

    In 1932, the epidemic of cholera in China was serious, spreading to all provinces nationwide, causing heavy casualties. In order to prevent cholera epidemics spread along the railway line, the National Government Ministry of Railways and the local railway administration had taken all countermeasures, including the promulgation of epidemic prevention laws and regulations, quarantine, isolated check-up, disinfection, vaccination and even interruption of traffic. The measures of railway authorities had achieved a certain success. In August 1932, cholera epidemic began to subside gradually. PMID:27049743

  2. Genetic contributions of nonautoimmune SWR mice toward lupus nephritis.

    Science.gov (United States)

    Xie, S; Chang, S; Yang, P; Jacob, C; Kaliyaperumal, A; Datta, S K; Mohan, C

    2001-12-15

    (SWR x New Zealand Black (NZB))F(1) (or SNF(1)) mice succumb to lupus nephritis. Although several NZB lupus susceptibility loci have been identified in other crosses, the potential genetic contributions of SWR to lupus remain unknown. To ascertain this, a panel of 86 NZB x F(1) backcross mice was immunophenotyped and genome scanned. Linkage analysis revealed four dominant SWR susceptibility loci (H2, Swrl-1, Swrl-2, and Swrl-3) and a recessive NZB locus, Nba1. Early mortality was most strongly linked to the H2 locus on chromosome (Chr) 17 (log likelihood of the odds (LOD) = 4.59 - 5.38). Susceptibility to glomerulonephritis was linked to H2 (Chr 17, LOD = 2.37 - 2.70), Swrl-2 (Chr 14, 36 cM, LOD = 2.48 - 2.71), and Nba1 (Chr 4, 75 cM, LOD = 2.15 - 2.23). IgG antinuclear autoantibody development was linked to H2 (Chr 17, LOD = 4.92 - 5.48), Swrl-1 (Chr 1, 86 cM, colocalizing with Sle1 and Nba2, LOD = 2.89 - 2.91), and Swrl-3 (Chr 18, 14 cM, LOD = 2.07 - 2.13). For each phenotype, epistatic interaction of two to three susceptibility loci was required to attain the high penetrance levels seen in the SNF(1) strain. Although the SWR contributions H2, Swrl-1, and Swrl-2 map to loci previously mapped in other strains, often linked to very similar phenotypes, Swrl-3 appears to be a novel locus. In conclusion, lupus in the SNF(1) strain is truly polygenic, with at least four dominant contributions from the SWR strain. The immunological functions and molecular identities of these loci await elucidation. PMID:11739537

  3. Acute Interstitial Nephritis Proteinuria and Herpes Simplex Virus Hepatitis in Pregnancy Mimic HELLP Syndrome (Hemolysis, Elevated Liver Enzymes, Low Platelets

    Directory of Open Access Journals (Sweden)

    Wendy M. White

    2011-12-01

    Full Text Available Elevated transaminases, hemolysis, and thrombocytopenia in pregnancy are most often caused by a preeclampsia variant—HELLP syndrome (hemolysis, elevated liver enzymes, low platelets. In atypical cases, it is important to consider other causes, such as herpes simplex virus (HSV hepatitis. Acute interstitial nephritis (AIN-induced proteinuria can make distinguishing HELLP from its mimics more difficult. A 43-year-old G4P3 gestational carrier at 28 weeks had abnormal laboratory findings consistent with HELLP, including proteinuria. However, she was normotensive and febrile, prompting an investigation into other possible causes of her signs and symptoms. She ultimately was diagnosed with disseminated HSV infection, started on definitive therapy, and allowed to continue her pregnancy to term. The proteinuria was attributed to AIN. AIN can cause proteinuria in the critically ill pregnant patient. When mimics of HELLP syndrome, such as disseminated HSV infection, are the cause of critical illness, the presence of AIN-induced proteinuria may falsely implicate a hypertensive disorder of pregnancy, resulting in iatrogenic premature delivery of the fetus and failure to initiate definitive potential lifesaving treatment.

  4. Epidemic processes in complex networks

    Science.gov (United States)

    Pastor-Satorras, Romualdo; Castellano, Claudio; Van Mieghem, Piet; Vespignani, Alessandro

    2015-07-01

    In recent years the research community has accumulated overwhelming evidence for the emergence of complex and heterogeneous connectivity patterns in a wide range of biological and sociotechnical systems. The complex properties of real-world networks have a profound impact on the behavior of equilibrium and nonequilibrium phenomena occurring in various systems, and the study of epidemic spreading is central to our understanding of the unfolding of dynamical processes in complex networks. The theoretical analysis of epidemic spreading in heterogeneous networks requires the development of novel analytical frameworks, and it has produced results of conceptual and practical relevance. A coherent and comprehensive review of the vast research activity concerning epidemic processes is presented, detailing the successful theoretical approaches as well as making their limits and assumptions clear. Physicists, mathematicians, epidemiologists, computer, and social scientists share a common interest in studying epidemic spreading and rely on similar models for the description of the diffusion of pathogens, knowledge, and innovation. For this reason, while focusing on the main results and the paradigmatic models in infectious disease modeling, the major results concerning generalized social contagion processes are also presented. Finally, the research activity at the forefront in the study of epidemic spreading in coevolving, coupled, and time-varying networks is reported.

  5. When Coke Is Not Hydrating: Cocaine-Induced Acute Interstitial Nephritis.

    Science.gov (United States)

    Bahaa Aldeen, Mohammed; Talibmamury, Nibras; Alalusi, Sumer; Nadham, Omar; Omer, Abdel Rahman; Smalligan, Roger D

    2014-01-01

    home with an improving Cr of 3.5 mg/dL, back to baseline of 1.5 in 8 weeks. Discussion. Internists encounter patients with acute kidney injury (AKI) on a daily basis, most of which can be explained by prerenal azotemia, acute tubular necrosis (ATN), obstruction, or rhabdomyolysis among other etiologies. Cocaine is only rarely implicated as an etiology of AKI and if it is, usually the injury is due to ATN or pigment effects. Acute interstitial nephritis (AIN) caused by cocaine, on the other hand, has only been described in a handful of cases. AIN is a renal lesion that causes a decline in creatinine clearance and is characterized by an inflammatory infiltrate in the kidney interstitium and is most often associated with drug therapy. AIN can also be seen in autoimmune disorders like systemic lupus erythematosus, Sjögren's syndrome, or sarcoidosis; or with infections remote to the kidney like Legionella, leptospirosis, and streptococcal disease. Our case was very similar to the other reported cases of AIN due to cocaine in that all have occurred in middle-aged African American males and all have responded to steroids. This case reminds clinicians to consider AIN in patients with AKI and a history of cocaine abuse. PMID:26425622

  6. Fungal Pneumonia: A Silent Epidemic Coccidioidomycosis (Valley Fever)

    Science.gov (United States)

    Fungal pneumonia: a silent epidemic Coccidioidomycosis (valley fever) Coccidioidomycosis, a fungal disease called “cocci” or “valley fever,” is a major cause of community-acquired pneumonia in the southwestern US. A costly problem • In ...

  7. Quaternary epitopes of α345(IV) collagen initiate Alport post-transplant anti-GBM nephritis

    DEFF Research Database (Denmark)

    Olaru, Florina; Luo, Wentian; Wang, Xu-Ping; Ge, Linna; Hertz, Jens Michael; Kashtan, Clifford E; Sado, Yoshikazu; Segal, Yoav; Hudson, Billy G; Borza, Dorin-Bogdan

    2013-01-01

    Alport post-transplant nephritis (APTN) is an aggressive form of anti-glomerular basement membrane disease that targets the allograft in transplanted patients with X-linked Alport syndrome. Alloantibodies develop against the NC1 domain of α5(IV) collagen, which occurs in normal kidneys, including...

  8. Clearing the complexity: immune complexes and their treatment in lupus nephritis

    Directory of Open Access Journals (Sweden)

    Catherine Toong

    2011-01-01

    Full Text Available Catherine Toong1, Stephen Adelstein1, Tri Giang Phan21Department of Clinical Immunology, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW, Australia; 2Immunology Program, Garvan Institute of Medical Research and St. Vincent’s Clinical School, University of New South Wales, Darlinghurst, NSW, AustraliaAbstract: Systemic lupus erythematosus (SLE is a classic antibody-mediated systemic autoimmune disease characterised by the development of autoantibodies to ubiquitous self-antigens (such as antinuclear antibodies and antidouble-stranded DNA antibodies and widespread deposition of immune complexes in affected tissues. Deposition of immune complexes in the kidney results in glomerular damage and occurs in all forms of lupus nephritis. The development of nephritis carries a poor prognosis and high risk of developing end-stage renal failure despite recent therapeutic advances. Here we review the role of DNA-anti-DNA immune complexes in the pathogenesis of lupus nephritis and possible new treatment strategies aimed at their control.Keywords: immune complex, systemic lupus erythematosus, nephritis, therapy

  9. Autoantibodies Targeting a Collecting Duct-Specific Water Channel in Tubulointerstitial Nephritis

    DEFF Research Database (Denmark)

    Landegren, Nils; Pourmousa Lindberg, Mina; Skov, Jakob; Hallgren, Åsa; Eriksson, Daniel; Lisberg Toft-Bertelsen, Trine; MacAulay, Nanna; Hagforsen, Eva; Räisänen-Sokolowski, Anne; Saha, Heikki; Nilsson, Thomas; Nordmark, Gunnel; Ohlsson, Sophie; Gustafsson, Jan; Husebye, Eystein S; Larsson, Erik; Anderson, Mark S; Perheentupa, Jaakko; Rorsman, Fredrik; Fenton, Robert A; Kämpe, Olle

    2016-01-01

    autoantibodies of the two other patients reacted against the HOXB7 or NFAT5 transcription factors, which regulate the aquaporin 2 promoter. Our findings suggest that tubulointerstitial nephritis developed in these patients as a result of an autoimmune insult on the kidney collecting duct cells....

  10. High risk of ischemic heart disease in patients with lupus nephritis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Mellemkjaer, Lene; Starklint, Henrik;

    2011-01-01

    Abstract OBJECTIVE: To investigate the occurrence of ischemic heart disease (IHD) in a cohort of 104 Danish patients with biopsy-proven lupus nephritis (LN). METHODS: Information on all hospitalizations in Denmark for IHD between 1977 and 2006 was obtained from the Danish National Hospital Register...

  11. Pregnancy complications in a patient with systemic lupus erythematosus and lupus nephritis

    DEFF Research Database (Denmark)

    Bisgaard, Helene; Jacobsen, Søren; Tvede, Niels;

    2014-01-01

    A woman with systemic lupus erythematosus (SLE) and lupus nephritis had two pregnancies which both resulted in complications known to be associated with SLE, i.e. late abortion, preterm delivery and pre-eclampsia. We conclude that disease quiescence is important for a successful outcome and that...

  12. Chronic tubulo-interstitial nephritis in common variable immunodeficiency: A rare association

    Directory of Open Access Journals (Sweden)

    Sumantra Sarkar

    2014-01-01

    Full Text Available Common variable immunodeficiency (CVID is characterized by reduced serum immunoglobulin levels and repeated serious bacterial infections involving different organ systems. Chronic kidney disease (CKD is an uncommon association with CVID. Chronic tubulo-interstitial nephritis in a case of CVID that progressed to CKD is distinctly rare.

  13. Prognostic value of renal hemodynamic characteristics in patients with proliferative lupus nephritis

    NARCIS (Netherlands)

    Martens, Henk A.; Bijl, Marc; Kallenberg, Cees G. M.

    2007-01-01

    Background/Aim: Previous studies showed that renal hemodynamic parameters, especially the filtration fraction ( FF), are decreased in patients with active lupus nephritis ( LN). In this study, we evaluate the prognostic value of renal hemodynamic function tests on the renal outcome in patients with

  14. Spontaneous rupture of the spleen: A rare complication in a patient with lupus nephritis on hemodialysis

    Directory of Open Access Journals (Sweden)

    Nadri Quaid

    2010-01-01

    Full Text Available Rupture of the spleen is a life threatening condition. We report a 40-year-old fe-male patient, a known case of lupus nephritis receiving hemodialysis, who developed spontaneous rupture of the spleen during the course of her illness. The patient was managed conservatively with gradual regression of hematoma without further complications.

  15. Dengue fever triggering systemic lupus erythematosus and lupus nephritis: a case report

    Directory of Open Access Journals (Sweden)

    Talib SH

    2013-10-01

    Full Text Available SH Talib, SR Bhattu, R Bhattu, SG Deshpande, DB Dahiphale Department of Medicine and Nephrology, MGM Medical College and Hospital, Aurangabad, Maharashtra, India Abstract: We report a rare case of dengue fever triggering systemic lupus erythematosus and lupus nephritis. The patient presented herself during a large outbreak of dengue fever in December 2012 in Maharashtra, India. The diagnosis of dengue fever was confirmed by the presence of NS-1 antigen during the first few days of febrile illness. Eight weeks later, kidney tissue biopsy studies revealed evidence of lupus nephritis on microscopic examination and immunofluorescence. The report interpreted it as focal proliferative glomerulonephritis and segmental sclerosis (Stage IIIC. The case was also found positive for perinuclear antineutrophil cytoplasmic antibodies by indirect immunofluorescence assay. An active and effective management of a case essentially calls for clear perception of differentiating dengue-induced lupus flare, antineutrophil cytoplasmic antibody-related nephropathy, and/or dengue-induced de-novo lupus disease. Dengue viremia may be the trigger for immune complex formation in patients who are predisposed to developing autoimmune diseases. The present case explains the importance of considering the diagnosis of dengue-related lupus nephritis as an atypical occurrence in appropriate situations, as in this case. It would not be improper to regard this escalating disease as an expanded feature of dengue. Keywords: kidney biopsy, glomerulonephritis, segmental sclerosis, lupus flare, dengue viremia, autoimmune, de-novo lupus nephritis

  16. Interstitial nephritis of slaughtered pigs in the State of Mato Grosso, Brazil

    Directory of Open Access Journals (Sweden)

    João X. Oliveira Filho

    2012-04-01

    Full Text Available This study evaluated histological lesions in kidney samples from pigs with nephritis in two slaughterhouses in the State of Mato Grosso, Brazil. Four hundred samples were subjected to histology, anti-porcine circovirus type 2 (PCV2 immunohistochemistry (IHC, anti-Leptospira sp. immunofluorescence (IF, and polymerase chain reaction (PCR for PCV2, porcine parvovirus (PPV, and Torque teno virus type 1 and 2 (TTV1, TTV2 detection. Histological lesions were found in 81% of the samples, and mononuclear interstitial nephritis was the most frequent lesion (77.50%. A follicular pattern was observed in 40.97% of the interstitial nephritis lesions. PCV2, PPV, TTV1, and TTV2 were identified in the kidneys by PCR in 27.25%, 28.50%, 94%, and 87.5% of the samples, respectively. Leptospira sp. was not detected through IF. Infection by PCV2 (PCR and the presence of histological lesions (P=0.008 and giant cells (P=0.0016 were significantly associated. An association was observed between the TTV2-TTV1 co-infection (P<0.0001 and the risk for pathogenesis. These findings indicated that PCV2, PPV, TTV1, and TTV2 were widely distributed among pigs in the local farms and that the presence of these agents should be considered in the differential diagnosis of kidneys with interstitial nephritis in pigs.

  17. Reactivity in ELISA with DNA-loaded nucleosomes in patients with proliferative lupus nephritis

    NARCIS (Netherlands)

    Dieker, J.W.; Schlumberger, W.; McHugh, N.; Hamann, P.; Vlag, J. van der; Berden, J.H.M.

    2015-01-01

    Autoantibodies against nucleosomes are considered a hallmark of systemic lupus erythematosus (SLE). We compared in patients with proliferative lupus nephritis the diagnostic usefulness of a dsDNA-loaded nucleosome ELISA (anti-dsDNA-NcX) with ELISAs in which dsDNA or nucleosomes alone were coated. Fi

  18. OBESITY: OVERVIEW OF AN EPIDEMIC

    OpenAIRE

    Mitchell, Nia; Catenacci, Vicki; Wyatt, Holly R.; Hill, James O.

    2011-01-01

    Despite growing recognition of the problem, the obesity epidemic continues in the U.S., and obesity rates are increasing around the world. The latest estimates are that approximately 34% of adults and 15–20% of children and adolescents in the U.S. are obese. Obesity affects every segment of the U.S. population. Obesity increases the risk of many chronic diseases in children and adults. The epidemic of obesity arose gradually over time, apparently from a small, consistent degree of positive en...

  19. [The Prevalence and prevention of Cattle Epidemics in Song dynasty].

    Science.gov (United States)

    Han, Yi

    2011-07-01

    Cattle epidemics broke out many times in Song Dynasty due to pasture transferring to south, abnormal climate, poor stabling hygiene and climatic sickness caused by migration. Mass Mortality and reduction of animal agriculture productivity threatened the stable production of grain, which influenced society and attracted attention from all social classes. Based on the principle of 'prevention before sicken' and 'contagion protection after sicken', the government took a series of medical and economical actions for prevention, such as veterinarians dispatching, drugs providing, pasturage rule regulating, law modifying (cattle trade permitted) and new farm implements popularization (to prevent missing the opportunity of cultivation), which was effective for Cattle Epidemics prevention at that time. PMID:22169486

  20. Comparing the epidemic in U.S. and Britain.

    Science.gov (United States)

    Harmon, K S

    1999-01-01

    Cultural differences between the United States and Britain influence how the AIDS/HIV epidemic is being addressed and why AIDS rates are smaller in the United Kingdom. The author proposes that highly diverse and racist societies, like in the United States, may cause distrust among different groups in the effort to challenge the spread of HIV/AIDS, leaving people to fend for themselves. Because of racism and distrust between ethnic and racial groups, as well as differences in financial resources between groups, the AIDS epidemic in the United States is being fought on too many fronts without the benefit of a uniform response. Ironically, this problem has also spurred a greater ability among US AIDS service providers to work with diverse communities during the course of the epidemic. PMID:11366770

  1. Mycophenolate mofetil versus azathioprine for maintenance treatment of lupus nephritis.

    Science.gov (United States)

    Kaballo, Babikir G; Ahmed, Ahmed Elias; Nur, Musa Mohammed; Khalid, Ismail Osman; Abu-Aisha, Hasan

    2016-01-01

    To compare the efficacy of mycophenolate mofetil (MMF) with that of azathioprine (AZA) drugs in the maintenance therapy of lupus nephritis (LN) patients, we studied 81 Sudanese patients with LN (32 in Class III, 34 in Class IV, and 15 in combined Class V + IV of the ISN/RPS 2003 Classification). All patients received induction therapy consisting of monthly intravenous pulse doses of cyclophosphamide (CYC) (500 mg/m 2 of body-surface area) for six months, plus three consecutive pulses of intravenous methylprednisolone 15 mg/kg/day of body weight (maximum 500 mg). Subsequently, 41 (50.6%) patients were randomized into a group that received oral MMF (22 mg/kg/day), and 40 (49.4%) patients randomized to a group that received oral AZA (2 mg/kg/day). All patients initially received oral prednisone (1 mg/kg of body weight daily) for four weeks. The baseline characteristics of the two groups were similar. Total remission rate was 75.3% (80.5% in MMF and 70% in AZA), complete remission rate of 54.3% (56.1% with MMF and 52.5% with AZA), and a partial remission rate of 21% (24.4% with MMF and 17.5% with AZA) over 29 months. During maintenance therapy, six patients died (four in the AZA group and two in the MMF group), and end-stage renal disease (ESRD) developed in five patients (three in the AZA group and two in the MMF group). During the 36-months of the study, both groups had comparable event-free survival rate for the composite end point of death or ESRD and rate of relapse-free survival. Furthermore, both groups had no significant differences in terms of frequency of hospitalization, amenorrhea, infection, nausea, and vomiting. We conclude that our study showed that short-term therapy with intravenous CYC followed by maintenance therapy with oral MMF or AZA had similar efficacy and safety for the treatment of patients with moderate to severe LN. PMID:27424688

  2. Bone disease in newly diagnosed lupus nephritis patients.

    Directory of Open Access Journals (Sweden)

    Aline Lázara Resende

    Full Text Available Bone loss in Lupus Nephritis (LN patients is common and multifactorial. The aim of this study was to evaluate the bone status of newly diagnosed LN patients and their correlation with inflammatory factors involved in LN physiopathology.We studied 15 pre-menopausal patients with ≤2 months of diagnosed SLE and LN. Patients with prior kidney or bone disease were excluded. In addition to biochemical evaluation (including 25-hydroxyvitamin D3 [25(OHD] and Monocyte Chemotactic Protein (MCP1 dosage, we performed bone biopsies followed by osteoblast culture, histomorphometric and immunohistochemistry analysis.LN patients presented a mean age of 29.5±10 years, a proteinuria of 4.7±2.9 g/day and an estimated glomerular filtration rate (GFR of 37(31-87 ml/min/1,73 m2. They were on glucocorticoid therapy for 34±12 days. All patients presented vitamin D insufficiency (9.9±4.4 ng/ml, range 4-20. Urinary MCP1 correlated negatively with 25(OHD (r = -0.53, p = 0.003 and positively with serum deoxypyridinoline (r = 0.53, p = 0.004. Osteoblasts isolated from LN bone biopsies presented a significantly higher expression of MCP-1 when compared to controls (32.0.±9.1 vs. 22.9±5.3 mean fluorescence intensities, p = 0.01. LN patients presented a significantly reduced osteoid volume, osteoid thickness, osteoid surface, mineralization surface and bone formation rate, associated with an increased eroded surface and osteoclast surface. Patient's bone specimens demonstrated a reduced immunostaining for osteoprotegerin (0.61±0.82 vs. 1.08±0.50%, p = 0.003, and an increased expression of Receptor Activator of NF-κB ligand (RANKL (1.76±0.92 vs. 0.41±0.28%, p<0.001 when compared to controls.Newly diagnosed LN patients presented a significant disturbance in bone metabolism, characterized by an impaired bone formation and mineralization, associated with an increase in resorption parameters. Glucocorticoid use, vitamin D insufficiency and

  3. Epidemics on random graphs with tunable clustering

    OpenAIRE

    Britton, Tom; Deijfen, Maria; Lagerås, Andreas Nordvall; Lindholm, Mathias

    2008-01-01

    In this paper, a branching process approximation for the spread of a Reed-Frost epidemic on a network with tunable clustering is derived. The approximation gives rise to expressions for the epidemic threshold and the probability of a large outbreak in the epidemic. It is investigated how these quantities varies with the clustering in the graph and it turns out for instance that, as the clustering increases, the epidemic threshold decreases. The network is modelled by a random intersection gra...

  4. Commentary: environmental disease--a preventable epidemic

    Energy Technology Data Exchange (ETDEWEB)

    Landrigan, P.J. (Department of Community Medicine, Mount Sinai School of Medicine, New York, NY (United States))

    1992-07-01

    Toxic environmental diseases are highly preventable causes of morbidity and mortality. Toxic diseases in the work environment cause an estimated 50,000 to 70,000 deaths and 350,000 new cases of illness each year in the United States; the asbestos pandemic will ultimately claim at least 300,000 lives; pediatric lead poisoning is epidemic, and an estimated 3 to 4 million US preschool children have blood lead levels above 10 micrograms/dl and could suffer long-term neuropsychological impairment. Prevention of environmental diseases can be achieved through legislation and regulation that control common-source exposures to chemical toxins. Modification of personal behaviors, such as tobacco and alcohol consumption, complements but does not replace control of toxic environmental exposures.

  5. Stochastic Processes in Epidemic Theory

    CERN Document Server

    Lefèvre, Claude; Picard, Philippe

    1990-01-01

    This collection of papers gives a representative cross-selectional view of recent developments in the field. After a survey paper by C. Lefèvre, 17 other research papers look at stochastic modeling of epidemics, both from a theoretical and a statistical point of view. Some look more specifically at a particular disease such as AIDS, malaria, schistosomiasis and diabetes.

  6. Visual Mining of Epidemic Networks

    CERN Document Server

    Clémençon, Stéphan; Rossi, Fabrice; Tran, Viet Chi; 10.1007/978-3-642-21498-1_35

    2012-01-01

    We show how an interactive graph visualization method based on maximal modularity clustering can be used to explore a large epidemic network. The visual representation is used to display statistical tests results that expose the relations between the propagation of HIV in a sexual contact network and the sexual orientation of the patients.

  7. Epidemic Spread in Human Networks

    CERN Document Server

    Sahneh, Faryad Darabi

    2011-01-01

    One of the popular dynamics on complex networks is the epidemic spreading. An epidemic model describes how infections spread throughout a network. Among the compartmental models used to describe epidemics, the Susceptible-Infected-Susceptible (SIS) model has been widely used. In the SIS model, each node can be susceptible, become infected with a given infection rate, and become again susceptible with a given curing rate. In this paper, we add a new compartment to the classic SIS model to account for human response to epidemic spread. Each individual can be infected, susceptible, or alert. Susceptible individuals can become alert with an alerting rate if infected individuals exist in their neighborhood. An individual in the alert state is less probable to become infected than an individual in the susceptible state; due to a newly adopted cautious behavior. The problem is formulated as a continuous-time Markov process on a general static graph and then modeled into a set of ordinary differential equations using...

  8. Glomerular expression of myxovirus resistance protein 1 in human mesangial cells: possible activation of innate immunity in the pathogenesis of lupus nephritis.

    Science.gov (United States)

    Watanabe, Shojiro; Imaizumi, Tadaatsu; Tsuruga, Kazushi; Aizawa, Tomomi; Ito, Tatsuya; Matsumiya, Tomoh; Yoshida, Hidemi; Joh, Kensuke; Ito, Etsuro; Tanaka, Hiroshi

    2013-12-01

    Since viral infections activate type I interferon (IFN) pathways and cause subsequent release of IFN-dependent proinflammatory chemokines and cytokines, the innate immune system plays an important role in the pathogenesis of lupus nephritis (LN). It has been reported that human myxovirus resistance protein 1 (Mx1), a type I IFN-dependent transcript, acts against a wide range of RNA viruses. Although the expression of Mx1 in biopsy specimens obtained from patients with dermatomyositis and cutaneous lupus has been described, the expression of Mx1 in human mesangial cells (MCs) has remained largely unknown. We treated normal human MCs in culture with polyinosinic-polycytidylic acid (poly IC), an authentic double-stranded RNA, and analyzed the expression of Mx1 by reverse transcription-polymerase chain reaction and western blotting. To elucidate the poly IC-signalling pathway, we subjected the cells to RNA interference against IFN-β. We also conducted an immunofluorescence study to examine mesangial Mx1 expression in biopsy specimens from patients with LN. Poly IC-induced Mx1 expression in MCs are shown both time- and dose-dependently, and RNA interference against IFN-β inhibited poly IC-induced Mx1 expression. Intense glomerular Mx1 expression was observed in biopsy specimens from patients with LN, whereas negative staining occurred in specimens from patients with IgA nephropathy or purpura nephritis. These preliminary observations support, at least in part, the theory of innate immune system activation in the pathogenesis of LN. PMID:24674141

  9. Epidemics spreading in interconnected complex networks

    International Nuclear Information System (INIS)

    We study epidemic spreading in two interconnected complex networks. It is found that in our model the epidemic threshold of the interconnected network is always lower than that in any of the two component networks. Detailed theoretical analysis is proposed which allows quick and accurate calculations of epidemic threshold and average outbreak/epidemic size. Theoretical analysis and simulation results show that, generally speaking, the epidemic size is not significantly affected by the inter-network correlation. In interdependent networks which can be viewed as a special case of interconnected networks, however, impacts of inter-network correlation on the epidemic threshold and outbreak size are more significant. -- Highlights: ► We study epidemic spreading in two interconnected complex networks. ► The epidemic threshold is lower than that in any of the two networks. And Interconnection correlation has impacts on threshold and average outbreak size. ► Detailed theoretical analysis is proposed which allows quick and accurate calculations of epidemic threshold and average outbreak/epidemic size. ► We demonstrated and proved that Interconnection correlation does not affect epidemic size significantly. ► In interdependent networks, impacts of inter-network correlation on the epidemic threshold and outbreak size are more significant.

  10. A geographic information system for the study of past epidemics: The 1705 epidemic in Martigues (Bouches-du-Rhône, France

    Directory of Open Access Journals (Sweden)

    Stéfan Tzortzis

    2012-01-01

    Full Text Available At the beginning of the 18th century, the Provence region was hit by several severe epidemics whose causes are still not clearly understood.To draw up epidemic profiles and to identify the pathogenic agents concerned, we constituted a large onomastic database and built ageographic information system for Martigues, a medium-sized community in the south of France. The cross-linking of epidemiological,spatial and demographical data allows us to propose a new diagnosis for the epidemic which reached Martigues in the autumn of 1705.

  11. [Clinical guideline for the treatment of lupus nephritis and single-centre results of mycofenolate mofetil among patients with lupus nephritis in the National Institute of Rheumatology and Physiotherapy, Budapest].

    Science.gov (United States)

    Szabó, Melinda Zsuzsanna; Kiss, Emese

    2016-08-01

    The authors present the latest guideline for the treatment of lupus nephritis and their own single-centre results with mycofenolate mofetil treated lupus nephritis. Lupus nephritis and mainly its proliferative form is a frequent and potentially life-threatening manifestation of systemic lupus erythematosus that can lead to end-stage renal disease. The treatment of lupus nephritis greatly improved in the last decades; mycofenolate mofetil has become an alternative of cyclophosphamide both in remission induction and as a maintenance regimen as well in the treatment of Class III and IV glomerulonephritis. The authors ordered mycofenolate mofetil for 25 patients with lupus nephritis so far. Histologically most of them had Class III (A/C) or IV (A) glomerulonephritis (30-30%), and only 16% of the patients had renal impairment at that time. Mycofenolate mofetil given after glucocorticoid and cyclophosphamide induction therapy reduced the daily proteinuria from 3.18 grs to 1.06 grs. Complete remission could be achieved in 24% and partial remission in 48% of the patients. The authors conclude that mycofenolate mofetil is effective in the therapy of lupus nephritis. Orv. Hetil., 2016, 157(35), 1385-1393. PMID:27569461

  12. Levels of IL-17 and Th17/Treg ratio reflect clinical and pathological activity in patients with lupus nephritis

    Institute of Scientific and Technical Information of China (English)

    许嵘

    2014-01-01

    Objective To explore the correlation of Th17/Treg ratio and related cytokines with clinical and pathological activity in patients with lupus nephritis(LN).Methods The patients with lupus nephritis were enrolled into this study from June 2011 to Feb 2012.The demographic data,clinical activity and pathological index were recorded and analyzed in details.The frequency of Th17 and Treg+

  13. Efficacy and safety of ocrelizumab in active proliferative lupus nephritis: Results from a randomized, double-blind, phase III study

    OpenAIRE

    Mysler, Eduardo F; Spindler, Alberto J.; Guzman, Renato; Bijl, Marc; Jayne, David; Furie, Richard A.; Houssiau, Frédéric; Drappa, Jorn; Close, David; Maciuca, Romeo; Rao, Kajal; Shahdad, Saba; Brunetta, Paul

    2013-01-01

    Objective To investigate the efficacy and safety of ocrelizumab in patients with class III/IV lupus nephritis (LN). Methods Patients were randomized 1:1:1 to receive placebo, 400 mg ocrelizumab, or 1,000 mg ocrelizumab given as an intravenous infusion on days 1 and 15, followed by a single infusion at week 16 and every 16 weeks thereafter, accompanied by background glucocorticoids plus either mycophenolate mofetil (MMF) or the Euro-Lupus Nephritis Trial (ELNT) regimen (cyclophosphamide follow...

  14. LAPping up dead cells to prevent lupus nephritis: a novel role for noncanonical autophagy in autoimmunity.

    Science.gov (United States)

    Leventhal, Jeremy S; Ross, Michael J

    2016-08-01

    The mechanisms underlying the development of systemic lupus erythematosus and lupus nephritis remain poorly understood. A recent study demonstrates that deficiencies in the immune system's ability to degrade scavenged dead cells via noncanonical autophagy is sufficient to break immune tolerance and produce features commonly seen in lupus, including circulating autoantibodies, inflammatory cytokines, and nephritis. This work provides a possible mechanism for the association of polymorphisms in autophagy genes with the risk of lupus. PMID:27418084

  15. Focal bacterial nephritis without pyuria in a boy presenting with high urinary β2-MG and NAG levels

    OpenAIRE

    Sekine, Hitomi; Kawasaki, Yukihiko; Ohara, Shinichiro; Suyama, Kazuhide; Hosoya, Mitsuaki

    2014-01-01

    Acute focal bacterial nephritis (AFBN) is a localized bacterial infection of the kidney presenting as an inflammatory mass without frank abscess formation. We report a case of acute focal bacterial nephritis without pyuria in a five-month-old boy presenting with high urinary β2-microglobulin (β2-MG) and N-Acetyl-β-(D)-Glucosaminidase (NAG) levels. The infant initially presented with high-grade fever, and plain computed tomography (CT) showed a nearly isodense mass, and contrast-enhanced abdom...

  16. Kallikrein transduced mesenchymal stem cells protect against anti-GBM disease and lupus nephritis by ameliorating inflammation and oxidative stress.

    Directory of Open Access Journals (Sweden)

    Yajuan Li

    Full Text Available Previously we have shown that kallikreins (klks play a renoprotective role in nephrotoxic serum induced nephritis. In this study, we have used mesenchymal stem cells (MSCs as vehicles to deliver klks into the injured kidneys and have measured their therapeutic effect on experimental antibody induced nephritis and lupus nephritis. Human KLK-1 (hKLK1 gene was transduced into murine MSCs using a retroviral vector to generate a stable cell line, hKLK1-MSC, expressing high levels of hKLK1. 129/svj mice subjected to anti-GBM induced nephritis were transplanted with 10(6 hKLK1-MSCs and hKLK1 expression was confirmed in the kidneys. Compared with vector-MSCs injected mice, the hKLK1-MSCs treated mice showed significantly reduced proteinuria, blood urea nitrogen (BUN and ameliorated renal pathology. Using the same strategy, we treated lupus-prone B6.Sle1.Sle3 bicongenic mice with hKLK1-MSCs and demonstrated that hKLK1-MSCs delivery also attenuated lupus nephritis. Mechanistically, hKLK1-MSCs reduced macrophage and T-lymphocyte infiltration into the kidney by suppressing the expression of inflammation cytokines. Moreover, hKLK1 transduced MSCs were more resistant to oxidative stress-induced apoptosis. These findings advance genetically modified MSCs as potential gene delivery tools for targeting therapeutic agents to the kidneys in order to modulate inflammation and oxidative stress in lupus nephritis.

  17. Epidemic propagation on adaptive coevolutionary networks with preferential local-world reconnecting strategy

    International Nuclear Information System (INIS)

    In the propagation of an epidemic in a population, individuals adaptively adjust their behavior to avoid the risk of an epidemic. Differently from existing studies where new links are established randomly, a local link is established preferentially in this paper. We propose a new preferentially reconnecting edge strategy depending on spatial distance (PR-SD). For the PR-SD strategy, the new link is established at random with probability p and in a shortest distance with the probability 1 − p. We establish the epidemic model on an adaptive network using Cellular Automata, and demonstrate the effectiveness of the proposed model by numerical simulations. The results show that the smaller the value of parameter p, the more difficult the epidemic spread is. The PR-SD strategy breaks long-range links and establishes as many short-range links as possible, which causes the network efficiency to decrease quickly and the propagation of the epidemic is restrained effectively. (general)

  18. Reducing progression of experimental lupus nephritis via inhibition of the B7/CD28 signaling pathway.

    Science.gov (United States)

    Huang, Li; Kong, Yong; Wang, Jing; Sun, Jie; Shi, Qin; Qiu, Yu-Hua

    2015-09-01

    The aim of the present study was to evaluate the effects of the B7/cluster of differentiation (CD)28 signaling pathway on experimental lupus nephritis and examine the molecular mechanism involved by inhibiting the B7/CD28 signaling pathway. A lupus nephritis model in C57BL/6 J mice was induced via intraperitoneal injection of pristane. A recombinant B7‑1 short hairpin RNA (shRNA) lentivirus vector was constructed by synthesis and splicing. A neutralizing mouse anti‑human B7‑1 antibody termed 4E5 was also prepared. The mouse model of lupus nephritis was treated with B7‑1 shRNA and 4E5 via injection through the tail vein. The silencing effects of B7‑1 shRNA lentiviral infection on target molecules were evaluated using immunofluorescence and flow cytometry. The levels of protein in the urine were detected using Albustix test paper each month over 10 months. The concentration of interleukin (IL)‑4 and interferon‑γ in the serum was determined using an ELISA. The immune complex (IC) deposits in the kidney were analyzed using direct immunofluorescence. The results demonstrated that the C57BL/6 J mouse lupus nephritis model was successfully constructed with immune cells activated in the spleen of the mice, increases in the concentration of anti‑nuclear antibody (ANA) and anti‑double stranded DNA antibodies as well as positive IC formation. Following B7‑1 shRNA lentivirus or 4E5 treatment, CD11b+B7‑1+, CD11c+B7‑1+ and CD21+B7‑1+ cells in the spleen of the mice were significantly reduced. The concentration of ANA and IL‑4 in the serum was also decreased. The concentration of urine protein was reduced and it was at its lowest level in the 4E5 early intervention group. It was also revealed that the immunofluorescence intensity of the IC deposits was weak in the 4E5 early intervention group. In conclusion, inhibiting the B7‑1/CD28 signaling pathway is able to alleviate experimental lupus nephritis and provides an experimental basis for the

  19. Multiple routes transmitted epidemics on multiplex networks

    International Nuclear Information System (INIS)

    This letter investigates the multiple routes transmitted epidemic process on multiplex networks. We propose detailed theoretical analysis that allows us to accurately calculate the epidemic threshold and outbreak size. It is found that the epidemic can spread across the multiplex network even if all the network layers are well below their respective epidemic thresholds. Strong positive degree–degree correlation of nodes in multiplex network could lead to a much lower epidemic threshold and a relatively smaller outbreak size. However, the average similarity of neighbors from different layers of nodes has no obvious effect on the epidemic threshold and outbreak size. -- Highlights: •We studies multiple routes transmitted epidemic process on multiplex networks. •SIR model and bond percolation theory are used to analyze the epidemic processes. •We derive equations to accurately calculate the epidemic threshold and outbreak size. •ASN has no effect on the epidemic threshold and outbreak size. •Strong positive DDC leads to a lower epidemic threshold and a smaller outbreak size.

  20. Next generation sequencing and functional analysis of patient urine renal progenitor-derived podocytes to unravel the diagnosis underlying refractory lupus nephritis.

    Science.gov (United States)

    Romagnani, Paola; Giglio, Sabrina; Angelotti, Maria Lucia; Provenzano, Aldesia; Becherucci, Francesca; Mazzinghi, Benedetta; Müller, Susanna; Amann, Kerstin; Weidenbusch, Marc; Romoli, Simone; Lazzeri, Elena; Anders, Hans-Joachim

    2016-09-01

    Often the cause of refractory lupus nephritis (RLN) remains unclear. We performed next-generation sequencing for podocyte genes in an RLN patient and identified compound heterozygosity for APOL1 risk alleles G1 and G2 and a novel homozygous c.[1049C>T]+[1049C>T] NPHS1 gene variant of unknown significance. To test for causality renal progenitor cells isolated from urine of this patient were differentiated into podocytes in vitro. Podocytes revealed aberrant nephrin trafficking, cytoskeletal structure and lysosomal leakage, and increased detachment as compared with podocytes isolated from controls. Thus, lupus podocytopathy can be confirmed as a cause of RLN by functional genetics on patient-derived podocytes. PMID:27325253

  1. One Hundred Years in the Making: The Global Tobacco Epidemic.

    Science.gov (United States)

    Wipfli, Heather; Samet, Jonathan M

    2016-03-18

    Today's global tobacco epidemic may represent one of the first instances of the globalization of a noninfectious cause of disease. This article focuses on the first century of the global tobacco epidemic and its current status, reviewing the current and projected future of the global tobacco epidemic and the steps that are in progress to end it. In the United States and many countries of Western Europe, tobacco consumption peaked during the 1960s and 1970s and declined as tobacco control programs were initiated, motivated by the evidence indicting smoking as a leading cause of disease. Despite this policy advancement and the subsequent reductions in tobacco consumption, the global tobacco epidemic continued to grow exponentially in the later years of the twentieth century, as the multinational companies sought new markets to replace those shrinking in high-income countries. In response, between 2000 and 2004, the World Health Organization developed its first public health treaty, the Framework Convention on Tobacco Control, which entered into force in 2005. An accompanying package of interventions has been implemented. New approaches to tobacco control, including plain packaging and single representation of brands, have been implemented by Australia and Uruguay, respectively, but have been challenged by the tobacco industry. PMID:26772406

  2. A canine distemper virus epidemic in Serengeti lions (Panthera leo).

    Science.gov (United States)

    Roelke-Parker, M E; Munson, L; Packer, C; Kock, R; Cleaveland, S; Carpenter, M; O'Brien, S J; Pospischil, A; Hofmann-Lehmann, R; Lutz, H; Mwamengele, G L; Mgasa, M N; Machange, G A; Summers, B A; Appel, M J

    1996-02-01

    Canine distemper virus (CDV) is thought to have caused several fatal epidemics in canids within the Serengeti-Mara ecosystem of East Africa, affecting silver-backed jackals (Canis mesomelas) and bat-eared foxes (Otocyon megalotis) in 1978 (ref. 1), and African wild dogs (Lycaon pictus) in 1991 (refs 2, 3). The large, closely monitored Serengeti lion population was not affected in these epidemics. However, an epidemic caused by a morbillivirus closely related to CDV emerged abruptly in the lion population of the Serengeti National Park, Tanzania, in early 1994, resulting in fatal neurological disease characterized by grand mal seizures and myoclonus; the lions that died had encephalitis and pneumonia. Here we report the identification of CDV from these lions, and the close phylogenetic relationship between CDV isolates from lions and domestic dogs. By August 1994, 85% of the Serengeti lion population had anti-CDV antibodies, and the epidemic spread north to lions in the Maasai Mara National reserve, Kenya, and uncounted hyaenas, bat-eared foxes, and leopards were also affected. PMID:8559247

  3. Clinical features and mortality in Chinese with lupus nephritis and neuropsychiatric lupus: A 124-patient study

    Directory of Open Access Journals (Sweden)

    Min Feng

    2014-01-01

    Full Text Available Background: Few investigation has focused on the patients with lupus nephritis (LN and neuropsychiatric systemic lupus erythematosus (NPSLE. This study was aimed to investigate the clinical features, mortality, and the predictors for mortality of this group of patients. Materials and Methods: Medical records were retrospectively reviewed in Sun Yat-sen Memorial Hospital from 1996 to 2012. Data of demographic information, clinical manifestations, laboratory tests, SLE disease activity index 2000 (SLEDAI-2K score, diagnosis, complications, treatment, and mortality was collected. Results: A total of 124 patients were included in our study. Thirty-five (29.1% patients had glomerular filtration rate <60 ml/min/1.73 m 2 , while 24 (19.4% experienced acute kidney injury (AKI. Thirteen of the 19 American College of Rheumatology defined NPSLE syndromes were identified. The most frequent manifestation was seizure disorder (56/124, 45.2%, followed by psychosis (37/124, 29.8% and cerebrovascular disease (35/124, 28.2%. One hundred and five (84.7% patients had SLEDAI-2K scores ≥15, the mean of which was 21.5 ± 6.2. The mortality during hospitalization was 12.9% (16/124 with NP involvement itself being the leading cause of death (7/16, 43.8%. Multivariate logistic regression confirmed that age <14 years at onset of NPSLE (odds ratios [OR]: 9.95, 95% confidence intervals [CI]: 1.43-69.36, P = 0.020, AKI (OR: 10.40, 95% CI: 2.33-46.48, P = 0.002 and pneumonia (OR: 4.52, 95% CI: 1.14-17.96, P = 0.032 were risk factors for mortality, while cyclophosphamide (CYC treatment (OR: 0.09, 95% CI: 0.02-0.54, P = 0.008 was a protective factor. Conclusion: Most of SLE patients with LN and new-onset NPSLE are in an active disease state. NP manifestation itself was the leading cause of death during hospitalization. Childhood-onset NPSLE, AKI and pneumonia might be predictors of mortality, whereas CYC treatment might improve the prognosis.

  4. Fluctuating epidemics on adaptive networks

    CERN Document Server

    Shaw, Leah B

    2008-01-01

    A model for epidemics on an adaptive network is considered. Nodes follow an SIRS (susceptible-infective-recovered-susceptible) pattern. Connections are rewired to break links from non-infected nodes to infected nodes and are reformed to connect to other non-infected nodes, as the nodes that are not infected try to avoid the infection. Monte Carlo simulation and numerical solution of a mean field model are employed. The introduction of rewiring affects both the network structure and the epidemic dynamics. Degree distributions are altered, and the average distance from a node to the nearest infective increases. The rewiring leads to regions of bistability where either an endemic or a disease-free steady state can exist. Fluctuations around the endemic state and the lifetime of the endemic state are considered. The fluctuations are found to exhibit power law behavior.

  5. The Economics of Epidemic Diseases

    Science.gov (United States)

    Dimitri, Nicola

    2015-01-01

    Epidemic, infectious, diseases affect a large number of individuals across developing as well as developed countries. With reference to some very simple diffusion models, in this paper we consider how available economic resources could be optimally allocated by health authorities to mitigate, possibly eradicate, the disease. Optimality was defined as the minimization of the long run number of infected people. The main goal of the work has been to introduce a methodology for deciding if it would be best to concentrate resources to prevent contact between individuals and with an external source, or to develop a new treatment for curing the disease, or both. The analysis suggests that this depends on the cost functions, that is the available technology, for controlling the relevant parameters underlying the epidemics as well as on the available financial resources. In the case of the recent Ebola outbreak, the suggestions of the model have been consistent with the policies adopted. PMID:26372353

  6. Epidemic Synchronization in Robotic Swarms

    DEFF Research Database (Denmark)

    Schiøler, Henrik; Nielsen, Jens Frederik Dalsgaard; Ngo, Trung Dung

    2009-01-01

    Clock synchronization in swarms of networked mobile robots is studied in a probabilistic, epidemic framework. In this setting communication and synchonization is considered to be a randomized process, taking place at unplanned instants of geographical rendezvous between robots. In combination...... with a Markovian mobility model the synchronization process yields overall evolutionary dynamics for first and second conditional moments of synchronization error given geographical position. The established dynamics assume the shape of partial integro-differential equations and the swarm is subsequently studied...

  7. Epidemic Spreading with External Agents

    OpenAIRE

    Banerjee, Siddhartha; Gopalan, Aditya; Das, Abhik Kumar; Shakkottai, Sanjay

    2012-01-01

    We study epidemic spreading processes in large networks, when the spread is assisted by a small number of external agents: infection sources with bounded spreading power, but whose movement is unrestricted vis-\\`a-vis the underlying network topology. For networks which are `spatially constrained', we show that the spread of infection can be significantly speeded up even by a few such external agents infecting randomly. Moreover, for general networks, we derive upper-bounds on the order of the...

  8. Spectral clustering with epidemic diffusion

    Science.gov (United States)

    Smith, Laura M.; Lerman, Kristina; Garcia-Cardona, Cristina; Percus, Allon G.; Ghosh, Rumi

    2013-10-01

    Spectral clustering is widely used to partition graphs into distinct modules or communities. Existing methods for spectral clustering use the eigenvalues and eigenvectors of the graph Laplacian, an operator that is closely associated with random walks on graphs. We propose a spectral partitioning method that exploits the properties of epidemic diffusion. An epidemic is a dynamic process that, unlike the random walk, simultaneously transitions to all the neighbors of a given node. We show that the replicator, an operator describing epidemic diffusion, is equivalent to the symmetric normalized Laplacian of a reweighted graph with edges reweighted by the eigenvector centralities of their incident nodes. Thus, more weight is given to edges connecting more central nodes. We describe a method that partitions the nodes based on the componentwise ratio of the replicator's second eigenvector to the first and compare its performance to traditional spectral clustering techniques on synthetic graphs with known community structure. We demonstrate that the replicator gives preference to dense, clique-like structures, enabling it to more effectively discover communities that may be obscured by dense intercommunity linking.

  9. Networked SIS Epidemics with Awareness

    CERN Document Server

    Paarporn, Keith; Weitz, Joshua S; Shamma, Jeff S

    2016-01-01

    We study an SIS epidemic process over a static contact network where the nodes have partial information about the epidemic state. They react by limiting their interactions with their neighbors when they believe the epidemic is currently prevalent. A node's awareness is weighted by the fraction of infected neighbors in their social network, and a global broadcast of the fraction of infected nodes in the entire network. The dynamics of the benchmark (no awareness) and awareness models are described by discrete-time Markov chains, from which mean-field approximations (MFA) are derived. The states of the MFA are interpreted as the nodes' probabilities of being infected. We show a sufficient condition for existence of a "metastable", or endemic, state of the awareness model coincides with that of the benchmark model. Furthermore, we use a coupling technique to give a full stochastic comparison analysis between the two chains, which serves as a probabilistic analogue to the MFA analysis. In particular, we show that...

  10. Short course of cyclophosphamide therapy may reduce recurrence in patients with tubulointerstitial nephritis and uveitis syndrome

    International Nuclear Information System (INIS)

    We report a 43-year-old woman with tubulointerstitial nephritis and uveitis syndrome (TINU syndrome) presented with a 5-day complaint of chills and fever, anorexia, nausea, and vomiting. She had elevated BUN and creatinine and urinalysis revealed decreased concentration, proteinuria, hematuria, and pyuria. A kidney biopsy showed non-caseating granulomatous tubulointerstitial nephritis. She suffered from anterior uveitis one month before, which was managed with local ophthalmic steroids. She received two months of oral high dose prednisolone, which was tapered over the next two months, and two months of 2 mg/kg cyclophosphamide. Her renal function recovered during the first two months. Her kidney and ocular symptoms did not recur during one year of follow-up. We suggest short course of cyclophosphamide and prednisolone for treatment of TINU syndrome to decrease the recurrence of kidney and ocular involvement. (author)

  11. Lupus nephritis in a Nigerian child: A first documented case report in South-East Nigeria

    Directory of Open Access Journals (Sweden)

    Odetunde O Israel

    2013-01-01

    Full Text Available Systemic lupus erythematosus (SLE is reportedly becoming a common condition among Black Africans in the sub-Saharan countries like Nigeria. Generally, clinical evidence of renal disease occurs in approximately half of the cases of SLE at presentation. The severity of the renal involvement determines the morbidity and mortality of the disease. We report the first documented case of lupus nephritis in an 11-year-old boy in South-East Nigeria. The diagnosis was based on the clinical presentation of a malar rash, photosensitivity rash, discoid skin lesion, oral ulcer, hematuria and massive proteinuria with anasarca; renal biopsy histology revealed lupus nephritis class IIB and constitutional symptoms. He is responding slowly and steadily to corticosteroids and oral cyclophosphamide. SLE with renal involvement is not an unusual disease and accessibility to diagnostic facilities may bring a major change in the approach of the disease in the sub-region.

  12. The Role of Hyaluronan and CD44 in the Pathogenesis of Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Susan Yung

    2012-01-01

    Full Text Available Systemic lupus erythematosus (SLE is a prototype autoimmune disease that affects multiorgan systems. Lupus nephritis is one of the most severe manifestations of SLE whereby immune-mediated inflammation can lead to permanent damage within the glomerular, tubulo-interstitial, and vascular compartments of the kidney, resulting in acute or chronic renal failure. The mechanisms that regulate host inflammatory responses and tissue injury are incompletely understood. Accumulating evidence suggests that hyaluronan and its interaction with its cell surface receptor CD44 plays an important role in mediating pathogenic mechanisms in SLE. This paper discusses the putative mechanisms through which hyaluronan and CD44 contribute to the pathogenesis of SLE, with particular emphasis on lupus nephritis.

  13. Acute interstitial nephritis induced by intermittent use of Rifampicin in patient with Brucellosis

    International Nuclear Information System (INIS)

    Acute oliguric renal failure (ARF) developed in a patient 2 days after she was started on intermittent anti-Brucella therapy including rifampicin. The clinical picture was compatible with acute allergic interstitial nephritis. Renal histology revealed mainly acute tubular necrosis with mild tubulo-intertitial mononuclear cellular infiltrate. Intermittent therapy, as in our patient, has been the major factor in the development of rifampicin induced ARF in cases reviewed in literature. (author)

  14. Histopathology of lupus nephritis: A single-center, cross-sectional study from Karnataka, India

    Directory of Open Access Journals (Sweden)

    Vineeta Shobha

    2014-07-01

    Full Text Available A cross-sectional study of SLE patients over a period of two years is reported. Renal biopsy of 32 selected patients revealed histopathological abnormalities and deposits of immune complexes, and were classified according to the WHO classification of LN (lupus nephritis. The clinical and laboratory parameters assessed were also in line with this classification, indicating the adequacy of these parameters for routine follow-up, and the biopsy was reserved for advanced cases of LN.

  15. Dysregulation of apoptosis: a possible mechanism leading to chronic progressive renal histological changes in lupus nephritis

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To evakuate apoptosis in lupus nephritis and the relationship between the existence of apoptotic cells in renal tissue and histopathological or clinical changes. Methods Apoptosis was detected by in situ nick-end labeling techniques (TUNEL) in renal biopsies from 25 patients with type Ⅳ lupus nephritis (LN),12 patientswith lgA nephropathy lgAN, 4 patients with idiopathic easangnioproliferative lomerulonephritis(MsPGN) and 3 patients with acute poststreptococcal gornerulonephritis (APGN).Normal renal tissue obtained at nephrectomy for hypernephroma in 4 adults wes used as control. Proliferating cells were identified by proliferating cell nuclear antigen (PCNA) in these patiants. Results Compared to other proliferative glomerulonephritis and controls, the patients with lupus nephritis had lase apoptotic cells, a higher ratio of PCNA+cells/TdT+cells (P/T) in renal tissues; and their P/T ratio in glomeruli and tubulointerstitium correlated with the chronicity index, r=0.4983 (P=0.0132), r -0.8399 (P<0.001), r=0.6614 (,P=0.0033),respactively. P/T retios in the glomerulus and tubule had a positive correlation with 24-hour urinary protein,r=0.8554(P<0.001) and r=0.7134 (P=0.001); and a negative correlation with crsetinine clearance (Ccr), r=-0.4880(P=0.0133) and r=-0.7229(P=0.001),which in tubules positively correlated with serum creatinine (Scr), r=0.4107 (P=0.0414). Conclusions Apoptosis is reduced in proliferative lupus nephritis. Intense proliferation without a commensurate increase in apoptosis is a possible mechanism that leads to chronic progressive renalhistopathological changes.

  16. Interstitial nephritis of slaughtered pigs in the State of Mato Grosso, Brazil

    OpenAIRE

    João X. Oliveira Filho; Daphine A.J. de Paula; Nelson Morés; Caroline A. Pescador; Janice R. Ciacci-Zanella; Arlei Coldebella; Valéria Dutra; Luciano Nakazato

    2012-01-01

    This study evaluated histological lesions in kidney samples from pigs with nephritis in two slaughterhouses in the State of Mato Grosso, Brazil. Four hundred samples were subjected to histology, anti-porcine circovirus type 2 (PCV2) immunohistochemistry (IHC), anti-Leptospira sp. immunofluorescence (IF), and polymerase chain reaction (PCR) for PCV2, porcine parvovirus (PPV), and Torque teno virus type 1 and 2 (TTV1, TTV2) detection. Histological lesions were found in 81% of the samples, and m...

  17. Rifampin-associated tubulointersititial nephritis and Fanconi syndrome presenting as hypokalemic paralysis

    OpenAIRE

    2013-01-01

    Background Rifampin is one of the most important drugs in first-line therapies for tuberculosis. The renal toxicity of rifampin has been reported sporadically and acute tubulointerstitial nephritis (ATIN) is a frequent histological finding. We describe for the first time a case of ATIN and Fanconi syndrome presenting as hypokalemic paralysis, associated with the use of rifampin. Case presentation A 42-year-old man was admitted with sudden-onset lower extremity paralysis and mild renal insuffi...

  18. Semi-quantitative evaluation of gallium-67 scintigraphy in lupus nephritis

    International Nuclear Information System (INIS)

    Within nuclear medicine there is a trend towards quantitative analysis. Gallium renal scan has been reported to be useful in monitoring the disease activity of lupus nephritis. However, only visual interpretation using a four-grade scale has been performed in previous studies, and this method is not sensitive enough for follow-up. In this study, we developed a semi-quantitative method for gallium renal scintigraphy to find a potential parameter for the evaluation of lupus nephritis. Forty-eight patients with lupus nephritis underwent renal biopsy to determine World Health Organization classification, activity index (AI) and chronicity index (CI). A delayed 48-h gallium scan was also performed and interpreted by visual and semi-quantitative methods. For semi-quantitative analysis of the gallium uptake in both kidneys, regions of interest (ROIs) were drawn over both kidneys, the right forearm and the adjacent spine. The uptake ratios between these ROIs were calculated and expressed as the ''kidney/spine ratio (K/S ratio)'' or the ''kidney/arm ratio (K/A ratio)''. Spearman's rank correlation test and Mann-Whitney U test were used for statistical analysis. Our data showed a good correlation between the semi-quantitative gallium scan and the results of visual interpretation. K/S ratios showed a better correlation with AI than did K/A ratios. Furthermore, the left K/S ratio displayed a better correlation with AI than did the right K/S ratio. In contrast, CI did not correlate well with the results of semi-quantitative gallium scan. In conclusion, semi-quantitative gallium renal scan is easy to perform and shows a good correlation with the results of visual interpretation and renal biopsy. The left K/S ratio from semi-quantitative renal gallium scintigraphy displays the best correlation with AI and is a useful parameter in evaluating the disease activity in lupus nephritis. (orig.)

  19. The role of lupus nephritis in development of adverse maternal and fetal outcomes during pregnancy

    OpenAIRE

    Alimohammad Fatemi; Reyhaneh Motamedi Fard; Zahra Sayedbonakdar; Ziba Farajzadegan; Mina Saber

    2013-01-01

    Background: We aimed to investigate the relationship of lupus nephritis (LN) with fetal and maternal outcomes of pregnant patients with systemic lupus erythematosus (SLE). Methods: In a retrospective study, profiles of pregnant women with SLE were selected. Before pregnancy and at the end of first, second and third trimesters, SLE disease activity index-2K was assessed. Clinical and laboratory evaluations were carried out regularly. Maternal and fetal outcomes were recorded. Assessments o...

  20. Dialysis and Pregnancy in End Stage Kidney Disease Associated with Lupus Nephritis

    OpenAIRE

    Goutham Sivasuthan; Rumbi Dahwa; John, George T.; Dwarakanathan Ranganathan

    2013-01-01

    Female patients with systemic lupus erythematosus are often of childbearing age at diagnosis, and though fertility in these patients is similar to the general population, successful pregnancy remains a rare occurrence. This incidence is, however, increasing and the management of these high risk pregnancies is often further complicated by the patient’s need for dialysis as a result of lupus nephritis (LN). We share our experience in managing two LN patients with successful pregnancies, one on ...

  1. Features and outcomes of lupus nephritis in Morocco: analysis of 114 patients

    OpenAIRE

    Haddiya I; Hamzaoui H; Tachfouti N; Al Hamany Z; Radoui A; Zbiti N; Amar Y; Rhou H; Benamar L; Ouzeddoun N; Bayahia R

    2013-01-01

    Intissar Haddiya,1 Hakim Hamzaoui,1 Nabil Tachfouti,2 Zitouna Al Hamany,3 Aicha Radoui,1 Najoua Zbiti,1 Yamama Amar,1 Hakima Rhou,1 Loubna Benamar,1 Naima Ouzeddoun,1 Rabea Bayahia1 1Department of Nephrology, Dialysis, and Renal Transplantation, Ibn Sina University Hospital, Rabat, Morocco; 2Department of Epidemiology, Fez, Morocco; 3Department of Pathology, Rabat Children's Hospital, Rabat, Morocco Background: There is wide variation in clinical presentation and outcome of lupus nephriti...

  2. Unusual coexistence between lupus nephritis and neurofibromatosis 1: a case report and review of previous cases

    OpenAIRE

    Manoj Kumar Roy; Rajdeep Basu; Jotideb Mukhopadhyay; Rajat Choudhuri

    2015-01-01

    The association of Neurofibromatosis 1 (NF 1), an autosomal dominant genetic disease with autoimmune diseases like systemic lupus erythematosus is rare, five case reports are there in medical literature showing such association. Here we have documented a case of Lupus nephritis associated with Neurofibromatosis 1 diagnosed in the same setting, in a 24 years old female patient presented with oliguria, hypertension, anasarca, cafe-au-lait spots, palmer freckling, subcutaneous nodules, alopecia ...

  3. Laparoscopic biopsy-proven lupus nephritis in autosomal dominant polycystic kidney disease

    OpenAIRE

    Park, Ji In; Lee, Hajeong; An, Jung Nam; Chin, Ho Jun; Kim, Suhnggwon

    2012-01-01

    A 48-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) presented with generalized edema and arthralgia. She showed evidences of acute glomerulonephritis including nephrotic-ranged proteinuria. Because her serologic test results were consistent with those for systemic lupus erythematosus (SLE), we performed laparoscopic renal biopsy that confirmed World Health Organization (WHO) class IV lupus nephritis. She was treated with steroids and intravenous cyclophosphamide puls...

  4. The Role of Hyaluronan and CD44 in the Pathogenesis of Lupus Nephritis

    OpenAIRE

    Susan Yung; Tak Mao Chan

    2012-01-01

    Systemic lupus erythematosus (SLE) is a prototype autoimmune disease that affects multiorgan systems. Lupus nephritis is one of the most severe manifestations of SLE whereby immune-mediated inflammation can lead to permanent damage within the glomerular, tubulo-interstitial, and vascular compartments of the kidney, resulting in acute or chronic renal failure. The mechanisms that regulate host inflammatory responses and tissue injury are incompletely understood. Accumulating evidence suggests ...

  5. Treatment of lupus nephritis with total lymphoid irradiation. Observations during a 12-79-month followup

    Energy Technology Data Exchange (ETDEWEB)

    Strober, S.; Farinas, M.C.; Field, E.H.; Solovera, J.J.; Kiberd, B.A.; Myers, B.D.; Hoppe, R.T.

    1988-07-01

    Seventeen patients with intractable lupus nephritis and nephrotic syndrome were treated with total lymphoid irradiation. Statistically significant improvement in mean renal disease and serologic activity parameters occurred within 3 months and persisted for at least 3 years. Although there was a marked reduction of T helper cell numbers and function after total lymphoid irradiation, recovery of these parameters was not associated with a return of disease activity. Risks of sterility, severe infections, and hematologic malignancy appeared to be lower than with alkylating agents.

  6. Dengue fever triggering systemic lupus erythematosus and lupus nephritis: a case report

    OpenAIRE

    Talib SH; Bhattu SR; Bhattu R; Deshpande SG; Dahiphale DB

    2013-01-01

    SH Talib, SR Bhattu, R Bhattu, SG Deshpande, DB Dahiphale Department of Medicine and Nephrology, MGM Medical College and Hospital, Aurangabad, Maharashtra, India Abstract: We report a rare case of dengue fever triggering systemic lupus erythematosus and lupus nephritis. The patient presented herself during a large outbreak of dengue fever in December 2012 in Maharashtra, India. The diagnosis of dengue fever was confirmed by the presence of NS-1 antigen during the first few days of febrile il...

  7. Glutathione S Transferases Polymorphisms Are Independent Prognostic Factors in Lupus Nephritis Treated with Cyclophosphamide

    OpenAIRE

    Audemard-Verger, Alexandra; Martin Silva, Nicolas; Verstuyft, Céline; Costedoat-Chalumeau, Nathalie; Hummel, Aurélie; Le Guern, Véronique; Sacré, Karim; Meyer, Olivier; Daugas, Eric; Goujard, Cécile; Sultan, Audrey; Lobbedez, Thierry; Galicier, Lionel; Pourrat, Jacques; Le Hello, Claire

    2016-01-01

    Objective To investigate association between genetic polymorphisms of GST, CYP and renal outcome or occurrence of adverse drug reactions (ADRs) in lupus nephritis (LN) treated with cyclophosphamide (CYC). CYC, as a pro-drug, requires bioactivation through multiple hepatic cytochrome P450s and glutathione S transferases (GST). Methods We carried out a multicentric retrospective study including 70 patients with proliferative LN treated with CYC. Patients were genotyped for polymorphisms of the ...

  8. Immunological aspects of biopsy-proven lupus nephritis in Bahraini patients with systemic lupus erythematosus

    OpenAIRE

    Eman M Farid; Hassan, Adla B; Ali A Abalkhail; Amgad E El-Agroudy; Sameer Al-M Arrayed; Sumaya M Al-Ghareeb

    2013-01-01

    Lupus nephritis (LN) is a frequent and potentially serious complication of systemic lupus erythematosus (SLE) that may influence morbidity and mortality. Immunological investigations are aiding tools to the kidney biopsy findings in early diagnosis, in addition to monitoring the effect of therapy. The aim of the present study is to highlight the role of these investigations in a group of Bahraini patients and to determine whether there is any positive association between these findings and th...

  9. Clinical features and histological patterns of lupus nephritis in Eastern Nepal

    OpenAIRE

    Subodh Sagar Dhakal; Sanjib Kumar Sharma; Narendra Bhatta; Sabina Bhattarai; Smriti Karki; Shailendra Shrestha; Suman Rijal; Prahlad Karkil

    2011-01-01

    To determine the clinical profile and patterns of lupus nephritis patients in Eastern Nepal, we studied 38 patients fulfilling the 1982 revised criteria of American College of Rheu-matology for systemic lupus erythematous (SLE), followed up from January 2004 to January 2008. Arthritis was a common initial feature in addition to variable cutaneous, cardiac, pulmonary and neuropsychiatric manifestations. Renal biopsy showed grade 1 changes in 5 (13.5%) patients, grade 2 changes in 13 (35.1%) pa...

  10. Early-Onset Neutropenia Induced by Rituximab in a Patient with Lupus Nephritis and Hemolytic Anemia

    OpenAIRE

    Mariangelí Arroyo-Ávila; Fred-Jiménez, Ruth M.; Vilá, Luis M.

    2015-01-01

    Rituximab is an anti-CD20 monoclonal antibody that has been used to treat several complications of systemic lupus erythematosus (SLE) including nephritis, cerebritis, and hematological disorders. Neutropenia is among the adverse events associated with rituximab; this usually occurs several weeks after therapy. However, early-onset neutropenia has been reported only in a few cases. Herein, we describe a 36-year-old Hispanic SLE woman who developed severe early-onset neutropenia (0.3 × 109/L) a...

  11. Case report: successful treatment of membranous lupus nephritis with belimumab in an African female immigrant.

    Science.gov (United States)

    De Scheerder, Marie-Angélique; Boey, O; Mahieu, E; Vanuytsel, J; Bogaert, Anne-Marie

    2016-06-01

    We describe the case of a 26-year-old African female who was treated successfully with belimumab in a case of severe membranous lupus nephritis and retinal vasculitis, resistant to first line therapy. She presented initially with chronic dacryoadenitis and screening showed nephrotic-range proteinuria. Biopsy of the kidney confirmed the diagnosis of membranous lupus nephritis. Clinical features (joint pain, dacryoadenitis, retinal vasculitis and lupus nephritis) in combination with serology (positive anti-double-stranded DNA (ds-DNA) antibodies, hypocomplementemia) confirmed the diagnosis of systemic lupus erythematosus (SLE). Treatment was immediately initiated with glucocorticosteroids (GCS), mycophenolate mofetil (MMF) and hydroxychloroquine sulphate (Plaquenil®). Tacrolimus was associated but no effect was observed with the proteinuria remaining in the nephrotic range and secondary effects of the glucocorticosteroids becoming a real concern. The patient was started on add-on belimumab with quasi-immediate effect on the proteinuria, making it possible to decrease the dosage of the other immunosuppressants and gradually stop them, even the GCS. The patient is currently in complete remission after 3 years of treatment with belimumab. We were able to stop immunosuppressive treatment but will keep her on antimalarial treatment as the most recent guidelines in treatment of SLE recommend. PMID:26712500

  12. An Overlapping Case of Lupus Nephritis and IgG4-Related Kidney Disease.

    Science.gov (United States)

    Zaarour, Mazen; Weerasinghe, Chanudi; Eter, Ahmad; El-Sayegh, Suzanne; El-Charabaty, Elie

    2015-07-01

    We report a case of a 71-year-old Filipino female who was admitted to the hospital for abdominal pain, vomiting and diarrhea of 8 days duration. The patient was found to have marked acute kidney injury (AKI), which required hemodialysis in the next 3 days. Extensive workup revealed hematuria, subnephrotic range proteinuria, elevated anti-nuclear antibody (ANA) and elevated total immunoglobulin G (IgG) levels, with normal IgG4 and anti-dsDNA levels. On kidney biopsy, mild membranous glomerulonephritis was found, along with autoimmune tubulointerstitial nephritis (TIN) with a "full-house" pattern of immune deposits. These findings were suggestive of lupus interstitial nephritis. However, IgG4+ plasma cells were detected in the interstitium by immunostaining, favoring a diagnosis of IgG4-related kidney disease (IgG4-RKD). Our case highlights the difficulty in differentiating lupus nephritis (LN) from IgG4-RKD in some patients, raising the suspicion that these two entities can co-exist. PMID:26015827

  13. Effects of Tridocosahexaenoyl-Glycerol Emulsion on Proteinuria in Rats with Nephrotoxic Serum Nephritis

    Directory of Open Access Journals (Sweden)

    Norio Nakamura

    2011-10-01

    Full Text Available Background: Docosahexaenoic acid (DHA is one of the n–3 polyunsaturated fatty acids and an important component of cell membrane phospholipids (PL. Nephrotoxic serum (NTS nephritis was a worldwide model of the Goodpasture syndrome. We investigated the effects of tridocosahexaenoyl-glycerol (DHA-TG emulsion on proteinuria in rats with NTS nephritis. Methods: Sixteen male Wistar rats weighing approximately 200 g were used. Twelve rats were treated with NTS via the tail vein and divided into 3 groups (groups A, B, and C. Another 4 rats treated with saline served as controls (group D. DHA-TG and soybean oil emulsions were intraperitoneally administered to the rats in groups A and B, respectively, 24 h prior to NTS injection, and 0, 1, 2, 3, 4, and 5 days after the injection. Saline was administered to the rats in groups C and D in the same manner. All rats were sacrificed on day 6 to obtain plasma and kidney samples. Analyses of urinary protein levels and fatty acid composition of plasma and kidney as well as histological examination of the kidneys were performed. Results: Urinary protein levels in group A were significantly lower than those in group C (35.0 ± 13.3 vs. 79.2 ± 11.8 mg/day on day 5, means ± SE, p Conclusions: These results suggest that the DHA-TG emulsion may have beneficial effects on NTS nephritis in the rat.

  14. Galectin-3 binding protein links circulating microparticles with electron dense glomerular deposits in lupus nephritis

    DEFF Research Database (Denmark)

    Nielsen, C T; Østergaard, O; Rekvig, O P;

    2015-01-01

    , explore putative clinical correlates, and examine if G3BP is present in immune complex deposits in kidney biopsies from patients with lupus nephritis. METHODS: Numbers of annexin V-binding and G3BP-exposing plasma microparticles from 56 SLE patients and 36 healthy controls were determined by flow...... kidney biopsies from one non-SLE control and from patients with class IV (n = 2) and class V (n = 1) lupus nephritis using co-localization immune electron microscopy. RESULTS: Microparticle-G3BP, microparticle-C1q and microparticle-immunoglobulins were significantly (P < 0.01) increased in SLE patients...... disease activity were found. Immune electron microscopy showed co-localization of G3BP with in vivo-bound IgG in glomerular electron dense immune complex deposits in all lupus nephritis biopsies. CONCLUSIONS: Both circulating microparticle-G3BP numbers as well as G3BP expression are increased in SLE...

  15. Plasma levels of M-CSF are increased in ANCA-associated vasculitides with active nephritis

    Directory of Open Access Journals (Sweden)

    Giuseppe A. Ramirez

    2015-01-01

    Full Text Available Anti-Neutrophil Cytoplasmic Antibodies (ANCA-associated vasculitides (AAV are characterized by small vessel injury and in some cases granulomatous lesions and glomerular inflammation. The pathogenic bases of these clinical phenotypes are incompletely understood, but evidence from patients with AAV and other inflammatory diseases suggest a role for monocyte/macrophages in the perpetuation of tissue injury. Macrophage colony stimulating factor (M-CSF is a promoter of monocyte recruitment and macrophage proliferation, involved in mesangial cell proliferation and experimental nephritis development. Serum concentrations of M-CSF mark and herald the onset of lupus nephritis. Plasma samples from 29 patients with AAV (18 granulomatosis with polyangiitis, GPA, 6 eosinophilic granulomatosis with polyangiitis, EGPA, and 5 microscopic polyangiitis, MPA and from 10 healthy controls were collected together with clinical data. Patients with AAV had higher levels of M-CSF when compared to controls. M-CSF levels correlated positively with the BVAS, serum C-reactive protein and erythrocyte sedimentation rate, while haemoglobin correlated inversely with M-CSF. Patients with active renal disease had significantly higher levels of M-CSF when compared to the other subgroups. M-CSF levels did not differ between ANCA subserotypes and were not associated with the involvement of other organs. In conclusion, M-CSF is higher in patients with AAV and active nephritis and could contribute to the pathogenesis of these diseases. In addition, M-CSF could behave as a useful marker of renal involvement in AAV.

  16. Phylogeographic analysis of the 2000-2002 foot-and-mouth disease epidemic in Argentina.

    Science.gov (United States)

    Brito, Barbara; König, Guido; Cabanne, Gustavo Sebastian; Beascoechea, Claudia Perez; Rodriguez, Luis; Perez, Andres

    2016-07-01

    Foot-and-mouth disease (FMD) is a highly transmissible disease of hooved livestock. Although FMD has been eradicated from many countries, economic and social consequences of FMD reintroductions are devastating. After achieving disease eradication, Argentina was affected by a major epidemic in 2000-2002, and within few months, FMD virus spread throughout most of the country and affected >2500 herds. Available records and viral strains allowed us to assess the origins, spread and progression of this FMD epidemic, which remained uncertain. We used whole genome viral sequences and a continuous phylogeographic diffusion approach, which revealed that the viruses that caused the outbreaks spread fast in different directions from a central area in Argentina. The analysis also suggests that the virus that caused the outbreaks in the year 2000 was different from those found during the 2001 epidemic. To estimate if the approximate overall genetic diversity of the virus was related to disease transmission, we reconstructed the viral demographic variation in time using Bayesian Skygrid approach and compared it with the epidemic curve and the within-herd transmission rate and showed that the genetic temporal diversity of the virus was associated with the increasing number of outbreaks in the exponential phase of the epidemic. Results here provide new evidence of how the disease entered and spread throughout the country. We further demonstrate that genetic data collected during a FMD epidemic can be informative indicators of the progression of an ongoing epidemic. PMID:27074336

  17. Effects of city-size heterogeneity on epidemic spreading in a metapopulation: A reaction-diffusion approach

    CERN Document Server

    Lund, Halvor; Simonsen, Ingve

    2012-01-01

    We review and introduce a generalized reaction-diffusion approach to epidemic spreading in a metapopulation modeled as a complex network. The metapopulation consists of susceptible and infected individuals that are grouped in subpopulations symbolising cities and villages that are coupled by human travel in a transportation network. By analytic methods and numerical simulations we calculate the fraction of infected people in the metaopoluation in the long time limit, as well as the relevant parameters characterising the epidemic threshold that separates an epidemic from a non-epidemic phase. Within this model, we investigate the effect of a heterogeneous network topology and a heterogeneous subpopulation size distribution. Such a system is suited for epidemic modeling where small villages and big cities exist simultaneously in the metapopulation. We find that the heterogeneous conditions cause the epidemic threshold to be a non-trivial function of the reaction rates (local parameters), the network's topology ...

  18. Competing activation mechanisms in epidemics on networks

    CERN Document Server

    Castellano, Claudio

    2011-01-01

    In stark contrast to previous common wisdom that epidemic activity and thresholds in heterogeneous networks are dominated by the elements with the largest number of connections (the hubs), recent research has pointed out the role of the most efficient spreaders, located at the innermost, dense core of the network, in sustaining epidemic processes. Here we show that the mechanism responsible of epidemic spreading depends on the dynamical pattern of the epidemic process. For epidemics with a transient state, activity is essentially boosted by the innermost core of the network. On the contrary, epidemics allowing a steady state present a dual scenario, where either the vertex with the largest connectivity independently sustains activity and propagates it to the rest of the system, or, alternatively, the innermost core of the network collectively turns into the active state, maintaining it on a global scale. Which one of these two mechanisms actually governs the dynamics depends on the network features. In uncorr...

  19. Epidemic characteristics and causes of death of 13 pediatric AIDS cases%13例儿童艾滋病病例流行病学特征及死亡原因分析

    Institute of Scientific and Technical Information of China (English)

    曹军

    2011-01-01

    目的 了解艾滋病患儿死亡前的流行病学特点及临床特征,为有针对性降低艾滋病患儿死亡率提供有价值的参考依据.方法 收集南宁市第四人民医院2007-2009年收治的13例5岁以下艾滋病患儿的人口学特征、传播途径、临床特征、并发症、实验室检查、治疗、死因等资料,并采用描述性流行病学方法进行分析.结果 13例患儿中女童10例,男童3例;年龄最小3月龄,最大4岁,平均2岁;有11例患儿为足月顺产,9例为母乳喂养;11例病例为母婴传播,2例传播途径不详,10例患儿母亲分娩时未采取母婴阻断措施,仅5例患儿母亲孕前开始采取抗病毒治疗.发病至死亡时间(中位数)为0.58年,平均入院至死亡时间(中位数)为5 d; 13例病例均有多种并发症,其中以肺部感染(12例)、口腔真菌感染(11例)为多.检测5例患儿的病毒载量,平均值为1.6×105 copies/mL;检测7例患儿的CD4+水平,平均值为263个/μL(17.00%).13例病例均采取对症、支持、抗逆转录病毒治疗等,抗病毒治疗一般采用AZT(d4T)+3TC+NVP(EFV)方案;艾滋病儿童死亡直接死亡原因分别为多器官功能衰竭(7例)、呼吸衰竭(4例)、脑水肿(2例).结论 受调查的艾滋病患儿主要为母婴传播,具有起病急、进展快、免疫功能水平低下、合并多种机会性感染、以多器官功能衰竭为主要死因等特点.%Objective To understand the epidemiologieal and clinical characteristics of the 13 pediatric AIDS cases, and provide valuable reference for reducing the deaths of children with AIDS. Methods Data of demographic characteristics, transmission, clinical features, complications, laboratory tests,treatment, cause of death were collected from 13 AIDS cases under 5 years old treated in the Fourth People' s Hospital of Nanning City from 2007 to 2009, for descriptive epidemiologic analysis. Results Of 13 eases, 10 were girls and 3 were boys, aged from 3 months to 4 years old

  20. Epidemic Model of Leptospirosis Containing Fractional Order

    OpenAIRE

    Muhammad Altaf Khan; Saddiq, S. F.; Saeed Islam; Ilyas Khan; Dennis Ling Chuan Ching

    2014-01-01

    We study an epidemic model of leptospirosis in fractional order numerically. The multistep generalized differential transform method is applied to find the accurate approximate solution of the epidemic model of leptospirosis disease in fractional order. A unique positive solution for the epidemic model in fractional order is presented. For the integer case derivative, the approximate solution of MGDTM is compared with the Runge-Kutta order four scheme. The numerical results are presented for ...

  1. Optimal control of epidemics in metapopulations

    OpenAIRE

    Rowthorn, Robert E.; Laxminarayan, Ramanan; Gilligan, Christopher A.

    2009-01-01

    Little is known about how best to deploy scarce resources for disease control when epidemics occur in different but interconnected regions. We use a combination of optimal control methods and epidemiological theory for metapopulations to address this problem. We consider what strategy should be used if the objective is to minimize the discounted number of infected individuals during the course of an epidemic. We show, for a system with two interconnected regions and an epidemic in which infec...

  2. Survey of American food trends and the growing obesity epidemic

    OpenAIRE

    Shao, Qin; Chin, Khew-Voon

    2011-01-01

    The rapid rise in the incidence of obesity has emerged as one of the most pressing global public health issues in recent years. The underlying etiological causes of obesity, whether behavioral, environmental, genetic, or a combination of several of them, have not been completely elucidated. The obesity epidemic has been attributed to the ready availability, abundance, and overconsumption of high-energy content food. We determined here by Pearson's correlation the relationship between food typ...

  3. Opioids: The Prescription Drug & Heroin Overdose Epidemic

    Science.gov (United States)

    ... Pain Medication Facts Prevention Treatment & Recovery Overdose Response Health Professionals Resources Law Enforcement Resources Opioids: The Prescription Drug & Heroin Overdose Epidemic Opioids are natural or synthetic chemicals ...

  4. Risk perception in epidemic modeling

    OpenAIRE

    Bagnoli, Franco; Lio, Pietro; Sguanci, Luca

    2007-01-01

    We investigate the effects of risk perception in a simple model of epidemic spreading. We assume that the perception of the risk of being infected depends on the fraction of neighbors that are ill. The effect of this factor is to decrease the infectivity, that therefore becomes a dynamical component of the model. We study the problem in the mean-field approximation and by numerical simulations for regular, random and scale-free networks. We show that for homogeneous and random networks, there...

  5. Fractional derivatives in Dengue epidemics

    CERN Document Server

    Pooseh, Shakoor; Torres, Delfim F M

    2011-01-01

    We introduce the use of fractional calculus, i.e., the use of integrals and derivatives of non-integer (arbitrary) order, in epidemiology. The proposed approach is illustrated with an outbreak of dengue disease, which is motivated by the first dengue epidemic ever recorded in the Cape Verde islands off the coast of west Africa, in 2009. Numerical simulations show that in some cases the fractional models fit better the reality when compared with the standard differential models. The classical results are obtained as particular cases by considering the order of the derivatives to take an integer value.

  6. SIS epidemic propagation on hypergraphs

    CERN Document Server

    Bodó, Ágnes; Simon, Péter L

    2015-01-01

    Mathematical modeling of epidemic propagation on networks is extended to hypergraphs in order to account for both the community structure and the nonlinear dependence of the infection pressure on the number of infected neighbours. The exact master equations of the propagation process are derived for an arbitrary hypergraph given by its incidence matrix. Based on these, moment closure approximation and mean-?eld models are introduced and compared to individual-based stochastic simulations. The simulation algorithm, developed for networks, is extended to hypergraphs. The e?ects of hypergraph structure and the model parameters are investigated via individual-based simulation results.

  7. IgG4-related tubulointerstitial nephritis associated with only lymphadenopathy and without elevated serum IgG4 or renal imaging abnormalities: a case report and literature review

    OpenAIRE

    Qiao, Xi; Wang, Lihua; Wang, Chen; Gao, Lifang; Yao, Shulei; Wu, Liran; Zhang, Xiaoqin

    2015-01-01

    IgG4-related tubulointerstitial nephritis (IgG4-TIN) is the most common renal manifestation of IgG4-related kidney disease (IgG4-RKD) and may cause acute or chronic renal dysfunction. Imaging often shows heterogeneous densities in the kidneys, such as a mass or multiple nodules. Serology usually demonstrates high levels of serum IgG4 and total IgG. Most patients have other organs involvement by IgG4 related disease. Although lymphadenopathy is frequently observed in patients with IgG4-TIN, it...

  8. The psychiatric epidemic in the American workplace.

    Science.gov (United States)

    Brodsky, C M

    1988-01-01

    make renouncement tantamount to betrayal. The mass psychogenic illness or psychiatric epidemic that occurs in the workplace offers an opportunity not only to study the elements of a biopsychosocial system, but also offers opportunities for medical anthropological studies that relate the causes and courses of specific episodes of MPI to the cultures of the individuals who develop symptoms and the cultures of the area in which the epidemic occurs. PMID:3067396

  9. A New Framework and Software to Estimate Time-Varying Reproduction Numbers During Epidemics

    OpenAIRE

    Cori, A.; Ferguson, N.M; Fraser, C; Cauchemez, S

    2013-01-01

    The quantification of transmissibility during epidemics is essential to designing and adjusting public health responses. Transmissibility can be measured by the reproduction number R, the average number of secondary cases caused by an infected individual. Several methods have been proposed to estimate R over the course of an epidemic; however, they are usually difficult to implement for people without a strong background in statistical modeling. Here, we present a ready-to-use tool for estima...

  10. The Impact of an Epidemic Outbreak on Consumer Expenditures:An Empirical Assessment for MERS Korea

    OpenAIRE

    Hojin Jung; Minjae Park; Kihoon Hong; Eunjung Hyun

    2016-01-01

    In this paper, we investigate the effect of an epidemic outbreak on consumer expenditures. In light of scanner panel data on consumers’ debit and credit card transactions, we present empirical evidence that outbreaks cause considerable disruption in total consumer expenditures with significant heterogeneity across categories. Our findings strongly imply that customers alter their behaviors to reduce the risk of infection. The estimated effect of an epidemic outbreak is qualitatively different...

  11. Critiquing the response to the Ebola epidemic through a Primary Health Care Approach

    OpenAIRE

    Scott, Vera; Crawford-Browne, Sarah; Sanders, David

    2016-01-01

    Background The 2014/2015 West Africa Ebola epidemic has caused the global public health community to engage in difficult self-reflection. First, it must consider the part it played in relation to an important public health question: why did this epidemic take hold and spread in this unprecedented manner? Second, it must use the lessons learnt to answer the subsequent question: what can be done now to prevent further such outbreaks in the future? These questions remain relevant, even as scient...

  12. A New Algorithm for Identifying Possible Epidemic Sources with Application to the German Escherichia coli Outbreak

    OpenAIRE

    Roberto Benzi; Masoud Asadi-Zeydabadi; Weldon Lodwick; Enzo Grossi; Alvin Bronstein; Massimo Buscema; Francis Newman

    2013-01-01

    In this paper we describe a recently developed algorithm called Topological Weighted Centroid (TWC). TWC takes locations of an event of interest and analyzes the possible associated dynamics using the ideas of free energy and entropy. This novel mathematical tool has been applied to a real world example, the epidemic outbreak caused by Escherichia coli that occurred in Germany in 2011, to point out the real source of the outbreak. Other four examples of application to other epidemic spreads a...

  13. Epidemic resurgence of dengue fever in Singapore in 2013-2014: A virological and entomological perspective

    OpenAIRE

    Hapuarachchi, Hapuarachchige Chanditha; Koo, Carmen; Rajarethinam, Jayanthi; Chong, Chee-Seng; Lin, Cui; Yap, Grace; Liu, Lilac; Lai, Yee-Ling; Ooi, Peng Lim; Cutter, Jeffery; Ng, Lee-Ching

    2016-01-01

    Background Dengue resurged in Singapore during 2013-14, causing an outbreak with unprecedented number of cases in the country. In the present study, we summarise the epidemiological, virological and entomological findings gathered through the dengue surveillance programme and highlight the drivers of the epidemic. We also describe how the surveillance system facilitated the preparedness to moderate epidemic transmission of dengue in the country. Methods The case surveillance was based on a ma...

  14. The problem of the periodicity of the epidemic process. [solar activity effects on diphtheria outbreak

    Science.gov (United States)

    Yagodinskiy, V. N.; Konovalenko, Z. P.; Druzhinin, I. P.

    1974-01-01

    An analysis of data from epidemics makes it possible to determine their principal causes, governed by environmental factors (solar activity, etc.) The results of an analysis of the periodicity of the epidemic process in the case of diphtheria are presented which was conducted with the aid of autocorrelation and spectral methods of analysis. Numerical data (annual figures) are used on the dynamics of diphtheria in 50 regions (points) with a total duration of 2,777 years.

  15. Oxford classification of IgA nephropathy is applicable to predict long-term outcomes of Henoch-Schönlein purpura nephritis.

    Directory of Open Access Journals (Sweden)

    Hamid Nasri

    2014-12-01

    Full Text Available Henoch-Schönlein purpura nephritis and IgA nephropathy are currently considered to be different clinical presentations of the same disease. There is need for a reliable proven, morphologic classification that can help clinicians more accurately formulate treatment strategies for patients with Henoch-Schönlein purpura nephritis. Considering that Henoch-Schönlein purpura nephritis and IgA nephropathy have common characteristics of pathogenesis and histopathologic findings, we postulate that, the Oxford classification could also help predict long-term outcomes in Henoch-Schönlein purpura nephritis. Hence, we suggest to applicate the Oxford classification for patients with Henoch-Schönlein purpura nephritis.

  16. Epidemic Survivability: Characterizing Networks Under Epidemic-like Failure Propagation Scenarios

    DEFF Research Database (Denmark)

    Manzano, Marc; Calle, Eusebi; Ripoll, Jordi; Fagertun, Anna Manolova; Torres-Padrosa, Víctor

    Epidemics theory has been used in different contexts in order to describe the propagation of diseases, human interactions or natural phenomena. In computer science, virus spreading has been also characterized using epidemic models. Although in the past the use of epidemic models in...... telecommunication networks has not been extensively considered, nowadays, with the increasing computation capacity and complexity of operating systems of modern network devices (routers, switches, etc.), the study of possible epidemic-like failure scenarios must be taken into account. When epidemics occur, such as...

  17. Epidemic corruption: a bio-economic homology

    OpenAIRE

    Hathroubi, Salem

    2013-01-01

    This paper aims to study corruption as an epidemic phenomenon using the epidemic diffusion model of Kermack and Mc-Kendrick (1927). We seek to determine the dynamics of corruption and its impact on the composition of the population at a given time. We determine a threshold epidemiological corruption based on the approximation of the honest population.

  18. Reemerging Threat of Epidemic Typhus in Algeria

    OpenAIRE

    Mokrani, K.; Fournier, P E; Dalichaouche, M.; Tebbal, S.; Aouati, A.; Raoult, D

    2004-01-01

    We report a case of epidemic typhus in a patient from the Batna region of Algeria, who presented with generalized febrile exanthema. The clinical diagnosis was confirmed by serological cross-adsorption followed by Western blotting. Our report emphasizes the threat of epidemic typhus in the highlands of Algeria.

  19. Epidemic Network Failures in Optical Transport Networks

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Katsikas, Dimitrios; Fagertun, Anna Manolova

    2013-01-01

    This paper presents a failure propagation model for transport networks which are affected by epidemic failures. The network is controlled using the GMPLS protocol suite. The Susceptible Infected Disabled (SID) epidemic model is investigated and new signaling functionality of GMPLS to support...

  20. Malaria Epidemic and Drug Resistance, Djibouti

    OpenAIRE

    Rogier, Christophe; Pradines, Bruno; H. Bogreau; Koeck, Jean-Louis; Kamil, Mohamed-Ali; Mercereau-Puijalon, Odile

    2005-01-01

    Analysis of Plasmodium falciparum isolates collected before, during, and after a 1999 malaria epidemic in Djibouti shows that, despite a high prevalence of resistance to chloroquine, the epidemic cannot be attributed to a sudden increase in drug resistance of local parasite populations.

  1. Epidemic centrality and the underestimated epidemic impact on network peripheral nodes

    CERN Document Server

    Sikic, Mile; Antulov-Fantulin, Nino; Stefancic, Hrvoje

    2011-01-01

    Studies of disease spreading on complex networks have provided a deep insight into the conditions of onset, dynamics and prevention of epidemics in human populations and malicious software propagation in computer networks. Identifying nodes which, when initially infected, infect the largest part of the network and ranking them according to their epidemic impact is a priority for public health policies. In simulations of the disease spreading in SIR model on studied empirical complex networks, it is shown that the ranking depends on the dynamical regime of the disease spreading. A possible mechanism leading to this dynamical dependence is illustrated in an analytically tractable example. A measure called epidemic centrality, averaging the epidemic impact over all possible disease spreading regimes, is introduced as a basis of epidemic ranking. Contrary to standard notion, the epidemic centrality of nodes with high degree, k-cores value or betweenness, which are structurally central, is comparable to epidemic c...

  2. A break in the obesity epidemic?

    DEFF Research Database (Denmark)

    Visscher, T L S; Heitmann, B L; Rissanen, A;

    2015-01-01

    epidemic. However, follow-ups of short duration may, in part, explain the apparent break or decrease in the obesity epidemic. On the other hand, a single focus on body mass index (BMI) ⩾25 or ⩾30 kg m(-)(2) is likely to mask a real increase in the obesity epidemic. And, in both children and adults, trends......Recent epidemiologic papers are presenting prevalence data suggesting breaks and decreases in obesity rates. However, before concluding that the obesity epidemic is not increasing anymore, the validity of the presented data should be discussed more thoroughly. We had a closer look...... into the literature presented in recent reviews to address the major potential biases and distortions, and to develop insights about how to interpret the presented suggestions for a potential break in the obesity epidemic. Decreasing participation rates, the use of reported rather than measured data and small sample...

  3. Monitoring linked epidemics: the case of tuberculosis and HIV.

    Directory of Open Access Journals (Sweden)

    María S Sánchez

    Full Text Available BACKGROUND: The tight epidemiological coupling between HIV and its associated opportunistic infections leads to challenges and opportunities for disease surveillance. METHODOLOGY/PRINCIPAL FINDINGS: We review efforts of WHO and collaborating agencies to track and fight the TB/HIV co-epidemic, and discuss modeling--via mathematical, statistical, and computational approaches--as a means to identify disease indicators designed to integrate data from linked diseases in order to characterize how co-epidemics change in time and space. We present R(TB/HIV, an index comparing changes in TB incidence relative to HIV prevalence, and use it to identify those sub-Saharan African countries with outlier TB/HIV dynamics. R(TB/HIV can also be used to predict epidemiological trends, investigate the coherency of reported trends, and cross-check the anticipated impact of public health interventions. Identifying the cause(s responsible for anomalous R(TB/HIV values can reveal information crucial to the management of public health. CONCLUSIONS/SIGNIFICANCE: We frame our suggestions for integrating and analyzing co-epidemic data within the context of global disease monitoring. Used routinely, joint disease indicators such as R(TB/HIV could greatly enhance the monitoring and evaluation of public health programs.

  4. Cooperative epidemics on multiplex networks

    CERN Document Server

    Azimi-Tafreshi, N

    2015-01-01

    The spread of one disease, in some cases, can stimulate the spreading of another infectious disease. Here, we treat analytically a symmetric co-infection model for spreading of two diseases on a 2-layer multiplex network. We allow layer overlapping, but we assume that each layer is random and locally loop-less. Infection with one of the diseases increases the probability to get infected by the other. Using generating function method, we calculate exactly the fraction of individuals infected with both diseases (so-called co-infected clusters) in the stationary state, as well as the epidemic spreading thresholds and the phase diagram of the model. With increasing cooperation, we observe a tricritical point and the type of transition changes from continuous to hybrid. Finally we compare the co-infected clusters in the case of co-operating diseases with the so-called viable clusters in networks with dependencies.

  5. Food allergy: an enigmatic epidemic.

    Science.gov (United States)

    Berin, M Cecilia; Sampson, Hugh A

    2013-08-01

    Food allergy is a common disease that is rapidly increasing in prevalence for reasons that remain unknown. Current research efforts are focused on understanding the immune basis of food allergy, identifying environmental factors that may contribute to its rising prevalence, and developing immunotherapeutic approaches to establish immune tolerance to foods. Technological advances such as peptide microarray and MHC class II tetramers have begun to provide a comprehensive profile of the immune response to foods. The burgeoning field of mucosal immunology has provided intriguing clues to the role of the diet and the microbiota as risk factors in the development of food allergy. The purpose of this review is to highlight significant gaps in our knowledge that need answers to stem the progression of this disorder that is reaching epidemic proportions. PMID:23648309

  6. Cooperative epidemics on multiplex networks

    Science.gov (United States)

    Azimi-Tafreshi, N.

    2016-04-01

    The spread of one disease, in some cases, can stimulate the spreading of another infectious disease. Here, we treat analytically a symmetric coinfection model for spreading of two diseases on a two-layer multiplex network. We allow layer overlapping, but we assume that each layer is random and locally loopless. Infection with one of the diseases increases the probability of getting infected with the other. Using the generating function method, we calculate exactly the fraction of individuals infected with both diseases (so-called coinfected clusters) in the stationary state, as well as the epidemic spreading thresholds and the phase diagram of the model. With increasing cooperation, we observe a tricritical point and the type of transition changes from continuous to hybrid. Finally, we compare the coinfected clusters in the case of cooperating diseases with the so-called "viable" clusters in networks with dependencies.

  7. Inhomogeneous epidemics on weighted networks

    CERN Document Server

    Britton, Tom

    2011-01-01

    A social (sexual) network is modeled by an extension of the configuration model to the situation where edges have weights, e.g. reflecting the number of sex-contacts between the individuals. An epidemic model is defined on the network such that individuals are heterogeneous in terms of how susceptible and infectious they are. The basic reproduction number R_0 is derived and studied for various examples, but also the size and probability of a major outbreak. The qualitative conclusion is that R_0 gets larger as the community becomes more heterogeneous but that different heterogeneities (degree distribution, weight, susceptibility and infectivity) can sometimes have the cumulative effect of homogenizing the community, thus making $R_0$ smaller. The effect on the probability and final size of an outbreak is more complicated.

  8. The West African ebola virus disease epidemic 2014-2015: A commissioned review.

    Science.gov (United States)

    Omilabu, S A; Salu, O B; Oke, B O; James, A B

    2016-01-01

    The first epidemic of Ebola haemorrhagic disease in West Africa is the largest and longest Ebola epidemic till date, where the outbreak notably involved three countries with distant spread to other countries. It has caused significant mortality, with reported case fatality rates of up to 70%. Data and relevant information were extracted from the review of majorly relevant publications/papers about the Ebola epidemic in West Africa and other previous outbreaks of Ebola virus (EBOV). As of 2016, with the epidemic under control, the World Health Organization has warned that flare-ups of the disease are likely to continue for some time as recently occurred in Sierra Leone and the on-going in Guinea. As this may not be the last outbreak of Ebola virus disease (EVD) in West Africa, there is a need to focus on diagnostic and research capacity required to curtail EVD with adequate measures for emergency preparedness and policies for innovative treatment strategies. PMID:27424613

  9. Nephritogenic antigen determinants in epidermal and renal basement membranes of kindreds with Alport-type familial nephritis.

    OpenAIRE

    Kashtan, C; Fish, A. J.; Kleppel, M; Yoshioka, K; Michael, A. F.

    1986-01-01

    We probed epidermal basement membranes (EBM) of acid-urea denatured skin from members of kindreds with Alport-type familial nephritis (FN) for the presence of antigens reactive with Goodpasture sera (GPS) and serum (FNS) from an Alport patient who developed anti-glomerular basement membrane (GBM) nephritis in a renal allograft. By immunoblotting, GPS reacted primarily with the 28,000 molecular weight (mol wt) monomer but also the 24,000 mol wt and 26,000 mol wt monomers of the noncollagenous ...

  10. IgG4 deposits in pure and combined membranous lupus nephritis.

    Science.gov (United States)

    Herrera van Oostdam, David; Martínez Martínez, Marco U; Oros-Ovalle, Cuauhtémoc; Martínez-Gala, David; Jaimes Piñón, Gerardo T; Abud Mendoza, Carlos

    2016-06-01

    The aim of this study is to determine the frequency and prognosis of IgG4 deposits in renal biopsy of patients with membranous lupus nephritis (MLN). This is a retrospective cohort study in which we included patients with class V alone or combined (III/V or IV/V) of lupus nephritis according to the 2004 ISN/RPS. All the patients included must have availability of renal tissue for immunohistochemistry analyses. We excluded other classes of lupus nephritis. The renal tissue was examined by a nephro-pathologist. We included 65 patients with MLN; of these, 24 (37 %) were class V, and the other had proliferative concomitant with membranous patterns. Seven renal specimens had IgG4 deposits (10 %). Patients with IgG4 deposits had higher levels of eosinophils in serum. All of the patients with IgG4 had renal involvement as first manifestations of systemic lupus erythematosus. The rate of renal failure was 42 and 43 % in IgG4 positive and negative, respectively, 28 % of IgG4 required renal replacement therapy. From a histological view, 42 % of IgG4 had evidence of arteriolar vasculitis in renal biopsies. Lupus patients with IgG4 deposits were more likely to have renal involvement as a first manifestation of systemic lupus erythematosus, and they course with a worse prognosis since they required more dialysis. Also, they have more probability of vascular inflammation on the renal biopsy. PMID:27139512

  11. Thirty-five Infantile Purpura Nephritis Patients Treated with Integrated Traditional Chinese and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@  Thirty-five patients of infantile purpura nephritis (IPN) were treated with integrated traditional Chinese and western medicine (TCM-WM) from January 1994 to December 1998, with good efficacy obtained, and following is the report. METHODS Clinical Data   All the 65 cases were inpatients, and conformed to the “Standards of the Diagnosis and Therapeutical Effect of Hematological Diseases” (edited by ZHANG Zhi-nan. Tianjin: Tianjin Science and Technology Press, 1999∶235-239). They were randomly divided into two groups: Treated group: 35 cases, 23 males, 12 females; aged 4-13 years, 7 years on average; disease course 4-18 days, the mean 10 days; mild type 19 cases (asymptomatic hematuria, proteinuria), nephritis syndrome type 13 cases (hematuria, proteinuria, edema, hypertension), and nephrotic syndrome type 3 cases (typical manifestation of nephrosis complicated with renal insufficiency). Control group: 30 cases, 20 males, 10 females; aged 3-14 years, 6 years on average; disease course 3-16 days, the mean 9 days; mild type 16 cases, nephritis syndrome type 10 cases, nephrotic syndrome type 4 cases. The clinical manifestation, sex, age, hospitalisation time of these 2 groups showed insignificant difference. Method of Treatment   The control group: Adopting intravenous dripping of dexamethasone 0.3-0.5 mg*kg-1*d-1, consecutively for 5-7 days, which was then shifted to prednisone 1-1.5 mg*kg-1*d-1, altogether 2-3 weeks, with Vit C, persantin, chlorphenamine, calcium, etc., orally taken.   The treated (TCM-WM) group, on the basis of the above-mentioned WM treatment, had also TCM syndrome differentiation performed, and were classified into 3 types:

  12. LUPUS NEPHRITIS COMPLICATED WITH MALIGNANT HYPERTENSION: FROM RENAL VASCULAR PATHOLOGY TO CLINICAL RELEVANCE

    Institute of Scientific and Technical Information of China (English)

    Jian-ling Tao; Hang Li; Yu Tang; Yu-bing Wen; Xue-wang Li

    2008-01-01

    Objective To investigate the clinical and pathological characteristics of lupus nephritis patients complicated with malignant hypertension.Methods We retrospectively studied 19 patients with lupus nephritis complicated with malignant hypertension who underwent renal biopsy between January 2002 and December 2006.Results Of 19 patients, 3 were men and 16 were women, with a mean age of 24. 4±7. 7 years old. All had positive antinuclear antibodies and low serum complement was found in 13 patients. All were anemic and 12 of them were thrombocytopenic. Impaired renal function was found in 17 patients with an average serum creatinine of 184. 5 ± 88.9 μmol/L. Severe intrarenai arteriolar lesion was found in all patients. Six patients had lupus vasculopathy, 11 patients had renal thrombotic microangiopathy lesion, 2 had severe arteriosclerosis. All patients received steroids and immunosuppressive drugs, 15 received angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker ( ARB ) with resultant well-controlled blood pressure. Thrombocytopenia and hemolytic anemia resolved remarkably.The renal function improved or recovered in 14 of 17 patients, and 3 developed end-stage renal disease on maintenance dialysis.Conclusions Severe intrarenal vascular lesion complicated with renal nephritis parallels clinical manifestation of malignant hypertension. Renal pathology is the key of treatment strategy emphasizing on the significance of renal vascular involvement and type. On the basis of immunosuppressive drugs and steroids to control systemic lupus activity, timely initiation of ACEI/ARB could be of benefit to blood pressure control and long term renal survival.

  13. Tacrolimus use in lupus nephritis: A systematic review and meta-analysis.

    Science.gov (United States)

    Hannah, Jennifer; Casian, Alina; D'Cruz, David

    2016-01-01

    There is growing interest in the role of tacrolimus as a potential therapeutic agent in SLE. This systematic review and meta-analysis evaluates the evidence for tacrolimus use in the management of lupus nephritis. Thirteen controlled studies were identified (9 suitable for inclusion), using Cochrane database, SCOPUS, Web of Science and OVID (MEDLINE and EMBASE). Data on complete and partial remission rates, proteinuria reduction and adverse events was extracted and analysed using RevMan software. The meta-analysis showed that overall tacrolimus is more effective at inducing complete renal remission than IVCYC (p=0.004), but there is no significant difference compared to MMF (p=0.87). Multi-target TAC+MMF therapy is more effective than IVCYC only when partial remission is included (p=0.0006). Frequency of key adverse effects seems comparable to other agents used in the management of lupus nephritis with fewer gastrointestinal side effects, leukopenia, menstrual disorders, infections and episodes of liver dysfunction reported, but more new onset hypertension and hyperglycaemia. Mortality was lower in the tacrolimus groups, but this was not statistically significant (p=0.15). Tacrolimus may be more effective at reducing proteinuria, but again this was not statistically significant. There are no controlled trials looking at use in pregnancy or juvenile patients, however case reports suggest potential efficacy and safety. In conclusion, in moderately severe lupus nephritis, there is some evidence supporting efficacy of tacrolimus or multi-target TAC+MMF over IVCYC, but no evidence supporting tacrolimus over MMF. Tacrolimus may be more effective at reducing proteinuria, having potential implications for long-term outcome. Key limitations of this study are the lack of long-term outcome data and the lack of high quality, large, blinded controlled trials in multi-ethnic groups. PMID:26427983

  14. Significance of mast cell renal infiltration in patients with anti-GBM nephritis.

    Science.gov (United States)

    Wu, Xiao-Mei; Zhang, Yi-Yan; Zhang, Ming-Chao; Zhang, Li-Hua; Zeng, Cai-Hong; Liu, Zhi-Hong; Tang, Zheng

    2016-07-01

    To investigate the role of mast cells (MCs) renal infiltration in the progression of human anti-GBM nephritis, 38 patients diagnosed with anti-GBM nephritis were enrolled. Renal biopsies were performed. Immunohistochemistry was conducted to detect MCs in renal tissues. Patients were divided into group 1 (MCs SCr 8.95 ± 3.66 vs. 4.75 ± 2.73 mg/dL, p < 0.001), urine retinol-binding protein (RBP 29.8 ± 13.9 vs. 15.7 ± 11.5 mg/dL, p = 0.005), and lower urinary osmotic pressure. Pathologically, patients of group 2 had a higher percentage of fibrous/fibrocellular crescents (66.7 ± 21.9 vs. 47.0 ± 33.6%, p = 0.037) but a lower percentage of cellular crescents. More CD8 (268 mm(-2) vs. 180 mm(-2), p = 0.045) and CD68 (268 mm(-2) vs. 180 mm(-2), p = 0.045) positive cells infiltrating the interstitium were observed in group 2. Furthermore, renal MCs correlated significantly with the total number of crescents and the tubular interstitial CD8 and CD68 positive cells. And, the number of MCs was associated with the histological types. The renal function was significantly different between the two groups at presentation. However, at 3 and 6 month follow-up, the patient outcome was associated with the histological types. Our study showed that MC infiltrations were associated with chronic lesions in anti-GBM nephritis and may be involved in the loss of renal function with pathological changes. PMID:27095326

  15. Reactivity in ELISA with DNA-loaded nucleosomes in patients with proliferative lupus nephritis.

    Science.gov (United States)

    Dieker, Jürgen; Schlumberger, Wolfgang; McHugh, Neil; Hamann, Philip; van der Vlag, Johan; Berden, Jo H

    2015-11-01

    Autoantibodies against nucleosomes are considered a hallmark of systemic lupus erythematosus (SLE). We compared in patients with proliferative lupus nephritis the diagnostic usefulness of a dsDNA-loaded nucleosome ELISA (anti-dsDNA-NcX) with ELISAs in which dsDNA or nucleosomes alone were coated. First, we analysed whether DNA loading on nucleosomes led to masking of epitopes by using defined monoclonal anti-DNA, anti-histone and nucleosome-specific autoantibodies to evaluate the accessibility of nucleosomal epitopes in the anti-dsDNA-NcX ELISA. Second, autoantibody levels were measured in these 3 ELISAs in 100 patients with proliferative lupus nephritis (LN) before immunosuppressive treatment and in 128 non-SLE disease controls. In patients with LN inter-assay comparisons and associations with clinical and serological parameters were analysed. The panel of monoclonal antibodies revealed that all epitopes were equally accessible in the anti-dsDNA-NcX ELISA as in the two other ELISAs. Patients with proliferative lupus nephritis were positive with dsDNA-loaded nucleosomes in 86%, with DNA in 66% and with nucleosomes in 85%. In the non-lupus disease control group these frequencies were 1.6% (2 out of 128) for both the anti-dsDNA-NcX and the anti-dsDNA ELISA and 0% in the anti-nucleosome ELISA. The levels in the anti-dsDNA-NcX ELISA were high in a group of patients with LN that showed absent reactivity in the anti-DNA or low levels in the anti-nucleosome ELISA. Anti-dsDNA-NcX positivity was associated with higher SLEDAI scores within this group. Within nucleosome-based ELISAs, we propose the anti-dsDNA-NcX ELISA as the preferred test system. PMID:26597199

  16. Virulence variation among epidemic and non-epidemic strains of Saint Louis encephalitis virus circulating in Argentina

    Directory of Open Access Journals (Sweden)

    María Elisa Rivarola

    2014-04-01

    Full Text Available Saint Louis encephalitis virus caused an outbreak of febrile illness and encephalitis cases in Córdoba, Argentina, in 2005. During this outbreak, the strain CbaAr-4005 was isolated from Culex quinquefasciatus mosquitoes. We hypothesised that this epidemic variant would be more virulent in a mouse model than two other non-epidemic strains (78V-6507 and CorAn-9275 isolated under different epidemiological conditions. To test this hypothesis, we performed a biological characterisation in a murine model, including mortality, morbidity and infection percentages and lethal infection indices using the three strains. Mice were separated into age groups (7, 10 and 21-day-old mice and analysed after infection. The strain CbaAr-4005 was the most infective and lethal of the three variants, whereas the other two strains exhibited a decreasing mortality percentage with increasing animal age. The strain CbaAr-4005 produced the highest morbidity percentages and no significant differences among age groups were observed. The epidemic strain caused signs of illness in all inoculated animals and showed narrower ranges from the onset of symptoms than the other strains. CbaAr-4005 was the most virulent for Swiss albino mice. Our results highlight the importance of performing biological characterisations of arbovirus strains likely to be responsible for emerging or reemerging human diseases.

  17. Mesangial cell-binding activity of serum immunoglobulin G in patients with lupus nephritis

    OpenAIRE

    Yap, Desmond Y.H.; Yung, Susan; Zhang, Qing; Tang, Colin; Chan, Tak Mao

    2014-01-01

    In vitro data showed that immunoglobulin G (IgG) from patients with lupus nephritis (LN) could bind to cultured human mesangial cells (HMC). The clinical relevance of such binding was unknown. Binding of IgG and subclasses was measured in 189 serial serum samples from 23 patients with Class III/IV+/-V LN (48 during renal flares, 141 during low level disease activity (LLDA)). 64 patients with non-lupus glomerular diseases (NLGD) and 23 healthy individuals were used as controls. HMC-binding was...

  18. Overview of IgG4-Related Tubulointerstitial Nephritis and Its Mimickers

    OpenAIRE

    Jeong, Hyeon Joo; Shin, Su-Jin; Lim, Beom Jin

    2015-01-01

    Tubulointerstitial nephritis (TIN) is the most common form of renal involvement in IgG4-related disease. It is characterized by a dominant infiltrate of IgG4-positive plasma cells in the interstitium and storiform fibrosis. Demonstration of IgG4-positive plasma cells is essential for diagnosis, but the number of IgG4-positive cells and the ratio of IgG4-positive/IgG-positive plasma cells may vary from case to case and depending on the methods of tissue sampling even in the same case. IgG4-pos...

  19. Immunohistochemical Characteristics of IgG4-Related Tubulointerstitial Nephritis: Detailed Analysis of 20 Japanese Cases

    OpenAIRE

    Mitsuhiro Kawano; Ichiro Mizushima; Yutaka Yamaguchi; Naofumi Imai; Hitoshi Nakashima; Shinichi Nishi; Satoshi Hisano; Nobuaki Yamanaka; Motohisa Yamamoto; Hiroki Takahashi; Hisanori Umehara; Takao Saito; Takako Saeki

    2012-01-01

    Although tubulointerstitial nephritis with IgG4+ plasma cell (PC) infiltration is a hallmark of IgG4-related kidney disease (IgG4-RKD), only a few studies are available about the minimum number of IgG4+ PC needed for diagnosis along with IgG4+/IgG+ PC ratio in the kidney. In addition, the significance of the deposition of IgG or complement as a reflection of humoral immunity involvement is still uncertain. In this study, we analyzed 20 Japanese patients with IgG4-RKD to evaluate the number of...

  20. Unusual coexistence between lupus nephritis and neurofibromatosis 1: a case report and review of previous cases

    Directory of Open Access Journals (Sweden)

    Manoj Kumar Roy

    2015-05-01

    Full Text Available The association of Neurofibromatosis 1 (NF 1, an autosomal dominant genetic disease with autoimmune diseases like systemic lupus erythematosus is rare, five case reports are there in medical literature showing such association. Here we have documented a case of Lupus nephritis associated with Neurofibromatosis 1 diagnosed in the same setting, in a 24 years old female patient presented with oliguria, hypertension, anasarca, cafe-au-lait spots, palmer freckling, subcutaneous nodules, alopecia areata and positive family history for NF 1. [Int J Res Med Sci 2015; 3(5.000: 1277-1280

  1. Semi-quantitative evaluation of gallium-67 scintigraphy in lupus nephritis

    Energy Technology Data Exchange (ETDEWEB)

    Lin Wanyu [Dept. of Nuclear Medicine, Taichung Veterans General Hospital, Taichung (Taiwan); Dept. of Radiological Technology, Chung-Tai College of Medical Technology, Taichung (Taiwan); Hsieh Jihfang [Section of Nuclear Medicine, Chi-Mei Foundation Hospital, Yunk Kang City, Tainan (Taiwan); Tsai Shihchuan [Dept. of Nuclear Medicine, Show Chwan Memorial Hospital, Changhua (Taiwan); Lan Joungliang [Dept. of Internal Medicine, Taichung Veterans General Hospital, Taichung (Taiwan); Cheng Kaiyuan [Dept. of Radiological Technology, Chung-Tai College of Medical Technology, Taichung (Taiwan); Wang Shyhjen [Dept. of Nuclear Medicine, Taichung Veterans General Hospital, Taichung (Taiwan)

    2000-11-01

    Within nuclear medicine there is a trend towards quantitative analysis. Gallium renal scan has been reported to be useful in monitoring the disease activity of lupus nephritis. However, only visual interpretation using a four-grade scale has been performed in previous studies, and this method is not sensitive enough for follow-up. In this study, we developed a semi-quantitative method for gallium renal scintigraphy to find a potential parameter for the evaluation of lupus nephritis. Forty-eight patients with lupus nephritis underwent renal biopsy to determine World Health Organization classification, activity index (AI) and chronicity index (CI). A delayed 48-h gallium scan was also performed and interpreted by visual and semi-quantitative methods. For semi-quantitative analysis of the gallium uptake in both kidneys, regions of interest (ROIs) were drawn over both kidneys, the right forearm and the adjacent spine. The uptake ratios between these ROIs were calculated and expressed as the ''kidney/spine ratio (K/S ratio)'' or the ''kidney/arm ratio (K/A ratio)''. Spearman's rank correlation test and Mann-Whitney U test were used for statistical analysis. Our data showed a good correlation between the semi-quantitative gallium scan and the results of visual interpretation. K/S ratios showed a better correlation with AI than did K/A ratios. Furthermore, the left K/S ratio displayed a better correlation with AI than did the right K/S ratio. In contrast, CI did not correlate well with the results of semi-quantitative gallium scan. In conclusion, semi-quantitative gallium renal scan is easy to perform and shows a good correlation with the results of visual interpretation and renal biopsy. The left K/S ratio from semi-quantitative renal gallium scintigraphy displays the best correlation with AI and is a useful parameter in evaluating the disease activity in lupus nephritis. (orig.)

  2. Transverse myelitis in a patient with severe Lupus Nephritis: A casereport

    International Nuclear Information System (INIS)

    We report here a case of severe lupus nephritis, Raynaud's phenomenon,digital gangrene and optic neuritis who, developed acute transverse myelitis(ATM). SLE can present virtually with any complication in the central nervoussystem (CNS) and ATM is a rare but serious manifestation. It is noteworthythat ATM developed in this patient while she was on intravenouscyclophosphamide (IVC) therapy having already finished six doses of monthlyinfusions of 10 mg/kg body weight. The patient responded well tomethyl-prednisolone pulse therapy, IVC and plasmapheresis. She recoveredfully and doing well after nine months of follow-up. (author)

  3. Surtos epidêmicos de dermatite causada por mariposas do gênero Hylesia (Lepidóptera: Hemileucidae no Estado de São Paulo, Brasil Epidemic outbreaks of dermatitis caused by Hylesia (Lepidoptera: Hemileucidae, in S. Paulo State, Brazil

    Directory of Open Access Journals (Sweden)

    Carmen Moreno Glasser

    1993-06-01

    Full Text Available Surtos epidêmicos de dermatite causada por Hylesia sp foram assinalados no litoral do Estado de São Paulo, no período de dezembro de 1989 a dezembro de 1991. O fenômeno assumiu sua maior intensidade em Bertioga, Município de Santos, onde foram registrados 612 casos. Foram atingidos outros 12 municípios da região, estimando-se que algumas centenas de casos procuraram os serviços de saúde locais. Na maioria dos casos verificou-se lesões eritemato-pápulo-pruriginosas, que regrediram em média de 7 a 14 dias. Para tratamento foram utilizados anti-histamímicos sistêmicos corticosteróides tópicos e compressas frias. Ocorreram três episódios epidêmicos no período citado, todos eles coincidindo com o início da estação chuvosa (novembro a janeiro. A cada episódio verificou-se um deslocamento do fenômeno no sentido Norte-Sul. A principal medida profilática utilizada foi a divulgação, junto à população, das medidas de redução de exposição ao agente. Para prédios com elevada infestação por mariposas, foi estudada a efetividade da aplicação de inseticida residual, como medida de redução dos níveis de infestação por mariposas. Obteve-se resultados satisfatórios com deltametrina na dose de 50 mg/m² de parede.Epidemic outbreaks of dermatitis caused by Hylesia sp wich occurred in the coastal region of the State of S. Paulo during the period of December 1989 to December 1991 are confirmed. The incident assumed its greatest intensity in Bertioga, in Santos County, where 612 cases were registered. The outbreak also affected 12 other counties in that region and it was estimated that hundred of affected persons sought the Local Health Service Care. The majority presented with erythematous and prutiginous lesions and papula which lasted 7 to 14 days on average. Treatment consisted of systemic administration of antihistamines, and the use of topic corticosteroides and cold compresses. During the abovementioned period, three

  4. Modal series solution for an epidemic model

    Science.gov (United States)

    Acedo, L.; González-Parra, Gilberto; Arenas, Abraham J.

    2010-03-01

    In this article, we generalize a recently proposed method to obtain an exact general solution for the classical Susceptible, Infected, Recovered and Susceptible (SIRS) epidemic mathematical model. This generalization is based upon the nonlinear coupling of two frequencies in an infinite modal series solution. It is shown that these series provide a nonstandard approach in order to obtain an accurate analytical solution for the classical SIRS epidemic model. Numerical results of the SIRS epidemic model for real and complex frequencies are included in order to test the validity and reliability of the method. This method could be applied to a wide class of models in physics, chemistry or engineering.

  5. Predicting extinction rates in stochastic epidemic models

    International Nuclear Information System (INIS)

    We investigate the stochastic extinction processes in a class of epidemic models. Motivated by the process of natural disease extinction in epidemics, we examine the rate of extinction as a function of disease spread. We show that the effective entropic barrier for extinction in a susceptible–infected–susceptible epidemic model displays scaling with the distance to the bifurcation point, with an unusual critical exponent. We make a direct comparison between predictions and numerical simulations. We also consider the effect of non-Gaussian vaccine schedules, and show numerically how the extinction process may be enhanced when the vaccine schedules are Poisson distributed

  6. Early-onset neutropenia induced by rituximab in a patient with lupus nephritis and hemolytic anemia.

    Science.gov (United States)

    Arroyo-Ávila, Mariangelí; Fred-Jiménez, Ruth M; Vilá, Luis M

    2015-01-01

    Rituximab is an anti-CD20 monoclonal antibody that has been used to treat several complications of systemic lupus erythematosus (SLE) including nephritis, cerebritis, and hematological disorders. Neutropenia is among the adverse events associated with rituximab; this usually occurs several weeks after therapy. However, early-onset neutropenia has been reported only in a few cases. Herein, we describe a 36-year-old Hispanic SLE woman who developed severe early-onset neutropenia (0.3 × 10(9)/L) after the second weekly rituximab infusion (375 mg/m(2) weekly × 4) given for nephritis and hemolytic anemia. She also had early-onset thrombocytopenia after rituximab therapy. Both hematological disorders resolved 12 days after the fourth and final dose. This case, together with few others, suggests that early-onset neutropenia may occur during rituximab therapy. Even though rituximab-induced neutropenia seems to be transient, it may predispose SLE patients to severe complications such as infections. PMID:25767732

  7. Early-Onset Neutropenia Induced by Rituximab in a Patient with Lupus Nephritis and Hemolytic Anemia

    Directory of Open Access Journals (Sweden)

    Mariangelí Arroyo-Ávila

    2015-01-01

    Full Text Available Rituximab is an anti-CD20 monoclonal antibody that has been used to treat several complications of systemic lupus erythematosus (SLE including nephritis, cerebritis, and hematological disorders. Neutropenia is among the adverse events associated with rituximab; this usually occurs several weeks after therapy. However, early-onset neutropenia has been reported only in a few cases. Herein, we describe a 36-year-old Hispanic SLE woman who developed severe early-onset neutropenia (0.3 × 109/L after the second weekly rituximab infusion (375 mg/m2 weekly × 4 given for nephritis and hemolytic anemia. She also had early-onset thrombocytopenia after rituximab therapy. Both hematological disorders resolved 12 days after the fourth and final dose. This case, together with few others, suggests that early-onset neutropenia may occur during rituximab therapy. Even though rituximab-induced neutropenia seems to be transient, it may predispose SLE patients to severe complications such as infections.

  8. Cardiovascular disease: the new epidemic in sub-Saharan Africa.

    Science.gov (United States)

    Ikem, Ifechukwude; Sumpio, Bauer E

    2011-12-01

    Sub-Saharan Africa (SSA) is now facing a double burden of disease where patients are suffering from non-communicable diseases such as coronary heart disease, along with the burden of the current human immunodeficiency virus (HIV) epidemic. Due to this double burden, cardiovascular disease (CVD) prevention and treatment has been overlooked, allowing the rates to continue to rise unchecked. A series of searches were conducted using PubMed as the primary database. From these searches, journal articles were compiled that related to diabetes, obesity and smoking rates in SSA. Also, the prevalence of CVD in the USA was reviewed. Although the USA has higher rates of CVD now, the rates were on the decline compared with SSA. Due to 'Westernization' of SSA, the rates of CVD risk factors, such as diabetes, are expected to increase by 50%. Because of this, 80% of CVD deaths worldwide took place in developing countries like those in SSA. Although HIV/acquired immunodeficiency syndrome (AIDS) is the current epidemic in SSA, CVD disease poses a threat as the new epidemic because of the increasing rates of these CVD risk factors. Without combating this disease now, SSA is facing an epidemiological shift from AIDS to CVD being the leading cause of death. PMID:21940758

  9. Nursing experience of patients with epidemic hemorrhagic fever

    OpenAIRE

    Zhang, Ling-Yan; Zhang, Rong-Rong; Liu, Yan

    2014-01-01

    Objective: To explore the nursing methods of patients with epidemic hemorrhagic fever. Methods: Through careful nursing, 1 case of patients with epidemic hemorrhagic fever, summed up the experience. Results: Patients with epidemic hemorrhagic fever were 2 days later improved, within 6 months to fully recover. Conclusion: With proper treatment and careful nursing, patients with epidemic hemorrhagic fever are able to fully recover.

  10. Phylodynamic analysis of HIV sub-epidemics in Mochudi, Botswana

    Directory of Open Access Journals (Sweden)

    Vlad Novitsky

    2015-12-01

    Real-time HIV genotyping and breaking down local HIV epidemics into phylogenetically distinct sub-epidemics may help to reveal the structure and dynamics of HIV transmission networks in communities, and aid in the design of targeted interventions for members of the acute sub-epidemics that likely fuel local HIV/AIDS epidemics.

  11. Role of MYH9 and APOL1 in African and non-African populations with lupus nephritis

    DEFF Research Database (Denmark)

    Lin, C P; Adrianto, I; Lessard, C J;

    2012-01-01

    Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by autoantibody production and organ damage. Lupus nephritis (LN) is one of the most severe manifestations of SLE. Multiple studies reported associations between renal diseases and variants in the non-muscle myosin...

  12. Anti-inflammatory Effect of Benincasae Semen Herbal-acupuncture at KI10 on nephritis in rats

    Directory of Open Access Journals (Sweden)

    Jeong-hwan Lee

    2010-06-01

    Full Text Available Objective : This study aimed to evaluate the effects of Benincasae Semen Herbal-acupuncture (BSHA at KI10 (Umgok on nephritis induced by LPS in rat. Methods : Rats with nephritis induced by LPS, were treated with Benincasae Semen Herbal-acupuncture(BS-HA injection at KI10. Two control groups, N.P. group and saline group, were treated with 26gauge needle at KI10, 3 times a week. In Saline group normal saline was injected at KI10. To evaluate the effects of Benincasae Semen Herbal-acupuncture at KI10 on nephritis in rats, WBC, Neutrophils in blood, BUN, Creatinine TNF-α, CINC-1 in serum, urinal volume and creatinine and Total protein in urine, reanl TNF-α, renal MPO were measured and reanl tissue was also analyzed. Results : BS-HA injected at KI10 significantly inhibited WBC and neutrophil in blood, creatinine in serum, and MPO in kidney of LPS-stimulated rats. BS-HA injected at KI10 reduced concentration of neutrophil in renal tissue of LPS-stimulated rats. Conclusion : BS-HA at KI10 has a therapeutic effect for nephritis in LPS-stimulated rat. Therefore, it is suggested that BS-HA at KI10 may be an useful therapeutics in clinical field after further researches.

  13. History and origin of the HIV-1 subtype C epidemic in South Africa and the greater southern African region

    Science.gov (United States)

    Wilkinson, Eduan; Engelbrecht, Susan; de Oliveira, Tulio

    2015-01-01

    HIV has spread at an alarming rate in South Africa, making it the country with the highest number of HIV infections. Several studies have investigated the histories of HIV-1 subtype C epidemics but none have done so in the context of social and political transformation in southern Africa. There is a need to understand how these processes affects epidemics, as socio-political transformation is a common and on-going process in Africa. Here, we genotyped strains from the start of the epidemic and applied phylodynamic techniques to determine the history of the southern Africa and South African epidemic from longitudinal sampled data. The southern African epidemic’s estimated dates of origin was placed around 1960 (95% HPD 1956–64), while dynamic reconstruction revealed strong growth during the 1970s and 80s. The South African epidemic has a similar origin, caused by multiple introductions from neighbouring countries, and grew exponentially during the 1980s and 90s, coinciding with socio-political changes in South Africa. These findings provide an indication as to when the epidemic started and how it has grown, while the inclusion of sequence data from the start of the epidemic provided better estimates. The epidemic have stabilized in recent years with the expansion of antiretroviral therapy. PMID:26574165

  14. Epidemic spreading on weighted complex networks

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Ye [Institute of Information Economy, Hangzhou Normal University, Hangzhou 311121 (China); Alibaba Research Center of Complexity Science, Hangzhou Normal University, Hangzhou 311121 (China); Liu, Chuang, E-mail: liuchuang@hznu.edu.cn [Institute of Information Economy, Hangzhou Normal University, Hangzhou 311121 (China); Alibaba Research Center of Complexity Science, Hangzhou Normal University, Hangzhou 311121 (China); Zhang, Chu-Xu [Institute of Information Economy, Hangzhou Normal University, Hangzhou 311121 (China); Alibaba Research Center of Complexity Science, Hangzhou Normal University, Hangzhou 311121 (China); Zhang, Zi-Ke, E-mail: zhangzike@gmail.com [Institute of Information Economy, Hangzhou Normal University, Hangzhou 311121 (China); Alibaba Research Center of Complexity Science, Hangzhou Normal University, Hangzhou 311121 (China)

    2014-01-31

    Nowadays, the emergence of online services provides various multi-relation information to support the comprehensive understanding of the epidemic spreading process. In this Letter, we consider the edge weights to represent such multi-role relations. In addition, we perform detailed analysis of two representative metrics, outbreak threshold and epidemic prevalence, on SIS and SIR models. Both theoretical and simulation results find good agreements with each other. Furthermore, experiments show that, on fully mixed networks, the weight distribution on edges would not affect the epidemic results once the average weight of whole network is fixed. This work may shed some light on the in-depth understanding of epidemic spreading on multi-relation and weighted networks.

  15. Epidemic spreading on weighted complex networks

    International Nuclear Information System (INIS)

    Nowadays, the emergence of online services provides various multi-relation information to support the comprehensive understanding of the epidemic spreading process. In this Letter, we consider the edge weights to represent such multi-role relations. In addition, we perform detailed analysis of two representative metrics, outbreak threshold and epidemic prevalence, on SIS and SIR models. Both theoretical and simulation results find good agreements with each other. Furthermore, experiments show that, on fully mixed networks, the weight distribution on edges would not affect the epidemic results once the average weight of whole network is fixed. This work may shed some light on the in-depth understanding of epidemic spreading on multi-relation and weighted networks.

  16. The Phantom Epidemic of Sexual Assault.

    Science.gov (United States)

    Gilbert, Neil

    1991-01-01

    Discusses definitions and reporting of sexual assault. Concludes that the epidemic of sexual assault suggested by the media reflects a radical feminist attitude which prevents objective analysis and trivializes cases of real abuse. (DM)

  17. CDC Vital Signs: Today's Heroin Epidemic

    Science.gov (United States)

    ... Opioid Painkiller Prescribing: Where You Live Makes a Difference Vital Signs: Prescription Painkiller Overdoses: A Growing Epidemic, Especially Among Women Vital Signs: Prescription Painkiller Overdoses: Use and Abuse of Methadone as a Painkiller Vital Signs: Prescription ...

  18. Clinical significance of determination of changes of serum ferritin, MMP-2 and MMP-9 levels and after transfusion of red blood cells in patients with chronic nephritis

    International Nuclear Information System (INIS)

    Objective: To explore the changes of serum Ferritin, MMP-2 and MMP-9 contents after transfusion of red blood cells in patients with chronic nephritis. Methods: Serum Ferritin (with RIA) and serum MMP-2, MMP-9 (with ELISA) levels were measured in 32 patients with chronic nephritis both before and after a course of transfusion of red blood cells and 35 controls. Results: Before transfusion, the serum Ferritin, MMP-9 levels in the patients were significantly lower than those in controls (P 0.05). Conclusion: Determination of serum Ferritin, MMP-2 and MMP-9 levels is clinically useful for management of patients with chronic nephritis. (authors)

  19. The Stochastic Dynamics of Epidemic Models

    OpenAIRE

    Black, Andrew James

    2010-01-01

    This thesis is concerned with quantifying the dynamical role of stochasticity in models of recurrent epidemics. Although the simulation of stochastic models can accurately capture the qualitative epidemic patterns of childhood diseases, there is still considerable discussion concerning the basic mechanisms generating these patterns. The novel aspect of this thesis is the use of analytic methods to quantify the results from simulations. All the models are formulated as continuous time Markov ...

  20. Epidemics and rumours in complex networks

    CERN Document Server

    Draief, Moez

    2009-01-01

    Information propagation through peer-to-peer systems, online social systems, wireless mobile ad hoc networks and other modern structures can be modelled as an epidemic on a network of contacts. Understanding how epidemic processes interact with network topology allows us to predict ultimate course, understand phase transitions and develop strategies to control and optimise dissemination. This book is a concise introduction for applied mathematicians and computer scientists to basic models, analytical tools and mathematical and algorithmic results. Mathematical tools introduced include coupling

  1. Preventing epidemics in a community of households.

    OpenAIRE

    Hall, R; Becker, N G

    1996-01-01

    The occurrence of epidemics of vaccine-preventable diseases, and the immunization coverage required to prevent them, is affected by the presence of households and heterogeneity in the community. We consider a community where individuals live in households and are of different types, according to infectivity and/or susceptibility to infection. We describe a method for computing the critical immunization coverage to prevent epidemics in such communities and discuss the effectiveness of immuniza...

  2. Detecting nonlinearity and chaos in epidemic data

    Energy Technology Data Exchange (ETDEWEB)

    Ellner, S.; Gallant, A.R. [North Carolina State Univ., Raleigh, NC (United States). Dept. of Statistics; Theiler, J. [Santa Fe Inst., NM (United States)]|[Los Alamos National Lab., NM (United States)

    1993-08-01

    Historical data on recurrent epidemics have been central to the debate about the prevalence of chaos in biological population dynamics. Schaffer and Kot who first recognized that the abundance and accuracy of disease incidence data opened the door to applying a range of methods for detecting chaos that had been devised in the early 1980`s. Using attractor reconstruction, estimates of dynamical invariants, and comparisons between data and simulation of SEIR models, the ``case for chaos in childhood epidemics`` was made through a series of influential papers beginning in the mid 1980`s. The proposition that the precise timing and magnitude of epidemic outbreaks are deterministic but chaotic is appealing, since it raises the hope of finding determinism and simplicity beneath the apparently stochastic and complicated surface of the data. The initial enthusiasm for methods of detecting chaos in data has been followed by critical re-evaluations of their limitations. Early hopes of a ``one size fits all`` algorithm to diagnose chaos vs. noise in any data set have given way to a recognition that a variety of methods must be used, and interpretation of results must take into account the limitations of each method and the imperfections of the data. Our goals here are to outline some newer methods for detecting nonlinearity and chaos that have a solid statistical basis and are suited to epidemic data, and to begin a re-evaluation of the claims for nonlinear dynamics and chaos in epidemics using these newer methods. We also identify features of epidemic data that create problems for the older, better known methods of detecting chaos. When we ask ``are epidemics nonlinear?``, we are not questioning the existence of global nonlinearities in epidemic dynamics, such as nonlinear transmission rates. Our question is whether the data`s deviations from an annual cyclic trend (which would reflect global nonlinearities) are described by a linear, noise-driven stochastic process.

  3. Second Quantization Approach to Stochastic Epidemic Models

    CERN Document Server

    Mondaini, Leonardo

    2015-01-01

    We show how the standard field theoretical language based on creation and annihilation operators may be used for a straightforward derivation of closed master equations describing the population dynamics of multivariate stochastic epidemic models. In order to do that, we introduce an SIR-inspired stochastic model for hepatitis C virus epidemic, from which we obtain the time evolution of the mean number of susceptible, infected, recovered and chronically infected individuals in a population whose total size is allowed to change.

  4. The obesity epidemic: prospects for prevention.

    Science.gov (United States)

    Skidmore, P M L; Yarnell, J W G

    2004-12-01

    Some 20-25% of UK adults are obese according to the WHO criterion (BMI >/=30 kg/m(2)). Type 2 diabetes, increasingly recognized as a major complication of overweight and obesity, is beginning to appear in UK adolescents, following the trends in the US. Epidemiological data indicate that the prevalence of overweight and obesity has doubled or tripled in the past few decades in the US, in Europe, and even in many developing countries. Thus obesity is increasingly seen as a public health problem requiring concerted action by both governmental and non-governmental organizations. A sound understanding of the root causes is crucial, if strategies for the prevention and treatment of this epidemic are to be developed. Many epidemiological studies suggest that physical activity at work, school or at leisure has declined to minimal levels, and that sedentary behaviours such as television viewing and computer games have become major pastimes. Thus energy requirements are substantially less than those for recent generations. Further, the food industry produces high-calorie foods which children and adults consume as snack meals, giving a substantial surfeit to their daily energy requirement. In children, a few school-based, preventive intervention trials have shown some promising results. Many negative trials have also been reported, and practical difficulties remain in the widespread implementation of appropriate protocols. Initiatives have been introduced by the government to increase the physical education syllabus in school to a minimum of 2 h/week, and the promotion of fruit and vegetables. Further research is required on the physiological and psychological causes of overweight and obesity in children and adults, and randomized, controlled, school and community-based trials are required to pilot preventative initiatives. Monitoring of the progress in prevention at both organizational and outcome level is required, and also of adverse outcomes such as a rise in the

  5. A prospective multicentre study of mycophenolate mofetil combined with prednisolone as induction therapy in 213 patients with active lupus nephritis.

    Science.gov (United States)

    F, Lu; Y, Tu; X, Peng; L, Wang; H, Wang; Z, Sun; H, Zheng; Z, Hu

    2008-07-01

    Mycophenolate mofetil (MMF) with prednisolone has been associated with high remission rates when used as induction treatment for lupus nephritis. This prospective, multicentre, cohort study investigates the efficacy and safety of this regimen over 24 weeks in 213 Chinese patients with active lupus nephritis (Classes III, IV, V or combination). Baseline activity index (AI) was 6.91+/-3.33 and chronicity index (CI) was 1.9+/-1.2. The remission rate was 82.6% at 24 weeks (complete remission, 34.3%; partial remission, 48.4%). There were significant (P<0.01) improvements in kidney function shown by reductions in proteinuria, serum albumin, serum creatinine and creatinine clearance, as well as in systemic lupus erythematosus disease activity index (SLEDAI) scores. Independent risk factors influencing remission were pathological classification (including Class V and III or Class V and IV nephritis) and elevated serum creatinine at baseline (OR 2.967, 95% CI: 1.479-6.332, P=0.001 and OR 1.007, 95% CI: 1.002-1.011, P=0.001, respectively). Patients with concomitant membranous features on biopsy had a lower remission rate than those with Class III and IV nephritis (66.7% vs 87.3%, P=0.002). Renal biopsy was repeated in 25 patients following treatment. There was a transition to less severe pathological morphologies in majority of subjects. Infections were monitored throughout treatment: eight patients (3.8%) experienced bacterial infections, whereas herpes zoster occurred in seven patients. Nine patients (4.2%) suffered from gastrointestinal upset, which resolved without discontinuation of MMF. One patient became leucopenic, whereas another died from active disease unrelated to kidney symptoms. MMF combined with prednisolone is an effective and well-tolerated induction treatment for patients with active lupus nephritis and for controlling SLE systemic activity. PMID:18625634

  6. Infectious and Environmental Influences on the Obesity Epidemic.

    Science.gov (United States)

    Huo, Lili; Lyons, Jasmine; Magliano, Dianna J

    2016-09-01

    Over the last two decades, the prevalence of obesity has increased rapidly. While it is intuitively appealing to believe that the causes of obesity are manifestly related to excess dietary intake, combined with a reduced expenditure of energy via a decrease in physical activity, it is also been noted that the evidence for these as the sole causes of the obesity epidemic is incomplete. This has led to the search for other causes of obesity, particularly those which stem from the environment we live in. This review will explore two putative causes of obesity: infections and environmental pollutants. It will focus on the key human infection associated with obesity-human adenovirus 36 (Ad36) and will discuss several environmental pollutants which have been postulated to be involved in the development of obesity: bisphenol A, phthalates and persistent organic pollutants. For each of these, the epidemiology and biological mechanisms underpinning the association of these agents with obesity will be reviewed. PMID:27394433

  7. “潜风扰络”与慢性肾炎病机探析%Analysis of “the Irritation of Kidney Collaterals by the Latent Wind Therewithin” and the Pathogenesis of Chronic Nephritis

    Institute of Scientific and Technical Information of China (English)

    蔡浔远

    2012-01-01

    文章根据古代医学文献及现代医学生理病理及解剖知识,认识到慢性肾炎的复发与加重,病程迁延难愈的原因在于潜风扰动肾络.因此,临证之时,对于慢性肾炎蛋白尿长期不消的患者,主张用祛风通络之剂,尤其是虫蚁辛咸之品,“搜剔络中混处之邪”,俾使蛋白尿得以消除,病情得以痊愈.%This paper addresses the etiology for recurrence and deterioration of chronic nephritis, referencing from ancient Chinese medicine literatures and contemporary knowledge on physiology, pathology and anatomy.The major cause is suggested to be the irritation of kidney collaterals by the latent wind therewithin. Hence, patients with chronic nephritis proteinuria should be managed in the direction of dispelling wind pathogen which hides in the nidus of kidney meridian and collaterals. Herbs with nature of spicy and salty tastes are especially desirable for such treatment in resuming the normal functioning of the kidney collaterals and thus eliminating proteinuria.

  8. Epidemic of mesothelioma in Egypt.

    Science.gov (United States)

    Gaafar, R M; Eldin, N H Aly

    2005-07-01

    Asbestos has been recognized in Egypt since a long time as ancient Egyptians were using it in mummification. Mesothelioma in Egypt is mainly attributed to environmental origin with a high incidence of women and young adults affected. The incidence of mesothelioma is rising in Egypt. Epidemiological data for 635 malignant mesothelioma (MM) patients over 4 years in the third Millennium were collected from the National Cancer Institute (NCI), Cairo University and Abbassia Chest hospital. This number is more than four times the number diagnosed in the previous 11 years at NCI. A clinicopathological study was done for 100 malignant pleural mesothelioma (MPM) patients and showed that asbestos exposure and SV40 positivity were evident in 67% and 60% of cases, respectively. The median survival was 14.3 months and the 1 and 2 year survival rates were 60% and 27%, respectively. Evaluation of p53 and pRb immunohistochemically showed that pRb alteration was related to poor survival. Other biological prognostic factors such as EGFR, HER-2, glutathione S transferase (GST) and MDR were evaluated in 50 cases. Overexpression of EGFR was correlated with lack of clinical benefit and poor survival. GST potentiated the effect of EGFR on survival. The use of EGFR inhibitors may have a role in the treatment of MM. Asbestos in Cairo is a silent killer and measures toward eliminating it entirely or at least strictly controlling human contact with this dangerous carcinogen have to be taken in order to combat the coming epidemic of mesothelioma in Egypt. PMID:15950794

  9. Validation and characterization of a human volunteer challenge model for cholera by using frozen bacteria of the new Vibrio cholerae epidemic serotype, O139

    NARCIS (Netherlands)

    Cohen, MB; Giannella, RA; Losonsky, GA; Lang, DR; Parker, S; Hawkins, JA; Gunther, C; Schiff, GA

    1999-01-01

    Until recently, all epidemic strains of Vibrio cholerae were of the O1 serotype. Current epidemics have also been caused by a new serotype, Vibrio cholerae O139. Although the pathogenesis and clinical features of O139 cholera are similar to those of O1 cholera, immunity to serotype O1 does not confe

  10. Epidemic Survivability: Characterizing Networks Under Epidemic-like Failure Propagation Scenarios

    DEFF Research Database (Denmark)

    Manzano, Marc; Calle, Eusebi; Ripoll, Jordi; Fagertun, Anna Manolova; Torres-Padrosa, Víctor

    telecommunication networks has not been extensively considered, nowadays, with the increasing computation capacity and complexity of operating systems of modern network devices (routers, switches, etc.), the study of possible epidemic-like failure scenarios must be taken into account. When epidemics occur, such as...

  11. Impact of the Tumor Necrosis Factor Receptor-Associated Protein 1 (Trap1) on Renal DNaseI Shutdown and on Progression of Murine and Human Lupus Nephritis

    DEFF Research Database (Denmark)

    Fismen, Silje; Thiyagarajan, Dhivya; Seredkina, Natalya;

    2013-01-01

    from the DNaseI gene. Furthermore, we translate these observations to human lupus nephritis. In this study, mouse and human DNaseI and Trap1 mRNA levels were determined by quantitative PCR and compared with protein expression levels and clinical data. Cellular localization was analyzed by immune...... electron microscopy, IHC, and in situ hybridization. Data indicate that silencing of DNaseI gene expression correlates inversely with expression of the Trap1 gene. Our observations suggest that the mouse model is relevant for the aspects of disease progression in human lupus nephritis. Acquired silencing...... of the renal DNaseI gene has been shown to be important for progression of disease in both the murine and human forms of lupus nephritis. Early mesangial nephritis initiates a cascade of inflammatory signals that lead to up-regulation of Trap1 and a consequent down-regulation of renal DNaseI by...

  12. Clinical outcomes of kidney transplants on patients with end-stage renal disease secondary to lupus nephritis, polycystic kidney disease and diabetic nephropathy

    Science.gov (United States)

    Nieto-Ríos, John Fredy; Builes-Rodriguez, Sheila Alexandra; Restrepo-Correa, Ricardo Cesar; Aristizabal-Alzate, Arbey; Ocampo-Kohn, Catalina; Serna-Campuzano, Angélica; Cardona-Díaz, Natalia; Giraldo-Ramirez, Nelson Darío; Zuluaga-Valencia, Gustavo Adolfo

    2016-01-01

    Background: Patients with lupus nephritis could progress to end-stage renal disease (10-22%); hence, kidney transplants should be considered as the treatment of choice for these patients. Objective: To evaluate the clinical outcomes after kidney transplants in patients with chronic kidney diseases secondary to lupus nephritis, polycystic kidney disease and diabetes nephropathy at Pablo Tobon Uribe Hospital. Methods: A descriptive and retrospective study performed at one kidney transplant center between 2005 and 2013. Results: A total of 136 patients, 27 with lupus nephritis (19.9%), 31 with polycystic kidney disease (22.8%) and 78 with diabetes nephropathy (57.4%), were included in the study. The graft survivals after one, three and five years were 96.3%, 82.5% and 82.5% for lupus nephritis; 90%, 86% and 76.5% for polycystic kidney disease and 91.7%, 80.3% and 67.9% for diabetes nephropathy, respectively, with no significant differences (p= 0.488); the rate of lupus nephritis recurrence was 0.94%/person-year. The etiology of lupus vs diabetes vs polycystic disease was not a risk factor for a decreased time of graft survival (Hazard ratio: 1.43; 95% CI: 0.52-3.93). Conclusion: Kidney transplant patients with end stage renal disease secondary to lupus nephritis has similar graft and patient survival success rates to patients with other kidney diseases. The complication rate and risk of recurrence for lupus nephritis are low. Kidney transplants should be considered as the treatment of choice for patients with end stage renal disease secondary to lupus nephritis. PMID:27226665

  13. Chronic predominant interstitial nephritis in a patient with systemic lupus erythematosus: a follow up of three years and review of the literature.

    OpenAIRE

    Gur, H.; Kopolovic, Y.; Gross, D J

    1987-01-01

    Predominant interstitial nephritis is a rare manifestation of systemic lupus erythematosus. Only seven cases have been reported in the literature. Owing to the rarity of this entity, the natural history of predominant interstitial nephritis in lupus has not been adequately recorded and an appropriate therapeutic approach has yet to be defined. In this report we present the case of a 25 year old woman with active systemic lupus erythematosus complicated by kidney failure and renal tubular acid...

  14. DRESS with delayed onset acute interstitial nephritis and profound refractory eosinophilia secondary to Vancomycin

    Directory of Open Access Journals (Sweden)

    O'Meara Paloma

    2011-10-01

    Full Text Available Abstract Background Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS is a relatively rare clinical entity; even more so in response to vancomycin. Methods Case report. Results We present a severe case of vancomycin-induced DRESS syndrome, which on presentation included only skin, hematological and mild liver involvement. The patient further developed severe acute interstitial nephritis, eosinophilic pneumonitis, central nervous system (CNS involvement and worsening hematological abnormalities despite immediate discontinuation of vancomycin and parenteral corticosteroids. High-dose corticosteroids for a prolonged period were necessary and tapering of steroids a challenge due to rebound-eosinophilia and skin involvement. Conclusion Patients with DRESS who are relatively resistant to corticosteroids with delayed onset of certain organ involvement should be treated with a more prolonged corticosteroid tapering schedule. Vancomycin is increasingly being recognized as a culprit agent in this syndrome.

  15. Interdisciplinary care for adequate adherence totreatment in patients with lupus nephritis

    Directory of Open Access Journals (Sweden)

    Gladys Gaviria-García

    2016-02-01

    Full Text Available The review is based on the contribution that each discipline should provide the patient for a holistic care, which include medical assessment, monitoring and counselling as emotional support, assessment and nutritional monitoring as a key element in core requirements, physical activity that optimize the quality of life, social activities that can enter the individual in active groups, follow-up by nurses to the fulfillment of the ordered drug treatment, car care and orientation education to the family. The novelty of this proposal is to basically carry out care of the interdisciplinary team for treatment adherence. This review concluded that patients with lupus nephritis (NL treated after assessment and follow-up holistic, such as system monitoring and adherence to the treatment of comprehensive care, provides better quality of life, and minimizes the risks of complication of the patient, avoiding recurrent hospitalizations.

  16. Effect of Emodin on Biological Behavior of Fibroblasts in Lupus Nephritis

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To observe the effect of emodin on the biological behavior of human fibroblasts (FB) in culture of kidney in patients with lupus nephritis (LN). Methods: FB were isolated from kidney culture of LN patients, and the effect of emodin on 3 H-TdR incorporated rate of FB was observed. The apoptosis and c-myc gene expression were detected in the same way by flow cytometry. Results: Emodin could markedly inhibit the proliferation of human kidney FB, and inducing cell apoptosis through up-regulating c-myc gene expression in human renal FB. Conclusion: Emodin can inhibit proliferation and promote apoptosis of FB, which may be important in ameliorating interstitial fibrosis, and thus improve prognosis of LN.

  17. Occult systemic lupus erythematosus with active lupus nephritis presenting as Libman-Sacks endocarditis

    Directory of Open Access Journals (Sweden)

    Pankajkumar Ashok Kasar

    2012-01-01

    Full Text Available The diagnosis of systemic lupus erythematosus (SLE depends on clinical evidence of renal, rheumatologic, cutaneous, and neurologic involvement, supported by serological markers. A previously healthy 14-year-old girl presented with Libman-Sacks endocarditis involving the aortic valve as the first manifestation of SLE. Even though she did not satisfy the American College of Rheumatology criteria for diagnosing SLE, she had anemia, proteinuria, elevated erythrocyte sedimentation rate, low complement 4 (C4 levels, and strongly positive antinuclear antibody titer. A renal biopsy showed stage IV lupus nephritis. Treatment was initiated with immunosuppressants and steroids. This type of presentation may be misdiagnosed as infective endocarditis missing the underlying collagen vascular disease.

  18. Acute lobar nephritis in children: Not so easy to recognize and manage.

    Science.gov (United States)

    Bibalo, Cristina; Apicella, Andrea; Guastalla, Veronica; Marzuillo, Pierluigi; Zennaro, Floriana; Tringali, Carmela; Taddio, Andrea; Germani, Claudio; Barbi, Egidio

    2016-02-01

    Acute lobar nephritis (ALN) is a localized non-liquefactive inflammatory renal bacterial infection, which typically involves one or more lobes. ALN is considered to be a midpoint in the spectrum of upper urinary tract infection, a spectrum ranging from uncomplicated pyelonephritis to intrarenal abscess. This condition may be difficult to recognize due to the lack of specific symptoms and laboratory findings. Therefore the disease is probably underdiagnosed. Computed tomography scanning represents the diagnostic gold standard for ALN, but magnetic resonance imagine could be considered in order to limit irradiation. The diagnosis is relevant since initial intravenous antibiotic therapy and overall length of treatment should not be shorter than 3 wk. We review the literature and analyze the ALN clinical presentation starting from four cases with the aim to give to the clinicians the elements to suspect and recognize the ALN in children. PMID:26862513

  19. Gender Differences in the Pathogenesis and Outcome of Lupus and of Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Julie Schwartzman-Morris

    2012-01-01

    Full Text Available Systemic Lupus Erythematosus (SLE typically affects females at far greater rates than males; however male SLE patients often have more severe disease than females. The gender disparities have been reported in clinical manifestations and in serological and hematological indices as well. In particular, SLE complicated with nephritis is more frequent in men than women, and several groups identified male gender as a risk factor for progression to renal failure. The specific differences in pathogenesis amongst genders have yet to be conclusively defined, though genetic, hormonal, and immune responses have been analyzed thus far. Further research is warranted to further elucidate these differences and permit the development of gender-tailored treatment regimens.

  20. Concurrent feline immune-complex nephritis. Tubular antigen-positive and renal amyloidosis.

    Science.gov (United States)

    Saegusa, S; Shimizu, F; Nagase, M; Kasegawa, A

    1979-08-01

    We describe tubular antigen-positive immune-complex nephritis in a case of feline renal amyloidosis. Amyloid deposition was observed in mesangial area, and thickening of capillary walls was shown in the majority of the glomeruli. This case was also characterized with typical fluorescent granular depositions of cat IgG and C3 along the glomerular capillary walls as seen in human membranous glomerulonephritis. The fluorescent pattern of tubular antigen was identical with that of IgG and C3. Electron micrograph showed the thickening and irregularity of glomerular basement membranes, fusion of foot processes, and deposits of electron-dense or sometimes translucent materials, mostly in the intramembranous location. The causal sequence of the coincidental deposition of amyloid and immune complexes is discussed. PMID:157110

  1. Reduced Incidence of Slowly Progressive Heymann Nephritis in Rats Immunized With a Modified Vaccination Technique

    Directory of Open Access Journals (Sweden)

    Arpad Z. Barabas

    2006-01-01

    Full Text Available A slowly progressive Heymann nephritis (SPHN was induced in three groups of rats by weekly injections of a chemically modified renal tubular antigen in an aqueous medium. A control group of rats received the chemically unmodified version of the antigen in an aqueous solution. One group of SPHN rats were pre- and post-treated with weekly injections of IC made up of rKF3 and rarKF3 IgM antibody at antigen excess (MIC (immune complexes [ICs] containing sonicated ultracentrifuged [u/c] rat kidney fraction 3 [rKF3] antigen and IgM antibodies specific against the antigen, at slight antigen excess. One group of SPHN rats were post-treated with MIC 3 weeks after the induction of the disease and one group of SPHN animals received no treatment. The control group of rats received pre- and post-treatment with sonicated u/c rKF3.

  2. Dimensionality reduction in epidemic spreading models

    Science.gov (United States)

    Frasca, M.; Rizzo, A.; Gallo, L.; Fortuna, L.; Porfiri, M.

    2015-09-01

    Complex dynamical systems often exhibit collective dynamics that are well described by a reduced set of key variables in a low-dimensional space. Such a low-dimensional description offers a privileged perspective to understand the system behavior across temporal and spatial scales. In this work, we propose a data-driven approach to establish low-dimensional representations of large epidemic datasets by using a dimensionality reduction algorithm based on isometric features mapping (ISOMAP). We demonstrate our approach on synthetic data for epidemic spreading in a population of mobile individuals. We find that ISOMAP is successful in embedding high-dimensional data into a low-dimensional manifold, whose topological features are associated with the epidemic outbreak. Across a range of simulation parameters and model instances, we observe that epidemic outbreaks are embedded into a family of closed curves in a three-dimensional space, in which neighboring points pertain to instants that are close in time. The orientation of each curve is unique to a specific outbreak, and the coordinates correlate with the number of infected individuals. A low-dimensional description of epidemic spreading is expected to improve our understanding of the role of individual response on the outbreak dynamics, inform the selection of meaningful global observables, and, possibly, aid in the design of control and quarantine procedures.

  3. Epidemic Spreading in Random Rectangular Networks

    CERN Document Server

    Estrada, Ernesto; Moreno, Yamir

    2015-01-01

    Recently, Estrada and Sheerin (Phys. Rev. E 91, 042805 (2015)) developed the random rectangular graph (RRG) model to account for the spatial distribution of nodes in a network allowing the variation of the shape of the unit square commonly used in random geometric graphs (RGGs). Here, we consider an epidemics dynamics taking place on the nodes and edges of an RRG and we derive analytically a lower bound for the epidemic threshold for a Susceptible-Infected-Susceptible (SIS) or Susceptible-Infected-Recovered (SIR) model on these networks. Using extensive numerical simulations of the SIS dynamics we show that the lower bound found is very tight. We conclude that the elongation of the area in which the nodes are distributed makes the network more resilient to the propagation of an epidemics due to the fact that the epidemic threshold increases with the elongation of the rectangle. On the other hand, using the "classical" RGG for modeling epidemics on non-squared cities generates a larger error due to the effects...

  4. A framework to gauge the epidemic potential of plant pathogens in environmental reservoirs: the example of kiwifruit canker.

    Science.gov (United States)

    Bartoli, Claudia; Lamichhane, Jay Ram; Berge, Odile; Guilbaud, Caroline; Varvaro, Leonardo; Balestra, Giorgio M; Vinatzer, Boris A; Morris, Cindy E

    2015-02-01

    New economically important diseases on crops and forest trees emerge recurrently. An understanding of where new pathogenic lines come from and how they evolve is fundamental for the deployment of accurate surveillance methods. We used kiwifruit bacterial canker as a model to assess the importance of potential reservoirs of new pathogenic lineages. The current kiwifruit canker epidemic is at least the fourth outbreak of the disease on kiwifruit caused by Pseudomonas syringae in the mere 50 years in which this crop has been cultivated worldwide, with each outbreak being caused by different genetic lines of the bacterium. Here, we ask whether strains in natural (non-agricultural) environments could cause future epidemics of canker on kiwifruit. To answer this question, we evaluated the pathogenicity, endophytic colonization capacity and competitiveness on kiwifruit of P. syringae strains genetically similar to epidemic strains and originally isolated from aquatic and subalpine habitats. All environmental strains possessing an operon involved in the degradation of aromatic compounds via the catechol pathway grew endophytically and caused symptoms in kiwifruit vascular tissue. Environmental and epidemic strains showed a wide host range, revealing their potential as future pathogens of a variety of hosts. Environmental strains co-existed endophytically with CFBP 7286, an epidemic strain, and shared about 20 virulence genes, but were missing six virulence genes found in all epidemic strains. By identifying the specific gene content in genetic backgrounds similar to known epidemic strains, we developed criteria to assess the epidemic potential and to survey for such strains as a means of forecasting and managing disease emergence. PMID:24986268

  5. Quaternary epitopes of α345(IV) collagen initiate Alport post-transplant anti-GBM nephritis.

    Science.gov (United States)

    Olaru, Florina; Luo, Wentian; Wang, Xu-Ping; Ge, Linna; Hertz, Jens Michael; Kashtan, Clifford E; Sado, Yoshikazu; Segal, Yoav; Hudson, Billy G; Borza, Dorin-Bogdan

    2013-05-01

    Alport post-transplant nephritis (APTN) is an aggressive form of anti-glomerular basement membrane disease that targets the allograft in transplanted patients with X-linked Alport syndrome. Alloantibodies develop against the NC1 domain of α5(IV) collagen, which occurs in normal kidneys, including renal allografts, forming distinct α345(IV) and α1256(IV) networks. Here, we studied the roles of these networks as antigens inciting alloimmunity and as targets of nephritogenic alloantibodies in APTN. We found that patients with APTN, but not those without nephritis, produce two kinds of alloantibodies against allogeneic collagen IV. Some alloantibodies targeted alloepitopes within α5NC1 monomers, shared by α345NC1 and α1256NC1 hexamers. Other alloantibodies specifically targeted alloepitopes that depended on the quaternary structure of α345NC1 hexamers. In Col4a5-null mice, immunization with native forms of allogeneic collagen IV exclusively elicited antibodies to quaternary α345NC1 alloepitopes, whereas alloimmunogens lacking native quaternary structure elicited antibodies to shared α5NC1 alloepitopes. These results imply that quaternary epitopes within α345NC1 hexamers may initiate alloimmune responses after transplant in X-linked Alport patients. Thus, α345NC1 hexamers are the culprit alloantigen and primary target of all alloantibodies mediating APTN, whereas α1256NC1 hexamers become secondary targets of anti-α5NC1 alloantibodies. Reliable detection of alloantibodies by immunoassays using α345NC1 hexamers may improve outcomes by facilitating early, accurate diagnosis. PMID:23620401

  6. Glomerular Autoimmune Multicomponents of Human Lupus Nephritis In Vivo (2): Planted Antigens.

    Science.gov (United States)

    Bruschi, Maurizio; Galetti, Maricla; Sinico, Renato Alberto; Moroni, Gabriella; Bonanni, Alice; Radice, Antonella; Tincani, Angela; Pratesi, Federico; Migliorini, Paola; Murtas, Corrado; Franceschini, Franco; Trezzi, Barbara; Brunini, Francesca; Gatti, Rita; Tardanico, Regina; Barbano, Giancarlo; Piaggio, Giorgio; Messa, Piergiorgio; Ravani, Pietro; Scolari, Francesco; Candiano, Giovanni; Martini, Alberto; Allegri, Landino; Ghiggeri, Gian Marco

    2015-08-01

    Glomerular planted antigens (histones, DNA, and C1q) are potential targets of autoimmunity in lupus nephritis (LN). However, the characterization of these antigens in human glomeruli in vivo remains inconsistent. We eluted glomerular autoantibodies recognizing planted antigens from laser-microdissected renal biopsy samples of 20 patients with LN. Prevalent antibody isotypes were defined, levels were determined, and glomerular colocalization was investigated. Renal and circulating antibodies were matched, and serum levels were compared in 104 patients with LN, 84 patients with SLE without LN, and 50 patients with rheumatoid arthritis (RA). Autoantibodies against podocyte antigens (anti-α-enolase/antiannexin AI) were also investigated. IgG2 autoantibodies against DNA, histones (H2A, H3, and H4), and C1q were detected in 50%, 55%, and 70% of biopsy samples, respectively. Anti-DNA IgG3 was the unique non-IgG2 anti-DNA deposit, and anti-C1q IgG4 was mainly detected in subepithelial membranous deposits. Anti-H3, anti-DNA, and anti-C1q IgG2 autoantibodies were also prevalent in LN serum, which also contained IgG3 against the antigen panel and anti-C1q IgG4. Serum and glomerular levels of autoantibodies were not strictly associated. High serum levels of all autoantibodies detected, including anti-α-enolase and antiannexin AI, identified LN versus SLE and RA. Anti-H3 and anti-α-enolase IgG2 levels had the most remarkable increase in LN serum and represented a discriminating feature of LN in principal component analysis. The highest levels of these two autoantibodies were also associated with proteinuria>3.5 g/24 hours and creatinine>1.2 mg/dl. Our findings suggest that timely autoantibody characterization might allow outcome prediction and targeted therapies for patients with nephritis. PMID:25398787

  7. Granulin exacerbates lupus nephritis via enhancing macrophage M2b polarization.

    Directory of Open Access Journals (Sweden)

    Xi Chen

    Full Text Available BACKGROUND AND AIMS: Lupus nephritis (LN, with considerable morbidity and mortality, is one of the most severe manifestations of systemic lupus erythematosus (SLE. Yet, the pathogenic mechanisms of LN have not been clearly elucidated, and efficient therapies are still in great need. Granulin (GRN, a multifunctional protein linked to inflammatory diseases, has recently been reported to correlate with the disease activity of autoimmune diseases. However, the role of GRN in the pathogenic process of LN still remains obscure. In this study, we explored its potential role and underlying mechanism in the pathogenesis of LN. METHODOLOGY/PRINCIPAL FINDINGS: We found that serum GRN levels were significantly up-regulated and were positively correlated with the severity of LN. Overexpression of GRN in vivo by transgenic injection remarkably exacerbated LN, whereas down-regulation of GRN with shRNA ameliorated LN, firmly demonstrating the critical role of GRN in the pathogenesis of LN. Notably, macrophage phenotype analysis revealed that overexpression of GRN could enhance macrophage polarization to M2b, a key mediator of the initiation and progression of LN. On the contrary, down-regulation of GRN resulted in impaired M2b differentiation, thus ameliorating LN. Moreover, we found that MAPK signals were necessary for the effect of GRN on macrophage M2b polarization. CONCLUSION/SIGNIFICANCE: We first demonstrated that GRN could aggravate lupus nephritis (LN via promoting macrophage M2b polarization, which might provide insights into the pathogenesis of LN as well as potential therapeutic strategies against LN.

  8. Remission of proteinuria indicates good prognosis in patients with diffuse proliferative lupus nephritis.

    Science.gov (United States)

    Koo, H S; Kim, S; Chin, H J

    2016-01-01

    Proteinuria is a well-known risk factor for the progression of renal dysfunction in chronic kidney disease; however, its importance for estimating the prognosis of lupus nephritis requires verification. Korean adult patients with renal biopsy-diagnosed diffuse proliferative lupus nephritis who had undergone three or more consecutive urine protein to creatinine ratio or urine dipstick tests within six months after renal biopsy were enrolled. The cumulative risks, predictors, and outcomes of proteinuric remission and flare were evaluated. This study included 26 men and 167 women with a mean age at renal biopsy of 31.2 ± 9.8 years. Eighty-two (42.5%) patients experienced proteinuric remission during the follow-up period. During a mean follow-up of 157.9 ± 69.5 months, among patients who achieved proteinuric remission, one died, one developed end-stage renal disease (ESRD), and two had composite outcomes; among patients without remission, nine died, 24 developed ESRD, and 30 had composite outcomes. Patients who achieved proteinuric remission had a 0.089-fold risk (95% CI: 0.011-0.736) of mortality, 0.110-fold risk (95% CI: 0.013-0.904) of incident ESRD, and 0.210-fold risk (95% CI: 0.048-0.920) of a composite outcome compared to patients without remission. Among the 82 patients who achieved proteinuric remission, 59 (72.0%) experienced at least one proteinuria flare; however, relapse did not correlate with the incidence of outcomes. In conclusion, proteinuric remission is an independent predictive prognostic marker of good renal survival and mortality, regardless of the interval from biopsy to remission, recurrence of proteinuria after remission, renal function status at remission, or hematuria remission. PMID:26159540

  9. The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition

    Indian Academy of Sciences (India)

    Peter Duesberg; Claus Koehnlein; David Rasnick

    2003-06-01

    In 1981 a new epidemic of about two-dozen heterogeneous diseases began to strike non-randomly growing numbers of male homosexuals and mostly male intravenous drug users in the US and Europe. Assuming immunodeficiency as the common denominator the US Centers for Disease Control (CDC) termed the epidemic, AIDS, for acquired immunodeficiency syndrome. From 1981–1984 leading researchers including those from the CDC proposed that recreational drug use was the cause of AIDS, because of exact correlations and of drug-specific diseases. However, in 1984 US government researchers proposed that a virus, now termed human immunodeficiency virus (HIV), is the cause of the non-random epidemics of the US and Europe but also of a new, sexually random epidemic in Africa. The virus-AIDS hypothesis was instantly accepted, but it is burdened with numerous paradoxes, none of which could be resolved by 2003: Why is there no HIV in most AIDS patients, only antibodies against it? Why would HIV take 10 years from infection to AIDS? Why is AIDS not self-limiting via antiviral immunity? Why is there no vaccine against AIDS? Why is AIDS in the US and Europe not random like other viral epidemics? Why did AIDS not rise and then decline exponentially owing to antiviral immunity like all other viral epidemics? Why is AIDS not contagious? Why would only HIV carriers get AIDS who use either recreational or anti-HIV drugs or are subject to malnutrition? Why is the mortality of HIV-antibody-positives treated with anti-HIV drugs 7–9%, but that of all (mostly untreated) HIV-positives globally is only 1.4%? Here we propose that AIDS is a collection of chemical epidemics, caused by recreational drugs, anti-HIV drugs, and malnutrition. According to this hypothesis AIDS is not contagious, not immunogenic, not treatable by vaccines or antiviral drugs, and HIV is just a passenger virus. The hypothesis explains why AIDS epidemics strike non-randomly if caused by drugs and randomly if caused by

  10. Glomerulonefrite lúpica: estudo da evolução a longo prazo Lupus nephritis: a long term follow-up

    Directory of Open Access Journals (Sweden)

    R. S. Martins

    2000-06-01

    Full Text Available OBJETIVO: Estudar a apresentação clínica e a evolução de pacientes portadores de glomerulonefrite lúpica. CASUÍSTICA E MÉTODOS: Foram estudados 37 pacientes portadores de glomerulonefrite lúpica, atendidos pela Disciplina de Nefrologia - Faculdade de Medicina de Botucatu, com seguimento médio de 52,4 ± 13,3 meses. Os dados foram obtidos através do levantamento retrospectivo dos prontuários. RESULTADOS: A idade média foi de 26,05 ± 11,12 anos, com predomínio do sexo feminino (84% sendo que a glomerulonefrite classe IV foi a mais freqüente (80%. No início do seguimento a média da creatinina sérica foi de 1,74 ± 1,15 mg/dl, e a da proteinúria de 24h foi de 2,62 ± 2.89 g. Cinqüenta e um porcento dos pacientes com creatinina sérica elevada apresentaram, durante o seguimento, diminuição desses valores. Dentre diferentes variáveis estudadas, à época da biopsia renal, (idade, sexo, proteinúria, presença de hipertensão arterial e creatinina sérica a única que se associou com pior prognóstico foi a elevação da creatinina sérica. Remissão da síndrome nefrótica ocorreu em 65% das vezes. A sobrevida atuarial foi de 96%, 82%, 70% e 70% em 1, 5, 10 e 12 anos. Cinco pacientes desenvolveram insuficiência renal crônica terminal e sete morreram, sendo infecção a principal causa de óbito (57% CONCLUSÃO: Em pacientes com nefropatia lúpica, o aumento da creatinina sérica, à época da biópsia, se associou com o desenvolvimento de insuficiência renal crônica ao fim do seguimento e a principal causa de óbito foi processo infeccioso.PURPOSE: To evaluate and the long term course of patients with lupus nephritis, METHOD: Thirty seven patients with lupus nephritis followed in a referral, tertiary care center of a developing country (Brazil were studied. The length of follow up was 52.4 + 13.3 months and mean age was 26.05 +11.12 years. 84% of the patients were females and class IV nephritis was found to be the most

  11. Interstitial nephritis

    Science.gov (United States)

    ... kidney damage in older people. Possible Complications Metabolic acidosis can occur because the kidneys aren't able ... stage kidney disease Injury - kidney and ureter Metabolic acidosis Renal Urine output - decreased Update Date 9/22/ ...

  12. Worm Epidemics in Wireless Adhoc Networks

    CERN Document Server

    Nekovee, Maziar

    2007-01-01

    A dramatic increase in the number of computing devices with wireless communication capability has resulted in the emergence of a new class of computer worms which specifically target such devices. The most striking feature of these worms is that they do not require Internet connectivity for their propagation but can spread directly from device to device using a short-range radio communication technology, such as WiFi or Bluetooth. In this paper, we develop a new model for epidemic spreading of these worms and investigate their spreading in wireless ad hoc networks via extensive Monte Carlo simulations. Our studies show that the threshold behaviour and dynamics of worm epidemics in these networks are greatly affected by a combination of spatial and temporal correlations which characterize these networks, and are significantly different from the previously studied epidemics in the Internet.

  13. Worm epidemics in wireless ad hoc networks

    Science.gov (United States)

    Nekovee, Maziar

    2007-06-01

    A dramatic increase in the number of computing devices with wireless communication capability has resulted in the emergence of a new class of computer worms which specifically target such devices. The most striking feature of these worms is that they do not require Internet connectivity for their propagation but can spread directly from device to device using a short-range radio communication technology, such as WiFi or Bluetooth. In this paper, we develop a new model for epidemic spreading of these worms and investigate their spreading in wireless ad hoc networks via extensive Monte Carlo simulations. Our studies show that the threshold behaviour and dynamics of worm epidemics in these networks are greatly affected by a combination of spatial and temporal correlations which characterize these networks, and are significantly different from the previously studied epidemics in the Internet.

  14. Invited review: Epidemics on social networks

    CERN Document Server

    Kuperman, Marcelo N

    2013-01-01

    Since its first formulations almost a century ago, mathematical models for disease spreading contributed to understand, evaluate and control the epidemic processes.They promoted a dramatic change in how epidemiologists thought of the propagation of infectious diseases.In the last decade, when the traditional epidemiological models seemed to be exhausted, new types of models were developed.These new models incorporated concepts from graph theory to describe and model the underlying social structure.Many of these works merely produced a more detailed extension of the previous results, but some others triggered a completely new paradigm in the mathematical study of epidemic processes. In this review, we will introduce the basic concepts of epidemiology, epidemic modeling and networks, to finally provide a brief description of the most relevant results in the field.

  15. Vaccination intervention on epidemic dynamics in networks

    CERN Document Server

    Peng, Xiao-Long; Fu, Xinchu; Zhou, Tao

    2013-01-01

    Vaccination is an important measure available for preventing or reducing the spread of infectious diseases. In this paper, an epidemic model including susceptible, infected, and imperfectly vaccinated compartments is studied on Watts-Strogatz small-world, Barab\\'asi-Albert scale-free, and random scale-free networks. The epidemic threshold and prevalence are analyzed. For small-world networks, the effective vaccination intervention is suggested and its influence on the threshold and prevalence is analyzed. For scale-free networks, the threshold is found to be strongly dependent both on the effective vaccination rate and on the connectivity distribution. Moreover, so long as vaccination is effective, it can linearly decrease the epidemic prevalence in small-world networks, whereas for scale-free networks it acts exponentially. These results can help in adopting pragmatic treatment upon diseases in structured populations.

  16. Urgent epidemic control mechanism for aviation networks

    KAUST Repository

    Peng, Chengbin

    2011-01-01

    In the current century, the highly developed transportation system can not only boost the economy, but also greatly accelerate the spreading of epidemics. While some epidemic diseases may infect quite a number of people ahead of our awareness, the health care resources such as vaccines and the medical staff are usually locally or even globally insufficient. In this research, with the network of major aviation routes as an example, we present a method to determine the optimal locations to allocate the medical service in order to minimize the impact of the infectious disease with limited resources. Specifically, we demonstrate that when the medical resources are insufficient, we should concentrate our efforts on the travelers with the objective of effectively controlling the spreading rate of the epidemic diseases. © 2011 Springer-Verlag Berlin Heidelberg.

  17. Worm epidemics in wireless ad hoc networks

    International Nuclear Information System (INIS)

    A dramatic increase in the number of computing devices with wireless communication capability has resulted in the emergence of a new class of computer worms which specifically target such devices. The most striking feature of these worms is that they do not require Internet connectivity for their propagation but can spread directly from device to device using a short-range radio communication technology, such as WiFi or Bluetooth. In this paper, we develop a new model for epidemic spreading of these worms and investigate their spreading in wireless ad hoc networks via extensive Monte Carlo simulations. Our studies show that the threshold behaviour and dynamics of worm epidemics in these networks are greatly affected by a combination of spatial and temporal correlations which characterize these networks, and are significantly different from the previously studied epidemics in the Internet

  18. Negligible risk for epidemics after geophysical disasters.

    Science.gov (United States)

    Floret, Nathalie; Viel, Jean-François; Mauny, Frédéric; Hoen, Bruno; Piarroux, Renaud

    2006-04-01

    After geophysical disasters (i.e., earthquakes, volcanic eruptions, tsunamis), media reports almost always stress the risk for epidemics; whether this risk is genuine has been debated. We analyzed the medical literature and data from humanitarian agencies and the World Health Organization from 1985 to 2004. Of >600 geophysical disasters recorded, we found only 3 reported outbreaks related to these disasters: 1 of measles after the eruption of Pinatubo in Philippines, 1 of coccidioidomycosis after an earthquake in California, and 1 of Plasmodium vivax malaria in Costa Rica related to an earthquake and heavy rainfall. Even though the humanitarian response may play a role in preventing epidemics, our results lend support to the epidemiologic evidence that short-term risk for epidemics after a geophysical disaster is very low. PMID:16704799

  19. Epidemic spreading on networks with vaccination

    Institute of Scientific and Technical Information of China (English)

    Shi Hong-Jing; Duan Zhi-Sheng; Chen Guan-Rong; Li Rong

    2009-01-01

    In this paper,a new susceptible-infected-susceptible (SIS) model on complex networks with imperfect vaccination is proposed.Two types of epidemic spreading patterns (the recovered individuals have or have not immunity) on scale-free networks are discussed.Both theoretical and numerical analyses are presented.The epidemic thresholds related to the vaccination rate,the vaccination-invalid rate and the vaccination success rate on scale-free networks are demonstrated,showing different results from the reported observations.This reveals that whether or not the epidemic can spread over a network under vaccination control is determined not only by the network structure but also by the medicine's effective duration.Moreover,for a given infective rate,the proportion of individuals to vaccinate can be calculated theoretically for the case that the recovered nodes have immunity.Finally,simulated results are presented to show how to control the disease prevalence.

  20. Epidemic occurrence of neonatal necrotizing enterocolitis.

    Science.gov (United States)

    Guinan, M; Schaberg, D; Bruhn, F W; Richardson, C J; Fox, W W

    1979-06-01

    In case-control studies of three epidemics of neonatal necrotizing enterocolitis (NEC) in three different high-risk nurseries in three states, no particular risk factor was associated with affected infants or their mothers. Epidemic cases had higher birth weights and Apgar scores and fewer perinatal difficulties than those previously reported for sporadic cases. Seven infants fed primarily breast milk were not protected against disease. Early antibiotic therapy was associated with a significantly decreased risk of disease in one outbreak. In two hospitals, affected infants who received antibiotic therapy during the first three days of life had a significantly later disease onset. The occurrence of the disease in epidemics and the decreased risk or modification of disease with antibiotic therapy support an infectious etiology for NEC. PMID:108997

  1. The epidemic threshold in directed networks

    CERN Document Server

    Li, Cong; Van Mieghem, Piet

    2013-01-01

    Epidemics have so far been mostly studied in undirected networks. However, many real-world networks, such as the social network Twitter and the WWW networks, upon which information, emotion or malware spreads, are shown to be directed networks, composed of both unidirectional links and bidirectional links. We define the directionality as the percentage of unidirectional links. The epidemic threshold for the susceptible-infected-susceptible (SIS) epidemic has been proved to be 1/lambda_{1} in directed networks by N-intertwined Mean-field Approximation, where lambda_{1}, also called as spectral radius, is the largest eigenvalue of the adjacency matrix. Here, we propose two algorithms to generate directed networks with a given degree distribution, where the directionality can be controlled. The effect of directionality on the spectral radius lambda_{1}, principal eigenvector x_{1}, spectral gap lambda_{1}-|lambda_{2}|) and algebraic connectivity |mu_{N-1}| is studied. Important findings are that the spectral rad...

  2. Can epidemics be non-communicable?

    DEFF Research Database (Denmark)

    Seeberg, Jens; Meinert, Lotte

    2015-01-01

    communicable, even if they are not infectious. We need to more critically explore how they might be communicable in specific environments. All diseases with epidemic potential, we argue, should be assumed to be commun icable in a broader sense, and that the underlying medical distinction between infectious and......This article argues that the concept of communicability that is central to the distinction between communicable diseases (CDs) and noncommunicable diseases (NCDs) is poorly conceptualized. The epidemic spread of NCDs such as diabetes, depression, and eating disorders demonstrates that they are...... noninfectious diseases confuses our understanding of NCD epidemics when these categories are treated as synonymous with ‘communicable’ and ‘noncommunicable’ diseases, respectively. The dominant role accorded to the concept of ‘lifestyle’, with its focus on individual responsibility, is part of the problem...

  3. Landscape changes in the environment due to military actions and their epidemic risks

    OpenAIRE

    Krushelnitsky, A. D.; Ogorodniychuk, I. V.; Ivanko, O. M.

    2016-01-01

    The article considers  the influence of the military-ecological and man-caused-anthropogenic factors on the environment state and natural processes. Epidemic risks and consequences resulted from landscapic changes of the environment which arise as a result of war and destruction of ecosystems are described.

  4. Landscape changes in the environment due to military actions and their epidemic risks

    OpenAIRE

    Krushelnitsky A.D.; Ogorodniychuk I.V.; Ivanko O.M.

    2016-01-01

    The article considers the influence of the military-ecological and man-caused-anthropogenic factors on the environment state and natural processes. Epidemic risks and consequences resulted from landscapic changes of the environment which arise as a result of war and destruction of ecosystems are described.

  5. Influence of infection rate and migration on extinction of disease in spatial epidemics

    NARCIS (Netherlands)

    Sun, G.Q.; Liu, Q.X.; Jin, Z.; Chakraborty, A.; Li, B.L.

    2010-01-01

    Extinction of disease can be explained by the patterns of epidemic spreading, yet the underlying causes of extinction are far from being well understood. To reveal a mechanism of disease extinction, a cellular automata model with both birth, death rate and migration is presented. We find that, in si

  6. The Impact of Epidemic, War, Prohibition and Media on Suicide: United States, 1910-1920.

    Science.gov (United States)

    Wasserman, Ira M.

    1992-01-01

    Estimated impact of exogenous social and political events on suicide behavior in the United States between 1910 and 1920. Concluded that World War I did not influence suicide; Great Influenza Epidemic caused suicide to increase; and continuing decline in alcohol consumption from 1910 to 1920 depressed national suicide rates. (Author/NB)

  7. Manure-borne PEDv (porcine epidemic diarrhea virus) survival in soil

    Science.gov (United States)

    The porcine epidemic diarrhea virus (PEDv) outbreak in the US has had a significant impact on swine production in recent years. Although strictly limited to pigs and hence poses no threat to other animals or humans, it is easily transmitted to suckling piglets where it causes nearly 100% mortality....

  8. Phocine distemper revisited: Multidisciplinary analysis of the 2002 phocine distemper virus epidemic in the Netherlands

    NARCIS (Netherlands)

    J.M. Rijks

    2008-01-01

    textabstractApril 1988, excess mortality of seals was observed on Anholt, a small Danish island in the Kattegat17. This announced the start of an epidemic that killed between 18 000 and 23 000 seals in European waters in 1988, mostly harbour seals (Phoca vitulina)17,28. The cause of this mortality w

  9. Landscape changes in the environment due to military actions and their epidemic risks

    Directory of Open Access Journals (Sweden)

    Krushelnitsky A.D.

    2016-05-01

    Full Text Available The article considers the influence of the military-ecological and man-caused-anthropogenic factors on the environment state and natural processes. Epidemic risks and consequences resulted from landscapic changes of the environment which arise as a result of war and destruction of ecosystems are described.

  10. Seroprevalence of human enterovirus 71 and coxsackievirus A16 in Guangdong, China, in pre- and post-2010 HFMD epidemic period.

    Directory of Open Access Journals (Sweden)

    Wei Li

    Full Text Available BACKGROUND: Human Enterovirus 71 and Coxsackie A16 have caused many outbreaks in the last decade in mainland China, resulting in thousands of fatal cases. Seroepidemiology which provides important information to document population immunity is rare in China. METHODOLOGY/PRINCIPAL FINDINGS: A cross sectional study of Enterovirus 71 (EV71 and Coxsackie A16 (CA16 seroprevalence was carried out in Guangdong, China, pre- and post- the 2010 hand, foot and mouth disease (HFMD epidemic period. The levels of EV71 and CA16 specific antibodies were evaluated by a microneutralization test and the geometric mean titer (GMT was calculated and compared. Our results indicated frequent infection by EV71 and CA16 in Guangdong before the 2010 epidemic. Only EV71 neutralizing antibody but not CA16 seroprevalence was significantly increased after the 2010 HFMD epidemic. Children less than 3 years old especially those aged 2 years showed the lowest positive rates for EV71 and CA16 NA before epidemic and the most significantly increased EV71 seroprevalence after epidemic. CA16 GMT values declined after the 2010 epidemic. CONCLUSIONS: These results indicate EV71 was the major pathogen of HFMD in Guangdong during the 2010 epidemic. The infection occurs largely in children less than 3 years, who should have first priority to receive an EV71 vaccine.

  11. Interleukin-17 expression positively correlates with disease severity of lupus nephritis by increasing anti-double-stranded DNA antibody production in a lupus model induced by activated lymphocyte derived DNA.

    Directory of Open Access Journals (Sweden)

    Zhenke Wen

    Full Text Available Lupus nephritis is one of the most serious manifestations and one of the strongest predictors of a poor outcome in systemic lupus erythematosus (SLE. Recent evidence implicated a potential role of interlukin-17 (IL-17 in the pathogenesis of lupus nephritis. However, the correlation between IL-17 expression level and the severity of lupus nephritis still remains incompletely understood. In this study, we found that serum IL-17 expression level was associated with the severity of lupus nephritis, which was evaluated by histopathology of kidney sections and urine protein. Of note, we showed that enforced expression of IL-17 using adenovirus construct that expresses IL-17 could enhance the severity of lupus nephritis, while blockade of IL-17 using neutralizing antibody resulted in decreased severity of lupus nephritis. Consistently, we observed an impaired induction of lupus nephritis in IL-17-deficient mice. Further, we revealed that IL-17 expression level was associated with immune complex deposition and complement activation in kidney. Of interest, we found that IL-17 was crucial for increasing anti-double-stranded DNA (dsDNA antibody production in SLE. Our results suggested that IL-17 expression level positively correlated with the severity of lupus nephritis, at least in part, because of its contribution to anti-dsDNA antibody production. These findings provided a novel mechanism for how IL-17 expression level correlated with disease pathogenesis and suggested that management of IL-17 expression level was a potential and promising approach for treatment of lupus nephritis.

  12. Epidemic spreading with immunization on bipartite networks

    CERN Document Server

    Tanimoto, Shinji

    2011-01-01

    Bipartite networks are composed of two types of nodes and there are no links between nodes of the same type. Thus the study of epidemic spread and control on such networks is relevant to sexually transmitted diseases (STDs). When entire populations of two types cannot be immunized and the effect of immunization is not perfect, we have to consider the targeted immunization with immunization rates. We derive the epidemic thresholds of SIR and SIS models with immunization and illustrate the results with STDs on heterosexual contact networks.

  13. Does a Mature AIDS Epidemic Threaten Growth?

    OpenAIRE

    Cuesta, José

    2008-01-01

    This paper models the impact on economic growth of HIV/AIDS when the epidemic is in a mature phase, in contrast with previous studies focused on periods of expansion, as in African countries. Simulations for Honduras, the epicenter of the epidemic in Central America, show that AIDS is not likely to threaten economic growth through either labor or capital accumulation channels; impacts are estimated between 0. 007 and 0. 27 percent points of GDP growth annually for the period 2001-10. Likewise...

  14. The Impact of an Epidemic Outbreak on Consumer Expenditures:An Empirical Assessment for MERS Korea

    Directory of Open Access Journals (Sweden)

    Hojin Jung

    2016-05-01

    Full Text Available In this paper, we investigate the effect of an epidemic outbreak on consumer expenditures. In light of scanner panel data on consumers’ debit and credit card transactions, we present empirical evidence that outbreaks cause considerable disruption in total consumer expenditures with significant heterogeneity across categories. Our findings strongly imply that customers alter their behaviors to reduce the risk of infection. The estimated effect of an epidemic outbreak is qualitatively different from that of other macroeconomic factors. The implications of this research provide important guidance for policy interventions and marketing decisions aimed at sustaining economic growth.

  15. Epidemic propagation on adaptive coevolutionary networks with preferential local-world reconnecting strategy

    Institute of Scientific and Technical Information of China (English)

    Song Yu-Rong; Jiang Guo-Ping; Gong Yong-Wang

    2013-01-01

    In the propagation of an epidemic in a population,individuals adaptively adjust their behavior to avoid the risk of an epidemic.Differently from existing studies where new links are established randomly,a local link is established preferentially in this paper.We propose a new preferentially reconnecting edge strategy depending on spatial distance (PRSD).For the PR-SD strategy,the new link is established at random with probability p and in a shortest distance with the probability 1-p.We establish the epidemic model on an adaptive network using Cellular Automata,and demonstrate the effectiveness of the proposed model by numerical simulations.The results show that the smaller the value of parameter p,the more difficult the epidemic spread is.The PR-SD strategy breaks long-range links and establishes as many short-range links as possible,which causes the network efficiency to decrease quickly and the propagation of the epidemic is restrained effectively.

  16. Knowledge, attitudes and practices about malaria among communities: Comparing epidemic and non-epidemic prone communities of Muleba district, North-western Tanzania

    Directory of Open Access Journals (Sweden)

    Kishamawe Coleman

    2010-07-01

    Full Text Available Abstract Background Muleba district in North-western Tanzania has experienced malaria epidemics in recent years. Community knowledge, attitudes and practices are important in enhancing disease control interventions. This study investigated determinants of malaria epidemics in the study area in relation to household knowledge, attitudes and practice on malaria. Methods A community based cross-sectional survey involving 504 study participants was conducted between April and June 2007 using a structured questionnaire focusing on knowledge, attitudes and practices of community members in epidemic and non-epidemic villages about malaria transmission, signs and symptoms, treatment, prevention and control. Multivariate logistic regression analysis was used to assess determinants of malaria epidemics. Results A total of 504 respondents (males = 36.9% were interviewed. Overall, 453 (90.1% mentioned malaria as the most important disease in the area. Four hundred and sixty four respondents (92.1% knew that malaria is transmitted through mosquito bite. A total of 436 (86.7%, 306 (60.8% and 162 (32.1% mentioned fever, vomiting and loss of appetite as major symptoms/signs of malaria, respectively. Of those interviewed 328 (65.1% remembered the recent outbreak of 2006. Of the 504 respondents interviewed, 296 (58.7% reported that their households owned at least one mosquito net. Three hundred and ninety seven respondents (78.8% knew insecticides used to impregnate bed nets. About two thirds (63.3% of the respondents had at least a household member who suffered from malaria during the recent epidemic. During the 2006 outbreak, 278 people (87.2% sought treatment from health facilities while 27 (8.5% obtained drugs from drug shops and 10 (3.1% used local herbs. Logistic regression analysis showed that household location and level of knowledge of cause of malaria were significant predictors of a household being affected by epidemic. Conclusions Residents of Muleba

  17. Passive Heymann Nephritis in the Rat Produced by a Heterologous Antibody to a Heterologous Kidney Fraction 3 Antigen

    OpenAIRE

    Barabas, A. Z.; Cornish, J.; Lannigan, R.

    1982-01-01

    Antibody to rabbit kidney Fraction 3 antigen was raised in guinea-pigs. In an indirect fluorescent antibody test the guinea-pig sera showed high levels of antibody to both rabbit and rat tubular nephritogenic antigen and a much lower level of antibody against their own kidney tubular antigen. I.v. injection of this guinea-pig anti-rabbit kidney Fraction 3 antibody into rats produced immune-complex glomerulonephritis, morphologically identical to passive Heymann nephritis.

  18. A Systematic Review and Meta-Analysis of Pregnancy Outcomes in Patients with Systemic Lupus Erythematosus and Lupus Nephritis

    OpenAIRE

    Smyth, Andrew; Oliveira, Guilherme H.M.; Lahr, Brian D.; Bailey, Kent R; Norby, Suzanne M.; Garovic, Vesna D.

    2010-01-01

    Background and objectives: Studies of the impact of systemic lupus erythematosus (SLE) and its pregnancy complications have yielded conflicting results. Major limitations of these studies relate to their small numbers of patients and retrospective designs. The aim of this study was to perform a systematic literature review of pregnancy outcomes in women with SLE and a meta-analysis of the association of lupus nephritis with adverse pregnancy outcomes.

  19. Anti-dsDNA negative and anti-Ro positive lupus nephritis: a report of a rare case

    OpenAIRE

    Jain, D.; H.K. Aggarwal; V. Kaverappa; S. Dhayia; Jain, P; Yadav, S.

    2014-01-01

    Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease, characterized by an autoantibody response to various nuclear and cytoplasmic antigens. Renal disease in SLE occurs in 40-75% of patients, most often within five years of onset of disease, and is one of the strongest predictors of a poor outcome. A hallmark of glomerular involvement in lupus nephritis is the presence of autoantibodies against double-stranded DNA (dsDNA). Its level usually correlates with disease activity. ...

  20. Alport familial nephritis. Absence of 28 kilodalton non-collagenous monomers of type IV collagen in glomerular basement membrane.

    OpenAIRE

    Kleppel, M M; Kashtan, C. E.; Butkowski, R J; Fish, A. J.; Michael, A. F.

    1987-01-01

    Alport-type familial nephritis (FN), a genetic disorder, results in progressive renal insufficiency and sensorineural hearing loss. Immunochemical and biochemical analyses of the non-collagenous (NC1) domain of type IV collagen isolated from the glomerular basement membranes (GBM) of three males with this disease demonstrate absence of the normally occurring 28-kilodalton (kD) NC1 monomers, but persistence of the 26- and 24-kD monomeric subunits derived from alpha 1 and 2 (both type IV) colla...

  1. HIV/AIDS and Drug Abuse: Intertwined Epidemics

    Science.gov (United States)

    ... Drug Abuse: Intertwined Epidemics DrugFacts: HIV/AIDS and Drug Abuse: Intertwined Epidemics Email Facebook Twitter Revised May 2012 Drug abuse and addiction have been inextricably linked with HIV/ ...

  2. Understanding Spatio-Temporal Variability in the Reproduction Ratio of the Bluetongue (BTV-1) Epidemic in Southern Spain (Andalusia) in 2007 Using Epidemic Trees

    Science.gov (United States)

    Napp, S.; Allepuz, A.; Purse, B. V.; Casal, J.; García-Bocanegra, I.; Burgin, L. E.; Searle, K. R.

    2016-01-01

    Andalusia (Southern Spain) is considered one of the main routes of introduction of bluetongue virus (BTV) into Europe, evidenced by a devastating epidemic caused by BTV-1 in 2007. Understanding the pattern and the drivers of BTV-1 spread in Andalusia is critical for effective detection and control of future epidemics. A long-standing metric for quantifying the behaviour of infectious diseases is the case-reproduction ratio (Rt), defined as the average number of secondary cases arising from a single infected case at time t (for t>0). Here we apply a method using epidemic trees to estimate the between-herd case reproduction ratio directly from epidemic data allowing the spatial and temporal variability in transmission to be described. We then relate this variability to predictors describing the hosts, vectors and the environment to better understand why the epidemic spread more quickly in some regions or periods. The Rt value for the BTV-1 epidemic in Andalusia peaked in July at 4.6, at the start of the epidemic, then decreased to 2.2 by August, dropped below 1 by September (0.8), and by October it had decreased to 0.02. BTV spread was the consequence of both local transmission within established disease foci and BTV expansion to distant new areas (i.e. new foci), which resulted in a high variability in BTV transmission, not only among different areas, but particularly through time, which suggests that general control measures applied at broad spatial scales are unlikely to be effective. This high variability through time was probably due to the impact of temperature on BTV transmission, as evidenced by a reduction in the value of Rt by 0.0041 for every unit increase (day) in the extrinsic incubation period (EIP), which is itself directly dependent on temperature. Moreover, within the range of values at which BTV-1 transmission occurred in Andalusia (20.6°C to 29.5°C) there was a positive correlation between temperature and Rt values, although the relationship was

  3. Understanding Spatio-Temporal Variability in the Reproduction Ratio of the Bluetongue (BTV-1 Epidemic in Southern Spain (Andalusia in 2007 Using Epidemic Trees.

    Directory of Open Access Journals (Sweden)

    S Napp

    Full Text Available Andalusia (Southern Spain is considered one of the main routes of introduction of bluetongue virus (BTV into Europe, evidenced by a devastating epidemic caused by BTV-1 in 2007. Understanding the pattern and the drivers of BTV-1 spread in Andalusia is critical for effective detection and control of future epidemics. A long-standing metric for quantifying the behaviour of infectious diseases is the case-reproduction ratio (Rt, defined as the average number of secondary cases arising from a single infected case at time t (for t>0. Here we apply a method using epidemic trees to estimate the between-herd case reproduction ratio directly from epidemic data allowing the spatial and temporal variability in transmission to be described. We then relate this variability to predictors describing the hosts, vectors and the environment to better understand why the epidemic spread more quickly in some regions or periods. The Rt value for the BTV-1 epidemic in Andalusia peaked in July at 4.6, at the start of the epidemic, then decreased to 2.2 by August, dropped below 1 by September (0.8, and by October it had decreased to 0.02. BTV spread was the consequence of both local transmission within established disease foci and BTV expansion to distant new areas (i.e. new foci, which resulted in a high variability in BTV transmission, not only among different areas, but particularly through time, which suggests that general control measures applied at broad spatial scales are unlikely to be effective. This high variability through time was probably due to the impact of temperature on BTV transmission, as evidenced by a reduction in the value of Rt by 0.0041 for every unit increase (day in the extrinsic incubation period (EIP, which is itself directly dependent on temperature. Moreover, within the range of values at which BTV-1 transmission occurred in Andalusia (20.6°C to 29.5°C there was a positive correlation between temperature and Rt values, although the

  4. Nursing experience of patients with epidemic hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Ling-yan ZHANG

    2014-04-01

    Full Text Available Objective: To explore the nursing methods of patients with epidemic hemorrhagic fever. Methods: Through careful nursing, 1 case of patients with epidemic hemorrhagic fever, summed up the experience. Results: Patients with epidemic hemorrhagic fever were 2 days later improved, within 6 months to fully recover. Conclusion: With proper treatment and careful nursing, patients with epidemic hemorrhagic fever are able to fully recover.

  5. The Epidemic Process and The Contagion Model

    Science.gov (United States)

    Worthen, Dennis B.

    1973-01-01

    Goffman's epidemic theory is presented and compared to the contagion theory developed by Menzel. An attempt is made to compare the two models presented and examine their similarities and differences. The conclusion drawn is that the two models are very similar in their approach to understanding communication processes. (14 references) (Author/SJ)

  6. Police Brutality--the New Epidemic

    Science.gov (United States)

    Sandoval, Ruben; Martinez, Douglas R.

    1978-01-01

    Recently, incidents of police abuse against Hispanics have increased so rapidly that the phenomenon has been called an epidemic. Of special concern to Hispanic leaders is the lack of Federal intervention in these police brutality cases. A list of 56 documented cases involving police brutality against Hispanics is included. (Author/NQ)

  7. The Prescription Opioid Pain Medication Overdose Epidemic

    Centers for Disease Control (CDC) Podcasts

    2016-04-19

    Overdose related to prescription opioids has become an epidemic. This podcast discusses the risks of this type of drug sometimes used to treat pain, and how to protect yourself. .  Created: 4/19/2016 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/19/2016.

  8. Social epidemics in the aftermath of disasters.

    NARCIS (Netherlands)

    IJzermans, C.J.

    2002-01-01

    Issue/problem: After disasters, terrorist attacks and wars social epidemics of medically unexplained physical symptoms/syndromes (ups) are often seen. In modern times people feel more vulnerable and especially under pressure of those incidents, everyday symptoms are interpreted as disease and causal

  9. The Global HIV Epidemics among Sex Workers

    OpenAIRE

    Kerrigan, Deanna; Wirtz, Andrea; Baral, Stefan; Decker, Michele; Murray, Laura; Poteat, Tonia; Pretorius, Carel; Sherman, Susan; Sweat, Mike; Semini, Iris; N'Jie, N'Della; Stanciole, Anderson; Butler, Jenny; Osornprasop, Sutayut; Oelrichs, Robert

    2013-01-01

    Since the beginning of the epidemic sex workers have experienced a heightened burden of HIV across settings, despite their higher levels of HIV protective behaviors (UNAIDS, 2009). Unfairly, sex workers have often been framed as 'vectors of disease' and 'core transmitters' rather than workers and human beings with rights in terms of HIV prevention and beyond. By gaining a deeper understand...

  10. Phylogenetics of the Danish HIV epidemic

    DEFF Research Database (Denmark)

    Audelin, Anne Margrethe; Cowan, Susan A; Obel, Niels;

    2013-01-01

    BACKGROUND:: In Denmark 300 new individuals are diagnosed with HIV every year, despite decades of public health campaigns aimed to raise awareness of potential risk behaviour for HIV transmission. It is important to identify the driving forces of the epidemic, to enable more targeted campaigns. T...

  11. [Notes about other epidemics in Colonial Chile].

    Science.gov (United States)

    Laval, Enrique

    2015-10-01

    In chronicles or in the historiography of the Colony in Chile there are few references about epidemics different to smallpox; like typhus, typhoid fever, dysentery, etc. Almost all, fast spreading in the country and some with high lethality, which led to overflowing the capacity of hospitals in the Chilean colonial period. PMID:26633117

  12. School Violence, the Media's Phanton Epidemic.

    Science.gov (United States)

    Best, Joel

    2002-01-01

    Argues that public perceptions of an epidemic of school violence are media-induced; asserts that violence in schools declined during the 1990s; supports assertion with evidence from the National School Safety Center; states the estimates of bullying in school are exaggerated. (PKP)

  13. Household epidemic models with varying infection response

    CERN Document Server

    Ball, Frank; Sirl, David

    2010-01-01

    This paper is concerned with SIR (susceptible $\\to$ infected $\\to$ removed) household epidemic models in which the infection response may be either mild or severe, with the type of response also affecting the infectiousness of an individual. Two different models are analysed. In the first model, the infection status of an individual is predetermined, perhaps due to partial immunity, and in the second, the infection status of an individual depends on the infection status of its infector and on whether the individual was infected by a within- or between-household contact. The first scenario may be modelled using a multitype household epidemic model, and the second scenario by a model we denote by the infector-dependent-severity household epidemic model. Large population results of the two models are derived, with the focus being on the distribution of the total numbers of mild and severe cases in a typical household, of any given size, in the event that the epidemic becomes established. The aim of the paper is ...

  14. Epidemic Models for SARS and Measles

    Science.gov (United States)

    Rozema, Edward

    2007-01-01

    Recent events have led to an increased interest in emerging infectious diseases. This article applies various deterministic models to the SARS epidemic of 2003 and a measles outbreak in the Netherlands in 1999-2000. We take a historical approach beginning with the well-known logistic curve and a lesser-known extension popularized by Pearl and Reed…

  15. Effects of awareness diffusion and self-initiated awareness behavior on epidemic spreading - an approach based on multiplex networks

    CERN Document Server

    Kan, Jia-Qian

    2015-01-01

    In this paper, we study the interplay between the epidemic spreading and the diffusion of awareness in multiplex networks. In the model, an infectious disease can spread in one network representing the paths of epidemic spreading (contact network), leading to the diffusion of awareness in the other network (information network), and then the diffusion of awareness will cause individuals to take social distances, which in turn affects the epidemic spreading. As for the diffusion of awareness, we assume that, on the one hand, individuals can be informed by other aware neighbors in information network, on the other hand, the susceptible individuals can be self-awareness induced by the infected neighbors in the contact networks (local information) or mass media (global information). Through Markov chain approach and numerical computations, we find that the density of infected individuals and the epidemic threshold can be affected by the structures of the two networks and the effective transmission rate of the awa...

  16. Exact Markovian SIR and SIS epidemics on networks and an upper bound for the epidemic threshold

    OpenAIRE

    Van Mieghem, Piet

    2014-01-01

    Exploiting the power of the expectation operator and indicator (or Bernoulli) random variables, we present the exact governing equations for both the SIR and SIS epidemic models on \\emph{networks}. Although SIR and SIS are basic epidemic models, deductions from their exact stochastic equations \\textbf{without} making approximations (such as the common mean-field approximation) are scarce. An exact analytic solution of the governing equations is highly unlikely to be found (for any network) du...

  17. Integrated travel network model for studying epidemics: Interplay between journeys and epidemic

    OpenAIRE

    Ruan, Zhongyuan; Wang, Chaoqing; Ming Hui, Pak; Liu, Zonghua

    2015-01-01

    The ease of travelling between cities has contributed much to globalization. Yet, it poses a threat on epidemic outbreaks. It is of great importance for network science and health control to understand the impact of frequent journeys on epidemics. We stress that a new framework of modelling that takes a traveller’s viewpoint is needed. Such integrated travel network (ITN) model should incorporate the diversity among links as dictated by the distances between cities and different speeds of dif...

  18. OmpU as a biomarker for rapid discrimination between toxigenic and epidemic Vibrio cholerae O1/O139 and non-epidemic Vibrio cholerae in a modified MALDI-TOF MS assay

    NARCIS (Netherlands)

    Paauw, A.; Trip, H.; Niemcewicz, M.; Sellek, R.; Heng, J.M.E.; Mars-Groenendijk, R.H.; Jong, A.L. de; Majchrzykiewicz-Koehorst, J.A.; Olsen, J.S.; Tsivtsivadze, E.

    2014-01-01

    Background Cholera is an acute diarrheal disease caused by Vibrio cholerae. Outbreaks are caused by a genetically homogenous group of strains from serogroup O1 or O139 that are able to produce the cholera toxin. Rapid detection and identification of these epidemic strains is essential for an effecti

  19. Mathematical models of the AIDS epidemic: An historical perspective

    Energy Technology Data Exchange (ETDEWEB)

    Stanley, E.A.

    1988-01-01

    Researchers developing mathematical models of the spreading of HIV, the Human Immunodeficiency Virus that causes AIDS, hope to achieve a number of goals. These goals may be classified rather broadly into three categories: understanding, prediction, and control. Understanding which are the key biological and sociological processes spreading this epidemic and leading to the deaths of those infected will allow AIDS researchers to collect better data and to identify ways of slowing the epidemic. Predicting the groups at risk and future numbers of ill people will allow an appropriate allocation of health-care resources. Analysis and comparison of proposed control methods will point out unexpected consequences and allow a better design of these programs. The processes which lead to the spread of HIV are biologically and sociologically complex. Mathematical models allow us to organize our knowledge into a coherent picture and examine the logical consequences, therefore they have the potential to be extremely useful in the search to control this disease. 24 refs., 3 figs.

  20. ObesiTV: how television is influencing the obesity epidemic.

    Science.gov (United States)

    Boulos, Rebecca; Vikre, Emily Kuross; Oppenheimer, Sophie; Chang, Hannah; Kanarek, Robin B

    2012-08-20

    Obesity is a major public health concern in the United States. Over the last several decades, the prevalence of obesity among both adults and children has grown at an alarming rate and is now reaching epidemic proportions. The increase in obesity has been associated with rises in a host of other chronic conditions including cardiovascular disease, type 2 diabetes, and some cancers. While the causes of obesity are multifaceted, there is growing evidence that television viewing is a major contributor. Results of numerous studies indicate a direct association between time spent watching television and body weight. Possible explanations for this relationship include: 1) watching television acts as a sedentary replacement for physical activity; 2) food advertisements for nutrient-poor, high-calorie foods stimulate food intake; and 3) television viewing is associated with "mindless" eating. In addition to decreasing physical activity and increasing the consumption of highly palatable foods, television viewing can also promote weight gain in indirect ways, such as through the use of targeted product placements in television shows; by influencing social perceptions of body image; and airing programs that portray cooking, eating and losing weight as entertainment. This paper will provide an interdisciplinary review of the direct and indirect ways in which television influences the obesity epidemic, and conclude with ways in which the negative impact of television on obesity could be reduced. PMID:22677722

  1. Slow epidemic extinction in populations with heterogeneous infection rates

    Science.gov (United States)

    Buono, C.; Vazquez, F.; Macri, P. A.; Braunstein, L. A.

    2013-08-01

    We explore how heterogeneity in the intensity of interactions between people affects epidemic spreading. For that, we study the susceptible-infected-susceptible model on a complex network, where a link connecting individuals i and j is endowed with an infection rate βij=λwij proportional to the intensity of their contact wij, with a distribution P(wij) taken from face-to-face experiments analyzed in Cattuto [PLoS ONE1932-620310.1371/journal.pone.0011596 5, e11596 (2010)]. We find an extremely slow decay of the fraction of infected individuals, for a wide range of the control parameter λ. Using a distribution of width a we identify two large regions in the a-λ space with anomalous behaviors, which are reminiscent of rare region effects (Griffiths phases) found in models with quenched disorder. We show that the slow approach to extinction is caused by isolated small groups of highly interacting individuals, which keep epidemics alive for very long times. A mean-field approximation and a percolation approach capture with very good accuracy the absorbing-active transition line for weak (small a) and strong (large a) disorder, respectively.

  2. Slow epidemic extinction in populations with heterogeneous infection rates

    CERN Document Server

    Buono, C; Macri, P A; Braunstein, L A

    2013-01-01

    We explore how heterogeneity in the intensity of interactions between people affects epidemic spreading. For that, we study the susceptible-infected-susceptible model on a complex network, where a link connecting individuals $i$ and $j$ is endowed with an infection rate $\\beta_{ij} = \\lambda w_{ij}$ proportional to the intensity of their contact $w_{ij}$, with a distribution $P(w_{ij})$ taken from face-to-face experiments analyzed in Cattuto $et\\;al.$ (PLoS ONE 5, e11596, 2010). We find an extremely slow decay of the fraction of infected individuals, for a wide range of the control parameter $\\lambda$. Using a distribution of width $a$ we identify two large regions in the $a-\\lambda$ space with anomalous behaviors, which are reminiscent of rare region effects (Griffiths phases) found in models with quenched disorder. We show that the slow approach to extinction is caused by isolated small groups of highly interacting individuals, which keep epidemic alive for very long times. A mean-field approximation and a ...

  3. Genomic Motifs as a Novel Indicator of the Relationship between Strains Isolated from the Epidemic of Porcine Epidemic Diarrhea in 2013-2014

    OpenAIRE

    Yamamoto, Takehisa; Suzuki, Tohru; Ohashi, Seiichi; Miyazaki, Ayako; TSUTSUI, Toshiyuki

    2016-01-01

    Porcine epidemic diarrhea virus (PEDV) is a positive-sense RNA virus that causes infectious gastroenteritis in pigs. Following a PED outbreak that occurred in China in 2010, the disease was identified for the first time in the United States in April 2013, and was reported in many other countries worldwide from 2013 to 2014. As a novel approach to elucidate the epidemiological relationship between PEDV strains, we explored their genome sequences to identify the motifs that were shared within r...

  4. Using a Negative Binomial Regression Model for Early Warning at the Start of a Hand Foot Mouth Disease Epidemic in Dalian, Liaoning Province, China.

    Directory of Open Access Journals (Sweden)

    Qingyu An

    Full Text Available The hand foot and mouth disease (HFMD is a human syndrome caused by intestinal viruses like that coxsackie A virus 16, enterovirus 71 and easily developed into outbreak in kindergarten and school. Scientifically and accurately early detection of the start time of HFMD epidemic is a key principle in planning of control measures and minimizing the impact of HFMD. The objective of this study was to establish a reliable early detection model for start timing of hand foot mouth disease epidemic in Dalian and to evaluate the performance of model by analyzing the sensitivity in detectability.The negative binomial regression model was used to estimate the weekly baseline case number of HFMD and identified the optimal alerting threshold between tested difference threshold values during the epidemic and non-epidemic year. Circular distribution method was used to calculate the gold standard of start timing of HFMD epidemic.From 2009 to 2014, a total of 62022 HFMD cases were reported (36879 males and 25143 females in Dalian, Liaoning Province, China, including 15 fatal cases. The median age of the patients was 3 years. The incidence rate of epidemic year ranged from 137.54 per 100,000 population to 231.44 per 100,000population, the incidence rate of non-epidemic year was lower than 112 per 100,000 population. The negative binomial regression model with AIC value 147.28 was finally selected to construct the baseline level. The threshold value was 100 for the epidemic year and 50 for the non- epidemic year had the highest sensitivity(100% both in retrospective and prospective early warning and the detection time-consuming was 2 weeks before the actual starting of HFMD epidemic.The negative binomial regression model could early warning the start of a HFMD epidemic with good sensitivity and appropriate detection time in Dalian.

  5. The finch epidemic strain of Trichomonas gallinae is predominant in British non-passerines.

    Science.gov (United States)

    Chi, Jean F; Lawson, Becki; Durrant, Chris; Beckmann, Katie; John, Shinto; Alrefaei, Abdulwahed F; Kirkbride, Kim; Bell, Diana J; Cunningham, Andrew A; Tyler, Kevin M

    2013-09-01

    Avian trichomonosis, caused by the flagellated protozoan Trichomonas gallinae, is a recently emerged infectious disease of British passerines. The aetiological agent, a clonal epidemic strain of the parasite, has caused unprecedented finch mortality and population-level declines in Britain and has since spread to continental Europe. To better understand the potential origin of this epidemic and to further investigate its host range, T. gallinae DNA extracts were collected from parasite culture and tissue samples from a range of avian species in Britain. Sequence typing at the ITS1/5.8S rRNA/ITS2 region resolved three distinct ITS region types circulating in free-ranging British birds. Subtyping by sequence analyses at the Fe-hydrogenase gene demonstrated further strain variation within these ITS region types. The UK finch epidemic strain was preponderant amongst columbids sampled, however, wide strain diversity was encountered in isolates from a relatively small number of pigeons, suggesting further strains present in columbid populations across the UK are yet to be identified. Fe-hydrogenase gene sequence data in isolates from birds of prey with disease were predominantly identical to the UK finch epidemic strain, demonstrating its presence as a virulent strain in UK birds of prey since at least 2009. PMID:23920088

  6. Deciphering the origin of the 2012 cholera epidemic in Guinea by integrating epidemiological and molecular analyses.

    Science.gov (United States)

    Rebaudet, Stanislas; Mengel, Martin A; Koivogui, Lamine; Moore, Sandra; Mutreja, Ankur; Kande, Yacouba; Yattara, Ousmane; Sarr Keita, Véronique; Njanpop-Lafourcade, Berthe-Marie; Fournier, Pierre-Edouard; Garnotel, Eric; Keita, Sakoba; Piarroux, Renaud

    2014-06-01

    Cholera is typically considered endemic in West Africa, especially in the Republic of Guinea. However, a three-year lull period was observed from 2009 to 2011, before a new epidemic struck the country in 2012, which was officially responsible for 7,350 suspected cases and 133 deaths. To determine whether cholera re-emerged from the aquatic environment or was rather imported due to human migration, a comprehensive epidemiological and molecular survey was conducted. A spatiotemporal analysis of the national case databases established Kaback Island, located off the southern coast of Guinea, as the initial focus of the epidemic in early February. According to the field investigations, the index case was found to be a fisherman who had recently arrived from a coastal district of neighboring Sierra Leone, where a cholera outbreak had recently occurred. MLVA-based genotype mapping of 38 clinical Vibrio cholerae O1 El Tor isolates sampled throughout the epidemic demonstrated a progressive genetic diversification of the strains from a single genotype isolated on Kaback Island in February, which correlated with spatial epidemic spread. Whole-genome sequencing characterized this strain as an "atypical" El Tor variant. Furthermore, genome-wide SNP-based phylogeny analysis grouped the Guinean strain into a new clade of the third wave of the seventh pandemic, distinct from previously analyzed African strains and directly related to a Bangladeshi isolate. Overall, these results highly suggest that the Guinean 2012 epidemic was caused by a V. cholerae clone that was likely imported from Sierra Leone by an infected individual. These results indicate the importance of promoting the cross-border identification and surveillance of mobile and vulnerable populations, including fishermen, to prevent, detect and control future epidemics in the region. Comprehensive epidemiological investigations should be expanded to better understand cholera dynamics and improve disease control

  7. "Kill" the messenger: Targeting of cell-derived microparticles in lupus nephritis.

    Science.gov (United States)

    Nielsen, Christoffer T; Rasmussen, Niclas S; Heegaard, Niels H H; Jacobsen, Søren

    2016-07-01

    Immune complex (IC) deposition in the glomerular basement membrane (GBM) is a key early pathogenic event in lupus nephritis (LN). The clarification of the mechanisms behind IC deposition will enable targeted therapy in the future. Circulating cell-derived microparticles (MPs) have been proposed as major sources of extracellular autoantigens and ICs and triggers of autoimmunity in LN. The overabundance of galectin-3-binding protein (G3BP) along with immunoglobulins and a few other proteins specifically distinguish circulating MPs in patients with systemic lupus erythematosus (SLE), and this is most pronounced in patients with active LN. G3BP co-localizes with deposited ICs in renal biopsies from LN patients supporting a significant presence of MPs in the IC deposits. G3BP binds strongly to glomerular basement membrane proteins and integrins. Accordingly, MP surface proteins, especially G3BP, may be essential for the deposition of ICs in kidneys and thus for the ensuing formation of MP-derived electron dense structures in the GBM, and immune activation in LN. This review focuses on the notion of targeting surface molecules on MPs as an entirely novel treatment strategy in LN. By targeting MPs, a double hit may be achieved by attenuating both the autoantigenic fueling of immune complexes and the triggering of the adaptive immune system. Thereby, early pathogenic events may be blocked in contrast to current treatment strategies that primarily target and modulate later events in the cellular and humoral immune response. PMID:26970484

  8. Overview of IgG4-Related Tubulointerstitial Nephritis and Its Mimickers.

    Science.gov (United States)

    Jeong, Hyeon Joo; Shin, Su-Jin; Lim, Beom Jin

    2016-01-01

    Tubulointerstitial nephritis (TIN) is the most common form of renal involvement in IgG4-related disease. It is characterized by a dominant infiltrate of IgG4-positive plasma cells in the interstitium and storiform fibrosis. Demonstration of IgG4-positive plasma cells is essential for diagnosis, but the number of IgG4-positive cells and the ratio of IgG4-positive/IgG-positive plasma cells may vary from case to case and depending on the methods of tissue sampling even in the same case. IgG4-positive plasma cells can be seen in TIN associated with systemic lupus erythematosus, Sjögren syndrome, or anti-neutrophil cytoplasmic antibody-associated vasculitis, which further add diagnostic confusion and difficulties. To have a more clear view of IgG4-TIN and to delineate differential points from other TIN with IgG4-positive plasma cell infiltrates, clinical and histological features of IgG4-TIN and its mimickers were reviewed. In the rear part, cases suggesting overlap of IgG4-TIN and its mimickers and glomerulonephritis associated with IgG4-TIN were briefly described. PMID:26666884

  9. Elevated expressions of myeloid-related proteins-8 and -14 are danger biomarkers for lupus nephritis.

    Science.gov (United States)

    Tantivitayakul, P; Benjachat, T; Somparn, P; Leelahavanichkul, A; Kittikovit, V; Hirankarn, N; Pisitkun, T; Avihingsanon, Y

    2016-01-01

    Myeloid-related proteins, MRP-8 and -14, which have been identified as molecules that mediate the danger signaling in innate immune response, are also known as the DAMPs (damage associated molecular pattern molecules). The proteins were found in infiltrating macrophages and neutrophils at inflammatory sites. Their expression was correlated with severe forms of glomerulonephritis. Therefore, this study examined whether or not MRP-8 and -14 can be used as biomarkers for identifying severely active lupus nephritis (LN). Total blood leukocyte samples and renal biopsy tissues from a prospective cohort of LN patients were used to determine mRNA and protein expression levels of MRP-8 and -14. The mRNA levels of MRP-8 and -14 in total blood leukocytes were significantly higher in active LN patients than quiescent LN patients and healthy controls. Moreover, the mRNA levels of MRP-8 and -14 in the total blood leukocytes and kidney tissues were significantly correlated with therapeutic response and the mRNA expression levels in the kidney were associated with an early loss of the kidney function. MRP-8 and -14 can be used as non-invasive prognostic biomarkers in patients with LN. PMID:26223295

  10. Rifampin-associated tubulointersititial nephritis and Fanconi syndrome presenting as hypokalemic paralysis

    Directory of Open Access Journals (Sweden)

    Min Hong Ki

    2013-01-01

    Full Text Available Abstract Background Rifampin is one of the most important drugs in first-line therapies for tuberculosis. The renal toxicity of rifampin has been reported sporadically and acute tubulointerstitial nephritis (ATIN is a frequent histological finding. We describe for the first time a case of ATIN and Fanconi syndrome presenting as hypokalemic paralysis, associated with the use of rifampin. Case presentation A 42-year-old man was admitted with sudden-onset lower extremity paralysis and mild renal insufficiency. He had been treated for pulmonary tuberculosis with isoniazid, rifampin, and ethambutol for 2 months. Laboratory tests revealed proteinuria, profound hypokalemia, hyperchloremic metabolic acidosis with a normal anion gap, positive urine anion gap, hypophosphatemia with hyperphosphaturia, hypouricemia with hyperuricosuria, glycosuria with normal serum glucose level, generalized aminoaciduria, and β2-microglobulinuria. A kidney biopsy revealed findings typical of ATIN and focal granular deposits of immunoglubulin A and complement 3 in the glomeruli and tubules. Electron microscopy showed epithelial foot process effacement and electron-dense deposits in the subendothelial and mesangial spaces. Cessation of rifampin resolved the patient’s clinical presentation of Fanconi syndrome, and improved his renal function and proteinuria. Conclusion This case demonstrates that rifampin therapy can be associated with Fanconi syndrome presenting as hypokalemic paralysis, which is a manifestation of ATIN. Kidney function and the markers of proximal tubular injury should be carefully monitored in patients receiving rifampin.

  11. The Role of Nephritis-Associated Plasmin Receptor (NAPlr) in Glomerulonephritis Associated with Streptococcal Infection

    Science.gov (United States)

    Oda, Takashi; Yoshizawa, Nobuyuki; Yamakami, Kazuo; Sakurai, Yutaka; Takechi, Hanako; Yamamoto, Kojiro; Oshima, Naoki; Kumagai, Hiroo

    2012-01-01

    It is well known that glomerulonephritis can occur after streptococcal infection, which is classically referred to as acute poststreptococcal glomerulonephritis (APSGN). The pathogenic mechanism of APSGN has been described by so-called immune complex theory, which involves glomerular deposition of nephritogenic streptococcal antigen and subsequent formation of immune complexes in situ and/or the deposition of circulating antigen-antibody complexes. However, the exact entity of the causative antigen has remained a matter of debate. We isolated a nephritogenic antigen for APSGN from the cytoplasmic fractions of group A streptococcus (GAS) depending on the affinity for IgG of APSGN patients. The amino acid and the nucleotide sequences of the isolated protein revealed to be highly identical to those of reported plasmin(ogen) receptor of GAS. Thus, we termed this antigen nephritis-associated plasmin receptor (NAPlr). Immunofluorescence staining of the renal biopsy tissues with anti-NAPlr antibody revealed glomerular NAPlr deposition in essentially all patients with early-phase APSGN. Furthermore, glomerular plasmin activity was detected by in situ zymography in the distribution almost identical to NAPlr deposition in renal biopsy tissues of APSGN patients. These data suggest that NAPlr has a direct, nonimmunologic function as a plasmin receptor and may contribute to the pathogenesis of APSGN by maintaining plasmin activity. PMID:23118507

  12. The Role of Nephritis-Associated Plasmin Receptor (NAPlr in Glomerulonephritis Associated with Streptococcal Infection

    Directory of Open Access Journals (Sweden)

    Takashi Oda

    2012-01-01

    Full Text Available It is well known that glomerulonephritis can occur after streptococcal infection, which is classically referred to as acute poststreptococcal glomerulonephritis (APSGN. The pathogenic mechanism of APSGN has been described by so-called immune complex theory, which involves glomerular deposition of nephritogenic streptococcal antigen and subsequent formation of immune complexes in situ and/or the deposition of circulating antigen-antibody complexes. However, the exact entity of the causative antigen has remained a matter of debate. We isolated a nephritogenic antigen for APSGN from the cytoplasmic fractions of group A streptococcus (GAS depending on the affinity for IgG of APSGN patients. The amino acid and the nucleotide sequences of the isolated protein revealed to be highly identical to those of reported plasmin(ogen receptor of GAS. Thus, we termed this antigen nephritis-associated plasmin receptor (NAPlr. Immunofluorescence staining of the renal biopsy tissues with anti-NAPlr antibody revealed glomerular NAPlr deposition in essentially all patients with early-phase APSGN. Furthermore, glomerular plasmin activity was detected by in situ zymography in the distribution almost identical to NAPlr deposition in renal biopsy tissues of APSGN patients. These data suggest that NAPlr has a direct, nonimmunologic function as a plasmin receptor and may contribute to the pathogenesis of APSGN by maintaining plasmin activity.

  13. Imbalance of Interleukin 18 and Interleukin 18 Binding Protein in Patients with Lupus Nephritis

    Institute of Scientific and Technical Information of China (English)

    Dong Liang; Wenfeng Ma; Cuiwei Yao; Huafeng Liu; Xiaowen Chen

    2006-01-01

    To evaluate the balance status of interleukin 18 (IL-18) and interleukin 18 binding protein (IL-18BP) in circulation in patients with lupus nephritis (LN) and primary nephrotic syndrome (PNS), plasma levels as well as mRNA expression in peripheral blood mononuclear cells (PBMCs) of IL-18 and IL-18BP were measured by ELISA and RT-PCR respectively. The ratio of IL-18/IL-18BP was also calculated. Both plasma IL-18 and IL-18BP increased significantly in LN patients while only IL-18BP increased in PNS, which resulted in an elevated ratio of IL-18/IL-18BP in LN but not in PNS patients when compared with normal controls. In contrast, increased level of IL-18 mRNA was only detected in LN but not in PNS group, although IL-18BP mRNA expressions in PBMCs in both groups were higher than that in control. The imbalance of IL-18 and IL-18BP might be involved in the pathogenesis of LN, based on which a therapeutic approach is valuable to be developed for LN. Cellular & Molecular Immunology. 2006;3(4):303-306.

  14. Clozapine-induced interstitial nephritis - a rare but important complication: a case report

    Directory of Open Access Journals (Sweden)

    Hunter Robert

    2009-08-01

    Full Text Available Abstract Introduction Given the limited range of effective drug treatments for patients with schizophrenia, increasing numbers of patients, often termed 'treatment-resistant' are prescribed clozapine. While the induction of neutropenia or agranulocytosis by clozapine is well appreciated, other rare potentially fatal adverse reactions may also occur including acute interstitial nephritis as reported in this case. Case presentation A 57-year-old Caucasian woman with treatment-resistant chronic schizophrenia developed acute renal failure following initiation of treatment with clozapine. The adverse reaction occurred after only four doses of the drug had been administered (titrated from 12.5 to 25 mg per day. After clozapine had been withdrawn, the patient's renal function returned to normal with no other changes to medication. The patient had been exposed to clozapine about 4 years previously when she had developed a similar reaction. Conclusion Renal reactions to clozapine are extremely rare but, if not recognized promptly, may prove fatal. Psychiatrists need to be aware of this possible complication when clozapine is initiated.

  15. Mannose-binding lectin blunts macrophage polarization and ameliorates lupus nephritis.

    Directory of Open Access Journals (Sweden)

    Yanxing Cai

    Full Text Available BACKGROUND: Deficiency in clearance of self nuclear antigens, including DNA, is the hallmark of systemic lupus erythematosus (SLE, a chronic autoimmnue disease characterized by the production of various autoantibodies, immune complex deposition and severe organ damage. Our previous studies revealed that administration of syngeneic BALB/c mice with activated lymphocyte-derived DNA (ALD-DNA could induce SLE disease. Mannose-binding lectin (MBL, a secreted pattern recognition receptor with binding activity to DNA, has been proved to be a modulator of inflammation, but whether MBL takes responsibility for DNA clearance, modulates the DNA-mediated immune responses, and is involved in the development of DNA-induced SLE disease remain poorly understood. METHODOLOGY/PRINCIPAL FINDINGS: The levels of serum MBL significantly decreased in lupus mice induced by ALD-DNA and were negatively correlated with SLE disease. MBL blunted macrophage M2b polarization by inhibiting the MAPK and NF-κB signaling while enhancing the activation of CREB. Furthermore, MBL suppressed the ability of ALD-DNA-stimulated macrophages to polarize T cells toward Th1 cells and Th17 cells. Importantly, MBL supplement in vivo could ameliorate lupus nephritis. CONCLUSION/SIGNIFICANCE: These results suggest MBL supplement could alleviate SLE disease and might imply a potential therapeutic strategy for DNA-induced SLE, which would further our understanding of the protective role of MBL in SLE disease.

  16. Detecting Genetic Associations between ATG5 and Lupus Nephritis by trans-eQTL

    Directory of Open Access Journals (Sweden)

    Yue-miao Zhang

    2015-01-01

    Full Text Available Objectives. Numerous loci were identified to perturb gene expression in trans. As elevated ATG5 expression was observed in systemic lupus erythematosus (SLE, the study was conducted to analyze the genome-wide genetic regulatory mechanisms associated with ATG5 expression in a Chinese population with lupus nephritis (LN. Methods. The online expression quantitative trait loci database was searched for trans-expression single nucleotide polymorphisms (trans-eSNPs of ATG5. Tagging trans-eSNPs were genotyped by a custom-made genotyping chip in 280 patients and 199 controls. For positive findings, clinical information and bioinformation analyses were performed. Results. Four trans-eSNPs were observed to be associated with susceptibility to LN (P < 0.05, including ANKRD50 rs17008504, AGA rs2271100, PAK7 rs6056923, and TET2 rs1391441, while seven other trans-eSNPs showed marginal significant associations (0.05 < P < 0.1. Correlations between the trans-eSNPs and ATG5 expression and different expression levels of ATG5 in SLE patients and controls were validated, and their regulatory effects were annotated. However, no significant associations were observed between different genotypes of trans-eSNPs and severity or outcome of the patients. Conclusion. Using the new systemic genetics approach, we identified 10 loci associated with susceptibility to LN potentially, which may be complementary to future pathway based genetic studies.

  17. Increased urinary excretion of platelet activating factor in mice with lupus nephritis

    Energy Technology Data Exchange (ETDEWEB)

    Macconi, D.; Noris, M.; Benfenati, E.; Quaglia, R.; Pagliarino, G. (Mario Negri Institute for Pharmacological Research, Bergamo (Italy)); Remuzzi, G. (Mario Negri Institute for Pharmacological Research, Bergamo (Italy) Ospedali Riuniti di Bergamo (Italy))

    1991-01-01

    Platelet activating factor (PAF) is present in urine from humans and experimental animals in normal conditions. Very little is known about changes in PAF urinary excretion under pathologic conditions and no data are available about the origin of PAF in the urine. In the present study we explored the possibility that immunologic renal disease is associated with an increase in PAF urinary excretion using gas chromatography-mass spectrometry technique. To clarify the renal or extrarenal origin of urinary PAF we evaluated whether exogenously administered PAF (1-(1{prime},2{prime}-{sup 3}H)alkyl) is filtered through the glomerulus and excreted in the urine. The results show that: (1) urine from mice with lupus nephritis in the early phase of the disease contained amounts of PAF comparable to those excreted in normal mouse urine, (2) PAF levels increased when animals started to develop high grade proteinuria, (3) after intravenous injection of ({sup 3}H) PAF In nephritic mice, a negligible amount of ({sup 3}H) ether lipid, corresponding to ({sup 3}H)1-alkyl -2-acyl-3-phosphocholine (alkyl-2-acyl-GPC), was recovered from the 24 h urine extract.

  18. Soluble Fas and the −670 Polymorphism of Fas in Lupus Nephritis

    Science.gov (United States)

    Bollain-y-Goytia, Juan José; Arellano-Rodríguez, Mariela; Torres-Del-Muro, Felipe de Jesús; Daza-Benítez, Leonel; Francisco Muñoz-Valle, José; Avalos-Díaz, Esperanza; Herrera-Esparza, Rafael

    2014-01-01

    This study was performed to clarify the role of soluble Fas (sFas) in lupus nephritis (LN) and establish a potential relationship between LN and the −670 polymorphism of Fas in 67 patients with systemic lupus erythematosus (SLE), including a subset of 24 LN patients with proteinuria. Additionally, a group of 54 healthy subjects (HS) was included. The allelic frequency of the −670 polymorphism of Fas was determined using PCR-RFLP analysis, and sFas levels were assessed by ELISA. Additionally, the WT-1 protein level in urine was measured. The Fas receptor was determined in biopsies by immunohistochemistry (IHC) and in situ hybridization (FISH) and apoptotic features by TUNEL. Results. The −670 Fas polymorphism showed that the G allele was associated with increased SLE susceptibility, with an odds ratio (OR) of 1.86. The sFas was significantly higher in LN patients with the G/G genotype, and this subgroup exhibited correlations between the sFas level and proteinuria and increased urinary WT-1 levels. LN group shows increased expression of Fas and apoptotic features. In conclusion, our results indicate that the G allele of the −670 polymorphism of Fas is associated with genetic susceptibility in SLE patients with elevated levels of sFas in LN with proteinuria. PMID:25505993

  19. Visceral leishmaniasis: a forgotten epidemic.

    Science.gov (United States)

    Zijlstra, Eduard E

    2016-06-01

    Visceral leishmaniasis (VL or kala-azar) is most endemic in Asia and Africa and commonly affects young children. It is usually caused by Leishmania donovani or Leishmania infantum that are transmitted by Phlebotomine sand flies. Transmission may be anthroponotic or zoonotic or both, depending on the endemic area. Clinical features include fever, hepatosplenomegaly, weight loss and pancytopenia. Younger age, malnutrition and immunosuppression (HIV infection, use of immunosuppressive drugs) are risk factors. Many infections remain asymptomatic. Diagnosis is made by demonstration of the Leishmania parasite in aspirates of lymph node, bone marrow or spleen. Serological tests such as rK39 strip test are widely used but the sensitivity varies. qPCR is useful to detect low numbers of parasites and to monitor treatment. Treatment is with AmBisome monotherapy in most areas but with drug combinations elsewhere. HIV co-infected patients are most difficult to treat and often relapse. Control efforts focus on case finding, availability of diagnostic tools, reservoir control and protection from sand flies (insecticides, bed nets). There is no human vaccine. PMID:26895806

  20. Restraining Epidemics by Improving Immunization Strategies

    CERN Document Server

    Schneider, Christian M; Havlin, Shlomo; Herrmann, Hans J

    2011-01-01

    The way diseases spread through social and global transportation networks is crucially determining their risk for humanity. Based on percolation theory we quantitatively analyze the effect of immunization strategies on the spreading of diseases through networks and propose a novel approach to improve their effectiveness. We find that the network's vulnerability to epidemics can be significantly reduced by implementing improved immunization strategies based on high betweenness centrality. We demonstrate this on two real networks, the global flight network, which is known as the most important source of pandemic spreading and a school friendship network. In theses networks, the average probability for a node to get infected is reduced by more than 10% compared to the betweenness centrality method believed to be the most efficient strategy to prevent epidemic spreading.

  1. How Clustering Affects Epidemics in Random Networks

    CERN Document Server

    Coupechoux, Emilie

    2012-01-01

    Motivated by the analysis of social networks, we study a model of random networks that has both a given degree distribution and a tunable clustering coefficient. We consider two types of growth processes on these graphs: diffusion and symmetric threshold model. The diffusion process is inspired from epidemic models. It is characterized by an infection probability, each neighbor transmitting the epidemic independently. In the symmetric threshold process, the interactions are still local but the propagation rule is governed by a threshold (that might vary among the different nodes). An interesting example of symmetric threshold process is the contagion process, which is inspired by a simple coordination game played on the network. Both types of processes have been used to model spread of new ideas, technologies, viruses or worms and results have been obtained for random graphs with no clustering. In this paper, we are able to analyze the impact of clustering on the growth processes. While clustering inhibits th...

  2. Emergence of epidemics in rapidly varying networks

    International Nuclear Information System (INIS)

    We describe a simple model mimicking disease spreading on a network with dynamically varying connections, and investigate the dynamical consequences of switching links in the network. Our central observation is that the disease cycles get more synchronized, indicating the onset of epidemics, as the underlying network changes more rapidly. This behavior is found for periodically switched links, as well as links that switch randomly in time. We find that the influence of changing links is more pronounced in networks where the nodes have lower degree, and the disease cycle has a longer infective stage. Further, when the switching of links is periodic we observe finer dynamical features, such as beating patterns in the emergent oscillations and resonant enhancement of synchronization, arising from the interplay between the time-scales of the connectivity changes and that of the epidemic outbreaks

  3. Epidemics and vaccination on weighted graphs

    CERN Document Server

    Deijfen, Maria

    2011-01-01

    A Reed-Frost epidemic with inhomogeneous infection probabilities on a graph with prescribed degree distribution is studied. Each edge $(u,v)$ in the graph is equipped with two weights $W_{(u,v)}$ and $W_{(v,u)}$ that represent the (subjective) strength of the connection and determine the probability that $u$ infects $v$ in case $u$ is infected and vice versa. Expressions for the epidemic threshold are derived for i.i.d.\\ weights and for weights that are functions of the degrees. For i.i.d.\\ weights, a variation of the so called acquaintance vaccination strategy is analyzed where vertices are chosen randomly and neighbors of these vertices with large edge weights are vaccinated. This strategy is shown to outperform the strategy where the neighbors are chosen randomly in the sense that the basic reproduction number is smaller for a given vaccination coverage.

  4. On the epidemic of financial crises

    OpenAIRE

    Demiris, Nikolaos; Kypraios, Theodore; Smith, L. Vanessa

    2012-01-01

    This paper proposes a framework for modelling financial contagion that is based on SIR (Susceptible-Infected-Recovered) transmission models from epidemic theory. This class of models addresses two important features of contagion modelling, which are a common shortcoming of most existing empirical approaches, namely the direct modelling of the inherent dependencies involved in the transmission mechanism, and an associated canonical measure of crisis severity. The proposed methodology naturally...

  5. HIV epidemic in Russia and neighbouring countries

    Directory of Open Access Journals (Sweden)

    Vadim Pokrovskiy

    2014-11-01

    Full Text Available Reports of HIV/AIDS cases attributed to sexual transmission from foreigners were published in the USSR in the mid of 80s. In the initial decade of the epidemic, the subtype B was found in men who have sex with men (MSM population and several non-B subtypes were identified in heterosexual persons. The first case of HIV infection in intravenous drug users (IVDU was reported in 1993 and since then a specific subtype A and its recombinants invaded the intravenous drug users (IVDU populations of the region with the highest rate in Estonia, Russia and Ukraine. The concentrated HIV epidemic in IVDUs is still the main problem in the Eastern Europe; however, the rate of heterosexual transmission is increasing and many evidences of HIV prevalence rise in MSM are published. UNAIDS estimations for the number of HIV-positive persons living in the region range from 980,000 to 1,300,000 but distribution of HIV-cases is uneven and the prevalence rate of HIV infection in separate regions is over 1%. Mass seasonal labour migration from Central Asia and Caucasian republics to Russia transmits HIV to these countries. Prevention programs in the region are limited, and ART coverage is not more than 20% of the total HIV-positive population. The lack of concern about the epidemic, absence of effective national strategies and limited allocated resources are the main barriers to prevention and care in many countries. Local conflicts, rising religiosity and discrimination are adverse factors. The near-term forecast for the epidemic in the region is pessimistic and further international advocacy is needed to improve the situation.

  6. New Approaches to the Methamphetamine Epidemic

    OpenAIRE

    Zusman, Mara B.

    2004-01-01

    Methamphetamine abuse has become an epidemic in the United States. As methamphetamine becomes increasingly available, more and more people are trying – and becoming addicted to – this potent drug. But although methamphetamine is made using over-the-counter (OTC) drugs containing pseudoephedrine, shifting OTC drugs containing pseudoephedrine to prescription status is not the solution to the methamphetamine crisis. Rather, society must adopt a comprehensive...

  7. Negligible Risk for Epidemics after Geophysical Disasters

    OpenAIRE

    Floret, Nathalie; Viel, Jean-François; Mauny, Frédéric; Hoen, Bruno; Piarroux, Renaud

    2006-01-01

    After geophysical disasters (i.e., earthquakes, volcanic eruptions, tsunamis), media reports almost always stress the risk for epidemics; whether this risk is genuine has been debated. We analyzed the medical literature and data from humanitarian agencies and the World Health Organization from 1985 to 2004. Of >600 geophysical disasters recorded, we found only 3 reported outbreaks related to these disasters: 1 of measles after the eruption of Pinatubo in Philippines, 1 of coccidioidomycosis a...

  8. Generalized epidemic process on modular networks

    OpenAIRE

    Chung, Kihong; Baek, Yongjoo; Kim, Daniel; Ha, Meesoon; Jeong, Hawoong

    2013-01-01

    Social reinforcement and modular structure are two salient features observed in the spreading of behavior through social contacts. In order to investigate the interplay between these two features, we study the generalized epidemic process on modular networks with equal-sized finite communities and adjustable modularity. Using the analytical approach originally applied to clique-based random networks, we show that the system exhibits a bond-percolation type continuous phase transition for weak...

  9. Genetic susceptibility, evolution and the kuru epidemic

    OpenAIRE

    Mead, S.; Whitfield, J; Poulter, M.; Shah, P.; Uphill, J; Beck, J.; Campbell, T.; Al-Dujaily, H.; Hummerich, H.; Alpers, M. P.; Collinge, J

    2008-01-01

    The acquired prion disease kuru was restricted to the Fore and neighbouring linguistic groups of the Papua New Guinea highlands and largely affected children and adult women. Oral history documents the onset of the epidemic in the early twentieth century, followed by a peak in the mid-twentieth century and subsequently a well-documented decline in frequency. In the context of these strong associations (gender, region and time), we have considered the genetic factors associated with susceptibi...

  10. Personal protective behaviour during an epidemic

    OpenAIRE

    Badham, Jennifer; Gilbert, Nigel

    2014-01-01

    The TELL ME simulation model is being developed to assist health authorities to understand the effects of their choices about how to communicate with citizens about protecting themselves from influenza epidemics. It will include an agent based model to simulate personal decisions to seek vaccination or adopt behaviour such as improved hand hygiene. This paper focusses on the design of the agents’ decisions, using a combination of personal attitude, average local attitude, the local number of ...

  11. Diabetes mellitus: The epidemic of the century

    OpenAIRE

    Kharroubi, Akram T.; Darwish, Hisham M.

    2015-01-01

    The epidemic nature of diabetes mellitus in different regions is reviewed. The Middle East and North Africa region has the highest prevalence of diabetes in adults (10.9%) whereas, the Western Pacific region has the highest number of adults diagnosed with diabetes and has countries with the highest prevalence of diabetes (37.5%). Different classes of diabetes mellitus, type 1, type 2, gestational diabetes and other types of diabetes mellitus are compared in terms of diagnostic criteria, etiol...

  12. Transitioning through AIDS epidemics - gender and temporality

    OpenAIRE

    Clarice Souza Pinto; Carlos Eurico dos Santos Fernandes; Roberto Dias de Oliveira; Vanessa Terezinha Gubert de Matos; Ana Rita Coimbra Motta de Castro

    2015-01-01

    ABSTRACT OBJECTIVE: To understand the evolution of AIDS over time in Mato Grosso do Sul, Brazil, using incidence, lethality, and mortality coefficients. METHODS: A descriptive epidemiological study based on time series analysis of secondary data from the Notifiable Diseases Information System reported between 1985 and 2012. RESULTS: The prevalence of AIDS was higher among men, with evidence of feminization during the first 14 years of the epidemic. There was no statistically significant...

  13. The 1982 epidemic--roller skating injuries.

    OpenAIRE

    Bunker, T. D.

    1983-01-01

    A series of 100 roller skating injuries is presented. Roller skating injuries have been occurring at a higher rate than the previously reported skateboarding epidemic of 1977. The severity of injury has been lower, 32% fractures and dislocations occurring whilst roller skating, compared to 60% whilst skateboarding. In particular a striking reduction is seen in ankle fractures. Fifty questionnaires detailing method of injury were analysed.

  14. SARS epidemical forecast research in mathematical model

    Institute of Scientific and Technical Information of China (English)

    DING Guanghong; LIU Chang; GONG Jianqiu; WANG Ling; CHENG Ke; ZHANG Di

    2004-01-01

    The SIJR model, simplified from the SEIJR model, is adopted to analyze the important parameters of the model of SARS epidemic such as the transmission rate, basic reproductive number. And some important parameters are obtained such as the transmission rate by applying this model to analyzing the situation in Hong Kong, Singapore and Canada at the outbreak of SARS. Then forecast of the transmission of SARS is drawn out here by the adjustment of parameters (such as quarantined rate) in the model. It is obvious that inflexion lies on the crunode of the graph, which indicates the big difference in transmission characteristics between the epidemic under control and not under control. This model can also be used in the comparison of the control effectiveness among different regions. The results from this model match well with the actual data in Hong Kong, Singapore and Canada and as a by-product, the index of the effectiveness of control in the later period can be acquired. It offers some quantitative indexes, which may help the further research in epidemic diseases.

  15. Global Seasonal Influenza Epidemics and Climate

    Science.gov (United States)

    Tamerius, James

    2013-04-01

    Recent evidence suggests that low specific humidity conditions facilitate the transmission of the influenza virus in temperate regions and result in annual winter epidemics. However, this relationship does not account for the epidemiology of influenza in tropical and subtropical regions where epidemics often occur during the rainy season or transmit year-round without a well-defined season. We assessed the role of specific humidity and other local climatic variables on influenza virus seasonality by modeling epidemiological and climatic information from 78 study sites sampled globally. We substantiated that there are two types of environmental conditions associated with seasonal influenza epidemics: "cold-dry" and "humid-rainy". For sites where monthly average specific humidity or temperature decreases below thresholds of approximately 11-12 g/kg and 18-21 °C during the year, influenza activity peaks during the cold-dry season (i.e., winter) when specific humidity and temperature are at minimal levels. For sites where specific humidity and temperature do not decrease below these thresholds, seasonal influenza activity is more likely to peak in months when average precipitation totals are maximal and greater than 150 mm per month. Based on these findings, we develop Susceptible-Exposed-Infected-Recovered-Susceptible (SEIRS) models forced by daily weather observations of specific humidity and precipitation that simulate the diversity of seasonal influenza signals worldwide.

  16. Epidemic model with isolation in multilayer networks

    CERN Document Server

    Zuzek, L G Alvarez; Braunstein, L A

    2014-01-01

    The Susceptible-Infected-Recovered (SIR) model has successfully mimicked the propagation of such airborne diseases as influenza A (H1N1). Although the SIR model has recently been studied in a multilayer networks configuration, in almost all the research the dynamic movement of infected individuals, e.g., how they are often kept in isolation, is disregarded. We study the SIR model in two multilayer networks and use an isolation parameter, indicating time period, to measure the effect of isolating infected individuals from both layers. This isolation reduces the transmission of the disease because the time in which infection can spread is reduced. In this scenario we find that the epidemic threshold increases with the isolation time and the isolation parameter and the impact of the propagation is reduced. We also find that when isolation is total there is a threshold for the isolation parameter above which the disease never becomes an epidemic. We also find that regular epidemic models always overestimate the e...

  17. The glue ear 'epidemic': a historical perspective.

    Science.gov (United States)

    Alderson, David

    2011-12-01

    This paper explores the historical context of the dramatic rise in surgery for glue ear in the mid-20th century, and questions the published assertion that this represented a manufactured 'epidemic'. In examining historical sources, the reader's theoretical viewpoint greatly influences their conclusions: the sustained rise in treatment for glue ear may be seen as the advance of science in a golden age or the resistance of insular professionals to reason in the light of new scientific study methods. Current views on the practice of medicine, consumerism, science and standardisation, rationing and the nature of 'truth' all affect the way that we see this period. Technological advances clearly allowed better diagnosis and more effective treatment, but these did not appear to drive an 'epidemic', rather they were developed to meet the pre-existing challenges of otological practice. The proposition that an 'epidemic' was created does not appear to have any solid grounding. Society's perception of what constitutes disease and what needs treatment may have evolved, but the prevalence of other important diseases changed dramatically over this time period, and a real change in the epidemiology of glue ear cannot be dismissed. In defining the case for and against surgical treatment, a solely positivist, quantitative worldview cannot give us a complete picture of benefit and risk to individuals, families and society at large. PMID:21653931

  18. The obesity epidemic in the United States.

    Science.gov (United States)

    Morrill, Allison C; Chinn, Christopher D

    2004-01-01

    We describe the epidemic of obesity in the United States: escalating rates of obesity in both adults and children, and why these qualify as an epidemic; disparities in overweight and obesity by race/ethnicity and sex, and the staggering health and economic consequences of obesity. Physical activity contributes to the epidemic as explained by new patterns of physical activity in adults and children. Changing patterns of food consumption, such as rising carbohydrate intake--particularly in the form of soda and other foods containing high fructose corn syrup--also contribute to obesity. We present as a central concept, the food environment--the contexts within which food choices are made--and its contribution to food consumption: the abundance and ubiquity of certain types of foods over others; limited food choices available in certain settings, such as schools; the market economy of the United States that exposes individuals to many marketing/advertising strategies. Advertising tailored to children plays an important role. PMID:15683071

  19. A weighted configuration model and inhomogeneous epidemics

    CERN Document Server

    Britton, Tom; Liljeros, Fredrik

    2011-01-01

    A random graph model with prescribed degree distribution and degree dependent edge weights is introduced. Each vertex is independently equipped with a random number of half-edges and each half-edge is assigned an integer valued weight according to a distribution that is allowed to depend on the degree of its vertex. Half-edges with the same weight are then paired randomly to create edges. An expression for the threshold for the appearance of a giant component in the resulting graph is derived using results on multi-type branching processes. The same technique also gives an expression for the basic reproduction number for an epidemic on the graph where the probability that a certain edge is used for transmission is a function of the edge weight. It is demonstrated that, if vertices with large degree tend to have large (small) weights on their edges and if the transmission probability increases with the edge weight, then it is easier (harder) for the epidemic to take off compared to a randomized epidemic with t...

  20. The macroeconomics of targeting: the case of an enduring epidemic.

    Science.gov (United States)

    Bell, Clive; Gersbach, Hans

    2009-01-01

    What is the right balance among policy interventions in order to ensure economic growth over the long run when an epidemic causes heavy mortality among young adults? We argue that, in general, policies to combat the disease and promote education must be concentrated, in certain ways, at first on some subgroups of society. This concentration involves what we term the macroeconomics of targeting. The central comparison is then between programs under which supported families enjoy the benefits of spending on health and education simultaneously (DT), and those under which the benefits in these two domains are sequenced (ST). When levels of human capital are uniformly low at the outbreak, DT is superior to ST if the mortality rate exceeds some threshold value. Outside aid makes DT more attractive; but DT restricts support to fewer families initially and so increases inequality. A summary account of the empirical evidence is followed by an application of the framework to South Africa. PMID:18977545

  1. Assessing node risk and vulnerability in epidemics on networks

    CERN Document Server

    Rogers, Tim

    2015-01-01

    Which nodes are most vulnerable to an epidemic spreading through a network, and which carry the highest risk of causing a major outbreak if they are the source of the infection? Here we show how these questions can be answered to good approximation using the cavity method. Several curious properties of node vulnerability and risk are explored: some nodes are more vulnerable than others to weaker infections, yet less vulnerable to stronger ones; a node is always more likely to be caught in an outbreak than it is to start one, except when the disease has a deterministic lifetime; the rank order of node risk depends on the details of the distribution of infectious periods.

  2. Clinical significance of determination of changes of serum GM-CSF, hs-CRP and IL-8 levels after treatment in pediatric patients with acute nephritis

    International Nuclear Information System (INIS)

    Objective: To explore the changes of serum GM-CSF, hs-CRP and IL-8 levels both before and after treatment in pediatric patirnts with acute nephritis. Methods: Serum GM-CSF, hs-CRP and IL-8 levels (with RIA) and hs-CRP levels (with Immuno-turbidity) in 31 pediatric patients with acute nephritis both before and after treatment as well in 30 controls. Results: Before treatment, the serum GM-CSF, hs-CRP and IL-8 levels were significantly higher in the patients than those in the controls (P0.05). Conclusion: Detection of serum GM-CSF, hs-CRP and IL-8 levels after treatment might be of prognostic value in patients with acute nephritis. (authors)

  3. Clinical significance of determination of serum hs-CRP, IL-2, IL-6 and GM-CSF levels after treatment in pediatric patients with acute nephritis

    International Nuclear Information System (INIS)

    Objective: To explore the clinical significance of determination of serum hs-CRP, IL-2, IL-6 and GM-CSF levels after treatment in pediatric patients with acute nephritis. Methods: Serum hs-CRP (with immuno-turbidity method), IL-2, IL-6 and GM-CSF (with RIA) levels were determined both before and after treatment in 31 pediatric patients with acute nephritis and 35 controls. Results: Before treatment,the serum hs-CRP, IL-6 and GM-CSF levels were significantly higher in the patients than those in controls (P0.05). Serum IL-2 levels were negatively correlated with the hs-CRP, IL-6 and GM-CSF levels (r=-0.5678, -0.6014, -0.5926, P<0.01). Conclusion: These cytokines participated in the pathogenesis of acute nephritis in pediatric patients. Monitoring the changes of their serum levels was helpful for the management of the diseases. (authors)

  4. Circulating chromatin-anti-chromatin antibody complexes bind with high affinity to dermo-epidermal structures in murine and human lupus nephritis

    DEFF Research Database (Denmark)

    Fismen, S; Hedberg, A; Fenton, K A;

    2009-01-01

    Murine and human lupus nephritis are characterized by glomerular deposits of electron-dense structures (EDS). Dominant components of EDS are chromatin fragments and IgG antibodies. Whether glomerular EDS predispose for similar deposits in skin is unknown. We analysed (i) whether dermo...... (NZBxNZW)F1 and MRL-lpr/lpr mice and from five patients with lupus nephritis were analysed by immunofluorescence, immune electron microscopy (IEM) and co-localization TUNEL IEM. Affinity of chromatin fragments for membrane structures was determined by surface plasmon resonance. Results demonstrated (i...... were present in capillary lumina in glomeruli and skin of all nephritic individuals. Thus, chromatin-IgG complexes accounting for lupus nephritis seem to reach skin through circulation, but other undetermined factors are required for these complexes to deposit within skin membranes....

  5. Sequential detection of influenza epidemics by the Kolmogorov-Smirnov test

    Directory of Open Access Journals (Sweden)

    Closas Pau

    2012-10-01

    Full Text Available Abstract Background Influenza is a well known and common human respiratory infection, causing significant morbidity and mortality every year. Despite Influenza variability, fast and reliable outbreak detection is required for health resource planning. Clinical health records, as published by the Diagnosticat database in Catalonia, host useful data for probabilistic detection of influenza outbreaks. Methods This paper proposes a statistical method to detect influenza epidemic activity. Non-epidemic incidence rates are modeled against the exponential distribution, and the maximum likelihood estimate for the decaying factor λ is calculated. The sequential detection algorithm updates the parameter as new data becomes available. Binary epidemic detection of weekly incidence rates is assessed by Kolmogorov-Smirnov test on the absolute difference between the empirical and the cumulative density function of the estimated exponential distribution with significance level 0 ≤ α ≤ 1. Results The main advantage with respect to other approaches is the adoption of a statistically meaningful test, which provides an indicator of epidemic activity with an associated probability. The detection algorithm was initiated with parameter λ0 = 3.8617 estimated from the training sequence (corresponding to non-epidemic incidence rates of the 2008-2009 influenza season and sequentially updated. Kolmogorov-Smirnov test detected the following weeks as epidemic for each influenza season: 50−10 (2008-2009 season, 38−50 (2009-2010 season, weeks 50−9 (2010-2011 season and weeks 3 to 12 for the current 2011-2012 season. Conclusions Real medical data was used to assess the validity of the approach, as well as to construct a realistic statistical model of weekly influenza incidence rates in non-epidemic periods. For the tested data, the results confirmed the ability of the algorithm to detect the start and the end of epidemic periods. In general, the proposed test could

  6. Winter mortality and its causes

    OpenAIRE

    Keatinge, W R

    2002-01-01

    In the 1970s scientific research focussed for the first time on dramatic rises in mortality every winter, and on smaller rises in unusually hot weather. Following the recent decline in influenza epidemics, approximately half of excess winter deaths are due to coronary thrombosis. These peak about two days after the peak of a cold spell. Approximately half the remaining winter deaths are caused by respiratory disease, and these peak about 12 days after peak cold. The rapid coronary deaths are ...

  7. Ebola hemorrhagic fever outbreaks: strategies for effective epidemic management, containment and control.

    Science.gov (United States)

    Matua, Gerald Amandu; Van der Wal, Dirk Mostert; Locsin, Rozzano C

    2015-01-01

    Ebola hemorrhagic fever, caused by the highly virulent RNA virus of the filoviridae family, has become one of the world's most feared pathogens. The virus induces acute fever and death, often associated with hemorrhagic symptoms in up to 90% of infected patients. The known sub-types of the virus are Zaire, Sudan, Taï Forest, Bundibugyo and Reston Ebola viruses. In the past, outbreaks were limited to the East and Central African tropical belt with the exception of Ebola Reston outbreaks that occurred in animal facilities in the Philippines, USA and Italy. The on-going outbreak in West Africa that is causing numerous deaths and severe socio-economic challenges has resulted in widespread anxiety globally. This panic may be attributed to the intense media interest, the rapid spread of the virus to other countries like United States and Spain, and moreover, to the absence of an approved treatment or vaccine. Informed by this widespread fear and anxiety, we analyzed the commonly used strategies to manage and control Ebola outbreaks and proposed new approaches that could improve epidemic management and control during future outbreaks. We based our recommendations on epidemic management practices employed during recent outbreaks in East, Central and West Africa, and synthesis of peer-reviewed publications as well as published "field" information from individuals and organizations recently involved in the management of Ebola epidemics. The current epidemic management approaches are largely "reactive", with containment efforts aimed at halting spread of existing outbreaks. We recommend that for better outcomes, in addition to "reactive" interventions, "pre-emptive" strategies also need to be instituted. We conclude that emphasizing both "reactive" and "pre-emptive" strategies is more likely to lead to better epidemic preparedness and response at individual, community, institutional, and government levels, resulting in timely containment of future Ebola outbreaks. PMID

  8. Ebola hemorrhagic fever outbreaks: strategies for effective epidemic management, containment and control

    Directory of Open Access Journals (Sweden)

    Gerald Amandu Matua

    2015-06-01

    Full Text Available Ebola hemorrhagic fever, caused by the highly virulent RNA virus of the filoviridaefamily, has become one of the world's most feared pathogens. The virus induces acute fever and death, often associated with hemorrhagic symptoms in up to 90% of infected patients. The known sub-types of the virus are Zaire, Sudan, Taï Forest, Bundibugyoand RestonEbola viruses. In the past, outbreaks were limited to the East and Central African tropical belt with the exception of Ebola Reston outbreaks that occurred in animal facilities in the Philippines, USA and Italy. The on-going outbreak in West Africa that is causing numerous deaths and severe socio-economic challenges has resulted in widespread anxiety globally. This panic may be attributed to the intense media interest, the rapid spread of the virus to other countries like United States and Spain, and moreover, to the absence of an approved treatment or vaccine. Informed by this widespread fear and anxiety, we analyzed the commonly used strategies to manage and control Ebola outbreaks and proposed new approaches that could improve epidemic management and control during future outbreaks. We based our recommendations on epidemic management practices employed during recent outbreaks in East, Central and West Africa, and synthesis of peer-reviewed publications as well as published "field" information from individuals and organizations recently involved in the management of Ebola epidemics. The current epidemic management approaches are largely "reactive", with containment efforts aimed at halting spread of existing outbreaks. We recommend that for better outcomes, in addition to "reactive" interventions, "pre-emptive" strategies also need to be instituted. We conclude that emphasizing both "reactive" and "pre-emptive" strategies is more likely to lead to better epidemic preparedness and response at individual, community, institutional, and government levels, resulting in timely containment of future Ebola

  9. Cutting Edge: IL-23 Receptor Deficiency Prevents the Development of Lupus Nephritis in C57BL/6–lpr/lpr Mice

    OpenAIRE

    Kyttaris, Vasileios C.; Zhang, Zheng; Kuchroo, Vijay K.; Oukka, Mohamed; Tsokos, George C.

    2010-01-01

    IL-17–producing T cells infiltrate kidneys of patients with lupus nephritis, and IL-23–treated lymph node cells from lupus-prone mice may transfer disease to Rag1-deficient mice. In this study, we show that IL-23R–deficient lupus-prone C57BL/6–lpr/lpr mice display decreased numbers of CD3+CD4−CD8− cells and IL-17A–producing cells in the lymph nodes and produce less anti-DNA Abs. In addition, clinical and pathology measures of lupus nephritis are abrogated. The presented experiments document t...

  10. Endogenous interleukin (IL)-17A promotes pristane-induced systemic autoimmunity and lupus nephritis induced by pristane.

    Science.gov (United States)

    Summers, S A; Odobasic, D; Khouri, M B; Steinmetz, O M; Yang, Y; Holdsworth, S R; Kitching, A R

    2014-06-01

    Interleukin (IL)-17A is increased both in serum and in kidney biopsies from patients with lupus nephritis, but direct evidence of pathogenicity is less well established. Administration of pristane to genetically intact mice results in the production of autoantibodies and proliferative glomerulonephritis, resembling human lupus nephritis. These studies sought to define the role of IL-17A in experimental lupus induced by pristane administration. Pristane was administered to wild-type (WT) and IL-17A(-/-) mice. Local and systemic immune responses were assessed after 6 days and 8 weeks, and autoimmunity, glomerular inflammation and renal injury were measured at 7 months. IL-17A production increased significantly 6 days after pristane injection, with innate immune cells, neutrophils (Ly6G(+)) and macrophages (F4/80(+)) being the predominant source of IL-17A. After 8 weeks, while systemic IL-17A was still readily detected in WT mice, the levels of proinflammatory cytokines, interferon (IFN)-γ and tumour necrosis factor (TNF) were diminished in the absence of endogenous IL-17A. Seven months after pristane treatment humoral autoimmunity was diminished in the absence of IL-17A, with decreased levels of immunoglobulin (Ig)G and anti-dsDNA antibodies. Renal inflammation and injury was less in the absence of IL-17A. Compared to WT mice, glomerular IgG, complement deposition, glomerular CD4(+) T cells and intrarenal expression of T helper type 1 (Th1)-associated proinflammatory mediators were decreased in IL-17A(-/-) mice. WT mice developed progressive proteinuria, but functional and histological renal injury was attenuated in the absence of IL-17A. Therefore, IL-17A is required for the full development of autoimmunity and lupus nephritis in experimental SLE, and early in the development of autoimmunity, innate immune cells produce IL-17A. PMID:24528105

  11. Actinobacillus suis and Actinobacillus equuli, emergent pathogens of septic embolic nephritis, a new challenge for the swine industry Actinobacillus suis y Actinobacillus equuli, patógenos emergentes de nefritis embólica séptica, un nuevo desafío para la industria porcina

    Directory of Open Access Journals (Sweden)

    CE Benavente

    2012-01-01

    Full Text Available Kidney lesions are an important cause of tissue condemnation in slaughterhouses. In addition to the potential public health implications, organ condemnations have a significant economic impact on the food animal industry. The condition classified broadly as "nephritis" is one of the main causes of tissue condemnation. Embolic nephritis resembling Actinobacillus equuli infection in foals has been recently detected in sows and market hogs. Actinobacillus suis is phenotypically and phylogenetically closely related to A. equuli. Both are Gram-negative bacteria, not easy to detect in routine exams. A. suis is an opportunistic pathogen that can produce fatal septicaemia in pigs, pneumonia, polyarthritis, septic embolic nephritis, abortion and mummified foetuses. Outbreaks of clinical disease appear to occur more frequently in high-health-status herds. In adult pigs the skin lesions may be confused with porcine erysipelas. A. suis and A. equuli are emerging opportunistic pathogens in the porcine industry and both have potential public health consequences to people that handles meat products. The objective of this paper is to present a literature review regarding the role of A. suis and A. equuli in the pathogenesis of nephritis in swine.Las lesiones renales son una causa importante de decomiso en los mataderos. Además de las posibles consecuencias en salud pública, el decomiso de órganos tiene un gran impacto económico en la industria de alimento animal. Recientemente, nefritis embólica séptica con lesiones semejantes a infecciones con Actinobacillus equuli en potrillos ha sido detectada en reproductoras y cerdos con peso de mercado. Actinobacillus equuli es fenotípica y genéticamente similar a Actinobacillus suis. Ambas son bacterias Gram-negativas difíciles de diagnosticar en exámenes de rutina. A. suis es un patógeno oportunista capaz de producir septicemia en cerdos, neumonía, poliartritis, nefritis embólica séptica, aborto y fetos

  12. Event history analysis of dengue fever epidemic and inter-epidemic spells in Barbados, Brazil, and Thailand

    Science.gov (United States)

    Parker, Daniel; Holman, Darryl

    2014-01-01

    SUMMARY Objective This study investigated meteorological and demographic factors affecting the length of dengue fever epidemics and the length of time between epidemics in Barbados, Brazil, and Thailand. Methods Region-specific meteorological and demographic data were collected for 104 sites from public sources. Fixed effects piecewise logistic event history analysis was used to quantify the effects of time-varying covariates on the duration of inter-epidemic spells and for the duration of epidemics. Results Mean monthly temperature was the most important factor affecting the duration of both inter-epidemic spells (β = 0.543; confidence interval (CI) 0.4954, 0.5906) and epidemic spells (β = −0.648; CI −0.7553, −0.5405). Drought conditions increased the time between epidemics. Increased temperature hastened the onset of an epidemic, and during an epidemic, higher mean temperature increased the duration of the epidemic. Conclusions By using a duration analysis, this study offers a novel approach for investigating the dynamics of dengue fever epidemiology. Furthermore, these results offer new insights into prior findings of a correlation between temperature and the geographic range and vector efficiency of dengue fever. PMID:22878174

  13. Tubulointersitial nephritis and uveitis syndrome%小管间质性肾炎-葡萄膜炎综合征

    Institute of Scientific and Technical Information of China (English)

    姚勇; 杨霁云

    2006-01-01

    TINU综合征(Tubulointerstitial nephritis and uveitis syndrome,TINU)即小管间质性肾炎-葡萄膜炎综合征,是一种不多见的临床综合征,是一类独立的、与机体免疫紊乱相关的、急性小管-间质性肾炎(ATIN)合并眼葡萄膜炎的临床症候群,至今病因尚不明确.

  14. Contrasuppression in autoimmunity. Abnormal contrasuppression facilitates expression of nephritogenic effector T cells and interstitial nephritis in kdkd mice

    OpenAIRE

    1987-01-01

    We have used the murine model of spontaneous autoimmune interstitial nephritis in kdkd mice to examine the importance of abnormal immunoregulation in the expression of disease. T cells from naive congenic CBA/Ca mice suppress both histologic renal injury in the kdkd strain as well as the DTH reactivity to CBA/Ca renal tubular antigens mediated by lymphocytes from nephritic kdkd mice. These antigen- specific suppressor T cells are Lyt-2+, L3T4+, I-Jk+, genetically dominant and I-Jk restricted....

  15. Impact of age at marriage and migration on HIV and AIDS epidemics in Japan

    Directory of Open Access Journals (Sweden)

    Ohkusa Yasushi

    2009-06-01

    Full Text Available Abstract The causes of wide variation in the rates of HIV and AIDS epidemics among Japanese and non-Japanese nationals are not well understood. So, this paper examines the associations and assesses the potential roles of mean age at marriage, and migration in the HIV and AIDS epidemics in Japan. For the purpose, bivariate and multivariate regression analysis have been performed using epidemiological panel data to build up the relationships among overall HIV and AIDS prevalence, mean age at marriage, and migration. The same analyses have done for non-Japanese nationals living with HIV and AIDS separately. These indicators were significantly correlated with mean age at marriage, and migration. Multivariate linear regression analysis identified non-Japanese nationals' HIV and AIDS prevalence and mean age at marriage as the two most prominent factors linked with the national HIV and AIDS epidemics. The findings of this study supported the hypotheses that a high average age at marriage in the population leads to long period of premarital sex and the non-Japanese nationals' high prevalence facilitating the spread of the HIV and AIDS epidemics in Japan.

  16. Effect of Heterogeneous Transmission Rate on Epidemic Spreading Over Scale Free Networks

    CERN Document Server

    Sagar, Vikram

    2016-01-01

    In the present work the spread of epidemic is studied over complex networks which are characterized by power law degree distribution of links and heterogeneous rate of disease transmission. The random allocation of epidemic transmission rates to the nodes results in the heterogeneity, which in turn causes the segregation of nodes in terms of various sub populations. The aim of the study is to gain microscopic insight into the effect of interactions among various sub populations in the spreading processes of disease over such networks. The discrete time Markov chain method based upon the susceptible infected susceptible (SIS) model of diseases transmission has been used to describe the spreading of epidemic over the networks. The study is parameterized in terms of variable $\\lambda$, defined as the number of contacts a node makes with the fraction of its neighboring nodes. From the simulation results, it is found that the spread of epidemic on such networks is critical in terms of number of minimum contacts ma...

  17. Mycobacterium tuberculosis strains potentially involved in the TB epidemic in Sweden a century ago.

    Directory of Open Access Journals (Sweden)

    Ramona Groenheit

    Full Text Available UNLABELLED: A hundred years ago the prevalence of tuberculosis (TB in Sweden was one of the highest in the world. In this study we conducted a population-based search for distinct strains of Mycobacterium tuberculosis complex isolated from patients born in Sweden before 1945. Many of these isolates represent the M. tuberculosis complex population that fueled the TB epidemic in Sweden during the first half of the 20(th century. METHODS: Genetic relationships between strains that caused the epidemic and present day strains were studied by spoligotyping and restriction fragment length polymorphism. RESULTS: The majority of the isolates from the elderly population were evolutionary recent Principal Genetic Group (PGG2/3 strains (363/409 or 88.8%, and only a low proportion were ancient PGG1 strains (24/409 or 5.9%. Twenty-two were undefined. The isolates demonstrated a population where the Euro-American superlineage dominated; in particular with Haarlem (41.1% and T (37.7% spoligotypes and only 21.2% belonged to other spoligotype families. Isolates from the elderly population clustered much less frequently than did isolates from a young control group population. CONCLUSIONS: A closely knit pool of PGG2/3 strains restricted to Sweden and its immediate neighbours appears to have played a role in the epidemic, while PGG1 strains are usually linked to migrants in todaýs Sweden. Further studies of these outbreak strains may give indications of why the epidemic waned.

  18. Epidemia de suicídio entre os Guaraní-Kaiwá: indagando suas causas e avançando a hipótese do recuo impossível The Guaraní-Kaiwá suicide epidemic: investigating its causes and suggesting the impossible return hypothesis

    Directory of Open Access Journals (Sweden)

    Anastácio F. Morgado

    1991-12-01

    Full Text Available O suicídio de seis jovens Guaraní-Kaiwá num período de duas semanas é por si só suficiente para preencher qualquer critério de epidemia. Em uma população de aproximadamente 7.500 indígenas, há informações de que foram registrados 52 suicídios de 1987 até agosto de 1991; a epidemia é mais dramática entre o subgrupo Kaiwá: 14 de seus membros suicidaram-se no ano de 1990, e uns tantos outros suicídios já ocorreram no 1º semestre de 1991. Predomina entre jovens de 12 a 20 anos de idade, atingindo igualmente rapazes e moças. Para explicar uma epidemia desse tipo, propõe-se a hipótese do recuo impossível, onde se verifica o esgotamento de qualquer possibilidade de recuar no espaço, diante da "civilização ocidental", e, simultaneamente, seus valores de dignidade humana são aviltados. Não há mais uma só opção de ir para uma floresta e foram virtualmente capturados pela cidade (a aldeia dos Kaiwá fica no perímetro urbano de Dourados, mas sem chances de qualquer inserção ocupacional - só restando-lhes alguma forma de prostituição. Em tal situação de desvalia extrema, a auto-imolação é a última forma de ainda sobreviver a sua cultura. Houve epidemias de suicídio em indígenas de outros países, mas esses encontravam-se também em limite de recuo e sem chances de inserção na civilização ocidental. No Brasil e no exterior, outras tribos indígenas foram urbanizadas, sem tragédias como a experimentada pelos Kaiwá, porque tiveram alguma inserção socialmente condigna.The suicide of six young Guaraní-Kaiwá Indians within the timespan of two weeks is enough to fulfill any criteria to define an epidemic. In a total population of 7,500 individuals, the available data account for 52 cases of suicide between 1987 and August 1991. The epidemic is more dramatic among the Kaiwá subgroup among which 14 individuals died in 1990 and a number of suicides were reported for the first semester of 1991. For both sexes

  19. Evolutionary relationships of endemic/epidemic and sylvatic dengue viruses.

    Science.gov (United States)

    Wang, E; Ni, H; Xu, R; Barrett, A D; Watowich, S J; Gubler, D J; Weaver, S C

    2000-04-01

    Endemic/epidemic dengue viruses (DEN) that are transmitted among humans by the mosquito vectors Aedes aegypti and Aedes albopictus are hypothesized to have evolved from sylvatic DEN strains that are transmitted among nonhuman primates in West Africa and Malaysia by other Aedes mosquitoes. We tested this hypothesis with phylogenetic studies using envelope protein gene sequences of both endemic/epidemic and sylvatic strains. The basal position of sylvatic lineages of DEN-1, -2, and -4 suggested that the endemic/epidemic lineages of these three DEN serotypes evolved independently from sylvatic progenitors. Time estimates for evolution of the endemic/epidemic forms ranged from 100 to 1,500 years ago, and the evolution of endemic/epidemic forms represents relatively recent events in the history of DEN evolution. Analysis of envelope protein amino acid changes predicted to have accompanied endemic/epidemic emergence suggested a role for domain III in adaptation to new mosquito and/or human hosts. PMID:10708439

  20. Beyond fast food and slow motion: weighty contributors to the obesity epidemic.

    Science.gov (United States)

    Cizza, G; Rother, K I

    2012-02-01

    Decreased physical activity and marketing-driven increased consumption of "junk" food, dubbed "The Big Two", are generally regarded as the most important contributors to the obesity epidemic. However, the full picture contains many more pieces of the puzzle. We address several additional issues and review current clinical developments in obesity research. In spite of dramatic advancements in our understanding of the adipose organ and its endocrine and immune products, the ultimate causes of the obesity epidemic remain elusive. Treatment is plagued by poor adherence to life style modifications, and available pharmacological options are marginally effective, often also associated with major side effects. Surgical treatments, albeit effective in decreasing body weight, are invasive and expensive. Thus, our approaches to finding the causes, improving the existing treatments, and inventing novel therapies must be manifold. PMID:22183119