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Sample records for causing epidemic nephritis

  1. Radiation nephritis causing nephrotic syndrome

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    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. Interstitial nephritis caused by HIV infection by itself: a case report.

    Science.gov (United States)

    Doi, Asako; Iwata, Kentaro; Hara, Shigeo; Imai, Yukihiro; Hasuike, Toshikazu; Nishioka, Hiroaki

    2016-01-01

    Interstitial nephritis is a common cause of renal dysfunction. It is primarily caused by drugs, infections, or autoimmune disorders. Patients with human immunodeficiency virus (HIV) infection can develop interstitial nephritis, although it typically occurs because of the aforementioned etiologies and not as a direct consequence of HIV infection. Interstitial lesions may occur in patients with HIV-associated nephropathy (HIVAN). However, interstitial nephritis without the glomerular injuries characteristic of HIVAN, and without the risk factors described earlier, is very rare. Here, we describe a rare case of interstitial nephritis that was likely caused directly by HIV infection and not by other etiologies.

  3. 75 FR 35492 - Guidance for Industry on Lupus Nephritis Caused By Systemic Lupus Erythematosus-Developing...

    Science.gov (United States)

    2010-06-22

    ... 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 This guidance finalizes the parts of the draft guidance entitled ``Systemic Lupus Erythematosus--Developing Drugs for Treatment'' (the draft...

  4. 77 FR 38305 - Guidance for Industry on Lupus Nephritis Caused by Systemic Lupus Erythematosus-Developing...

    Science.gov (United States)

    2012-06-27

    ... availability of a guidance entitled ``Lupus Nephritis Caused By Systemic Lupus Erythematosus--Developing... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Lupus Nephritis Caused by Systemic Lupus Erythematosus--Developing Medical Products for Treatment; Withdrawal of Guidance AGENCY: Food...

  5. Interstitial nephritis caused by HIV infection by itself: a case report

    Directory of Open Access Journals (Sweden)

    Doi A

    2016-09-01

    Full Text Available Asako Doi,1,2 Kentaro Iwata,3 Shigeo Hara,4 Yukihiro Imai,5 Toshikazu Hasuike,1,2 Hiroaki Nishioka,1,2 1Department of Infectious Diseases, 2Department of General Internal Medicine, Kobe City Medical Center General Hospital, 3Division of Infectious Diseases, 4Department of Diagnostic Pathology, Kobe University Hospital, 5Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan Abstract: Interstitial nephritis is a common cause of renal dysfunction. It is primarily caused by drugs, infections, or autoimmune disorders. Patients with human immunodeficiency virus (HIV infection can develop interstitial nephritis, although it typically occurs because of the aforementioned etiologies and not as a direct consequence of HIV infection. Interstitial lesions may occur in patients with HIV-associated nephropathy (HIVAN. However, interstitial nephritis without the glomerular injuries characteristic of HIVAN, and without the risk factors described earlier, is very rare. Here, we describe a rare case of interstitial nephritis that was likely caused directly by HIV infection and not by other etiologies. Keywords: human immunodeficiency virus, interstitial nephritis, HIV-associated nephropathy

  6. Interstitial nephritis caused by HIV infection by itself: a case report

    OpenAIRE

    2016-01-01

    Asako Doi,1,2 Kentaro Iwata,3 Shigeo Hara,4 Yukihiro Imai,5 Toshikazu Hasuike,1,2 Hiroaki Nishioka,1,2 1Department of Infectious Diseases, 2Department of General Internal Medicine, Kobe City Medical Center General Hospital, 3Division of Infectious Diseases, 4Department of Diagnostic Pathology, Kobe University Hospital, 5Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan Abstract: Interstitial nephritis is a common cause of renal dysfunction. It is primarily...

  7. FAN1 mutations cause karyomegalic interstitial nephritis, linking chronic kidney failure to defective DNA damage repair.

    Science.gov (United States)

    Zhou, Weibin; Otto, Edgar A; Cluckey, Andrew; Airik, Rannar; Hurd, Toby W; Chaki, Moumita; Diaz, Katrina; Lach, Francis P; Bennett, Geoffrey R; Gee, Heon Yung; Ghosh, Amiya K; Natarajan, Sivakumar; Thongthip, Supawat; Veturi, Uma; Allen, Susan J; Janssen, Sabine; Ramaswami, Gokul; Dixon, Joanne; Burkhalter, Felix; Spoendlin, Martin; Moch, Holger; Mihatsch, Michael J; Verine, Jerome; Reade, Richard; Soliman, Hany; Godin, Michel; Kiss, Denes; Monga, Guido; Mazzucco, Gianna; Amann, Kerstin; Artunc, Ferruh; Newland, Ronald C; Wiech, Thorsten; Zschiedrich, Stefan; Huber, Tobias B; Friedl, Andreas; Slaats, Gisela G; Joles, Jaap A; Goldschmeding, Roel; Washburn, Joseph; Giles, Rachel H; Levy, Shawn; Smogorzewska, Agata; Hildebrandt, Friedhelm

    2012-08-01

    Chronic kidney disease (CKD) represents a major health burden. Its central feature of renal fibrosis is not well understood. By exome sequencing, we identified mutations in FAN1 as a cause of karyomegalic interstitial nephritis (KIN), a disorder that serves as a model for renal fibrosis. Renal histology in KIN is indistinguishable from that of nephronophthisis, except for the presence of karyomegaly. The FAN1 protein has nuclease activity and acts in DNA interstrand cross-link (ICL) repair within the Fanconi anemia DNA damage response (DDR) pathway. We show that cells from individuals with FAN1 mutations have sensitivity to the ICL-inducing agent mitomycin C but do not exhibit chromosome breakage or cell cycle arrest after diepoxybutane treatment, unlike cells from individuals with Fanconi anemia. We complemented ICL sensitivity with wild-type FAN1 but not with cDNA having mutations found in individuals with KIN. Depletion of fan1 in zebrafish caused increased DDR, apoptosis and kidney cysts. Our findings implicate susceptibility to environmental genotoxins and inadequate DNA repair as novel mechanisms contributing to renal fibrosis and CKD.

  8. [Human factors caused the third plague epidemic in Harbin].

    Science.gov (United States)

    Jin, Dong-Ying; Li, Zhi-Ping

    2011-03-01

    The third plague epidemic in Harbin broke out in 1946 and ended in 1954. Different from the first two plague epidemics (imported), the third prevalence was both imported and idiopathic infectious disease which was caused by human factors. Japanese troops set forbidden zones to build a biological weapon center, which destroyed the natural environment and offered a good growth condition for Citellus Undulatus. In 1945, on the eve of surrender, the Japanese blew up the Unit 731 germ factory located in a bungalow district, which caused diffusion of infected plague fleas. Mice of the district were infected and a man-made plague focus was created. During the prevalence of the third plague, prevention departments at all levels took a series of actions and with people's efforts, the plague was effectively controlled.

  9. Visceral leishmaniasis in a kidney transplant recipient: parasitic interstitial nephritis, a cause of renal dysfunction.

    Science.gov (United States)

    Dettwiler, S; McKee, T; Hadaya, K; Chappuis, F; van Delden, C; Moll, S

    2010-06-01

    Visceral leishmaniasis (VL) due to Leishmania infantum is an endemic parasitic infection in the Mediterranean area. It most commonly affects immunosuppressed individuals, especially HIV patients and less frequently organ transplant recipients. Renal involvement seems to be frequent and is mostly associated with tubulointerstitial nephritis, as described in autopsy reports. In the 61 cases of renal transplant recipients with VL reported in the literature, renal dysfunction was noted at clinical presentation and was more frequently observed as a complication of antiparasitic therapy. However, no pathological analysis of the allograft lesions was reported. We present the case of a Swiss renal transplant recipient who developed VL after vacations in Spain and Tunisia, complicated by acute parasitic nephritis in the renal allograft 3 months after a well-conducted treatment of liposomal amphotericin B.

  10. A Unique Cause of Proteinuria in Pregnancy: Class II Lupus Nephritis with Concomitant Minimal Change Disease

    Science.gov (United States)

    Kunjal, Ryan; Adam-Eldien, Rabie; Makary, Raafat; Jo-Hoy, Francois; Heilig, Charles W.

    2016-01-01

    We report the case of a 22-year-old African American female who presented to another facility for routine follow-up in the 34th week of pregnancy with lower extremity swelling and nephrotic-range proteinuria. Although she was normotensive, it was initially thought that she had preeclampsia. She was monitored carefully and delivery was induced at 37 weeks of gestation. She was transferred to our hospital, where she was diagnosed with systemic lupus erythematosus (SLE) based on clinical and laboratory criteria. Renal biopsy revealed a surprising finding of minimal change disease (MCD) concomitant with class II lupus nephritis (LN). She was managed with pulses and then tapering doses of steroid therapy with dramatic resolution of the nephrotic syndrome. This case demonstrates not only the rare de novo occurrence of SLE in pregnancy, but the unique finding of MCD coexisting with class II LN. We propose that altered T cell activity may be the link between these seemingly distinct entities.

  11. [A recombinant HIV-1 strain causing an epidemic among injection drug addicts in Kaliningrad].

    Science.gov (United States)

    Korovina, G I; Smol'skaia, T T; Tashkinova, I P; Momot, O F; Kevlova, N A; Liitsola, K; Leinikki, P; Salminen, M

    1999-01-01

    The analysis of the genetic structure of HIV causing the epidemic in Kaliningrad Province. A new recombinant virus of subtype A/B was detected with the use of the polymerase chain reaction, the cloning of amplified fragments, sequencing and the phylogenetic analysis of the obtained data. The results thus obtained indicate that the epidemic in Kaliningrad was caused by a recombinant strain, and not due to co-infection caused by two HIV strains of different subtypes. The study of HIV-1 DNA revealed the divergence between the samples was extremely low, which was characteristic of epidemics connected with the transmission of the virus in the process of the intravenous use of narcotic drugs.

  12. Did the 1918 influenza cause the twentieth century cardiovascular mortality epidemic in the United States?

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    Steven Tate

    2016-10-01

    Full Text Available During most of the twentieth century, cardiovascular mortality increased in the United States while other causes of death declined. By 1958, the age-standardized death rate (ASDR for cardiovascular causes for females was 1.84 times that for all other causes, combined (and, for males, 1.79×. Although contemporary observers believed that cardiovascular mortality would remain high, the late 1950s and early 1960s turned out to be the peak of a roughly 70-year epidemic. By 1988 for females (1986 for males, a spectacular decline had occurred, wherein the ASDR for cardiovascular causes was less than that for other causes combined. We discuss this phenomenon from a demographic point of view. We also test a hypothesis from the literature, that the 1918 influenza pandemic caused the cardiovascular mortality epidemic; we fail to find support.

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

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    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. Hyperinfectivity: a critical element in the ability of V. cholerae to cause epidemics?

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    David M Hartley

    2006-01-01

    Full Text Available Cholera is an ancient disease that continues to cause epidemic and pandemic disease despite ongoing efforts to limit its spread. Mathematical models provide one means of assessing the utility of various proposed interventions. However, cholera models that have been developed to date have had limitations, suggesting that there are basic elements of cholera transmission that we still do not understand.Recent laboratory findings suggest that passage of Vibrio cholerae O1 Inaba El Tor through the gastrointestinal tract results in a short-lived, hyperinfectious state of the organism that decays in a matter of hours into a state of lower infectiousness. Incorporation of this hyperinfectious state into our disease model provides a much better fit with the observed epidemic pattern of cholera. These findings help to substantiate the clinical relevance of laboratory observations regarding the hyperinfectious state, and underscore the critical importance of human-to-human versus environment-to-human transmission in the generation of epidemic and pandemic disease.To have maximal impact on limiting epidemic spread of cholera, interventions should be targeted toward minimizing risk of transmission of the short-lived, hyperinfectious form of toxigenic Vibrio cholerae. The possibility of comparable hyperinfectious states in other major epidemic diseases also needs to be evaluated and, as appropriate, incorporated into models of disease prevention.

  15. Widespread epidemic cholera caused by a restricted subset of Vibrio cholerae clones.

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    Moore, S; Thomson, N; Mutreja, A; Piarroux, R

    2014-05-01

    Since 1817, seven cholera pandemics have plagued humankind. As the causative agent, Vibrio cholerae, is autochthonous in the aquatic ecosystem and some studies have revealed links between outbreaks and fluctuations in climatic and aquatic conditions, it has been widely assumed that cholera epidemics are triggered by environmental factors that promote the growth of local bacterial reservoirs. However, mounting epidemiological findings and genome sequence analysis of clinical isolates have indicated that epidemics are largely unassociated with most of the V. cholerae strains in aquatic ecosystems. Instead, only a specific subset of V. cholerae El Tor 'types' appears to be responsible for current epidemics. A recent report examining the evolution of a variety of V. cholerae strains indicates that the current pandemic is monophyletic and originated from a single ancestral clone that has spread globally in successive waves. In this review, we examine the clonal nature of the disease, with the example of the recent history of cholera in the Americas. Epidemiological data and genome sequence-based analysis of V. cholerae isolates demonstrate that the cholera epidemics of the 1990s in South America were triggered by the importation of a pathogenic V. cholerae strain that gradually spread throughout the region until local outbreaks ceased in 2001. Latin America remained almost unaffected by the disease until a new toxigenic V. cholerae clone was imported into Haiti in 2010. Overall, cholera appears to be largely caused by a subset of specific V. cholerae clones rather than by the vast diversity of V. cholerae strains in the environment.

  16. Renal failure due to granulomatous interstitial nephritis in native and allograft renal biopsies: experience from a tertiary care hospital.

    Science.gov (United States)

    Gupta, Pallav; Rana, D S; Bhalla, A K; Gupta, Ashwini; Malik, Manish; Gupta, Anurag; Bhargava, Vinant

    2014-10-01

    Granulomatous interstitial nephritis is a rare cause of renal failure in both native and allograft renal biopsies. Drugs and sarcoidosis are the commonest causes of granulomatous interstitial nephritis as reported in Western countries. Unlike the west, tuberculosis is the commonest cause of granulomatous interstitial nephritis in Indian subcontinent. The etiological factors, clinical course, glomerular and tubulointerstitial changes associated with granulomatous interstitial nephritis have been analyzed in the present study along with the outcome in patients with granulomatous interstitial nephritis.

  17. Lupus Nephritis

    Science.gov (United States)

    ... Disease Chronic Kidney Disease (CKD) What Is Chronic Kidney Disease? Causes of CKD Tests & Diagnosis Managing CKD Eating Right Preventing CKD What If My Kidneys Fail? Clinical Trials Anemia High Blood Pressure Heart ... Nephropathy Kidney Disease in Children Childhood Nephrotic Syndrome Hemolytic ...

  18. Treatment of lupus nephritis.

    NARCIS (Netherlands)

    Dolff, S.; Berden, J.H.M.; Bijl, M. van der

    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. 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)

  20. Acute interstitial nephritis, a rare complication of Giardiasis

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    Antonio De Pascalis

    2011-12-01

    Full Text Available Acute interstitial nephritis is a relevant cause of acute renal failure. Drugs are the predominant cause, followed by infections and idiopathic lesions. Acute interstitial nephritis as a form of hypersensitivity reaction is an uncommon manifestation in the setting of human parasitic infections. We present a case of acute interstitial nephritis in association with Giardia infection in a 54-year-old woman who developed an impairment of renal function after a prolonged period of slight fever and diarrhea. After an attempt to recover renal impairment by vigorous rehydratation, because of the unclear origin of the persisting renal failure, a percutaneous renal biopsy was performed and a diagnosis of severe acute interstitial nephritis was made. Steroid therapy was started and after six weeks, renal function had completely recovered. In cases of unexplained renal failure in patients affected by parasitic infections, interstitial nephritis should be considered and it is our opinion that a renal biopsy should be always performed.

  1. [Lupus nephritis treatment].

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    Santos-Araújo, Carla; Pestana, Manuel

    2008-01-01

    Systemic lupus erithematosus (SLE) is a multiorganic inflammatory disease characterized by a significant morbidity and mortality related not just to disease evolution but also to therapeutic side effects. Sixty percent of SLE patients develop renal disease related to lupus. Moreover, several studies report that lupus nephritis is an important predictor of both renal impairment and global mortality in these patients. In lupus nephritis, the renal biopsy still represents a cornerstone for both histological grading and therapeutical management. Several classification schemes for lupus nephritis based mainly on morphological parameters have been proposed so far. In the WHO grading system the most severe form of lupus nephritis is the diffuse proliferative lupus nephritis or lupus nephritis class IV. In fact, several authors have documented an invariable course to end stage renal failure in these patients, in the absence of specific therapy. Despite the considerable improvement observed since the introduction of corticosteroid and cyclophosphamide treatment, a significant number of patients still present an incomplete response to therapy. Moreover, even in the cases of good response to therapy adverse events related to the treatment such as infertility, hemorrhagic cystitis or increased susceptibility to infection frequently supervenes.

  2. Mitigating epidemics caused by non-persistently transmitted aphid-borne viruses: the role of the pliant environment.

    Science.gov (United States)

    Irwin, M E; Ruesink, W G; Isard, S A; Kampmeier, G E

    2000-11-01

    Using Soybean mosaic virus as a model system, the rate, magnitude and timing of epidemics caused by non-persistently transmitted, aphid-borne viruses are examined under various field conditions. Emphasis is placed on the behavioural responses of vectors to environmental cues, although all three biotic components (host plant, vector and virus) are considered. Both single and double manipulations of the cropping system environment are explored using a computer model developed earlier by Ruesink and Irwin (Plant Virus Epidemics: Monitoring, Modelling and Predicting Outbreaks.

  3. Biopsy proven acute interstitial nephritis after treatment with moxifloxacin

    OpenAIRE

    2010-01-01

    Abstract Background Acute interstitial nephritis (AIN) is an important cause of reversible acute kidney injury. At least 70% of AIN is caused by various drugs, mainly penicillines and non-steroidal anti-inflammatory drugs. Quinolones are only rarely known to cause AIN and so far cases have been mainly described with older fluoroquinolones. Case Presentation Here we describe a case of biopsy proven interstitial nephritis after moxifloxacin treatment. The patient presented with fever, rigors an...

  4. Sildenafil Induced Acute Interstitial Nephritis

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    Ryan Burkhart

    2015-01-01

    Full Text Available Acute interstitial nephritis (AIN is characterized by inflammation of the renal interstitium and usually occurs in a temporal relationship with the medication. We present a case of an Asian male who had nephrotic range proteinuria and presented with acute kidney injury. The patient reported an acute change in physical appearance and symptomatology after the ingestion of a single dose of sildenafil. Renal biopsy was notable for minimal change disease (MCD with acute and chronic interstitial nephritis. Renal replacement and glucocorticoid therapy were initiated. Renal recovery within six weeks permitted discontinuation of dialysis. AIN superimposed on MCD is a known association of NSAID induced nephropathy. The temporal association and the absence of any new drugs suggest that the AIN was most likely due to the sildenafil. NSAIDs are less likely to have caused the AIN given their remote use. The ease of steroid responsiveness would also suggest another cause as NSAID induced AIN is often steroid resistant. The MCD was most likely idiopathic given the lack of temporal association with a secondary cause. As the number of sildenafil prescriptions increases, more cases of AIN may be identified and physician awareness for this potential drug disease association is necessary.

  5. Five new genome types of adenovirus type 37 caused epidemic keratoconjunctivitis in Sapporo, Japan, for more than 10 years.

    Science.gov (United States)

    Ariga, Toshihide; Shimada, Yasushi; Shiratori, Kenji; Ohgami, Kazuhiro; Yamazaki, Shudo; Tagawa, Yoshitsugu; Kikuchi, Masayuki; Miyakita, Yoshie; Fujita, Kozo; Ishiko, Hiroaki; Aoki, Koki; Ohno, Shigeaki

    2005-02-01

    Human adenovirus type 37 (HAdV-37) is a major cause of epidemic keratoconjunctivitis and has recently been the largest causative agent of keratoconjunctivitis in Japan. To investigate the genetic characteristics of HAdV-37 strains isolated in Sapporo, we analyzed the genome types and genetic relationships of 51 strains isolated there from 1990 through 2001. By using DNA restriction analysis, eight genome types (HAdV-37/D1, HAdV-37/D3, and HAdV-37/D6 to HAdV-37/D11) were identified, including five new ones. The restriction fragments of these genome types shared more than 95% identity with those of the prototype strain. By DNA sequence analysis, five and three single nucleotide substitutions, respectively, were found in partial sequences of the hexon and fiber genes. The combinations of mutations resulted in four hexon and fiber types (hx1 to hx4 and f1 to f4) and six hexon/fiber pairs (hx1/f1, hx2/f1, hx1/f2, hx1/f3, hx3/f4, and hx4/f4). The six pairs correlated well with certain genome types. In all three epidemics of keratoconjunctivitis to strike Sapporo in the past 12 years, specific genome types and fiber types were usually isolated: in the first epidemic, HAdV-37/D1 (f1) and HAdV-37/D3 (f1); in the second, HAdV-37/D6 (f2) and HAdV-37/D8 (f3); and in the third, HAdV-37/D10 (f4) and HAdV-37/D11 (f4). We conclude that mutations in the adenovirus genome occurred chronologically and that certain mutations were correlated with the epidemics of adenoviral keratoconjunctivitis.

  6. 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....

  7. Pro: Cyclophosphamide in lupus nephritis

    NARCIS (Netherlands)

    Kallenberg, Cees G. M.

    2016-01-01

    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 d

  8. Epidemic septic arthritis caused by Serratia marcescens and associated with a benzalkonium chloride antiseptic.

    Science.gov (United States)

    Nakashima, A K; McCarthy, M A; Martone, W J; Anderson, R L

    1987-01-01

    During a 6-week period, 10 patients were admitted to a hospital for treatment of knee or shoulder joint infections due to Serratia species. Isolates from eight patients were identified as Serratia marcescens with identical biochemical characteristics and antibiotic susceptibility patterns. Before the onset of infections, all patients had been treated by two orthopedic surgeons who shared an office. Studies revealed that infections were associated with previous joint injections (P = 4.44 X 10(-5] of methylprednisolone and lidocaine. Environmental cultures revealed that a canister of cotton balls soaked in aqueous benzalkonium chloride and two multiple-dose vials of methylprednisolone previously used by office personnel were contaminated with the epidemic strain of S. marcescens. The canister may have served as a potential reservoir for contamination of sterile solutions and equipment used for joint injections, of skin at the injection site, and of hands of personnel. No further cases occurred after the use of aqueous benzalkonium chloride was discontinued. PMID:3298308

  9. Evidence that dirty electricity is causing the worldwide epidemics of obesity and diabetes.

    Science.gov (United States)

    Milham, Samuel

    2014-01-01

    The epidemics of obesity and diabetes most apparent in recent years had their origins with Thomas Edison's development of distributed electricity in New York City in 1882. His original direct current (DC) generators suffered serious commutator brush arcing which is a major source of high-frequency voltage transients (dirty electricity). From the onset of the electrical grid, electrified populations have been exposed to dirty electricity. Diesel generator sets are a major source of dirty electricity today and are used almost universally to electrify small islands and places unreachable by the conventional electric grid. This accounts for the fact that diabetes prevalence, fasting plasma glucose and obesity are highest on small islands and other places electrified by generator sets and lowest in places with low levels of electrification like sub-Saharan Africa and east and Southeast Asia.

  10. Pregnancy and Lupus Nephritis.

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    Kattah, Andrea G; Garovic, Vesna D

    2015-09-01

    The management of lupus nephritis in pregnancy presents a diagnostic and therapeutic challenge for providers. Pregnancy creates a series of physiologic changes in the immune system and kidney that may result in an increased risk of disease flare and adverse maternal and fetal outcomes, such as preeclampsia, fetal loss, and preterm delivery. Conception should be delayed until disease is in remission to ensure the best pregnancy outcomes. Maternal disease activity and fetal well-being should be monitored closely by an interdisciplinary team, including obstetricians, rheumatologists, and nephrologists throughout pregnancy. Careful attention must be paid to the dosing and potential teratogenicity of medications.

  11. [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.

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

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    Duggirala Sivaram Prasad

    2011-01-01

    Full Text Available 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.

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

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    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.

  14. [Acute interstitial nephritis induced by loratadine].

    Science.gov (United States)

    Alvarez Navascués, R; Bastardo, Z; Fernández Díaz, M; Guerediaga, J; Quiñones, L; Pinto, J

    2003-01-01

    Loratadine is a second generation histamine H1 receptor antagonist, that has high potency antiallergic properties and is associated with low adverse effects compared with other antihistamines. Acute interstitial nephritis is a cause of acute renal failure that is most often induced by drugs or, less frequently, infection or sarcoidosis. Although the number of drugs associated with acute intersticial nephritis is too large, the antihistaminic loratadine have never been reported before. We report a case of an interstitial nephritis with acute renal failure that suggesting hypersensitivity reaction in a 77 old man who had received loratadine (10 mg/day) during ten days before his assessment to our hospital by disseminated pruritic syndrome. The initial suspect was rapidly progressive glomerulonephitis and renal biopsy was practice and treatment with corticosteroids were initiated (prednisone bolus of 500 mg three days and 1 mg/kg/day/later). The loratadine therapy was cessation. He exhibiting a slow and progressive improvement on renal function and one month later, urea and creatinine levels was normal and hematuria and proteinuria had disappeared. The corticosteroids therapy were progressive decreased until withdrawal. We think that this is an interesting case, basing in its clinical presentation and that it had never been reported before.

  15. Unrecognized Ingestion of Toxoplasma gondii Oocysts Leads to Congenital Toxoplasmosis and Causes Epidemics in North America

    OpenAIRE

    Boyer, Kenneth; Hill, Dolores; Mui, Ernest; Wroblewski, Kristen; Karrison, Theodore; Dubey, J. P.; SAUTTER, MARI; Noble, A. Gwendolyn; Withers, Shawn; Swisher, Charles; Heydemann, Peter; Hosten, Tiffany; Babiarz, Jane; Lee, Daniel; Meier, Paul

    2011-01-01

    Undetected contamination of food and water by oocysts causes human infections in North America. Risks often are unrecognized. Education alone cannot prevent suffering and economic consequences associated with congenital toxoplasmosis. Prenatal screening can facilitate prevention and treatment of congenital toxoplasmosis.

  16. Epidemics Don’t Cause Wars, But They Can End ’Em

    Science.gov (United States)

    2002-07-01

    Disease in Europe, and bubonic plague in India have caused disruptions in tourism and trade. Developing nations are being required to devote increasing...under consideration. HEPATITIS C Hepatitis C is a viral infection from the same family as Yellow Fever, Japanese Encephalitis, Dengue Fever, and West...retinal injury by the virus occurs in 1-10% of cases. A vaccine for use in cattle is under study. DENGUE FEVER Dengue Fever is caused by four

  17. Efficacy of Hospital Germicides against Adenovirus 8, a Common Cause of Epidemic Keratoconjunctivitis in Health Care Facilities

    Science.gov (United States)

    Rutala, William A.; Peacock, Jeffrey E.; Gergen, Maria F.; Sobsey, Mark D.; Weber, David J.

    2006-01-01

    The inactivation of virus-contaminated nonporous inanimate surfaces was investigated using adenovirus type 8, a common cause of epidemic keratoconjunctivitis. A 10-μl inoculum of adenovirus was placed onto each stainless steel disk (1-cm diameter), and the inoculum was allowed to air dry for 40 min. Twenty-one different germicides (including disinfectants and antiseptics) were selected for this study based on their current uses in health care. After a 1- or 5-minute exposure to 50 μl of the germicide, the virus-germicide test mixture was neutralized and assayed for infectivity. Using an efficacy criterion of a 3-log10 reduction in the titer of virus infectivity and regardless of the virus suspending medium (i.e., hard water, sterile water, and hard water with 5% fetal calf serum), only five disinfectants proved to be effective against the test virus at 1 min: 0.55% ortho-phthalaldehyde, 2.4% glutaraldehyde, 2.65% glutaraldehyde, ∼6,000 ppm chlorine, and ∼1,900 ppm chlorine. Four other disinfectants showed effectiveness under four of the five testing conditions: 70% ethanol, 65% ethanol with 0.63% quaternary ammonium compound, 79.6% ethanol with 0.1% quaternary ammonium compound, and 0.2% peracetic acid. Of the germicides suitable for use as an antiseptic, 70% ethanol achieved a 3-log10 reduction under four of the five test conditions. These results emphasize the need for proper selection of germicides for use in disinfecting noncritical surfaces and semicritical medical devices, such as applanation tonometers, in order to prevent outbreaks of epidemic keratoconjunctivitis. PMID:16569860

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

    Science.gov (United States)

    Ludlam, H; Cookson, B

    1986-08-09

    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.

  19. Lead exposure: a contributing cause of the current breast cancer epidemic in Nigerian women.

    Science.gov (United States)

    Alatise, Olusegun I; Schrauzer, Gerhard N

    2010-08-01

    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 murine mammary tumor virus-infected female C3H mice at levels as low of 0.5 ppm Pb in the drinking water. Lead belongs to the group of selenium-antagonistic elements that interact with selenium (Se), abolishing its anti-carcinogenic effect. Lead on chronic, low-level exposure in addition also accelerates tumor growth rates. Higher levels of Pb were found in blood and head hair samples of newly diagnosed patients with breast cancer, all with infiltrating ductal carcinoma, the most common form of breast cancer in Nigeria, seen at Obafemi Awolowo University, than in cancer-free controls from the same area. Evidence for interactions between Pb and Se was obtained from blood, hair, and tumor biopsy tissue analyses. Furthermore, the Pb levels in hair samples of the patients were directly correlated with the volumes of their tumors, in accord with the tumor growth-promoting effects of Pb. Conversely, Se levels in hair and blood were inversely correlated with the tumor volumes, consistent with the anti-proliferative effects of Se. Several other elements, e.g., Cd, Hg, Cr, Sn, and As, were detected in the scalp hair of the patients and the controls, although at significantly lower levels than those of Pb. However, correlation calculations revealed them also to interact with Se, suggesting that only a fraction of the Se in organs and tissues is actually present in bioactive forms. In metal-exposed subjects, a state of latent Se deficiency may exist, resulting in depressed immune functions

  20. Persistent Chaos of Measles Epidemics in the Prevaccination United States Caused by a Small Change in Seasonal Transmission Patterns.

    Directory of Open Access Journals (Sweden)

    Benjamin D Dalziel

    2016-02-01

    Full Text Available Epidemics of infectious diseases often occur in predictable limit cycles. Theory suggests these cycles can be disrupted by high amplitude seasonal fluctuations in transmission rates, resulting in deterministic chaos. However, persistent deterministic chaos has never been observed, in part because sufficiently large oscillations in transmission rates are uncommon. Where they do occur, the resulting deep epidemic troughs break the chain of transmission, leading to epidemic extinction, even in large cities. Here we demonstrate a new path to locally persistent chaotic epidemics via subtle shifts in seasonal patterns of transmission, rather than through high-amplitude fluctuations in transmission rates. We base our analysis on a comparison of measles incidence in 80 major cities in the prevaccination era United States and United Kingdom. Unlike the regular limit cycles seen in the UK, measles cycles in US cities consistently exhibit spontaneous shifts in epidemic periodicity resulting in chaotic patterns. We show that these patterns were driven by small systematic differences between countries in the duration of the summer period of low transmission. This example demonstrates empirically that small perturbations in disease transmission patterns can fundamentally alter the regularity and spatiotemporal coherence of epidemics.

  1. Radiation nephritis following combined abdominal radiation and chemotherapy (bleomycin-vinblastine)

    Energy Technology Data Exchange (ETDEWEB)

    Churchill, D.N.; Hong, K.; Gault, M.H.

    1978-06-01

    A 29-year-old man presented with acute glomerulonephritis five weeks following completion of combined chemotherapy (bleomycin-vinblastine) and abdominal radiation for testicular carcinoma. There was no evidence for a post-infectious cause or a systemic collagen disorder. The renal biopsy showed changes consistent with radiation nephritis. The combined radiation and chemotherapy may have, by additive or synergistic action, caused the early appearance of radiation nephritis.

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

    DEFF Research Database (Denmark)

    Landegren, Nils; Pourmousa Lindberg, Mina; Skov, Jakob

    2016-01-01

    Tubulointerstitial nephritis is a common cause of kidney failure and may have diverse etiologies. This form of nephritis is sometimes associated with autoimmune disease, but the role of autoimmune mechanisms in disease development is not well understood. Here, we present the cases of three patients...... with autoimmune polyendocrine syndrome type 1 who developed tubulointerstitial nephritis and ESRD in association with autoantibodies against kidney collecting duct cells. One of the patients developed autoantibodies targeting the collecting duct-specific water channel aquaporin 2, whereas autoantibodies...

  3. Bacterial Interstitial Nephritis in Children

    OpenAIRE

    Bobadilla Chang, Fernando; Departamento de Ciencias Dinámicas Facultad de Medicina Universidad Nacional Mayor de San Marcos Lima, Perú; Villanueva, Dolores; Departamento de Ciencias Dinámicas Facultad de Medicina Universidad Nacional Mayor de San Marcos Lima, Perú

    2014-01-01

    OBJECTIVE: To assess the diagnosis approach to urinary tract infections in children. MATERIAL AND METHODS: Medical records from 103 children with diagnosis of interstitial bacterial nephritis were retrospectively reviewed. Diagnosis was supported by the dramatic involvement of renal parenquima, which is not addressed as "urinary tract infection". RESULTS: From all 103 patients, 49 were 2-years-old or younger, 33 were between 2 and 5-years-old, and 21 were between 6 to 10. Clinical picture inc...

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

    OpenAIRE

    Xiaofeng Liao; Tharshikha Pirapakaran; 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 potentia...

  5. Complement in Lupus Nephritis: New Perspectives

    Science.gov (United States)

    Bao, Lihua; Cunningham, Patrick N.; Quigg, Richard J.

    2015-01-01

    Background Systemic lupus erythematosus (SLE) is an autoimmune disorder caused by loss of tolerance to self-antigens, the production of autoantibodies and deposition of complement-fixing immune complexes (ICs) in injured tissues. SLE is characterized by a wide range of clinical manifestations and targeted organs, with lupus nephritis being one of the most serious complications. The complement system consists of three pathways and is tightly controlled by a set of regulatory proteins to prevent injudicious complement activation on host tissue. The involvement of the complement system in the pathogenesis of SLE is well accepted; yet, its exact role is still not clear. Summary Complement plays dual roles in the pathogenesis of SLE. On the one hand, the complement system appears to have protective features in that hereditary homozygous deficiencies of classical pathway components, such as C1q and C4, are associated with an increased risk for SLE. On the other hand, IC-mediated activation of complement in affected tissues is clearly evident in both experimental and human SLE along with pathological features that are logical consequences of complement activation. Studies in genetically altered mice have shown that lack of complement inhibitors, such as complement factor H (CFH) or decay-accelerating factor (DAF) accelerates the development of experimental lupus nephritis, while treatment with recombinant protein inhibitors, such as Crry-Ig, CR2-Crry, CR2-DAF and CR2-CFH, ameliorates the disease development. Complement-targeted drugs, including soluble complement receptor 1 (TP10), C1 esterase inhibitor and a monoclonal anti-C5 antibody (eculizumab), have been shown to inhibit complement safely, and are now being investigated in a variety of clinical conditions. Key Messages SLE is an autoimmune disorder which targets multiple systems. Complement is centrally involved and plays dual roles in the pathogenesis of SLE. Studies from experimental lupus models and clinical

  6. 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

  7. Renoprotective strategies in lupus nephritis: beyond immunosuppression.

    Science.gov (United States)

    Griffin, B; Lightstone, L

    2013-10-01

    Lupus nephritis needs to be diagnosed promptly and treated specifically with appropriate immunosuppression. However, all patients with lupus nephritis have by definition chronic kidney disease (CKD) as they will have proteinuria with varying degrees of renal impairment. CKD requires careful additional management, not only to reduce the risk of progression to end-stage renal disease but also because it is probably the strongest risk for cardiovascular morbidity and mortality. This review focuses on the evidence underscoring strategies to prevent progression of CKD beyond the "simple" treatment of the lupus nephritis. The strategies include immaculate control of blood pressure, inhibition of the renin-angiotensin system to reduce blood pressure and proteinuria, and the benefits of lifestyle modifications such as tackling smoking, obesity and exercise. We also review the literature on control of dyslipidaemias which, although clearly of cardiovascular benefit, provide less compelling data for offering renoprotection. We touch on the emerging area of the importance of controlling urate levels in protecting against progressive renal impairment. Finally, there is a reminder about the importance of considering the nephrotoxicity of all medications prescribed for patients with lupus nephritis - above all the need to avoid the use of non-steroidal anti-inflammatory drugs. Overall, the theme is that there is much more to the management of patients with lupus nephritis than "just" the nephritis - a multidisciplinary approach involving nephrologists as well as rheumatologists is more likely to provide the appropriate wider care required for all patients with lupus nephritis.

  8. What can reunification of East and West Germany tell us about the cause of the allergy epidemic?

    Science.gov (United States)

    Krämer, U; Schmitz, R; Ring, J; Behrendt, H

    2015-01-01

    The increase of allergies in East Germany--reaching West German prevalence shortly after the reunification--is considered a model for the allergy epidemic in the western world. Whether such a pattern was observed in all comparison studies and for all allergic manifestations is not known because a complete overview is missing. Hints about possible causal factors for the allergy epidemic could be gained by identifying known risk factors, which explain the observed pattern of allergy development in Germany. Again, an overview about these efforts is missing. We identified 14 cross-sectional studies conducted after 1989 and calculated prevalence ratios (West/East) for asthma, hayfever, eczema and allergic sensitization. Additionally, a tabular overview about the explanatory power of risk factors hypothesized in the nineties and covering outdoor exposure, indoor factors, early childhood influences, nutrition as well as awareness is given. At the time of the German reunification, the prevalence ratio West/East was largest for hayfever and sensitization to birch pollen, less pronounced for the other phenotypes and even less than one for atopic eczema. Hayfever and sensitization to birch pollen also showed the steepest increase in East Germany afterwards. Single-room heating with fossil fuels and living as only child in a family were identified as explaining up to 23.5% of the excess trend in East compared to the trend in West. Hayfever as most typical atopic disease showed the difference in allergy pattern between East and West Germany clearest. Risk factors identified for these phenotypes are completely different (single child) or even act in the opposite direction (single-room heating) from classical risk factors for airway diseases. This might be the most important lesson from the West/East German experience. It already stimulated many other studies focussing on protective factors such as microbial stimulation.

  9. Concurrent Kimura disease and lupus nephritis

    Science.gov (United States)

    Wang, Haitao; Fang, Fang; Sun, Ying; Wang, Songlan; Mao, Yonghui

    2016-01-01

    Abstract Background: Kimura disease is a rare chronic inflammatory disorder with peripheral eosinophilia and elevated serum IgE and is also frequently complicated by nephropathy. Methods: We report a rare case of Kimura disease concomitant with lupus nephritis in a 72-year old male patient with recurrent unexplained lymphadenopathy, renal lesions, and immunologic abnormalities. Results: The patient was successfully managed with gamma immunoglobulin, intravenous pulse methylprednisolone therapy, hydroxychloroquine, and prednisone. Conclusion: This is the first report of a case of Kimura disease concomitant with lupus nephritis and highlights the importance of considering lupus nephritis as a possible concurrent disease in patients with Kimura disease that have immunologic abnormalities. PMID:27741124

  10. Acute tubulointerstitial nephritis complicating Legionnaires' disease: a case report

    Directory of Open Access Journals (Sweden)

    Daumas Aurélie

    2012-04-01

    Full Text Available Abstract Introduction Legionnaires' disease is recognized as a multi-systemic illness. Afflicted patients may have pulmonary, renal, gastrointestinal tract and central nervous system complications. However, renal insufficiency is uncommon. The spectrum of renal involvement may range from a mild and transient elevation of serum creatinine levels to anuric renal failure requiring dialysis and may be linked to several causes. In our present case report, we would like to draw attention to the importance of the pathological documentation of acute renal failure by reporting a case of a patient with acute tubulointerstitial nephritis complicating Legionnaires' disease. Case presentation A 55-year-old Caucasian man was admitted to our hospital for community-acquired pneumonia complicated by acute renal failure. Legionella pneumophila serogroup type 1 was diagnosed. Although the patient's respiratory illness responded to intravenous erythromycin and ofloxacin therapy, his renal failure worsened, he became anuric, and hemodialysis was started. A renal biopsy was performed, which revealed severe tubulointerstitial nephritis. After initiation of steroid therapy, his renal function improved dramatically. Conclusions This case highlights the importance of kidney biopsies in cases where acute renal failure is a complicating factor in Legionnaires' disease. If the presence of acute tubulointerstitial nephritis can be confirmed, it will likely respond favorably to steroidal treatment and thus irreversible renal damage and chronic renal failure will be avoided.

  11. 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,...

  12. Analysis of Occurrence and Epidemic Causes of Zoonosis%人兽共患病的发生及流行原因分析

    Institute of Scientific and Technical Information of China (English)

    张伟; 任超; 王轶敏; 胡烨; 崔君; 孙跃; 诸葛增玉; 金天明

    2016-01-01

    近年来,人兽共患病猖獗,造成了巨大经济损失,同时也严重威胁着人类健康。本文从自然因素、抗生素滥用、生产力水平、易感者活动范围、宠物饲养等方面分析了人兽共患病的发生及流行原因,为实施有效的防控措施提供理论依据。%In recent years, zoonoses were rampant. Epidemic of them lead to hugelosses of economy and seriously threaten to human health as well. Epidemic causes of zoonoses in this article were analyzed from natural factors, abuse of antibiotics, productivity level, activity range of susceptible persons, pet-keeping, et al. The analysis would provide theoretical bases for the effective prevention and control measures.

  13. [Lupus nephritis: up-to-date].

    Science.gov (United States)

    Karras, A

    2015-02-01

    Renal involvement is frequent during natural history of systemic lupus erythematosus (SLE) and has a major prognostic value in this systemic disease. Screening for renal symptoms, such as proteinuria, micro-haematuria or renal failure must be performed at initial diagnosis and repeated during subsequent follow-ups. Any significant abnormality of these parameters may reveal active glomerulonephritis (GN) and should lead to a renal biopsy, which will significantly impact the therapeutic choices. Proliferative GN, defined as class III or IV by the actual histo-pathological classification, is the most severe form of SLE-associated nephropathy and can lead to end-stage renal disease (ESRD) in up to 60% of cases, according to ethnicity and follow-up duration. Standard induction treatment of active proliferative GN includes corticosteroids combined with an immunosuppressive drug, which can either be cyclophosphamide or mycophenolate mofetil (MMF). Even though, recent biotherapies have not yet proved their efficacy in the field of lupus nephritis, new protocols are expected, aiming higher remission rates and avoidance of high-dose corticosteroids regimens. When remission is achieved in proliferative GN, a maintenance therapy is required to decrease the risk of relapse, using either azathioprine or MMF. Immunosuppressive drugs are responsible for an increased risk of infectious or neoplastic complications but cardiovascular disease is actually one of the main causes of mortality among lupus patients, especially for patients with SLE-related kidney disease, well before reaching ESRD.

  14. Acute tubulo-interstitial nephritis leading to acute renal failure following multiple hornet stings

    Directory of Open Access Journals (Sweden)

    Bambery Pradeep

    2006-11-01

    Full Text Available Abstract Background Hornet stings are generally associated with local and occasionally anaphylactic reactions. Rarely systemic complications like acute renal failure can occur following multiple stings. Renal failure is usually due to development of acute tubular necrosis as a result of intravascular haemolysis, rhabdomyolysis or shock. Rarely it can be following development of acute tubulo-interstitial nephritis. Case presentation We describe a young male, who was stung on face, head, shoulders and upper limbs by multiple hornets (Vespa orientalis. He developed acute renal failure as a result of acute tubulo-interstitial nephritis and responded to steroids. Conclusion Rare causes of acute renal failure like tubulo-interstitial nephritis should be considered in a patient with persistent oliguria and azotemia following multiple hornet stings. Renal biopsy should be undertaken early, as institution of steroid therapy may help in recovery of renal function

  15. 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.

  16. Megalocytic interstitial nephritis following acute pyelonephritis with Escherichia coli bacteremia: a case report.

    Science.gov (United States)

    Kwon, Hee Jin; Yoo, Kwai Han; Kim, In Young; Lee, Seulkee; Jang, Hye Ryoun; Kwon, Ghee Young

    2015-01-01

    Megalocytic interstitial nephritis is a rare form of kidney disease caused by chronic inflammation. We report a case of megalocytic interstitial nephritis occurring in a 45-yrold woman who presented with oliguric acute kidney injury and acute pyelonephritis accompanied by Escherichia coli bacteremia. Her renal function was not recovered despite adequate duration of susceptible antibiotic treatment, accompanied by negative conversion of bacteremia and bacteriuria. Kidney biopsy revealed an infiltration of numerous histiocytes without Michaelis-Gutmann bodies. The patient's renal function was markedly improved after short-term treatment with high-dose steroid.

  17. 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.

  18. 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.

  19. PATHOPHYSIOLOGY OF LUPUS NEPHRITIS : THE ROLE OF NUCLEOSOMES

    NARCIS (Netherlands)

    VANBRUGGEN, MCJ; KRAMERS, C; HYLKEMA, MN; SMEENK, RJT; BERDEN, JHM; Hylkema, Machteld

    1994-01-01

    Lupus nephritis is regarded as an immune complex mediated disease. Since anti-DNA antibodies are present in the circulation and in diseased glomeruli of patients with lupus nephritis, these antibodies have been assigned a pivotal role in the initiation of lupus nephritis. It remains however unclear

  20. A diagnostic conundrum: acute interstitial nephritis due to armodafinil versus acute cellular rejection in a renal transplant recipient--a case report.

    Science.gov (United States)

    Baradhi, K M; Gohh, R

    2013-03-01

    Acute interstitial nephritis is a well-recognized cause of acute kidney injury in native kidneys. While the most common etiology being drug-induced, other causes are infectious, autoimmune, and idiopathic forms of disease. Drug-induced acute interstitial nephritis is not only uncommon in renal transplant recipients but is difficult to diagnose as it mimics acute cellular rejection histologically. We have described herein a renal transplant recipient with acute kidney injury to highlight the difficulties to distinguish acute interstitial nephritis from acute cellular rejection.

  1. 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.

  2. Biopsy proven acute interstitial nephritis after treatment with moxifloxacin

    Directory of Open Access Journals (Sweden)

    Chatzikyrkou Christos

    2010-08-01

    Full Text Available Abstract Background Acute interstitial nephritis (AIN is an important cause of reversible acute kidney injury. At least 70% of AIN is caused by various drugs, mainly penicillines and non-steroidal anti-inflammatory drugs. Quinolones are only rarely known to cause AIN and so far cases have been mainly described with older fluoroquinolones. Case Presentation Here we describe a case of biopsy proven interstitial nephritis after moxifloxacin treatment. The patient presented with fever, rigors and dialysis dependent acute kidney injury, just a few days after treatment of a respiratory tract infection with moxifloxacin. The renal biopsy revealed dense infiltrates mainly composed of eosinophils and severe interstitial edema. A course of oral prednisolone (1 mg/kg/day was commenced and rapidly tapered to zero within three weeks. The renal function improved, and the patient was discharged with a creatinine of 107 μmol/l. Conclusion This case illustrates that pharmacovigilance is important to early detect rare side effects, such as AIN, even in drugs with a favourable risk/benefit ratio such as moxifloxacin.

  3. Presenting A Case with Tubulointerstitial Nephritis and Uveitis (TINU- Syndrome

    Directory of Open Access Journals (Sweden)

    E Fotouhi Ardakani

    2008-10-01

    Full Text Available Concurrence of interstitial nephritis and uveitis named tubulointestitioal nephritis and uveitis syndrome (TINU are unusual and uncommon presentations of interstitial nephritis. This syndrome is considered after ruling out other differential diagnoses. A-38-year old man presented with acute renal failure and uveitis. The histologic findings of renal biopsy showed acute tubulointestitioal nephritis. The patient had no clinical and paraclinical manifestations of other etiologies of interstitial nephritis and uveitis such as Wegener's granulomatosis , Sjogren's syndrome or sarcoidosis. The diagnosis of TINU-Syndrome was therefore considered. The patient was treated by oral and ophthalmic prednisolone and had a good response to treatment.

  4. 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.

  5. Features of a clinical course of the acute respiratory diseases caused by adenoviruses of epidemic significant serotypes

    Directory of Open Access Journals (Sweden)

    N. I. L`vov

    2014-01-01

    Full Text Available The objective: To investigate etiological structure of adenoviral diseases in young people from organized groups and the clinical features of acute respiratory disease caused by different serotypes of adenovirus were identified.Materials and methods: A total 382 patients with adenovirusinfections were investigated. Virus isolation from nasopharyngeal swabs was carried out in cell cultures Vero, HeLa, Hep-2. Typing of adenoviruses was performed by virus neutralization test with polyclonal rabbit subtype specific sera. The average (M, standard deviation (SD and frequency of occurrence (% of clinical signs (respiratory and non-respiratory syndromes of pneumonia, protracted and recurrent course was calculated. Significance of the differences (p<0,05 of average frequency of cases compared to independent group of patients was evaluated by Student t-test and criterion φ2 (phi – square Fischer, respectively.Results: As result of investigation 199 adenovirus strains (52,1 % were isolated. 183 strains were serotyped: 64 (32,2 % – 3 serotype, 42 (21,1 % – 4 serotype, 38 (19,1 % – 7 serotype, 15 (7,5 % – 5 serotype, 11 (5,5 % – 21 serotype, 8 (4,0 % – 1 serotype, 3 (1,5 % – 2 serotype, 2 (1,0 % – 6 serotype. In assessing the features of the clinical course of adenoviral infection caused by the most actual serotypes (3, 4, 7 of adenovirus revealed that duration of diseases caused by serotype 7 was significantly longer and remained febrile fever (4,3±2,74 days, p<0,05, rhinitis (9,4±6,01 days, p<0,05, pharyngitis (7,9±2,87 days, p<0,05, laryngitis (7,3±2,87 days, p<0,05 and bronchitis (11,8±8,03 days, p<0,05, tonsillitis (63,0%, φ2=12,6, p<0,05, lymphadenopathy (63,0%, φ2=4,1, p<0,05, and pneumonia (34,2%, φ2=3,84, p<0,05 were registered significantly more frequently.Conclusion: The study showed that the adenoviruses of 3, 4 and 7 serotype have the greatest epidemiological significance. Clinical features

  6. 人为因素与哈尔滨第三次鼠疫大流行%Human factors caused the third plague epidemic in Harbin

    Institute of Scientific and Technical Information of China (English)

    金东英; 李志平

    2011-01-01

    The third plague epidemic in Harbin broke out in 1946 and ended in 1954. Different from the first two plague epidemics (imported), the third prevalence was both imported and idiopathic infectious disease which was caused by human factors. Japanese troops set forbidden zones to build a biological weapon center, which destroyed the natural environment and offered a good growth condition for Citellus Undulatus. In 1945, on the eve of surrender, the Japanese blew up the Unit 731 germ factory located in a bungalow district, which caused diffusion of infected plague fleas. Mice of the district were infected and a man - made plague focus was created. During the prevalence of the third plague, prevention departments at all levels took a series of actions and with people' s efforts, the plague was effectively controlled.%哈尔滨第三次鼠疫流行始发于1946年,终止于1954年.与前两次由外来传入不同,第三次鼠疫流行是当地原发与外地传人兼有.其中,当地原发是由人为因素造成的.日军在哈尔滨市平房区建立细菌武器研制中心后,强占土地,设立禁区,致使自然环境发生变化,为黄鼠种群数量的稳定创造了条件.1945年,日军投降前夕,为掩盖其罪行,将设在哈尔滨平房区的"731部队"细菌工厂炸毁,致使大批染疫鼠蚤扩散,传染了平房及其周围地区的鼠类,最终导致人为鼠疫疫源地的形成.哈尔滨市第三次鼠疫流行期间,各级防疫部门采取了一系列措施,在广大人民群众多年的努力下,人间鼠疫和鼠间鼠疫得到有效控制,但哈尔滨市鼠疫疫源地并未根除.

  7. 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.

  8. [Epidemic parotiditis, a reportable disease].

    Science.gov (United States)

    Boverhoff, J C; Baart, J A

    2013-01-01

    Three consecutive patients with an acute swelling of one of the cheeks, were diagnosed with epidemic parotiditis. The first phase of the diagnostic procedure for an acute cheek swelling is to eliminate the possibility of odontogenic causes. When odontogenic problems have been excluded, non-dentition-related causes may be considered. An acute, progressive swelling in the preauricular area can often be attributed to an inflammation of the parotid gland, but epidemic parotiditis should also be considered. Epidemic parotiditis, or mumps, is caused by the mumps virus. Contamination occurs aerogenically. In the Netherlands, mumps vaccine is an ingredient of the governmental combined mump-measles-rubella inoculation programme. However, in recent years several small-scale parotiditis epidemics have broken out, predominantly among young, inoculated adults. Oropharyngeal mucus and blood samples are needed to diagnose the disease. Each case of the disease should be reported to the community healthcare service.

  9. Acute Tubulointerstitial Nephritis and Anterior Uveitis (TINU Syndrome: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Mortajil Fatima

    2006-01-01

    Full Text Available TINU or Dobrin syndrome is a rare oculo-renal inflammatory condition which is comprised of acute idiopathic tubulointerstitial nephritis and uveitis. We report here two female patients aged 35 and 44 years, who were admitted with severe renal failure of acute onset (serum creatinine of 607 and 310 Umol/L [Editor note: do you mean "µmol/L"?] respectively with the first patient requiring hemodialysis. The cause of acute renal failure was unclear on clinical and laboratory assessment, and a percutaneous renal biopsy was performed which showed features of acute tubulointerstitial nephritis in both cases. Both patients were started on oral steroids at a dose of 1 mg/kg/day. There was progressive improvement of their renal function. Three months later, the two patients presented with bilateral anterior uveitis requiring local corticosteroid therapy. This was followed by total resolution of the uveitis. The cause of the interstitial nephritis and the uveitis could not be identified in the two cases. The renal function was normal in these patients after 24 and 27 months of follow-up, respectively. Dobrin or TINU syndrome is rare, and must be considered in patients who present with acute tubular interstitial [Editor note: for consistency with the title, you may wish to replace this with "tubulointerstitial"] nephritis and anterior uveitis.

  10. 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.

  11. 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...

  12. Epidemic outbreak of candidemia caused by unusual types of Candida non-albicans: clinical course patterns and search for the source

    OpenAIRE

    I. I. Kalinina; D. V. Litvinov; I. V. Veselova; N. I. Ponomareva; L. N. Shelikhova; V. V. Fominykh; G. A. Klyasova; A. A. Maschan

    2014-01-01

    Introduction: Invasive fungal infections (IFI) remain an unresolved issue of hematology/oncology despite the introduction of methods of early diagnostic and invent of new highly active antimycotics. In etiologic structure of IFI the leading role belongs to candidiasis, the most frequent clinical form of which is candidemia. Candidemias in the pediatric hematology/oncology departments usually occur as sporadic cases, and epidemics are very rare. We describe an epidemic outbreak of candidemia c...

  13. 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

  14. 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.

  15. 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.

  16. Allergic Interstitial Nephritis Manifesting as a Striated Nephrogram

    Directory of Open Access Journals (Sweden)

    Irfan Moinuddin

    2015-01-01

    Full Text Available Allergic interstitial nephritis (AIN is an underdiagnosed cause of acute kidney injury (AKI. Guidelines suggest that AIN should be suspected in a patient who presents with an elevated serum creatinine and a urinalysis that shows white cells, white cell casts, or eosinophiluria. Drug-induced AIN is suspected if AKI is temporally related to the initiation of a new drug. However, patients with bland sediment and normal urinalysis can also have AIN. Currently, a definitive diagnosis of AIN is made by renal biopsy which is invasive and fraught with risks such as bleeding, infection, and hematoma. Additionally, it is frequently unclear when a kidney biopsy should be undertaken. We describe a biopsy proven case of allergic interstitial nephritis which manifested on contrast enhanced Magnetic Resonance Imaging (MRI as a striated nephrogram. Newer and more stable macrocyclic gadolinium contrast agents have a well-demonstrated safety profile. Additionally, in the presentation of AKI, gadolinium contrast agents are safe to administer in patients who demonstrate good urine output and a downtrending creatinine. We propose that the differential for a striated nephrogram may include AIN. In cases in which the suspicion for AIN is high, this diagnostic consideration may be further characterized by contrast enhanced MRI.

  17. Sustained remission in lupus nephritis: still a hard road ahead.

    Science.gov (United States)

    Quintana, Luis F; Jayne, David

    2016-12-01

    End-stage renal disease caused by lupus nephritis (LN) is an avoidable outcome yet there is considerable uncertainty and variability among nephrologists in their approaches to this disorder. This review discusses recent evidence relevant to the management of LN including recent consensus statements. Long-term results are encouraging compared with 30 years ago, but despite the use of the best available current therapies and achieving high levels of early clinical responses, the kidney often sustains long-term damage and nephritis relapses affect over 50%. Major hurdles to management include the complexity of the clinical presentation, histological features and serological tests, and the absence of reliable outcome predictors or markers of treatment response. The key serological and histopathological characteristics relevant to the practising nephrologist are reviewed, and the limitations of current disease activity markers discussed. There are many potential biomarkers under evaluation, and a framework for their validation is presented. Clinical trials of existing or newer agents for LN have typically been inconclusive and have raised problems of trial design and interpretation that are a barrier to new drug development. The major issues affecting clinical trial design and their potential solutions are summarized.

  18. 莫西沙星和左氧氟沙星致急性肾小管间质肾病%Acute interstitial nephritis caused by moxifloxacin and levofloxacin

    Institute of Scientific and Technical Information of China (English)

    李颖慧; 杭永付; 梁雁

    2016-01-01

    A 31-year-old male patient received an oral moxifloxacin 0. 4 g once daily for respiratory infection and after 3 days of treatment,his symptoms were not improved and appeared urine decrease. Moxifloxacin was stopped and changed into levofloxacin 0. 2 g twice daily by mouth. After 8 days of treatment,the patient's symptoms was not improved apparently and appeared urinary protein( + ),5-10 erythrocytes/ high magnification( HP),3-5 white blood cells/ HP,serum creatinine 419 μmol/ L. Renal biopsy showed acute tubular interstitial nephropathy. Drug-induced acute interstitial nephritis-induced by moxifloxacin and levofloxacin was considered. Levofloxacin was stopped and an IV infusion of methylpred-nisolone 250 mg once daily was given,and 3 days later,it was changed into oral prednison 40 mg once daily. After 7 days of treatment,the patient' s blood creatinine was 168 mol/ L,urea 13. 6 mmol/ L, glomerular filtration rate 45. 8 ml/ min/ 1. 73 m2 . The patient got better and was discharged. At 2 months of follow up,the patient's blood creatinine was 119 μmol/ L and urea was 6. 2 mmol/ L.%1例31岁男性患者因呼吸道感染给予莫西沙星0.4 g、1次/ d 口服,用药3 d 病情无改善并出现尿量减少;换用左氧氟沙星0.2 g、2次/ d 口服,用药8 d 病情仍无明显好转,且出现尿蛋白(+),5~10个红细胞/ HP,3~5个白细胞/ HP,Scr 419μmol/ L。肾活检示急性肾小管间质肾病。考虑可能为莫西沙星和左氧氟沙星引起的急性间质性肾炎。停用左氧氟沙星,给予甲泼尼龙250 mg、1次/ d 静脉滴注;3 d 后改为泼尼松40 mg、1次/ d 口服。治疗7 d 后患者 Scr 降至168μmol/ L,尿素13.6 mmol/ L,eGFR 45.8 ml·min-1·1.73 m-2。2个月后复查,患者 Scr 119μmol/ L,尿素6.2 mmol/ L。

  19. Clarithromycin-induced acute interstitial nephritis and minimal change disease

    OpenAIRE

    Russell, Wendy; Smith, William

    2009-01-01

    Drug associated acute interstitial nephritis and minimal change disease has been well documented but the simultaneous presentation of both is rare and has not been reported with clarithromycin. We describe a case of simultaneous acute tubulointerstitial nephritis and minimal change disease induced by clarithromycin. The patient had acute kidney injury, nephrotic syndrome, eosinophilic pneumonitis and a maculopapular skin rash. The role of steroid therapy in acute interstitial nephritis is con...

  20. The Complement System in Lupus Nephritis.

    Science.gov (United States)

    Birmingham, Daniel J; Hebert, Lee A

    2015-09-01

    The complement system is composed of a family of soluble and membrane-bound proteins that historically has been viewed as a key component of the innate immune system, with a primary role of providing a first-line defense against microorganisms. Although this role indeed is important, complement has many other physiological roles, including the following: (1) influencing appropriate immune responses, (2) disposing of waste in the circulation (immune complexes, cellular debris), and (3) contributing to damage of self-tissue through inflammatory pathways. These three roles are believed to be significant factors in the pathogenesis of systemic lupus erythematosus, particularly its renal manifestation (lupus nephritis), contributing both protective and damaging effects. In this review, we provide an overview of the human complement system and its functions, and discuss its intricate and seemingly contradictory roles in the pathogenesis of lupus nephritis.

  1. [Karyomegalic interstitial nephritis: A new French case].

    Science.gov (United States)

    Verine, Jérôme; Reade, Richard; Janin, Anne; Droz, Dominique

    2010-06-01

    Karyomegalic interstitial nephritis (KIN) is a rare and slowly progressive chronic interstitial nephritis (CIN) (28 cases reported), described for the first time by Mihatsch et al. in 1979. Here, we report on a 50-year-old woman who presented with asymptomatic renal failure and mild proteinuria without hematuria. Renal biopsy showed large tubulo-interstitial fibrosis and massively enlarged tubular epithelial cell nuclei, without viral inclusion. KIN is a rare CIN defined by a karyomegaly of tubular epithelial cell nuclei. Its pathogenesis remains obscure. Nevertheless, an exogenous factor is suspected, ochratoxin A particularly. The familial clustering of patients and the frequency of HLA-A9 and HLA-B35 haplotypes suggest the presence of a possible genetic susceptibility to this disorder.

  2. 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.

  3. 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

  4. Relapsing steroid-responsive idiopathic acute interstitial nephritis.

    Science.gov (United States)

    Enriquez, R; Gonzalez, C; Cabezuelo, J B; Lacueva, J; Ruiz, J A; Tovar, J V; Niembro, E

    1993-01-01

    A 49-year-old woman developed acute renal failure secondary to interstitial nephritis. Her clinical history, complementary studies and two renal biopsies could not establish the etiology. She showed signs of incomplete Fanconi syndrome. Treatment with corticosteroids was very effective, though she tended to relapse. We comment briefly on some aspects of idiopathic acute interstitial nephritis.

  5. Spread of Epidemic MRSA-ST5-IV Clone Encoding PVL as a Major Cause of Community Onset Staphylococcal Infections in Argentinean Children

    Science.gov (United States)

    Sola, Claudia; Egea, Ana L.; Moyano, Alejandro J.; Garnero, Analia; Kevric, Ines; Culasso, Catalina; Vindel, Ana; Lopardo, Horacio; Bocco, José L.

    2012-01-01

    /Significance The dissemination of epidemic MRSA clone, ST5-IV-PVL+ was the main cause of increasing staphylococcal community-onset infections in Argentinean children (2003–2008), conversely to other countries. The predominance of this clone, which has capacity to express the h-VISA phenotype, in healthcare-associated community-onset cases suggests that it has infiltrated into hospital-settings. PMID:22291965

  6. Spread of epidemic MRSA-ST5-IV clone encoding PVL as a major cause of community onset staphylococcal infections in Argentinean children.

    Directory of Open Access Journals (Sweden)

    Claudia Sola

    associated with a SCCmec type closely related to SCCmecIV(2B&5. CONCLUSIONS/SIGNIFICANCE: The dissemination of epidemic MRSA clone, ST5-IV-PVL(+ was the main cause of increasing staphylococcal community-onset infections in Argentinean children (2003-2008, conversely to other countries. The predominance of this clone, which has capacity to express the h-VISA phenotype, in healthcare-associated community-onset cases suggests that it has infiltrated into hospital-settings.

  7. 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.

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

    Science.gov (United States)

    Beiraghdar, Fatemeh; Maddani, Abbas; Taheri, Saeed; Sharifi-Bonab, Mir Mohsen; Esfahani, Taher; Panahi, Yunes; Einollahi, Behzad

    2009-05-01

    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.

  9. Failure of Gallium-67 scintigraphy to identify reliably noninfectious interstitial nephritis: concise communication

    Energy Technology Data Exchange (ETDEWEB)

    Graham, G.D.; Lundy, M.M.; Moreno, A.J.

    1983-07-01

    Gallium-67 scintigraphy has been reported to be useful in the diagnosis of noninfectious interstitial nephritis. We studied 12 patients with Ga-67 citrate that were diagnosed as having noninfectious interstitial nephritis on renal biopsy. Only seven of the twelve patients with interstitial nephritis on biopsy were scan-positive. Gallium-67 scintigraphy may not reliably identify noninfectious interstitial nephritis.

  10. 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。

  11. A Rare Case of Tubulointerstitial Nephritis and Uveitis Syndrome Treated with a Multi-Specialty Approach.

    Science.gov (United States)

    Purt, Boonkit; Hiremath, Siri; Smith, Sarah; Erzurum, Sergul; Sarac, Erdal

    2016-11-21

    BACKGROUND It is important for an ophthalmologist and nephrologist to look for hidden causes of uveitis and nephritis, respectively. Delay in diagnosis leads to increased morbidity and failure to systemically manage the patient results in future recurrence of disease. It is likely that TINU remains underdiagnosed and could potentially account for some of the cases of idiopathic uveitis, especially when greater than 50% of uveitis cases have no identifiable cause. Fewer than 300 cases of tubulointerstitial nephritis and uveitis (TINU) syndrome have been reported. In TINU syndrome, inflammation affects the renal tubules, interstitial tissue, and uveal tract. Its pathogenesis remains poorly understood. CASE REPORT We report a rare case of TINU syndrome in a 23-year-old female who was treated using a multispecialty approach. Her primary care physician diagnosed her with proteinuria and acute kidney injury and referred her to the nephrologist, who later referred her to the ophthalmologist. A left kidney biopsy confirmed acute interstitial nephritis. Following the discovery of a "pink eye", the patient was referred to ophthalmology and diagnosed with anterior uveitis, confirming TINU syndrome. Without the additional findings of uveitis, the diagnosis would have been missed. Resolution was obtained through steroid therapy. CONCLUSIONS Correctly diagnosing TINU syndrome requires a multispecialty approach and may not be obvious upon initial presentation. Therefore, the ophthalmologist needs to consider TINU in the differential diagnosis for a patient with bilateral uveitis and evaluate a urinalysis for proteinuria as part of the work up.

  12. Intramolecular epitope spreading in Heymann nephritis.

    Science.gov (United States)

    Shah, Pallavi; Tramontano, Alfonso; Makker, Sudesh P

    2007-12-01

    Immunization with megalin induces active Heymann nephritis, which reproduces features of human idiopathic membranous glomerulonephritis. Megalin is a complex immunological target with four discrete ligand-binding domains (LBDs) that may contain epitopes to which pathogenic autoantibodies are directed. Recently, a 236-residue N-terminal fragment, termed "L6," that spans the first LBD was shown to induce autoantibodies and severe disease. We used this model to examine epitope-specific contributions to pathogenesis. Sera obtained from rats 4 weeks after immunization with L6 demonstrated reactivity only with the L6 fragment on Western blot, whereas sera obtained after 8 weeks demonstrated reactivity with all four recombinant fragments of interest (L6 and LBDs II, III, and IV). We demonstrated that the L6 immunogen does not contain the epitopes responsible for the reactivity to the LBD fragments. Therefore, the appearance of antibodies directed at LBD fragments several weeks after the primary immune response suggests intramolecular epitope spreading. In vivo, we observed a temporal association between increased proteinuria and the appearance of antibodies to LBD fragments. These data implicate B cell epitope spreading in antibody-mediated pathogenesis of active Heymann nephritis, a model that should prove valuable for further study of autoimmune dysregulation.

  13. Clarithromycin-induced acute interstitial nephritis and minimal change disease.

    Science.gov (United States)

    Russell, Wendy; Smith, William

    2009-10-01

    Drug associated acute interstitial nephritis and minimal change disease has been well documented but the simultaneous presentation of both is rare and has not been reported with clarithromycin. We describe a case of simultaneous acute tubulointerstitial nephritis and minimal change disease induced by clarithromycin. The patient had acute kidney injury, nephrotic syndrome, eosinophilic pneumonitis and a maculopapular skin rash. The role of steroid therapy in acute interstitial nephritis is controversial but is accepted as beneficial in minimal change nephrotic syndrome. Steroid therapy in our patient resulted in complete clinical resolution.

  14. 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...... cells constitute a quantitatively important source of auto-antibody-inducing nuclear auto-antigens in human lupus nephritis....

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    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 the control or nephritis biopsies. Scarce apoptotic tubular cells were seen in 13 of 35 (37%) of the nephritis specimens and in two of five (40%) of the control sections. Within the SLE cohort, patients with TUNEL-positive tubular cells in their renal biopsies had significantly higher activity index scores...

  16. Lupus nephritis: induction therapy in severe lupus nephritis--should MMF be considered the drug of choice?

    Science.gov (United States)

    Rovin, Brad H; Parikh, Samir V; Hebert, Lee A; Chan, Tak Mao; Mok, Chi Chiu; Ginzler, Ellen M; Hooi, Lai Seong; Brunetta, Paul; Maciuca, Romeo; Solomons, Neil

    2013-01-01

    Severe lupus nephritis is an aggressive disease that requires an aggressive approach to treatment. Recent randomized clinical trials showed that mycophenolate mofetil compared favorably with cyclophosphamide (traditional approach) for remission induction. Consequently, mycophenolate mofetil is now commonly recommended as first-line therapy. Nevertheless, the role of mycophenolate mofetil in treating severe lupus nephritis is unclear, because such patients were excluded from these trials. With this limitation as background, this work addresses the question of mycophenolate mofetil for induction therapy for severe lupus nephritis. We performed a systematic review of the outcomes of treating severe lupus nephritis with mycophenolate mofetil or cyclophosphamide. Because no studies directly addressed this question, these data were extracted from the published literature or obtained by personal communications from investigators. There is no universally accepted definition, and therefore, severe lupus nephritis was arbitrarily defined by renal histology, resistance to therapy, or level of kidney function at presentation. For each trial analyzed, we determined the partial and complete remission rates. Long-term outcomes were compared when available. The pooled results suggest that mycophenolate mofetil and cyclophosphamide are equally effective in inducing remission of severe lupus nephritis. However, relapse rates and risk of developing ESRD were higher for mycophenolate mofetil compared with cyclophosphamide. In conclusion, in the short term, mycophenolate mofetil and cyclophosphamide are about equal in inducing remission. However, long-term outcomes suggest better preservation of kidney function and fewer relapses with cyclophosphamide therapy. Therefore, mycophenolate mofetil should not yet be considered the induction drug of choice for severe lupus nephritis.

  17. 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.

  18. Pauci-immune lupus nephritis: possibility or co-incidence?

    Science.gov (United States)

    Cansu, Döndü Üsküdar; Temiz, Gökhan; Açıkalın, Mustafa F.; Korkmaz, Cengiz

    2017-01-01

    Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized with immune complex formation and renal involvement of lupus and may include several kinds of pathological conditions, but mostly, it is associated with immune complex-induced glomerular disease. Pauci-immune lupus nephritis is a very rare condition. We describe a 45-year-old female patient with pauci-immune crescentic necrotizing lupus nephritis and briefly discuss the possible mechanism and pathogenesis.

  19. Granulomatous interstitial nephritis associated with hydrochlorothiazide/amiloride.

    Science.gov (United States)

    Enríquez, R; Cabezuelo, J B; González, C; Lacueva, J; Teruel, A; Fernández, J; Arenas, M D

    1995-01-01

    A 74-year-old woman developed acute renal failure and granulomatous interstitial nephritis associated with hydrochlorothiazide/amiloride. On stopping the drug the renal function improved, but not significantly. Around 20 months after prednisone administration, the renal function had stabilized, with a moderate degree of renal insufficiency. The case is discussed, and some aspects of acute interstitial nephritis induced by diuretics are briefly reviewed.

  20. Con: Cyclophosphamide for the treatment of lupus nephritis.

    Science.gov (United States)

    Mok, Chi Chiu

    2016-07-01

    Kidney involvement is a major determinant for morbidity and mortality in patients with systemic lupus erythematosus. The treatment target of lupus renal disease is to induce and maintain remission and to minimize disease or treatment-related comorbidities. Cyclophosphamide (CYC), in conjunction with glucocorticoids, has conventionally been used for the initial treatment of lupus nephritis. However, the major concerns of CYC are its toxicities, such as infertility, urotoxicity and oncogenicity, which are particularly relevant in women of childbearing age. As a result, maintenance therapy of lupus nephritis with an extended course of CYC pulses has largely been replaced by other immunosuppressive agents such as mycophenolate mofetil (MMF) and azathioprine. Recent randomized controlled trials have demonstrated non-inferiority of MMF to pulse CYC as induction therapy of lupus nephritis. Although MMF as induction-maintenance therapy has been increasingly used in lupus nephritis, its efficacy in the long-term preservation of renal function remains to be elucidated. MMF is not necessarily less toxic than CYC. Meta-analyses of clinical trials show similar incidence of infective complications and gastrointestinal adverse events in both MMF- and CYC-based regimens. However, considering the reduction in gonadal toxicity and the risk of oncogenicity, MMF may be used as first-line therapy of lupus nephritis. Tacrolimus (TAC) has recently been shown to be equivalent to either MMF or CYC for inducing remission of lupus nephritis and may be considered as another non-CYC alternative. Combined low-dose MMF and TAC appears to be more effective than CYC pulses in Chinese patients with lupus nephritis and has the potential to replace the more toxic CYC regimens in high-risk patients. Currently, CYC still plays an important role in the management of lupus nephritis patients with impaired or rapidly deteriorating renal function, crescentic glomerulonephritis or as salvage therapy for

  1. The Current Treatment for SLE Nephritis

    Directory of Open Access Journals (Sweden)

    Davut Akın

    2008-01-01

    Full Text Available Renal involvement in systemic lupus erythematosus (SLE is a serious and common complication of the disease that significantly worsens morbidity and mortality. However, the optimal treatment of lupus nephritis remains unclear. Treatment may be divided into immunologic and non-immunologic categories. Non-immunologic treatment consists of anti-hypertensive, anti-proteinüric, and anti-hyperlipidemic options. Immunologic treatment must be designed according to the classification by International Society of Nephrology/Renal Pathology Society (ISN/RPS in induction and remission topics. New regimens consisting mycophenolate are successful in induction and remission. The potential of other new therapeutic agents is discussed together with results of studies performed with commonly used drugs. As a conclusion, treatment must be based histological classification of ISN/RPS and individualized.

  2. 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.

  3. Mycophenolate mofetil in the treatment of lupus nephritis

    Directory of Open Access Journals (Sweden)

    Patrick FK Yong

    2008-06-01

    Full Text Available 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, although cyclophosphamide induces remission, long-term mortality does not seem to be altered. Mycophenolate mofetil (MMF is an immunosuppressive agent originally used in solid organ transplantation, which has been compared with cyclophosphamide in trials for lupus nephritis. Randomized trials with MMF have been relatively small, although pooled data seem to suggest that it is at least as effective as cyclophosphamide in inducing remission. In addition, MMF has also been associated with a reduced risk of infection and amenorrhea, although this finding is not universal. MMF appears to be associated with more diarrhea compared with cyclophosphamide. MMF is likely to be a useful treatment for lupus nephritis, although available trial data are limited due to the small size of previous studies. A large trial (the Aspreva Lupus Management Study is currently underway to attempt to establish the place of MMF in treatment of lupus nephritis.Keywords: mycophenolate mofetil, lupus nephritis, systemic lupus erythematosus

  4. Posterior reversible encephalopathy syndrome in a patient with lupus nephritis

    Directory of Open Access Journals (Sweden)

    Huseyin Kadikoy

    2012-01-01

    Full Text Available Posterior reversible encephalopathy syndrome (PRES is characterized by acute onset of headache, nausea, focal neurological deficits or seizures along with radiological findings of white matter defects in the parietal and occipital lobes. Causes of PRES include uremia, hypertensive encephalopathy, eclampsia and immunosuppressive medications. Usually, the treat-ment of choice involves correcting the underlying abnormality. We describe an unusual case of recurrent PRES caused by uremia during a lupus flare in a patient with biopsy-proven Class IV Lupus Nephritis (LN with vasculitis. PRES in systemic lupus erythematosis (SLE is a rare clin-ical phenomenon and, when reported, it is associated with hypertensive encephalopathy. Our patient did not have hypertensive crisis, but had uremic encephalopathy. The patient′s PRES-related symptoms resolved after initiation of hemodialysis. The temporal correlation of the correc-tion of the uremia and the resolution of the symptoms of PRES show the etiology to be uremic encephalopathy, making this the first reported case of uremia-induced PRES in Class IV LN with vasculitis.

  5. 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.

  6. Acute encephalopathy and tubulointerstitial nephritis associated with Yersinia pseudotuberculosis.

    Science.gov (United States)

    Kaito, Hiroshi; Kamei, Koichi; Ogura, Masao; Kikuchi, Eriko; Hoshino, Hideki; Nakagawa, Satoshi; Matsuoka, Kentaro; Abe, Jun; Ito, Shuichi

    2012-12-01

    We report the case of a 28-month-old boy with encephalopathy and acute tubulointerstitial nephritis possibly associated with Yersinia pseudotuberculosis (Yp) infection. He was transferred to our center because of impairment of renal function and altered consciousness. He had fever for 5 days after recurrent vomiting and diarrhea. Computed tomography scan was normal, but electroencephalogram (EEG) analyses showed generalized slow wave patterns. Continuous hemodialysis was undergone and then his renal function was improved, but altered consciousness persisted. Single photon emission computed tomography (SPECT) revealed abnormally low signals at entire field, which suggested that he was suffered from encephalopathy. Phenobarbital administration and post-encephalopathy rehabilitation were started, and he recovered in fully premorbid state with normal EEG and SPECT findings on the 33rd hospital day. Various bacterial cultures were negative, but both Yp antibody and Yp-derived mitogen (YPM) antibody, the antibody of a specific Yp exotoxin, had an extremely high titer. This is the first report of encephalopathy potentially caused by Yp, indicated by the presence of a high Yp and YPM antibody titer.

  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. 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

    ) that 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 nephritis...... to the evolution of lupus nephritis in human SLE....

  9. 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.

  10. Recent news in the treatment of lupus nephritis.

    Science.gov (United States)

    Tesar, V; Hruskova, Z

    2012-08-01

    Patient survival and renal survival of patients with lupus nephritis improved, but still in a significant proportion of patients the disease progresses to end-stage renal failure, possibly at least partly due to slow and incomplete response to induction treatment and high relapse rate on the maintenance treatment. Mycophenolate mofetil was recently demonstrated to be a comparably effective and safe induction treatment of lupus nephritis as high-dose cyclophosphamide pulses, in Caucasian patients it has become a reasonable alternative to low-dose cyclophosphamide pulses according to the EUROLUPUS protocol. Mycophenolate was shown to be more effective than azathioprine in the maintenance treatment and is currently the treatment of choice for this phase of the disease. Rituximab should be reserved for patients refractory (or intolerant) to cyclophosphamide and/or mycophenolate. Therapy of lupus nephritis should be individually tailored; more aggressive therapy should be reserved for patients at high risk for renal dysfunction and its progression.

  11. 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...

  12. 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.

  13. 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.

  14. 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...

  15. 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

  16. 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

  17. The new epidemic.

    Science.gov (United States)

    Allen, Jeanne V; Mellin, Grace C

    2014-03-01

    Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over the last century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives will be a frequent column, containing articles selected to fit today's topics and times.This month's article, from the November 1982 issue, is the first AJN article published on AIDS. It was early in the epidemic; only 608 cases of Kaposi's sarcoma and opportunistic infections had been reported to the Centers for Disease Control and Prevention-a mere trickle in the flood that was to come. Reading it now, aware of all we've learned since, we have a sense of how much we were fumbling around in the dark in those early days, searching for a cause and a cure, often going in wrong directions. The closest we had come to the true nature of the syndrome was an understanding that "life-style factors seem to be involved and the agent appears to be infectious." To read the complete article from our archives, go to http://bit.ly/1iswhZe.

  18. Reemergence of Enterovirus 71 Epidemic in Northern Taiwan, 2012

    OpenAIRE

    Shu-Ting Luo; Pai-Shan Chiang; Wan-Yu Chung; Min-Yuan Chia; Kuo-Chien Tsao; Ying-Hsiang Wang; Tzou-Yien Lin; Min-Shi Lee

    2015-01-01

    Background Enterovirus 71 (EV71) belongs to picornavirus family and could be classified phylogenetically into three major genogroups (A, B and C) including 11 genotypes (A, B1-B5 and C1-C5). Since 1997, EV71 has caused large-scale of epidemics with neurological complications in Asian children. In Taiwan, nationwide EV71 epidemics with different predominant genotypes have occurred cyclically since 1998. A nationwide EV71 epidemic occurred again in 2012. We conducted genetic and antigenic chara...

  19. 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...

  20. 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

  1. Pregnancy, chimerism and lupus nephritis : a multi-centre study

    NARCIS (Netherlands)

    Hovinga, I. C. L. Kremer; Koopmans, M.; Grootscholten, C.; van der Wal, A. M.; Bijl, M.; Derksen, R. H. W. M.; Voslcuyl, A. E.; de Heer, E.; Bruijn, J. A.; Berden, J. H. M.; Rajema, I. M.

    2008-01-01

    Chimerism occurs twice as often in the kidneys of women with lupus nephritis as in normal kidneys and may he involved in the pathogenesis of systemic lupus erythematosus. Pregnancy is considered the most important source of chimerism, but the exact relationship between pregnancy, the persistence of

  2. 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.

  3. Pregnancy, chimerism and lupus nephritis: a multi-centre study.

    NARCIS (Netherlands)

    Hovinga, I.C. Kremer; Koopmans, M.; Grootscholten, C.; Wal, A.M. van der; Bijl, M. van der; Derksen, R.H.; Voskuyl, A.E.; Heer, E. de; Bruijn, J.A.; Berden, J.H.M.; Bajema, I.M.

    2008-01-01

    Chimerism occurs twice as often in the kidneys of women with lupus nephritis as in normal kidneys and may be involved in the pathogenesis of systemic lupus erythematosus. Pregnancy is considered the most important source of chimerism, but the exact relationship between pregnancy, the persistence of

  4. 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

  5. Henoch-Schonlein Purpura Nephritis: Pathophysiology, Treatment, and Future Strategy

    NARCIS (Netherlands)

    J.C. Davin

    2011-01-01

    Henoch-Schonlein purpura nephritis is a rare kidney disease leading to chronic kidney disease in a non-negligible percentage of patients. Although retrospective studies suggest beneficial effects of some therapies, prospective randomized clinical trials proving treatment efficacy are still lacking.

  6. Epidemic of Chemical Peritonitis in Patients on Continuous Ambulatory Peritoneal Dialysis: A Report from Western India.

    Science.gov (United States)

    Jamale, Tukaram; Dhokare, Aniruddha; Satpute, Kushal; Kulkarni, Renu; Usulumarty, Deepa; Vishwanath, Billa; Noronha, Santosh; Hase, Niwrutti

    2016-01-01

    While non-infectious etiologies like chemical irritants are rare causes of epidemics of peritonitis, this possibility should be considered when one encounters an unusual clustering of peritonitis cases. We describe here an epidemic of chemical peritonitis at our center.

  7. Modularity promotes epidemic recurrence

    CERN Document Server

    Jesan, T; Sinha, Sitabhra

    2016-01-01

    The long-term evolution of epidemic processes depends crucially on the structure of contact networks. As empirical evidence indicates that human populations exhibit strong community organization, we investigate here how such mesoscopic configurations affect the likelihood of epidemic recurrence. Through numerical simulations on real social networks and theoretical arguments using spectral methods, we demonstrate that highly contagious diseases that would have otherwise died out rapidly can persist indefinitely for an optimal range of modularity in contact networks.

  8. Drug-induced interstitial nephritis in a child with idiopathic nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Printza Nikoleta

    2009-01-01

    Full Text Available Acute renal failure (ARF is a rare but severe complication of active idiopathic nephrotic syndrome (INS in children. It may be due to several causes with different outcomes. Both the clinical picture of the patient as well as laboratory, imaging and histopathological findings may help in the diagnosis. We present a case of drug-induced acute interstitial nephritis (AIN, complicated with ARF, in a 2½ -year-old girl with active INS. The child was referred to the Hippokration General Hospital, Thessaloniki, Greece hospital with steroid-resistant NS; renal biopsy was performed, which did not show any remarkable findings and cyclosporine was admi-nistered in addition to steroid therapy. The first day after biopsy, the child developed gross hematuria and abdominal pain and an antibiotic was added to her treatment. In the following days, fever, vomiting, hypertension and ARF occurred. Ultrasound study revealed enlarged kidneys with increased echogenity and loss of corticomedullary differentiation. The antibiotic and cyclos-porine were stopped and the child was managed with furosemide, nifedipine and steroids. A second renal biopsy was performed, which confirmed the diagnosis of acute interstitial nephritis. The child did not require dialysis therapy. Her urine output improved gradually and the serum creatinine normalized one month after the initial episode. Our case re-emphasizes the need for investigation of factors precipitating ARF in children with idiopathic NS.

  9. Overlapped glomerular lesions of chronic rejection and recurrent lupus nephritis in transplanted kidney: a case report.

    Science.gov (United States)

    Masuzawa, Naoko; Urasaki, Koji; Okamoto, Masahiko; Nobori, Shuji; Ushigome, Hidetaka; Yoshimura, Norio; Yanagisawa, Akio

    2011-07-01

    We describe a renal transplant recipient with systemic lupus erythematosus (SLE) who showed continuous proteinuria and low complement levels without clinical evidence of active SLE. Her first renal allograft biopsy, performed nine yr and eight months after transplantation, revealed unusual histological change of glomeruli, and it initially led us to make a contradictory diagnosis based on light and electron microscopic examinations. Diffuse global double- or multi-contour glomerular basement membrane was caused by chronic endothelial injury owing to chronic rejection, and mesangial proliferation associated with mesangial electron-dense deposit was a histological change characteristic of recurrent lupus nephritis (RLN). Immunofluorescence study displayed weak mesangial staining of IgM and C1q. We concluded that this case presented overlapped chronic rejection and RLN. Because both transplant nephropathy and lupus nephritis present constellations of various histologies, it is difficult to diagnose their overlap. Complete morphologic studies with both immunofluorescence and electron microscopic evaluations in addition to microscopic examination should be performed to elucidate complex histological findings.

  10. WKB theory of epidemic fade-out in stochastic populations

    OpenAIRE

    Meerson, Baruch; Sasorov, Pavel V.

    2009-01-01

    Stochastic effects may cause fade-out of an infectious disease in a population immediately after an epidemic outbreak. We develop WKB theory to determine the most probable path of the system toward epidemic fade-out and to evaluate the fade-out probability. The most probable path is an instanton-like orbit in the phase space of the underlying Hamiltonian flow.

  11. 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

  12. An Experimental Study for Radiation Nephritis in Rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Myung Jae [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1972-09-15

    Experimental radiation nephritis was produced in 15 rabbits by X-irradiation. About 2, 000gamma(tissue doses) were given to both kidneys of a rabbit in 5 days. Other tissues and organs except both kidneys were protected with 2 mm thickened lead plates. 5 weeks after the last irradiation, blood pictures, blood pressures, B.U.N., serum creatinine, Ca, Mg, Fe levels and serum erythropoietin activity of the irradiated rabbits were studied. After finishing above studies, rabbits were sacrificed and both kidneys were removed and examined histopathologically. Same laboratory and pathological studies were performed in 6 control rabbits. In this study, the author obtained following results. 1) Both kidneys of rabbits with experimental radiation nephritis showed marked histopathological changes, i.e.: renal tubules showed diffuse cloudy swelling, impacted intraluminal hyaline casts and focal precipitations of lime salts on the tubular epithelium. Diffuse interstitial fatty necrosis and various degrees of fibrotic infiltrations on the interstitium were also seen in association with focal lymphocytic infiltrations. Hyaline degenerations were observed on the glomeruli and small vessels. 2) Experimental radiation nephritis rabbits showed marked lowering in R.B.C. counts, decreased hemoglobin levels, low hematocrit values and leucopenia in comparison with those of control rabbits. (P<0.01). (Table 1 and 2). 3) Mild proteinuria were observed in experimental radiation nephritis in rabbits. 4) The levels of B.U.N. and serum creatinine increased in experimental radiation nephritis. (P<0.01). (Table 1, 3 and 4). 5) The levels of serum Ca and Mg Showed no statistical difference in comparison with those of control rabbits. (P>0.05). (Table 3 and 4). 6) No statistical correlations were observable between the levels of B.U.N. and Hb. values. (gamma=-0. 223). No close correlations (gamma=-0.338) were noticed between the levels of B.U.N. and serum iron levels. 7) Erythropoietin activity (R

  13. 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

  14. 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...

  15. Configuring the autism epidemic

    DEFF Research Database (Denmark)

    Christensen, Fie Lund Lindegaard; Seeberg, Jens

    2017-01-01

    Autism has been described as an epidemic, but this claim is contested and may point to an awareness epidemic, i.e. changes in the definition of what autism is and more attention being invested in diagnosis leading to a rise in registered cases. The sex ratio of children diagnosed with autism...... is skewed in favour of boys, and girls with autism tend to be diagnosed much later than boys. Building and further developing the notion of ‘configuration’ of epidemics, this article explores the configuration of autism in Denmark, with a particular focus on the health system and social support to families...... with children diagnosed with autism, seen from a parental perspective. The article points to diagnostic dynamics that contribute to explaining why girls with autism are not diagnosed as easily as boys. We unfold these dynamics through the analysis of a case of a Danish family with autism....

  16. 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.

  17. Detection of avian nephritis virus in Australian chicken flocks.

    Science.gov (United States)

    Hewson, Kylie A; O'Rourke, Denise; Noormohammadi, Amir H

    2010-09-01

    Avian nephritis virus (ANV) is thought to infect poultry flocks worldwide, but no confirmed case has been reported in Australia. The first such case is described in this study. Cases of young chickens with clinical signs of dehydration and diarrhea were submitted to our laboratory and histopathology detected interstitial nephritis. Vaccine strains of infectious bronchitis virus were detected in some of these cases but were not considered to be the causative agent. A total of seven fresh submissions from broiler chicken flocks were collected at 8-11 days of age. Degenerate PCR primers were designed based on published ANV polymerase gene sequences and used to analyze historic cases as well as the fresh submissions. Six of the seven fresh submissions, and one historic case, were positive for ANV with nucleotide sequencing confirming these results. These results establish ANV as an infectious pathogen circulating in Australian poultry.

  18. Enzymatic electrochemical detection of epidemic-causing Vibrio cholerae with a disposable oligonucleotide-modified screen-printed bisensor coupled to a dry-reagent-based nucleic acid amplification assay.

    Science.gov (United States)

    Yu, Choo Yee; Ang, Geik Yong; Chan, Kok Gan; Banga Singh, Kirnpal Kaur; Chan, Yean Yean

    2015-08-15

    In this study, we developed a nucleic acid-sensing platform in which a simple, dry-reagent-based nucleic acid amplification assay is combined with a portable multiplex electrochemical genosensor. Preparation of an amplification reaction mix targeting multiple DNA regions of interest is greatly simplified because the lyophilized reagents need only be reconstituted with ultrapure water before the DNA sample is added. The presence of single or multiple target DNAs causes the corresponding single-stranded DNA (ssDNA) amplicons to be generated and tagged with a fluorescein label. The fluorescein-labeled ssDNA amplicons are then analyzed using capture probe-modified screen-printed gold electrode bisensors. Enzymatic amplification of the hybridization event is achieved through the catalytic production of electroactive α-naphthol by anti-fluorescein-conjugated alkaline phosphatase. The applicability of this platform as a diagnostic tool is demonstrated with the detection of toxigenic Vibrio cholerae serogroups O1 and O139, which are associated with cholera epidemics and pandemics. The platform showed excellent diagnostic sensitivity and specificity (100%) when challenged with 168 spiked stool samples. The limit of detection was low (10 colony-forming units/ml) for both toxigenic V. cholerae serogroups. A heat stability assay revealed that the dry-reagent amplification reaction mix was stable at temperatures of 4-56 °C, with an estimated shelf life of seven months. The findings of this study highlight the potential of combining a dry-reagent-based nucleic acid amplification assay with an electrochemical genosensor in a more convenient, sensitive, and sequence-specific detection strategy for multiple target nucleic acids.

  19. Early Prediction of Lupus Nephritis Using Advanced Proteomics

    Science.gov (United States)

    2010-06-01

    abstracts submitted (which represent journal manuscripts in preparation). ABSTRACTS SUBMITTED: Michael R. Bennett, PhD, Michiko Suzuki, MD, PhD...IV vs Class V lupus nephritis. Abstract submitted to the Annual Meeting of the American Society of Nephrology , 2010, and to the American College of...Rheumatology Annual Meeting, 2010. and for poster presentation at the American Society of Nephrology meeting. 11 CONCLUSION Thus far, we

  20. Interstitial Nephritis in a Patient with Inflammatory Bowel Disease

    Science.gov (United States)

    Vasanth, Payaswini; Parmley, Michelle; Torrealba, Jose

    2016-01-01

    Tubulointerstitial nephritis in patients with inflammatory bowel disease has been linked to the use of 5-ASA derivatives. Various aspects of this theory have been challenged with a potential role for the underlying autoimmune disorder. Steroids are the mainstay of treatment and mycophenolate mofetil might be an effective alternative. We report a patient who responded well to mycophenolate despite continuing mesalamine, the suspected offending agent. PMID:27703822

  1. Interstitial Nephritis in a Patient with Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Payaswini Vasanth

    2016-01-01

    Full Text Available Tubulointerstitial nephritis in patients with inflammatory bowel disease has been linked to the use of 5-ASA derivatives. Various aspects of this theory have been challenged with a potential role for the underlying autoimmune disorder. Steroids are the mainstay of treatment and mycophenolate mofetil might be an effective alternative. We report a patient who responded well to mycophenolate despite continuing mesalamine, the suspected offending agent.

  2. Renal biopsy in the management of lupus nephritis during pregnancy.

    Science.gov (United States)

    Chen, T K; Gelber, A C; Witter, F R; Petri, M; Fine, D M

    2015-02-01

    The differential diagnosis of proteinuria and hematuria in pregnancy is broad and includes active lupus nephritis. Identification of the correct diagnosis often has a profound therapeutic impact on not only the mother but also the fetus. To date, relatively few reports exist on the role of renal biopsy during pregnancy among women with systemic lupus erythematosus (SLE). We present a case series of 11 pregnant women with SLE who underwent a renal biopsy to evaluate a presumptive flare of lupus nephritis. The electronic medical record was retrospectively analyzed for pre-biopsy serum creatinine, proteinuria, hematuria, antinuclear antibodies (ANA), and antibodies to double-stranded DNA (anti-dsDNA); histologic findings on renal biopsy; and the clinical course of each mother and fetus. From 2001 to 2012, 11 pregnant women with SLE flares during pregnancy underwent a renal biopsy at an academic tertiary medical center. At the time of biopsy, median gestational age was 16 weeks (range 9 to 27), median serum creatinine was 0.6 mg/dl (interquartile range 0.5 to 0.9), six (55%) had hematuria, and all had proteinuria >500 mg/24 hours. Proliferative lupus nephritis was found in 10 (91%) of 11 biopsies (five with ISN/RPS Class III; five with ISN/RPS Class IV). All but one individual underwent a change in management guided by information gleaned from renal biopsy. No apparent biopsy-related complications occurred to mother or fetus. Three women elected to terminate their pregnancy; although many factors were involved, the findings on renal biopsy informed the decision-making process. Among the remaining cases, there were three pre-term deliveries, one fetus with complete heart block, one in utero demise, and one maternal death. Renal biopsy is helpful at informing the management of patients with lupus nephritis during pregnancy.

  3. 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.

  4. 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.

  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. Transplacental transmission of antibodies to tubular basement membrane in guinea-pigs with autoimmune tubulointerstitial nephritis.

    Science.gov (United States)

    Albini, B; Milgrom, M; Noble, B; Albini, C; Ossi, E; Andres, G A

    1984-04-01

    The offspring of female guinea-pigs with tubulo-interstitial nephritis were studied for possible passive transfer of disease. Whereas no immune deposits were seen on or before day 30 of gestation, IgG was detected in the tubular basement membrane (TBM) of fetuses at and after day 44. Serum of offspring contained antibodies to TBM, albeit in much lower titres than found in circulation of the mother guinea-pigs. No histopathological changes were seen in fetal kidneys. Thus, autoantibodies induced by heteroimmunization of pregnant guinea-pigs may be transmitted to offspring in the last third of the gestation period and can bind to fetal TBM. However, this transfer of antibodies does not cause disease.

  7. 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.

  8. Epidemic suicide among Micronesian adolescents.

    Science.gov (United States)

    Rubinstein, D H

    1983-01-01

    Suicide rates since 1960 in Micronesia (the U.S. Trust Territory of the Pacific Islands) have undergone an epidemic-like increase. This phenomenon is focused narrowly within the 15--24-year male age-group. Extremely high rates and culturally patterned motives and methods are now characteristic of this group. Survey research throughout Micronesia suggests that the epidemic increase in adolescent male suicide is a cohort effect among the first post-war generation. Traditional adolescent socialization in pre-war Micronesia largely involved village-level subsistence activities organized around communal lineage-houses. This extra-familial level of socialization served as a cultural solution to the residential and psychological distance post-pubertal males maintained from their domestic families. With the post-war social change in Micronesia, the communal village-level of organization has largely disintegrated, causing adolescent socialization functions to be absorbed by the nuclear family. The resulting situations of intergenerational domestic discord appear the primary social triggers for adolescent suicide. At the same time, suicides have acquired subcultural significance among male youth, giving rise to fad-like and imitative acts. A 3-year research project is now being undertaken to conduct an ethnographic study of factors contributing to adolescent stress and suicide in one Micronesian community.

  9. Hemorrhagic nephritis and enteritis in a goose flock in Poland--disease course analysis and characterization of etiologic agent.

    Science.gov (United States)

    Gaweł, Andrzej; Woźniakowski, Grzegorz; Samorek-Salamonowicz, Elzbieta; Kozdruń, Wojciech; Bobrek, Kamila; Bobusia, Katarzyna; Nowak, Marcin

    2014-12-01

    Hemorrhagic nephritis enteritis of geese (HNEG) is an epizootic viral disease caused by infection with goose hemorrhagic polyomavirus (GHPV) that affects domestic geese. This study describes the epizootic analysis, laboratory diagnosis, and molecular characterization of GHPV isolates associated with HNEG cases in Poland. HNEG symptoms persisted in infected flocks for 2 wk with a 32% mortality rate. Primary gross lesions included hemorrhaging of the kidneys, intestines, and lungs. Histopathologic examination confirmed HNEG and identified that the causative agent was similar to other GHPV isolates and identical to the Toulouse 2008 isolate.

  10. Acute tubulointerstitial nephritis and uveitis syndrome: A report on four adult cases

    Directory of Open Access Journals (Sweden)

    Yosra Ben Ariba

    2017-01-01

    Full Text Available Acute tubulointerstitial nephritis and uveitis (TINU syndrome is a rare disease, generally presenting in children and young women. The interstitial nephritis may precede, follow, or develop concurrent to the uveitis. We report the clinical features and outcomes of four adult patients, aged 41-70 years with the TINU syndrome.

  11. 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)....

  12. Azathioprine/methylprednisolone versus cyclophosphamide in proliferative lupus nephritis. A randomized controlled trial

    NARCIS (Netherlands)

    Grootscholten, C.; Ligtenberg, G.; Hagen, E. C.; van den Wall Bake, A. W. L.; de Glas-Vos, J. W.; Bijl, M.; Assmann, K. J.; Bruijn, J. A.; van Houwelingen, H. C.; Derksen, R. H. W. M.; Berden, J. H. M.; Weening, J.J.

    2006-01-01

    Until recently, intravenous cyclophosphamide pulses with oral corticosteroids were regarded standard therapy for proliferative lupus nephritis (LN). Azathioprine, a less toxic alternative, was never proven to be inferior. In the first Dutch lupus nephritis study (enrollment between 1995 and 2001), w

  13. Azathioprine/methylprednisolone versus cyclophosphamide in proliferative lupus nephritis. A randomized controlled trial.

    NARCIS (Netherlands)

    Grootscholten, C.; Ligtenberg, G.; Hagen, E.C.; Wall Bake, A.W. van den; Glas-Vos, J.W. de; Bijl, M.; Assmann, K.J.M.; Bruijn, J.A.; Weening, J.J.; Houwelingen, H.C. van; Derksen, R.H.W.M.; Berden, J.H.M.

    2006-01-01

    Until recently, intravenous cyclophosphamide pulses with oral corticosteroids were regarded standard therapy for proliferative lupus nephritis (LN). Azathioprine, a less toxic alternative, was never proven to be inferior. In the first Dutch lupus nephritis study (enrollment between 1995 and 2001), w

  14. TRANSIENT ARTHRITIS WITH POSITIVE TESTS FOR RHEUMATOID-FACTOR AS PRESENTING SIGN OF SHUNT NEPHRITIS

    NARCIS (Netherlands)

    TERBORG, EJ; VANRIJSWIJK, MH; KALLENBERG, CGM

    1991-01-01

    Shunt nephritis is a rare complication of a chronically infected ventriculoatrial shunt. A 17 year old boy is described, with arthritis in both ankles and positive rheumatoid factor tests, who presented with symptoms of shunt nephritis. Blood cultures were positive for Staphylococcus epidermidis. Th

  15. Resilience of epidemics on networks

    CERN Document Server

    Lu, Dan; Zhang, Jiaquan; Wang, Huijuan; Li, Daqing

    2016-01-01

    Epidemic propagation on complex networks has been widely investigated, mostly with invariant parameters. However, the process of epidemic propagation is not always constant. Epidemics can be affected by various perturbations, and may bounce back to its original state, which is considered resilient. Here, we study the resilience of epidemics on networks, by introducing a different infection rate ${\\lambda_{2}}$ during SIS (susceptible-infected-susceptible) epidemic propagation to model perturbations (control state), whereas the infection rate is ${\\lambda_{1}}$ in the rest of time. Through simulations and theoretical analysis, we find that even for ${\\lambda_{2}<\\lambda_{c}}$, epidemics eventually could bounce back if control duration is below a threshold. This critical control time for epidemic resilience, i.e., ${cd_{max}}$ can be predicted by the diameter (${d}$) of the underlying network, with the quantitative relation ${cd_{max}\\sim d^{\\alpha}}$. Our findings can help to design a better mitigation stra...

  16. Chronicle of malaria epidemics in Thailand, 1980-2000.

    Science.gov (United States)

    Konchom, Supawadee; Singhasivanon, Pratap; Kaewkungwal, Jaranit; Chuprapawan, Sirichai; Thimasarn, Krongthong; Kidson, Chev; Yimsamran, Surapon; Rojanawatsirivet, Chaiporn

    2005-01-01

    The occurrence of malaria epidemics in Thailand was reviewed from the malaria surveillance report of the National Malaria Control Program. The literature review revealed that the four epidemic periods recorded during 1980-2000 almost always occurred in the provinces and districts located along international borders. Malaria epidemics are caused by various factors such as: extensive population movement, multi-drug resistance development, low immune status of the population, lack of knowledge and appropriate personal protection against mosquito biting, and the re-emergence of malaria transmission in low malarious areas. Such factors can lead to changes in the parasite ratio and appearance of malaria epidemics throughout the country. Evidence related to the burden of malaria epidemics was also reviewed to identify causal factors that will be helpful in future research.

  17. Relationship between anti-dsDNA, anti-nucleosome and anti-alpha-actinin antibodies and markers of renal disease in patients with lupus nephritis: a prospective longitudinal study.

    NARCIS (Netherlands)

    Manson, J.J.; Ma, A.; Rogers, P.; Mason, L.J.; Berden, J.H.M.; Vlag, J. van der; D'Cruz, D.P.; Isenberg, D.A.; Rahman, A.

    2009-01-01

    INTRODUCTION: Glomerulonephritis is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Deposition of autoantibodies in the glomeruli plays a key role in the development of lupus nephritis (LN). Different groups have proposed that either anti-nucleosome anti

  18. Analysis of The Causes of Bovine Viral Diarrhea Virus Epidemic Transmission in Beijing Area%北京地区牛病毒性腹泻病毒流行传播的原因分析

    Institute of Scientific and Technical Information of China (English)

    张俊杰; 李栋梁; 马翀; 曹杰

    2013-01-01

    在对北京地区20个奶牛群进行抗体水平检测和全群抗原筛查的基础上,将牛群中牛病毒性腹泻病毒流行状况同牛群在3年内是否引入过动物进行相关性比较.结果显示,20个牛群中,引入过动物的8个牛群中后备牛群血清抗体平均水平为80.0%,抗原筛查的总体阳性率为0.61%;未引入过动物的12个牛群中后备牛血清抗体平均水平为65.5%,抗原筛查的总体阳性率为0.15%,两组数据之间差异极显著,表明牛群在3年内是否引进过动物对牛群持续感染牛的分布影响极显著,动物引进可能是造成BVDV在北京地区流行传播的主要原因之一.%Based on the detection of the antibody level and the whole group antigen screening in 20 dairy herds in Beijing area,the prevalence of bovine viral diarrhea virus in herds was compared with the introduction of animal into herds in 3 years.Within the 20 herds,the 8 herds that had introduced animal from other herds have an average serum antibody level of 80% in replacement group,the positive rate of antigen screening is 0.61%; the average serum antibody level of replacement group in 12 herds that had not introduced animal was 65.5%,the overall positive rate of antigen screening is 0.15%,the difference between two sets of data is extremely significant.The results show,whether introduced animals into a herd within 3 years influence the distribution of PI animals in herds significantly,and the introduction of animal may be one of the main causes of BVDV epidemic transmission in Beijing area

  19. 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 ...

  20. Decay-accelerating factor 1 deficiency exacerbates leptospiral-induced murine chronic nephritis and renal fibrosis.

    Directory of Open Access Journals (Sweden)

    María F Ferrer

    Full Text Available Leptospirosis is a global zoonosis caused by pathogenic Leptospira, which can colonize the proximal renal tubules and persist for long periods in the kidneys of infected hosts. Here, we characterized the infection of C57BL/6J wild-type and Daf1-/- mice, which have an enhanced host response, with a virulent Leptospira interrogans strain at 14 days post-infection, its persistence in the kidney, and its link to kidney fibrosis at 90 days post-infection. We found that Leptospira interrogans can induce acute moderate nephritis in wild-type mice and is able to persist in some animals, inducing fibrosis in the absence of mortality. In contrast, Daf1-/- mice showed acute mortality, with a higher bacterial burden. At the chronic stage, Daf1-/- mice showed greater inflammation and fibrosis than at 14 days post-infection and higher levels at all times than the wild-type counterpart. Compared with uninfected mice, infected wild-type mice showed higher levels of IL-4, IL-10 and IL-13, with similar levels of α-smooth muscle actin, galectin-3, TGF-β1, IL-17, IFN-γ, and lower IL-12 levels at 90 days post-infection. In contrast, fibrosis in Daf1-/- mice was accompanied by high expression of α-smooth muscle actin, galectin-3, IL-10, IL-13, and IFN-γ, similar levels of TGF-β1, IL-12, and IL-17 and lower IL-4 levels. This study demonstrates the link between Leptospira-induced murine chronic nephritis with renal fibrosis and shows a protective role of Daf1.

  1. Decay-accelerating factor 1 deficiency exacerbates leptospiral-induced murine chronic nephritis and renal fibrosis.

    Science.gov (United States)

    Ferrer, María F; Scharrig, Emilia; Alberdi, Lucrecia; Cedola, Maia; Pretre, Gabriela; Drut, Ricardo; Song, Wen-Chao; Gomez, Ricardo M

    2014-01-01

    Leptospirosis is a global zoonosis caused by pathogenic Leptospira, which can colonize the proximal renal tubules and persist for long periods in the kidneys of infected hosts. Here, we characterized the infection of C57BL/6J wild-type and Daf1-/- mice, which have an enhanced host response, with a virulent Leptospira interrogans strain at 14 days post-infection, its persistence in the kidney, and its link to kidney fibrosis at 90 days post-infection. We found that Leptospira interrogans can induce acute moderate nephritis in wild-type mice and is able to persist in some animals, inducing fibrosis in the absence of mortality. In contrast, Daf1-/- mice showed acute mortality, with a higher bacterial burden. At the chronic stage, Daf1-/- mice showed greater inflammation and fibrosis than at 14 days post-infection and higher levels at all times than the wild-type counterpart. Compared with uninfected mice, infected wild-type mice showed higher levels of IL-4, IL-10 and IL-13, with similar levels of α-smooth muscle actin, galectin-3, TGF-β1, IL-17, IFN-γ, and lower IL-12 levels at 90 days post-infection. In contrast, fibrosis in Daf1-/- mice was accompanied by high expression of α-smooth muscle actin, galectin-3, IL-10, IL-13, and IFN-γ, similar levels of TGF-β1, IL-12, and IL-17 and lower IL-4 levels. This study demonstrates the link between Leptospira-induced murine chronic nephritis with renal fibrosis and shows a protective role of Daf1.

  2. An etiological survey on a foodborne disease epidemic outbreak caused by salmonella enteritidis%一起由肠炎沙门菌所致食源性疾病暴发疫情的病原学研究

    Institute of Scientific and Technical Information of China (English)

    杨晋川; 夏杨; 郭惠; 许静静; 王路梅; 童晶; 张雷; 梁俊容; 景怀琦

    2013-01-01

    Objective To conduct an etiological molecular epidemiological survey and laboratory test on a foodborne disease epidemic outbreak to make clear of the cause and implement effective prevention and control on it.Methods On May 12th 2012,135 kindergarten children were sent to Xuzhou City People's Hospital and Children's Hospital with gastrointestinal infection disease.A total of 34 anus swabsamples and 4 vomit samples were collected from the patients.Real-time PCR rapid detection,strains separation and cultivation,phagelysis experiments,ATB automated identification system were used to make etiological detection and identification.The genomic DNA of salmonella enteritidis were typed with the pulsedfield gel electrophoresis (PFGE),cluster analysis were carried out together with the patterns of local Salmonella infections.Results Children in 20 classes were suffered from the gastrointestinal infection among the 21 classes.There were no significant aggregation of class distribution.Among the 135 patients,76 were boys (56.3%) and 59 were girls (43.7%).The main symptoms were fever(above 38 ℃),diarrhea and bellyache.Through real-time PCR detection and strains separation,19 salmonella enteritidis were isolated from 34 anus swab samples of suspected cases and the detection rate was 56%.Thcre were no strains detected from vomit samples.All of the 19 salmonella enteritidis showed the same serological subtype,biochemical reaction,drug sensitivity and phage lysis pattern.The salmonella enteritidis had the identical PFGE pattern (100% similarity),and were different from the pattern of local sporadic infection cases.Conclusion It was confirmed that this was an epidemic outbreak of foodborne disease caused by homologous salmonella entertidis by epidemiological survey,clinical information,lab etiological test and molecular typing.%目的 对一起食源性疾病暴发疫情进行病原学分子流行病学调查和细菌学检测,以便明确病因,进

  3. 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.

  4. Lupus nephritis: the central role of nucleosomes revealed.

    Science.gov (United States)

    Mortensen, Elin S; Fenton, Kristin A; Rekvig, Ole P

    2008-02-01

    Systemic lupus erythematosus (SLE) is an autoimmune syndrome characterized by autoantibodies to nuclear constituents. Some of these antibodies are diagnostically important, whereas others act as disease-modifying factors. One clinically important factor is autoantibodies against dsDNA and nucleosomes, which have overlapping diagnostic and nephritogenic impact in SLE. Although a scientific focus for 5 decades, the molecular and cellular origin of these antibodies, and why they are associated with lupus nephritis, is still not fully understood. A consensus has, however, evolved that antibodies to dsDNA and nucleosomes are central pathogenic factors in the development of lupus nephritis. In contrast, no agreement has been reached as to which glomerular structures are bound by nephritogenic anti-nucleosome antibodies in vivo. Mutually contradictory paradigms and models have evolved simply because we still lack precise and conclusive data to provide definitive insight into how autoantibodies induce lupus nephritis and which specificity is critical in the nephritic process(es). In this review, data demonstrating the central role of nucleosomes in inducing and binding potentially nephritogenic antibodies to DNA and nucleosomes are presented and discussed. These autoimmune-inducing processes are discussed in the context of Matzinger's danger model (Matzinger P: Friendly and dangerous signals: is the tissue in control? Nat Immunol 2007, 8:11-13; Matzinger P: The danger model: a renewed sense of self. Science 2002, 296:301-305; Matzinger P: Tolerance, danger, and the extended family. Annu Rev Immunol 1994, 12:991-1045) and Medzhitov's and Janeway's (Medzhitov R, Janeway CA Jr: Decoding the patterns of self and nonself by the innate immune system. Science 2002, 296:298-300; Medzhitov R, Janeway CA Jr: How does the immune system distinguish self from nonself? Semin Immunol 2000, 12:185-188; Janeway CA Jr, Medzhitov R: Innate immune recognition. Annu Rev Immunol 2002, 20

  5. The use of angiogenic and antiangiogenic factors in the differential diagnosis of pre-eclampsia, antiphospholipid syndrome nephropathy and lupus nephritis.

    Science.gov (United States)

    de Jesus, G R; de Jesus, N R; Levy, R A; Klumb, E M

    2014-10-01

    Pre-eclampsia (PE) is a major cause of maternal mortality and morbidity, perinatal deaths, preterm birth and intrauterine growth restriction. Differential diagnosis with antiphospholipid syndrome (APS) nephropathy and systemic lupus erythematosus (SLE) nephritis during pregnancy is difficult, if not sometimes impossible, as all three diseases may present hypertension and proteinuria. Improvement in diagnosis of PE has also offered new paths for differential diagnosis with other conditions and the analysis of angiogenic (vascular endothelial growth factor, placental growth factor) and antiangiogenic factors (serum soluble fms-like tyrosine kinase 1, soluble endoglin) is promising for differentiation between PE, APS nephropathy and SLE nephritis. This article reviews published studies about those factors in non-pregnant and pregnant patients with APS and SLE, comparing with patterns described in PE.

  6. [Late sequelae of epidemic viral meningitis].

    Science.gov (United States)

    Pierzchała, K; Grudzińska, B; Bara, M; Kłosińska, E

    1989-02-01

    In autumn 1982 during an epidemic of meningitis caused by Coxsackie A9 and ECHO4 viruses 36 patients, usually young, were hospitalized. After 3-4 years 22 of them were subjected to control examinations, carrying out medical examination. EEG, ACG, motor nerve conduction velocity measurements and psychological examinations by the tests od Eysenck, Bender-Koppitz and Wechsler. The studied group comprised 14 men and 8 women with mean age 29.8 years.

  7. 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.

  8. Familial epidemic of meningococcal disease.

    Science.gov (United States)

    Smilović, V; Vrbanec-Megla, L; Payerl-Pal, M; Puntarić, D; Baklaić, Z

    1998-03-01

    Two closely related boys from the same house hold (Home 1), aged two and three, were affected with fulminant meningococcal sepsis known as Waterhouse-Friderichsen syndrome. Neisseria meningitidis serogorup B was isolated from their blood and cerebrospinal fluid. The two-year-old boy died one day after the onset of the disease. Epidemiological examination of contacts and pharyngeal swabs were performed in 14 persons from the household, all of them relatives of the affected children, as well as in a number of other contacts. Chemoprophylaxis with cotrimoxazole was simultaneously administered to all contacts. Family histories revealed that two contacts from the household where the patients did not live (Home 2) were inadvertently omitted. Subsequent examinations, following a report of another contagious disease (salmonelosis), revealed that these two persons were Neisseria meningitidis carriers, together with another one in the same household. The carriers most probably caused the infection of a third, five-year-old boy, the deceased boy's brother (Home 1) who also developed fulminant meningococcal sepsis. The failure to take the appropriate prophylaxis led to a prolonged carrier state in the carrier from the second household. Repeated pharyngeal swab sampling revealed two more carriers from both households that had previously been negative. Control of the epidemic was achieved after 5 weeks by repeated and controlled chemoprophylaxis with ciprofloxacin, and by repeated epidemiological examinations, disinfection, and daily health surveillance by the Sanitary Inspectorate. This extremely rare instance of a familial epidemic with three infected persons emphasizes the need for consistent chemoprophylaxis in meningococcal disease contacts.

  9. Cause analysis and nursing measures for epidemic situation of influenza outbreak in the psychiatric ward%精神科病房暴发流行性感冒疫情的原因分析及护理对策

    Institute of Scientific and Technical Information of China (English)

    章文峰; 殷凤莲

    2014-01-01

    目的:探讨精神科病房暴发流行性感冒疫情的原因及对策。方法选取本院一精神科病房流行性感冒疫情暴发的32例住院精神病患者,将其按年龄分为<40岁组和≥40岁组,按住院时间分为<90 d组和≥90 d组,按病程分为<3年组和≥3年组,按疾病类型分为精神分裂症组和其他精神障碍组。结果年龄<40岁和≥40岁组、住院时间<90 d和住院时间≥90 d组、病程<3年和病程≥3年组、精神分裂症与其他精神障碍组暴发流行性感冒的感染率比较,差异有统计学意义(P<0.01)。结论患者年龄越大、住院时间越长、病程越长,精神分裂症患者更易被感染,应当根据专科易感因素制订合理的护理措施,加强住院患者的生活护理,积极引导患者进行适当的体育锻炼,增强机体抵抗力,改善病房管理,做好各项护理措施,积极控制感染和宣传防病意识,降低医院感染风险。%Objective To explore the cause and measures for epidemic situation of influenza outbreak in the psychiatric ward. Methods 32 psychiatric patients hospitalized in the first psychiatric ward of our hospital during influenza out-break were selected and assigned to the<40 years old group and≥40 years old group according to the age,the hospital stay<90 days group and the≥90 days group according to the hospital stay,the course of disease<3 years group and≥3 years group according to the course of disease,and the schizophrenia group and the group with other mental disorder ac-cording to the disease type. Results There was a statistical difference of infection rate of outbreaking the influenza be-tween the age<40 years old group and ≥40 years old group,between the hospital stay<90 days group and the ≥90 days group,between the course of disease<3 years group and ≥3 years group,between the schizophrenia group and the group with other mental disorder (P<0.01). Conclusion Patients with senility

  10. Is the New Heroin Epidemic Really New? Racializing Heroin.

    Science.gov (United States)

    Bowser, Benjamin; Fullilove, Robert; Word, Carl

    2017-01-01

    Heroin abuse as an outcome of the prior use of painkillers increased rapidly over the past decade. This "new epidemic" is unique because the new heroin users are primarily young White Americans in rural areas of virtually every state. This commentary argues that the painkiller-to-heroin transition could not be the only cause of heroin use on such a scale and that the new and old heroin epidemics are linked. The social marketing that so successfully drove the old heroin epidemic has innovated and expanded due to the use of cell-phones, text messaging and the "dark web" which requires a Tor browser, and software that allows one to communicate with encrypted sites without detection. Central city gentrification has forced traffickers to take advantage of larger and more lucrative markets. A second outcome is that urban black and Latino communities are no longer needed as heroin stages areas for suburban and exurban illicit drug distribution. Drug dealing can be done directly in predominantly white suburbs and rural areas without the accompanying violence associated with the old epidemic. Denial of the link between the new and old heroin epidemics racially segregates heroin users and more proactive prevention and treatment in the new epidemic than in the old. It also cuts off a half-century of knowledge about the supply-side of heroin drug dealing and the inevitable public policy measures that will have to be implemented to effectively slow and stop both the old and new epidemic.

  11. 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.

  12. The HIV epidemic in Greenland - a slow spreading infection among adult heterosexual Greenlanders

    DEFF Research Database (Denmark)

    Bjørn-Mortensen, Karen; Ladefoged, Karin; Obel, Niels;

    2013-01-01

    We aimed to characterise the HIV epidemic in Greenland and to determine incidence, prevalence, mortality rates (MR) and specific causes of deaths.......We aimed to characterise the HIV epidemic in Greenland and to determine incidence, prevalence, mortality rates (MR) and specific causes of deaths....

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

    Institute of Scientific and Technical Information of China (English)

    ZHENG; Tian-wen

    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.

  14. 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...

  15. Influence of periodic traffic congestion on epidemic spreading

    Science.gov (United States)

    Zheng, Muhua; Ruan, Zhongyuan; Tang, Ming; Do, Younghae; Liu, Zonghua

    2016-11-01

    In the metropolis, traffic congestion has become a very serious problem, especially in rush hours. This congestion causes people to have more chance to contact each other and thus will accelerate epidemic spreading. To explain this observation, we present a reaction-diffusion (RD) model with a periodic varying diffusion rate to represent the daily traveling behaviors of human beings and its influence to epidemic spreading. By extensive numerical simulations, we find that the epidemic spreading can be significantly influenced by traffic congestion where the amplitude, period and duration of diffusion rate are the three key parameters. Furthermore, a brief theory is presented to explain the effects of the three key parameters. These findings suggest that except the normal ways of controlling contagion in working places and long-distance traveling, controlling the contagion in daily traffic congestion may be another effective way to reduce epidemic spreading.

  16. Effects of active links on epidemic transmission over social networks

    Science.gov (United States)

    Zhu, Guanghu; Chen, Guanrong; Fu, Xinchu

    2017-02-01

    A new epidemic model with two infection periods is developed to account for the human behavior in social network, where newly infected individuals gradually restrict most of future contacts or are quarantined, causing infectivity change from a degree-dependent form to a constant. The corresponding dynamics are formulated by a set of ordinary differential equations (ODEs) via mean-field approximation. The effects of diverse infectivity on the epidemic dynamics ​are examined, with a behavioral interpretation of the basic reproduction number. Results show that such simple adaptive reactions largely determine the impact of network structure on epidemics. Particularly, a theorem proposed by Lajmanovich and Yorke in 1976 is generalized, so that it can be applied for the analysis of the epidemic models with multi-compartments especially network-coupled ODE systems.

  17. 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

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

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Kamper, Anne-Lise; Starklint, Henrik

    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....

  19. Hereditary nephritis (with unusual renal histology): report of a first case from the West Indies.

    Science.gov (United States)

    Hayes, J S; Jankey, N

    1976-11-01

    A 21-year-old Grenadian girl undergoing investigation in Trinidad for anaemia was diagnosed as a case of hereditary nephritis. She had the clinical features of a nephropathy, nerve deafness and an ocular defect. Renal histology was exceptional in that in addition to the typical findings of a hereditary nephritis, cystic areas generally associated with medullary cystic disease were noted. Several members of the patient's maternal family were afflicted with either deafness visual distrubances or renal disease.

  20. 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.

  1. Minimal change disease: a variant of lupus nephritis.

    Science.gov (United States)

    Moysés-Neto, Miguel; Costa, Roberto S; Rodrigues, Fernanda F; Vieira Neto, Osvaldo M; Reis, Marlene A; Louzada Júnior, Paulo; Romão, Elen A; Dantas, Márcio

    2011-02-01

    Some patients with systemic lupus erythematosus (SLE) present with nephrotic syndrome due to minimal change disease (MCD). Histopathological diagnosis of patients with SLE and nephrotic-range proteinuria has shown that these patients present with diffuse proliferative glomerulonephritis and membranous glomerulonephritis, World Health Organization (WHO) classes IV and V, respectively, more frequently than the other classes. In the present study, we reported a case of nephrotic syndrome and renal biopsy-proven MCD associated with SLE. A complete remission occurred after steroid treatment, which was followed by a relapse 15 months later with a concomitant reactivation of SLE. A second biopsy showed WHO class IIb lupus nephritis. Prednisone treatment was restarted, and the patient went into complete remission again. The association of MCD and SLE may not be a coincidence, and MCD should be considered as an associated SLE nephropathy.

  2. Rapidly progressive lupus nephritis and concomitant thrombotic microangiopathy.

    Science.gov (United States)

    Gharbi, Chems; Bourry, Edward; Rouvier, Philippe; Hacini, Sabria; Letaief, Ahmed; Baumelou, Alain; Izzedine, Hassane

    2010-10-01

    Although uncommon, thrombotic microangiopathy (TMA) is one of the most serious complications in patients with systemic lupus erythematosus. A 30-year-old black woman admitted to our hospital because of fever, fatigue, 'dark' urine and rapidly progressive renal failure was found to have systemic lupus erythematous and atypical hemolytic uremic syndrome. Kidney biopsy showed WHO class IV lupus nephritis with crescents and TMA. Hemodialysis was initiated for worsening renal failure. The patient was treated with corticosteroids, monthly pulse intravenous Cyclophosphamide, plasmapheresis and Rituximab on a weekly basis for 4 weeks. The patient's blood pressure was aggressively controlled using antihypertensive agents. Despite this extensive therapy, she remained dialysis dependent although hematological parameters returned to normal values.

  3. 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.

  4. Karyomegalic interstitial nephritis and DNA damage-induced polyploidy in Fan1 nuclease-defective knock-in mice.

    Science.gov (United States)

    Lachaud, Christophe; Slean, Meghan; Marchesi, Francesco; Lock, Claire; Odell, Edward; Castor, Dennis; Toth, Rachel; Rouse, John

    2016-03-15

    The Fan1 endonuclease is required for repair of DNA interstrand cross-links (ICLs). Mutations in human Fan1 cause karyomegalic interstitial nephritis (KIN), but it is unclear whether defective ICL repair is responsible or whether Fan1 nuclease activity is relevant. We show that Fan1 nuclease-defective (Fan1(nd/nd)) mice develop a mild form of KIN. The karyomegalic nuclei from Fan1(nd/nd) kidneys are polyploid, and fibroblasts from Fan1(nd/nd) mice become polyploid upon ICL induction, suggesting that defective ICL repair causes karyomegaly. Thus, Fan1 nuclease activity promotes ICL repair in a manner that controls ploidy, a role that we show is not shared by the Fanconi anemia pathway or the Slx4-Slx1 nuclease also involved in ICL repair.

  5. Impact of previous lupus nephritis on maternal and fetal outcomes during pregnancy.

    Science.gov (United States)

    Saavedra, Miguel A; Cruz-Reyes, Claudia; Vera-Lastra, Olga; Romero, Griselda T; Cruz-Cruz, Polita; Arias-Flores, Rafael; Jara, Luis J

    2012-05-01

    Previous reports suggest that renal involvement before pregnancy or active renal disease during pregnancy may be associated with poor fetal and maternal outcomes in systemic lupus erythematosus (SLE) women. We report our experience of fetal and maternal complications in pregnant lupus women with and without previous lupus nephritis. We analyzed the clinical records of pregnant SLE patients attended in a tertiary reference center during a 5-year period. Patients were allocated into two groups according to the presence or absence of previous lupus nephritis. Women were evaluated monthly during pregnancy and at least 1 month postpartum. Maternal and fetal outcomes of pregnancy were abstracted. We included 95 pregnancies in 92 patients. Compared with pregnant women without lupus nephritis (n = 60), pregnancies with previous lupus nephritis (n = 35) were associated with a higher risk of maternal complications (88.5% vs. 43.3%, p = 0.00001), higher rate of lupus flares (54.2% vs. 25%, p = 0.004), and renal flares (45.7% vs. 6.6%, p = 0.00001), but most of which in most instances were reversible. On the other hand, fetal outcome was similar in both groups. Multivariate analysis showed that previous lupus nephritis and active lupus at conception were predictors of adverse maternal outcome. Pregnancies in women with previous lupus nephritis had a higher rate of maternal complications in comparison with those without. However, fetal prognosis was similar in both groups.

  6. Phylogeography and molecular epidemiology of an epidemic strain of dengue virus type 1 in Sri Lanka.

    Science.gov (United States)

    Ocwieja, Karen E; Fernando, Anira N; Sherrill-Mix, Scott; Sundararaman, Sesh A; Tennekoon, Rashika N; Tippalagama, Rashmi; Krishnananthasivam, Shivankari; Premawansa, Gayani; Premawansa, Sunil; De Silva, Aruna Dharshan

    2014-08-01

    In 2009, a severe epidemic of dengue disease occurred in Sri Lanka, with higher mortality and morbidity than any previously recorded epidemic in the country. It corresponded to a shift to dengue virus 1 as the major disease-causing serotype in Sri Lanka. Dengue disease reached epidemic levels in the next 3 years. We report phylogenetic evidence that the 2009 epidemic DENV-1 strain continued to circulate within the population and caused severe disease in the epidemic of 2012. Bayesian phylogeographic analyses suggest that the 2009 Sri Lankan epidemic DENV-1 strain may have traveled directly or indirectly from Thailand through China to Sri Lanka, and after spreading within the Sri Lankan population, it traveled to Pakistan and Singapore. Our findings delineate the dissemination route of a virulent DENV-1 strain in Asia. Understanding such routes will be of particular importance to global control efforts.

  7. 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.

  8. Epidemic dynamics on complex networks

    Institute of Scientific and Technical Information of China (English)

    ZHOU Tao; FU Zhongqian; WANG Binghong

    2006-01-01

    Recently, motivated by the pioneer work in revealing the small-world effect and scale-free property of various real-life networks, many scientists devote themselves to studying complex networks. One of the ultimate goals is to understand how the topological structures affect the dynamics upon networks. In this paper, we give a brief review on the studies of epidemic dynamics on complex networks, including the description of classical epidemic models, the epidemic spread on small-world and scale-free networks, and network immunization. Finally, perspectives and some interesting problems are proposed.

  9. Epidemic Diffusion on Complex Networks

    Institute of Scientific and Technical Information of China (English)

    WU Xiao-Yan; LIU Zong-Hua

    2007-01-01

    Boyh diffusion and epidemic are well studied in the stochastic systems and complex networks,respetively.Here we combine these two fields and study epidemic diffusion in complex networks.Instead of studying the threshold of infection,which was focused on in previous works,we focus on the diffusion.behaviour.We find that the epidemic diffusion in a complex network is an anomalous superdiffusion with varyingg diffusion exponext γand that γ is influenced seriously by the network structure,such as the clustering coefficient and the degree distribution.Numerical simulations have confirmed the theoretical predictions.

  10. 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.

  11. Human mobility and epidemic invasion

    Science.gov (United States)

    Colizza, Vittoria

    2010-03-01

    The current H1N1 influenza pandemic is just the latest example of how human mobility helps drive infectious diseases. Travel has grown explosively in the last decades, contributing to an emerging complex pattern of traffic flows that unfolds at different scales, shaping the spread of epidemics. Restrictions on people's mobility are thus investigated to design possible containment measures. By considering a theoretical framework in terms of reaction-diffusion processes, it is possible to study the invasion dynamics of epidemics in a metapopulation system with heterogeneous mobility patterns. The system is found to exhibit a global invasion threshold that sets the critical mobility rate below which the epidemic is contained. The results provide a general framework for the understanding of the numerical evidence from detailed data-driven simulations that show the limited benefit provided by travel flows reduction in slowing down or containing an emerging epidemic.

  12. Epidemic cholera spreads like wildfire

    Science.gov (United States)

    Roy, Manojit; Zinck, Richard D.; Bouma, Menno J.; Pascual, Mercedes

    2014-01-01

    Cholera is on the rise globally, especially epidemic cholera which is characterized by intermittent and unpredictable outbreaks that punctuate periods of regional disease fade-out. These epidemic dynamics remain however poorly understood. Here we examine records for epidemic cholera over both contemporary and historical timelines, from Africa (1990-2006) and former British India (1882-1939). We find that the frequency distribution of outbreak size is fat-tailed, scaling approximately as a power-law. This pattern which shows strong parallels with wildfires is incompatible with existing cholera models developed for endemic regions, as it implies a fundamental role for stochastic transmission and local depletion of susceptible hosts. Application of a recently developed forest-fire model indicates that epidemic cholera dynamics are located above a critical phase transition and propagate in similar ways to aggressive wildfires. These findings have implications for the effectiveness of control measures and the mechanisms that ultimately limit the size of outbreaks.

  13. 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...... epidemic failure resolution is proposed. The results provide important input to service recovery mechanisms under epidemic failures....

  14. 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.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    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......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...

  16. A patient with systemic lupus erythematosus and lupus nephritis: A 12-year follow-up

    Directory of Open Access Journals (Sweden)

    Jovanović Nataša

    2011-01-01

    Full Text Available Introduction. Systemic lupus erythematosus (SLE is a chronic immunological disease causing a significant morbidity and mortality in younger women and involving several organs and systems, most often the kidneys, being consequently the incidence of lupus nephritis (LN about 60%. Case report. We reported a 57 year-old patient with the diagnosed SLE in 1995. Pathohistological analysis of kidney biopsy revealed LN type V. The patient was treated with corticosteroid pulses and azathioprine during one year. A remission was achieved and maintained with prednisone, 15 mg daily. Nephrotic relapse was diagnosed in 2006 and the second kidney biopsy revealed recent kidney infarction due to extensive vasculitis. Soon, a cerebrovascul insult developed and CT-scan revealed endocranial infarctus. The patient was treated with corticosteroids and cyclophosphamide pulses (totally VI monthly pulses, and also with low-molecular heparine, anticoagulants and salicylates because of the right leg phlebothrombosis. After the pulses, the patient was adviced to take prednisone 20 mg daily and azothioprine 100 mg daily, and 6 months later mycophenolate mofetil because of persistent active serological immunological findings (ANA 1 : 320 and nephrotic syndrome. Mycophenolate mofetil was efficient in inducing and maintaining remission of nephrotic syndrome. Conclusion. The aim of LN treatment is to achieve and maintain remission, improve patients’ outcome, reduce the toxicity of immunosuppressive drugs and the incidence of relapses. Mycophenolate mofetil was shown to be efficient in inducing and maintaining remission of nephrotic syndrome in the frame of LN.

  17. 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.

  18. [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.

  19. 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.].

  20. Status of vaccines for porcine epidemic diarrhea virus in the United States and Canada

    Science.gov (United States)

    In 2013, porcine epidemic diarrhea virus (PEDV) emerged in the United States as a rapidly spreading epidemic causing dramatic death losses in suckling piglets. Neonatal piglets are most vulnerable to clinical disease and their only protection is passive immunity from their dam. At the end of the thi...

  1. Evolutionary genomics of epidemic and nonepidemic strains of Pseudomonas aeruginosa.

    Science.gov (United States)

    Dettman, Jeremy R; Rodrigue, Nicolas; Aaron, Shawn D; Kassen, Rees

    2013-12-24

    Pseudomonas aeruginosa is an opportunistic pathogen of humans and is a major cause of morbidity and mortality in patients with cystic fibrosis (CF). Prolonged infection of the respiratory tract can lead to adaptation of the pathogen to the CF lung environment. To examine the general patterns of adaptation associated with chronic infection, we obtained genome sequences from a collection of P. aeruginosa isolated from airways of patients with CF. Our analyses support a nonclonal epidemic population structure, with a background of unique, recombining genotypes, and the rare occurrence of successful epidemic clones. We present unique genome sequence evidence for the intercontinental spread of an epidemic strain shared between CF clinics in the United Kingdom and North America. Analyses of core and accessory genomes identified candidate genes and important functional pathways associated with adaptive evolution. Many genes of interest were involved in biological functions with obvious roles in this pathosystem, such as biofilm formation, antibiotic metabolism, pathogenesis, transport, reduction/oxidation, and secretion. Key factors driving the adaptive evolution of this pathogen within the host appear to be the presence of oxidative stressors and antibiotics. Regions of the accessory genome unique to the epidemic strain were enriched for genes in transporter families that efflux heavy metals and antibiotics. The epidemic strain was significantly more resistant than nonepidemic strains to three different antibiotics. Multiple lines of evidence suggest that selection imposed by the CF lung environment has a major influence on genomic evolution and the genetic characteristics of P. aeruginosa isolates causing contemporary infection.

  2. The safety and efficacy of MMF in lupus nephritis: a pilot study.

    Science.gov (United States)

    Kingdon, E J; McLean, A G; Psimenou, E; Davenport, A; Powis, S H; Sweny, P; Burns, A

    2001-01-01

    Inducing and maintaining remission in patients with lupus nephritis may be difficult. Current treatments have significant toxicity. Mycophenolate mofetil (MMF) limits damage in murine models of lupus nephritis. We have assessed the efficacy and tolerability of MMF in the treatment of patients with long-standing or resistant lupus nephritis. We have treated 13 patients with biopsy proven lupus nephritis (two membranous nephropathy, four membranous nephropathy with superimposed proliferative changes, seven with proliferative glomerulonephritis). All patients had relapsed on conventional treatment or there were pressing indications to minimise steroid dosage or avoid alkylating agents. Nine out of 13 were treated with MMF and prednisolone, 3/10 with MMF alone and 1/10 with MMF, prednisolone and cyclosporine. Thirteen patients were treated with MMF for up to 37 months (median 25 months). Three patients were withdrawn from MMF during the first 8 months of treatment. The remainder tolerated MMF (median dose 1 g/day). Serological improvements were observed in 9/13 and steroid dosage was reduced in 8/10 patients. Infections occurred in 3/13. One patient relapsed. MMF significantly reduced the rate of decline of renal function. MMF should be considered in the treatment of long-standing or resistant lupus nephritis. Controlled clinical trials are required to confirm these findings.

  3. Obstetric nephrology: lupus and lupus nephritis in pregnancy.

    Science.gov (United States)

    Stanhope, Todd J; White, Wendy M; Moder, Kevin G; Smyth, Andrew; Garovic, Vesna D

    2012-12-01

    SLE is a multi-organ autoimmune disease that affects women of childbearing age. Renal involvement in the form of either active lupus nephritis (LN) at the time of conception, or a LN new onset or flare during pregnancy increases the risks of preterm delivery, pre-eclampsia, maternal mortality, fetal/neonatal demise, and intrauterine growth restriction. Consequently, current recommendations advise that the affected woman achieve a stable remission of her renal disease for at least 6 months before conception. Hormonal and immune system changes in pregnancy may affect disease activity and progression, and published evidence suggests that there is an increased risk for a LN flare during pregnancy. The major goal of immunosuppressive therapy in pregnancy is control of disease activity with medications that are relatively safe for a growing fetus. Therefore, the use of mycophenolate mofetil, due to increasing evidence supporting its teratogenicity, is contraindicated during pregnancy. Worsening proteinuria, which commonly occurs in proteinuric renal diseases toward the end of pregnancy, should be differentiated from a LN flare and/or pre-eclampsia, a pregnancy-specific condition clinically characterized by hypertension and proteinuria. These considerations present challenges that underscore the importance of a multidisciplinary team approach when caring for these patients, including a nephrologist, rheumatologist, and obstetrician who have experience with these pregnancy-related complications. This review discusses the pathogenesis, maternal and fetal risks, and management pertinent to SLE patients with new onset or a history of LN predating pregnancy.

  4. Trauma- related xanthogranulomatous interstitial nephritis:a clinicopathological analysis

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the pathogenesis, exact nature, histologic feature of xanthogranulomatous interstitial nephritis (XGIN) as well as its significance in clinical medicine.Methods: The medical histories concerned were collected with diagnostic images including CT scanning,ultrasonography, intravenous urography ( IVU ) and laboratory data being synthesized by comparison with what was discovered during operations and pathologic examinations.Results: All patients were ever struck on their loins or backs by blunt violence over 4-12 years. The diseases were dinically diagnosed as "renal cancer" before, during and after operations, and treated with radical nephrectomy. Located at cortical parts, the tumor focus had penetrated the renal capsules and invaded other organs. However, immunohistochemistry demonstrated that the lesions were xanthogranulomas, not tumors, in which there were stacks of foam cells and lymphocytes with vast extends of fibrotic tissues obliterating the cortical interstitial structures. Urinary tracts yielded no bacterium,obstruction or calculus.Conclusions: XGIN is likely to be one kind of immunologic mediated granuloma following blunt renal trauma. It is imperative to clarify pathogenesis and character of this lesion so as to find out any approach to diagnosis and cure of such an unusual nephropathy.

  5. Severe Necrotizing Adenovirus Tubulointerstitial Nephritis in a Kidney Transplant Recipient

    Directory of Open Access Journals (Sweden)

    Ravi Parasuraman

    2013-01-01

    Full Text Available Adenoviruses (AdV are emerging pathogens with a prevalence of 11% viruria and 6.5% viremia in kidney transplant recipients. Although AdV infection is common, interstitial nephritis (ADVIN is rare with only 13 biopsy proven cases reported in the literature. We report a case of severe ADVIN with characteristic histological features that includes severe necrotizing granulomatous lesion with widespread tubular basement membrane rupture and hyperchromatic smudgy intranuclear inclusions in the tubular epithelial cells. The patient was asymptomatic at presentation, and the high AdV viral load (quantitative PCR>2,000,000 copies/mL in the urine and 646,642 copies/mL in the serum confirmed the diagnosis. The patient showed excellent response to a combination of immunosuppression reduction, intravenous cidofovir, and immunoglobulin therapy resulting in complete resolution of infection and recovery of allograft function. Awareness of characteristic biopsy findings may help to clinch the diagnosis early which is essential since the disseminated infection is associated with high mortality of 18% in kidney transplant recipients. Cidofovir is considered the agent of choice for AdV infection in immunocompromised despite lack of randomized trials, and the addition of intravenous immunoglobulin may aid in resolution of infection while help prevention of rejection.

  6. 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.

  7. Value of repeat biopsy in lupus nephritis flares

    Science.gov (United States)

    Greloni, G; Scolnik, M; Marin, J; Lancioni, E; Quiroz, C; Zacariaz, J; De la Iglesia Niveyro, P; Christiansen, S; Pierangelo, M A; Varela, C F; Rosa-Diez, G J; Catoggio, L J; Soriano, E R

    2014-01-01

    Objectives Renal flares are common in lupus nephritis (LN), and class switch is thought to be characteristic. There is no agreement on indications for performing a repeat renal biopsy. Our objective was to retrospectively review patients who had more than one renal biopsy performed on clinical indications, and analyse clinical, pathological and treatment changes after successive biopsies. Methods Forty-five patients with LN and one or more repeat renal biopsies were included, with a total of 116 biopsies. Results Of the 71 repeat biopsies, pathological transition occurred in 39 (54.9%). When having a previous biopsy with a proliferative lesion, class switch occurred in 55.6%, with 24.4% evolving into non-proliferative classes. When previous biopsy was class V, transition to other classes occurred in 58.3% and changes were all into proliferative classes. Conversion from one pure proliferative form to another (class III to class IV or vice versa) happened in 11.3% of the rebiopsies, with 62 rebiopsies (87.3%) leading to a change in the treatment regimen. Conclusions Histological transformations were common, and they occurred when the previous biopsy had non-proliferative lesions as well as when lesions were proliferative. Treatments were modified after repeat renal biopsy in the majority of patients. In this experience, kidney repeat biopsies were useful in guiding treatment of LN flares. PMID:25396056

  8. Rituximab in the treatment of refractory lupus nephritis with vasculitis

    Directory of Open Access Journals (Sweden)

    Huseyin Kadikoy

    2012-01-01

    Full Text Available Dysfunction of the B lymphocyte, an important component of adaptive immunity, is thought to be important in the pathogenesis of lupus nephritis (LN. There are several novel strategies emerging including B-cell depletion by the monoclonal antibodies to B-cell markers, rituximab. We describe an unusual clinical response of a 22-year-old Hispanic woman with class IV LN with vasculitis while on dialysis to cyclophosphamide (CY and adjunct rituximab. The patient had a history of class III/V LN and was treated with nine months of CY and maintenance therapy with mycophenolate mofetil (MMF for three years. While on MMF, the patient deve-loped class IV LN with vasculitis leading to end-stage renal disease (ESRD. While the patient was on peritoneal dialysis, the patient was treated with two doses of rituximab and six doses of intravenous CY. The patient responded to this regimen and recovered kidney function within four months. The kidney function remained stable nine months after discontinuing peritoneal dialysis.

  9. Advances in the care of children with lupus nephritis.

    Science.gov (United States)

    Wenderfer, Scott E; Ruth, Natasha M; Brunner, Hermine I

    2017-01-04

    The care of children with lupus nephritis (LN) has changed dramatically over the past 50 y. The majority of patients with childhood-onset systemic lupus erythematosus (cSLE) develop LN. In the 1960's, prognosis in children was worse than in adults; therapies were limited and toxic. Nearly half of cases resulted in death within 2 y. Since this time, several diagnostic recommendations and disease-specific indices have been developed to assist physicians caring for patients with LN. Pediatric researchers are validating and adapting these indices and guidelines for the treatment of LN in cSLE. Classification systems, activity, and chronicity indices for kidney biopsy have been validated in pediatric cohorts in several countries. Implementation of contemporary immunosuppressive agents has reduced treatment toxicity and improved outcomes. Biomarkers sensitive to LN in children have been identified in the kidney, urine, and blood. Multi-institutional collaborative networks have formed to address the challenges of pediatric LN research. Considerable variation in evaluation and treatment has been addressed for proliferative forms of LN by development of consensus treatment practices. Patient survival at 5 y is now 95-97% and renal survival exceeds 90%. Moreover, international consensus exists for quality indicators for cSLE that consider the unique aspects of chronic disease in childhood.Pediatric Research (2017); doi:10.1038/pr.2016.247.

  10. 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

  11. 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)....

  12. Epidemic Law of Cassava Brown Leaf Spot Caused by Passalora henningsii in the Red River Basin of Yunnan Province%云南红河流域木薯褐斑病流行规律初步研究

    Institute of Scientific and Technical Information of China (English)

    张光勇; 黄绍中; 陈伟强; 孙寅虎; 张建春; 邓成菊; 李芹; 刘学敏; 杨绍琼; 王晓燕

    2016-01-01

    采用系统观察方法对红河流域木薯主产区木薯褐斑病发生和流行规律进行研究,结果表明:病害在木薯生长前期5月份开始发病,生长中、后期的7月份后病情呈明显上升,9、10月份达到最高峰,危害率达100%,病情指数20.50~30.77;下游区域的病情>中游>上游,病情的周年消长和区域性差异主要是降雨量和湿度的影响;高海拔区域(350~400 m)病情高于低海拔区域(250~300 m),这与高海拔区域气温相对偏低有关。%The occurrence and epidemic law of cassava Brown Leaf Spot were studied through systematic observation. The re-sults indicated that this disease appeared in the early stage of growth in May, and significantly become more seriously in the middle and late growth stage in July, finally to the peak in September and October, with 100% of infection. The disease index ranged in 20.50 to 30.77. It was found that the disease was getting worse from upstream, the middle segment to the down-stream of this basin. The rainfall and humidity have greatly effect on the dynamics of the disease in a year. Why there are more serious disease at high altitude of 350 to 400 m than that of at altitude of 250 to 300 m, just because of the low temperature.

  13. Epidemic spreading by objective traveling

    Science.gov (United States)

    Tang, Ming; Liu, Zonghua; Li, Baowen

    2009-07-01

    A fundamental feature of agent traveling in social networks is that traveling is usually not a random walk but with a specific destination and goes through the shortest path from starting to destination. A serious consequence of the objective traveling is that it may result in a fast epidemic spreading, such as SARS etc. In this letter we present a reaction-traveling model to study how the objective traveling influences the epidemic spreading. We consider a random scale-free meta-population network with sub-population at each node. Through a SIS model we theoretically prove that near the threshold of epidemic outbreak, the objective traveling can significantly enhance the final infected population and the infected fraction at a node is proportional to its betweenness for the traveling agents and approximately proportional to its degree for the non-traveling agents. Numerical simulations have confirmed the theoretical predictions.

  14. Reemergence of enterovirus 71 epidemic in northern Taiwan, 2012.

    Directory of Open Access Journals (Sweden)

    Shu-Ting Luo

    Full Text Available Enterovirus 71 (EV71 belongs to picornavirus family and could be classified phylogenetically into three major genogroups (A, B and C including 11 genotypes (A, B1-B5 and C1-C5. Since 1997, EV71 has caused large-scale of epidemics with neurological complications in Asian children. In Taiwan, nationwide EV71 epidemics with different predominant genotypes have occurred cyclically since 1998. A nationwide EV71 epidemic occurred again in 2012. We conducted genetic and antigenic characterizations of the 2012 epidemic.Chang Gung Memorial Hospital (CGMH is a medical center in northern Taiwan. In CGMH, specimens were collected from pediatric inpatients with suspected enterovirus infections for virus isolation. Enterovirus isolates were serotyped and genotyped and sera from EV71 inpatients were collected for measuring neutralizing antibody titers.There were 10, 16 and 99 EV71 inpatients identified in 2010, 2011 and 2012, respectively. There were 82 EV71 isolates genotyped, which identified 17 genotype C4a viruses and 65 genotype B5 viruses. The genotype B5 viruses were not detected until November 2011 and caused epidemics in 2012. Interestingly, the B5-2011 viruses were genetically distinguishable from the B5 viruses causing the 2008 epidemic and are likely introduced from China or Southeastern Asia. Based on antigenic analysis, minor antigenic variations were detected among the B5-2008, B5-2011, C4a-2008 and C4a-2012 viruses but these viruses antigenically differed from genotype A.Genotype B5 and C4a viruses antigenically differ from genotype A viruses which have disappeared globally for 30 years but have been detected in China since 2008. Enterovirus surveillance should monitor genetic and antigenic variations of EV71.

  15. Potato late blight epidemics and population structure of Phytophthora infestans.

    NARCIS (Netherlands)

    Zwankhuizen, M.J.

    1998-01-01

    Potato late blight is caused by the fungus Phytophthora infestans . To study the relative importance of oospores in the epidemiology, and to estimate the relative impact of various infection sources, late blight epidemics in Southern Flevoland (The Netherlands) were studied using epidemiological and

  16. Development of Reversible Posterior Leukoencephalopathy Syndrome after Cyclophosphamide Treatment in a Patient with Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Serkan YILDIZ

    2011-01-01

    Full Text Available Renal involvement in systemic lupus erythematosus is a frequent and serious complication that significantly increases morbidity and mortality. Despite all studies and usage of new drugs, treatment of lupus nephritis continues to be a problem. Diffuse proliferative lupus nephritis has a poor prognosis and aggressive treatment must be undertaken. Cyclophosphamide is commonly used in treatment despite its side effects. Reversible posterior leucoencephalopathy syndrome is a clinico-radiological syndrome manifested by blood pressure elevation, headache, visual disturbances, confusion, seizures and sometimes focal neurological signs that can develop due to usage of cytotoxic drugs. We present a case of lupus nephritis in which reversible posterior leucoencephalopathy syndrome developed after intravenous cyclophosphamide administration and recovered spontaneously by symptomatic treatment in this article.

  17. 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.

  18. 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.

  19. CHEMICAL VERSUS SERUM TREATMENT OF EPIDEMIC MENINGITIS.

    Science.gov (United States)

    Flexner, S; Amoss, H L

    1916-05-01

    of meningococci, and neither possesses antitoxic power. The mixture of antiserum with lysol and with protargol reduces to a certain extent the antileukotactic and antiphagocytic effect of the chemicals; but this action is insufficient to set aside wholly the injurious effects which they produce. It follows, therefore, that whatever theoretical advantages might accrue from a bactericidal activity exerted by these chemicals independently of the type of meningococcus causing epidemic meningitis, is more than offset by the harmful effects which they cause. Hence specific antiserum seems to provide the logical therapeutic agent with which to combat epidemic meningitis, since it is itself innocuous and promotes those processes essential to recovery from the disease. The problem up to the present has been that of producing an antiserum which represents the several types of the meningococcus, and this problem is now in a fair way to being solved.

  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. Interstitial nephritis with moderate-to-heavy proteinuria: An unusual combination

    Directory of Open Access Journals (Sweden)

    Biplab Ghosh

    2012-01-01

    Full Text Available Interstitial nephritis with proteinuria >1 g/day is uncommon and almost always the result of drug-induced ATIN with an associated minimal change glomerulonephritis (GN. Here, we present a series of five unusual cases of interstitial nephritis without GN but with proteinuria >1 g/day, and they were identified from renal biopsies done from February 2008 to March 2009. Out of 236 patients who underwent renal biopsy, only five met the inclusion criteria. Three patients presented with edema and two with oliguria, while none had frank hematuria, fever, arthralgia, skin rash or history of exposure to nonsteroidal antiinflamatory drugs, analgesics, anti-biotics, allopurinol, or Chinese herb before presentation. Urinalysis revealed hematuria in two patients, pyuria in three and nephrotic range proteinuria in two. All had normal complement levels and were negative for antinuclear antibodies, Anti-dsDNA antibody, and antineutrophil cyto-plasmic antibodies. Clinical diagnosis was nephrotic syndrome in two patients, the third had diagnosis of rapidly progressive GN, the fourth had HIV associated nephropathy, and the fifth had unexplained advanced renal failure. Though three patients had renal dysfunction only one required dialysis. Light microscopy of renal biopsies revealed granulomatous interstitial nephritis in three patients and small vessel vasculitis in two of them. One patient had nongranulomatous interstitial nephritis along with vasculitis. Acute interstitial nephritis was the only finding in one patient. In conclusion, patients with interstitial nephritis can present with moderate-to-heavy proteinuria probably due to cytokine-like permeability increasing factor secreted by inflammatory cells in the interstitium.

  2. Battling the Obesity Epidemic.

    Science.gov (United States)

    Kelly, Mark; Moag-Stahlberg, Alicia

    2002-01-01

    Describes causes of overweight and obesity in children; cites research linking good nutrition and a child's capacity to learn; includes six Web-based links to resources to help principals and teachers reduce the serious problem of overweight and obese children. (PKP)

  3. History, Epidemic Evolution, and Model Burn-In for a Network of Annual Invasion: Soybean Rust.

    Science.gov (United States)

    Sanatkar, M R; Scoglio, C; Natarajan, B; Isard, S A; Garrett, K A

    2015-07-01

    Ecological history may be an important driver of epidemics and disease emergence. We evaluated the role of history and two related concepts, the evolution of epidemics and the burn-in period required for fitting a model to epidemic observations, for the U.S. soybean rust epidemic (caused by Phakopsora pachyrhizi). This disease allows evaluation of replicate epidemics because the pathogen reinvades the United States each year. We used a new maximum likelihood estimation approach for fitting the network model based on observed U.S. epidemics. We evaluated the model burn-in period by comparing model fit based on each combination of other years of observation. When the miss error rates were weighted by 0.9 and false alarm error rates by 0.1, the mean error rate did decline, for most years, as more years were used to construct models. Models based on observations in years closer in time to the season being estimated gave lower miss error rates for later epidemic years. The weighted mean error rate was lower in backcasting than in forecasting, reflecting how the epidemic had evolved. Ongoing epidemic evolution, and potential model failure, can occur because of changes in climate, host resistance and spatial patterns, or pathogen evolution.

  4. Fungal granulomatous interstitial nephritis presenting as acute kidney injury diagnosed by renal histology including PCR assay.

    Science.gov (United States)

    Ogura, Makoto; Kagami, Shino; Nakao, Masatsugu; Kono, Midori; Kanetsuna, Yukiko; Hosoya, Tatsuo

    2012-10-01

    We describe two cases of fungal granulomatous interstitial nephritis (GIN) presenting as acute kidney injury (AKI). Increased serum creatinine was detected in Patient 1 after chemotherapy for pharyngeal cancer and in Patient 2 after steroid pulse therapy for bronchial asthma. Renal histology of both patients revealed GIN. Polymerase chain reaction (PCR)-based detection of fungal DNA sequences from kidney tissue demonstrated Trichosporon laibachii and Candida albicans, respectively. When AKI occurs in an immunocompromised host, differential diagnosis of fungal interstitial nephritis should be considered. Furthermore, PCR-based detection of fungal DNA sequences from renal specimens can be useful for rapid diagnosis.

  5. Absence of epidemic thresholds in a growing adaptive network

    CERN Document Server

    Demirel, Güven

    2012-01-01

    The structure of social contact networks strongly influences the dynamics of epidemic diseases. In particular the scale-free structure of real-world social networks allows unlikely diseases with low infection rates to spread and become endemic. However, in particular for potentially fatal diseases, also the impact of the disease on the social structure cannot be neglected, leading to a complex interplay. Here, we consider the growth of a network by preferential attachment from which nodes are simultaneously removed due to an SIR epidemic. We show that increased infectiousness increases the prevalence of the disease and simultaneously causes a transition from scale-free to exponential topology. Although a transition to a degree distribution with finite variance takes place, the network still exhibits no epidemic threshold in the thermodynamic limit. We illustrate these results using agent-based simulations and analytically tractable approximation schemes.

  6. Epidemic spreading on dual-structure networks with mobile agents

    Science.gov (United States)

    Yao, Yiyang; Zhou, Yinzuo

    2017-02-01

    The rapid development of modern society continually transforms the social structure which leads to an increasingly distinct dual structure of higher population density in urban areas and lower density in rural areas. Such structure may induce distinctive spreading behavior of epidemics which does not happen in a single type structure. In this paper, we study the epidemic spreading of mobile agents on dual structure networks based on SIRS model. First, beyond the well known epidemic threshold for generic epidemic model that when the infection rate is below the threshold a pertinent infectious disease will die out, we find the other epidemic threshold which appears when the infection rate of a disease is relatively high. This feature of two thresholds for the SIRS model may lead to the elimination of infectious disease when social network has either high population density or low population density. Interestingly, however, we find that when a high density area is connected to a low density may cause persistent spreading of the infectious disease, even though the same disease will die out when it spreads in each single area. This phenomenon indicates the critical role of the connection between the two areas which could radically change the behavior of spreading dynamics. Our findings, therefore, provide new understanding of epidemiology pertinent to the characteristic modern social structure and have potential to develop controlling strategies accordingly.

  7. 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.

  8. Effects and mechanism of Tripterygium wilfordii on chronic glomerulo nephritis.

    Science.gov (United States)

    Pei, W Y; Yang, C H; Zhang, X L

    2016-02-05

    The objective of this study was to investigate the clinical effects of Tripterygium wilfordii on chronic glomerulo nephritis (CGN) and its mechanisms. Eighty-two cases of CGN treated in our hospital were randomly divided into observation and control groups. The control group was treated with conventional western medicine, and the observation group was treated with conventional western medicine and orally-administered T. wilfordii pills for three courses of treatment, each consisting of 4 weeks. Changes in serum reatinine, blood urea nitrogen, blood total cholesterol, blood albumin, and 24-h urine protein were observed. The levels of peripheral tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined with enzyme-linked immunosorbent assay. The curative effects of both groups were evaluated respectively. Both groups had significantly improved serum creatinine, blood urea nitrogen, blood total cholesterol, blood albumin, and 24-h urine protein (P < 0.05), and the observation group exhibited a more significant improvement (P < 0.05). TNF-α and IL-6 levels in both groups obviously decreased (P < 0.05), and the observation group exhibited remarkable changes (P < 0.05). After treatment, the total efficiency of the observation group was 90.24%, which was significantly higher than the 73.17% of the control group (P < 0.05). In conclusion, T. wilfordii can significantly improve kidney function and clinical symptoms in CGN patients, and the mechanism is possibly related to its inhibition of the secretion of TNF-α and IL-6.

  9. A Clinicopathological Study of Lupus Nephritis in Children

    Directory of Open Access Journals (Sweden)

    Ahmadzadeh Ali

    2008-01-01

    Full Text Available To assess clinical characteristics, pathological findings, and therapeutic response in children with lupus nephritis (LN, we retrospectively studied 25 children under 16 years of age with LN at the Abozar children′s hospital from 1995 to 2006. The study included 13(65% girls and 7(35% boys. The mean age at the time of diagnosis of SLE was 10.2 (± 4.8 years. Eighteen patients (90% were more than 8 years old. Sixty percent of the patients presented as nephritic-nephrotic syndrome. All the patients underwent percutaneous renal biopsy and were followed up for at least 36 months. The clinical and serologic parameters at the time of renal biopsy were recorded. Twenty patients were treated with the following regimens: one (class I with low dose prednisone, 7 (class II, III with high-dose of prednisone, 12 (class IV with high-dose prednisone plus 13 intermittent intravenous cyclophosphamide (CTX pulses (monthly for 6 months and then every 3 months, followed by mycophenolate mofetil (MMF as maintenance therapy. Remission was achieved in 17 (85% cases; one required hemodialysis and 2 died due to renal failure and central nervous system involvement. Among 12 cases with class IV, 11 responded to prednisone and intravenous CTX pulses. We conclude that i.v. pulses of CTX induced clinical remission of renal disease in the majority of children with severe LN. MMF maintenance therapy was effective after induction of remission in refractory cases. However, this study was performed in a small number of subjects, further studies to confirm the long-term efficacy and safety of CTX pulse therapy on larger numbers of patients are warranted.

  10. 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.

  11. 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.

  12. 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...

  13. 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 wit...

  14. Association of Drought with Typhus Epidemics in Central Mexico

    Science.gov (United States)

    Acuna-Soto, R.; Stahle, D.; Villanueva Diaz, J.; Therrell, M.

    2007-05-01

    Typhus is an acute infectious disease caused by the bacteria Rickettsia prowazekii, which is transmitted among humans by the body lice (Pediculus humanus corporis). The disease is highly contagious and transmission is favored in populations living in crowded conditions. Under these circumstances, typhus transmission is facilitated by factors that favor the colonization and proliferation of body lice such as absence of personal hygiene and wearing the same clothes for long periods of time. Historically, periods of war and famine were associated with devastating epidemics with high mortality rates in many parts of the world. Central Mexico has a long record of typhus epidemics. In this region, at > 2000 meters above sea level, the disease was endemic and occurred with a seasonal pattern in winter, with occasional large epidemics. Recently, we completed a chronology of epidemics in Mexico. A total of 22 well-defined major typhus epidemics were identified between 1650 and 1920. All of them caused periods of increased mortality that lasted 2 - 4 years (more than one standard deviation from the previous ten year period). The record of typhus epidemics was evaluated against the tree-ring record of Cuauhtmoc La Fragua, Puebla. This chronology, based on Douglas fir, has demonstrated to be a faithful record of precipitation in central Mexico. The results indicate that a statistically significant drought (t test, p < .05) prevailed during the first year of all 22 large outbreaks of typhus in recent Mexican history. No distinction is made between times of peace and war. This indicates that drought alone was capable of inducing the social conditions for increased transmission of typhus in pre-industrial central Mexico.

  15. Epidemics spreading in interconnected complex networks

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Y. [School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore 639798 (Singapore); Institute of High Performance Computing, Agency for Science, Technology and Research (A-STAR), Singapore 138632 (Singapore); Xiao, G., E-mail: egxxiao@ntu.edu.sg [School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore 639798 (Singapore)

    2012-09-03

    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.

  16. 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.

  17. Anti-dsDNA negative and anti-Ro positive lupus nephritis: a report of a rare case.

    Science.gov (United States)

    Jain, D; Aggarwal, H K; Kaverappa, V; Dhayia, S; Jain, P; Yadav, S

    2014-03-17

    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. Our patient presented with a rash resembling malar rash and features of nephrotic syndrome. On investigating, patient was found to have pancytopenia, raised erythrocyte sedimentation rate and depressed serum C3 levels with positivity of antinuclear antibodies and anti- Ro antibodies. However, most of the markers of lupus nephritis including anti dsDNA antibody were negative. Renal biopsy showed features of lupus nephritis (class-IV). Differential item functioning studies showed a full house immunoflourescence staining pattern characteristic of lupus nephritis. Association of Anti-Ro antibody alone with lupus nephritis is less known in literature. Negativity of anti-dsDNA antibody, which is usually considered to be diagnostic of lupus nephritis, poses a diagnostic dilemma short of renal biopsy. Till date only very few cases of non-drug induced lupus nephritis with negative dsDNA antibodies have been reported. In this report we wish to highlight a case of lupus nephritis which was negative for its specific anti dsDNA antibodies and with possible role of anti-Ro antibodies in the pathogenesis of lupus nephritis although the underlying mechanism is incompletely understood.

  18. 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

  19. 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.

  20. Ibuprofen-induced Henoch–Schönlein purpura nephritis: First reported case

    Directory of Open Access Journals (Sweden)

    Christopher Lim Thiam Seong

    2016-01-01

    Full Text Available Ibuprofen is a nonsteroidal anti-inflammatory drug that is used widely in treating pain, fever, and inflammation. Its side effects are mainly due to acute renal impairment and gastric discomfort. We hereby report a rare case of Henoch–Schönlein purpura nephritis secondary to ibuprofen consumption which has not been reported in literature before.

  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

    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...

  2. Steroid-dependent nephrotic syndrome in lupus nephritis. Response to chlorambucil.

    Science.gov (United States)

    Abuelo, J G; Esparza, A R; Garella, S

    1984-12-01

    Nephrotic syndrome associated with mesangial lupus nephritis developed in a young woman. The heavy proteinuria exhibited a striking steroid-dependent course during a three-year period of time, with ten relapses occurring whenever attempts were made to withdraw prednisone therapy. A prolonged remission was induced by the administration of chlorambucil.

  3. 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

  4. Macrophage Chemotaxis in Anti-tubular Basement Membrane-Induced Interstitial Nephritis in Guinea Pigs

    NARCIS (Netherlands)

    Kennedy, Thomas L.; Merrow, Martha; Phillips, S. Michael; Norman, Michael; Neilson, Eric G.

    1985-01-01

    Interstitial renal lesions containing T cells and macrophages develop after 14 days in guinea pigs immunized to produce anti-tubular basement membrane-induced interstitial nephritis. We serially examined the renal venous and systemic arterial sera from such animals to determine if chemotactic factor

  5. Ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia in a patient with systemic lupus erythematosus and lupus nephritis

    OpenAIRE

    Akyol, Lütfi; Önem, Soner; Özgen, Metin; Sayarlıoğlu, Mehmet

    2015-01-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by several immunological abnormalities. We wish to communicate the case of a patient with SLE and lupus nephritis (LN) who developed pseudothrombocytopenia. Pseudothrombocytopenia can occur in patients with SLE and LN and should be considered when diagnosing patients with thrombocytopenia without bleeding.

  6. 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...

  7. 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

  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. Cystitis and interstitial nephritis related to the use of tiaprofenic acid (Surgam (TM))

    NARCIS (Netherlands)

    van Gameren, [No Value; Gokemeijer, JDM

    1997-01-01

    We describe a case of concurrent presentation of severe haemorrhagic cystitis and acute interstitial nephritis with eventually lethal outcome, associated with the use of tiaprofenic acid (Surgam(TM)), a propionic acid-derived non-steroidal anti-inflammatory drug (NSAID). Although interstitial nephri

  10. Presentations and outcome analysis of 205 adult patients with Henoch-Schnlein purpura nephritis

    Institute of Scientific and Technical Information of China (English)

    宣萍

    2014-01-01

    Objective To analyze the clinical,pathological data and outcomes of the adult patients with HenochSchnlein purpura nephritis(HSPN).Methods The data of 205 HSPN patients who were diagnosed in Kidney Disease Center of the First Affiliated Hospital of Zhejiang University betwee Jan 2004 and May 2013 were collected and analyzed in different groups.Results The average

  11. Multiple routes transmitted epidemics on multiplex networks

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Dawei [Information Security Center, State Key Laboratory of Networking and Switching Technology, Beijing University of Posts and Telecommunications, P.O. Box 145, Beijing 100876 (China); National Engineering Laboratory for Disaster Backup and Recovery, Beijing University of Posts and Telecommunications, Beijing 100876 (China); Shandong Provincial Key Laboratory of Computer Network, Shandong Computer Science Center, Jinan 250014 (China); Li, Lixiang [Information Security Center, State Key Laboratory of Networking and Switching Technology, Beijing University of Posts and Telecommunications, P.O. Box 145, Beijing 100876 (China); National Engineering Laboratory for Disaster Backup and Recovery, Beijing University of Posts and Telecommunications, Beijing 100876 (China); Peng, Haipeng, E-mail: penghaipeng@bupt.edu.cn [Information Security Center, State Key Laboratory of Networking and Switching Technology, Beijing University of Posts and Telecommunications, P.O. Box 145, Beijing 100876 (China); National Engineering Laboratory for Disaster Backup and Recovery, Beijing University of Posts and Telecommunications, Beijing 100876 (China); Luo, Qun; Yang, Yixian [Information Security Center, State Key Laboratory of Networking and Switching Technology, Beijing University of Posts and Telecommunications, P.O. Box 145, Beijing 100876 (China); National Engineering Laboratory for Disaster Backup and Recovery, Beijing University of Posts and Telecommunications, Beijing 100876 (China)

    2014-02-01

    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.

  12. The Role of Anti-DNA Antibodies in the Development of Lupus Nephritis: A Complementary, or Alternative, Viewpoint?

    Science.gov (United States)

    Goilav, Beatrice; Putterman, Chaim

    2015-09-01

    Kidney disease, or lupus nephritis, is the organ involvement that is most closely associated with specific autoantibodies in patients with SLE. The concept of anti-DNA antibodies being instrumental in the pathogenesis of lupus nephritis emerged ~50 years ago, and has been a topic of debate ever since. This article focuses on the description of the renal sub-cellular targets of nephritogenic autoantibodies and offers a counter-point opinion to the article by Pedersen et al. In addition, we provide an overview of some of the mechanisms by which anti-DNA antibodies bind to their renal targets and the pathogenic relevance to clinical nephritis.

  13. 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.

  14. Curing the noise epidemic

    Science.gov (United States)

    Mazer, Susan

    2005-09-01

    The argument is made that design does not stop when the fixed architectural and acoustical components are in place. Spaces live and breathe with the people who reside in them. Research and examples are presented that show that noise, auditory clutter, thrives on itself in hospitals. Application of the Lombard reflex studies fit into the hospital setting, but do not offer solutions as to how one might reduce the impact. In addition, the basis for looking at the noise component as a physical as well cultural dynamic will be addressed. Whether the result of the wrong conversation in the wrong place or the right conversation in an unfortunate place, talk mixed with sounds of technology is shown to cause its own symptoms. From heightened anxiety and stress to medical errors, staff burnout, or HIPAA violations, the case is made that noise is pandemic in hospitals and demands financial and operational investment. An explanation of how to reduce noise by design of the dynamic environment - equipment, technology, staff protocols is also provided.

  15. 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.

  16. Severe Nephrotoxic Nephritis following Conditional and Kidney-Specific Knockdown of Stanniocalcin-1.

    Directory of Open Access Journals (Sweden)

    Luping Huang

    Full Text Available Inflammation is the hallmark of nephrotoxic nephritis. Stanniocalcin-1 (STC1, a pro-survival factor, inhibits macrophages, stabilizes endothelial barrier function, and diminishes trans-endothelial migration of leukocytes; consistently, transgenic (Tg overexpression of STC1 protects from nephrotoxic nephritis. Herein, we sought to determine the phenotype of nephrotoxic nephritis after conditional and kidney-specific knockdown of STC1.We used Tg mice that, express either STC1 shRNA (70% knockdown of STC1 within 4d or scrambled shRNA (control upon delivery of Cre-expressing plasmid to the kidney using ultrasound microbubble technique. Sheep anti-mouse GBM antibody was administered 4d after shRNA activation; and mice were euthanized 10 days later for analysis.Serum creatinine, proteinuria, albuminuria and urine output were similar 10 days after anti-GBM delivery in both groups; however, anti-GBM antibody delivery to mice with kidney-specific knockdown of STC1 produced severe nephrotoxic nephritis, characterized by severe tubular necrosis, glomerular hyalinosis/necrosis and massive cast formation, while control mice manifested mild tubular injury and crescentic glomerulonephritis. Surprisingly, the expression of cytokines/chemokines and infiltration with T-cells and macrophages were also diminished in STC1 knockdown kidneys. Staining for sheep anti-mouse GBM antibody, deposition of mouse C3 and IgG in the kidney, and antibody response to sheep IgG were equal.nephrotoxic nephritis after kidney-specific knockdown of STC1 is characterized by severe tubular and glomerular necrosis, possibly due to loss of STC1-mediated pro-survival factors, and we attribute the paucity of inflammation to diminished release of cytokines/chemokines/growth factors from the necrotic epithelium.

  17. Urinary monocyte chemoattractant protein-1 as a biomarker of lupus nephritis activity in children.

    Science.gov (United States)

    Ghobrial, Emad E; El Hamshary, Azza A; Mohamed, Ashraf G; Abd El Raheim, Yomna A; Talaat, Ahmed A

    2015-01-01

    Systemic lupus erythematosus (SLE) is a life-long, life-limiting and multi-systemic autoimmune disease. Glomerulonephritis is one of the most serious manifestations of SLE. Younger children have an increased incidence, severity and morbidity of lupus nephritis (LN) compared with adult-onset disease. Monocyte chemoattractant protein-1 (MCP-1) enhances leukocyte adhesiveness and endothelial permeability in the kidneys of murine and human LN models. Our study aimed to assess the role of urinary MCP-1 in the early diagnosis of LN activity. Sixty children, of whom 45 children aged from six to 12 years old and of both sexes (15 SLE patients without nephritis, 15 active LN and 15 inactive LN) fulfilling the American College of Rheumatology Classification Criteria for SLE were studied in comparison with 15 healthy subjects. We investigated the serum and urinary MCP-1 in all groups using the enzyme-linked immunosorbent assay test. Urinary MCP-1 was significantly higher in active LN in comparison with inactive LN and controls, and also significantly higher in inactive LN in comparison with SLE without nephritis and controls. There was also a significant difference between SLE without nephritis and controls. Serum MCP-1 was significantly higher in the group with active LN in comparison with the inactive group and SLE without nephritis and controls, but there was no significant difference between SLE and controls. The urinary MCP-1 level correlated well with SLE disease activity as measured by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Urinary MCP-1 correlates positively with proteinuria, blood urea nitrogen level and creatinine and negatively with hemoglobin and creatinine clearance. We concluded that measurement of MCP-1 in urine may be useful for monitoring the severity of renal involvement in SLE. We recommend measuring urinary MCP-1 in pediatric SLE for the early diagnosis of LN and for the evaluation of the severity of renal involvement.

  18. Pro: The use of calcineurin inhibitors in the treatment of lupus nephritis.

    Science.gov (United States)

    Mok, Chi Chiu

    2016-10-01

    Renal disease in systemic lupus erythematosus (SLE) carries significant morbidity and mortality. Cyclophosphamide (CYC)- and mycophenolate mofetil (MMF)-based induction regimens are not ideal in terms of efficacy and toxicity. The adverse effects of CYC, such as infection risk, infertility, urotoxicity and oncogenicity, limit its use in lupus nephritis. Although MMF is non-inferior to CYC as induction therapy and has reduced gonadal toxicity and oncogenic potential, meta-analyses of clinical trials do not show a lower rate of infective and gastrointestinal complications. Tacrolimus (TAC) has recently been shown to have equal efficacy to either MMF or CYC for inducing remission of lupus nephritis. A low-dose combination of MMF and TAC appears to be more effective than intravenous CYC pulses in Chinese patients, and has potential to replace the more toxic CYC regimens in high-risk subgroups. TAC may be considered as another non-CYC alternative for induction therapy of lupus nephritis and in those with refractory disease or intolerance to CYC or MMF. TAC has no negative effect on fertility in younger women, and unlike MMF and CYC, it is safe in pregnancy. However, TAC has a narrow therapeutic window and drug level monitoring is required to ensure drug exposure and minimize acute toxicities. Current evidence for the efficacy of TAC in lupus nephritis is limited to 6 months and the incidence of renal flare after discontinuation of therapy or switching to azathioprine appears to be higher than other induction agents. Long-term data and the incidence of chronic nephrotoxicity of TAC as maintenance therapy in lupus nephritis are currently lacking and further prospective trials are needed to address these issues.

  19. 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...

  20. Spatiotemporal dynamics of the epidemic transmission in a predator-prey system.

    Science.gov (United States)

    Su, Min; Hui, Cang; Zhang, Yanyu; Li, Zizhen

    2008-11-01

    Epidemic transmission is one of the critical density-dependent mechanisms that affect species viability and dynamics. In a predator-prey system, epidemic transmission can strongly affect the success probability of hunting, especially for social animals. Predators, therefore, will suffer from the positive density-dependence, i.e., Allee effect, due to epidemic transmission in the population. The rate of species contacting the epidemic, especially for those endangered or invasive, has largely increased due to the habitat destruction caused by anthropogenic disturbance. Using ordinary differential equations and cellular automata, we here explored the epidemic transmission in a predator-prey system. Results show that a moderate Allee effect will destabilize the dynamics, but it is not true for the extreme Allee effect (weak or strong). The predator-prey dynamics amazingly stabilize by the extreme Allee effect. Predators suffer the most from the epidemic disease at moderate transmission probability. Counter-intuitively, habitat destruction will benefit the control of the epidemic disease. The demographic stochasticity dramatically influences the spatial distribution of the system. The spatial distribution changes from oil-bubble-like (due to local interaction) to aggregated spatially scattered points (due to local interaction and demographic stochasticity). It indicates the possibility of using human disturbance in habitat as a potential epidemic-control method in conservation.

  1. 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.

  2. A Longitudinal Analysis of Outcomes of Lupus Nephritis in an International Inception Cohort Using a Multistate Model Approach

    DEFF Research Database (Denmark)

    Hanly, John G; Su, Li; Urowitz, Murray B

    2016-01-01

    OBJECTIVE: To study bidirectional change and predictors of change in estimated glomerular filtration rate (GFR) and proteinuria in lupus nephritis (LN) using a multistate modeling approach. METHODS: Patients in the Systemic Lupus International Collaborating Clinics inception cohort were classifie...

  3. A Study on Clinical and Pathologic Features in Lupus Nephritis with Mainly IgA Deposits and a Literature Review

    OpenAIRE

    2013-01-01

    Objective. To study the clinical and pathologic features of systemic lupus erythematosus (SLE) that has atypical lupus nephritis (LN) with mainly IgA deposits. Methods. We searched the SLE patients who had nephritis with mainly IgA deposits in our hospital and selected the information including clinical manifestations, laboratory tests, treatments, and prognosis. Results. From January 2009 to June 2012, 5 patients were definitely diagnosed as SLE according to both 1982 and 2009 ACR classifica...

  4. 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+

  5. 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.

  6. 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 ...

  7. A social contagious model of the obesity epidemic

    Science.gov (United States)

    Huang, He; Yan, Zhijun; Chen, Yahong; Liu, Fangyan

    2016-11-01

    Obesity has been recognized as a global epidemic by WHO, followed by many empirical evidences to prove its infectiousness. However, the inter-person spreading dynamics of obesity are seldom studied. A distinguishing feature of the obesity epidemic is that it is driven by a social contagion process which cannot be perfectly described by the infectious disease models. In this paper, we propose a novel belief decision model based on the famous Dempster-Shafer theory of evidence to model obesity epidemic as the competing spread of two obesity-related behaviors: physical inactivity and physical activity. The transition of health states is described by an SIS model. Results reveal the existence of obesity epidemic threshold, above which obesity is quickly eradicated. When increasing the fading level of information spread, enlarging the clustering of initial obese seeds, or introducing small-world characteristics into the network topology, the threshold is easily met. Social discrimination against the obese people plays completely different roles in two cases: on one hand, when obesity cannot be eradicated, social discrimination can reduce the number of obese people; on the other hand, when obesity is eradicable, social discrimination may instead cause it breaking out.

  8. 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...

  9. 肠道感染致泻性大肠埃希菌的检测与流行分析%Detection of diarrheagenic Escherichia coli causing intestinal infections and analysis of epidemic

    Institute of Scientific and Technical Information of China (English)

    黄勇; 童萍; 张文

    2015-01-01

    目的:为检测肠道感染致泻性大肠埃希菌(DEC ),并对疾病流行进行分析,为预防和诊治疾病提供依据。方法选取2009年5月-2014年5月医院消化门诊腹泻患者841例,所有患者均通过粪便标本以及PCR基因检测方法检测病原菌种类,统计致泻性大肠埃希菌,并结合患者的临床资料,分析其流行情况。结果841例标本中检出DEC 151例,阳性率为17.95%,其中肠致病性大肠埃细菌(EPEC)22株、肠出血性大肠埃希菌(EHEC)1株、肠产毒性大肠埃希菌(ETEC)64株、肠聚集性大肠埃希菌(EAEC)15株、弥散聚集性大肠埃希菌(DAEC)29株,分别占14.57%、0.66%、42.38%、9.39%和19.21%;仅e as tA基因阳性未能分类20株占13.25%;发病年龄与DEC检出率:0~12岁为6.62%、13~59岁为75.50%、≥60岁为17.88%;DEC好发于夏秋季(6~11月),共检出DEC106例占70.20%。结论 DEC是导致肠道感染腹泻的主要病原菌之一,DEC在不同季节和不同年龄的人群检出率有所差异,好发于夏秋季,且年龄在13~60岁检出率较高。%OBJECTIVE To detect the diarrheagenic Escherichia coli causing intestinal infections and analyze the ep‐idemic so as to provide guidance for clinical prevention and treatment .METHODS A total of 841 diarrhea patients who were treated in the gastroenterology outpatient department from May 2009 to May 2014 were enrolled in the study .The stool specimens were collected from all the patients ,the species of pathogens were detected by using PCR method ,the diarrheagenic E .coli strains were taken for statistics ,and the prevalence was observed by com‐bining the clinical data of the patients .RESULTS The diarrheagenic E .coli was detected positive in 841 of 151 specimens with the positive rate of 17 .95% ;there were 22 (14 .57% ) strains of enteropathogenic E . coli ,1 (0 .66% ) strain of enterohaemorrhagic

  10. 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.

  11. 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.

  12. Obesity and diabetes epidemics: cancer repercussions.

    Science.gov (United States)

    Hjartåker, Anette; Langseth, Hilde; Weiderpass, Elisabete

    2008-01-01

    The prevalence of overweight (body mass index, BMI, between 25 and 30 kg/m2) and obesity (BMI of 30 kg/m2 or higher) is increasing rapidly worldwide, especially in developing countries and countries undergoing economic transition to a market economy. One consequence of obesity is an increased risk of developing type II diabetes. Overall, there is considerable evidence that overweight and obesity are associated with risk for some of the most common cancers. There is convincing evidence of a positive association between overweight/obesity and risk for adenocarcinoma of the oesophagus and the gastric cardia, colorectal cancer, postmenopausal breast cancer, endometrial cancer and kidney cancer (renal-cell). Premenopausal breast cancer seems to be inversely related to obesity. For all other cancer sites the evidence of an association between overweight/obesity and cancer is inadequate, although there are studies suggesting an increased risk of cancers of the liver, gallbladder, pancreas, thyroid gland and in lymphoid and haematopoietic tissue. Far less is known about the association between diabetes mellitus type I (also called insulin dependent diabetes mellitus or juvenile diabetes), type II diabetes (called non-insulin dependent diabetes mellitus or adult onset diabetes mellitus) and cancer risk. The most common type of diabetes mellitus, type II, seems to be associated with liver and pancreas cancer and probably with colorectal cancer. Some studies suggest an association with endometrial and postmenopausal breast cancer. Studies reporting on the association between type I diabetes mellitus, which is relatively rare in most populations and cancer risk are scanty, but suggest a possible association with endometrial cancer. Overweight and obesity, as well as type II diabetes mellitus are largely preventable through changes in lifestyle. The fundamental causes of the obesity epidemic-and consequently the diabetes type II epidemic-are societal, resulting from an

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

    DEFF Research Database (Denmark)

    Manzano, Marc; Calle, Eusebi; Ripoll, Jordi

    2013-01-01

    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 in other multiple failure scenarios, identifying the level of vulnerability offered by a network is one of the main challenges. In this paper, we present epidemic survivability, a new network measure that describes the vulnerability of each node of a network under a specific epidemic intensity. Moreover......, this metric is able to identify the set of nodes which are more vulnerable under an epidemic attack. In addition, two applications of epidemic survivability are provided. First, we introduce epidemic criticality, a novel robustness metric for epidemic failure scenarios. A case study shows the utility...

  14. 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.

  15. Fractional Derivatives in Dengue Epidemics

    Science.gov (United States)

    Pooseh, Shakoor; Rodrigues, Helena Sofia; Torres, Delfim F. M.

    2011-09-01

    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.

  16. An epidemic outbreak of cryptosporidiosis

    DEFF Research Database (Denmark)

    Mølbak, Kåre; Højlyng, Niels; Ingholt, Liselotte;

    1990-01-01

    significantly associated with diarrhea (OR = 2.79, P = 0.0006). The seasonal distribution was striking, with a peak prevalence in the beginning of the rainy season (May 17.6%) when an epidemic outbreak of diarrhea started. The prevalence was highest in children younger than 18 months, an age at which......In the first year of a prospective community study of childhood diarrhea conducted in a semiurban area in the capital of Guinea Bissau, Cryptosporidium sp. was found in 73 (6.0%) of 1216 episodes of diarrhea. The parasite was the second most prevalent intestinal parasite, and the only one...

  17. 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.

  18. Aspectos da epidemia de encefalite por arbovirus na região do Vale do Ribeira, S. Paulo, Brasil, no período de 1975 a 1978 Aspects of the encephalitis epidemic caused by arbovirus in the Ribeira Valley, S. Paulo, Brazil, during 1975-1978

    Directory of Open Access Journals (Sweden)

    Lygia Busch Iversson

    1980-03-01

    Full Text Available Foi realizado estudo epidemiológico da encefalite por arbovirus na região do Vale do Ribeira, S. Paulo, Brasil. Uma epidemia da moléstia ocorreu em 1975, 1976 e 1977, com picos nas épocas de maior temperatura e pluviosidade. A partir de 1978 a moléstia manteve-se em níveis baixos numa presumível ende-micidade. A epidemia se deslocou em onda em direção leste-oeste e leste-sudoeste para a região litorânea vizinha. A cadeia montanhosa situada ao norte e noroeste atuou como barreira à propagação da moléstia. Considerou-se a hipótese que o agente etiológico, arbovirus Rocio, deva ter começado a infectar a população humana recentemente, tendo sido veiculado ao homem de reservatórios silvestres, aves e pequenos mamíferos, por culicídeos silvestres. Discutiu-se também prováveis formas de transmissão domiciliar. Verificou-se que os grupos populacionais que apresentaram as formas mais graves foram os de idades extremas e os que apresentavam piores condições de vida. Considerou-se que a perspectiva epidemiológica desta arbovirose é que ela persista na região, uma vez que a mesma apresenta condições ótimas para o desenvolvimento do agente etiológico, dos reservatórios e dos vetores biológicos, além de receber um contínuo afluxo de população suscetível, migrantes ou turistas.In 1975, 1976, and 1977, arbovirus caused an encephalitis epidemic in the Ribeira Valley in the state of S. Paulo. The epidemic would peak when the temperature and pluvial levels were higher. From 1978 on the disease maintained low levels within a presumed endemic zone. The epidemic had swept from east to west and from east to southwest in a wave toward the neighboring coastal region. The mountain chain to the north and northwest acted as a barrier. It was only logical natural that the hypothesis that the etiological agent, arbovirus Rocio may have recently infected the human population be considered. Mosquitos must have transmitted the infection

  19. 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.

  20. [Systemic karyomegaly with chronic interstitial nephritis. Discussion of the disease picture based on an autopsy case].

    Science.gov (United States)

    Moch, H; Spöndlin, M; Schmassmann, A; Mihatsch, M J

    1994-02-01

    Systemic karyomegaly associated with interstitial nephritis was first described in 1978 by Mihatsch. Seven cases have been reported to date. We give an account of an autopsy case of systemic karyomegaly in a 30-year-old Italian man. Bizarre enlargement of nuclei was found in renal tubular epithelial cells, Schwann cells and in smooth muscle cells of vessels and bowel and, less obviously, in endothelial and adventitial cells of vessels, in alveolar epithelial cells and in astrocytes of the brain. These findings were associated with chronic interstitial nephritis, nonspecific hepatopathy, adenocarcinoma of the rectum and multiple sclerosis. The clinical course was marked by chronic renal failure, chronic haemodialysis and renal transplantation. The patient died 8 years after diagnosis in septic-toxic shock. The aetiology and pathogenesis of the disease are discussed.

  1. Systemic karyomegaly associated with chronic interstitial nephritis. A new disease entity?

    Science.gov (United States)

    Mihatsch, M J; Gudat, F; Zollinger, H U; Heierli, C; Thölen, H; Reutter, F W

    1979-08-01

    In 3 patients, two 26 and one 29 years of age, a nephropathy was accidentally discovered which progressed to end stage renal failure within 4 to 6 years. Renal biopsy revealed an unusually marked karyomegaly particularly of the tubular epithelium. These cytopathological changes were associated with chronic interstitial nephritis. Biopsies of other organs, i.e. liver, colon, bronchus and lungs indicated in 2 patients a systemic distribution of the karyomegaly, particularly in mesenchymal cells. Neither the chronic interstitial nephritis nor the karyomegaly could be ascribed to a recognized etiology. This suggests, therefore, that there is a relationship between these changes. The karyomegaly could be the result of the action of some antimitotic agent such as chemical toxins or virus infections.

  2. 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.

  3. Effect of acteoside on mesangial proliferation in rat anti-Thy 1 nephritis.

    Science.gov (United States)

    Hattori, T; Fujitsuka, N; Shindo, S

    1996-05-01

    We investigated whether acteoside can inhibit mesangial matrix expansion or mesangial cell proliferation in mesangioproliferative anti-Thy 1 nephritis. Untreated control rats were compared to the rats treated with acteoside either during early (day 1 to 8) or late (day 4 to 12) period after the induction of anti-Thy 1 nephritis. The result showed that acteoside and prednisolone treatments (in either early or late period) significantly reduced proteinuria, mesangial matrix expansion (the index of matrix expansion) and mesangial proliferation as determined by the number of proliferating nuclear cell antigen (PCNA)-positive cells. Acteoside also reduced glomerular macrophage infiltration and ICAM-1 expression in glomeruli of anti-Thy 1 nephritic rats. Furthermore, acteoside treatment markedly increased the activities of matrix metaloproteinases (MMP) in glomeruli. These results suggest that acteoside can inhibit mesangial cell proliferation and extracellular matrix overproduction by either inhibiting ICAM-1 expression or increasing activities of MMP.

  4. 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

    OBJECTIVE: A high level of galectin-3-binding protein (G3BP) appears to distinguish circulating cell-derived microparticles in systemic lupus erythematosus (SLE). The aim of this study is to characterize the population of G3BP-positive microparticles from SLE patients compared to healthy controls......, 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...... in 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 

  5. Peritoneal dialysis treatment for severe lupus nephritis patients complicated with essential organ dysfunction

    OpenAIRE

    Zhou, Yan; Yu, Yusheng; Tang, Zheng; Li, Shijun; Hu, Weixin; LUO, CHUNLEI; Liu,Zhihong

    2015-01-01

    The aim of the present study was to evaluate the clinical efficacy of peritoneal dialysis (PD) in patients with severe lupus nephritis (LN) complicated with organ dysfunction. In total, 13 severe LN patients complicated with multiple-organ dysfunction, who underwent PD treatment between November 2003 and September 2010, were enrolled in the study. Six patients received methylprednisolone pulse therapy due to lupus activity and progressive renal failure. These patients were complicated with se...

  6. 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.

  7. Tubulointerstitial Nephritis Complicated by Fanconi Syndrome and Renal Tubular Acidosis Associated with three autoimmune diseases

    OpenAIRE

    Io, Kumiko; Obata, Yoko; Nishino, Tomoya; Hirose, Misaki; Yamashita, Hiroshi; Uramatsu, Tadashi; Ichikawa, Tatsuki; Hayashi, Tomayoshi; Kawakami, Atsushi; Taguchi, Takashi; Kohno, Shigeru

    2013-01-01

    A 45-year-old woman experiencing back pain showed signs of metabolic acidosis and electrolyte imbalances. The results of blood and urine tests indicated Fanconi syndrome and renal tubular acidosis. An x-ray showed vertebral fractures, which were thought to responsible for the back pain. In addition, the patient had proteinuria and renal dysfunction; therefore, renal biopsy was performed, and tubulointerstitial nephritis (TIN) was diagnosed. While investigating TIN, primary biliary cirrhosis a...

  8. 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.

  9. Acute Interstitial Nephritis induced by Intermittent use of Rifampicin in Patient with Brucellosis

    Directory of Open Access Journals (Sweden)

    Salih S

    2008-01-01

    Full Text Available 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.

  10. Inhibition of the TWEAK/Fn14 pathway attenuates renal disease in nephrotoxic serum nephritis.

    Science.gov (United States)

    Xia, Yumin; Campbell, Sean R; Broder, Anna; Herlitz, Leal; Abadi, Maria; Wu, Ping; Michaelson, Jennifer S; Burkly, Linda C; Putterman, Chaim

    2012-11-01

    Previously it was shown that the TNF superfamily member TWEAK (TNFSF12) acts through its receptor, Fn14, to promote proinflammatory responses in kidney cells, including the production of MCP-1, RANTES, IP-10 and KC. In addition, the TWEAK/Fn14 pathway promotes mesangial cell proliferation, vascular cell activation, and renal cell death. To study the relevance of the TWEAK/Fn14 pathway in the pathogenesis of antibody-induced nephritis using the mouse model of nephrotoxic serum nephritis (NTN), we induced NTN by passive transfer of rabbit anti-glomerular antibodies into Fn14 knockout (KO) and wild type (WT) mice. Severe proteinuria as well as renal histopathology were induced in WT but not in Fn14 KO mice. Similarly, a pharmacologic approach of anti-TWEAK mAb administration into WT mice in the NTN model significantly ameliorated proteinuria and improved kidney histology. Anti-TWEAK treatment did not affect the generation of mouse anti-rabbit antibodies; however, within the kidney there was a significant decrease in glomerular immunoglobulin deposition, as well as macrophage infiltrates and tubulointerstitial fibrosis. The mechanism of action is most likely due to reductions in downstream targets of TWEAK/Fn14 signaling, including reduced renal expression of MCP-1, VCAM-1, IP-10, RANTES as well as Fn14 itself, and other molecular pathways associated with fibrosis in anti-TWEAK treated mice. Thus, TWEAK/Fn14 interactions are instrumental in the pathogenesis of nephritis in the NTN model, apparently mediating a cascade of pathologic events locally in the kidney rather than by impacting the systemic immune response. Disrupting TWEAK/Fn14 interactions may be an innovative kidney-protective approach for the treatment of lupus nephritis and other antibody-induced renal diseases.

  11. Long-term Outcome of Lupus Nephritis Class II in Argentine Patients

    Science.gov (United States)

    Collado, Maria Victoria; Dorado, Enrique; Rausch, Silvia; Gomez, Graciela; Khoury, Marina; Zazzetti, Federico; Gargiulo, María; Suarez, Lorena; Chaparro, Rafael; Paira, Sergio; Galvan, Laura; Juarez, Vicente; Pisoni, Cecilia; Garcia, Mercedes; Martinez, Liliana; Alvarez, Analia; Alvarez, Clarisa; Barreira, Juan; Sarano, Judith

    2016-01-01

    Background There is controversy in medical literature over the outcome of patients with lupus nephritis (LN) class II. The aim of this study was to explore the risk of histological transformation (HT) and possible factors related to negative response to treatment in patients with mesangial LN class II. Methods A retrospective and multicenter study was carried out that includes patients who had received a diagnosis of LN class II on their first renal biopsy. Creatinine, urine sediment, and proteinuria were recorded at the time of the first biopsy, 6 months, and 1, 2, and 5 years after the first biopsy. Response to treatment, HT, and long-term outcome were evaluated. Results Forty-one patients were included. The manifestation at first biopsy was proteinuria greater than 0.5 g/d in 28 patients (68.29%; 8 [28.57%] of 28 patients had nephrotic syndrome), hematuria in 18 patients (43.90%), and deterioration of renal function in 3 patients (7.31%). During the follow-up (median, 8 years; range, 1–35 years), a new biopsy was performed in 18 patients (43.90%), and in 17 patients (17/18 [94.44%]), there was HT. Median time at rebiopsy was 32 months (range, 11–305 months). Of the 18 patients who had a second biopsy, 10 (55.55%) were on hydroxychloroquine versus 100% (19/19) of patients who did not undergo the procedure (P = 0.001). A year after the first renal biopsy, there are data available from 34 patients; of them, 24 patients (70.58%) had achieved response, and 10 patients (29.41%) had no response (NR) (missing data in 7). A higher 24-hour urinary protein at 6 months was predictor of worse outcome at 1 year, with statistical significance difference for the nonresponder group (median proteinuria, 2.3 g/d [range, 0–4.7 g/d]) compared with responders (median proteinuria, 0.28 g/d [range, 0–1.7 g/d]) (P = 0.0133). In the long-term follow-up (5 years), HT was the main cause of unfavorable outcome and was measured in 78.57% of patients (11/14 patients). Conclusions This

  12. Karyomegalic interstitial nephritis: further support for a distinct entity and evidence for a genetic defect.

    Science.gov (United States)

    Spoendlin, M; Moch, H; Brunner, F; Brunner, W; Burger, H R; Kiss, D; Wegmann, W; Dalquen, P; Oberholzer, M; Thiel, G

    1995-02-01

    Karyomegalic interstitial nephritis was first described in 1979 by Mihatsch, who was reporting three such cases. We report here four additional cases as well as two family investigations. Our findings support the association of karyomegaly and interstitial nephritis as a distinct entity. Typical clinical features are asymptomatic progressive renal failure in the third decade of life and recurrent infections, mostly of the upper respiratory tract. Histologic alterations consist of markedly enlarged and hyperchromic nuclei in many tubular epithelial cells throughout the nephron accompanied by interstitial fibrosis in the surrounding atrophic tubules. Karyomegaly is not limited to the kidneys. In one case, autopsy revealed karyomegaly in epithelial and mesenchymal cells of many other organs. However, no association of karyomegaly with further histologic damage is evident except in the kidneys. Because of the familial clustering, karyomegalic interstitial nephritis seems to be an inherited disease. Examination of the nuclear proliferation-associated structures proliferating cell nuclear antigen/cyclin, Ki 67, and p53 suggests an inhibition of mitosis in karyomegalic cells. The finding of the same HLA haplotype, A9/B35, in four of six HLA-typed cases suggests the possibility of a genetic defect on chromosome 6, which is inherited and linked to the HLA locus.

  13. Tubulointerstitial Nephritis and Uveitis Syndrome in an Elderly Man: Case Report and Literature Review.

    Science.gov (United States)

    Lei, Wen-Hui; Xin, Jun; Yu, Xue-Ping; Li, Jie; Mao, Ming-Feng; Ji, Jian-Song; Wu, Chui-Fen; Zhu, Chao-Yong; Jin, Lie

    2015-11-01

    Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease of unknown etiology defined by the combination of tubulointerstitial nephritis, uveitis, and biochemical abnormalities. It has been reported that TINU mainly affects adolescents and young women. Here we reported a special case regarding a 60-year-old man with acute renal failure due to TINU syndrome documented by renal biopsy.We present a rare case of an elderly patient, who had been suffering from a fever for 2 weeks, characterized by sudden onset and resolving spontaneously, and accompanied by extreme fatigue, loss of appetite, and shivering. Renal biopsy showed a tubulointerstitial nephritis, with polymorphonuclear infiltration and acute tubulitis. In the outpatient clinic, he was diagnosed with idiopathic bilateral anterior uveitis 1 month ago. Ophthalmological examination revealed anterior asymptomatic bilateral uveitis. Human leukocyte antigen (HLA) typing (HLA-DQA1*0101/0201 and HLA-DQB1*0303/0503) was found which supported the suspect of TINU syndrome. The patient was treated with oral prednisone (1 mg/kg) and continued for 8 weeks on tapering doses. Serum creatinine normalized within 3 and 6 months later renal function also recovered completely.This case highlights that TINU syndrome is probably an underdiagnosed disease responsible for some cases of idiopathic anterior uveitis in elderly male patients. It is of critical importance to be aware of this syndrome by nephrologist and ophthalmologists in this special population. Further studies are needed to elucidate clinical characteristic and pathogenesis of TINU syndrome in elderly population.

  14. Therapeutic Effect of Polysaccharide of Large Yellow Croaker Swim Bladder on Lupus Nephritis of Mice

    Directory of Open Access Journals (Sweden)

    Xianhong Jiang

    2014-03-01

    Full Text Available The therapeutic effect of polysaccharide of large yellow croaker swim bladder (PLYCSB on lupus nephritis has been studied in vivo. A high concentration (50 mg/kg dose of PLYCSB reduced the levels of serum inflammatory cytokine levels of IL-6, IL-12, TNF-α and IFN-γ compared to a low concentration (25 mg/kg dose and control mice. SCr, BUN, TC and TG serum levels of PLYCSB treated mice were lower than those of control mice, and TP and ALB serum levels were higher than control mice. Control mice tested ds-DNA positive at the 6th week, and 50 mg/kg treated mice tested at the 10th week after the experiment began. The output of urine protein of 50 mg/kg PLYCSB treated mice was most closely comparable to the normal mice. The glomerular number of 50 mg/kg PLYCSB treated mice was more than the 25 mg/kg dose and control groups, and the 50 mg/kg dose group showed the lowest glomerular sclerosis index in lupus nephritis mice. By RT-PCR and western blot assay, PLYCSB significantly induced inflammation in kidney tissues of mice by downregulating NF-κB-p65, TGF-β1, Fas, FasL and upregulating IκB-α. These results suggest that PLYCSB showed a potential curative effect on lupus nephritis as a drug or functional food.

  15. Bullous Systemic Lupus Erythematosus and Lupus Nephritis in a Young Girl

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    Tooba Momen

    2016-11-01

    Full Text Available Bullous systemic lupus erythematosus (BSLE is an autoimmune blistering disease occurring in patients with systemic lupus erythematosus (SLE. It is a rare disease, especially in children. A 14-year-old girl initially presented with fatigue, generalized vesiculobullous skin lesions, and ulcers over the hard palate and oral mucosa. Clinical investigations revealed hematuria and proteinuria, a high erythrocyte sedimentation rate and titer of antinuclear antibody, and anti-double-stranded DNA. Skin biopsy findings were suggestive of BSLE. A renal biopsy confirmed the features of class V lupus nephritis. Based on the clinical features and investigations, a diagnosis of BSLE with nephritis was made. She received methylprednisolone pulse therapy and hydroxychloroquine; however, it did not alleviate the vesiculobullous eruption, so treatment with dapsone started and resulted in the dramatic disappearance of the lesions. Interruption of dapsone due to hemolysis did not aggravate the bullous disease. During follow-up, she had multiple flare-ups of disease and nephritis without rebound of bullous lesions. BSLE is a rare presentation of SLE in children. Differentiating it from other skin bullous diseases and SLE with blister is important for the correct management. The unusual presentation of this disease may delay the diagnosis and therefore requires a high index of clinical suspicion.

  16. 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.

  17. To TDM or not to TDM in lupus nephritis patients treated with MMF?

    Science.gov (United States)

    van Gelder, Teun; Berden, Jo H M; Berger, Stefan P

    2015-04-01

    Mycophenolic acid (MPA) has become the cornerstone in the treatment of lupus nephritis. However, response rates are still far from ideal in clinical trials. Uncertainty exists regarding the correct dosing of MPA, and the recommended doses vary between recently published guidelines. Side effects are an additional problem resulting in frequent dose reduction and possible suboptimal exposure.In this review, we discuss the large variability between patients in drug exposure to MPA and the evidence for a relationship between drug exposure and efficacy in lupus nephritis. Methods for drug monitoring of MPA are discussed, and based on the current literature, we suggest as potential target levels a pre-dose level of 3.0 mg/L and an area under the concentration-versus-time curve between 35 and 45 mg h/L.Therapeutic drug monitoring may improve response rates in lupus nephritis by preventing low exposure and at the same time may reduce unnecessary side effects in patients who have high drug exposure with standard dose MPA. We specifically advise assessment of MPA drug exposure early after start of treatment and before concluding that treatment with MPA has failed.

  18. [Little epidemic caused by Salmonella panama (author's transl)].

    Science.gov (United States)

    Kienitz, M; Licht, W; Richter, M

    1977-05-01

    Between 8. 1. 1976 and 10. 8. 1976 16 new or premature born children got a gastroenteritis due to salmonella panama. All these children were together in one pediatric ward of the hospital. Most of them came directly for the labour ward or from the newborn-ward. They had antibiotic therapy due to the indication of the mother or the child. It was impossible to fine the source of the salmonella infection, therefore, finally the ward was closed. After radical desinfection new patients came to the ward. Again they were infected with salmonella panama. Now it became clear that contaminated milk (Humanan-Heilnahrung) was the source of infections. Most papers mention a mild benign course of the infections. In contrary we could see severe conditions dependent on the pre-damage of the child or his reduced immunity. The minimal number of germs of dietic food products needs to be examinated.

  19. Epidemics in interconnected small-world networks

    NARCIS (Netherlands)

    Liu, M.; Li, D.; Qin, P.; Liu, C.; Wang, H.; Wang, F.

    2015-01-01

    Networks can be used to describe the interconnections among individuals, which play an important role in the spread of disease. Although the small-world effect has been found to have a significant impact on epidemics in single networks, the small-world effect on epidemics in interconnected networks

  20. Modeling and simulation of epidemic spread

    DEFF Research Database (Denmark)

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

    2013-01-01

    and control such epidemics. This paper presents an overview of the epidemic spread modeling and simulation, and summarizes the main technical challenges in this field. It further investigates the most relevant recent approaches carried out towards this perspective and provides a comparison and classification...

  1. Malaria Epidemic and Drug Resistance, Djibouti

    OpenAIRE

    Rogier, Christophe; Pradines, Bruno; Bogreau, H.; 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.

  2. A prolonged course of Group A streptococcus-associated nephritis: a mild case of dense deposit disease (DDD)?

    Science.gov (United States)

    Sawanobori, E; Umino, A; Kanai, H; Matsushita, K; Iwasa, S; Kitamura, H; Oda, T; Yoshizawa, N; Sugita, K; Higashida, K

    2009-06-01

    We herein report the case of a 12-year-old boy with dense deposit disease (DDD) evoked by streptococcal infection. He had been diagnosed to have asymptomatic hematuria syndrome at the age of 6 during school screening. At 12 years of age, he was found to have macrohematuria and overt proteinuria with hypocomplementemia 2 months after streptococcal pharyngitis. Renal biopsy showed endocapillary proliferative glomerulonephritis with double contours of the glomerular basement membrane. Hypocomplementemia and proteinuria were sustained for over 8 weeks. He was suspected to have dense deposit disease due to intramembranous deposits in the first and the second biopsies. 1 month after treatment with methylprednisolone pulse therapy, proteinuria decreased to a normal level. Microscopic hematuria disappeared 2 years later, but mild hypocomplementemia persisted for more than 7 years. Nephritis-associated plasmin receptor (NAPlr), a nephritic antigen for acute poststreptococcal glomerulonephritis, was found to be positive in the glomeruli for more than 8 weeks. DDD is suggested to be caused by dysgeneration of the alternative pathway due to C3NeF and impaired Factor H activity. A persistent deposition of NAPlr might be one of the factors which lead to complement dysgeneration. A close relationship was suggested to exist between the streptococcal infection and dense deposit disease in this case.

  3. Inferring epidemic contact structure from phylogenetic trees.

    Directory of Open Access Journals (Sweden)

    Gabriel E Leventhal

    Full Text Available Contact structure is believed to have a large impact on epidemic spreading and consequently using networks to model such contact structure continues to gain interest in epidemiology. However, detailed knowledge of the exact contact structure underlying real epidemics is limited. Here we address the question whether the structure of the contact network leaves a detectable genetic fingerprint in the pathogen population. To this end we compare phylogenies generated by disease outbreaks in simulated populations with different types of contact networks. We find that the shape of these phylogenies strongly depends on contact structure. In particular, measures of tree imbalance allow us to quantify to what extent the contact structure underlying an epidemic deviates from a null model contact network and illustrate this in the case of random mixing. Using a phylogeny from the Swiss HIV epidemic, we show that this epidemic has a significantly more unbalanced tree than would be expected from random mixing.

  4. 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...

  5. 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.

  6. Plague Epidemic s in Syria b etween XIII - XV. Centuries

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    Esra ATMACA

    2015-07-01

    Full Text Available Epidemic diseases that cause mass death has been one of the greatest fears of the society in the past century Usually due to poor living conditions, poverty, the inadequate treatment. Plague is one of them. Plague word is sometimes used synonymously with t he word tâûn, sometimes considered to be a greater sense of the Word plague. These outbreaks occured repeatedly in human society and many times occured between XIII - XV. centuries. Our research aims to examine the plague occured in Syria in the Mamluk state domination discussed period. One of the outbreaks have occured in the period between the years 1347 - 1351. Epidemic was looming at the same time with the European named the black death or large extinction. Many people have been killed in Syria as in other places where the epidemic has spread. Rumors about them are given in the source is situated in the form of the issuance of the number of people who died in one day and sometimes the total number of deaths took place at a given date range. In this study, we aimed to determine which is more severe than the others in the outbreak, to assess the rumor about the number of deaths from this cause, to reveal the difficulties of the funeral of the dead, to uncover practices that people do to get rid of this disease.

  7. 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.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    outbreaks and is endemic in 10 nursing homes. Five staff members from nursing homes have been infected with MRSA. MRSA commonly causes skin and soft tissue infections (76%), but serious infections such as septicaemia and pneumonia are also found. CONCLUSION: Treatment of MRSA-infected patients is costly due......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...... resources for handling the epidemic are not available. Without active intervention, this situation will have serious implications for the health care system....

  9. The emerging epidemic of hypertension in Asian children and adolescents.

    Science.gov (United States)

    Lee, Chong Guk

    2014-12-01

    Hypertension has become a serious global public health burden because of its high incidence and concomitant risk of cardiovascular disease. Many studies have verified that risk factors, such as hypertension and obesity which are responsible for cardiovascular disease, start in early childhood. In Asian countries, the prevalence of hypertension in the pediatric age group has become more prevalent than ever before with the increasing obesity epidemic. To tackle the epidemic of cardiovascular disease, a leading cause of death and disability of non-communicable diseases in Asian countries, population-based measures aiming at reducing harmful environmental factors to blood pressure and body weight must be applied to individuals in their early childhood, as early as the fetal stage. This review focused on the prevalence of pediatric hypertension in Asian countries and outlined several considerations for accurate blood pressure (BP) measurement and evaluation, along with an overview of pathophysiology of fetal programming and obesity related with childhood hypertension.

  10. Porcine Epidemic Diarrhea Virus Induces Autophagy to Benefit Its Replication

    Directory of Open Access Journals (Sweden)

    Xiaozhen Guo

    2017-03-01

    Full Text Available The new porcine epidemic diarrhea (PED has caused devastating economic losses to the swine industry worldwide. Despite extensive research on the relationship between autophagy and virus infection, the concrete role of autophagy in porcine epidemic diarrhea virus (PEDV infection has not been reported. In this study, autophagy was demonstrated to be triggered by the effective replication of PEDV through transmission electron microscopy, confocal microscopy, and Western blot analysis. Moreover, autophagy was confirmed to benefit PEDV replication by using autophagy regulators and RNA interference. Furthermore, autophagy might be associated with the expression of inflammatory cytokines and have a positive feedback loop with the NF-κB signaling pathway during PEDV infection. This work is the first attempt to explore the complex interplay between autophagy and PEDV infection. Our findings might accelerate our understanding of the pathogenesis of PEDV infection and provide new insights into the development of effective therapeutic strategies.

  11. Heterogeneous edge weights promote epidemic diffusion in weighted evolving networks

    Science.gov (United States)

    Duan, Wei; Song, Zhichao; Qiu, Xiaogang

    2016-08-01

    The impact that the heterogeneities of links’ weights have on epidemic diffusion in weighted networks has received much attention. Investigating how heterogeneous edge weights affect epidemic spread is helpful for disease control. In this paper, we study a Reed-Frost epidemic model in weighted evolving networks. Our results indicate that a higher heterogeneity of edge weights leads to higher epidemic prevalence and epidemic incidence at earlier stage of epidemic diffusion in weighted evolving networks. In addition, weighted evolving scale-free networks come with a higher epidemic prevalence and epidemic incidence than unweighted scale-free networks.

  12. 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.

  13. Copper-2 Hypothesis for Causation of the Current Alzheimer's Disease Epidemic Together with Dietary Changes That Enhance the Epidemic.

    Science.gov (United States)

    Brewer, George J

    2017-03-20

    Alzheimer's disease, the most common cause of dementia, is at epidemic proportions (15 to 44% depending on age, of those age 65 to 84) in the U.S. and other developed countries but remains relatively rare in undeveloped countries. Surprisingly, solid historical data reveal the epidemic is a creature of the last century. That is, the disease was also rare in developed countries, until the 20th century. It is disappointing that these historical and demographic facts have been ignored by the Alzheimer's disease scientific community. Disappointing because these facts clearly point at an environmental change in the 20th century in developed countries as a major factor in causing the epidemic. Some scientists have discarded the claimed rarity of the disease in the 19th century as incorrect, saying that Alzheimer's disease is a disease of aging and that the increasing lifespan of people accounts for the current high prevalence of the disease, but this cavalier attitude ignores historical data indicating there were many elderly people in the 19th century who were not getting Alzheimer's disease with any significant frequency. In this review, after documenting that the observed assertions about historical and demographic facts are correct, evidence is amassed that the main environmental culprit causing the Alzheimer's epidemic is ingestion of divalent copper or copper-2. The two sources of copper-2 ingestion are drinking water and multimineral supplement pills containing copper. The increase in copper plumbing use in developed countries parallels the increasing prevalence of Alzheimer's disease. It has been shown that enough copper is leached from copper plumbing in most households to cause Alzheimer's disease, using the Alzheimer's disease animal model studies as a guide to toxic levels. It is relatively easy to avoid or greatly diminish copper-2 ingestion by not using copper containing supplement pills and testing drinking water for copper levels. If the copper in water

  14. 一起由肠道病毒CoxB4引起的手足口病聚集性疫情的病原学鉴定及其基因型分析%Pathogenic identification and genotype analysis of an hand-foot-mouth disease epidemic caused by coxsackievirus B4

    Institute of Scientific and Technical Information of China (English)

    马智龙; 查杰

    2011-01-01

    目的:对引起一起手足口病聚集性疫情的未分型肠道病毒进行病原学鉴定,并分析其基因型.方法:对采集的标本用Real-time PCR方法检测肠道病毒核酸,并选取其中通用阳性,EV71和CoxA16阴性的标本用自行设计长距离PCR通用引物进行两步法RT一PCR,将得到的PCR产物进行测序,将所得序列在GenBank中进行同源性搜索以确定是何种血清型肠道病毒,同时选取部分标本进行全序列的测定并构建分子系统树,从而确定引起本次手足口肠道病毒为何种基因型.结果:34份标本经Real一time PCR检测,19份标本肠道病毒核酸通用阳性,EV71阴性和COX16阴性,选取其中的10份测定其VP1区序列,经同源性搜索确定为肠道病毒CoxB4,且10标本的序列同源性均在99%以上.全序列测定结果与其他CoxB4进行系统发生分析显示,本次分离到的CoxB4属于第Ⅷ类基因型.结论:引起本次手足口病聚集性病例的病原为肠道病毒CoxB4,第Ⅷ类基因型.%Objective: To identify the pathogen that caused the outbreak of HFMD epidemic, and to find out the genetic character of the pathogen. Methods; After pan - enterovirus PCR primers positive - detected but EV71 and CoxA16 negative - detected specimens were screened by Real - time PCR kit, ten positive specimens were subject to two - step RT - PCR using our designed long range PCR universal primers. After sequencing of the PCR products, the sequence homology search was done on Gen-Bank to determine which serotype they belong, and further the molecular phylogeny tree was constructed to determine which genotype the enterovirus belong. Results; 19 of the total 34 specimens were pan - enterovirus positive - detected but EV71 and Cox-A16 negative - detected by realtime PCR. The 10 positive specimens were subject to VP1 sequencing, and classified to coxsack-ievirus B4 by homology search. And the phylogeny analysis with other coxsackievirus B4 indicated that the isolated

  15. 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

  16. Drivers of Rift Valley fever epidemics in Madagascar

    Science.gov (United States)

    Lancelot, Renaud; Béral, Marina; Rakotoharinome, Vincent Michel; Andriamandimby, Soa-Fy; Héraud, Jean-Michel; Coste, Caroline; Apolloni, Andrea; Squarzoni-Diaw, Cécile; de La Rocque, Stéphane; Wint, G. R. William; Cardinale, Eric

    2017-01-01

    Rift Valley fever (RVF) is a vector-borne viral disease widespread in Africa. The primary cycle involves mosquitoes and wild and domestic ruminant hosts. Humans are usually contaminated after contact with infected ruminants. As many environmental, agricultural, epidemiological, and anthropogenic factors are implicated in RVF spread, the multidisciplinary One Health approach was needed to identify the drivers of RVF epidemics in Madagascar. We examined the environmental patterns associated with these epidemics, comparing human and ruminant serological data with environmental and cattle-trade data. In contrast to East Africa, environmental drivers did not trigger the epidemics: They only modulated local Rift Valley fever virus (RVFV) transmission in ruminants. Instead, RVFV was introduced through ruminant trade and subsequent movement of cattle between trade hubs caused its long-distance spread within the country. Contact with cattle brought in from infected districts was associated with higher infection risk in slaughterhouse workers. The finding that anthropogenic rather than environmental factors are the main drivers of RVF infection in humans can be used to design better prevention and early detection in the case of RVF resurgence in the region. PMID:28096420

  17. 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.

  18. Fibroid Tumors in Women: A Hidden Epidemic?

    Science.gov (United States)

    ... Issue Past Issues Fibroid Tumors in Women: A Hidden Epidemic? Past Issues / Spring 2007 Table of Contents ... fibroids@rics.bwh.harvard.edu , or visit our Web site: www.fibroids.net . You may also write ...

  19. Some discrete SI and SIS epidemic models

    Institute of Scientific and Technical Information of China (English)

    LI Jian-quan; LOU Jie; LOU Mei-zhi

    2008-01-01

    The probability is introduced to formulate the death of individuals, the recovery of the infected individuals and incidence of epidemic disease. Based on the assumption that the number of individuals in a population is a constant, discrete-time SI and SIS epidemic models with vital dynamics are established respectively corresponding to the case that the infectives can recover from the disease or not. For these two models, the results obtained in this paper show that there is the same dynamical behavior as their corresponding continuous ones, and the threshold determining its dynamical behavior is found. Below the threshold the epidemic disease dies out eventually, above the threshold the epidemic disease becomes an endemic eventually, and the number of the infectives approaches a positive constant.

  20. 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.

  1. 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.

  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. 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

  4. 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.

  5. 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.

  6. 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:

  7. 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.)

  8. [Effects of an antiinflammatory drug (diclofenac) in primary chronic glomerulo-nephritis (author's transl)].

    Science.gov (United States)

    Lagrue, G; Hirbec, G

    Chronic Glomerulo-Nephritis (GN) are among nephrologic diseases, frequent and severe. In most of them immunological process are involved. Non steroïdal antiinflammatory drugs are able to reduce proteinuria, mainly in Membrano-Proliferative GN and IgA Mesengial GN. A protracted administration is necessary for proteinuria reappeared when treatment is interrupted. With long term administration renal prognosis is improved and severe renal insufficiency delayed. Among active antiinflammatory drugs (indometacine, ketoprofen, diclofenac, flurbiprofen, etc.) diclofenac is one of the best tolerated.

  9. IgG4-Related Tubulointerstitial Nephritis Pattern in 18F-FDG PET/CT.

    Science.gov (United States)

    Bélissant, Ophélie; Guernou, Mohamed; Rouvier, Philippe; Compain, Caroline; Bonardel, Gérald

    2015-10-01

    A 17-year-old adolescent girl was admitted with chronic arthralgia, Raynaud phenomenon, pericarditis, and evidences of chronic diffuse inflammation. F-FDG PET/CT scan was performed to search systemic vasculitis and showed diffuse moderate uptake in the kidneys. We suggested the existence of a nephritis, but the ultrasonography result was normal, and no treatment was introduced. Another F-FDG PET/CT scan was performed 7 months later to explore abdominal pain. It showed again diffuse intense uptake in both kidneys. A proteinuria was highlighted, and renal biopsy allowed to diagnose IgG4-related disease.

  10. Mycotic encephalitis and nephritis in a dog due to infection with Cladosporium cladosporioides.

    Science.gov (United States)

    Poutahidis, T; Angelopoulou, K; Karamanavi, E; Polizopoulou, Z S; Doulberis, M; Latsari, M; Kaldrymidou, E

    2009-01-01

    The dematiaceous fungus Cladosporium cladosporioides is a widely distributed saprophyte that is reported to occasionally infect the lung, skin, eye and brain of humans. This report describes a German shepherd dog with granulomatous encephalitis and nephritis due to C. cladosporioides infection. Although the fungal organisms appeared non-pigmented in haematoxylin and eosin stained sections, they were readily identified with histochemical stains. Semi-nested polymerase chain reaction using universal fungal primers amplified fungal DNA from fixed tissue that had identity to that of C. cladosporioides on sequencing.

  11. 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

  12. Cholera epidemic threatens Sierra Leone.

    Science.gov (United States)

    Dyer, O

    1995-07-08

    Sierra Leone faces the threat of a major epidemic of cholera with the onset of the rainy season, according to the World Health Organization (WHO). The situation is particularly grave for the two million people displaced by the country's civil war. Already 1709 cases of cholera have been registered in Freetown, with 57 deaths. Freetown's population has doubled since the start of the war in 1991 with 750,000 refugees camping out in the town. The insurgent Revolutionary United Front is now within 32 km of the capital. Provinces are cut off from the capital, medical supplies are scarce. Doctors and aid workers are forced to rely on a private helicopter service for personal transport. As many as 10,000 people were affected by the disease last year. WHO experts predict that pneumonia is likely to claim the lives of many children, and a highly drug resistant strain of Plasmodium falciparum malaria is also looming. The greatest problems are the lack of safe drinking water and the attendant risks of cholera and dysentery. At one site in Freetown the 6000 refugees have to fetch water from a well and have no latrines. As a result there have been 277 cases of cholera and 2 deaths already among that group. The health department has set up five centers to treat cholera in Freetown and is organizing mobile clinics. WHO's Sierra Leone office is assisting the government mobile health teams, which provide free primary care to displaced people. Medicines and vaccines, however, are lacking. Many of the staff of the 13 district health authorities have been displaced to Freetown. Aid agencies such as Medecins Sans Frontieres and Oxfam have stepped into the role in many districts. Ironically, one of the Revolutionary United Front's main demands is for a free national health service.

  13. [Abortion in sheep: epidemic Salmonella abortusovis outbreak 2005 in Switzerland].

    Science.gov (United States)

    von Tavel, L; Fivian, R; Kirchhofer, M; Boujon, P; Hirsbrunner, G

    2005-10-01

    In spring 2005, the outbreak of contagious abortion caused by Salmonella Abortusovis in 6 sheep flocks in Switzerland led to considerable economic losses. The Swiss small ruminant health service (BGK) evaluated this case. The aim was to identify the source of the epidemic in order to avoid further spread of infection and to evaluate the possibility of using vaccination. Moreover, a strategy for prevention of future outbreaks was developed. This article aims to increase disease awareness of food animal practitioners for Salmonella Abortusovis abortion in sheep.

  14. Monitoring Epidemic of Tobacco Use, Promote Tobacco Control

    Institute of Scientific and Technical Information of China (English)

    Gong-Huan YANG

    2010-01-01

    @@ Tobacco use is a major cause of preventable disease and premature death. The tobacco epidemic is responsible for 5.4 million deaths annually and killed 100 million people worldwide in the last century. It is estimated that by 2030 there will be more than 8 million deaths every year attributable to tobacco use and that more than 80% of these will occur in developing countries. By the end of the 21st century,1 billion people will have died from cigarette smoke[1].

  15. 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

  16. Atypical Hemolytic Uremic Syndrome Secondary to Lupus Nephritis, Responsive to Eculizumab

    Science.gov (United States)

    Raufi, Alexander G.; Scott, Shruti; Darwish, Omar; Harley, Kevin; Kahlon, Kanwarpal; Desai, Sheetal; Lu, Yuxin; Tran, Minh-Ha

    2016-01-01

    Among the spectrum of disease manifestations associated with systemic lupus erythematosus, lupus nephritis is particularly concerning due to the potential for renal failure. This autoimmune attack may not, however, be limited to the kidney and is increasingly being recognized as a trigger for atypical Hemolytic Uremic Syndrome (aHUS). Atypical HUS falls under the spectrum of the thrombotic microangiopathies (TMAs) – a group of disorders characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end organ damage. Although plasma exchange is considered first-line therapy for thrombotic thrombocytopenic purpura – a TMA classically associated with autoimmune depletion of ADAMTS-13 – aHUS demonstrates less reliable responsiveness to this modality. Instead, use of the late complement inhibitor Eculizumab has emerged as an effective modality for the management of such patients. Diagnosis of aHUS, however, is largely clinically based, relying heavily upon a multidisciplinary approach. Herein we present the case of a patient with atypical HUS successfully treated with Eculizumab in the setting of Class IV-G (A) lupus nephritis and hypocomplementemia.

  17. Atypical hemolytic uremic syndrome secondary to lupus nephritis, responsive to eculizumab

    Directory of Open Access Journals (Sweden)

    Alexander G. Raufi

    2016-09-01

    Full Text Available Among the spectrum of disease manifestations associated with systemic lupus erythematosus, lupus nephritis is particularly concerning due to the potential for renal failure. This autoimmune attack may not, however, be limited to the kidney and is increasingly being recognized as a trigger for atypical Hemolytic Uremic Syndrome (aHUS. Atypical HUS falls under the spectrum of the thrombotic microangiopathies (TMAs – a group of disorders characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end organ damage. Although plasma exchange is considered first-line therapy for thrombotic thrombocytopenic purpura – a TMA classically associated with autoimmune depletion of ADAMTS-13 – aHUS demonstrates less reliable responsiveness to this modality. Instead, use of the late complement inhibitor Eculizumab has emerged as an effective modality for the management of such patients. Diagnosis of aHUS, however, is largely clinically based, relying heavily upon a multidisciplinary approach. Herein we present the case of a patient with atypical HUS successfully treated with Eculizumab in the setting of Class IV-G (A lupus nephritis and hypocomplementemia.

  18. Insulin-Like Growth Factor Binding Protein-4 as a Marker of Chronic Lupus Nephritis.

    Directory of Open Access Journals (Sweden)

    Tianfu Wu

    Full Text Available Kidney biopsy remains the mainstay of Lupus Nephritis (LN diagnosis and prognostication. The objective of this study is to identify non-invasive biomarkers that closely parallel renal pathology in LN. Previous reports have demonstrated that serum Insulin-like growth factor binding protein 4 (IGFBP-4 was increased in diabetic nephropathy in both animal models and patients. We proceeded to assess if IGFBP4 could be associated with LN. We performed ELISA using the serum of 86 patients with LN. Normal healthy adults (N = 23 and patients with other glomerular diseases (N = 20 served as controls. Compared to the healthy controls or other glomerular disease controls, serum IGFBP-4 levels were significantly higher in the patients with LN. Serum IGFBP-4 did not correlate well with systemic lupus erythematosus disease activity index (SLEDAI, renal SLEDAI or proteinuria, but it did correlate with estimated glomerular filtration rate (R = 0.609, P < 0.0001. Interestingly, in 18 patients with proliferative LN whose blood samples were obtained at the time of renal biopsy, serum IGFBP-4 levels correlated strongly with the chronicity index of renal pathology (R = 0.713, P < 0.001. IGFBP-4 emerges a potential marker of lupus nephritis, reflective of renal pathology chronicity changes.

  19. NMR based serum metabolomics reveals a distinctive signature in patients with Lupus Nephritis

    Science.gov (United States)

    Guleria, Anupam; Pratap, Avadhesh; Dubey, Durgesh; Rawat, Atul; Chaurasia, Smriti; Sukesh, Edavalath; Phatak, Sanat; Ajmani, Sajal; Kumar, Umesh; Khetrapal, Chunni Lal; Bacon, Paul; Misra, Ramnath; Kumar, Dinesh

    2016-01-01

    Management of patient with Lupus Nephritis (LN) continues to remain a challenge for the treating physicians because of considerable morbidity and even mortality. The search of biomarkers in serum and urine is a focus of researchers to unravel new targets for therapy. In the present study, the utility of NMR-based serum metabolomics has been evaluated for the first time in discriminating LN patients from non-nephritis lupus patients (SLE) and further to get new insights into the underlying disease processes for better clinical management. Metabolic profiling of sera obtained from 22 SLE patients, 40 LN patients and 30 healthy controls (HC) were performed using high resolution 1D 1H-CPMG and diffusion edited NMR spectra to identify the potential molecular biomarkers. Using multivariate analysis, we could distinguish SLE and LN patients from HC and LN from SLE patients. Compared to SLE patients, the LN patients had increased serum levels of lipid metabolites (including LDL/VLDL lipoproteins), creatinine and decreased levels of acetate. Our results revealed that metabolic markers especially lipids and acetate derived from NMR spectroscopy has high sensitivity and specificity to distinguish LN among SLE patients and has the potential to be a useful adjunctive tool in diagnosis and clinical management of LN. PMID:27739464

  20. Role of TWEAK/Fn14 signalling pathway in lupus nephritis and other clinical settings.

    Science.gov (United States)

    González-Sánchez, Diego A; Álvarez, Cristian M; Vásquez, Gloria; Gómez-Puerta, José A

    2016-08-29

    Knowledge of the signalling pathways involved in various diseases has enabled advances in the understanding of pathophysiological, diagnostic and therapeutic models of several inflammatory and autoimmune diseases. Systemic lupus erythematosus is a widely studied autoimmune disease that can affect multiple organs, with a major impact on morbidity and mortality when it involves the kidneys. Over the past 10 years, interest in the role of the TWEAK/Fn14 signalling pathway in lupus nephritis, as well as other clinical settings, has increased. By reviewing the literature, this article assesses the role of this pathway in lupus nephritis, underlines the importance of TWEAK in urine (uTWEAK) as a biomarker of the disease and stresses the favourable results published in the literature from the inhibition of the TWEAK/Fn14 pathway as a therapeutic target in experimental animal models, demonstrating its potential application in other settings. Results of ongoing clinical trials and future research will give us a better understanding of the real benefit of blocking this pathway in the clinical course of several conditions.

  1. Interstitial nephritis, acute renal failure in a patient with non-fulminant hepatitis A infection.

    Science.gov (United States)

    Vaboe, A L; Leh, S; Forslund, T

    2002-02-01

    This is the first report from Norway of a patient with interstitial nephritis and renal failure due to non-fulminant hepatitis A virus (HAV) infection. HAV infection was confirmed by positive anti-HAV IgM serology. All tests for other virus infections were negative. At admittance serum creatinine (s-Creat) and blood urea nitrogen (BUN) concentration were 539 microlmol/l and 32.6 mmol/l increasing the following days to 890 micromol/l and 39.9 mmol/l, respectively. Nine courses of hemodialysis had to be given. Kidney biopsy specimen showed interstitial edema, lymphocytic cell infiltration and acute tubular injury with normal glomeruli. Examination with immunohistochemistry was negative. In contrast to the findings associated with HBV and HCV infection in which glomerular disease is predominantly found, the HAV infection in our patient was associated with interstitial nephritis and acute tubular necrosis. The prognosis of the renal failure due to HAV infection was good although the recovery was substantially delayed.

  2. Successful Treatment with Mycophenolate Mofetil and Tacrolimus in Juvenile Severe Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Tomoo Kise

    2015-01-01

    Full Text Available Lupus nephritis (LN of juvenile onset often has severe disease presentation. Despite aggressive induction therapy, up to 20% of patients with LN are resistant to initial therapy and up to 44% suffer a renal relapse. However, there is no consensus on an appropriate therapeutic regimen for refractory LN. We report a 13-year-old girl with recurrent LN who was not taking her medications. At age of 11 years, she was diagnosed with LN classified as International Society of Nephrology/Renal Pathology Society (ISN/RPS class IV G (A + V. She was treated with prednisolone and MMF after nine methylprednisolone pulses. Nineteen months later, she was admitted to the hospital with generalized edema. Her symptoms were nephrotic syndrome and acute renal dysfunction. She received three methylprednisolone pulses for 3 days, followed by oral prednisolone and MMF. Twenty-seven days after the three methylprednisolone pulses, her acute renal dysfunction was improved, but the nephrotic syndrome was not improved. A second biopsy showed diffuse lupus nephritis classified as the predominant finding of ISN/RPS class V. We added tacrolimus to the MMF. Four months after adding tacrolimus, the nephrotic syndrome improved. We conclude that adding tacrolimus to the treatment regimen for LN resistant to MMF is effective.

  3. [Tubulointerstitial nephritis associated with treatment with selective Cox-2 inhibitors, celecoxib and rofecoxib].

    Science.gov (United States)

    Ortiz, M; Mon, C; Fernández, M J; Sánchez, R; Mampaso, F; Alvarez Ude, F

    2005-01-01

    The nephrotoxic effect of nonselective nonsteroidal anti-inflamatory drugs (NSAIDS) has been widely described. The main benefit of the Cox-2 inhibitors in relation to the NSAIDS is the production of a very similar analgesic effect, but with fewer gastrointestinal side effects. However, their effects on renal function are little known as yet and their long-term safety is still pending definition. The use of selective Cox-2 inhibitors as anti-inflamatory analgesic is becoming more and more common in our environment. We report two cases of tubulointersticial nephritis confirmed by renal biopsy, associated with administration of the two Cox-2 inhibitors currently available on the market, celecoxib and rofecoxib. In both cases, we were talking about elderly women, with deterioration of the general condition and acute renal failure. In the former case, renal biopsy showed an acute tubulo-intersticial nephritis (TIN) so highly "variegated" in its histologic expression. In the second case, was associated with strong indications of chronicity. Treatment with steroid was initiated in both patients and improvement of renal function was observed.

  4. The Cuban Response to the Ebola Epidemic in West Africa: Lessons in Solidarity.

    Science.gov (United States)

    Chaple, Enrique Beldarraín; Mercer, Mary Anne

    2017-01-01

    In December 2013 the first case of Ebola appeared in Guinea. In September 2014 the United Nations (UN) and its specialized agency the World Health Organization (WHO) issued a call for medical collaboration in response to the medical crisis and social disaster caused by the Ebola virus epidemic in West Africa. Cuban authorities responded immediately to the call by offering specialized help for the epidemic, in collaboration with WHO. A group of 256 Cuban doctors, nurses and other health professionals provided direct care during the Ebola epidemic in Sierra Leone, Liberia and Equatorial Guinea from October 2014 to April 2015. This paper explains the main features of the Cuban health system, describes the development of Cuba's international medical cooperation approach, and highlights the work done by Cuban health collaborators in addressing the damage caused by the Ebola epidemic. Information used includes reports and documents of the Ministry of Public Health of Cuba, reports of WHO and PAHO, and articles published in scientific journals and newspaper articles. The response of the Cuban medical teams to the Ebola epidemic in West Africa is only one example of the Cuban efforts to strengthening health care provision in areas of need throughout the world.

  5. 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 h...

  6. Anti-DNA autoantibodies initiate experimental lupus nephritis by binding directly to the glomerular basement membrane in mice.

    Science.gov (United States)

    Krishnan, Meera R; Wang, Congmiao; Marion, Tony N

    2012-07-01

    The strongest serological correlate for lupus nephritis is antibody to double-stranded DNA, although the mechanism by which anti-DNA antibodies initiate lupus nephritis is unresolved. Most recent reports indicate that anti-DNA must bind chromatin in the glomerular basement membrane or mesangial matrix to form glomerular deposits. Here we determined whether direct binding of anti-DNA antibody to glomerular basement membrane is critical to initiate glomerular binding of anti-DNA in experimental lupus nephritis. Mice were co-injected with IgG monoclonal antibodies or hybridomas with similar specificity for DNA and chromatin but different IgG subclass and different relative affinity for basement membrane. Only anti-DNA antibodies that bound basement membrane bound to glomeruli, activated complement, and induced proteinuria whether injected alone or co-injected with a non-basement-membrane-binding anti-DNA antibody. Basement membrane-binding anti-DNA antibodies co-localized with heparan sulfate proteoglycan in glomerular basement membrane and mesangial matrix but not with chromatin. Thus, direct binding of anti-DNA antibody to antigens in the glomerular basement membrane or mesangial matrix may be critical to initiate glomerular inflammation. This may accelerate and exacerbate glomerular immune complex formation in human and murine lupus nephritis.

  7. 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...

  8. Etiological analysis of the first gathered cases of epidemic cerebrospinal meningitis caused by serogroup C neisseria meningitis in Meizhou city%梅州市首次C群流行性脑脊髓膜炎聚集性病例病原学分析

    Institute of Scientific and Technical Information of China (English)

    陈志青; 刘美真; 蔡芳华; 曾丽珍; 古汉福; 肖胜传

    2013-01-01

    目的 对梅州市首次C群流行性脑脊髓膜炎(流脑)聚集性病例进行病原宇分析.方法 对梅州市首次C群流脑聚集性病例进行流行病学调查,标本采集,菌株分离、鉴定、血清学分群及药物敏感性检测,并进行多位点序列分型(MLST)分析.结果 梅州市首次从2例流脑病例中分离到2株C群脑膜炎奈瑟菌(Nm),第2例病例脑脊液标本PCR检测出C群siaD基因阳性.第2例及17例密切接触者咽拭子标本均未检出脑膜炎奈瑟菌.菌株对环丙沙星、萘啶酸、甲氧苄啶/磺胺甲恶唑耐药,但对头孢噻肟、头孢曲松、美罗培南、阿奇霉素、咪诺霉素、氯霉素、利福平、青霉素、氨苄西林敏感.首例患者分离菌株MLST分型为ST-4821型.结论 此为近年梅州市首次报告的C群流脑聚集性疫情,提示应加强对C群奈瑟菌的监测,密切关注C群流脑的发病及流行趋势.%Objective To analyze the etiology of first gathered cases of epidemic cerebrospinal meningitis(ECM)caused by serogroup C neisseria meningitis(Nm)in Meizhou city.Methods The first gathered cases of serogroup C ECM in Meizhou city were analyzed by epidemiological investigation,specimens collecting,strains isolation,identification,serological grouping,antimicribiol susceptibility test and Multilocus sequence typing(MLST).Results Two serogroup C Nm strains were isolated from two cases in Meizhou city first.Nothing isolated from the second case and 17 close contacts.PCR identified siaD(C)gene was positive from the second case cerebrospinal fluid.The strain resistant to ciprofloxacin,nalidixic acid,trimethoprim/sulfamethoxazole,but sensitive to cefotaxime,ceftriaxone,meropenem,azithromycin,cefminox,chloramphenicol,rifampin,penicillin and ampicillin.MLST of the first strain was type ST-4821.Conclusion This is the first gathered cases of ECM caused by serogroup C Nm in Meizhou city.Serogroup C Nm monitoring,serogroup C ECM incidence and prevalence trend should be

  9. 新生儿Fc受体在人肾小球肾炎及大鼠肾炎模型中的表达%Expression of neonatal Fc receptor on human nephritis and rat nephritis models

    Institute of Scientific and Technical Information of China (English)

    冯松涛; 甘华磊; 孙建永; 蒋涛; 刘宝利; 赵仲华; 郭慕依; 张志刚

    2012-01-01

    Objective To study the expression of neonatal Fc receptor in podocytes in human nephritis and immune-induced rat nephritis models:anti-Thy1.1 nephritis and Heymann nephritis.Methods Thirty-nine cases of renal biopsies were enrolled from September 2009 to February 2010,including 8 cases of minimal change disease, 4 cases of focal segmental glomerulosclerosis, 9 cases of membranous nephropathy,12 cases of IgA nephropathy and 6 cases of lupus nephritis.Five normal kidney tissue samples adjacent to renal clear-cell carcinoma were served as normal controls.Laser capture microdissection and realtime RT-PCR were used to assess the expression level of FcRn mRNA in glomeruli of various glomerulonephritides,and immunohistochemistry (IHC) of FcRn by SuperVision method was performed.In addition,rat models of mesangial proliferative nephritis (anti-Thyl.1 nephritis) and passive membranous nephropathy (Heymann nephritis ) were established and FcRn was examined in renal tissues by IHC.Results The FcRn mRNA level in lupus nephritis was statistically higher than that of normal controls ( P < 0.05 ).FcRn protein expression by IHC was seen in lupus nephritis (6/6),membranous nephropathy (6/9) and IgA nephropathy (7/12),significantly higher than that of normal controls (0/5),P < 0.05.Minimal change disease and focal segmental glomerular sclerosis showed minimal or none expression of FcRn (1/8,0/4 respectively) and not statistically difference from that of normal controls. Furthermore,FcRn expression in podocytes was detected in rat anti-Thy1.1 (3/5) and Heymann nephritis models (2/7) but was not detected in normal controls. Conclusions Expression of FcRn in podocytes was up-regulated in immune-induced human nephritis and rat nephritis models of anti-Thyl.1 nephritis and Heymann nephritis.FcRn may play a role in the development of immune-induced glomerulonephritis.%目的 观察人肾小球肾炎及大鼠肾炎动物模型中,足细胞新生儿Fc受体(FcRn)的表达.方法 (1)

  10. The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition.

    Science.gov (United States)

    Duesberg, Peter; Koehnlein, Claus; Rasnick, David

    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 malnutrition

  11. 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

  12. 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.

  13. Inferring epidemic network topology from surveillance data.

    Science.gov (United States)

    Wan, Xiang; Liu, Jiming; Cheung, William K; Tong, Tiejun

    2014-01-01

    The transmission of infectious diseases can be affected by many or even hidden factors, making it difficult to accurately predict when and where outbreaks may emerge. One approach at the moment is to develop and deploy surveillance systems in an effort to detect outbreaks as timely as possible. This enables policy makers to modify and implement strategies for the control of the transmission. The accumulated surveillance data including temporal, spatial, clinical, and demographic information, can provide valuable information with which to infer the underlying epidemic networks. Such networks can be quite informative and insightful as they characterize how infectious diseases transmit from one location to another. The aim of this work is to develop a computational model that allows inferences to be made regarding epidemic network topology in heterogeneous populations. We apply our model on the surveillance data from the 2009 H1N1 pandemic in Hong Kong. The inferred epidemic network displays significant effect on the propagation of infectious diseases.

  14. Epidemic and Cascading Survivability of Complex Networks

    CERN Document Server

    Manzano, Marc; Ripoll, Jordi; Fagertun, Anna Manolova; Torres-Padrosa, Victor; Pahwa, Sakshi; Scoglio, Caterina

    2014-01-01

    Our society nowadays is governed by complex networks, examples being the power grids, telecommunication networks, biological networks, and social networks. It has become of paramount importance to understand and characterize the dynamic events (e.g. failures) that might happen in these complex networks. For this reason, in this paper, we propose two measures to evaluate the vulnerability of complex networks in two different dynamic multiple failure scenarios: epidemic-like and cascading failures. Firstly, we present \\emph{epidemic survivability} ($ES$), a new network measure that describes the vulnerability of each node of a network under a specific epidemic intensity. Secondly, we propose \\emph{cascading survivability} ($CS$), which characterizes how potentially injurious a node is according to a cascading failure scenario. Then, we show that by using the distribution of values obtained from $ES$ and $CS$ it is possible to describe the vulnerability of a given network. We consider a set of 17 different compl...

  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. 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.

  17. Identification of the characteristics and risk factors of the BSE epidemic in the Netherlands.

    NARCIS (Netherlands)

    Heres, L.; Elbers, A.R.W.; Schreuder, B.E.C.; Zijderveld, van F.G.

    2007-01-01

    It is generally accepted that the bovine spongiform encephalopathy (BSE) epidemic is transmitted by feed contamination with meat and bone meal (MBM). Whether in some cases substances other than MBM have caused the spread of this disease cannot be excluded at present. Detailed knowledge about country

  18. Phocine distemper revisited: Multidisciplinary analysis of the 2002 phocine distemper virus epidemic in the Netherlands

    NARCIS (Netherlands)

    J.M. Rijks (Jolianne)

    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

  19. 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.

  20. 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.

  1. 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.

  2. Epidemic transmission of intestinal schistosomiasis in the seasonal part of the Okavango Delta, Botswana

    DEFF Research Database (Denmark)

    Appleton, C.C.; Ellery, W.N.; Byskov, Jens;

    2008-01-01

    A well documented epidemic of human intestinal schistosomiasis caused by Schistosoma mansoni occurred at Maun in the seasonal part of the Okavango Delta, Botswana, building from very few cases in the 1950s and early 1960s to a peak prevalence of >80% in the 1980s. A retrospective analysis was per...... with a lag period of 5-6 years between the rise and fall of discharge and the rise and fall of transmission. Since the hydrological events in the delta follow a cyclical pattern, another epidemic around 2020 appears likely....

  3. Beyond Tsetse--Implications for Research and Control of Human African Trypanosomiasis Epidemics.

    Science.gov (United States)

    Welburn, Susan C; Molyneux, David H; Maudlin, Ian

    2016-03-01

    Epidemics of both forms of human African trypanosomiasis (HAT) are confined to spatially stable foci in Sub-Saharan Africa while tsetse distribution is widespread. Infection rates of Trypanosoma brucei gambiense in tsetse are extremely low and cannot account for the catastrophic epidemics of Gambian HAT (gHAT) seen over the past century. Here we examine the origins of gHAT epidemics and evidence implicating human genetics in HAT epidemiology. We discuss the role of stress causing breakdown of heritable tolerance in silent disease carriers generating gHAT outbreaks and see how peculiarities in the epidemiologies of gHAT and Rhodesian HAT (rHAT) impact on strategies for disease control.

  4. West Nile virus epidemics in North America are driven by shifts in mosquito feeding behavior.

    Science.gov (United States)

    Kilpatrick, A Marm; Kramer, Laura D; Jones, Matthew J; Marra, Peter P; Daszak, Peter

    2006-04-01

    West Nile virus (WNV) has caused repeated large-scale human epidemics in North America since it was first detected in 1999 and is now the dominant vector-borne disease in this continent. Understanding the factors that determine the intensity of the spillover of this zoonotic pathogen from birds to humans (via mosquitoes) is a prerequisite for predicting and preventing human epidemics. We integrated mosquito feeding behavior with data on the population dynamics and WNV epidemiology of mosquitoes, birds, and humans. We show that Culex pipiens, the dominant enzootic (bird-to-bird) and bridge (bird-to-human) vector of WNV in urbanized areas in the northeast and north-central United States, shifted its feeding preferences from birds to humans by 7-fold during late summer and early fall, coinciding with the dispersal of its preferred host (American robins, Turdus migratorius) and the rise in human WNV infections. We also show that feeding shifts in Cx. tarsalis amplify human WNV epidemics in Colorado and California and occur during periods of robin dispersal and migration. Our results provide a direct explanation for the timing and intensity of human WNV epidemics. Shifts in feeding from competent avian hosts early in an epidemic to incompetent humans after mosquito infection prevalences are high result in synergistic effects that greatly amplify the number of human infections of this and other pathogens. Our results underscore the dramatic effects of vector behavior in driving the transmission of zoonotic pathogens to humans.

  5. West Nile virus epidemics in North America are driven by shifts in mosquito feeding behavior.

    Directory of Open Access Journals (Sweden)

    A Marm Kilpatrick

    2006-04-01

    Full Text Available West Nile virus (WNV has caused repeated large-scale human epidemics in North America since it was first detected in 1999 and is now the dominant vector-borne disease in this continent. Understanding the factors that determine the intensity of the spillover of this zoonotic pathogen from birds to humans (via mosquitoes is a prerequisite for predicting and preventing human epidemics. We integrated mosquito feeding behavior with data on the population dynamics and WNV epidemiology of mosquitoes, birds, and humans. We show that Culex pipiens, the dominant enzootic (bird-to-bird and bridge (bird-to-human vector of WNV in urbanized areas in the northeast and north-central United States, shifted its feeding preferences from birds to humans by 7-fold during late summer and early fall, coinciding with the dispersal of its preferred host (American robins, Turdus migratorius and the rise in human WNV infections. We also show that feeding shifts in Cx. tarsalis amplify human WNV epidemics in Colorado and California and occur during periods of robin dispersal and migration. Our results provide a direct explanation for the timing and intensity of human WNV epidemics. Shifts in feeding from competent avian hosts early in an epidemic to incompetent humans after mosquito infection prevalences are high result in synergistic effects that greatly amplify the number of human infections of this and other pathogens. Our results underscore the dramatic effects of vector behavior in driving the transmission of zoonotic pathogens to humans.

  6. 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.

  7. Mortality from contact-related epidemics among indigenous populations in Greater Amazonia.

    Science.gov (United States)

    Walker, Robert S; Sattenspiel, Lisa; Hill, Kim R

    2015-09-10

    European expansion and contact with indigenous populations led to catastrophic depopulation primarily through the introduction of novel infectious diseases to which native peoples had limited exposure and immunity. In the Amazon Basin such contacts continue to occur with more than 50 isolated indigenous societies likely to make further contacts with the outside world in the near future. Ethnohistorical accounts are useful for quantifying trends in the severity and frequency of epidemics through time and may provide insight into the likely demographic consequences of future contacts. Here we compile information for 117 epidemics that affected 59 different indigenous societies in Greater Amazonia and caused over 11,000 deaths between 1875 and 2008, mostly (75%) from measles, influenza, and malaria. Results show that mortality rates from epidemics decline exponentially through time and, independently, with time since peaceful contact. The frequency of documented epidemics also decreases with time since contact. While previous work on virgin soil epidemics generally emphasizes the calamity of contacts, we focus instead on improvements through time. The prospects for better survivorship during future contacts are good provided modern health care procedures are implemented immediately.

  8. HIV/AIDS and Drug Abuse: Intertwined Epidemics

    Science.gov (United States)

    ... DrugFacts » HIV/AIDS and Drug Abuse: Intertwined Epidemics HIV/AIDS and Drug Abuse: Intertwined Epidemics Email Facebook ... to AIDS, greatly prolonging lives. What Exactly Is HIV/AIDS? HIV stands for human immunodeficiency virus. This ...

  9. 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

  10. 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

  11. Cardiovascular disease in Latin America: the growing epidemic.

    Science.gov (United States)

    Fernando, Lanas; Pamela, Serón; Alejandra, Lanas

    2014-01-01

    Cardiovascular diseases (CVD) produce almost a million deaths a year in Latin America (LA), becoming the main cause of death in the last years, and it is estimated that the number of deaths in the region attributable to CVD will increase in the near future. This new epidemic is a consequence of the demographic, economic and social changes observed in LA in recent years. Coronary heart disease and stroke causes 42.5% and 28.8%, respectively of the CVD mortality in the region. Chagas heart involvement and rheumatic heart disease, once a major health problem, are responsible of only 1% of the mortality each. Improving in socioeconomic status, increased life expectancy and high prevalence of risk factors for atherosclerosis have been the major determinants of this marked epidemiologic change.

  12. Nine challenges for deterministic epidemic models

    DEFF Research Database (Denmark)

    Roberts, Mick G; Andreasen, Viggo; Lloyd, Alun;

    2015-01-01

    , infections with time-varying infectivity, and those where superinfection is possible. We then consider the need for advances in spatial epidemic models, and draw attention to the lack of models that explore the relationship between communicable and non-communicable diseases. The final two challenges concern...

  13. Can epidemics be non-communicable?

    DEFF Research Database (Denmark)

    Seeberg, Jens; Meinert, Lotte

    2015-01-01

    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 co......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 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 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...

  14. 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...

  15. 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

  16. 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)

  17. 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)

  18. 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.

  19. 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

  20. 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.

  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. Granulomatous Interstitial Nephritis and Acute Renal Failure due to Renal-limited Sarcoidosis

    Directory of Open Access Journals (Sweden)

    El-Reshaid Kamel

    2000-01-01

    Full Text Available Renal failure secondary to granulomatous sarcoidosis without clinical features or radiological evidence of disease is rare. In this case report, we describe a 14-year old girl who developed progressive renal failure over a two-month period which was associated with weight loss and epigastric pain. Physical examination did not show any abnormality. Laboratory investigations were normal except for normocytic normochromic anemia, high serum urea, high serum creatinine (452 tmol/L and polyclonal gammopathy. Percutaneous kidney biopsy showed severe interstitial nephritis with non-caseating granulomata. She was treated with tapered prednisone after a starting dose of 1 mg/kg. The treatment with prednisolone resulted in a complete remission that lasted up to two years of follow up. This case highlights the variable expression of sarcoidosis, which should be considered in the management of such disease.

  3. 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.

  4. 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.

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

    DEFF Research Database (Denmark)

    Olaru, Florina; Luo, Wentian; Wang, Xu-Ping

    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...... 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...

  6. THE RELATIONSHIp BETWEEN CAUSES AND DETERMINANTS OF JOB BURNOUT OF STAFF ENGAGING IN CONTROLLING EPIDEMIC DISEASE%传染病防疫人员职业倦怠的产生及其影响因素的相关研究

    Institute of Scientific and Technical Information of China (English)

    李霞; 谷金君; 李晓雯; 张雪芹; 吴秀荣

    2012-01-01

    [Objective] To analyze the relationship between job burnout and influential factors of staff in controlling epidemic disease, and to provide basic data for intervention. [Methods] This study used quantitative method to examine the relationship between job burnout, work pressure, responding strategies to work pressure, self-esteem and social support, conducted a survey of 200 staff working in epidemic disease control. I Results j The scores of job burnout in epidemic disease control were 54.97 ± 12.02, which was found positively related to work pressure, responding strategy but negatively correlated to self-esleera and social support. [Conclusion] The occurrence rate of job burnout of staff in controlling epidemic disease is relatively high because the increase in public incidences leads to heavy workload and high risk. High self-esteem, active responding strategy, and efficient social support play an important role in relieving the job burnout.%[目的]探讨传染病防疫人员职业倦怠的产生及其影响因素的关系,为进行干预提供参考依据.[方法]采用工作压力量表、工作压力应对策略调查表、自尊量表、社会支持量表、职业倦怠量表,对200名传染病防疫人员进行了调查,探讨各影响因素之间的相关性.[结果]其职业倦怠与工作压力、应对策略呈正相关、与自尊、社会支持呈负相关,传染病防疫人员职业倦怠评分为5497±12.02.[结论]传染病防疫人员职业倦怠发生率较高,主要因突发公共卫生事件的增多,导致工作量大且风险高而致.高自尊、积极的应对策略、有效的社会支持对缓解职业倦怠起到重要的作用.

  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. Autoantibodies against Modified Histone Peptides in SLE Patients Are Associated with Disease Activity and Lupus Nephritis

    Science.gov (United States)

    Dieker, Jürgen; Berden, Jo H.; Bakker, Marinka; Briand, Jean-Paul; Muller, Sylviane; Voll, Reinhard; Sjöwall, Christopher; Herrmann, Martin; Hilbrands, Luuk B.; van der Vlag, Johan

    2016-01-01

    Persistent exposure of the immune system to death cell debris leads to autoantibodies against chromatin in patients with systemic lupus erythematosus (SLE). Deposition of anti-chromatin/chromatin complexes can instigate inflammation in multiple organs including the kidney. Previously we identified specific cell death-associated histone modifications as targets of autoantibodies in SLE. In this study we addressed, in a large cohort of SLE patients and controls, the question whether plasma reactivities with specific histone peptides associated with serology and clinical features. Plasma from SLE patients with and without lupus nephritis, disease controls, and healthy controls, were tested in ELISA with histone H4 peptide acetylated at lysines 8, 12 and 16 (H4pac), H2B peptide acetylated at lysine 12 (H2Bpac), H3 peptide trimethylated at lysine 27 (H3pme), and their unmodified equivalents. SLE patients displayed a higher reactivity with the modified equivalent of each peptide. Reactivity with H4pac showed both a high sensitivity (89%) and specificity (91%) for SLE, while H2Bpac exhibited a high specificity (96%) but lower sensitivity (69%). Reactivity with H3pme appeared not specific for SLE. Anti-H4pac and anti-H2Bpac reactivity demonstrated a high correlation with disease activity. Moreover, patients reacting with multiple modified histone peptides exhibited higher SLEDAI and lower C3 levels. SLE patients with renal involvement showed higher reactivity with H2B/H2Bpac and a more pronounced reactivity with the modified equivalent of H3pme and H2Bpac. In conclusion, reactivity with H4pac and H2Bpac is specific for SLE patients and correlates with disease activity, whereas reactivity with H2Bpac is in particular associated with lupus nephritis. PMID:27780265

  9. 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.

  10. 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...

  11. 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

  12. Interstitial nephritis

    Science.gov (United States)

    ... 2015:chap 64. Read More Acute Acute kidney failure Allergic reactions Analgesic nephropathy Chronic Chronic kidney disease End-stage kidney disease Injury - kidney and ureter Metabolic acidosis Renal Urine output - decreased Review Date 9/22/2015 Updated by: Charles Silberberg, ...

  13. 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

  14. Temporal Heterogeneities Increase the Prevalence of Epidemics on Evolving Networks

    CERN Document Server

    Rocha, Luis Enrique Correa

    2012-01-01

    Empirical studies suggest that contact patterns follow heterogeneous inter-event times, meaning that intervals of high activity are followed by periods of inactivity. Combined with birth and death of individuals, these temporal constraints affect the spread of infections in a non-trivial way and are dependent on the particular contact dynamics. We propose a stochastic model to generate temporal networks where vertices make instantaneous contacts following heterogeneous inter-event times, and leave and enter the system at fixed rates. We study how these temporal properties affect the prevalence of an infection and estimate R0, the number of secondary infections, by modeling simulated infections (SIR, SI and SIS) co-evolving with the network structure. We find that heterogeneous contact patterns cause earlier and larger epidemics on the SIR model in comparison to homogeneous scenarios. In case of SI and SIS, the epidemics is faster in the early stages (up to 90% of prevalence) followed by a slowdown in the asym...

  15. Secular trends in new childhood epidemics: insights from evolutionary medicine.

    Science.gov (United States)

    Brüne, Martin; Hochberg, Ze'ev

    2013-10-21

    In the last few decades, pediatric medicine has observed a dramatic increase in the prevalence of hitherto rare illnesses, among which obesity, diabetes, allergies and other autoimmune diseases stand out. In addition, secular trends towards earlier onset of puberty and sexual activity contribute to the psychological problems of youth and adolescents. All this has occurred in spite of the improved health care provision for children, yet traditional concepts of medicine have failed to explain these new "epidemics". A recent conference and science school of the European Society of Paediatric Endocrinology (ESPE) in Acre, Israel, has taken up this challenge. Experts across disciplines including medicine, anthropology and developmental psychology discussed potential causes of childhood ill-health from an evolutionary point-of-view. Seen from an evolutionary vantage point, the "epidemics" of childhood obesity, diabetes and psychological dysfunction appear, in part, to be related to a mismatch between ancestral adaptations and novel environmental contingencies. These include changing exposures to pathogens, which impact on the function of the immune system, as well as changing patterns of parenting, which influence the timing of puberty and the risk for developing psychopathology.

  16. 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.

  17. 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 ...

  18. Research on Difference in High-risk Birth Defect Epidemic Cause between Zhuang People and Han People in Nanning%南宁壮族与汉族高发出生缺陷流行病因差异研究

    Institute of Scientific and Technical Information of China (English)

    蒋武; 覃頔; 黄永全; 韦金露; 言京礼

    2016-01-01

    Objective To know whether there is a national difference in the incidence rate between different high-risk birth defects in Nanning and study its causes, and summarize the strategies of reducing the incidence rate of birth defects accord-ing to various risk factors and realize the sound child rearing in Nanning region. Methods The exposed risk factors of par-ents of 1274 perinatal infants with birth defects in Nanning were given 1 : 1 matched case-control study, the relevant influ-ence factors were studied and analyzed, and the case data base was established by Excel, and then the data was analyzed and treated by SPSS16.0 statistical software. Results In the defect group, 574 cases were Zhuang people, 666 cases were Han people, the incidence rates of congenital heart disease, cleft palate , harelip and cleft palate, hypospadias and gas-troschisis in Han people were higher than those in Zhuang people, the incidence rates of harelip, congenital hydrocephalus, neural tube defect, fetal edema syndrome, esophageal a-tresia or stenosis, anorectum atresia or stenosis and con-genital diaphragmatic hernia in Zhuang people were high-er than those in Han people, and the differences had sta-tistical significance, living in the polluted environment, exposure to radiation or toxic chemicals during pregnancy, medication without guidance of doctors during pregnancy, age of pregnant women more than 35, congenital disease family history, chemical exposure history of fathers, smoking and alcohol history of fathers, nutrition of pregnant women and dysthymia during pregnancy were related to the birth defects, and all of them were risk factors of birth defects. Conclusion There is a difference in the high-risk birth defect epidemic cause be-tween Zhuang people and Han people in Nanning with national specificity, the intervention in predicting birth defects in our region can be conducted from the aspects of environment, bad living habits, vocational factor and mental factor to reduce

  19. Viral causes of diarrhea.

    Science.gov (United States)

    Goodgame, R W

    2001-09-01

    Viruses are important causes of diarrhea. In healthy adults, the main clinical manifestation is acute, self-limited gastroenteritis. Advances in molecular diagnostics have shown that epidemics of acute gastroenteritis most frequently are due to caliciviruses spread through contaminated food or through person-to-person contact. Application of similar technology is needed to make a definitive statement about the role of such candidate viruses as rotavirus, astrovirus, and adenovirus as the cause of nonepidemic acute gastroenteritis in adults. Rarely a previously healthy adult gets acute CMV colitis. CMV and EBV mainly cause diarrhea in immunocompromised patients, however. Advances in prophylaxis and treatment have reduced the frequency and severity of these diseases. Acute infantile gastroenteritis is caused by rotavirus, calcivirus, astrovirus, and adenovirus. These viral diseases of the gut are seen by the physician as routine and rare clinical problems.

  20. Epidemic thresholds in a heterogenous population with competing strains

    Institute of Scientific and Technical Information of China (English)

    Wu Qing-Chu; FU Xin-Chu; Yang Meng

    2011-01-01

    Among many epidemic models, one epidemic disease may transmit with the existence of other pathogens or other strains from the same pathogen. In this paper, we consider the case where all of the strains obey the susceptible-infectedsusceptible mechanism and compete with each other at the expense of common susceptible individuals. By using the heterogenous mean-field approach, we discuss the epidemic threshold for one of two strains. We confirm the xistence of epidemic threshold in both finite and infinite populations subject to underlying epidemic transmission. Simulations in the Barabasi-Albert(BA)scale-free networks are in good agreement with the analytical results.

  1. 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.

  2. Modeling historical tuberculosis epidemics among Canadian First Nations: effects of malnutrition and genetic variation

    Directory of Open Access Journals (Sweden)

    Sarah F. Ackley

    2015-09-01

    Full Text Available Late 19th century epidemics of tuberculosis (TB in Western Canadian First Nations resulted in peak TB mortality rates more than six times the highest rates recorded in Europe. Using a mathematical modeling approach and historical TB mortality time series, we investigate potential causes of high TB mortality and rapid epidemic decline in First Nations from 1885 to 1940. We explore two potential causes of dramatic epidemic dynamics observed in this setting: first, we explore effects of famine prior to 1900 on both TB and population dynamics. Malnutrition is recognized as an individual-level risk factor for TB progression and mortality; its population-level effects on TB epidemics have not been explored previously. Second, we explore effects of heterogeneity in susceptibility to TB in two ways: modeling heterogeneity in susceptibility to infection, and heterogeneity in risk of developing disease once infected. Our results indicate that models lacking famine-related changes in TB parameters or heterogeneity result in an implausibly poor fit to both the TB mortality time series and census data; the inclusion of these features allows for the characteristic decline and rise in population observed in First Nations during this time period and confers improved fits to TB mortality data.

  3. The hidden epidemic of hypertension.

    Science.gov (United States)

    Grenfell, Robert; Lee, Rebecca; Stavreski, Bill; Page, Karen

    2014-04-01

    The majority of cardiovascular disease (CVD) is caused by risk factors that can be controlled, treated or modified. In terms of attributable deaths, the leading cardiovascular disease risk factor is hypertension. The Australian Health Survey results showed some startling figures-4.6 million adult Australians are hypertensive (>140/90 mmHg). Further, a fifth of the adult population experience hypertension, with more than two out of three not attaining blood pressure target levels. This is despite an estimated cost of $1 billion per annum spent on managing hypertension. It is now well recognised that the level of risk for coronary heart disease is linked to an individual's risk profile. Results indicate that many Australians have multiple risk factors, including hypertension. It could be considered that these numbers provide a proxy indicator of secondary prevention failure. Considerable attention needs to be given to the assessment of the combined risk of those with hypertension enabling effective management of identified, modifiable risk factors. We look forward to presenting the absolute risk profiles when the Australian Health Survey biometric results are released.

  4. Deciphering the origin of the 2012 cholera epidemic in Guinea by integrating epidemiological and molecular analyses.

    Directory of Open Access Journals (Sweden)

    Stanislas Rebaudet

    2014-06-01

    Full Text Available 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

  5. [The depression epidemic does not exist].

    Science.gov (United States)

    van der Feltz-Cornelis, Christina M

    2009-01-01

    There has been much discussion in the media about the question of the existence of a depression epidemic. This leads on to the questions of whether the social and economic approaches are adequate, and what the alternatives are. The concept of the disease 'depression' can be defined using a medical model, or from a patient's or a societal perspective. From a medical perspective, indeed a depression epidemic has ensued from the increased prosperity and the associated decompression of the mortality rate. Society responded with preventative measures and policies aimed at improving functioning in the workplace. However, patients with a major depressive disorder (MDD) who are eligible for treatment are often not motivated to take it up, or are undertreated. Research is necessary in order to explore what patients think about the identification and treatment of depression. The confusion regarding the concept of depression found in the media, needs to be cleared.

  6. [Epidemics and colonial medicine in West Africa].

    Science.gov (United States)

    Becker, C; Collignon, R

    1998-01-01

    We studied colonial medical practices and health policies in West Africa, which has faced endemics and epidemics that have affected entire societies. We found that attempts to centralize the organization of colonial medicine, which began in the late 19th Century, were limited until the end of World War I. Research and control programs expanded after 1920, concentrating on epidemics, but largely ignoring many major health problems, such as measles, whooping cough and malnutrition, the importance of which were not recognized until after World War II. This appraisal of colonial medicine highlights the difficulties of introducing modern medicine and its ideas into African societies. There have been various social reactions, resulting in the current duality in which traditional and modern medicine coexist.

  7. Computational algebraic geometry of epidemic models

    Science.gov (United States)

    Rodríguez Vega, Martín.

    2014-06-01

    Computational Algebraic Geometry is applied to the analysis of various epidemic models for Schistosomiasis and Dengue, both, for the case without control measures and for the case where control measures are applied. The models were analyzed using the mathematical software Maple. Explicitly the analysis is performed using Groebner basis, Hilbert dimension and Hilbert polynomials. These computational tools are included automatically in Maple. Each of these models is represented by a system of ordinary differential equations, and for each model the basic reproductive number (R0) is calculated. The effects of the control measures are observed by the changes in the algebraic structure of R0, the changes in Groebner basis, the changes in Hilbert dimension, and the changes in Hilbert polynomials. It is hoped that the results obtained in this paper become of importance for designing control measures against the epidemic diseases described. For future researches it is proposed the use of algebraic epidemiology to analyze models for airborne and waterborne diseases.

  8. Eight challenges for network epidemic models

    Directory of Open Access Journals (Sweden)

    Lorenzo Pellis

    2015-03-01

    Full Text Available Networks offer a fertile framework for studying the spread of infection in human and animal populations. However, owing to the inherent high-dimensionality of networks themselves, modelling transmission through networks is mathematically and computationally challenging. Even the simplest network epidemic models present unanswered questions. Attempts to improve the practical usefulness of network models by including realistic features of contact networks and of host–pathogen biology (e.g. waning immunity have made some progress, but robust analytical results remain scarce. A more general theory is needed to understand the impact of network structure on the dynamics and control of infection. Here we identify a set of challenges that provide scope for active research in the field of network epidemic models.

  9. 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.

  10. 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...

  11. 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.

  12. A Study on Clinical and Pathologic Features in Lupus Nephritis with Mainly IgA Deposits and a Literature Review

    Directory of Open Access Journals (Sweden)

    Liu Hongyan

    2013-01-01

    Full Text Available Objective. To study the clinical and pathologic features of systemic lupus erythematosus (SLE that has atypical lupus nephritis (LN with mainly IgA deposits. Methods. We searched the SLE patients who had nephritis with mainly IgA deposits in our hospital and selected the information including clinical manifestations, laboratory tests, treatments, and prognosis. Results. From January 2009 to June 2012, 5 patients were definitely diagnosed as SLE according to both 1982 and 2009 ACR classification criteria. But renal biopsy showed that all cases had mainly IgA deposits and were free of IgG, C1q, and fibrinogen-related antigen deposits under immunofluorescent microscopy, which did not match with typical LN. There were 2 males and 3 females, aging from 31 to 64 years and with an average of years. The 5 cases had multiple-system involvements, mainly the renal system. Compared to primary IgAN, the atypical LN showed some differences: older than primary IgAN, more women than men, no previous infection history, lower incidence of serum IgA elevation, and ACL positive rate as high as 100%. Conclusion. Nephritis with mainly IgAN deposits, as an atypical LN, may be a special subtype of SLE.

  13. Acute poststreptococcal glomerulo-nephritis in general practice: the contribution of infection to its onset and course.

    Science.gov (United States)

    Higgins, P M

    1996-04-01

    Twenty-one patients considered to have acute poststreptococcal glumerulo-nephritis were encountered during 35 years of general practice. In ten of them good evidence of active streptococcal infection at the time of discovery of nephritis was recorded. The more complete the data the more convincing was the evidence of active infection. In over half of those whose urine were routinely cultured pathogens were isolated and over a third were treated for infection of the urinary tract. Such infections were associated with adverse effects and prolonged illness. As compared with children, adults in general had a longer history of ill-health, were less likely to present with acute infections and more likely to have urinary tract infections and prolonged illness. Vigorous antistreptococcal treatment was followed by rapid recovery in those patients so treated whose illnesses were not complicated by urinary tract infections. Concurrent streptococcal infection and secondary infection of the urinary tract may contribute more to the onset of acute poststreptococcal glomerulo-nephritis and to its course than is currently believed.

  14. The use of low-dose cyclophosphamide followed by AZA/MMF treatment in childhood lupus nephritis.

    Science.gov (United States)

    Baskin, Esra; Ozen, Seza; Cakar, Nilgun; Bayrakci, Umut S; Demirkaya, Erkan; Bakkaloglu, Aysin

    2010-01-01

    Cyclophosphamide (CYC) has been the landmark in the treatment of lupus nephritis. However, long-term treatment with CYC is associated with significant side effects. We aimed to evaluate the efficacy of short-term intravenous (IV) CYC treatment as a remission induction treatment followed by azathioprine (AZA) or mycophenolate mofetil (MMF) as a maintenance treatment. Twenty patients (18 girls) with biopsy-proven class III (5) and IV (15) lupus nephritis were included in to the study. Detailed clinical and laboratory data and patient outcomes were evaluated. All patients received three methylprednisolone (MP) IV pulses, followed by oral prednisone 0.5-1 mg/kg per day and one IV pulse of CYC per month for 6 months. Azathioprine was started as a remission-maintaining treatment. In ten of 20 patients, treatment was switched to MMF. The mean age at the time of diagnosis was 16.11 +/- 3.49 years, and the mean duration of follow-up was 49.6 +/- 27 months. Fourteen patients (70%) had complete remission, three (15%) had partial remission, one (5%) continued to have active disease, and two (10%) progressed to end-stage renal disease. Nine of the patients (45%) with complete remission had received AZA, and switching to MMF increased complete remission rate (additional five patients; 25%). In conclusion, short-term (6-month) IV bolus CYC treatment followed by AZA is a safe and effective treatment in children with severe lupus nephritis, and using MMF increases remission rate in resistant cases.

  15. 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.

  16. Distribution of carbapenem resistance determinants among epidemic and non-epidemic types of Acinetobacter species in Japan.

    Science.gov (United States)

    Matsui, Mari; Suzuki, Satowa; Yamane, Kunikazu; Suzuki, Masato; Konda, Toshifumi; Arakawa, Yoshichika; Shibayama, Keigo

    2014-06-01

    We performed a comparative molecular analysis on three types of clinically isolated Acinetobacter spp.: epidemic sequence types (STs) of Acinetobacter baumannii (epidemic ST-AB), non-epidemic sequence types of A. baumannii (non-epidemic ST-AB) and non-baumannii Acinetobacter spp. A total of 87 isolates - 46 A. baumannii, 25 A. pittii and 16 A. nosocomialis - from 43 hospitals were analysed. Of these, 31 A. baumannii isolates were ST1 or ST2 according to the Pasteur Institute multilocus sequence typing scheme and were defined as epidemic ST-AB. The other 15 A. baumannii isolates were defined as non-epidemic ST-AB. The epidemic ST-AB isolates harboured the blaOXA-23-like gene or had an ISAba1 element upstream of blaOXA-51-like, or both, whereas non-epidemic ST-AB and non-baumannii Acinetobacter spp. isolates harboured blaOXA-58-like or metallo-β-lactamase genes, or both. The proportion of multidrug-resistant isolates was significantly higher in the epidemic ST-AB isolates (48 %) than that in the other types of Acinetobacter isolates (5 %) (PAcinetobacter spp. isolates than with epidemic ST-AB isolates, regardless of bacterial species. In addition, this study revealed that, even in Japan, where IMP-type metallo-β-lactamase producers are endemic, epidemic ST-AB harbouring blaIMP have not yet emerged.

  17. Optimal Vaccination For A Probabilistic Epidemic

    Science.gov (United States)

    Yuan, Edwin; Stromberg, Sean; Carlson, Jean

    2014-03-01

    In epidemiology, herd immunity is the well-known idea that by vaccinating a sufficient fraction of a susceptible population, one lowers the basic reproduction number of the pathogen below one, and thereby prevents an epidemic. A natural conclusion from this is that given two identical populations, and enough vaccine to induce herd immunity in only one, we can prevent the greatest number of people from infection by inequitably distributing vaccine to completely protect one population while leaving the other much more relatively susceptible. This heuristic has been verified by simulation of the standard deterministic SIR epidemic. We show, however, that when stochasticity is introduced to the system, or more specifically when there is now a significant probability that an epidemic will not develop independently, it is counter-intuitively optimal to distribute vaccine more equally and not induce herd immunity in either population. There is thus a regime where the purely deterministic SIR model is a poor predictor of the optimal vaccination scheme.

  18. 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...

  19. A break in the obesity epidemic?

    DEFF Research Database (Denmark)

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

    2015-01-01

    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 litera......, focusing on trends in waist circumference rather than BMI leads to a less optimistic conclusion: the public health problem of obesity is still increasing.International Journal of Obesity advance online publication, 22 July 2014; doi:10.1038/ijo.2014.98.......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...

  20. 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.

  1. [Fight against epidemics: Austrian prisoners in Troyes].

    Science.gov (United States)

    Hetzel, Géraldine

    2014-01-01

    The victories near Ulm and Elchingen, where the Napoleonic army took 60000 prisoners between 15th and 20th of October 1805, lead to the arrival at Troyes (county "Aube") of nearly 2000 Austrian soldiers to be held inside former monasteries among whose, mainly the Jacobinians casern where more than half of them stayed. At the beginning of 1806, the government sent the epidemics medical practitioner Dr Desgenettes on an inspection tour to control the state of health of the populations of places where foreign prisoners were held, which lead him through several counties of the North-eastern part of France, where he surveyed several diseases ranging from all kinds offevers up to dysentery, scabies or gangrenes. With the means of acid fumigations invented by the chemist Guyton Morveau from Dijon, the authorities took care of combating and preventing the epidemics in the caserns. As soon as October 1805, the epidemics medical practitioner Dr Pigeotte from Troyes wrote to the county governor his observations recommending a better diet, airing of the rooms and also calls to take some exercise. All these precepts showed an astonishing modernity.

  2. Politicians and Epidemics in the Bible Belt

    Directory of Open Access Journals (Sweden)

    Geurt Henk Spruyt

    2016-07-01

    Full Text Available The Netherlands has a high vaccination coverage, but due to a concentration of people objecting to vaccination on religious grounds in the Bible belt, several polio and measles epidemics have occurred there in the past. This article analyses how and in what way Dutch politicians responded to parents refusing to have their children vaccinated. First, during these epidemics Members of Parliament mainly addressed written questions of a highly technical or procedural nature to the responsible State Secretary or Minister of Public Health. Secondly, the government always requested advice from an advisory body with regard to matters of health after an epidemic. These reports were opposed to mandatory vaccination mainly by using practical arguments. However, by advocating the idea of strengthening the position of minors in public healthcare these reports contributed to legislation codifying the rights of minors concerning public health. The most important rationale behind this response is the complexity of the issue of mandatory vaccination, because different human rights are involved. On the one hand, mandatory vaccination infringes the constitutional rights to the freedom of thought, conscience and religion and encroaches on parental autonomy. On the other hand, children have a right to physical integrity. To find a way out of this unsolvable dilemma, the government and its advisory bodies mainly used practical arguments against mandatory vaccination.

  3. Memory effects on epidemic evolution: The susceptible-infected-recovered epidemic model

    Science.gov (United States)

    Saeedian, M.; Khalighi, M.; Azimi-Tafreshi, N.; Jafari, G. R.; Ausloos, M.

    2017-02-01

    Memory has a great impact on the evolution of every process related to human societies. Among them, the evolution of an epidemic is directly related to the individuals' experiences. Indeed, any real epidemic process is clearly sustained by a non-Markovian dynamics: memory effects play an essential role in the spreading of diseases. Including memory effects in the susceptible-infected-recovered (SIR) epidemic model seems very appropriate for such an investigation. Thus, the memory prone SIR model dynamics is investigated using fractional derivatives. The decay of long-range memory, taken as a power-law function, is directly controlled by the order of the fractional derivatives in the corresponding nonlinear fractional differential evolution equations. Here we assume "fully mixed" approximation and show that the epidemic threshold is shifted to higher values than those for the memoryless system, depending on this memory "length" decay exponent. We also consider the SIR model on structured networks and study the effect of topology on threshold points in a non-Markovian dynamics. Furthermore, the lack of access to the precise information about the initial conditions or the past events plays a very relevant role in the correct estimation or prediction of the epidemic evolution. Such a "constraint" is analyzed and discussed.

  4. Effects of awareness diffusion and self-initiated awareness behavior on epidemic spreading - An approach based on multiplex networks

    Science.gov (United States)

    Kan, Jia-Qian; Zhang, Hai-Feng

    2017-03-01

    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 awareness. However, we prove that though the introduction of the self-awareness can lower the density of infection, which cannot increase the epidemic threshold no matter of the local information or global information. Our finding is remarkably different to many previous results on single-layer network: local information based behavioral response can alter the epidemic threshold. Furthermore, our results indicate that the nodes with more neighbors (hub nodes) in information networks are easier to be informed, as a result, their risk of infection in contact networks can be effectively reduced.

  5. [Epidemics, state and society: the case of Minas Gerais in the second half of the 19th century].

    Science.gov (United States)

    Torres Silveira, Anny Jackeline

    2011-01-01

    One of the characteristics of historical analyses of epidemic diseases is the notion of crisis: epidemics are generally perceived as events that do not fit within the framework of everyday order and practices and go beyond individual experiences (suffering, threat of death), jeopardizing social structures, public order, economic activities and moral values. However, epidemic events also shed light on how societies organize healthcare in times of normality, including the extent and limits of the action of health authorities and the role of populations in meeting their own daily needs. This article discusses the organization of healthcare in Minas Gerais province of Brazil during two epidemic episodes, i.e., smallpox (from 1873 to 1875) and cholera (from 1855 to 1856), with the aim of identifying the problems experienced by the population of Minas and the actions taken by the public health authorities during these epidemics. We suggest that the difficulties caused by the arrival of cholera and/or intensification of the smallpox epidemic contributed to expose and exacerbate the shortcomings characterizing healthcare in that society. We also observe that the social mobilization of patients during these events was nothing new, given the low participation of the state in public health during this period, which counted on initiatives and support from civil society.

  6. 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.

  7. Kaposi´s sarcoma, epidemic type. Case presentation

    Directory of Open Access Journals (Sweden)

    Gilberto Serrano Ocaña

    2009-05-01

    Full Text Available Before the AIDS epidemic, Kaposi's sarcoma was found mainly in elderly men of Mediterranean coast, eastern European background and Jewish ancestry (rarely in older women and is a slow growing skin tumor. In AIDS patients, the KS tends to develop more rapidly compromising the skin, lungs, gastrointestinal tract and other organs. In people with AIDS, Kaposi's sarcoma is caused by an interaction between HIV, a weakened immune system and human herpes virus 8. It affects approximately 20% of people with HIV that don’t take antiretroviral drugs. It is more common in homosexual’s patients, but may appear in any HIV positive individual, in Africa where heterosexual HIV transmission route is the most important can also be found in children and women. We are presenting a case of Kaposi sarcoma in a young female admitted at the Internal Medicine Department of Dora Nginza Hospital.

  8. Urinary Transforming Growth Factor-beta 1 as a marker of response to immunosuppressive treatment, in patients with crescentic nephritis

    Directory of Open Access Journals (Sweden)

    Sotsiou Florentia

    2005-12-01

    Full Text Available Abstract Background Crescentic nephritis is characterized by formation of cellular crescents that soon become fibrotic and result in irreversible damage, unless an effective immunosuppressive therapy is rapidly commenced. TGF-β1 is involved in the development of crescents through various pathways. The aim of this study was to identify whether the determination of urinary TGF-β1 levels in patients with crescentic nephritis could be used as a marker of response to treatment. Methods Fifteen patients with crescentic nephritis were included in the study. The renal expression of TGF-β1 was estimated in biopsy sections by immunohistochemistry and urinary TGF-β1 levels were determined by quantitative sandwich enzyme immunoassay (EIA. TGF-β1 levels were determined at the time of renal biopsy, before the initiation of immunosuppressive treatment (corticosteroids, cyclophosphamide and plasma exchange. Twelve patients with other types of proliferative glomerulonephritis and ten healthy subjects were used as controls. Results Improvement of renal function with immunosuppressive therapy was observed in 6 and stabilization in 4 patients (serum creatinine from 3.2 ± 1.5 to 1.4 ± 0.1 mg/dl and from 4.4 ± 1.2 to 4.1 ± 0.6 mg/dl, respectively. In 5 patients, with severe impairment of renal function who started on dialysis, no improvement was noted. The main histological feature differentiating these 5 patients from others with improved or stabilized renal function was the percentage patients with poor response to treatment were the percentage of glomeruli with crescents and the presence of ruptured Bowman's capsule and glomerular necrosis. Urinary TGF-β1 levels were significantly higher in patients who showed no improvement of renal function with immunosuppressive therapy (930 ± 126 ng/24 h vs. 376 ± 84 ng/24 h, p 1 was identified in crescents and tubular epithelial cells, whereas a significant correlation of TGF-β1 immunostaining with the presence

  9. Epidemic and Non-Epidemic Hot Spots of Malaria Transmission Occur in Indigenous Comarcas of Panama.

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    William Lainhart

    2016-05-01

    Full Text Available From 2002-2005, Panama experienced a malaria epidemic that has been associated with El Niño Southern Oscillation weather patterns, decreased funding for malaria control, and landscape modification. Case numbers quickly decreased afterward, and Panama is now in the pre-elimination stage of malaria eradication. To achieve this new goal, the characterization of epidemiological risk factors, foci of transmission, and important anopheline vectors is needed. Of the 24,681 reported cases in these analyses (2000-2014, ~62% occurred in epidemic years and ~44% in indigenous comarcas (5.9% of Panama's population. Sub-analyses comparing overall numbers of cases in epidemic and non-epidemic years identified females, comarcas and some 5-year age categories as those disproportionately affected by malaria during epidemic years. Annual parasites indices (APIs; number of cases per 1,000 persons for Plasmodium vivax were higher in comarcas compared to provinces for all study years, though P. falciparum APIs were only higher in comarcas during epidemic years. Interestingly, two comarcas report increasing numbers of cases annually, despite national annual decreases. Inclusion of these comarcas within identified foci of malaria transmission confirmed their roles in continued transmission. Comparison of species distribution models for two important anophelines with Plasmodium case distribution suggest An. albimanus is the primary malaria vector in Panama, confirmed by identification of nine P. vivax-infected specimen pools. Future malaria eradication strategies in Panama should focus on indigenous comarcas and include both active surveillance for cases and comprehensive anopheline vector surveys.

  10. Epidemic and Non-Epidemic Hot Spots of Malaria Transmission Occur in Indigenous Comarcas of Panama

    Science.gov (United States)

    Dutari, Larissa C.; Rovira, Jose R.; Sucupira, Izis M. C.; Póvoa, Marinete M.; Conn, Jan E.; Loaiza, Jose R.

    2016-01-01

    From 2002–2005, Panama experienced a malaria epidemic that has been associated with El Niño Southern Oscillation weather patterns, decreased funding for malaria control, and landscape modification. Case numbers quickly decreased afterward, and Panama is now in the pre-elimination stage of malaria eradication. To achieve this new goal, the characterization of epidemiological risk factors, foci of transmission, and important anopheline vectors is needed. Of the 24,681 reported cases in these analyses (2000–2014), ~62% occurred in epidemic years and ~44% in indigenous comarcas (5.9% of Panama’s population). Sub-analyses comparing overall numbers of cases in epidemic and non-epidemic years identified females, comarcas and some 5-year age categories as those disproportionately affected by malaria during epidemic years. Annual parasites indices (APIs; number of cases per 1,000 persons) for Plasmodium vivax were higher in comarcas compared to provinces for all study years, though P. falciparum APIs were only higher in comarcas during epidemic years. Interestingly, two comarcas report increasing numbers of cases annually, despite national annual decreases. Inclusion of these comarcas within identified foci of malaria transmission confirmed their roles in continued transmission. Comparison of species distribution models for two important anophelines with Plasmodium case distribution suggest An. albimanus is the primary malaria vector in Panama, confirmed by identification of nine P. vivax-infected specimen pools. Future malaria eradication strategies in Panama should focus on indigenous comarcas and include both active surveillance for cases and comprehensive anopheline vector surveys. PMID:27182773

  11. An epidemic model for the future progression of the current Haiti cholera epidemic

    Science.gov (United States)

    Bertuzzo, E.; Mari, L.; Righetto, L.; Casagrandi, R.; Gatto, M.; Rodriguez-Iturbe, I.; Rinaldo, A.

    2012-04-01

    As a major cholera epidemic progresses in Haiti, and the figures of the infection, up to December 2011, climb to 522,000 cases and 7,000 deaths, the development of general models to track and predict the evolution of the outbreak, so as to guide the allocation of medical supplies and staff, is gaining notable urgency. We propose here a spatially explicit epidemic model that accounts for the dynamics of susceptible and infected individuals as well as the redistribution of Vibrio cholera, the causative agent of the disease, among different human communities. In particular, we model two spreading pathways: the advection of pathogens through hydrologic connections and the dissemination due to human mobility described by means of a gravity-like model. To this end the country has been divided into hydrologic units based on drainage directions derived from a digital terrain model. Moreover the population of each unit has been estimated from census data downscaled to 1 km x 1 km resolution via remotely sensed geomorphological information (LandScan project). The model directly accounts for the role of rainfall patterns in driving the seasonality of cholera outbreaks. The two main outbreaks in fact occurred during the rainy seasons (October and May) when extensive floodings severely worsened the sanitation conditions and, in turn, raised the risk of infection. The model capability to reproduce the spatiotemporal features of the epidemic up to date grants robustness to the foreseen future development. To this end, we generate realistic scenario of future precipitation in order to forecast possible epidemic paths up to the end of the 2013. In this context, the duration of acquired immunity, a hotly debated topic in the scientific community, emerges as a controlling factor for progression of the epidemic in the near future. The framework presented here can straightforwardly be used to evaluate the effectiveness of alternative intervention strategies like mass vaccinations

  12. 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.

  13. Ebola hemorrhagic fever outbreaks: strategies for effective epidemic management, containment and control

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    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

  14. Significance of enzyme linked immunosorbent assay (ELISA) for antibodies to double stranded and single stranded DNA in patients with lupus nephritis: correlation with severity of renal histology.

    Science.gov (United States)

    Okamura, M; Kanayama, Y; Amastu, K; Negoro, N; Kohda, S; Takeda, T; Inoue, T

    1993-01-01

    The correlation between renal histology and class specific (IgG and IgM) antibodies to double stranded DNA (dsDNA) and single stranded DNA (ssDNA) was studied by enzyme linked immunosorbent assay (ELISA) in 40 untreated patients with systemic lupus erythematosus (SLE). The levels of IgG antibodies to dsDNA were significantly higher in patients with World Health Organisation class IV nephritis than in those with class I, class II, or class III nephritis. IgG antibodies to ssDNA were higher in patients with class IV than in those with class II nephritis. IgG antibodies to dsDNA showed a close correlation with the histological activity score and the amount of electron dense deposit. IgG antibodies to ssDNA showed only a weak correlation with the renal histological activity score. IgM antibodies to dsDNA and IgM antibodies to ssDNA were not correlated with renal histological features. Patients with moderate to severe nephritis had a lower ratio of IgM antibodies to dsDNA to IgG antibodies to dsDNA than those with mild nephritis. These results indicate that the measurement of IgG antibodies to dsDNA is predictive in evaluating renal histological activity in patients with SLE.

  15. Impact of age at marriage and migration on HIV and AIDS epidemics in Japan.

    Science.gov (United States)

    Mondal, Nazrul Islam; Takaku, Hiroshi; Ohkusa, Yasushi

    2009-06-10

    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. Mycobacterium tuberculosis strains potentially involved in the TB epidemic in Sweden a century ago.

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    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.

  17. 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...

  18. Impact of age at marriage and migration on HIV and AIDS epidemics in Japan

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    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.

  19. [Multilocus sequence-typing of vibrio cholerae strains with various epidemic importance].

    Science.gov (United States)

    Mironova, L V; Afanas'ev, M V; Goldapel, E G; Balakhonov, S V

    2015-01-01

    The allele polymorphism of the housekeeping genes (dnaE, lap, recA, pgm, gyrB, cat, chi, gmd) from the Vibrio cholerae strains with different epidemic importance (n = 41) isolated in Siberia and at the Far East during the cholera pandemic VII was tested. All toxigenic strains isolated at the period of epidemic complications irrespective of time and source of isolation were characterized by the identical allele profile and belonged to the same sequence-type. Nine sequence types were detected in non-epidemic isolates. The dendrogram clustering was associated with the serogroup and in some cases with the territory and time of isolation. The structure heterogeneity of the non-toxigenic V. cholerae housekeeping genes was in most cases caused by the synonymous nucleotide replacements (Dn/Ds cholerae at the analyzed genome sites. The revealed distinctions in the structure of housekeeping genes of the V. cholerae with different epidemic importance can be regarded as evidence of various evolutional directions in these strain groups.

  20. Formation of Medical Units in Response to Epidemics in the Australian Imperial Force in Palestine 1918

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    Prof. G Dennis Shanks MD

    2014-06-01

    Full Text Available In the closing days of the First World War, British cavalry operations defeated the Turkish Armies in Palestine. Australian Light Horse Regiments as part of the Australian Imperial Forces (AIF were prominent in the capture of Amman, Beirut and Damascus. Epidemic infectious diseases were part of the severe desert environment faced by soldiers in the Middle East. Cholera and dysentery epidemics required reformation of medical units to emphasize mobility in an austere environment. A large epidemic of falciparum malaria coinciding with pandemic influenza shut down military operations and caused many deaths in late 1918. Three separate military medical units were formed in Egypt to address epidemic infectious diseases during mobile operations in the desert: ANZAC Field Laboratory, 5th Malaria Diagnosis Station and 7th Mobile Sanitary Section. Laboratory and preventive medicine units were critical to the military’s ability to conduct operations in the Middle East in 1918 and are likely to become vital for future missions in developing countries. As was the case in 1918, military medical units may have to be acutely restructured to control infectious disease outbreaks

  1. Epidemic Spreading in Contact Networks Based on Exposure Level

    Institute of Scientific and Technical Information of China (English)

    DUAN Wen-Qi; CHEN Zhong; LIU Zeng-Rong

    2006-01-01

    @@ Most epidemic models for the spread of diseases in contact networks take the assumption of the infected probability of a susceptible agent dependent on its absolute number of infectious neighbours. We introduce a new epidemic model in which the infected probability of a susceptible agent in contact networks depends not on its degree but on its exposure level. We find that effective average infection rate (λ) (i.e., the average number of infections produced by a single contact between infected individuals and susceptible individuals) has an epidemic threshold (λ)c = 1, which is related to recovery rate, epidemic mechanisms and topology of contact network. Furthermore,we show the dominating importance of epidemic mechanisms in determining epidemic patterns and discussed the implications of our model for infection control policy.

  2. Cleaved Form of Osteopontin in Urine as a Clinical Marker of Lupus Nephritis

    Science.gov (United States)

    Kitagori, Koji; Yoshifuji, Hajime; Oku, Takuma; Sasaki, Chiyomi; Miyata, Hitomi; Mori, Keita P.; Nakajima, Toshiki; Ohmura, Koichiro; Kawabata, Daisuke; Yukawa, Naoichiro; Imura, Yoshitaka; Murakami, Kosaku; Nakashima, Ran; Usui, Takashi; Fujii, Takao; Sakai, Kaoru; Yanagita, Motoko; Hirayama, Yoshitaka; Mimori, Tsuneyo

    2016-01-01

    We assessed the utility of two forms of osteopontin (OPN), OPN full and its cleaved form (OPN N-half), in plasma and urine as markers of disease activity in lupus nephritis (LN). Samples were collected from patients with systemic lupus erythematosus (SLE) (LN: N = 29, non-LN: N = 27), IgA nephropathy (IgAN) (N = 14), minimal change nephrotic syndrome (MCNS) (N = 5), diabetic nephropathy (DN) (N = 14) and healthy volunteers (HC) (N = 17). While there was no significant difference in urine OPN full concentration between groups, urine OPN N-half concentration was significantly higher in patients with LN than HC (p 0.5) than LN patients with minimal proteinuria (P/C 0.5, p < 0.01). Urine thrombin activity correlated with urine OPN N-half concentration (p < 0.0001), but not with urine OPN full concentration. These results suggest that urine OPN N-half concentration reflects renal inflammation. Thus, urine OPN N-half may be a novel disease activity marker for LN. PMID:27992535

  3. Acute tubulointerstitial nephritis with severe renal impairment associated with multisystem IgG4-related disease

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    Rafael Coimbra Ferreira Beltrame

    Full Text Available Abstract The IgG4-related disease has a wide clinical spectrum where multiple organs can be affected, and the diagnosis depends on typical histopathological findings and an elevated IgG4 expression in plasma cells in the affected tissue. We describe the clinical presentation and evolution of a patient with acute tubulointerstitial nephritis, severe kidney failure and systemic manifestations such as lymphadenomegaly and chronic pancreatitis. The diagnosis was confirmed by the clinical picture and kidney and lymph node histopathology, in which immunohistochemistry of the lymphoid tissue showed policlonality and increased expression of IgG4, with a IgG4/total IgG ratio > 80%. The patient was treated with prednisone at a dose of 60 mg/day, followed by mycophenolate mofetil, and showed clinical and renal function improvement at 6 months of follow-up. The high index of suspicion of IgG4-related disease with multisystem involvement and the early treatment of this condition are essential to improve the prognosis of affected patients.

  4. Mannose-binding lectin blunts macrophage polarization and ameliorates lupus nephritis.

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    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.

  5. Association of Serum CXCL13 with Intrarenal Ectopic Lymphoid Tissue Formation in Lupus Nephritis

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    De Ning He

    2016-01-01

    Full Text Available Aims. To assess the concentrations of serum CXCL13 and intrarenal ectopic lymphoid tissue (ELT profiles and their correlation in the patients with lupus nephritis (LN. Methods. Serum CXCL13 levels were measured using enzyme-linked immunosorbent assays (ELISA. The expression of CD3, CD20, and CD21 in renal biopsy specimens was tested using immunohistochemical methods. Results. Serum CXCL13 levels were significantly higher in the LN group than those in the SLE group without LN and also in the type III and IV LN patients than in type V LN patients. LN patients with positive CD20 expression (CD20+ LN had a longer disease course and poorer response to combination therapy and higher serum CXCL13 levels than CD20− LN patients. Moreover, the serum CXCL13 level was positively correlated with the number of B cells/HP in the renal tissue of LN patients. The coexpression patterns of CD3, CD20, and CD21 in the renal tissue of LN patients with different WHO pathological types were significantly different. Serum CXCL13 levels were significantly higher in ELT-2 type LN patients than in 0 or 1 type LN patients. Conclusions. This study suggested that increased serum levels of CXCL13 might be involved in renal ELT formation and renal impairment process in LN.

  6. TAC-TIC use of tacrolimus-based regimens in lupus nephritis

    Science.gov (United States)

    Bredewold, Obbo W; Trompet, Stella; Huizinga, Tom W J; Rabelink, Ton J; de Craen, Anton J M; Teng, Y K Onno

    2016-01-01

    Current guidelines do not mention tacrolimus (TAC) as a treatment option and no consensus has been reported on the role of TAC in lupus nephritis (LN). The present study aimed to guide clinical judgement on the use of TAC in patients with LN. A meta-analysis was performed for clinical studies investigating TAC regimens in LN on the basis of treatment target (induction or maintenance), concomitant immunosuppression and quality of the data. 23 clinical studies performed in patients with LN were identified: 6 case series, 9 cohort studies, 2 case-control studies and 6 randomised controlled trials (RCTs). Of the 6 RCTs, 5 RCTs investigated TAC regimens as induction treatment and 1 RCT as maintenance treatment. Five RCTs investigated TAC in combination with steroids and 2 TAC with mycophenolate plus steroids. All RCTs were performed in patients of Asian ethnicity. In a meta-analysis, TAC regimens achieved a significantly higher total response (relative risk (RR) 1.23, 95% CI 1.12 to 1.34, pstudies on TAC regimens for LN are limited to patients of Asian ethnicity and hampered by significant heterogeneity. The positive results on clinical efficacy of TAC as induction treatment in LN cannot be extrapolated beyond Asian patients with LN. Therefore, further confirmation in multiethnic, randomised trials is mandatory. Until then, TAC can be considered in selected patients with LN. PMID:28123768

  7. Autoantibodies targeting glomerular annexin A2 identify patients with proliferative lupus nephritis

    Science.gov (United States)

    Caster, Dawn J.; Korte, Erik A.; Merchant, Michael L.; Klein, Jon B.; Wilkey, Daniel W.; Rovin, Brad H.; Birmingham, Dan J.; Harley, John B.; Cobb, Beth L.; Namjou, Bahram; McLeish, Kenneth R.; Powell, David W.

    2015-01-01

    PURPOSE Patients with systemic lupus erythematosus (SLE) frequently develop lupus nephritis (LN), a complication frequently leading to end stage kidney disease. Immune complex deposition in the glomerulus is central to the development of LN. Using a targeted proteomic approach, we tested the hypothesis that autoantibodies targeting glomerular antigens contribute to the development of LN. EXPERIMENTAL DESIGN Human podocyte and glomerular proteins were separated by SDS-PAGE and immunoblotted with sera from SLE patients with and without LN. The regions of those gels corresponding to reactive bands observed with sera from LN patients were analyzed using LC-MS/MS. RESULTS LN reactive bands were seen at approximately 50 kDa in podocyte extracts and between 36-50 kDa in glomerular extracts. Those bands were analyzed by LC-MS/MS and 102 overlapping proteins were identified. Bioinformatic analysis determined that 36 of those proteins were membrane associated, including a protein previously suggested to contribute to glomerulonephritis and LN, annexin A2. By ELISA, patients with proliferative LN demonstrated significantly increased antibodies against annexin A2. CONCLUSION AND CLINICAL RELEVANCE Proteomic approaches identified multiple candidate antigens for autoantibodies in patients with LN. Serum antibodies against annexin A2 were significantly elevated in subjects with proliferative LN, validating those antibodies as potential biomarkers. PMID:25824007

  8. "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.

  9. Ac-SDKP ameliorates the progression of lupus nephritis in MRL/lpr mice.

    Science.gov (United States)

    Tan, Hechang; Zhao, Jijun; Wang, Shuang; Zhang, Lili; Wang, Hongyue; Huang, Bin; Liang, Yingjie; Yu, Xueqing; Yang, Niansheng

    2012-12-01

    N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP) is an endogenous tetrapeptide which can inhibit the differentiation, migration and activation of macrophages and suppress the proliferation of fibroblast. This study examined the effects of Ac-SDKP on the progression of lupus nephritis (LN). MRL/lpr mice received subcutaneous infusion of Ac-SDKP (1.0 mg kg(-1) d(-1)) or vehicle through implanted osmotic mini-pumps from 12 to 20 weeks until being euthanized. MRL/MpJ mice served as normal controls. The data indicative of renal inflammation and fibrosis were evaluated before and after treatment. Ac-SDKP-treated MRL/lpr mice showed reduced proteinuria and improved renal function compared with vehicle-treated controls. Ac-SDKP-treated mice demonstrated decreased inflammatory infiltrates of T cells and macrophages in the kidneys as compared to vehicle-treated animals. The treatment also inhibited the activation of NF-κB and production of TNF-α. Despite this, immune complex deposition and plasma anti-dsDNA levels were not statistically different between the two groups. In addition, the treatment inhibited renal expression of TGF-β1, α-SMA and fibronectin as well as the phosphorylation of Smad2/3. Ac-SDKP treatment ameliorated LN through exerting anti-inflammatory and anti-fibrotic effects on MRL/lpr mice, providing therapeutic potential for halting the progression of LN.

  10. Relevance of anti-C1q autoantibodies to lupus nephritis.

    Science.gov (United States)

    Tsirogianni, Alexandra; Pipi, Elena; Soufleros, Kostantinos

    2009-09-01

    The first component of the classical pathway of the complement system (C1q) is considered to have a crucial role in the clearance of immune complexes (ICs) as well as in the removal of waste material originating from apoptotic cells. A prolonged exposure of C1q epitopes to the immune system could eventually lead to an autoimmune response against itself. Although autoantibodies against C1q are found in several diseases, their clinical interest originates from their strong association to active lupus nephritis (LN). Several studies indicate that anti-C1q autoantibodies could serve as a reliable serologic marker in the assessment of LN activity compared to other immunological tests. Additionally, it was suggested that anti-C1q autoantibodies could play a role in LN pathogenesis. Their potential pathogenic actions likely depend on genetic background, titers, Ig classes and subclasses, and specific epitopes of anti-C1q autoantibodies as well as C1q availability and allocation. It is still unclear which different types of anti-C1q autoantibodies dominate in each case and if their upregulation is pathogenic, an epiphenomenon of aberrant tissue damage, or compensatory to an uncontrolled immune response.

  11. Cross-species transcriptional network analysis defines shared inflammatory responses in murine and human lupus nephritis.

    Science.gov (United States)

    Berthier, Celine C; Bethunaickan, Ramalingam; Gonzalez-Rivera, Tania; Nair, Viji; Ramanujam, Meera; Zhang, Weijia; Bottinger, Erwin P; Segerer, Stephan; Lindenmeyer, Maja; Cohen, Clemens D; Davidson, Anne; Kretzler, Matthias

    2012-07-15

    Lupus nephritis (LN) is a serious manifestation of systemic lupus erythematosus. Therapeutic studies in mouse LN models do not always predict outcomes of human therapeutic trials, raising concerns about the human relevance of these preclinical models. In this study, we used an unbiased transcriptional network approach to define, in molecular terms, similarities and differences among three lupus models and human LN. Genome-wide gene-expression networks were generated using natural language processing and automated promoter analysis and compared across species via suboptimal graph matching. The three murine models and human LN share both common and unique features. The 20 commonly shared network nodes reflect the key pathologic processes of immune cell infiltration/activation, endothelial cell activation/injury, and tissue remodeling/fibrosis, with macrophage/dendritic cell activation as a dominant cross-species shared transcriptional pathway. The unique nodes reflect differences in numbers and types of infiltrating cells and degree of remodeling among the three mouse strains. To define mononuclear phagocyte-derived pathways in human LN, gene sets activated in isolated NZB/W renal mononuclear cells were compared with human LN kidney profiles. A tissue compartment-specific macrophage-activation pattern was seen, with NF-κB1 and PPARγ as major regulatory nodes in the tubulointerstitial and glomerular networks, respectively. Our study defines which pathologic processes in murine models of LN recapitulate the key transcriptional processes active in human LN and suggests that there are functional differences between mononuclear phagocytes infiltrating different renal microenvironments.

  12. Linezolid-induced interstitial nephritis in a kidney-transplant patient.

    Science.gov (United States)

    Esposito, L; Kamar, N; Guilbeau-Frugier, C; Mehrenberger, M; Modesto, A; Rostaing, L

    2007-11-01

    Linezolid is a recent oral antibiotic used in drug-resistant Gram-positive cocci infections. Herein, we report on the first case of linezolid-related acute renal failure in a kidney-transplant patient. A 60-year-old male having autosomic polycystic kidney disease with liver involvement, on cyclosporin A, mycophenolate mofetil and very low dose prednisolone, presented with an Enterococcus faecium abscess of a huge liver cyst, which was treated by percutaneous drainage and linezolid therapy. Eight days after starting linezolid, he presented with acute renal failure, i.e. serum creatinine increased from 136- 221 micromol/l, associated with mild hypereosinophilia, anemia and thrombocytopenia. There was no skin rash, arthralgia, eosinophiluria or proteinuria. The transplant kidney biopsy, performed 15 days after the beginning of linezolid therapy, showed interstitial nephritis and focal tubular atrophy. After linezolid withdrawal and increasing prednisolone daily dose to 20 mg/d, within a few days, serum creatinine had decreased; after 2 and 4 weeks post linezolid withdrawal, his serum creatinine was 166 and 159 micromol/l, respectively. Because of the potential side effects of linezolid, i.e. myelosuppression and possibly nephrotoxicity, we recommend close monitoring of these parameters when linezolid therapy is attempted in kidney transplant patients.

  13. Avian nephritis virus (ANV) on Brazilian chickens farms: circulating genotypes and intra-genotypic diversity.

    Science.gov (United States)

    Espinoza, Luis Luna; Beserra, Laila A R; Soares, Rodrigo M; Gregori, Fabio

    2016-12-01

    Avian nephritis virus (ANV), which belongs to the family Astroviridae, is associated with different clinical manifestations (including enteric disorders). Despite being frequently found in the avian industry worldwide, information regarding genetic features of these viruses in Brazil is scarce. Therefore, sixty fecal sample pools (5-6 birds of the same flock), representing 60 poultry farms from six Brazilian States, were screened using an astrovirus-specific hemi-nested-PCR assay targeting the conserved ORF1b gene, followed by nucleotide sequencing of amplified products. PCR and phylogenetic analysis confirmed the detection of 21 positive samples to ANV (35 %). In order to investigate the genetic diversity represented by these viruses, amplification, cloning and phylogenetic analysis of the deduced amino acid sequence of ORF2 gene were attempted. Eight samples were successfully cloned (generating 32 clones in total) and sequenced. Based on phylogenetic analysis of ORF2, sequences defined in this study were classified into three genotypes: genotype 5, which has already been described in birds, and two other novel genotypes, tentatively named genotype 8 and 9, all of which occurred in single or mixed infections. Moreover, high intra-genotypic diversity and co-circulation of distinct strains in a same host population were observed. This study revealed the presence of new strains of ANV in Brazilian poultry and their circulation in commercial chicken flocks.

  14. Soluble Fas and the −670 Polymorphism of Fas in Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Juan José Bollain-y-Goytia

    2014-01-01

    Full Text Available 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.

  15. Acute interstitial nephritis in patients with viperine snake bite: Single center experience of a rare presentation

    Directory of Open Access Journals (Sweden)

    Vishal Golay

    2012-01-01

    Full Text Available Acute renal failure following vasculotoxic viperine snake bites is very common in South Asia. Acute tubular necrosis and acute cortical necrosis are the common findings, with acute interstitial nephritis (AIN being a rare presentation. We conducted renal biopsies in all patients who were admitted in our institute with viperine snake bite-related acute kidney injury (AKI and who did not improve after three weeks of supportive care. Patients who had findings of AIN on renal histology were included for this study. Of a total of 42 patients, there were five patients (11.9% with AIN. Our series of five patients is the largest series of this rare presentation in the literature. All of these five patients had features of severe envenomation, severe AKI network stage of AKI and very high antivenom requirements. They had a very prolonged stay in the hospital, and four of the five patients developed chronic kidney disease on follow-up. The overall outcome in this group was worse as compared with those who did not have AIN. AIN following viperine snake bites is not a very rare presentation. The reason for the development of this pathology is unclear, but direct venom-related effects are possible. This presentation portends a poor overall long-term prognosis as demonstrated in our case series.

  16. Correlation of renal histology with outcome in children with lupus nephritis.

    Science.gov (United States)

    Rush, P J; Baumal, R; Shore, A; Balfe, J W; Schreiber, M

    1986-05-01

    We assessed renal histological features in 20 children with diffuse proliferative lupus nephritis (DPLN) to determine whether they were useful in predicting clinical outcome. Renal biopsies were analyzed by assigning scores indicating an activity index (AI) and chronicity index (CI). Clinical assessment of renal function at biopsy and outcome were graded according to urinalysis, serum creatinine, need for dialysis and/or transplantation, and/or death from end-stage renal failure. Renal function at biopsy correlated significantly with AI and CI. Serum complement (C3 and C4) correlated significantly with CI but not with AI. The usefulness of the clinical grading system was confirmed in ten patients who underwent repeat biopsies. Of these, four converted from DPLN to mesangial or membranous lupus and showed improvement in their grade, while only one of the six with DPLN on both biopsies improved. After a mean follow-up of 4.0 years, 14 of the 20 patients showed clinical improvement, four were unchanged, and two were worse. CI predicted clinical outcome (P less than 0.01) but AI did not. Histologic scores of AI and CI obtained from renal biopsies showing DPLN may be useful in predicting therapeutic responses and designing prospective clinical trials to determine optimum management of children with DPLN.

  17. Relation between serological data at the time of biopsy and renal histology in lupus nephritis.

    Science.gov (United States)

    Nossent, J C; Henzen-Logmans, S C; Vroom, T M; Huysen, V; Berden, J H; Swaak, A J

    1991-01-01

    As autoantibodies are thought to participate in the pathogenesis of renal inflammation in systemic lupus erythematosis (SLE) we investigated associations between serological markers of disease activity in SLE and the activity of renal histopathological lesions in thirty-five patients with lupus nephritis (LN). We found the following prevalence of serum auto-antibodies in LN: IgG antinuclear antibodies (ANA) 100%, IgM ANA 69%, IgA ANA 60%, IgG anti-dsDNA 60%, IgM anti-dsDNA 71%, IgA anti-dsDNA 60%, anti-RNP 20%, anti-Sm 14%, anti-SSA 31%, anti-SSB 14%, anti-histone 37%, anti-cardiolipin 80% and antibody to ribosomal protein (anti-P) 6%. No correlation was found between serological parameters and the WHO-classification of biopsies. The activity-index of histological lesion, assessed according to the NIH-renal histology scoring system, correlated with IgM ANA and IgM anti-dsDNA titers. Of all the specific features of histological renal inflammation, glomerular proliferation showed the best overall correlation with serological parameters of disease activity. Anticardiolipin antibodies were correlated with overall disease activity, but not with renal histological activity. Thus, serological markers of disease activity did not adequately reflect the amount of renal inflammation in LN and cannot replace renal biopsy as a diagnostic tool.

  18. Biomarkers for Refractory Lupus Nephritis: A Microarray Study of Kidney Tissue.

    Science.gov (United States)

    Benjachat, Thitima; Tongyoo, Pumipat; Tantivitayakul, Pornpen; Somparn, Poorichaya; Hirankarn, Nattiya; Prom-On, Santitham; Pisitkun, Prapaporn; Leelahavanichkul, Asada; Avihingsanon, Yingyos; Townamchai, Natavudh

    2015-06-23

    The prognosis of severe lupus nephritis (LN) is very different among individual patients. None of the current biomarkers can be used to predict the development of refractory LN. Because kidney histology is the gold standard for diagnosing LN, the authors hypothesize that molecular signatures detected in kidney biopsy tissue may have predictive value in determining the therapeutic response. Sixty-seven patients with biopsy-proven severely active LN by International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification III/IV were recruited. Twenty-three kidney tissue samples were used for RNA microarray analysis, while the remaining 44 samples were used for validation by real-time polymerase chain reaction (PCR) gene expression analysis. From hundreds of differential gene expressions in refractory LN, 12 candidates were selected for validation based on gene expression levels as well as relevant functions. The candidate biomarkers were members of the innate immune response molecules, adhesion molecules, calcium-binding receptors, and paracellular tight junction proteins. S100A8, ANXA13, CLDN19 and FAM46B were identified as the best kidney biomarkers for refractory LN, and COL8A1 was identified as the best marker for early loss of kidney function. These new molecular markers can be used to predict refractory LN and may eventually lead to novel molecular targets for therapy.

  19. Biomarkers for Refractory Lupus Nephritis: A Microarray Study of Kidney Tissue

    Directory of Open Access Journals (Sweden)

    Thitima Benjachat

    2015-06-01

    Full Text Available The prognosis of severe lupus nephritis (LN is very different among individual patients. None of the current biomarkers can be used to predict the development of refractory LN. Because kidney histology is the gold standard for diagnosing LN, the authors hypothesize that molecular signatures detected in kidney biopsy tissue may have predictive value in determining the therapeutic response. Sixty-seven patients with biopsy-proven severely active LN by International Society of Nephrology/Renal Pathology Society (ISN/RPS classification III/IV were recruited. Twenty-three kidney tissue samples were used for RNA microarray analysis, while the remaining 44 samples were used for validation by real-time polymerase chain reaction (PCR gene expression analysis. From hundreds of differential gene expressions in refractory LN, 12 candidates were selected for validation based on gene expression levels as well as relevant functions. The candidate biomarkers were members of the innate immune response molecules, adhesion molecules, calcium-binding receptors, and paracellular tight junction proteins. S100A8, ANXA13, CLDN19 and FAM46B were identified as the best kidney biomarkers for refractory LN, and COL8A1 was identified as the best marker for early loss of kidney function. These new molecular markers can be used to predict refractory LN and may eventually lead to novel molecular targets for therapy.

  20. Acute tubulo-interstitial nephritis requiring dialysis associated with intermittent rifampicin use: case report.

    Science.gov (United States)

    Gallieni, M; Braidotti, P; Cozzolino, M; Romagnoli, S; Carpani, P

    1999-07-01

    Rifampicin is one of the most effective antibiotics used for the treatment of tuberculosis and severe staphylococcal infections. Intermittent administration of high doses of rifampicin has been associated with frequent adverse reactions, including hepatotoxicity and nephrotoxicity, sometimes resulting in acute renal failure. We describe a case of rifampicin-associated acute renal failure, with biopsy findings of tubulointerstitial nephritis; inflammatory cells were characterized by immunohistochemistry, which showed immunoreactivity for CD3 and CD5 (T lymphocytes) and for CD68 (macrophages). The patient presented with a very rapid systemic reaction to the offending drug and rapid deterioration of renal function, which required dialysis treatment. The response to rifampicin discontinuation was excellent: no further therapy was required, as renal function began to improve within several days and returned to normal values (serum creatinine 1.17 mg/dl) seven months after the onset of symptoms. When prescribing rifampicin the physician should investigate previous use of the drug, because re-exposure is a critical factor in predicting the possibility of drug-induced acute renal failure.

  1. Association of Serum CXCL13 with Intrarenal Ectopic Lymphoid Tissue Formation in Lupus Nephritis

    Science.gov (United States)

    Chen, Wen Li; Long, Kang Xia; Zhang, Xiao

    2016-01-01

    Aims. To assess the concentrations of serum CXCL13 and intrarenal ectopic lymphoid tissue (ELT) profiles and their correlation in the patients with lupus nephritis (LN). Methods. Serum CXCL13 levels were measured using enzyme-linked immunosorbent assays (ELISA). The expression of CD3, CD20, and CD21 in renal biopsy specimens was tested using immunohistochemical methods. Results. Serum CXCL13 levels were significantly higher in the LN group than those in the SLE group without LN and also in the type III and IV LN patients than in type V LN patients. LN patients with positive CD20 expression (CD20+ LN) had a longer disease course and poorer response to combination therapy and higher serum CXCL13 levels than CD20− LN patients. Moreover, the serum CXCL13 level was positively correlated with the number of B cells/HP in the renal tissue of LN patients. The coexpression patterns of CD3, CD20, and CD21 in the renal tissue of LN patients with different WHO pathological types were significantly different. Serum CXCL13 levels were significantly higher in ELT-2 type LN patients than in 0 or 1 type LN patients. Conclusions. This study suggested that increased serum levels of CXCL13 might be involved in renal ELT formation and renal impairment process in LN. PMID:27990444

  2. Kidney Expression of Toll Like Receptors in Lupus Nephritis: Quantification and Clinicopathological Correlations

    Directory of Open Access Journals (Sweden)

    Fabrizio Conti

    2016-01-01

    Full Text Available Objective. The study aimed at locating and quantifying Toll Like Receptor (TLR 3, 7, 8, and 9 expression in kidney of patients with lupus nephritis (LN and correlating them with clinicopathological features. Methods. Kidney sections from 26 LN patients and 4 controls were analyzed by immunohistochemistry using anti-human TLR3, TLR7, TLR8, and TLR9 polyclonal antibodies; the number of TLR-positive nuclei/mm2 was evaluated on digitalized images. Results. Compared to controls, LN showed a significantly higher amount of glomerular and tubulointerstitial TLR9 (p=0.003 and p=0.007, whole and tubulointerstitial TLR3 (p=0.026 and p=0.031, and a higher tubulointerstitial TLR7 (p=0.022. TLR9 positively correlated with activity index (p=0.0063 and tubular TLR7 with chronicity index (p=0.026. TLR9 positively correlated with Renal-SLEDAI (p=0.01. Conclusions. This is the first study quantifying kidney expressions of TLRs in LN patients; the results show an overexpression of TLR3, TLR7, and TLR9 and demonstrate a correlation with clinicopathological indices supporting a role of these mediators in the pathogenesis of LN.

  3. Akt-dependent enhanced migratory capacity of Th17 cells from children with lupus nephritis.

    Science.gov (United States)

    Kshirsagar, Sudhir; Riedl, Magdalena; Billing, Heiko; Tönshoff, Burkhard; Thangavadivel, Shanmugapriya; Steuber, Christian; Staude, Hagen; Wechselberger, Gottfried; Edelbauer, Monika

    2014-11-15

    Th17 cells infiltrate the kidneys of patients with lupus nephritis (LN) and are critical for the pathogenesis of this disease. In this study, we show that enhanced activity of Stat3 in CD4(+)CD45RA(-)Foxp3(-) and Foxp3(low) effector T cells from children with LN correlates with increased frequencies of IL-17-producing cells within these T cell populations. The levels of retinoic acid-related orphan receptor c and IL-17 mRNA are significantly higher in PBMCs from children with LN than in those from controls. Mammalian target of rapamycin inhibition by rapamycin reduces both Stat3 activation in effector T cells and the frequency of IL-17-producing T cells in lupus patients. Complement factor C5a slightly increases the expression of IL-17 and induces activation of Akt in anti-CD3-activated lupus effector T cells. Th17 cells from children with LN exhibit high Akt activity and enhanced migratory capacity. Inhibition of the Akt signaling pathway significantly decreases Th17 cell migration. These findings indicate that the Akt signaling pathway plays a significant role in the migratory activity of Th17 cells from children with LN and suggest that therapeutic modulation of the Akt activity may inhibit Th17 cell trafficking to sites of inflammation and thus suppress chronic inflammatory processes in children with LN.

  4. 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

  5. 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.

  6. 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.

  7. Beyond fast food and slow motion: Weighty contributors to the obesity epidemic

    Science.gov (United States)

    Cizza, G.; Rother, K.I.

    2012-01-01

    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

  8. [Environmental drivers of emergence and spreading of Vibrio epidemics in South America].

    Science.gov (United States)

    Gavilán, Ronnie G; Martínez-Urtaza, Jaime

    2011-03-01

    Vibrio cholerae and V. parahaemolyticus are the two Vibrio species with a major impact on human health. Diseases caused by both pathogens are acquiring increasing relevance due to their expansion at global scale. In this paper, we resume the ecological aspects associated with the arrival and spreading of infections caused by V. parahaemolyticus and V. cholerae in Peru from a South American perspective. Moreover, we discuss the similarities in the emergence in Peru of cholera cases in 1991 and V. parahaemolyticus infections in 1997. These constituted exceptional experiments to evaluate the relationships between the Vibrio epidemics and changes in the environment. The epidemic radiations of V. cholerae and V. parahaemolyticus constitute to clear examples supporting the oceanic dispersion of pathogenic vibrios and have enabled the identification of El Niño events as a potential mechanism for the spreading of diseases through the ocean.

  9. A dynamic epidemic control model on uncorrelated complex networks

    Institute of Scientific and Technical Information of China (English)

    Pei Wei-Dong; Chen Zeng-Qiang; Yuan Zhu-Zhi

    2008-01-01

    In this paper,a dynamic epidemic control model on the uncorrelated complex networks is proposed.By means of theoretical analysis,we found that the new model has a similar epidemic threshold as that of the susceptible-infectedrecovered (SIR) model on the above networks,but it can reduce the prevalence of the infected individuals remarkably.This result may help us understand epidemic spreading phenomena on real networks and design appropriate strategies to control infections.

  10. Epidemic Dynamics with Feedback Mechanism in Exponential Networks

    Institute of Scientific and Technical Information of China (English)

    LIU Zi-Ran; YAN Jia-Ren; ZHANG Jian-Guo; WANG Li

    2006-01-01

    @@ We introduce a feedback mechanism to study the spreading of an epidemic by analytical methods and large scale simulations in exponential networks. It is found that introducing the feedback mechanism can reduce the density of infected individuals. Furthermore, it does not change the epidemic threshold (critical point) λc. These results can help us to understand epidemic spreading phenomena on social networks more practically and design appropriate strategies to control social infections.

  11. Overweight and obesity in Massachusetts: epidemic, hype or policy opportunity?

    Science.gov (United States)

    Lewis, Katharine Kranz; Man, Lynne H

    2007-01-23

    In 2005, more than 56 percent of Massachusetts adults were overweight, a 40 percent increase from rates reported in 1990. Overall, nearly 21 percent of Massachusetts adults are obese. Both Blacks and Hispanics in the state are more likely than whites to be both overweight and obese, whereas Asians are the least likely to be overweight or obese. Nationally, rates of overweight and obesity are even higher. Obesity is a risk factor for multiple serious health problems in adults, including heart disease, hardening of the arteries, high cholesterol, high blood pressure, certain types of cancer, stroke, diabetes, muscle and bone disorders and gallbladder disease. In Massachusetts, it is estimated that direct costs for obesity-related medical expenditures came to a total of $1.8 billion (4.7% of total medical expenditures) in 2003. Medical expenditures for obese people are estimated to be 25-27% higher than normal weight people, and 44% higher among people who are very obese. Costs are largely attributed to higher rates of coronary heart disease, hypertension and diabetes, and longer hospital stays. Indirect costs associated with obesity approached $3.9 billion in 1995 reflecting 39.2 million lost workdays, 239 million restricted activity days, 89.5 million hospital bed-days, and 62.6 million physician visits. Causes of obesity include the wide availability of unhealthy foods, increased consumption, changing eating habits, high-calorie beverages, advertising and lack of physical activity. Although a number federal, state and local programs, policies and initiatives aimed at curbing the obesity epidemic have been implemented, more needs to be done. What is the responsibility of government in curbing the obesity epidemic, and how much of the burden should be left up to the individual? These important questions will be discussed at the Massachusetts Health Policy Forum on January 23, 2007. Overweight and obesity continue to climb steadily in the United States among both

  12. 猪流行性腹泻的研究进展%Progress in research of porcine epidemic diarrhea

    Institute of Scientific and Technical Information of China (English)

    陈刚; 李伟; 张阳; 吴昊; 施慈; 任晓峰; 赵凯

    2013-01-01

    猪流行性腹泻(porcine epidemic diarrhea,PED)是由猪流行性腹泻病毒(porcine epidemic diarrhea virus,PEDV)引起的猪的一种急性接触性肠道传染病,以呕吐、腹泻、食欲下降和脱水为基本特征.近年来,该病的流行区域和强度有不断扩大和增强的趋势,对哺乳仔猪造成了很高的致死率,给养猪业造成了很大经济损失.为了能有效的防制PED,本文就PED病原学、发病机制、诊断和预防等方面的研究进展做一概述.%Porcine epidemic diarrhea (PED) is a highly contagious, enteric swine disease caused by porcine epidemic diarrhea virus (PEDV), which is characterized by severe enteritis with vomiting, acute diarrhea, anorexia, and dehydration. In recent years, the epidemic area and intensity of PED have continuously enlarged, causing a significantly high mortality of suckling piglets and huge economic losses in pig industry. This paper summarizes the etiology, pathogenesis, diagnosis, and prevention of PED.

  13. Effects of superspreaders in spread of epidemic

    Science.gov (United States)

    Fujie, Ryo; Odagaki, Takashi

    2007-02-01

    Within the standard SIR model with spatial structure, we propose two models for the superspreader. In one model, superspreaders have intrinsically strong infectiousness. In other model, they have many social connections. By Monte Carlo simulation, we obtain the percolation probability, the propagation speed, the epidemic curve, the distribution of secondary infected and the propagation path as functions of population and the density of superspreaders. By comparing the results with the data of SARS in Singapore 2003, we conclude that the latter model can explain the observation.

  14. Improving epidemic control strategies by extended detection

    Science.gov (United States)

    Karp, Paweł; Dybiec, Bartłomiej; Kleczkowski, Adam

    2014-11-01

    Majority of epidemics eradication programs work in preventive responsive way. The lack of exact information about epidemiological status of individuals makes responsive actions less efficient. Here, we demonstrate that additional tests can significantly increase the efficiency of "blind" treatment (vaccination or culling). Eradication strategy consisting of "blind" treatment in very limited local neighborhood supplemented by extra tests in a little bit larger neighborhood is able to prevent invasion of even highly infectious diseases and to achieve this at a cost lower than for the "blind" strategy. The effectiveness of the extended strategy depends on such parameters as the test efficiency and test cost.

  15. Generalized epidemic process on modular networks

    CERN Document Server

    Chung, Kihong; 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 social reinforcement, whereas a discontinuous phase transition occurs for sufficiently strong social reinforcement. Our findings are numerically verified by the finite-size scaling analysis for critical behaviors and the bimodality coefficient test for discontinuous transitions.

  16. Effects of local and global network connectivity on synergistic epidemics

    CERN Document Server

    Broder-Rodgers, David; Taraskin, Sergei N

    2015-01-01

    The effects of local and global connectivity on the spread of synergistic susceptible-infected-removed epidemics were studied in lattice models with infinite- and finite-range rewiring (small-world and small-world-like models). Several effects were found numerically and supported analytically within a simple model: (i) rewiring enhanced resilience to epidemics with strong constructive synergy on networks with high local connectivity; (ii) rewiring enhanced spread of epidemics with destructive or weak constructive synergy on networks with arbitrary local connectivity; (iii) rewiring enhanced spread of epidemics, independent of synergy, in networks with low local connectivity.

  17. Collective versus hub activation of epidemic phases on networks

    CERN Document Server

    Ferreira, Silvio C; Pastor-Satorras, Romualdo

    2015-01-01

    We consider a general criterion to discern the nature of the threshold in epidemic models on scale-free (SF) networks. Comparing the epidemic lifespan of the nodes with largest degrees with the infection time between them, we propose a general dual scenario, in which the epidemic transition is either ruled by a hub activation process, leading to a null threshold in the thermodynamic limit, or given by a collective activation process, corresponding to a standard phase transition with a finite threshold. We validate the proposed criterion applying it different to epidemic models, with waning immunity or heterogeneous infection rates.

  18. Abia State HIV epidemic and response: challenges and prospects.

    Science.gov (United States)

    Onyeonoro, Ugochukwu Uchenna; Emelumadu, Obiageli Fidelia; Nwamoh, Uche Ngozi; Ukegbu, Andrew Ugwunna; Okafor, Godwin Oc

    2014-11-13

    Since the first seroprevalence survey in 1999, the HIV prevalence in Abia State has increased from 1.8% to 7.3% in 2010. The state is currently experiencing a generalized epidemic, with most transmission occurring through heterosexual low-risk sex. Drivers of the epidemic include low knowledge of HIV prevention, low risk perception, predominantly male factor-driven risky sexual behavior, and low condom use. This study reviewed the state HIV epidemic trend in relation to response, sought to identify the gaps between the epidemic and response, and recommended measures to strengthen the state response.

  19. Emergence of Strange Spatial Pattern in a Spatial Epidemic Model

    Institute of Scientific and Technical Information of China (English)

    SUN Gui-Quan; JIN Zhen; LIU Quan-Xing; LI Li

    2008-01-01

    Pattern formation of a spatial epidemic model with nonlinear incidence rate kI2 S/ (1 + αI2) is investigated. Our results show that strange spatial dynamics, i.e., filament-like pattern, can be obtained by both mathematical analysis and numerical simulation, which are different from the previous results in the spatial epidemic model such as stripe-like or spotted or coexistence of both pattern and so on. The obtained results well extend the finding of pattern formation in the epidemic model and may well explain the distribution of the infected of some epidemic.

  20. Untangling the Interplay between Epidemic Spread and Transmission Network Dynamics.

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    Christel Kamp

    Full Text Available The epidemic spread of infectious diseases is ubiquitous and often has a considerable impact on public health and economic wealth. The large variability in the spatio-temporal patterns of epidemics prohibits simple interventions and requires a detailed analysis of each epidemic with respect to its infectious agent and the corresponding routes of transmission. To facilitate this analysis, we introduce a mathematical framework which links epidemic patterns to the topology and dynamics of the underlying transmission network. The evolution, both in disease prevalence and transmission network topology, is derived from a closed set of partial differential equations for infections without allowing for recovery. The predictions are in excellent agreement with complementarily conducted agent-based simulations. The capacity of this new method is demonstrated in several case studies on HIV epidemics in synthetic populations: it allows us to monitor the evolution of contact behavior among healthy and infected individuals and the contributions of different disease stages to the spreading of the epidemic. This gives both direction to and a test bed for targeted intervention strategies for epidemic control. In conclusion, this mathematical framework provides a capable toolbox for the analysis of epidemics from first principles. This allows for fast, in silico modeling--and manipulation--of epidemics and is especially powerful if complemented with adequate empirical data for parameterization.

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

    DEFF Research Database (Denmark)

    Rozanova, Liudmila; Alekseev, Vadim; Temerev, Alexander

    2014-01-01

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

  2. The epidemiology and socio-economic impact of Rift Valley fever epidemics in Tanzania: A review

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    Calvin Sindato

    2012-06-01

    Full Text Available A review was conducted to provide comprehensive update on Rift Valley fever (RVF in Tanzania, with particular attention devoted to trend of occurrence, epidemiological factors, socio-economic impact and measures which were applied to its control. Information presented in this paper was obtained through extensive literature review. Rift Valley fever was documented for the first time in Tanzania in 1977. This was followed by epidemics in 1997 and 2007. Contrary to the latest epidemic in 2007 sporadic cases of RVF during the previous epidemics were confined to mainly livestock and mostly affecting northern parts of Tanzania. The latest disease epidemic expanded to cover wider areas (mostly northern and central zones of the country involving both human and domestic ruminants. During the latest disease outbreak 52.4% (n = 21 of regions in Tanzania mainland were affected and majority (72.7, n = 11 of the regions had concurrent infections in human and animals. Phylogenetic comparison of nucleotide and amimo acid sequences revealed different virus strains between Kenya and Tanzania.Epidemiological factors that were considered responsible for the previous RVF epidemics in Tanzania included farming systems, climatic factors, vector activities and presence of large population of ruminant species, animal movements and food consumption habits. Majority of the RVF positive cases in the latest epidemic were livestock under pastoral and agro-pastoral farming systems.The disease caused serious effects on rural people’s food security and household nutrition and on direct and indirect losses to livestock producers in the country. Psycho-social distress that communities went through was enormous, which involved the thinking about the loss of their family members and/or relatives, their livestock and crop production. Socially, the status of most livestock producers was eroded in their communities.Cessation of lucrative trade in ruminants resulted in serious

  3. Phylodynamics of the HIV-1 epidemic in Cuba.

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    Edson Delatorre

    Full Text Available Previous studies have shown that the HIV-1 epidemic in Cuba displayed a complex molecular epidemiologic profile with circulation of several subtypes and circulating recombinant forms (CRF; but the evolutionary and population history of those viral variants remains unknown. HIV-1 pol sequences of the most prevalent Cuban lineages (subtypes B, C and G, CRF18_cpx, CRF19_cpx, and CRFs20/23/24_BG isolated between 1999 and 2011 were analyzed. Maximum-likelihood analyses revealed multiple introductions of subtype B (n≥66, subtype C (n≥10, subtype G (n≥8 and CRF18_cpx (n≥2 viruses in Cuba. The bulk of HIV-1 infections in this country, however, was caused by dissemination of a few founder strains probably introduced from North America/Europe (clades B(CU-I and B(CU-II, east Africa (clade C(CU-I and central Africa (clades G(CU, CRF18(CU and CRF19(CU, or locally generated (clades CRFs20/23/24_BG. Bayesian-coalescent analyses show that the major HIV-1 founder strains were introduced into Cuba during 1985-1995; whereas the CRFs_BG strains emerged in the second half of the 1990s. Most HIV-1 Cuban clades appear to have experienced an initial period of fast exponential spread during the 1990s and early 2000s, followed by a more recent decline in growth rate. The median initial growth rate of HIV-1 Cuban clades ranged from 0.4 year⁻¹ to 1.6 year⁻¹. Thus, the HIV-1 epidemic in Cuba has been a result of the successful introduction of a few viral strains that began to circulate at a rather late time of the AIDS pandemic, but then were rapidly disseminated through local transmission networks.

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

    Science.gov (United States)

    Shao, Qin; Chin, Khew-Voon

    2011-06-01

    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 type consumption and rising obesity using the loss-adjusted food availability data from the United States Department of Agriculture (USDA) Economic Research Services (ERS) as well as the obesity prevalence data from the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health and Nutrition Examination Survey (NHANES) at the Centers for Disease Control and Prevention (CDC). Our analysis showed that total calorie intake and consumption of high fructose corn syrup (HFCS) did not correlate with rising obesity trends. Intake of other major food types, including chicken, dairy fats, salad and cooking oils, and cheese also did not correlate with obesity trends. However, our results surprisingly revealed that consumption of corn products correlated with rising obesity and was independent of gender and race/ethnicity among population dynamics in the U.S. Therefore, we were able to demonstrate a novel link between the consumption of corn products and rising obesity trends that has not been previously attributed to the obesity epidemic. This correlation coincides with the introduction of bioengineered corns into the human food chain, thus raising a new hypothesis that should be tested in molecular and animal models of obesity.

  5. Phylodynamics of the HIV-1 epidemic in Cuba.

    Science.gov (United States)

    Delatorre, Edson; Bello, Gonzalo

    2013-01-01

    Previous studies have shown that the HIV-1 epidemic in Cuba displayed a complex molecular epidemiologic profile with circulation of several subtypes and circulating recombinant forms (CRF); but the evolutionary and population history of those viral variants remains unknown. HIV-1 pol sequences of the most prevalent Cuban lineages (subtypes B, C and G, CRF18_cpx, CRF19_cpx, and CRFs20/23/24_BG) isolated between 1999 and 2011 were analyzed. Maximum-likelihood analyses revealed multiple introductions of subtype B (n≥66), subtype C (n≥10), subtype G (n≥8) and CRF18_cpx (n≥2) viruses in Cuba. The bulk of HIV-1 infections in this country, however, was caused by dissemination of a few founder strains probably introduced from North America/Europe (clades B(CU-I) and B(CU-II)), east Africa (clade C(CU-I)) and central Africa (clades G(CU), CRF18(CU) and CRF19(CU)), or locally generated (clades CRFs20/23/24_BG). Bayesian-coalescent analyses show that the major HIV-1 founder strains were introduced into Cuba during 1985-1995; whereas the CRFs_BG strains emerged in the second half of the 1990s. Most HIV-1 Cuban clades appear to have experienced an initial period of fast exponential spread during the 1990s and early 2000s, followed by a more recent decline in growth rate. The median initial growth rate of HIV-1 Cuban clades ranged from 0.4 year⁻¹ to 1.6 year⁻¹. Thus, the HIV-1 epidemic in Cuba has been a result of the successful introduction of a few viral strains that began to circulate at a rather late time of the AIDS pandemic, but then were rapidly disseminated through local transmission networks.

  6. Impact of porcine epidemic diarrhea on performance of growing pigs.

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    Julio Alvarez

    Full Text Available The impact of porcine epidemic diarrhea virus (PEDv infection on the US pork industry has mainly been attributed to the mortality that it causes in suckling piglets, and, consequently, much effort has been invested in the quantification of its effect in sow farms. However, no information on the performance of surviving pigs that were exposed to the PEDv as piglets is available. Here, a retrospective cohort study to evaluate the impact of porcine epidemic diarrhea virus (PEDv infection on growing pigs' performance, as indicated by mortality, average daily gain (ADG, average daily feed intake (ADFI, and feed conversion ratio (FCR was performed using production records from weaned pigs in nursery and wean-to-finish sites from sow farms that became PEDv-infected between May 2013 and June 2014. Production records from the first batch of growing pigs weaned in infected flows after the PEDv outbreak ("infected batches" were compared with those from pigs weaned within the previous 14 to 120 days ("control batches". Performance records from infected and control batches, paired by flow, were compared using non-parametric paired tests. Mortality, ADG and FCR were significantly different in PEDv-positive (infected compared with PEDv-negative (control batches, with a mean increase of mortality and FCR of 11% and 0.5, respectively, and a decrease of ADG of 0.16 lb/day. Our results demonstrate a poorer performance of growing pigs weaned after a PEDv outbreak compared with those weaned within the previous 14-120 days, suggesting that in addition to the mortality induced by PEDv in suckling pigs, the disease also impairs the performance of surviving pig. These findings help to quantify the impact of PEDv infection in the US and, ultimately, contribute to efforts to quantify the cost-effectiveness of disease prevention and control measures.

  7. Phenotypic and Genotypic Comparison of Epidemic and Non-Epidemic Strains of Pseudomonas aeruginosa from Individuals with Cystic Fibrosis.

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    Jessica Duong

    Full Text Available Epidemic strains of Pseudomonas aeruginosa have been found worldwide among the cystic fibrosis (CF patient population. Using pulse-field gel electrophoresis, the Prairie Epidemic Strain (PES has recently been found in one-third of patients attending the Calgary Adult CF Clinic in Canada. Using multi-locus sequence typing, PES isolates from unrelated patients were found to consistently have ST192. Though most patients acquired PES prior to enrolling in the clinic, some patients were observed to experience strain replacement upon transitioning to the clinic whereby local non-epidemic P. aeruginosa isolates were displaced by PES. Here we genotypically and phenotypically compared PES to other P. aeruginosa epidemic strains (OES found around the world as well as local non-epidemic CF P. aeruginosa isolates in order to characterize PES. Since some epidemic strains are associated with worse clinical outcomes, we assessed the pathogenic potential of PES to determine if these isolates are virulent, shared properties with OES, and if its phenotypic properties may offer a competitive advantage in displacing local non-epidemic isolates during strain replacement. As such, we conducted a comparative analysis using fourteen phenotypic traits, including virulence factor production, biofilm formation, planktonic growth, mucoidy, and antibiotic susceptibility to characterize PES, OES, and local non-epidemic isolates. We observed that PES and OES could be differentiated from local non-epidemic isolates based on biofilm growth with PES isolates being more mucoid. Pairwise comparisons indicated that PES produced significantly higher levels of proteases and formed better biofilms than OES but were more susceptible to antibiotic treatment. Amongst five patients experiencing strain replacement, we found that super-infecting PES produced lower levels of proteases and elastases but were more resistant to antibiotics compared to the displaced non-epidemic isolates. This

  8. Phenotypic and Genotypic Comparison of Epidemic and Non-Epidemic Strains of Pseudomonas aeruginosa from Individuals with Cystic Fibrosis.

    Science.gov (United States)

    Duong, Jessica; Booth, Sean C; McCartney, Nathan K; Rabin, Harvey R; Parkins, Michael D; Storey, Douglas G

    2015-01-01

    Epidemic strains of Pseudomonas aeruginosa have been found worldwide among the cystic fibrosis (CF) patient population. Using pulse-field gel electrophoresis, the Prairie Epidemic Strain (PES) has recently been found in one-third of patients attending the Calgary Adult CF Clinic in Canada. Using multi-locus sequence typing, PES isolates from unrelated patients were found to consistently have ST192. Though most patients acquired PES prior to enrolling in the clinic, some patients were observed to experience strain replacement upon transitioning to the clinic whereby local non-epidemic P. aeruginosa isolates were displaced by PES. Here we genotypically and phenotypically compared PES to other P. aeruginosa epidemic strains (OES) found around the world as well as local non-epidemic CF P. aeruginosa isolates in order to characterize PES. Since some epidemic strains are associated with worse clinical outcomes, we assessed the pathogenic potential of PES to determine if these isolates are virulent, shared properties with OES, and if its phenotypic properties may offer a competitive advantage in displacing local non-epidemic isolates during strain replacement. As such, we conducted a comparative analysis using fourteen phenotypic traits, including virulence factor production, biofilm formation, planktonic growth, mucoidy, and antibiotic susceptibility to characterize PES, OES, and local non-epidemic isolates. We observed that PES and OES could be differentiated from local non-epidemic isolates based on biofilm growth with PES isolates being more mucoid. Pairwise comparisons indicated that PES produced significantly higher levels of proteases and formed better biofilms than OES but were more susceptible to antibiotic treatment. Amongst five patients experiencing strain replacement, we found that super-infecting PES produced lower levels of proteases and elastases but were more resistant to antibiotics compared to the displaced non-epidemic isolates. This comparative

  9. SIS epidemics on Triadic Random Graphs

    CERN Document Server

    Rausch, Ilja

    2016-01-01

    It has been shown in the past that many real-world networks exhibit community structures and non-trivial clustering which comes with the occurrence of a notable number of triangular connections. Yet the influence of such connection patterns on the dynamics of disease transmission is not fully understood. In order to study their role in the context of Susceptible-Infected-Susceptible (SIS) epidemics we use the Triadic Random Graph (TRG) model to construct small networks (N=49) from distinct, closed, directed triadic subpatterns. We compare various global properties of TRGs and use the N-intertwined mean-field approximation (NIMFA) model to perform numerical simulations of SIS-dynamics on TRGs. The results show that the infection spread on undirected TRGs displays very similar behavior to TRGs with an abundance of (directed) feed-back-loops, while using (directed) feed-forward-loops as network-entities significantly slows down the epidemic and lowers the number of infected individuals in the endemic state. More...

  10. Colliding Epidemics and the Rise of Cryptococcosis

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    Christina C. Chang

    2015-12-01

    Full Text Available Discovered more than 100 years ago as a human pathogen, the Cryptococcus neoformans–Cryptococcus gattii (C. neoformans–C. gattii complex has seen a large global resurgence in its association with clinical disease in the last 30 years. First isolated in fermenting peach juice, and identified as a human pathogen in 1894 in a patient with bone lesions, this environmental pathogen has now found niches in soil, trees, birds, and domestic pets. Cryptococcosis is well recognized as an opportunistic infection and was first noted to be associated with reticuloendothelial cancers in the 1950s. Since then, advances in transplant immunology, medical science and surgical techniques have led to increasing numbers of solid organ transplantations (SOT and hematological stem cell transplantations being performed, and the use of biological immunotherapeutics in increasingly high-risk and older individuals, have contributed to the further rise in cryptococcosis. Globally, however, the major driver for revivification of cryptococcosis is undoubtedly the HIV epidemic, particularly in Sub-Saharan Africa where access to care and antiretroviral therapy remains limited and advanced immunodeficiency, poverty and malnutrition remains the norm. As a zoonotic disease, environmental outbreaks of both human and animal cryptococcosis have been reported, possibly driven by climate change. This is best exemplified by the resurgence of C. gattii infection in Vancouver Island, Canada, and the Pacific Northwest of the United States since 1999. Here we describe how the colliding epidemics of HIV, transplantation and immunologics, climate change and migration have contributed to the rise of cryptococcosis.

  11. Epidemic spreading in random rectangular networks

    Science.gov (United States)

    Estrada, Ernesto; Meloni, Sandro; Sheerin, Matthew; Moreno, Yamir

    2016-11-01

    The use of network theory to model disease propagation on populations introduces important elements of reality to the classical epidemiological models. The use of random geometric graphs (RGGs) is one of such network models that allows for the consideration of spatial properties on disease propagation. In certain real-world scenarios—like in the analysis of a disease propagating through plants—the shape of the plots and fields where the host of the disease is located may play a fundamental role in the propagation dynamics. Here we consider a generalization of the RGG to account for the variation of the shape of the plots or fields where the hosts of a disease are allocated. We consider a disease propagation taking place on the nodes of a random rectangular graph and we consider a lower bound for the epidemic threshold of a susceptible-infected-susceptible model or a susceptible-infected-recovered model on these networks. Using extensive numerical simulations and based on our analytical results we conclude that (ceteris paribus) the elongation of the plot or field in which the nodes are distributed makes the network more resilient to the propagation of a disease due to the fact that the epidemic threshold increases with the elongation of the rectangle. These results agree with accumulated empirical evidence and simulation results about the propagation of diseases on plants in plots or fields of the same area and different shapes.

  12. Epidemic contact tracing via communication traces.

    Directory of Open Access Journals (Sweden)

    Katayoun Farrahi

    Full Text Available Traditional contact tracing relies on knowledge of the interpersonal network of physical interactions, where contagious outbreaks propagate. However, due to privacy constraints and noisy data assimilation, this network is generally difficult to reconstruct accurately. Communication traces obtained by mobile phones are known to be good proxies for the physical interaction network, and they may provide a valuable tool for contact tracing. Motivated by this assumption, we propose a model for contact tracing, where an infection is spreading in the physical interpersonal network, which can never be fully recovered; and contact tracing is occurring in a communication network which acts as a proxy for the first. We apply this dual model to a dataset covering 72 students over a 9 month period, for which both the physical interactions as well as the mobile communication traces are known. Our results suggest that a wide range of contact tracing strategies may significantly reduce the final size of the epidemic, by mainly affecting its peak of incidence. However, we find that for low overlap between the face-to-face and communication interaction network, contact tracing is only efficient at the beginning of the outbreak, due to rapidly increasing costs as the epidemic evolves. Overall, contact tracing via mobile phone communication traces may be a viable option to arrest contagious outbreaks.

  13. Resource allocation for epidemic control in metapopulations.

    Directory of Open Access Journals (Sweden)

    Martial L Ndeffo Mbah

    Full Text Available Deployment of limited resources is an issue of major importance for decision-making in crisis events. This is especially true for large-scale outbreaks of infectious diseases. Little is known when it comes to identifying the most efficient way of deploying scarce resources for control when disease outbreaks occur in different but interconnected regions. The policy maker is frequently faced with the challenge of optimizing efficiency (e.g. minimizing the burden of infection while accounting for social equity (e.g. equal opportunity for infected individuals to access treatment. For a large range of diseases described by a simple SIRS model, we consider strategies that should be used to minimize the discounted number of infected individuals during the course of an epidemic. We show that when faced with the dilemma of choosing between socially equitable and purely efficient strategies, the choice of the control strategy should be informed by key measurable epidemiological factors such as the basic reproductive number and the efficiency of the treatment measure. Our model provides new insights for policy makers in the optimal deployment of limited resources for control in the event of epidemic outbreaks at the landscape scale.

  14. Competitive epidemic spreading over arbitrary multilayer networks

    Science.gov (United States)

    Darabi Sahneh, Faryad; Scoglio, Caterina

    2014-06-01

    This study extends the Susceptible-Infected-Susceptible (SIS) epidemic model for single-virus propagation over an arbitrary graph to an Susceptible-Infected by virus 1-Susceptible-Infected by virus 2-Susceptible (SI1SI2S) epidemic model of two exclusive, competitive viruses over a two-layer network with generic structure, where network layers represent the distinct transmission routes of the viruses. We find analytical expressions determining extinction, coexistence, and absolute dominance of the viruses after we introduce the concepts of survival threshold and absolute-dominance threshold. The main outcome of our analysis is the discovery and proof of a region for long-term coexistence of competitive viruses in nontrivial multilayer networks. We show coexistence is impossible if network layers are identical yet possible if network layers are distinct. Not only do we rigorously prove a region of coexistence, but we can quantitate it via interrelation of central nodes across the network layers. Little to no overlapping of the layers' central nodes is the key determinant of coexistence. For example, we show both analytically and numerically that positive correlation of network layers makes it difficult for a virus to survive, while in a network with negatively correlated layers, survival is easier, but total removal of the other virus is more difficult.

  15. Suppressed epidemics in multi-relational networks

    CERN Document Server

    Xu, Elvis H W; Xu, C; Tang, Ming; Do, Younghae; Hui, P M

    2014-01-01

    A two-state epidemic model in networks with links mimicking two kinds of relationships between connected nodes is introduced. Links of weights w1 and w0 occur with probabilities p and 1-p, respectively. The fraction of infected nodes rho(p) shows a non-monotonic behavior, with rho drops with p for small p and increases for large p. For small to moderate w1/w0 ratios, rho(p) exhibits a minimum that signifies an optimal suppression. For large w1/w0 ratios, the suppression leads to an absorbing phase consisting only of healthy nodes within a range p_L =p_R. A mean field theory that ignores spatial correlation is shown to give qualitative agreement and capture all the key features. A physical picture that emphasizes the intricate interplay between infections via w0 links and within clusters formed by nodes carrying the w1 links is presented. The absorbing state at large w1/w0 ratios results when the clusters are big enough to disrupt the spread via w0 links and yet small enough to avoid an epidemic within the clu...

  16. Modelling dengue epidemic spreading with human mobility

    Science.gov (United States)

    Barmak, D. H.; Dorso, C. O.; Otero, M.

    2016-04-01

    We explored the effect of human mobility on the spatio-temporal dynamics of Dengue with a stochastic model that takes into account the epidemiological dynamics of the infected mosquitoes and humans, with different mobility patterns of the human population. We observed that human mobility strongly affects the spread of infection by increasing the final size and by changing the morphology of the epidemic outbreaks. When the spreading of the disease is driven only by mosquito dispersal (flight), a main central focus expands diffusively. On the contrary, when human mobility is taken into account, multiple foci appear throughout the evolution of the outbreaks. These secondary foci generated throughout the outbreaks could be of little importance according to their mass or size compared with the largest main focus. However, the coalescence of these foci with the main one generates an effect, through which the latter develops a size greater than the one obtained in the case driven only by mosquito dispersal. This increase in growth rate due to human mobility and the coalescence of the foci are particularly relevant in temperate cities such as the city of Buenos Aires, since they give more possibilities to the outbreak to grow before the arrival of the low-temperature season. The findings of this work indicate that human mobility could be the main driving force in the dynamics of vector epidemics.

  17. [A pseudo-epidemic of puerperal sepsis].

    Science.gov (United States)

    Dietz, V; Derks, J B; Mascini, E M; Bruinse, H W

    2003-12-20

    Within a four-week period, five patients were admitted to the maternity ward of the Utrecht Children's Hospital diagnosed with puerperal sepsis due to group-A streptococcal infection. The clinical presentation was different for each patient. All patients recovered upon adequate antibiotic treatment. One of the children died, possibly due to sepsis and hypotension of his mother. As group-A streptococci can be extremely contagious and an epidemic was suspected, measures for additional hygiene were taken. Furthermore, all personnel at the maternity ward and the obstetric centre were tested. T-serotyping, M-genotyping, exotoxin A- and C-gene amplification and pulsed field gel electrophoresis were used to characterize the cultured group-A streptococci. Cross-contamination was not found. Therefore, this increase in puerperal sepsis was attributed to polyclonal expansion rather than an epidemic. All mothers of newly born children who present with fever and lower abdominal pain should be suspected of group-A streptococcal infection. Evaluation and treatment in hospital is indicated due to a sometimes fulminant course. When group-A streptococci are cultured again in a new pregnancy, eradication therapy during pregnancy or prophylactic treatment during birth should be considered to prevent recurrent infection.

  18. Plasmid profile analysis in identification of epidemic strains of Salmonella enterica serovar Enteritidis

    Directory of Open Access Journals (Sweden)

    Miljković-Selimović Biljana

    2008-01-01

    Full Text Available Background/Aim. As illness caused by Sallmonella enterica serovar Enteritidis (S. Enteritidis occurs not only as sporadic cases but as outbreaks, to reveal the source and routes of spreading of infection it is necessary to identify epidemic strain by the use of some typing methods. To determine whether plasmid profile analysis, as genotyping method, could be applied for the investigation of epidemic strains, isolates of S. Enteritidis, recovered from patient's stools and food associated with outbreaks and those isolated from sporadic cases of diarrhea, were investigated. Methods. Investigation of antibiotic resistance was performed by Kirby - Bauer disc-diffusion method. Isolation of plasmid DNA was carried out by Birnboim and Dolly alkaline lysis method, modified by Ish-Horovitz. Results. Out of 276 izolates of S. Enteritidis 94 were isolated from patient's stools and food associated with outbreaks and 182 were isolated from sporadic cases of diarrhea. The presence of 12 plasmid profiles was established. An average correlation degree of plasmid profiles between the strains was 0.84, that implies high degree of similarity of plasmid profiles of epidemic and non- epidemic strains isolated at our geographic region for the given period of time. Conclusion. The strains of S. Enteritidis, isolated in outbreaks of enterocolitis as well as from spordic cases of diarrhea in the same period of time and at the same area, frequently exhibit the same plasmid profile characterized by a single plasmid of 38 MDa. Therefore, in most cases plasmid profile analysis is not valuable in the identification of epidemic strains of S. Enteritidis. However, for this purpose plasmid profile analysis could be used when drug-resistant strains of S. Enteritidis are isolated, as they often possess additional resistant plasmids what increases discrimination power of this method.

  19. Epidemic Process over the Commute Network in a Metropolitan Area

    Science.gov (United States)

    Yashima, Kenta; Sasaki, Akira

    2014-01-01

    An understanding of epidemiological dynamics is important for prevention and control of epidemic outbreaks. However, previous studies tend to focus only on specific areas, indicating that application to another area or intervention strategy requires a similar time-consuming simulation. Here, we study the epidemic dynamics of the disease-spread over a commute network, using the Tokyo metropolitan area as an example, in an attempt to elucidate the general properties of epidemic spread over a commute network that could be used for a prediction in any metropolitan area. The model is formulated on the basis of a metapopulation network in which local populations are interconnected by actual commuter flows in the Tokyo metropolitan area and the spread of infection is simulated by an individual-based model. We find that the probability of a global epidemic as well as the final epidemic sizes in both global and local populations, the timing of the epidemic peak, and the time at which the epidemic reaches a local population are mainly determined by the joint distribution of the local population sizes connected by the commuter flows, but are insensitive to geographical or topological structure of the network. Moreover, there is a strong relation between the population size and the time that the epidemic reaches this local population and we are able to determine the reason for this relation as well as its dependence on the commute network structure and epidemic parameters. This study shows that the model based on the connection between the population size classes is sufficient to predict both global and local epidemic dynamics in metropolitan area. Moreover, the clear relation of the time taken by the epidemic to reach each local population can be used as a novel measure for intervention; this enables efficient intervention strategies in each local population prior to the actual arrival. PMID:24905831

  20. Effect of alprostadil combined with Shenkang injection on urine protein, renal function and serum inflammatory in patients with chronic nephritis

    Institute of Scientific and Technical Information of China (English)

    Chen Wang; Zhi-Feng Gu; Shuo Wang; Liang-Lan Shen; Fen Zhang

    2016-01-01

    Objective:To study the effect of alprostadil combined with Shenkang injection on urine protein, renal function and serum inflammatory in patients with chronic nephritis.Methods:A total of 96 patients with chronic nephritis in our hospital from May 2013 to May 2016 were enrolled in this study. The subjects were divided into control group (n=48) and treatment group (n=48) randomly. Patients in control group were treated with Shenkang injection, the treatment group were treated with alprostadil combined with Shenkang injection. The two groups were treated for 12 days. The levels of 24 h Upro, Uβ2-MG, SCr, BUN, UAER, hs-CRP, TNF-α, IL-6, IL-8 and IL-18 of the two groups before and after treatment were compared. Results:There were no significantly differences of the levels of 24 h Upro, Uβ2-MG, SCr, BUN, UAER, hs-CRP, TNF-α, IL-6, IL-8 and IL-18 of the two groups before treatment (P>0.05). The levels of 24 h Upro, Uβ2-MG, SCr, BUN and UAER of the two groups after treatment were significantly lower than before treatment (P<0.05), and that of experiment were significantly lower than control group (P<0.05). The levels of hs-CRP, TNF-α, IL-6, IL-8 and IL-18 of the two groups after treatment were significantly lower than before treatment (P<0.05), and that of experiment were significantly lower than control group (P<0.05).Conclusions: Alprostadil combined with Shenkang injection can significantly reduce urine protein and serum inflammatory, protect renal function of patients with chronic nephritis, and it is worthy clinical application.