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Sample records for fever accentuates transmural

  1. Nonfluoroscopic endoscopic ultrasound-guided transmural drainage of pancreatic pseudocysts at atypical locations

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    Surinder Singh Rana

    2016-01-01

    Full Text Available Background: Pancreatic pseudocysts (PP at atypical locations are a therapeutic challenge and are usually managed surgically. Objective: We evaluated safety and efficacy of nonfluoroscopic endoscopic ultrasound (NF-EUS-guided transmural drainage in the management of PP at atypical locations. Patients and Methods: Retrospective analysis of 11 patients (all males; age range: 28-46 years with PP at atypical locations who were treated with NF-EUS-guided transmural drainage during the last 18 months was done. Results: Four patients had intra/peri-splenic, three patients had mediastinal, three patients had intrahepatic, and one patient had renal PP. Nine patients had chronic pancreatitis whereas two patients had acute pancreatitis. Alcohol was the etiology of pancreatitis in ten patients. The size of PP ranged from 4 to 10 cm. All patients had abdominal pain, and two patients had fever whereas one patient with mediastinal PP also had dysphagia. NF-EUS-guided transmural drainage could be done successfully in all patients. 7 Fr transmural stent (s was/were placed in six patients whereas single-time complete aspiration of PP was done in five patients. On endoscopic retrograde pancreatography, six patients had partial duct disruption whereas five patients had complete disruption. Bridging transpapillary stent (5 Fr was placed in all patients with partial disruption. All PP healed in 10/11 (91% patients within 2-4 weeks, and there has been no recurrence in 9 of these patients during a follow-up period of 4-18 months. One patient with splenic PP needed surgery for gastrointestinal bleed. Conclusion: PP at atypical locations can be effectively and safely treated with NF-EUS-guided transmural drainage.

  2. Dutch transmural nurse clinics for chronic patients: a descriptive study.

    NARCIS (Netherlands)

    Temmink, D.; Francke, A.L.; Kerkstra, A.; Huyer Abu-Saad, H.

    2000-01-01

    'Transmural care' can be defined as patient-tailored care provided on the basis of close collaboration and joint responsibility between hospitals and home care organizations. One form of transmural care is transmural nurse clinics for chronically ill. This study describes 62 transmural nurse clinics

  3. Transmural care in the rehabilitation sector: implementation experiences with a transmural care model for people with spinal cord injury

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    J.H.A. Bloemen-Vrencken

    2005-06-01

    Full Text Available Purposes: The purpose of this article is first to describe the development and content of a transmural care model in the rehabilitation sector, which aims to reduce the number and severity of health problems of people with spinal cord injury (SCI and improve the continuity of care. Second, the purpose is to describe the applicability and implementation experiences of a transmural care model in the rehabilitation sector. Methods: The transmural care model was developed in cooperation with the Dutch Association of Spinal Cord Injured Patients, community nurses, general practitioners, rehabilitation nurses, rehabilitation managers, physiatrists and researchers. The core component of the care model consists of a transmural nurse, who ‘liaises’ between people with SCI living in the community, professional primary care professionals and the rehabilitation centre. The transmural care model provides a job description containing activities to support people with SCI and their family/partners and activities to promote continuity of care. The transmural care model was implemented in two Dutch rehabilitation centres. The following three aspects, as experienced by the transmural nurses, were evaluated: the extent to which the care model was implemented; enabling factors and barriers for implementation; strength and weakness of the care model. Results: The transmural care model was not implemented in all its details, with a clear difference between the two rehabilitation centres. Enabling factors and barriers for implementation were found at three levels: 1. the level of the individual professional (e.g. competencies, attitude and motivation, 2. the organisational and financing level (e.g. availability of facilities and finances, and 3. the social context (the opinion of colleagues, managers and other professionals involved with the care. The most important weakness experienced was that there was not enough time to put all the activities into practice

  4. ACCENTUATION OF PERSONALITY TRAITS IN THE PATIENTS WITH GRANULOMATOUS LESIONS OF RESPIRATORY ORGANS IN CASE OF SARCOIDOSIS AND TUBERCULOSIS

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    A. Yu. Chernikov

    2017-01-01

    Full Text Available 404 sarcoidosis and 404 tuberculosis patients were examined in order to detect correlations between clinical manifestations, psychological adaptation and accentuation of personality traits and granulomatous lesions of respiratory organs in case of sarcoidosis and tuberculosis. All patients had subjective and objective examinations and answered the following questionnaires: Schmieschek questionnaire to identify accentuation of personality traits, clinical questionnaire to detect and evaluate neurotic disorders, Taylor Manifest Anxiety Scale to detect the level of anxiety. It has been found out that sarcoidosis patients are characterized both by asymptomatic course of the disease as well as diverse clinical manifestations: pain syndrome, nodal fever, intoxication with expressed general fatigue, respiratory insufficiency. It is combined with stuck, pedant, cycloid, exalted, emotive accentuations of personality traits, with psychological maladaptation as per the scores of autonomic imbalance, neurotic depression, asthenia, with average high level of anxiety. The following is typical of tuberculosis patients: syndrome of bronchial tree lesions and respiratory insufficiency; distymny, demonstrative, excitable, exalted, anxiety-hypochondriac accentuations of personality traits, with psychological maladaptation as per the scores of autonomic imbalance, obsessive-phobic disorders and hysteria; average high level of anxiety. The strong correlation has been found between the degree of symptoms expression, level of anxiety and psychological maladaptation and the type of patient's accentuation of personality traits.

  5. Acute perimyocarditis mimicking transmural myocardial infarction

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    Omar Hesham R

    2009-12-01

    Full Text Available Abstract Although acute pericarditis has charachteristic electrocardiographic (ECG findings that differentiate it from acute ST segment elevation myocardial infarction (MI; in certain cases diagnosis is somewhat difficult especially when the ECG reveals focal instead of diffuse changes and moreover when pericarditis is associated with an underlying myocarditis causing elevation of the cardiac biomarkers therefore increasing the difficulty in differentiating between both enteties. This is especially important because adverse lethal side effect can occur if thrombolytic therapy is administered for a patient with acute pericarditis, or if a diagnosis of transmural MI is missed. In this case report we are describing an 18 year old male patient who presented with an acute onset of severe chest pain associated with focal ECG changes and elevated cardiac enzymes mimicking transmural MI. This report aims to sensitize readers to this debate and create awareness among cardiologists and intensivists with both presentations and how to reach an accurate diagnosis.

  6. A new principle of figure-ground segregation: The accentuation.

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    Pinna, Baingio; Reeves, Adam; Koenderink, Jan; van Doorn, Andrea; Deiana, Katia

    2018-02-01

    The problem of perceptual organization was studied by Gestalt psychologists in terms of figure-ground segregation. In this paper we explore a new principle of figure-ground segregation: accentuation. We demonstrate the effectiveness of accentuation relative to other Gestalt principles, and also consider it autonomous as it can agree with or oppose them. We consider three dynamic aspects of the principle, namely: attraction, accentuation and assignment. Each creature needs to attract, fascinate, seduce, draw attention (e.g., a mate or a prey animal) or distract, refuse, dissuade, discourage, repulse (e.g., a predator). Similarly, each organism needs to accentuate, highlight, stress, underline, emphasize or distract from another. Thus, accentuation assigns meaning to a visual pattern such as a coat, a plumage or a flower. False eyes (ocelli) and dots (diematic patterns) demonstrate "deceiving camouflage by accentuation" that confuses predators/preys and hides or highlights vital body parts (butterflies/flowers). They also display the deceiving appearance and exhibition of biological fitness. The same accents may serve different or even opposite goals. We conclude that accentuation improves the adaptive fitness of organisms in multifarious ways. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. A new principle of figure-ground segregation : The accentuation

    NARCIS (Netherlands)

    Pinna, Baingio; Reeves, Adam; Koenderink, Jan; van Doorn, Andrea; Deiana, Katia

    2018-01-01

    The problem of perceptual organization was studied by Gestalt psychologists in terms of figure-ground segregation. In this paper we explore a new principle of figure-ground segregation: accentuation. We demonstrate the effectiveness of accentuation relative to other Gestalt principles, and also

  8. Accentuated Factors of Handheld Computing

    DEFF Research Database (Denmark)

    Andersson, Bo; Henningsson, Stefan

    2013-01-01

    and the mobile technology. In this chapter, we deductively, from previous research on aspects on mobility, synthesize a tentative analytical framework capturing factors accentuated in mobile IS design. We evaluate the framework based on criteria of completeness, distinctiveness and simplicity. Eventually...

  9. Endoscopic ultrasound-guided endoscopic transmural drainage of pancreatic pseudocysts Drenagem transmural de pseudocistos de pâncreas guiada por ecoendoscopia

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    César Vivian Lopes

    2008-03-01

    Full Text Available BACKGROUND: Surgery is the traditional treatment for symptomatic pancreatic pseudocysts, but the morbidity is still too high. Minimally invasive endoscopic approaches have been encouraged. AIMS: To evaluate the efficacy of endoscopic ultrasound-guided endoscopic transmural drainage of pancreatic pseudocysts. METHODS: From January, 2003 to August, 2006, 31 consecutive symptomatic patients submitted to 37 procedures at the same endoscopic unit were retrospectively analysed. Chronic and acute pancreatitis were found in, respectively, 17 (54.8% and 10 (32.3% cases. Bulging was present in 14 (37.8% cases. Cystogastrostomy or cystoduodenostomy were created with an interventional linear echoendoscope under endosonographic and fluoroscopic control. By protocol, only a single plastic stent, without nasocystic drain, was used. Straight or double pigtail stents were used in, respectively, 22 (59.5% and 15 (40.5% procedures. RESULTS: Endoscopic ultrasound-guided transmural drainage was successful in 29 (93.5% patients. Two cases needed surgery, both due to procedure-related complications. There was no mortality related to the procedure. Twenty-four patients were followed-up longer than 4 weeks. During a mean follow-up of 12.6 months, there were six (25% symptomatic recurrences due to stent clogging or migration, with two secondary infections. Median time for developing complications and recurrence of the collections was 3 weeks. These cases were successfully managed with new stents. Complications were more frequent in patients treated with straight stents and in those with a recent episode of acute pancreatitis. CONCLUSIONS: Endoscopic transmural drainage provides an effective approach to the management of pancreatic pseudocysts.RACIONAL: A abordagem cirúrgica é o tratamento tradicional para os pseudocistos sintomáticos de pâncreas, contudo a morbidade permanece elevada. Terapêuticas endoscópicas minimamente invasivas têm sido encorajadas. OBJETIVO

  10. Vertex Accentuation in Female Pattern Hair Loss in Asians

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    Chavalit Supsrisunjai

    2016-05-01

    Full Text Available Background: The most common cause of hair loss seen in women is female pattern hair loss (FPHL, also known as female androgenetic alopecia. It affects the central part of the scalp, but spares the frontal hairline. Frontal accentuation was also described by Olsen. In Asian women, vertex thinning patterns are frequently developed, but there has been no report about vertex thinning pattern in female pattern hair loss. Objective: To find prevalence of vertex accentuation in female pattern hair loss (FPHL in Asian women. Methods: Scalp hair counting (n/cm2 were measured at 3 different areas; vertex, mid scalp and frontal area respectively by digital dermoscope (Dino digital AM-413T. Visual counting and photography were performed. Outcomes were evaluated by gross appearance of vertex thinning and/or hair density <120 /cm2 in any of 3 areas. Results: 143 patients were evaluated. Mean age was 45.54 years. Of the hair loss type, 36.4% were mid-scalp, 33.6% were vertex accentuation and 30.1% were frontal accentuation, respectively. Age was not significantly different among the 3 types of hair loss (P- value 0.859. Conclusion: Although the most common female pattern hair loss type is diffuse type (Ludwig type, vertex accentuation pattern is the second most common pattern in this study. This study is the first to mention “Vertex accentuation” to be another pattern for FPHL.

  11. Some Notes about Unit Accentuation in Danish

    DEFF Research Database (Denmark)

    Togeby, Ole

    2006-01-01

    Unit accentuation in Danish, e.g.:han ostod 'op (he got up) vs han 'stod 'op (he was standing)  is described as consisting of a stress loser (stod) and a stress keeper (op). A destinction is made between progressive stress loss, which is discontinous,  and regressive stress loss, which is not dis......Unit accentuation in Danish, e.g.:han ostod 'op (he got up) vs han 'stod 'op (he was standing)  is described as consisting of a stress loser (stod) and a stress keeper (op). A destinction is made between progressive stress loss, which is discontinous,  and regressive stress loss, which...

  12. Spatial characterization of electrogram morphology from transmural recordings in the intact normal heart.

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    Jim Pouliopoulos

    Full Text Available PURPOSE: Unipolar (UE and bipolar electrograms (BE are utilized to identify arrhythmogenic substrate. We quantified the effect of increasing distance from the source of propagation on local electrogram amplitude; and determined if transmural electrophysiological gradients exist with respect to propagation and stimulation depth. METHODS: Mapping was performed on 5 sheep. Deployment of >50 quadripolar transmural needles in the LV were located in Cartesian space using Ensite. Contact electrograms from all needles were recorded during multisite bipolar pacing from epicardial then endocardial electrodes. Analysis was performed to determine stimulus distance to local activation time, peak negative amplitude (V-P, and peak-peak amplitude (VP-P for (1 unfiltered UE, and (2 unfiltered and 30 Hz high-pass filtered BEs. Each sheep was analysed using repeated ANOVA. RESULTS: Increasing distance from the pacing sites led to significant (p0.01 during endocardial stimulation, and 2.3±2.4 ms (UE and 1.8±3.7 ms (BE during epicardal stimulation (all pVP-P. Conduction propagates preferentially via the epicardium during stimulation and is believed to contribute to a transmural amplitude gradient.

  13. Effect of Transmural Differences in Excitation-Contraction Delay and Contraction Velocity on Left Ventricle Isovolumic Contraction: A Simulation Study

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    J. Vaverka

    2018-01-01

    Full Text Available Recent studies have shown that left ventricle (LV exhibits considerable transmural differences in active mechanical properties induced by transmural differences in electrical activity, excitation-contraction coupling, and contractile properties of individual myocytes. It was shown that the time between electrical and mechanical activation of myocytes (electromechanical delay: EMD decreases from subendocardium to subepicardium and, on the contrary, the myocyte shortening velocity (MSV increases in the same direction. To investigate the physiological importance of this inhomogeneity, we developed a new finite element model of LV incorporating the observed transmural gradients in EMD and MSV. Comparative simulations with the model showed that when EMD or MSV or both were set constant across the LV wall, the LV contractility during isovolumic contraction (IVC decreased significantly (dp/dtmax⁡  was reduced by 2 to 38% and IVC was prolonged by 18 to 73%. This was accompanied by an increase of transmural differences in wall stress. These results suggest that the transmural differences in EMD and MSV play an important role in physiological contractility of LV by synchronising the contraction of individual layers of ventricular wall during the systole. Reduction or enhancement of these differences may therefore impair the function of LV and contribute to heart failure.

  14. Dispersion of repolarization in canine ventricle and the electrocardiographic T wave: Tp-e interval does not reflect transmural dispersion

    NARCIS (Netherlands)

    Opthof, Tobias; Coronel, Ruben; Wilms-Schopman, Francien J. G.; Plotnikov, Alexei N.; Shlapakova, Iryna N.; Danilo, Peter; Rosen, Michael R.; Janse, Michiel J.

    2007-01-01

    BACKGROUND: The concept that the interval between the peak (T(peak)) and the end (T(end)) of the T wave (T(p-e)) is a measure of transmural dispersion of repolarization time is widely accepted but has not been tested rigorously by transmural mapping of the intact heart. OBJECTIVES: The purpose of

  15. Accentuation-suppression and scaling

    DEFF Research Database (Denmark)

    Sørensen, Thomas Alrik; Bundesen, Claus

    2012-01-01

    The limitations of the visual short-term memory (VSTM) system have become an increasingly popular field of study. One line of inquiry has focused on the way attention selects objects for encoding into VSTM. Using the framework of the Theory of Visual Attention (TVA; Bundesen, 1990 Psychological...... a scaling mechanism modulating the decision bias of the observer and also through an accentuation-suppression mechanism that modulates the degree of subjective relevance of objects, contracting attention around fewer, highly relevant objects while suppressing less relevant objects. These mechanisms may...

  16. Myocardial oxygenation and transmural lactate metabolism during experimental acute coronary stenosis in pigs.

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    Gonschior, P; Gonschior, G M; Conzen, P F; Hobbhahn, J; Goetz, A E; Peter, K; Brendel, W

    1992-01-01

    Measurement of surface tissue pO2 (ptO2) with surface electrodes is increasingly applied in experimental medicine. Its use on the beating heart may seem to be problematic because transmural gradients of tissue pO2 would reduce the validity of pO2 determinations in the epicardial layers. This study attempted to determine whether ptO2 may be a valid and sensitive indicator of transmural myocardial oxygenation. In order to measure ptO2, two eight-channel Clark-type electrodes were placed on a beating porcine left ventricle (n = 13). Measurements were made at different degrees of acute stenosis of the left anterior descending artery (LAD). A 24-F cannula was inserted into the great cardiac vein, draining the poststenotic myocardium to obtain coronary venous blood samples. Transmural metabolic changes were detected simultaneously by coronary venous blood gas parameters and lactate levels. Epicardial tissue pO2 was 49 +/- 2 mm Hg (mean +/- SEM) before stenosis and decreased to a mean value of 25 +/- 2 mm Hg during stenosis. Different degrees of LAD stenosis (ptO2 range: 12-35 mm Hg) were substantial enough to alter arterio-coronary venous lactate difference (avd lactate) from +0.31 +/- 0.07 mmol/l (control) to -0.62 +/- 0.15 mmol/l (stenosis). A significant linear correlation between changes of ptO2 (delta ptO2) and changes of avd lactate (delta avd lactate) resulted (y = 0.59 + 0.62x; r = 0.86; p less than or equal to 0.001). However, linear regression analysis between delta ptO2 correlated with the corresponding data from coronary venous pO2 (delta pO2cv) oxygen content (delta O2contcv), and oxygen saturation (delta O2satcv) showed no significant correlations. We conclude that measurement of ptO2 is a sensitive and valuable indicator of transmural oxygenation in ischemic myocardium, whereas pO2cv, O2contcv and O2satcv do not seem to be valid predictors of ischemia in myocardial oxygenation.

  17. Infeasibility of endoscopic transmural drainage due to pancreatic pseudocyst wall calcifications - case report.

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    Krajewski, Andrzej; Lech, Gustaw; Makiewicz, Marcin; Kluciński, Andrzej; Wojtasik, Monika; Kozieł, Sławomir; Słodkowski, Maciej

    2017-02-28

    Postinflammatory pancreatic pseudocysts are one of the most common complications of acute pancreatitis. In most cases, pseudocysts self-absorb in the course of treatment of pancreatitis. In some patients, pancreatic pseudocysts are symptomatic and cause pain, problems with gastrointestinal transit, and other complications. In such cases, drainage or resection should be performed. Among the invasive methods, mini invasive procedures like endoscopic transmural drainage through the wall of the stomach or duodenum play an important role. For endoscopic transmural drainage, it is necessary that the cyst wall adheres to the stomach or duodenum, making a visible impression. We present a very rare case of infeasibility of endoscopic drainage of a postinflammatory pancreatic pseudocyst, impressing the stomach, due to cyst wall calcifications. A 55-year-old man after acute pancreatitis presented with a 1-year history of epigastric pain and was admitted due to a postinflammatory pseudocyst in the body and tail of pancreas. On admission, blood tests, including CA 19-9 and CEA, were normal. An ultrasound examination revealed a 100-mm pseudocyst in the tail of pancreas, which was confirmed on CT and EUS. Acoustic shadowing caused by cyst wall calcifications made the cyst unavailable to ultrasound assessment and percutaneous drainage. Gastroscopy revealed an impression on the stomach wall from the outside. The patient was scheduled for endoscopic transmural drainage. After insufflation of the stomach, a large mass protruding from the wall was observed. The stomach mucosa was punctured with a cystotome needle knife, and the pancreatic cyst wall was reached. Due to cyst wall calcifications, endoscopic drainage of the cyst was unfeasible. Profuse submucosal bleeding at the puncture site was stopped by placing clips. The patient was scheduled for open surgery, and distal pancreatectomy with splenectomy was performed. The histopathological examination confirmed the initial diagnosis

  18. Accentuate or repeat? Brain signatures of developmental periods in infant word recognition.

    Science.gov (United States)

    Männel, Claudia; Friederici, Angela D

    2013-01-01

    Language acquisition has long been discussed as an interaction between biological preconditions and environmental input. This general interaction seems particularly salient in lexical acquisition, where infants are already able to detect unknown words in sentences at 7 months of age, guided by phonological and statistical information in the speech input. While this information results from the linguistic structure of a given language, infants also exploit situational information, such as speakers' additional word accentuation and word repetition. The current study investigated the developmental trajectory of infants' sensitivity to these two situational input cues in word recognition. Testing infants at 6, 9, and 12 months of age, we hypothesized that different age groups are differentially sensitive to accentuation and repetition. In a familiarization-test paradigm, event-related brain potentials (ERPs) revealed age-related differences in infants' word recognition as a function of situational input cues: at 6 months infants only recognized previously accentuated words, at 9 months both accentuation and repetition played a role, while at 12 months only repetition was effective. These developmental changes are suggested to result from infants' advancing linguistic experience and parallel auditory cortex maturation. Our data indicate very narrow and specific input-sensitive periods in infant word recognition, with accentuation being effective prior to repetition. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Transmural variation in elastin fiber orientation distribution in the arterial wall.

    Science.gov (United States)

    Yu, Xunjie; Wang, Yunjie; Zhang, Yanhang

    2018-01-01

    The complex three-dimensional elastin network is a major load-bearing extracellular matrix (ECM) component of an artery. Despite the reported anisotropic behavior of arterial elastin network, it is usually treated as an isotropic material in constitutive models. Our recent multiphoton microscopy study reported a relatively uniform elastin fiber orientation distribution in porcine thoracic aorta when imaging from the intima side (Chow et al., 2014). However it is questionable whether the fiber orientation distribution obtained from a small depth is representative of the elastin network structure in the arterial wall, especially when developing structure-based constitutive models. To date, the structural basis for the anisotropic mechanical behavior of elastin is still not fully understood. In this study, we examined the transmural variation in elastin fiber orientation distribution in porcine thoracic aorta and its association with elastin anisotropy. Using multi-photon microscopy, we observed that the elastin fibers orientation changes from a relatively uniform distribution in regions close to the luminal surface to a more circumferential distribution in regions that dominate the media, then to a longitudinal distribution in regions close to the outer media. Planar biaxial tensile test was performed to characterize the anisotropic behavior of elastin network. A new structure-based constitutive model of elastin network was developed to incorporate the transmural variation in fiber orientation distribution. The new model well captures the anisotropic mechanical behavior of elastin network under both equi- and nonequi-biaxial loading and showed improvements in both fitting and predicting capabilities when compared to a model that only considers the fiber orientation distribution from the intima side. We submit that the transmural variation in fiber orientation distribution is important in characterizing the anisotropic mechanical behavior of elastin network and

  20. Pressure overload-induced mild cardiac hypertrophy reduces leftventricular transmural differences in mitochondrial respiratory chainactivity and increases oxidative stress

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    Michel eKINDO

    2012-08-01

    Full Text Available Objective: Increased mechanical stress and contractility characterizes normal left ventricular subendocardium (Endo but whether Endo mitochondrial respiratory chain complex activities is reduced as compared to subepicardium (Epi and whether pressure overload-induced left ventricular hypertrophy (LVH might modulate transmural gradients through increased reactive oxygen species (ROS production is unknown. Methods: LVH was induced by 6 weeks abdominal aortic banding and cardiac structure and function were determined with echocardiography and catheterization in sham-operated and LVH rats (n=10 for each group. Mitochondrial respiration rates, coupling, content and ROS production were measured in LV Endo and Epi, using saponin-permeabilised fibres, Amplex Red fluorescence and citrate synthase activity.Results: In sham, a transmural respiratory gradient was observed with decreases in endo maximal oxidative capacity (-36.7%, P<0.01 and complex IV activity (-57.4%, P<0.05. Mitochondrial hydrogen peroxide (H2O2 production was similar in both LV layers.Aortic banding induced mild LVH (+31.7% LV mass, associated with normal LV fractional shortening and end diastolic pressure. LVH reduced maximal oxidative capacity (-23.6 and -33.3%, increased mitochondrial H2O2 production (+86.9 and +73.1%, free radical leak (+27.2% and +36.3% and citrate synthase activity (+27.2% and +36.3% in Endo and Epi, respectively.Transmural mitochondrial respiratory chain complex IV activity was reduced in LVH (-57.4 vs –12.2%; P=0.02. Conclusions: Endo mitochondrial respiratory chain complexes activities are reduced compared to LV Epi. Mild LVH impairs mitochondrial oxidative capacity, increases oxidative stress and reduces transmural complex IV activity. Further studies will be helpful to determine whether reduced LV transmural gradient in mitochondrial respiration might be a new marker of a transition from uncomplicated toward complicated LVH.

  1. Transmural Variation and Anisotropy of Microvascular Flow Conductivity in the Rat Myocardium

    KAUST Repository

    Smith, Amy F.

    2014-05-28

    Transmural variations in the relationship between structural and fluid transport properties of myocardial capillary networks are determined via continuum modeling approaches using recent three-dimensional (3D) data on the microvascular structure. Specifically, the permeability tensor, which quantifies the inverse of the blood flow resistivity of the capillary network, is computed by volume-averaging flow solutions in synthetic networks with geometrical and topological properties derived from an anatomically-detailed microvascular data set extracted from the rat myocardium. Results show that the permeability is approximately ten times higher in the principal direction of capillary alignment (the "longitudinal" direction) than perpendicular to this direction, reflecting the strong anisotropy of the microvascular network. Additionally, a 30% increase in capillary diameter from subepicardium to subendocardium is shown to translate to a 130% transmural rise in permeability in the longitudinal capillary direction. This result supports the hypothesis that perfusion is preferentially facilitated during diastole in the subendocardial microvasculature to compensate for the severely-reduced systolic perfusion in the subendocardium.

  2. Drenagem endoscópica transmural de pseudocisto pancreático: resultados a longo prazo Transmural endoscopy drainage of pancreatic pseudocyst: long-term outcome

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    Rone Antônio Alves de Abreu

    2007-03-01

    Full Text Available RACIONAL: Os pseudocistos pancreáticos são complicações relativamente comuns em pacientes adultos com pancreatite. OBJETIVO: Avaliar os resultados a longo prazo da drenagem endoscópica transmural, estabelecendo seu papel no manejo do pseudocisto pancreático. MÉTODOS: Foram estudados 14 pacientes com pseudocisto de pâncreas, cuja principal queixa à apresentação foi dor no andar superior do abdome e massa abdominal palpável, submetidos a cistogastrostomia (n = 12 e cistoduodenostomia (n = 2, acompanhados clinicamente e com tomografia computadorizada de abdome por até 51 meses. A colangiopancreatografia endoscópica retrógrada era tentada em todos os casos para estudo do ducto pancreático e classificação dos cistos. RESULTADOS: A pancreatite crônica alcoólica agudizada foi responsável por 10 casos (71,5% e a biliar por 4 (28,5%. As duas formas de drenagens (cistogastrostomia e cistoduodenostomia endoscópicas foram efetivas. Não houve mudança na conduta terapêutica proposta; em dois pacientes a migração da órtese para o interior do pseudocisto, no momento da inserção, foi a principal complicação, sendo possível sua retirada no mesmo ato, com o uso da cesta de Dormia, sob o auxílio de fluoroscopia. Não houve mortalidade, nem recidiva até o momento. O tempo médio de permanência hospitalar foi de 3 dias. CONCLUSÃO: A drenagem endoscópica transmural se apresentou como terapêutica eficaz, com baixo índice de complicações, mortalidade nula e pequeno tempo de internação hospitalar.BACKGROUND: Pancreatic pseudocysts are relatively common complications of pancreatitis in adults. OBJECTIVE: To evaluate the long-term results from transmural endoscopic drainage and thus to establish its role in managing pancreatic pseudocyst. METHODS: Fourteen patients with pancreatic pseudocyst were studied. Their main complaint was pain in the upper levels of the abdomen. They presented palpable abdominal mass and underwent

  3. Transmural palliative care by means of teleconsultation: a window of opportunities and new restrictions

    NARCIS (Netherlands)

    Gurp, J.L.P. van; Selm, M. van; Leeuwen, E. van; Hasselaar, J.G.

    2013-01-01

    BACKGROUND: Audio-visual teleconsultation is expected to help home-based palliative patients, hospital-based palliative care professionals, and family physicians to jointly design better, pro-active care. Consensual knowledge of the possibilities and limitations of teleconsultation in transmural

  4. Transmural palliative care by means of teleconsultation: a window of opportunities and new restrictions

    NARCIS (Netherlands)

    van Gurp, J.; van Selm, M.; van Leeuwen, E.; Hasselaar, J.

    2013-01-01

    Background: Audio-visual teleconsultation is expected to help home-based palliative patients, hospital-based palliative care professionals, and family physicians to jointly design better, pro-active care. Consensual knowledge of the possibilities and limitations of teleconsultation in transmural

  5. Relationship between stent characteristics and treatment outcomes in endoscopic transmural drainage of uncomplicated pancreatic pseudocysts.

    Science.gov (United States)

    Bang, Ji Young; Wilcox, C Mel; Trevino, Jessica M; Ramesh, Jayapal; Hasan, Muhammad; Hawes, Robert H; Varadarajulu, Shyam

    2014-10-01

    Transmural stents are placed at endoscopy to drain pancreatic fluid collections. This study evaluated the relationship between stent placement and treatment outcomes in patients undergoing endoscopic transmural drainage of uncomplicated pancreatic pseudocysts. This is a retrospective study of all patients who underwent endoscopic drainage of uncomplicated pancreatic pseudocysts over a 10-year period. After dilating the transmural tracts in the range of 8-15 mm, single or multiple, 7 or 10Fr double-pigtail plastic stents were deployed. The main outcome measure was to evaluate the relationship between stent characteristics and the number of endoscopic interventions required to achieve resolution of the pancreatic pseudocyst (treatment success). Of 122 patients, 45 (36.9%) had 10Fr stents of which 30 patients (66.7%) had more than one stent; the remaining 77 (63.1%) patients had 7Fr stents of which 56 (72.7%) had more than one stent. The overall treatment success was 94.3%. Treatment was successful in 102 patients (83.6%) with one intervention; 13 patients (10.7%) required re-intervention for successful drainage and 7 patients (5.7%) failed endoscopic treatment. There was no significant difference in the number of interventions required for treatment success between patients with 7 or 10Fr stents (one intervention required in 87.7 vs. 90.5%, respectively; p = 0.766) and between patients with 1 or >1 stent (one intervention required in 88.9 vs. 88.6%, respectively; p = 0.999). On multiple logistic regression analysis, the stent size (OR 1.54; 95% CI 0.23-10.4) and number (OR 1.15; 95% CI 0.25-5.25) were not associated with the number of interventions required for treatment success when adjusted for pseudocyst size, location, drainage modality, the presence or absence of pancreatic duct stent and luminal compression. There appears to be no relationship between the number of interventions required for treatment success and stent characteristics in patients undergoing

  6. Robust assessment of the transmural extent of myocardial infarction in late gadolinium-enhanced MRI studies using appropriate angular and circumferential subdivision of the myocardium

    International Nuclear Information System (INIS)

    Kachenoura, Nadjia; Herment, Alain; Frouin, Frederique; Redheuil, Alban; Mousseaux, Elie

    2008-01-01

    A computer-assisted method is proposed to estimate transmural extent of myocardial infarction. In 40 patients with chronic myocardial infarction and 3 control subjects, late gadolinium enhancement images were acquired with magnetic resonance imaging. Segmental infarct transmural extent was visually assessed by two experts on a 5-point scale. A fuzzy c-means algorithm was applied on both the cavity and myocardium to estimate an enhancement index for 12 sub-regions of each segment. A threshold was defined on a training database (n=29) to establish the transmurality extent of each sub-segment and was applied to the validation database (n=14). Inter-observer reproducibility reached an absolute agreement (Aa) of 85% and a kappa value (κ) of 0.83 when considering the whole training database; Aa decreased to 62% and κ to 0.68 when excluding homogeneous segments. On the validation database, segments were subdivided into three angular sub-segments. Then, inter-observer visual reproducibility reached Aa of 93% and κ of 0.92. Moreover, the absolute comparison of each expert with the computer-assisted method yielded Aa higher than 88% and κ higher than 0.86. The computer-assisted method quantifies infarct transmurality without defining remote and infarcted regions, and the transmural extent is accurately characterized when dividing each segment into three angular sub-segments. (orig.)

  7. COMPORTAMIENTO ANTIARRÍTMICO DE LA HIPOXIA EN SIMULACIONES DE PARED TRANSMURAL CARDÍACA EN PRESENCIA DE ISQUEMIA SUB-EPICÁRDICA

    Directory of Open Access Journals (Sweden)

    Oscar Henao Gallo

    2011-01-01

    Full Text Available

    RESUMEN 

    El papel preponderante de la corriente de potasio sensitiva a Adenosin Trifosfato y su contribución a cambios electrofi siológicos que ocurren durante heterogeneidades y alteraciones fisicoquímicas debido a isquemia en la pared transmural cardíaca son aún debatidos. El objetivo de este trabajo fue estudiar la infl uencia de la activación de la hipoxia en la desestabilización del frente de onda eléctrico en pared transmural heterogénea en presencia de isquemia subepicárdica en un modelo computacional de tejido virtual. La taquicardia polimórfi ca obtenida de las simulaciones muestra que la activación de la hipoxia presenta un comportamiento antiarrítmico. La hiperkalemia es el principal agente capaz de generar bloqueo de conducción y alteraciones del segmento TQ y el segmento ST en los electrogramas obtenidos.

     

    Palabras clave: Electrogramas, hipoxia, isquemia, modelo Luo-Rudy, pared transmural heterogénea, reentrada espiral, taquicardia ventricular polimórfica.

     

    ABSTRACT

     

    ANTIARRHYTHMIC BEHAVIOR OF HYPOXIA IN CARDIAC TRANSMURAL WALL SIMULATIONS IN PRESENCE OF SUB-EPICARDIC ISCHEMIA

    The role of potassium adenosine triphosphate sensitive fl ow and its contributions to electrophysiological changes that occur during chemical-physical alterations and heterogeneities due to ischemia in cardiac transmural wall is still debated.

     

    The aim of this work was to study hypoxia activation influence in wavefront electric disturbance in heterogeneous transmural wall subjected to sub-epicardial ischemia, using a virtual tissue computational model. Polymorphic tachycardia obtained

  8. Change of Direction Speed: Toward a Strength Training Approach with Accentuated Eccentric Muscle Actions.

    Science.gov (United States)

    Chaabene, Helmi; Prieske, Olaf; Negra, Yassine; Granacher, Urs

    2018-03-28

    There is growing evidence that eccentric strength training appears to have benefits over traditional strength training (i.e., strength training with combined concentric and eccentric muscle actions) from muscular, neuromuscular, tendinous, and metabolic perspectives. Eccentric muscle strength is particularly needed to decelerate and stabilize the body during the braking phase of a jump exercise or during rapid changes of direction (CoD) tasks. However, surprisingly little research has been conducted to elucidate the effects of eccentric strength training or strength training with accentuated eccentric muscle actions on CoD speed performance. In this current opinion article, we present findings from cross-sectional studies on the relationship between measures of eccentric muscle strength and CoD speed performance. In addition, we summarize the few available studies on the effects of strength training with accentuated eccentric muscle actions on CoD speed performance in athletic populations. Finally, we propose strength training with accentuated eccentric muscle actions as a promising element in strength and conditioning programs of sports with high CoD speed demands. Our findings from five cross-sectional studies revealed statistically significant moderate- to large-sized correlations (r = 0.45-0.89) between measures of eccentric muscle strength and CoD speed performance in athletic populations. The identified three intervention studies were of limited methodological quality and reported small- to large-sized effects (d = 0.46-1.31) of strength training with accentuated eccentric muscle actions on CoD speed performance in athletes. With reference to the available but preliminary literature and from a performance-related point of view, we recommend strength and conditioning coaches to include strength training with accentuated eccentric muscle actions in training routines of sports with high CoD speed demands (e.g., soccer, handball, basketball, hockey) to

  9. Role of accentuation in the selection/rejection task framing effect.

    Science.gov (United States)

    Chen, Jing; Proctor, Robert W

    2017-04-01

    Procedure invariance is a basic assumption of rational theories of choice, however, it has been shown to be violated: Different response modes, or task frames, sometimes reveal opposite preferences. The current study focused on selection and rejection task frames, involving a unique type of problem with enriched and impoverished options, which has previously led to conflicting findings and theoretical explanations: the compatibility hypothesis (Shafir, 1993) and the accentuation hypothesis (Wedell, 1997). We examined the role of task frame by distinguishing these 2 hypotheses and evaluating the information-processing basis of the choices. Experiments conducted online (Experiments 1 and 3) and in-lab (Experiment 4 with eye-tracking technique) revealed a difference between the 2 task frames in the choice data (i.e., the task-framing effect) as a function of the relative attractiveness of the options. Also, this task-framing effect was not influenced by imposed time constraints (Experiments 5 and 6) and was similarly evident with a more direct measure for the option attractiveness (obtained in Experiment 7). Experiment 2, conducted in a lab setting with verbal-protocol requirements, yielded no task-framing effect, suggesting that a requirement to verbalize reasons for choice minimizes accentuation. With this exception, the choice data are in agreement with the accentuation hypothesis, and the combined findings in choice, decision time, task confusion, and eye-tracking data provide evidence of a basis in cognitive effort rather than motivation, as Wedell proposed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Greater Strength Gains after Training with Accentuated Eccentric than Traditional Isoinertial Loads in Already Strength-Trained Men

    Science.gov (United States)

    Walker, Simon; Blazevich, Anthony J.; Haff, G. Gregory; Tufano, James J.; Newton, Robert U.; Häkkinen, Keijo

    2016-01-01

    As training experience increases it becomes more challenging to induce further neuromuscular adaptation. Consequently, strength trainers seek alternative training methods in order to further increase strength and muscle mass. One method is to utilize accentuated eccentric loading, which applies a greater external load during the eccentric phase of the lift as compared to the concentric phase. Based upon this practice, the purpose of this study was to determine the effects of 10 weeks of accentuated eccentric loading vs. traditional isoinertial resistance training in strength-trained men. Young (22 ± 3 years, 177 ± 6 cm, 76 ± 10 kg, n = 28) strength-trained men (2.6 ± 2.2 years experience) were allocated to concentric-eccentric resistance training in the form of accentuated eccentric load (eccentric load = concentric load + 40%) or traditional resistance training, while the control group continued their normal unsupervised training program. Both intervention groups performed three sets of 6-RM (session 1) and three sets of 10-RM (session 2) bilateral leg press and unilateral knee extension exercises per week. Maximum force production was measured by unilateral isometric (110° knee angle) and isokinetic (concentric and eccentric 30°.s−1) knee extension tests, and work capacity was measured by a knee extension repetition-to-failure test. Muscle mass was assessed using panoramic ultrasonography and dual-energy x-ray absorptiometry. Surface electromyogram amplitude normalized to maximum M-wave and the twitch interpolation technique were used to examine maximal muscle activation. After training, maximum isometric torque increased significantly more in the accentuated eccentric load group than control (18 ± 10 vs. 1 ± 5%, p < 0.01), which was accompanied by an increase in voluntary activation (3.5 ± 5%, p < 0.05). Isokinetic eccentric torque increased significantly after accentuated eccentric load training only (10 ± 9%, p < 0.05), whereas concentric torque

  11. The accentuation principle of figure-ground segregation and the downbeat illusion.

    Science.gov (United States)

    Pinna, Baingio; Sirigu, Luca

    2016-10-01

    Pinna and Sirigu (2011) demonstrated a new principle of grouping, called the accentuation principle, stating that, all else being equal, elements tend to group in the same oriented direction of the discontinuous element placed within a whole set of continuous/homogeneous components. The discontinuous element behaves like an accent, i.e. a visual emphasis within the wholeness of components as shown in the next section. In this work, the accentuation principle has been extended to new visual domains. In particular, it is shown how this principle affects shape perception. Moreover several visual object attributes are also highlighted, among which orientation, spatial position, inner dynamics and apparent motion that determine the so-called organic segmentation and furthermore tend to induce figure-ground segregation. On the basis of the results of experimental phenomenology, the accentuation can be considered as a complex principle ruling grouping, figure-ground segregation, shape and meaning formation. Through a new musical illusion of downbeat, it is also demonstrated that this principle influences perceptual organization not only in space but also in time and, thus, in both visual and musical domains. This illusion can be heard in eight measures of Pagodes, a solo piano music by Claude Debussy (1862-1918), where a strong physical-perceptual discrepancy in terms of upbeats and downbeats inversion is strongly perceived in both staves. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Anterior ST depression with acute transmural inferior infarction due to posterior infarction. A vectorcardiographic and scintigraphic study

    International Nuclear Information System (INIS)

    Mukharji, J.; Murray, S.; Lewis, S.E.; Croft, C.H.; Corbett, J.R.; Willerson, J.T.; Rude, R.E.

    1984-01-01

    The hypothesis that anterior ST segment depression represents concomitant posterior infarction was tested in 49 patients admitted with a first transmural inferior myocardial infarction. Anterior ST depression was defined as 0.1 mV or more ST depression in leads V1, V2 or V3 on an electrocardiogram recorded within 18 hours of infarction. Serial vectorcardiograms and technetium pyrophosphate scans were obtained. Eighty percent of the patients (39 of 49) had anterior ST depression. Of these 39 patients, 34% fulfilled vectorcardiographic criteria for posterior infarction, and 60% had pyrophosphate scanning evidence of posterior infarction. Early anterior ST depression was neither highly sensitive (84%) nor specific (20%) for the detection of posterior infarction as defined by pyrophosphate imaging. Of patients with persistent anterior ST depression (greater than 72 hours), 87% had posterior infarction detected by pyrophosphate scan. In patients with inferior myocardial infarction, vectorcardiographic evidence of posterior infarction correlated poorly with pyrophosphate imaging data. Right ventricular infarction was present on pyrophosphate imaging in 40% of patients with pyrophosphate changes of posterior infarction but without vectorcardiographic evidence of posterior infarction. It is concluded that: 1) the majority of patients with acute inferior myocardial infarction have anterior ST segment depression; 2) early anterior ST segment depression in such patients is not a specific marker for posterior infarction; and 3) standard vectorcardiographic criteria for transmural posterior infarction may be inaccurate in patients with concomitant transmural inferior myocardial infarction or right ventricular infarction, or both

  13. Transmural myocardial perfusion gradients in relation to coronary artery stenoses severity assessed by cardiac multidetector computed tomography

    DEFF Research Database (Denmark)

    Linde, Jesper James; Kühl, Jørgen Tobias; Hove, Jens Dahlgaard

    2015-01-01

    To assess the relationship between epicardial coronary artery stenosis severity and the corresponding regional transmural perfusion at rest and during adenosine stress, using multidetector computed tomography (MDCT). We evaluated the relationship between the severity of coronary artery diameter...

  14. Finland Has it All? Examining the Media Accentuation of "Finnish Education" in Australia, Germany and South Korea

    Science.gov (United States)

    Takayama, Keita; Waldow, Florian; Sung, Youl-Kwan

    2013-01-01

    Drawing on the conceptual work of externalisation in comparative education and multi-accentual signs in cultural studies, this article examines how the print news media accentuate "Finnish education" in the process of inserting this external reference into the domestic political discourses around education reform in Australia, Germany…

  15. [The influence of occupational lead exposure on transmural repolarization dispersion].

    Science.gov (United States)

    Zyśko, Dorota; Gajek, Jacek; Chlebda, Ewa; Mazurek, Walentyna

    2005-02-01

    The parts of QT interval: time from Q wave to the peak of T wave (QTp) representing the de- and repolarization of subepicardial layer and the time from the peak of T wave to its end (QTp-e) building the transmural dispersion of repolarization enable more exact assessment of repolarization period of the heart muscle. Occupational exposure to lead influences the electrophysiologic properties of the heart. The aim of our study was to assess the QTp and QTp-e interval in workers occupationally exposed to lead. The study was carried out in 22 copper smelters aged 41.8 +/- 8.7 years, occupationally exposed to lead. The control group consisted of 14 healthy men. In all studied subjects blood lead concentration (Pb) and the concentration of free protoporphyrins in erytrocytes were assessed. 24-hour ECG holter monitoring was done to study rhythm disturbances and the duration in lead CM5 of QT interval, QTp interval, RR interval preceding the assessed QT interval (pRR) during sleep, rest during the awake state and moderate daily activity. The QTp-e interval is the difference between the duration of QT and QTp interval. The duration of QTp and QTp-e in occupationally exposed workers and healthy persons did not differ significantly. These parameters were significantly lower in both groups during moderately physical activity comparing to the values during sleep. The QTp-e/ QTp ratio in occupationally exposed workers during night hours was significantly lower than during daily activity what was not the case in control persons. Occupational exposure to lead do not change significantly the transmural dispersion of repolarization. Occupational exposure to lead diminishes the QTp-e/QTp ratio during the night.

  16. Endoscopic transmural management of abdominal fluid collection following gastrointestinal, bariatric, and hepato-bilio-pancreatic surgery.

    Science.gov (United States)

    Donatelli, Gianfranco; Fuks, David; Cereatti, Fabrizio; Pourcher, Guillaume; Perniceni, Thierry; Dumont, Jean-Loup; Tuszynski, Thierry; Vergeau, Bertrand Marie; Meduri, Bruno; Gayet, Brice

    2018-05-01

    Post-operative collections are a recognized source of morbidity after abdominal surgery. Percutaneous drainage is currently considered the standard treatment but not all collections are accessible using this method. Since the adoption of EUS, endoscopic transmural drainage has become an attractive option in the management of such complications. The present study aimed to assess the efficacy, safety and modalities of endoscopic transmural drainage in the treatment of post-operative collections. Data of all patients referred to our dedicated multidisciplinary facility from 2014 to 2017 for endoscopic drainage of symptomatic post-operative collections after failure of percutaneous drainage or when it was deemed impossible, were retrospectively analyzed. Thirty-two patients (17 males and 15 females) with a median age of 53 years old (range 31-74) were included. Collections resulted from pancreatic (n = 10), colorectal (n = 6), bariatric (n  = 5), and other type of surgery (n  = 11). Collection size was less than 5 cm in diameter in 10 (31%), between 5 and 10 cm in 17 (53%) ,and more than 10 cm in 5 (16%) patients. The median time from surgery to endoscopic drainage was 38 days (range 6-360). Eight (25%) patients underwent endoscopic guided drainage whereas 24 (75%) patients underwent EUS-guided drainage. Technical success was 100% and clinical success was achieved in 30 (93.4%) after a mean follow-up of 13.5 months (1.2-24.8). Overall complication was 12.5% including four patients who bled following trans-gastric drainage treated with conservative therapy. The present series suggests that endoscopic transmural drainage represents an interesting alternative in the treatment of post-operative collection when percutaneous drainage is not possible or fails.

  17. Acute NSAID-related transmural duodenitis and extensive duodenal ulceration.

    Science.gov (United States)

    Hashash, Jana G; Atweh, Lamya A; Saliba, Teddy; Chakhachiro, Zaher; Al-Kutoubi, Aghiad; Tawil, Ayman; Barada, Kassem A

    2007-11-01

    A 40-year-old previously healthy white man presented to the emergency department at American University of Beirut Medical Center, Beirut, Lebanon, with severe upper abdominal pain of 36-hour duration. The pain started a few hours after the intake of a single tablet of tiaprofenic acid and became more intense after the intake of another tablet 24 hours later. He had no other symptoms. He had no prior upper gastrointestinal (GI) symptoms, ulcer disease, steroidal or nonsteroidal anti-inflammatory drug use, or ethanol intake. Physical examination revealed mild upper abdominal tenderness. Complete blood count, amylase, lipase, and liver function tests were unremarkable. Computed tomography of the abdomen showed marked thickening of the duodenal wall with surrounding mesenteric streaking. Upper GI endoscopy revealed extensive ulceration involving the duodenal bulb, apex, and proximal D2, as well as a few gastric erosions. Histopathologic examination of duodenal biopsy samples showed extensive epithelial cell necrosis and infiltration of the lamina propria with neutrophils and eosinophils. The patient responded well to rabeprazole 20 mg BID and remains well 5 months later. We performed a literature search of PubMed for all English-language articles published between January 1970 and present (June 2007) using the key words tiaprofenic acid, nonsteroidal anti-inflammatory drugs, NSAID, duodenitis, duodenal erosion, duodenal ulcer, gastritis, gastric erosion, gastric ulcer, or peptic ulcer. We reviewed all randomized controlled trials involving NSAIDs found using PubMed, with a focus on their GI adverse effects. Based on the PubMed search, there were no published reports of acute transmural duodenitis and complicated duodenal ulcers associated with short-term exposure to tiaprofenic acid or other NSAIDs. The Naranjo adverse drug reaction (ADR) probability scale was used and a score of 6 was obtained, indicating a probable ADR from tiaprofenic acid use. We report a patient

  18. Thallium 201 Exercise Scintigraphy for Detection of Multivessel Coronary Artery Disease After Transmural Myocardial Infarction

    Science.gov (United States)

    Ahmadpour, Hedayatolah; Siegel, Michael E.; Colletti, Patrick; Haywood, L. Julian

    1984-01-01

    Fifty patients with prior transmural myocardial infarction were studied with cardiac catheterization, coronary angiography, and thallium 201 exercise perfusion scintigraphy. Obstructive coronary disease involved two or three vessels in 37 patients. The sensitivity of a positive electrocardiographic test during exercise for detecting multivessel coronary disease was only 40 percent (15/37), and the sensitivity of a reversible defect on 201Tl perfusion scintigraphy was 48 percent (18/37). The combination of exercise testing and 201Tl scintigraphy detected multivessel coronary disease in 75 percent (28/37) (P < .05). New perfusion defects occurred in 61 percent (13/21) of patients with inferior myocardial infarction and multivessel coronary disease whereas it occurred in only 35 percent (5/14) of patients with prior anterior infarction and multivessel coronary disease (P < .05). 201Tl exercise perfusion scintigraphy appears to be more sensitive for detecting significant multivessel coronary disease in the presence of previous inferior infarction compared with previous anterior infarction. Combined graded exercise testing and 201Tl perfusion scintigraphy can reliably detect the presence of significant multivessel coronary disease after transmural myocardial infarction. ImagesFigure 3 PMID:6512876

  19. Tri-phasic fever in dengue fever.

    Science.gov (United States)

    D, Pradeepa H; Rao, Sathish B; B, Ganaraj; Bhat, Gopalakrishna; M, Chakrapani

    2018-04-01

    Dengue fever is an acute febrile illness with a duration of 2-12 days. Our observational study observed the 24-h continuous tympanic temperature pattern of 15 patients with dengue fever and compared this with 26 others with fever due to a non-dengue aetiology. A tri-phasic fever pattern was seen among two-thirds of dengue fever patients, but in only one with an inflammatory disease. One-third of dengue fever patients exhibited a single peak temperature. Continuous temperature monitoring and temperature pattern analysis in clinical settings can aid in the early differentiation of dengue fever from non-dengue aetiology.

  20. Transmural Colonic Infarction after Routine Colonoscopy in a Young Patient without Risk Factors

    Directory of Open Access Journals (Sweden)

    Maurizio Zizzo

    2016-09-01

    Full Text Available Colonoscopy is one of the most widely used procedures in medical practice for the diagnosis and treatment of many benign and malignant diseases of the colorectal tract. Colonscopy has become the reference procedure for screening and surveillance of colorectal cancer. The overall rate of adverse events is estimated to be about 2.8 per 1,000 procedures, while complications requiring hospitalization are about 1.9 per 1,000 colonoscopies. Mortality from all causes and colonoscopy-specific mortality are estimated to be 0.07 and 0.007%, respectively. An exceptional fearsome postcolonoscopy complication is colon ischemia (CI; only few cases have been reported worldwide. We present the case of a 43-year-old woman who presented to the emergency department complaining of abdominal pain; fever and rectal bleeding appeared 12 h after a voluntary ‘screening’ colonoscopy. She had no risk factors for CI. Her laboratory tests showed alterations in inflammatory markers and a computed tomography scan showed a circumferential thickening in the left colon and free fluid in the abdomen. After 12 h of observation and conservative therapy, the clinical state of the patient worsened with the rising of signs of peritonitis. Laparoscopy showed that colon infarction extended from the distal third of the transverse colon to the proximal rectum. Laparotomy, resection of the pathological colon and terminal colostomy were performed. The specimen examined confirmed an extended ischemic colitis and transmural infarction on the antimesocolic side, in the absence of a vasculitis. The patient underwent recanalization after 8 months. CI after colonoscopy is a rare and alarming complication that must be known and taken into account in the differential diagnosis of symptomatic cases after colonoscopy, particularly in patients with known risk factors. The diagnosis is mainly based on clinical data, imaging and especially endoscopy. Treatment is almost always conservative but, in

    1. RESPONSE OF VOLTA CHILDREN TO JET INOCULATION OF COMBINED LIVE MEASLES, SMALLPOX AND YELLOW FEVER VACCINES.

      Science.gov (United States)

      MEYER, H M; HOSTETLER, D D; BERNHEIN, B C; ROGERS, N G; LAMBIN, P; CHASSARY, A; LABUSQUIERE, R; SMADEL, J E

      1964-01-01

      An earlier study established that Upper Volta children respond to vaccination with the Enders live attenuated measles strain in the same general fashion as do children in the USA. The present report describes a second pilot project carried out in Ouagadougou, Upper Volta. During this investigation various mixtures of live measles, smallpox and 17D yellow fever vaccines were introduced into susceptible infants by jet injection. Combining the attenuated virus vaccines did not alter or accentuate the characteristic clinical reactions elicited by the individual components, nor was there evidence of significant immunological interference. From this experience it is concluded that combined vaccination with these agents may be safely and effectively employed in larger programmes as the need dictates.

    2. How and When Accentuation Influences Temporally Selective Attention and Subsequent Semantic Processing during On-Line Spoken Language Comprehension: An ERP Study

      Science.gov (United States)

      Li, Xiao-qing; Ren, Gui-qin

      2012-01-01

      An event-related brain potentials (ERP) experiment was carried out to investigate how and when accentuation influences temporally selective attention and subsequent semantic processing during on-line spoken language comprehension, and how the effect of accentuation on attention allocation and semantic processing changed with the degree of…

    3. Study protocol: Cost-effectiveness of transmural nutritional support in malnourished elderly patients in comparison with usual care

      Directory of Open Access Journals (Sweden)

      van Bokhorst-de van der Schueren Marian AE

      2010-02-01

      Full Text Available Abstract Background Malnutrition is a common consequence of disease in older patients. Both in hospital setting and in community setting oral nutritional support has proven to be effective. However, cost-effectiveness studies are scarce. Therefore, the aim of our study is to investigate the effectiveness and cost-effectiveness of transmural nutritional support in malnourished elderly patients, starting at hospital admission until three months after discharge. Methods This study is a randomized controlled trial. Patients are included at hospital admission and followed until three months after discharge. Patients are eligible to be included when they are ≥ 60 years old and malnourished according to the following objective standards: Body Mass Index (BMI in kg/m2 Conclusion In this randomized controlled trial we will evaluate the effect of transmural nutritional support in malnourished elderly patients after hospital discharge, compared to usual care. Primary endpoints of the study are changes in activities of daily living, body weight, body composition, quality of life, and muscle strength. An economic evaluation will be performed to evaluate the cost-effectiveness of the intervention in comparison with usual care. Trial registration Netherlands Trial Register (ISRCTN29617677, registered 14-Sep-2005

    4. Left ventricular epicardial activation increases transmural dispersion of repolarization in healthy, long QT, and dilated cardiomyopathy dogs.

      Science.gov (United States)

      Bai, Rong; Lü, Jiagao; Pu, Jun; Liu, Nian; Zhou, Qiang; Ruan, Yanfei; Niu, Huiyan; Zhang, Cuntai; Wang, Lin; Kam, Ruth

      2005-10-01

      Benefits of cardiac resynchronization therapy (CRT) are well established. However, less is understood concerning its effects on myocardial repolarization and the potential proarrhythmic risk. Healthy dogs (n = 8) were compared to a long QT interval (LQT) model (n = 8, induced by cesium chloride, CsCl) and a dilated cardiomyopathy with congestive heart failure (DCM-CHF, induced by rapid ventricular pacing, n = 5). Monophasic action potential (MAP) recordings were obtained from the subendocardium, midmyocardium, subepicardium, and the transmural dispersion of repolarization (TDR) was calculated. The QT interval and the interval from the peak to the end of the T wave (T(p-e)) were measured. All these characteristics were compared during left ventricular epicardial (LV-Epi), right ventricular endocardial (RV-Endo), and biventricular (Bi-V) pacing. In healthy dogs, TDR prolonged to 37.54 ms for Bi-V pacing and to 47.16 ms for LV-Epi pacing as compared to 26.75 ms for RV-Endo pacing (P canine models in addition to their intrinsic transmural heterogeneity in the intact heart. This mechanism may contribute to the development of malignant ventricular arrhythmias, such as torsades de pointes (TdP) in congestive heart failure (CHF) patients treated with CRT.

    5. Bilingualism accentuates children's conversational understanding.

      Directory of Open Access Journals (Sweden)

      Michael Siegal

      Full Text Available BACKGROUND: Although bilingualism is prevalent throughout the world, little is known about the extent to which it influences children's conversational understanding. Our investigation involved children aged 3-6 years exposed to one or more of four major languages: English, German, Italian, and Japanese. In two experiments, we examined the children's ability to identify responses to questions as violations of conversational maxims (to be informative and avoid redundancy, to speak the truth, be relevant, and be polite. PRINCIPAL FINDINGS: In Experiment 1, with increasing age, children showed greater sensitivity to maxim violations. Children in Italy who were bilingual in German and Italian (with German as the dominant language L1 significantly outperformed Italian monolinguals. In Experiment 2, children in England who were bilingual in English and Japanese (with English as L1 significantly outperformed Japanese monolinguals in Japan with vocabulary age partialled out. CONCLUSIONS: As the monolingual and bilingual groups had a similar family SES background (Experiment 1 and similar family cultural identity (Experiment 2, these results point to a specific role for early bilingualism in accentuating children's developing ability to appreciate effective communicative responses.

    6. Yellow Fever

      Science.gov (United States)

      ... Testing Vaccine Information Testing for Vaccine Adverse Events Yellow fever Vaccine Continuing Education Course Yellow Fever Home Prevention Vaccine Vaccine Recommendations Reactions to Yellow Fever Vacine Yellow Fever Vaccine, Pregnancy, & ... Transmission Symptoms, Diagnosis, & Treatment Maps Africa ...

    7. Fever

      Directory of Open Access Journals (Sweden)

      Tamas Bartfai

      2010-01-01

      Full Text Available Measurement of body temperature remains one of the most common ways to assess health. An increase in temperature above what is considered to be a normal value is inevitably regarded as a sure sign of disease and referred to with one simple word: fever. In this review, we summarize how research on fever allowed the identification of the exogenous and endogenous molecules and pathways mediating the fever response. We also show how temperature elevation is common to different pathologies and how the molecular components of the fever-generation pathway represent drug targets for antipyretics, such as acetylsalicylic acid, the first “blockbuster drug”. We also show how fever research provided new insights into temperature and energy homeostasis, and into treatment of infection and inflammation.

    8. Effect of beam hardening on transmural myocardial perfusion quantification in myocardial CT imaging

      Science.gov (United States)

      Fahmi, Rachid; Eck, Brendan L.; Levi, Jacob; Fares, Anas; Wu, Hao; Vembar, Mani; Dhanantwari, Amar; Bezerra, Hiram G.; Wilson, David L.

      2016-03-01

      The detection of subendocardial ischemia exhibiting an abnormal transmural perfusion gradient (TPG) may help identify ischemic conditions due to micro-vascular dysfunction. We evaluated the effect of beam hardening (BH) artifacts on TPG quantification using myocardial CT perfusion (CTP). We used a prototype spectral detector CT scanner (Philips Healthcare) to acquire dynamic myocardial CTP scans in a porcine ischemia model with partial occlusion of the left anterior descending (LAD) coronary artery guided by pressure wire-derived fractional flow reserve (FFR) measurements. Conventional 120 kVp and 70 keV projection-based mono-energetic images were reconstructed from the same projection data and used to compute myocardial blood flow (MBF) using the Johnson-Wilson model. Under moderate LAD occlusion (FFR~0.7), we used three 5 mm short axis slices and divided the myocardium into three LAD segments and three remote segments. For each slice and each segment, we characterized TPG as the mean "endo-to-epi" transmural flow ratio (TFR). BH-induced hypoenhancement on the ischemic anterior wall at 120 kVp resulted in significantly lower mean TFR value as compared to the 70 keV TFR value (0.29+/-0.01 vs. 0.55+/-0.01 pvalues on segments moderately affected or unaffected by BH. In the entire ischemic LAD territory, 120 kVp mean endocardial flow was significantly reduced as compared to mean epicardial flow (15.80+/-10.98 vs. 40.85+/-23.44 ml/min/100g; p<1e-04). At 70 keV, BH was effectively minimized resulting in mean endocardial MBF of 40.85+/-15.3407 ml/min/100g vs. 74.09+/-5.07 ml/min/100g (p=0.0054) in the epicardium. We also found that BH artifact in the conventional 120 kVp images resulted in falsely reduced MBF measurements even under non-ischemic conditions.

    9. How and when predictability interacts with accentuation in temporally selective attention during speech comprehension.

      Science.gov (United States)

      Li, Xiaoqing; Lu, Yong; Zhao, Haiyan

      2014-11-01

      The present study used EEG to investigate how and when top-down prediction interacts with bottom-up acoustic signals in temporally selective attention during speech comprehension. Mandarin Chinese spoken sentences were used as stimuli. We systematically manipulated the predictability and de/accentuation of the critical words in the sentence context. Meanwhile, a linguistic attention probe 'ba' was presented concurrently with the critical words or not. The results showed that, first, words with a linguistic attention probe elicited a larger N1 than those without a probe. The latency of this N1 effect was shortened for accented or lowly predictable words, indicating more attentional resources allocated to these words. Importantly, prediction and accentuation showed a complementary interplay on the latency of this N1 effect, demonstrating that when the words had already attracted attention due to low predictability or due to the presence of pitch accent, the other factor did not modulate attention allocation anymore. Second, relative to the lowly predictable words, the highly predictable words elicited a reduced N400 and enhanced gamma-band power increases, especially under the accented conditions; moreover, under the accented conditions, shorter N1 peak-latency was found to correlate with larger gamma-band power enhancement, which indicates that a close relationship might exist between early selective attention and later semantic integration. Finally, the interaction between top-down selective attention (driven by prediction) and bottom-up selective attention (driven by accentuation) occurred before lexical-semantic processing, namely before the N400 effect evoked by predictability, which was discussed with regard to the language comprehension models. Copyright © 2014 Elsevier Ltd. All rights reserved.

    10. Short-term Beneficial Effects of 12 Sessions of Neurofeedback on Avoidant Personality Accentuation in the Treatment of Alcohol Use Disorder.

      Science.gov (United States)

      Dalkner, Nina; Unterrainer, Human F; Wood, Guilherme; Skliris, Dimitris; Holasek, Sandra J; Gruzelier, John H; Neuper, Christa

      2017-01-01

      This study evaluated the effects of alpha/theta neurofeedback on Clinical Personality Accentuations in individuals with alcohol use disorder. Twenty-five males were investigated using a pre-test/post-test design with a waiting-list control group. Participants were randomly assigned either to an experimental group ( n = 13) receiving 12 sessions of neurofeedback twice a week as a treatment adjunct over a period of 6 weeks, or to a control group ( n = 12) receiving treatment as usual. The Inventory of Clinical Personality Accentuations and the NEO-Five-Factor Inventory were applied at pre- and post-test. The neurofeedback protocol focused on enhancement of the EEG alpha (8-12 Hz) and theta (4-7 Hz) and used a visual feedback paradigm. Analyses of covariance showed improvements in Avoidant Personality Accentuation within the experimental group. Our data suggest that 12 sessions of this neurofeedback intervention might be effective in reducing avoidant and stress-related personality traits in patients with alcohol use disorder.

    11. Short-term Beneficial Effects of 12 Sessions of Neurofeedback on Avoidant Personality Accentuation in the Treatment of Alcohol Use Disorder

      Directory of Open Access Journals (Sweden)

      Nina Dalkner

      2017-09-01

      Full Text Available This study evaluated the effects of alpha/theta neurofeedback on Clinical Personality Accentuations in individuals with alcohol use disorder. Twenty-five males were investigated using a pre-test/post-test design with a waiting-list control group. Participants were randomly assigned either to an experimental group (n = 13 receiving 12 sessions of neurofeedback twice a week as a treatment adjunct over a period of 6 weeks, or to a control group (n = 12 receiving treatment as usual. The Inventory of Clinical Personality Accentuations and the NEO-Five-Factor Inventory were applied at pre- and post-test. The neurofeedback protocol focused on enhancement of the EEG alpha (8–12 Hz and theta (4–7 Hz and used a visual feedback paradigm. Analyses of covariance showed improvements in Avoidant Personality Accentuation within the experimental group. Our data suggest that 12 sessions of this neurofeedback intervention might be effective in reducing avoidant and stress-related personality traits in patients with alcohol use disorder.

    12. Rat bite fever without fever.

      Science.gov (United States)

      Stehle, P; Dubuis, O; So, A; Dudler, J

      2003-09-01

      Rat bite fever is a rarely reported acute febrile bacterial illness caused by Streptobacillus moniliformis or Spirillum minus following a rat bite. It is classically characterised by abrupt onset of fever with rigors, myalgias, headache, and the appearance of a generalised maculopapular petechial skin rash. Polyarthritis complicates the course of the disease in up to 50% of infected patients, and numerous hurdles can make the diagnosis particularly difficult in the absence of fever or rash, as in the present case. A high degree of awareness is necessary to make the correct diagnosis in such cases. Diagnosis has important prognostic implications as the disease is potentially lethal, but easily treatable.

    13. Dengue fever (image)

      Science.gov (United States)

      Dengue fever, or West Nile fever, is a mild viral illness transmitted by mosquitoes which causes fever, ... second exposure to the virus can result in Dengue hemorrhagic fever, a life-threatening illness.

    14. Hemorrhagic Fever with Renal Syndrome (Korean Hemorrhagic Fever).

      Science.gov (United States)

      1986-07-23

      fever , chills, nausea, headache and muscle ache in July 1985. One day after admission he developed petechial haemorrhage over his body and limbs and in...ftOA179 565 NENORNAGIC FEVER WI TH RENAL SYNDOMNE (KOREAN HEMORRHAIC FEVER )(U) KOREN UNIV SEOUL COLL OF MEDICINE N N LEE 23 JUL " DAD7-94-G-4616...34,, , " S , S S .S =. 5 5 . S S S * B M Lfl IC) uIeuCc FVM WITH RENAL SYNDR~OME (KOREAN EMORRHAGIC FEVER ) ANNUAL AND FINAL REPORT S HO WANG LIZB N.D. 5

    15. Triple Pancreatic Walled-off Fluid Collections Treated Simultaneously with Endoscopic Transmural Drainage.

      Science.gov (United States)

      Khalid, Sameen; Abbass, Aamer; Nellis, Eric; Shah, Shashin; Shah, Hiral

      2018-01-09

      Pancreatic pseudocysts and walled-off pancreatic necrosis arise as a complication of pancreatitis. Multiple fluid collections are seen in 5-20% of the patients who have walled-off peripancreatic fluid collections. There is a paucity of data regarding the role of endoscopic transmural drainage in the management of multiple pancreatic fluid collections. In this case report, we present the case of a 72-year-old male with three walled-off pancreatic fluid collections in the setting of acute necrotizing pancreatitis. The patient underwent simultaneous endoscopic ultrasound-assisted cyst gastrostomy and cyst duodenostomy and aggressive irrigation without index endoscopic necrosectomy of the three peripancreatic fluid collections. Significant improvement in the size of the fluid collections was seen on the computed tomography scan, as well as a remarkable immediate clinical improvement after 24 hours of the endoscopic intervention.

    16. A sonographic lesion index for Crohn's disease helps monitor changes in transmural bowel damage during therapy.

      Science.gov (United States)

      Zorzi, Francesca; Stasi, Elisa; Bevivino, Gerolamo; Scarozza, Patrizio; Biancone, Livia; Zuzzi, Sara; Rossi, Carla; Pallone, Francesco; Calabrese, Emma

      2014-12-01

      Therapeutic antibodies against tumor necrosis factor α (anti-TNF) are effective in patients with Crohn's disease (CD). Mucosal healing is a surrogate marker of efficacy, but little is known about the effects of anti-TNF agents on structural damage in the intestine. Small-intestine contrast ultrasonography (SICUS) is a valuable tool for assessing CD lesions. A new sonographic quantitative index (the sonographic lesion index for CD [SLIC]) was developed to quantify changes in CD lesions detected by SICUS. We explored whether the SLIC can be used to monitor transmural bowel damage in CD patients during anti-TNF therapy. We performed a prospective study of 29 patients with ileal or ileocolonic CD treated with anti-TNF agents; patients underwent SICUS before and after scheduled induction and maintenance therapy. To determine whether changes that can be detected by SICUS occur independently of anti-TNF therapy, 7 patients with ileal CD treated with mesalamine were enrolled as controls. A clinical response was defined as steroid-free remission, with CD activity index scores less than 150. We observed significant improvements in SLIC scores and subscores after induction and maintenance therapy with anti-TNFs, compared with before therapy. SLIC scores and subscores and index classes were improved significantly in patients with vs without clinical responses. Controls had no improvements in terms of CD activity index or SLIC scores, or index classes. Sonographic assessment using the quantitative index SLIC can be used to monitor changes in transmural bowel damage during anti-TNF therapy for CD. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

    17. The human ether-a-go-go-related gene (hERG) current inhibition selectively prolongs action potential of midmyocardial cells to augment transmural dispersion.

      Science.gov (United States)

      Yasuda, C; Yasuda, S; Yamashita, H; Okada, J; Hisada, T; Sugiura, S

      2015-08-01

      The majority of drug induced arrhythmias are related to the prolongation of action potential duration following inhibition of rapidly activating delayed rectifier potassium current (I(Kr)) mediated by the hERG channel. However, for arrhythmias to develop and be sustained, not only the prolongation of action potential duration but also its transmural dispersion are required. Herein, we evaluated the effect of hERG inhibition on transmural dispersion of action potential duration using the action potential clamp technique that combined an in silico myocyte model with the actual I(Kr) measurement. Whole cell I(Kr) current was measured in Chinese hamster ovary cells stably expressing the hERG channel. The measured current was coupled with models of ventricular endocardial, M-, and epicardial cells to calculate the action potentials. Action potentials were evaluated under control condition and in the presence of 1, 10, or 100 μM disopyramide, an hERG inhibitor. Disopyramide dose-dependently increased the action potential durations of the three cell types. However, action potential duration of M-cells increased disproportionately at higher doses, and was significantly different from that of epicardial and endocardial cells (dispersion of repolarization). By contrast, the effects of disopyramide on peak I(Kr) and instantaneous current-voltage relation were similar in all cell types. Simulation study suggested that the reduced repolarization reserve of M-cell with smaller amount of slowly activating delayed rectifier potassium current levels off at longer action potential duration to make such differences. The action potential clamp technique is useful for studying the mechanism of arrhythmogenesis by hERG inhibition through the transmural dispersion of repolarization.

    18. Health care in patients 1 year post-stroke in general practice : research on the utilisation of the Dutch Transmural Protocol transient ischaemic attack/cerebrovascular accident

      NARCIS (Netherlands)

      de Weerd, L.; Rutgers, A.W.F.; Groenier, K.H.; van der Meer, K.

      2012-01-01

      This study evaluates the kind of aftercare that ischaemic stroke patients receive and the extent that aftercare fulfils the criteria of the 'Dutch Transmural Protocol transient ischaemic attack/cerebrovascular accident'. Fifty-seven patients were interviewed 1 year post-stroke about secondary

    19. Fever

      Science.gov (United States)

      ... also cause fevers. Some examples are: Arthritis or connective tissue illnesses such as rheumatoid arthritis and systemic lupus erythematosus Ulcerative colitis and Crohn disease Vasculitis or periarteritis nodosa The first symptom of a cancer may be a fever. This is particularly true ...

    20. A Q fever case mimicking crimean-congo haemorrhagic fever

      Directory of Open Access Journals (Sweden)

      O Karabay

      2011-01-01

      Full Text Available Coxiella burnetii is the bacterium that causes Q fever. Human infection is mainly transmitted from cattle, goats and sheep. The disease is usually self-limited. Pneumonia and hepatitis are the most common clinical manifestations. In this study, we present a case of Q fever from the western part of Turkey mimicking Crimean-Congo haemorrhagic fever (CCHF in terms of clinical and laboratory findings.

    1. [Surveillance data on typhoid fever and paratyphoid fever in 2015, China].

      Science.gov (United States)

      Liu, F F; Zhao, S L; Chen, Q; Chang, Z R; Zhang, J; Zheng, Y M; Luo, L; Ran, L; Liao, Q H

      2017-06-10

      Objective: Through analyzing the surveillance data on typhoid fever and paratyphoid fever in 2015 to understand the related epidemiological features and most possible clustering areas of high incidence. Methods: Individual data was collected from the passive surveillance program and analyzed by descriptive statistic method. Characteristics on seasonal, regional and distribution of the diseases were described. Spatial-temporal clustering characteristics were estimated, under the retrospective space-time method. Results: A total of 8 850 typhoid fever cases were reported from the surveillance system, with incidence rate as 0.65/100 000. The number of paratyphoid fever cases was 2 794, with incidence rate as 0.21/100 000. Both cases of typhoid fever and paratyphoid fever occurred all year round, with high epidemic season from May to October. Most cases involved farmers (39.68 % ), children (15.89 % ) and students (12.01 % ). Children under 5 years showed the highest incidence rate. Retrospective space-time analysis for provinces with high incidence rates would include Yunnan, Guangxi, Guizhou, Hunan and Guangdong, indicating the first and second class clusters were mainly distributed near the bordering adjacent districts and counties among the provinces. Conclusion: In 2015, the prevalence rates of typhoid fever and paratyphoid fever were low, however with regional high prevalence areas. Cross regional transmission existed among provinces with high incidence rates which might be responsible for the clusters to appear in these areas.

    2. Yellow fever

      Science.gov (United States)

      ... to thrive. Blood tests can confirm the diagnosis. Treatment There is no specific treatment for yellow fever. ... SJ, Endy TP, Rothman AL, Barrett AD. Flaviviruses (dengue, yellow fever, Japanese encephalitis, West Nile encephalitis, St. ...

    3. Typhoid fever

      Science.gov (United States)

      Typhoid fever is an infection that causes diarrhea and a rash . It is most commonly caused due to ... in their stools for years, spreading the disease. Typhoid fever is common in developing countries. Most cases in ...

    4. Fever in Infants and Children

      Science.gov (United States)

      ... or higher that is unresponsive to fever-reducing medicine?YesNoDoes your child have a low-grade fever (up to 101°) ... fever, give your child a nonaspirin fever-reducing medicine. Call your child’s doctor after 24 hours if the fever continues ...

    5. Dengue fever

      African Journals Online (AJOL)

      symptoms and research has been limited to studies ... severity and problems with vaccination (4). History of ... Americas in 1970s reduced the spread of dengue fever. After this .... Reiter P. Yellow fever and dengue: a threat to Europe? 9.

    6. Fever with Rashes.

      Science.gov (United States)

      Soman, Letha

      2018-07-01

      Fever with rashes is one of the commonest clinical problems a general practitioner or pediatrician has to face in day-to-day clinical practice. It can be a mild viral illness or a life-threatening illness like meningococcemia or Dengue hemorrhagic fever or it can be one with a lifelong consequence like Kawasaki disease. It is very important to arrive at a clinical diagnosis as early as possible with the minimum investigational facilities. The common causes associated with fever and rashes are infections, viral followed by other infections. There can be so many non-infectious causes also for fever and rashes like auto immune diseases, drug allergies etc. The type of rashes, their appearance in relation to the fever and pattern of spread to different parts of body and the disappearance, all will help in making a diagnosis. Often the diagnosis is clinical. In certain situations laboratory work up becomes essential.

    7. Rocky Mountain spotted fever

      Science.gov (United States)

      ... spotted fever on the foot Rocky Mountain spotted fever, petechial rash Antibodies Deer and dog tick References McElligott SC, Kihiczak GG, Schwartz RA. Rocky Mountain spotted fever and other rickettsial infections. In: Lebwohl MG, Heymann ...

    8. The Future of Qualitative Research in Psychology: Accentuating the Positive.

      Science.gov (United States)

      Gough, Brendan; Lyons, Antonia

      2016-06-01

      In this paper we reflect on current trends and anticipate future prospects regarding qualitative research in Psychology. We highlight various institutional and disciplinary obstacles to qualitative research diversity, complexity and quality. At the same time, we note some causes for optimism, including publication breakthroughs and vitality within the field. The paper is structured into three main sections which consider: 1) the positioning of qualitative research within Psychology; 2) celebrating the different kinds of knowledge produced by qualitative research; and 3) implementing high quality qualitative research. In general we accentuate the positive, recognising and illustrating innovative qualitative research practices which generate new insights and propel the field forward. We conclude by emphasising the importance of research training: for qualitative research to flourish within Psychology (and beyond), students and early career researchers require more sophisticated, in-depth instruction than is currently offered.

    9. True-3D accentuating of grids and streets in urban topographic maps enhances human object location memory.

      Directory of Open Access Journals (Sweden)

      Dennis Edler

      Full Text Available Cognitive representations of learned map information are subject to systematic distortion errors. Map elements that divide a map surface into regions, such as content-related linear symbols (e.g. streets, rivers, railway systems or additional artificial layers (coordinate grids, provide an orientation pattern that can help users to reduce distortions in their mental representations. In recent years, the television industry has started to establish True-3D (autostereoscopic displays as mass media. These modern displays make it possible to watch dynamic and static images including depth illusions without additional devices, such as 3D glasses. In these images, visual details can be distributed over different positions along the depth axis. Some empirical studies of vision research provided first evidence that 3D stereoscopic content attracts higher attention and is processed faster. So far, the impact of True-3D accentuating has not yet been explored concerning spatial memory tasks and cartography. This paper reports the results of two empirical studies that focus on investigations whether True-3D accentuating of artificial, regular overlaying line features (i.e. grids and content-related, irregular line features (i.e. highways and main streets in official urban topographic maps (scale 1/10,000 further improves human object location memory performance. The memory performance is measured as both the percentage of correctly recalled object locations (hit rate and the mean distances of correctly recalled objects (spatial accuracy. It is shown that the True-3D accentuating of grids (depth offset: 5 cm significantly enhances the spatial accuracy of recalled map object locations, whereas the True-3D emphasis of streets significantly improves the hit rate of recalled map object locations. These results show the potential of True-3D displays for an improvement of the cognitive representation of learned cartographic information.

    10. Yellow fever: epidemiology and prevention.

      Science.gov (United States)

      Barnett, Elizabeth D

      2007-03-15

      Yellow fever continues to occur in regions of Africa and South America, despite the availability of effective vaccines. Recently, some cases of severe neurologic disease and multiorgan system disease have been described in individuals who received yellow fever vaccine. These events have focused attention on the need to define criteria for judicious use of yellow fever vaccine and to describe the spectrum of adverse events that may be associated with yellow fever vaccine. Describing host factors that would increase risk of these events and identifying potential treatment modalities for yellow fever and yellow fever vaccine-associated adverse events are subjects of intense investigation.

    11. Q fever in Greenland

      DEFF Research Database (Denmark)

      Koch, Anders; Svendsen, Claus Bo; Christensen, Jens Jorgen

      2010-01-01

      We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection.......We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection....

    12. The effect of different accentuated eccentric load levels in eccentric-concentric loading contractions on acute neuromuscular, growth hormone and blood lactate responses during a hypertrophic protocol

      OpenAIRE

      Ojasto, Timo

      2007-01-01

      When accentuated load is applied during the eccentric (ECC) phase of eccentric-concentric (ECC-CON) contractions, it is defined as dynamic accentuated external resistance (DAER) exercise. This study monitored acute neuromuscular responses, growth hormone (GH) and blood lactate (La) concentrations to find out the most efficient ECC-CON loading strategy for muscle hypertrophy by employing various DAER resistances in the bench-press. Male subjects (age=32.4±4.3years, n=11) were assigned as subje...

    13. Diagnostic value of transmural perfusion ratio derived from dynamic CT-based myocardial perfusion imaging for the detection of haemodynamically relevant coronary artery stenosis

      Energy Technology Data Exchange (ETDEWEB)

      Coenen, Adriaan; Lubbers, Marisa M.; Dedic, Admir; Chelu, Raluca G.; Geuns, Robert-Jan M. van; Nieman, Koen [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Cardiology, Rotterdam (Netherlands); Kurata, Akira; Kono, Atsushi; Dijkshoorn, Marcel L. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Rossi, Alexia [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Barts Health NHS Trust, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London and Department of Cardiology, London (United Kingdom)

      2017-06-15

      To investigate the additional value of transmural perfusion ratio (TPR) in dynamic CT myocardial perfusion imaging for detection of haemodynamically significant coronary artery disease compared with fractional flow reserve (FFR). Subjects with suspected or known coronary artery disease were prospectively included and underwent a CT-MPI examination. From the CT-MPI time-point data absolute myocardial blood flow (MBF) values were temporally resolved using a hybrid deconvolution model. An absolute MBF value was measured in the suspected perfusion defect. TPR was defined as the ratio between the subendocardial and subepicardial MBF. TPR and MBF results were compared with invasive FFR using a threshold of 0.80. Forty-three patients and 94 territories were analysed. The area under the receiver operator curve was larger for MBF (0.78) compared with TPR (0.65, P = 0.026). No significant differences were found in diagnostic classification between MBF and TPR with a territory-based accuracy of 77 % (67-86 %) for MBF compared with 70 % (60-81 %) for TPR. Combined MBF and TPR classification did not improve the diagnostic classification. Dynamic CT-MPI-based transmural perfusion ratio predicts haemodynamically significant coronary artery disease. However, diagnostic performance of dynamic CT-MPI-derived TPR is inferior to quantified MBF and has limited incremental value. (orig.)

    14. Mechanisms of fever production and lysis: lessons from experimental LPS fever.

      Science.gov (United States)

      Roth, Joachim; Blatteis, Clark M

      2014-10-01

      Fever is a cardinal symptom of infectious or inflammatory insults, but it can also arise from noninfectious causes. The fever-inducing agent that has been used most frequently in experimental studies designed to characterize the physiological, immunological and neuroendocrine processes and to identify the neuronal circuits that underlie the manifestation of the febrile response is lipopolysaccharide (LPS). Our knowledge of the mechanisms of fever production and lysis is largely based on this model. Fever is usually initiated in the periphery of the challenged host by the immediate activation of the innate immune system by LPS, specifically of the complement (C) cascade and Toll-like receptors. The first results in the immediate generation of the C component C5a and the subsequent rapid production of prostaglandin E2 (PGE2). The second, occurring after some delay, induces the further production of PGE2 by induction of its synthesizing enzymes and transcription and translation of proinflammatory cytokines. The Kupffer cells (Kc) of the liver seem to be essential for these initial processes. The subsequent transfer of the pyrogenic message from the periphery to the brain is achieved by neuronal and humoral mechanisms. These pathways subserve the genesis of early (neuronal signals) and late (humoral signals) phases of the characteristically biphasic febrile response to LPS. During the course of fever, counterinflammatory factors, "endogenous antipyretics," are elaborated peripherally and centrally to limit fever in strength and duration. The multiple interacting pro- and antipyretic signals and their mechanistic effects that underlie endotoxic fever are the subjects of this review.

    15. Endoscopic ultrasound-guided transmural drainage of postoperative pancreatic collections.

      Science.gov (United States)

      Tilara, Amy; Gerdes, Hans; Allen, Peter; Jarnagin, William; Kingham, Peter; Fong, Yuman; DeMatteo, Ronald; D'Angelica, Michael; Schattner, Mark

      2014-01-01

      Pancreatic leak is a major cause of morbidity after pancreatectomy. Traditionally, peripancreatic fluid collections have been managed by percutaneous or operative drainage. Data for endoscopic ultrasound (EUS)-guided drainage of postoperative fluid collections are limited. Here we report on the safety, efficacy, and timing of EUS-guided drainage of postoperative peripancreatic collections. This is a retrospective review of 31 patients who underwent EUS-guided drainage of fluid collections after pancreatic resection. Technical success was defined as successful transgastric deployment of at least one double pigtail plastic stent. Clinical success was defined as resolution of the fluid collection on follow-up CT scan and resolution of symptoms. Early drainage was defined as initial transmural stent placement within 30 days after surgery. Endoscopic ultrasound-guided drainage was performed effectively with a technical success rate of 100%. Clinical success was achieved in 29 of 31 patients (93%). Nineteen of the 29 patients (65%) had complete resolution of their symptoms and collection with the first endoscopic procedure. Repeat drainage procedures, including some with necrosectomy, were required in the remaining 10 patients, with eventual resolution of collection and symptoms. Two patients who did not achieve durable clinical success required percutaneous drainage by interventional radiology. Seventeen (55%) of 31 patients had successful early drainage completed within 30 days of their operation. Endoscopic ultrasound-guided drainage of fluid collections after pancreatic resection is safe and effective. Early drainage (collections was not associated with increased complications in this series. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

    16. Discriminating fever behavior in house flies.

      Directory of Open Access Journals (Sweden)

      Robert D Anderson

      Full Text Available Fever has generally been shown to benefit infected hosts. However, fever temperatures also carry costs. While endotherms are able to limit fever costs physiologically, the means by which behavioral thermoregulators constrain these costs are less understood. Here we investigated the behavioral fever response of house flies (Musca domestica L. challenged with different doses of the fungal entomopathogen, Beauveria bassiana. Infected flies invoked a behavioral fever selecting the hottest temperature early in the day and then moving to cooler temperatures as the day progressed. In addition, flies infected with a higher dose of fungus exhibited more intense fever responses. These variable patterns of fever are consistent with the observation that higher fever temperatures had greater impact on fungal growth. The results demonstrate the capacity of insects to modulate the degree and duration of the fever response depending on the severity of the pathogen challenge and in so doing, balance the costs and benefits of fever.

    17. Oropouche Fever: A Review.

      Science.gov (United States)

      Sakkas, Hercules; Bozidis, Petros; Franks, Ashley; Papadopoulou, Chrissanthy

      2018-04-04

      Oropouche fever is an emerging zoonotic disease caused by Oropouche virus (OROV), an arthropod transmitted Orthobunyavirus circulating in South and Central America. During the last 60 years, more than 30 epidemics and over half a million clinical cases attributed to OROV infection have been reported in Brazil, Peru, Panama, Trinidad and Tobago. OROV fever is considered the second most frequent arboviral febrile disease in Brazil after dengue fever. OROV is transmitted through both urban and sylvatic transmission cycles, with the primary vector in the urban cycle being the anthropophilic biting midge Culicoides paraensis . Currently, there is no evidence of direct human-to-human OROV transmission. OROV fever is usually either undiagnosed due to its mild, self-limited manifestations or misdiagnosed because its clinical characteristics are similar to dengue, chikungunya, Zika and yellow fever, including malaria as well. At present, there is no specific antiviral treatment, and in the absence of a vaccine for effective prophylaxis of human populations in endemic areas, the disease prevention relies solely on vector control strategies and personal protection measures. OROV fever is considered to have the potential to spread across the American continent and under favorable climatic conditions may expand its geographic distribution to other continents. In view of OROV's emergence, increased interest for formerly neglected tropical diseases and within the One Health concept, the existing knowledge and gaps of knowledge on OROV fever are reviewed.

    18. Travelers' Health: Typhoid and Paratyphoid Fever

      Science.gov (United States)

      ... days should raise suspicion of typhoid or paratyphoid fever. Typhoid fever is a nationally notifiable disease. TREATMENT Specific ... typhoid-fever Table 3-21. Vaccines to prevent typhoid fever VACCINA- TION AGE (y) DOSE, MODE OF ADMINISTRA- ...

    19. Endoscopic, transmural drainage and necrosectomy for walled-off pancreatic and peripancreatic necrosis is associated with low mortality--a single-center experience

      DEFF Research Database (Denmark)

      Schmidt, Palle Nordblad; Novovic, Srdan; Roug, Stine

      2015-01-01

      OBJECTIVE: Endoscopic transmural drainage and necrosectomy (ETDN) is a promising alternative to percutaneous drainage and surgical intervention in the treatment of walled-off pancreatic and peripancreatic necroses (WONs). We assessed the outcome and safety profile of ETDN in a single-center patient......). Gallstones were the predominant etiology of pancreatitis (41%), followed by alcohol (33%). Median time from debut of symptoms to first endoscopic treatment was 44 (9-246) days. Culture-proven infected necrosis was found in 71% of the cases. Twenty-three patients (28%) required admission in intensive care...

    20. NNDSS - Table II. Salmonellosis (excluding typhoid fever and paratyphoid fever) to Shigellosis

      Data.gov (United States)

      U.S. Department of Health & Human Services — NNDSS - Table II. Salmonellosis (excluding typhoid fever and paratyphoid fever) to Shigellosis - 2018. In this Table, provisional cases of selected notifiable...

    1. Prevention of wrong absorption of pancreatic pseudocyst using guided transmural drainage under endoscopic ultrasonography%超声内镜引导经胃内引流术治疗胰腺假性囊肿误吸的预防

      Institute of Scientific and Technical Information of China (English)

      梁运啸; 郑琴芳; 覃柳; 农兵; 梁列新; 潘咏

      2017-01-01

      目的 探讨如何预防在超声内镜(EUS)引导下经胃内治疗胰腺假性囊肿引起的误吸.方法 对该院所做的EUS引导下经胃内引流胰腺假性囊肿的资料进行回顾性分析.结果 16例胰腺假性囊肿患者,经EUS引导胃内穿刺放置内支架引流成功16例,穿刺引流操作成功率为100.0%.囊肿完全吸收16例,治愈率100.0%.穿刺后囊液反流导致误吸2例,发生率为12.5%.3例患者通过内镜拔出引流支架,另外13例患者支架自行脱落排出.结论 头高脚低位、精细操作及食管套管可以防止EUS穿刺后胰腺假性囊肿囊液误吸入气管.%Objective To discuss how to preven wrong absorption of pancreatic pseudocyst using guided transmural drainage under endoscopic ultrasonography.Methods Retrospectively analyzed the clinical data of patients with pancreatic pseudocysts underwent operations of Endoscopic ultrasonography guided transmural drainage.Results 16 cases of pancreatic pseudocysts were finished with guided transmural drainage under endoscopic ultrasonography using needling to place bypass grafting with successful rate 100.0% of guided transmural drainage by needling. After needling, 2 cased happened regurgitation which led to wrongly absorbed, rate of occurrence is 12.5%. Generally, pancreatic pseudocysts of 16 cases disappeared completely with cure rate 100.0%. From above, stents were pulled out by endoscope in 3 cases while stents were removed voluntarily in another 13 cases.Conclusion Dorsal elevated position, detailed operation and esophageal annular tubes can effectively prevent wrong absorption of guided transmural drainage under endoscopic ultrasonography of pancreatic pseudocysts.

    2. Rat bite fever.

      NARCIS (Netherlands)

      Gaastra, W.; Boot, R.G.A.; Ho, H.; Lipman, L.J.A.

      2009-01-01

      Rat bite fever (RBF) is a bacterial zoonosis for which two causal bacterial species have been identified: Streptobacillis moniliformis and Spirillum minus. Haverhill fever (HF) is a form of S. moniliformis infection believed to develop after ingestion of contaminated food or water. Here the

    3. Oropouche Fever: A Review

      Directory of Open Access Journals (Sweden)

      Hercules Sakkas

      2018-04-01

      Full Text Available Oropouche fever is an emerging zoonotic disease caused by Oropouche virus (OROV, an arthropod transmitted Orthobunyavirus circulating in South and Central America. During the last 60 years, more than 30 epidemics and over half a million clinical cases attributed to OROV infection have been reported in Brazil, Peru, Panama, Trinidad and Tobago. OROV fever is considered the second most frequent arboviral febrile disease in Brazil after dengue fever. OROV is transmitted through both urban and sylvatic transmission cycles, with the primary vector in the urban cycle being the anthropophilic biting midge Culicoides paraensis. Currently, there is no evidence of direct human-to-human OROV transmission. OROV fever is usually either undiagnosed due to its mild, self-limited manifestations or misdiagnosed because its clinical characteristics are similar to dengue, chikungunya, Zika and yellow fever, including malaria as well. At present, there is no specific antiviral treatment, and in the absence of a vaccine for effective prophylaxis of human populations in endemic areas, the disease prevention relies solely on vector control strategies and personal protection measures. OROV fever is considered to have the potential to spread across the American continent and under favorable climatic conditions may expand its geographic distribution to other continents. In view of OROV’s emergence, increased interest for formerly neglected tropical diseases and within the One Health concept, the existing knowledge and gaps of knowledge on OROV fever are reviewed.

    4. Yellow Fever Vaccine: What You Need to Know

      Science.gov (United States)

      ... How can I prevent yellow fever? Yellow fever vaccine Yellow fever vaccine can prevent yellow fever. Yellow fever vaccine ... such as those containing DEET. 3 Yellow fever vaccine Yellow fever vaccine is a live, weakened virus. It is ...

    5. Psychosis in dengue fever

      OpenAIRE

      Suprakash Chaudhury; Biswajit Jagtap; Deepak Kumar Ghosh

      2017-01-01

      An 18-year-old male student developed abnormal behavior while undergoing treatment for dengue fever. He was ill-kempt, irritable and had auditory and visual hallucinations and vague persecutory delusions in clear sensorium with impaired insight. The psychotic episode had a temporal correlation with dengue fever. Psychiatric comorbidities of dengue fever including mania, anxiety, depression, and catatonia are mentioned in literature but the literature on the psychosis following dengue is spars...

    6. Effect of (social) media on the political figure fever model: Jokowi-fever model

      Science.gov (United States)

      Yong, Benny; Samat, Nor Azah

      2016-02-01

      In recent years, political figures begin to utilize social media as one of alternative to engage in communication with their supporters. Publics referred to Jokowi, one of the candidates in Indonesia presidential election in 2014, as the first politician in Indonesia to truly understand the power of social media. Social media is very important in shaping public opinion. In this paper, effect of social media on the Jokowi-fever model in a closed population will be discussed. Supporter population is divided into three class sub-population, i.e susceptible supporters, Jokowi infected supporters, and recovered supporters. For case no positive media, there are two equilibrium points; the Jokowi-fever free equilibrium point in which it locally stable if basic reproductive ratio less than one and the Jokowi-fever endemic equilibrium point in which it locally stable if basic reproductive ratio greater than one. For case no negative media, there is only the Jokowi-fever endemic equilibrium point in which it locally stable if the condition is satisfied. Generally, for case positive media proportion is positive, there is no Jokowi-fever free equilibrium point. The numerical result shows that social media gives significantly effect on Jokowi-fever model, a sharp increase or a sharp decrease in the number of Jokowi infected supporters. It is also shown that the boredom rate is one of the sensitive parameters in the Jokowi-fever model; it affects the number of Jokowi infected supporters.

    7. Short-term memory and electrical restitution in the canine transmural ventricle

      International Nuclear Information System (INIS)

      Zhang, Hong; Ueyama, Takeshi; Lin, Shien-Fong; Wang, Juan; Wu, Rui-Juan

      2011-01-01

      Cardiac short-term memory is an intrinsic property of paced myocardium that reflects the influence of pacing history. Using an optical mapping method to record membrane voltage and intracellular calcium (Ca 2+ i ), this study investigated the properties and mechanisms of short-term memory in isolated and perfused canine wedge preparations. In addition to the dynamic and S1S2 pacing protocols, a perturbed downsweep pacing protocol was used to get a complete overview of the restitution portrait. Abrupt changes in basic cycle length (BCL) were applied to investigate the accommodation process of action potential duration (APD). The results showed unobvious differences of memory among the epi-, mid- and endo-myocytes, implying an insignificant memory-induced transient heterogeneity in APD across the transmural canine hearts. With the decrease of pacing rate S1, memory gradually elevated and achieved a maximum around 400 ms, and then reduced as S1 decreased further, indicating a non-monotonic relationship between memory and the pacing rate. After suppressing the Ca 2+ i transient with ryanodine (3 µmol l −1 ), the accommodation process of APD to a new BCL significantly abbreviated (τ = 37.41 ± 4.42 stimuli before ryanodine, τ = 15.84 ± 4.74 stimuli after ryanodine, p < 0.01). Therefore, Ca 2+ i cycling was suggested to play an important role in memory during dynamic pacing

    8. STUDIES ON TUBERCULIN FEVER

      Science.gov (United States)

      Hall, Charles H.; Atkins, Elisha

      1959-01-01

      Evidence has been presented that the fever elicited by intravenous administration of old tuberculin (O.T.) in BCG-infected rabbits is a specific property of this hypersensitivity system and is probably not due to contamination of tuberculin with bacterial endotoxins. Daily injections of O.T. in sensitized animals resulted in a rapid tolerance to its pyrogenic effect. Tuberculin tolerance can be differentiated from that occurring with endotoxins and was invariably associated with the development of a negative skin test. The mechanism of this tolerance would thus appear to be desensitization. A circulating pyrogen found during tuberculin fever was indistinguishable in its biologic effects from endogenous pyrogens obtained in several other types of experimental fever. This material produced fevers in normal recipients and therefore may be clearly differentiated from O.T. itself which was pyrogenic only to sensitized animals. Since the titer of serum pyrogen was directly proportional to the degree of fever induced by injection of O.T. in the donor animals, a causal relation is suggested. On the basis of these findings, it is postulated that tuberculin fever is due to a circulating endogenous pyrogen released by a specific action of O.T. on sensitized cells of the host. PMID:13641561

    9. Yellow fever: an update.

      Science.gov (United States)

      Monath, T P

      2001-08-01

      Yellow fever, the original viral haemorrhagic fever, was one of the most feared lethal diseases before the development of an effective vaccine. Today the disease still affects as many as 200,000 persons annually in tropical regions of Africa and South America, and poses a significant hazard to unvaccinated travellers to these areas. Yellow fever is transmitted in a cycle involving monkeys and mosquitoes, but human beings can also serve as the viraemic host for mosquito infection. Recent increases in the density and distribution of the urban mosquito vector, Aedes aegypti, as well as the rise in air travel increase the risk of introduction and spread of yellow fever to North and Central America, the Caribbean and Asia. Here I review the clinical features of the disease, its pathogenesis and pathophysiology. The disease mechanisms are poorly understood and have not been the subject of modern clinical research. Since there is no specific treatment, and management of patients with the disease is extremely problematic, the emphasis is on preventative vaccination. As a zoonosis, yellow fever cannot be eradicated, but reduction of the human disease burden is achievable through routine childhood vaccination in endemic countries, with a low cost for the benefits obtained. The biological characteristics, safety, and efficacy of live attenuated, yellow fever 17D vaccine are reviewed. New applications of yellow fever 17D virus as a vector for foreign genes hold considerable promise as a means of developing new vaccines against other viruses, and possibly against cancers.

    10. Transmural expression of ion channels and transporters in human nondiseased and end-stage failing hearts

      DEFF Research Database (Denmark)

      Soltysinska, Ewa; Olesen, Søren-Peter; Christ, Torsten

      2009-01-01

      The cardiac action potential is primarily shaped by the orchestrated function of several different types of ion channels and transporters. One of the regional differences believed to play a major role in the progression and stability of the action potential is the transmural gradient of electrica...... cardiac ion channels and transporters which may in part explain the increased susceptibility to arrhythmia in end-state failing hearts....... activity across the ventricular wall. An altered balance in the ionic currents across the free wall is assumed to be a substrate for arrhythmia. A large fraction of patients with heart failure experience ventricular arrhythmia. However, the underlying substrate of these functional changes is not well......-established as expression analyses of human heart failure (HF) are sparse. We have investigated steady-state RNA levels by quantitative polymerase chain reaction of ion channels, transporters, connexin 43, and miR-1 in 11 end-stage HF and seven nonfailing (NF) hearts. The quantifications were performed on endo-, mid...

    11. Typhoid fever

      DEFF Research Database (Denmark)

      Wain, John; Hendriksen, Rene S.; Mikoleit, Matthew L.

      2015-01-01

      Control of typhoid fever relies on clinical information, diagnosis, and an understanding for the epidemiology of the disease. Despite the breadth of work done so far, much is not known about the biology of this human-adapted bacterial pathogen and the complexity of the disease in endemic areas...... with shifting trends in enteric fever. This knowledge is crucial, both to control the disease and to manage cases. Additionally, salmonella serovars that cause human infection can change over time and location. In areas of Asia, multidrug-resistant Salmonella enterica serovar Typhi (S Typhi) has been the main...... cause of enteric fever, but now S Typhi is being displaced by infections with drug-resistant S enterica serovar Paratyphi A. New conjugate vaccines are imminent and new treatments have been promised, but the engagement of local medical and public health institutions in endemic areas is needed to allow...

    12. Oropouche Fever: A Review

      OpenAIRE

      Hercules Sakkas; Petros Bozidis; Ashley Franks; Chrissanthy Papadopoulou

      2018-01-01

      Oropouche fever is an emerging zoonotic disease caused by Oropouche virus (OROV), an arthropod transmitted Orthobunyavirus circulating in South and Central America. During the last 60 years, more than 30 epidemics and over half a million clinical cases attributed to OROV infection have been reported in Brazil, Peru, Panama, Trinidad and Tobago. OROV fever is considered the second most frequent arboviral febrile disease in Brazil after dengue fever. OROV is transmitted through both urban and s...

    13. Lithotrites and postoperative fever

      DEFF Research Database (Denmark)

      Chu, David I; Lipkin, Michael E; Wang, Agnes J

      2013-01-01

      OBJECTIVE: To compare the risks of fever from different lithotrites after percutaneous nephrolithotomy (PNL). MATERIALS AND METHODS: The Clinical Research Office of the Endourological Society (CROES) PNL database is a prospective, multi-institutional, international PNL registry. Of 5,803 total...... with fever [Odds Ratio (OR) 1.17, p = 0.413], while diabetes (OR 1.32, p = 0.048), positive urine culture (OR 2.08, p PNL...... fever was not significantly different among the various lithotrites used in the CROES PNL study....

    14. Familial Mediterranean Fever

      Directory of Open Access Journals (Sweden)

      Adem Kucuk

      2014-01-01

      Full Text Available Familial Mediterranean Fever is an autosomal recessive inherited disease with a course of autoinflammation, which is characterized by the episodes of fever and serositis. It affects the populations from Mediterranean basin. Genetic mutation of the disease is on MEFV gene located on short arm of Chromosome 16. The disease is diagnosed based on clinical evaluation. Amyloidosis is the most important complication. The only agent that decreases the development of amyloidosis and the frequency and severity of the episodes is colchicine, which has been used for about 40 years. In this review, we aimed to discuss especially the most recent advances about Familial Mediterranean Fever which is commonly seen in our population.

    15. Allergies and Hay Fever

      Science.gov (United States)

      ... ENTCareers Marketplace Find an ENT Doctor Near You Allergies and Hay Fever Allergies and Hay Fever Patient ... life more enjoyable. Why does the body develop allergies? Allergy symptoms appear when the immune system reacts ...

    16. Context dependency and generality of fever in insects

      Science.gov (United States)

      Stahlschmidt, Z. R.; Adamo, S. A.

      2013-07-01

      Fever can reduce mortality in infected animals. Yet, despite its fitness-enhancing qualities, fever often varies among animals. We used several approaches to examine this variation in insects. Texas field crickets ( Gryllus texensis) exhibited a modest fever (1 °C increase in preferred body temperature, T pref) after injection of prostaglandin, which putatively mediates fever in both vertebrates and invertebrates, but they did not exhibit fever during chronic exposure to heat-killed bacteria. Further, chronic food limitation and mating status did not affect T pref or the expression of behavioural fever, suggesting limited context dependency of fever in G. texensis. Our meta-analysis of behavioural fever studies indicated that behavioural fever occurs in many insects, but it is not ubiquitous. Thus, both empirical and meta-analytical results suggest that the fever response in insects `is widespread, although certainly not inevitable' (Moore 2002). We highlight the need for future work focusing on standardizing an experimental protocol to measure behavioural fever, understanding the specific mechanism(s) underlying fever in insects, and examining whether ecological or physiological costs often outweigh the benefits of fever and can explain the sporadic nature of fever in insects.

    17. Antimicrobial resistance problems in typhoid fever

      Science.gov (United States)

      Saragih, R. H.; Purba, G. C. F.

      2018-03-01

      Typhoid fever (enteric fever) remains a burden in developing countries and a major health problem in Southern and Southeastern Asia. Salmonella typhi (S. typhi), the causative agent of typhoid fever, is a gram-negative, motile, rod-shaped, facultative anaerobe and solely a human pathogen with no animal reservoir. Infection of S. typhi can cause fever, abdominal pain and many worsenonspecific symptoms, including gastrointestinal symptoms suchas nausea, vomiting, constipation, and diarrhea. Chloramphenicol, ampicillin,and cotrimoxazole were the first-recommended antibiotics in treating typhoid fever. In the last two decades though, these three traditional drugs started to show resistance and developed multidrug resistance (MDR) S. typhi strains. In many parts of the world, the changing modes ofpresentation and the development of MDR have made typhoid fever increasingly difficult to treat.The use of first-line antimicrobials had been recommended to be fluoroquinolone as a replacement. However, this wassoonfollowedbyreportsof isolates ofS. typhi showing resistancetofluoroquinolones as well. These antimicrobial resistance problems in typhoid fever have been an alarming situation ever since and need to be taken seriously or else typhoid fever will no longer be taken care completely by administering antibiotics.

    18. Hemorrhagic Fevers - Multiple Languages

      Science.gov (United States)

      ... dialect) (繁體中文) Expand Section Vaccine Information Statement (VIS) -- Yellow Fever Vaccine: What You Need to Know - English PDF Vaccine Information Statement (VIS) -- Yellow Fever Vaccine: What You Need to Know - 繁體中文 (Chinese, Traditional ( ...

    19. Need yellow fever vaccine? Plan ahead

      Science.gov (United States)

      ... Submit What's this? Submit Button Past Emails Need yellow fever vaccine? Plan ahead. Language: English (US) Español (Spanish) ... none were from the United States). What is yellow fever? Yellow fever is caused by a virus that ...

    20. Rocky Mountain Spotted Fever

      Science.gov (United States)

      ... with facebook share with twitter share with linkedin Rocky Mountain Spotted Fever Credit: CDC A male cayenne tick, Amblyomma cajennense, ... and New Mexico. Why Is the Study of Rocky Mountain Spotted Fever a Priority for NIAID? Tickborne diseases are becoming ...

    1. Dengue fever: a Wikipedia clinical review

      OpenAIRE

      Heilman, James M; Wolff, Jacob De; Beards, Graham M; Basden, Brian J

      2014-01-01

      Dengue fever, also known as breakbone fever, is a mosquito-borne infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles. In a small proportion of cases, the disease develops into life-threatening dengue hemorrhagic fever, which results in bleeding, thrombocytopenia, and leakage of blood plasma, or into dengue shock syndrome, in which dangerously low blood pressure occurs. Treat...

    2. Lassa fever or lassa hemorrhagic fever risk to humans from rodent-borne zoonoses.

      Science.gov (United States)

      El-Bahnasawy, Mamdouh M; Megahed, Laila Abdel-Mawla; Abdalla Saleh, Hala Ahmed; Morsy, Tosson A

      2015-04-01

      Viral hemorrhagic fevers (VHFs) typically manifest as rapidly progressing acute febrile syndromes with profound hemorrhagic manifestations and very high fatality rates. Lassa fever, an acute hemorrhagic fever characterized by fever, muscle aches, sore throat, nausea, vomiting, diarrhea and chest and abdominal pain. Rodents are important reservoirs of rodent-borne zoonosis worldwide. Transmission rodents to humans occur by aerosol spread, either from the genus Mastomys rodents' excreta (multimammate rat) or through the close contact with infected patients (nosocomial infection). Other rodents of the genera Rattus, Mus, Lemniscomys, and Praomys are incriminated rodents hosts. Now one may ask do the rodents' ectoparasites play a role in Lassa virus zoonotic transmission. This paper summarized the update knowledge on LHV; hopping it might be useful to the clinicians, nursing staff, laboratories' personals as well as those concerned zoonoses from rodents and rodent control.

    3. Treating viral hemorrhagic fever.

      NARCIS (Netherlands)

      Mairuhu, A.T.; Brandjes, D.P.; Gorp, E. van

      2003-01-01

      Viral hemorrhagic fevers are illnesses associated with a number of geographically restricted, mostly tropical areas. Over recent decades a number of new hemorrhagic fever viruses have emerged. Advances in our understanding of the pathophysiology of these diseases have improved our initial supportive

    4. PATHOGENETIC MECHANISMS IN EXPERIMENTAL IMMUNE FEVER

      Science.gov (United States)

      Root, Richard K.; Wolff, Sheldon M.

      1968-01-01

      When rabbits sensitized to human serum albumin (HSA) are challenged intravenously with specific antigen, fever develops and two transferable pyrogens can be demonstrated in the circulation. The first appears prior to the development of fever and has properties consistent with soluble antigen-antibody complexes. These have been shown to be pyrogenic when prepared in vitro and to produce a state of febrile tolerance when repeatedly administered. The second pyrogen, demonstrable during fever in donor rabbits, appears to be similar to endogenous pyrogen described in other experimental fevers. It is postulated that the formation of antigen-antibody complexes constitutes an important initial phase of the febrile reaction in this type of immune fever. PMID:4873023

    5. Phylogeny of Yellow Fever Virus, Uganda, 2016.

      Science.gov (United States)

      Hughes, Holly R; Kayiwa, John; Mossel, Eric C; Lutwama, Julius; Staples, J Erin; Lambert, Amy J

      2018-08-17

      In April 2016, a yellow fever outbreak was detected in Uganda. Removal of contaminating ribosomal RNA in a clinical sample improved the sensitivity of next-generation sequencing. Molecular analyses determined the Uganda yellow fever outbreak was distinct from the concurrent yellow fever outbreak in Angola, improving our understanding of yellow fever epidemiology.

    6. Rocky Mountain spotted fever in Argentina.

      Science.gov (United States)

      Paddock, Christopher D; Fernandez, Susana; Echenique, Gustavo A; Sumner, John W; Reeves, Will K; Zaki, Sherif R; Remondegui, Carlos E

      2008-04-01

      We describe the first molecular confirmation of Rickettsia rickettsii, the cause of Rocky Mountain spotted fever (RMSF), from a tick vector, Amblyomma cajennense, and from a cluster of fatal spotted fever cases in Argentina. Questing A. cajennense ticks were collected at or near sites of presumed or confirmed cases of spotted fever rickettsiosis in Jujuy Province and evaluated by polymerase chain reaction assays for spotted fever group rickettsiae. DNA of R. rickettsii was amplified from a pool of A. cajennense ticks and from tissues of one of four patients who died during 2003-2004 after illnesses characterized by high fever, severe headache, myalgias, and petechial rash. The diagnosis of spotted fever rickettsiosis was confirmed in the other patients by indirect immunofluorescence antibody and immunohistochemical staining techniques. These findings show the existence of RMSF in Argentina and emphasize the need for clinicians throughout the Americas to consider RMSF in patients with febrile rash illnesses.

    7. Postural vascular response in human skin: passive and active reactions to alteration of transmural pressure.

      Science.gov (United States)

      Jepsen, H; Gaehtgens, P

      1993-09-01

      Laser-Doppler (LD) fluxmetry was performed in the palmar finger skin of healthy subjects to study the mechanisms contributing to the postural vascular response. Local transmural pressure in the skin blood vessels of the region studied was altered for 1 min in two experimental series either by passive movement of the arm to different vertical hand positions relative to heart level or by application of external pressure (-120-180 mmHg) to the finger. Heart and respiratory rate, arterial blood pressure, and LD flux in the contralateral finger (kept at heart level) were measured. The measurements suggest a compound reaction of local (myogenic) and systemic (neurogenic) mechanisms: the local regulatory component appears as a graded active vascular response elicited by passive vessel distension or compression. A systemic component, associated with a single deep inspiration, is frequently observed during the actual movement of the arm. In addition, prolonged holding of the test hand in a given vertical position also elicits a delayed vascular response in the control hand at heart level, which may be generated by volume receptors in the intrathoracic low-pressure system.

    8. Dengue fever: a Wikipedia clinical review.

      Science.gov (United States)

      Heilman, James M; De Wolff, Jacob; Beards, Graham M; Basden, Brian J

      2014-01-01

      Dengue fever, also known as breakbone fever, is a mosquito-borne infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles. In a small proportion of cases, the disease develops into life-threatening dengue hemorrhagic fever, which results in bleeding, thrombocytopenia, and leakage of blood plasma, or into dengue shock syndrome, in which dangerously low blood pressure occurs. Treatment of acute dengue fever is supportive, with either oral or intravenous rehydration for mild or moderate disease and use of intravenous fluids and blood transfusion for more severe cases. Along with attempts to eliminate the mosquito vector, work is ongoing to develop a vaccine and medications targeted directly at the virus.

    9. A Series of Unfortunate Events: Prinzmetal Angina Culminating in Transmural Infarction in the Setting of Acute Gastrointestinal Hemorrhage

      Directory of Open Access Journals (Sweden)

      Michael Ruisi

      2013-01-01

      Full Text Available Prinzmetal angina or vasospastic angina is a clinical phenomenon that is often transient and self-resolving. Clinically it is associated with ST elevations on the electrocardiogram, and initially it may be difficult to differentiate from an acute myocardial infarction. The vasospasm induced in this setting occurs in normal or mildly to moderately diseased vessels and can be triggered by a number of etiologies including smoking, changes in autonomic activity, or drug ingestion. While the ischemia induced is usually transient, myocardial infarction and life-threatening arrhythmias can occur in 25% of cases. We present the case of a 65-year-old female where repetitive intermittent coronary vasospasm culminated in transmural infarction in the setting of gastrointestinal bleeding. This case highlights the mortality associated with prinzmetal angina and the importance of recognizing the underlying etiology.

    10. Review of current typhoid fever vaccines, cross-protection against paratyphoid fever, and the European guidelines.

      Science.gov (United States)

      Zuckerman, Jane N; Hatz, Christoph; Kantele, Anu

      2017-10-01

      Typhoid and paratyphoid fever remain a global health problem, which - in non-endemic countries - are mainly seen in travelers, particularly in VFRs (visiting friends and relatives), with occasional local outbreaks occurring. A rise in anti-microbial resistance emphasizes the role of preventive measures, especially vaccinations against typhoid and paratyphoid fever for travelers visiting endemic countries. Areas covered: This state-of-the-art review recapitulates the epidemiology and mechanisms of disease of typhoid and paratyphoid fever, depicts the perspective of non-endemic countries and travelers (VFRs), and collectively presents current European recommendations for typhoid fever vaccination. We provide a brief overview of available (and developmental) vaccines in Europe, present current data on cross-protection to S. Paratyphi, and aim to provide a background for typhoid vaccine decision-making in travelers. Expert commentary: European recommendations are not harmonized. Experts must assess vaccination of travelers based on current country-specific recommendations. Travel health practitioners should be aware of the issues surrounding vaccination of travelers and be motivated to increase awareness of typhoid and paratyphoid fever risks.

    11. Equilibrium radionuclide ventriculography in male patients after transmural myocardial infarction

      Energy Technology Data Exchange (ETDEWEB)

      Nestaval, A; Stanek, V; Malek, I; Kidery, J; Runczik, I [Institut pro Klinickou a Experimentalni Medicinu, Prague (Czechoslovakia); Cernoch, V; Oppelt, A [Institut pro Dalsi Vzdelavani Lekaru a Farmaceutu, Prague (Czechoslovakia)

      1982-12-17

      The ejection fraction of the left ventricle was measured using the method of equilibrium radionuclide ventriculography in 10 healthy males and 57 males after the first transmural myocardial infarction. The examination was effected 4 to 7 months after the event and the sample is representative for males after myocardial infarction who are younger than 65 years and show no signs of heart insufficiency by the time of examination. The resting value of the ejection fraction was 63+-5% in healthy males, 54+-7% in patients with uncomplicated myocardial infarction and 37+-8% in patients with clinical manifestations of heart insufficiency in acute phase. The differences between the groups are statistically significant. In patients with anteroseptal localization of myocardial infarction there was a negative correlation between the ejection fraction on the one hand and the sum of the voltages of Q waves in precordial ECG map and the maximum value of serum creatine kinase in acute phase on the other. The ejection fraction was in correlation to the degree of pulmonary hypertension measured in equal phase during exercise. The ejection fraction was measured in 31 patients under the working load of 50 W; significant changes were not found in healthy males or in patients after myocardial infarction. No changes were found when the state just before discharge from the hospital was compared with his state 6 months after myocardial infarction. The results obtained in compensated patients showed a relative stability of the value of the ejection fraction both during the first 6 months after discharge and under a mild working load. A comparison between the indicators in acute phase and hemodynamic examination after 6 months shows that the value of the ejection fraction is a sensitive indicator of the extent of necrosis and functional lesion of the left ventricle.

    12. Typhoid fever: case report and literature review.

      Science.gov (United States)

      Sanhueza Palma, Natalia Carolina; Farías Molina, Solange; Calzadilla Riveras, Jeannette; Hermoso, Amalia

      2016-06-21

      Typhoid fever remains a major health problem worldwide, in contrast to Chile, where this disease is an isolated finding. Clinical presentation is varied, mainly presenting with fever, malaise, abdominal discomfort, and nonspecific symptoms often confused with other causes of febrile syndrome. We report a six-year-old, male patient presenting with fever of two weeks associated with gastrointestinal symptoms, malaise, hepatomegaly and elevated liver enzymes. Differential diagnoses were considered and a Widal reaction and two blood cultures were requested; both came back positive, confirming the diagnosis of typhoid fever caused by Salmonella typhi. Prior to diagnosis confirmation, empirical treatment was initiated with ceftriaxone and metronidazole, with partial response; then drug therapy was adjusted according to ciprofloxacin susceptibility testing with a favorable clinical response. We discuss diagnostic methods and treatment of enteric fever with special emphasis on typhoid fever.

    13. CAREGIVERS' KNOWLEDGE AND HOME MANAGEMENT OF FEVER IN CHILDREN.

      Science.gov (United States)

      Koech, P J; Onyango, F E; Jowi, C

      2014-05-01

      Fever is one of the most common complaints presented to the Paediatric Emergency Unit (PEU). It is a sign that there is an underlying pathologic process, the most common being infection. Many childhood illnesses are accompanied by fever, many of which are treated at home prior to presentation to hospital. Most febrile episodes are benign. Caregivers are the primary contacts to children with fever. Adequate caregivers' knowledge and proper management of fever at home leads to better management of febrile illnesses and reduces complications. To determine the caregivers' knowledge and practices regarding fever in children. A cross-sectional study. Peadiatric Emergency Unit at Kenyatta National Hospital (KNH) SUBJECTS: Two hundred and fifty caregivers of children under 12 years presenting with fever in August to October 2011 to the PEU. Three quarters of the caregivers' defined fever correctly. Their knowledge on the normal body was at 47.6%. Infection was cited as the leading cause of fever (95.2%). Brain damage (77.6%) and dehydration (65.6%) were viewed as the most common complication. Fever was treated at home by 97.2% of caregivers, most of them used medication. Fever was defined correctly by 75.2% of the study participants and a majority of them used touch to detect fever. Fever was managed at home with medications. Public Health Education should be implemented in order to enlighten caregivers on fever and advocate for the use of a clinical thermometer to monitor fever at home.

    14. Mechanism of fever induction in rabbits.

      Science.gov (United States)

      Siegert, R; Philipp-Dormston, W K; Radsak, K; Menzel, H

      1976-01-01

      Three exogenous pyrogens (Escherichia coli lipopolysaccharide, synthetic double-stranded ribonucleic acid. Newcastle disease virus) were compared with respect to their mechanisms of fever induction in rabbits. All inducers stimulated the production of an endogenous pyrogen demonstrated in the blood as well as prostaglandins of the E group, and of cyclic adenosine 3',5'-monophosphate in the cerebrospinal fluid. The concentrations of these compounds were elevated approximately twofold as compared to the controls. Independently of the mode of induction, the fever reaction could be prevented by pretreatment with 5 mg of cycloheximide per kg, although the three fever mediators were induced as in febrile animals. Consequently, at least one additional fever mediator that is sensitive to a 30 to 50% inhibition of protein synthesis by cycloheximide has to be postulated. The comparable reactions of the rabbits after administration of different pyrogens argues for a similar fever mechanism. In contrast to fever induction there was no stimulation of endogenous pyrogen, prostaglandins of the E group, and cyclic adenosine 3',5'-monophosphate in hyperthermia as a consequence of exposure of the animals to exogenous overheating. Furthermore, hyperthermia could not be prevented by cycloheximide. PMID:185148

    15. Identification of factors for physicians to facilitate early differential diagnosis of scrub typhus, murine typhus, and Q fever from dengue fever in Taiwan.

      Science.gov (United States)

      Chang, Ko; Lee, Nan-Yao; Ko, Wen-Chien; Tsai, Jih-Jin; Lin, Wei-Ru; Chen, Tun-Chieh; Lu, Po-Liang; Chen, Yen-Hsu

      2017-02-01

      Dengue fever, rickettsial diseases, and Q fever are acute febrile illnesses with similar manifestations in tropical areas. Early differential diagnosis of scrub typhus, murine typhus, and Q fever from dengue fever may be made by understanding the distinguishing clinical characteristics and the significance of demographic and weather factors. We conducted a retrospective study to identify clinical, demographic, and meteorological characteristics of 454 dengue fever, 178 scrub typhus, 143 Q fever, and 81 murine typhus cases in three Taiwan hospitals. Case numbers of murine typhus and Q fever correlated significantly with temperature and rainfall; the scrub typhus case number was only significantly related with temperature. Neither temperature nor rainfall correlated with the case number of dengue fever. The rarity of dengue fever cases from January to June in Taiwan may be a helpful clue for diagnosis in the area. A male predominance was observed, as the male-to-female rate was 2.1 for murine typhus and 7.4 for Q fever. Multivariate analysis revealed the following six important factors for differentiating the rickettsial diseases and Q fever group from the dengue fever group: fever ≥8 days, alanine aminotransferase > aspartate aminotransferase, platelets >63,000/mL, C-reactive protein >31.9 mg/L, absence of bone pain, and absence of a bleeding syndrome. Understanding the rarity of dengue in the first half of a year in Taiwan and the six differentiating factors may help facilitate the early differential diagnosis of rickettsial diseases and Q fever from dengue fever, permitting early antibiotic treatment. Copyright © 2015. Published by Elsevier B.V.

    16. Perinatal Yellow Fever: A Case Report.

      Science.gov (United States)

      Diniz, Lilian Martins Oliveira; Romanelli, Roberta Maia Castro; de Carvalho, Andréa Lucchesi; Teixeira, Daniela Caldas; de Carvalho, Luis Fernando Andrade; Cury, Verônica Ferreira; Filho, Marcelo Pereira Lima; Perígolo, Graciele; Heringer, Tiago Pires

      2018-04-09

      An outbreak of yellow fever in Brazil made it possible to assess different presentations of disease such as perinatal transmission. A pregnant woman was admitted to hospital with yellow fever symptoms. She was submitted to cesarean section and died due to fulminant hepatitis. On the 6th day the newborn developed liver failure and died 13 days later. Yellow fever PCR was positive for both.

    17. Educational Fever and South Korean Higher Education

      Directory of Open Access Journals (Sweden)

      Jeong-Kyu Lee

      2006-05-01

      Full Text Available This paper examines the influence of educational fever on the development of the Republic of Korea education and economy in the context of the cultural history of this country. In order to examine this study, the author explains the concept of educational fever and discusses the relation between Confucianism and education zeal. Educational fever and human capitalization in South Korean higher education are analyzed from a comparative viewpoint. The study evaluates the effects and problems of education fever this country’s current higher education, and it concludes that Koreans’ educational fever has been a core factor by which to achieve the development of the national economy as well as the rapid expansion of higher education.

    18. Autoinflammatory Diseases with Periodic Fevers.

      Science.gov (United States)

      Sag, Erdal; Bilginer, Yelda; Ozen, Seza

      2017-07-01

      One purpose of this review was to raise awareness for the new autoinflammatory syndromes. These diseases are increasingly recognized and are in the differential diagnosis of many disease states. We also aimed to review the latest recommendations for the diagnosis, management, and treatment of these patients. Familial Mediterranean fever (FMF), cryopyrin-associated periodic syndrome (CAPS), tumor necrosis factor receptor-associated periodic fever syndrome (TRAPS), and hyperimmunoglobulinemia D and periodic fever syndrome/mevalonate kinase deficiency (HIDS/MVKD) are the more common autoinflammatory diseases that are characterized by periodic fevers and attacks of inflammation. Recently much collaborative work has been done to understand the characteristics of these patients and to develop recommendations to guide the physicians in the care of these patients. These recent recommendations will be summarized for all four diseases. FMF is the most common periodic fever disease. We need to further understand the pathogenesis and the role of single mutations in the disease. Recently, the management and treatment of the disease have been nicely reviewed. CAPS is another interesting disease associated with severe complications. Anti-interleukin-1 (anti-IL-1) treatment provides cure for these patients. TRAPS is characterized by the longest delay in diagnosis; thus, both pediatricians and internists should be aware of the characteristic features and the follow-up of these patients. HIDS/MVKD is another autoinflammatory diseases characterized with fever attacks. The spectrum of disease manifestation is rather large in this disease, and we need further research on biomarkers for the optimal management of these patients.

    19. 17DD yellow fever vaccine

      Science.gov (United States)

      Martins, Reinaldo M.; Maia, Maria de Lourdes S.; Farias, Roberto Henrique G.; Camacho, Luiz Antonio B.; Freire, Marcos S.; Galler, Ricardo; Yamamura, Anna Maya Yoshida; Almeida, Luiz Fernando C.; Lima, Sheila Maria B.; Nogueira, Rita Maria R.; Sá, Gloria Regina S.; Hokama, Darcy A.; de Carvalho, Ricardo; Freire, Ricardo Aguiar V.; Filho, Edson Pereira; Leal, Maria da Luz Fernandes; Homma, Akira

      2013-01-01

      Objective: To verify if the Bio-Manguinhos 17DD yellow fever vaccine (17DD-YFV) used in lower doses is as immunogenic and safe as the current formulation. Results: Doses from 27,476 IU to 587 IU induced similar seroconversion rates and neutralizing antibodies geometric mean titers (GMTs). Immunity of those who seroconverted to YF was maintained for 10 mo. Reactogenicity was low for all groups. Methods: Young and healthy adult males (n = 900) were recruited and randomized into 6 groups, to receive de-escalating doses of 17DD-YFV, from 27,476 IU to 31 IU. Blood samples were collected before vaccination (for neutralization tests to yellow fever, serology for dengue and clinical chemistry), 3 to 7 d after vaccination (for viremia and clinical chemistry) and 30 d after vaccination (for new yellow fever serology and clinical chemistry). Adverse events diaries were filled out by volunteers during 10 d after vaccination. Volunteers were retested for yellow fever and dengue antibodies 10 mo later. Seropositivity for dengue was found in 87.6% of volunteers before vaccination, but this had no significant influence on conclusions. Conclusion: In young healthy adults Bio-Manguinhos/Fiocruz yellow fever vaccine can be used in much lower doses than usual. International Register ISRCTN 38082350. PMID:23364472

    20. The dipeptidyl peptidase 4 inhibitor vildagliptin does not accentuate glibenclamide-induced hypoglycemia but reduces glucose-induced glucagon-like peptide 1 and gastric inhibitory polypeptide secretion

      DEFF Research Database (Denmark)

      El-Ouaghlidi, Andrea; Rehring, Erika; Holst, Jens Juul

      2007-01-01

      BACKGROUND/AIMS: Inhibition of dipeptidyl peptidase 4 by vildagliptin enhances the concentrations of the active form of the incretin hormones glucagon-like peptide 1 (GLP-1) and gastric inhibitory polypeptide (GIP). The present study asked whether vildagliptin accentuates glibenclamide-induced hy...

    1. Fatal Yellow Fever in Travelers to Brazil, 2018.

      Science.gov (United States)

      Hamer, Davidson H; Angelo, Kristina; Caumes, Eric; van Genderen, Perry J J; Florescu, Simin A; Popescu, Corneliu P; Perret, Cecilia; McBride, Angela; Checkley, Anna; Ryan, Jenny; Cetron, Martin; Schlagenhauf, Patricia

      2018-03-23

      Yellow fever virus is a mosquito-borne flavivirus that causes yellow fever, an acute infectious disease that occurs in South America and sub-Saharan Africa. Most patients with yellow fever are asymptomatic, but among the 15% who develop severe illness, the case fatality rate is 20%-60%. Effective live-attenuated virus vaccines are available that protect against yellow fever (1). An outbreak of yellow fever began in Brazil in December 2016; since July 2017, cases in both humans and nonhuman primates have been reported from the states of São Paulo, Minas Gerais, and Rio de Janeiro, including cases occurring near large urban centers in these states (2). On January 16, 2018, the World Health Organization updated yellow fever vaccination recommendations for Brazil to include all persons traveling to or living in Espírito Santo, São Paulo, and Rio de Janeiro states, and certain cities in Bahia state, in addition to areas where vaccination had been recommended before the recent outbreak (3). Since January 2018, 10 travel-related cases of yellow fever, including four deaths, have been reported in international travelers returning from Brazil. None of the 10 travelers had received yellow fever vaccination.

    2. Dengue fever outbreak: a clinical management experience

      International Nuclear Information System (INIS)

      Ahmed, S.; Illyas, M.

      2008-01-01

      To determine the frequency of dengue as a cause of fever and compare the clinical and haematological characteristics of Dengue-probable and Dengue-proven cases. All patients with age above 14 years, who were either hospitalized or treated in medical outdoor clinic due to acute febrile illness, were evaluated for clinical features of Dengue Fever (DF), Dengue haemorrhagic fever (DHF) and Dengue Shock Syndrome (DSS). Patients showing typical clinical features and haematological findings suggestive of Dengue fever (As per WHO criteria) were evaluated in detail for comparison of probable and confirmed cases of Dengue fever. All other cases of acute febrile illness, not showing clinical features or haematological abnormalities of Dengue fever, were excluded. The clinical and laboratory features were recorded on SPSS 11.0 programme and graded where required, for descriptive and statistical analysis. Out of 5200 patients with febrile illness, 107 (2%) presented with typical features of DF, 40/107 (37%) were Dengue-proven while 67/107 (63%) were Dengue-probable. Out of Dengue-proven cases, 38 were of DF and 2 were of DHF. Day 1 temperature ranged from 99-105 degreeC (mean 101 degree C). Chills and rigors were noticed in 86 (80%), myalgia in 67%, headache in 54%, pharyngitis in 35%, rash in 28%, and bleeding manifestations in 2% cases. Hepatomegaly in 1(0.5%), lymphadenopathy in 1 (0.5%) and splenomegaly in 12 (11.2%) cases. Leucopoenia (count 40 U/L in 57% cases. Frequency of clinically suspected dengue virus infection was 107 (2%), while confirmed dengue fever cases were 40 (0.8%) out of 5200 fever cases. Fever with chills and rigors, body aches, headache, myalgia, rash, haemorrhagic manifestations, platelet count, total leukocyte count, and ALT, are parameters to screen the cases of suspected dengue virus infection, the diagnosis cannot be confirmed unless supported by molecular studies or dengue specific IgM. (author)

    3. Q fever: a new ocular manifestation

      Directory of Open Access Journals (Sweden)

      Udaondo P

      2011-09-01

      Full Text Available P Udaondo1,3, S Garcia-Delpech1,2, D Salom1,2, M Garcia-Pous1, M Diaz-Llopis1,21Department of Ophthalmology, Nuevo Hospital Universitario y Politecnico La Fe, Valencia, Spain; 2Faculty of Medicine, Universitat de València, Valencia, Spain; 3Universidad Cardenal Herrera CEU, Valencia, SpainAbstract: Q Fever is a zoonosis caused by Coxiella burnetii. Ocular manifestations are rare in this infection. We describe the case of a man complaining of an intense retro-orbital headache, fever, arthralgia, and bilateral loss of vision, who showed an anterior uveitis accompanied by exudative bilateral inferior retinal detachment and optic disk edema. At the beginning, a Vogt–Koyanagi–Harada (VKH syndrome was suspected, but the patient was diagnosed with Q fever and treatment with doxycycline was initiated, with complete resolution after 2 weeks. We wondered if Q fever could unleash VKH syndrome or simulate a VKH syndrome by a similar immunological process.Keywords: Q fever, Vogt–Koyanagi–Harada syndrome, panuveitis, exudative retinal detachment

    4. Rift Valley Fever.

      Science.gov (United States)

      Hartman, Amy

      2017-06-01

      Rift Valley fever (RVF) is a severe veterinary disease of livestock that also causes moderate to severe illness in people. The life cycle of RVF is complex and involves mosquitoes, livestock, people, and the environment. RVF virus is transmitted from either mosquitoes or farm animals to humans, but is generally not transmitted from person to person. People can develop different diseases after infection, including febrile illness, ocular disease, hemorrhagic fever, or encephalitis. There is a significant risk for emergence of RVF into new locations, which would affect human health and livestock industries. Copyright © 2017 Elsevier Inc. All rights reserved.

    5. The role of infarct transmural extent in infarct extension: A computational study.

      Science.gov (United States)

      Leong, Chin-Neng; Lim, Einly; Andriyana, Andri; Al Abed, Amr; Lovell, Nigel Hamilton; Hayward, Christopher; Hamilton-Craig, Christian; Dokos, Socrates

      2017-02-01

      Infarct extension, a process involving progressive extension of the infarct zone (IZ) into the normally perfused border zone (BZ), leads to continuous degradation of the myocardial function and adverse remodelling. Despite carrying a high risk of mortality, detailed understanding of the mechanisms leading to BZ hypoxia and infarct extension remains unexplored. In the present study, we developed a 3D truncated ellipsoidal left ventricular model incorporating realistic electromechanical properties and fibre orientation to examine the mechanical interaction among the remote, infarct and BZs in the presence of varying infarct transmural extent (TME). Localized highly abnormal systolic fibre stress was observed at the BZ, owing to the simultaneous presence of moderately increased stiffness and fibre strain at this region, caused by the mechanical tethering effect imposed by the overstretched IZ. Our simulations also demonstrated the greatest tethering effect and stress in BZ regions with fibre direction tangential to the BZ-remote zone boundary. This can be explained by the lower stiffness in the cross-fibre direction, which gave rise to a greater stretching of the IZ in this direction. The average fibre strain of the IZ, as well as the maximum stress in the sub-endocardial layer, increased steeply from 10% to 50% infarct TME, and slower thereafter. Based on our stress-strain loop analysis, we found impairment in the myocardial energy efficiency and elevated energy expenditure with increasing infarct TME, which we believe to place the BZ at further risk of hypoxia. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

    6. Conserved Fever Pathways across Vertebrates: A Herpesvirus Expressed Decoy TNF-α Receptor Delays Behavioral Fever in Fish.

      Science.gov (United States)

      Rakus, Krzysztof; Ronsmans, Maygane; Forlenza, Maria; Boutier, Maxime; Piazzon, M Carla; Jazowiecka-Rakus, Joanna; Gatherer, Derek; Athanasiadis, Alekos; Farnir, Frédéric; Davison, Andrew J; Boudinot, Pierre; Michiels, Thomas; Wiegertjes, Geert F; Vanderplasschen, Alain

      2017-02-08

      Both endotherms and ectotherms (e.g., fish) increase their body temperature to limit pathogen infection. Ectotherms do so by moving to warmer places, hence the term "behavioral fever." We studied the manifestation of behavioral fever in the common carp infected by cyprinid herpesvirus 3, a native carp pathogen. Carp maintained at 24°C died from the infection, whereas those housed in multi-chamber tanks encompassing a 24°C-32°C gradient migrated transiently to the warmest compartment and survived as a consequence. Behavioral fever manifested only at advanced stages of infection. Consistent with this, expression of CyHV-3 ORF12, encoding a soluble decoy receptor for TNF-α, delayed the manifestation of behavioral fever and promoted CyHV-3 replication in the context of a temperature gradient. Injection of anti-TNF-α neutralizing antibodies suppressed behavioral fever, and decreased fish survival in response to infection. This study provides a unique example of how viruses have evolved to alter host behavior to increase fitness. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

    7. Rocky Mountain spotted fever, Colombia.

      Science.gov (United States)

      Hidalgo, Marylin; Orejuela, Leonora; Fuya, Patricia; Carrillo, Pilar; Hernandez, Jorge; Parra, Edgar; Keng, Colette; Small, Melissa; Olano, Juan P; Bouyer, Donald; Castaneda, Elizabeth; Walker, David; Valbuena, Gustavo

      2007-07-01

      We investigated 2 fatal cases of Rocky Mountain spotted fever that occurred in 2003 and 2004 near the same locality in Colombia where the disease was first reported in the 1930s. A retrospective serosurvey of febrile patients showed that > 21% of the serum samples had antibodies aaainst spotted fever group rickettsiae.

    8. Paediatric fever management: continuing education for clinical nurses.

      Science.gov (United States)

      Walsh, Anne M; Edwards, Helen E; Courtney, Mary D; Wilson, Jenny E; Monaghan, Sarah J

      2006-01-01

      This study examined the influence of level of practice, additional paediatric education and length of paediatric and current experience on nurses' knowledge of and beliefs about fever and fever management. Fifty-one nurses from medical wards in an Australian metropolitan paediatric hospital completed a self-report descriptive survey. Knowledge of fever management was mediocre (Mean 12.4, SD 2.18 on 20 items). Nurses practicing at a higher level and those with between one and four years paediatric or current experience were more knowledgeable than novices or more experienced nurses. Negative beliefs that would impact nursing practice were identified. Interestingly, beliefs about fever, antipyretic use in fever management and febrile seizures were similar; they were not influenced by nurses' knowledge, experience, education or level of practice. Paediatric nurses are not expert fever managers. Knowledge deficits and negative attitudes influence their practice irrespective of additional paediatric education, paediatric or current experience or level of practice. Continuing education is therefore needed for all paediatric nurses to ensure the latest clear evidence available in the literature for best practice in fever management is applied.

    9. Moderate ethanol administration accentuates cardiomyocyte contractile dysfunction and mitochondrial injury in high fat diet-induced obesity.

      Science.gov (United States)

      Yuan, Fang; Lei, Yonghong; Wang, Qiurong; Esberg, Lucy B; Huang, Zaixing; Scott, Glenda I; Li, Xue; Ren, Jun

      2015-03-18

      Light to moderate drinking confers cardioprotection although it remains unclear with regards to the role of moderate drinking on cardiac function in obesity. This study was designed to examine the impact of moderate ethanol intake on myocardial function in high fat diet intake-induced obesity and the mechanism(s) involved with a focus on mitochondrial integrity. C57BL/6 mice were fed low or high fat diet for 16 weeks prior to ethanol challenge (1g/kg/d for 3 days). Cardiac contractile function, intracellular Ca(2+) homeostasis, myocardial histology, and mitochondrial integrity [aconitase activity and the mitochondrial proteins SOD1, UCP-2 and PPARγ coactivator 1α (PGC-1α)] were assessed 24h after the final ethanol challenge. Fat diet intake compromised cardiomyocyte contractile and intracellular Ca(2+) properties (depressed peak shortening and maximal velocities of shortening/relengthening, prolonged duration of relengthening, dampened intracellular Ca(2+) rise and clearance without affecting duration of shortening). Although moderate ethanol challenge failed to alter cardiomyocyte mechanical property under low fat diet intake, it accentuated high fat diet intake-induced changes in cardiomyocyte contractile function and intracellular Ca(2+) handling. Moderate ethanol challenge failed to affect fat diet intake-induced cardiac hypertrophy as evidenced by H&E staining. High fat diet intake reduced myocardial aconitase activity, downregulated levels of mitochondrial protein UCP-2, PGC-1α, SOD1 and interrupted intracellular Ca(2+) regulatory proteins, the effect of which was augmented by moderate ethanol challenge. Neither high fat diet intake nor moderate ethanol challenge affected protein or mRNA levels as well as phosphorylation of Akt and GSK3β in mouse hearts. Taken together, our data revealed that moderate ethanol challenge accentuated high fat diet-induced cardiac contractile and intracellular Ca(2+) anomalies as well as mitochondrial injury. Copyright

    10. Q Fever: Statistics and Epidemiology

      Science.gov (United States)

      ... Q Fever in the United States Hospitalization Rates Geography Seasonal trends People at Risk Q fever was first recognized as a human disease in Australia in 1935 and in the United States in the early 1940s. The “Q” stands for “query” and was applied at a time when the cause was unknown. ...

    11. Monoacylglycerol Lipase Regulates Fever Response.

      Directory of Open Access Journals (Sweden)

      Manuel Sanchez-Alavez

      Full Text Available Cyclooxygenase inhibitors such as ibuprofen have been used for decades to control fever through reducing the levels of the pyrogenic lipid transmitter prostaglandin E2 (PGE2. Historically, phospholipases have been considered to be the primary generator of the arachidonic acid (AA precursor pool for generating PGE2 and other eicosanoids. However, recent studies have demonstrated that monoacyglycerol lipase (MAGL, through hydrolysis of the endocannabinoid 2-arachidonoylglycerol, provides a major source of AA for PGE2 synthesis in the mammalian brain under basal and neuroinflammatory states. We show here that either genetic or pharmacological ablation of MAGL leads to significantly reduced fever responses in both centrally or peripherally-administered lipopolysaccharide or interleukin-1β-induced fever models in mice. We also show that a cannabinoid CB1 receptor antagonist does not attenuate these anti-pyrogenic effects of MAGL inhibitors. Thus, much like traditional nonsteroidal anti-inflammatory drugs, MAGL inhibitors can control fever, but appear to do so through restricted control over prostaglandin production in the nervous system.

    12. Radiological observation in typhoid fever

      Energy Technology Data Exchange (ETDEWEB)

      Lim, K Y; Park, H Y; Kim, J D; Rhee, H S [Presbyterian Medical Center, Jeonju (Korea, Republic of)

      1985-12-15

      Radiographic findings in plain abdominal films, chest PA and liver scanning are considered to be ancillary diagnostic methods for uncomplicated typhoid fever and a valuable method for detection of complication such as intestinal perforation. 189 cases of clinically proven typhoid fever from Mar. 1973 to Feb. 1979 in this Hospital were reviewed and radiographic findings were analyzed carefully. The results are as follows: 1. Most (73.6%) cases were between 20 and 40 years of age. 2. Three of the most common radiographic findings were as follows: 1) Localized paralytic ileus in RLQ or diffuse paralytic ileus (96.3%). 2) Hepatomegaly (56.5%). 3) Splenomegaly (49.7%). 3. In cases of typhoid fever with intestinal perforation there were additional significant findings such as free air under diaphragm (85%), free fluid in peritoneal cavity (90%) and air fluid levels in RLQ (80%). 4. The most frequent chest x-ray finding was elevation of diaphragm (11.1%). 5. 8 cases of complicated typhoid fever which eventually came to operation were diagnosed only by radiographic method.

    13. Radiological observation in typhoid fever

      International Nuclear Information System (INIS)

      Lim, K. Y.; Park, H. Y.; Kim, J. D.; Rhee, H. S.

      1985-01-01

      Radiographic findings in plain abdominal films, chest PA and liver scanning are considered to be ancillary diagnostic methods for uncomplicated typhoid fever and a valuable method for detection of complication such as intestinal perforation. 189 cases of clinically proven typhoid fever from Mar. 1973 to Feb. 1979 in this Hospital were reviewed and radiographic findings were analyzed carefully. The results are as follows: 1. Most (73.6%) cases were between 20 and 40 years of age. 2. Three of the most common radiographic findings were as follows: 1) Localized paralytic ileus in RLQ or diffuse paralytic ileus (96.3%). 2) Hepatomegaly (56.5%). 3) Splenomegaly (49.7%). 3. In cases of typhoid fever with intestinal perforation there were additional significant findings such as free air under diaphragm (85%), free fluid in peritoneal cavity (90%) and air fluid levels in RLQ (80%). 4. The most frequent chest x-ray finding was elevation of diaphragm (11.1%). 5. 8 cases of complicated typhoid fever which eventually came to operation were diagnosed only by radiographic method.

    14. Acute infectious purpura fulminans due to probable spotted fever

      Directory of Open Access Journals (Sweden)

      A Kundavaram

      2014-01-01

      Full Text Available Purpura fulminans (PF is associated with several infections, most notably with meningococcus, staphylococcus, and streptococcus infections. However, there are few reports of association of this entity with spotted fever from India. We report the case of a 55-year-old man who presented with fever, headache, and myalgia. On the seventh day of fever he developed nonblanching purple hemorrhagic purpura on the trunk and most prominently on the extremities consistent with purpura fulminans. Immunofluorescent assay confirmed the diagnosis of spotted fever. PF though common with rocky mountain spotted fever (RMSF is rarely seen in association with Indian tick typhus, the usual cause of spotted fever in India.

    15. STUDIES ON THE PATHOGENESIS OF FEVER

      Science.gov (United States)

      Atkins, Elisha; Wood, W. Barry

      1955-01-01

      Further studies have been made of a pyrogenic substance which appears in the circulation of rabbits during the course of experimental fever induced by injection of typhoid vaccine. With the use of a passive transfer method and pyrogen-tolerant recipients, the biological properties of this substance have been differentiated from those of the uncleared vaccine in the circulation. The newly identified factor resembles leucocytic pyrogen in the rapidity with which it produces fever and in its failure to exhibit cross-tolerance with bacterial pyrogen. This striking similarity of properties suggests that the circulating factor is of endogenous origin and may arise from cell injury. A close correlation between its presence in the circulation and the existence of fever has been demonstrated. The possible relationship of these findings to the pathogenesis of fever is evident. PMID:13271667

    16. Viscerotropic disease following yellow fever vaccination in Peru.

      Science.gov (United States)

      Whittembury, Alvaro; Ramirez, Gladys; Hernández, Herminio; Ropero, Alba Maria; Waterman, Steve; Ticona, María; Brinton, Margo; Uchuya, Jorge; Gershman, Mark; Toledo, Washington; Staples, Erin; Campos, Clarense; Martínez, Mario; Chang, Gwong-Jen J; Cabezas, Cesar; Lanciotti, Robert; Zaki, Sherif; Montgomery, Joel M; Monath, Thomas; Hayes, Edward

      2009-10-09

      Five suspected cases of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) clustered in space and time following a vaccination campaign in Ica, Peru in 2007. All five people received the same lot of 17DD live attenuated yellow fever vaccine before their illness; four of the five died of confirmed YEL-AVD. The surviving case was classified as probable YEL-AVD. Intensive investigation yielded no abnormalities of the implicated vaccine lot and no common risk factors. This is the first described space-time cluster of yellow fever viscerotropic disease involving more than two cases. Mass yellow fever vaccination should be avoided in areas that present extremely low risk of yellow fever.

    17. Epidural Labor Analgesia and Maternal Fever.

      Science.gov (United States)

      Sharpe, Emily E; Arendt, Katherine W

      2017-06-01

      Women receiving an epidural for labor analgesia are at increased risk for intrapartum fever. This relationship has been supported by observational, before and after, and randomized controlled trials. The etiology is not well understood but is likely a result of noninfectious inflammation as studies have found women with fever have higher levels of inflammatory markers. Maternal pyrexia may change obstetric management and women are more likely to receive antibiotics or undergo cesarean delivery. Maternal pyrexia is associated with adverse neonatal outcomes. With these consequences, understanding and preventing maternal fever is imperative.

    18. Dengue fever outbreak: a clinical management experience.

      Science.gov (United States)

      Ahmed, Shahid; Ali, Nadir; Ashraf, Shahzad; Ilyas, Mohammad; Tariq, Waheed-Uz-Zaman; Chotani, Rashid A

      2008-01-01

      To determine the frequency of dengue as a cause of fever and compare the clinical and haematological characteristics of Dengue-probable and Dengue-proven cases. An observational study. The Combined Military Hospital, Malir Cantt., Karachi, from August 2005 to December 2006. All patients with age above 14 years, who were either hospitalized or treated in medical outdoor clinic due to acute febrile illness, were evaluated for clinical features of Dengue Fever (DF), Dengue haemorrhagic fever (DHF) and Dengue Shock Syndrome (DSS). Patients showing typical clinical features and haematological findings suggestive of Dengue fever (As per WHO criteria) were evaluated in detail for comparison of probable and confirmed cases of Dengue fever. All other cases of acute febrile illness, not showing clinical features or haematological abnormalities of Dengue fever, were excluded. The clinical and laboratory features were recorded on SPSS 11.0 programme and graded where required, for descriptive and statistical analysis. Out of 5200 patients with febrile illness, 107(2%) presented with typical features of DF, 40/107(37%) were Dengue-proven while 67/107(63%) were Dengue-probable. Out of Dengue-proven cases, 38 were of DF and 2 were of DHF. Day 1 temperature ranged from 99-1050C (mean 1010C). Chills and rigors were noticed in 86 (80%), myalgia in 67%, headache in 54%, pharyngitis in 35%, rash in 28%, and bleeding manifestations in 2% cases. Hepatomegaly in 1(0.5%), lymphadenopathy in 1(0.5%) and splenomegaly in 12 (11.2%) cases. Leucopoenia (count40 U/L in 57% cases. Frequency of clinically suspected dengue virus infection was 107 (2%), while confirmed dengue fever cases were 40 (0.8%) out of 5200 fever cases. Fever with chills and rigors, body aches, headache, myalgia, rash, haemorrhagic manifestations, platelet count, total leukocyte count, and ALT, are parameters to screen the cases of suspected dengue virus infection; the diagnosis cannot be confirmed unless supported by

    19. Short-term Beneficial Effects of 12 Sessions of Neurofeedback on Avoidant Personality Accentuation in the Treatment of Alcohol Use Disorder

      OpenAIRE

      Dalkner, Nina; Unterrainer, Human F.; Wood, Guilherme; Skliris, Dimitris; Holasek, Sandra J.; Gruzelier, John H.; Neuper, Christa

      2017-01-01

      This study evaluated the effects of alpha/theta neurofeedback on Clinical Personality Accentuations in individuals with alcohol use disorder. Twenty-five males were investigated using a pre-test/post-test design with a waiting-list control group. Participants were randomly assigned either to an experimental group (n = 13) receiving 12 sessions of neurofeedback twice a week as a treatment adjunct over a period of 6 weeks, or to a control group (n = 12) receiving treatment as usual. The Invento...

    20. Alcohol consumption and accentuated personality traits among young adults in Romania: a cross-sectional study.

      Science.gov (United States)

      Rada, Cornelia; Ispas, Alexandru Teodor

      2016-10-27

      Alcohol consumption (AC) has negative social and economic consequences, affects health, and can create dependence. As dependence is particularly difficult to cure, prevention is important. This study aimed to identify the frequency, quantity, occasions, reasons, type of AC, and correlation with accentuated personality traits among young adults in Romania. Participants were 1359 young adults aged 18-30 years (average age, 22.67 years; standard deviation [SD], 3.02 years) from urban environments including the main university centers. Several questionnaires covering issues such as health risk behavior (smoking, alcohol abuse, unprotected sex, sedentary lifestyles, unhealthy eating), aggression, personality, adaptability, cohesion, and communication were administered to participants between 2013 and 2014. Pearson's chi-square tests and z-tests were used for the analyses. Common reasons young adults first tried AC were curiosity (67.8 %), to be like peers (17.9 %), and adult influence (6.5 %). In terms of AC frequency, 72.5 % consumed alcohol only on special occasions/holidays, 19.4 % on weekends, 4.8 % three to four times per week, and 0.4 % on a daily basis. To overcome sexual/emotional inhibitions or for courage, 2.1 % of participants drank frequently and 23.5 % drank from time to time. AC most often occurred with a group of friends (62.3 %). For 9.7 % of participants, AC was a reason for poor concentration, or problems at work/school. At the time of interview, participants had consumed an average of 319.48 ml beer (SD, 1223.02 ml), 82.75 ml wine (SD, 385.39 ml) and 25.62 ml spirits (SD, 131.34 ml) in the previous week. AC was significantly higher in males (p aged 23-30 years (p socializing. AC also correlated with some accentuated personality traits. Therefore, public health education programs should be targeted for these categories.

    1. Managing Rocky Mountain spotted fever.

      Science.gov (United States)

      Minniear, Timothy D; Buckingham, Steven C

      2009-11-01

      Rocky Mountain spotted fever is caused by the tick-borne bacterium Rickettsia rickettsii. Symptoms range from moderate illness to severe illness, including cardiovascular compromise, coma and death. The disease is prevalent in most of the USA, especially during warmer months. The trademark presentation is fever and rash with a history of tick bite, although tick exposure is unappreciated in over a third of cases. Other signature symptoms include headache and abdominal pain. The antibiotic therapy of choice for R. rickettsii infection is doxycycline. Preventive measures for Rocky Mountain spotted fever and other tick-borne diseases include: wearing long-sleeved, light colored clothing; checking for tick attachment and removing attached ticks promptly; applying topical insect repellent; and treating clothing with permethrin.

    2. 78 FR 8960 - Texas (Splenetic) Fever in Cattle

      Science.gov (United States)

      2013-02-07

      ... microscopic parasites (Babesia) that cause bovine babesiosis. We are amending the list by clarifying that... cattle from areas of the United States that are quarantined because of ticks that are vectors for bovine... this section to indicate that the terms southern fever, cattle fever, Texas fever, bovine piroplasmosis...

    3. Education Fever and Happiness in Korean Higher Education

      Science.gov (United States)

      Lee, Jeong-Kyu

      2017-01-01

      This article discusses relevance between education fever and happiness from the viewpoint of Korean higher education. To review this study systematically, three research questions are addressed. First, what is education fever from the viewpoint of the Korean people? Second, what are relations between education fever and happiness? Last, can…

    4. THE MEANING OF FEVER IN CHILDREN

      Directory of Open Access Journals (Sweden)

      A. S. Polyakova

      2015-01-01

      Full Text Available Fever is a normal physiological response to illness in young children and it is often associated with a self-limiting viral infection. Fever is not a diagnosis, but a symptom of illness. A diagnosis of the underlying illness is essential to institute appropriate treatment. Although it is a normal response, that facilitates and accelerates recovery, some people, including many doctors, believe that fever should be treated to reduce temperature without determining the underlying illness causing the fever. Antipyretics should be used to make the child more comfortable and not used routinely with the sole aim of reducing the temperature. This article aims to acquaint primary healthcare workers and general practitioners with last guidelines to assist the measurement of body temperature, deciding on when to refer and the appropriate use of antipyretic medication in children, efficacy and safety of paracetamol and ibuprofen in oral and rectal forms. 

    5. Scarlet Fever

      Centers for Disease Control (CDC) Podcasts

      2011-06-09

      Katherine Fleming-Dutra, pediatrician, discusses scarlet fever, its cause, how to treat it, and how to prevent its spread.  Created: 6/9/2011 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 6/9/2011.

    6. Early fever after trauma: Does it matter?

      Science.gov (United States)

      Hinson, Holly E; Rowell, Susan; Morris, Cynthia; Lin, Amber L; Schreiber, Martin A

      2018-01-01

      Fever is strongly associated with poor outcome after traumatic brain injury (TBI). We hypothesized that early fever is a direct result of brain injury and thus would be more common in TBI than in patients without brain injury and associated with inflammation. We prospectively enrolled patients with major trauma with and without TBI from a busy Level I trauma center intensive care unit (ICU). Patients were assigned to one of four groups based on their presenting Head Abbreviated Injury Severity Scale scores: multiple injuries: head Abbreviated Injury Scale (AIS) score greater than 2, one other region greater than 2; isolated head: head AIS score greater than 2, all other regions less than 3; isolated body: one region greater than 2, excluding head/face; minor injury: no region with AIS greater than 2. Early fever was defined as at least one recorded temperature greater than 38.3°C in the first 48 hours after admission. Outcome measures included neurologic deterioration, length of stay in the ICU, hospital mortality, discharge Glasgow Outcome Scale-Extended, and plasma levels of seven key cytokines at admission and 24 hours (exploratory). Two hundred sixty-eight patients were enrolled, including subjects with multiple injuries (n = 59), isolated head (n = 97), isolated body (n = 100), and minor trauma (n = 12). The incidence of fever was similar in all groups irrespective of injury (11-24%). In all groups, there was a significant association between the presence of early fever and death in the hospital (6-18% vs. 0-3%), as well as longer median ICU stays (3-7 days vs. 2-3 days). Fever was significantly associated with elevated IL-6 at admission (50.7 pg/dL vs. 16.9 pg/dL, p = 0.0067) and at 24 hours (83.1 pg/dL vs. 17.1 pg/dL, p = 0.0025) in the isolated head injury group. Contrary to our hypothesis, early fever was not more common in patients with brain injury, though fever was associated with longer ICU stays and death in all groups. Additionally, fever was

    7. Hemodynamic and oxygenation changes in surgical intensive care unit patients with fever and fever lowering nursing interventions.

      Science.gov (United States)

      Çelik, Sevim; Yildirim, Ismail; Arslan, Ibrahim; Yildirim, Sinan; Erdal, Fatih; Yandi, Yunus Emre

      2011-12-01

      The purpose of this study was to determine the effects of fever and nursing interventions to lower fever on hemodynamic values and oxygenation in febrile (temperature greater than 38.3°C) surgical intensive care unit patients. This retrospective study was conducted in 53 febrile patients out of 519 patients admitted to the surgical intensive care unit at a university hospital. Data were obtained from the medical records, laboratory files and nursing notes. Statistical analysis of the data was analyzed by repeated measures analysis of variance and a paired sample t-test. The average hourly urine output (F = 5.46; P = 0.002) and systolic blood pressure (F = 2.87; P = 0.03) were significantly lower after fever onset. Heart rate, respiratory rate, positive end-expiratory pressure settings and FiO(2) settings were unchanged after the development of fever. Diastolic blood pressure and oxygen saturation had non-statistically significant decreases. Nursing interventions for febrile patients consisted of medication administration (69.8%), ice (62.3%) and sponging with tepid water (62.3%). The present results showed that fever was associated with an increase in heart rate, decreased systolic arterial pressure, mean arterial pressure, oxygen saturation and hourly urine output. © 2011 Blackwell Publishing Asia Pty Ltd.

    8. Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

      Energy Technology Data Exchange (ETDEWEB)

      Blokhuis, Gijsbert J.; Diender, Marije G.; Oyen, Wim J.G. [Radboud University Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); Bleeker-Rovers, Chantal P. [Radboud University Medical Center, Division of Infectious Diseases, Department of Internal Medicine, Nijmegen (Netherlands); Draaisma, Jos M.T. [Radboud University Medical Center, Department of Paediatrics, Nijmegen (Netherlands); Geus-Oei, Lioe-Fee de [Radboud University Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); University of Twente, MIRA Institute for Biomedical Technology and Technical Medicine, Biomedical Photonic Imaging Group, Enschede (Netherlands)

      2014-10-15

      Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression. All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis. FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively. FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. (orig.)

    9. Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

      International Nuclear Information System (INIS)

      Blokhuis, Gijsbert J.; Diender, Marije G.; Oyen, Wim J.G.; Bleeker-Rovers, Chantal P.; Draaisma, Jos M.T.; Geus-Oei, Lioe-Fee de

      2014-01-01

      Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression. All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis. FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively. FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. (orig.)

    10. Rat bite fever in a pet lover.

      Science.gov (United States)

      Cunningham, B B; Paller, A S; Katz, B Z

      1998-02-01

      Rat-bite fever is an uncommon bacterial illness resulting from infection with Streptobacillus moniliformis that is often transmitted by the bite of a rat. The cutaneous findings in rat-bite fever are nonspecific but have been described as maculopapular or petechial. We describe a 9-year-old girl with acrally distributed hemorrhagic pustules, fever, and arthralgias. Diagnosis was delayed because of difficulty in identifying the pathologic organism. She was successfully treated with 10 days of ceftriaxone.

    11. Valley Fever

      Science.gov (United States)

      ... valley fever. These fungi are commonly found in soil in specific regions. The fungi's spores can be stirred into the air by ... species have a complex life cycle. In the soil, they grow as a mold with long filaments that break off into airborne ...

    12. Dengue hemorrhagic fever and acute hepatitis: a case report

      Directory of Open Access Journals (Sweden)

      Maria Paula Gomes Mourão

      Full Text Available Dengue fever is the world's most important viral hemorrhagic fever disease, the most geographically wide-spread of the arthropod-born viruses, and it causes a wide clinical spectrum of disease. We report a case of dengue hemorrhagic fever complicated by acute hepatitis. The initial picture of classical dengue fever was followed by painful liver enlargement, vomiting, hematemesis, epistaxis and diarrhea. Severe liver injury was detected by laboratory investigation, according to a syndromic surveillance protocol, expressed in a self-limiting pattern and the patient had a complete recovery. The serological tests for hepatitis and yellow fever viruses were negative. MAC-ELISA for dengue was positive.

    13. Dengue hemorrhagic fever and acute hepatitis: a case report.

      Science.gov (United States)

      Mourão, Maria Paula Gomes; Lacerda, Marcus Vinícius Guimarães de; Bastos, Michele de Souza; Albuquerque, Bernardino Cláudio de; Alecrim, Wilson Duarte

      2004-12-01

      Dengue fever is the world's most important viral hemorrhagic fever disease, the most geographically wide-spread of the arthropod-born viruses, and it causes a wide clinical spectrum of disease. We report a case of dengue hemorrhagic fever complicated by acute hepatitis. The initial picture of classical dengue fever was followed by painful liver enlargement, vomiting, hematemesis, epistaxis and diarrhea. Severe liver injury was detected by laboratory investigation, according to a syndromic surveillance protocol, expressed in a self-limiting pattern and the patient had a complete recovery. The serological tests for hepatitis and yellow fever viruses were negative. MAC-ELISA for dengue was positive.

    14. Dengue fever with rectus sheath hematoma: A case report

      Directory of Open Access Journals (Sweden)

      Anurag Sharma

      2014-01-01

      Full Text Available Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the Dengue virus. It is associated with a number of complications, which are well documented. However, Dengue fever associated with rectus sheath hematoma (RSH is a very rare complication. Only one case report has been published prior supporting the association of Dengue fever with RSH. We report a case of Dengue fever who presented with RSH and was successfully treated conservatively. RSH is also an uncommon cause of acute abdominal pain. It is accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear.

    15. Studies on the pathogenesis of fever. VIII. Further observations on the role of endogenous pyrogen in endotoxin fever.

      Science.gov (United States)

      GILLMAN, S M; BORNSTEIN, D L; WOOD, W B

      1961-11-01

      Rabbits made granulocytopenic with nitrogen mustard have been shown to generate serum endogenous pyrogen when given a fever-producing dose of bacterial endotoxin. This finding is in accord with the hypothesis that endogenous pyrogen plays a central role in the pathogenesis of endotoxin fever. The fact that leucopenic animals produce less serum-endogenous pyrogen than normal animals given the same dose of endotoxin has also been confirmed and suggests that polymorphonuclear leucocytes constitute a major source of the endogenous pyrogen which is demonstrable in the circulation during endotoxin fever.

    16. CLINICAL AND LABORATORY PROFILE OF DENGUE FEVER

      Directory of Open Access Journals (Sweden)

      Farhan Fazal

      2015-02-01

      Full Text Available AIM: Dengue is a major health problem in many parts of India and Gulbarga (North Karnataka was previously not a known endemic area f or dengue. Infection with dengue virus can cause a spectrum of three clinical syndromes , classic dengue fever (DF , dengue hemorrhagic fever (DHF and dengue shock syndrome (DSS. The present study was undertaken to determine the disease profile of dengue virus infection in hospitalized patients. METHODS AND MATERIAL: One hundred patients admitted in Basaveshwar Teaching and General hospital with fever more than 38.5 degree Celsius and IgM dengue positive were selected. They were followed from the onset of fever to twelve days or till they are recovered according to WHO discharge criteria whichever is earlier. They underwent relevant investigations to identify specific organ dysfunction and categorize them into the spectrum of Dengue fever in accordance to W HO criteria . RESULTS: Out of 100 cases in this study 70 cases belongs to DF , 23 cases to DHF and 7 cases to DSS based on WHO criteria. All the cases had fever (100%. Other common symptoms noted were myalgia (61% , joint pain (54% , headache (66% , vomitin g (55% , pain abdomen (48% , rash (41% , hepatomegaly (20% , bleeding (21% and shock (8%. Hess test was positive in 24% patients. Low platelet count of less than 100 , 000/cu mm according to WHO criteria was present in 73% patients. Deranged liver functio n test and renal parameters were seen in 26 and 8 patients respectively . Mortality documented was 7 patients due to delayed presentation. The average duration of hospital stay was 4.65 days. CONCLUSION: Dengue fever was a more common manifestation than DHF or DSS. During aepidemic , dengue should be strongly considered on the differential diagnosis of any patient with fever. The treatment of dengue is mainly fluid management and supportive. Early recognition and management of alarm symptoms is the key to bet ter outcome

    17. Clinical Features Of Malaria And Typhoid Fever | Mba | Journal of ...

      African Journals Online (AJOL)

      Features to distinguish Malaria from Typhoid fever. These can be discerned from a good and detailed clinical history, in addition to a thorough physical examination. The following would help. The paroxysms of malaria fever as against the step ladder pattern fever of typhoid fever. The prominence of headaches in typhoid ...

    18. [Crimean-Congo hemorrhagic fever].

      Science.gov (United States)

      Saijo, Masayuki; Moriikawa, Shigeru; Kurane, Ichiro

      2004-12-01

      Crimean-Congo hemorrhagic fever (CCHF) is an acute infectious disease caused by CCHF virus (CCHFV), a member of the family Bunyaviridae, genus Nairovirus. The case fatality rate of CCHF ranges from 10-40%. Because CCHF is not present in Japan, many Japanese virologists and clinicians are not very familiar with this disease. However, there remains the possibility of an introduction of CCHFV or other hemorrhagic fever viruses into Japan from surrounding endemic areas. Development of diagnostic laboratory capacity for viral hemorrhagic fevers is necessary even in countries without these diseases. At the National Institute of Infectious Diseases, Tokyo, Japan, laboratory-based systems such as recombinant protein-based antibody detection, antigen-capture and pathological examination have been developed. In this review article, epidemiologic and clinical data on CCHF in the Xinjiang Uygur Autonomous Region, compiled through field investigations and diagnostic testing utilizing the aforementioned laboratory systems, are presented. CCHFV infections are closely associated with the environmental conditions, life styles, religion, occupation, and human economic activities. Based on these data, preventive measures for CCHFV infections are also discussed.

    19. Infection, fever, and exogenous and endogenous pyrogens: some concepts have changed.

      Science.gov (United States)

      Dinarello, Charles A

      2004-01-01

      For many years, it was thought that bacterial products caused fever via the intermediate production of a host-derived, fever-producing molecule, called endogenous pyrogen (EP). Bacterial products and other fever-producing substances were termed exogenous pyrogens. It was considered highly unlikely that exogenous pyrogens caused fever by acting directly on the hypothalamic thermoregulatory center since there were countless fever-producing microbial products, mostly large molecules, with no common physical structure. In vivo and in vitro, lipopolysaccharides (LPSs) and other microbial products induced EP, subsequently shown to be interleukin-1 (IL-1). The concept of the 'endogenous pyrogen' cause of fever gained considerable support when pure, recombinant IL-1 produced fever in humans and in animals at subnanomolar concentrations. Subsequently, recombinant tumor necrosis factor-alpha (TNF-alpha), IL-6 and other cytokines were also shown to cause fever and EPs are now termed pyrogenic cytokines. However, the concept was challenged when specific blockade of either IL-1 or TNF activity did not diminish the febrile response to LPS, to other microbial products or to natural infections in animals and in humans. During infection, fever could occur independently of IL-1 or TNF activity. The cytokine-like property of Toll-like receptor (TLR) signal transduction provides an explanation by which any microbial product can cause fever by engaging its specific TLR on the vascular network supplying the thermoregulatory center in the anterior hypothalamus. Since fever induced by IL-1, TNF-alpha, IL-6 or TLR ligands requires cyclooxygenase-2, production of prostaglandin E2 (PGE2) and activation of hypothalamic PGE2 receptors provides a unifying mechanism for fever by endogenous and exogenous pyrogens. Thus, fever is the result of either cytokine receptor or TLR triggering; in autoimmune diseases, fever is mostly cytokine mediated whereas both cytokine and TLR account for fever during

    20. Typhoid Fever in South Africa in an Endemic HIV Setting.

      Science.gov (United States)

      Keddy, Karen H; Sooka, Arvinda; Smith, Anthony M; Musekiwa, Alfred; Tau, Nomsa P; Klugman, Keith P; Angulo, Frederick J

      2016-01-01

      Typhoid fever remains an important disease in Africa, associated with outbreaks and the emerging multidrug resistant Salmonella enterica serotype Typhi (Salmonella Typhi) haplotype, H58. This study describes the incidence of, and factors associated with mortality due to, typhoid fever in South Africa, where HIV prevalence is high. Nationwide active laboratory-based surveillance for culture-confirmed typhoid fever was undertaken from 2003-2013. At selected institutions, additional clinical data from patients were collected including age, sex, HIV status, disease severity and outcome. HIV prevalence among typhoid fever patients was compared to national HIV seroprevalence estimates. The national reference laboratory tested Salmonella Typhi isolates for antimicrobial susceptibility and haplotype. Unadjusted and adjusted logistic regression analyses were conducted determining factors associated with typhoid fever mortality. We identified 855 typhoid fever cases: annual incidence ranged from 0.11 to 0.39 per 100,000 population. Additional clinical data were available for 369 (46.8%) cases presenting to the selected sites. Among typhoid fever patients with known HIV status, 19.3% (29/150) were HIV-infected. In adult females, HIV prevalence in typhoid fever patients was 43.2% (19/44) versus 15.7% national HIV seroprevalence (P Typhoid fever incidence in South Africa was largely unchanged from 2003-2013. Typhoid fever mortality was associated disease severity. HIV infection may be a contributing factor. Interventions mandate improved health care access, including to HIV management programmes as well as patient education. Further studies are necessary to clarify relationships between HIV infection and typhoid fever in adults.

    1. Q Fever: An Old but Still a Poorly Understood Disease

      Directory of Open Access Journals (Sweden)

      Hamidreza Honarmand

      2012-01-01

      Full Text Available Q fever is a bacterial infection affecting mainly the lungs, liver, and heart. It is found around the world and is caused by the bacteria Coxiella burnetii. The bacteria affects sheep, goats, cattle, dogs, cats, birds, rodents, and ticks. Infected animals shed this bacteria in birth products, feces, milk, and urine. Humans usually get Q fever by breathing in contaminated droplets released by infected animals and drinking raw milk. People at highest risk for this infection are farmers, laboratory workers, sheep and dairy workers, and veterinarians. Chronic Q fever develops in people who have been infected for more than 6 months. It usually takes about 20 days after exposure to the bacteria for symptoms to occur. Most cases are mild, yet some severe cases have been reported. Symptoms of acute Q fever may include: chest pain with breathing, cough, fever, headache, jaundice, muscle pains, and shortness of breath. Symptoms of chronic Q fever may include chills, fatigue, night sweats, prolonged fever, and shortness of breath. Q fever is diagnosed with a blood antibody test. The main treatment for the disease is with antibiotics. For acute Q fever, doxycycline is recommended. For chronic Q fever, a combination of doxycycline and hydroxychloroquine is often used long term. Complications are cirrhosis, hepatitis, encephalitis, endocarditis, pericarditis, myocarditis, interstitial pulmonary fibrosis, meningitis, and pneumonia. People at risk should always: carefully dispose of animal products that may be infected, disinfect any contaminated areas, and thoroughly wash their hands. Pasteurizing milk can also help prevent Q fever.

    2. The Significance of Prolonged and Saddleback Fever in Hospitalised Adult Dengue.

      Directory of Open Access Journals (Sweden)

      Deborah Hl Ng

      Full Text Available Dengue fever is gaining importance in Singapore with an increase in the number of cases and mortality in recent years. Although prolonged and saddleback fever have been reported in dengue fever, there are no specific studies on their significance in dengue. This study aims to examine the prevalence of prolonged and saddleback fever in dengue as well as their associations with dengue severity. A total of 2843 polymerase-chain reaction (PCR confirmed dengue patients admitted to Tan Tock Seng Hospital from 2004 to 2008 were included in the study. Sixty-nine percent of them were male with a median age of 34 years. Prolonged fever (fever > 7 days duration was present in 572 (20.1% of patients. Dengue hemorrhagic fever (DHF, dengue shock syndrome (DSS and severe dengue (SD were significantly more likely to occur in patients with prolonged fever. Mucosal bleeding, anorexia, diarrhea, abdominal pain, nausea or vomiting, lethargy, rash, clinical fluid accumulation, hepatomegaly, nosocomial infection, leukopenia, higher neutrophil count, higher hematocrit, higher alanine transaminase (ALT and aspartate transaminase (AST, higher creatinine, lower protein and prolonged activated partial thromboplastin time (APTT were significantly associated with prolonged fever but not platelet count or prothrombin time (PT. Saddleback fever was present in 165 (5.8%. Although DHF and SD were more likely to occur in patients in those with saddleback fever, DSS was not. Compared with prolonged fever, saddleback fever did not show many significant associations except for diarrhea, abdominal pain, clinical fluid accumulation, hematocrit and platelet change, and lower systolic blood pressure. This study demonstrates that prolonged fever may be associated with various warning signs and more severe forms of dengue (SD, DSS, DHF, while saddleback fever showed associations with DHF and SD but not DSS. The presence of prolonged or saddleback fever in dengue patients should therefore

    3. Typhoid Fever in nineteenth-century Colombia: between medical geography and bacteriology.

      Science.gov (United States)

      García, Mónica

      2014-01-01

      This paper analyses how the Colombian medical elites made sense of typhoid fever before and during the inception of bacteriological ideas and practices in the second half of the nineteenth century. Assuming that the identity of typhoid fever has to be understood within the broader concerns of the medical community in question, I show how doctors first identified Bogotá's epidemics as typhoid fever during the 1850s, and how they also attached specificity to the fever amongst other continuous fevers, such as its European and North American counterparts. I also found that, in contrast with the discussions amongst their colleagues from other countries, debates about typhoid fever in 1860-70 among doctors in Colombia were framed within the medico-geographical scheme and strongly shaped by the fear of typhoid fever appearing alongside 'paludic' fevers in the highlands. By arguing in medico-geographical and clinical terms that typhoid fever had specificity in Colombia, and by denying the medico-geographical law of antagonism between typhoid and paludic fevers proposed by the Frenchman Charles Boudin, Colombian doctors managed to question European knowledge and claimed that typhoid fever had distinct features in Colombia. The focus on paludic and typhoid fevers in the highlands might explain why the bacteriological aetiology of typhoid fever was ignored and even contested during the 1880s. Anti-Pasteurian arguments were raised against its germ identity and some physicians even supported the idea of spontaneous origin of the disease. By the 1890s, Pasteurian knowledge had come to shape clinical and hygienic practices.

    4. Environmental Transmission of Typhoid Fever in an Urban Slum.

      Science.gov (United States)

      Akullian, Adam; Ng'eno, Eric; Matheson, Alastair I; Cosmas, Leonard; Macharia, Daniel; Fields, Barry; Bigogo, Godfrey; Mugoh, Maina; John-Stewart, Grace; Walson, Judd L; Wakefield, Jonathan; Montgomery, Joel M

      2015-12-01

      Enteric fever due to Salmonella Typhi (typhoid fever) occurs in urban areas with poor sanitation. While direct fecal-oral transmission is thought to be the predominant mode of transmission, recent evidence suggests that indirect environmental transmission may also contribute to disease spread. Data from a population-based infectious disease surveillance system (28,000 individuals followed biweekly) were used to map the spatial pattern of typhoid fever in Kibera, an urban informal settlement in Nairobi Kenya, between 2010-2011. Spatial modeling was used to test whether variations in topography and accumulation of surface water explain the geographic patterns of risk. Among children less than ten years of age, risk of typhoid fever was geographically heterogeneous across the study area (p = 0.016) and was positively associated with lower elevation, OR = 1.87, 95% CI (1.36-2.57), p typhoid fever did not vary geographically or with elevation among individuals more than ten years of age [corrected]. Our results provide evidence of indirect, environmental transmission of typhoid fever among children, a group with high exposure to fecal pathogens in the environment. Spatially targeting sanitation interventions may decrease enteric fever transmission.

    5. Environmental Transmission of Typhoid Fever in an Urban Slum.

      Directory of Open Access Journals (Sweden)

      Adam Akullian

      2015-12-01

      Full Text Available Enteric fever due to Salmonella Typhi (typhoid fever occurs in urban areas with poor sanitation. While direct fecal-oral transmission is thought to be the predominant mode of transmission, recent evidence suggests that indirect environmental transmission may also contribute to disease spread.Data from a population-based infectious disease surveillance system (28,000 individuals followed biweekly were used to map the spatial pattern of typhoid fever in Kibera, an urban informal settlement in Nairobi Kenya, between 2010-2011. Spatial modeling was used to test whether variations in topography and accumulation of surface water explain the geographic patterns of risk.Among children less than ten years of age, risk of typhoid fever was geographically heterogeneous across the study area (p = 0.016 and was positively associated with lower elevation, OR = 1.87, 95% CI (1.36-2.57, p <0.001. In contrast, the risk of typhoid fever did not vary geographically or with elevation among individuals more than ten years of age [corrected].Our results provide evidence of indirect, environmental transmission of typhoid fever among children, a group with high exposure to fecal pathogens in the environment. Spatially targeting sanitation interventions may decrease enteric fever transmission.

    6. Yellow fever

      Directory of Open Access Journals (Sweden)

      Marcelo Nóbrega Litvoc

      Full Text Available Summary The yellow fever (YF virus is a Flavivirus, transmitted by Haemagogus, Sabethes or Aedes aegypti mosquitoes. The disease is endemic in forest areas in Africa and Latin America leading to epizootics in monkeys that constitute the reservoir of the disease. There are two forms of YF: sylvatic, transmitted accidentally when approaching the forests, and urban, which can be perpetuated by Aedes aegypti. In Brazil, the last case of urban YF occurred in 1942. Since then, there has been an expansion of transmission areas from the North and Midwest regions to the South and Southeast. In 2017, the country faced an important outbreak of the disease mainly in the states of Minas Gerais, Espírito Santo and Rio de Janeiro. In 2018, its reach extended from Minas Gerais toward São Paulo. Yellow fever has an incubation period of 3 to 6 days and sudden onset of symptoms with high fever, myalgia, headache, nausea/vomiting and increased transaminases. The disease ranges from asymptomatic to severe forms. The most serious forms occur in around 15% of those infected, with high lethality rates. These forms lead to renal, hepatic and neurological impairment, and bleeding episodes. Treatment of mild and moderate forms is symptomatic, while severe and malignant forms depend on intensive care. Prevention is achieved by administering the vaccine, which is an effective (immunogenicity at 90-98% and safe (0.4 severe events per 100,000 doses measure. In 2018, the first transplants in the world due to YF were performed. There is also an attempt to evaluate the use of active drugs against the virus in order to reduce disease severity.

    7. Rocky Mountain spotted fever in children.

      Science.gov (United States)

      Woods, Charles R

      2013-04-01

      Rocky Mountain spotted fever is typically undifferentiated from many other infections in the first few days of illness. Treatment should not be delayed pending confirmation of infection when Rocky Mountain spotted fever is suspected. Doxycycline is the drug of choice even for infants and children less than 8 years old. Copyright © 2013 Elsevier Inc. All rights reserved.

    8. Rocky Mountain Spotted Fever: Statistics and Epidemiology

      Science.gov (United States)

      ... Search Form Controls Cancel Submit Search the CDC Rocky Mountain Spotted Fever (RMSF) Note: Javascript is disabled or is not ... message, please visit this page: About CDC.gov . Rocky Mountain Spotted Fever (RMSF) Transmission Signs and Symptoms Diagnosis and Testing ...

    9. Burden of typhoid fever in Sulaimania, Iraqi Kurdistan.

      Science.gov (United States)

      Dworkin, Jonathan; Saeed, Rebeen; Mykhan, Hawar; Kanan, Shwan; Farhad, Dlawer; Ali, Kocher Omer; Abdulwahab, Runak Hama Kareem; Palardy, John; Neill, Marguerite A

      2014-10-01

      Typhoid fever imposes a high disease burden worldwide, but resource limitations mean that the burden of typhoid fever in many countries is poorly understood. The authors conducted a prospective surveillance study at the adult and pediatric teaching hospitals in Sulaimania, Iraqi Kurdistan. All patients presenting with an undifferentiated febrile illness consistent with typhoid were eligible for enrollment. Enrolled patients had blood cultures and Brucella serologies performed. Incidence was calculated with reference to census data. Both typhoid fever and brucellosis were common, and the incidence of typhoid fever was 21 cases/100 000 patient-years. Classic disease symptoms were uncommonly observed. Cost-effective surveillance projects to calculate disease burden of typhoid fever are practical and replicable. Typhoid has successfully adapted to the healthcare environment in Sulaimania. Additional work in the region should focus on antibiotic resistance and other enteric pathogens such as Brucella spp. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

    10. The 2007-2010 Q fever epidemic in The Netherlands: characteristics of notified acute Q fever patients and the association with dairy goat farming.

      NARCIS (Netherlands)

      Dijkstra, F.; Hoek, W. van der; Wijers, N.; Schimmer, B.; Rietveld, A.; Wijkmans, C.J.; Vellema, P.; Schneeberger, P.M.

      2012-01-01

      We describe the Q fever epidemic in the Netherlands with emphasis on the epidemiological characteristics of acute Q fever patients and the association with veterinary factors. Data from 3264 notifications for acute Q fever in the period from 2007 through 2009 were analysed. The patients most

    11. A Study of Renogram in Korean Hemorrhagic Fever

      International Nuclear Information System (INIS)

      Choi, Tae Kyu; Lee, Jung Sang; Koh, Chang Soon; Lee, Mun Ho

      1974-01-01

      The patterns of renogram in patients with Korean hemorrhagic fever were evaluated with clinical course and renal hemodynamic changes in various clinical stages. The renal plasma flow was measured by hippuran blood clearance using 131 I-ortho-iodohippurate and hippuran renogram was analysed means of quantitative and qualitative methods in 26 patients of Korean hemorrhagic fever. The results obtained with this study were as follows;1) During the oliguric phase of Korean hemorrhagic fever, the renogram showed non-functioning (flat) or obstructive pattern. The group of patients with non-functioning pattern of renogram had more severe impairment of renal function and grave prognosis than the group with obstructive pattern of renogram. 2) During the diuretic phase, the renogram showed obstructive or dysfunction ar normal pattern, which was related with the recovery of renal function. Obstruction pattern of renogram was observed till the 2nd week of diuretic phase. Normal pattern of renogram began to appear by the 2nd week of diuretic phase. 3) During the convalescent phase of Korean hemorrhagic fever, 40% of patients showed dysfunction pattern of renogram, and the recovery of abnormal renogram in Korean hemorrhagic fever was more delayed than the recovery of clinical features and laboratory findings. 4) The renogram showed normal pattern 6 months after onset of Korean hemorrhagic fever in all cases. 5) There was significant correlationship between the pattern of renogram and the decrease of renal plasma flow in the patients with Korean hemorrhagic fever. The decrease of renal plasma flow was marked in the patients with non-functioning pattern of renogram and was least in the patients with dysfunction pattern of renogram. All above results suggested that the renogram reflects the effective renal plasma flow and degree of renal impairment, and the renogram may be one of the important indexes which could give us a more precise prognosis in Korean hemorrhagic fever.

    12. Congo crimean hemorrhagic fever in balochistan

      International Nuclear Information System (INIS)

      Durrani, A.B.; Shaikh, M.; Khan, Z.

      2007-01-01

      To observe the pattern and mortality of Congo-Crimean Hemorrhagic Fever (CCHF) in Balochistan. Two hundred and twenty-six febrile patients with bleeding of sudden onset, with initial signs and symptoms including headache, high fever, back pain, joint pain, stomach pain, vomiting, red eyes, flushed face, red throat and petechiae on the palate of both sexes were screened for CCHF over a period of 10 years. Clinical criteria for initial diagnosis directed the subsequent diagnostic work-up. The ages of these patients ranged from 7 years to 74 years. Sixty-three percent of these patients were positive for CCHF. Males were 68% of the total patients. Over the years, CCHF showed a gradual increase ranging from 43% to 80%. Total mortality was 15%, all being secondary cases. Death was not observed in primary CCHF cases. In this study, suspicion of viral hemorrhagic fever was raised in 62% cases at the time of admission and the patients were immediately isolated, noninvasive procedures were instigated and barrier nursing was implemented. None of the family and hospital staff members who had close contact with the patient became ill, while those who were not suspected initially (38%) infected the health care workers and the family members. Although CCHF is rare, this study stresses the need for proper health facilities in Pakistan and to include VHF (viral hemorrhagic fevers) in the differential diagnosis of unexplained fever with hemorrhagic tendencies of sudden onset. (author)

    13. Is there a fever phobia present in parents of young children?

      Directory of Open Access Journals (Sweden)

      Samo Stadler

      2005-09-01

      Full Text Available Background: Fever is one of the most common reasons for parents to seek medical attention for their child. Parents are commonly very concerned about their child’s fever and sometimes this overconcern can almost reach the level of a phobia. This is due to a widely accepted belief that fever is a disease on its own. Many parents believe that fever can cause different harmful effects to a child. The aim of this study was to determine how much Slovenian parents know about fever, whether they have any fears and anxieties when their child has experienced fever and to determine how they treat febrile children at home. Our main hypothesis was that in Slovenia there is a parental overconcern over fever in children.Methods: A questionnaire consisting of 24 questions was administered to parents who brought their child to a routine visit in two pediatric dispensaries. During October 2003 and January 2004 we managed to obtain 76 filled-out questionnaires.Results: 14% of parents said they were very worried and an additional 72% were somewhat worried about potential consequences of fever. 49% believe fever can cause brain damage and 18% believe this can be caused by temperatures below 41°C. 8% of parents overdose paracetamol, 33% use an incorrect technique of sponging and 38% awaken their child at night.Conclusions: In Slovenia there also exists a fever phobia. Slovenian parents are undereducated about the meaning, causes end effects of fever and they often deal with their child’s fever overwhelmingly and improperly.

    14. Thrombosis and antiphospholipid antibody syndrome during acute Q fever

      Science.gov (United States)

      Million, Matthieu; Bardin, Nathalie; Bessis, Simon; Nouiakh, Nadia; Douliery, Charlaine; Edouard, Sophie; Angelakis, Emmanouil; Bosseray, Annick; Epaulard, Olivier; Branger, Stéphanie; Chaudier, Bernard; Blanc-Laserre, Karine; Ferreira-Maldent, Nicole; Demonchy, Elisa; Roblot, France; Reynes, Jacques; Djossou, Felix; Protopopescu, Camelia; Carrieri, Patrizia; Camoin-Jau, Laurence; Mege, Jean-Louis; Raoult, Didier

      2017-01-01

      Abstract Q fever is a neglected and potentially fatal disease. During acute Q fever, antiphospholipid antibodies are very prevalent and have been associated with fever, thrombocytopenia, acquired heart valve disease, and progression to chronic endocarditis. However, thrombosis, the main clinical criterion of the 2006 updated classification of the antiphospholipid syndrome, has not been assessed in this context. To test whether thrombosis is associated with antiphospholipid antibodies and whether the criteria for antiphospholipid syndrome can be met in patients with acute Q fever, we conducted a cross-sectional study at the French National Referral Center for Q fever. Patients included were diagnosed with acute Q fever in our Center between January 2007 and December 2015. Each patient's history and clinical characteristics were recorded with a standardized questionnaire. Predictive factors associated with thrombosis were assessed using a rare events logistic regression model. IgG anticardiolipin antibodies (IgG aCL) assessed by an enzyme-linked immunosorbent assay were tested on the Q fever diagnostic serum. A dose-dependent relationship between IgG aCL levels and thrombosis was tested using a receiver operating characteristic (ROC) analysis. Of the 664 patients identified for inclusion in the study, 313 (47.1%) had positive IgG aCL and 13 (1.9%) were diagnosed with thrombosis. Three patients fulfilled the antiphospholipid syndrome criteria. After multiple adjustments, only positive IgG aCL (relative risk, 14.46 [1.85–113.14], P = .011) were independently associated with thrombosis. ROC analysis identified a dose-dependent relationship between IgG aCL levels and occurrence of thrombosis (area under curve, 0.83, 95%CI [0.73–0.93], P antiphospholipid antibodies are associated with thrombosis, thrombocytopenia, and acquired valvular heart disease. Antiphospholipid antibodies should be systematically assessed in acute Q fever patients. Hydroxychloroquine

    15. Yellow fever cases in Asia: primed for an epidemic.

      Science.gov (United States)

      Wasserman, Sean; Tambyah, Paul Anantharajah; Lim, Poh Lian

      2016-07-01

      There is currently an emerging outbreak of yellow fever in Angola. Cases in infected travellers have been reported in a number of other African countries, as well as in China, representing the first ever documented cases of yellow fever in Asia. There is a large Chinese workforce in Angola, many of whom may be unvaccinated, increasing the risk of ongoing importation of yellow fever into Asia via busy commercial airline routes. Large parts of the region are hyperendemic for the related Flavivirus dengue and are widely infested by Aedes aegypti, the primary mosquito vector of urban yellow fever transmission. The combination of sustained introduction of viraemic travellers, an ecology conducive to local transmission, and an unimmunized population raises the possibility of a yellow fever epidemic in Asia. This represents a major global health threat, particularly in the context of a depleted emergency vaccine stockpile and untested surveillance systems in the region. In this review, the potential for a yellow fever outbreak in Asia is discussed with reference to the ecological and historical forces that have shaped global yellow fever epidemiology. The limitations of surveillance and vector control in the region are highlighted, and priorities for outbreak preparedness and response are suggested. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

    16. Yellow fever cases in Asia: primed for an epidemic

      Directory of Open Access Journals (Sweden)

      Sean Wasserman

      2016-07-01

      Full Text Available There is currently an emerging outbreak of yellow fever in Angola. Cases in infected travellers have been reported in a number of other African countries, as well as in China, representing the first ever documented cases of yellow fever in Asia. There is a large Chinese workforce in Angola, many of whom may be unvaccinated, increasing the risk of ongoing importation of yellow fever into Asia via busy commercial airline routes. Large parts of the region are hyperendemic for the related Flavivirus dengue and are widely infested by Aedes aegypti, the primary mosquito vector of urban yellow fever transmission. The combination of sustained introduction of viraemic travellers, an ecology conducive to local transmission, and an unimmunized population raises the possibility of a yellow fever epidemic in Asia. This represents a major global health threat, particularly in the context of a depleted emergency vaccine stockpile and untested surveillance systems in the region. In this review, the potential for a yellow fever outbreak in Asia is discussed with reference to the ecological and historical forces that have shaped global yellow fever epidemiology. The limitations of surveillance and vector control in the region are highlighted, and priorities for outbreak preparedness and response are suggested.

    17. International travel between global urban centres vulnerable to yellow fever transmission.

      Science.gov (United States)

      Brent, Shannon E; Watts, Alexander; Cetron, Martin; German, Matthew; Kraemer, Moritz Ug; Bogoch, Isaac I; Brady, Oliver J; Hay, Simon I; Creatore, Maria I; Khan, Kamran

      2018-05-01

      To examine the potential for international travel to spread yellow fever virus to cities around the world. We obtained data on the international flight itineraries of travellers who departed yellow fever-endemic areas of the world in 2016 for cities either where yellow fever was endemic or which were suitable for viral transmission. Using a global ecological model of dengue virus transmission, we predicted the suitability of cities in non-endemic areas for yellow fever transmission. We obtained information on national entry requirements for yellow fever vaccination at travellers' destination cities. In 2016, 45.2 million international air travellers departed from yellow fever-endemic areas of the world. Of 11.7 million travellers with destinations in 472 cities where yellow fever was not endemic but which were suitable for virus transmission, 7.7 million (65.7%) were not required to provide proof of vaccination upon arrival. Brazil, China, India, Mexico, Peru and the United States of America had the highest volumes of travellers arriving from yellow fever-endemic areas and the largest populations living in cities suitable for yellow fever transmission. Each year millions of travellers depart from yellow fever-endemic areas of the world for cities in non-endemic areas that appear suitable for viral transmission without having to provide proof of vaccination. Rapid global changes in human mobility and urbanization make it vital for countries to re-examine their vaccination policies and practices to prevent urban yellow fever epidemics.

    18. [Familial Mediterranean fever: not to be missed

      NARCIS (Netherlands)

      Frenkel, J.; Bemelman, F.J.; Potter van Loon, B.J.; Simon, A.

      2013-01-01

      Familial Mediterranean fever (FMF) is common among Turkish and Moroccan migrants. We describe three patients with FMF. A 3-year-old girl with recurrent fever and abdominal pain who was diagnosed early with FMF and treated effectively with colchicine. An adolescent girl who required interleukin

    19. Lassa fever – full recovery without ribavarin treatment: a case report ...

      African Journals Online (AJOL)

      Her close contacts showed no evidence of Lassa virus infection. Conclusion: This report adds to the literature on the natural history of Lassa fever; and that individuals may survive Lassa fever with conservative management of symptoms of the disease and its complications. Keywords: Lassa fever; viral hemorrhagic fever, ...

    20. Facing dengue fever - our first experience

      Directory of Open Access Journals (Sweden)

      Cvjetković Dejan

      2017-01-01

      Full Text Available Introduction. Dengue fever is a mosquito-borne disease caused by dengue virus, endemic in tropical and subtropical regions, where it is mostly imported from. The most common clinical form is classic dengue fever. We presented the first dengue case microbiologically confirmed in Serbia. Case report. A 34-year-old male got classic dengue fever after arrival from Cuba. The disease occurred suddenly with fever, myalgias, skin rash, hepatosplenomegaly, cytopenia, abnormal aminotransferase and creatine kinase levels. The diagnosis was confirmed with virological diagnostic methods. Significant leukopenia and thrombocytopenia as well as elevation of serum creatine kinase activity were recorded from the very beginning of hospitalization, but were gradually normalized. The whole duration of hospitalization was accompanied by laboratory signs of liver lesion. The disease had favourable outcome. At hospital discharge, the patient was afebrile, asymptomatic, with discrete erythematous rash on torso and arms, normal hemathological values and creatine kinase level and moderately elevated alanine-aminotransferase level. Conclusion. Considering global climate changes and growing international traffic, our health care service needs to be ready for possible massive outbreaks of dengue and other tropical infectious diseases in forthcoming years.

    1. Absorption fever characteristics due to percutaneous renal biopsy-related hematoma.

      Science.gov (United States)

      Hu, Tingyang; Liu, Qingquan; Xu, Qin; Liu, Hui; Feng, Yan; Qiu, Wenhui; Huang, Fei; Lv, Yongman

      2016-09-01

      This study aims to describe the unique characteristics of absorption fever in patients with a hematoma after percutaneous renal biopsy (PRB) and distinguish it from secondary infection of hematoma.We retrospectively studied 2639 percutaneous renal biopsies of native kidneys. We compared the clinical characteristics between 2 groups: complication group (gross hematuria and/or perirenal hematoma) and no complication group. The axillary temperature of patients with a hematoma who presented with fever was measured at 06:00, 10:00, 14:00, and 18:00. The onset and duration of fever and the highest body temperature were recorded. Thereafter, we described the time distribution of absorption fever and obtained the curve of fever pattern.Of 2639 patients, PRB complications were observed in 154 (5.8%) patients. Perirenal hematoma was the most common complication, which occurred in 118 (4.5%) of biopsies, including 74 small hematoma cases (thickness ≤3 cm) and 44 large hematoma cases (thickness >3 cm). Major complications were observed in only 6 (0.2%) cases resulting from a large hematoma. Of 118 patients with a perirenal hematoma, absorption fever was observed in 48 cases. Furthermore, large hematomas had a 5.23-fold higher risk for absorption fever than the small ones.Blood pressure, renal insufficiency, and prothrombin time could be risk factors for complications. Fever is common in patients with hematoma because of renal biopsy and is usually noninfectious. Evaluation of patients with post-biopsy fever is necessary to identify any obvious infection sources. If no focus is identified, empiric antibiotic therapy should not be initiated nor should prophylactic antibiotics be extended for prolonged durations. Absorption fevers will resolve in time without specific therapeutic interventions.

    2. Evidence-based provisional clinical classification criteria for autoinflammatory periodic fevers

      NARCIS (Netherlands)

      Federici, Silvia; Sormani, Maria Pia; Ozen, Seza; Lachmann, Helen J; Amaryan, Gayane; Woo, Patricia; Koné-Paut, Isabelle; Dewarrat, Natacha; Cantarini, Luca; Insalaco, Antonella; Uziel, Yosef; Rigante, Donato; Quartier, Pierre; Demirkaya, Erkan; Herlin, Troels; Meini, Antonella; Fabio, Giovanna; Kallinich, Tilmann; Martino, Silvana; Butbul, Aviel Yonatan; Olivieri, Alma; Kuemmerle-Deschner, Jasmin; Neven, Benedicte; Simon, Anna; Ozdogan, Huri; Touitou, Isabelle; Frenkel, Joost; Hofer, Michael; Martini, Alberto; Ruperto, Nicolino; Gattorno, Marco

      2015-01-01

      The objective of this work was to develop and validate a set of clinical criteria for the classification of patients affected by periodic fevers. Patients with inherited periodic fevers (familial Mediterranean fever (FMF); mevalonate kinase deficiency (MKD); tumour necrosis factor

    3. Genetic and environmental contributions to hay fever among young adult twins

      DEFF Research Database (Denmark)

      Thomsen, Simon Francis; Suppli Ulrik, Charlotte; Kyvik, Kirsten Ohm

      2006-01-01

      environment, whereas the aetiology of 'sporadic' hay fever was mainly genetic. CONCLUSIONS: The susceptibility to develop hay fever is attributable to major genetic influences. However, effects of family environment and upbringing are also of importance in families where asthma is present. These results......BACKGROUND: The susceptibility to develop hay fever is putatively the result both of genetic and environmental causes. We estimated the significance and magnitude of genetic and environmental contributions to hay fever among young adult twins. METHODS: From the birth cohorts 1953-82 of The Danish...... effects accounted for 29% of the individual susceptibility to hay fever. The same genes contributed to the susceptibility to hay fever both in males and in females. In families with asthma, the susceptibility to develop hay fever was, in addition to genes, to a great extent ascribable to family...

    4. Dengue fever/dengue haemorrhagic fever in Filipino children: clinical experience during the 1983-1984 epidemic.

      Science.gov (United States)

      Songco, R S; Hayes, C G; Leus, C D; Manaloto, C O

      1987-09-01

      A total of 377 Filipino children out of a total of 5,427 admissions from October 31, 1983 to March 31, 1984 were found to have dengue fever/dengue haemorrhagic fever The present clinical presentation of these infections was basically similar to that in previous epidemics but hepatomegaly and pleural effusion were less frequent and cardiac involvement, more frequent. The discrepancies between the clinical syndromes and HI antibody responses were evident; thus, the values used for the interpretation of the antibody titers must be reassessed.

    5. Urinary tract infections and post-operative fever in percutaneous nephrolithotomy.

      Science.gov (United States)

      Gutierrez, Jorge; Smith, Arthur; Geavlete, Petrisor; Shah, Hemendra; Kural, Ali Riza; de Sio, Marco; Amón Sesmero, José H; Hoznek, András; de la Rosette, Jean

      2013-10-01

      To review the incidence of UTIs, post-operative fever, and risk factors for post-operative fever in PCNL patients. Between 2007 and 2009, consecutive PCNL patients were enrolled from 96 centers participating in the PCNL Global Study. Only data from patients with pre-operative urine samples and who received antibiotic prophylaxis were included. Pre-operative bladder urine culture and post-operative fever (>38.5°C) were assessed. Relationship between various patient and operative factors and occurrence of post-operative fever was assessed using logistic regression analyses. Eight hundred and sixty-five (16.2%) patients had a positive urine culture; Escherichia coli was the most common micro-organism found in urine of the 350 patients (6.5%). Of the patients with negative pre-operative urine cultures, 8.8% developed a fever post-PCNL, in contrast to 18.2% of patients with positive urine cultures. Fever developed more often among the patients whose urine cultures consisted of Gram-negative micro-organisms (19.4-23.8%) versus those with Gram-positive micro-organisms (9.7-14.5%). Multivariate analysis indicated that a positive urine culture (odds ratio [OR] = 2.12, CI [1.69-2.65]), staghorn calculus (OR = 1.59, CI [1.28-1.96]), pre-operative nephrostomy (OR = 1.61, CI [1.19-2.17]), lower patient age (OR for each year of 0.99, CI [0.99-1.00]), and diabetes (OR = 1.38, CI [1.05-1.81]) all increased the risk of post-operative fever. Limitations include the use of fever as a predictor of systemic infection. Approximately 10% of PCNL-treated patients developed fever in the post-operative period despite receiving antibiotic prophylaxis. Risk of post-operative fever increased in the presence of a positive urine bacterial culture, diabetes, staghorn calculi, and a pre-operative nephrostomy.

    6. Appendicular perforation in dengue fever: our experience

      Directory of Open Access Journals (Sweden)

      Gunjan Desai

      2014-09-01

      Full Text Available Dengue viral infections have become one of major emerging infectious diseases in the tropics. Acute abdomen occurring in dengue viral infection is not uncommon. The spectrums of acute surgical emergencies which raise suspicion of an abdominal catastrophe in patients presenting with dengue fever include acute pancreatitis, acute acalculous cholecystitis, non-specific peritonitis and very rarely acute appendicitis. The presence of low white cell count and platelet count can raise suspicion of a diagnosis of dengue in a patient presenting with acute abdominal pain, during a dengue epidemic. We herein report three patients with dengue fever who had appendicular perforation during the course of their viral fever.

    7. PREDICTION OF DENGUE FEVER EPIDEMIC SPREADING USING DYNAMICS TRANSMISSION VECTOR MODEL

      Directory of Open Access Journals (Sweden)

      Retno Widyaningrum

      2014-05-01

      Full Text Available Increasing number of dengue cases in Surabaya shows that its city has high potential of dengue fever epidemic. Although some policies were designed by Surabaya Health Department, such as fogging and mosquito’s nest eradication, but these efforts still out of target because of inaccurate predictions. Ineffectiveness eradication of dengue fever epidemic is caused by lack of information and knowledge on environmental conditions in Surabaya. Developing spread and prediction system to minimize dengue fever epidemic is necessary to be conducted immediately. Spread and prediction system can improve eradication and prevention accuracy. The transmission dynamics vector simulation will be used as an approach to draw a complex system ofmosquito life cycle in which involve a lot offactors. Dynamics transmission model used to build model in mosquito model (oviposition rate and pre adult mosquito, infected and death cases in dengue fever. The model of mosquito and infected population can represent system. The output of this research is website of spread and prediction system of dengue fever epidemics to predict growth rate of Aedes Aegypti mosquito, infected, and death population because of dengue fever epidemics. The deviation of infected population is 0,519. The model of death cases in dengue fever is less precision with the deviation 1,229. Death cases model need improvement by adding some variables that influence to dengue fever death cases. Spread ofdengue fever prediction will help the government, health department to decide the best policies in minimizing the spread ofdengue fever epidemics.

    8. Class II malocclusion with accentuated occlusal plane inclination corrected with miniplate: a case report

      Science.gov (United States)

      Farret, Marcel Marchiori; Farret, Milton M. Benitez

      2016-01-01

      ABSTRACT Introduction: A canted occlusal plane presents an unesthetic element of the smile. The correction of this asymmetry has been typically considered difficult by orthodontists, as it requires complex mechanics and may sometimes even require orthognathic surgery. Objective: This paper outlines the case of a 29-year-old woman with Class II malocclusion, pronounced midline deviation and accentuated occlusal plane inclination caused by mandibular deciduous molar ankylosis. Methods: The patient was treated with a miniplate used to provide anchorage in order to intrude maxillary teeth and extrude mandibular teeth on one side, thus eliminating asymmetry. Class II was corrected on the left side by means of distalization, anchored in the miniplate as well. On the right side, maxillary first premolar was extracted and molar relationship was kept in Class II, while canines were moved to Class I relationship. The patient received implant-prosthetic rehabilitation for maxillary left lateral incisor and mandibular left second premolar. Results: At the end of treatment, Class II was corrected, midlines were matched and the canted occlusal plane was totally corrected, thereby improving smile function and esthetics. PMID:27409658

    9. EpiReview: Typhoid fever, NSW, 2005-2011.

      Science.gov (United States)

      Gunaratnam, Praveena; Tobin, Sean; Seale, Holly; Musto, Jennie

      2013-11-01

      To examine trends in the incidence of typhoid fever in NSW to inform the development of prevention strategies. Typhoid fever case notification data for the period 2005-2011 were extracted from the NSW Notifiable Conditions Information Management System. Population incidence rates were calculated and analysed by demographic variables. There were 250 case notifications of typhoid fever in NSW from 2005 to 2011, of which 240 are likely to have been acquired overseas. Case notifications remained relatively stable over the review period with the highest rates in Western Sydney Local Health District (10.9 per 100,000 population). Two-thirds (66.4%) of all case notifications are likely to have been acquired in South Asia, and about half of overseas-acquired case notifications were most likely to have been associated with travel to visit friends and relatives. Hospitalisation was required for 79.6% of cases where hospitalisation status was known. Prior typhoid vaccination was reported in 7% of cases in 2010 and 2011 where vaccination status was known. While typhoid fever rates remain low in NSW, case notifications of this preventable infection continue to be reported, particularly in travellers visiting friends and relatives in South Asia. Further research to better understand barriers to the use of preventive measures may be useful in targeting typhoid fever prevention messages in high-risk groups, particularly South Asian communities in NSW.

    10. Parental beliefs and practices regarding childhood fever in Turkish primary care.

      Science.gov (United States)

      Yavuz, E; Yayla, E; Cebeci, S E; Kırımlı, E; Gümüştakım, R Ş; Çakır, L; Doğan, S

      2017-01-01

      Fever is a very common problem in pediatric age and is one of the most common reasons parents seek medical attention. We aimed to investigate beliefs, habits, and concerns of Turkish parents regarding their children's fever. We performed a cross-sectional survey which was conducted as face-to-face interviews by family physicians from April to June 2014 in family healthcare centers in nine different cities in Turkey. Parents with a child with fever aged between 0 and 14 years were interviewed. The participants were asked questions about sociodemographic data, the definition and measurement of fever, antipyretics, and other interventions used to reduce fever before presenting to the primary care center. A total of 205 parents participated in this study. Ninety-four parents (45.8%) measured fever with a thermometer prior to presentation. Only 36 parents (38%) used the thermometer correctly. Thirty-eight parents (18.5%) knew the correct temperature definition of fever for the measured site. A mercury-in-glass thermometer was the choice for most parents (78%) and preferred site for measurement was axillary region (85%). The fever was treated prior to arrival by 171 parents (83.4%). Paracetamol was the most frequently used antipyretic. Fifty-four parents (31.5%) failed to administer the correct antipyretic dose, and 73 parents (42.6%) failed to give the antipyretics at proper intervals. One hundred and fifty-three parents (67%) believed that if not treated fever could cause convulsions. We conclude that parents share important misconceptions about definition, treatment, and consequences of childhood fever and tend to treat fever before seeking medical care with a substantial rate of wrong doses and wrong intervals.

    11. Overview of Classical Swine Fever (Hog Cholera, Classical Swine fever)

      Science.gov (United States)

      Classical swine fever is a contagious often fatal disease of pigs clinically characterized by high body temperature, lethargy, yellowish diarrhea, vomits and purple skin discoloration of ears, lower abdomen and legs. It was first described in the early 19th century in the USA. Later, a condition i...

    12. Breathing Valley Fever

      Centers for Disease Control (CDC) Podcasts

      2014-02-04

      Dr. Duc Vugia, chief of the Infectious Diseases Branch in the California Department of Public Health, discusses Valley Fever.  Created: 2/4/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/5/2014.

    13. Orbital cellulitis in course of typhoid fever

      International Nuclear Information System (INIS)

      Nowacka, K.; Szreter, M.; Mikolajewicz, J.

      1993-01-01

      In 18 months girl with exophthalmus of the left eye and extensive swelling of the soft tissues in both orbits during continued fever was observed. Typhoid fever with a non-typical course and ophthalmic complications were diagnosed on the basis of serological tests. Complete cure after treatment with augmenting was obtained. (author)

    14. New assay of protective activity of Rocky Mountain spotted fever vaccines.

      Science.gov (United States)

      Anacker, R L; Smith, R F; Mann, R E; Hamilton, M A

      1976-01-01

      Areas under the fever curves of guinea pigs inoculated with Rocky Mountain spotted fever vaccine over a restricted dose range and infected with a standardized dose of Rickettsia rickettsii varied linearly with log10 dose of vaccine. A calculator was programmed to plot fever curves and calculate the vaccine dose that reduced the fever of infected animals by 50%. PMID:823177

    15. Immunological features underlying viral hemorrhagic fevers.

      Science.gov (United States)

      Messaoudi, Ilhem; Basler, Christopher F

      2015-10-01

      Several enveloped RNA viruses of the arenavirus, bunyavirus, filovirus and flavivirus families are associated with a syndrome known as viral hemorrhagic fever (VHF). VHF is characterized by fever, vascular leakage, coagulation defects and multi organ system failure. VHF is currently viewed as a disease precipitated by viral suppression of innate immunity, which promotes systemic virus replication and excessive proinflammatory cytokine responses that trigger the manifestations of severe disease. However, the mechanisms by which immune dysregulation contributes to disease remain poorly understood. Infection of nonhuman primates closely recapitulates human VHF, notably Ebola and yellow fever, thereby providing excellent models to better define the immunological basis for this syndrome. Here we review the current state of our knowledge and suggest future directions that will better define the immunological mechanisms underlying VHF. Copyright © 2015 Elsevier Ltd. All rights reserved.

    16. Cardiac manifestations of Familial Mediterranean fever

      OpenAIRE

      Alsarah, Ahmad; Alsara, Osama; Laird-Fick, Heather S.

      2017-01-01

      Familial Mediterranean fever (FMF) is autoinflammatory disorder characterized by sporadic attacks of fever, peritonitis, pleuritis, and arthritis. It is mainly seen in patients from Mediterranean origins, but it is now reported more frequently in Europe and North America due to immigration. To analyze the data on the cardiovascular manifestations in FMF patients, we searched PubMed using the terms “Familial Mediterranean Fever” or “FMF” in combination with other key words including “cardiovas...

    17. Yellow Fever outbreaks in unvaccinated populations, Brazil, 2008-2009.

      Directory of Open Access Journals (Sweden)

      Alessandro Pecego Martins Romano

      2014-03-01

      Full Text Available Due to the risk of severe vaccine-associated adverse events, yellow fever vaccination in Brazil is only recommended in areas considered at risk for disease. From September 2008 through June 2009, two outbreaks of yellow fever in previously unvaccinated populations resulted in 21 confirmed cases with 9 deaths (case-fatality, 43% in the southern state of Rio Grande do Sul and 28 cases with 11 deaths (39% in Sao Paulo state. Epizootic deaths of non-human primates were reported before and during the outbreak. Over 5.5 million doses of yellow fever vaccine were administered in the two most affected states. Vaccine-associated adverse events were associated with six deaths due to acute viscerotropic disease (0.8 deaths per million doses administered and 45 cases of acute neurotropic disease (5.6 per million doses administered. Yellow fever vaccine recommendations were revised to include areas in Brazil previously not considered at risk for yellow fever.

    18. Dengue-yellow fever sera cross-reactivity; challenges for diagnosis

      OpenAIRE

      Houghton-Triviño, Natalia; Montaña, Diana; Castellanos, Jaime

      2008-01-01

      Objective The Flavivirus genera share epitopes inducing cross-reactive antibodies leading to great difficulty in differentially diagnosing flaviviral infections. This work was aimed at evaluating the complexity of dengue and yellow fever serological differential diagnosis. Material and methods Dengue antibody capture ELISA and a yellow fever neutralisation test were carried out on 13 serum samples obtained from yellow fever patients, 20 acute serum samples from dengue patients and 19 voluntan...

    19. Fatigue following Acute Q-Fever: A Systematic Literature Review

      Science.gov (United States)

      Delsing, Corine E.; Bleijenberg, Gijs; Langendam, Miranda; Timen, Aura; Bleeker-Rovers, Chantal P.

      2016-01-01

      Background Long-term fatigue with detrimental effects on daily functioning often occurs following acute Q-fever. Following the 2007–2010 Q-fever outbreak in the Netherlands with over 4000 notified cases, the emphasis on long-term consequences of Q-fever increased. The aim of this study was to provide an overview of all relevant available literature, and to identify knowledge gaps regarding the definition, diagnosis, background, description, aetiology, prevention, therapy, and prognosis, of fatigue following acute Q-fever. Design A systematic review was conducted through searching Pubmed, Embase, and PsycInfo for relevant literature up to 26th May 2015. References of included articles were hand searched for additional documents, and included articles were quality assessed. Results Fifty-seven articles were included and four documents classified as grey literature. The quality of most studies was low. The studies suggest that although most patients recover from fatigue within 6–12 months after acute Q-fever, approximately 20% remain chronically fatigued. Several names are used indicating fatigue following acute Q-fever, of which Q-fever fatigue syndrome (QFS) is most customary. Although QFS is described to occur frequently in many countries, a uniform definition is lacking. The studies report major health and work-related consequences, and is frequently accompanied by nonspecific complaints. There is no consensus with regard to aetiology, prevention, treatment, and prognosis. Conclusions Long-term fatigue following acute Q-fever, generally referred to as QFS, has major health-related consequences. However, information on aetiology, prevention, treatment, and prognosis of QFS is underrepresented in the international literature. In order to facilitate comparison of findings, and as platform for future studies, a uniform definition and diagnostic work-up and uniform measurement tools for QFS are proposed. PMID:27223465

    20. Endogenous opioids: role in prostaglandin-dependent and -independent fever.

      Science.gov (United States)

      Fraga, Daniel; Machado, Renes R; Fernandes, Luíz C; Souza, Glória E P; Zampronio, Aleksander R

      2008-02-01

      This study evaluated the participation of mu-opioid-receptor activation in body temperature (T(b)) during normal and febrile conditions (including activation of heat conservation mechanisms) and in different pathways of LPS-induced fever. The intracerebroventricular treatment of male Wistar rats with the selective opioid mu-receptor-antagonist cyclic d-Phe-Cys-Try-d-Trp-Arg-Thr-Pen-Thr-NH(2) (CTAP; 0.1-1.0 microg) reduced fever induced by LPS (5.0 microg/kg) but did not change T(b) at ambient temperatures of either 20 degrees C or 28 degrees C. The subcutaneous, intracerebroventricular, and intrahypothalamic injection of morphine (1.0-10.0 mg/kg, 3.0-30.0 microg, and 1-100 ng, respectively) produced a dose-dependent increase in T(b). Intracerebroventricular morphine also produced a peripheral vasoconstriction. Both effects were abolished by CTAP. CTAP (1.0 microg icv) reduced the fever induced by intracerebroventricular administration of TNF-alpha (250 ng), IL-6 (300 ng), CRF (2.5 microg), endothelin-1 (1.0 pmol), and macrophage inflammatory protein (500 pg) and the first phase of the fever induced by PGF(2alpha) (500.0 ng) but not the fever induced by IL-1beta (3.12 ng) or PGE(2) (125.0 ng) or the second phase of the fever induced by PGF(2alpha). Morphine-induced fever was not modified by the cyclooxygenase (COX) inhibitor indomethacin (2.0 mg/kg). In addition, morphine injection did not induce the expression of COX-2 in the hypothalamus, and CTAP did not modify PGE(2) levels in cerebrospinal fluid or COX-2 expression in the hypothalamus after LPS injection. In conclusion, our results suggest that LPS and endogenous pyrogens (except IL-1beta and prostaglandins) recruit the opioid system to cause a mu-receptor-mediated fever.

    1. 42 CFR 71.3 - Designation of yellow fever vaccination centers; Validation stamps.

      Science.gov (United States)

      2010-10-01

      ... safe, potent, and pure yellow fever vaccine. Medical facilities of Federal agencies are authorized to obtain yellow fever vaccine without being designated as a yellow fever vaccination center by the Director..., storage, and administration of yellow fever vaccine. If a designated center fails to comply with such...

    2. Medical cost of Lassa fever treatment in Irrua Specialist Teaching ...

      African Journals Online (AJOL)

      This cross-sectional study sought to estimate the direct medical cost of Lassa fever treatment on patients in South-South Nigeria. All the 73 confirmed Lassa fever cases admitted in the isolation ward of the Institute Of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital (ISTH) Irrua, in Edo State, Nigeria, ...

    3. Dengue fever: diagnosis and treatment.

      Science.gov (United States)

      Wiwanitkit, Viroj

      2010-07-01

      Dengue fever is a common tropical infection. This acute febrile illness can be a deadly infection in cases of severe manifestation, causing dengue hemorrhagic shock. In this brief article, I will summarize and discuss the diagnosis and treatment of this disease. For diagnosis of dengue, most tropical doctors make use of presumptive diagnosis; however, the definite diagnosis should be based on immunodiagnosis or viral study. Focusing on treatment, symptomatic and supportive treatment is the main therapeutic approach. The role of antiviral drugs in the treatment of dengue fever has been limited, but is currently widely studied.

    4. [Rocky Mountain spotted fever in Brazil].

      Science.gov (United States)

      del Sá DelFiol, Fernando; Junqueira, Fábio Miranda; da Rocha, Maria Carolina Pereira; de Toledo, Maria Inês; Filho, Silvio Barberato

      2010-06-01

      Although the number of confirmed cases of spotted fever has been declining in Brazil since 2005, the mortality rate (20% to 30%) is still high in comparison to other countries. This high mortality rate is closely related to the difficulty in making the diagnosis and starting the correct treatment. Only two groups of antibiotics have proven clinical effectiveness against spotted fever: chloramphenicol and tetracyclines. Until recently, the use of tetracyclines was restricted to adults because of the associated bone and tooth changes in children. Recently, however, the American Academy of Pediatrics and various researchers have recommended the use of doxycycline in children. In more severe cases, chloramphenicol injections are often preferred in Brazil because of the lack of experience with injectable tetracycline. Since early diagnosis and the adequate drug treatment are key to a good prognosis, health care professionals must be better prepared to recognize and treat spotted fever.

    5. Ebola haemorrhagic fever

      Science.gov (United States)

      Feldmann, Heinz; Geisbert, Thomas W

      2012-01-01

      Ebola viruses are the causative agents of a severe form of viral haemorrhagic fever in man, designated Ebola haemorrhagic fever, and are endemic in regions of central Africa. The exception is the species Reston Ebola virus, which has not been associated with human disease and is found in the Philippines. Ebola virus constitutes an important local public health threat in Africa, with a worldwide effect through imported infections and through the fear of misuse for biological terrorism. Ebola virus is thought to also have a detrimental effect on the great ape population in Africa. Case-fatality rates of the African species in man are as high as 90%, with no prophylaxis or treatment available. Ebola virus infections are characterised by immune suppression and a systemic inflammatory response that causes impairment of the vascular, coagulation, and immune systems, leading to multiorgan failure and shock, and thus, in some ways, resembling septic shock. PMID:21084112

    6. Acute cholecystitis in a child with scarlet fever: A rare association

      African Journals Online (AJOL)

      clinical features are exudative pharyngitis, fever and bright red exanthema. Otitis media, pneumonia, septicaemia, osteomyelitis, rheumatic fever and acute glomerulonephritis are the common complications associated with scarlet fever. However, hepatitis and vasculitis are other rare complications described in the literature.

    7. Fever in pregnancy and the risk of congenital malformations

      DEFF Research Database (Denmark)

      Sass, L.; Urhoj, S. K.; Kjærgaard, J.

      2017-01-01

      fetal malformations or death. Fever during pregnancy, especially during embryogenesis, has also been associated with congenital malformations in human offspring. The purpose of this large cohort study of clinically recognized pregnancies was to investigate whether fever during first trimester...... was associated with an increased risk of congenital malformations in the offspring. Methods: The Danish National Birth Cohort is a population-based cohort of 100,418 pregnant women and their offspring recruited in 1996 to 2002. Information on fever during pregnancy was collected prospectively by means of two....... Congenital malformations within the first three and a half years of life were categorized according to EUROCAT's classification criteria. Logistic regression models were used to estimate the associations between fever in first trimester and overall congenital malformations and congenital malformations...

    8. Frequency of splenomegaly in dengue fever in children

      International Nuclear Information System (INIS)

      Javaid, A.; Asghar, M.; Butt, M.A.

      2015-01-01

      Dengue Fever is caused by arthropod born viruses.According to World Health Organization approximately 50-100 million infections of dengue fever occur yearly. Objective of this study was to determine the frequency of splenomegaly in dengue fever in children. Methods: This cross sectional study was conducted at the Department of Paediatrics, Allied Hospital, Faisalabad, during a period from June 2012 to May 2013 by including 93 Children, aged 4-14 years presenting with fever of less than 14 days with thrombocytopenia and positive IgM or IgM and IgG dengue antibodies by ELISA. Patients were thoroughly evaluated by detailed history and clinical examination. Ultrasonography of the patients was performed to confirm the splenomegaly. The data was analysed to determine the frequency and percentage of disease. Results: Out of 93 children, 51 (54.8%) were male and 42 (45.2%) were female. The most common clinical presentation was noted is chills and rigors in 80 (86.02%). Unusual clinical features were encephalopathy in 37 (39.78%) followed by bleeding manifestations and upper respiratory tract infection (upper RTI). Splenomegaly was seen in 45 (48.4%) children. Conclusion: Dengue fever is increasingly presenting with atypical presentation like splenomegaly, encephalopathy, bleeding manifestations and upper RTI. (author)

    9. Rapid diagnostic tests for typhoid and paratyphoid (enteric) fever

      Science.gov (United States)

      Wijedoru, Lalith; Mallett, Sue; Parry, Christopher M

      2017-01-01

      Background Differentiating both typhoid (Salmonella Typhi) and paratyphoid (Salmonella Paratyphi A) infection from other causes of fever in endemic areas is a diagnostic challenge. Although commercial point-of-care rapid diagnostic tests (RDTs) for enteric fever are available as alternatives to the current reference standard test of blood or bone marrow culture, or to the widely used Widal Test, their diagnostic accuracy is unclear. If accurate, they could potentially replace blood culture as the World Health Organization (WHO)-recommended main diagnostic test for enteric fever. Objectives To assess the diagnostic accuracy of commercially available rapid diagnostic tests (RDTs) and prototypes for detecting Salmonella Typhi or Paratyphi A infection in symptomatic persons living in endemic areas. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, Embase, Science Citation Index, IndMED, African Index Medicus, LILACS, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) up to 4 March 2016. We manually searched WHO reports, and papers from international conferences on Salmonella infections. We also contacted test manufacturers to identify studies. Selection criteria We included diagnostic accuracy studies of enteric fever RDTs in patients with fever or with symptoms suggestive of enteric fever living in endemic areas. We classified the reference standard used as either Grade 1 (result from a blood culture and a bone marrow culture) or Grade 2 (result from blood culture and blood polymerase chain reaction, or from blood culture alone). Data collection and analysis Two review authors independently extracted the test result data. We used a modified QUADAS-2 extraction form to assess methodological quality. We performed a meta-analysis when there were sufficient studies for the test and heterogeneity was reasonable. Main results Thirty-seven studies met the inclusion

    10. Outcome of Pediatric Gastroenterology Outpatients With Fever and Central Line.

      Science.gov (United States)

      Alexander, Thomas; Blatt, Julie; Skinner, Asheley Cockrell; Jhaveri, Ravi; Jobson, Meghan; Freeman, Katherine

      2016-11-01

      Although management algorithms for fever and central venous catheters (CVCs) have been implemented for pediatric oncology (PO) patients, management of pediatric outpatients with noncancer diagnoses and CVCs lacks clear protocols. The aim of the study was to assess outcomes for pediatric outpatients with gastrointestinal disorders presenting with fever and CVC. Using a microbiology database and emergency department records, we created a database of pediatric gastroenterology (PGI) and PO outpatients with fever and a CVC who presented to our emergency department or clinics from January 2010 through December 2012. We excluded patients who had severe neutropenia (absolute neutrophil count, gastroenterology outpatients with fever and a CVC have a high prevalence of bloodstream infection. Algorithms for management need to be subspecialty specific. Pediatric gastroenterology patients presenting to emergency departments or clinics with fever and CVC require admission for monitoring and management.

    11. STUDIES ON SOUTH AMERICAN YELLOW FEVER

      Science.gov (United States)

      Davis, Nelson C.; Shannon, Raymond C.

      1929-01-01

      Yellow fever virus from M. rhesus has been inoculated into a South American monkey (Cebus macrocephalus) by blood injection and by bites of infected mosquitoes. The Cebus does not develop the clinical or pathological signs of yellow fever. Nevertheless, the virus persists in the Cebus for a time as shown by the typical symptoms and lesions which develop when the susceptible M. rhesus is inoculated from a Cebus by direct transfer of blood or by mosquito (A. aegypti) transmission. PMID:19869607

    12. Familial Mediterranean Fever: Review of Literature and Report of Two Cases

      Directory of Open Access Journals (Sweden)

      Shama Khan

      2017-12-01

      Full Text Available Familial Mediterranean fever, an autosomal recessive disorder, is a member of the periodic fever syndromes, and considered to be the most common cause of recurrent febrile episodes in children. It is important to understand the disorder as familial Mediterranean fever falls on a spectrum of various presentations; the recurrent episodes of familial Mediterranean fever may be so severe that the quality of life may be affected in such patients. Therefore, physicians should not delay the evaluation in such cases and promptly initiate treatment to not only improve quality of life but to also avoid complications, such as amyloidosis. This study reports two different cases of familial Mediterranean fever, with varying clinical presentations, and established diagnosis via genetic testing as well as cessation of symptoms with a trial of therapy. Furthermore, this study discusses the various manifestations of familial Mediterranean fever, laboratory findings, and current therapies available for management.

    13. Febre amarela Yellow fever

      Directory of Open Access Journals (Sweden)

      Pedro Fernando da Costa Vasconcelos

      2003-04-01

      Full Text Available A febre amarela é doenca infecciosa não-contagiosa causada por um arbovírus mantido em ciclos silvestres em que macacos atuam como hospedeiros amplificadores e mosquitos dos gêneros Aedes na África, e Haemagogus e Sabethes na América, são os transmissores. Cerca de 90% dos casos da doença apresentam-se com formas clínicas benignas que evoluem para a cura, enquanto 10% desenvolvem quadros dramáticos com mortalidade em torno de 50%. O problema mostra-se mais grave em África onde ainda há casos urbanos. Nas Américas, no período de 1970-2001, descreveram-se 4.543 casos. Os países que mais diagnosticaram a doença foram o Peru (51,5%, a Bolívia (20,1% e o Brasil (18,7%. Os métodos diagnósticos utilizados incluem a sorologia (IgM, isolamento viral, imunohistoquímica e RT-PCR. A zoonose não pode ser erradicada, mas, a doença humana é prevenível mediante a vacinação com a amostra 17D do vírus amarílico. A OMS recomenda nova vacinação a cada 10 anos. Neste artigo são revistos os principais conceitos da doença e os casos de mortes associados à vacina.Yellow fever is an infectious and non-contagious disease caused by an arbovirus, the yellow fever virus. The agent is maintained in jungle cycles among primates as vertebrate hosts and mosquitoes, especially Aedes in Africa, and Haemagogus and Sabethes in America. Approximately 90% of the infections are mild or asymptomatic, while 10% course to a severe clinical picture with 50% case-fatality rate. Yellow fever is largely distributed in Africa where urban epidemics are still reported. In South America, between 1970-2001, 4,543 cases were reported, mostly from Peru (51.5%, Bolivia (20.1% and Brazil (18.7%. The disease is diagnosed by serology (detection of IgM, virus isolation, immunohistochemistry and RT-PCR. Yellow fever is a zoonosis and cannot be eradicated, but it is preventable in man by using the 17D vaccine. A single dose is enough to protect an individual for at least

    14. Rheumatic fever associated with antiphospholipid syndrome: systematic review.

      Science.gov (United States)

      da Silva, Felipe; de Carvalho, Jozélio

      2014-01-01

      To evaluate the clinical associations between rheumatic fever and antiphospholipid syndrome and the impact of coexistence of these two diseases in an individual. Systematic review in electronics databases, regarding the period from 1983 to 2012. The keywords: "Rheumatic Fever," "Antiphospholipid Syndrome," and "Antiphospholipid Antibody Syndrome" are used. were identified 11 cases described in the literature about the association of rheumatic fever and antiphospholipid syndrome. Clinical presentation of rheumatic fever was characterized by the predominance of carditis (11/11) and chorea (7/11). Regarding the manifestations of APS, the stroke was observed in 7/11 (63.6%), with one of them having probable embolic origin. The present study brings the information that the association between APS and RF is quite rare, however, is of great clinical importance. Doctors who deal with the RF should include in their differential diagnosis the APS, especially in the presence of stroke in patients with RF and whose echocardiogram does not show intracavitary thrombi.

    15. [Analysis of parental knowledge and care in childhood fever].

      Science.gov (United States)

      Pérez-Conesa, Maria-Cristina; Sánchez Pina, Inés; Ridao Manonellas, Saida; Tormo Esparza, Antoni; García Hernando, Verónica; López Fernández, Marta

      2017-10-01

      To describe the parental knowledge and care of fever in children under 2years. Relate this data with socio-demographic with characteristics. Cross-sectional and correlation multicenter study. Five teams of Primary Care in Barcelona. Parents of children under 2years attended to administer a vaccine included in the pediatric systematic calendar. A total of 311 subjects participated. The main variables are 9 items of knowledge and 8 of care or management of fever obtained with the adaptation of the questionnaire by Chiappini et al. (2012). 69.8% had a correct care/management of fever. 3.9% matched all items of knowledge. The knowledge score is lower in people with no education (p=0.03); higher in Europe and South America and lowest in Asia and Africa (P<.001). 100% of patients that had chronic problems answered correctly all items of fever care (P=.03). It is important to note that the correlation between the scores of knowledge and management is positive (rho=0.15, P=.008). A correct care of fever is observed despite the low knowledge. A good strategy to promote a correct care of febrile child is to do sanitary education with update information and adapted it to parents, focusing on the differences between ethnic groups because they seem to have inaccurate beliefs about fever. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

    16. Transmission of yellow fever vaccine virus through breast-feeding - Brazil, 2009.

      Science.gov (United States)

      2010-02-12

      In April, 2009, the state health department of Rio Grande do Sul, Brazil, was notified by the Cachoeira do Sul municipal health department of a case of meningoencephalitis requiring hospitalization in an infant whose mother recently had received yellow fever vaccine during a postpartum visit. The Field Epidemiology Training Program of the Secretariat of Surveillance in Health of the Brazilian Ministry of Health assisted state and municipal health departments with an investigation. This report summarizes the results of that investigation, which determined that the infant acquired yellow fever vaccine virus through breast-feeding. The mother reported 2 days of headache, malaise, and low fever occurring 5 days after receipt of yellow fever vaccine. The infant, who was exclusively breast-fed, was hospitalized at age 23 days with seizures requiring continuous infusion of intravenous anticonvulsants. The infant received antimicrobial and antiviral treatment for meningoencephalitis. The presence of 17DD yellow fever virus was detected by reverse transcription--polymerase chain reaction (RT-PCR) in the infant's cerebrospinal fluid (CSF); yellow fever--specific immunoglobulin M (IgM) antibodies also were present in serum and CSF. The infant recovered completely, was discharged after 24 days of hospitalization, and has had normal neurodevelopment and growth through age 6 months. The findings in this report provide documentation that yellow fever vaccine virus can be transmitted via breast-feeding. Administration of yellow fever vaccine to breast-feeding women should be avoided except in situations where exposure to yellow fever viruses cannot be avoided or postponed.

    17. Hemophagocytic syndrome in classic dengue fever

      Directory of Open Access Journals (Sweden)

      Sayantan Ray

      2011-01-01

      Full Text Available A 24-year-old previously healthy girl presented with persistent fever, headache, and jaundice. Rapid-test anti-dengue virus IgM antibody was positive but anti-dengue IgG was nonreactive, which is suggestive of primary dengue infection. There was clinical deterioration during empiric antibiotic and symptomatic therapy. Bone marrow examination demonstrated the presence of hemophagocytosis. Diagnosis of dengue fever with virus-associated hemophagocytic syndrome was made according to the diagnostic criteria of the HLH 2004 protocol of the Histiocyte Society. The patient recovered with corticosteroid therapy. A review of literature revealed only a handful of case reports that showed the evidence that this syndrome is caused by dengue virus. Our patient is an interesting case of hemophagocytic syndrome associated with classic dengue fever and contributes an additional case to the existing literature on this topic. This case highlights the need for increased awareness even in infections not typically associated with hemophagocytic syndrome.

    18. Clinical features and patient management of Lujo hemorrhagic fever.

      Directory of Open Access Journals (Sweden)

      Nivesh H Sewlall

      Full Text Available In 2008 a nosocomial outbreak of five cases of viral hemorrhagic fever due to a novel arenavirus, Lujo virus, occurred in Johannesburg, South Africa. Lujo virus is only the second pathogenic arenavirus, after Lassa virus, to be recognized in Africa and the first in over 40 years. Because of the remote, resource-poor, and often politically unstable regions where Lassa fever and other viral hemorrhagic fevers typically occur, there have been few opportunities to undertake in-depth study of their clinical manifestations, transmission dynamics, pathogenesis, or response to treatment options typically available in industrialized countries.We describe the clinical features of five cases of Lujo hemorrhagic fever and summarize their clinical management, as well as providing additional epidemiologic detail regarding the 2008 outbreak. Illness typically began with the abrupt onset of fever, malaise, headache, and myalgias followed successively by sore throat, chest pain, gastrointestinal symptoms, rash, minor hemorrhage, subconjunctival injection, and neck and facial swelling over the first week of illness. No major hemorrhage was noted. Neurological signs were sometimes seen in the late stages. Shock and multi-organ system failure, often with evidence of disseminated intravascular coagulopathy, ensued in the second week, with death in four of the five cases. Distinctive treatment components of the one surviving patient included rapid commencement of the antiviral drug ribavirin and administration of HMG-CoA reductase inhibitors (statins, N-acetylcysteine, and recombinant factor VIIa.Lujo virus causes a clinical syndrome remarkably similar to Lassa fever. Considering the high case-fatality and significant logistical impediments to controlled treatment efficacy trials for viral hemorrhagic fever, it is both logical and ethical to explore the use of the various compounds used in the treatment of the surviving case reported here in future outbreaks

    19. Marburg haemorrhagic fever: recent advances | AdegborO | African ...

      African Journals Online (AJOL)

      With the exception of a vaccine for yellow fever and ribavirin, which is used for treatment of some arenaviral infections, no specific chemotherapy for viral hemorrhagic fever exists. Only supportive treatment is possible The filoviruses, Marburg virus (MARV) and Ebola virus (EBOV), have been associated with hemorrhagic ...

    20. Q fever in infancy: a review of 18 cases.

      Science.gov (United States)

      Richardus, J H; Dumas, A M; Huisman, J; Schaap, G J

      1985-01-01

      Infection with Coxiella burnetti (Q fever) was diagnosed in 18 children younger than 3 years of age in The Netherlands during a 16-month period. The diagnosis was confirmed serologically by means of a complement-fixation test and immunofluorescence for IgM determination. A summary of the clinical, hematologic, serologic and epidemiologic features is given. Four children had relapsing episodes of fever during several months. The problem of childhood infection with C. burnetii, particularly in relation to the possibility of intrauterine infection or infection during birth and in the neonatal period, is discussed. In at least one child of this series, an infection by means of breast feeding was considered likely. Q fever is possibly underdiagnosed in children; it should be considered in children with fever of unknown origin.

    1. Is it time for a new yellow fever vaccine?

      Science.gov (United States)

      Hayes, Edward B

      2010-11-29

      An inexpensive live attenuated vaccine (the 17D vaccine) against yellow fever has been effectively used to prevent yellow fever for more than 70 years. Interest in developing new inactivated vaccines has been spurred by recognition of rare but serious, sometimes fatal adverse events following live virus vaccination. A safer inactivated yellow fever vaccine could be useful for vaccinating people at higher risk of adverse events from the live vaccine, but could also have broader global health utility by lowering the risk-benefit threshold for assuring high levels of yellow fever vaccine coverage. If ongoing trials demonstrate favorable immunogenicity and safety compared to the current vaccine, the practical global health utility of an inactivated vaccine is likely to be determined mostly by cost. Copyright © 2010 Elsevier Ltd. All rights reserved.

    2. Class II malocclusion with accentuated occlusal plane inclination corrected with miniplate: a case report

      Directory of Open Access Journals (Sweden)

      Marcel Marchiori Farret

      Full Text Available ABSTRACT Introduction: A canted occlusal plane presents an unesthetic element of the smile. The correction of this asymmetry has been typically considered difficult by orthodontists, as it requires complex mechanics and may sometimes even require orthognathic surgery. Objective: This paper outlines the case of a 29-year-old woman with Class II malocclusion, pronounced midline deviation and accentuated occlusal plane inclination caused by mandibular deciduous molar ankylosis. Methods: The patient was treated with a miniplate used to provide anchorage in order to intrude maxillary teeth and extrude mandibular teeth on one side, thus eliminating asymmetry. Class II was corrected on the left side by means of distalization, anchored in the miniplate as well. On the right side, maxillary first premolar was extracted and molar relationship was kept in Class II, while canines were moved to Class I relationship. The patient received implant-prosthetic rehabilitation for maxillary left lateral incisor and mandibular left second premolar. Results: At the end of treatment, Class II was corrected, midlines were matched and the canted occlusal plane was totally corrected, thereby improving smile function and esthetics.

    3. Clinical and Haematological Manifestations of Typhoid Fever in Children in Eastern Turkey.

      Science.gov (United States)

      Akbayram, S; Parlak, M; Dogan, M; Karasin, G; Akbayram, H T; Karaman, K

      2016-01-12

      Typhoid fever can involve various organs, leading to a wide range of presentations: from uncomplicated to complicated typhoid fever. The haematological changes are common in typhoid fever and include anaemia, leucopaenia, thrombocytopaenia and bleeding diathesis. This study was undertaken in order to determine the clinical and haematological presentation of typhoid fever in children. In this study, records of children and adolescents with typhoid fever aged under or equal to 16 years, admitted to Yuzuncu Yil University Hospital between 2010 and 2014, were analysed retrospectively. The cases (56%) were admitted to our hospital in July and October. Major symptoms of patients were abdominal pain (24%), arthralgia (21%) and fever (11%). In our study, decreased mean platelet volume (31%), eosinopaenia 20%), abnormal platelet count (19%), anaemia (16%), leucocytosis (16%) and eosinophilia (12%) were the most common haematological findings in the children. Typhoid fever is predominant in children at school age with a slight male predominance. Decreased mean platelet volume and abdominal pain might be useful as early diagnostic clues.

    4. Fundus Findings in Dengue Fever: A Case Report

      Directory of Open Access Journals (Sweden)

      Berna Şahan

      2015-10-01

      Full Text Available Dengue fever is a flavivirus infection transmitted through infected mosquitoes, and is endemic in Southeast Asia, Central and South America, the Pacific, Africa and the Eastern Mediterranean region. A 41-year-old male patient had visual impairment after travelling to Thailand, which is one of the endemic areas. Cotton wool spots were observed on fundus examination. Fundus fluorescein angiography showed minimal vascular leakage from areas near the cotton wool spots and dot hemorrhages in the macula. Dengue fever should be considered in patients with visual complaints who traveled to endemic areas of dengue fever. (Turk J Ophthalmol 2015; 45: 223-225

    5. Celiac Disease Presenting as Fever of Unknown Origin

      Directory of Open Access Journals (Sweden)

      Megan J. Cooney

      2013-01-01

      Full Text Available Celiac disease (CD is a common autoimmune enteropathy that occurs, in affected individuals, with exposure to gluten in the diet and improves with removal of dietary gluten. Although CD is readily considered in patients with classical presentations of the disease, atypical manifestations may be the only presenting symptoms. We present a case of CD in a 16-year-old female presenting as fever of unknown origin, which has not been reported previously. The postulated mechanism for fever in CD and the importance of clinicians having a low threshold for considering CD in the differential diagnosis of fever of unknown origin and other enigmatic clinical presentations is discussed.

    6. Serologic assessment of yellow fever immunity in the rural population of a yellow fever-endemic area in Central Brazil

      Directory of Open Access Journals (Sweden)

      Vanessa Wolff Machado

      2013-04-01

      Full Text Available Introduction The yellow fever epidemic that occurred in 1972/73 in Central Brazil surprised the majority of the population unprotected. A clinical-epidemiological survey conducted at that time in the rural area of 19 municipalities found that the highest (13.8% number of disease cases were present in the municipality of Luziânia, State of Goiás. Methods Thirty-eight years later, a new seroepidemiological survey was conducted with the aim of assessing the degree of immune protection of the rural population of Luziânia, following the continuous attempts of public health services to obtain vaccination coverage in the region. A total of 383 volunteers, aged between 5 and 89 years and with predominant rural labor activities (75.5%, were interviewed. The presence of antibodies against the yellow fever was also investigated in these individuals, by using plaque reduction neutralization test, and correlated to information regarding residency, occupation, epidemiological data and immunity against the yellow fever virus. Results We found a high (97.6% frequency of protective titers (>1:10 of neutralizing antibodies against the yellow fever virus; the frequency of titers of 1:640 or higher was 23.2%, indicating wide immune protection against the disease in the study population. The presence of protective immunity was correlated to increasing age. Conclusions This study reinforces the importance of surveys to address the immune state of a population at risk for yellow fever infection and to the surveillance of actions to control the disease in endemic areas.

    7. Transmural endoscopic necrosectomy of infected pancreatic necroses and drainage of infected pseudocysts: a tailored approach.

      Science.gov (United States)

      Rische, Susanne; Riecken, Bettina; Degenkolb, Johannes; Kayser, Thomas; Caca, Karel

      2013-02-01

      Transmural endoscopic drainage and necrosectomy have become favored treatment modes for infected pancreatic pseudocysts and necroses. In this analysis, we summarize the outcome of 40 patients with complicated course of acute pancreatitis after endoscopic treatment. From January 2006 through May 2011, 40 patients of our department with complicated pancreatitis were included in this retrospective analysis. All patients underwent endosonographic transgastric puncture followed by wire-guided insertion of one or more double pigtail stents. Patients with extensive necroses were treated repeatedly with transgastric necrosectomy. Treatment success was determined by clinical, laboratory, and radiological parameters. Nine patients had interstitial pancreatitis (IP) with pancreatic pseudocysts. Thirty-one patients had necrotizing pancreatitis (NP) with acute pancreatic necroses (n = 4) or walled-off pancreatic necrosis (n = 27). All patients with IP and nine patients with NP had pseudocysts without solid material and underwent transgastric drainage only. In this group major complications occurred in 11.1% and no mortality was observed. Twenty-two NP patients were treated with additional repeated necrosectomy. In patients with localized peripancreatic necroses (n = 10) no need of surgery or mortality was observed, major complications occurred in 10%. In patients with extensive necroses reaching the lower abdomen (n = 12), three needed subsequent surgery and three died. Transgastric endoscopy is an effective minimally invasive procedure even in patients with advanced pancreatic necroses. Complication rate is low particularly in patients with sole pseudocysts or localized necroses. The extent of the fluid collections and necroses is a new predictive parameter for the outcome of the patients.

    8. Fever in trauma patients: evaluation of risk factors, including traumatic brain injury.

      Science.gov (United States)

      Bengualid, Victoria; Talari, Goutham; Rubin, David; Albaeni, Aiham; Ciubotaru, Ronald L; Berger, Judith

      2015-03-01

      The role of fever in trauma patients remains unclear. Fever occurs as a response to release of cytokines and prostaglandins by white blood cells. Many factors, including trauma, can trigger release of these factors. To determine whether (1) fever in the first 48 hours is related to a favorable outcome in trauma patients and (2) fever is more common in patients with head trauma. Retrospective study of trauma patients admitted to the intensive care unit for at least 2 days. Data were analyzed by using multivariate analysis. Of 162 patients studied, 40% had fever during the first 48 hours. Febrile patients had higher mortality rates than did afebrile patients. When adjusted for severity of injuries, fever did not correlate with mortality. Neither the incidence of fever in the first 48 hours after admission to the intensive care unit nor the number of days febrile in the unit differed between patients with and patients without head trauma (traumatic brain injury). About 70% of febrile patients did not have a source found for their fever. Febrile patients without an identified source of infection had lower peak white blood cell counts, lower maximum body temperature, and higher minimum platelet counts than did febrile patients who had an infectious source identified. The most common infection was pneumonia. No relationship was found between the presence of fever during the first 48 hours and mortality. Patients with traumatic brain injury did not have a higher incidence of fever than did patients without traumatic brain injury. About 30% of febrile patients had an identifiable source of infection. Further studies are needed to understand the origin and role of fever in trauma patients. ©2015 American Association of Critical-Care Nurses.

    9. Fever of unknown origin

      International Nuclear Information System (INIS)

      Misaki, Takashi; Matsui, Akira; Tanaka, Fumiko; Okuno, Yoshishige; Mitsumori, Michihide; Torizuka, Tatsurou; Dokoh, Shigeharu; Hayakawa, Katsumi; Shimbo, Shin-ichirou

      1990-01-01

      Gallium-67 scintigraphy is a commonly performed imaging modality in deteting pyrogenic lesions in cases of long-standing inexplainable fever. To re-evaluate the significance of gallium imaging in such cases, a retrospective review was made of 56 scans performed in febrile patients in whom sufficient clinical and laboratory findings were obtained. Gallium scans were true positive in 30 patients, false positive in 3, true negative in 19, and false negative in 4. In the group of true positive, local inflammatory lesions were detected in 23 patients with a final diagnosis of lung tuberculosis, urinary tract infection, and inflammatory joint disease. Abnormal gallium accumulation, as shown in the other 7 patients, provided clues to the diagnosis of generalized disorders, such as hematological malignancies (n=3), systemic autoimmune diseases (n=3), and severe infectious mononucleosis (n=one). In the group of false positive, gallium imaging revealed intestinal excretion of gallium in 2 patients and physiological pulmonary hilar accumulation in one. In the true negative group of 19 patients, fever of unknown origin was resolved spontaneously in 12 patients, and with antibiotics and corticosteroids in 2 and 5 patients, respectively. Four patients having false negative scans were finally diagnosed as having urinary tract infection (n=2), bacterial meningitis (n=one), and polyarteritis (n=one). Gallium imaging would remain the technique of choice in searching for origin of unknown fever. It may also be useful for early diagnosis of systemic disease, as well as focal inflammation. (N.K.)

    10. Public health importance of lassa fever epidemiology, clinical ...

      African Journals Online (AJOL)

      The public health importance of Lassa fever can not be over emphasized if one considers the high infectivity and mortality rates associated with the disease. This study dealt extensively on the epidemiology, clinical features and current management of Lassa fever through literature review. The aim of this study is to sensitise ...

    11. Typhoid Fever Complicated by Hemophagocytic Lymphohistiocytosis and Rhabdomyolysis.

      Science.gov (United States)

      Non, Lemuel R; Patel, Rupa; Esmaeeli, Amir; Despotovic, Vladimir

      2015-11-01

      Hemophagocytic lymphohistiocytosis (HLH) and rhabdomyolysis are rare complications of typhoid fever from Salmonella enterica serovar Typhi. Herein, we describe the clinical features in a 21-year-old female from India who presented to the intensive care unit with fever, severe pancytopenia, and rhabdomyolysis. © The American Society of Tropical Medicine and Hygiene.

    12. [Alarm symptoms of meningitis in children with fever].

      NARCIS (Netherlands)

      D.H.F. Geurts (Dorien); H.A. Moll (Henriëtte)

      2011-01-01

      textabstractA 15-year-old girl presented with fever and pain in her legs. A viral infection was suspected, but within 24 hours she became confused and developed meningeal signs, based on which she was diagnosed as having meningitis. Within a few hours a 6-month-old boy developed fever, a grey

    13. [Marburg and Ebola hemorrhagic fevers--pathogens, epidemiology and therapy].

      Science.gov (United States)

      Stock, Ingo

      2014-09-01

      Marburg and Ebola hemorrhagic fevers are severe, systemic viral diseases affecting humans and non-human primates. They are characterized by multiple symptoms such as hemorrhages, fever, headache, muscle and abdominal pain, chills, sore throat, nausea, vomiting and diarrhea. Elevated liver-associated enzyme levels and coagulopathy are also associated with these diseases. Marburg and Ebola hemorrhagic fevers are caused by (Lake victoria) Marburg virus and different species of Ebola viruses, respectively. They are enveloped, single-stranded RNA viruses and belong to the family of filoviridae. Case fatality rates of filovirus disease outbreaks are among the highest reported for any human pathogen, ranging from 25 to 90% or more. Outbreaks of Marburg and Ebola hemorrhagic fever occur in certain regions of equatorial Africa at irregular intervals. Since 2000, the number of outbreaks has increased. In 2014, the biggest outbreak of a filovirus-induced hemorrhagic fever that has been documented so far occurred from March to July 2014 in Guinea, Sierra Leone, Liberia and Nigeria. The outbreak was caused by a new variant of Zaire Ebola-Virus, affected more than 2600 people (stated 20 August) and was associated with case-fatality rates of up to 67% (Guinea). Treatment of Marburg and Ebola hemorrhagic fevers is symptomatic and supportive, licensed antiviral agents are currently not available. Recently, BCX4430, a promising synthetic adenosine analogue with high in vitro and in vivo activity against filoviruses and other RNA viruses, has been described. BCX4430 inhibits viral RNA polymerase activity and protects cynomolgus macaques from Marburg virus infection when administered as late as 48 hours after infection. Nucleic acid-based products, recombinant vaccines and antibodies appear to be less suitable for the treatment of Marburg and Ebola hemorrhagic fevers.

    14. Q fever in Spain: Description of a new series, and systematic review.

      Science.gov (United States)

      Alende-Castro, Vanesa; Macía-Rodríguez, Cristina; Novo-Veleiro, Ignacio; García-Fernández, Xana; Treviño-Castellano, Mercedes; Rodríguez-Fernández, Sergio; González-Quintela, Arturo

      2018-03-01

      Forms of presentation of Q fever vary widely across Spain, with differences between the north and south. In the absence of reported case series from Galicia (north-west Spain), this study sought to describe a Q-fever case series in this region for the first time, and conduct a systematic review to analyse all available data on the disease in Spain. Patients with positive serum antibodies to Coxiella burnetii from a single institution over a 5-year period (January 2011-December 2015) were included. Patients with phase II titres above 1/128 (or documented seroconversion) and compatible clinical criterial were considered as having Q fever. Patients with clinical suspicion of chronic Q-fever and IgG antibodies to phase I-antigen of over 1/1024, or persistently high levels six months after treatment were considered to be cases of probable chronic Q-fever. Systematic review: We conducted a search of the Pubmed/Medline database using the terms: Q Fever OR Coxiella burnetii AND Spain. Our search yielded a total of 318 studies: 244 were excluded because they failed to match the main criteria, and 41 were discarded due to methodological problems, incomplete information or duplication. Finally, 33 studies were included. A total of 155 patients, all of them from Galicia, with positive serological determination were located during the study period; 116 (75%) were deemed to be serologically positive patients without Q fever and the remaining 39 (25%) were diagnosed with Q fever. A potential exposure risk was found in 2 patients (5%). The most frequent form of presentation was pneumonia (87%), followed by isolated fever (5%), diarrhoea (5%) and endocarditis (3%). The main symptoms were headache (100%), cough (77%) and fever (69%). A trend to a paucisymptomatic illness was observed in women. Hospital admission was required in 37 cases, and 6 patients died while in hospital. Only 2 patients developed chronic Q-fever. Systematic review: Most cases were sporadic, mainly presented

    15. Anamnestic immune response to dengue and decreased severity of yellow fever

      Directory of Open Access Journals (Sweden)

      Ricardo O Izurieta

      2009-01-01

      Full Text Available A protective immunity against yellow fever, from cross-reactive dengue antibodies, has been hypothesized as an explanation for the absence of yellow fever in Southern Asia where dengue immunity is almost universal. This study evaluates the association between protective immunity from cross-reactive dengue antibodies with yellow fever infection and severity of the disease. The study population consisted of military personnel of a jungle garrison and its detachments located in the Ecuadorian Amazonian rainforest. The cross-sectional study employed interviews as well as seroepidemiological methods. Humoral immune response to yellow fever, Mayaro, Venezuelan equine encephalitis, Oropouche, and dengue 2 infections was assessed by evaluating IgM and IgG specific antibodies. Log-linear regression analysis was used to evaluate age and presence of antibodies, against dengue type 2 virus, as predictors of yellow fever infection or severe disease. During the seroepidemiological survey, presence of dengue antibodies among yellow fever cases were observed in 77.3% cases from the coastal region, where dengue is endemic, 14.3% cases from the Amazon and 16.7 % cases from the Andean region. Dengue cross-reactive antibodies were not significantly associated with yellow fever infection but significantly associated with severity of the disease. The findings of this study suggest that previous exposure to dengue infection may have induced an anamnestic immune response that did not prevent yellow fever infection but greatly reduced the severity of the disease.

    16. Secondary bacteraemia in adult patients with prolonged dengue fever.

      Science.gov (United States)

      Premaratna, R; Dissanayake, D; Silva, F H D S; Dassanayake, M; de Silva, H J

      2015-03-01

      Although dengue management guidelines do not advice on use of antibiotics in dengue shock syndrome, unrecognised bactraemia is likely to contribute to morbidity and mortality. To assess the occurance of secondary bacteraemia in adult patients with prolonged dengue fever. A prospective study was conducted recruiting patients with confirmed acute dengue infection who had prolonged fever (>5 days). Two sets of blood cultures were taken in such patients prior to institution of antibiotic therapy. Demographic, clinical, haematological and biochemical parameters were recorded. Development of ascites and pleural effusions were detected using ultrasonography. Fourty patients (52.5% males) with a mean age of 29.8 years (SD 13.6) were studied. The average duration of fever was 7.9 days (SD 1.8). Ten patients (25%) had bacterial isolates in their blood cultures; Staphylococcus aureus (n=2), coliforms (n=3), pseudomonas (n=1) and 4 had mixed growths. The culture positive group had severe body aches at admission and higher fever, third space fluid accumulation, a significant drop in platelets and a higher CRP. A quarter of dengue patients with prolonged fever had a bacterial isolate. Culture positive patients appeared more ill with body aches and had higher degrees of fever during the latter part of the illness. Increased vascular permeability may predispose to bacterial seepage into blood. Although white cell count is not helpful in detecting bacteraemia, low platelet count and elevation of CRP seem to be helpful.

    17. Seroprevalence of Q fever in Goats in the Sudan

      Directory of Open Access Journals (Sweden)

      Diaeldin A Salih

      Full Text Available Aim: The survey was carried out to detect anti- C. burnetii antibodies in goat's sera samples in eight States in the Sudan during September 2010 – July 2011. Materials and Methods: In a preliminary study, four hundred and sixty caprine sera samples collected from eight States in the Sudan were screened for anti- Coxiella burnetii (the causative agent of Q fever antibodies using a commercial indirect ELISA (iELISA kit. Results: The results showed an overall prevalence rate 24.22% of Q fever antibodies. The prevalence rate of antibodies ranged from 6.7% in Kassala to 40% in South Darfur. The prevalence rates were highest in South Darfur (40% and South Kordofan (34.7%, moderate in El Gazira (29.7%, Khartoum (29.1%, the Northern (24% and the River Nile (20.2% States. It was lowest in the White Nile (7.5% and Kassala (6.7% States. Conclusion: It could be concluded that Q fever is prevalent in goats in the Sudan. Therefore, further epizootiological investigations on Q fever in other farm animals and man at the country level is important to monitor and determine the magnitude of Q fever infection in order to estimate its economic impact on animal industry and its public health hazard in the Sudan. In addition, the impact of Q fever among shepherds should be studied. [Vet. World 2012; 5(7.000: 394-397

    18. Comparison of sampling techniques for Rift Valley Fever virus ...

      African Journals Online (AJOL)

      time for trapping potential vectors for Rift Valley Fever virus. ..... Krockel, U., Rose, A., Eiras, A.E. & Geier, M. (2006) New tools for surveillance of adult yellow fever ... baited trapping systems for sampling outdoor mosquito populations in ...

    19. Q fever outbreak in the terraced vineyards of Lavaux, Switzerland

      Directory of Open Access Journals (Sweden)

      C. Bellini

      2014-07-01

      Full Text Available Coxiella burnetii infection (Q fever is a widespread zoonosis with low endemicity in Switzerland, therefore no mandatory public report was required. A cluster of initially ten human cases of acute Q fever infections characterized by prolonged fever, asthenia and mild hepatitis occurred in 2012 in the terraced vineyard of Lavaux. Epidemiological investigations based on patients’ interviews and veterinary investigations included environmental sampling as well as Coxiella-specific serological assay and molecular examinations (real-time PCR in vaginal secretions of suspected sheep. These investigations demonstrated that 43% of sheep carried the bacteria whereas 30% exhibited anti-Coxiella antibodies. Mitigation measures, including limiting human contacts with the flock, hygiene measures, flock vaccination and a public official alert, have permitted the detection of four additional human cases and the avoidance of a much larger outbreak. Since November 2012, mandatory reporting of Q fever to Swiss public health authorities has been reintroduced. A close follow up of human cases will be necessary to identify chronic Q fever.

    20. What a rheumatologist needs to know about yellow fever vaccine.

      Science.gov (United States)

      Oliveira, Ana Cristina Vanderley; Mota, Licia Maria Henrique da; Santos-Neto, Leopoldo Luiz Dos; Tauil, Pedro Luiz

      2013-04-01

      Patients with rheumatic diseases are more susceptible to infection, due to the underlying disease itself or to its treatment. The rheumatologist should prevent infections in those patients, vaccination being one preventive measure to be adopted. Yellow fever is one of such infectious diseases that can be avoided.The yellow fever vaccine is safe and effective for the general population, but, being an attenuated live virus vaccine, it should be avoided whenever possible in rheumatic patients on immunosuppressive drugs. Considering that yellow fever is endemic in a large area of Brazil, and that vaccination against that disease is indicated for those living in such area or travelling there, rheumatologists need to know that disease, as well as the indications for the yellow fever vaccine and contraindications to it. Our paper was aimed at highlighting the major aspects rheumatologists need to know about the yellow fever vaccine to decide about its indication or contraindication in specific situations. 2013 Elsevier Editora Ltda. All rights reserved.

    1. Yellow Fever Outbreaks in Unvaccinated Populations, Brazil, 2008–2009

      Science.gov (United States)

      Romano, Alessandro Pecego Martins; Costa, Zouraide Guerra Antunes; Ramos, Daniel Garkauskas; Andrade, Maria Auxiliadora; Jayme, Valéria de Sá; de Almeida, Marco Antônio Barreto; Vettorello, Kátia Campomar; Mascheretti, Melissa; Flannery, Brendan

      2014-01-01

      Due to the risk of severe vaccine-associated adverse events, yellow fever vaccination in Brazil is only recommended in areas considered at risk for disease. From September 2008 through June 2009, two outbreaks of yellow fever in previously unvaccinated populations resulted in 21 confirmed cases with 9 deaths (case-fatality, 43%) in the southern state of Rio Grande do Sul and 28 cases with 11 deaths (39%) in Sao Paulo state. Epizootic deaths of non-human primates were reported before and during the outbreak. Over 5.5 million doses of yellow fever vaccine were administered in the two most affected states. Vaccine-associated adverse events were associated with six deaths due to acute viscerotropic disease (0.8 deaths per million doses administered) and 45 cases of acute neurotropic disease (5.6 per million doses administered). Yellow fever vaccine recommendations were revised to include areas in Brazil previously not considered at risk for yellow fever. PMID:24625634

    2. [Q fever. Description of a case].

      Science.gov (United States)

      Peña-Irún, Á; González Santamaría, A R; Munguía Rozadilla, F; Herrero González, J L

      2013-01-01

      Q fever is a zoonosis of global distribution with an incidence of 3 cases per 100,000 inhabitants/year. A variety of animals can be the coxiella reservoir which always must be taken into account when faced with a fever process in a compatible context. Rapid diagnosis and treatment are essential to improve the prognosis, and prevent the development of chronic infection or other potential complications associated with the coxelliosis. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

    3. [The fourth horseman: The yellow fever].

      Science.gov (United States)

      Vallejos-Parás, Alfonso; Cabrera-Gaytán, David Alejandro

      2017-01-01

      Dengue virus three, Chikunguya and Zika have entered the national territory through the south of the country. Cases and outbreaks of yellow fever have now been identified in the Americas where it threatens to expand. Although Mexico has a robust epidemiological surveillance system for vector-borne diseases, our country must be alert in case of its possible introduction into the national territory. This paper presents theoretical assumptions based on factual data on the behavior of yellow fever in the Americas, as well as reflections on the epidemiological surveillance of vector-borne diseases.

    4. Biomagnetic Pair Therapy and Typhoid Fever: A Pilot Study.

      Science.gov (United States)

      Frank, Bryan L

      2017-10-01

      Objective: This pilot study examined the laboratory responses of patients with laboratory-documented typhoid fever who were treated with Biomagnetic Pair Therapy (BPT; medical biomagnetism), a specific application of pairs of magnets for various ailments that are infectious and otherwise. Materials and Methods: This study was an assessment of patients' response to treatment with only BPT for Salmonella typhi infections (typhoid fever) using standard conventional laboratory techniques. The research was conducted in an outpatient village clinic in Kenya. There were 52 participants who were evaluated for possible systemic illness, including typhoid fever, from an open-label study. Participants who felt sick and requested testing for possible typhoid fever were tested with a standard Widal test by a certified laboratory technician. Participants who tested positive (13 patients) were then treated with BPT (a "First Aid" approach) only. These participants then returned for follow-up laboratory and clinical evaluations after 2 days. Results: Most of the participants (10 of 13) retested as negative, and all patients reported symptomatic clinical improvement. Conclusions: As a significant majority of participants demonstrated clearing of their S. typhi after BPT, this technique should be studied further in larger trials for its efficacy in treating typhoid fever.

    5. Fever: Views in Anthroposophic Medicine and Their Scientific Validity

      Directory of Open Access Journals (Sweden)

      David D. Martin

      2016-01-01

      Full Text Available Objective. To conduct a scoping review to characterize how fever is viewed in anthroposophic medicine (AM and discuss the scientific validity of these views. Methods. Systematic searches were run in Medline, Embase, CAMbase, and Google Scholar. Material from anthroposophic medical textbooks and articles was also used. Data was extracted and interpreted. Results. Most of the anthroposophic literature on this subject is in the German language. Anthroposophic physicians hold a beneficial view on fever, rarely suppress fever with antipyretics, and often use complementary means of alleviating discomfort. In AM, fever is considered to have the following potential benefits: promoting more complete recovery; preventing infection recurrences and atopic diseases; providing a unique opportunity for caregivers to provide loving care; facilitating individual development and resilience; protecting against cancer and boosting the anticancer effects of mistletoe products. These views are discussed with regard to the available scientific data. Conclusion. AM postulates that fever can be of short-term and long-term benefit in several ways; many of these opinions have become evidence-based (though still often not practiced while others still need empirical studies to be validated, refuted, or modified.

    6. Psychogenic fever in a patient with small cell lung cancer: a case report

      International Nuclear Information System (INIS)

      Xu, Mengdan; Zhang, Xiaoye; Xu, Zhaoguo; Cui, Guoyuan; Yu, Li; Qi, Xiaoying; Lin, Jia; Liu, Yan

      2015-01-01

      Fever is common in malignant tumors. We report an exceptional case of psychogenic fever in a patient with small cell lung cancer. This is the first case report of psychogenic fever in a patient with small cell lung cancer. A 61-year-old Chinese man diagnosed with small cell carcinoma on June 30, 2012, came to our department with a complaint of fever lasting more than 1 month. He had undergone chemoradiotherapy for lung cancer 6 months previously. After admission, his body temperature fluctuated in the range of 37 °C to 39 °C. Somatic symptoms associated with anxiety were obvious. A 24-item Hamilton Anxiety Scale was used to assess the patient’s condition. A score of 32 confirmed a diagnosis of severe anxiety. After a week of antianxiety treatment, the patient’s temperature returned to normal. Psychogenic fever is common in cancer patients and deserves more attention. Patients with psychogenic fever must be distinguished from patients with infectious fever (including neutropenic fever), and tumor fever. Additionally, antianxiety or antidepression treatment should be provided. A concern is that continual anxiety may adversely affect anticancer therapy

    7. Seasonal Allergies (Hay Fever)

      Science.gov (United States)

      ... Safe Videos for Educators Search English Español Seasonal Allergies (Hay Fever) KidsHealth / For Parents / Seasonal Allergies (Hay ... español Alergia estacional (fiebre del heno) About Seasonal Allergies "Achoo!" It's your son's third sneezing fit of ...

    8. Spotted fever rickettsiosis in Coronel Fabriciano, Minas Gerais State

      Directory of Open Access Journals (Sweden)

      Galvão Márcio Antônio Moreira

      2003-01-01

      Full Text Available We report cases of spotted fever rickettsiosis in Coronel Fabriciano Municipality of Minas Gerais State, Brazil. The cases occurred in May and June of 2000. During this period there were two deaths among children from an area named Pedreira in a periurban area of this municipality. In a boy who died with clinical manifestations of Brazilian spotted fever, a necropsy revealed the presence of a spotted fever group Rickettsia. The serological results confirm the difficulty in the differential diagnosis of patients with symptoms of rickettsial diseases.

    9. Acute gingival bleeding as a complication of dengue hemorrhagic fever

      Directory of Open Access Journals (Sweden)

      Saif Khan

      2013-01-01

      Full Text Available Dengue fever is mosquito borne disease caused by dengue virus (DENV of Flaviviridae family. The clinical manifestations range from fever to severe hemorrhage, shock and death. Here, we report a case of 20-year-old male patient undergoing orthodontic treatment presenting with acute gingival bleeding with a history of fever, weakness, backache, retro orbital pain and ecchymosis over his right arm. The hematological investigations revealed anemia, thrombocytopenia and positive dengue non-structural protein-1 antigen and also positive immunoglobulin M and immunoglobulin G antibodies for DENV. Patient was diagnosed as a case of dengue hemorrhagic fever and was immediately referred for appropriate management. This case report emphasizes the importance of taking correct and thorough medical history.

    10. Fever and sickness behavior: Friend or foe?

      Science.gov (United States)

      Harden, L M; Kent, S; Pittman, Q J; Roth, J

      2015-11-01

      Fever has been recognized as an important symptom of disease since ancient times. For many years, fever was treated as a putative life-threatening phenomenon. More recently, it has been recognized as an important part of the body's defense mechanisms; indeed at times it has even been used as a therapeutic agent. The knowledge of the functional role of the central nervous system in the genesis of fever has greatly improved over the last decade. It is clear that the febrile process, which develops in the sick individual, is just one of many brain-controlled sickness symptoms. Not only will the sick individual appear "feverish" but they may also display a range of behavioral changes, such as anorexia, fatigue, loss of interest in usual daily activities, social withdrawal, listlessness or malaise, hyperalgesia, sleep disturbances and cognitive dysfunction, collectively termed "sickness behavior". In this review we consider the issue of whether fever and sickness behaviors are friend or foe during: a critical illness, the common cold or influenza, in pregnancy and in the newborn. Deciding whether these sickness responses are beneficial or harmful will very much shape our approach to the use of antipyretics during illness. Copyright © 2015 Elsevier Inc. All rights reserved.

    11. African Swine Fever Virus Biology and Vaccine Approaches.

      Science.gov (United States)

      Revilla, Yolanda; Pérez-Núñez, Daniel; Richt, Juergen A

      2018-01-01

      African swine fever (ASF) is an acute and often fatal disease affecting domestic pigs and wild boar, with severe economic consequences for affected countries. ASF is endemic in sub-Saharan Africa and the island of Sardinia, Italy. Since 2007, the virus emerged in the republic of Georgia, and since then spread throughout the Caucasus region and Russia. Outbreaks have also been reported in Belarus, Ukraine, Lithuania, Latvia, Estonia, Romania, Moldova, Czech Republic, and Poland, threatening neighboring West European countries. The causative agent, the African swine fever virus (ASFV), is a large, enveloped, double-stranded DNA virus that enters the cell by macropinocytosis and a clathrin-dependent mechanism. African Swine Fever Virus is able to interfere with various cellular signaling pathways resulting in immunomodulation, thus making the development of an efficacious vaccine very challenging. Inactivated preparations of African Swine Fever Virus do not confer protection, and the role of antibodies in protection remains unclear. The use of live-attenuated vaccines, although rendering suitable levels of protection, presents difficulties due to safety and side effects in the vaccinated animals. Several African Swine Fever Virus proteins have been reported to induce neutralizing antibodies in immunized pigs, and vaccination strategies based on DNA vaccines and recombinant proteins have also been explored, however, without being very successful. The complexity of the virus particle and the ability of the virus to modulate host immune responses are most likely the reason for this failure. Furthermore, no permanent cell lines able to sustain productive virus infection by both virulent and naturally attenuated African Swine Fever Virus strains exist so far, thus impairing basic research and the commercial production of attenuated vaccine candidates. © 2018 Elsevier Inc. All rights reserved.

    12. Dipyrone metabolite 4-MAA induces hypothermia and inhibits PGE2 -dependent and -independent fever while 4-AA only blocks PGE2 -dependent fever.

      Science.gov (United States)

      Malvar, David do C; Aguiar, Fernando A; Vaz, Artur de L L; Assis, Débora C R; de Melo, Miriam C C; Jabor, Valquíria A P; Kalapothakis, Evanguedes; Ferreira, Sérgio H; Clososki, Giuliano C; de Souza, Glória E P

      2014-08-01

      The antipyretic and hypothermic prodrug dipyrone prevents PGE2 -dependent and -independent fever induced by LPS from Escherichia coli and Tityus serrulatus venom (Tsv) respectively. We aimed to identify the dipyrone metabolites responsible for the antipyretic and hypothermic effects. Male Wistar rats were treated i.p. with indomethacin (2 mg·kg(-1) ), dipyrone, 4-methylaminoantipyrine (4-MAA), 4-aminoantipyrine (4-AA) (60-360 mg·kg(-1) ), 4-formylaminoantipyrine, 4-acethylaminoantipyrine (120-360 mg·kg(-1) ) or vehicle 30 min before i.p. injection of LPS (50 μg·kg(-1) ), Tsv (150 μg·kg(-1) ) or saline. Rectal temperatures were measured by tele-thermometry and dipyrone metabolite concentrations determined in the plasma, CSF and hypothalamus by LC-MS/MS. PGE2 concentrations were determined in the CSF and hypothalamus by elisa. In contrast to LPS, Tsv-induced fever was not followed by increased PGE2 in the CSF or hypothalamus. The antipyretic time-course of 4-MAA and 4-AA on LPS-induced fever overlapped with the period of the highest concentrations of 4-MAA and 4-AA in the hypothalamus, CSF and plasma. These metabolites reduced LPS-induced fever and the PGE2 increase in the plasma, CSF and hypothalamus. Only 4-MAA inhibited Tsv-induced fever. The higher doses of dipyrone and 4-MAA also induced hypothermia. The presence of 4-MAA and 4-AA in the CSF and hypothalamus was associated with PGE2 synthesis inhibition and a decrease in LPS-induced fever. 4-MAA was also shown to be an antipyretic metabolite for PGE2 -independent fever induced by Tsv suggesting that it is responsible for the additional antipyretic mechanism of dipyrone. Moreover, 4-MAA is the hypothermic metabolite of dipyrone. © 2014 The British Pharmacological Society.

    13. Serious adverse events associated with yellow fever vaccine.

      Science.gov (United States)

      de Menezes Martins, Reinaldo; Fernandes Leal, Maria da Luz; Homma, Akira

      2015-01-01

      Yellow fever vaccine was considered one of the safest vaccines, but in recent years it was found that it could rarely cause invasive and disseminated disease in some otherwise healthy individuals, with high lethality. After extensive studies, although some risk factors have been identified, the real cause of causes of this serious adverse event are largely unknown, but findings point to individual host factors. Meningoencephalitis, once considered to happen only in children less than 6 months of age, has also been identified in older children and adults, but with good prognosis. Efforts are being made to develop a safer yellow fever vaccine, and an inactivated vaccine or a vaccine prepared with the vaccine virus envelope produced in plants are being tested. Even with serious and rare adverse events, yellow fever vaccine is the best way to avoid yellow fever, a disease of high lethality and should be used routinely in endemic areas, and on people from non-endemic areas that could be exposed, according to a careful risk-benefit analysis.

    14. [Alarm symptoms of meningitis in children with fever].

      Science.gov (United States)

      Geurts, Dorien H F; Moll, Henriette A

      2011-01-01

      A 15-year-old girl presented with fever and pain in her legs. A viral infection was suspected, but within 24 hours she became confused and developed meningeal signs, based on which she was diagnosed as having meningitis. Within a few hours a 6-month-old boy developed fever, a grey colour, bulging fontanel, cold hands and feet, and was groaning. He too appeared to have meningitis. It is important to recognize this serious infection in children with fever, since delay of diagnosis and treatment may result in serious complications. Recognition is difficult because of non-specific symptoms on presentation and a lack of alarm symptoms early in the course of the disease. Alarm symptoms of serious infection in children are cyanosis, rapid breathing, decreased capillary refill, petechial rash, meningeal signs, leg pain and decreased consciousness. If serious infection is uncertain in a child with fever, parents should be advised on the potential course of the disease, the alarm symptoms and the need to seek medical help in time.

    15. Rheumatic Fever Associated with Antiphospholipid Syndrome: Systematic Review

      Directory of Open Access Journals (Sweden)

      Felipe da Silva

      2014-01-01

      Full Text Available Objective. To evaluate the clinical associations between rheumatic fever and antiphospholipid syndrome and the impact of coexistence of these two diseases in an individual. Methods. Systematic review in electronics databases, regarding the period from 1983 to 2012. The keywords: “Rheumatic Fever,” “Antiphospholipid Syndrome,” and “Antiphospholipid Antibody Syndrome” are used. Results. were identified 11 cases described in the literature about the association of rheumatic fever and antiphospholipid syndrome. Clinical presentation of rheumatic fever was characterized by the predominance of carditis (11/11 and chorea (7/11. Regarding the manifestations of APS, the stroke was observed in 7/11 (63.6%, with one of them having probable embolic origin. Conclusion. The present study brings the information that the association between APS and RF is quite rare, however, is of great clinical importance. Doctors who deal with the RF should include in their differential diagnosis the APS, especially in the presence of stroke in patients with RF and whose echocardiogram does not show intracavitary thrombi.

    16. Impaired fibrinolysis in the pathogenesis of dengue hemorrhagic fever.

      NARCIS (Netherlands)

      Gorp, E. van; Setiati, T.E.; Mairuhu, A.T.; Suharti, C.; Cate, H.H.; Dolmans, W.M.V.; Meer, J.W.M. van der; Hack, C.E.; Brandjes, D.P.

      2002-01-01

      The mechanisms contributing to bleeding complications in dengue hemorrhagic fever were studied by investigating the pattern of activation of the coagulation and fibrinolytic systems in 50 children with severe dengue hemorrhagic fever. Thirteen patients (26%) died, and activation of coagulation was

    17. Impaired fibrinolysis in the pathogenesis of dengue hemorrhagic fever

      NARCIS (Netherlands)

      van Gorp, Eric C. M.; Setiati, Tatty E.; Mairuhu, Albert T. A.; Suharti, Catharina; Cate Ht, Hugo ten; Dolmans, Wil M. V.; van der Meer, Jos W. M.; Hack, C. Erik; Brandjes, Dees P. M.

      2002-01-01

      The mechanisms contributing to bleeding complications in dengue hemorrhagic fever were studied by investigating the pattern of activation of the coagulation and fibrinolytic systems in 50 children with severe dengue hemorrhagic fever. Thirteen patients (26%) died, and activation of coagulation was

    18. Trends and risk factors for human Q fever in Australia, 1991-2014.

      Science.gov (United States)

      Sloan-Gardner, T S; Massey, P D; Hutchinson, P; Knope, K; Fearnley, E

      2017-03-01

      Australian abattoir workers, farmers, veterinarians and people handling animal birthing products or slaughtering animals continue to be at high risk of Q fever despite an effective vaccine being available. National Notifiable Diseases Surveillance System data were analysed for the period 1991-2014, along with enhanced risk factor data from notified cases in the states of New South Wales and Queensland, to examine changes in the epidemiology of Q fever in Australia. The national Q fever notification rate reduced by 20% [incident rate ratio (IRR) 0·82] following the end of the National Q fever Management Program in 2006, and has increased since 2009 (IRR 1·01-1·34). Highest rates were in males aged 40-59 years (5·9/100 000) and 87% of Q fever cases occurred in New South Wales and Queensland. The age of Q fever cases and proportion of females increased over the study period. Based on the enhanced risk factor data, the most frequently listed occupation for Q fever cases involved contact with livestock, followed by 'no known risk' occupations. More complete and comparable enhanced risk factor data, at the State/Territory and national levels, would aid in further understanding of the epidemiology of Q fever.

    19. Dengue fever and dengue haemorrhagic fever in adolescents and adults.

      Science.gov (United States)

      Tantawichien, Terapong

      2012-05-01

      Dengue fever (DF) is endemic in tropical and subtropical zones and the prevalence is increasing across South-east Asia, Africa, the Western Pacific and the Americas. In recent years, the spread of unplanned urbanisation, with associated substandard housing, overcrowding and deterioration in water, sewage and waste management systems, has created ideal conditions for increased transmission of the dengue virus in tropical urban centres. While dengue infection has traditionally been considered a paediatric disease, the age distribution of dengue has been rising and more cases have been observed in adolescents and adults. Furthermore, the development of tourism in the tropics has led to an increase in the number of tourists who become infected, most of whom are adults. Symptoms and risk factors for dengue haemorrhagic fever (DHF) and severe dengue differ between children and adults, with co-morbidities and incidence in more elderly patients associated with greater risk of mortality. Treatment options for DF and DHF in adults, as for children, centre round fluid replacement (either orally or intravenously, depending on severity) and antipyretics. Further data are needed on the optimal treatment of adult patients.

    20. Comparisons of predictors for typhoid and paratyphoid fever in Kolkata, India

      Directory of Open Access Journals (Sweden)

      Deen Jacqueline L

      2007-10-01

      Full Text Available Abstract Background: Exposure of the individual to contaminated food or water correlates closely with the risk for enteric fever. Since public health interventions such as water improvement or vaccination campaigns are implemented for groups of individuals we were interested whether risk factors not only for the individual but for households, neighbourhoods and larger areas can be recognised? Methods: We conducted a large enteric fever surveillance study and analyzed factors which correlate with enteric fever on an individual level and factors associated with high and low risk areas with enteric fever incidence. Individual level data were linked to a population based geographic information systems. Individual and household level variables were fitted in Generalized Estimating Equations (GEE with the logit link function to take into account the likelihood that household factors correlated within household members. Results: Over a 12-month period 80 typhoid fever cases and 47 paratyphoid fever cases were detected among 56,946 residents in two bustees (slums of Kolkata, India. The incidence of paratyphoid fever was lower (0.8/1000/year, and the mean age of paratyphoid patients was older (17.1 years than for typhoid fever (incidence 1.4/1000/year, mean age 14.7 years. Residents in areas with a high risk for typhoid fever had lower literacy rates and economic status, bigger household size, and resided closer to waterbodies and study treatment centers than residents in low risk areas. Conclusion: There was a close correlation between the characteristics detected based on individual cases and characteristics associated with high incidence areas. Because the comparison of risk factors of populations living in high versus low risk areas is statistically very powerful this methodology holds promise to detect risk factors associated with diseases using geographic information systems.

    1. Severe neutropenia revealing a rare presentation of dengue fever: a case report.

      Science.gov (United States)

      Shourick, J; Dinh, A; Matt, M; Salomon, J; Davido, B

      2017-08-17

      Arboviruses are a common cause of fever in the returned traveler often associated with leucopenia, especially lymphopenia and thrombocytopenia. Transient neutropenia has been described in a few cases of arboviruses. However, prolonged and severe neutropenia (dengue fever, especially in the returned traveler in Europe. A 26-year-old healthy female without any medical past history, flying back from Thailand, presented a transient fever with severe neutropenia (dengue fever. Outcome was favorable without any antimicrobial therapy. Physicians should be wary of possible unusual presentation of dengue fever with prolonged neutropenia. Although such biological sign is more often associated with malaria or severe bacterial infection, it may be a sign of arbovirus.

    2. Behavioural fever is a synergic signal amplifying the innate immune response.

      Science.gov (United States)

      Boltaña, Sebastian; Rey, Sonia; Roher, Nerea; Vargas, Reynaldo; Huerta, Mario; Huntingford, Felicity Anne; Goetz, Frederick William; Moore, Janice; Garcia-Valtanen, Pablo; Estepa, Amparo; Mackenzie, S

      2013-09-07

      Behavioural fever, defined as an acute change in thermal preference driven by pathogen recognition, has been reported in a variety of invertebrates and ectothermic vertebrates. It has been suggested, but so far not confirmed, that such changes in thermal regime favour the immune response and thus promote survival. Here, we show that zebrafish display behavioural fever that acts to promote extensive and highly specific temperature-dependent changes in the brain transcriptome. The observed coupling of the immune response to fever acts at the gene-environment level to promote a robust, highly specific time-dependent anti-viral response that, under viral infection, increases survival. Fish that are not offered a choice of temperatures and that therefore cannot express behavioural fever show decreased survival under viral challenge. This phenomenon provides an underlying explanation for the varied functional responses observed during systemic fever. Given the effects of behavioural fever on survival and the fact that it exists across considerable phylogenetic space, such immunity-environment interactions are likely to be under strong positive selection.

    3. Yellow fever vaccine used in a psoriatic arthritis patient treated with methotrexate

      OpenAIRE

      Štuhec, Matej

      2015-01-01

      The yellow fever vaccines on the market are contraindicated for immunocompromised and elderly patients. A case of yellow fever vaccine used in a 27-year-old Slovenian male with psoriatic arthritis during treatment with methotrexate is described. We demonstrate a positive case, since there were noadverse effects in concurrent administration of yellow fever vaccine and methotrexate. This patient did not show severe adverse reactions and did not contract yellow fever despite potential exposure. ...

    4. Traveling Abroad: Latest Yellow Fever Vaccine Update | Poster

      Science.gov (United States)

      Earlier this month, the U.S. Centers for Disease Control and Prevention (CDC) released its list of clinics that are administering the yellow fever vaccine Stamaril, which has been made available to address the total depletion of the United States’ primary yellow fever vaccine, YF-VAX. These clinics will provide the vaccine to individuals preparing for international travel,

    5. Advanced Vaccine Candidates for Lassa Fever

      Directory of Open Access Journals (Sweden)

      Igor S. Lukashevich

      2012-10-01

      Full Text Available Lassa virus (LASV is the most prominent human pathogen of the Arenaviridae. The virus is transmitted to humans by a rodent reservoir, Mastomys natalensis, and is capable of causing lethal Lassa Fever (LF. LASV has the highest human impact of any of the viral hemorrhagic fevers (with the exception of Dengue Fever with an estimated several hundred thousand infections annually, resulting in thousands of deaths in Western Africa. The sizeable disease burden, numerous imported cases of LF in non-endemic countries, and the possibility that LASV can be used as an agent of biological warfare make a strong case for vaccine development. Presently there is no licensed vaccine against LF or approved treatment. Recently, several promising vaccine candidates have been developed which can potentially target different groups at risk. The purpose of this manuscript is to review the LASV pathogenesis and immune mechanisms involved in protection. The current status of pre-clinical development of the advanced vaccine candidates that have been tested in non-human primates will be discussed. Major scientific, manufacturing, and regulatory challenges will also be considered.

    6. Vitamin D serostatus and dengue fever progression to dengue hemorrhagic fever/dengue shock syndrome.

      Science.gov (United States)

      Villamor, E; Villar, L A; Lozano, A; Herrera, V M; Herrán, O F

      2017-10-01

      Vitamin D could modulate pathways leading to dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). We examined the associations of serum total 25-hydroxy vitamin D [25(OH)D] and vitamin D binding protein (VDBP) concentrations in patients with uncomplicated dengue fever (DF) with risk of progression to DHF/DSS. In a case-control study nested in a cohort of DF patients who were followed during the acute episode in Bucaramanga, Colombia, we compared 25(OH)D and VDBP at onset of fever between 110 cases who progressed to DHF/DSS and 235 DF controls who did not progress. 25(OH)D concentrations were also compared between the acute sample and a sample collected >1 year post-convalescence in a subgroup. Compared with 25(OH)D ⩾75 nmol/l, adjusted odds ratios (95% CI) for progression were 0·44 (0·22-0·88) and 0·13 (0·02-1·05) for 50 to 75 nmol/l (vitamin D insufficiency) and <50 nmol/l (vitamin D deficiency), respectively (P, trend = 0·003). Mean 25(OH)D concentrations were much lower post-convalescence compared with the acute episode, regardless of case status. Compared with controls, mean VDBP was non-significantly lower in cases. We conclude that low serum 25(OH)D concentrations in DF patients predict decreased odds of progression to DHF/DSS.

    7. Typhoid fever : aspects of environment, host and pathogen interaction

      NARCIS (Netherlands)

      Ali, Soegianto

      2006-01-01

      In a surveillance study in Jakarta, Indonesia, 88 typhoid and 26 paratyphoid fever patients were identified by blood culture. Risk factors for transmission of typhoid fever were mainly intra-household factors (poor hand-washing hygiene, recent household contacts), whereas paratyphoid was mainly

    8. Rationalizing the approach to children with fever in neutropenia

      NARCIS (Netherlands)

      Ammann, Roland A.; Tissing, Wim J. E.; Phillips, Bob

      Purpose of review Fever in neutropenia is the most frequent potentially life-threatening complication of chemotherapy in children and adolescents with cancer. This review summarizes recent studies that refine our knowledge of how to manage pediatric fever in neutropenia, and their implications for

    9. Antibody response to 17D yellow fever vaccine in Ghanaian infants.

      Science.gov (United States)

      Osei-Kwasi, M; Dunyo, S K; Koram, K A; Afari, E A; Odoom, J K; Nkrumah, F K

      2001-01-01

      To assess the seroresponses to yellow fever vaccination at 6 and 9 months of age; assess any possible adverse effects of immunization with the 17D yellow fever vaccine in infants, particularly at 6 months of age. Four hundred and twenty infants who had completed BCG, OPV and DPT immunizations were randomized to receive yellow fever immunization at either 6 or 9 months. A single dose of 0.5 ml of the reconstituted vaccine was administered to each infant by subcutaneous injection. To determine the yellow fever antibody levels of the infants, each donated 1 ml whole blood prior to immunization and 3 months post-immunization. Each serum sample was titred on Vero cells against the vaccine virus. The most common adverse reactions reported were fever, cough, diarrhoea and mild reactions at the inoculation site. The incidences of adverse reactions were not statistically different in both groups. None of the pre-immunization sera in both age groups had detectable yellow fever antibodies. Infants immunized at 6 months recorded seroconversion of 98.6% and those immunized at 9 months recorded 98% seroconversion. The GMT of their antibodies were 158.5 and 129.8, respectively. The results indicate that seroresponses to yellow fever immunization at 6 and 9 months as determined by seroconversion and GMTs of antibodies are similar. The findings of good seroresponses at 6 months without significant adverse effects would suggest that the 17D yellow fever vaccine could be recommended for use in children at 6 months in outbreak situations or in high risk endemic areas.

    10. Hereditary periodic fever syndromes

      NARCIS (Netherlands)

      McDermott, MF; Frenkel, J

      Hereditary periodic fever syndromes are defined by recurrent attacks of generalised inflammation for which no infectious or auto-immune cause can be identified. For most of these disorders, the molecular basis has recently been elucidated. This has opened the prospect of novel therapeutic

    11. Rotavirus infection as a frequent cause of neonatal fever.

      Science.gov (United States)

      Kang, Ha-Na; Park, Hyun Kyung; Lee, Hyun-Ju; Moon, Jin-Hwa; Oh, Jae Won; Kim, Chang-Ryul

      2018-04-01

      Fever rather than diarrhea or vomiting was the most common symptom of neonatal rotavirus (RV) infection in our previous study. We investigated whether RV infection is a major cause of neonatal fever and compared the clinical characteristics of bacterial infection, viral infection and unknown causes of neonatal fever. We reviewed the electronic medical records of 48 newborns aged ≤28 days who were admitted to the Special Care Nursery of Hanyang University Guri Hospital for fever (≥38°C) from 2005 to 2009. All the newborns underwent complete blood count, urinalysis, C-reactive protein, cultures of blood, urine, and cerebrospinal fluid as well as stool RV enzyme-linked immunosorbent assay. Respiratory virus polymerase chain reaction for cough or rhinorrhea, and stool culture for diarrhea were also done. All the babies were term, with mean age 13 ± 8 days and peak body temperature 38.5 ± 0.5°C. The causes of neonatal fever were viral (44%), bacterial (10%) and unknown (46%). The viral infections included RV (n = 12), enterovirus (n = 6), respiratory syncytial virus (n = 2), and rhinovirus (n = 1). All the rotavirus genotypes were G4P[6]. Only three of 12 RV-infected febrile newborns had diarrhea. The bacterial infections included three cases of urinary tract infection (Escherichia coli, n = 2; Klebsiella pneumoniae, n = 1), and two cases of sepsis complicated with meningitis (all Streptococcus agalactiae). RV infection is the most common single cause of neonatal fever. It may be necessary to include stool RV tests for febrile newborns. © 2017 Japan Pediatric Society.

    12. Maternal perception of fever in children by tactile technique how valid it is

      International Nuclear Information System (INIS)

      Jalil, J.; Bashir, F.

      2014-01-01

      To determine the validity of tactile technique as a tool for fever assessment in children by mothers. Study Design: A cohort study. Place and Duration of Study: The study was conducted at the department of Paediatrics, Combined Military Hospital, Bahawalpur, Pakistan, from September 2007 to September 2009. Patients and Methods: Convenient sampling technique was employed. Three hundred and ninety three children between the ages of 6 months and 5 years, brought to hospital by mothers with history of prolonged fever (7 days or more) perceived by tactile technique. Children were not supposed to be necessarily febrile at the time of enrollment. A six hourly temperature recording was done. Moreover, whenever mothers felt that their child is febrile by using tactile method of their choice, axillary thermometry was done irrespective of the number of recordings. Standard mercury thermometry by axillary technique (without adding a degree to measured value) was chosen. Reading of more than 99.50 Fahrenheit (37.50 centigrade) was labeled as fever. Cases that remained fever free for five days were labeled afebrile and discharged. Mothers were advised to watch for fever for one week at home and to report back immediately if they felt that their child has fever, confirmed by a single tactile measurement. Those who reported back were readmitted and subjected to the same method of monitoring and recording as was applied on first admission. Data was analyzed using SPSS version 17. Descriptive statistics were applied to calculate the frequencies, means and standard deviations. Results: Among the 392 children 58.4% were males and 41.4% were females. The mean age was 24.4 +-14.39 months. Majority had a history of fever of 5 to 24 days (70.2%). In only 184 (46.93%) patients fever was confirmed. In 208 (53.08%) patients no fever was recorded and were discharged. Twenty one patients reported back with fever. However, fever was confirmed in only 11 patients. In summary, a total of 195 (49

    13. Population Explosions of Tiger Moth Lead to Lepidopterism Mimicking Infectious Fever Outbreaks.

      Directory of Open Access Journals (Sweden)

      Pallara Janardhanan Wills

      Full Text Available Lepidopterism is a disease caused by the urticating scales and toxic fluids of adult moths, butterflies or its caterpillars. The resulting cutaneous eruptions and systemic problems progress to clinical complications sometimes leading to death. High incidence of fever epidemics were associated with massive outbreaks of tiger moth Asota caricae adult populations during monsoon in Kerala, India. A significant number of monsoon related fever characteristic to lepidopterism was erroneously treated as infectious fevers due to lookalike symptoms. To diagnose tiger moth lepidopterism, we conducted immunoblots for tiger moth specific IgE in fever patients' sera. We selected a cohort of patients (n = 155 with hallmark symptoms of infectious fevers but were tested negative to infectious fevers. In these cases, the total IgE was elevated and was detected positive (78.6% for tiger moth specific IgE allergens. Chemical characterization of caterpillar and adult moth fluids was performed by HPLC and GC-MS analysis and structural identification of moth scales was performed by SEM analysis. The body fluids and chitinous scales were found to be highly toxic and inflammatory in nature. To replicate the disease in experimental model, wistar rats were exposed to live tiger moths in a dose dependant manner and observed similar clinico-pathological complications reported during the fever epidemics. Further, to link larval abundance and fever epidemics we conducted cointegration test for the period 2009 to 2012 and physical presence of the tiger moths were found to be cointegrated with fever epidemics. In conclusion, our experiments demonstrate that inhalation of aerosols containing tiger moth fluids, scales and hairs cause systemic reactions that can be fatal to human. All these evidences points to the possible involvement of tiger moth disease as a major cause to the massive and fatal fever epidemics observed in Kerala.

    14. Acute atrial fibrillation during dengue hemorrhagic fever

      Directory of Open Access Journals (Sweden)

      Henrique Horta Veloso

      Full Text Available Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.

    15. Acute atrial fibrillation during dengue hemorrhagic fever

      Directory of Open Access Journals (Sweden)

      Veloso Henrique Horta

      2003-01-01

      Full Text Available Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.

    16. Typhoid Fever Presenting With Acute Renal Failure And Hepatitis Simultaneously - A Rare Presentation

      Directory of Open Access Journals (Sweden)

      Rajput R.

      2016-05-01

      Full Text Available Typhoid fever is an important health problem worldwide but its incidence is more in developing countries. Hepatic involvement is common, but both hepatic and renal involvement is rare in typhoid fever. We report a case of typhoid fever presenting with hepatitis and acute renal failure. A 17 year old male presenting with fever and pain abdomen was found to have raised blood urea, creatinine, liver enzymes and bilirubin. Widal and typhidot (IgM,IgG test were positive. His symptoms subsided and deranged parameters resolved with treatment of typhoid fever.

    17. Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010

      Directory of Open Access Journals (Sweden)

      Geoffrey C. Buckle

      2012-06-01

      Full Text Available Typhoid and paratyphoid fever remain important causes of morbidity worldwide. Accurate disease burden estimates are needed to guide policy decisions and prevention and control strategies.

    18. A case of Rocky Mountain spotted fever.

      Science.gov (United States)

      Rubel, Barry S

      2007-01-01

      Rocky Mountain spotted fever is a serious, generalized infection that is spread to humans through the bite of infected ticks. It can be lethal but it is curable. The disease gets its name from the Rocky Mountain region where it was first identified in 1896. The fever is caused by the bacterium Rickettsia rickettsii and is maintained in nature in a complex life cycle involving ticks and mammals. Humans are considered to be accidental hosts and are not involved in the natural transmission cycle of this pathogen. The author examined a 47-year-old woman during a periodic recall appointment. The patient had no dental problems other than the need for routine prophylaxis but mentioned a recent problem with swelling of her extremities with an accompanying rash and general malaise and soreness in her neck region. Tests were conducted and a diagnosis of Rocky Mountain spotted fever was made.

    19. Yellow fever, Asia and the East African slave trade.

      Science.gov (United States)

      Cathey, John T; Marr, John S

      2014-05-01

      Yellow fever is endemic in parts of sub-Saharan Africa and South America, yet its principal vectors--species of mosquito of the genus Aedes--are found throughout tropical and subtropical latitudes. Phylogenetic analyses indicate that yellow fever originated in Africa and that its spread to the New World coincided with the slave trade, but why yellow fever has never appeared in Asia remains a mystery. None of several previously proposed explanations for its absence there is considered satisfactory. We contrast the trans-Atlantic slave trade, and trade across the Sahara and to the Arabian Peninsula and Mesopotamia, with that to Far East and Southeast Asian ports before abolition of the African slave trade, and before the scientific community understood the transmission vector of yellow fever and the viral life cycle, and the need for shipboard mosquito control. We propose that these differences in slave trading had a primary role in the avoidance of yellow fever transmission into Asia in the centuries before the 20(th) century. The relatively small volume of the Black African slave trade between Africa and East and Southeast Asia has heretofore been largely ignored. Although focal epidemics may have occurred, the volume was insufficient to reach the threshold for endemicity.

    20. Poverty and fever vulnerability in Nigeria: a multilevel analysis

      Directory of Open Access Journals (Sweden)

      Yusuf Oyindamola B

      2010-08-01

      Full Text Available Abstract Background Malaria remains a major public health problem in Sub Saharan Africa, where widespread poverty also contribute to the burden of the disease. This study was designed to investigate the relationship between the prevalence of childhood fever and socioeconomic factors including poverty in Nigeria, and to examine these effects at the regional levels. Methods Determinants of fever in the last two weeks among children under five years were examined from the 25004 children records extracted from the Nigeria Demographic and Health Survey 2008 data set. A two-level random effects logistic model was fitted. Results About 16% of children reported having fever in the two weeks preceding the survey. The prevalence of fever was highest among children from the poorest households (17%, compared to 15.8% among the middle households and lowest among the wealthiest (13% (p6months, whereas the effect of wealth no longer reached statistical significance. Conclusion While, overall bednet possession was low, less fever was reported in households that possessed bednets. Malaria control strategies and interventions should be designed that will target the poor and make an impact on poverty. The mechanism through which wealth may affect malaria occurrence needs further investigation.

    1. The history of fever, leukocytic pyrogen and interleukin-1.

      Science.gov (United States)

      Dinarello, Charles A

      2015-01-01

      There has been great progress in the 30 y since the reporting in 1984 of the cDNA for interleukin1 (IL1) β in the human and IL1α in the mouse. However, the history of IL1 begins in the early 1940s with investigations into the nature of an endogenous fever-producing protein released rabbit peritoneal neutrophils. Most researchers in immunology today are unaware that the field of cytokines, particularly the field of inflammatory cytokines. Toll-like receptors and innate immunity traces back to studies on fever. Researchers in infectious diseases wanted to know about an endogenous protein that caused fever, independent of infection. The endogenous fever-producing protein was called by various names: granulocyte, endogenous or leukocytic pyrogen. It is a fascinating and sometimes controversial story for biology and medicine and for the treatment of inflammatory diseases. Few imagined that this fever-producing protein would play such a major role in nearly every cell and in most diseases. This paper reviews the true background and milestones of interleukin1 from the purification of leukocytic pyrogen to the first cDNA of IL1β and the validation of cytokine biology from ill-defined factors to its present day importance.

    2. [Experience of diagnosis and treatment of exogenous high-grade fever].

      Science.gov (United States)

      Xiong, Xing-jiang; Wang, Jie

      2011-06-01

      There is a regular pattern in the diagnosis and treatment of exogenous high-grade fever, of which the key point is formula syndrome identification. Syndrome differentiation of the six channels is appropriate for not only exogenous cold but also various other conditions. The diagnosis and treatment of high-grade fever can also follow the law of syndrome differentiation of the six channels. The theory of epidemic febrile diseases stems from and elaborates on an understanding of exogenous febrile conditions, so many effective formulas used to treat epidemic febrile diseases also have great value in the treatment of high-grade fever. Deteriorated syndrome, which is central to this condition, is very commonly seen in cases of high-grade fever, the key therapeutic principle of which is established according to syndromes. Allowing analysis that does not rigidly adhere to either established modern diagnosis or traditional Chinese syndromes, prominent achievements could be made in treating high-grade fever by summarizing the regular presenting patterns in terms of the constitution and symptoms.

    3. Pattern differences in experimental fevers induced by endotoxin, endogenous pyrogen, and prostaglandins.

      Science.gov (United States)

      Morimoto, A; Nakamori, T; Watanabe, T; Ono, T; Murakami, N

      1988-04-01

      To distinguish pattern differences in experimentally induced fevers, we investigated febrile responses induced by intravenous (IV), intracerebroventricular (ICV), and intra-preoptic/anterior hypothalamic (POA) administration of bacterial endotoxin (lipopolysaccharide, LPS), endogenous pyrogen (EP), human recombinant interleukin-1 alpha (IL-1), and prostaglandins E2 and F2 alpha (PGE2 and PGF2 alpha). Intravenous LPS, EP, or IL-1 in high concentrations caused biphasic fever. In low concentrations, they induced only the first phase of fever. Latency to onset and time to first peak of fever induced by IV injection of LPS or EP were almost the same as those after ICV or POA injection of PGE2. Fever induced by ICV or POA administration of LPS, EP, IL-1, or PGF2 alpha had a long latency to onset and a prolonged time course. There were significant differences among the latencies to fever onset exhibited by groups that received ICV or POA injections of LPS, EP, or PGF2 alpha and by groups given IV injections of LPS or EP and ICV or POA injections of PGE2. Present observations indicate different patterns of fever produced by several kinds of pyrogens when given by various routes. These results permit us to consider the possibility that there are several mediators or multiprocesses underlying the pathogenesis of fever.

    4. Typhoid fever in a South African in-patient population

      NARCIS (Netherlands)

      Khan, Mohammad Enayet Hossain

      2004-01-01

      In conclusion, the data presented herein show that no single clinical or paraclinical parameter is reliable in arriving at a correct clinical diagnosis of typhoid fever and that bacteriologic confirmation is necessary for the diagnosis of typhoid fever. Patients ’ age and sex influence the clinical

    5. Jungle fever

      OpenAIRE

      Waeckerlé, Emmanuelle

      2011-01-01

      This project developed from the premise that the global economy and media have transformed the world and its inhabitants into tourist attractions – so it sets out to reclaim not tourism, but everyday life. Jungle Fever explores the poetics and politics of the everyday, using the body and mind as tools: it offers a 42-page user guide in three languages, with a map and three accompanying posters, proposing destinations, activities and excursions for 8-hour and 24-hour journeys. The instructions...

    6. Widal agglutination titre: a rapid serological diagnosis of typhoid fever in developing countries

      International Nuclear Information System (INIS)

      Aftab, R.; Khurshid, R.

      2009-01-01

      To study the reliability of a single Widal test and to find out the diagnostic significance of 'O' and 'H' agglutinin titre in the diagnosis of typhoid fever. Community-based case-control study conducted from Jan 2001 to June 2007. The blood samples were collected from the medical and out door department of Sir Ganga Ram Hospitals, Lahore. The diagnostic value of an acute phase single Widal agglutination test for suspected typhoid fever was evaluated in 733 consecutive patients with fever lasting 6 or more days. In 733 patients with fever 84 (11.45%) were positive for Widal test. A noteworthy rise 1/320 of H and/or O agglutinin titre was observed in 86 (11.3%) of patients with typhoid fever. In the absence of vaccination an elevated level of H and/or O agglutinin titre of 1: 320 is of diagnostic value for typhoid fever especially in our setting where a single sample of serum is relied on for the diagnosis of typhoid fever. (author)

    7. Widal agglutination titre: a rapid serological diagnosis of typhoid fever in developing countries

      Energy Technology Data Exchange (ETDEWEB)

      Aftab, R [Fatima Jinnah Medical College Lahore, Lahore (Pakistan). Dept. of Pathology; Khurshid, R [Fatima Jinnah Medical College Lahore, Lahore (Pakistan). Dept. of Biochemistry

      2009-01-15

      To study the reliability of a single Widal test and to find out the diagnostic significance of 'O' and 'H' agglutinin titre in the diagnosis of typhoid fever. Community-based case-control study conducted from Jan 2001 to June 2007. The blood samples were collected from the medical and out door department of Sir Ganga Ram Hospitals, Lahore. The diagnostic value of an acute phase single Widal agglutination test for suspected typhoid fever was evaluated in 733 consecutive patients with fever lasting 6 or more days. In 733 patients with fever 84 (11.45%) were positive for Widal test. A noteworthy rise 1/320 of H and/or O agglutinin titre was observed in 86 (11.3%) of patients with typhoid fever. In the absence of vaccination an elevated level of H and/or O agglutinin titre of 1: 320 is of diagnostic value for typhoid fever especially in our setting where a single sample of serum is relied on for the diagnosis of typhoid fever. (author)

    8. Defining travel-associated cases of enteric fever.

      Science.gov (United States)

      Freedman, Joanne; Lighton, Lorraine; Jones, Jane

      2014-01-01

      There is no internationally recognized case-definition for travel-associated enteric fever in non-endemic countries. This study describes the patterns of case reporting between 2007 and 2011 as travel-associated or not from the surveillance data in England, Wales and Northern Ireland (EWNI), before and after a change in the time component of the case-definition in January 2011. It examines in particular the role of a time frame based on the reported typical incubation period in defining a case of travel-associated enteric fever. The results showed no significant differences in the distribution of cases of enteric fever in regards to the interval between the onset and UK arrival in 2011 compared to 2007-2010 (p=0.98 for typhoid and paratyphoid A); the distribution for paratyphoid B was also similar in both time periods. During 2007-2010, 93% (1730/1853) of all of the cases were classified as travel-associated compared to 94% (448/477) in 2011. This difference was not statistically significant. Changing the time component of the definition of travel-associated enteric fever did not make a significant difference to the proportion of travel-associated cases reported by investigators. Our analysis suggests that time might be subordinate to other considerations when investigators classify a case as travel-associated. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

    9. Yellow fever vaccine-associated neurological disease, a suspicious case.

      Science.gov (United States)

      Beirão, Pedro; Pereira, Patrícia; Nunes, Andreia; Antunes, Pedro

      2017-03-02

      A 70-year-old man with known cardiovascular risk factors, presented with acute onset expression aphasia, agraphia, dyscalculia, right-left disorientation and finger agnosia, without fever or meningeal signs. Stroke was thought to be the cause, but cerebrovascular disease investigation was negative. Interviewing the family revealed he had undergone yellow fever vaccination 18 days before. Lumbar puncture revealed mild protein elevation. Cultural examinations, Coxiella burnetti, and neurotropic virus serologies were negative. Regarding the yellow fever virus, IgG was identified in serum and cerebrospinal fluid (CSF), with negative IgM and virus PCR in CSF. EEG showed an encephalopathic pattern. The patient improved gradually and a week after discharge was his usual self. Only criteria for suspect neurotropic disease were met, but it's possible the time spent between symptom onset and lumbar puncture prevented a definite diagnosis of yellow fever vaccine-associated neurological disease. This gap would have been smaller if the vaccination history had been collected earlier. 2017 BMJ Publishing Group Ltd.

    10. Gallbladder perforation complicating typhoid fever: report of two cases.

      Science.gov (United States)

      Gali, B M; Ali, N; Agbese, G O; Duna, V D; Dawha, S D; Ismai, G I; Mohammed, M

      2011-01-01

      Gallbladder perforation (GBP) is rare and as a complication of typhoid fever is extremely rare. We present two consecutive patients with GBP diagnosed incidentally at laparotomy. Information on the management of two patients with gallbladder perforation seen at Federal Medical Centre Azare in June and October 2008 was extracted from their case records. The two patients were both males aged 13 years and 16 years. They both presented with high fever of more than 2 weeks duration; and abdominal pain and distension. Both patients had features of generalised peritonitis. Pre-operative diagnoses of typhoid enteric perforation were made based on a positive Widal test. Intra-operative findings however, were that of bile peritonitis and gallbladder perforation. Both had cholecystectomy. Culture of the bile aspirate yielded Salmonella typhi. Gallbladder perforation secondary to typhoid fever should be considered as a differential diagnosis in patients with suspected typhoid enteric perforation in typhoid fever endemic region.

    11. Adult Onset Still's Disease and Rocky Mountain Spotted Fever

      Directory of Open Access Journals (Sweden)

      Paul Persad

      2010-01-01

      Full Text Available Adult Still's Disease was first described in 1971 by Bywaters in fourteen adult female patients who presented with symptoms indistinguishable from that of classic childhood Still's Disease (Bywaters, 1971. George Still in 1896 first recognized this triad of quotidian (daily fevers, evanescent rash, and arthritis in children with what later became known as juvenile inflammatory arthritis (Still, 1990. Adult Onset Still's Disease (AOSD is an inflammatory condition of unknown etiology characterized by an evanescent rash, quotidian fevers, and arthralgias. Numerous infectious agents have been associated with its presentation. This case is to our knowledge the first presentation of AOSD in the setting of Rocky Mountain Spotted Fever. Although numerous infectious agents have been suggested, the etiology of this disorder remains elusive. Nevertheless, infection may in fact play a role in triggering the onset of symptoms in those with this disorder. Our case presentation is, to our knowledge, the first case of Adult Onset Still's Disease associated with Rocky Mountain spotted fever (RMSF.

    12. Rat-bite fever presenting with rash and septic arthritis.

      Science.gov (United States)

      Kanechorn Na Ayuthaya, Rajyani; Niumpradit, Nucha

      2005-11-01

      Rat-bite fever is an uncommon disease known for its endemicity to occur worldwide. Although most patients tend to develop mild symptoms with improvement from conventional antibiotics, it can progress with severe complications with a mortality rate as high as 13% without proper treatment. The authors report a complicated case of rat bite-fever involving a 61-year old woman who presented with fever petechial rash, and septic arthritis following a rat bite. Initially, multiple antibiotics were administered but were not effective. As a consequence, invasive procedures such as arthrotomy and joint debridement were done and prolonged antibiotic was administered until clinical resolution. Since many cases do not have a history of rat bite and may present with fever, rashes, and arthritis it is essential to distinguish it from other diseases. Here, the authors will provide details on the etiology, clinical manifestations, diagnosis, and management to aid prompt detection and treatment of the disease.

    13. FEVER AS INDICATOR TO SECONDARY INFECTION IN DENGUE VIRAL INFECTION

      Directory of Open Access Journals (Sweden)

      Soegeng Soegijanto

      2018-04-01

      Full Text Available Dengue Virus Infections are distributed in tropical and sub-tropical regions and transmitted by the mosquitoes such as Aedes aegypti and Aedes albopictus. Dengue virus can cause dengue fever, dengue hemorrhagic fever and dengue shock syndrome or dengue and severe dengue classified by World Health Organization. Beside it concurrent infection virus salmonella had been found some cases who showed fever more than 7 days. Concurrent infection with two agents can result in an illness having overlapping symptoms creating a diagnostic dilemma for treating physician, such as dengue fever with typhoid fever. The aim of this research is detection of dengue virus and secondary infection with Salmonella typhi in patients suspected dengue virus infection. Detection of dengue virus and Salmonella typhi using immunochromatography test such as NS1, IgG/IgM for dengue virus infection, and IgM/IgG Salmonella and blood culture. The fifty children with dengue virus infection came to Soerya hospital and 17 cases suspected dengue virus infection, five cases showed a positive NS1 on the second day of fever and one case concurrent with clinical manifestation of convulsi on the third days of fever there were five cases only showed positive. It was showed in this study that on the fourth to six day of fever in dengue virus infection accompanied by antibody IgM & IgG dengue. There were 12 cases showed the clinical manifestation of concurrent dengue viral infection and Salmonella, all of them showed a mild clinical manifestation and did not show plasma leakage and shock. In this study we found the length of stay of concurrent Dengue Virus Infection and Salmonella infection is more than 10 days. These patients were also more likely to have co-existing haemodynamic disturbances and bacterial septicaemia which would have required treatment with inotropes and antibiotics. This idea is very important to make update dengue viral management to decrease mortality in outbreak try to

    14. Dengue fever and dengue haemorrhagic fever in adolescents and adults

      OpenAIRE

      Tantawichien, Terapong

      2012-01-01

      Dengue fever (DF) is endemic in tropical and subtropical zones and the prevalence is increasing across South-east Asia, Africa, the Western Pacific and the Americas. In recent years, the spread of unplanned urbanisation, with associated substandard housing, overcrowding and deterioration in water, sewage and waste management systems, has created ideal conditions for increased transmission of the dengue virus in tropical urban centres. While dengue infection has traditionally been considered a...

    15. Behavioral Fever Drives Epigenetic Modulation of the Immune Response in Fish.

      Science.gov (United States)

      Boltana, Sebastian; Aguilar, Andrea; Sanhueza, Nataly; Donoso, Andrea; Mercado, Luis; Imarai, Monica; Mackenzie, Simon

      2018-01-01

      Ectotherms choose the best thermal conditions to mount a successful immune response, a phenomenon known as behavioral fever. The cumulative evidence suggests that behavioral fever impacts positively upon lymphocyte proliferation, inflammatory cytokine expression, and other immune functions. In this study, we have explored how thermal choice during infection impacts upon underpinning molecular processes and how temperature increase is coupled to the immune response. Our results show that behavioral fever results in a widespread, plastic imprint on gene regulation, and lymphocyte proliferation. We further explored the possible contribution of histone modification and identified global associations between temperature and histone changes that suggest epigenetic remodeling as a result of behavioral fever. Together, these results highlight the critical importance of thermal choice in mobile ectotherms, particularly in response to an infection, and demonstrate the key role of epigenetic modification to orchestrate the thermocoupling of the immune response during behavioral fever.

    16. Vaccination for typhoid fever in sub-Saharan Africa.

      Science.gov (United States)

      Slayton, Rachel B; Date, Kashmira A; Mintz, Eric D

      2013-04-01

      Emerging data on the epidemiologic, clinical and microbiologic aspects of typhoid fever in sub-Saharan Africa call for new strategies and new resources to bring the regional epidemic under control. Areas with endemic disease at rates approaching those in south Asia have been identified; large, prolonged and severe outbreaks are occurring more frequently; and resistance to antimicrobial agents, including fluoroquinolones is increasing. Surveillance for typhoid fever is hampered by the lack of laboratory resources for rapid diagnosis, culture confirmation and antimicrobial susceptibility testing. Nonetheless, in 2010, typhoid fever was estimated to cause 725 incident cases and 7 deaths per 100,000 person years in sub-Saharan Africa. Efforts for prevention and outbreak control are challenged by limited access to safe drinking water and sanitation and by a lack of resources to initiate typhoid immunization. A comprehensive approach to typhoid fever prevention including laboratory and epidemiologic capacity building, investments in water, sanitation and hygiene and reconsideration of the role of currently available vaccines could significantly reduce the disease burden. Targeted vaccination using currently available typhoid vaccines should be considered as a short- to intermediate-term risk reduction strategy for high-risk groups across sub-Saharan Africa.

    17. [Rocky Mountain spotted fever in an American tourist].

      Science.gov (United States)

      de Pender, A M G; Bauer, A G C; van Genderen, P J J

      2005-04-02

      In a 28-year-old male American tourist who presented in the hospital with fever, cold shivers, headache, nausea, myalgia and arthralgia, Rocky Mountain spotted fever was suspected, partly because he came from an endemic region (the state of Georgia). The patient was treated with doxycycline, 100 mg b.i.d.; 9 days after the first appearance of the symptoms, the diagnosis was confirmed by the report of a positive antibody titre against Rickettsia rickettsii. The patient did not have exanthema. He was discharged in good general condition after two weeks of treatment. Rocky Mountain spotted fever, caused by the Gram-negative bacterium R. rickettsii, is a serious rickettsiosis. The disease is seen only sporadically in the Netherlands because the ticks in the Netherlands do not carry the bacterium. The travel history is still not a standard component of the anamnesis and is therefore often forgotten. This can lead to under-diagnosis and delayed treatment of diseases that were formerly limited to the continent. The early recognition and treatment of Rocky Mountain spotted fever is important since delayed treatment is associated with a clear increase in both morbidity and mortality.

    18. Kawasaki disease following Rocky Mountain spotted fever: a case report.

      Science.gov (United States)

      Bal, Aswine K; Kairys, Steven W

      2009-07-06

      Kawasaki disease is an idiopathic acute systemic vasculitis of childhood. Although it simulates the clinical features of many infectious diseases, an infectious etiology has not been established. This is the first reported case of Kawasaki disease following Rocky Mountain spotted fever. We report the case of a 4-year-old girl who presented with fever and petechial rash. Serology confirmed Rocky Mountain spotted fever. While being treated with intravenous doxycycline, she developed swelling of her hands and feet. She had the clinical features of Kawasaki disease which resolved after therapy with intravenous immune globulin (IVIG) and aspirin. This case report suggests that Kawasaki disease can occur concurrently or immediately after a rickettsial illness such as Rocky Mountain spotted fever, hypothesizing an antigen-driven immune response to a rickettsial antigen.

    19. Yellow Fever Outbreak - Kongo Central Province, Democratic Republic of the Congo, August 2016.

      Science.gov (United States)

      Otshudiema, John O; Ndakala, Nestor G; Mawanda, Elande-Taty K; Tshapenda, Gaston P; Kimfuta, Jacques M; Nsibu, Loupy-Régence N; Gueye, Abdou S; Dee, Jacob; Philen, Rossanne M; Giese, Coralie; Murrill, Christopher S; Arthur, Ray R; Kebela, Benoit I

      2017-03-31

      On April 23, 2016, the Democratic Republic of the Congo's (DRC's) Ministry of Health declared a yellow fever outbreak. As of May 24, 2016, approximately 90% of suspected yellow fever cases (n = 459) and deaths (45) were reported in a single province, Kongo Central Province, that borders Angola, where a large yellow fever outbreak had begun in December 2015. Two yellow fever mass vaccination campaigns were conducted in Kongo Central Province during May 25-June 7, 2016 and August 17-28, 2016. In June 2016, the DRC Ministry of Health requested assistance from CDC to control the outbreak. As of August 18, 2016, a total of 410 suspected yellow fever cases and 42 deaths were reported in Kongo Central Province. Thirty seven of the 393 specimens tested in the laboratory were confirmed as positive for yellow fever virus (local outbreak threshold is one laboratory-confirmed case of yellow fever). Although not well-documented for this outbreak, malaria, viral hepatitis, and typhoid fever are common differential diagnoses among suspected yellow fever cases in this region. Other possible diagnoses include Zika, West Nile, or dengue viruses; however, no laboratory-confirmed cases of these viruses were reported. Thirty five of the 37 cases of yellow fever were imported from Angola. Two-thirds of confirmed cases occurred in persons who crossed the DRC-Angola border at one market city on the DRC side, where ≤40,000 travelers cross the border each week on market day. Strategies to improve coordination between health surveillance and cross-border trade activities at land borders and to enhance laboratory and case-based surveillance and health border screening capacity are needed to prevent and control future yellow fever outbreaks.

    20. A Case of Acute Q Fever Hepatitis Diagnosed by F-18 FDG PET/CT

      Energy Technology Data Exchange (ETDEWEB)

      Beak, Sora [Hallym Univ. College of Medicine, Seoul (Korea, Republic of); Oh, Minyoung; Lee, Sand-Oh; Yu, Eunsil; Ryu Jin-Sook [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

      2012-06-15

      A 53-year-old man with fever of unknown origin underwent F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) as a workup for a fever of unknown origin. On presentation, he complained of fever, chills, and myalgia. The F-18 FDG PET/CT scan showed diffusely increased uptake of the liver with mild hepatomegaly. A liver biopsy then revealed fibrin-ring granulomas typically seen in Q fever. The patient was later serologically diagnosed as having acute Q fever as the titers for C. IgM and IgG were 64:1 and -16:1, respectively. He recovered completely following administration of doxycycline. This indicates that F-18 FDG PET/CT may be helpful for identifying hepatic involvement in Q fever as a cause of fever of unknown origin.

    1. Is a rheumatic fever register the best surveillance tool to evaluate rheumatic fever control in the Auckland region?

      Science.gov (United States)

      Moxon, Te Aro; Reed, Peter; Jelleyman, Timothy; Anderson, Philippa; Leversha, Alison; Jackson, Catherine; Lennon, Diana

      2017-08-11

      To determine the most accurate data source for acute rheumatic fever (ARF) epidemiology in the Auckland region. To assess coverage of the Auckland Regional Rheumatic Fever Register (ARRFR), (1998-2010) for children Auckland at the time of illness, register, hospitalisation and notification data were compared. A consistent definition was applied to determine definite and probable cases of ARF using clinical records. (www.heartfoundation.org.nz) RESULTS: Of 559 confirmed (definite and probable) RF cases Auckland. This was significantly more accurate than medical officer of health notification and hospitalisation data.

    2. Maternal fever during labor--what does it mean?

      Science.gov (United States)

      Churgay, C A; Smith, M A; Blok, B

      1994-01-01

      Several studies have shown maternal fever to be associated with chorioamnionitis and neonatal sepsis if at least two of the following five criteria are also present: maternal tachycardia, purulent or foul-smelling amniotic fluid, fetal tachycardia, uterine tenderness, or maternal leukocytosis. Less is known about the risk of neonatal sepsis when the presence of maternal fever in labor is the only criterion. A retrospective medical record review searching for women who had a fever greater than 100.4 degrees F while in the active phase of labor during a 1-year period at the University of Michigan was undertaken to investigate the relation between isolated maternal fever in labor and neonatal sepsis. Eighty-two cases of maternal fever were found. Forty-six women met the clinical criteria for chorioamnionitis, and 6 of the 7 neonates with sepsis diagnosed were born to these mothers. There were no significant differences found in admission or intrapartum factors between women who did and did not meet clinical criteria for chorioamnionitis, and there was no association between these factors and neonatal sepsis. Epidural anesthesia was administered to 91 percent of these women and might be associated with maternal fever during labor. Using maternal clinical criteria for chorioamnionitis and a neonatal band cell-total neutrophil ratio of 0.2 or greater instead of the current system to determine the need for newborn antibiotic administration would improve the positive predictive value (12.5 percent versus 9.3 percent) and specificity (34.6 percent versus 16 percent) without compromising sensitivity (100 percent). All septic and probably septic newborns would be treated, and neonatal antibiotic administration would be reduced by 17 percent. The addition of the maternal clinical criteria for chorioamnionitis to the criteria already used for diagnosing and treating neonatal sepsis could prove useful in decisions regarding the selective administration of intrapartum antibiotics

    3. Caregivers' Knowledge and Home Management of Fever in Children

      African Journals Online (AJOL)

      Background: Fever is one of the most common complaints presented to the Paediatric Emergency Unit (PEU). It is a sign that there is an underlying pathologic process, the most common being infection. Many childhood illnesses are accompanied by fever, many of which are treated at home prior to presentation to hospital.

    4. Molecular characterization of African swine fever virus in apparently ...

      African Journals Online (AJOL)

      African swine fever (ASF) is a highly lethal and economically significant disease of domestic pigs in Uganda where outbreaks regularly occur. There is neither a vaccine nor treatment available for ASF control. Twenty two African swine fever virus (ASFV) genotypes (I - XXII) have been identified based on partial sequencing ...

    5. [Evaluation on the effects of prevention and control programs regarding typhoid fever and paratyphoid fever in Guizhou province, from 2007 to 2012].

      Science.gov (United States)

      Yao, Guanghai; Zou, Zhiting; Wang, Dan; Huang, Yanping; Nie, Wei; Liu, Huihui; Tang, Guangpeng

      2014-05-01

      This study was to evaluate the effects of prevention and control regarding programs on typhoid fever and paratyphoid fever, in Guizhou province, from 2007 to 2012, to provide evidence for the improvement of related programs. Data on typhoid fever and paratyphoid including information on epidemics, individual, cases, measures for prevention and control programs taken and relative government documents were collected and analyzed in Guizhou province, from 2007 to 2012. Information related to the average annual incidence, nature of outbreaks, time span before confirmed diagnosis was made, unit which carried the case report, proportion of laboratory confirmed diagnosed cases and case-management were compared between 2007-2009 and 2010-2012 descriptively while chi-square test with Excel and EpiInfo software were used for data analysis. In the period of 2007-2009, a total of 5 978 typhoid fever and paratyphoid fever cases were reported in Guizhou province with the average yearly incidence as 5.29/100 000. In the period of 2010-2012, 2 765 cases were reported with the average yearly incidence as 2.57/100 000. When compared to the former, data from the latter period showed that the average yearly incidence had declined 51.31% in all the prefectures. There were still some outbreaks appeared but the total number of cases involved reduced 87.50%. The time span before the confirmation of diagnosis became shorter but the difference was not statistically significant (χ² = 0.08, P = 0.99). Number of cases reported by hospitals at county or above had 11.51% of increase while those cases reported at the township hospitals or below decreased for 61.47% . The proportion of laboratory diagnosed cases increased 23.63%. Rates of timeliness on cards being filled in, input and audited showed increase of 8.44%, 6.76% and 2.40% respectively. Successful measures for prevention and control on typhoid fever and paratyphoid fever had been remarkably taken in Guizhou province, but the potential

    6. The Effect of Exercise-Induced Muscle Damage After a Bout of Accentuated Eccentric Load Drop Jumps and the Repeated Bout Effect.

      Science.gov (United States)

      Bridgeman, Lee A; Gill, Nicholas D; Dulson, Deborah K; McGuigan, Michael R

      2017-02-01

      Bridgeman, LA, Gill, ND, Dulson, DK, and McGuigan, MR. The effect of exercise induced muscle damage after a bout of accentuated eccentric load drop jumps and the repeated bout effect. J Strength Cond Res 31(2): 386-394, 2017-Although previous studies have investigated exercise-induced muscle damage (EIMD) after a bout of unloaded drop jumps (DJs), none have investigated the effects of accentuated eccentric load (AEL) DJs on EIMD. The purpose of this study was to investigate the effects of 30 and 50 AEL DJs on strength, jump performance, muscle soreness, and blood markers. Eight resistance trained athletes participated in this study. In week 1, baseline countermovement jump (CMJ), squat jump (SJ), concentric and eccentric peak force (PF), creatine kinase, and muscle soreness were assessed. Subjects then completed 30 AEL DJs and baseline measures were retested immediately postintervention, 1, 24, and 48 hours later. Two weeks later, the subjects completed the same protocol with an increase in AEL DJ volume (50). Subjects' SJ height was reduced in week 1 compared with week 3, postintervention, 1, 24, and 48 hours later (ES = -0.34, -0.44, -0.38, and -0.40). Subjects' CMJ height was reduced in week 1 compared with week 3, postintervention, 1, and 24 hours later (ES = -0.37, -0.29, and -0.39). Concentric PF was reduced in week 1 compared with week 3, postintervention and 24 and 48 hours later (ES = -0.02, -0.23, and -0.32). Eccentric PF was reduced in week 1 compared with week 3, postintervention, 24, and 48 hours later (ES = -0.24, -0.16, and -0.50). In this sample, 30 AEL DJs attenuated the effects of EIMD following which 50 AEL DJs completed 2 weeks later.

    7. STUDIES ON THE PATHOGENESIS OF FEVER WITH INFLUENZAL VIRUSES

      Science.gov (United States)

      Atkins, Elisha; Huang, Wei Cheng

      1958-01-01

      A substance with pyrogenic properties appears in the blood streams of rabbits made febrile by the intravenous inoculation of the PR8 strain of influenza A and Newcastle disease viruses (NDV). By means of a technique involving passive transfer of sera from animals given virus to recipient rabbits, the titer of circulating pyrogen was found to be closely correlated with the course of fever produced by virus. Certain properties of the pyrogen are described which differentiate it from the originally injected virus and suggest that the induced pyrogen is of endogenous origin. These properties resemble those of endogenous pyrogens occurring in other forms of experimental fever. The source of virus-induced pyrogen is unknown. In vitro incubation of virus with various constituents of the circulation did not result in the appearance of endogenous pyrogen. Granulocytopenia induced by HN2 failed to influence either fever or the production of endogenous pyrogen in rabbits injected with NDV. Similarly, the intraperitoneal inoculation of NDV into prepared exudates did not modify the febrile response. These findings do not lend support to the possibility that the polymorphonuclear leukocyte is a significant source of endogenous pyrogen in virus-induced fever. It is concluded that the liberation of an endogenous pyrogen from some as yet undefined source is an essential step in the pathogenesis of fever caused by the influenza group of viruses. PMID:13513908

    8. THE PREVALENCE OF CELIAC DISEASE AMONG PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER

      Directory of Open Access Journals (Sweden)

      Sedat IŞIKAY

      2015-03-01

      Full Text Available Background Familial Mediterranean Fever and celiac disease are both related to auto-inflammation and/or auto-immunity and they share some common clinical features such as abdominal pain, diarrhea, bloating and flatulence. Objectives We aimed to determine the association of these two diseases, if present. Methods Totally 112 patients diagnosed with Familial Mediterranean Fever and 32 cases as healthy control were included in the study. All participants were examined for the evidence of celiac disease, with serum tissue transglutaminase IgA levels (tTG IgA. Results Totally 144 cases, 112 with Familial Mediterranean Fever and 32 healthy control cases were included in the study. tTG IgA positivity was determined in three cases with Familial Mediterranean Fever and in one case in control group. In that aspect there was no significant difference regarding the tTG IgA positivity between groups (P=0.81. Duodenum biopsy was performed to the tTG IgA positive cases and revealed Marsh Type 3b in two Familial Mediterranean Fever cases and Marsh Type 3c in the other one while the biopsy results were of the only tTG IgA positive case in control group was Marsh Type 3b. In HLA evaluation of the celiac cases; HLA DQ2 was present in two celiac cases of the Familial Mediterranean Fever group and in the only celiac case of the control group while HLA DQ8 was present in one celiac case of the Familial Mediterranean Fever group. Conclusions We did not determine an association of Familial Mediterranean Fever with celiac disease. Larger studies with subgroup analysis are warranted to determine the relationship of these two diseases.

    9. FastStats: Allergies/Hay Fever

      Science.gov (United States)

      ... this? Submit What's this? Submit Button NCHS Home Allergies and Hay Fever Recommend on Facebook Tweet Share ... 12 months: 7.5% Number with reported respiratory allergies in the past 12 months: 7.6 million ...

    10. Laboratory diagnosis of tick-borne African relapsing fevers: latest developments

      Directory of Open Access Journals (Sweden)

      Aurélien eFotso Fotso

      2015-11-01

      Full Text Available In Africa, relapsing fevers caused by ectoparasite-borne Borrelia species are transmitted by ticks, with the exception of Borrelia recurrentis, which is a louse-borne spirochete. These tropical diseases responsible for mild to deadly spirochetemia. Cultured B. crocidurae, B. duttonii and B. hispanica circulate alongside at least six species which have not yet been cultured in vectors. Direct diagnosis is hindered by the use of non-specific laboratory tools. Indeed, microscopic observation of Borrelia spirochaeta in smears of peripheral blood taken from febrile patients lacks sensitivity and specificity. Although best visualised using dark-field microscopy, the organisms can also be detected using Wright-Giemsa or acridine orange stains.. PCR-based detection of specific sequences in total DNA extracted from a specimen can be used to discriminate different relapsing fever Borreliae. In our laboratory, we developed a multiplex real-time PCR assay for the specific detection of B. duttonii/recurrentis and B. crocidurae: Multispacer Sequence Typing accurately identified cultured relapsing fever borreliae and revealed diversity among them. Other molecular typing techniques, such as multilocus sequence analysis of tick-borne relapsing fever borreliae, showed the potential risk of human infection in Africa. Recent efforts to culture and sequence relapsing fever borreliae have provided new information for reassessment of the diversity of these bacteria. Recently, matrix-assisted laser desorption ionization time-of-flight mass spectrometry has been reported as a means of identifying cultured borreliae and of identifying both vectors and vectorised pathogens such as detecting relapsing fever borreliae directly in ticks. The lack of a rapid diagnosis test restricts the management of such diseases. We produced monoclonal antibodies against Borrelia crocidurae in order to develop cheap assays for the rapid detection of relapsing fever borreliae. In this paper

    11. Transmission Dinamics Model Of Dengue Fever

      Science.gov (United States)

      Debora; Rendy; Rahmi

      2018-01-01

      Dengue fever is an endemic disease that is transmitted through the Aedes aegypti mosquito vector. The disease is present in more than 100 countries in America, Africa, and Asia, especially tropical countries. Differential equations can be used to represent the spread of dengue virus occurring in time intervals and model in the form of mathematical models. The mathematical model in this study tries to represent the spread of dengue fever based on the data obtained and the assumptions used. The mathematical model used is a mathematical model consisting of Susceptible (S), Infected (I), Viruses (V) subpopulations. The SIV mathematical model is then analyzed to see the solution behaviour of the system.

    12. Dengue Haemorrhagic Fever presenting as Acute Abdomen

      OpenAIRE

      Al-Araimi, Hanaa; Al-Jabri, Amal; Mehmoud, Arshad; Al-Abri, Seif

      2011-01-01

      We describe a case of a 38 year-old Sri Lankan female who was referred to the surgeon on call with a picture of acute abdomen. She presented with a three-day history of fever, headache, abdominal pain and diarrhoea; however, the physical examination was not consistent with acute abdomen. Her platelet count was 22 ×109/L. A diagnosis of dengue haemorrhagic fever (DHF) was made and dengue serology was positive. Dengue epidemics have been associated with a variety of gastrointestinal symptoms an...

    13. Hyperglycemic crisis precipitated by Lassa fever in a patient with ...

      African Journals Online (AJOL)

      Hyperglycemic crisis precipitated by Lassa fever in a patient with previously undiagnosed type 2 diabetes mellitus. ... Nigerian Journal of Clinical Practice ... To report a rare case of HC unmasked by Lassa fever in a patient previously not ...

    14. Fish can show emotional fever: stress-induced hyperthermia in zebrafish.

      Science.gov (United States)

      Rey, Sonia; Huntingford, Felicity A; Boltaña, Sebastian; Vargas, Reynaldo; Knowles, Toby G; Mackenzie, Simon

      2015-11-22

      Whether fishes are sentient beings remains an unresolved and controversial question. Among characteristics thought to reflect a low level of sentience in fishes is an inability to show stress-induced hyperthermia (SIH), a transient rise in body temperature shown in response to a variety of stressors. This is a real fever response, so is often referred to as 'emotional fever'. It has been suggested that the capacity for emotional fever evolved only in amniotes (mammals, birds and reptiles), in association with the evolution of consciousness in these groups. According to this view, lack of emotional fever in fishes reflects a lack of consciousness. We report here on a study in which six zebrafish groups with access to a temperature gradient were either left as undisturbed controls or subjected to a short period of confinement. The results were striking: compared to controls, stressed zebrafish spent significantly more time at higher temperatures, achieving an estimated rise in body temperature of about 2-4°C. Thus, zebrafish clearly have the capacity to show emotional fever. While the link between emotion and consciousness is still debated, this finding removes a key argument for lack of consciousness in fishes. © 2015 The Authors.

    15. Causes of fever in adults in thall and surrounding areas

      International Nuclear Information System (INIS)

      Javed, S.A.S.; Javed, A.; Ali, S.

      2015-01-01

      The most common symptom for which the patients are admitted in our hospitals is fever. This study was carried out to know the causes of fever based on clinical and laboratory findings. Methods: In this cross sectional study, 865 consecutive male patients with fever of 100 degree F and above were included in the study conducted from January 2010 to April 2012. Results: All the patients were male having age between 17 years and 45 years. Out of the 865 patients, 507 (58.61%) came out to be malarial parasite slide positive, 186 (21.50%) patients were malarial parasite slide negative but were having clinical picture of malaria and responded to anti-malarial treatment, 73 (8.44%) patients were of respiratory tract infections, 21 (2.43%) patients were having gastro enteritis, 20 (2.31%) were diagnosed as cases of typhoid fever, 17 (1.97%) were having urinary tract infections, 24 (2.77%) patients were referred to medical specialist and the rest 17 (1.97%) were grouped as others. Conclusion: The most common cause of fever in our study was malaria. Respiratory tract infections are the second most common cause. (author)

    16. Kawasaki disease following Rocky Mountain spotted fever: a case report

      Directory of Open Access Journals (Sweden)

      Bal Aswine K

      2009-07-01

      Full Text Available Abstract Introduction Kawasaki disease is an idiopathic acute systemic vasculitis of childhood. Although it simulates the clinical features of many infectious diseases, an infectious etiology has not been established. This is the first reported case of Kawasaki disease following Rocky Mountain spotted fever. Case presentation We report the case of a 4-year-old girl who presented with fever and petechial rash. Serology confirmed Rocky Mountain spotted fever. While being treated with intravenous doxycycline, she developed swelling of her hands and feet. She had the clinical features of Kawasaki disease which resolved after therapy with intravenous immune globulin (IVIG and aspirin. Conclusion This case report suggests that Kawasaki disease can occur concurrently or immediately after a rickettsial illness such as Rocky Mountain spotted fever, hypothesizing an antigen-driven immune response to a rickettsial antigen.

    17. Fever. The Variety of Causes and Complexity of Decision

      Directory of Open Access Journals (Sweden)

      V.M. Delyagin

      2013-02-01

      Full Text Available The paper presents the principles of thermometry in children, interpretation of the measurement results, as well as the biological mechanisms of fever and the principles of its treatment. It is shown that the drug of choice in the symptomatic treatment of fever in children is ibuprofen (Nurofen for children.

    18. Parental beliefs and practices regarding childhood fever in Turkish ...

      African Journals Online (AJOL)

      Parental beliefs and practices regarding childhood fever in Turkish primary care. ... Log in or Register to get access to full text downloads. ... problem in pediatric age and is one of the most common reasons parents seek medical attention. ... Parents with a child with fever aged between 0 and 14 years were interviewed.

    19. Crimean-Congo Hemorrhagic Fever

      Directory of Open Access Journals (Sweden)

      Emadi Koochak H

      2003-10-01

      Full Text Available Crimean-Congo hemorrhagic fever (CCHF was first described in the Crimea in 1944 and then in 1956 in congo. CCHF is a viral hemorrhagic fever of the Nairovirus group that belongs to Bunyaviridae family virus. It is transmitted to human by tick bite. The most efficient and common tick that is the vectors of CCHF is a member of the Hyalomma genus which infected many mammals such as livestock, this tick is the main reservoire of virus in nature. Humans also become infected with CCHF virus by direct contact with blood or other infected tissues from livestock or human patients (nosocomial infection. Disease has been found in saharic Africa, Eastern Europe, Pakistan, India and Middle East (specially Iran and Iraq. This disease recently spread in Iran so in 1999 to 2001 at least 222 suspected case(81 definite case reported that led to the death of 15 of 81 cases. It is estimated that 30 percent of the country's cattle are contaminated with this virus."nIn humans, after a short incubation period it appears suddenly with fever, chills, myalgia and GI symptoms followed by severe bleeding and DIC that led to death .If the patient improved, has a long {2-4 weeks convalescence period. Disease diagnosed by clinical manifestations, serologic tests, viral culture and PCR and its specific treatment is oral ribavirin for 10 days, for prevention of disease personal protective measures from tick bite, spraying poison of mews to reduce of ticks crowd, isolation of patients and dis-infection of contaminated personal equipments that who suffering from CCHF is recommended.

    20. Fever of unknown origin as a presenting manifestation of craniopharyngioma in a child

      OpenAIRE

      NANDI, Madhumita; MONDAL, Rakesh

      2010-01-01

      An unusual case of cranio-pharyngioma which presented with prolonged fever described here. Investigation revealed that the child was suffering from leaking craniopharyngioma with hypo-pituitarism Fever was due to chemical meningitis following cranio-pharyngioma as evident from the CSF findings. Craniopharyngioma can cause prolonged or recurrent fever due to various reasons [1]. Prolonged fever as the sole manifestation of cranio-pharyngioma has been rarely reported in literature and this is p...

    1. Dengue hemorrhagic fever and typhoid fever association based on spatial standpoint using scan statistics in DKI Jakarta

      Science.gov (United States)

      Hervind, Widyaningsih, Y.

      2017-07-01

      Concurrent infection with multiple infectious agents may occur in one patient, it appears frequently in dengue hemorrhagic fever (DHF) and typhoid fever. This paper depicted association between DHF and typhoid based on spatial point of view. Since paucity of data regarding dengue and typhoid co-infection, data that be used are the number of patients of those diseases in every district (kecamatan) in Jakarta in 2014 and 2015 obtained from Jakarta surveillance website. Poisson spatial scan statistics is used to detect DHF and typhoid hotspots area district in Jakarta separately. After obtain the hotspot, Fisher's exact test is applied to validate association between those two diseases' hotspot. The result exhibit hotspots of DHF and typhoid are located around central Jakarta. The further analysis used Poisson space-time scan statistics to reveal the hotspot in term of spatial and time. DHF and typhoid fever more likely occurr from January until May in the area which is relatively similar with pure spatial result. Preventive action could be done especially in the hotspot areas and it is required further study to observe the causes based on characteristics of the hotspot area.

    2. Yellow Fever Vaccine Booster Doses: Recommendations of the Advisory Committee on Immunization Practices, 2015.

      Science.gov (United States)

      Staples, J Erin; Bocchini, Joseph A; Rubin, Lorry; Fischer, Marc

      2015-06-19

      On February 26, 2015, the Advisory Committee on Immunization Practices (ACIP) voted that a single primary dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers. ACIP also approved recommendations for at-risk laboratory personnel and certain travelers to receive additional doses of yellow fever vaccine (Box). The ACIP Japanese Encephalitis and Yellow Fever Vaccines Workgroup evaluated published and unpublished data on yellow fever vaccine immunogenicity and safety. The evidence for benefits and risks associated with yellow fever vaccine booster doses was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. This report summarizes the evidence considered by ACIP and provides the updated recommendations for yellow fever vaccine booster doses.

    3. Interim Report on SNP analysis and forensic microarray probe design for South American hemorrhagic fever viruses, tick-borne encephalitis virus, henipaviruses, Old World Arenaviruses, filoviruses, Crimean-Congo hemorrhagic fever viruses, Rift Valley fever

      Energy Technology Data Exchange (ETDEWEB)

      Jaing, C; Gardner, S

      2012-06-05

      The goal of this project is to develop forensic genotyping assays for select agent viruses, enhancing the current capabilities for the viral bioforensics and law enforcement community. We used a multipronged approach combining bioinformatics analysis, PCR-enriched samples, microarrays and TaqMan assays to develop high resolution and cost effective genotyping methods for strain level forensic discrimination of viruses. We have leveraged substantial experience and efficiency gained through year 1 on software development, SNP discovery, TaqMan signature design and phylogenetic signature mapping to scale up the development of forensics signatures in year 2. In this report, we have summarized the whole genome wide SNP analysis and microarray probe design for forensics characterization of South American hemorrhagic fever viruses, tick-borne encephalitis viruses and henipaviruses, Old World Arenaviruses, filoviruses, Crimean-Congo hemorrhagic fever virus, Rift Valley fever virus and Japanese encephalitis virus.

    4. TRAINING PROGRAM FOR NURSING STAFF REGARDING VIRAL HEMORRHAGIC FEVERS IN A MILITARY HOSPITAL.

      Science.gov (United States)

      El-Bahnasawy, Mamdouh M; Megahed, Laila Abdel-Mawla; Saleh, Halla Ahmed Abdullah; Abdelfattah, Magda Abdelhamid; Morsy, Tosson Aly

      2015-08-01

      Viral hemorrhagic fevers (VHFs) refer to a group of illnesses caused by several distinct families of viruses. In general, the term "viral hemorrhagic fever" is used to describe a severe multisystem syndrome (multisystem in that multiple organ systems in the bpdy are affected). Characteristically, the overall vascular system is damaged, and the body's ability to regulate itself is impaired. These symptoms are often accompanied by hemorrhage (bleeding); however, the bleeding is it rarely life-threatening. While some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses cause severe, life-threatening disease. The selected disaster diseases for this study included: 1-Crimean-Congo hemorrhagic Fever, 2-Dengue Fever, 3-Ebola Fever, 4-Hem-orrhagic Fever with renal syndrome (HFRS), 5-Hantavirus Pulmonary Syndrome, 6-Lassa Fever, 7-Marburg Fever, 8-Rift Valley Fever and 9-Yellow Fever. The educational training program was given over ten sessions to a group of Staff Nurses. The results showed that the program succeeded in enhancing nurse' knowledge, awareness, responsibility, and obligations toward patients with the Viral Hemorrhagic Fevers The results showed a significant impact of training sessions illuminated in the follow-up test on the knowledge score of nurses in all types of diseases except for the Congo hemorrhagic fever, while, statistical significance varied in some diseases in the study when it comes to the comparison between pretest and post-test. All results confirmed on the positive impact of the training program in enhancing the knowledge of nurses toward VHFs patients and their relevant. There was a significant positive impact of the training sessions on changing the attitude of nurses toward patients with VHFs. This result was confirmed on the collective level since the total scores on tests revealed significant positive impact of the study on changing the attitude of nurses toward relevant patients. The relationship

    5. Dengue fever associated with acute scrotal oedema: two case reports

      International Nuclear Information System (INIS)

      Shamim, M.; Naqvi, S.Z.G.

      2011-01-01

      Scrotal oedema associated with dengue fever is a rare and self limiting condition resolving in a few days without any complication or sequelae. This is a report of two cases of dengue fever associated with acute scrotal and penile oedema. (author)

    6. Cholestatic hepatitis in a patient with typhoid fever - a case report

      Directory of Open Access Journals (Sweden)

      Wijesiriwardena Bandula C

      2011-10-01

      Full Text Available Abstract Typhoid fever is a very common infectious disease, particularly in developing countries such as Sri Lanka. Although multiple organs are known to be affected by the disease, hepatic involvement could be considered the most important as studies have showed that it is associated with a higher relapse rate. We report a young patient who presented with fever and jaundice and found to have cholestatic hepatitis secondary to typhoid fever.

    7. Parental knowledge, attitudes and beliefs regarding fever in children: an interview study

      Directory of Open Access Journals (Sweden)

      Maria Kelly

      2016-07-01

      Full Text Available Abstract Background Fever is one of the most common childhood symptoms. It causes significant worry and concern for parents. Every year there are numerous cases of over- and under-dosing with antipyretics. Caregivers seek reassurance from a variety of sources including healthcare practitioners. The aim of this study was to describe parental knowledge, attitudes and beliefs regarding management of childhood fever in children aged 5 years and under. Method Semi-structured interviews were conducted with 23 parents at six ante-natal clinics in the south west of Ireland during March and April 2015. The Francis method was used to detect data saturation and thereby identify sample size. Thematic analysis was used to analyse the data. Results Twenty-three parents participated in the study. Five themes emerged from the data: assessing and managing the fever; parental knowledge and beliefs regarding fever; knowledge source; pharmaceutical products; initiatives. Parents illustrated a good knowledge of fever as a symptom. However, management practices varied between participants. Parents revealed a reluctance to use medication in the form of suppositories. There was a desire for more accessible, consistent information to be made available for use by parents when their child had a fever or febrile illness. Conclusion Parents indicated that further initiatives are required to provide trustworthy information on the management of fever and febrile illness in children. Healthcare professionals should play a significant role in educating parents in how to manage fever and febrile illnesses in their children. The accessible nature and location of pharmacies could provide useful support for both parents and General Practitioners.

    8. Parental knowledge, attitudes and beliefs regarding fever in children: an interview study.

      Science.gov (United States)

      Kelly, Maria; Sahm, Laura J; Shiely, Frances; O'Sullivan, Ronan; McGillicuddy, Aoife; McCarthy, Suzanne

      2016-07-11

      Fever is one of the most common childhood symptoms. It causes significant worry and concern for parents. Every year there are numerous cases of over- and under-dosing with antipyretics. Caregivers seek reassurance from a variety of sources including healthcare practitioners. The aim of this study was to describe parental knowledge, attitudes and beliefs regarding management of childhood fever in children aged 5 years and under. Semi-structured interviews were conducted with 23 parents at six ante-natal clinics in the south west of Ireland during March and April 2015. The Francis method was used to detect data saturation and thereby identify sample size. Thematic analysis was used to analyse the data. Twenty-three parents participated in the study. Five themes emerged from the data: assessing and managing the fever; parental knowledge and beliefs regarding fever; knowledge source; pharmaceutical products; initiatives. Parents illustrated a good knowledge of fever as a symptom. However, management practices varied between participants. Parents revealed a reluctance to use medication in the form of suppositories. There was a desire for more accessible, consistent information to be made available for use by parents when their child had a fever or febrile illness. Parents indicated that further initiatives are required to provide trustworthy information on the management of fever and febrile illness in children. Healthcare professionals should play a significant role in educating parents in how to manage fever and febrile illnesses in their children. The accessible nature and location of pharmacies could provide useful support for both parents and General Practitioners.

    9. SECONDARY BACTERIAL INFECTION IN ADULT PATIENTS WITH PROLONGED AND SEVERE DENGUE FEVER

      Directory of Open Access Journals (Sweden)

      Anil Kumar

      2016-05-01

      Full Text Available INTRODUCTION Generally, in dengue shock syndrome antibiotics are not advised. But unrecognised bacterial infection is likely to contribute to morbidity and mortality, probably because of increased vascular permeability. OBJECTIVES To assess the incidence of secondary bacterial infection in adult patients with prolonged and severe dengue fever. METHODS A prospective study was conducted recruiting patients with confirmed acute dengue infection who had prolonged fever (>5 days. Prior to institution of antibiotic therapy, two sets of blood cultures were taken from patients. Demographic, clinical, haematological and biochemical parameters were recorded. Severity of fever & associated symptoms assessed. Ultrasonography done to find out development of ascites and pleural effusions. RESULTS Sixty patients (60.0% males with a mean age of 33.5 years (SD 12.1 were studied. The average duration of fever was 6.9 days (SD 1.6. Fifteen patients (25% had bacterial isolates in their blood cultures; Staphylococcus aureus (n=3, coliforms (n=7, pseudomonas (n=2 and 3 had mixed growths. The culture positive group had severe body aches and joints paint at admission and high grade fever, third space fluid accumulation and significant drop in platelets compared to culture-negative group. CONCLUSIONS A quarter of dengue patients with prolonged fever had a bacterial isolate. Culture-positive patients appeared more ill with body aches and had higher degrees of fever during the course of the illness. Increased vascular permeability may predispose to bacterial seepage into blood. Although white cell count is not helpful in detecting bacteraemia in dengue fever, low platelet count and severe symptoms at presentation may be helpful.

    10. Rapid diagnostic tests for typhoid and paratyphoid (enteric) fever.

      Science.gov (United States)

      Wijedoru, Lalith; Mallett, Sue; Parry, Christopher M

      2017-05-26

      Differentiating both typhoid (Salmonella Typhi) and paratyphoid (Salmonella Paratyphi A) infection from other causes of fever in endemic areas is a diagnostic challenge. Although commercial point-of-care rapid diagnostic tests (RDTs) for enteric fever are available as alternatives to the current reference standard test of blood or bone marrow culture, or to the widely used Widal Test, their diagnostic accuracy is unclear. If accurate, they could potentially replace blood culture as the World Health Organization (WHO)-recommended main diagnostic test for enteric fever. To assess the diagnostic accuracy of commercially available rapid diagnostic tests (RDTs) and prototypes for detecting Salmonella Typhi or Paratyphi A infection in symptomatic persons living in endemic areas. We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, Embase, Science Citation Index, IndMED, African Index Medicus, LILACS, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) up to 4 March 2016. We manually searched WHO reports, and papers from international conferences on Salmonella infections. We also contacted test manufacturers to identify studies. We included diagnostic accuracy studies of enteric fever RDTs in patients with fever or with symptoms suggestive of enteric fever living in endemic areas. We classified the reference standard used as either Grade 1 (result from a blood culture and a bone marrow culture) or Grade 2 (result from blood culture and blood polymerase chain reaction, or from blood culture alone). Two review authors independently extracted the test result data. We used a modified QUADAS-2 extraction form to assess methodological quality. We performed a meta-analysis when there were sufficient studies for the test and heterogeneity was reasonable. Thirty-seven studies met the inclusion criteria and included a total of 5080 participants (range 50 to 1732). Enteric fever prevalence

    11. Typhoid fever cases in the U.S. military.

      Science.gov (United States)

      Sorrell, Tia; Selig, Daniel J; Riddle, Mark S; Porter, Chad K

      2015-10-14

      Salmonella enterica, serovar Typhi (S. Typhi), a causative agent of enteric fever (typhoid fever), predominately affects populations in developing regions with poor access to clean food and water. In addition, travelers to these regions are at risk of exposure. We report the epidemiological characteristics of S. Typhi cases among active duty United States military personnel from 1998 to 2011 using data obtained from the Defense Medical Surveillance System. Cases were identified based on International Classification for Disease Ninth Edition - Clinical Modification codes. We identified a total of 205 cases S. Typhi for an incidence of 1.09 per 100,000 person-years. Cases were on average 31.7 years old, predominately married (n = 129, 62.9 %), Caucasian (n = 142, 69.3 %), male (n = 176, 85.9 %), and had a high school education (n = 101, 49.3 %). Of the identified cases, 122 had received a Typhoid vaccination within 4 years of diagnosis. This study provides an overview of enteric fever in the United States military. The incidence was similar to the general U.S. population except for increased incidence from 1998 to 2000, perhaps attributable to operational deployments in that period. Given that vaccination is an effective primary prevention measure against typhoid fever, active monitoring of pre-deployment vaccine history is warranted.

    12. A Rare Case of Mediterranean Spotted Fever and Encephalitis

      Directory of Open Access Journals (Sweden)

      Raquel Sousa Almeida

      2016-01-01

      Full Text Available Mediterranean spotted fever is a tick-borne zoonotic disease caused by Rickettsia conorii. It is transmitted by the dog tick Rhipicephalus sanguineus. It usually presents as a benign self-limited disease characterized by a skin rash, high fever, and, sometimes, a characteristic ulcer at the tick bite site called tache noir. The course of this disease is usually benign, although severe manifestations have been previously described, mainly in adults. Neurological manifestations are very unusual. We present a case of Mediterranean spotted fever with encephalitis to highlight the importance of clinical suspicion, mainly in endemic areas, the potential severity of this disease, and the need of early initiation of therapy in order to prevent severe complications.

    13. Fever and rash.

      Science.gov (United States)

      Schlossberg, D

      1996-03-01

      The combination of fever and rash comprises an extensive differential diagnosis. Many of the causes of this presentation are life-threatening. In this article, rashes are categorized as petechial, maculopapular, vesicular, erythematous, and urticarial. Each type of rash is then divided into infectious etiologies, both treatable and nontreatable, and noninfectious etiologies. It is usually possible to arrive at a workable differential diagnosis when clinical, historical, and epidemiologic factors are considered.

    14. Frequency of typhoid fever and its association with seasonal variations in Taxila, Pakistan

      Directory of Open Access Journals (Sweden)

      Naeem Bukhari

      2016-08-01

      Full Text Available Objective: To analyse seropositivity rates of salmonella with seasonal variations in the population of Taxila and the surrounding rural areas. Methods: The study was conducted among 760 suspected patients with symptoms of fever, headache, nausea and decreased white blood cells count screened for the typhoid fever. Blood samples collected from the suspected patients were tested for seropositivity by slide agglutination (Widal test and Immunochromatographic test, i.e. Typhidot. Results: From overall 760 suspected patients of typhoid fever only 192 (25.26% samples were positive for Widal and Typhidot test. The peak seropositivity rates were identified during the months of April–June, while decreased cases were observed from January to March. Age wise distribution of typhoid fever reflected that age groups of 10–15 years and 25–35 years were at higher risks of developing enteric fever with respect to age groups of 5–10 years and 61–70 years, respectively. On gender basis evaluation, females (24.49% were slightly at low risks of developing typhoid fever than males (25.9%. Conclusions: The present study highlights a higher burden of typhoid fever in Taxila and the surrounding areas population that directly reflects the poor hygienic condition and contamination of drinking water. The frequency of typhoid fever fluctuates with seasonal variations as higher rates found during the summer as compared to winter season.

    15. Severe thrombocytopenia in a child with typhoid fever: a case report.

      Science.gov (United States)

      Al Reesi, Mohammed; Stephens, Glenn; McMullan, Brendan

      2016-11-30

      Although thrombocytopenia is common in typhoid fever, its course, response to treatment, and need for specific therapies such as platelet transfusion are not well characterized. We report a case of typhoid fever in a 4-year-old Asian male returned traveler, admitted with prolonged fever and found to have severe thrombocytopenia (platelets 16 × 10 9 /L). Despite appropriate antibiotic therapy, his platelet recovery was slow, but did not lead to complications and he did not require platelet transfusion. There is no consensus in the medical literature guiding the optimal management of severe thrombocytopenia in typhoid fever, but it may improve with conservative management, as in our case. The epidemiology and management of this condition merits further research to guide clinical practice.

    16. Fever of unknown origin as a presenting manifestation of craniopharyngioma in a child

      Directory of Open Access Journals (Sweden)

      Madhumita Nandi and Rakesh Kumar Mondal

      2010-01-01

      Full Text Available An unusual case of cranio-pharyngioma which presented with prolonged fever described here. Investigation revealed that the child was suffering from leaking craniopharyngioma with hypo-pituitarism Fever was due to chemical meningitis following cranio-pharyngioma as evident from the CSF findings. Craniopharyngioma can cause prolonged or recurrent fever due to various reasons. Prolonged fever as the sole manifestation of cranio-pharyngioma has been rarely reported in literature and this is probably first such report in Indian children.

    17. Chikungunya fever: current status in Mexico.

      Science.gov (United States)

      Nava-Frías, Margarita; Searcy-Pavía, Ricardo Efrén; Juárez-Contreras, Carina Aurora; Valencia-Bautista, Anayeli

      Chikungunya fever is a tropical vector-borne disease that has been spreading rapidly around the world during the last 10 years, and which has been usually misdiagnosed as dengue. Nowadays, this disease is increasing in Mexico, mainly in the southern and central zones of the country, being significantly more common in women, children and young adults (28% in<20 years of age). The classical presentation includes fever, arthralgia, polyarthritis, back-pain, and skin rashes. Although symptoms and treatment are similar to those for dengue, there are key clinical features to differentiate these two diseases. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

    18. Persistence of yellow fever vaccine-induced antibodies after solid organ transplantation.

      Science.gov (United States)

      Wyplosz, B; Burdet, C; François, H; Durrbach, A; Duclos-Vallée, J C; Mamzer-Bruneel, M-F; Poujol, P; Launay, O; Samuel, D; Vittecoq, D; Consigny, P H

      2013-09-01

      Immunization using live attenuated vaccines represents a contra-indication after solid organ transplantation (SOT): consequently, transplant candidates planning to travel in countries where yellow fever is endemic should be vaccinated prior to transplantation. The persistence of yellow fever vaccine-induced antibodies after transplantation has not been studied yet. We measured yellow-fever neutralizing antibodies in 53 SOT recipients vaccinated prior to transplantation (including 29 kidney recipients and 18 liver recipients). All but one (98%) had protective titers of antibodies after a median duration of 3 years (min.: 0.8, max.: 21) after transplantation. The median antibody level was 40 U/L (interquartile range: 40-80). For the 46 patients with a known or estimated date of vaccination, yellow-fever antibodies were still detectable after a median time of 13 years (range: 2-32 years) post-immunization. Our data suggest there is long-term persistence of antibodies to yellow fever in SOT recipients who have been vaccinated prior to transplantation. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

    19. Risk factors for typhoid and paratyphoid fever in Jakarta, Indonesia.

      NARCIS (Netherlands)

      Vollaard, A.M.; Ali, S.; Asten, H.A.G.H. van; Widjaja, S.; Visser, L.G.; Surjadi, C.; Dissel, J.T. van

      2004-01-01

      CONTEXT: The proportion of paratyphoid fever cases to typhoid fever cases may change due to urbanization and increased dependency on food purchased from street vendors. For containment of paratyphoid a different strategy may be needed than for typhoid, because risk factors for disease may not

    20. Vaccines for preventing typhoid fever.

      Science.gov (United States)

      Milligan, Rachael; Paul, Mical; Richardson, Marty; Neuberger, Ami

      2018-05-31

      Typhoid fever and paratyphoid fever continue to be important causes of illness and death, particularly among children and adolescents in south-central and southeast Asia. Two typhoid vaccines are widely available, Ty21a (oral) and Vi polysaccharide (parenteral). Newer typhoid conjugate vaccines are at varying stages of development and use. The World Health Organization has recently recommended a Vi tetanus toxoid (Vi-TT) conjugate vaccine, Typbar-TCV, as the preferred vaccine for all ages. To assess the effects of vaccines for preventing typhoid fever. In February 2018, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, and mRCT. We also searched the reference lists of all included trials. Randomized and quasi-randomized controlled trials (RCTs) comparing typhoid fever vaccines with other typhoid fever vaccines or with an inactive agent (placebo or vaccine for a different disease) in adults and children. Human challenge studies were not eligible. Two review authors independently applied inclusion criteria and extracted data, and assessed the certainty of the evidence using the GRADE approach. We computed vaccine efficacy per year of follow-up and cumulative three-year efficacy, stratifying for vaccine type and dose. The outcome addressed was typhoid fever, defined as isolation of Salmonella enterica serovar Typhi in blood. We calculated risk ratios (RRs) and efficacy (1 - RR as a percentage) with 95% confidence intervals (CIs). In total, 18 RCTs contributed to the quantitative analysis in this review: 13 evaluated efficacy (Ty21a: 5 trials; Vi polysaccharide: 6 trials; Vi-rEPA: 1 trial; Vi-TT: 1 trial), and 9 reported on adverse events. All trials but one took place in typhoid-endemic countries. There was no information on vaccination in adults aged over 55 years of age, pregnant women, or travellers. Only one trial included data on children under two years of age.Ty21a vaccine (oral vaccine, three doses

    1. Recurrent paratyphoid fever A co-infected with hepatitis A reactivated chronic hepatitis B.

      Science.gov (United States)

      Liu, Yanling; Xiong, Yujiao; Huang, Wenxiang; Jia, Bei

      2014-05-12

      We report here a case of recurrent paratyphoid fever A with hepatitis A co-infection in a patient with chronic hepatitis B. A 26-year-old male patient, who was a hepatitis B virus carrier, was co-infected with Salmonella enterica serovar Paratyphi A and hepatitis A virus. The recurrence of the paratyphoid fever may be ascribed to the coexistence of hepatitis B, a course of ceftriaxone plus levofloxacin that was too short and the insensitivity of paratyphoid fever A to levofloxacin. We find that an adequate course and dose of ceftriaxone is a better strategy for treating paratyphoid fever. Furthermore, the co-infection of paratyphoid fever with hepatitis A may stimulate cellular immunity and break immunotolerance. Thus, the administration of the anti-viral agent entecavir may greatly improve the prognosis of this patient with chronic hepatitis B, and the episodes of paratyphoid fever and hepatitis A infection prompt the use of timely antiviral therapy.

    2. Long-Term Serological Follow-Up of Acute Q-Fever Patients after a Large Epidemic.

      Directory of Open Access Journals (Sweden)

      Cornelia C H Wielders

      Full Text Available Serological follow-up of acute Q-fever patients is important for detection of chronic infection but there is no consensus on its frequency and duration. The 2007-2009 Q-fever epidemic in the Netherlands allowed for long-term follow-up of a large cohort of acute Q-fever patients. The aim of this study was to validate the current follow-up strategy targeted to identify patients with chronic Q-fever.A cohort of adult acute Q-fever patients, diagnosed between 2007 and 2009, for whom a twelve-month follow-up sample was available, was invited to complete a questionnaire and provide a blood sample, four years after the acute episode. Antibody profiles, determined by immunofluorescence assay in serum, were investigated with a special focus on high titres of IgG antibodies against phase I of Coxiella burnetii, as these are considered indicative for possible chronic Q-fever.Of the invited 1,907 patients fulfilling inclusion criteria, 1,289 (67.6% were included in the analysis. At any time during the four-year follow-up period, 58 (4.5% patients were classified as possible, probable, or proven chronic Q-fever according to the Dutch Q-fever Consensus Group criteria (which uses IgG phase I ≥1:1,024 to as serologic criterion for chronic Q-fever. Fifty-two (89.7% of these were identified within the first year after the acute episode. Of the six patients that were detected for the first time at four-year follow-up, five had an IgG phase I titre of 1:512 at twelve months.A twelve-month follow-up check after acute Q-fever is recommended as it adequately detects chronic Q-fever in patients without known risk factors. Additional serological and clinical follow-up is recommended for patients with IgG phase I ≥1:512, as they showed the highest risk to progress to chronic Q-fever.

    3. Impact of esophageal temperature monitoring guided atrial fibrillation ablation on preventing asymptomatic excessive transmural injury

      Science.gov (United States)

      Kiuchi, Kunihiko; Okajima, Katsunori; Shimane, Akira; Kanda, Gaku; Yokoi, Kiminobu; Teranishi, Jin; Aoki, Kousuke; Chimura, Misato; Toba, Takayoshi; Oishi, Shogo; Sawada, Takahiro; Tsukishiro, Yasue; Onishi, Tetsuari; Kobayashi, Seiichi; Taniguchi, Yasuyo; Yamada, Shinichiro; Yasaka, Yoshinori; Kawai, Hiroya; Yoshida, Akihiro; Fukuzawa, Koji; Itoh, Mitsuaki; Imamura, Kimitake; Fujiwara, Ryudo; Suzuki, Atsushi; Nakanishi, Tomoyuki; Yamashita, Soichiro; Hirata, Ken-ichi; Tada, Hiroshi; Yamasaki, Hiro; Naruse, Yoshihisa; Igarashi, Miyako; Aonuma, Kazutaka

      2015-01-01

      Background Even with the use of a reduced energy setting (20–25 W), excessive transmural injury (ETI) following catheter ablation of atrial fibrillation (AF) is reported to develop in 10% of patients. However, the incidence of ETI depends on the pulmonary vein isolation (PVI) method and its esophageal temperature monitor setting. Data comparing the incidence of ETI following AF ablation with and without esophageal temperature monitoring (ETM) are still lacking. Methods This study was comprised of 160 patients with AF (54% paroxysmal, mean: 24.0±2.9 kg/m2). Eighty patients underwent ablation accompanied by ETM. The primary endpoint was defined as the occurrence of ETI assessed by endoscopy within 5 d after the AF ablation. The secondary endpoint was defined as AF recurrence after a single procedure. If the esophageal temperature probe registered >39 °C, the radiofrequency (RF) application was stopped immediately. RF applications could be performed in a point-by-point manner for a maximum of 20 s and 20 W. ETI was defined as any injury that resulted from AF ablation, including esophageal injury or periesophageal nerve injury (peri-ENI). Results The incidence of esophageal injury was significantly lower in patients whose AF ablation included ETM compared with patients without ETM (0 [0%] vs. 6 [7.5%], p=0.028), but not the incidence of peri-ENI (2 [2.5%] vs. 3 [3.8%], p=1.0). AF recurrence 12 months after the procedure was similar between the groups (20 [25%] in the ETM group vs. 19 [24%] in the non-ETM group, p=1.00). Conclusions Catheter ablation using ETM may reduce the incidence of esophageal injury without increasing the incidence of AF recurrence but not the incidence of peri-ENI. PMID:26949429

    4. Modeling the Geographic Consequence and Pattern of Dengue Fever Transmission in Thailand.

      Science.gov (United States)

      Bekoe, Collins; Pansombut, Tatdow; Riyapan, Pakwan; Kakchapati, Sampurna; Phon-On, Aniruth

      2017-05-04

      Dengue fever is one of the infectious diseases that is still a public health problem in Thailand. This study considers in detail, the geographic consequence, seasonal and pattern of dengue fever transmission among the 76 provinces of Thailand from 2003 to 2015. A cross-sectional study. The data for the study was from the Department of Disease Control under the Bureau of Epidemiology, Thailand. The quarterly effects and location on the transmission of dengue was modeled using an alternative additive log-linear model. The model fitted well as illustrated by the residual plots and the  Again, the model showed that dengue fever is high in the second quarter of every year from May to August. There was an evidence of an increase in the trend of dengue annually from 2003 to 2015. There was a difference in the distribution of dengue fever within and between provinces. The areas of high risks were the central and southern regions of Thailand. The log-linear model provided a simple medium of modeling dengue fever transmission. The results are very important in the geographic distribution of dengue fever patterns.

    5. A cost-effectiveness analysis of typhoid fever vaccines in US military personnel.

      Science.gov (United States)

      Warren, T A; Finder, S F; Brier, K L; Ries, A J; Weber, M P; Miller, M R; Potyk, R P; Reeves, C S; Moran, E L; Tornow, J J

      1996-11-01

      Typhoid fever has been a problem for military personnel throughout history. A cost-effectiveness analysis of typhoid fever vaccines from the perspective of the US military was performed. Currently 3 vaccine preparations are available in the US: an oral live Type 21A whole cell vaccine; a single-dose parenteral, cell subunit vaccine; and a 2-dose parenteral heat-phenol killed, whole cell vaccine. This analysis assumed all vaccinees were US military personnel. Two pharmacoeconomic models were developed, one for personnel who have not yet been deployed, and the other for personnel who are deployed to an area endemic for typhoid fever. Drug acquisition, administration, adverse effect and lost work costs, as well as the costs associated with typhoid fever, were included in this analysis. Unique military issues, typhoid fever attack rates, vaccine efficacy, and compliance with each vaccine's dosage regimen were included in this analysis. A sensitivity analysis was performed to test the robustness of the models. Typhoid fever immunisation is not cost-effective for US military personnel unless they are considered imminently deployable or are deployed. The most cost-effective vaccine for US military personnel is the single-dose, cell subunit parenteral vaccine.

    6. Fever Management in Parents who Have Children Aged 0-5 Year

      Directory of Open Access Journals (Sweden)

      S. Reshadat

      2012-07-01

      Full Text Available Introduction & Objective: Fever is very common in children and is usually due to self-limiting viral infections. Management of fever is based on culture, community and religion of people all over the world. Parental concerns arise in part because of the belief that fever is a disease rather than a symptom or sign of illness. Misconceptions about childhood fevers heighten parents' concerns leading to inappropriate use of antipyretic drugs or overdosing may cause drug toxicity and frequent use of health care services. This study aimed to identify parental views of fever management in their children aged 0-5 yr.Materials & Methods: In this cross sectional study, 350 parents with children less than 5 years referred to various units of clinics covered by community oriented center of Kermanshah, completed the research questionnaire. Validity and reliability of the questionnaire were determined and the data was analyzed by SPSS Software.Results: Findings showed that the first medical care was sponging (53.1%. Sponging with saltwater was common (47.7% and Over - the - counter medications were (30%. Acetaminophen was the first drug in 90% of the cases. However, many parents express high levels of anxiety so that they seek for self-medication with antibiotic 34% of the cases. Our study showed that correlation between over concern about fever management and parents who had a positive past medical history in their children with P=0.02, parents education (P=0.018 and in employed mothers (P=0.005 was statistically significant.Conclusion: Considerable efforts will be required to educate parents about fever and its management.(Sci J Hamadan Univ Med Sci 2012;19(2:28-33

    7. Rocky Mountain spotted fever from an unexpected tick vector in Arizona.

      Science.gov (United States)

      Demma, Linda J; Traeger, Marc S; Nicholson, William L; Paddock, Christopher D; Blau, Dianna M; Eremeeva, Marina E; Dasch, Gregory A; Levin, Michael L; Singleton, Joseph; Zaki, Sherif R; Cheek, James E; Swerdlow, David L; McQuiston, Jennifer H

      2005-08-11

      Rocky Mountain spotted fever is a life-threatening, tick-borne disease caused by Rickettsia rickettsii. This disease is rarely reported in Arizona, and the principal vectors, Dermacentor species ticks, are uncommon in the state. From 2002 through 2004, a focus of Rocky Mountain spotted fever was investigated in rural eastern Arizona. We obtained blood and tissue specimens from patients with suspected Rocky Mountain spotted fever and ticks from patients' homesites. Serologic, molecular, immunohistochemical, and culture assays were performed to identify the causative agent. On the basis of specific laboratory criteria, patients were classified as having confirmed or probable Rocky Mountain spotted fever infection. A total of 16 patients with Rocky Mountain spotted fever infection (11 with confirmed and 5 with probable infection) were identified. Of these patients, 13 (81 percent) were children 12 years of age or younger, 15 (94 percent) were hospitalized, and 2 (12 percent) died. Dense populations of Rhipicephalus sanguineus ticks were found on dogs and in the yards of patients' homesites. All patients with confirmed Rocky Mountain spotted fever had contact with tick-infested dogs, and four had a reported history of tick bite preceding the illness. R. rickettsii DNA was detected in nonengorged R. sanguineus ticks collected at one home, and R. rickettsii isolates were cultured from these ticks. This investigation documents the presence of Rocky Mountain spotted fever in eastern Arizona, with common brown dog ticks (R. sanguineus) implicated as a vector of R. rickettsii. The broad distribution of this common tick raises concern about its potential to transmit R. rickettsii in other settings. Copyright 2005 Massachusetts Medical Society.

    8. Natural biological variation of white matter microstructure is accentuated in Huntington's disease.

      Science.gov (United States)

      Gregory, Sarah; Crawford, Helen; Seunarine, Kiran; Leavitt, Blair; Durr, Alexandra; Roos, Raymund A C; Scahill, Rachael I; Tabrizi, Sarah J; Rees, Geraint; Langbehn, Douglas; Orth, Michael

      2018-04-22

      Huntington's disease (HD) is a monogenic neurodegenerative disorder caused by a CAG-repeat expansion in the Huntingtin gene. Presence of this expansion signifies certainty of disease onset, but only partly explains age at which onset occurs. Genome-wide association studies have shown that naturally occurring genetic variability influences HD pathogenesis and disease onset. Investigating the influence of biological traits in the normal population, such as variability in white matter properties, on HD pathogenesis could provide a complementary approach to understanding disease modification. We have previously shown that while white matter diffusivity patterns in the left sensorimotor network were similar in controls and HD gene-carriers, they were more extreme in the HD group. We hypothesized that the influence of natural variation in diffusivity on effects of HD pathogenesis on white matter is not limited to the sensorimotor network but extends to cognitive, limbic, and visual networks. Using tractography, we investigated 32 bilateral pathways within HD-related networks, including motor, cognitive, and limbic, and examined diffusivity metrics using principal components analysis. We identified three independent patterns of diffusivity common to controls and HD gene-carriers that predicted HD status. The first pattern involved almost all tracts, the second was limited to sensorimotor tracts, and the third encompassed cognitive network tracts. Each diffusivity pattern was associated with network specific performance. The consistency in diffusivity patterns across both groups coupled with their association with disease status and task performance indicates that naturally-occurring patterns of diffusivity can become accentuated in the presence of the HD gene mutation to influence clinical brain function. © 2018 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

    9. [Control discourses and power relations of yellow fever: Philadelphia in 1793].

      Science.gov (United States)

      Kim, Seohyung

      2014-12-01

      1793 Yellow fever in Philadelphia was the most severe epidemics in the late 18th century in the United States. More than 10% of the population in the city died and many people fled to other cities. The cause of yellow fever in the United States had close relationship with slaves and sugar in Philadelphia. Sugarcane plantation had needed many labors to produce sugar and lots of Africans had to move to America as slaves. In this process, Aëdes aegypti, the vector of yellow fever had migrated to America and the circumstances of ships or cities provided appropriate conditions for its breeding. In this period, the cause of yellow fever could not be established exactly, so suggestions of doctors became entangled in political and intellectual discourses in American society. There was a critical conflict between Jeffersonian Republicanism and Federalism about the origin and treatment of yellow fever. Benjamin Rush, a Jeffersonian Republican, suggested urban sanitation reform and bloodletting. He believed the infectious disease happened because of unsanitary city condition, so he thought the United States could be a healthy nation by improvement of the public health and sanitation. He would like to cope with national crisis and develop American society on the basis of republicanism. While Rush suggested the improvement of public health and sanitation, the city government of Philadelphia suggested isolation of yellow fever patients and quarantine. City government isolated the patients from healthy people and it reconstructed space of hospital. Also, it built orphanages to take care of children who lost their parents during the epidemic and implemented power to control people put in the state of exception. Of course, city government tried to protect the city and nation by quarantine of every ship to Philadelphia. Control policies of yellow fever in 1793 showed different conflicts and interactions. Through the yellow fever, Jeffersonian Republicanism and Federalism had

    10. Fever of Unknown Origin: the Value of FDG-PET/CT

      NARCIS (Netherlands)

      Kouijzer, I.J.E.; Mulders-Manders, C.M.; Bleeker-Rovers, C.P.; Oyen, W.J.G.

      2018-01-01

      Fever of unknown origin (FUO) is commonly defined as fever higher than 38.3 degrees C on several occasions during at least 3 weeks with uncertain diagnosis after a number of obligatory investigations. The differential diagnosis of FUO can be subdivided in four categories: infections, malignancies,

    11. Limitations of typhoid fever diagnostics and the need for prevention

      NARCIS (Netherlands)

      Smits, Henk L.

      2013-01-01

      Evaluation of: Siba V, Horwood PF, Vanuga K et al. Evaluation of serological diagnostic tests for typhoid fever in Papua New Guinea using a composite reference standard. Clin. Vaccine Immunol. 19(11), 1833-1837 (2012). The study under review evaluated serological tests for typhoid fever against PCR

    12. Marburg hemorrhagic fever associated with multiple genetic lineages of virus

      DEFF Research Database (Denmark)

      Bausch, D G; Nichol, S T; Muyembe-Tamfum, J J

      2006-01-01

      Background An outbreak of Marburg hemorrhagic fever was first observed in a gold-mining village in northeastern Democratic Republic of the Congo in October 1998. Methods We investigated the outbreak of Marburg hemorrhagic fever most intensively in May and October 1999. Sporadic cases and short ch...

    13. Urinary tract infections and post-operative fever in percutaneous nephrolithotomy

      DEFF Research Database (Denmark)

      Gutierrez, Jorge; Smith, Arthur; Geavlete, Petrisor

      2013-01-01

      PURPOSE: To review the incidence of UTIs, post-operative fever, and risk factors for post-operative fever in PCNL patients. MATERIALS AND METHODS: Between 2007 and 2009, consecutive PCNL patients were enrolled from 96 centers participating in the PCNL Global Study. Only data from patients with pre...

    14. Prolonged fever in peritoneal tuberculosis: A case report

      Science.gov (United States)

      Zein, U.; Irwandi, S.; Habib, H.; Lim, H.; Pasha, M.; Janis, I.; Saragih, R. H.; Ginting, Y.; Effendy-Y S, R.

      2018-03-01

      Peritoneal tuberculosis may lead to delayed diagnosis because of the nonspecific features such as fever, abdominal distension, abdominal tenderness, ascites, and weight loss. Here, wereported a case of prolonged fever and abdominal pain which was due to peritoneal tuberculosis. Initial examinations including acomplete blood test and serologic tests did not lead to the diagnosis. A final diagnosis was made by abdominal CT-scan and laparoscopy combined with histopathological studies. Antituberculous medications provided a good clinical response in this patient.

    15. Dengue Hemorrhagic Fever: Epidemiology, Pathogenesis, and Its Transmission Risk Factors

      Directory of Open Access Journals (Sweden)

      Aryu Candra

      2010-12-01

      Full Text Available Dengue hemorrhagic fever is an infectious disease resulting spectrum of clinical manifestations that vary from the lightest, dengue fever, hemorrhagic fever and dengue fever are accompanied by shock or dengue shock syndrome. Its caused by dengue virus, transmitted by Aedes mosquitoes. The case is spread in the tropics, especially in Southeast Asia, Central America, America and the Caribbean, many causes of death in children 90% of them attacking children under 15 years old. Until now pathogenesis is unclear. There are two theories or hypotheses immuno-patogenesis DHF and DSS is still controversial which secondary infections (secondary heterologus infection and antibody-dependent enhancement. Risk factors for dengue transmission are rapid urban population growth, mobilization of the population because of improved transportation facilities and disrupted or weakened so that population control. Another risk factor is poverty which result in people not has the ability to provide a decent home and healthy, drinking water supply and proper waste disposal.

    16. Ongoing Cerebral Vasculitis During Treatment of Rocky Mountain Spotted Fever.

      Science.gov (United States)

      Sun, Lisa R; Huisman, Thierry A G M; Yeshokumar, Anusha K; Johnston, Michael V

      2015-11-01

      Rocky Mountain spotted fever is a tickborne infection that produces a systemic small-vessel vasculitis; its prognosis is excellent if appropriate treatment is initiated early. Because the advent of effective antirickettsial therapies predates the widespread use of brain magnetic resonance imaging, there are limited data on the effect of untreated Rocky Mountain spotted fever infection on neuroimaging studies. We describe a 7-year-old girl with delayed treatment of Rocky Mountain spotted fever who suffered severe neurological impairment. Serial brain magnetic resonance images revealed a progressive "starry sky appearance," which is proposed to result from the same small vessel vasculitis that causes the characteristic skin rash of this infection. Neurological injury can continue to occur despite specific antirickettsial therapy in Rocky Mountain spotted fever. This child's clinical features raise questions about the optimal management of this infection, particularly the utility of immune modulating therapies in cases of delayed treatment and neurological involvement. Copyright © 2015 Elsevier Inc. All rights reserved.

    17. Fever during pregnancy and motor development in children

      DEFF Research Database (Denmark)

      Holst, Charlotte; Jørgensen, Sanne Ellegaard; Wohlfahrt, Jan

      2015-01-01

      AIM: The aim of this study was to examine how fever during pregnancy is associated with motor development in the child. METHOD: This cohort study was based on data from females and their children, from the Danish National Birth Cohort, who took part in an 18-month and/or 7-year follow-up study....... Information regarding fever (number of episodes, temperature, duration, and pregnancy week) was obtained around gestation week 12 and at the end of pregnancy. Assessments of motor development in early childhood were based on the ages at which the motor milestones 'sitting unsupported' (n=44 256) and 'walking...... unassisted' (n=53 959) were attained. The Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07) was used to identify children with indication of developmental coordination disorder (DCD) at age 7 years (n=29 401). Any associations between the exposure to fever during pregnancy and motor...

    18. Usefulness of the early molecular diagnosis of Q fever and rickettsial diseases in patients with fever of intermediate duration.

      Science.gov (United States)

      Bolaños-Rivero, Margarita; Carranza-Rodríguez, Cristina; Hernández-Cabrera, Michele; Pisos-Álamo, Elena; Jaén-Sánchez, Nieves; Pérez-Arellano, José-Luis

      2017-12-01

      Most cases of fever of intermediate duration (FDI) in Spain are associated with infectious diseases (mainly Q fever and rickettsia infections). In clinical practice, the causal diagnosis of these entities is based on immunodiagnostic techniques, which are of little help in the early stages. Therefore, the aim of this study was to evaluate the usefulness of molecular techniques for the early diagnosis of Q fever and rickettsia diseases in patients with FDI. A PCR method was used to detect the presence of genetic material of Coxiella burnetii and Rickettsia spp. in blood specimens from 271 patients with FDI. The specificity of both techniques is high, allowing diagnosis in cases undiagnosed by specific antibodies detection. These data suggest that the use of molecular techniques, with proper selection of the study specimen, and using appropriate primers is a useful tool in the early diagnosis of the main causes of FDI, especially if serology is negative or inconclusive. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

    19. PFAPA (Periodic fever, aphtous stomatitis, pharingitis, cervical adenitis) or Marshall’s syndrome in children

      OpenAIRE

      N N Kuzmina; G R Movsisyan

      2005-01-01

      PFAPA (periodic fever, aphtous stomatitis, pharingitis, cervical adenitis) or Marshall’s syndrome is one of the rare periodic fever conditions appearing in children. Its cause is unknown. This syndrome may continue for several years. During interictal period the child is quite well, grows and develops normally. The disease should be differentiated from Behcet’s disease, cyclic neutropenia, familial Mediterranean fever, familial Ireland fever, hyperimmunoglobulinemia D syndrome, systemic juven...

    20. Thrombosis and antiphospholipid antibody syndrome during acute Q fever: A cross-sectional study.

      Science.gov (United States)

      Million, Matthieu; Bardin, Nathalie; Bessis, Simon; Nouiakh, Nadia; Douliery, Charlaine; Edouard, Sophie; Angelakis, Emmanouil; Bosseray, Annick; Epaulard, Olivier; Branger, Stéphanie; Chaudier, Bernard; Blanc-Laserre, Karine; Ferreira-Maldent, Nicole; Demonchy, Elisa; Roblot, France; Reynes, Jacques; Djossou, Felix; Protopopescu, Camelia; Carrieri, Patrizia; Camoin-Jau, Laurence; Mege, Jean-Louis; Raoult, Didier

      2017-07-01

      Q fever is a neglected and potentially fatal disease. During acute Q fever, antiphospholipid antibodies are very prevalent and have been associated with fever, thrombocytopenia, acquired heart valve disease, and progression to chronic endocarditis. However, thrombosis, the main clinical criterion of the 2006 updated classification of the antiphospholipid syndrome, has not been assessed in this context. To test whether thrombosis is associated with antiphospholipid antibodies and whether the criteria for antiphospholipid syndrome can be met in patients with acute Q fever, we conducted a cross-sectional study at the French National Referral Center for Q fever.Patients included were diagnosed with acute Q fever in our Center between January 2007 and December 2015. Each patient's history and clinical characteristics were recorded with a standardized questionnaire. Predictive factors associated with thrombosis were assessed using a rare events logistic regression model. IgG anticardiolipin antibodies (IgG aCL) assessed by an enzyme-linked immunosorbent assay were tested on the Q fever diagnostic serum. A dose-dependent relationship between IgG aCL levels and thrombosis was tested using a receiver operating characteristic (ROC) analysis.Of the 664 patients identified for inclusion in the study, 313 (47.1%) had positive IgG aCL and 13 (1.9%) were diagnosed with thrombosis. Three patients fulfilled the antiphospholipid syndrome criteria. After multiple adjustments, only positive IgG aCL (relative risk, 14.46 [1.85-113.14], P = .011) were independently associated with thrombosis. ROC analysis identified a dose-dependent relationship between IgG aCL levels and occurrence of thrombosis (area under curve, 0.83, 95%CI [0.73-0.93], P antiphospholipid antibodies are associated with thrombosis, thrombocytopenia, and acquired valvular heart disease. Antiphospholipid antibodies should be systematically assessed in acute Q fever patients. Hydroxychloroquine, which has been

    1. Urinary tract infections and post-operative fever in percutaneous nephrolithotomy

      NARCIS (Netherlands)

      Gutierrez, Jorge; Smith, Arthur; Geavlete, Petrisor; Shah, Hemendra; Kural, Ali Riza; de Sio, Marco; Amón Sesmero, José H.; Hoznek, András; de la Rosette, Jean

      2013-01-01

      To review the incidence of UTIs, post-operative fever, and risk factors for post-operative fever in PCNL patients. Between 2007 and 2009, consecutive PCNL patients were enrolled from 96 centers participating in the PCNL Global Study. Only data from patients with pre-operative urine samples and who

    2. Dengue fever treatment with Carica papaya leaves extracts.

      Science.gov (United States)

      Ahmad, Nisar; Fazal, Hina; Ayaz, Muhammad; Abbasi, Bilal Haider; Mohammad, Ijaz; Fazal, Lubna

      2011-08-01

      The main objective of the current study is to investigate the potential of Carica papaya leaves extracts against Dengue fever in 45 year old patient bitten by carrier mosquitoes. For the treatment of Dengue fever the extract was prepared in water. 25 mL of aqueous extract of C. papaya leaves was administered to patient infected with Dengue fever twice daily i.e. morning and evening for five consecutive days. Before the extract administration the blood samples from patient were analyzed. Platelets count (PLT), White Blood Cells (WBC) and Neutrophils (NEUT) decreased from 176×10(3)/µL, 8.10×10(3)/µL, 84.0% to 55×10(3)/µL, 3.7×10(3)/µL and 46.0%. Subsequently, the blood samples were rechecked after the administration of leaves extract. It was observed that the PLT count increased from 55×10(3)/µL to 168×10(3)/µL, WBC from 3.7×10(3)/µL to 7.7×10(3)/µL and NEUT from 46.0% to 78.3%. From the patient feelings and blood reports it showed that Carica papaya leaves aqueous extract exhibited potential activity against Dengue fever. Furthermore, the different parts of this valuable specie can be further used as a strong natural candidate against viral diseases.

    3. Geriatric Fever Score: a new decision rule for geriatric care.

      Directory of Open Access Journals (Sweden)

      Min-Hsien Chung

      Full Text Available Evaluating geriatric patients with fever is time-consuming and challenging. We investigated independent mortality predictors of geriatric patients with fever and developed a prediction rule for emergency care, critical care, and geriatric care physicians to classify patients into mortality risk and disposition groups.Consecutive geriatric patients (≥65 years old visiting the emergency department (ED of a university-affiliated medical center between June 1 and July 21, 2010, were enrolled when they met the criteria of fever: a tympanic temperature ≥37.2°C or a baseline temperature elevated ≥1.3°C. Thirty-day mortality was the primary endpoint. Internal validation with bootstrap re-sampling was done.Three hundred thirty geriatric patients were enrolled. We found three independent mortality predictors: Leukocytosis (WBC >12,000 cells/mm3, Severe coma (GCS ≤ 8, and Thrombocytopenia (platelets <150 10(3/mm3 (LST. After assigning weights to each predictor, we developed a Geriatric Fever Score that stratifies patients into two mortality-risk and disposition groups: low (4.0% (95% CI: 2.3-6.9%: a general ward or treatment in the ED then discharge and high (30.3% (95% CI: 17.4-47.3%: consider the intensive care unit. The area under the curve for the rule was 0.73.We found that the Geriatric Fever Score is a simple and rapid rule for predicting 30-day mortality and classifying mortality risk and disposition in geriatric patients with fever, although external validation should be performed to confirm its usefulness in other clinical settings. It might help preserve medical resources for patients in greater need.

    4. Fluoroscopy-assisted vs fluoroless endoscopic ultrasound-guided transmural drainage of pancreatic fluid collections: A comparative study.

      Science.gov (United States)

      Consiglieri, Claudia F; Gornals, Joan B; Busquets, Juli; Peláez, Nuria; Secanella, Lluis; De-La-Hera, Meritxell; Sanzol, Resurrección; Fabregat, Joan; Castellote, José

      2018-01-01

      The need for fluoroscopy guidance in patients undergoing endoscopic ultrasound-guided transmural drainage (EUS-TMD) of peripancreatic fluid collections (PFCs) remains unclear. The aim of this study was to compare general outcomes of EUS-TMD of PFCs under fluoroscopy (F) vs fluoroless (FL). This is a comparative study with a retrospective analysis of a prospective and consecutive inclusion database at a tertiary centre, from 2009 to 2015. All patients were symptomatic pseudocyst (PSC) and walled-off pancreatic necrosis (WON). Two groups were assigned depending on availability of fluoroscopy. The groups were heterogeneous in terms of their demographic characteristics, PFCs and procedure. The main outcome measures included technical and clinical success, incidences, adverse events (AEs), and follow-up. Fifty EUS-TMD of PFCs from 86 EUS-guided drainages were included during the study period. Group F included 26 procedures, PSC 69.2%, WON 30.8%, metal stents 61.5% (46.1% lumen-apposing stent) and plastic stents 38.5%. Group FL included 24 procedures, PSC 37.5%, WON 62.5%, and metal stents 95.8% (lumen-apposing stents). Technical success was 100% in both groups, and clinical success was similar (F 88.5%, FL 87.5%). Technical incidences and intra-procedure AEs were only described in group F (7.6% and 11.5%, respectively) and none in group FL. Procedure time was less in group FL (8min, p=0.0341). Fluoroless in the EUS-TMD of PFCs does not involve more technical incidences or intra-procedure AEs. Technical and clinical success was similar in the two groups. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

    5. Diarrhea associated with typhoid fever

      NARCIS (Netherlands)

      Roy, S. K.; Speelman, P.; Butler, T.; Nath, S.; Rahman, H.; Stoll, B. J.

      1985-01-01

      To study the pathogenesis of diarrhea occurring with typhoid fever, we selected 42 patients with diarrhea and blood cultures positive for Salmonella typhi or Salmonella paratyphi A, but without diarrheal copathogens, for measurement of stool output and examination of fecal composition. The mean

    6. Can internet search queries be used for dengue fever surveillance in China?

      Science.gov (United States)

      Guo, Pi; Wang, Li; Zhang, Yanhong; Luo, Ganfeng; Zhang, Yanting; Deng, Changyu; Zhang, Qin; Zhang, Qingying

      2017-10-01

      China experienced an unprecedented outbreak of dengue fever in 2014, and the number of cases reached the highest level over the past 25 years. Traditional sentinel surveillance systems of dengue fever in China have an obvious drawback that the average delay from receipt to dissemination of dengue case data is roughly 1-2 weeks. In order to exploit internet search queries to timely monitor dengue fever, we analyzed data of dengue incidence and Baidu search query from 31 provinces in mainland China during the period of January 2011 to December 2014. We found that there was a strong correlation between changes in people's online health-seeking behavior and dengue fever incidence. Our study represents the first attempt demonstrating a strong temporal and spatial correlation between internet search trends and dengue epidemics nationwide in China. The findings will help the government to strengthen the capacity of traditional surveillance systems for dengue fever. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

    7. Estimating the number of unvaccinated Chinese workers against yellow fever in Angola.

      Science.gov (United States)

      Wilder-Smith, A; Massad, E

      2018-04-17

      A yellow fever epidemic occurred in Angola in 2016 with 884 laboratory confirmed cases and 373 deaths. Eleven unvaccinated Chinese nationals working in Angola were also infected and imported the disease to China, thereby presenting the first importation of yellow fever into Asia. In Angola, there are about 259,000 Chinese foreign workers. The fact that 11 unvaccinated Chinese workers acquired yellow fever suggests that many more Chinese workers in Angola were not vaccinated. We applied a previously developed model to back-calculate the number of unvaccinated Chinese workers in Angola in order to determine the extent of lack of vaccine coverage. Our models suggest that none of the 259,000 Chinese had been vaccinated, although yellow fever vaccination is mandated by the International Health Regulations. Governments around the world including China need to ensure that their citizens obtain YF vaccination when traveling to countries where such vaccines are required in order to prevent the international spread of yellow fever.

    8. Pathogenesis of Rift Valley Fever in Rhesus Monkeys: Role of Interferon Response

      Science.gov (United States)

      1990-01-01

      hemorrhagic fever characterized by epistaxis, petechial to purpuric cutaneous lesions, anorexia, and vomiting prior to death. The 14 remaining monkeys survived...DMI, FILE Copy Arch Virol (1990) 110: 195-212 Amhivesirology ( by Springer-Verlag 1990 00 N Pathogenesis of Rift Valley fever in rhesus monkeys: (NI...inoculated intravenously with Rift Valley fever (RVF) virus presented clinical disease syndromes similar to human cases of RVF. All 17 infected monkeys

    9. Association between Intrapartum Magnesium Administration and the Incidence of Maternal Fever: A Retrospective Cross-sectional Study.

      Science.gov (United States)

      Lange, Elizabeth M S; Segal, Scott; Pancaro, Carlo; Wong, Cynthia A; Grobman, William A; Russell, Gregory B; Toledo, Paloma

      2017-12-01

      Intrapartum maternal fever is associated with several adverse neonatal outcomes. Intrapartum fever can be infectious or inflammatory in etiology. Increases in interleukin 6 and other inflammatory markers are associated with maternal fever. Magnesium has been shown to attenuate interleukin 6-mediated fever in animal models. We hypothesized that parturients exposed to intrapartum magnesium would have a lower incidence of fever than nonexposed parturients. In this study, electronic medical record data from all deliveries at Northwestern Memorial Hospital (Chicago, Illinois) between 2007 and 2014 were evaluated. The primary outcome was intrapartum fever (temperature at or higher than 38.0°C). Factors associated with the development of maternal fever were evaluated using a multivariable logistic regression model. Propensity score matching was used to reduce potential bias from nonrandom selection of magnesium administration. Of the 58,541 women who met inclusion criteria, 5,924 (10.1%) developed intrapartum fever. Febrile parturients were more likely to be nulliparous, have used neuraxial analgesia, and have been delivered via cesarean section. The incidence of fever was lower in women exposed to magnesium (6.0%) than those who were not (10.2%). In multivariable logistic regression, women exposed to magnesium were less likely to develop a fever (adjusted odds ratio = 0.42 [95% CI, 0.31 to 0.58]). After propensity matching (N = 959 per group), the odds ratio of developing fever was lower in women who received magnesium therapy (odds ratio = 0.68 [95% CI, 0.48 to 0.98]). Magnesium may play a protective role against the development of intrapartum fever. Future work should further explore the association between magnesium dosing and the incidence of maternal fever.

    10. Dengue Fever in the United States

      Centers for Disease Control (CDC) Podcasts

      Dr. Amesh Adalja, an associate at the Center for Biosecurity and clinical assistant professor at the University of Pittsburgh School, of Medicine, discusses dengue fever outbreaks in the United States.

    11. The Sensitivity Of Diazo Test In The Diagnosis Of Enteric Fevers ...

      African Journals Online (AJOL)

      serological) test in the diagnosis of enteric fevers, blood specimens from101 patients suspected of having enteric fevers were collected. 54.5% (55) of the patients were significantly seropositive. Fifteen urine specimens from these 55 seropositive ...

    12. IBUPROFEN IN COMPLEX TREATMENT OF FEVER IN CHILDREN

      Directory of Open Access Journals (Sweden)

      А.А. Alexeeva

      2011-01-01

      Full Text Available Pain and fever are one of the most frequent conditions in pediatric practice. Frequent occurrence of fever accompanied by a pain syndrome stipulates combined antipyretic and analgesic medications. This article contains information upon ibuprofen use («Nurofen for children» in pediatric patients as an antipyretic and analgesic medication to be used as part of complex treatment of acute respiratory infections.Key words: fewer, children, ibuprofen. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (6: 137–140

    13. Approach to postoperative fever in pediatric cardiac patients

      International Nuclear Information System (INIS)

      Gupta, Ajay K; Singh, Vishal K; Varma, Amit

      2012-01-01

      Fever in the postoperative period in children undergoing surgery for congenital heart disease is fairly common and tends to cause anxiety to both the surgeon and the patient. Such fever is associated with the metabolic response to trauma, systemic response to the cardiopulmonary bypass, hypothermia, presence of drainage tubes, drugs, blood transfusion as well as infections. Establishing the diagnosis requires proper assessment of the patient with focused history, targeted physical examination and judicious use of investigations with the knowledge of the common causes

    14. Rift Valley fever potential mosquito vectors and their infection status ...

      African Journals Online (AJOL)

      Background: Rift Valley fever (RVF) is a mosquito-borne viral zoonotic disease. Rift Valley fever virus (RVFV) has been isolated from more than 40 species of mosquitoes from eight genera. This study was conducted to determine the abundance of potential mosquito vectors and their RVFV infection status in Ngorongoro ...

    15. Epidural Analgesia and Fever at Labor

      Directory of Open Access Journals (Sweden)

      Ye. M. Shifman

      2008-01-01

      Full Text Available Objective: to study the incidence of labor fever under epidural analgesia (EA and to evaluate its impact on the courses of puerperium and early neonatality. Subjects and methods. The paper presents the data of a prospective study of the course of labor, puerperium, and early neonatality in 397 women in whom labors occurred at the Republican Peritoneal Center in 2006. A study group included 324 parturients in whom labor pain was relieved by EA. A comparison group comprised 55 parturients in whom no analgesics were used at labor. Results. There were no significant statistical differences between the groups in the incidence of labor fever and complicated puerperium and in that of neonatal pyoseptic diseases. Key words: labor hyperthermia, epidural analgesia, labor pain relief.

    16. Predictors of serious bacterial infections in pediatric burn patients with fever.

      Science.gov (United States)

      Vyles, David; Sinha, Madhumita; Rosenberg, David I; Foster, Kevin N; Tran, Melissa; Drachman, David

      2014-01-01

      To determine predictors of serious bacterial infections in pediatric burn patients with fever (core temp ≥38.5°C), the authors conducted a retrospective review of medical records of pediatric (0-18 years) patients admitted to the Arizona Burn Center between 2008 and 2011 with greater than 5% TBSA and inpatient hospitalization for ≥72 hours. The study group comprised patients with a febrile episode during their inpatient stay. Serious bacterial infection (the primary outcome variable) was defined as: bacteremia, urinary tract infection, meningitis (blood, urine, or cerebrospinal fluid culture positive for a pathogen respectively), pneumonia, line, and wound infection. A generalized estimating equation analysis was done to predict the presence or absence of serious bacterial infection. Of 1082 pediatric burn patients hospitalized during the study period, 353 met the study eligibility criteria. A total of 108 patients (30.6%) had at least one fever episode (fever group). No difference in demographic characteristics was noted between the fever and no-fever groups; significant differences were observed for: third-degree TBSA, second-degree TBSA, total operating room visits, length of stay, Injury Severity Score, and death. A total of 47.2% of the patients had one or more episodes of fever with serious bacterial infection. In a generalized estimating equation predictive model, presence of a central line, second-, and third-degree TBSA were predictive of serious bacterial infection in burn patients with fever. In this study, individual clinical variables such as tachypnea and tachycardia were not predictive of serious bacterial infections, but the presence of a central line, and larger TBSA were significant predictors of serious bacterial infections. Younger age (P =.08) and ventilator support (P =.057) also approached significance as predictors of serious bacterial infections.

    17. Dengue fever in patients admitted in tertiary care hospitals in Pakistan

      International Nuclear Information System (INIS)

      Munir, M. A.; Saqib, M. A. N.; Qureshi, H.; Alam, S. E.; Arif, A.; Khan, Z. U.; Saeed, Q.; Iqbal, R.

      2014-01-01

      Objectives: To assess the gaps in the diagnosis and management of dengue fever cases. Methods: The retrospective descriptive analytical study was done with a case record analysis of patients with dengue fever admitted from January to December 2010 at five tertiary care hospitals in different Pakistani cities. Using a questionnaire, information was gathered on demography, haematological profile, management, use of blood and platelet transfusions and the outcome. For comparison, data of serologically-confirmed dengue patients from a private laboratory in Islamabad was collected to see the age, gender and month-wise distribution of cases tested over the same period. SPSS 16 was used for statistical analysis. Results: Out of the 841 confirmed dengue cases, 514 (79%) were males and 139 (21%) females. The overall mean age was 31.3+-14.0 years. Dengue fever was seen in 653 (78%) and dengue haemorrhagic fever (DHF) in 188 (22%) patients. Most cases were between 20 and 49 years of age. A gradual increase in dengue fever and dengue haemorrhagic fever was seen from August, with a peak in October/November. Tourniquet test was done only in 20 (2.3%) cases, out of which 11 (55%) were positive and 9 (45%) were negative. Serial haematocrit was not done in any case. Total deaths were 5 (0.6%). Conclusions: Most cases were seen in October/November with the majority being in the 20-39 age group. Tourniquet test and serial haematocrit were infrequently used. No standard national guidelines were employed. (author)

    18. Multifocal choroiditis following simultaneous hepatitis A, typhoid, and yellow fever vaccination

      Directory of Open Access Journals (Sweden)

      Escott S

      2013-02-01

      Full Text Available Sarah Escott, Ahmad B Tarabishy, Frederick H DavidorfHavener Eye Institute, The Ohio State University, Columbus, OH, USAAbstract: The paper describes the first reported case of multifocal choroiditis following simultaneous hepatitis-A, typhoid, and yellow fever vaccinations. A 33-year-old male developed sudden onset of flashing lights and floaters in his right eye 3 weeks following hepatitis A, typhoid, and yellow fever vaccinations. Fundus examination and angiography confirmed the presence of multiple peripheral chorioretinal lesions. These lesions demonstrated characteristic morphologic changes over a period of 8 weeks which were consistent with a diagnosis of self-resolving multifocal choroiditis. Vaccine-induced intraocular inflammation has been described infrequently. We demonstrate the first case of self-resolving multifocal choroiditis following simultaneous administration of hepatitis A, yellow fever, and typhoid immunizations.Keywords: multifocal choroiditis, vaccination, hepatitis A, typhoid, yellow fever

    19. Malaria fever therapy for general paralysis of the insane in Denmark.

      Science.gov (United States)

      Kragh, Jesper Vaczy

      2010-12-01

      This article explores the history of general paralysis and malaria fever therapy in Denmark. I argue that the small size of the country gave Danish psychiatrists excellent opportunities for performing statistical studies of general paralysis in the 19th century. In the early 1920s malaria fever therapy was introduced in Danish mental hospitals and raised hopes of a cure for paralytics. Malaria fever therapy became popular among Danish psychiatrists, but the new therapy also raised ethical questions and led to the first regulations concerning informed consent in the history of Danish psychiatry.

    20. Prospective cohort study of fever incidence and risk in elderly persons living at home

      Science.gov (United States)

      Yokobayashi, Kenichi; Matsushima, Masato; Watanabe, Takamasa; Fujinuma, Yasuki; Tazuma, Susumu

      2014-01-01

      Objective To determine the incidence of fever among elderly persons under home medical management, diagnosis at fever onset and outcomes from a practical standpoint. Design Prospective cohort study. Setting 5 clinics in residential areas of Tokyo that process an average of 50–200 outpatients/day. Participants Patients (n=419) aged ≥65 years who received home medical management from the five clinics between 1 October 2009 and 30 September 2010. Main outcome measures Fever (≥37.5°C or ≥1.5°C above usual body temperature), diagnosis at onset and outcomes (cure at home, hospitalisation and death). Results The incidence of fever was 2.5/1000 patient-days (95% CI 2.2 to 2.8). Fever occurred at least once (229 fever events) among one-third of the participants during the study period. Fever was more likely to arise in the wheelchair users or bedridden than in ambulatory individuals (HR 1.9 (95% CI 1.3 to 2.8; p<0.01); in patients with moderate-to-severe rather than those with none-to-mild cognitive impairment (HR, 1.7 (95% CI 1.1 to 2.6, p=0.01); and in those whose care-need levels were ≥3 rather than ≤2 (HR, 4.5 (95% CI 2.9 to 7.0; p<0.01). The causes of fever were pneumonia/bronchitis (n=103), skin and soft tissue infection (n=26), urinary tract infection (n=22) and the common cold (n=13). Fever was cured in 67% and 23% of patients at home and in hospital, respectively, and 5% of patients each died at home and in hospital. Antimicrobial agents treated 153 (67%) events in the home medical care setting. Conclusions Fever was more likely to occur in those requiring higher care levels and the main cause of fever was pneumonia/bronchitis. Healthcare providers should consider the conditions of elderly residents with lower objective functional status. PMID:25009132

    1. Parental and medical knowledge and management of fever in Italian pre-school children

      Directory of Open Access Journals (Sweden)

      Chiappini Elena

      2012-07-01

      Full Text Available Abstract Background Guidelines for the management of fever in children have been recently published, however “fever phobia” is still spreading. To provide information which may sustain educational interventions tailored to our population we investigated the parental and medical knowledge and management of fever in preschool children. Methods A questionnaire was administered to a convenient sample of Italian parents and paediatricians. The questionnaire elicited information about definition and cause of fever, concerns about fever, method of temperature measurement, and treatment modalities. Results Overall, 388 parents and 480 paediatricians were interviewed. All the parents believed that fever could cause at least one harmful effect and 89.9% (n = 349 believed that, if left untreated, it can cause brain damage or seizures. Parents used multiple resources to obtain information about fever but 67.8% (n = 264 considered paediatricians as their primary resource. Several wrong behaviours were found in the same proportions among parents and paediatricians: 78.5% of paediatricians (n = 377 and 77.8% of parents (n = 302 used physical method to reduce fever (P = 0.867; 27.0% of paediatricians (n = 103 and 21.4% (n = 83 of parents declared to alternate ibuprofen and acetaminophen (P = 0.953. Differently, 73.1% (n = 351 of paediatricians preferred oral to rectal administration of antipyretics compared to 48.7% (n = 190 of parents (P  Conclusions Paediatricians’ attitudes greatly influence the parental behaviours and beliefs. Implementation of educational programs regarding the management of the febrile child are needed in our setting.

    2. Transmural gradients in Na/K pump activity and [Na+]I in canine ventricle.

      Science.gov (United States)

      Gao, J; Wang, W; Cohen, I S; Mathias, R T

      2005-09-01

      There are well-documented differences in ion channel activity and action potential shape between epicardial (EPI), midmyocardial (MID), and endocardial (ENDO) ventricular myocytes. The purpose of this study was to determine if differences exist in Na/K pump activity. The whole cell patch-clamp was used to measure Na/K pump current (I(P)) and inward background Na(+)-current (I(inb)) in cells isolated from canine left ventricle. All currents were normalized to membrane capacitance. I(P) was measured as the current blocked by a saturating concentration of dihydro-ouabain. [Na(+)](i) was measured using SBFI-AM. I(P)(ENDO) (0.34 +/- 0.04 pA/pF, n = 17) was smaller than I(P)(EPI) (0.68 +/- 0.09 pA/pF, n = 38); the ratio was 0.50 with I(P)(MID) being intermediate (0.53 +/- 0.13 pA/pF, n = 19). The dependence of I(P) on [Na(+)](i) or voltage was essentially identical in EPI and ENDO (half-maximal activation at 9-10 mM [Na(+)](i) or approximately -90 mV). Increasing [K(+)](o) from 5.4 to 15 mM caused both I(P)(ENDO) and I(P)(EPI) to increase, but the ratio remained approximately 0.5. I(inb) in EPI and ENDO were nearly identical ( approximately 0.6 pA/pF). Physiological [Na(+)](i) was lower in EPI (7 +/- 2 mM, n = 31) than ENDO (12 +/- 3 mM, n = 29), with MID being intermediate (9 +/- 3 mM, n = 22). When cells were paced at 2 Hz, [Na(+)](i) increased but the differences persisted (ENDO 14 +/- 3 mM, n = 10; EPI 9 +/- 2 mM, n = 10; and MID intermediate, 11 +/- 2 mM, n = 9). Based on these results, the larger I(P) in EPI appears to reflect a higher maximum turnover rate, which implies either a larger number of active pumps or a higher turnover rate per pump protein. The transmural gradient in [Na(+)](i) means physiological I(P) is approximately uniform across the ventricular wall, whereas transporters that utilize the transmembrane electrochemical gradient for Na(+), such as Na/Ca exchange, have a larger driving force in EPI than ENDO.

    3. What would PCR assessment change in the management of fevers in a malaria endemic area? A school-based study in Benin in children with and without fever

      Directory of Open Access Journals (Sweden)

      Faucher Jean-François

      2010-08-01

      Full Text Available Abstract Background A recent school-based study in Benin showed that applying a policy of anti-malarial prescriptions restricted to parasitologically-confirmed cases on the management of fever is safe and feasible. Additional PCR data were analysed in order to touch patho-physiological issues, such as the usefulness of PCR in the management of malaria in an endemic area or the triggering of a malaria attack in children with submicroscopic malaria. Methods PCR data were prospectively collected in the setting of an exposed (with fever/non exposed (without fever study design. All children had a negative malaria rapid diagnostic test (RDT at baseline, were followed up to day 14 and did not receive drugs with anti-malarial activity. The index group was defined by children with fever at baseline and the control group by children without fever at baseline. Children with submicroscopic malaria in these two groups were defined by a positive PCR at baseline. Results PCR was positive in 66 (27% children of the index group and in 104 (44% children of the control group respectively. The only significant factor positively related to PCR positivity at baseline was the clinical status (control group. When definition of malaria attacks included PCR results, no difference of malaria incidence was observed between the index and control groups, neither in the whole cohort, nor in children with submicroscopic malaria. The rate of undiagnosed malaria at baseline was estimated to 3.7% at baseline in the index group. Conclusions Treating all children with fever and a positive PCR would have led to a significant increase of anti-malarial consumption, with few benefits in terms of clinical events. Non malarial fevers do not or do not frequently trigger malaria attacks in children with submicroscopic malaria.

    4. Inflammatory myofibroblastic tumor of the mesentery associated with high fever and positive Widal test

      International Nuclear Information System (INIS)

      Chouairy, Camil J.; Bechara, Elie A.; Ghabril, Ramy H.; Gebran, Sleiman J.

      2008-01-01

      Inflammatory myofibroblastic tumor (IMT) is associated in 15-30% of cases with systemic symptomatology , such as prolonged fever, weight loss, elevated erythrocyte sedimentation rate (ESR) , anemia, thrombocytosis and leukocytosis. We report the case of a 4-year-old Lebanese boy who presented with high-grade fever of long duration and a single (unpaired) positive Widal agglutination test. Blood culture was negative. A diagnosis of typhoid fever was made. An abdominal (mesenteric) IMT was incidentally discovered, 30 days after the fever had appeared. After surgery, the fever disappeared immediately, and the ESR returned. We strongly favor the possibility of a false positive Widal test, due to polyclonal increase in serum immunoglobulins, which often occurs in IMT. We also think that IMT might be a mimicker of typhoid fever, both clinically and serologically. Physicians, especially pediatricians practicing in endemic areas, should probably be aware of this mimicry. (author)

    5. Inflammatory myofibroblastic tumor of the mesentery associated with high fever and positive Widal test

      Energy Technology Data Exchange (ETDEWEB)

      Chouairy, Camil J [Dept. of Pathology, Saint George Hospital, Beirut (Lebanon); Bechara, Elie A; Ghabril, Ramy H [Dept. of Pediatrics, Saint George Hospital, Beirut (Lebanon); Gebran, Sleiman J [Dept. of Pediatric Surgery, AlHada Armed Forces Hospital, Taif (Saudi Arabia)

      2008-07-01

      Inflammatory myofibroblastic tumor (IMT) is associated in 15-30% of cases with systemic symptomatology , such as prolonged fever, weight loss, elevated erythrocyte sedimentation rate (ESR) , anemia, thrombocytosis and leukocytosis. We report the case of a 4-year-old Lebanese boy who presented with high-grade fever of long duration and a single (unpaired) positive Widal agglutination test. Blood culture was negative. A diagnosis of typhoid fever was made. An abdominal (mesenteric) IMT was incidentally discovered, 30 days after the fever had appeared. After surgery, the fever disappeared immediately, and the ESR returned. We strongly favor the possibility of a false positive Widal test, due to polyclonal increase in serum immunoglobulins, which often occurs in IMT. We also think that IMT might be a mimicker of typhoid fever, both clinically and serologically. Physicians, especially pediatricians practicing in endemic areas, should probably be aware of this mimicry. (author)

    6. Outbreak of Rocky Mountain spotted fever in Córdoba, Colombia.

      Science.gov (United States)

      Hidalgo, Marylin; Miranda, Jorge; Heredia, Damaris; Zambrano, Pilar; Vesga, Juan Fernando; Lizarazo, Diana; Mattar, Salim; Valbuena, Gustavo

      2011-02-01

      Rocky Mountain spotted fever (RMSF) is a tick-borne disease caused by the obligate intracellular bacterium Rickettsia rickettsii. Although RMSF was first reported in Colombia in 1937, it remains a neglected disease. Herein, we describe the investigation of a large cluster of cases of spotted fever rickettsiosis in a new area of Colombia.

    7. Dengue as a cause of acute undifferentiated fever in Vietnam

      NARCIS (Netherlands)

      Phuong, H.L.; de Vries, P.J.; Nga, T.T.T.; Giao, P.T.; Hung, L.Q.; Binh, T.Q.; Nam, N.V.; Nagelkerke, N.; Kager, P.A.

      2006-01-01

      Background: Dengue is a common cause of fever in the tropics but its contribution to the total burden of febrile illnesses that is presented to primary health facilities in endemic regions such as Vietnam, is largely unknown. We aimed to report the frequency of dengue as a cause of fever in Binh

    8. Dengue as a cause of acute undifferentiated fever in Vietnam

      NARCIS (Netherlands)

      Phuong, Hoang Lan; de Vries, Peter J.; Nga, Tran T. T.; Giao, Phan T.; Hung, Le Q.; Binh, Tran Q.; Nam, Nguyen V.; Nagelkerke, Nico; Kager, Piet A.

      2006-01-01

      BACKGROUND: Dengue is a common cause of fever in the tropics but its contribution to the total burden of febrile illnesses that is presented to primary health facilities in endemic regions such as Vietnam, is largely unknown. We aimed to report the frequency of dengue as a cause of fever in Binh

    9. Spontaneous muscle hematomas in a patient with Dengue hemorrhagic fever

      Directory of Open Access Journals (Sweden)

      Jency Maria Koshy

      2014-01-01

      Full Text Available Dengue hemorrhagic fever (DHF and Dengue shock syndrome manifest in various forms, ranging from petechial skin hemorrhage to life threatening cerebral, pulmonary, gastrointestinal and genitourinary hemorrhages. However it is very rare to have muscle hematomas in DHF. We report a rare case of spontaneous Iliopsoas hematoma complicating Dengue hemorrhagic fever.

    10. Accentuated Virchow-Robin spaces in the centrum semiovale in children with autistic disorder.

      Science.gov (United States)

      Taber, Katherine H; Shaw, J Bryant; Loveland, Katherine A; Pearson, Deborah A; Lane, David M; Hayman, L Anne

      2004-01-01

      The purpose of this study was to assess the incidence of abnormal Virchow-Robin (VR) spaces in children and adolescents with an autistic disorder (AD). An increased incidence of enlarged VR spaces in children has been reported in several developmental disorders. Sixteen children and adolescents (13 male, 3 female; mean age = 143.5 months; mean IQ = 95.1) with an AD, verified by use of standardized procedures (Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule-Revised), received cranial magnetic resonance (MR) imaging. Sixteen children and adolescents (13 male, 3 female; mean age = 160.7 months; mean IQ = 111.6) without AD, as determined using the same procedures, were scanned as a comparison group. The MR scans were performed using a 1.5-T scanner. Two T1-weighted spoiled GRASS sequences (0.7-mm coronal thin-slice, 0-mm gap; 1.5-mm sagittal, 0-mm gap) and a complementary T2-weighted fast spin echo sequence (1.5-mm, 0-mm gap) were obtained. A neuroradiologist and a neurobiologist without clinical information determined the incidence of normal, accentuated, and/or dilated VR spaces. Seven of 16 subjects with AD (approximately 44%) had dilated VR spaces in the centrum semiovale. No grossly abnormal spaces were present in the control subjects. Unusually large VR spaces are seen in at most 22% to 27% of MR scans in children with tension headaches and other psychiatric disorders, suggesting that the incidence of spaces of this type is greater in AD than in other abnormal populations. The origin and significance of this phenomenon remain unknown.

    11. Body Temperature Measurement Skills and Fever Knowledge of Caregivers with a Child Having Cancer

      Directory of Open Access Journals (Sweden)

      Begul Yagci-Kupeli

      2013-08-01

      Full Text Available Purpose: We did not encounter a study dealing with the knowledge of fever and attitudes of caregivers having children with a diagnosis of malignant disease toward fever in English literature. Materials and Methods: Caregivers of 124 pediatric oncology patients and 72 patients without any malignant disease were recruited and interviewed using a 26-item questionnaire about fever and its management in two hospital clinics in Diyarbakir, Turkey. Results: Seventy point one percent of the mothers in oncology group were illiterate and in 75% of the cases, caregiver was the mother of the patient. Most of the caregivers in control group (72.2% knew at least one harmful effect of high fever (p=0.001. The primary method of measurement however was palpation in both groups. 41.9% of the caregivers in oncology group knew the correct measurement of fever, but only 2.7% in control group (p=0.001. Resources of fever konowledge was mainly doctors and nurses in oncology group (p=0.001. Conclusion: Pediatric health care providers must have more initiative and exploit oppportunities on parental understanding of fever and its management. Educational interventions are needed to correct caregivers’ misconceptions about fever and to promote appropriate management of febrile pediatric oncology patients. [Cukurova Med J 2013; 38(4.000: 706-711

    12. [Drug-induced fever: a diagnosis to remember].

      Science.gov (United States)

      Vodovar, D; Le Beller, C; Lillo-Le-Louet, A; Hanslik, T; Megarbane, B

      2014-03-01

      Drug fever (DF) is a febrile reaction induced by a drug without additional clinical features like skin eruption. This adverse drug reaction is probably common but under diagnosed. While its outcome is generally favourable, DF generates unnecessary diagnostic procedures as well as hospitalisations or hospitalisation prolongations. Clinical presentation and biological findings are not specific. Fever is generally well tolerated but may be accompanied by general symptoms mimicking sepsis. Moderate biological disorders could be expected, including elevation or decrease in white blood cell count, eosinophilia, liver cytolysis, and increased C-reactive protein. An infection should be systematically ruled out. Clinical or biological signs of severity should question DF diagnosis. When DF is suspected, the involved drug(s) should be stopped after a reliable assessment of imputability. Antibiotics represent the most often implicated drugs. Fever disappearance after discontinuing the suspected drug is the cornerstone of DF diagnosis. Before stopping the administration of the suspected drug(s), a risk/benefit ratio assessment is necessary. Consistently, it may be complicated to stop an antimicrobial drug when treating an infection or an immunosuppressive drug if required. Copyright © 2013. Published by Elsevier SAS.

    13. Hay fever & homeopathy: a case series evaluation.

      Science.gov (United States)

      Pandey, Vinita

      2016-05-01

      Seasonal allergic rhinitis (hay fever) is common and can considerably reduce the quality of life of sufferers. Despite the wide everyday application and promising results with homeopathy, scientific evidence of its effectiveness for most ailments is scarce. The assessment of the clinical effectiveness of homeopathic remedies in the alleviation of hay fever symptoms in a typical clinical setting. We performed a clinical observational study of eight patients in the treatment of hay fever symptoms over a two-year period (2012 and 2013) using Measure Yourself Medical Outcome Profile (MYMOP) self-evaluation questionnaires at baseline and again after two weeks and four weeks of homeopathic treatment. The individualized prescription - either a single remedy or multiple remedies - was based on the totality of each patient's symptoms. The average MYMOP scores for the eyes, nose, activity and wellbeing had improved significantly after two and four weeks of homeopathic treatment. The overall average MYMOP profile score at baseline was 3.83 (standard deviation, SD, 0.78). After 14 and 28 days of treatment the average score had fallen to 1.14 (SD, 0.36; PHomeopathy. Published by Elsevier Ltd. All rights reserved.

    14. Alkhurma Hemorrhagic Fever in Saudi Arabia

      Centers for Disease Control (CDC) Podcasts

      This podcast looks at the epidemiologic characteristics of Alkhurma Hemorrhagic Fever in humans in Najran City, Saudi Arabia. CDC epidemiologist Dr. Adam MacNeil discusses the severity and risk factors for the illness.

    15. Accentuated lines in the enamel of primary incisors from skeletal remains: A contribution to the explanation of early childhood mortality in a medieval population from Poland.

      Science.gov (United States)

      Żądzińska, Elżbieta; Lorkiewicz, Wiesław; Kurek, Marta; Borowska-Strugińska, Beata

      2015-07-01

      Physiological disruptions resulting from an impoverished environment during the first years of life are of key importance for the health and biological status of individuals and populations. Studies of growth processes in archaeological populations point to the fact that the main causes of childhood mortality in the past are to be sought among extrinsic factors. Based on this assumption, one would expect random mortality of children, with the deceased individuals representing the entire subadult population. The purpose of this study is to explore whether differences in early childhood survival are reflected in differences in deciduous tooth enamel, which can provide an insight into the development of an individual during prenatal and perinatal ontogeny. Deciduous incisors were taken from 83 individuals aged 2.0-6.5 years from a medieval inhumation cemetery dated AD 1300-1600. Prenatal and postnatal enamel formation time, neonatal line width, and the number of accentuated lines were measured using an optical microscope. The significantly wider neonatal line and the higher frequency of accentuated lines in the enamel of the incisors of children who died at the age of 2-3 years suggest the occurrence of stronger or more frequent stress events in this group. These results indicate that in skeletal populations mortality was not exclusively determined by random external factors. Individuals predisposed by an unfavorable course of prenatal and perinatal growth were more likely to die in early childhood. © 2015 Wiley Periodicals, Inc.

    16. Addressing a Yellow Fever Vaccine Shortage - United States, 2016-2017.

      Science.gov (United States)

      Gershman, Mark D; Angelo, Kristina M; Ritchey, Julian; Greenberg, David P; Muhammad, Riyadh D; Brunette, Gary; Cetron, Martin S; Sotir, Mark J

      2017-05-05

      Recent manufacturing problems resulted in a shortage of the only U.S.-licensed yellow fever vaccine. This shortage is expected to lead to a complete depletion of yellow fever vaccine available for the immunization of U.S. travelers by mid-2017. CDC, the Food and Drug Administration (FDA), and Sanofi Pasteur are collaborating to ensure a continuous yellow fever vaccine supply in the United States. As part of this collaboration, Sanofi Pasteur submitted an expanded access investigational new drug (eIND) application to FDA in September 2016 to allow for the importation and use of an alternative yellow fever vaccine manufactured by Sanofi Pasteur France, with safety and efficacy comparable to the U.S.-licensed vaccine; the eIND was accepted by FDA in October 2016. The implementation of this eIND protocol included developing a systematic process for selecting a limited number of clinic sites to provide the vaccine. CDC and Sanofi Pasteur will continue to communicate with the public and other stakeholders, and CDC will provide a list of locations that will be administering the replacement vaccine at a later date.

    17. A randomized trial of the effects of antibiotic prophylaxis on epidural-related fever in labor.

      Science.gov (United States)

      Sharma, Shiv K; Rogers, Beverly B; Alexander, James M; McIntire, Donald D; Leveno, Kenneth J

      2014-03-01

      It has been suggested that the development of maternal fever during epidural analgesia could be due to intrapartum infection. We investigated whether antibiotic prophylaxis before epidural placement decreases the rate of epidural-related fever. In this double-blind, placebo-controlled trial, 400 healthy nulliparous women requesting epidural analgesia were randomly assigned to receive either cefoxitin 2 g or placebo immediately preceding initiation of epidural labor analgesia. Maternal tympanic temperature was measured hourly, and intrapartum fever was defined as a maternal temperature of ≥38°C. Neonates born to women with fever were evaluated for possible sepsis, and available placentas were evaluated for the presence of neutrophilic inflammation. The primary outcome was maternal fever during epidural analgesia. Thirty-eight percent of women in the cefoxitin group and 40% of women in the placebo group developed fever (P = 0.68). The risk difference (95% confidence interval) for fever ≥38°C during labor (antibiotic versus placebo) was -2.0% (-11.5 to 7.5), and for fever >39°C during labor was -1.5% (-4.7 to 1.7). Approximately half of each study group had placental neutrophilic inflammation, but administration of cefoxitin had no significant effect on any grade of neutrophilic inflammation. Fever developed significantly more often in the women with placental neutrophilic inflammation compared with those without such inflammation (73/158 vs 33/144, P labor epidural analgesia is associated with placental inflammation, but fever and placental inflammation were not reduced with antibiotic prophylaxis. This finding suggests that infection is unlikely to be the cause in its development.

    18. Fever of unknown origin; Re-evaluation of sup 67 Ga scintigraphy in detecting causes of fever

      Energy Technology Data Exchange (ETDEWEB)

      Misaki, Takashi; Matsui, Akira; Tanaka, Fumiko; Okuno, Yoshishige; Mitsumori, Michihide; Torizuka, Tatsurou; Dokoh, Shigeharu; Hayakawa, Katsumi; Shimbo, Shin-ichirou (Kyoto City Hospital (Japan))

      1990-06-01

      Gallium-67 scintigraphy is a commonly performed imaging modality in deteting pyrogenic lesions in cases of long-standing inexplainable fever. To re-evaluate the significance of gallium imaging in such cases, a retrospective review was made of 56 scans performed in febrile patients in whom sufficient clinical and laboratory findings were obtained. Gallium scans were true positive in 30 patients, false positive in 3, true negative in 19, and false negative in 4. In the group of true positive, local inflammatory lesions were detected in 23 patients with a final diagnosis of lung tuberculosis, urinary tract infection, and inflammatory joint disease. Abnormal gallium accumulation, as shown in the other 7 patients, provided clues to the diagnosis of generalized disorders, such as hematological malignancies (n=3), systemic autoimmune diseases (n=3), and severe infectious mononucleosis (n=one). In the group of false positive, gallium imaging revealed intestinal excretion of gallium in 2 patients and physiological pulmonary hilar accumulation in one. In the true negative group of 19 patients, fever of unknown origin was resolved spontaneously in 12 patients, and with antibiotics and corticosteroids in 2 and 5 patients, respectively. Four patients having false negative scans were finally diagnosed as having urinary tract infection (n=2), bacterial meningitis (n=one), and polyarteritis (n=one). Gallium imaging would remain the technique of choice in searching for origin of unknown fever. It may also be useful for early diagnosis of systemic disease, as well as focal inflammation. (N.K.).

    19. Poor food hygiene and housing as risk factors for typhoid fever in Semarang, Indonesia.

      NARCIS (Netherlands)

      Gasem, M.H.; Dolmans, W.M.V.; Keuter, M.; Djokomoeljanto, R.J.

      2001-01-01

      To identify risk factors for typhoid fever in Semarang city and its surroundings, 75 culture-proven typhoid fever patients discharged 2 weeks earlier from hospital and 75 controls were studied. Control subjects were neighbours of cases with no history of typhoid fever, not family members, randomly

    20. The death of Alexander the Great: malaria or typhoid fever?

      Science.gov (United States)

      Cunha, Burke A

      2004-03-01

      Alexander the Great had a profound effect on world history. His conquests covered the entire known world at the time, and he was responsible for the spread of Greek culture throughout the ancient world. In Babylon in 323 BC, Alexander died when he was nearly 33 years old. Possible explanations for his death have included alcoholic liver disease and strychnine poisoning, but little data support either condition as the cause of his death. Alexander most likely died from malaria or typhoid fever, which were rampant in ancient Babylon. The description of his final illness from the royal diaries is consistent with typhoid fever or malaria but is most characteristic of typhoid fever.

    1. Yellow fever vaccine used in a psoriatic arthritis patient treated with methotrexate: a case report.

      Science.gov (United States)

      Stuhec, Matej

      2014-01-01

      The yellow fever vaccines on the market are contraindicated for immunocompromised and elderly patients. A case of yellow fever vaccine used in a 27-year-old Slovenian male with psoriatic arthritis during treatment with methotrexate is described. We demonstrate a positive case, since there were no adverse effects in concurrent administration of yellow fever vaccine and methotrexate. This patient did not show severe adverse reactions and did not contract yellow fever despite potential exposure. More research is needed on possible adverse effects of concurrent administration of yellow fever vaccine and methotrexate to determine the potential of this method for more frequent use.

    2. Ebola hemorrhagic Fever.

      Science.gov (United States)

      Burnett, Mark W

      2014-01-01

      Ebola hemorrhagic fever is an often-fatal disease caused by a virus of the Filoviridae family, genus Ebolavirus. Initial signs and symptoms of the disease are nonspecific, often progressing on to a severe hemorrhagic illness. Special Operations Forces Medical Providers should be aware of this disease, which occurs in sporadic outbreaks throughout Africa. Treatment at the present time is mainly supportive. Special care should be taken to prevent contact with bodily fluids of those infected, which can transmit the virus to caregivers. 2014.

    3. The cost of uncomplicated childhood fevers to Kenyan households: implications for reaching international access targets

      Directory of Open Access Journals (Sweden)

      Noor Abdisalan M

      2006-12-01

      Full Text Available Abstract Background Fever is the clinical hallmark of malaria disease. The Roll Back Malaria (RBM movement promotes prompt, effective treatment of childhood fevers as a key component to achieving its optimistic mortality reduction goals by 2010. A neglected concern is how communities will access these new medicines promptly and the costs to poor households when they are located in rural areas distant to health services. Methods We assemble data developed between 2001 and 2002 in Kenya to describe treatment choices made by rural households to treat a child's fever and the related costs to households. Using a cost-of-illness approach, we estimate the expected cost of a childhood fever to Kenyan households in 2002. We develop two scenarios to explore how expected costs to households would change if more children were treated at a health care facility with an effective antimalarial within 48 hours of fever onset. Results 30% of uncomplicated fevers were managed at home with modern medicines, 38% were taken to a health care facility (HCF, and 32% were managed at home without the use of modern medicines. Direct household cash expenditures were estimated at $0.44 per fever, while the total expected cost to households (cash and time of an uncomplicated childhood fever is estimated to be $1.91. An estimated mean of 1.42 days of caretaker time devoted to each fever accounts for the majority of household costs of managing fevers. The aggregate cost to Kenyan households of managing uncomplicated childhood fevers was at least $96 million in 2002, equivalent to 1.00% of the Kenyan GDP. Fewer than 8% of all fevers were treated with an antimalarial drug within 24 hours of fever onset, while 17.5% were treated within 48 hours at a HCF. To achieve an increase from 17.5% to 33% of fevers treated with an antimalarial drug within 48 hours at a HCF (Scenario 1, children already being taken to a HCF would need to be taken earlier. Under this scenario, direct cash

    4. Standardized assessment of infrared thermographic fever screening system performance

      Science.gov (United States)

      Ghassemi, Pejhman; Pfefer, Joshua; Casamento, Jon; Wang, Quanzeng

      2017-03-01

      Thermal modalities represent the only currently viable mass fever screening approach for outbreaks of infectious disease pandemics such as Ebola and SARS. Non-contact infrared thermometers (NCITs) and infrared thermographs (IRTs) have been previously used for mass fever screening in transportation hubs such as airports to reduce the spread of disease. While NCITs remain a more popular choice for fever screening in the field and at fixed locations, there has been increasing evidence in the literature that IRTs can provide greater accuracy in estimating core body temperature if appropriate measurement practices are applied - including the use of technically suitable thermographs. Therefore, the purpose of this study was to develop a battery of evaluation test methods for standardized, objective and quantitative assessment of thermograph performance characteristics critical to assessing suitability for clinical use. These factors include stability, drift, uniformity, minimum resolvable temperature difference, and accuracy. Two commercial IRT models were characterized. An external temperature reference source with high temperature accuracy was utilized as part of the screening thermograph. Results showed that both IRTs are relatively accurate and stable (<1% error of reading with stability of +/-0.05°C). Overall, results of this study may facilitate development of standardized consensus test methods to enable consistent and accurate use of IRTs for fever screening.

    5. Facing up to re-emergence of urban yellow fever.

      Science.gov (United States)

      Monath, T P

      1999-05-08

      Transmitted from person to person by Aedes aegypti, urban yellow fever was eliminated in the first half of this century, with the eradication of its mosquito vector from most of South America. However, reinfestation began in the 1970s is now almost complete, and vector control is considerably more difficult now than before. The threat of urban yellow fever is greatest in towns such as Santa Cruz, Bolivia, near the forest, but improved transport links increase the likelihood of spread by viremic people to nonendemic areas. Van der Stuyft et al. have reported the first instance of urban transmission of yellow fever in the Americas in 44 years. Since residents of the densely populated cities and much visited areas in coastal South America have never been vaccinated, an outbreak there would facilitate widespread dissemination of the disease, even to other continents. While urban yellow fever is a significant threat, carrying a case-fatality rate of about 20%, the constrained dynamics of transmission, early recognition of the striking clinical presentation, and efforts to control the infection should limit the impact of the disease. Laboratory-based surveillance, together with the prevention and control strategies outlined by van der Stuyft et al. are the key defensive measures against the future threat of urban epidemics.

    6. Yellow Fever Virus Vaccine–associated Deaths in Young Women 1

      OpenAIRE

      Seligman, Stephen J.

      2011-01-01

      Yellow fever vaccine–associated viscerotropic disease is a rare sequela of live-attenuated virus vaccine. Elderly persons and persons who have had thymectomies have increased susceptibility. A review of published and other data suggested a higher than expected number of deaths from yellow fever vaccine–associated viscerotropic disease among women 19–34 years of age without known immunodeficiency.

    7. Outbreak of Rocky Mountain spotted fever in Córdoba, Colombia

      Directory of Open Access Journals (Sweden)

      Marylin Hidalgo

      2011-02-01

      Full Text Available Rocky Mountain spotted fever (RMSF is a tick-borne disease caused by the obligate intracellular bacterium Rickettsia rickettsii. Although RMSF was first reported in Colombia in 1937, it remains a neglected disease. Herein, we describe the investigation of a large cluster of cases of spotted fever rickettsiosis in a new area of Colombia.

    8. Close Relationship of Ruminant Pestiviruses and Classical Swine Fever Virus

      Science.gov (United States)

      Postel, Alexander; Schmeiser, Stefanie; Oguzoglu, Tuba Cigdem; Indenbirken, Daniela; Alawi, Malik; Fischer, Nicole; Grundhoff, Adam

      2015-01-01

      To determine why serum from small ruminants infected with ruminant pestiviruses reacted positively to classical swine fever virus (CSFV)–specific diagnostic tests, we analyzed 2 pestiviruses from Turkey. They differed genetically and antigenically from known Pestivirus species and were closely related to CSFV. Cross-reactions would interfere with classical swine fever diagnosis in pigs. PMID:25811683

    9. Rocky Mountain spotted fever in Panama: a cluster description.

      Science.gov (United States)

      Tribaldos, Maribel; Zaldivar, Yamitzel; Bermudez, Sergio; Samudio, Franklyn; Mendoza, Yaxelis; Martinez, Alexander A; Villalobos, Rodrigo; Eremeeva, Marina E; Paddock, Christopher D; Page, Kathleen; Smith, Rebecca E; Pascale, Juan Miguel

      2011-10-13

      Rocky Mountain spotted fever (RMSF) is a tick-borne infection caused by Rickettsia rickettsii. We report a cluster of fatal cases of RMSF in 2007 in Panama, involving a pregnant woman and two children from the same family.  The woman presented with a fever followed by respiratory distress, maculopapular rash, and an eschar at the site from which a tick had been removed.  She died four days after disease onset.  This is the second published report of an eschar in a patient confirmed by PCR to be infected with R. rickettsii.  One month later, the children presented within days of one another with fever and rash and died three and four days after disease onset. The diagnosis was confirmed by immunohistochemistry, PCR and sequencing of the genes of R. rickettsii in tissues obtained at autopsy. 

    10. Prenatal Exposure to Fever and Infections and Academic Performance

      DEFF Research Database (Denmark)

      Dreier, Julie Werenberg; Berg-Beckhoff, Gabriele; Kragh Andersen, Per

      2017-01-01

      of academic performance from the 2010–2013 Danish National Tests. Hierarchical multilevel linear regression of 216,350 assessments made in 71,850 children born to 67,528 mothers revealed no differences in academic performance among the children according to prenatal exposure to fever (odds ratio (OR) = 1......Prenatal exposure to fever and infections has been linked to various neurodevelopmental disorders, but it is not yet known whether more subtle effects on neurodevelopment may exist as well. Therefore, we aimed to investigate whether these early-life exposures were associated with academic...... performance in childhood and early adolescence. Children and mothers who were enrolled in the Danish National Birth Cohort during 1996–2002 were included in this study. Information on fever and infections common in pregnancy was prospectively collected in 2 pregnancy interviews and linked with assessments...

    11. Het instellen op insuline van patiënten met diabetes mellitus type 2: In een transmurale organisatievorm minstens even effectief als poliklinisch; een retrospectief onderzoek met 4 jaar follow-up [Initiating insulin therapy in patients with diabetes mellitus type 2: In a transmural form of care at least as effective as an outpatients form; a retrospective study with a 4-year follow-up

      NARCIS (Netherlands)

      Rosendal, H.; Vondeling, H.; Witte, L.P. de; Hutubessy, R.C.W.; Beekum, W.T. van; Heine, R.J.

      2002-01-01

      Objective. Assessing whether the initiation of insulin therapy in patients with diabetes mellitus type 2 can be delivered as effectively in a structured transmural care model as in the more usual outpatients structure. Design. Retrospective comparative cohort study. Method. In 1997 data were

    12. Florence Nightingale: her Crimean fever and chronic illness.

      Science.gov (United States)

      Dossey, Barbara M

      2010-03-01

      Florence Nightingale's Crimean fever and chronic illness have intrigued historians for more than a century and a half. The purpose of this article is threefold: (a) to discuss the facts that point to the cause of Nightingale's Crimean fever as brucellosis, (b) to show that her debilitating illness for 32 years (1855-1887) was compatible with the specific form of chronic brucellosis, and (c) to present new evidence that she was still having severe symptoms in December 1887, when it was previously felt that she had no severe symptoms after 1870.

    13. Q fever in pregnant Goats: PAthogenesis and excretion of Coxiella burnetii

      NARCIS (Netherlands)

      Roest, H.I.J.; Gelderen, van E.; Dinkla, A.; Frangoulidis, D.; Zijderveld, van F.G.; Rebel, J.M.J.; Keulen, van L.J.M.

      2012-01-01

      Coxiella burnetii is an intracellular bacterial pathogen that causes Q fever. Infected pregnant goats are a major source of human infection. However, the tissue dissemination and excretion pathway of the pathogen in goats are still poorly understood. To better understand Q fever pathogenesis, we

    14. Establishment of recombinase polymerase amplification assay for five hemorrhagic fever-related viruses

      Directory of Open Access Journals (Sweden)

      Xue-feng CAO

      2017-08-01

      Full Text Available Objective To establish a one-step recombinase polymerase amplification (RPA method for pathogen screening and rapid detection in the field targeting for five hemorrhagic fever related viruses (Zaire ebola virus, Sudan ebola virus, Marburg virus, Lassa virus and Yellow fever virus. Methods The specific nucleic acid (NA fragments of each virus were selected as target genes by genome sequence analysis, and the primers and probes for RPA assays were designed according to the sequence. A series of diluted template genes were used for RPA detection to determine the sensitivity. The hemorrhagic fever-related viral nucleic acids were used for RPA detection to determine the specificity. The amplification experiments were carried out at different temperature ranging from 37℃ to 42℃ to validate the reaction temperature range. Results The RPA reaction systems of the five hemorrhagic fever viruses could effectively amplify the target genes, the sensitivities were between 1.5×102 and 1.5×103 copies. No cross reactions existed with the other hemorrhagic fever-related viral genes. Meanwhile, RPA assay could effectively amplify the target genes at 37-42℃. Conclusion The isothermal RPA assays of five hemorrhagic fever viruses are established, which may amply target genes fast and react at a wide temperature range, and be potentially useful for in field pathogens detection. DOI: 10.11855/j.issn.0577-7402.2017.06.09

    15. Persistent fever during treatment of a pregnant woman with acute pyelonephritis

      Directory of Open Access Journals (Sweden)

      Hasan Tahsin Gozdas

      2017-01-01

      Full Text Available Acute pyelonephritis is a serious infection in pregnancy. It is presented with fever, shaking chills and flank pain. Intravenous hydration and antimicrobial therapy are sufficient in the treatment unless pyelonephritis is complicated. In case of fever persisting for more than 48 h despite appropriate antimicrobial treatment, a possible complication such as urinary tract obstruction, abscess or phlegmon should be considered. Here, we present an 18-year-old pregnant woman with acute pyelonephritis whose persistent fever returned to normal after double-J ureteral stent was placed even if she had no finding of such a complication.

    16. Hemorrhagic Fever with Renal Syndrome (HFRS)

      Science.gov (United States)

      ... Care includes careful management of the patient’s fluid (hydration) and electrolyte (e.g., sodium, potassium, chloride) levels, ... TG, Peters CJ. Viral Hemorrhagic Fevers. Seminars in Pediatric Infectious Diseases 1997;8(Suppl 1):64-73 . ...

    17. Changing clinical profile of acute rheumatic fever and rheumatic recurrence

      International Nuclear Information System (INIS)

      Sheikh, A.M.; Sadiq, M.; Rehman, A.U.

      2016-01-01

      Background: Clinical profile of acute rheumatic fever and rheumatic recurrence seems to have changed in countries where rheumatic fever is still endemic. The objectives of this study were to compare clinical profile and outcome of patients suffering initial and recurrent episodes of acute rheumatic fever in children. Methods: This prospective study was conducted in two tertiary care hospitals from January to June 2011. The diagnosis was based on the modified Jones criteria. Sixty children were included in the study, 15 having first episode of rheumatic fever and 45 with rheumatic recurrence. The severity of carditis was assessed by Clinical and echocardiography means. Results: Carditis was the commonest presentation in both first (80 percentage) and recurrent attacks (100 percentage). Arthritis was seen in 60 percentage of children with first episode and in 26.7 percentage with recurrence. The frequency of subcutaneous nodules, invariably associated with carditis, was very high (33.3 percentage in the first and 48.3 percentage in recurrent episodes). Carditis was generally mild during first episode (53.3 percentage) and severe with rheumatic recurrence (55.6 percentage). There was no death in either group. One patient with severe mitral regurgitation and rheumatic recurrence underwent mitral valve repair for intractable heart failure. Conclusion: Clinical profile of rheumatic recurrence and acute rheumatic fever has changed. Rheumatic recurrence is associated with severe carditis. Carditis is more common than arthritis even in the first attack. Sub-cutaneous nodules are a frequent finding invariably associated with carditis. (author)

    18. Seroepidemiological survey of Q fever and brucellosis in Kurdistan Province, western Iran.

      Science.gov (United States)

      Esmaeili, Saber; Pourhossein, Behzad; Gouya, Mohammad Mehdi; Amiri, Fahimeh Bagheri; Mostafavi, Ehsan

      2014-01-01

      Given that the there is little information about the current status of brucellosis and Q fever in most parts of Iran, the aim of this study was to assay the seroprevalence of these two diseases in high-risk populations of Kurdistan Province in western Iran. Two hundred fifty sera samples were collected from hunters and their families, butchers, health care workers, and those referred to medical diagnostic laboratories in the southwestern regions of Kurdistan Province. Sera were tested to detect specific immunoglobulin G (IgG) antibodies against brucellosis and Coxiella burnetii (phase I and II). The seroprevalence of brucellosis and Q fever (C. burnetii IgG phase I and II) was 6.4% and 27.83% (20% and 14.52%), respectively. The highest seroprevalence of Q fever (38%) and brucellosis (12%) was seen in butchers, who handled cattle, sheep, and goats during their work. Age had a significant positive association with Q fever seropositivity (p=0.04). The seroprevalence of Q fever was higher in those people who had been in employment for more than 10 years (21.88%) compared to others (7.79%) (p=0.02). The keeping of animals (p=0.03), hunting and eating the meat of wild animals (p=0.02), and not disinfecting hands and faces after working (for health care workers and butchers) (p=0.02) were risk factors for Q fever seropositivity. This study showed a relatively high seroprevalence of brucellosis and Q fever in high-risk populations of Kurdistan Province. It is suggested that complementary studies be carried out in other parts of western Iran to clarify the epidemiological aspects of these diseases.

    19. Managing fever in children: a national survey of parents' knowledge and practices in France.

      Science.gov (United States)

      Bertille, Nathalie; Fournier-Charrière, Elisabeth; Pons, Gérard; Chalumeau, Martin

      2013-01-01

      Identifying targets to improve parental practices for managing fever in children is the first step to reducing the overloaded healthcare system related to this common symptom. We aimed to study parents' knowledge and practices and their determinants in managing fever symptoms in children in France as compared with current recommendations. We conducted an observational national study between 2007 and 2008 of French general practitioners, primary care pediatricians and pharmacists. These healthcare professionals (HPs) were asked to include 5 consecutive patients from 1 month to 12 years old with fever for up to 48 hr who were accompanied by a family member. Parents completed a questionnaire about their knowledge of fever in children and their attitudes about the current fever episode. We used a multilevel logistic regression model to assess the joint effects of patient- and HP-level variables. In all, 1,534 HPs (participation rate 13%) included 6,596 children. Parental concordance with current recommendations for temperature measurement methods, the threshold for defining fever, and physical (oral hydration, undressing, room temperature) and drug treatment was 89%, 61%, 15%, and 23%, respectively. Multivariate multi-level analyses revealed a significant HP effect. In general, high concordance with recommendations was associated with high educational level of parents and the HP consulted being a pediatrician. In France, parents' knowledge and practices related to managing fever symptoms in children frequently differ from recommendations. Targeted health education interventions are needed to effectively manage fever symptoms in children.

    20. An inactivated cell-culture vaccine against yellow fever.

      Science.gov (United States)

      Monath, Thomas P; Fowler, Elizabeth; Johnson, Casey T; Balser, John; Morin, Merribeth J; Sisti, Maggie; Trent, Dennis W

      2011-04-07

      Yellow fever is a lethal viral hemorrhagic fever occurring in Africa and South America. A highly effective live vaccine (17D) is widely used for travelers to and residents of areas in which yellow fever is endemic, but the vaccine can cause serious adverse events, including viscerotropic disease, which is associated with a high rate of death. A safer, nonreplicating vaccine is needed. In a double-blind, placebo-controlled, dose-escalation, phase 1 study of 60 healthy subjects between 18 and 49 years of age, we investigated the safety and immunogenicity of XRX-001 purified whole-virus, β-propiolactone-inactivated yellow fever vaccine produced in Vero cell cultures and adsorbed to aluminum hydroxide (alum) adjuvant. On two visits 21 days apart, subjects received intramuscular injections of vaccine that contained 0.48 μg or 4.8 μg of antigen. Levels of neutralizing antibodies were measured at baseline and on days 21, 31, and 42. The vaccine induced the development of neutralizing antibodies in 100% of subjects receiving 4.8 μg of antigen in each injection and in 88% of subjects receiving 0.48 μg of antigen in each injection. Antibody levels increased by day 10 after the second injection, at which time levels were significantly higher with the 4.8-μg formulation than with the 0.48-μg formulation (geometric mean titer, 146 vs. 39; Pvaccine groups than in the placebo group: mild pain, tenderness, and (much less frequently) itching at the injection site. One case of urticaria was observed on day 3 after the second dose of 4.8 μg of vaccine. A two-dose regimen of the XRX-001 vaccine, containing inactivated yellow fever antigen with an alum adjuvant, induced neutralizing antibodies in a high percentage of subjects. XRX-001 has the potential to be a safer alternative to live attenuated 17D vaccine. (Funded by Xcellerex; ClinicalTrials.gov number, NCT00995865.).

    1. Comparative Evaluation of Tubex TF (Inhibition Magnetic Binding Immunoassay) for Typhoid Fever in Endemic Area.

      Science.gov (United States)

      Khanna, Ashish; Khanna, Menka; Gill, Karamjit Singh

      2015-11-01

      Typhoid fever remains a significant health problem in endemic countries like India. Various serological tests for the diagnosis of typhoid fever are available commercially. We assessed the usefulness of rapid test based on magnetic particle separation to detect Immunoglobulin against Salmonella typhi O9 lipopolysaccharide. Aim of this study was to compare the sensitivity and specificity of widal test, typhidot and tubex TF test for the diagnosis of typhoid fever in an endemic country like India. Serum samples collected from 50 patients of typhoid fever, 50 patients of non typhoid fever and 100 normal healthy individuals residing in Amritsar were subjected to widal test, typhidot test and tubex TF test as per manufacturer's instructions. Data collected was assessed to find sensitivity and specificity of these tests in an endemic area. Significant widal test results were found positive in 68% of patients of typhoid fever and only 4% of non typhoid fever patients. Typhidot (IgM or IgG) was positive in 72% of typhoid fever patients and 10% and 6% in non typhoid fever and normal healthy individuals respectively. Tubex TF showed higher sensitivity of 76% and specificity of 96-99% which was higher than typhidot and comparable to widal test. This was the first evaluation of rapid tubex TF test in northern India. In countries which can afford high cost of test, tubex TF should be recommended for the diagnosis in acute stage of the disease in clinical setting. However, there is urgent need for a highly specific and sensitive test for the diagnosis of typhoid fever in clinical settings in endemic areas.

    2. Malaria, from natural to supernatural: a qualitative study of mothers' reactions to fever (Dienga, Gabon).

      Science.gov (United States)

      Pilkington, Hugo; Mayombo, Justice; Aubouy, Nicolas; Deloron, Philippe

      2004-10-01

      Decision making for health care at the household level is a crucial factor for malaria management and control among young children. This study sought to determine exactly how mothers reacted when faced with fever in a child. Qualitative study based on in depth semistructured interviews of mothers and free form discussion with traditional healers (Nganga). Village of Dienga, a rural area of Gabon (Central Africa). 12 mothers and three traditional healers. All mothers thought that fever and malaria were identical. Mothers home treated or went to the village treatment centre, or both, on the last episode of fever, if they judged it to be "natural" fever. However, if fever was thought to be a result of malicious intent, then a Nganga was consulted first. It was believed that strong and above all persistent fever was "supernatural". In this case, traditional treatment was thought to be best. Results indicate that fever is perceived as a dual condition, with two distinct but non-mutually exclusive aetiologies (either "natural" or from witchcraft). In contrast with what is commonly believed, there seems to be no clear cut distinction between diseases suitable for management by western medicine and diseases to be managed solely by traditional health practitioners. Moreover, these data do not support the commonly held notion that the decision to seek western medicine to treat fever is considered a "last resort". Results strongly imply that some severe cases of fever, being initially considered supernatural, may partially or completely escape medical attention.

    3. Hemorrhagic Fever Caused by a Novel Bunyavirus in China: Pathogenesis and Correlates of Fatal Outcome

      NARCIS (Netherlands)

      Zhang, Yong-Zhen; He, Yong-Wen; Dai, Yong-An; Xiong, Yanwen; Zheng, Han; Zhou, Dun-Jin; Li, Juan; Sun, Qiangzheng; Luo, Xue-Lian; Cheng, Yu-Li; Qin, Xin-Cheng; Tian, Jun-Hua; Chen, Xiao-Ping; Yu, Bin; Jin, Dong; Guo, Wen-Ping; Li, Wei; Wang, Wen; Peng, Jin-Song; Zhang, Guo-Bin; Zhang, Shaomin; Chen, Xiao-Min; Wang, Yan; Li, Ming-Hui; Li, Zhenjun; Lu, Shan; Ye, Changyun; de Jong, Menno D.; Xu, Jianguo

      2012-01-01

      Background. Hemorrhagic fever-like illness caused by a novel Bunyavirus, Huaiyangshan virus (HYSV, also known as Severe Fever with Thrombocytopenia virus [SFTSV] and Fever, Thrombocytopenia and Leukopenia Syndrome [FTLS]), has recently been described in China. Methods. Patients with

    4. Guillain-Barre syndrome associated with hemorrhagic fever with renal syndrome in China: a case report.

      Science.gov (United States)

      Jiao, Jie; Wu, Lei; Yin, Jianyuan; Quan, Xiaojiao; Chen, Wei; Hu, Jie

      2018-03-27

      We describe a case of Guillain-Barre syndrome (GBS) associated with hemorrhagic fever with renal syndrome. To our knowledge, only five cases of GBS associated with Hantavirus infection have been reported so far. A 62-year-old man presented intermittent fever, chill and oliguria. According to remarkable leukocytosis, atypical lymphocytes, thrombocytopenia and former dwelling in hemorrhagic fever-endemic area, he was suspected as hemorrhagic fever with renal syndromeand certified with positive Hantavirus IgG. Later, the patient had symmetrical flaccid paralysis of all extremities. Electromyography showed peripheral nerve injury (mainly in axon). The patient was diagnosed as having acute motor sensory axonal neuropathy (AMSAN). After immunoglobulin infusion, patient showed progressive recovery and was transferred 3 weeks after his first admission to a rehabilitation center. Our case was the 6th reported case of GBS associated with hemorrhagic fever with renal syndrome. Moreover, we for the first time classified the subtype of GBS (AMSAN) based on the electrophysiology characteristics. GBS should be suspected in patients who are already diagnosed as hemorrhagic fever with renal syndrome when delayed symmetrical limb paralysis occurs. Until recent now, GBS was only reported in hemorrhagic fever patients in Europe and Asia, which termed as hemorrhagic fever with renal syndrome.

    5. Yellow fever vaccine used in a psoriatic arthritis patient treated with methotrexate: a case report:

      OpenAIRE

      Štuhec, Matej

      2014-01-01

      The yellow fever vaccines on the market are contraindicated for immunocompromised and elderly patients. A case of yellow fever vaccine used in a 27-year-old Slovenian male with psoriatic arthritis during treatment with methotrexate is described. We demonstrate a positive case, since there were noadverse effects in concurrent administration of yellow fever vaccine and methotrexate. This patient did not show severe adverse reactions and did not contract yellow fever despite potential exposure. ...

    6. Geographic patterns and environmental factors associated with human yellow fever presence in the Americas.

      Science.gov (United States)

      Hamrick, Patricia Najera; Aldighieri, Sylvain; Machado, Gustavo; Leonel, Deise Galan; Vilca, Luz Maria; Uriona, Sonia; Schneider, Maria Cristina

      2017-09-01

      In the Americas, yellow fever virus transmission is a latent threat due to the proximity between urban and wild environments. Although yellow fever has nearly vanished from North and Central America, there are still 13 countries in the Americas considered endemic by the World Health Organization. Human cases usually occur as a result of the exposure to sylvatic yellow fever in tropical forested environments; but urban outbreaks reported during the last decade demonstrate that the risk in this environment still exists. The objective of this study was to identify spatial patterns and the relationship between key geographic and environmental factors with the distribution of yellow fever human cases in the Americas. An ecological study was carried out to analyze yellow fever human cases reported to the Pan American Health Organization from 2000 to 2014, aggregated by second administrative level subdivisions (counties). Presence of yellow fever by county was used as the outcome variable and eight geo-environmental factors were used as independent variables. Spatial analysis was performed to identify and examine natural settings per county. Subsequently, a multivariable logistic regression model was built. During the study period, 1,164 cases were reported in eight out of the 13 endemic countries. Nearly 83.8% of these cases were concentrated in three countries: Peru (37.4%), Brazil (28.1%) and Colombia (18.4%); and distributed in 57 states/provinces, specifically in 286 counties (3.4% of total counties). Yellow fever presence was significantly associated with altitude, rain, diversity of non-human primate hosts and temperature. A positive spatial autocorrelation revealed a clustered geographic pattern in 138/286 yellow fever positive counties (48.3%). A clustered geographic pattern of yellow fever was identified mostly along the Andes eastern foothills. This risk map could support health policies in endemic countries. Geo-environmental factors associated with presence

    7. Open study of short course Fleroxacin for Typhoid and Paratyphoid Fever

      Directory of Open Access Journals (Sweden)

      R. H.H. Nelwan

      2002-03-01

      Full Text Available The objective of this study was to evaluate clinical and bacteriological effect of short course fleroxacin in uncomplicated typhoid and paratyphoid fever patients. Four hundred mg of fleroxacin was given oraly once daily for a period of 3 to 5 days. The diagnosis of typhoid and paratyphoid fever was established by clinical picture as well as blood culture or Widal serology test. Thirty patients in whom the clinical picture was confirmed as a typhoid or paratyphoid infection were eligible for this investigation. They consisted of 15 males and 15 females ranging in age from 18-38 years average 27.5 years of whom 18 were diagnosed by blood culture consisting of 16 S.typhi positive cases and two S.paratyphi A, while 12 other cases were positively confirmed by serial Widal agglutination serology. These cases suffered from fever between 3-14 days with a minimum recorded body temperature elevation of 38.5 degrees Celsius. Clinical response with defervescence of fever was obtained in the positive blood culture group within 3 days (8 patients including 2 cases positive for S.paratyphi A and within two additional days (5 days in the remaining 10 cases. In the twelve cases with a positive serology for typhoid fever a clinical response was obtained for defervescence within 3 days (6 cases with 4 of these cases were on 3 days of fleroxacin and 2 cases on 5 days of fleroxacin. In the remaining 6 serologic positive cases fever resolved after 4-6 days with an average of 5 days with one on 3 days of fleroxacin and the rest (5 cases on 5 days of fleroxacin. All positive blood culture cases reverted to negative after the fleroxacin course. No relapse or carrier state was recorded in this serie. It may be concluded that a 3 to 5 days closely monitored course of fleroxacin has excellent clinical as well as bacteriological efficacy in noncomplicated typhoid and paratyphoid fever. (Med J Indones 2002; 11: 41-7Keywords: fluoroquinolones, enteric infections, short

    8. Hemorrhagic fever with renal syndrome and coexisting hantavirus pulmonary syndrome

      Directory of Open Access Journals (Sweden)

      Young Min Hong

      2012-06-01

      Full Text Available Hemorrhagic fever with renal syndrome (HFRS is an acute viral disease with fever, hemorrhage and renal failure caused by hantavirus infection. Hantavirus induces HFRS or hantavirus pulmonary syndrome (HPS. HPS progression to a life-threatening pulmonary disease is found primarily in the USA and very rarely in South Korea. Here, we report a case of HFRS and coexisting HPS.

    9. 18F-FDG-PET/CT in fever of unknown origin

      DEFF Research Database (Denmark)

      Middelbo Buch-Olsen, Karen; Andersen, Rikke V; Hess, Søren

      2014-01-01

      OBJECTIVE: Fever of unknown origin continues to be a diagnostic challenge for clinicians. The aim of this study was to confirm whether (18)F-fluorodeoxyglucose ((18)F-FDG)-PET/computed tomography (CT) is a helpful tool in patients suffering from this condition. PATIENTS AND METHODS: Fifty......-seven patients with fever of unknown origin were examined with (18)F-FDG-PET/CT as part of their diagnostic workup at the clinicians' discretion. The medical records were read retrospectively to establish the final diagnosis and evaluate the degree to which PET/CT contributed to the diagnosis. RESULTS......-FDG-PET/CT is a useful tool in the investigation of fever of unknown origin; it can reduce patient inconvenience and possibly costs to society if used earlier in the diagnostic process....

    10. Knowledge, attitudes and misconceptions of primary care physicians regarding fever in children: a cross sectional study

      Directory of Open Access Journals (Sweden)

      Demir Figen

      2012-09-01

      Full Text Available Abstract Background Fever is an extremely common sign in paediatric patients and the most common cause for a child to be taken to the doctor. The literature indicates that physicians and parents have too many misconceptions and conflicting results about fever management. In this study we aim to identify knowledge, attitudes and misconceptions of primary care physicians regarding fever in children. Methods This cross-sectional study was conducted in April-May 2010 involving primary care physicians (n=80. The physicians were surveyed using a self-administered questionnaire. Descriptive statistics were used. Results In our study only 10% of the physicians knew that a body temperature of above 37.2°C according to an auxiliary measurement is defined as fever. Only 26.2% of the physicians took into consideration signs and symptoms other than fever to prescribe antipyretics. 85% of the physicians prescribed antipyretics to control fever or prevent complications of fever especially febrile seizures. Most of the physicians (76.3% in this study reported that the height of fever may be used as an indicator for severe bacterial infection. A great majority of physicians (91.3% stated that they advised parents to alternate the use of ibuprofen and paracetamol. Conclusions There were misconceptions about the management and complications of fever. There is a perceived need to improve the recognition, assessment, and management of fever with regards to underlying illnesses in children.

    11. Olson method for locating and calculating the extent of transmural ischemic areas at risk of infarction.

      Science.gov (United States)

      Olson, Charles W; Wagner, Galen S; Terkelsen, Christian Juhl; Stickney, Ronald; Lim, Tobin; Pahlm, Olle; Estes, E Harvey

      2014-01-01

      The purpose of this study is to present a new and improved method for translating the electrocardiographic changes of acute myocardial ischemia into a display which reflects the location and extent of the ischemic area and the associated culprit coronary artery. This method could be automated to present a graphic image of the ischemic area in a manner understandable by all levels of caregivers; from emergency transport personnel to the consulting cardiologist. Current methods for the ECG diagnosis of ST elevated myocardial infarction (STEMI) are criteria driven, and complex, and beyond the interpretive capability of many caregivers. New methods are needed to accurately diagnose the presence of acute transmural myocardial ischemia in order to accelerate a patient's clinical "door to balloon time." The proposed new method could potentially provide the information needed to accomplish this objective. The new method improves the precision of diagnosis and quantification of ischemia by normalizing the ST segment inputs from the standard 12 lead ECG, transforming these into a three dimensional vector representation of the ischemia at the electrical center of the heart. The myocardial areas likely to be involved in this ischemia are separately analyzed to assess the probability that they contributed to this event. The source of the ischemia is revealed as a specific region of the heart, and the likely location of the associated culprit coronary artery. Seventy 12 lead ECGs from subjects with known single artery occlusion in one of the three main coronary arteries were selected to test this new method. Graphic plots of the distribution of ischemia as indicated by the method are consistent with the known occlusion. The analysis of the distribution of ischemic areas in the myocardium reveals that the relationships between leads with either ST elevation or ST depression, provide critical information improving the current method. Copyright © 2014 Elsevier Inc. All rights

    12. Atypical Rocky Mountain spotted fever with polyarticular arthritis.

      Science.gov (United States)

      Chaudhry, Muhammad A; Scofield, Robert Hal

      2013-11-01

      Rocky Mountain spotted fever (RMSF) is an acute, serious tick borne illness caused by Rickettsia rickettsi. Frequently, RMSF is manifested by headache, a typical rash and fever but atypical disease is common, making diagnosis difficult. Inflammatory arthritis as a manifestation is rare. The purpose of this study is to describe a patient with serologically proven RMSF who presented in an atypical manner with inflammatory arthritis of the small joints of the hands and to review the previously reported patients with rickettsial infection and inflammatory arthritis. An 18-year-old woman presented with a rash that began on the distal extremities and spread centrally, along with hand pain and swelling. She had tenderness and swelling of the metacarpophlangeal joints on examination in addition to an erythematosus macular rash and occasional fever. Acute and convalescent serology demonstrated R rickettsi infection. She was successfully treated with doxycycline. Inflammatory arthritis is a rare manifestation of RMSF or other rickettsial infection with 8 previously reported patients, only 1 of whom had RMSF. Physician must have a high index of suspicion for RMSF because of atypical presentations.

    13. Evaluation of fever in infants and young children.

      Science.gov (United States)

      Hamilton, Jennifer L; John, Sony P

      2013-02-15

      Febrile illness in children younger than 36 months is common and has potentially serious consequences. With the widespread use of immunizations against Streptococcus pneumoniae and Haemophilus influenzae type b, the epidemiology of bacterial infections causing fever has changed. Although an extensive diagnostic evaluation is still recommended for neonates, lumbar puncture and chest radiography are no longer recommended for older children with fever but no other indications. With an increase in the incidence of urinary tract infections in children, urine testing is important in those with unexplained fever. Signs of a serious bacterial infection include cyanosis, poor peripheral circulation, petechial rash, and inconsolability. Parental and physician concern have also been validated as indications of serious illness. Rapid testing for influenza and other viruses may help reduce the need for more invasive studies. Hospitalization and antibiotics are encouraged for infants and young children who are thought to have a serious bacterial infection. Suggested empiric antibiotics include ampicillin and gentamicin for neonates; ceftriaxone and cefotaxime for young infants; and cefixime, amoxicillin, or azithromycin for older infants.

    14. Rapid Generation and Testing of a Lassa Fever Vaccine Using VaxCelerate Platform

      Science.gov (United States)

      2014-08-28

      P.O. Box 12211 Research Triangle Park, NC 27709-2211 vaccine , emerging infectious diseases, public health, distributed development, Lassa fever ...that are restricted by HLA-A2. J Virol 2006;80(17):8351-61. Bredenbeek PJ, Molenkamp R, Spaan WJM. A recombinant Yellow Fever 17D vaccine ...SECURITY CLASSIFICATION OF: In this project, the VaxCelerate Consortium completed the generation and testing of a new vaccine against Lassa fever

    15. Rocky Mountain spotted fever: a clinician's dilemma.

      Science.gov (United States)

      Masters, Edwin J; Olson, Gary S; Weiner, Scott J; Paddock, Christopher D

      2003-04-14

      Rocky Mountain spotted fever is still the most lethal tick-vectored illness in the United States. We examine the dilemmas facing the clinician who is evaluating the patient with possible Rocky Mountain spotted fever, with particular attention to the following 8 pitfalls in diagnosis and treatment: (1) waiting for a petechial rash to develop before diagnosis; (2) misdiagnosing as gastroenteritis; (3) discounting a diagnosis when there is no history of a tick bite; (4) using an inappropriate geographic exclusion; (5) using an inappropriate seasonal exclusion; (6) failing to treat on clinical suspicion; (7) failing to elicit an appropriate history; and (8) failing to treat with doxycycline. Early diagnosis and proper treatment save lives.

    16. No evidence of African swine fever virus replication in hard ticks

      NARCIS (Netherlands)

      Carvalho Ferreira, de H.C.; Zúquete, S.T.; Wijnveld, M.; Weesendorp, E.; Jongejan, F.; Stegeman, J.A.; Loeffen, W.L.A.

      2014-01-01

      African swine fever (ASF) is caused by African swine fever virus (ASFV), a tick-borne DNA virus. Soft ticks of the genus Ornithodoros are the only biological vectors of ASFV recognized so far. Although other hard ticks have been tested for vector competence, two commonly found tick species in

    17. No evidence of African swine fever virus replication in hard ticks

      NARCIS (Netherlands)

      de Carvalho Ferreira, Helena C; Tudela Zúquete, Sara; Wijnveld, Michiel; Weesendorp, Eefke; Jongejan, Frans; Stegeman, Arjan; Loeffen, Willie L A

      African swine fever (ASF) is caused by African swine fever virus (ASFV), a tick-borne DNA virus. Soft ticks of the genus Ornithodoros are the only biological vectors of ASFV recognized so far. Although other hard ticks have been tested for vector competence, two commonly found tick species in

    18. The management of fever and petechiae: making sense of rash decisions.

      Science.gov (United States)

      Brogan, P A; Raffles, A

      2000-12-01

      In a retrospective and prospective audit of 55 children presenting to the paediatric assessment unit of a district general hospital with fever and petechial rash, 9% had significant bacterial sepsis. The "ILL criteria" (irritability, lethargy, low capillary refill) for the management of children with fever and petechiae are proposed.

    19. Autism, fever, epigenetics and the locus coeruleus.

      Science.gov (United States)

      Mehler, Mark F; Purpura, Dominick P

      2009-03-01

      Some children with autism spectrum disorders (ASD) exhibit improved behaviors and enhanced communication during febrile episodes. We hypothesize that febrigenesis and the behavioral-state changes associated with fever in autism depend upon selective normalization of key components of a functionally impaired locus coeruleus-noradrenergic (LC-NA) system. We posit that autistic behaviors result from developmental dysregulation of LC-NA system specification and neural network deployment and modulation linked to the core behavioral features of autism. Fever transiently restores the modulatory functions of the LC-NA system and ameliorates autistic behaviors. Fever-induced reversibility of autism suggests preserved functional integrity of widespread neural networks subserving the LC-NA system and specifically the subsystems involved in mediating the cognitive and behavioral repertoires compromised in ASD. Alterations of complex gene-environmental interactions and associated epigenetic mechanisms during seminal developmental critical periods are viewed as instrumental in LC-NA dysregulation as emphasized by the timing and severity of prenatal maternal stressors on autism prevalence. Our hypothesis has implications for a rational approach to further interrogate the interdisciplinary etiology of ASD and for designing novel biological detection systems and therapeutic agents that target the LC-NA system's diverse network of pre- and postsynaptic receptors, intracellular signaling pathways and dynamic epigenetic remodeling processes involved in their regulation and functional plasticity.

    20. Managing fever in children: a national survey of parents' knowledge and practices in France.

      Directory of Open Access Journals (Sweden)

      Nathalie Bertille

      Full Text Available INTRODUCTION: Identifying targets to improve parental practices for managing fever in children is the first step to reducing the overloaded healthcare system related to this common symptom. We aimed to study parents' knowledge and practices and their determinants in managing fever symptoms in children in France as compared with current recommendations. METHODS: We conducted an observational national study between 2007 and 2008 of French general practitioners, primary care pediatricians and pharmacists. These healthcare professionals (HPs were asked to include 5 consecutive patients from 1 month to 12 years old with fever for up to 48 hr who were accompanied by a family member. Parents completed a questionnaire about their knowledge of fever in children and their attitudes about the current fever episode. We used a multilevel logistic regression model to assess the joint effects of patient- and HP-level variables. RESULTS: In all, 1,534 HPs (participation rate 13% included 6,596 children. Parental concordance with current recommendations for temperature measurement methods, the threshold for defining fever, and physical (oral hydration, undressing, room temperature and drug treatment was 89%, 61%, 15%, and 23%, respectively. Multivariate multi-level analyses revealed a significant HP effect. In general, high concordance with recommendations was associated with high educational level of parents and the HP consulted being a pediatrician. CONCLUSIONS: In France, parents' knowledge and practices related to managing fever symptoms in children frequently differ from recommendations. Targeted health education interventions are needed to effectively manage fever symptoms in children.

    1. Rocky Mountain Spotted Fever and Pregnancy: Four Cases from Sonora, Mexico.

      Science.gov (United States)

      Licona-Enriquez, Jesus David; Delgado-de la Mora, Jesus; Paddock, Christopher D; Ramirez-Rodriguez, Carlos Arturo; Candia-Plata, María Del Carmen; Hernández, Gerardo Álvarez

      2017-09-01

      We present a series of four pregnant women with Rocky Mountain spotted fever (RMSF) that occurred in Sonora, Mexico, during 2015-2016. Confirmatory diagnoses were made by polymerase chain reaction or serological reactivity to antigens of Rickettsia rickettsii by using an indirect immunofluorescence antibody assay. Each patient presented with fever and petechial rash and was treated successfully with doxycycline. Each of the women and one full-term infant delivered at 36 weeks gestation survived the infection. Three of the patients in their first trimester of pregnancy suffered spontaneous abortions. RMSF should be suspected in any pregnant woman presenting with fever, malaise and rash in regions where R. rickettsii is endemic.

    2. A hospital-based study of hepatic dysfunction in children with dengue fever

      Directory of Open Access Journals (Sweden)

      Surjeet Singh

      2015-12-01

      Full Text Available Objective: To study the hepatic dysfunction in children with dengue infection and find out its correlation with the severity of dengue fever. Methods: Seventy-two cases of dengue fever as per the World Health Organization aged from 2 months to 18 years of age guidelines serologically confirmed by dengue NS1 antigen detection or dengue IgM capture ELISA were studied for their hepatic dysfunction after excluding malaria, enteric fever, hepatitis A and hepatitis B. The duration of the study was from April 2013 to March 2014. Results: These 72 cases were grouped into severe dengue, dengue fever with warning sign and dengue fever without warning sign as per the World Health Organization guidelines. The spectrums of hepatic manifestations included hepatomegaly (66%, hepatic tenderness (44%, jaundice (9.72%, raised levels of aspartate transaminase (86%, alanine transaminase (90%, alkaline phosphatase (39%, prolonged prothrombin time (11% and reduced levels of serum albumin (66%. Conclusions: Tender hepatomegaly and elevated liver enzymes were seen more frequently in severe dengue. There was significant derangement between liver function and tender hepatomegaly. Altered liver function may be evident even in the absence of hepatomegaly.

    3. High Lassa Fever activity in Northern part of Edo State, Nigeria ...

      African Journals Online (AJOL)

      The purpose was to establish simple statistics of the effects of lassa fever in northern part of Edo State, Nigeria. Lassa fever activity in the northern part of Edo state, Nigeria, was confirmed in 2004 by laboratory analysis of samples sent to Bernhard–Nocht Institute (BNI) for Tropical Medicine Hamburg, Germany.

    4. Crimean-Congo Haemorrhagic Fever in Kosova : a fatal case report

      Directory of Open Access Journals (Sweden)

      Raka Lul

      2006-10-01

      Full Text Available Abstract Crimean-Congo haemorrhagic fever (CCHF is an often fatal viral infection described in about 30 countries around the world. The authors report a fatal case of Crimean-Congo hemorrhagic fever (CCHF observed in a patient from Kosova. The diagnosis of CCHF was confirmed by reverse transcription-PCR. Late diagnosis decreased the efficacy of treatment and patient died due to severe complications of infection.

    5. Yellow fever vaccine: worthy friend or stealthy foe?

      Science.gov (United States)

      Seligman, Stephen J; Casanova, Jean-Laurent

      2016-06-01

      Recognition that the live yellow fever vaccine may rarely be associated with viscerotropic disease (YEL-AVD) has diminished its safety status. However, the vaccine remains the principal tool for limiting the occurrence of yellow fever, making large portions of Africa and South America more habitable. The subject has previously been exhaustively reviewed. Novel concepts in the current report include the description of a systematic method for deciding whom to vaccinate, recommendations for obtaining data helpful in making that decision, and suggestions for additional study. The vaccine is indeed a worthy friend, but its adverse reactions need to be recognized.

    6. [Rocky mountain spotted fever: report of two cases].

      Science.gov (United States)

      Martínez-Medina, Miguel Angel; Padilla-Zamudio, Guillermo; Solís-Gallardo, Lilia Patricia; Guevara-Tovar, Marcela

      2005-01-01

      Rocky Mountain spotted fever (RMSF) is an acute febrile illness caused by infection with Ricketsia Rickettsii, characterized by the presence of petechial rash. Even though the etiology, clinical characteristics and availability of effective antibiotics are known, RMSF related deaths have a prevalence of 4%. In its early stages RMFS can resemble many others infectious conditions and the diagnosis can be difficult. The present paper reports two patients with RMSF; these cases underscore the importance of prompt diagnosis and appropriate antimicrobial therapy, and consider RMSF as a differential diagnosis in any patient who develops fever and rash in an endemic area.

    7. Frequency, Pattern and Management of Acute Abdomen in Dengue Fever in Karachi, Pakistan

      OpenAIRE

      Muhammad Shamim

      2010-01-01

      This study aimed to determine the frequency, pattern and management of acute abdomen in patients with dengue fever. Methods: This descriptive case series is a prospective analysis of acute abdomen in dengue fever that was performed at three secondary care hospitals in Karachi, Pakistan from June 1, 2005 to December 31, 2008. The inclusion criterion was all patients with confirmed diagnosis of dengue fever. Patients with incomplete laboratory, ultrasound or histopathology data were excluded...

    8. A Kikuchi-Fujimoto Disease Case Mimicking T Cell Lymphoma with Prolonged Fever

      Directory of Open Access Journals (Sweden)

      Serap Yadigar

      2014-01-01

      Full Text Available Kikuchi-Fujimoto disease (KFD is a self-limited disease characterized by necrotizing lymphadenitis. Although cervical lymphadenitis in young women is the most familiar clinical presentation, it may take place in the etiology of fever in cases presenting with fever of unknown origin. A 33-year-old male case admitted with fever, nausea, vomiting, weight loss, and leukopenia for one month, subsequently developing axillary lymphadenopathy during followup, diagnosed as KFD with typical histopathological findings, and showing full recovery after the excision of lymph node was presented in this report.

    9. Demographic and clinico-epidemiological features of dengue fever in Faisalabad, Pakistan.

      Directory of Open Access Journals (Sweden)

      Faiz Ahmed Raza

      Full Text Available This cross-sectional study was carried out to explore the epidemiological and clinical features of dengue fever in Faisalabad, Pakistan during 2011 and 2012. During the study period, anti-dengue IgM positive cases were reported in the post-monsoon period during the months of August-December. Certain hotspots for the dengue infection were identified in the city that coincide with the clusters of densely populated urban regions of the city. Out of total 299 IgM positive patients (male 218 and female 81; there were 239 dengue fever (DF and 60 dengue hemorrhagic fever (DHF patients. There was decrease in the median age of dengue patients from 31 years in 2011 to 21.5 years in 2012 (p<0.001. Abdominal pain was seen in 35% DHF patients followed by nausea in 28.3%, epistaxis in 25% and rash in 20% patients (p<0.05. Patients reported to be suffering from high-grade fever for an average of 8.83 days in DHF as compared to 5.82 days in DF before being hospitalized. Co-morbidities were found to be risk factor for the development of DHF in dengue patients. Clinical and laboratory features of dengue cases studied could be used for the early identification of patients at risk of severe dengue fever.

    10. Crimean-Congo Hemorrhagic Fever, Sudan, 2008

      Centers for Disease Control (CDC) Podcasts

      This podcast describes the emergence of the first human cases of Crimean-Congo Hemorrhagic Fever in Sudan in 2008. CDC epidemiologist Dr. Stuart Nichol discusses how the disease was found in Sudan and how it spread in a hospital there.

    11. Nutritional management in Ebola haemorrhagic fever

      Directory of Open Access Journals (Sweden)

      Kamon Chaiyasit

      2015-06-01

      Full Text Available Ebola haemorrhagic fever is a viral infection causing a major health problem worldwide. In this short article, the authors briefly review and discuss on the nutritional management (energy, protein, fat and micronutrient in management of Ebola infection.

    12. Recurrent fevers and failure to thrive in an infant.

      Science.gov (United States)

      Scott, David R; Chan, Sarah; Chang, Johanna; Broderick, Lori; Hoffman, Hal M

      2013-01-01

      We describe a 2-year old boy with consanguineous parents who recently emigrated from India and presented with oral ulcers and lymphadenopathy. He also had a history of recurrent fevers, polyarticular arthritis, chronic diarrhea, failure to thrive, and developmental delay. Infectious workup revealed herpes simplex virus 1 viremia and radiological evaluation revealed osteopenia and erosions involving multiple joints. We describe the immunologic and genetic evaluation of this patient and discuss the diagnostic and therapeutic approach to an infant with recurrent fevers.

    13. The 2007–2010 Q fever epidemic in The Netherlands: characteristics of notified acute Q fever patients and the association with dairy goat farming.

      Science.gov (United States)

      Dijkstra, Frederika; van der Hoek, Wim; Wijers, Nancy; Schimmer, Barbara; Rietveld, Ariene; Wijkmans, Clementine J; Vellema, Piet; Schneeberger, Peter M

      2012-02-01

      We describe the Q fever epidemic in the Netherlands with emphasis on the epidemiological characteristics of acute Q fever patients and the association with veterinary factors. Data from 3264 notifications for acute Q fever in the period from 2007 through 2009 were analysed. The patients most affected were men, smokers and persons aged 40–60 years. Pneumonia was the most common clinical presentation (62% in 2007 and 2008). Only 3.2% of the patients were working in the agriculture sector and 0.5% in the meat-processing industry including abattoirs. Dairy goat farms with Coxiella burnetii-induced abortion waves were mainly located in the same area where human cases occurred. Airborne transmission of contaminated dust particles from commercial dairy goat farms in densely populated areas has probably caused this epidemic. In 2010, there was a sharp decline in the number of notified cases following the implementation of control measures on dairy goat and sheep farms such as vaccination, hygiene measures and culling of pregnant animals on infected farms. In combination with a rise in the human population with antibodies against C. burnetii, these have most likely ended the outbreak. Development of chronic Q fever in infected patients remains an important problem for years to come.

    14. High Lassa Fever activity in Northern part of Edo State, Nigeria: re ...

      African Journals Online (AJOL)

      for the control of lassa fever in Nigeria. [Afr J Health Sci. 2010 ... by the Centre for Disease Control (CDC), Atlanta,. USA, in 1969 ... malaria, typhoid, yellow fever, upper respiratory tract infection and other ..... Health Policy Plan. 2006; 21: 411.

    15. Recent Change of locality as Risk factor for Malaria Fever Among ...

      African Journals Online (AJOL)

      Recent Change of locality as Risk factor for Malaria Fever Among New Residents of Ahoada East Local Government Area in Southern Nigeria. ... an endemic region, which serves as an indicator of exposure to new variants of P falciparum; for which specific immunity is lacking, is a significant risk factor for malaria fever.

    16. Host genetic diversity enables Ebola hemorrhagic fever pathogenesis and resistance.

      Science.gov (United States)

      Rasmussen, Angela L; Okumura, Atsushi; Ferris, Martin T; Green, Richard; Feldmann, Friederike; Kelly, Sara M; Scott, Dana P; Safronetz, David; Haddock, Elaine; LaCasse, Rachel; Thomas, Matthew J; Sova, Pavel; Carter, Victoria S; Weiss, Jeffrey M; Miller, Darla R; Shaw, Ginger D; Korth, Marcus J; Heise, Mark T; Baric, Ralph S; de Villena, Fernando Pardo-Manuel; Feldmann, Heinz; Katze, Michael G

      2014-11-21

      Existing mouse models of lethal Ebola virus infection do not reproduce hallmark symptoms of Ebola hemorrhagic fever, neither delayed blood coagulation and disseminated intravascular coagulation nor death from shock, thus restricting pathogenesis studies to nonhuman primates. Here we show that mice from the Collaborative Cross panel of recombinant inbred mice exhibit distinct disease phenotypes after mouse-adapted Ebola virus infection. Phenotypes range from complete resistance to lethal disease to severe hemorrhagic fever characterized by prolonged coagulation times and 100% mortality. Inflammatory signaling was associated with vascular permeability and endothelial activation, and resistance to lethal infection arose by induction of lymphocyte differentiation and cellular adhesion, probably mediated by the susceptibility allele Tek. These data indicate that genetic background determines susceptibility to Ebola hemorrhagic fever. Copyright © 2014, American Association for the Advancement of Science.

    17. Rocky Mountain spotted fever, Panama.

      Science.gov (United States)

      Estripeaut, Dora; Aramburú, María Gabriela; Sáez-Llorens, Xavier; Thompson, Herbert A; Dasch, Gregory A; Paddock, Christopher D; Zaki, Sherif; Eremeeva, Marina E

      2007-11-01

      We describe a fatal pediatric case of Rocky Mountain spotted fever in Panama, the first, to our knowledge, since the 1950s. Diagnosis was established by immunohistochemistry, PCR, and isolation of Rickettsia rickettsii from postmortem tissues. Molecular typing demonstrated strong relatedness of the isolate to strains of R. rickettsii from Central and South America.

    18. Yellow fever risk assessment in the Central African Republic.

      Science.gov (United States)

      Ramos Junior, Alberto Novaes; Heukelbach, Jorg

      2015-04-01

      Yellow fever still causes high burden in several areas of sub-Saharan Africa and Latin America. There are few well-designed epidemiological studies and limited data about yellow fever in Africa. Staples et al., in a recently published paper in Transactions of the Royal Society of Tropical Medicine & Hygiene, performed a nationwide study in the Central African Republic (CAR) assessing infection risk and the operational impact of preventive measures. The rapid assessment of human, non-human and mosquito data call attention to the potential risk of future yellow fever outbreaks in the CAR and elsewhere. The study reinforces the need for intensified applied and operational research to address problems and human capacity needs in the realm of neglected tropical diseases in the post-2015 agenda. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

    19. Acute Compressive Ulnar Neuropathy in a Patient of Dengue Fever: An Unusual Presentation

      Directory of Open Access Journals (Sweden)

      Anil K Mehtani

      2013-04-01

      Full Text Available Introduction: Dengue haemorrhagic fever is known for its haemorrhagic and neurologic complications. Neurologic complications are caused by three mechanism namely neurotropism, systemic complications causing encephalopathy and postinfectious immune-mediated mechanisms. However acute compressive neuropathy due to haemorrhage is not frequent and we could find no literature describing this Case Report: We report a case of acute compressive ulnar neuropathy due to peri neural hematoma, following an attempt at intravenous cannulation in the cubital fossa in a patient of dengue haemorrhagic fever with thrombocytopenia. Immediate fasciotomy and removal of haematoma was performed to relieve the symptoms. Conclusion: Compression neuropathies can be seen in dengue hemorrhagic fever and removal of compressing hematoma relieves symptoms. Keywords: Dengue haemmorrhagic fever; coagulopathy; peri neural haematoma.

    20. Global yellow fever vaccination coverage from 1970 to 2016: an adjusted retrospective analysis.

      Science.gov (United States)

      Shearer, Freya M; Moyes, Catherine L; Pigott, David M; Brady, Oliver J; Marinho, Fatima; Deshpande, Aniruddha; Longbottom, Joshua; Browne, Annie J; Kraemer, Moritz U G; O'Reilly, Kathleen M; Hombach, Joachim; Yactayo, Sergio; de Araújo, Valdelaine E M; da Nóbrega, Aglaêr A; Mosser, Jonathan F; Stanaway, Jeffrey D; Lim, Stephen S; Hay, Simon I; Golding, Nick; Reiner, Robert C

      2017-11-01

      Substantial outbreaks of yellow fever in Angola and Brazil in the past 2 years, combined with global shortages in vaccine stockpiles, highlight a pressing need to assess present control strategies. The aims of this study were to estimate global yellow fever vaccination coverage from 1970 through to 2016 at high spatial resolution and to calculate the number of individuals still requiring vaccination to reach population coverage thresholds for outbreak prevention. For this adjusted retrospective analysis, we compiled data from a range of sources (eg, WHO reports and health-service-provider registeries) reporting on yellow fever vaccination activities between May 1, 1939, and Oct 29, 2016. To account for uncertainty in how vaccine campaigns were targeted, we calculated three population coverage values to encompass alternative scenarios. We combined these data with demographic information and tracked vaccination coverage through time to estimate the proportion of the population who had ever received a yellow fever vaccine for each second level administrative division across countries at risk of yellow fever virus transmission from 1970 to 2016. Overall, substantial increases in vaccine coverage have occurred since 1970, but notable gaps still exist in contemporary coverage within yellow fever risk zones. We estimate that between 393·7 million and 472·9 million people still require vaccination in areas at risk of yellow fever virus transmission to achieve the 80% population coverage threshold recommended by WHO; this represents between 43% and 52% of the population within yellow fever risk zones, compared with between 66% and 76% of the population who would have required vaccination in 1970. Our results highlight important gaps in yellow fever vaccination coverage, can contribute to improved quantification of outbreak risk, and help to guide planning of future vaccination efforts and emergency stockpiling. The Rhodes Trust, Bill & Melinda Gates Foundation, the

    1. Dutch Q fever epidemic in a ‘One Health’ context: outbreaks, seroprevalence and occupational risks

      NARCIS (Netherlands)

      Schimmer, Barbara

      2018-01-01

      Q fever is a worldwide zoonosis caused by the bacterium Coxiella burnetii (C. burnetii). Small ruminants, in particular sheep and goats, have been associated with community Q fever outbreaks in other countries. Just prior to the Dutch Q fever epidemic, a nationwide survey indicated that only 2.4% of

    2. Identification of insecticidal principals from cucumber seed oil against the yellow fever mosquito, Aedes aegypti

      Science.gov (United States)

      The yellow fever mosquito, Aedes aegypti, is one of the most medically important mosquito species due to its ability to spread viruses of yellow fever, dengue fever and Zika in humans. In this study, the insecticidal activity of seventeen plant essential oils were evaluated to toxicity by topical a...

    3. Existing and potential infection risk zones of yellow fever worldwide: a modelling analysis

      OpenAIRE

      Shearer, Freya M; Longbottom, Joshua; Browne, Annie J; Pigott, David M; Brady, Oliver J; Kraemer, Moritz U G; Marinho, Fatima; Yactayo, Sergio; de Araújo, Valdelaine E M; da Nóbrega, Aglaêr A; Fullman, Nancy; Ray, Sarah E; Mosser, Jonathan F; Stanaway, Jeffrey D; Lim, Stephen S

      2018-01-01

      Summary: Background: Yellow fever cases are under-reported and the exact distribution of the disease is unknown. An effective vaccine is available but more information is needed about which populations within risk zones should be targeted to implement interventions. Substantial outbreaks of yellow fever in Angola, Democratic Republic of the Congo, and Brazil, coupled with the global expansion of the range of its main urban vector, Aedes aegypti, suggest that yellow fever has the propensity t...

    4. Estimated percentage of typhoid fever in adult pakistani population (TAP) study

      International Nuclear Information System (INIS)

      Mehboob, F.; Arshad, A.; Firdous, S.; Ahmed, S.; Rehma, S.

      2013-01-01

      Typhoid fever is a serious infection with high morbidity and mortality in untreated cases. It is one of the very common infections in developing countries due to various factors involving hygiene and sanitation. Objective: To determine the estimated percentage of typhoid fever in Pakistani population and to find the commonly prescribed antibiotics for the disease. Material and Methods: This cross sectional study was conducted on 1036 patients, selected from forty five general practitioner clinics, between June to October 2010. Patients of > 18 years of age with > 3 days history of fever (> 100 degree F) and high index of suspicion for typhoid fever were tested for typhoid fever using Typhidot kits and positive cases were recruited for monitoring response to treatment. The febrile patients with clear cut history of urinary or respiratory infect-ion, hypovolemic shock or hepatobiliary disease were excluded and not tested by typhidot kit. The antibiotics prescribed to study population by various general practitioners were noted. Data was analysed on SPSS. Results were expressed in percentages and proportions. Results: Total 1036 patients were recruited. Typhoidot test was negative in 63.9% and positive in 36.1% patients with highest percentages of positive cases in Karachi, Rawalpindi and Hyderabad. The maximum number of cases were reported in summer season especially from June to August. Most of the patients were between ages of 19 - 39 years. The commonest anti-biotics prescribed were Ofloxacin, Ciprofloxacin and Levofloxacin. Conclusion: Typhoid fever is very common infection in Pakistan caused by Salmonella typhi which is transmitted among humans through faecooral route. Disease can be controlled not only by antibiotics like fluoroquinolones but by patient education, improvement in hygiene and sanitation, safe supply of clean drinking water and prophylactic vaccination as well. However, timely diagnosis and appropriate management with proper antibiotics is the key

    5. Estimated percentage of typhoid fever in adult pakistani population (TAP) study

      Energy Technology Data Exchange (ETDEWEB)

      Mehboob, F.; Arshad, A.; Firdous, S.; Ahmed, S.; Rehma, S. [Mayo Hospital, Lahore (Pakistan). Dept. of Medicine

      2013-01-15

      Typhoid fever is a serious infection with high morbidity and mortality in untreated cases. It is one of the very common infections in developing countries due to various factors involving hygiene and sanitation. Objective: To determine the estimated percentage of typhoid fever in Pakistani population and to find the commonly prescribed antibiotics for the disease. Material and Methods: This cross sectional study was conducted on 1036 patients, selected from forty five general practitioner clinics, between June to October 2010. Patients of > 18 years of age with > 3 days history of fever (> 100 degree F) and high index of suspicion for typhoid fever were tested for typhoid fever using Typhidot kits and positive cases were recruited for monitoring response to treatment. The febrile patients with clear cut history of urinary or respiratory infect-ion, hypovolemic shock or hepatobiliary disease were excluded and not tested by typhidot kit. The antibiotics prescribed to study population by various general practitioners were noted. Data was analysed on SPSS. Results were expressed in percentages and proportions. Results: Total 1036 patients were recruited. Typhoidot test was negative in 63.9% and positive in 36.1% patients with highest percentages of positive cases in Karachi, Rawalpindi and Hyderabad. The maximum number of cases were reported in summer season especially from June to August. Most of the patients were between ages of 19 - 39 years. The commonest anti-biotics prescribed were Ofloxacin, Ciprofloxacin and Levofloxacin. Conclusion: Typhoid fever is very common infection in Pakistan caused by Salmonella typhi which is transmitted among humans through faecooral route. Disease can be controlled not only by antibiotics like fluoroquinolones but by patient education, improvement in hygiene and sanitation, safe supply of clean drinking water and prophylactic vaccination as well. However, timely diagnosis and appropriate management with proper antibiotics is the key

    6. Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program.

      Science.gov (United States)

      Panzner, Ursula; Pak, Gi Deok; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Bjerregaard-Andersen, Morten; Crump, John A; Deerin, Jessica; Cruz Espinoza, Ligia Maria; Gasmelseed, Nagla; Heriniaina, Jean Noël; Hertz, Julian T; Im, Justin; von Kalckreuth, Vera; Keddy, Karen H; Lankoande, Bruno; Løfberg, Sandra; Meyer, Christian G; Oresto, Michael Munishi; Park, Jin Kyung; Park, Se Eun; Rakotozandrindrainy, Raphaël; Sarpong, Nimako; Soura, Abdramane Bassiahi; Gassama Sow, Amy; Tall, Adama; Teferi, Mekonnen; Worku, Alemayehu; Yeshitela, Biruk; Wierzba, Thomas F; Marks, Florian

      2016-03-15

      Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population. A healthcare utilization survey was developed for the Typhoid Fever Surveillance in Africa Program (TSAP) to adjust incidences of salmonellosis determined through passive, healthcare facility-based surveillance. This cross-sectional survey was conducted at 11 sites in 9 sub-Saharan African countries. Demographic data and healthcare-seeking behavior were assessed at selected households. Overall and age-stratified percentages of each study population that sought healthcare at a TSAP healthcare facility and elsewhere were determined. Overall, 88% (1007/1145) and 81% (1811/2238) of the population in Polesgo and Nioko 2, Burkina Faso, respectively, and 63% (1636/2590) in Butajira, Ethiopia, sought healthcare for fever at any TSAP healthcare facility. A far smaller proportion-namely, 20%-45% of the population in Bissau, Guinea-Bissau (1743/3885), Pikine, Senegal (1473/4659), Wad-Medani, Sudan (861/3169), and Pietermaritzburg, South Africa (667/2819); 18% (483/2622) and 9% (197/2293) in Imerintsiatosika and Isotry, Madagascar, respectively; and 4% (127/3089) in Moshi, Tanzania-sought healthcare at a TSAP healthcare facility. Patients with fever preferred to visit pharmacies in Imerintsiatosika and Isotry, and favored self-management of fever in Moshi. Age-dependent differences in healthcare utilization were also observed within and across sites. Healthcare utilization for fever varied greatly across sites, and revealed that not all studied populations were under optimal surveillance. This demonstrates the importance of assessing healthcare utilization. Survey data were pivotal for the adjustment of the program's estimates of salmonellosis and other conditions associated with fever. © The Author 2016. Published by Oxford University Press for the

    7. Existing and potential infection risk zones of yellow fever worldwide: a modelling analysis

      Directory of Open Access Journals (Sweden)

      Freya M Shearer, BSc

      2018-03-01

      Full Text Available Summary: Background: Yellow fever cases are under-reported and the exact distribution of the disease is unknown. An effective vaccine is available but more information is needed about which populations within risk zones should be targeted to implement interventions. Substantial outbreaks of yellow fever in Angola, Democratic Republic of the Congo, and Brazil, coupled with the global expansion of the range of its main urban vector, Aedes aegypti, suggest that yellow fever has the propensity to spread further internationally. The aim of this study was to estimate the disease's contemporary distribution and potential for spread into new areas to help inform optimal control and prevention strategies. Methods: We assembled 1155 geographical records of yellow fever virus infection in people from 1970 to 2016. We used a Poisson point process boosted regression tree model that explicitly incorporated environmental and biological explanatory covariates, vaccination coverage, and spatial variability in disease reporting rates to predict the relative risk of apparent yellow fever virus infection at a 5 × 5 km resolution across all risk zones (47 countries across the Americas and Africa. We also used the fitted model to predict the receptivity of areas outside at-risk zones to the introduction or reintroduction of yellow fever transmission. By use of previously published estimates of annual national case numbers, we used the model to map subnational variation in incidence of yellow fever across at-risk countries and to estimate the number of cases averted by vaccination worldwide. Findings: Substantial international and subnational spatial variation exists in relative risk and incidence of yellow fever as well as varied success of vaccination in reducing incidence in several high-risk regions, including Brazil, Cameroon, and Togo. Areas with the highest predicted average annual case numbers include large parts of Nigeria, the Democratic Republic of the

    8. An Atypical Local Vesicular Reaction to the Yellow Fever Vaccine

      OpenAIRE

      Wauters, Robert H.; Hernandez, Camellia L.; Petersen, Maureen M.

      2017-01-01

      Yellow fever vaccine is a live attenuated viral inoculation indicated for patients traveling to endemic areas. The vaccine is generally well tolerated with minimal adverse effects. Typical side effects include malaise, pain at the injection site, and, albeit rarely, immediate hypersensitivity reactions. We present a case of a rare adverse reaction to yellow fever vaccine in which a patient developed vesicular lesions resulting in bullae and circumferential hyperpigmentation.

    9. An Atypical Local Vesicular Reaction to the Yellow Fever Vaccine.

      Science.gov (United States)

      Wauters, Robert H; Hernandez, Camellia L; Petersen, Maureen M

      2017-09-19

      Yellow fever vaccine is a live attenuated viral inoculation indicated for patients traveling to endemic areas. The vaccine is generally well tolerated with minimal adverse effects. Typical side effects include malaise, pain at the injection site, and, albeit rarely, immediate hypersensitivity reactions. We present a case of a rare adverse reaction to yellow fever vaccine in which a patient developed vesicular lesions resulting in bullae and circumferential hyperpigmentation.

    10. Present status of yellow fever: Memorandum from a PAHO Meeting

      OpenAIRE

      1986-01-01

      An international seminar on the treatment and laboratory diagnosis of yellow fever, sponsored by the Pan American Health Organization (PAHO) and held in 1984, differed from previous meetings on yellow fever because of its emphasis on the care and management of patients and because the participants included specialists from several branches of medicine, such as hepatology, haematology, cardiology, infectious diseases, pathology and nephrology. The meeting reviewed the current status of yellow ...

    11. First case of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) in Hong Kong.

      Science.gov (United States)

      Leung, Wai Shing; Chan, Man Chun; Chik, Shiu Hong; Tsang, Tak Yin

      2016-04-01

      Yellow fever is an important and potentially fatal infection in tropical regions of Africa, South America, eastern Panama in Central America and Trinidad in the Caribbean. Yellow fever vaccination is not only crucial to reduce the disease risk and mortality in individuals travelling to these areas, but also an important public health measure to prevent the spread of the disease. Despite generally considered as a safe vaccine, yellow fever vaccine can rarely be associated with severe adverse reactions including yellow fever vaccine-associated viscerotropic disease (YEL-AVD). Here, we report the first case of YEL-AVD in Hong Kong. Clinicians should alert to the possibility of YEL-AVD in vaccinees presenting with compatible symptoms after yellow fever vaccination, particularly in people at higher risk of adverse events. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

    12. The unrecognized burden of typhoid fever.

      Science.gov (United States)

      Obaro, Stephen K; Iroh Tam, Pui-Ying; Mintz, Eric Daniel

      2017-03-01

      Typhoid fever (TF), caused by Salmonella enterica serovar Typhi, is the most common cause of enteric fever, responsible for an estimated 129,000 deaths and more than 11 million cases annually. Although several reviews have provided global and regional TF disease burden estimates, major gaps in our understanding of TF epidemiology remain. Areas covered: We provide an overview of the gaps in current estimates of TF disease burden and offer suggestions for addressing them, so that affected communities can receive the full potential of disease prevention offered by vaccination and water, sanitation, and hygiene interventions. Expert commentary: Current disease burden estimates for TF do not capture cases from certain host populations, nor those with atypical presentations of TF, which may lead to substantial underestimation of TF cases and deaths. These knowledge gaps pose major obstacles to the informed use of current and new generation typhoid vaccines.

    13. DMPD: Cytokines, PGE2 and endotoxic fever: a re-assessment. [Dynamic Macrophage Pathway CSML Database

      Lifescience Database Archive (English)

      Full Text Available 15967158 Cytokines, PGE2 and endotoxic fever: a re-assessment. Blatteis CM, Li S, L... (.svg) (.html) (.csml) Show Cytokines, PGE2 and endotoxic fever: a re-assessment. PubmedID 15967158 Title C...ytokines, PGE2 and endotoxic fever: a re-assessment. Authors Blatteis CM, Li S, L

    14. Katayama fever ID scuba divers

      African Journals Online (AJOL)

      1991-03-02

      Mar 2, 1991 ... A. C. EVANS, D. J. MARTIN, B. D. GINSBURG. Summary. Katayama fever or acute schistosomiasis probably occurs more commonly than is recorded. Interviews with a 3-man scuba diving team who had had contact with a large dam in an·endemic area of the eastern Transvaal Lowveld at the same time ...

    15. Typhoid fever as a triggering factor in acute and intractable bronchial asthma attack.

      Science.gov (United States)

      Wardhana; Surachmanto, Eko E; Datau, E A

      2013-10-01

      Typhoid fever is an enteric infection caused by Salmonella typhi. In Indonesia, typhoid fever is endemic with high incidence of the disease. In daily practice we frequently have patients with bronchial asthma, and it is becoming worse when these patients get typhoid fever. After oral ingestion, Salmonella typhi invades the the intestine mucosa after conducted by microbial binding to epithelial cells, destroying the microfold cells (M cell) then passed through the lamina propria and detected by dendritic cells (DC) which express a variety of pathogen recognition receptors on the surfaces, including Toll-Like Receptor (TLR). expressed on macrophages and on intestinal epithelial cells inducing degradation of IB, and translocation of NF-B (Nuclear Factor-Kappa Beta). This process initiates the induction of pro-inflammatory gene expression profile adhesion molecules, chemokines, adhesion molecules, and other proteins that induce and perpetuate the inflammation in host cells then will induce acute ant intractable attack of bronchial asthma. The role of typhoid fever in bronchial asthma, especially in persons with acute attack of bronchial asthma, is not well understood. In this article, we will discuss the role of typhoid fever in the bronchial asthma patients which may cause bronchial asthma significantly become more severe even triggering the acute and intractable attack of bronchial asthma. This fact makes an important point, to treat completely the typhoid fever in patients with bronchial asthma.

    16. Acute Rheumatic Fever versus Post-Streptococcal Reactive Arthritis

      International Nuclear Information System (INIS)

      Ashry, K.M.

      2009-01-01

      Rheumatic fever is an inflammatory disease that may develop after a Group A streptococcal infection and can involve the heart, joints, skin, and brain. A migrating polyarthritis after throat infection with group A β-haemolytic streptococci is classically attributed to acute rheumatic fever (ARF). Sterile non-migratory arthritis may occur as a separate entity, the so called post streptococcal reactive arthritis (PSRA). This study aimed to identify clinical and serological differences of patients with reactive arthritis after infection with Lance field group Aβ-haemolytic streptococci, compared with acute rheumatic fever. Hundred and twenty patients were recruited for the study , they were classified into two groups according to the diagnosis of ARF and PSRA patients consecutively seen in the Rheumatology and the Pediatric wards. Clinical and laboratory data were assessed through a questionnaire. The diagnosis of rheumatic fever was made based on revised modified Jones' criteria, while the diagnosis of post streptococcal reactive arthritis was made based on Deighton criteria; these associated with laboratory data, electrocardiography, chest X-ray, and bi-dimensional echocardiography. Results revealed no significant differences between both groups as regard age where ρ>0.05, while there were a significant difference regarding the date of antecedent upper respiratory tract infection (ρ 0.05). Regarding the cardio logical changes P-R interval by ECG was prolonged in 19 patients (31.67%)and Echo study showed changes in 12 patient (20%) of cases of ARF patient only. On the basis of simple laboratory variables and management, it ws possible to differentiate ARF from PSRA patients. So it could be concluded that these two conditions are actually distinct identities

    17. Skin lesions in hospitalized cases of dengue fever

      International Nuclear Information System (INIS)

      Saleem, K.; Shaikh, I.

      2008-01-01

      To determine the frequency and types of skin lesions in cases of dengue fever in patients admitted in three hospitals of Karachi. One hundred patients of dengue fever with positive anti-dengue Immunoglobulin M (IgM) serology were included in the study. The admitted patients in PNS Shifa Hospital, Jinnah Postgraduate Medical Centre (JPMC) and Civil Hospital, Karachi were selected for the study. Presenting features were noted. The patients were physically examined for the presence of skin and mucosal lesions and findings were recorded. Total and Differential Leukocyte Count (TLC and DLC), platelet count and Liver Function Tests (LFTs) were done in all the patients. All the patients had low leukocyte and low platelet counts. The common presenting symptoms were high-grade fever with or without rigors, headache, body aches, backache, vomiting, sore throat with cough and generalized weakness (seen in 86% patients). The uncommon presenting features were diarrhea, abdominal pain, bleeding from gums and nosebleeds (seen in 14% patients). Sixty-eight (68%) patients had skin lesions. The most common skin presentation was generalized macular blanchable erythema involving trunk and limbs, seen in 44 (65%) cases. Discrete petechial lesions were seen on various body areas in 24 (35%) cases. Palmer erythema was seen in 20 (30%) patients. Generalized itching was seen in 16 (23%) cases. Isolated itching of palms and soles was seen in 20 (30%) cases. Twenty-eight (28%) patients had deranged LFTs. Out of those, 4 patients had raised serum bilirubin level whereas rest of the 24 had raised ALT. Dengue fever commonly presents with specific skin lesions. The skin lesions can be a clue to the diagnosis in difficult cases. (author)

    18. Skin lesions in hospitalized cases of dengue fever

      Energy Technology Data Exchange (ETDEWEB)

      Saleem, K; Shaikh, I [Jinnah Postgraduate Medical Hospital, Karachi (Pakistan)

      2008-10-15

      To determine the frequency and types of skin lesions in cases of dengue fever in patients admitted in three hospitals of Karachi. One hundred patients of dengue fever with positive anti-dengue Immunoglobulin M (IgM) serology were included in the study. The admitted patients in PNS Shifa Hospital, Jinnah Postgraduate Medical Centre (JPMC) and Civil Hospital, Karachi were selected for the study. Presenting features were noted. The patients were physically examined for the presence of skin and mucosal lesions and findings were recorded. Total and Differential Leukocyte Count (TLC and DLC), platelet count and Liver Function Tests (LFTs) were done in all the patients. All the patients had low leukocyte and low platelet counts. The common presenting symptoms were high-grade fever with or without rigors, headache, body aches, backache, vomiting, sore throat with cough and generalized weakness (seen in 86% patients). The uncommon presenting features were diarrhea, abdominal pain, bleeding from gums and nosebleeds (seen in 14% patients). Sixty-eight (68%) patients had skin lesions. The most common skin presentation was generalized macular blanchable erythema involving trunk and limbs, seen in 44 (65%) cases. Discrete petechial lesions were seen on various body areas in 24 (35%) cases. Palmer erythema was seen in 20 (30%) patients. Generalized itching was seen in 16 (23%) cases. Isolated itching of palms and soles was seen in 20 (30%) cases. Twenty-eight (28%) patients had deranged LFTs. Out of those, 4 patients had raised serum bilirubin level whereas rest of the 24 had raised ALT. Dengue fever commonly presents with specific skin lesions. The skin lesions can be a clue to the diagnosis in difficult cases. (author)

    19. Duration of fever and markers of serious bacterial infection in young febrile children.

      Science.gov (United States)

      Pratt, Amanda; Attia, Magdy W

      2007-02-01

      Despite the drastic change in the evaluation of the febrile young child due to the decreased incidence of serious bacterial infections (SBI) effected by Haemophilus influenza type B and pneumococcal vaccine, there remains a small role for blood work in the evaluation of these patients. Bacterial markers including white blood cell (WBC) count, absolute neutrophil count (ANC) and C-reactive protein (CRP) have been studied and are widely used as predictors of SBI in febrile children. It has been suggested that CRP values should be interpreted cautiously when fever has been present predictors of SBI in relation to duration of fever. Patients who presented to a pediatric emergency department between the ages of 1 and 36 months, with fever > or =39 degrees C and no source of infection had a complete blood count (CBC) blood culture, and CRP level drawn. A urinalysis and/or urine culture was obtained when age and gender appropriate. A chest X-ray was performed at the discretion of the treating physician. The study subjects were enrolled prospectively and then divided into two groups based on duration of fever of 12 h, and compared. One hundred and twenty-eight patients were originally enrolled. Nine patients were excluded. Seventeen patients (14%) had SBI. One patient (urinary tract infections. Forty-five patients presented with fever 12 h. Area under the curve (AUC) for WBC, ANC and CRP was significantly larger in patients with SBI presenting with fever >12 h (0.85, 0.83, 0.92 respectively) compared to patients with SBI who presented with fever for 12 h as shown by the AUC. CRP performed better than WBC and ANC in both scenarios.

    20. Smooth incidence maps give valuable insight into Q fever outbreaks in The Netherlands

      Directory of Open Access Journals (Sweden)

      Wim van der Hoek

      2012-11-01

      Full Text Available From 2007 through 2009, The Netherlands faced large outbreaks of human Q fever. Control measures focused primarily on dairy goat farms because these were implicated as the main source of infection for the surrounding population. However, in other countries, outbreaks have mainly been associated with non-dairy sheep and The Netherlands has many more sheep than goats. Therefore, a public discussion arose about the possible role of non-dairy (meat sheep in the outbreaks. To inform decision makers about the relative importance of different infection sources, we developed accurate and high-resolution incidence maps for detection of Q fever hot spots. In the high incidence area in the south of the country, full postal codes of notified Q fever patients with onset of illness in 2009, were georeferenced. Q fever cases (n = 1,740 were treated as a spatial point process. A 500 x 500 m grid was imposed over the area of interest. The number of cases and the population number were counted in each cell. The number of cases was modelled as an inhomogeneous Poisson process where the underlying incidence was estimated by 2-dimensional P-spline smoothing. Modelling of numbers of Q fever cases based on residential addresses and population size produced smooth incidence maps that clearly showed Q fever hotspots around infected dairy goat farms. No such increased incidence was noted around infected meat sheep farms. We conclude that smooth incidence maps of human notifications give valuable information about the Q fever epidemic and are a promising method to provide decision support for the control of other infectious diseases with an environmental source.

    1. Multispacer sequence typing relapsing fever Borreliae in Africa.

      Directory of Open Access Journals (Sweden)

      Haitham Elbir

      Full Text Available BACKGROUND: In Africa, relapsing fevers are neglected arthropod-borne infections caused by closely related Borrelia species. They cause mild to deadly undifferentiated fever particularly severe in pregnant women. Lack of a tool to genotype these Borrelia organisms limits knowledge regarding their reservoirs and their epidemiology. METHODOLOGY/PRINCIPAL FINDINGS: Genome sequence analysis of Borrelia crocidurae, Borrelia duttonii and Borrelia recurrentis yielded 5 intergenic spacers scattered between 10 chromosomal genes that were incorporated into a multispacer sequence typing (MST approach. Sequencing these spacers directly from human blood specimens previously found to be infected by B. recurrentis (30 specimens, B. duttonii (17 specimens and B. crocidurae (13 specimens resolved these 60 strains and the 3 type strains into 13 species-specific spacer types in the presence of negative controls. B. crocidurae comprised of 8 spacer types, B. duttonii of 3 spacer types and B. recurrentis of 2 spacer types. CONCLUSIONS/SIGNIFICANCE: Phylogenetic analyses of MST data suggested that B. duttonii, B. crocidurae and B. recurrentis are variants of a unique ancestral Borrelia species. MST proved to be a suitable approach for identifying and genotyping relapsing fever borreliae in Africa. It could be applied to both vectors and clinical specimens.

    2. [Study of patients with prolonged fever with (18)F-FDG PET/CT].

      Science.gov (United States)

      Moragas, M; Cozar, M Puig; Buxeda, M; Soler, M; Riera, E; García, J R

      2015-01-01

      To review the findings on (18)F-FDG PET-CT in patients with fever of unknown origin lasting more than 7 days. This retrospective descriptive observational study included 93 (18)F-FDG PET-CT studies to detect a fever-causing focus done at three nuclear medicine centers from October 2006 through February 2014. A nuclear medicine specialist and a radiologist reviewed the images for foci of pathological uptake; another specialist's opinion resolved discrepancies. The findings on (18)F-FDG PET-CT studies were checked against clinical and/or histological findings. Abnormal (18)F-FDG uptake on PET-CT that could explain the cause of the fever was found in 52 (56%) of the 93 studies, and the cause of the fever was confirmed in 50 of these 52 studies. In the 50 cases in which the cause of the fever was confirmed, infection was the most common cause (54%), followed by noninfectious inflammatory disease (28%) and tumors (18%). (18)F-FDG PET-CT is useful in diagnosing the cause of prolonged febrile illness, so it might be practical to use it earlier in the diagnostic process. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

    3. The cross wavelet analysis of dengue fever variability influenced by meteorological conditions

      Science.gov (United States)

      Lin, Yuan-Chien; Yu, Hwa-Lung; Lee, Chieh-Han

      2015-04-01

      The multiyear variation of meteorological conditions induced by climate change causes the changing diffusion pattern of infectious disease and serious epidemic situation. Among them, dengue fever is one of the most serious vector-borne diseases distributed in tropical and sub-tropical regions. Dengue virus is transmitted by several species of mosquito and causing lots amount of human deaths every year around the world. The objective of this study is to investigate the impact of meteorological variables to the temporal variation of dengue fever epidemic in southern Taiwan. Several extreme and average indices of meteorological variables, i.e. temperature and humidity, were used for this analysis, including averaged, maximum and minimum temperature, and average rainfall, maximum 1-hr rainfall, and maximum 24-hr rainfall. This study plans to identify and quantify the nonlinear relationship of meteorological variables and dengue fever epidemic, finding the non-stationary time-frequency relationship and phase lag effects of those time series from 1998-2011 by using cross wavelet method. Results show that meteorological variables all have a significant time-frequency correlation region to dengue fever epidemic in frequency about one year (52 weeks). The associated phases can range from 0 to 90 degrees (0-13 weeks lag from meteorological factors to dengue incidences). Keywords: dengue fever, cross wavelet analysis, meteorological factor

    4. Yellow fever in a traveller returning from Suriname to the Netherlands, March 2017.

      Science.gov (United States)

      Wouthuyzen-Bakker, Marjan; Knoester, Marjolein; van den Berg, Aad P; GeurtsvanKessel, Corine H; Koopmans, Marion Pg; Van Leer-Buter, Coretta; Oude Velthuis, Bob; Pas, Suzan D; Ruijs, Wilhelmina Lm; Schmidt-Chanasit, Jonas; Vreden, Stephen Gs; van der Werf, Tjip S; Reusken, Chantal Bem; Bierman, Wouter Fw

      2017-03-16

      A Dutch traveller returning from Suriname in early March 2017, presented with fever and severe acute liver injury. Yellow fever was diagnosed by (q)RT-PCR and sequencing. During hospital stay, the patient's condition deteriorated and she developed hepatic encephalopathy requiring transfer to the intensive care. Although yellow fever has not been reported in the last four decades in Suriname, vaccination is recommended by the World Health Organization for visitors to this country. This article is copyright of The Authors, 2017.

    5. [YEL-AND meningoencephalitis in a 4-year-old boy consecutive to a yellow-fever vaccine].

      Science.gov (United States)

      Gerin, M; Wroblewski, I; Bost-Bru, C; N'guyen, M-A; Debillon, T

      2014-04-01

      Yellow fever is a vector-borne disease transmitted by an endemic mosquito in sub-Saharan Africa and tropical South America. It causes fever and possibly liver and renal failure with hemorrhagic signs, which may be fatal. The yellow-fever vaccine is an attenuated vaccine that is recommended for all travelers over the age of 9 months in high-risk areas. Adverse effects have been reported: minor symptoms (such as viral syndrome), hypersensitivity reactions, and major symptoms such as viscerotropic disease (YEL-AVD) and neurotropic disease (YEL-AND). The yellow-fever vaccine-associated autoimmune disease with central nervous system involvement (such as acute disseminated encephalomyelitis) associates fever and headaches, neurologic dysfunction, seizures, cerebrospinal fluid (CSF) pleocytosis, and elevated protein, with neuroimaging consistent with multifocal areas of demyelization. The presence of antibodies or virus in CSF, within 1-30 days following vaccination, and the exclusion of other causes is necessary for diagnosis. We describe herein the case of a 4-year-old child who presented with severe encephalitis consecutive to a yellow-fever vaccine, with favorable progression. Diagnosis is based on the chronology of clinical and paraclinical signs and the presence of yellow-fever-specific antibodies in CSF. The treatment consists of symptomatic treatment and immunoglobulin injection. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

    6. Typhoid fever as a cause of opportunistic infection: case report

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      Tumminia Salvatore

      2006-02-01

      Full Text Available Abstract Background Typhoid fever is a systemic infection caused by the bacterium Salmonella enterica subspecies enterica serotype typhi, which is acquired by ingestion of contaminated food and water. Each year the disease affects at least 16 million persons world-wide, most of whom reside in the developing countries of Southeast Asia and Africa. In Italy the disease is uncommon with a greater number of cases in Southern regions than in Northern ones. Case presentation We report on a 57-year-old Sri-Lankan male affected by typhoid fever, the onset of which was accompanied by oropharyngeal candidiasis. This clinical sign was due to a transient cell-mediated immunity depression (CD4+ cell count was 130 cells/mm3 probably caused by Salmonella typhi infection. Human immunodeficiency virus infection was ruled out. Diagnosis of typhoid fever was made by the isolation of Salmonella typhi from two consecutive blood cultures. The patient recovered after a ten days therapy with ciprofloxacin and his CD4+ cell count improved gradually until normalization within 3 weeks. Conclusion Our patient is the first reported case of typhoid fever associated with oropharyngeal candidiasis. This finding suggests a close correlation between Salmonella typhi infection and transitory immunodepression.

    7. Site of action of calcium channel blockers in inhibiting endogenous pyrogen fever in rats.

      Science.gov (United States)

      Stitt, J T; Shimada, S G

      1991-09-01

      We have demonstrated that the Ca2+ channel blocker verapamil, administered intravenously, exerts an antipyretic effect on the febrile responses of rats to intravenously injected endogenous pyrogen (EP). We have also shown that the same intravenous dose of verapamil is ineffective in blocking fevers induced by the microinjection of exogenous prostaglandin E (PGE) into the organum vasculosum laminae terminalis (OVLT) of rats. Experiments were conducted to determine whether the site of this verapamil antipyresis was in the OVLT itself. The febrile responses of six male Sprague-Dawley rats to EP were determined at thermoneutrality. Verapamil (10 micrograms/rat) was microinjected directly into the OVLT, and the febrile responses to the EP dose were redetermined 15-30 min later. In every case the EP fevers were attenuated after verapamil pretreatment. Intra-OVLT injections of verapamil alone were without effect on body temperature. When the same dose of verapamil was injected into the OVLT 15 min before the injection of PGE into the same site, it had no effect on the ensuing PGE-induced fever. In view of the fact that less than 1/250th of the effective systemic dose of verapamil, when injected into the OVLT, was equally effective in blocking the EP fevers, we conclude that verapamil acts within the OVLT to block fever rather than peripherally. Furthermore, because verapamil administered into the OVLT does not block PGE fevers, it is unlikely that PGE produces fever by acting as a Ca2+ ionophore on hypothalamic neurons.

    8. HMGB1 Is a Potential Biomarker for Severe Viral Hemorrhagic Fevers.

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      Katarina Resman Rus

      2016-06-01

      Full Text Available Hemorrhagic fever with renal syndrome (HFRS and Crimean-Congo hemorrhagic fever (CCHF are common representatives of viral hemorrhagic fevers still often neglected in some parts of the world. Infection with Dobrava or Puumala virus (HFRS and Crimean-Congo hemorrhagic fever virus (CCHFV can result in a mild, nonspecific febrile illness or as a severe disease with hemorrhaging and high fatality rate. An important factor in optimizing survival rate in patients with VHF is instant recognition of the severe form of the disease for which significant biomarkers need to be elucidated. To determine the prognostic value of High Mobility Group Box 1 (HMGB1 as a biomarker for disease severity, we tested acute serum samples of patients with HFRS or CCHF. Our results showed that HMGB1 levels are increased in patients with CCHFV, DOBV or PUUV infection. Above that, concentration of HMGB1 is higher in patients with severe disease progression when compared to the mild clinical course of the disease. Our results indicate that HMGB1 could be a useful prognostic biomarker for disease severity in PUUV and CCHFV infection, where the difference between the mild and severe patients group was highly significant. Even in patients with severe DOBV infection concentrations of HMGB1 were 2.8-times higher than in the mild group, but the difference was not statistically significant. Our results indicated HMGB1 as a potential biomarker for severe hemorrhagic fevers.

    9. Host-pathogen interactions in typhoid fever

      NARCIS (Netherlands)

      de Jong, H.K.

      2015-01-01

      This thesis focuses on host-pathogen interactions in Salmonella Typhi and Burkholderia pseudomallei infections and explores the interplay between these bacteria and the innate immune system. Typhoid fever is one of the most common causes of bacterial infection in low-income countries. With adequate

    10. Modeled Forecasts of Dengue Fever in San Juan, PR Using NASA Satellite Enhanced Weather Forecasts

      Science.gov (United States)

      Morin, Cory; Quattrochi, Dale; Zavodsky, Bradley; Case, Jonathan

      2015-01-01

      Dengue virus is transmitted between humans and mosquitoes of the genus Aedes and causes approximately 96 million cases of disease (dengue fever) each year (Bhatet al. 2013). Symptoms of dengue fever include fever, headache, nausea, vomiting, and eye, muscle and joint pain (CDC). More sever manifestations such as abdominal pain, bleeding from nose and gums, vomiting of blood, and clammy skin occur in rare cases of dengue hemorrhagic fever (CDC). Dengue fever occurs throughout tropical and sub-tropical regions worldwide, however, the geographical range and size of epidemics is increasing. Weather and climate are drivers of dengue virus transmission dynamics (Morin et al. 2013) by affecting mosquito proliferation and the virus extrinsic incubation period (i.e. required time for the virus to replicate and disseminate within the mosquito before it can retransmit the virus).

    11. Fever prevalence and management among three rural communities in the North West Zone, Somalia.

      Science.gov (United States)

      Youssef, R M; Alegana, V A; Amran, J; Noor, A M; Snow, R W

      2010-06-01

      Between March and August 2008 we undertook 2 cross-sectional surveys among 1375 residents of 3 randomly selected villages in the district of Gebiley in the North-West Zone, Somalia. We investigated for the presence of malaria infection and the period prevalence of self-reported fever 14 days prior to both surveys. All blood samples examined were negative for both species of Plasmodium. The period prevalence of 14-day fevers was 4.8% in March and 0.6% in August; the majority of fevers (84.4%) were associated with other symptoms including cough, running nose and sore throat; 48/64 cases had resolved by the day of interview (mean duration 5.4 days). Only 18 (37.5%) fever cases were managed at a formal health care facility: 7 within 24 hours and 10 within 24-72 hours of onset. None of the fevers were investigated for malaria; they were treated with antibiotics, antipyretics and vitamins.

    12. Genome-wide association analysis identifies 11 risk variants associated with the asthma with hay fever phenotype.

      Science.gov (United States)

      Ferreira, Manuel A R; Matheson, Melanie C; Tang, Clara S; Granell, Raquel; Ang, Wei; Hui, Jennie; Kiefer, Amy K; Duffy, David L; Baltic, Svetlana; Danoy, Patrick; Bui, Minh; Price, Loren; Sly, Peter D; Eriksson, Nicholas; Madden, Pamela A; Abramson, Michael J; Holt, Patrick G; Heath, Andrew C; Hunter, Michael; Musk, Bill; Robertson, Colin F; Le Souëf, Peter; Montgomery, Grant W; Henderson, A John; Tung, Joyce Y; Dharmage, Shyamali C; Brown, Matthew A; James, Alan; Thompson, Philip J; Pennell, Craig; Martin, Nicholas G; Evans, David M; Hinds, David A; Hopper, John L

      2014-06-01

      To date, no genome-wide association study (GWAS) has considered the combined phenotype of asthma with hay fever. Previous analyses of family data from the Tasmanian Longitudinal Health Study provide evidence that this phenotype has a stronger genetic cause than asthma without hay fever. We sought to perform a GWAS of asthma with hay fever to identify variants associated with having both diseases. We performed a meta-analysis of GWASs comparing persons with both physician-diagnosed asthma and hay fever (n = 6,685) with persons with neither disease (n = 14,091). At genome-wide significance, we identified 11 independent variants associated with the risk of having asthma with hay fever, including 2 associations reaching this level of significance with allergic disease for the first time: ZBTB10 (rs7009110; odds ratio [OR], 1.14; P = 4 × 10(-9)) and CLEC16A (rs62026376; OR, 1.17; P = 1 × 10(-8)). The rs62026376:C allele associated with increased asthma with hay fever risk has been found to be associated also with decreased expression of the nearby DEXI gene in monocytes. The 11 variants were associated with the risk of asthma and hay fever separately, but the estimated associations with the individual phenotypes were weaker than with the combined asthma with hay fever phenotype. A variant near LRRC32 was a stronger risk factor for hay fever than for asthma, whereas the reverse was observed for variants in/near GSDMA and TSLP. Single nucleotide polymorphisms with suggestive evidence for association with asthma with hay fever risk included rs41295115 near IL2RA (OR, 1.28; P = 5 × 10(-7)) and rs76043829 in TNS1 (OR, 1.23; P = 2 × 10(-6)). By focusing on the combined phenotype of asthma with hay fever, variants associated with the risk of allergic disease can be identified with greater efficiency. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

    13. Functional analysis of replication determinantsin classical swine fever virus

      DEFF Research Database (Denmark)

      Hadsbjerg, Johanne

      and animal pathogens should facilitate finding new approaches for efficient disease control. The principal aim of this thesis is to characterise determinants involved in the replication of classical swine fever virus (CSFV). Classical swine fever is a highly contagious virus disease of domestic pigs and wild...... in cell culture. Knowledge of these sequence variations and putative long-range interactions will provide valuable insights into mechanisms underlying virustranslation and replication. In manuscript 3, a selection marker has been inserted into a CSFV-based replicon making it suitable for screening...

    14. A case of acute quadriplegia complicating Mediterranean spotted fever.

      Science.gov (United States)

      Caroleo, Santo; Longo, Chiara; Pirritano, Domenico; Nisticò, Rita; Valentino, Paola; Iocco, Maurizio; Santangelo, Ermenegildo; Amantea, Bruno

      2007-06-01

      Mediterranean spotted fever is a rickettsiosis caused by Rickettsia conorii. Mediterranean spotted fever is considered to be a benign disease, however, approximately 10% of patients present with a severe systemic manifestation in which neurologic involvement occurs. We present a case of an 80-year-old man with a R. conorii infection who developed an acute quadriplegia secondary to an axonal polyneuropathy. The characteristic tache noire was observed on the lateral region of the thigh and elevated IgM antibody titres against R. conorii were detected by an indirect immunofluorescence test.

    15. Evaluating the safety and immunogenicity of yellow fever vaccines: a systematic review

      Directory of Open Access Journals (Sweden)

      Thomas RE

      2015-04-01

      Full Text Available Roger E Thomas Department of Family Medicine, G012 Health Sciences Center, University of Calgary Medical School, Calgary, AB, Canada Purpose: To review the safety and immunogenicity of yellow fever vaccines. Literature search: The Cochrane Library (including the Cochrane CENTRAL Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the NHS Database of Abstracts of Reviews of Effects; MEDLINE; EMBASE; BIOSIS Previews; Global Health; CAB Abstracts; and the Lilacs Database of Latin American and Caribbean literature were searched for individual studies and systematic reviews through January 1, 2015. Results: Six yellow fever vaccines are currently produced, and they are effective against all seven yellow fever virus strains. There is a 99.2% homology of the genome sequences of the six current vaccines. Four systematic reviews identified very small numbers of serious adverse events. A systematic review (updated of all published cases identified 133 serious adverse events that met the Brighton Collaboration criteria: 32 anaphylactic, 42 neurologic (one death, 57 viscerotropic (25 deaths, and two of both neurologic and viscerotropic SAEs. The Sanofi Pasteur Global Pharmacovigilance database reported 276 million doses of Stamaril™ distributed worldwide and identified 12 reports of yellow fever vaccine-associated viscerotropic disease (YEL-AVD, 24 of yellow fever vaccine-associated neurologic disease (YEL-AND, and 33 reports of anaphylaxis (many already published. The Biomanguinhos manufacturer's database reported 110 million doses distributed worldwide between 1999 and 2009, and the rate of YEL-AND was estimated at 0.084/100,000 doses distributed and YEL-AVD at 0.02/100,000 doses distributed. Conclusion: Reports of serious adverse events are mostly from travelers from developed countries, and there is likely serious underreporting for developing countries. On the basis of the published reports, the yellow fever vaccines are

    16. STUDY OF ULTRASOUND FINDING IN DENGUE FEVER

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      Sunita Bajaj

      2016-10-01

      Full Text Available BACKGROUND Dengue fever (DF is a viral haemorrhagic fever causing severe morbidity and mortality in affected patients. The aim of the study is to describe the role of ultrasonography (USG in the assessment of patients with Dengue fever, and its complications and to prove ultrasound is useful in the diagnosis during an epidemic. MATERIALS AND METHODS It is a prospective study was conducted in 2016 comprising of 178 patients who were serologically positive for dengue, radiological investigations were conducted in all cases. RESULTS Out of 178 patients Males (N=117 are more effected subjects in the study. female: Male ratio is 1:2. Hepatomegaly 74.1% which is most common findings in study, 113 (63.4% had GB wall thickening 98 had ascites (55%, 32 had pleural effusion (17.9%. most commonly seen in the age group of 20-39 years. Hepatomegaly was the most common finding noted in 67 patients (37.6%, followed by GB wall thickening in 65 patients (36.1%. Hepatomegaly was more common in 0-19 is 56 patients with 31.4% years age group Ascites in >40 years age group (16.8%. Hepatomegaly was seen in most of the patients whose platelet count was <40,000. (94.7%. GB wall thickening (88.5% common findings seen in patients whose platelet count was <40,000. In patients with platelet count of 40,000-80,000, Ascites is most common finding (87.5%, followed by Splenomegaly (60.7%. In patients whose platelet count was 80,000-150,000, Ascites (50% was more common than Splenomegaly (45.8%. In three patients with platelet count more than 150,000, no sonological abnormality was detected. CONCLUSIONS Ultrasound findings of hepatic changes, GB wall oedema, splenomegaly, ascites and pleural effusion in patients presenting with signs and symptoms of Dengue fever during an epidemic are diagnostic. Contributing in the differential diagnosis with other causes of febrile disease.

    17. NSs protein of severe fever with thrombocytopenia syndrome virus suppresses interferon production through different mechanism than Rift Valley fever virus.

      Science.gov (United States)

      Zhang, S; Zheng, B; Wang, T; Li, A; Wan, J; Qu, J; Li, C H; Li, D; Liang, M

      Severe fever with thrombocytopenia syndrome virus (SFTSV) is a newly identified Phlebovirus that causes severe fever with thrombocytopenia syndrome. Our study demonstrated that SFTSV NSs functioned as IFN antagonist mainly by suppressing TBK1/IKKε-IRF3 signaling pathway. NSs interacted with and relocalized TANK-binding kinase 1 (TBK1) into NSs-induced cytoplasmic structures and this interaction could effectively inhibit downstream phosphorylation and dimerization of interferon regulatory factor 3 (IRF3), resulting in the suppression of antiviral signaling and IFN induction. Functional sites of SFTSV NSs binding with TBK1 were then studied and results showed that NSs had lost their IFN-inhibiting activity after deleting the 25 amino acids in N-terminal. Furthermore, the mechanism of Rift Valley fever virus (RVFV) NSs blocking IFN-β response were also investigated. Preliminary results showed that RVFV NSs proteins could neither interact nor co-localize with TBK1 in cytoplasm, but suppressed its expression levels, phosphorylation and dimerization of IRF3 in the subsequent steps, resulting in inhibition of the IFN-β production. Altogether, our data demonstrated the probable mechanism used by SFTSV to inhibit IFN responses which was different from RVFV and pointed toward a novel mechanism for RVFV suppressing IFN responses.

    18. Acute Inhalation Exposure to Titanium Ethanolate as a Possible Cause of Metal Fume Fever

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      M Ahmadimanesh

      2014-04-01

      Full Text Available Occupational inhalation exposure to noxious agents is not uncommon. Herein, we present a 26-year-old male student who had accidental acute inhalation exposure to a large quantity of titanium ethanolate and hydrogen chloride in chemistry lab. He was referred to the emergency department of our hospital with low-grade fever, dyspnea, headache, fatigue and myalgia. After 24 hrs of symptomatic treatment (oxygen therapy and acetaminophen, the fever was subsided and the patient discharged home in a good clinical condition. The presented symptoms could be interpreted as a form of metal fume fever. It can therefore be concluded that organo-metallic compound of titanium metal may have the potential to produce metal fume fever in human.

    19. Legionella (Legionnaires' Disease and Pontiac Fever): Diagnosis

      Science.gov (United States)

      ... Search Form Controls Cancel Submit Search The CDC Legionella (Legionnaires' Disease and Pontiac Fever) Note: Javascript is ... message, please visit this page: About CDC.gov . Legionella Home About the Disease Causes, How it Spreads, & ...

    20. Clinical presentation of acute Q fever in lanzarote (Canary Islands): a 2-year prospective study.

      Science.gov (United States)

      Pascual Velasco, F; Borobio Enciso, M V; González Lama, Z; Carrascosa Porras, M

      1996-01-01

      The clinical manifestations of acute Q fever may differ markedly from country to country. In this regard, fever and hepatitis seem to be the dominant clinical features of acute Coxiella burnetii infection in Lanzarote, Canary Islands. A possible interaction between environmental factors and some strains of C. burnetii could explain the different clinical presentations of acute Q fever.