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Sample records for immunocompetence disease incidence

  1. Annual incidence rates of herpes zoster among an immunocompetent population in the United States.

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    Johnson, Barbara H; Palmer, Liisa; Gatwood, Justin; Lenhart, Gregory; Kawai, Kosuke; Acosta, Camilo J

    2015-11-06

    Herpes zoster (HZ), also known as shingles, is a painful and commonly occurring condition in the United States. In spite of a universally recommended vaccine for use in immunocompetent adults aged 60 years and older, HZ continues to impact the American public, and a better understanding of its current incidence is needed. The objective of the current study is to estimate the overall and age- and gender-specific incidence rates (IRs) of HZ among an immunocompetent US population in 2011 following availability of a vaccine. Claims data from the Truven Health MarketScan® Research databases between 01/01/2011 and 12/31/2011 were extracted. Immunocompetent adult patients, enrolled as of January 1, 2011 were analyzed. The denominator was defined as eligible subjects who were immunocompetent, had no evidence of zoster vaccination, and no diagnosis of HZ (International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code 053.xx) in the 90 days prior to January 1, 2011. Subjects contributed person-days to the denominator until the occurrence of one of the following events: end of continuous enrollment in the database, a claim for zoster vaccination, diagnosis of HZ or end of the observation period (December 31, 2011). The numerator was defined as enrollees within the denominator file exhibiting evidence of HZ. Annual IRs were calculated for the entire population in the database as well as by gender and age group; standardized IRs were also produced using the 2010 US Census data. The overall annual IR of HZ across all ages was 4.47 per 1000 person-years (95% confidence interval [CI]: 4.44-4.50) which monotonically increased with age from 0.86 (95% CI: 0.84-0.88) for those aged ≤ 19 to 12.78 (95% CI: 12.49-13.07) for patients ≥ 80 years. The IR was 8.46 (95% CI: 8.39-8.52) among adults ≥ 50 years and 10.46 (95% CI: 10.35-10.56) among those aged ≥ 60 years. Women compared to men had higher HZ incidence (5.25, 95% CI: 5.21-5.29 vs. 3.66, 95

  2. Late effects of selected immunosuppressants on immunocompetence, disease incidence, and mean life-span. III. Disease incidence and life expectancy. [Mice, x radiation

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    Peter, C P; Perkins, E H; Peterson, W J; Walburg, H E; Makinodan, T

    1975-01-01

    The effect of various immunosuppressive treatments on mean life-span and disease incidence have been studied. Significant life shortening was seen only in mice which received X-irradiation early in life and can be ascribed primarily to an increased incidence of certain malignancies. Marginal life shortening was seen in cyclophosphamide-treated animals, however, survival patterns between those and control animals did not differ until 30 months of age and the magnitude of life-shortening never approached that seen in X-irradiated animals. Thymectomy, splenectomy or cortisone treatment did not alter survival. All immunosuppressive treatments enhanced mortality due to non-neoplastic diseases, however, only a small percentage of animals die with these disease entities. With the exception of cortisone all immunosuppressive treatments increased the incidence of neoplastic disease. However, their effects on various neoplastic processes were variable and unpredictable. Four primary patterns in terms of relative immune competence, disease incidence and life expectancy were seen. Thus, immunodepression may or may not correlate with increased disease incidence, which in turn may or may not have a life-shortening effect. These findings are discussed in terms of the marked reduction of both humoral and cell-mediated immunity normally seen in aged mice and the significance of postulated immune surveillance mechanisms to survival.

  3. Atypical form of cat scratch disease in immunocompetent patient

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    Kojić Miroslav

    2013-01-01

    Full Text Available Introduction. Cat scratch disease (CSD is an acute infectious disease with benign course caused by the bacteria Bartonella henselae. Clinically, it is usually manifested as regional lymphadenopathy and mild infective syndrome. Rare forms of the disease which usually occur in immunocompromised presons are: encephalitis, transverse myelitis, neuroretinitis, granulomatosus conjunctivitis, arthritis, hepatitis etc. Case report. We presented an atypical form of cat scratch disease in a young immunocompetent female person. The disease was manifested with prolonged fever, rash, purulent lymphadenitis and hepatitis. The diagnosis was based on characteristic patohystological finding and exclusion of the other causes of lymphadenopathy. The patient was treated by antibiotics for a few weeks, with surgical incision and drainage of the purulent lymphadenitis. Conclusion. Atypical forms of CSD could be an important differential-diagnostic problem, especially if there is no opportunity for serological confirmation of the disease.

  4. Cost-Effectiveness of Vaccinating Immunocompetent ≥65 Year Olds with the 13-Valent Pneumococcal Conjugate Vaccine in England.

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    Albert Jan van Hoek

    Full Text Available Recently a large clinical trial showed that the use of 13-valent pneumococcal conjugate vaccine (PCV13 among immunocompetent individuals aged 65 years and over was safe and efficacious. The aim of this study was to assess the cost-effectiveness of vaccinating immunocompetent 65 year olds with PCV13 vaccine in England. England is a country with universal childhood pneumococcal conjugate vaccination programme in place (7-valent (PCV7 since 2006 and PCV13 since 2010, as well as a 23-valent pneumococcal polysaccharide (PPV23 vaccination programme targeting clinical risk-groups and those ≥65 years.A static cohort cost-effectiveness model was developed to follow a cohort of 65 year olds until death, which will be vaccinated in the autumn of 2016 with PCV13. Sensitivity analysis was performed to test the robustness of the results.The childhood vaccination programme with PCV7 has induced herd protection among older unvaccinated age groups, with a resultant low residual disease burden caused by PCV7 vaccine types. We show similar herd protection effects for the 6 additional serotypes included in PCV13, and project a new low post-introduction equilibrium of vaccine-type disease in 2018/19. Applying these incidence projections for both invasive disease and community-acquired pneumonia (CAP, and using recent measures of vaccine efficacy against these endpoints for ≥65 year olds, we estimate that vaccination of a cohort of immunocompetent 65 year olds with PCV13 would directly prevent 26 cases of IPD, 69 cases of CAP and 15 deaths. The associated cost-effectiveness ratio is £257,771 per QALY gained (using list price of £49.10 per dose and £7.51 administration costs and is therefore considered not cost-effective. To obtain a cost-effective programme the price per dose would need to be negative. The results were sensitive to disease incidence, waning vaccine protection and case fatality rate; despite this, the overall conclusion was robust

  5. Severe form of Legionnaires' disease in an immunocompetent patient

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    Andrijević Ilija

    2009-01-01

    Full Text Available Background. Legionnaires' disease (LD is a pneumonia caused by Legionella pneumophila (LP. The disease occurs more often in immunocompromised persons and can be manifested by severe pneumonia, multiple organ failure and has a high mortality. Case report. Immunocompetent patient, male, 53- year old, with severe form of LB had fever, cough, weakness and diarrhea as the initial symptoms of the disease. Laboratory results showed increased number of leukocytes, increased values of acute phase proteins, liver enzymes and hyponatremia. Computed tomography of the chest showed the marked inflammatory lesions on both sides. Pathohystological analysis of the samples retrieved by bronchoscopy pointed to a pneumonia, and diagnosis of LD was confirmed by positive urine test for LP antigen. Later, the disease was complicated by acute adult respiratory distress syndrome (ARDS. Treatment with antibiotics (erythromycin, rifampicin, azithromycin combined with ARDS treatment led to a clinical recovery of the patient together with complete resolution of inflammatory lesions seen on chest radiography. Conclusion. In severe pneumonias it is necessary to consider LD in differential diagnosis, perform tests with aim of detecting LP and apply adequate antibiotic treatment in order to accomplish positive outcome of the therapy and prevent complications.

  6. Pulmonary aspergillosis in immunocompetent patients without air-meniscus sign and underlying lung disease: CT findings and histopathologic features

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    Yoon, Soon Ho; Park, Chang Min; Goo, Jin Mo; Lee, Hyun Ju (Dept. of Radiology and Institute of Radiation Medicine, Seoul National Univ. Hospital, Seoul (Korea, Republic of)), email: rosaceci@radiol.snu.ac.kr

    2011-09-15

    Background: Pulmonary aspergillosis in immunocompetent patients has been described as a saprophytic infection with pre-existing lung lesions showing an air-meniscus sign on chest radiograph or CT scans. There have been rare articles dealing with pulmonary aspergillosis in immunocompetent patients without pre-existing lung lesions. Purpose: To evaluate the CT findings of pulmonary aspergillosis in immunocompetent patients without air-meniscus and underlying lung disease and to correlate the CT findings and pathologic features of pulmonary aspergillosis in these patients. Material and Methods: A total of seven surgically proven pulmonary aspergillosis found in immunocompetent patients without an air-meniscus and underlying lung disease (M:F = 1:6; mean age 63.4 years) were included. On CT, the lesion shape, margin, type, location, diameter, presence of satellite nodules, presence of CT halo sign or hypodense sign, and interval growth were evaluated. Histopathologic features of each lesion were classified as one of the following; primary aspergilloma, chronic necrotizing pulmonary aspergillosis, or invasive pulmonary aspergillosis. Correlation between CT findings and pathological features was performed. Results: All lesions presented as a nodule or mass unable to differentiate from malignancy. Most lesions had well-defined margins (n = 4), appeared as solid lesions (n = 7), and were located in the upper lobe (n = 5). Mean diameter of lesions was 2.3 cm. Satellite nodules (n = 2), CT halo sign (n = 1), and hypodense sign (n = 4) were found. Only one lesion increased in size during follow-up. Lesions were pathologically classified as primary aspergilloma (n = 3) and chronic necrotizing pulmonary aspergillosis (n = 4). The hypodense sign on CT was pathologically proved as dense fungal hyphae filled in bronchus and CT halo sign as parenchymal hemorrhage. Conclusion: Pulmonary aspergillosis predominantly presented as a nodule or mass mimicking malignancy in the upper lobes

  7. Pulmonary aspergillosis in immunocompetent patients without air-meniscus sign and underlying lung disease: CT findings and histopathologic features

    International Nuclear Information System (INIS)

    Yoon, Soon Ho; Park, Chang Min; Goo, Jin Mo; Lee, Hyun Ju

    2011-01-01

    Background: Pulmonary aspergillosis in immunocompetent patients has been described as a saprophytic infection with pre-existing lung lesions showing an air-meniscus sign on chest radiograph or CT scans. There have been rare articles dealing with pulmonary aspergillosis in immunocompetent patients without pre-existing lung lesions. Purpose: To evaluate the CT findings of pulmonary aspergillosis in immunocompetent patients without air-meniscus and underlying lung disease and to correlate the CT findings and pathologic features of pulmonary aspergillosis in these patients. Material and Methods: A total of seven surgically proven pulmonary aspergillosis found in immunocompetent patients without an air-meniscus and underlying lung disease (M:F = 1:6; mean age 63.4 years) were included. On CT, the lesion shape, margin, type, location, diameter, presence of satellite nodules, presence of CT halo sign or hypodense sign, and interval growth were evaluated. Histopathologic features of each lesion were classified as one of the following; primary aspergilloma, chronic necrotizing pulmonary aspergillosis, or invasive pulmonary aspergillosis. Correlation between CT findings and pathological features was performed. Results: All lesions presented as a nodule or mass unable to differentiate from malignancy. Most lesions had well-defined margins (n = 4), appeared as solid lesions (n = 7), and were located in the upper lobe (n = 5). Mean diameter of lesions was 2.3 cm. Satellite nodules (n = 2), CT halo sign (n = 1), and hypodense sign (n = 4) were found. Only one lesion increased in size during follow-up. Lesions were pathologically classified as primary aspergilloma (n = 3) and chronic necrotizing pulmonary aspergillosis (n = 4). The hypodense sign on CT was pathologically proved as dense fungal hyphae filled in bronchus and CT halo sign as parenchymal hemorrhage. Conclusion: Pulmonary aspergillosis predominantly presented as a nodule or mass mimicking malignancy in the upper lobes

  8. Disseminated Mycobacterium avium complex in an immunocompetent host

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    Joseph M Yabes

    2017-01-01

    Full Text Available Disseminated Mycobacterium avium complex (DMAC has historically been described in the immunocompromised. The current epidemiologic research suggests that the incidence of nontuberculous mycobacterial infections is increasing. We present a case of DMAC infection manifesting as hepatic granulomas in a 35-year-old immunocompetent female. This case suggests DMAC infection in a patient without traditional epidemiological risk factors.

  9. Radiographic findings in 37 cases of primary CNS lymphoma in immunocompetent patients

    International Nuclear Information System (INIS)

    Coulon, A.; Lafitte, F.; Martin-Duverneuil, N.; Chiras, J.; Hoang-Xuan, K.; Mokhtari, K.; Blustajn, J.

    2002-01-01

    Because of the increasing incidence of primary central nervous system lymphoma (PCNSL), it is essential to recognize this disease in order to start appropriate treatment. We present the characteristic CT and MRI features of this tumour. The findings of 32 CT and 31 MR of 37 immunocompetent patients with biopsy-proved PCNSL are reviewed. The main features are presented and analysed, and are discussed in comparison with proven literature data. Primary central nervous system lymphoma presents as supratentorial solitary lesions in approximately 80% of the patients and multiple lesions in 20%. In contrast to classical data, the lesions are located in deep structures only in one-third of the cases, and involve posterior fossa in 10% of cases. Most of the lesions are hyperdense or isodense (92%) on CT, hypointense or isointense on T1-weighted images, and only about 40% are hyperintense on T2-weighted images. Nearly all the lesions enhance, except after corticosteroid administration. They produce mild oedema and mass effect. Meningeal or ventricular enhancement are rare but suggestive. Calcification, haemorrhage or necrosis are scarce. Although PCNSL in immunocompetent patients have a variable CT and MR appearance, the imaging data often suggest the diagnosis. (orig.)

  10. Radiographic findings in 37 cases of primary CNS lymphoma in immunocompetent patients

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    Coulon, A.; Lafitte, F.; Martin-Duverneuil, N.; Chiras, J. [Department of Neuroradiology, Hopital de la Salpetriere, Paris (France); Hoang-Xuan, K. [Department of Neurology, Hopital de la Salpetriere, Paris (France); Mokhtari, K. [Department of Anatomopathology, Hopital de la Salpetriere, Paris (France); Blustajn, J. [Department of Radiology, Fondation Rothschild, Paris (France)

    2002-02-01

    Because of the increasing incidence of primary central nervous system lymphoma (PCNSL), it is essential to recognize this disease in order to start appropriate treatment. We present the characteristic CT and MRI features of this tumour. The findings of 32 CT and 31 MR of 37 immunocompetent patients with biopsy-proved PCNSL are reviewed. The main features are presented and analysed, and are discussed in comparison with proven literature data. Primary central nervous system lymphoma presents as supratentorial solitary lesions in approximately 80% of the patients and multiple lesions in 20%. In contrast to classical data, the lesions are located in deep structures only in one-third of the cases, and involve posterior fossa in 10% of cases. Most of the lesions are hyperdense or isodense (92%) on CT, hypointense or isointense on T1-weighted images, and only about 40% are hyperintense on T2-weighted images. Nearly all the lesions enhance, except after corticosteroid administration. They produce mild oedema and mass effect. Meningeal or ventricular enhancement are rare but suggestive. Calcification, haemorrhage or necrosis are scarce. Although PCNSL in immunocompetent patients have a variable CT and MR appearance, the imaging data often suggest the diagnosis. (orig.)

  11. Mycobacterium chelonae empyema with bronchopleural fistula in an immunocompetent patient

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    Wali, Siraj

    2009-01-01

    Mycobacterium Calhoun is one of the rapidly growing mycobacteria that rarely cause lung disease. M chelonae more commonly causes skin and soft tissue infections primarily in immunosuppressed individuals. Thoracic empyema caused by rapidly growing mycobacteria and complicated with bronchopleural fistula is rarely reported, especially in immunocompetent patients. In this article we report the first immunocompetent Arabian patient presented with M chelonae- related empyema with bronchopleural fistula which mimics, clinically and radiologically, empyema caused by Mycobacterium tuberculosis. (author)

  12. Incidence, risk factors and treatment of diarrhoea among Dutch travellers: reasons not to routinely prescribe antibiotics

    NARCIS (Netherlands)

    Belderok, Sanne-Meike; van den Hoek, Anneke; Kint, Joan A.; Schim van der Loeff, Maarten F.; Sonder, Gerard Jb

    2011-01-01

    Travellers' diarrhoea (TD) is the most common infectious disease among travellers. In the Netherlands, stand-by or prophylactic antibiotics are not routinely prescribed to travellers. This study prospectively assessed the incidence rate, risk factors, and treatment of TD among immunocompetent

  13. Cryptosporidium Pig Genotype II in Immunocompetent Man

    Czech Academy of Sciences Publication Activity Database

    Kváč, Martin; Květoňová, Dana; Sak, Bohumil; Ditrich, Oleg

    2009-01-01

    Roč. 15, č. 6 (2009), s. 982-983 ISSN 1080-6040 R&D Projects: GA ČR GP523/07/P117 Institutional research plan: CEZ:AV0Z60220518 Keywords : immunocompetent patients * cryptosporidiosis * Cryptosporidium pig genotype II Subject RIV: GJ - Animal Vermins ; Diseases , Veterinary Medicine Impact factor: 6.794, year: 2009

  14. [Disseminated cryptococcosis in an immunocompetent patient].

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    Elkhihal, B; Hasnaoui, A; Ghfir, I; Moustachi, A; Aoufi, S; Lyagoubi, M

    2015-09-01

    Disseminated cryptococcosis is a serious opportunistic fungal infection caused by a yeast-encapsulated fungus of the genus Cryptococcus neoformans. It occurs most often in patients with a significant deficit of cellular immunity and preferentially affects the central nervous system. The skin and the lungs are the most commonly affected sites outside the neuro-subarachnoid location. We report the case of a patient apparently immunocompetent who had a disseminated cryptococcosis. The disease started with the multiple purplish skin lesions, large umbilicated on the face, groin, forearm and leg with progressively increasing volume. This symptomatology had evolved in the context of weight loss and poor general condition. The diagnosis was established by the presence of cryptococcal at the skin biopsy and cerebrospinal fluid. Research of immunosuppression common pathologies were negative. Treatment was initiated based on amphotericin B for 40 days. The patient's condition deteriorates onset of paraplegia and swallowing disorders causing death in an array of cachexia. This observation points out that disseminated cryptococcosis can occur in an immunocompetent patient. The skin lesions may be the first sign of the disease. Copyright © 2015. Published by Elsevier Masson SAS.

  15. Computed Tomography Features of Pulmonary Nocardiosis in Immunocompromised and Immunocompetent Patients

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    Mehrian, Payam; Esfandiari, Ehsan; Karimi, Mohammad Ali; Memari, Behzad

    2015-01-01

    Nocardiosis primarily occurs in the setting of immunocompromising conditions. However, it may also occur in immunocompetent patients. We described computed tomography features of pulmonary nocardiosis and compared immunocompetent and immunocompromised patients. CT images of 25 patients (Mean age of 39.5 years; 76% male) with pulmonary nocardiosis proved by bronchoalveolar lavage or biopsy were reviewed by two experienced pulmonary radiologists and detailed findings were reported on. Fourteen patients (56%) were immunocompetent, while 44% had an underlying immunocompromising condition, including chronic granulomatous disease (CGD) (n=4), diabetes mellitus (DM) (n=2), malignancy (n=2), HIV (n=1), concomitant CGD and DM (n=1), and steroid therapy for nephrotic syndrome (n=1). Most patients had bilateral involvement with no zonal predominance. Multiple pulmonary nodules (96%) were the most common CT findings, followed by consolidation (76%) and cavity (52%). Other findings included bronchiectasis (48%), pleural thickening (40%), ground glass opacity (32%), mass-like consolidation (20%), intrathoracic lymphadenopathy (16%), pleural effusion (12%), reticular infiltration (4%), and pericardial effusion (4%). There was no statistically significant difference in the CT findings of immunocompromised and immunocompetent groups. Pulmonary nocardiosis presents mainly as multiple pulmonary nodules, consolidations, and cavity in both immunocompromised and immunocompetent patients. However, these features are more suggestive of nocardiosis in the setting of an underling immunocompromised condition

  16. Tuberculous disseminated lymphadenopathy in an immunocompetent non-HIV patient: a case report

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    Karadonta Argiroula-Vasiliki

    2009-12-01

    Full Text Available Abstract Introduction In cases of patients with disseminated lymphadenopathy, the differential diagnosis has to include both benign and malignant causes, including sarcoidosis, metastatic disease, lymphoma and, although rarely present, tuberculosis. Tuberculosis is still one of the most frequently occurring infectious diseases worldwide. However, disseminated mycobacterial lymphadenitis is rare in immunocompetent patients. Case presentation We present the case of a 56-year-old Caucasian Greek male, who was immunocompetent and HIV negative, with a two-month history of recurring fever, loss of appetite and disseminated lymphadenopathy. The patient was diagnosed with mycobacterial lymphadenopathy. Conclusion This case highlights the need for suspicion in order to identify mycobacterial infection in patients with generalized lymphadenopathy, since misdiagnosis is possible and may lead to fatal complications for the patient.

  17. Prevalence and fungal profile of pulmonary aspergillosis in immunocompromised and immunocompetent patients of a tertiary care hospital

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    Prakash Ved, Mishra Prem P, Verma Shashi K, Sinha Shivani, Sharma Mahendra

    2014-01-01

    Background: Aspergillus is a fungus which may present an array of pulmonary manifestations, depending on the patient’s immunological and physiological state. Although the incidence of pulmonary aspergillosis occurs primarily in immunocompromised patients but the incidence is also rising in immunocompetent individuals, especially in developing countries. Aim: The objective of the study was to determine the prevalence and predisposing factors of pulmonary aspergillosis along with species identi...

  18. [Cladophilaphora bantiana brain abscess treated with voriconazole in an immunocompetent patient].

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    Atalay, Mustafa Altay; Koç, Ayşe Nedret; Koyuncu, Sümeyra; Ulu Kiliç, Ayşegül; Kurtsoy, Ali; Alp Meşe, Emine

    2014-07-01

    Phaeohyphomycosis is a term used to define infections caused by darkly pigmented fungi with septate hyphae which contain melanin in their cell walls. Although fungi rarely cause central nervous system (CNS) infections, the incidence of CNS infections caused by melanin-containing fungi has been increasing in the recent years. Cladophialophora bantiana is the most frequently isolated species from cerebral phaeohyphomycosis. It mostly affects adult men in the second and third decade of life and about half of the cases occurs in immunocompetent patients. In this report, the isolation of C.bantiana from brain tissue of an immunocompetent patient who was operated with the initial diagnosis of a brain abscess, was presented. A 27 year-old male patient presenting without any chronic disease was admitted to the emergency department of our hospital with the complaints of persistent headache and diplopia. Magnetic resonance imaging (MRI) showed a space-occupying lesion in the right parietal lobe and left frontal lobe. Brain abscess was diagnosed in the patient who was referred to the neurosurgery department. Treatment was initiated with ceftriaxone and metronidazole. The abscess material sent for direct microscopic examination in the mycology laboratory was stained with Gram and Giemsa and cultured in the Sabouraud dextrose agar medium (SDA) with and without antibiotics (cycloheximide and chloramphenicol). Then, it was incubated at 37°C and 25°C. Direct examination and staining revealed a septate hyphae. The patient who received liposomal amphotericin B was referred to the infectious diseases department. Surface colors of all media including SDA with cycloheximide were olive-gray to black and contained velvety colonies. Lemon-like very long and integrated chains of conidium with poor branching in cornmeal Tween 80 agar, as well as growth at 42°C in passages, positive urease test result and cycloheximide resistance suggested C.bantiana. The isolate was confirmed as C

  19. Disseminated cutaneous histoplasmosis in an immunocompetent adult

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    Manoj Harnalikar

    2012-01-01

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

  20. Histoplasmosis in immunocompetent individuals living in an endemic area in the Brazilian Southeast

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    Rivian Christina Lopes Faiolla

    2013-07-01

    Full Text Available Introduction The distribution of infection by Histoplasma capsulatum in Brazil is heterogeneous, and the number of cases affecting immunocompetent individuals is relatively small. This study reports the epidemiological and clinical data regarding histoplasmosis in non-immunosuppressed individuals. Methods The study included only the immunocompetent patients with histoplasmosis who were diagnosed between 1970 and 2012 at a university hospital located in Ribeirão Preto, State of São Paulo, Brazil. Clinical and epidemiological data were collected retrospectively from the patient records. Results Of the 123 patients analyzed, 95 had an active disease that manifested in the different clinical forms of histoplasmosis. Men were the predominant gender, and most patients resided in the Northeast of the State of São Paulo and in the nearby municipalities of the State of Minas Gerais. The risk factors for acquiring histoplasmosis and prolonged contact in a rural environment were recorded in 43.9% and 82.9% of cases, respectively. Smoking, alcoholism, and comorbidity rates were high among the patients with the chronic pulmonary and subacute/chronic disseminated forms of histoplasmosis. Many patients achieved clinical cure spontaneously, but 58.9% required antifungals; the disease lethality rate was 5.3%. Conclusions Immunocompetent individuals manifested the diverse clinical forms of histoplasmosis over a period of 4 decades, revealing an additional endemic area of this fungal disease in the Brazilian Southeast.

  1. Disseminated cutaneous sporotrichosis in an immunocompetent individual.

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    Yap, Felix Boon-Bin

    2011-10-01

    Sporotrichosis is a subacute or chronic fungal infection caused by the ubiquitous fungus Sporothrix schenckii. Disseminated cutaneous sporotrichosis is an uncommon entity and is usually present in the immunosuppressed. Here, a case of disseminated cutaneous sporotrichosis in an immunocompetent patient is reported. This 70-year-old healthy woman presented with multiple painful ulcerated nodules on her face and upper and lower extremities of 6-month duration, associated with low-grade fever, night sweats, loss of appetite, and loss of weight. Histopathological examination of the skin biopsy revealed epidermal hyperplasia and granulomatous inflammation in the dermis, with budding yeast. Fungal culture identified S. schenckii. She had total resolution of the lesions after 2 weeks of intravenous amphotericin B and 8 months of oral itraconazole. All investigations for underlying immunosuppression and internal organ involvement were negative. This case reiterates that disseminated cutaneous sporotrichosis, although common in the immunosuppressed, can also be seen in immunocompetent patients. Copyright © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  2. Cutaneous Paecilomyces lilacinus infections in immunocompromised and immunocompetent patients

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    Shahindokht Bassiri-Jahromi

    2014-01-01

    Full Text Available Paecilomyces is a genus of saprophytic fungus that has been associated, in rare instances, with human disease. We report two cases in which Paecilomyces lilacinus was isolated from cutaneous and subcutaneous lesions in an immunocompromised and an immunocompetent host. The first case was a subcutaneous infection due to P. lilacinus in a patient with a renal transplant and diabetes mellitus. The second case was an immunocompetent young woman who developed a cutaneous infection, with no identified predisposing factors. A biopsy from each patient provided an initial diagnosis of fungal elements in the tissues under examination and multiple positive fungal cultures were obtained from the tissue biopsy samples. Both microscopic and macroscopic examinations of the biopsy revealed the presence of P. lilacinus. Each of the two cases was successfully treated with oral ketoconazole (200 mg/day and itraconazole. We also review previously reported cases in which the clinical history and response to therapy were noted.

  3. A virtual tissue bank for primary central nervous system lymphomas in immunocompetent individuals.

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    Ponzoni, Maurilio; Kwee, Ivo; Mazzucchelli, Luca; Ferreri, Andrés J M; Zucca, Emanuele; Doglioni, Claudio; Cavalli, Franco; Bertoni, Francesco

    2007-01-01

    Primary central nervous system lymphoma (PCNSL) is a rare form of extranodal non-Hodgkin's lymphoma with continuously increasing incidence in both immunosuppressed and immunocompetent individuals. PCNSL is a very aggressive tumor with a poor outcome, and its clinical outcome is much worse than for nodal lymphomas. Differently from lymphomas arising in lymph nodes or in other extranodal sites, the treatment of PCNSL remains very unsatisfactory. Current biologic knowledge of PCNSL is still limited and several fundamental questions remain to be answered. This is mainly due to the paucity of PCNSL material for adequate translational research. With the aim of providing biologic material to investigators interested in PCNSL, we have implemented a virtual tissue bank (VTB) for PCNSL in immunocompetent patients. After registration, the VTB is accessible via any web browser at www.ielsg.org. Only anonymous data are centralized at the website of the International Extranodal Lymphoma Study Group, whilst the pathologic material is maintained at the local pathology institutes. (c) 2007 S. Karger AG, Basel.

  4. Successful Intra-peritoneal Antibiotic Therapy for Primary Abdominal Nocardiosis in an Immunocompetent Young Female Masquerading as Carcinoma Ovary

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    Ravi N Patil

    2012-01-01

    Full Text Available Nocardiosis is a common opportunistic infection in the immunocompromised and in patients with chronic debilitating diseases,e.g continuous ambulatory peritoneal dialysis (CAPD patients. Primary abdominal nocardiosis is rare and is indeed a very rare infection in immunocompetent persons. Only two cases have been reported in immunocompetent patients so far and this may be third case to the best of our knowledge and first in India. About 11 cases have been reported in CAPD patients and AIDS patients.We report a case of Nocardiosis in an immunocompetent young female who presented with an abdomino-pelvic mass masquerading as carcinoma ovary.After initial resistance to various antibiotics, she responded to intraperitoneal and oral linezolid and oral ciprofloxacin.

  5. Do pheromones reveal male immunocompetence?

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    Rantala, Markus J; Jokinen, Ilmari; Kortet, Raine; Vainikka, Anssi; Suhonen, Jukka

    2002-01-01

    Pheromones function not only as mate attractors, but they may also relay important information to prospective mates. It has been shown that vertebrates can distinguish, via olfactory mechanisms, major histocompatibility complex types in their prospective mates. However, whether pheromones can transmit information about immunocompetence is unknown. Here, we show that female mealworm beetles (Tenebrio molitor) prefer pheromones from males with better immunocompetence, indicated by a faster encapsulation rate against a novel antigen, and higher levels of phenoloxidase in haemolymph. Thus, the present study indicates that pheromones could transmit information about males' parasite resistance ability and may work as a reliable sexual ornament for female choice. PMID:12204128

  6. Cystoisospora belli Infection of the Gallbladder in Immunocompetent Patients: A Clinicopathologic Review of 18 Cases.

    Science.gov (United States)

    Lai, Keith K; Goyne, Hannah E; Hernandez-Gonzalo, David; Miller, Kennon A; Tuohy, Marion; Procop, Gary W; Lamps, Laura W; Patil, Deepa T

    2016-08-01

    Cystoisospora belli, previously known as Isospora belli, is an obligate intracellular coccidian parasite that is most often associated with gastrointestinal disease in immunocompromised patients. In this study, we detail the clinicopathologic features of 18 cases of Cystoisospora infection affecting the gallbladder in immunocompetent individuals and compare them with a control group. Each case was reviewed for cholecystitis (none, acute, chronic), epithelial disarray, presence of intraepithelial lymphocytes (none, rare [≤5 per 20 epithelial cells], present [>5 per 20 epithelial cells]), architectural distortion, intramucosal eosinophilia, and mural thickening/serositis. The mean age of patients with Cystoisospora infection was 33 years and the male to female ratio 1:4.3. Cholecystectomy was performed for biliary dyskinesia (n=7), abdominal pain (n=7), suspected cholelithiasis (n=5), and cholecystitis (n=3). In 2 cases, Cystoisospora was found in donor gallbladders resected at the time of liver transplantation. Each case was characterized by eosinophilic, oval or banana-shaped intraepithelial parasites within perinuclear parasitophorous vacuoles. Most cases showed epithelial disarray and minimal intraepithelial lymphocytosis. Of the 11 cases with an average follow-up of 15 months, none had evidence of disease related to Cystoisospora infection within the biliary tract or elsewhere in the gastrointestinal tract. We present the largest series of gallbladder cystoisosporiasis in immunocompetent patients to date. Cystoisospora infection is underrecognized in the gallbladders of immunocompetent patients, in part due to the subtle findings in routine cholecystectomy specimens. On the basis of the clinical follow-up, gallbladder cystoisosporiasis in immunocompetent individuals appears to be a self-limited infection.

  7. A case of an immunocompetent young man obtaining community-acquired disseminated Nocardia brasiliensis.

    Science.gov (United States)

    Li, Jinna; Cao, Jie; Wu, Yueqing; Wan, Nansheng; Pan, Li; Chen, Yuanbao

    2014-01-01

    Nocardiosis is a rare but severe pyogenic or granulomatous disease and caused by Nocardia that mainly infects immunocompromised patients. We report here a case of an immunocompetent 24-year-old male student with community-acquired pneumonia with asymptomatic disseminated cerebral abscess by Brasiliensis nocardiosis. The patient was fully recovered after receiving optimized antimicrobial therapy without relapse. This case suggests the health professionals such as the physicians of pulmonary, infection, neurology department and et al should always think about unusual cause of community acquired pneumonia, even in immunocompetent patients and when having pulmonary nocardiosis we should do a radiological neurological work up, even with the absence of neurological finding or symptom. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Bacteremia due to Rhodococcus equi in an immunocompetent infant

    Directory of Open Access Journals (Sweden)

    P Devi

    2011-01-01

    Full Text Available Rhodococcus equi , previously known as Corynebacterium equi, is one of the most important causes of zoonotic infection in grazing animals. Increased cases of human infection with R. equi have been reported especially in immunocompromised patients. Infection in immunocompetent patients is extremely rare. We report a case of R. equi bacteremia in a 26-day-old immunocompetent infant with recurrent swellings on different parts of the body. To the best of our knowledge, this is the first ever report of R. equi bacteremia from an immunocompetent patient from Northern India.

  9. Non-healing genital herpes mimicking donovanosis in an immunocompetent man.

    Science.gov (United States)

    Gupta, Vishal; Khute, Prakash; Patel, Anjali; Gupta, Somesh

    2016-01-01

    Although atypical presentations of herpetic infection in immunocompetent individuals are common, they very rarely have the extensive, chronic and verrucous appearances seen in the immunocompromised host. We report a case of genital herpes manifesting as painless chronic non-healing genital ulcers with exuberant granulation tissue in an immunocompetent man. Owing to this morphology, the ulcers were initially mistaken for donovanosis. To the best of our knowledge, such a presentation of genital herpes in an immunocompetent individual has not been described previously. © The Author(s) 2015.

  10. Cardiovascular disease incidence and survival

    DEFF Research Database (Denmark)

    Byberg, Stine; Agyemang, Charles; Zwisler, Ann Dorthe

    2016-01-01

    Studies on cardiovascular disease (CVD) incidence and survival show varying results between different ethnic groups. Our aim was to add a new dimension by exploring the role of migrant status in combination with ethnic background on incidence of-and survival from-CVD and more specifically acute...... of some types of cardiovascular disease compared to Danish-born. Family-reunified migrants on the other hand had lower rates of CVD. All migrants had better survival than Danish-born indicating that migrants may not always be disadvantaged in health....

  11. Unusual MRI findings in an immunocompetent patient with EBV encephalitis: a case report

    International Nuclear Information System (INIS)

    Di Carlo, Paola; Trizzino, Marcello; Titone, Lucina; Capra, Giuseppina; Colletti, Piero; Mazzola, Giovanni; Pistoia, Daniela; Sarno, Caterina

    2011-01-01

    It is well-known that Epstein-Barr virus (EBV) can affect the central nervous system (CNS). Herein the authors report unusual timely Magnetic Resonance Imaging (MRI) brain scan findings in an immunocompetent patient with EBV encephalitis. Diffusion weighted MRI sequence performed during the acute phase of the disease was normal, whereas the Fast Relaxation Fast Spin Echo T2 image showed diffuse signal intensity changes in white matter. The enhancement pattern suggested an inflammatory response restricted to the brain microcirculation. Acyclovir and corticosteroid therapy was administered. After three weeks, all signal intensities returned to normal and the patient showed clinical recovery. This report demonstrates that EBV in an immunocompetent adult can present with diffuse, reversible brain white matter involvement in the acute phase of mononucleosis. Moreover, our case suggests that a negative DWI sequence is associated with a favorable improvement in severe EBV CNS infection. More extensive studies are needed to assess what other instrumental data can help to distinguish viral lesions from other causes in the acute phase of disease

  12. Cryptococcal meningitis with secondary cutaneous involvement in an immunocompetent host.

    Science.gov (United States)

    Tabassum, Saadia; Rahman, Atiya; Herekar, Fivzia; Masood, Sadia

    2013-09-16

    Cryptococcosis is a potentially fatal fungal disease caused by variants of Cryptococcus neoformans species.  The respiratory tract is the usual portal of entry, with a peculiar predilection to invade the central nervous system.  The skin can be secondarily involved in disseminated infection or be exceptionally involved as primary cutaneous infection by inoculation.  The disease is mostly seen in immunodeficiency states.  The diagnosis is frequently unsuspected in immunocompetent patients. We report a case of disseminated cryptococcal meningitis in an immunocompetent young adult. The cutaneous eruption prompted the accurate diagnosis.  The patient, a 20-year-old female, had fever, cough, headache and intractable vomiting for the past two months and was being managed as a case of tuberculous meningitis. Two weeks after starting antituberculous treatment she developed umbilicated papules on the head and neck region. Necessary laboratory workup identified C. neoformans in cerebrospinal fluid (CSF) and skin specimens.  The titers of cryptococcal antigen were measured in CSF and serum for diagnostic and prognostic purposes.  Anti-fungal treatment resulted in regression of the cutaneous lesions and resolution of systemic complaints. The case highlights the need for high degree of suspicion, especially in healthy young adults, in the diagnosis of cryptococcosis. The cutaneous eruptions can be the first manifestation or a diagnostic clue of enormous significance.

  13. Melanoma in Organ Transplant Recipients: Incidence, Outcomes and Management Considerations

    Directory of Open Access Journals (Sweden)

    Faisal R. Ali

    2012-01-01

    Full Text Available The incidence of melanoma continues to increase year on year. With better surgical techniques and medical management, greater numbers of organ transplants are being performed annually with much longer graft survival. The authors review our current understanding of the incidence of melanoma amongst organ transplant recipients, outcomes compared to the immunocompetent population, and management strategies in this burgeoning group.

  14. Cryptococcus neoformans infective endocarditis of native valves in an immunocompetent host

    Directory of Open Access Journals (Sweden)

    Moni Roy

    Full Text Available With the emergence of Human immunodeficiency virus (HIV and the resulting immunocompromised state, Cryptococcus neoformans infections have gained more importance in clinical practice. Cryptococcal infections in immunocompetent hosts continue to be uncommon. We present a rare case of Cryptococcus neoformans infective endocarditis (IE in a young immunocompetent male. As per our literature review, this is the first reported case of native valve Cryptococcus neoformans endocarditis in an immunocompetent host. All cases till date have been reported in patients with underlying immunocompromised state or prosthetic valve.

  15. A rare case of onychomycosis in all 10 fingers of an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Asima Banu

    2013-01-01

    Full Text Available Onychomycosis, traditionally referred as a non-dermatophytic infection of the nail, is now used as a general term to denote any fungal nail infection. It is an important public health problem due to its increasing incidence and has significant clinical consequences in addition to serving as a reservoir of infection. We report a case of Onychomycosis in all 10 fingers of an immunocompetent male with no co-morbid conditions caused by a non-dermatophytic fungus, Aspergillus niger. To the best of our knowledge, this is the first case of its kind to be reported.

  16. Two cases of cytomegalovirus panuveitis in immunocompetent patients

    Directory of Open Access Journals (Sweden)

    Masato Sakai

    2018-06-01

    Full Text Available Purpose: To report two cases of panuveitis in immunocompetent patients in which cytomegalovirus was involved. Observation: Case 1 was a 46-year-old man who had a history of recurrent anterior chamber inflammations in his left eye. After Nd:YAG laser posterior capsulotomy, he developed panuveitis with vitreous haze and periphlebitis. Polymerase chain reaction (PCR examination revealed the presence of cytomegalovirus (CMV DNA in the anterior chamber (AC. He responded well to a series of intravitreal injections of ganciclovir (GCV. Case 2 was a 63-year-old woman who had a history of recurrent anterior uveitis in her left eye. Two years after cataract surgery, AC inflammation, diffuse vitreous haze, and periphlebitis had developed. CMV DNA was detected in the AC. Intravitreal injections of GCV and oral valganciclovir were administered, and ocular inflammation finally improved. Conclusions: and importance: We experienced two cases of CMV panuveitis in immunocompetent adults, both of which responded well to anti-viral therapies. Keywords: Cytomegalovirus, Panuveitis, Immunocompetent, Intravitreal injection, PCR

  17. Changes of disease incidence among atomic-bomb survivors 1956-78

    International Nuclear Information System (INIS)

    Hamada, Tadao; Matsushita, Hiroshi.

    1978-01-01

    Statistical observation was made concerning changes with time of incidences of various diseases in autopsy cases since 1956 when Atomic Bomb Hospital was established, and the following results were obtained. The incidence of lung cancer tended to increase in men and women of both groups (an exposed group and a non-exposed group). A marked decrease of the incidence of leukemia was recognized in men and women of both groups, and a decrease of that of malignant lymphoma was recognized in men. The incidence of liver cirrhosis and hepatic cancer tended to decrease in men and women of both groups. The incidence of colon cancer tended to increase in both groups, but that of stomach cancer decreased recently in men and women of both groups. Incidences of digestive organ diseases, cardiovascular diseases, cerebrovascular disorder, and respiratory organ diseases tended to increase in both groups, but urinary tract diseases, infectious diseases, and blood diseases tended to decrease in both groups, which suggested an increase of older persons' diseases due to aging of the exposed. Incidences of various diseases in the exposed changed almost in parallel with those in the non-exposed, and a difference in incidences of various diseases tended to be shortened. (Tsunoda, M.)

  18. A Case Report of NK-Cell Lymphoproliferative Disease With a Wide Involvement of Digestive Tract Develop Into Epstein-Barr Virus Associated NK/T Cell Lymphoma in an Immunocompetent Patient.

    Science.gov (United States)

    Chen, Haotian; Zhang, Yu; Jiang, Zhinong; Zhou, Wei; Cao, Qian

    2016-03-01

    Epstein-Barr virus (EBV) plays an important role in various diseases. EBV-associated lymphoproliferative disease (LPD) is a rare disease with a canceration tendency. It is difficult to differentiate LPD with involvement of digestive tract from Crohn disease due to similar clinical and endoscopic manifestations. We present a case report of multiple ulcers with esophagus, small bowel and the entire colon involved, proved to be NK-Cell LPD, developed into EBV-associated NK/T Cell lymphoma, in an immunocompetent man who was initially misdiagnosed as Crohn disease.This report underscores that intestinal ulcers should be cautiously diagnosed, for it sometimes could be a precancerous lesion.

  19. Cervical Lymphadenitis by Mycobacterium triplex in an Immunocompetent Child: Case Report and Review

    OpenAIRE

    Caruso, G.; Angotti, R.; Molinaro, F.; Benicchi, E.; Cerchia, E.; Messina, M.

    2013-01-01

    Mycobacterium triplex was first described in 1996. This nontuberculous Mycobacterium causes a severe pulmonary disease in immunocompromised patients but it can involve also healthy patients. A literature search was made on the PubMed database and it produced only few cases of children with cervical lymphadenitis due to this Mycobacterium Triplex. We are describing a case of M. triplex cervical lymphadenitis in an immunocompetent child.

  20. Non-tuberculous mycobacterial soft tissue swelling in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Virendra S Athavale

    2014-01-01

    Full Text Available Non-tuberculosis mycobacteria (NTM include those mycobacterium species that are not members of the Mycobacterium tuberculosis complex. They assumed significance with the growing pandemic of the acquired immune deficiency syndrome (AIDS since the 1980s, when Mycobacterium avium infections were found to be associated with AIDS. However, the epidemiology of NTM disease among patients without Human immunodeficiency virus infections is not well documented. We report a case of NTM soft tissue swelling in an immunocompetent 18-year-old male who responded well to local excision and antitubercular treatment.

  1. Estimating cardiovascular disease incidence from prevalence: a spreadsheet based model

    Directory of Open Access Journals (Sweden)

    Xue Feng Hu

    2017-01-01

    Full Text Available Abstract Background Disease incidence and prevalence are both core indicators of population health. Incidence is generally not as readily accessible as prevalence. Cohort studies and electronic health record systems are two major way to estimate disease incidence. The former is time-consuming and expensive; the latter is not available in most developing countries. Alternatively, mathematical models could be used to estimate disease incidence from prevalence. Methods We proposed and validated a method to estimate the age-standardized incidence of cardiovascular disease (CVD, with prevalence data from successive surveys and mortality data from empirical studies. Hallett’s method designed for estimating HIV infections in Africa was modified to estimate the incidence of myocardial infarction (MI in the U.S. population and incidence of heart disease in the Canadian population. Results Model-derived estimates were in close agreement with observed incidence from cohort studies and population surveillance systems. This method correctly captured the trend in incidence given sufficient waves of cross-sectional surveys. The estimated MI declining rate in the U.S. population was in accordance with the literature. This method was superior to closed cohort, in terms of the estimating trend of population cardiovascular disease incidence. Conclusion It is possible to estimate CVD incidence accurately at the population level from cross-sectional prevalence data. This method has the potential to be used for age- and sex- specific incidence estimates, or to be expanded to other chronic conditions.

  2. Bacteremia due to Rhodococcus equi in an immunocompetent infant

    OpenAIRE

    P Devi; S Malhotra; A Chadha

    2011-01-01

    Rhodococcus equi , previously known as Corynebacterium equi, is one of the most important causes of zoonotic infection in grazing animals. Increased cases of human infection with R. equi have been reported especially in immunocompromised patients. Infection in immunocompetent patients is extremely rare. We report a case of R. equi bacteremia in a 26-day-old immunocompetent infant with recurrent swellings on different parts of the body. To the best of our knowledge, this is the first ever repo...

  3. Cardiovascular Risks Associated with Incident and Prevalent Periodontal Disease

    Science.gov (United States)

    Yu, Yau-Hua; Chasman, Daniel I; Buring, Julie E; Rose, Lynda; Ridker, Paul M

    2014-01-01

    Aim While prevalent periodontal disease associates with cardiovascular risk, little is known about how incident periodontal disease influences future vascular risk. We compared effects of incident versus prevalent periodontal disease in developing major cardiovascular diseases (CVD), myocardial infarction (MI), ischemic stroke and total CVD. Material and Methods In a prospective cohort of 39863 predominantly white women, age ≥ 45 years and free of cardiovascular disease at baseline were followed for an average of 15.7 years. Cox proportional hazard models with time-varying periodontal status (prevalent [18%], incident [7.3%] vs. never [74.7%]) were used to assess future cardiovascular risks. Results Incidence rates of all CVD outcomes were higher in women with prevalent or incident periodontal disease. For women with incident periodontal disease, risk factor adjusted hazard ratios (HRs) were 1.42 (95% CI, 1.14–1.77) for major CVD, 1.72 (1.25–2.38) for MI, 1.41(1.02–1.95) for ischemic stroke, and 1.27(1.06–1.52) for total CVD. For women with prevalent periodontal disease, adjusted HRs were 1.14 (1.00–1.31) for major CVD, 1.27 (1.04–1.56) for MI, 1.12(0.91–1.37) for ischemic stroke, and 1.15(1.03–1.28) for total CVD. Conclusion New cases of periodontal disease, not just those that are pre-existing, place women at significantly elevated risks for future cardiovascular events. PMID:25385537

  4. Atypical Cutaneous Sporotrichosis in an Immunocompetent Adult: Response to Potassium Iodide.

    Science.gov (United States)

    Gandhi, Nikita; Chander, Ram; Jain, Arpita; Sanke, Sarita; Garg, Taru

    2016-01-01

    Cutaneous sporotrichosis, also known as "Rose Gardener's disease," caused by dimorphic fungus Sporothrix schenkii, is usually characterized by indolent nodular or nodulo-ulcerative lesions arranged in a linear pattern. We report bizarre nonlinear presentation of Sporotrichosis, in an immunocompetent adult occurring after a visit to Amazon rain forest, speculating infection with more virulent species of Sporothrix. The diagnosis was reached with the help of periodic acid-Schiff positive yeast cells and cigar shaped bodies seen in skin biopsy along with the therapeutic response to potassium iodide.

  5. Primary pulmonary cryptococcosis: evaluation of CT characteristics in 26 immunocompetent Chinese patients

    Energy Technology Data Exchange (ETDEWEB)

    Qu, Yanjuan; Liu, Guobing; Ghimire, Prasanna; Liao, Meiyan; Xu, Liying [Dept. of Radiology, Zhongnan Hospital of Wuhan Univ., Wuhan (China)], E-mail: leometeor123@gmail.com; Shi, Heshui [Dept. of Radiology, Union Hospital affiliated to Tongji Medical College of Huazhong Univ. of Science and Technology, Wuhan (China); Yang, Guifang [Dept. of Pathology, Zhongnan Hospital of Wuhan Univ., Wuhan (China); Wang, Guanliang [Dept. of Radiology, Taizhou Hospital of Zhejiang Province, Taizhou (China)

    2012-07-15

    Background. Discrepancies still exist in the diagnosis of primary pulmonary cryptococcosis in immunocompetent patients. Purpose. To describe and evaluate radiological manifestations of pulmonary cryptococcosis in immunocompetent patients. Material and Methods. Twenty-six histopathologically confirmed cases of pulmonary cryptococcosis were analyzed for clinical, pathological, and CT characteristics. Necessary statistical tests for differences in CT presentations and correlation analysis between clinical and CT characteristics were performed. Results. The patients' ages ranged from 24 to 79 years, with 20 men and six women. Eighteen patients were symptomatic, with cough as the most common symptom (n = 14, 53.8%). Nodules (n = 21, 80.8%) were the most common CT findings. Eight cases presented with solitary and nine with multiple nodules, while 13 cases presented with irregular and 19 with ill-defined nodules. The halo sign was demonstrated, encompassing nodules in 14 of the 21 patients. Lesions were mainly localized in the lower lobes of the lungs (n = 15, 57.7%) with peripheral distribution (n = 18, 69.2%). Ground-glass opacities (GGOs) were more easily detected in older patients (66.7%, P <0.01). No significant differences in CT abnormalities were found between male and female patients. Conclusion. Primary pulmonary cryptococcosis in immunocompetent patients exhibits certain CT characteristics. The typical presentation includes multiple nodules with the halo sign scattered in the peripheral field in the lower lobes of the bilateral lungs. This could contribute to diagnosis of the disease entity. However, vigilance should be exercised when facing GGOs, with or without nodules, in older patients.

  6. CT findings of pulmonary cryptococcosis in immunocompetent children

    International Nuclear Information System (INIS)

    Wang Bei; Peng Yun; Zhou Chunjun; Zhao Shunying

    2012-01-01

    Objective: The aim of our study was to study the CT findings of cryptococcosis in immunocompetent children. Methods: CT scan and clinical data of 21 immunocompetent children with proven pulmonary cryptococcosis were retrospectively collected and analyzed. Results: The CT scans demonstrated 1 mm subpleural nodule in the lingula of left lung in 1 patient and multiple nodules in 20 patients.Of 20 patients with multiple nodules, peripheral or subpleural distribution was found in 12 patients,and diffuse distribution in 8 patients. Of 20 patients with multiple nodules,Nodules of < 10 mm was found in 18 patients,< 3 mm in 14 patients, and > 10 mm in 2 patients. Round nodular with smooth margin was detected in 15 of 20 patients with multiple nodules. Lymphadenopathy was found in 17 patients including 3 patients with mild contrast enhancement and 2 patients with circular enhancement. Extrapulmonary lesions distributing in liver, spleen, kidney, and the nervous system were found in 14 patients. In follow-up, 1 patient died and 20 patients fully recovered. Conclusions: Pulmonary multiple nodules with lymphadenopathy is the characteristic CT findings in immunocompetent children with pulmonary cryptococcosis which is prone to involve multiple extra-pulmonary organs. (authors)

  7. The incidence of inflammatory bowel disease in Denmark 1980-2013

    DEFF Research Database (Denmark)

    Lophaven, S. N.; Lynge, E.; Burisch, J.

    2017-01-01

    Background: Globally, the incidence rates of inflammatory bowel disease (IBD) are increasing; however, data from high-incidence areas are conflicting. Previous studies in Denmark have assessed incidence rates of Crohn's disease (CD) and ulcerative colitis (UC) using short observation periods. Aim...

  8. Tomographic findings of acute pulmonary toxoplasmosis in immunocompetent patients.

    Science.gov (United States)

    de Souza Giassi, Karina; Costa, Andre Nathan; Apanavicius, Andre; Teixeira, Fernando Bin; Fernandes, Caio Julio Cesar; Helito, Alfredo Salim; Kairalla, Ronaldo Adib

    2014-11-25

    Toxoplasmosis is one of the most common human zoonosis, and is generally benign in most of the individuals. Pulmonary involvement is common in immunocompromised subjects, but very rare in immunocompetents and there are scarce reports of tomographic findings in the literature. The aim of the study is to describe three immunocompetent patients diagnosed with acute pulmonary toxoplasmosis and their respective thoracic tomographic findings. Acute toxoplasmosis was diagnosed according to the results of serological tests suggestive of recent primary infection and the absence of an alternative etiology. From 2009 to 2013, three patients were diagnosed with acute respiratory failure secondary to acute toxoplasmosis. The patients were two female and one male, and were 38, 56 and 36 years old. Similarly they presented a two-week febrile illness and progressive dyspnea before admission. Laboratory tests demonstrated lymphocytosis, slight changes in liver enzymes and high inflammatory markers. Tomographic findings were bilateral smooth septal and peribronchovascular thickening (100%), ground-glass opacities (100%), atelectasis (33%), random nodules (33%), lymph node enlargement (33%) and pleural effusion (66%). All the patients improved their symptoms after treatment, and complete resolution of tomographic findings were found in the followup. These cases provide a unique description of the presentation and evolution of pulmonary tomographic manifestations of toxoplasmosis in immunocompetent patients. Toxoplasma pneumonia manifests with fever, dyspnea and a non-productive cough that may result in respiratory failure. In animal models, changes were described as interstitial pneumonitis with focal infiltrates of neutrophils that can finally evolve into a pattern of diffuse alveolar damage with focal necrosis. The tomographic findings are characterized as ground glass opacities, smooth septal and marked peribronchovascular thickening; and may mimic pulmonary congestion

  9. Atypical cutaneous sporotrichosis in an immunocompetent adult: Response to potassium iodide

    Directory of Open Access Journals (Sweden)

    Nikita Gandhi

    2016-01-01

    Full Text Available Cutaneous sporotrichosis, also known as “Rose Gardener's disease,” caused by dimorphic fungus Sporothrix schenkii, is usually characterized by indolent nodular or nodulo-ulcerative lesions arranged in a linear pattern. We report bizarre nonlinear presentation of Sporotrichosis, in an immunocompetent adult occurring after a visit to Amazon rain forest, speculating infection with more virulent species of Sporothrix. The diagnosis was reached with the help of periodic acid-Schiff positive yeast cells and cigar shaped bodies seen in skin biopsy along with the therapeutic response to potassium iodide.

  10. Measures of Disease Frequency: Prevalence and Incidence

    NARCIS (Netherlands)

    Noordzij, Marlies; Dekker, Friedo W.; Zoccali, Carmine; Jager, Kitty J.

    2010-01-01

    To describe how often a disease or another health event occurs in a population, different measures of disease frequency can be used. The prevalence reflects the number of existing cases of a disease. In contrast to the prevalence, the incidence reflects the number of new cases of disease and can be

  11. Incidence, disease phenotype at diagnosis, and early disease course in inflammatory bowel diseases in Western Hungary, 2002-2006.

    Science.gov (United States)

    Lakatos, Laszlo; Kiss, Lajos S; David, Gyula; Pandur, Tunde; Erdelyi, Zsuzsanna; Mester, Gabor; Balogh, Mihaly; Szipocs, Istvan; Molnar, Csaba; Komaromi, Erzsebet; Lakatos, Peter Laszlo

    2011-12-01

    Recent trends indicate a change in the epidemiology of inflammatory bowel diseases (IBD), with previously low incidence areas now reporting a progressive rise in the incidence. Our aim was to analyze the incidence and disease phenotype at diagnosis in IBD in the population-based Veszprem Province database, which included incident patients diagnosed between January 1, 2002 and December 31, 2006. Data of 393 incident patients were analyzed (ulcerative colitis [UC]: 220, age-at-diagnosis: 40.5 years; Crohn's disease [CD]: 163, age-at-diagnosis: 32.5 years; and indeterminate colitis [IC]: 10). Both hospital and outpatient records were collected and comprehensively reviewed. Adjusted mean incidence rates were 8.9/10(5) person-years for CD and 11.9/10(5) person-years in UC. Peak onset age in both CD and UC patients was 21-30 years old. Location at diagnosis in UC was proctitis in 26.8%, left-sided colitis in 50.9%, and pancolitis in 22.3%. The probability of proximal extension and colectomy after 5 years was 12.7% and 2.8%. The disease location in CD was ileal in 20.2%, colonic in 35.6%, ileocolonic in 44.2%, and upper gastrointestinal in four patients. Behavior at diagnosis was stenosing/penetrating in 35.6% and perianal in 11.1%. Patients with colonic disease were older at diagnosis compared to patients with ileal or ileocolonic disease. In a Kaplan-Meier analysis, probability of surgical resection was 9.8%, 18.5%, and 21.3% after 1, 3, and 5 years of disease duration, respectively. The incidence of IBD in Veszprem Province in the last decade was high, equal to that in high-incidence areas in Western European countries. Early disease course is milder compared to data reported in the literature. Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.

  12. Cerebellar cysticercosis caused by larval Taenia crassiceps tapeworm in immunocompetent woman, Germany.

    Science.gov (United States)

    Ntoukas, Vasileios; Tappe, Dennis; Pfütze, Daniel; Simon, Michaela; Holzmann, Thomas

    2013-12-01

    Human cysticercosis caused by Taenia crassiceps tapeworm larvae involves the muscles and subcutis mostly in immunocompromised patients and the eye in immunocompetent persons. We report a successfully treated cerebellar infection in an immunocompetent woman. We developed serologic tests, and the parasite was identified by histologic examination and 12s rDNA PCR and sequencing.

  13. MRI features of toxoplasma encephalitis in the immunocompetent host: a report of two cases

    International Nuclear Information System (INIS)

    Vastava, P.B.; Kumar, S.; Gupta, R.K.; Pradhan, S.; Jha, S.; Prasad, K.N.

    2002-01-01

    Central nervous system involvement due to toxoplasmosis in an immunocompetent host is rare. We describe MRI features in two immunocompetent patients with of cerebral toxoplasmosis and compare these with those for the immunocompromised host. (orig.)

  14. MRI features of toxoplasma encephalitis in the immunocompetent host: a report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Vastava, P.B.; Kumar, S.; Gupta, R.K. [Department of Radiology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Rae Bareli Road, Lucknow 226014, UP (India); Pradhan, S.; Jha, S. [Department of Neurology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Rae Bareli Road, Lucknow 226014, UP (India); Prasad, K.N. [Department of Microbiology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Rae Bareli Road, Lucknow 226014, UP (India)

    2002-10-01

    Central nervous system involvement due to toxoplasmosis in an immunocompetent host is rare. We describe MRI features in two immunocompetent patients with of cerebral toxoplasmosis and compare these with those for the immunocompromised host. (orig.)

  15. Clostridium subterminale septicemia in an immunocompetent patient

    OpenAIRE

    Daganou Maria; Kyriakoudi Ann; Moraitou Helen; Pontikis Konstantinos; Avgeropoulou Stavrina; Tripolitsioti Paraskevi; Koutsoukou Antonia

    2016-01-01

    Clostridium subterminale is a Clostridium species that has been rarely isolated in the blood of immunocompromised patients. We report a case of C. subterminale septicemia in an immunocompetent patient who presented with acute mediastinitis following spontaneous esophageal rupture.

  16. Clostridium subterminale septicemia in an immunocompetent patient.

    Science.gov (United States)

    Daganou, Maria; Kyriakoudi, Ann; Moraitou, Helen; Pontikis, Konstantinos; Avgeropoulou, Stavrina; Tripolitsioti, Paraskevi; Koutsoukou, Antonia

    2016-01-01

    Clostridium subterminale is a Clostridium species that has been rarely isolated in the blood of immunocompromised patients. We report a case of C. subterminale septicemia in an immunocompetent patient who presented with acute mediastinitis following spontaneous esophageal rupture.

  17. Clostridium subterminale septicemia in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Daganou Maria

    2016-01-01

    Full Text Available Clostridium subterminale is a Clostridium species that has been rarely isolated in the blood of immunocompromised patients. We report a case of C. subterminale septicemia in an immunocompetent patient who presented with acute mediastinitis following spontaneous esophageal rupture.

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

    Directory of Open Access Journals (Sweden)

    Ulku Ergene

    2013-01-01

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

  19. Disseminated Mycobacterium kansasii infection with cutaneous lesions in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Miaomiao Zhang

    2017-09-01

    Full Text Available A case of disseminated Mycobacterium kansasii infection involving the skin and soft tissue in a 57-year-old male farmer who presented with recurrent fever, respiratory syndromes, and skin lesions is reported. The positive findings of syndromes, laboratory examinations, and identification of M. kansasii in puncture fluid indicated the diagnosis of disseminated M. kansasii infection involving the skin and soft tissue, lungs, and mediastinal lymph nodes. After applying the standard HRE regimen (isoniazid 300 mg/day, rifampicin 600 mg/day, and ethambutol 750 mg/day, the patient’s temperature normalized and his symptoms improved gradually. No notable adverse drug reactions occurred and the skin lesions had healed after 4 months of follow-up. Disseminated M. kansasii infections occur mainly in immunocompromised patients. Moreover, disseminated infections with skin lesions is rare in immunocompetent patients. Following a review of the literature, only eight similar cases were identified as of disseminated M. kansasii infection with cutaneous lesions, and thecase presented here appears to be the second involving an immunocompetent individual. Special attention should be paid to a persistent and chronic rash following a chronic respiratory syndrome in order to exclude skin disease caused by non-tuberculous mycobacteria.

  20. Distribution, incidence and severity of viral diseases of yam ...

    African Journals Online (AJOL)

    A survey was conducted in major yam cultivation zones in Côte d'Ivoire in 2009 to determine the incidence, severity of viral diseases, and viruses associated with the infected plants. Incidence and severity of the viral diseases were estimated based on symptoms. Enzyme-linked immunosorbent assay (ELISA) and ...

  1. Necrotizing fasciitis caused by Apophysomyces variabilis in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    José Y. Rodríguez

    2018-06-01

    Full Text Available Mucormycosis caused by Apophysomyces variabilis is rarely reported in humans. A case of A. variabilis infection in an immunocompetent men after friction burns in a car accident is described. The infection presented as a rapidly progressive necrotizing infection of the skin and soft tissue, which required extensive surgical debridement and total colonic defunctioning colostomy associated with prolonged antifungal therapy. A. variabilis infection should be considered as a differential diagnosis of rapidly progressive necrotizing skin and soft tissue infections in immunocompetent individuals. Keywords: Mucormycosis, Zygomycetes, Apophysomyces variabilis, Amphotericin B

  2. [Trochanteric bursitis due to tuberculosis in an immunocompetent young woman].

    Science.gov (United States)

    Soro Marín, Sandra; Sánchez Trenado, María Asunción; Mínguez Sánchez, María Dolores; Paulino Huertas, Marcos; García Morales, Paula Virginia; Salas Manzanedo, Verónica

    2012-01-01

    Soft tissue infection due to Mycobacterium tuberculosis can affect muscle, tendons, fascia, bursa and synovial tissue. Tuberculous trochanteric bursitis is a rare entity that usually affects immunocompromised patients. Manifestations usually occur insidiously, which delays diagnosis and treatment. We present the case of an immunocompetent young woman who came to our department for chronic left hip pain. The study confirms the diagnosis of tuberculous trochanteric bursitis. This case demonstrates the importance of considering a possible infectious origin of bursitis in immunocompetent patients. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  3. Mycobacterium mageritense Parotitis in an Immunocompetent Adult.

    Science.gov (United States)

    Okabe, Taro; Sasahara, Teppei; Suzuki, Jun; Onishi, Tsubasa; Komura, Masayoshi; Hagiwara, Shigehiro; Suzuki, Hiromichi; Morisawa, Yuji

    2018-03-01

    Mycobacterium mageritense , a rapidly growing mycobacterium, is a rare clinical pathogen. Furthermore, parotitis due to non-tuberculosis mycobacterium is very rare in adults. Herein, we report the first case of M. mageritense parotitis in an immunocompetent adult. A 40-year-old man presented with swelling in a left parotid lesion. He was diagnosed with parotitis. The culture from the parotid abscess grew M. mageritense . He was unsuccessfully treated with levofloxacin monotherapy. Trimethoprim-sulfamethoxazole was added, leading to some clinical response; however, the erythema persisted despite 14 months of antibiotic therapy. Subsequently, the skin lesion was surgically removed. The antibiotic treatment was ceased a week after surgery as the postoperative course was uneventful and the lesion had improved. No recurrence was noted at 7 months after surgery. Although extremely rare, M. mageritense can cause parotitis in immunocompetent adults, and may not be sufficiently treated with antibiotics alone.

  4. Primary Cutaneous Aspergillosis in an Immunocompetent Patient

    African Journals Online (AJOL)

    are the lungs, central nervous system (CNS), and sinuses, however, the rare cutaneous infection is usually associated with immunodeficiency. Primary cutaneous infection, especially in immunocompetent patients, is extremely rare, but an increase in prevalence has been noted in the last. 20 years. The predisposing factors ...

  5. Pseudomonas aeruginosa Bacteremia among Immunocompetent and Immunocompromised Patients: Relation to Initial Antibiotic Therapy and Survival.

    Science.gov (United States)

    Migiyama, Yohei; Yanagihara, Katsunori; Kaku, Norihito; Harada, Yosuke; Yamada, Koichi; Nagaoka, Kentaro; Morinaga, Yoshitomo; Akamatsu, Norihiko; Matsuda, Junichi; Izumikawa, Koichi; Kohrogi, Hirotsugu; Kohno, Shigeru

    2016-01-01

    Pseudomonas aeruginosa bacteremia occurs mainly in immunocompromised patients. However, P. aeruginosa bacteremia in immunocompetent patients has also been reported. The aim of this study was to evaluate the clinical characteristics of P. aeruginosa bacteremia in relation to the immune status of the patients. The medical records of 126 adult patients with P. aeruginosa bacteremia in Nagasaki University Hospital were retrospectively reviewed between January 2003 and December 2012. Of 126 patients with P. aeruginosa bacteremia, 60 patients (47.6%) were classified as immunocompetent. Mortality in immunocompetent patients tended to be lower than in immunocompromised patients (7-day mortality, 8% vs. 30%, P antibiotic therapy (HR: 0.21, P immunocompromised, but not immunocompetent patients, initial appropriate antibiotic therapy was associated with lower mortality (30-day mortality 20.5% vs. 66.7%, P < 0.01 by log-rank test).

  6. Recurrent seizures during acute acquired toxoplasmosis in an immunocompetent traveller returning from Africa.

    Science.gov (United States)

    Beltrame, Anna; Venturini, Sergio; Crichiutti, Giovanni; Meroni, Valeria; Buonfrate, Dora; Bassetti, Matteo

    2016-04-01

    We report an unusual case of acute acquired toxoplasmosis (AAT) presenting as lymphadenopathy and recurrent seizures in an immunocompetent 15-year-old boy. The patient reported an 18-day vacation to Africa (Ethiopia), 39 days prior to the first seizure. Electroencephalogram (EEG) showed sporadic single-spike or sharp-wave paroxysms and the magnetic resonance imaging (RMI) of the brain was negative. The serology for T. gondii was compatible with an acute infection defined as positive for both toxoplasma-specific IgG and IgM and a low avidity (6 %), confirmed by a reference laboratory. The patient reported other two episodes of seizures, occurring 7 days apart. He was treated with pyrimethamine plus sulfadiazine and leucovorin for 4 weeks, with an improvement of lymphadenitis and normalization of EEG. After 5 months, new seizures were reported and a diagnosis of epilepsy was done. Toxoplasma polymerase chain reaction (PCR) of cerebrospinal fluid (CSF) and blood were negative. A treatment with valproic acid was started, obtaining control of the neurological disease. Awareness of this neurologic manifestation by clinicians is required, also in immunocompetent patients. The relationship between toxoplasmosis and recurrent seizure needs to be investigated by new studies.

  7. Reappraisal of in situ immunophenotypic analysis of psoriasis skin: interaction of activated HLA-DR+ immunocompetent cells and endothelial cells is a major feature of psoriatic lesions

    NARCIS (Netherlands)

    de Boer, O. J.; van der Loos, C. M.; Hamerlinck, F.; Bos, J. D.; Das, P. K.

    1994-01-01

    Psoriasis is an inflammatory skin disease of unknown aetiology. Many observations indicate that T cells play an important role in the pathogenesis of the disease. Upregulation of MHC class-II molecules on immunocompetent cells, endothelial cells and keratinocytes on lesional psoriatic skin has been

  8. Immunocompetence of breeding females is sensitive to cortisol levels but not to communal rearing in the degu (Octodon degus).

    Science.gov (United States)

    Ebensperger, Luis A; León, Cecilia; Ramírez-Estrada, Juan; Abades, Sebastian; Hayes, Loren D; Nova, Esteban; Salazar, Fabián; Bhattacharjee, Joydeep; Becker, María Inés

    2015-03-01

    One hypothesis largely examined in social insects is that cooperation in the context of breeding benefits individuals through decreasing the burden of immunocompetence and provide passive immunity through social contact. Similarly, communal rearing in social mammals may benefit adult female members of social groups by reducing the cost of immunocompetence, and through the transfer of immunological compounds during allonursing. Yet, these benefits may come at a cost to breeders in terms of a need to increase investment in individual immunocompetence. We examined how these potential immunocompetence costs and benefits relate to reproductive success and survival in a natural population of the communally rearing rodent, Octodon degus. We related immunocompetence (based on ratios of white blood cell counts, total and specific immunoglobulins of G isotype titers) and fecal glucocorticoid metabolite (FGC) levels of adults immunized with hemocyanin from the mollusk Concholepas concholepas to measures of sociality (group size) and communal rearing (number of breeding females). Offspring immunocompetence was quantified based on circulating levels of the same immune parameters. Neither female nor offspring immunocompetence was influenced by communal rearing or sociality. These findings did not support that communal rearing and sociality enhance the ability of females to respond to immunological challenges during lactation, or contribute to enhance offspring condition (based on immunocompetence) or early survival (i.e., to 3months of age). Instead, levels of humoral and cellular components of immunocompetence were associated with variation in glucorcorticoid levels of females. We hypothesize that this covariation is driven by physiological (life-history) adjustments needed to sustain breeding. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. CNS infections in immunocompetent patients

    International Nuclear Information System (INIS)

    Hartmann, K.M.; Zimmer, A.; Reith, W.

    2008-01-01

    This article gives a review of the most frequent infective agents reasonable for CNS infections in immunocompetent patients as well as their localisation and imaging specifications. MRI scanning is the gold standard to detect inflammatory conditions in the CNS. Imaging can be normal or nonspecifically altered although the infection is culturally or bioptically proven. There are no pathognomonic, pathogen-specific imaging criteria. The localization and dimension of the inflammation depends on the infection pathway. (orig.) [de

  10. Parasitemia in an immunocompetent horse experimentally challenged with Sarcocystis neurona sporocysts.

    Science.gov (United States)

    Rossano, M G; Schott, H C; Murphy, A J; Kaneene, J B; Sellon, D C; Hines, M T; Hochstatter, T; Bell, J A; Mansfield, L S

    2005-01-04

    Equine protozoal myeloencephalitis (EPM) is a serious neurological disease of horses in Americans. Most cases are attributed to infection of the central nervous system with Sarcocystis neurona. Parasitemia has not been demonstrated in immunocompetent horses, but has been documented in one immunocompromised foal. The objective of this study was to isolate viable S. neurona from the blood of immunocompetent horses. Horses used in this study received orally administered S. neurona sporocysts (strain SN 37-R) daily for 112 days at the following doses: 100/day for 28 days, followed by 500/day for 28 days, followed by 1000/day for 56 days. On day 98 of the study, six yearling colts were selected for attempted culture of S. neurona from blood, two testing positive, two testing suspect and two testing negative for antibodies against S. neurona on day 84 of the study. Two 10 ml tubes with EDTA were filled from each horse by jugular venipuncture and the plasma fraction rich in mononuclear cells was pipetted onto confluent equine dermal cell cultures. The cultures were monitored weekly for parasite growth for 12 weeks. Merozoites grown from cultures were harvested and tested using S. neurona-specific PCR with RFLP to confirm species identity. PCR products were sequenced and compared to known strains of S. neurona. After 38 days of in vitro incubation, one cell culture from a horse testing positive for antibodies against S. neurona was positive for parasite growth while the five remaining cultures remained negative for parasite growth for all 12 weeks. The Sarcocystis isolate recovered from cell culture was confirmed to be S. neurona by PCR with RFLP. Gene sequence analysis revealed that the isolate was identical to the challenge strain SN-37R and differed from two known strains UCD1 and MIH1. To our knowledge this is the first report of parasitemia with S. neurona in an immunocompetent horse.

  11. Invasive orbital aspergillosis in an apparently immunocompetent host without evidence of sinusitis

    Directory of Open Access Journals (Sweden)

    Jennifer Primeggia

    2012-09-01

    Full Text Available Invasive aspergillosis is uncommon in healthy individuals. We report a case of Aspergillus fumigatus orbital cellulitiswith intracranial extension in an apparently immunocompetent patient with a history of benign lymphoid hyperplasiaof the lacrimal gland. A 68 year-old man with no significant past medical history underwent orbitotomy and biopsy of alacrimal gland mass. Pathology showed benign lymphoid hyperplasia of the lacrimal gland and he completed radiationtherapy. Three months after orbitotomy and one month after completion of radiation therapy, he presented with orbitalcellulitis. Brain magnetic resonance imaging demonstrated invasion into the frontal lobe. Clinical and radiographicfindings failed to improve with prolonged antibiotic therapy; transcranial orbitotomy with right frontal craniotomy forabscess drainage and orbit washout was performed. Intraoperative cultures grew Aspergillus fumigatus. The patientcompleted a six month course of therapy with oral voriconazole and has remained free from relapse with long-termfollow-up. Efficacy of voriconazole was guided by serial imaging and voriconazole trough levels. Aspergillus may causeinvasive disease in immunocompetent hosts, even without evidence of sinusitis, and should be considered in the differentialdiagnosis when patients do not demonstrate clinical improvement with antibiotic therapy. J Microbiol Infect Dis2012; 2(3: 113-116Key words: Aspergillosis, orbital cellulitis, brain abscess

  12. Necrotising otitis externa in the immunocompetent patient: case series.

    Science.gov (United States)

    Unadkat, S; Kanzara, T; Watters, G

    2018-01-01

    Necrotising otitis externa can be a devastating form of otitis externa. It typically tends to affect patients who are immunocompromised or diabetic. To date, there is very little in the literature about necrotising otitis externa in the immunocompetent patient population. The present paper discusses both the clinical and radiological findings in three cases of necrotising otitis externa in an immunocompetent patient cohort. The common factor among all three patients was their advanced age. Diagnosing necrotising otitis externa can be challenging because of the potentially non-specific symptoms and the absence of early radiological signs, particularly if patients are neither immunocompromised nor diabetic. Elderly patients should be considered in the same light as immunocompromised and diabetic patients in the context of necrotising otitis externa.

  13. Subcutaneous infection by Ochroconis mirabilis in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Dongmei Shi

    2016-03-01

    Full Text Available Recently, the taxonomy of Ochroconis (Ascomycota, Pezizomycotina, Venturiales, Sympoventuriaceae has been revised with the recognition of an additional genus, Verruconis. Ochroconis comprises mesophilic saprobes that occasionally infect vertebrates which mostly are cold-blooded, while Verruconis contains thermophilic species which is a neurotrope in humans and birds. On the basis of molecular data it is noted that only a single Ochroconis species regularly infects immunocompetent human hosts. Here we report a subcutaneous infection due to Ochroconis mirabilis in a 50-year-old immunocompetent female patient. In vitro antifungal susceptibility tests revealed that terbinafine was the most effective drug. The patient was successfully cured with oral administration of terbinafine 250 mg daily in combination with 3 times of topical ALA-photodynamic therapy for 9 months.

  14. Incidence of invasive Haemophilus influenzae type b disease in Italian children

    International Nuclear Information System (INIS)

    Tozzi, Alberto E.; Salmaso, Stefania; Atti, Marta L. Ciofi degli; Panei, Pietro; Anemona, Alessandra; Scuderi, Gabriella; Wassilak, Steven G.F.

    1997-01-01

    To estimate the incidence of Haemophilus influenzae type b (Hib) invasive disease in Italian infants we performed a prospective study in a cohort of newborns enrolled for a randomized trial on safety and efficacy of three pertussis vaccines and followed for onset of serious disease or pertussis. The overall cumulative incidence observed in 15,601 children was 51.3/100,000 for all invasive Hib infections and 38.4/100,000 for Hib meningitis, over 27 months of observation. The incidence density of all invasive Hib diseases was 28.7/100,000 person-years, while meningitis occurred with an incidence of 21.5/100,000 person-years. Among the eight cases detected, six were meningitis, one sepsis, and one cellulitis. The child with sepsis died. The incidence and epidemiology of invasive Hib disease in Italy are comparable to those reported from other European countries. Cost-benefit analyses are needed for planning Italian vaccination policy

  15. Cryptococcoma mimicking a brain tumor in an immunocompetent patient: case report of an extremely rare presentation.

    Science.gov (United States)

    Paiva, Aline Lariessy Campos; Aguiar, Guilherme Brasileiro de; Lovato, Renan Maximilian; Zanetti, Arthus Vilar Deolindo; Panagopoulos, Alexandros Theodoros; Veiga, José Carlos Esteves

    2017-11-06

    Central nervous system (CNS) infectious diseases have high prevalence in developing countries and their proper diagnosis and treatment are very important for public health planning. Cryptococcus neoformans is a fungus that may cause several CNS manifestations, especially in immunocompromised patients. Cryptococcal meningitis is the most common type of involvement. Mass-effect lesions are uncommon: they are described as cryptococcomas and their prevalence is even lower among immunocompetent patients. The aim here was to report an extremely rare case of cryptococcoma causing a mass effect and mimicking a brain tumor in an immunocompetent patient. The literature on CNS cryptococcal infections was reviewed with emphasis on cryptococcomas. Clinical, surgical and radiological data on a female patient with this rare presentation of cryptococcoma mimicking a brain tumor are described. A 54-year-old female patient presented to the emergency department with a rapid-onset progressive history of confusion and completely dependency for basic activities. Neuroimaging showed a left occipital lesion and neurosurgical treatment was proposed. From histopathological evaluation, a diagnosis of cryptococcoma was established. She received clinical support with antifungals, but despite optimal clinical treatment, her condition evolved to death. Cryptococcal infections have several forms of presentation and, in immunocompetent patients, their manifestation may be even more different. Cryptococcoma is an extremely rare presentation in which proper surgical and clinical treatment should be instituted as quickly as possible, but even so, there is a high mortality rate.

  16. Increasing incidence of Crohn's disease in Victorian children.

    Science.gov (United States)

    Phavichitr, Nopaorn; Cameron, Donald J S; Catto-Smith, Anthony G

    2003-03-01

    The incidence of Crohn's disease has been increasing in Western communities, but there are no published studies which have examined this change in children in Australia. The centralization of pediatric gastroenterology services in Victoria provides an opportunity to examine these changes within one state. We undertook a retrospective study over a 31-year period of all children aged 16 years or less initially diagnosed with Crohn's disease at either the Royal Children's Hospital, or Monash Medical Center, Melbourne, Victoria. We identified 351 patients who met the diagnostic criteria between 1971 and 2001. The incidence of Crohn's disease in children aged 16 years or less rose from 0.128 to 2.0 per 100,000 per year over the three decades (r = 0.964, P Victorian children. The pattern of disease has also changed with colonic disease now more frequent, and inflammatory indices less abnormal. The increased use of endoscopy has established the frequent involvement of the upper gastrointestinal tract.

  17. Cerebellar cryptococcosis characterized by a space-occupying lesion in an immunocompetent non-HIV patient

    Directory of Open Access Journals (Sweden)

    Liu BX

    2014-12-01

    Full Text Available Bi-Xia Liu,1,* Xi-Jian Dai,2,3,* Heng Liu,4,* Hong-Han Gong,3 Yi-Xiang J Wang,2 Lun-Li Zhang1 1Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 2Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; 3Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 4Department of Radiology, Affiliated Hospital of Zunyi Medical University, Guizhou, People’s Republic of China *These authors contributed equally to this work Abstract: Central nervous system (CNS cryptococcosis is an opportunistic fungal infection that typically occurs in patients with reduced immunological function, such as patients with AIDS, patients receiving organ transplants, or patients receiving corticosteroid and immunosuppressive therapy. CNS cryptococcosis rarely occurs in immunocompetent patients. CNS cryptococcosis is characterized by meningitis and encephalitis and occasionally forms isolated granulomas. Isolated cerebellar cryptococcoma is a rare condition, especially in immunocompetent patients, and the misdiagnosis rate is high. A definite diagnosis must be based on pathology. To raise awareness of this disease, the clinical data of a patient with cryptococcomas in the right side of the cerebellum are reported. Keywords: cryptococcosis, cerebellar, central nervous system, magnetic resonance imaging, immunosuppressive

  18. Progressive outer retinal necrosis-like retinitis in immunocompetent hosts.

    Science.gov (United States)

    Chawla, Rohan; Tripathy, Koushik; Gogia, Varun; Venkatesh, Pradeep

    2016-08-10

    We describe two young immunocompetent women presenting with bilateral retinitis with outer retinal necrosis involving posterior pole with centrifugal spread and multifocal lesions simulating progressive outer retinal necrosis (PORN) like retinitis. Serology was negative for HIV and CD4 counts were normal; however, both women were on oral steroids at presentation for suspected autoimmune chorioretinitis. The retinitis in both eyes responded well to oral valaciclovir therapy. However, the eye with the more fulminant involvement developed retinal detachment with a loss of vision. Retinal atrophy was seen in the less involved eye with preservation of vision. Through these cases, we aim to describe a unique evolution of PORN-like retinitis in immunocompetent women, which was probably aggravated by a short-term immunosuppression secondary to oral steroids. 2016 BMJ Publishing Group Ltd.

  19. Parkinson's disease in Russia: prevalence and incidence

    Directory of Open Access Journals (Sweden)

    Razdorskaya V.V.

    2016-09-01

    Full Text Available The results of the regional studies on the frequency of Parkinson's disease (PD and the incidence of it in Russia have been generalized, the main factors that determine the quality of the estimates of this disease epidemiological indicators have been identifyd. The article summarizes data from 19 original studies on the epidemiology of parkinsonism and Parkinson's disease in Russia published between 2005-2015. Due to the statistical heterogeneity of the primary results computational analytics was not applied to the data; however, data consolidation allowed to perform a trend analysis of epidemiological indicators. The methodological basis of the majority of studies was medical aid appealabil-ity; two of the studies used door-to-door surveys. One of the studies returned questionably low epidemiological indicators obtained from the medical records, and the rest showed the standardized prevalence of 30.0-139.9/100,000 and incidence of 7.63-21.8/100,000 per year. Contribution of Parkinson's disease to the nosological structure of parkinsonism was >61.3%. Estimate of the number of patients with PD in Russia is approximately 210,000 people. Conclusions are made regarding the prevalence of PD in Russia according to the cross-cutting research on the level of indicators in the Western countries. The prevalence of PD by appealability is 2-3 times less than the prevalence in continuous research, both national and foreign. The incidence of PD, demonstrated in half of the studies, is stable from region to region and is comparable with the universally recognized values.

  20. [Pyomyositis, sacroiliitis and spondylodiscitis caused by Staphylococcus hominis in a immunocompetent woman].

    Science.gov (United States)

    Gómez Rodríguez, N; Durán Muñoz, O

    2006-12-01

    In absence of risk factors, osteoarticular infections by coagulase-negative staphylococci are very infrequent. We described the case of a immunocompetent 73-year-old-woman that suffered pyomyositis, left sacroiliitis and spondylodiscitis involving the first and second thoracic vertebrae by Staphylococcus hominis. This multifocal infection occurred five-weeks after intramuscular administration of NSAI for treatment of low back pain associated with a herniated disc L4-L5. This is the first know case of a multifocal muscle skeletal infection by Staphylococcus hominis in a patient immunocompetent.

  1. Perceived job insecurity as a risk factor for incident coronary heart disease

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Nyberg, Solja T; Batty, George David

    2013-01-01

    To determine the association between self reported job insecurity and incident coronary heart disease.......To determine the association between self reported job insecurity and incident coronary heart disease....

  2. Periodontal Disease, Regular Dental Care Use, and Incident Ischemic Stroke.

    Science.gov (United States)

    Sen, Souvik; Giamberardino, Lauren D; Moss, Kevin; Morelli, Thiago; Rosamond, Wayne D; Gottesman, Rebecca F; Beck, James; Offenbacher, Steven

    2018-02-01

    Periodontal disease is independently associated with cardiovascular disease. Identification of periodontal disease as a risk factor for incident ischemic stroke raises the possibility that regular dental care utilization may reduce the stroke risk. In the ARIC (Atherosclerosis Risk in Communities) study, pattern of dental visits were classified as regular or episodic dental care users. In the ancillary dental ARIC study, selected subjects from ARIC underwent fullmouth periodontal measurements collected at 6 sites per tooth and classified into 7 periodontal profile classes (PPCs). In the ARIC study 10 362 stroke-free participants, 584 participants had incident ischemic strokes over a 15-year period. In the dental ARIC study, 6736 dentate subjects were assessed for periodontal disease status using PPC with a total of 299 incident ischemic strokes over the 15-year period. The 7 levels of PPC showed a trend toward an increased stroke risk (χ 2 trend P periodontal disease). Periodontal disease was significantly associated with cardioembolic (hazard ratio, 2.6; 95% confidence interval, 1.2-5.6) and thrombotic (hazard ratio, 2.2; 95% confidence interval, 1.3-3.8) stroke subtypes. Regular dental care utilization was associated with lower adjusted stroke risk (hazard ratio, 0.77; 95% confidence interval, 0.63-0.94). We confirm an independent association between periodontal disease and incident stroke risk, particularly cardioembolic and thrombotic stroke subtype. Further, we report that regular dental care utilization may lower this risk for stroke. © 2018 American Heart Association, Inc.

  3. MRI findings in primary brain lymphoma in immunocompetent patients

    Directory of Open Access Journals (Sweden)

    Saeed Nadhim Younis

    2017-08-01

    Full Text Available Background and objective: Primary brain lymphoma is an extranodal aggressive intracranial neoplasm of lymphocytic origin originating and confined to the brain parenchyma and meninges. It is rare in immune competent patients, but its incidence is increasing. This retrospective study was conducted to record the MRI features of primary brain lymphoma at the time of diagnosis in immunocompetent patients. Methods: Of the 450 patients diagnosed with the brain tumor during a period of five years from 2008 to 2013, the clinical features and MRI findings of 16 cases of pathologically proven to be non-Hodgkin’s lymphoma were studied. All the patients were tested negative for HIV and there was no history of immune suppression drugs or any other chronic illness. All the patients were examined with MRI observing the tumor location, multifocality, signal intensity in different sequences, enhancement patterns, peritumoral edema, the presence of hemorrhage and calcification. Results: Of the 16 patients, including the monofocal and multifocal cases, 30 lesions exhibited. The mean age at diagnosis was 53 years. Nine patients (56.25% found to have a multifocal disease. In more than 75% of lesions, MRI was hypo to iso signal on T1 and T2. Mild to moderate perilesional edema, strong contrast enhancement and restricted diffusion were seen in all cases. The hemorrhagic tumor was noticed in four lesions (13.3%. No calcification and no leptomeningeal lesions were noted. The MRI images in post steroid therapy were studied within one month of treatment. Tumour regression was noticed in 21/30 (70%, stable in 3/30 (10% and progressing in 6/30 (20%. Conclusion: MRI is a reliable imaging technique in the management of patients with primary brain lymphoma. Early accurate diagnosis is crucial to avoid the unnecessary operation and shift patients from extensive surgery to chemoradiotherapy.

  4. Severe pulmonary compromise in an immunocompetent patient with acute disseminated toxoplasmosis: A Case Report

    International Nuclear Information System (INIS)

    Salinas, Jorge; Pino, Luis; Lopez Consuelo

    2008-01-01

    Introduction: The acute toxoplasmosis in the immunocompetent patient, unlike of the positive HIV patient, it is characterizes for prolonged fever, lymph node and nonspecific infectious symptoms, generally with benign course and without systemic commitment. This pathology acquired a very importance in the pregnancy people, where the primary infection can to derivates in the congenital transmission of the illness with irreversible sequels in newborn. Nevertheless, the travel of the people to inhospitable woodsy areas, and the contact with wild-type strain of toxoplasma gondii, to be permitted a new expression of the illness in the immunocompetent patient, with pulmonary, cardiovascular and central nervous system manifestations. They are a high risk for the patient life's. In this study, one case of severe pulmonary commitment for toxoplasma gondii in immunocompetent patient is review; he is admitted to Internal Medicine Service of the Militar Central Hospital's in Bogota. He has a favorable evolution and adequate survival. Objective: To describe the clinical characteristics and follow-up of one patient with severe pulmonary commitment caused by toxoplasma gondii. Design: Case report. Materials and methods: The clinical records of the one patient who was hospitalized in the Militar Central Hospital's in Bogota was reviewed and described. Afterwards, the existing literature on Acute toxoplasmosis in immunocompetent patient was reviewed in PubMed, MD consult and OVID databases. Conclusions: The toxoplasma gondii infection's in immunocompetent patient generally has a benign course without systemic manifestations; nevertheless, the exposure to wild-type strain can to be related with severe pulmonary commitment.

  5. Contextual factors and social consequences of incident disease

    DEFF Research Database (Denmark)

    Christensen, Ulla; Kriegbaum, Margit; Hougaard, Charlotte Ørsted

    2008-01-01

    practice modify the employment effect of disease. We have studied risk of labour market exclusion following incident hospitalization for ischaemic heart disease (IHD), and whether this risk may be modified by contextual factors on the municipal level. Methods: A cohort design on a 10% random sample...

  6. Incidence of very mild to severe dementia and Alzheimer's disease in Denmark

    DEFF Research Database (Denmark)

    Andersen, K; Nielsen, H; Lolk, A

    1999-01-01

    Calculation of incidence of dementia and AD, including cases in the earliest phases of the diseases.......Calculation of incidence of dementia and AD, including cases in the earliest phases of the diseases....

  7. Prevalence and fungal profile of pulmonary aspergillosis in immunocompromised and immunocompetent patients of a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Prakash Ved, Mishra Prem P, Verma Shashi K, Sinha Shivani, Sharma Mahendra

    2014-03-01

    Full Text Available Background: Aspergillus is a fungus which may present an array of pulmonary manifestations, depending on the patient’s immunological and physiological state. Although the incidence of pulmonary aspergillosis occurs primarily in immunocompromised patients but the incidence is also rising in immunocompetent individuals, especially in developing countries. Aim: The objective of the study was to determine the prevalence and predisposing factors of pulmonary aspergillosis along with species identification. Materials and Methods: One hundred and three patients admitted to the Department of Chest and Tuberculosis and in the Department of Medicine from Jan 2012 to Jan 2013 were included in this study. The patients were epitomized on the basis of clinical signs and symptoms, physical examination, chest radiography, CT scans, histopathological examination, bronchoscopy and fungal examination including potassium hydroxide mount, fungal culture of sputum and bronchoalveolar lavage. Species identification was done by colony characteristics, slide culture and Lactophenol Cotton blue mount. Results: Out of the 103 patients, (63 males and 40 females Aspergillus species has been isolated from 17 (16.5% males and 07 (6.79% females. Various predisposing factors of pulmonary aspergillosis have been identified in which pulmonary tuberculosis, chronic smoking and environmental exposure to asbestos, cement its tops the list. Many of the patients had multiple predisposing factors. Aspergillus species were isolated in 24 (23.3% cases. Aspergillus fumigatus was the predominant species isolated in 13 (54.16% cases followed by Aspergillus flavus in 07 (29.16% cases, Aspergillus niger in 03 (12.5 % and Aspergillus terrus in 1 (4.16% cases. Conclusion: It is concluded that the prevalence of pulmonary Aspergillosis is quite high in immunocompromised individuals and low in immunocompetent individuals. An adequate and efficient evaluation of the etiological agents has a

  8. Cutaneous Paecilomyces lilacinus infection mimicking cellulitis in an immunocompetent patient: Report of a case and review of the literature

    Directory of Open Access Journals (Sweden)

    Yen-Ta Chen

    2016-03-01

    Full Text Available Paecilomyces lilacinus, a ubiquitous saprophytic mold found in the environment, is an emerging pathogen that causes localized to severe systemic diseases, especially in immunocompromised patients. Thus far, there are only eight reports on immunocompetent patients with cutaneous P. lilacinus in the English literature. We herein present the case of an 87-year-old immunocompetent Taiwanese man who presented with a progressive, tender, erythematous plaque mimicking cellulitis on the ventral surface of the right forearm for 2 weeks. The patient was initially diagnosed as a case of cellulitis; however, due to unresponsiveness to the treatment for 1 week, we decided to perform skin biopsy and tissue culture. Results of histopathologic analysis, tissue culture, and polymerase chain reaction assay indicated cutaneous P. lilacinus infection. Consequently, systemic antifungal treatment with oral itraconazole (200 mg/d was initiated and the skin lesion resolved after a 4-week treatment.

  9. Nephrotic syndrome with a nephritic component associated with toxoplasmosis in an immunocompetent young man.

    OpenAIRE

    Barrios, Julio E; Duran Botello, Claudia; González Velásquez, Tania

    2012-01-01

    Introduction: Although the association of infection by toxoplasmosis with the development of nephrotic syndrome is uncommon, cases of this association have nevertheless been reported in the literature for more than two decades, not only for congenital toxoplasmosis, but also in acquired cases, and occasionally in immunocompetent patients. Development: A case is presented of an immunocompetent patient aged 15 with clinical and laboratory indications of nephrotic/nephritic syndrome, in whom ser...

  10. The neonicotinoids thiacloprid, imidacloprid, and clothianidin affect the immunocompetence of honey bees (Apis mellifera L.).

    Science.gov (United States)

    Brandt, Annely; Gorenflo, Anna; Siede, Reinhold; Meixner, Marina; Büchler, Ralph

    2016-03-01

    A strong immune defense is vital for honey bee health and colony survival. This defense can be weakened by environmental factors that may render honey bees more vulnerable to parasites and pathogens. Honey bees are frequently exposed to neonicotinoid pesticides, which are being discussed as one of the stress factors that may lead to colony failure. We investigated the sublethal effects of the neonicotinoids thiacloprid, imidacloprid, and clothianidin on individual immunity, by studying three major aspects of immunocompetence in worker bees: total hemocyte number, encapsulation response, and antimicrobial activity of the hemolymph. In laboratory experiments, we found a strong impact of all three neonicotinoids. Thiacloprid (24h oral exposure, 200 μg/l or 2000 μg/l) and imidacloprid (1 μg/l or 10 μg/l) reduced hemocyte density, encapsulation response, and antimicrobial activity even at field realistic concentrations. Clothianidin had an effect on these immune parameters only at higher than field realistic concentrations (50-200 μg/l). These results suggest that neonicotinoids affect the individual immunocompetence of honey bees, possibly leading to an impaired disease resistance capacity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Incidence of bacterial diseases associated with irrigation methods on onions (Allium cepa).

    Science.gov (United States)

    Chorolque, A; Pozzo Ardizzi, C; Pellejero, G; Aschkar, G; García Navarro, F J; Jiménez Ballesta, R

    2018-04-24

    In the last decade, diseases of bacterial origin in onions have increased and this has led to significant losses in production. These diseases are currently observed in both the Old and New Worlds. The aim of the experimental work reported here was to evaluate whether the irrigation method influences the incidence of diseases of bacterial origin. In cases where the inoculum was natural, the initial incidence of Soft Bacterial Rot was not manifested in any treatment in the first year, whereas at the end of the conservation period all treatments had increased incidences of infection. Sprinkler irrigation (8%) was statistically differentiated from the other treatments, for which the final incidence was similar (4.5%). For all irrigation treatments, the final incidence of Bacterial Soft Rot decreased or remained stable towards the end of the cycle, with the exception of sprinkler irrigation in 2015, which increased. It can be inferred from the results that the irrigation method does have an influence on the incidence of diseases of bacterial origin in the post-harvest stage for onions. This article is protected by copyright. All rights reserved.

  12. Dry Eye Disease Incidence Associated with Chronic Graft-Host Disease: Nonconcurrent Cohort Study (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Mian, Shahzad I.; De la Parra-Colín, Paola; De Melo-Franco, Rafael; Johnson, Christopher; Barrientos-Gutierrez, Tonatiuh

    2015-01-01

    Purpose: To determine if chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT) is associated with stable or progressive dry eye disease and to determine the true incidence in patients with no prior history of dry eye disease. Methods: A nonconcurrent cohort study at a single institution with 136 patients who had no previous history of dry eye disease before HSCT. Survival analysis was used to estimate dry eye disease incidence. The incidence rate was calculated using life tables as the number of observed dry eye disease cases divided by the person-time at risk accumulated by the cohort. Transition probabilities were calculated from time of transplant to time of diagnosis, and then to last recorded visit. Results: Incidence rate was 0.8 cases of dry eye disease per person-year, and half of the population at risk developed dry eye disease during the first 10 months post transplant. Time to develop dry eye disease was 2.5 months for mild dry eye disease, 9.6 months for moderate dry eye disease, and 13.2 months for severe dry eye disease. In terms of cumulative incidence, 73% of subjects developed dry eye disease (50% mild, 16% moderate, and 7% severe) at the time of diagnosis. Conclusions: Our findings suggest that dry eye disease associated with cGVHD is an extremely frequent event and shows a wide spectrum of severity, with a mild form presenting early and a moderate to severe form presenting later after HSCT. These findings need to be studied further to elucidate if these are two different pathophysiological entities or just different expressions of the same pathology. PMID:27507907

  13. Mitochondrial function, ornamentation, and immunocompetence.

    Science.gov (United States)

    Koch, Rebecca E; Josefson, Chloe C; Hill, Geoffrey E

    2017-08-01

    Understanding the mechanisms that link ornamental displays and individual condition is key to understanding the evolution and function of ornaments. Immune function is an aspect of individual quality that is often associated with the expression of ornamentation, but a general explanation for why the expression of some ornaments seems to be consistently linked to immunocompetence remains elusive. We propose that condition-dependent ornaments may be linked to key aspects of immunocompetence through co-dependence on mitochondrial function. Mitochondrial involvement in immune function is rarely considered outside of the biomedical literature, but the role of mitochondria as the primary energy producers of the cell and the centres of biosynthesis, the oxidative stress response, and cellular signalling place them at the hub of a variety of immune pathways. A promising new mechanistic explanation for correlations between a wide range of ornamental traits and the properties of individual quality is that mitochondrial function may be the 'shared pathway' responsible for links between ornament production and individual condition. Herein, we first review the role of mitochondria as both signal transducers and metabolic regulators of immune function. We then describe connections between hormonal pathways and mitochondria, with implications for both immune function and the expression of ornamentation. Finally, we explore the possibility that ornament expression may link directly to mitochondrial function. Considering condition-dependent traits within the framework of mitochondrial function has the potential to unify central tenets within the study of sexual selection, eco-immunology, oxidative stress ecology, stress and reproductive hormone biology, and animal physiology. © 2016 Cambridge Philosophical Society.

  14. Twenty years of childhood coeliac disease in The Netherlands: A rapidly increasing incidence

    NARCIS (Netherlands)

    George, E.K.; Mearin, M.L.; Franken, H.C.M.; Houwen, R.H.J.; Hirasing, R.A.; Vandenbroucke, J.P.

    1997-01-01

    Background - The incidence of coeliac disease varies internationally. Aims - To assess the incidence of childhood coeliac disease in The Netherlands and to study the clinical features and the presence of associated disorders. Subjects - Identified cases of childhood coeliac disease in The

  15. Herpes Simplex Virus-2 Esophagitis in a Young Immunocompetent Adult

    Directory of Open Access Journals (Sweden)

    Deepak K. Kadayakkara

    2016-01-01

    Full Text Available Herpes simplex esophagitis (HSE is commonly identified in immunosuppressed patients. It is rare among immunocompetent patients and almost all of the reported cases are due to HSV-1 infection. HSV-2 esophagitis is extremely rare. We report the case of a young immunocompetent male who presented with dysphagia, odynophagia, and epigastric pain. Endoscopy showed multitudes of white nummular lesions in the distal esophagus initially suspected to be candida esophagitis. However, classic histopathological findings of multinucleated giant cells with eosinophilic intranuclear inclusions and positive HSV-2 IgM confirmed the diagnosis of HSV-2 esophagitis. The patient rapidly responded to acyclovir treatment. Although HSV-2 is predominantly associated with genital herpes, it can cause infections in other parts of the body previously attributed to only HSV-1 infection.

  16. Disseminated cryptococcosis in an immunocompetent patient.

    Science.gov (United States)

    Mada, Pradeep; Nowack, Brad; Cady, Beth; Joel Chandranesan, Andrew Stevenson

    2017-07-18

    Cryptococcosis is a fungal infection which is commonly associated with immune-compromised state. Disseminated infection in immunocompetent individuals is extremely rare. We present a case of a 56-year-old African American patient who presented with unilateral knee pain and swelling and was subsequently diagnosed with cryptococcal bone mass with dissemination of infection. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Incidence and initial disease course of inflammatory bowel diseases in 2011 in Europe and Australia

    DEFF Research Database (Denmark)

    Vegh, Z; Burisch, J.; Pedersen, N.

    2014-01-01

    participating centers in 2011 and an Australian center to investigate whether there is a difference in the incidence of IBD between Eastern and Western European countries and Australia. METHODS: Fourteen centers from 5 Eastern and 9 Western European countries and one center from Australia participated...... (25%) from Eastern, 461 (65%) from Western Europe and 72 (10%) from Australia; 259 (37%) patients were diagnosed with Crohn's disease, 380 (53%) with ulcerative colitis and 72 (10%) with IBD unclassified. The mean annual incidence rate for IBD was 11.3/100,000 in Eastern Europe, 14.......0/100,000 in Western Europe and 30.3/100,000 in Australia. Significantly more patients were diagnosed with complicated disease at diagnosis in Eastern Europe compared to Western Europe (43% vs. 27%, p=0.02). CONCLUSION: Incidence rates, disease phenotype and initial treatment characteristics in the 2011 ECCO...

  18. Simultaneous Chronic Invasive Fungal Infection and Tracheal Fungus Ball Mimicking Cancer in an Immunocompetent Patient

    Directory of Open Access Journals (Sweden)

    Erdoğan Çetinkaya

    2016-01-01

    Full Text Available Fungal infections of the lung are uncommon and mainly affect people with immune deficiency. There are crucial problems in the diagnosis and treatment of this condition. Invasive pulmonary aspergillosis and candidiasis are the most common opportunistic fungal infections. Aspergillus species (spp. are saprophytes molds that exist in nature as spores and rarely cause disease in immunocompetent individuals. In patients with immune deficiency or chronic lung disease, such as cavitary lung disease or bronchiectasis, Aspergillus may cause a variety of aspergillosis infections. Here we present a case of a 57-year-old patient without immunodeficiency or chronic lung disease who was diagnosed with endotracheal fungus ball and chronic fungal infection, possibly due to Aspergillus. Bronchoscopic examination showed a paralyzed right vocal cord and vegetating mass that was yellow in color, at the posterior wall of tracheal lumen. After 3 months, both the parenchymal and tracheal lesions were completely resolved.

  19. Incidence of skin and respiratory diseases among Danish hairdressing apprentices

    DEFF Research Database (Denmark)

    Foss-Skiftesvik, Majken H.; Winther, Lone; Johnsen, Claus R.

    2017-01-01

    .8% of the hairdressing apprentices had left the trade, and 70.3% of these had left because of health complaints. The most frequently reported reasons for leaving were musculoskeletal pain (47.4%) and skin diseases (47.4%), followed by respiratory symptoms (23.7%). Conclusions: Hairdressing apprentices are at increased......Background: Hairdressing is one of the professions with the highest risk of occupational skin and respiratory diseases. The incidence of these diseases in hairdressing apprentices has been studied only sparsely. Objective: To determine the incidence of skin and respiratory diseases in hairdressing...... apprentices, and to explore whether hairdressing apprentices leave the trade during training because of these diseases. Methods: A 3-year follow-up questionnaire study was conducted among 248 hairdressing apprentices and a control group comprising 816 young adults from the general population. Results...

  20. Immunocompromised and immunocompetent mouse models for head and neck squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Lei ZG

    2016-01-01

    Full Text Available Zhen-ge Lei,1,* Xiao-hua Ren,2,* Sha-sha Wang,3 Xin-hua Liang,3,4 Ya-ling Tang3,5 1Department of Oral and Maxillofacial Surgery, Stomatological Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, 2Department of Stomatology, Sichuan Medical Science Academy and Sichuan Provincial People’s Hospital, 3State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, 4Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, 5Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China *These authors contributed equally to this work Abstract: Mouse models can closely mimic human oral squamous epithelial carcinogenesis, greatly expand the in vivo research possibilities, and play a critical role in the development of diagnosis, monitoring, and treatment of head and neck squamous cell carcinoma. With the development of the recent research on the contribution of immunity/inflammation to cancer initiation and progression, mouse models have been divided into two categories, namely, immunocompromised and immunocompetent mouse models. And thus, this paper will review these two kinds of models applied in head and neck squamous cell carcinoma to provide a platform to understand the complicated histological, molecular, and genetic changes of oral squamous epithelial tumorigenesis. Keywords: head and neck squamous cell carcinoma, HNSCC, mouse models, immunocompromised models, immunocompetent models, transgenic models

  1. Incidence of herpes zoster amongst adults varies by severity of immunosuppression.

    Science.gov (United States)

    Schröder, Carsten; Enders, Dirk; Schink, Tania; Riedel, Oliver

    2017-09-01

    We examined the incidence of herpes zoster in immunocompromised adults (≥18 years) with different severities of immunosuppression and assessed the prevalence of complications and of various kinds of healthcare resource utilisation. German claims data from more than ten million adults were used to calculate annual incidence rates of herpes zoster for the years 2006-2012 and to analyse the prevalence of complications, physician visits, hospitalisations, and antiviral and analgesic treatments using a cohort design. The analyses were stratified by age, sex, and severity of immunosuppression, defined by immunocompromising conditions and drug therapies. The incidence rate per 1000 person-years of herpes zoster was almost twice as high in immunocompromised patients (11.5 (95% confidence interval (CI): 11.4-11.6)) compared to immunocompetent subjects (5.9 (95% CI: 5.8-5.9)). The incidence rate was higher in highly immunocompromised patients (13.4 (95% CI: 13.2-13.6)) than in patients with a low severity of immunosuppression (10.0 (95% CI: 9.8-10.1)). These differences were observed for both sexes and in all age groups. Complications, outpatient physician visits, hospitalisations, and analgesic treatments occurred more frequently in immunocompromised patients as well. Our results show that immunocompromised individuals are affected by the disease in particular and that the burden of herpes zoster is highest in severely immunocompromised patients. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  2. Cytomegalovirus as a cause of anterior uveitis in immunocompetent patients

    NARCIS (Netherlands)

    van Boxtel, Lonneke A. A.; van der Lelij, Allegonda; van der Meer, Johannes; Los, Leonoor I.

    Purpose: To describe 7 cases of unilateral, chronic and/or recurrent anterior uveitis caused by cytomegalovirus (CMV) in immunocompetent patients; to identify specific ophthalmologic characteristics; and to evaluate the clinical effect of valganciclovir treatment. Design: Retrospective observational

  3. Incidence and risk factors of Parkinson's disease in The Netherlands.

    NARCIS (Netherlands)

    Hofman, A.; Collette, H.J.A.; Bartelds, A.I.M.

    1989-01-01

    The incidence and some risk factors of Parkinson's disease were investigated in a study performed in The Netherlands. The study was based on a disease register of the Sentinel Stations, which provide a complete ascertainment of new patients with Parkinson's disease in 60 general practices in The

  4. Biomarkers of cardiovascular stress and incident chronic kidney disease.

    Science.gov (United States)

    Ho, Jennifer E; Hwang, Shih-Jen; Wollert, Kai C; Larson, Martin G; Cheng, Susan; Kempf, Tibor; Vasan, Ramachandran S; Januzzi, James L; Wang, Thomas J; Fox, Caroline S

    2013-11-01

    Growth differentiation factor-15 (GDF-15), soluble ST2 (sST2), and high-sensitivity troponin I (hsTnI) are emerging predictors of adverse clinical outcomes. We examined whether circulating concentrations are related to the development of kidney disease in the community. Plasma GDF-15, sST2, and hsTnI concentrations were measured in 2614 Framingham Offspring cohort participants (mean age 57 years, 54% women) at the sixth examination cycle (1995-1998). Associations of biomarkers with incident chronic kidney disease [CKD, eGFR statistically significant in primary analyses. Participants were followed over a mean of 9.5 years. Higher plasma GDF-15 was associated with incident CKD [multivariable-adjusted odds ratio (OR) 1.9 per 1-U increase in log-GDF-15, 95% CI 1.6-2.3, P statistic increased from 0.826 to 0.845 (P = 0.0007), and categorical net reclassification was 6.3% (95% CI, 2.7-9.9%). Higher circulating GDF-15 is associated with incident renal outcomes and improves risk prediction of incident CKD. These findings may provide insights into the mechanisms of renal injury.

  5. Pulmonary cryptococcosis in rheumatoid arthritis (RA) patients: Comparison of imaging characteristics among RA, acquired immunodeficiency syndrome, and immunocompetent patients

    International Nuclear Information System (INIS)

    Yanagawa, Noriyo; Sakai, Fumikazu; Takemura, Tamiko; Ishikawa, Satoru; Takaki, Yasunobu; Hishima, Tsunekazu; Kamata, Noriko

    2013-01-01

    Purpose: The imaging characteristics of cryptococcosis in rheumatoid arthritis (RA) patients were analyzed by comparing them with those of acquired immunodeficiency syndrome (AIDS) and immunocompetent patients, and the imaging findings were correlated with pathological findings. Methods: Two radiologists retrospectively compared the computed tomographic (CT) findings of 35 episodes of pulmonary cryptococcosis in 31 patients with 3 kinds of underlying states (10 RA, 12 AIDS, 13 immunocompetent), focusing on the nature, number, and distribution of lesions. The pathological findings of 18 patients (8 RA, 2 AIDS, 8 immunocompetent) were analyzed by two pathologists, and then correlated with imaging findings. Results: The frequencies of consolidation and ground glass attenuation (GGA) were significantly higher, and the frequency of peripheral distribution was significantly lower in the RA group than in the immunocompetent group. Peripheral distribution was less common and generalized distribution was more frequent in the RA group than in the AIDS group. The pathological findings of the AIDS and immunocompetent groups reflected their immune status: There was lack of a granuloma reaction in the AIDS group, and a complete granuloma reaction in the immunocompetent group, while the findings of the RA group varied, including a complete granuloma reaction, a loose granuloma reaction and a hyper-immune reaction. Cases with the last two pathologic findings were symptomatic and showed generalized or central distribution on CT. Conclusion: Cryptococcosis in the RA group showed characteristic radiological and pathological findings compared with the other 2 groups

  6. Pulmonary cryptococcosis in rheumatoid arthritis (RA) patients: Comparison of imaging characteristics among RA, acquired immunodeficiency syndrome, and immunocompetent patients

    Energy Technology Data Exchange (ETDEWEB)

    Yanagawa, Noriyo, E-mail: noriyo_yana@ybb.ne.jp [Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Sakai, Fumikazu [Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama 350-1298 (Japan); Takemura, Tamiko [Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935 (Japan); Ishikawa, Satoru [Department of Respiratory Medicine, National Hospital Organization Chiba-East-Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba 260-8712 (Japan); Takaki, Yasunobu [Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Hishima, Tsunekazu [Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Kamata, Noriko [Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan)

    2013-11-01

    Purpose: The imaging characteristics of cryptococcosis in rheumatoid arthritis (RA) patients were analyzed by comparing them with those of acquired immunodeficiency syndrome (AIDS) and immunocompetent patients, and the imaging findings were correlated with pathological findings. Methods: Two radiologists retrospectively compared the computed tomographic (CT) findings of 35 episodes of pulmonary cryptococcosis in 31 patients with 3 kinds of underlying states (10 RA, 12 AIDS, 13 immunocompetent), focusing on the nature, number, and distribution of lesions. The pathological findings of 18 patients (8 RA, 2 AIDS, 8 immunocompetent) were analyzed by two pathologists, and then correlated with imaging findings. Results: The frequencies of consolidation and ground glass attenuation (GGA) were significantly higher, and the frequency of peripheral distribution was significantly lower in the RA group than in the immunocompetent group. Peripheral distribution was less common and generalized distribution was more frequent in the RA group than in the AIDS group. The pathological findings of the AIDS and immunocompetent groups reflected their immune status: There was lack of a granuloma reaction in the AIDS group, and a complete granuloma reaction in the immunocompetent group, while the findings of the RA group varied, including a complete granuloma reaction, a loose granuloma reaction and a hyper-immune reaction. Cases with the last two pathologic findings were symptomatic and showed generalized or central distribution on CT. Conclusion: Cryptococcosis in the RA group showed characteristic radiological and pathological findings compared with the other 2 groups.

  7. [Mixed invasive fungal infection due to Rhizomucor pusillus and Aspergillus niger in an immunocompetent patient].

    Science.gov (United States)

    Pozo-Laderas, Juan Carlos; Pontes-Moreno, Antonio; Robles-Arista, Juan Carlos; Bautista-Rodriguez, M Dolores; Candau-Alvarez, Alberto; Caro-Cuenca, Maria Teresa; Linares-Sicilia, María José

    2015-01-01

    Mucormycosis infections are rare in immunocompetent patients, and very few cases of mucormycosis associated with aspergillosis in non-haematological patients have been reported. A 17-year-old male, immunocompetent and without any previously known risk factors, was admitted to hospital due to a seizure episode 11 days after a motorcycle accident. He had a complicated clinical course as he had a mixed invasive fungal infection with pulmonary involvement due to Aspergillus niger and disseminated mucormycosis due to Rhizomucor pusillus (histopathological and microbiological diagnosis in several non-contiguous sites). He was treated with liposomal amphotericin B for 7 weeks (total cumulative dose >10 g) and required several surgical operations. The patient survived and was discharged from ICU after 5 months and multiple complications. Treatment with liposomal amphotericin B and aggressive surgical management achieved the eradication of a mixed invasive fungal infection. However, we emphasise the need to maintain a higher level of clinical suspicion and to perform microbiological techniques for early diagnosis of invasive fungal infections in non-immunocompromised patients, in order to prevent spread of the disease and the poor prognosis associated with it. Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  8. Natural background radiation and oncologic disease incidence

    International Nuclear Information System (INIS)

    Burenin, P.I.

    1982-01-01

    Cause and effect relationships between oncologic disease incidence in human population and environmental factors are examined using investigation materials of Soviet and foreign authors. The data concerning US white population are adduced. The role and contribution of natural background radiation oncologic disease prevalence have been determined with the help of system information analysis. The probable damage of oncologic disease is shown to decrease as the background radiation level diminishes. The linear nature of dose-response relationspip has been established. The necessity to include the life history of the studied population along with environmental factors in epidemiological study under conditions of multiplicity of cancerogenesis causes is emphasized

  9. Cytomegalovirus-induced colonic stricture presenting as acute intestinal obstruction in an immunocompetent adult.

    Science.gov (United States)

    Dinesh, B V; Selvaraju, Karthikeyan; Kumar, Sampath; Thota, Sumath

    2013-09-10

    Cytomegalovirus (CMV) infection causes significant morbidty and mortality in immunopromised patients. Though it is usually silent in immunocompetent adults, rarely it can cause serious life-threatening complications. Gastrointestinal tract is one of the commonly involved organs, where it produces a spectrum of clinical manifestation ranging from mild non-specific abdominal pain and diarrhoea to severe infection with toxic megacolon and death. We present a 65-year-old immunocompetent male patient admitted with acute colonic obstruction secondary to CMV-induced colonic stricture, highlighting the importance of considering it as a differential diagnosis for colonic obstruction and reviewing its management.

  10. [Necrotising fasciitis caused by Saksenaea vasiformis in an immunocompetent patient after a car accident].

    Science.gov (United States)

    Mayayo, Emilio; Stchigel, Alberto M; Cano, José F; Bernal-Escoté, Xana; Guarro, Josep

    2013-01-03

    Cutaneous mucormycosis (zygomycosis), with subcutaneous spreading and dissemination, in immunocompetent patients is an uncommon disease caused by species belonging to the fungal genera Apophysomyces, Rhizopus and Saksenaea, among others. A case of necrotising fasciitis by Saksenaea vasiformis in an immunocompetent woman is described. The infection was acquired through a car accident resulting in multiple injuries affecting mainly her right arm. After the surgical reduction of fractures, skin lesions worsened and led to necrosis. The patient quickly developed a severe necrotising fasciitis with negative cultures at first. Despite the extensive surgical debridement and the aggressive antifungal treatment, the patient died. The histopathological study showed a fungal infection due to a fungus belonging to the Mucorales order, which was confirmed by culturing the clinical sample on Sabouraud agar, and identifying the species by cultures on Czapek-Dox agar, and sequencing of the ITS region of the ribosomal DNA. This case confirm the presence of this fungus in Spain, the value of histopathology for the mucormycosis diagnosis, as well as the need to perform special cultures to facilitate their isolation and identification to the species level by the combined use of Czapek-Dox agar and sequencing of the ITS region. Copyright © 2012 Revista Iberoamericana de Micología. Published by Elsevier España, S.L. All rights reserved.

  11. Fusarium solani causing quasi-invasive infection of the foot in an immunocompetent middle-aged man from South India

    Directory of Open Access Journals (Sweden)

    Mohan H Kudur

    2013-01-01

    Full Text Available Fusarium solani is commonly found in soil, and it is associated with infections in immunocompromised individuals. Fusaroium solani causing infection in immunocompetent adult male is rare and usually overlooked. We report a case of mycetoma caused by Fusariom solani in an immunocompetent adult male from South India.

  12. Autoimmune diseases incidence in Belarus after Chernobyl accident

    International Nuclear Information System (INIS)

    Yanovich, O.O.; Titov, L.P

    2010-01-01

    The statistical analysis has shown undulation the incidence of thyroiditis since 1998. The prevalence of diabetes mellitus is characterized by a constant increase of cases. Data testify to the tendency of increasing the prevalence autoimmune diseases in Republic of Belarus. (authors)

  13. Conditional predictive inference for online surveillance of spatial disease incidence

    Science.gov (United States)

    Corberán-Vallet, Ana; Lawson, Andrew B.

    2012-01-01

    This paper deals with the development of statistical methodology for timely detection of incident disease clusters in space and time. The increasing availability of data on both the time and the location of events enables the construction of multivariate surveillance techniques, which may enhance the ability to detect localized clusters of disease relative to the surveillance of the overall count of disease cases across the entire study region. We introduce the surveillance conditional predictive ordinate as a general Bayesian model-based surveillance technique that allows us to detect small areas of increased disease incidence when spatial data are available. To address the problem of multiple comparisons, we incorporate a common probability that each small area signals an alarm when no change in the risk pattern of disease takes place into the analysis. We investigate the performance of the proposed surveillance technique within the framework of Bayesian hierarchical Poisson models using a simulation study. Finally, we present a case study of salmonellosis in South Carolina. PMID:21898522

  14. Encephalitis, acute renal failure, and acute hepatitis triggered by a viral infection in an immunocompetent young adult: a case report

    Directory of Open Access Journals (Sweden)

    Khattab Mahmoud

    2009-11-01

    Full Text Available Abstract Introduction Cytomegalovirus generally causes self-limited, mild and asymptomatic infections in immunocompetent patients. An aggressive course in immunocompetent healthy patients is unusual. Case presentation We report the case of an immunocompetent 16-year-old Egyptian boy with encephalitis, acute renal failure, and acute hepatitis triggered by viral infection with a complete recovery following antiviral treatment. Conclusion We believe that this case adds to the understanding of the molecular biology, clinical presentation and increasing index of suspicion of many viral infections.

  15. Disseminated toxocariasis in an immunocompetent host

    Directory of Open Access Journals (Sweden)

    Madan Raj Aryal

    2014-10-01

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

  16. Meningitis secondary to Cryptococcus gattii,an emerging pathogen affecting immunocompetent hosts

    Institute of Scientific and Technical Information of China (English)

    Laura Cookman; Maria Hugi

    2013-01-01

    BACKGROUND:Meningitis continues to be one of the most important infections diagnosed and treated by emergency physicians.Despite the advent of anti-infective therapy,meningitis carries a mortality rate of 20%-40%.In this study,we describe the first reported emergency medicine case of meningitis associated with Cryptococcus gattii to alert providers of this insidious,emerging global pathogen infecting immunocompetent individuals.METHODS:We provided a case report and accompanying review of the literature.A MEDLINE search for the term Cryptoccocus gattii was performed to obtain background information on Cryptococcus gattii.RESULTS:After two months of hospitalization,the patient was eventually discharged neurologically intact except for a continued mild bilateral hearing deficit.CONCLUSION:Cryptococcus gattii is an emerging world pathogen,which affects otherwise healthy,immunocompetent patients and requires timely identification and treatment in order to prevent severe neurological sequelae.

  17. Disseminated herpes zoster ophthalmicus in an immunocompetent 8-year old boy.

    Science.gov (United States)

    Oladokun, Regina Eziuka; Olomukoro, Chikodili N; Owa, Adewale B

    2013-08-02

    Varicella results from a primary infection with the varicella virus while herpes zoster is caused by a reactivation of a latent infection. Dissemination of herpes zoster is uncommon in immunocompetent individuals. Reports of disseminated herpes zoster in children are even less common than in adults. An unusual case of disseminated herpes zoster ophthalmicus in an 8-year old immunocompetent black boy is presented. He had a previous primary Varicella zoster virus infection at three years of age. In the current report, he presented during an on-going chicken pox outbreak and survived with no significant complications. A breakthrough varicella virus re-infection or a reactivation is possible, both of which could present as zoster. This case emphasizes the need for prevention of varicella virus infection through universal childhood immunization and effective infection control strategies in health care settings.

  18. Disseminated herpes zoster ophthalmicus in an immunocompetent 8-year old boy

    Directory of Open Access Journals (Sweden)

    Regina Eziuka Oladokun

    2013-05-01

    Full Text Available Varicella results from a primary infection with the varicella virus while herpes zoster is caused by a reactivation of a latent infection. Dissemination of herpes zoster is uncommon in immunocompetent individuals. Reports of disseminated herpes zoster in children are even less common than in adults. An unusual case of disseminated herpes zoster ophthalmicus in an 8-year old immunocompetent black boy is presented. He had a previous primary Varicella zoster virus infection at three years of age. In the current report, he presented during an on-going chicken pox outbreak and survived with no significant complications. A breakthrough varicella virus re-infection or a reactivation is possible, both of which could present as zoster. This case emphasizes the need for prevention of varicella virus infection through universal childhood immunization and effective infection control strategies in health care settings.

  19. Prevalence, incidence, and autoimmune comorbidities of celiac disease

    DEFF Research Database (Denmark)

    Grode, Louise; Bech, Bodil H; Jensen, Thomas Møller

    2018-01-01

    AIM: The aim of this study was to describe and identify potential trends with respect to prevalence, incidence, age, sex, and autoimmune comorbidity of celiac disease (CD). PATIENTS AND METHODS: A Danish nationwide cohort study of CD using data from The National Patient Register. Patients...

  20. Incidence of chronic kidney disease among people with diabetes: a systematic review of observational studies.

    Science.gov (United States)

    Koye, D N; Shaw, J E; Reid, C M; Atkins, R C; Reutens, A T; Magliano, D J

    2017-07-01

    The aim was to systematically review published articles that reported the incidence of chronic kidney disease among people with diabetes. A systematic literature search was performed using MEDLINE, Embase and CINAHL databases. The titles and abstracts of all publications identified by the search were reviewed and 10 047 studies were retrieved. A total of 71 studies from 30 different countries with sample sizes ranging from 505 to 211 132 met the inclusion criteria. The annual incidence of microalbuminuria and albuminuria ranged from 1.3% to 3.8% for Type 1 diabetes. For Type 2 diabetes and studies combining both diabetes types, the range was from 3.8% to 12.7%, with four of six studies reporting annual rates between 7.4% and 8.6%. In studies reporting the incidence of eGFR Disease (MDRD) equation, apart from one study which reported an annual incidence of 8.9%, the annual incidence ranged from 1.9% to 4.3%. The annual incidence of end-stage renal disease ranged from 0.04% to 1.8%. The annual incidence of microalbuminuria and albuminuria is ~ 2-3% in Type 1 diabetes, and ~ 8% in Type 2 diabetes or mixed diabetes type. The incidence of developing eGFR kidney disease, there was only modest variation in incidence rates. These findings may be useful in clinical settings to help understand the risk of developing kidney disease among those with diabetes. © 2017 Diabetes UK.

  1. The impact of strain-specific immunity on Lyme disease incidence is spatially heterogeneous.

    Science.gov (United States)

    Khatchikian, Camilo E; Nadelman, Robert B; Nowakowski, John; Schwartz, Ira; Wormser, Gary P; Brisson, Dustin

    2017-12-01

    Lyme disease, caused by the bacterium Borrelia burgdorferi, is the most common tick-borne infection in the US. Recent studies have demonstrated that the incidence of human Lyme disease would have been even greater were it not for the presence of strain-specific immunity, which protects previously infected patients against subsequent infections by the same B. burgdorferi strain. Here, spatial heterogeneity is incorporated into epidemiological models to accurately estimate the impact of strain-specific immunity on human Lyme disease incidence. The estimated reduction in the number of Lyme disease cases is greater in epidemiologic models that explicitly include the spatial distribution of Lyme disease cases reported at the county level than those that utilize nationwide data. strain-specific immunity has the greatest epidemiologic impact in geographic areas with the highest Lyme disease incidence due to the greater proportion of people that have been previously infected and have developed strain-specific immunity. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Disseminated aspergillosis in an immunocompetent patient with detectable bis(methylthio)gliotoxin and negative galactomannan.

    Science.gov (United States)

    Vidal-García, Matxalen; Sánchez-Chueca, Pilar; Domingo, María Pilar; Ballester, Carlos; Roc, Lourdes; Ferrer, Isabel; Revillo, María José; Pardo, Julián; Gálvez, Eva María; Rezusta, Antonio

    Disseminated invasive aspergillosis is an exceptional finding in immunocompetent hosts. As in immunocompromised patients, it has high mortality rates. Early diagnostic methods are required in order to properly manage the patient. Bis(methylthio)gliotoxin (bmGT) is a novel biomarker, useful in onco-hematological patients. A 70-year-old male, with non-insulin dependent type II diabetes mellitus and a past surgery history of aortic valve replacement with coronary by-pass five years ago, was seen in the emergency department with blurred vision. Three days later, endogen endophthalmitis was diagnosed in the ophthalmology clinic. During admission for the vitrectomy, he suffered an ischemia of the right lower limb. A thoracic computed tomography revealed a mycotic aneurysm of the ascending thoracic aorta and parietal thrombus. The ascending aorta was replaced and abundant brittle material of infectious appearance, found between the aortic valve graft and the aneurysm, was removed. Aspergillus fumigatus sensu stricto grew in both vitreous and aorta cultures. BmGT was detected in two serum samples obtained prior to intravenous antifungal treatment, which was then reduced after voriconazole treatment was started. Disseminated invasive aspergillosis is a severe disease regardless of the immune status of the patient. This case report suggests that bmGT could be a suitable early diagnostic biomarker, not only in neutropenic patients, but also in immunocompetent hosts. Copyright © 2016 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Prion protein immunocytochemistry helps to establish the true incidence of prion diseases.

    Science.gov (United States)

    Lantos, P L; McGill, I S; Janota, I; Doey, L J; Collinge, J; Bruce, M T; Whatley, S A; Anderton, B H; Clinton, J; Roberts, G W

    1992-11-23

    Creutzfeldt-Jakob disease (CJD) and Gerstmann-Strüssler-Scheinker disease (GSSD) are transmissible spongiform encephalopathies or prion diseases affecting man. It has been reported that prion diseases may occur without the histological hallmarks of spongiform encephalopathies: vacuolation of the cerebral grey matter, neuronal loss and astrocytosis. These cases without characteristic neuropathology may go undiagnosed and consequently the true incidence of transmissible dementias is likely to have been under-estimated. Immunocytochemistry using antibodies to prion protein gives positive staining of these cases, albeit the pattern of immunostaining differs from that seen in typical forms. Accumulation of prion protein is a molecular hallmark of prion diseases, and thus a reproducible, speedy and cost-efficient immunocytochemical screening of unusual dementias may help to establish the true incidence of prion diseases.

  4. Incident solar radiation and coronary heart disease mortality rates in Europe

    International Nuclear Information System (INIS)

    Wong, Alfred

    2008-01-01

    The reported low mortality rate from coronary heart disease in Portugal, Spain, Italy, Greece, and France, to a lesser extent, has been attributed in numerous nutritional studies to the consumption of a Mediterranean-type diet. There are still many unresolved issues about the direct causal effect of the Mediterranean dietary regime on low incidence of coronary heart disease. An analysis of coronary heart disease mortality rates in Europe from a latitudinal gradient perspective has shown to have a close correlation to incident solar radiation. It is surmised that the resulting increased in situ biosynthesis of Vitamin D 3 could be the critical missing confounder in the analysis of the beneficial health outcome of the Mediterranean diet

  5. Weighted Markov chains for forecasting and analysis in Incidence of infectious diseases in jiangsu Province, China☆

    Science.gov (United States)

    Peng, Zhihang; Bao, Changjun; Zhao, Yang; Yi, Honggang; Xia, Letian; Yu, Hao; Shen, Hongbing; Chen, Feng

    2010-01-01

    This paper first applies the sequential cluster method to set up the classification standard of infectious disease incidence state based on the fact that there are many uncertainty characteristics in the incidence course. Then the paper presents a weighted Markov chain, a method which is used to predict the future incidence state. This method assumes the standardized self-coefficients as weights based on the special characteristics of infectious disease incidence being a dependent stochastic variable. It also analyzes the characteristics of infectious diseases incidence via the Markov chain Monte Carlo method to make the long-term benefit of decision optimal. Our method is successfully validated using existing incidents data of infectious diseases in Jiangsu Province. In summation, this paper proposes ways to improve the accuracy of the weighted Markov chain, specifically in the field of infection epidemiology. PMID:23554632

  6. Weighted Markov chains for forecasting and analysis in Incidence of infectious diseases in jiangsu Province, China.

    Science.gov (United States)

    Peng, Zhihang; Bao, Changjun; Zhao, Yang; Yi, Honggang; Xia, Letian; Yu, Hao; Shen, Hongbing; Chen, Feng

    2010-05-01

    This paper first applies the sequential cluster method to set up the classification standard of infectious disease incidence state based on the fact that there are many uncertainty characteristics in the incidence course. Then the paper presents a weighted Markov chain, a method which is used to predict the future incidence state. This method assumes the standardized self-coefficients as weights based on the special characteristics of infectious disease incidence being a dependent stochastic variable. It also analyzes the characteristics of infectious diseases incidence via the Markov chain Monte Carlo method to make the long-term benefit of decision optimal. Our method is successfully validated using existing incidents data of infectious diseases in Jiangsu Province. In summation, this paper proposes ways to improve the accuracy of the weighted Markov chain, specifically in the field of infection epidemiology.

  7. Use of surface water in drinking water production associated with municipal Legionnaires' disease incidence

    NARCIS (Netherlands)

    den Boer, J. W.; Coutinho, R. A.; Yzerman, E. P. F.; van der Sande, M. A. B.

    2008-01-01

    STUDY OBJECTIVES: Given an observed geographical variation in Legionnaires' disease incidence in The Netherlands, the aim of the study was to test the hypothesis that the type of drinking water production was an independent determinant of the incidence of Legionnaires' disease. DESIGN: For the

  8. Herpes zoster duplex bilateralis in an immunocompetent adolescent boy: a case report and literature review.

    Science.gov (United States)

    Yan, Chen; Laguna, Benjamin A; Marlowe, Lauren E; Keller, Michael D; Treat, James R

    2014-01-01

    Simultaneous involvement of herpes zoster in multiple dermatomes is uncommon, and even more so in immunocompetent individuals. We report a case wherein a healthy adolescent boy presented with herpes zoster in two distinct dermatomes, raising concern for immunodeficiency, but he was found to be immunocompetent on further testing. A 14-year-old boy with no significant past medical history developed painless vesicular eruptions in two distinct distributions. Varicella zoster virus polymerase chain reaction was positive from unroofed vesicles in both regions. Initial laboratory studies disclosed abnormalities of unknown significance in natural killer (NK) cell percentage and function. The patient was treated with appropriate antiviral therapy. Repeat studies while healthy were not suggestive of an underlying NK cell defect. There are few case reports describing herpes zoster in two or more dermatomes in children. Previously described presentations most commonly occurred in the context of primary immunodeficiency, acquired immunodeficiency, or immunosuppressive medications. Because of the rarity of this presentation in immunocompetent patients, the authors recommend a thorough immune evaluation of all children presenting with isolated multidermatomal zoster. © 2014 Wiley Periodicals, Inc.

  9. Incidence of poultry diseases in different seasons in Khushab district, Pakistan

    Directory of Open Access Journals (Sweden)

    Ghulam Abbas

    2015-06-01

    Full Text Available A field study was conducted to determine the prevalence of various poultry diseases in broilers and layers at Khushab district in Pakistan. The prevalence study was conducted in 360 poultry farms. Diagnosis of diseases in poultry was done based on history, clinical signs, post-mortem examination, cultural, and biochemical characterization. Overall, incidence of Newcastle disease (ND was found as the highest (avg. 7.85% in broiler, followed by Fowl typhoid (avg. 6.58%, Mycoplasma (avg. 5.68%, Escherichia coli infection (avg. 5.52%, Coccidiosis (avg. 4.59%, Mycotoxicosis (avg. 4.56%, Infectious Bursal Disease (IBD; avg. 2.84%, Infectious coryza (avg. 2.50%, Hydropericardium syndrome (HPS; avg. 1.67%, and Infectious bronchitis (IB; avg. 1.59%. The period during April to June appeared to be comparatively safer for the broilers as low incidence of disease was recorded at this period. In case of layers, incidence of ND was the highest (avg. 7.92%, followed by Fowl typhoid (avg. 6.97%, Mycotoxicosis (avg. 5.52%, Coccidiosis (avg. 4.75%, IBD (avg. 3.17%, Mycoplasmosis (avg. 3.0%, Infectious coryza (avg. 2.52%, Fowl cholera (avg. 1.52%, IB (avg. 0.90k%, E. coli infection (avg. 0.73%, and HPS (avg. 0.46%. For layers, the period during January to March appeared to be safer. In conclusion, diversified diseases are prevalent in both layers and broilers. Thus, proper vaccination practices, brooding arrangements, preventive measures, and biosecurity practices are recommended.

  10. Soluble CD163 predicts incident chronic lung, kidney and liver disease in HIV infection

    DEFF Research Database (Denmark)

    Kirkegaard-Klitbo, Ditte M; Mejer, Niels; Knudsen, Troels B

    2017-01-01

    OBJECTIVE: To examine if monocyte and macrophage activity may be on the mechanistic pathway to non-AIDS comorbidity by investigating the associations between plasma-soluble CD163 (sCD163) and incident non-AIDS comorbidities in well treated HIV-infected individuals. DESIGN: Prospective single...... was examined using multivariable Cox proportional hazards models adjusted for pertinent covariates. RESULTS: In HIV-1-infected individuals (n = 799), the highest quartile of plasma sCD163 was associated with incident chronic lung disease [adjusted hazard ratio (aHR), 3.2; 95% confidence interval (CI): 1.34; 7.......46] and incident chronic kidney disease (aHR, 10.94; 95% CI: 2.32; 51.35), when compared with lowest quartiles. Further, (every 1 mg) increase in plasma sCD163 was positively correlated with incident liver disease (aHR, 1.12; 95% CI: 1.05; 1.19). The sCD163 level was not associated with incident cancer...

  11. Daytime napping and increased risk of incident respiratory diseases: symptom, marker, or risk factor?

    Science.gov (United States)

    Leng, Yue; Wainwright, Nick W J; Cappuccio, Francesco P; Surtees, Paul G; Hayat, Shabina; Luben, Robert; Brayne, Carol; Khaw, Kay-Tee

    2016-07-01

    We have identified a strong association between daytime napping and increased mortality risk from respiratory diseases, but little is known about the relationship between daytime napping and respiratory morbidity. Data were drawn from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort. Participants reported napping habits during 1998-2000 and were followed up for respiratory disease hospital admissions until March 2009. Cox proportional hazards regression was used to examine the association between daytime napping and respiratory disease incidence risk. The study sample included 10,978 men and women with a mean age of 61.9 years, and a total of 946 incident respiratory disease cases were recorded. After adjustment for age, sex, social class, education, marital status, employment status, nightshift work, body mass index, physical activity, smoking, alcohol intake, self-reported general health, hypnotic drug use, habitual sleep duration, and preexisting health conditions, daytime napping was associated with an increase in the overall respiratory disease incidence risk (hazard ratio (HR) = 1.32, 95% confidence interval (CI) 1.15, 1.52 for napping respiratory diseases, especially for the risk of chronic lower respiratory diseases (HR = 1.52, 95% CI: 1.18, 1.96 for napping respiratory disease incidence risk. Further studies are required to confirm these findings and help understand potential mechanisms. Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.

  12. Cladophialophora bantiana brain abscess masquerading cerebral tuberculoma in an immunocompetent host

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2014-03-01

    Full Text Available Phaeohyphomycosis is a term that collectively describes fungal infections caused by moulds and yeasts that have brown-pigmented cell walls (due to the presence of melanin. We report a case of 45 year female who had multiple coalescing lesions in the right basal ganglionic and thalamic region. Based on the imaging and investigation findings a diagnosis of cerebral tuberculoma was suspected. Histopathology of the excised specimen showed brown colored fungal hyphae surrounded by neutrophilic infiltrate. A diagnosis of phaeohyphomycosis caused by Cladophialophora bantiana was made and accordingly antifungal treatment was started. Brain abscess caused by Cladophialophora bantiana in an immunocompetent host is relatively uncommon and usually associated with overall high mortality. The best outcomes have been reported in patients who receive both surgical excision of the abscess followed by systemic antifungal therapy. In view of its rarity of these lesions preoperative diagnosis is difficult particularly in an immunocompetent host and absence of other risk factors.

  13. Cryptococcus gattii in an Immunocompetent Patient in the Southeastern United States

    Directory of Open Access Journals (Sweden)

    John W. Amburgy

    2016-01-01

    Full Text Available Cryptococcal infections are seen throughout the United States in both immunocompromised and immunocompetent patients. The most common form is C. neoformans. In the Northwestern United States, C. gattii has received considerable attention secondary to increased virulence resulting in significant morbidity and mortality. There are no cases in the extant literature describing a patient with C. gattii requiring neurosurgical intervention in Alabama. A middle-aged immunocompetent male with no recent travel or identifiable exposure presented with meningitis secondary to C. gattii. The patient underwent 12 lumbar punctures and a ventriculoperitoneal shunt and required 83 days of inpatient therapy with 5-flucytosine and amphotericin B. The patient was found to have multiple intracranial lesions and a large intramedullary spinal cryptococcoma within his conus. Following an almost 3-month hospitalization the patient required treatment with oral voriconazole for one year. In the United States meningitis caused by C. gattii infection is not isolated to the Northwestern region.

  14. Primary extradural leiomyosarcoma involving cavernous sinus in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Hanni V Gulwani

    2014-01-01

    Full Text Available Intracranial leiomyosarcoma (LMS are uncommon malignancies and usually encountered after systemic metastases. Limited cases of primary intracranial LMSs have been reported in the literature. It mostly affects immunocompromised individuals in association with Epstein-Barr virus infection. This is the unusual first case being reported of primary LMS in immunocompetent patient with involvement of cavernous sinus.

  15. Incidence rates of occupational diseases in the Dutch construction sector, 2010-2014

    NARCIS (Netherlands)

    van der Molen, Henk F.; de Vries, Sanne C.; Stocks, S. Jill; Warning, Jan; Frings-Dresen, Monique H. W.

    2016-01-01

    To estimate incidence and trends in incidence of occupational diseases (ODs) in the Dutch construction sector. In a dynamic prospective cohort over a 5-year period (2010-2014), ODs assessed by occupational physicians (OPs) participating in a voluntary construction workers health surveillance (WHS)

  16. Incidence and prevalence of Crohn's disease in the county of Copenhagen, 1962-87

    DEFF Research Database (Denmark)

    Munkholm, P; Langholz, E; Nielsen, O H

    1992-01-01

    The incidence of Crohn's disease increased sixfold from 1962 to 1987 in the county of Copenhagen. The mean annual incidence for 1979-87 was 4.1 per 10(5) inhabitants. The increase was found equally in both sexes, with an approximately 40% higher incidence in women. The maximal incidence was found...... in the 15- to 24-year age group, being 12.8 per 10(5) per year for women and 6.0 per 10(5) per year for men, as mean of the period 1979-87. The prevalence at the end of the study was 54 per 10(5) inhabitants, 46 per 10(5) in men and 63 per 10(5) in women. The clinical appearance of the disease at the time...

  17. Estimating the contribution of genetic variants to difference in incidence of disease between population groups

    Science.gov (United States)

    Moonesinghe, Ramal; Ioannidis, John PA; Flanders, W Dana; Yang, Quanhe; Truman, Benedict I; Khoury, Muin J

    2012-01-01

    Genome-wide association studies have identified multiple genetic susceptibility variants to several complex human diseases. However, risk-genotype frequency at loci showing robust associations might differ substantially among different populations. In this paper, we present methods to assess the contribution of genetic variants to the difference in the incidence of disease between different population groups for different scenarios. We derive expressions for the contribution of a single genetic variant, multiple genetic variants, and the contribution of the joint effect of a genetic variant and an environmental factor to the difference in the incidence of disease. The contribution of genetic variants to the difference in incidence increases with increasing difference in risk-genotype frequency, but declines with increasing difference in incidence between the two populations. The contribution of genetic variants also increases with increasing relative risk and the contribution of joint effect of genetic and environmental factors increases with increasing relative risk of the gene–environmental interaction. The contribution of genetic variants to the difference in incidence between two populations can be expressed as a function of the population attributable risks of the genetic variants in the two populations. The contribution of a group of genetic variants to the disparity in incidence of disease could change considerably by adding one more genetic variant to the group. Any estimate of genetic contribution to the disparity in incidence of disease between two populations at this stage seems to be an elusive goal. PMID:22333905

  18. Estimating the contribution of genetic variants to difference in incidence of disease between population groups.

    Science.gov (United States)

    Moonesinghe, Ramal; Ioannidis, John P A; Flanders, W Dana; Yang, Quanhe; Truman, Benedict I; Khoury, Muin J

    2012-08-01

    Genome-wide association studies have identified multiple genetic susceptibility variants to several complex human diseases. However, risk-genotype frequency at loci showing robust associations might differ substantially among different populations. In this paper, we present methods to assess the contribution of genetic variants to the difference in the incidence of disease between different population groups for different scenarios. We derive expressions for the contribution of a single genetic variant, multiple genetic variants, and the contribution of the joint effect of a genetic variant and an environmental factor to the difference in the incidence of disease. The contribution of genetic variants to the difference in incidence increases with increasing difference in risk-genotype frequency, but declines with increasing difference in incidence between the two populations. The contribution of genetic variants also increases with increasing relative risk and the contribution of joint effect of genetic and environmental factors increases with increasing relative risk of the gene-environmental interaction. The contribution of genetic variants to the difference in incidence between two populations can be expressed as a function of the population attributable risks of the genetic variants in the two populations. The contribution of a group of genetic variants to the disparity in incidence of disease could change considerably by adding one more genetic variant to the group. Any estimate of genetic contribution to the disparity in incidence of disease between two populations at this stage seems to be an elusive goal.

  19. Epstein-Barr viral load assessment in immunocompetent patients with fulminant infectious mononucleosis.

    NARCIS (Netherlands)

    Laar, J.A. van; Buysse, C.M.; Vossen, A.C.; Hjalmarsson, B.; Berg, B. van de; Lom, K. van; Deinum, J.

    2002-01-01

    We describe 2 immunocompetent adolescents with fulminant infectious mononucleosis and virus-associated hemophagocytosis. A new quantitative polymerase chain reaction revealed high serum Epstein-Barr virus DNA levels in these patients. One patient died with an increasing viral load not responding to

  20. Prevalence and incidence of Alzheimer's disease in Europe: A meta-analysis.

    Science.gov (United States)

    Niu, H; Álvarez-Álvarez, I; Guillén-Grima, F; Aguinaga-Ontoso, I

    2017-10-01

    A disease of unknown aetiology, Alzheimer's disease (AD) is the most common type of dementia. As the elderly population grows worldwide, the number of patients with AD also increases rapidly. The aim of this meta-analysis is to evaluate the prevalence and incidence of AD in Europe. We conducted a literature search on Medline, Scopus, and CINAHL Complete using the keywords «Alzheimer», «Alzheimer's disease», and «AD» combined with «prevalence», «incidence», and «epidemiology». A Bayesian random effects model with 95% credible intervals was used. The I 2 statistic was applied to assess heterogeneity. The prevalence of Alzheimer's disease in Europe was estimated at 5.05% (95% CI, 4.73-5.39). The prevalence in men was 3.31% (95% CI, 2.85-3.80) and in women, 7.13% (95% CI, 6.56-7.72), and increased with age. The incidence of Alzheimer's disease in Europe was 11.08 per 1000 person-years (95% CI, 10.30-11.89). Broken down by sex, it was 7.02 per 1000 person-years (95% CI, 6.06-8.05) in men and 13.25 per 1000 person-years (95% CI, 12.05-14.51) in women; again these rates increased with age. The results of our meta-analysis allow a better grasp of the impact of this disease in Europe. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. The role of juvenile hormone in immune function and pheromone production trade-offs: a test of the immunocompetence handicap principle.

    Science.gov (United States)

    Rantala, Markus J; Vainikka, Anssi; Kortet, Raine

    2003-01-01

    The immunocompetence handicap hypothesis postulates that secondary sexual traits are honest signals of mate quality because the hormones (e.g. testosterone) needed to develop secondary sexual traits have immunosuppressive effects. The best support for predictions arising from the immunocompetence handicap hypothesis so far comes from studies of insects, although they lack male-specific hormones such as testosterone. In our previous studies, we found that female mealworm beetles prefer pheromones of immunocompetent males. Here, we tested how juvenile hormone (JH) affects male investment in secondary sexual characteristics and immune functions in the mealworm beetle, Tenebrio molitor. We injected male mealworm beetles with JH (type III) and found that injection increased the attractiveness of male pheromones but simultaneously suppressed immune functions (phenoloxidase activity and encapsulation). Our results suggest that JH, which is involved in the control of reproduction and morphogenesis, also plays a central role in the regulation of a trade-off between the immune system and sexual advertisement in insects. Thus, the results reflect a general mechanism by which the immunocompetence handicap hypothesis may work in insects. PMID:14613612

  2. Hemorrhagic Cystitis due to BK Reactivation in a Young Female Treated for Hodgkin-Disease

    Directory of Open Access Journals (Sweden)

    R. Le Calloch

    2011-01-01

    Full Text Available Hodgkin's lymphoma is a disease with a high rate of curability under classic chemo-radiotherapy regimes. Complications due to chemotherapy could include viral reactivation due to chronic lymphopenia. BK virus (BKV is a polyoma virus belonging to the Papovaviridae family with antibody seroprevalences in healthy populations varying from 60% to 80%. Initial infections are asymptomatic usually occur in early childhood, after which the viruses remain latent in the kidneys or urothelium. Reactivation of BKV occurs in individuals with severe immunosuppression during HIV infections, transplantation or, exceptionally, after classical chemotherapy. BKV incidence is approximately 0% to 5% in immunocompetent individuals. Reactivation is associated with nephropathy and haemorrhagic cystitis. Herein, we present a case of a haemorrhagic cystitis due to BKV reactivation in a patient with Hodgkin's disease treated with chemotherapy.

  3. The great simulator: A historical presentation involving miliary tuberculosis and Pott’s disease in an immunocompetent young female patient aged 25

    Directory of Open Access Journals (Sweden)

    Safaa Belghali

    2017-07-01

    Full Text Available The association between miliary tuberculous and spondylodiscitis is rarely described in the literature and usually occurs in immunocompromised patients. We report the case of an immunocompetent woman aged 25, suffering from inflammatory back pain associated with fever and weight loss in postpartum. Chest CT-scan showed a miliary and spine CT-scan revealed the presence of staged spondylodiscitis with epiduritis. The diagnosis of tuberculosis was made by the detection of bacillus in the pus of paravertebral abscess.

  4. Incidence and prevalence of pregnancy-related heart disease.

    Science.gov (United States)

    Sliwa, Karen; Böhm, Michael

    2014-03-15

    Worldwide, the numbers of women who have a pre-existing cardiovascular disease or develop cardiac problems during pregnancy are increasing and, due to the lack of evidenced-based data, this provides challenges for the treating physician. Cardiovascular disease in pregnancy is a complex topic as women can present either pre- or post-partum, due to a pre-existing heart disease such as operated on or unoperated on congenital heart disease, valvular heart disease, chronic hypertension, or familial dilated cardiomyopathy. Women often present with symptoms and signs of acute heart failure. On the other hand, there are diseases which are directly related to pregnancy, such as hypertensive disorders of pregnancy and peripartum cardiomyopathy, or where pregnancy increases risk of a disease as, for example, the risk of myocardial infarction. These diseases can have long-term implications to the life of the affected women and their families. There is, in particular, a paucity of data from developing countries of this unique disease pattern and its presentations. This review summarizes the current knowledge of the incidence and prevalence of pregnancy-related cardiovascular disease in women presenting pre- or post-partum.

  5. Defining New Therapeutics Using a More Immunocompetent Mouse Model of Antibody-Enhanced Dengue Virus Infection.

    Science.gov (United States)

    Pinto, Amelia K; Brien, James D; Lam, Chia-Ying Kao; Johnson, Syd; Chiang, Cindy; Hiscott, John; Sarathy, Vanessa V; Barrett, Alan D; Shresta, Sujan; Diamond, Michael S

    2015-09-15

    With over 3.5 billion people at risk and approximately 390 million human infections per year, dengue virus (DENV) disease strains health care resources worldwide. Previously, we and others established models for DENV pathogenesis in mice that completely lack subunits of the receptors (Ifnar and Ifngr) for type I and type II interferon (IFN) signaling; however, the utility of these models is limited by the pleotropic effect of these cytokines on innate and adaptive immune system development and function. Here, we demonstrate that the specific deletion of Ifnar expression on subsets of murine myeloid cells (LysM Cre(+) Ifnar(flox/flox) [denoted as Ifnar(f/f) herein]) resulted in enhanced DENV replication in vivo. The administration of subneutralizing amounts of cross-reactive anti-DENV monoclonal antibodies to LysM Cre(+) Ifnar(f/f) mice prior to infection with DENV serotype 2 or 3 resulted in antibody-dependent enhancement (ADE) of infection with many of the characteristics associated with severe DENV disease in humans, including plasma leakage, hypercytokinemia, liver injury, hemoconcentration, and thrombocytopenia. Notably, the pathogenesis of severe DENV-2 or DENV-3 infection in LysM Cre(+) Ifnar(f/f) mice was blocked by pre- or postexposure administration of a bispecific dual-affinity retargeting molecule (DART) or an optimized RIG-I receptor agonist that stimulates innate immune responses. Our findings establish a more immunocompetent animal model of ADE of infection with multiple DENV serotypes in which disease is inhibited by treatment with broad-spectrum antibody derivatives or innate immune stimulatory agents. Although dengue virus (DENV) infects hundreds of millions of people annually and results in morbidity and mortality on a global scale, there are no approved antiviral treatments or vaccines. Part of the difficulty in evaluating therapeutic candidates is the lack of small animal models that are permissive to DENV and recapitulate the clinical features

  6. Ferrets as a Novel Animal Model for Studying Human Respiratory Syncytial Virus Infections in Immunocompetent and Immunocompromised Hosts

    Science.gov (United States)

    Stittelaar, Koert J.; de Waal, Leon; van Amerongen, Geert; Veldhuis Kroeze, Edwin J.B.; Fraaij, Pieter L.A.; van Baalen, Carel A.; van Kampen, Jeroen J.A.; van der Vries, Erhard; Osterhaus, Albert D.M.E.; de Swart, Rik L.

    2016-01-01

    Human respiratory syncytial virus (HRSV) is an important cause of severe respiratory tract disease in immunocompromised patients. Animal models are indispensable for evaluating novel intervention strategies in this complex patient population. To complement existing models in rodents and non-human primates, we have evaluated the potential benefits of an HRSV infection model in ferrets (Mustela putorius furo). Nine- to 12-month-old HRSV-seronegative immunocompetent or immunocompromised ferrets were infected with a low-passage wild-type strain of HRSV subgroup A (105 TCID50) administered by intra-tracheal or intra-nasal inoculation. Immune suppression was achieved by bi-daily oral administration of tacrolimus, mycophenolate mofetil, and prednisolone. Throat and nose swabs were collected daily and animals were euthanized four, seven, or 21 days post-infection (DPI). Virus loads were determined by quantitative virus culture and qPCR. We observed efficient HRSV replication in both the upper and lower respiratory tract. In immunocompromised ferrets, virus loads reached higher levels and showed delayed clearance as compared to those in immunocompetent animals. Histopathological evaluation of animals euthanized 4 DPI demonstrated that the virus replicated in the respiratory epithelial cells of the trachea, bronchi, and bronchioles. These animal models can contribute to an assessment of the efficacy and safety of novel HRSV intervention strategies. PMID:27314379

  7. Ferrets as a Novel Animal Model for Studying Human Respiratory Syncytial Virus Infections in Immunocompetent and Immunocompromised Hosts

    Directory of Open Access Journals (Sweden)

    Koert J. Stittelaar

    2016-06-01

    Full Text Available Human respiratory syncytial virus (HRSV is an important cause of severe respiratory tract disease in immunocompromised patients. Animal models are indispensable for evaluating novel intervention strategies in this complex patient population. To complement existing models in rodents and non-human primates, we have evaluated the potential benefits of an HRSV infection model in ferrets (Mustela putorius furo. Nine- to 12-month-old HRSV-seronegative immunocompetent or immunocompromised ferrets were infected with a low-passage wild-type strain of HRSV subgroup A (105 TCID50 administered by intra-tracheal or intra-nasal inoculation. Immune suppression was achieved by bi-daily oral administration of tacrolimus, mycophenolate mofetil, and prednisolone. Throat and nose swabs were collected daily and animals were euthanized four, seven, or 21 days post-infection (DPI. Virus loads were determined by quantitative virus culture and qPCR. We observed efficient HRSV replication in both the upper and lower respiratory tract. In immunocompromised ferrets, virus loads reached higher levels and showed delayed clearance as compared to those in immunocompetent animals. Histopathological evaluation of animals euthanized 4 DPI demonstrated that the virus replicated in the respiratory epithelial cells of the trachea, bronchi, and bronchioles. These animal models can contribute to an assessment of the efficacy and safety of novel HRSV intervention strategies.

  8. Salmonella enterica serovar Ohio septic arthritis and bone abscess in an immunocompetent patient: a case report

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    Kato Hideaki

    2012-07-01

    Full Text Available Abstract Introduction Non-typhi Salmonella species cause severe extra-intestinal focal infection after occult bacteremia. Although the number of cases of non-typhi salmonellosis is increasing worldwide among patients with immunocompromising conditions such as human immunodeficiency virus infection, infection is uncommon in immunocompetent subjects. We report a case of septic arthritis and bone abscess due to a rare non-typhi Salmonella organism that developed after a prolonged asymptomatic period. Case presentation A 44-year-old Japanese immunocompetent man presented with acute-onset left knee pain and swelling. He had no history of food poisoning, and his most recent travel to an endemic area was 19 years ago. Salmonella enterica serovar Ohio was identified from samples of bone abscess and joint tissue. Arthrotomy and necrotic tissue debridement followed by intravenous ceftriaxone was successful. Conclusions Non-typhi Salmonella species only rarely cause extra-intestinal focal infections in immunocompetent patients. Our case suggests that non-typhi Salmonella species can cause severe focal infections many years after the occult bacteremia associated with food poisoning.

  9. Kaposi’s Sarcoma Presenting as Lymphadenopathy in an Immunocompetent Patient

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    Hana Zoubeidi

    2016-11-01

    Full Text Available Introduction: Kaposi’s sarcoma (KS is an angioproliferative disorder first described in 1872 by Moritz Kaposi. Four main clinical presentations of KS have been described: classic, endemic, iatrogenic and epidemic. KS involvement of the lymph nodes is extremely uncommon in the classical variant form, especially if it precedes the skin manifestations. We describe the case of an elderly HIV-negative patient presenting with lymphadenopathy who was found to have KS. Case Report: A 67-year-old patient was admitted for exploration of polyadenopathies in the context of a general decline in health. Physical examination revealed an erythematosus left lower limb rash associated with angiomatous nodules and multiple lymphadenopathies. The diagnosis of erysipelas in the left leg was retained and the patient was treated with good evolution of the rash but persistence of the angiomatous nodules and the polyadenopathies. Skin and lymph node biopsies led to a diagnosis of KS. The patient is proposed for polychemotherapy. Conclusion: KS must be suspected in lymphadenopathies despite the absence of typical cutaneous signs of the disease and in immunocompetent patients.

  10. Risk and course of motor complications in a population-based incident Parkinson's disease cohort.

    Science.gov (United States)

    Bjornestad, Anders; Forsaa, Elin B; Pedersen, Kenn Freddy; Tysnes, Ole-Bjorn; Larsen, Jan Petter; Alves, Guido

    2016-01-01

    Motor complications may become major challenges in the management of patients with Parkinson's disease. In this study, we sought to determine the incidence, risk factors, evolution, and treatment of motor fluctuations and dyskinesias in a population-representative, incident Parkinson's disease cohort. In this prospective population-based 5-year longitudinal study, we followed 189 incident and initially drug-naïve Parkinson's disease patients biannually for detailed examination of dyskinesias and motor fluctuations as defined by the Unified Parkinson's disease Rating Scale. We performed Kaplan-Meier survival and Cox regression analyses to assess cumulative incidence and risk factors of these motor complications. The 5-year cumulative incidence of motor complications was 52.4%. Motor fluctuations occurred in 42.9% and dyskinesias in 24.3%. Besides higher motor severity predicting both motor fluctuations (p = 0.016) and dyskinesias (p motor fluctuations (p = 0.001), whereas female gender predicted dyskinesias (p = 0.001). Actual levodopa dose at onset of motor fluctuations (p = 0.037) or dyskinesias (p 0.1) independently predicted development of motor complications. Motor fluctuations reversed in 37% and dyskinesias in 49% of patients on oral treatment and remained generally mild in those with persistent complications. No patients received device-aided therapies during the study. More than 50% in the general Parkinson's disease population develop motor complications within 5 years of diagnosis. However, they remain mild in the vast majority and are reversible in a substantial proportion of patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. THE EFFECT OF WAIST CIRCUMFERENCES MORE THAN NORMAL ON THE INCIDENT OF CORONARY HEART DISEASE

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    Pria Wahyu

    2017-07-01

    Full Text Available Introduction: Coronary heart disease is known as the most common disease that causes mortality in the world, one of the examination to identify the risks of coronary heart disease is measuring waist circumference. The purpose of this study was to identify correlation between large waist circumferences and the incident of coroner heart disease. Method: Design used in this study was analytic observational (retrospective with cross sectional approach. There were 63 respondents which sampling by simple random sampling. The independent variable was waist circumferences and the dependent variable was coronary heart disease. Data were collected by direct observation then analyzed by spearman correlation statistic test with significance level α≤0.05. Result: The result showed that waist circumferences more than normal had significant correlation with the incident of coronary heart disease (p=0.02. Analysis: It can be concluded that there was correlation between waist circumferences more than normal and the incident of coronary heart disease to the clients with coroner cardiac disease. Discussion: Earlier screening and detection is needed to prevent coronary heart disease.

  12. High incidence of diseases endemic to the Amazon region of Brazil, 2001-2006.

    Science.gov (United States)

    Penna, Gerson; Pinto, Luiz Felipe; Soranz, Daniel; Glatt, Ruth

    2009-04-01

    In Brazil, reportable diseases are the responsibility of the Secretariat of Health Surveillance of the Brazilian Federal Ministry of Health. During 2001-2006, to determine incidence and hospitalization rates, we analyzed 5 diseases (malaria, leishmaniasis [cutaneous and visceral], dengue fever, leprosy, and tuberculosis) that are endemic to the Amazon region of Brazil. Data were obtained from 773 municipalities in 3 regions. Although incidence rates of malaria, leishmaniasis, tuberculosis, and leprosy are decreasing, persons in lower socioeconomic classes with insufficient formal education are affected more by these diseases and other health inequalities than are other population groups in the region.

  13. Zika (PRVABC59 Infection Is Associated with T cell Infiltration and Neurodegeneration in CNS of Immunocompetent Neonatal C57Bl/6 Mice.

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    Mohanraj Manangeeswaran

    2016-11-01

    Full Text Available The recent spread of Zika virus (ZIKV and its association with increased rates of Guillain Barre and other neurological disorders as well as congenital defects that include microcephaly has created an urgent need to develop animal models to examine the pathogenesis of the disease and explore the efficacy of potential therapeutics and vaccines. Recently developed infection models for ZIKV utilize mice defective in interferon responses. In this study we establish and characterize a new model of peripheral ZIKV infection using immunocompetent neonatal C57BL/6 mice and compare its clinical progression, virus distribution, immune response, and neuropathology with that of C57BL/6-IFNAR KO mice. We show that while ZIKV infected IFNAR KO mice develop bilateral hind limb paralysis and die 5-6 days post-infection (dpi, immunocompetent B6 WT mice develop signs of neurological disease including unsteady gait, kinetic tremors, severe ataxia and seizures by 13 dpi that subside gradually over 2 weeks. Immunohistochemistry show viral antigen predominantly in cerebellum at the peak of the disease in both models. However, whereas IFNAR KO mice showed infiltration by neutrophils and macrophages and higher expression of IL-1, IL-6 and Cox2, B6 WT mice show a cellular infiltration in the CNS composed predominantly of T cells, particularly CD8+ T cells, and increased mRNA expression levels of IFNg, GzmB and Prf1 at peak of disease. Lastly, the CNS of B6 WT mice shows evidence of neurodegeneration predominantly in the cerebellum that are less prominent in mice lacking the IFN response possibly due to the difference in cellular infiltrates and rapid progression of the disease in that model. The development of the B6 WT model of ZIKV infection will provide insight into the immunopathology of the virus and facilitate assessments of possible therapeutics and vaccines.

  14. Enterococcus faecium small colony variant endocarditis in an immunocompetent patient

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    S. Hernández Egido

    2016-01-01

    Full Text Available Small colony variants (SCV are slow-growing subpopulations of bacteria usually associated with auxotrophism, causing persistent or recurrent infections. Enterococcus faecalis SCV have been seldom described, and only one case of Enterococcus faecium SCV has been reported, associated with sepsis in a leukaemia patient. Here we report the first case described of bacteraemia and endocarditis by SCV E. faecium in an immunocompetent patient.

  15. Intestinal IgA responses to Giardia muris in mice depleted of helper T lymphocytes and in immunocompetent mice.

    Science.gov (United States)

    Heyworth, M F

    1989-04-01

    Immunocompetent mice infected with Giardia muris generate an intestinal antibody response to this parasite and clear G. muris infection. Previous work has shown that G. muris infection is prolonged in mice that have been depleted of helper (CD4+) T lymphocytes by treatment with a monoclonal antibody (mAb) directed against the murine CD4 antigen. The aim of the present study was to compare the intestinal anti-Giardia antibody response in immunocompetent mice and in mice depleted of helper T (Th) lymphocytes by treatment with anti-CD4 mAb. Immunocompetent mice generated an IgA response to G. muris, as judged by the presence of IgA on Giardia trophozoites harvested from the intestine of these animals more than 10 days after the start of the infection. The anti-Giardia IgA response was impaired in mice depleted of Th lymphocytes, as judged by virtual absence of immunofluorescent staining of trophozoites from these animals for surface-bound IgA. Clearance of G. muris infection was impaired by treatment of mice with anti-CD4 mAb. The results suggest that Th (CD4+) lymphocytes are important for the generation of a local IgA response against G. muris trophozoites in the mouse intestine and that IgA anti-trophozoite antibody may contribute to the clearance of G. muris from the intestine of immunocompetent mice.

  16. Testicular toxoplasmosis in a 26-year-old immunocompetent man.

    Science.gov (United States)

    Wong, Vincent; Amarasekera, Channa; Kundu, Shilajit

    2018-06-04

    Testicular toxoplasmosis is a very rare presentation of Toxoplasma gondii A 26-year-old immunocompetent man presented to us with right testicular pain and a right epididymal mass. Ultrasound was concerning for malignancy and a radical orchiectomy was performed. Surgical pathology revealed chronic granulomatous inflammation which stained positive for T. gondii . © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Comprehensive metabolomic profiling and incident cardiovascular disease: a systematic review

    Science.gov (United States)

    Background: Metabolomics is a promising tool of cardiovascular biomarker discovery. We systematically reviewed the literature on comprehensive metabolomic profiling in association with incident cardiovascular disease (CVD). Methods and Results: We searched MEDLINE and EMBASE from inception to Janua...

  18. THE INCIDENCE AND PREVALENCE OF RHEUMATIC DISEASES IN RUSSIA IN 2012–2013

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    R. M. Balabanova

    2015-01-01

    Full Text Available The incidence of major rheumatic diseases was analyzed inRussia's adult population  in 2012–2013 on the basis of the statistical reports of the Ministry of Health ofRussia(Form No. 12.Among the adult population  ofRussia, the overall incidence of acute rheumatic fever (ARF decreased by 11.6% (from 1666 to 1474 cases. No case of ARF was registered in 11 of the 83 subjects of the Federation in 2013. The inci- dence rates per 100,000 adult population  compared toRussia's ones were higher in theRepublicofIngushetia(21.0%, theChechen Republic(13.2%, and the Chukotka Autonomous District (26.2%. All cases of ARF were first notified. The overall incidence rates of chronic rheumatic heart diseases amongRussia's adult population  tend to reduce slightly [by 5.3% (from 182,286 to 172,687 cases].In the period in question, the total number of patients with musculoskeletal diseases (MSD  slightly rose. The bulk of rheumatic  patients from the MSD group are more than 4 million patients with osteoarthritis  (OA, half of them (2,454,563 being those who are older than able-bodied  age. The incidence of OA tends to increase in all Federal Districts (FD.  The most common  joint inflammatory diseases are rheumatoid  arthritis (RA (286,000 cases, spondylopathies  (90,000 cases, and osteoporosis (152,000 cases. The incidence rates of MSD per 100,000 adult population  are higher in the North-Western (19,397.7, Volga (16,552.6, and Siberian (16,133.4 FD thanRussia's mean rate (14,205.5. There were somewhat higher incidence rates of RA per 100,000 population  in 2013 than in 2012 (241.4 and 245.6, respectively. The rates in the North-Western, Ural, Far Eastern, and Volga FDs are higher than the mean Russian ones.In 2011, the rubric of «Ankylosing spondylitis» (AS was replaced by that of «Spondylopathies» that, besides AS (ICD-10 M45, encompasses other inflammatory spondylopathies  (M46, including infectious one, which does not allow single out the

  19. Measures of chronic kidney disease and risk of incident peripheral artery disease: a collaborative meta-analysis of individual participant data.

    Science.gov (United States)

    Matsushita, Kunihiro; Ballew, Shoshana H; Coresh, Josef; Arima, Hisatomi; Ärnlöv, Johan; Cirillo, Massimo; Ebert, Natalie; Hiramoto, Jade S; Kimm, Heejin; Shlipak, Michael G; Visseren, Frank L J; Gansevoort, Ron T; Kovesdy, Csaba P; Shalev, Varda; Woodward, Mark; Kronenberg, Florian

    2017-09-01

    Some evidence suggests that chronic kidney disease is a risk factor for lower-extremity peripheral artery disease. We aimed to quantify the independent and joint associations of two measures of chronic kidney disease (estimated glomerular filtration rate [eGFR] and albuminuria) with the incidence of peripheral artery disease. In this collaborative meta-analysis of international cohorts included in the Chronic Kidney Disease Prognosis Consortium (baseline measurements obtained between 1972 and 2014) with baseline measurements of eGFR and albuminuria, at least 1000 participants (this criterion not applied to cohorts exclusively enrolling patients with chronic kidney disease), and at least 50 peripheral artery disease events, we analysed adult participants without peripheral artery disease at baseline at the individual patient level with Cox proportional hazards models to quantify associations of creatinine-based eGFR, urine albumin-to-creatinine ratio (ACR), and dipstick proteinuria with the incidence of peripheral artery disease (including hospitalisation with a diagnosis of peripheral artery disease, intermittent claudication, leg revascularisation, and leg amputation). We assessed discrimination improvement through c-statistics. We analysed 817 084 individuals without a history of peripheral artery disease at baseline from 21 cohorts. 18 261 cases of peripheral artery disease were recorded during follow-up across cohorts (median follow-up was 7·4 years [IQR 5·7-8·9], range 2·0-15·8 years across cohorts). Both chronic kidney disease measures were independently associated with the incidence of peripheral artery disease. Compared with an eGFR of 95 mL/min per 1·73 m 2 , adjusted hazard ratios (HRs) for incident study-specific peripheral artery disease was 1·22 (95% CI 1·14-1·30) at an eGFR of 45 mL/min per 1·73 m 2 and 2·06 (1·70-2·48) at an eGFR of 15 mL/min per 1·73 m 2 . Compared with an ACR of 5 mg/g, the adjusted HR for incident study

  20. Mixture models for undiagnosed prevalent disease and interval-censored incident disease: applications to a cohort assembled from electronic health records.

    Science.gov (United States)

    Cheung, Li C; Pan, Qing; Hyun, Noorie; Schiffman, Mark; Fetterman, Barbara; Castle, Philip E; Lorey, Thomas; Katki, Hormuzd A

    2017-09-30

    For cost-effectiveness and efficiency, many large-scale general-purpose cohort studies are being assembled within large health-care providers who use electronic health records. Two key features of such data are that incident disease is interval-censored between irregular visits and there can be pre-existing (prevalent) disease. Because prevalent disease is not always immediately diagnosed, some disease diagnosed at later visits are actually undiagnosed prevalent disease. We consider prevalent disease as a point mass at time zero for clinical applications where there is no interest in time of prevalent disease onset. We demonstrate that the naive Kaplan-Meier cumulative risk estimator underestimates risks at early time points and overestimates later risks. We propose a general family of mixture models for undiagnosed prevalent disease and interval-censored incident disease that we call prevalence-incidence models. Parameters for parametric prevalence-incidence models, such as the logistic regression and Weibull survival (logistic-Weibull) model, are estimated by direct likelihood maximization or by EM algorithm. Non-parametric methods are proposed to calculate cumulative risks for cases without covariates. We compare naive Kaplan-Meier, logistic-Weibull, and non-parametric estimates of cumulative risk in the cervical cancer screening program at Kaiser Permanente Northern California. Kaplan-Meier provided poor estimates while the logistic-Weibull model was a close fit to the non-parametric. Our findings support our use of logistic-Weibull models to develop the risk estimates that underlie current US risk-based cervical cancer screening guidelines. Published 2017. This article has been contributed to by US Government employees and their work is in the public domain in the USA. Published 2017. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

  1. Thin-section computed tomography findings in 104 immunocompetent patients with adenovirus pneumonia.

    Science.gov (United States)

    Park, Chan Kue; Kwon, Hoon; Park, Ji Young

    2017-08-01

    Background To date, there has been no computed tomography (CT) evaluation of adenovirus pneumonia in a large number of immunocompetent patients. Purpose To describe the thin-section CT findings of immunocompetent patients with adenovirus pneumonia. Material and Methods We prospectively enrolled 104 patients with adenovirus pneumonia from a military hospital. CT scans of each patient were retrospectively and independently assessed by two radiologists for the presence of abnormalities, laterality and zonal predominance of the parenchymal abnormalities, and dominant imaging patterns and their anatomic distributions. Results CT findings included consolidation (n = 92), ground-glass opacity (GGO; n = 82), septal thickening (n = 34), nodules (n = 46), bronchial wall thickening (n = 32), pleural effusion (n = 16), and lymphadenopathy (n = 3). Eighty-four patients (81%) exhibited unilateral parenchymal abnormalities and 57 (57%) exhibited lower lung zone abnormalities. The most frequently dominant CT pattern was consolidation with surrounding GGO (n = 50), with subpleural (70%) and peribronchovascular (94%) distributions. Consolidation-the second-most common pattern (n = 33)-also exhibited subpleural (79%) and peribronchovascular (97%) distributions. The dominant nodule pattern (n = 14) exhibited mixed (64%) and peribronchovascular (100%) distributions. A dominant GGO pattern was only observed in four patients; none had central distribution. Conclusion Although the manifestations of adenovirus pneumonia on CT are varied, we found the most frequent pattern was consolidation with or without surrounding GGO, with subpleural and peribronchovascular distributions. Parenchymal abnormalities were predominantly unilateral and located in the lower lung zone. If dominant consolidation findings are present in immunocompetent patients during the early stages, adenovirus pneumonia should be considered.

  2. Genetic influences on incidence and case-fatality of infectious disease

    DEFF Research Database (Denmark)

    Petersen, Liselotte; Andersen, Per Kragh; Sørensen, Thorkild I A

    2010-01-01

    Family, twin and adoption studies suggest that genetic susceptibility contributes to familial aggregation of infectious diseases or to death from infections. We estimated genetic and shared environmental influences separately on the risk of acquiring an infection (incidence) and on dying from...

  3. Psychiatric disease incidence among Danish Seventh-day Adventists and Baptists.

    Science.gov (United States)

    Thygesen, Lau Caspar; Dalton, Susanne Oksbjerg; Johansen, Christoffer; Ross, Lone; Kessing, Lars Vedel; Hvidt, Niels Christian

    2013-10-01

    Previous studies suggest that religious practice can have a positive effect on mental health, but may also have potential for harm. In Denmark, unique possibilities are available for studying the influence of religious practice on mental health: Denmark is characterized as a secular society and it is possible to follow members of religious societies in nationwide registers. In this study, we follow a cohort of Danish Seventh-day Adventists (SDA) and Baptists in a nationwide psychiatry register and compare the incidence in this cohort with the general population. We followed a cohort of 5,614 SDA and 3,663 Baptists in the Danish Psychiatric Central Register, which contained information on psychiatric hospitalizations from 1970 to 2009. Psychiatric disease incidence in the cohort was compared with that in the general Danish population as standardized incidence ratios and within-cohort comparisons were made with a Cox model. The cohort had decreased incidence of abuse disorders compared to the general population. Furthermore, among Baptists, decreased incidence of unipolar disorders among men and decreased incidence of schizophrenia among women were observed. Surprisingly, we observed an increased incidence rate of unipolar disorder among women. In this nationwide cohort study with 40 years of follow-up, we observed increased incidence rates of unipolar disorders among women and decreased rates of alcohol- and drug-related psychiatric disorders compared to the general Danish population. We have no mechanistic explanation for the increased incidence of unipolar disorders among women, but discuss several hypotheses that could explain this observation.

  4. Incidence of insects, diseases, and other damaging agents in Oregon forests.

    Science.gov (United States)

    Paul A. Dunham

    2008-01-01

    This report uses data from a network of forest inventory plots sampled at two points in time, annual aerial insect and disease surveys, and specialized pest damage surveys to quantify the incidence and impact of insects, diseases, and other damaging agents on Oregon's forests. The number and volume of trees damaged or killed by various agents is summarized....

  5. Wolbachia mediate variation of host immunocompetence.

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    Christine Braquart-Varnier

    Full Text Available BACKGROUND: After decades during which endosymbionts were considered as silent in their hosts, in particular concerning the immune system, recent studies have revealed the contrary. In the present paper, we addressed the effect of Wolbachia, the most prevalent endosymbiont in arthropods, on host immunocompetence. To this end, we chose the A. vulgare-Wolbachia symbiosis as a model system because it leads to compare consequences of two Wolbachia strains (wVulC and wVulM on hosts from the same population. Moreover, A. vulgare is the only host-species in which Wolbachia have been directly observed within haemocytes which are responsible for both humoral and cellular immune responses. METHODOLOGY/PRINCIPAL FINDINGS: We sampled gravid females from the same population that were either asymbiotic, infected with wVulC, or infected with wVulM. The offspring from these females were tested and it was revealed that individuals harbouring wVulC exhibited: (i lower haemocyte densities, (ii more intense septicaemia in their haemolymph and (iii a reduced lifespan as compared to individuals habouring wVulM or asymbiotic ones. Therefore, individuals in this population of A. vulgare appeared to suffer more from wVulC than from wVulM. Symbiotic titer and location in the haemocytes did not differ for the two Wolbachia strains showing that these two parameters were not responsible for differences observed in their extended phenotypes in A. vulgare. CONCLUSION/SIGNIFICANCE: The two Wolbachia strains infecting A. vulgare in the same population induced variation in immunocompetence and survival of their hosts. Such variation should highly influence the dynamics of this host-symbiont system. We propose in accordance with previous population genetic works, that wVulM is a local strain that has attenuated its virulence through a long term adaptation process towards local A. vulgare genotypes whereas wVulC, which is a widespread and invasive strain, is not locally adapted.

  6. Nocardia brasiliensis primary pulmonary nocardiosis with subcutaneous involvement in an immunocompetent patient.

    Science.gov (United States)

    Amatya, R; Koirala, R; Khanal, B; Dhakal, S S

    2011-01-01

    This is a report of an unusual case of Nocardia brasiliensis causing primary pulmonary nocardiosis with disseminated subcutaneous lesions in an immunocompetent patient. This case highlights the importance of considering nocardiosis as a differential diagnosis in patients with pulmonary and cutaneous lesions and the need for vigorous management for complete cure.

  7. Incidence of Congenital Heart Diseases Anomalies in Newborns with Oral Clefts, Zahedan, Iran

    OpenAIRE

    Noor Mohammad Noori; Alireza Teimouri; Tahereh Boryri; Sirous Risbaf Fakour; Fateme Shahramian

    2016-01-01

    Background Oral cleft is the most common orofacial congenital anomaly among live births. This anomaly at birth is one of the main causes of children disability and mortality.  Congenital heart disease (CHD) is one of the most common anomalies in oral clefts.  This study aimed to assess the incidence of congenital heart diseases anomalies in newborns with oral clefts. Materials and Methods This study performed on 48,692 live born to estimate incidence of oral clefts from 1 st December 2013 to ...

  8. Serum 25-hydroxyvitamin D, mortality, and incident cardiovascular disease, respiratory disease, cancers, and fractures: a 13-y prospective population study.

    Science.gov (United States)

    Khaw, Kay-Tee; Luben, Robert; Wareham, Nicholas

    2014-11-01

    Vitamin D is associated with many health conditions, but optimal blood concentrations are still uncertain. We examined the prospective relation between serum 25-hydroxyvitamin D [25(OH)D] concentrations [which comprised 25(OH)D3 and 25(OH)D2] and subsequent mortality by the cause and incident diseases in a prospective population study. Serum vitamin D concentrations were measured in 14,641 men and women aged 42-82 y in 1997-2000 who were living in Norfolk, United Kingdom, and were followed up to 2012. Participants were categorized into 5 groups according to baseline serum concentrations of total 25(OH)D increasing vitamin D category were 1, 0.84 (0.74, 0.94), 0.72 (0.63, 0.81), 0.71 (0.62, 0.82), and 0.66 (0.55, 0.79) (P-trend disease, diabetes, or cancer, HRs for a 20-nmol/L increase in 25(OH)D were 0.92 (0.88, 0.96) (P disease, 0.89 (0.85, 0.93) (P respiratory disease, 0.89 (0.81, 0.98) (P = 0.012) (563 events) for fractures, and 1.02 (0.99, 1.06) (P = 0.21) (3121 events) for incident total cancers. Plasma 25(OH)D concentrations predict subsequent lower 13-y total mortality and incident cardiovascular disease, respiratory disease, and fractures but not total incident cancers. For mortality, lowest risks were in subjects with concentrations >90 nmol/L, and there was no evidence of increased mortality at high concentrations, suggesting that a moderate increase in population mean concentrations may have potential health benefit, but 120 nmol/L.

  9. East-West gradient in the incidence of inflammatory bowel disease in Europe

    DEFF Research Database (Denmark)

    Burisch, J.; Pedersen, N; Cukovic-Cavka, S

    2014-01-01

    OBJECTIVE: The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe. The reasons for these changes remain unknown. The aim of this study was to investigate whether an East-West gradient in the incidence of IBD in Europe exists. DESIGN: A prospective, uniformly diagnosed...... treatment as rescue therapy. Of all European CD patients, 20% received only 5-aminosalicylates as induction therapy. CONCLUSIONS: An East-West gradient in IBD incidence exists in Europe. Among this inception cohort-including indolent and aggressive cases-international guidelines for diagnosis and initial...

  10. Establishment of an immunocompetent nipple valve anastomosis to prevent faecal reflux after ileocolic resection in dogs.

    Science.gov (United States)

    Ecker, K W; Pistorius, G; Menger, M D; Feifel, G

    2000-05-01

    To construct an immunocompetent nipple valve anastomosis (NVA) to exclude faecal reflux and compare it with an end-to-end anastomosis to see if it would prevent recurrent inflammation caused by intraluminal bacterial antigens in Crohn's disease. Laboratory study. Teaching hospital, Germany. Two groups of six beagle dogs each of which had NVA or end-to-end anastomosis. Construction of a NVA by stapling the telescoped nipple, and replacing the ileal mucosa on the valve by colonic mucosa; end-to-end anastomosis. Radiological, bacteriological, angiographic, and morphometric results. Absolute retrograde pressure-competence and free orthograde permeability of the NVA resulted in significantly lower intestinal bacterial counts compared with the end-to-end anastomosis (p < 0.05). Transposition of colonic mucosa was successful as demonstrated by revascularisation from the ileal nipple and looked normal on morphometry. If NVA were constructed in patients with Crohn's disease, recurrences should be prevented, which would verify the immunopathogenetic hypothesis of new inflammation.

  11. Aeromonas caviae septicemia in immunocompetent gastrointestinal carriers

    Directory of Open Access Journals (Sweden)

    M. Dwivedi

    Full Text Available Aeromonas caviae strains have been isolated from blood and stool cultures of three immunocompetent patients, residents of Northern India, who presented with community acquired septicemia without any recent history of diarrhea. Cell culture infectivity test performed on Hep-2 cells have shown substantial degree of invasiveness in the isolated strains. This case unleashes a possibility of asymptomatic gastrointestinal carriage of such strains of A. caviae in a very large population of India, as several areas of India have very high rates of Aeromonas induced acute diarrhea/gastroenteritis (up to 13%. It needs to be appraised further in India as well as other countries having high rates of Aeromonas induced acute diarrhea/gastroenteritis.

  12. Statin Use, Incident Dementia and Alzheimer Disease in Elderly African Americans.

    Science.gov (United States)

    Hendrie, Hugh C; Hake, Ann; Lane, Kathleen; Purnell, Christianna; Unverzagt, Frederick; Smith-Gamble, Valerie; Murrell, Jill; Ogunniyi, Adesola; Baiyewu, Olusegun; Callahan, Chris; Saykin, Andrew; Taylor, Stanley; Hall, Kathleen; Gao, Su

    2015-08-07

    To investigate the association between statin use, incident dementia, and Alzheimer disease (AD) in a prospective elderly African American cohort. Two stage design with a screening interview followed by a comprehensive in-home assessment conducted over an eight-year period. Diagnoses of incident AD and dementia were made by consensus. Statin use was collected at each evaluation. Measurements of low-density lipoprotein cholesterol (LDL), C-reactive protein (CRP) and APOE genotype were obtained from baseline blood samples. Logistic regression models were used to test the association of statin use on incident dementia and AD and its possible association with lipid and CRP levels. Indianapolis, Indiana. From an original cohort of 2629 participants, a subsample of 974 African Americans aged >70 years with normal cognition, at least one follow up evaluation, complete statin information, and biomarker availability were included. Incident dementia and incident AD. After controlling for age at diagnosis, sex, education level, presence of the APOE ε4 allele and history of stroke for the incident dementia model, baseline use of statins was associated with a significantly decreased risk of incident dementia (OR=.44, P=.029) and incident AD (OR=.40, P=.029). The significant effect of statin use on reduced AD risk and trend for dementia risk was found only for those participants who reported consistent use over the observational period (incident AD: P=.034; incident dementia: P=.061). Additional models found no significant interaction between baseline statin use, baseline LDL, or CRP level and incident dementia/AD. Consistent use of statin medications during eight years of follow-up resulted in significantly reduced risk for incident AD and a trend toward reduced risk for incident dementia.

  13. Aspergillus niger endocarditis in an immunocompetent patient: an unusual course

    Science.gov (United States)

    Kreiss, Y.; Vered, Z.; Keller, N.; Kochva, I.; Sidi, Y.; Gur, H.

    2000-01-01

    Aspergillus is an opportunistic nosocomial fungus generally associated with a high mortality rate. A niger has been rarely associated with infection, and most cases have occurred in patients who have recently undergone heart surgery or in immunocompromised patients. We present a case of an immunocompetent patient with A niger endocarditis which illustrates the difficulties in diagnosis and the possible insidious course of fungal endocarditis.


Keywords: endocarditis; Aspergillus niger; transoesophageal echocardiography PMID:10644391

  14. High Incidence of Diseases Endemic to the Amazon Region of Brazil, 2001–2006

    Science.gov (United States)

    Pinto, Luiz Felipe; Soranz, Daniel; Glatt, Ruth

    2009-01-01

    In Brazil, reportable diseases are the responsibility of the Secretariat of Health Surveillance of the Brazilian Federal Ministry of Health. During 2001–2006, to determine incidence and hospitalization rates, we analyzed 5 diseases (malaria, leishmaniasis [cutaneous and visceral], dengue fever, leprosy, and tuberculosis) that are endemic to the Amazon region of Brazil. Data were obtained from 773 municipalities in 3 regions. Although incidence rates of malaria, leishmaniasis, tuberculosis, and leprosy are decreasing, persons in lower socioeconomic classes with insufficient formal education are affected more by these diseases and other health inequalities than are other population groups in the region. PMID:19331758

  15. Nondermatophytic onychomycosis by Fusarium oxysporum in an immunocompetent host.

    Science.gov (United States)

    Shah, S R; Dalal, B D; Modak, M S

    2016-03-01

    Fusarium onychomycosis is not uncommon in tropical countries but is worth reporting. We report a case of nondermatophytic onychomycosis by Fusarium oxysporum in an immunocompetent woman from Buldhana district of Maharashtra (India). Bilateral involvement of great toe nail, chronic duration and acquisition of infection due to peculiar practice of daily pasting floors with mud and dung, is interesting. The case was successfully treated with topical and oral terbinafine with a dose of 250 mg daily for 3 weeks. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Treatment of a solid tumor using engineered drug-resistant immunocompetent cells and cytotoxic chemotherapy.

    Science.gov (United States)

    Dasgupta, Anindya; Shields, Jordan E; Spencer, H Trent

    2012-07-01

    Multimodal therapy approaches, such as combining chemotherapy agents with cellular immunotherapy, suffers from potential drug-mediated toxicity to immune effector cells. Overcoming such toxic effects of anticancer cellular products is a potential critical barrier to the development of combined therapeutic approaches. We are evaluating an anticancer strategy that focuses on overcoming such a barrier by genetically engineering drug-resistant variants of immunocompetent cells, thereby allowing for the coadministration of cellular therapy with cytotoxic chemotherapy, a method we refer to as drug-resistant immunotherapy (DRI). The strategy relies on the use of cDNA sequences that confer drug resistance and recombinant lentiviral vectors to transfer nucleic acid sequences into immunocompetent cells. In the present study, we evaluated a DRI-based strategy that incorporates the immunocompetent cell line NK-92, which has intrinsic antitumor properties, genetically engineered to be resistant to both temozolomide and trimetrexate. These immune effector cells efficiently lysed neuroblastoma cell lines, which we show are also sensitive to both chemotherapy agents. The antitumor efficacy of the DRI strategy was demonstrated in vivo, whereby neuroblastoma-bearing NOD/SCID/γ-chain knockout (NSG) mice treated with dual drug-resistant NK-92 cell therapy followed by dual cytotoxic chemotherapy showed tumor regression and significantly enhanced survival compared with animals receiving either nonengineered cell-based therapy and chemotherapy, immunotherapy alone, or chemotherapy alone. These data show there is a benefit to using drug-resistant cellular therapy when combined with cytotoxic chemotherapy approaches.

  17. Clostridium Difficile Infection Complicated By Toxic Megacolon In Immunocompetent Patient

    Directory of Open Access Journals (Sweden)

    Draganescu Miruna

    2017-02-01

    Full Text Available Toxic megacolon can be a form of severe clinical course of the infection with Clostridium difficile (ICD, life-threatening, requiring a particular course of treatment. Infection with Clostridium difficile in the Galati Infectious Disease Hospital presents rising number of cases, namely 172 cases in 2014, 271 cases in 2015 and 301 cases in 2016 with clinical evolutions with different severity degrees, including toxic megacolon and death. Among 744 patients with ICD in our clinic, since 1st January 2014 to 31 December 2016. The frequency of toxic megacolon (TM was 0,537%, so: 3 toxic megacolon cases with favorable evolution with treatment with vancomycin and metronidazole and just one case whose evolution was aggravated under this therapy and evolved favorably under treatment with tigecycline. The work presents this last case of ICD occurred in a 69 years old, immunocompetent man with unknown concomitant chronic diseases which undergoes surgery for bilateral inguinal hernia and receives antibiotherapy with cephalosporin IIIrd generation during surgery and after 7 days develops medium degree ICD with score Atlas 3 and receives therapy with oral vancomycin. He presents clinical aggravation during this therapy with the occurrence of colon dilatation, ascites and right pleurisy at ultrasound and therapy associated with metronidazole is decided. Clinical aggravation continues in this combined therapy with defining the clinical, colonoscopy and tomography criteria for TM and is decided surgical monitoring and replacing antibiotherapy with tigecycline. Evolution is favorable with tigecycline without surgical intervention.

  18. Nocardia brasiliensis primary pulmonary nocardiosis with subcutaneous involvement in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    R Amatya

    2011-01-01

    Full Text Available This is a report of an unusual case of Nocardia brasiliensis causing primary pulmonary nocardiosis with disseminated subcutaneous lesions in an immunocompetent patient. This case highlights the importance of considering nocardiosis as a differential diagnosis in patients with pulmonary and cutaneous lesions and the need for vigorous management for complete cure.

  19. The Role of Heterotypic DENV-specific CD8+T Lymphocytes in an Immunocompetent Mouse Model of Secondary Dengue Virus Infection.

    Science.gov (United States)

    Talarico, Laura B; Batalle, Juan P; Byrne, Alana B; Brahamian, Jorge M; Ferretti, Adrián; García, Ayelén G; Mauri, Aldana; Simonetto, Carla; Hijano, Diego R; Lawrence, Andrea; Acosta, Patricio L; Caballero, Mauricio T; Paredes Rojas, Yésica; Ibañez, Lorena I; Melendi, Guillermina A; Rey, Félix A; Damonte, Elsa B; Harris, Eva; Polack, Fernando P

    2017-06-01

    Dengue is the most prevalent arthropod-borne viral disease worldwide and is caused by the four dengue virus serotypes (DENV-1-4). Sequential heterologous DENV infections can be associated with severe disease manifestations. Here, we present an immunocompetent mouse model of secondary DENV infection using non mouse-adapted DENV strains to investigate the pathogenesis of severe dengue disease. C57BL/6 mice infected sequentially with DENV-1 (strain Puerto Rico/94) and DENV-2 (strain Tonga/74) developed low platelet counts, internal hemorrhages, and increase of liver enzymes. Cross-reactive CD8 + T lymphocytes were found to be necessary and sufficient for signs of severe disease by adoptively transferring of DENV-1-immune CD8 + T lymphocytes before DENV-2 challenge. Disease signs were associated with production of tumor necrosis factor (TNF)-α and elevated cytotoxicity displayed by heterotypic anti-DENV-1 CD8 + T lymphocytes. These findings highlight the critical role of heterotypic anti-DENV CD8 + T lymphocytes in manifestations of severe dengue disease. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  20. The incidence of inflammatory bowel disease in Northern China: a prospective population-based study.

    Directory of Open Access Journals (Sweden)

    Hong Yang

    Full Text Available AIMS & BACKGROUNDS: Although inflammatory bowel diseases (IBD are emerging and increasing in China, epidemiologic data are rarely available. This study was to investigate the epidemiological and clinical characteristics of IBD in Northern China. METHODS: This is a prospective, population-based study of incidence of IBD in Daqing, Heilongjiang province of Northern China from March 1, 2012 to February 28, 2013. All incident patients with IBD were clinically identified by IBD specialist group from five main General Hospitals covering the healthcare service for 1,343,364 residents in the urban areas of Daqing. IBD cases included in this study were followed-up for three months for diagnosis confirmation. RESULTS: A total of 27 new IBD cases including 25 cases of ulcerative colitis (UC and 2 cases of Crohn's disease (CD were identified. The population at risk was 1,343,364 person years. Age-adjusted incidence for total IBD, CD and UC were 1.77, 0.13, and 1.64 per 100,000 population, respectively. A male predominance was found in CD patients (male to female ratio was 2 ∶ 0. In contrast, no obvious gender predominance was found in UC patients (male to female ratio was 1 ∶ 1.1. CD patients were diagnosed at an average age of 39.5 years. The main disease phenotypes of UC were distal colitis with a 24% of proctitis and 56% of left-sided colitis. The mean diagnostic age of UC patients was 48.9 years. CONCLUSIONS: This is the first report on the incidence of IBD in the Northern Chinese population. A lower incidence of IBD, similar male predominance for CD, similar disease phenotype of UC, and lower disease activity was observed in Daqing compared to that in Southern China.

  1. Incidence and prevalence of inflammatory bowel diseases in gastroenterology primary care setting.

    Science.gov (United States)

    Tursi, Antonio; Elisei, Walter; Picchio, Marcello

    2013-12-01

    The incidence of inflammatory bowel diseases (IBDs) has markedly increased over the last years, but no epidemiological study has been performed in gastroenterology primary care setting. We describe the epidemiology of IBD in a gastroenterology primary care unit using its records as the primary data source. Case finding used predefined read codes to systematically search computer diagnostic and prescribing records from January 2009 to December 2012. A specialist diagnosis of Ulcerative colitis (UC), Crohn's disease (CD), inflammatory bowel disease unclassified (IBDU) or segmental colitis associated with diverticulosis (SCAD), based on clinical, histological or radiological findings, was a prerequisite for the inclusion in the study. Secondary, infective and apparent acute self-limiting colitis were excluded. We identified 176 patients with IBD in a population of 94,000 with a prevalence 187.2/100,000 (95% CI: 160.6-217.0). Between 2009 and 2012 there were 61 new cases. In particular, there were 23 new cases of UC, 19 new cases of CD, 15 new cases of SCAD, and 4 new cases of IBDU. The incidence of IBD was 16.2/100,000 (95% CI 12.5-20.7) per year. The incidence per year was 6/100,000 (95% CI 3.8 to 8.9) for UC, 5/100,000 (95% CI 3.0-7.7) for CD, 4/100,000 (95% CI 2.3-6.5) for SCAD, and 1/100,000 (95% CI 0.3-2.6) for IBDU. We assessed for the first time which is the prevalence and incidence of IBD in a gastroenterology primary care unit. This confirms that specialist primary care unit is a key factor in providing early diagnosis of chronic diseases. Copyright © 2013 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  2. Incident Cardiovascular Disease Among Adults With Blood Pressure Hg.

    Science.gov (United States)

    Tajeu, Gabriel S; Booth, John N; Colantonio, Lisandro D; Gottesman, Rebecca F; Howard, George; Lackland, Daniel T; O'Brien, Emily C; Oparil, Suzanne; Ravenell, Joseph; Safford, Monika M; Seals, Samantha R; Shimbo, Daichi; Shea, Steven; Spruill, Tanya M; Tanner, Rikki M; Muntner, Paul

    2017-08-29

    Data from before the 2000s indicate that the majority of incident cardiovascular disease (CVD) events occur among US adults with systolic and diastolic blood pressure (SBP/DBP) ≥140/90 mm Hg. Over the past several decades, BP has declined and hypertension control has improved. We estimated the percentage of incident CVD events that occur at SBP/DBP Hg in a pooled analysis of 3 contemporary US cohorts: the REGARDS study (Reasons for Geographic and Racial Differences in Stroke), the MESA (Multi-Ethnic Study of Atherosclerosis), and the JHS (Jackson Heart Study) (n=31 856; REGARDS=21 208; MESA=6779; JHS=3869). Baseline study visits were conducted in 2003 to 2007 for REGARDS, 2000 to 2002 for MESA, and 2000 to 2004 for JHS. BP was measured by trained staff using standardized methods. Antihypertensive medication use was self-reported. The primary outcome was incident CVD, defined by the first occurrence of fatal or nonfatal stroke, nonfatal myocardial infarction, fatal coronary heart disease, or heart failure. Events were adjudicated in each study. Over a mean follow-up of 7.7 years, 2584 participants had incident CVD events. Overall, 63.0% (95% confidence interval [CI], 54.9-71.1) of events occurred in participants with SBP/DBP Hg; 58.4% (95% CI, 47.7-69.2) and 68.1% (95% CI, 60.1-76.0) among those taking and not taking antihypertensive medication, respectively. The majority of events occurred in participants with SBP/DBP Hg among those Hg, 76.6% (95% CI, 75.8-77.5) were eligible for statin treatment, but only 33.2% (95% CI, 32.1-34.3) were taking one, and 19.5% (95% CI, 18.5-20.5) met the SPRINT (Systolic Blood Pressure Intervention Trial) eligibility criteria and may benefit from a SBP target goal of 120 mm Hg. Although higher BP levels are associated with increased CVD risk, in the modern era, the majority of incident CVD events occur in US adults with SBP/DBP Hg. While absolute risk and cost-effectiveness should be considered, additional CVD risk

  3. Incidence, risk factors and treatment of diarrhoea among Dutch travellers: reasons not to routinely prescribe antibiotics

    Directory of Open Access Journals (Sweden)

    Belderok Sanne-Meike

    2011-10-01

    Full Text Available Abstract Background Travellers' diarrhoea (TD is the most common infectious disease among travellers. In the Netherlands, stand-by or prophylactic antibiotics are not routinely prescribed to travellers. This study prospectively assessed the incidence rate, risk factors, and treatment of TD among immunocompetent travellers. Methods Persons who attended the travel clinic of the Public Health Service Amsterdam in 2006-2007 before short-term travel to tropical and subtropical countries were invited to answer a questionnaire regarding sociodemographics and travel purpose; they were also asked to keep a daily structured travel diary, recording their itinerary, symptoms, and self-medication or consultation with a doctor. Diarrhoea episodes containing blood or mucous were considered severe. Results Of 1202 travellers, the median age was 38 years, and the median travel duration 3 weeks. Of all episodes, 96% were mild. The median duration of TD was 2 days and significantly shorter in subsequent episodes compared to first episodes (p Conclusions TD is common among travellers, but the overall course is mild, not requiring treatment. The incidence rates for first and second episodes are comparable. Female sex is a risk factor for the first episode, as well as subsequent ones. Prescription antibiotics are not needed in short-term healthy travellers.

  4. Short communication: Association of disease incidence and adaptive immune response in Holstein dairy cows.

    Science.gov (United States)

    Thompson-Crispi, K A; Hine, B; Quinton, M; Miglior, F; Mallard, B A

    2012-07-01

    The objective of this study was to use previously calculated estimated breeding values for cell- (CMIR) and antibody-mediated immune responses (AMIR) to determine associations between immune response (IR) and economically important diseases of dairy cattle. In total, 699 Holsteins were classified as high, average, or low for CMIR, AMIR, and overall IR (combined CMIR and AMIR), and associations with mastitis, metritis, ketosis, displaced abomasums, and retained fetal membranes were determined. The incidence of mastitis was higher among average cows as compared with cows classified as high AMIR [odds ratio (OR)=2.5], high CMIR (OR=1.8), or high IR (OR=1.8). Low-CMIR cows had a higher incidence of metritis (OR=11.3) and low-IR cows had a higher incidence of displaced abomasum (OR=4.1) and retained fetal membrane (OR=2.8) than did average responders. Results of this study show that cows classified as high immune responders have lower occurrence of disease, suggesting that breeding cattle for enhanced IR may be a feasible approach to decrease the incidence of infectious and metabolic diseases in the dairy industry. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  5. Brevibacterium casei as a cause of brain abscess in an immunocompetent patient.

    Science.gov (United States)

    Kumar, V Anil; Augustine, Deepthi; Panikar, Dilip; Nandakumar, Aswathy; Dinesh, Kavitha R; Karim, Shamsul; Philip, Rosamma

    2011-12-01

    Coryneform bacteria belonging to the genus Brevibacterium have emerged as opportunistic pathogens. Of the nine known species of Brevibacterium isolated from human clinical samples, Brevibacterium casei is the most frequently reported species from clinical specimens. We report the first case of B. casei brain abscess in an immunocompetent patient successfully treated by surgery and antimicrobial therapy.

  6. Combined influence of multiple climatic factors on the incidence of bacterial foodborne diseases.

    Science.gov (United States)

    Park, Myoung Su; Park, Ki Hwan; Bahk, Gyung Jin

    2018-01-01

    Information regarding the relationship between the incidence of foodborne diseases (FBD) and climatic factors is useful in designing preventive strategies for FBD based on anticipated future climate change. To better predict the effect of climate change on foodborne pathogens, the present study investigated the combined influence of multiple climatic factors on bacterial FBD incidence in South Korea. During 2011-2015, the relationships between 8 climatic factors and the incidences of 13 bacterial FBD, were determined based on inpatient stays, on a monthly basis using the Pearson correlation analyses, multicollinearity tests, principal component analysis (PCA), and the seasonal autoregressive integrated moving average (SARIMA) modeling. Of the 8 climatic variables, the combination of temperature, relative humidity, precipitation, insolation, and cloudiness was significantly associated with salmonellosis (Pclimatic factors. These findings indicate that the relationships between multiple climatic factors and bacterial FBD incidence can be valuable for the development of prediction models for future patterns of diseases in response to changes in climate. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Incidence of diseases primarily affecting the skin by age group: population-based epidemiologic study in Olmsted County, Minnesota, and comparison with age-specific incidence rates worldwide.

    Science.gov (United States)

    Wessman, Laurel L; Andersen, Louise K; Davis, Mark D P

    2018-01-29

    Understanding the effects of age on the epidemiology of diseases primarily affecting the skin is important to the practice of dermatology, both for proper allocation of resources and for optimal patient-centered care. To fully appreciate the effect that age may have on the population-based calculations of incidence of diseases primarily affecting the skin in Olmsted County, Minnesota, and worldwide, we performed a review of all relevant Rochester Epidemiology Project-published data and compared them to similar reports in the worldwide English literature. Using the Rochester Epidemiology Project, population-based epidemiologic studies have been performed to estimate the incidence of specific skin diseases over the past 50 years. In older persons (>65 years), nonmelanoma skin cancer, lentigo maligna, herpes zoster, delusional infestation, venous stasis syndrome, venous ulcer, and burning mouth syndrome were more commonly diagnosed. In those younger than 65 years, atypical nevi, psoriatic arthritis, pityriasis rosea, herpes progenitalis, genital warts, alopecia areata, hidradenitis suppurativa, infantile hemangioma, Behçet's disease, and sarcoidosis (isolated cutaneous, with sarcoidosis-specific cutaneous lesions and with erythema nodosum) had a higher incidence. Many of the incidence rates by age group of diseases primarily affecting the skin derived from the Rochester Epidemiology Project were similar to those reported elsewhere. © 2018 The International Society of Dermatology.

  8. Pulmonary fungal infection: Imaging findings in immunocompetent and immunocompromised patients

    International Nuclear Information System (INIS)

    Chong, Semin; Lee, Kyung Soo; Yi, Chin A; Chung, Myung Jin; Kim, Tae Sung; Han, Joungho

    2006-01-01

    Histoplasmosis is the most common endemic mycosis in North America, and is followed by coccidioidomycosis and blastomycosis. Although the majority of these infections in immunocompetent persons are self-limited, some patients can develop severe pneumonitis or various forms of chronic pulmonary infection. Cryptococcoci, Aspergillus, Candidas, and Mucorals are ubiquitous organisms, which may affect immunocompromised patients. Specific imaging findings can be expected, depending on the organisms involved, underlying patients' conditions (immune status), and specific situations after immune depleting procedures

  9. Occupational diseases in the Netherlands: incidence, type, consequences and risk factors: abstract and presentation

    NARCIS (Netherlands)

    Venema, A.; Steenbeek, R.; Dam, L. van; Vroome, E. de

    2017-01-01

    Objectives: Occupational diseases are common and result in a substantial disease burden and high sickness absence. Reliable data on the incidence and a better understanding of the risk factors will help to develop preventive measures. Methods: Several sources of measuring occupational diseases were

  10. Comparison of chest-CT findings of Influenza virus-associated pneumonia in immunocompetent vs. immunocompromised patients

    Energy Technology Data Exchange (ETDEWEB)

    Kloth, C., E-mail: christopher.kloth@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen (Germany); Forler, S.; Gatidis, S. [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen (Germany); Beck, R. [Institute of Medical Virology and Epidemiology of Viral Diseases, Eberhard-Karls-University, Elfriede-Aulhorn-Straße 6, 72076 Tübingen (Germany); Spira, D.; Nikolaou, K.; Horger, M. [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen (Germany)

    2015-06-15

    Highlights: • Patterns of pulmonary infiltration caused by Influenza viruses do not significantly differ between immunocompetent and immunocompromised patients or between different types and subtypes of Influenza virus. • Patterns of pulmonary infiltration caused by Influenza viruses seem to be interchangeable which might in part explain the great overlap in CT-imaging findings that has been reported in the past. • Interestingly, pattern transition from interstitial into airway-centric pattern seems to be frequent in immunocompromised patients receiving specific antiviral therapy, whereas the conversion of the airway-centric pattern into an interstitial pattern was observed more frequent in immunocompetent patients developing ARDS. - Abstract: Purpose: To retrospectively compare CT-patterns of pulmonary infiltration caused by different Influenza virus types and subtypes in immunocompetent and immunocompromised patients for possible discrimination. Materials and methods: Retrospective database search at our institution yielded 237 patients who were tested positive for Influenza virus type A or type B by bronchoalveolar lavage between January 2009 and April 2014. Fifty-six of these patients (female 26; male 30; median age 55.8 y, range 17–86 y; SD ± 14.4 y) underwent chest-HRCT due to a more severe clinical course of pulmonary infection. We registered all CT-findings compatible with pulmonary infection classifying them as airway predominant (tree-in-bud, centrilobular nodules, bronchial wall thickening ± peribronchial ground-glass opacity and consolidation) vs. interstitial-parenchymal predominant (bilateral, symmetrical GGO, consolidation, crazy paving and/or interlobular septal thickening). Twenty-six patients (46.4%) had follow-up CT-studies (0.78 mean, SD ± 5.8 scans). Results: Thirty-six patients were immunocompromised (group I) whereas 20 patients were immunocompetent (group II). An airway-centric pattern of infection was found in 15 patients (group

  11. Protein Interaction-Based Genome-Wide Analysis of Incident Coronary Heart Disease

    DEFF Research Database (Denmark)

    Jensen, Majken Karoline; Pers, Tune Hannes; Dworzynski, Piotr

    2011-01-01

    in genes associated with risk of coronary heart disease (CHD). Methods and Results-Genome-wide association analyses of approximately approximate to 700 000 single-nucleotide polymorphisms in 899 incident CHD cases and 1823 age-and sex-matched controls within the Nurses' Health and the Health Professionals...... complex. Conclusions-The integration of a GWA study with PPI data successfully identifies a set of candidate susceptibility genes for incident CHD that would have been missed in single-marker GWA analysis. (Circ Cardiovasc Genet. 2011; 4:549-556.)...

  12. Molecular detection and species identification of Enterocytozoon bieneusi isolated from immunocompetent Orang Asli in Malaysia.

    Science.gov (United States)

    Ashikin, Azah; Al-Mekhlafi, Hesham M; Moktar, Norhayati; Anuar, Tengku Shahrul

    2017-04-01

    Most studies of opportunistic infections focus on immunocompromised patients. However, there is a lack of information on microsporidiosis in healthy people (immunocompetent) worldwide. This study aimed to detect and identify microsporidia species in immunocompetent Orang Asli living in Pahang, Malaysia. Orang Asli is a collective term for a group of indigenous people that usually reside in the interior regions of Peninsular Malaysia. They comprise about 0.7% of the total population in Malaysia and 76% of them lived below the poverty line i.e., poor housing conditions with the lack of access to safe drinking water and adequate sanitation, contaminated environment, high illiteracy rate and unhygienic practices by these people. Stool samples were collected from 209 Orang Asli and analyzed for detecting the presence of Enterocytozoon bieneusi and Encephalitozoon intestinalis by polymerase chain reaction assay targeting small subunit ribosomal RNA gene. E. bieneusi was detected in 8 individuals (3.83%). This infection was commonly found in males than females (5.2% vs. 2.7%). All infected Orang Asli were adults, with a mean age of 44years. Diarrhea and other gastrointestinal symptoms were reported in one case (12.5%) among individuals infected with this species. These findings clearly show that exposure to E. bieneusi may actually be common than reported. The accurate detection and identification of microsporidian species by molecular technique will improve therapy, clinical manifestations and prognosis of this infection, as no antiparasitic therapy has been approved for E. bieneusi. It is hoped that these findings will allow the formulation of better health management and disease prevention advisories, and improvement in the standards of health in similar communities. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Declining trend in the incidence of biopsy-verified coeliac disease in the adult population of Finland, 2005-2014.

    Science.gov (United States)

    Virta, L J; Saarinen, M M; Kolho, K-L

    2017-12-01

    The frequency of coeliac disease (CD) has been on the rise over the past decades, especially in Western Europe, but current trends are unclear. To research the recent temporal changes in the incidence of adult, biopsy-verified coeliac disease and dermatitis herpetiformis (DH) in Finland, a country with a high frequency of coeliac disease. All coeliac disease and DH cases diagnosed at age 20-79 years during 2005-2014 were retrieved from a nationwide database documenting all applicants for monthly compensation to cover the extra cost of maintaining a gluten-free diet. This benefit is granted on the basis of histology, not socioeconomic status. Temporal trends in the annual incidences were estimated using Poisson regression analyses. The total incidence of coeliac disease decreased from 33/100 000 during the years 2005-2006 to 29/100 000 during 2013-2014. The mean annual incidence of coeliac disease was nearly twice as high among women as among men, 42 vs 22 per 100 000, respectively. For middle- and old-aged women, the average rate of decrease in incidence was 4.8% (95% CI 3.9-5.7) per year and for men 3.0% (1.8-4.1) (P for linear trend adults, the rate of change remained low and nonsignificant throughout the period 2005-2014. Although the awareness of coeliac disease has increased during the past decades, the incidence of biopsy-verified diagnoses is not increasing, which suggests that exposure to yet unidentified triggering factors for coeliac disease has plateaued among the Finnish adult population. © 2017 John Wiley & Sons Ltd.

  14. Pelvic incidence-lumbar lordosis mismatch predisposes to adjacent segment disease after lumbar spinal fusion.

    Science.gov (United States)

    Rothenfluh, Dominique A; Mueller, Daniel A; Rothenfluh, Esin; Min, Kan

    2015-06-01

    Several risk factors and causes of adjacent segment disease have been debated; however, no quantitative relationship to spino-pelvic parameters has been established so far. A retrospective case-control study was carried out to investigate spino-pelvic alignment in patients with adjacent segment disease compared to a control group. 45 patients (ASDis) were identified that underwent revision surgery for adjacent segment disease after on average 49 months (7-125), 39 patients were selected as control group (CTRL) similar in the distribution of the matching variables, such as age, gender, preoperative degenerative changes, and numbers of segments fused with a mean follow-up of 84 months (61-142) (total n = 84). Several radiographic parameters were measured on pre- and postoperative radiographs, including lumbar lordosis measured (LL), sacral slope, pelvic incidence (PI), and tilt. Significant differences between ASDis and CTRL groups on preoperative radiographs were seen for PI (60.9 ± 10.0° vs. 51.7 ± 10.4°, p = 0.001) and LL (48.1 ± 12.5° vs. 53.8 ± 10.8°, p = 0.012). Pelvic incidence was put into relation to lumbar lordosis by calculating the difference between pelvic incidence and lumbar lordosis (∆PILL = PI-LL, ASDis 12.5 ± 16.7° vs. CTRL 3.4 ± 12.1°, p = 0.001). A cutoff value of 9.8° was determined by logistic regression and ROC analysis and patients classified into a type A (∆PILL lordosis mismatch. In type A spino-pelvic alignment, 25.5 % of patients underwent revision surgery for adjacent segment disease, whereas 78.3 % of patients classified as type B alignment had revision surgery. Classification of patients into type A and B alignments yields a sensitivity for predicting adjacent segment disease of 71 %, a specificity of 81 % and an odds ratio of 10.6. In degenerative disease of the lumbar spine a high pelvic incidence with diminished lumbar lordosis seems to predispose to adjacent segment disease. Patients with such pelvic incidence

  15. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases

    Science.gov (United States)

    Gabriel, Sherine E; Michaud, Kaleb

    2009-01-01

    Epidemiology is the study of the distribution and determinants of disease in human populations. Over the past decade there has been considerable progress in our understanding of the fundamental descriptive epidemiology (levels of disease frequency: incidence and prevalence, comorbidity, mortality, trends over time, geographic distributions, and clinical characteristics) of the rheumatic diseases. This progress is reviewed for the following major rheumatic diseases: rheumatoid arthritis (RA), juvenile rheumatoid arthritis, psoriatic arthritis, osteoarthritis, systemic lupus erythematosus, giant cell arteritis, polymyalgia rheumatica, gout, Sjögren's syndrome, and ankylosing spondylitis. These findings demonstrate the dynamic nature of the incidence and prevalence of these conditions – a reflection of the impact of genetic and environmental factors. The past decade has also brought new insights regarding the comorbidity associated with rheumatic diseases. Strong evidence now shows that persons with RA are at a high risk for developing several comorbid disorders, that these conditions may have atypical features and thus may be difficult to diagnose, and that persons with RA experience poorer outcomes after comorbidity compared with the general population. Taken together, these findings underscore the complexity of the rheumatic diseases and highlight the key role of epidemiological research in understanding these intriguing conditions. PMID:19519924

  16. Incidence of and mortality from kidney disease in over 600,000 insured Swedish dogs.

    Science.gov (United States)

    Pelander, L; Ljungvall, I; Egenvall, A; Syme, H; Elliott, J; Häggström, J

    2015-06-20

    Kidney disease is an important cause of morbidity and mortality in dogs. Knowledge about the epidemiology of kidney disease in the dog population is valuable and large-scale epidemiological studies are needed. The aim of the present study was to use insurance data to estimate kidney-related morbidity and mortality in the Swedish dog population. Insurance company data from insured dogs during the years 1995-2006 were studied retrospectively. Incidence and mortality were calculated for the whole group of dogs as well as divided by sex and breed. The total number of veterinary care insured dogs was 665,245. The total incidence of kidney disease in this group of dogs was 15.8 (15.3-16.2) cases/10,000 dog-years at risk. The number of dogs in the life insurance was 548,346 and in this group the total kidney-related mortality was 9.7 (9.3-10.2) deaths/10,000 dog-years at risk. The three breeds with the highest incidence of kidney disease were the Bernese mountain dog, miniature schnauzer and boxer. The three breeds with the highest mortality caused by kidney disease were the Bernese mountain dog, Shetland sheepdog and flat-coated retriever. In conclusion, the epidemiological information provided in this study concerning kidney disease in dogs can provide valuable information for future research. British Veterinary Association.

  17. Comparing the Incidence of Falls/Fractures in Parkinson's Disease Patients in the US Population.

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    Linda Kalilani

    Full Text Available Patients with Parkinson's disease (PD may experience falls and/or fractures as a result of disease symptoms. There are limited data available from long-term studies estimating the incidence of falls/fractures in patients with PD. The objective was to compare the incidence rate of falls/fractures in PD patients with non-PD patients in a US population. This was a retrospective study using a US-based claims database (Truven Health MarketScan® that compared the incidence rate of falls/fractures in PD subjects with non-PD subjects. The study period included the 12 months prior to index date (defined as earliest PD diagnosis [International Classification of Diseases, Ninth Revision, Clinical Modification code 332.0] and a postindex period to the end of data availability. Fractures were defined by inpatient/outpatient claims as a principal or secondary diagnosis and accompanying procedure codes during the postindex period. Incidence rates and 95% CIs for falls/fractures were calculated as the number of events per 10,000 person-years of follow-up using negative binomial or Poisson regression models. Twenty-eight thousand two hundred and eighty PD subjects were matched to non-PD subjects for the analysis (mean [SD] age, 71.4 [11.8] years; 53% male. A higher incidence rate (adjusted for comorbidities and medications of all fall/fracture cases and by fall and fracture types was observed for PD subjects versus non-PD subjects; the overall adjusted incidence rate ratio comparing PD to non-PD subjects was 2.05; 95% CI, 1.88-2.24. The incidence rate of falls/fractures was significantly higher in subjects with PD compared with non-PD subjects in a US population.

  18. Disseminated cutaneous sporotrichosis associated with ocular lesion in an immunocompetent patient*

    Science.gov (United States)

    Medeiros, Karina Bittencourt; Landeiro, Luana Gomes; Diniz, Lucia Martins; Falqueto, Aloísio

    2016-01-01

    A 59-year-old female patient, previously healthy, immunocompetent, presented left bulbar conjunctiva lesions and nodular-ulcerated lesions on the arms and cervical region, besides left cervical and retroauricular lymphadenopathy. She had previous contact with domestic cats that excoriated her face. The diagnosis was conclusive of disseminated sporotrichosis through clinical and epidemiological history and cultures of skin and ocular secretions. It evolved with good response to oral antifungal therapy. PMID:27579758

  19. Disseminated cutaneous sporotrichosis associated with ocular lesion in an immunocompetent patient.

    Science.gov (United States)

    Medeiros, Karina Bittencourt; Landeiro, Luana Gomes; Diniz, Lucia Martins; Falqueto, Aloísio

    2016-01-01

    A 59-year-old female patient, previously healthy, immunocompetent, presented left bulbar conjunctiva lesions and nodular-ulcerated lesions on the arms and cervical region, besides left cervical and retroauricular lymphadenopathy. She had previous contact with domestic cats that excoriated her face. The diagnosis was conclusive of disseminated sporotrichosis through clinical and epidemiological history and cultures of skin and ocular secretions. It evolved with good response to oral antifungal therapy.

  20. Incidence, epidemiology and clinical features of Kawasaki disease in Catalonia, Spain.

    Science.gov (United States)

    Sánchez-Manubens, Judith; Antón, Jordi; Bou, Rosa; Iglesias, Estíbaliz; Calzada-Hernandez, Joan

    2016-01-01

    To assess the incidence, epidemiology and clinical features of Kawasaki disease (KD) in Catalonia (northeast region of Spain). This was an observational population-based study including all Paediatric Units in Catalonia, under both public and private management. Retrospective data retrieval was performed for 10 years (2004-2013). A 12-month (March 2013 to March 2014) prospective collection of new cases of KD was carried out to determine the incidence of KD. Data from 399 patients over the 10-year study period was analysed, revealing that 233 (58.4%) had complete KD, 159 (39.8) incomplete KD and 7 (1.7%) were considered atypical KD. Mean annual incidence was 3.5/105 children 10(th) day of illness, ages 8 yo and the presence of sterile piuria, aseptic meningitis, abdominal pain and uveitis at diagnosis were found to have higher risk of coronary aneurisms (CAA) (pIncidence, clinical features and treatment plans in our cohort are similar to those described in other European studies.

  1. Increased Kawasaki Disease Incidence Associated With Higher Precipitation and Lower Temperatures, Japan, 1991-2004.

    Science.gov (United States)

    Abrams, Joseph Y; Blase, Jennifer L; Belay, Ermias D; Uehara, Ritei; Maddox, Ryan A; Schonberger, Lawrence B; Nakamura, Yosikazu

    2018-06-01

    Kawasaki disease (KD) is an acute febrile vasculitis, which primarily affects children. The etiology of KD is unknown; while certain characteristics of the disease suggest an infectious origin, genetic or environmental factors may also be important. Seasonal patterns of KD incidence are well documented, but it is unclear whether these patterns are caused by changes in climate or by other unknown seasonal effects. The relationship between KD incidence and deviations from expected temperature and precipitation were analyzed using KD incidence data from Japanese nationwide epidemiologic surveys (1991-2004) and climate data from 136 weather stations of the Japan Meteorological Agency. Seven separate Poisson-distributed generalized linear regression models were run to examine the effects of temperature and precipitation on KD incidence in the same month as KD onset and the previous 1, 2, 3, 4, 5 and 6 months, controlling for geography as well as seasonal and long-term trends in KD incidence. KD incidence was negatively associated with temperature in the previous 2, 3, 4 and 5 months and positively associated with precipitation in the previous 1 and 2 months. The model that best predicted variations in KD incidence used climate data from the previous 2 months. An increase in total monthly precipitation by 100 mm was associated with increased KD incidence (rate ratio [RR] 1.012, 95% confidence interval [CI]: 1.005-1.019), and an increase of monthly mean temperature by 1°C was associated with decreased KD incidence (RR 0.984, 95% CI: 0.978-0.990). KD incidence was significantly affected by temperature and precipitation in previous months independent of other unknown seasonal factors. Climate data from the previous 2 months best predicted the variations in KD incidence. Although fairly minor, the effect of temperature and precipitation independent of season may provide additional clues to the etiology of KD.

  2. Human methanogen diversity and incidence in healthy and diseased colonic groups using mcrA gene analysis

    Directory of Open Access Journals (Sweden)

    Scanlan Pauline D

    2008-05-01

    Full Text Available Abstract Background The incidence and diversity of human methanogens are insufficiently characterised in the gastrointestinal tract of both health and disease. A PCR and clone library methodology targeting the mcrA gene was adopted to facilitate the two-fold aim of surveying the relative incidence of methanogens in health and disease groups and also to provide an overview of methanogen diversity in the human gastrointestinal tract. Results DNA faecal extracts (207 in total from a group of healthy controls and five gastrointestinal disease groups were investigated. Colorectal cancer, polypectomised, irritable bowel syndrome and the control group had largely equivalent numbers of individuals positive for methanogens (range 45–50%. Methanogen incidence in the inflammatory bowel disease groups was reduced, 24% for ulcerative colitis and 30% for Crohn's disease. Four unique mcrA gene restriction fragment length polymorphism profiles were identified and bioinformatic analyses revealed that the majority of all sequences (94% retrieved from libraries were 100% identical to Methanobrevibacter smithii mcrA gene. In addition, mcrA gene sequences most closely related to Methanobrevibacter oralis and members of the order Methanosarcinales were also recovered. Conclusion The mcrA gene serves as a useful biomarker for methanogen detection in the human gut and the varying trends of methanogen incidence in the human gut could serve as important indicators of intestinal function. Although Methanobrevibacter smithii is the dominant methanogen in both the distal colon of individuals in health and disease, the diversity of methanogens is greater than previously reported. In conclusion, the low incidence of methanogens in Inflammatory Bowel Disease, the functionality of the methanogens and impact of methane production in addition to competitive interactions between methanogens and other microbial groups in the human gastrointestinal tract warrants further

  3. Annual incidence of occupational diseases in economic sectors in The Netherlands

    NARCIS (Netherlands)

    van der Molen, Henk F.; Kuijer, P. Paul F. M.; Smits, Paul B. A.; Schop, Astrid; Moeijes, Fred; Spreeuwers, Dick; Frings-Dresen, Monique H. W.

    2012-01-01

    Objective To report the annual incidence of occupational diseases (ODs) in economic sectors in The Netherlands. Methods In a 5-year prospective cohort study (2009-2013), occupational physicians were asked to participate in a sentinel surveillance system for OD notification. The inclusion criteria

  4. Efficiency of radioiodine therapy in Graves disease and adenoma toxicum and incidence of hypothyroidism

    International Nuclear Information System (INIS)

    Petrovski, Z.P.

    2002-01-01

    The aim of the this study was to evaluate different states in hyperthyroid patients and incidence of hypothyroidism after I-131 therapy.We observed a total of 184 hyperthyroid pts, from which 108(58,7%)pts with Graves' disease,65(35,3%)pts with single toxicum nodule and 11(6%)pts with toxicum multinodular goitre,treated with radioiodine therapy during the period 1986-2001.Dose of I-131 orally administered ranged 150-1100MBq and was calculated according to the 'MBq/gram' method.The radioiodine-131 therapy was performed once in 69,5%(128/184)pts,twice in 21,2%(39/184)pts and in 9,3%(17/184)pts more than two doses. Completely cured of hyperthyroidism occurred in 61%(66/108)pts with Graves' disease,81,8%(9/11)pts with toxic multinodular goiter and 90,7%(59/65)pts with single toxic nodule. The patients in our study were evaluated 6 months to 15 years after received J-131 therapy. Incidence of early hypothyroidism within one year was 23,1%(25/108) in Graves' disease,9%(1/11) in toxic multinodular goiter and 4,6%(3/65) with single toxicum nodule.Overall incidence of hypothyroidism within one year was 17,6% and had cumulative increase of Graves' disease every following year approximately for 3%,while for adenoma toxicum there was no any significant changes. We concluded that radioiodine therapy is simple,comfortable radical method for medical treatment of hyperthyroidism and indicate higher incidence of hypothyroidism in patients treated with I-131 for Graves' disease than that of patients treated for toxicum multinodular goiters and single toxic nodule

  5. Increasing prevalence and high incidence of celiac disease in elderly people: a population-based study.

    Science.gov (United States)

    Vilppula, Anitta; Kaukinen, Katri; Luostarinen, Liisa; Krekelä, Ilkka; Patrikainen, Heikki; Valve, Raisa; Mäki, Markku; Collin, Pekka

    2009-06-29

    Celiac disease may emerge at any age, but little is known of its appearance in elderly people. We evaluated the prevalence of the condition in individuals over 55 years of age, and determined the incidence of biopsy-proven celiac disease (CDb) and celiac disease including seropositive subjects for anti-tissue transglutaminase antibodies (CDb+s). The study based on prevalence figures in 2815 randomly selected subjects who had undergone a clinical examination and serologic screening for celiac disease in 2002. A second screening in the same population was carried out in 2005, comprising now 2216 individuals. Positive tissue transglutaminase antibodies were confirmed with small bowel biopsy. Within three years the prevalence of CDb increased from 2.13 to 2.34%, and that of CDb+s from 2.45 to 2.70%. Five new cases were found among patients previously seronegative; two had minor abdominal symptoms and three were asymptomatic. The incidence of celiac disease in 2002-2005 was 0.23%, giving an annual incidence of 0.08% in this population. The prevalence of celiac disease was high in elderly people, but the symptoms were subtle. Repeated screening detected five biopsy-proven cases in three years, indicating that the disorder may develop even in the elderly. Increased alertness to the disorder is therefore warranted.

  6. Incidence of Congenital Heart Diseases Anomalies in Newborns with Oral Clefts, Zahedan, Iran

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    Noor Mohammad Noori

    2016-09-01

    Full Text Available Background Oral cleft is the most common orofacial congenital anomaly among live births. This anomaly at birth is one of the main causes of children disability and mortality.  Congenital heart disease (CHD is one of the most common anomalies in oral clefts.  This study aimed to assess the incidence of congenital heart diseases anomalies in newborns with oral clefts. Materials and Methods This study performed on 48,692 live born to estimate incidence of oral clefts from 1 st December 2013 to 31 th November 2015 from three general hospitals in Zahedan, The capital city of the Sistan & Baluchestan  province, Iran. All oral cleft patients were under echocardiography to diagnosis the incidence of CHD as associated anomaly. The collected data were processed using SPSS-16. Results The results of the analysis showed that the incidence of cleft lip was higher in boys than girls, while the cleft palate was higher in girls. Lip/palate cleft was higher for boys.  Oral clefts patients accounted of 102 (0.2% with incidence rate of 2.095 per 1000 lives. Of 102 patients 19 (18.62%, 39(35.24% and 44(43.14% were oral lip, oral palate and both respectively. The incidence of CHD in patients with oral clefts was 26.5%, while the incidences for cleft lip, cleft palate and both were 15.79%, 20.51%, and 36.36% respectively. Conclusion From the study concluded that the rate of CHD among children with oral clefts was high compared with the healthy children.  Strongly is suggested the echocardiography for these patients to have early diagnostic of CHD to manage any life-threatening.

  7. Incidence Trends and Geographical Variability of Pediatric Inflammatory Bowel Disease in Slovenia: A Nationwide Study.

    Science.gov (United States)

    Urlep, Darja; Blagus, Rok; Orel, Rok

    2015-01-01

    The aims of the study were to determine the incidence rate of pediatric inflammatory bowel disease (PIBD) and its trends for the period of 2002-2010 and to assess the geographical distribution of PIBD in Slovenia. Medical records of patients (0-18 years) with newly diagnosed IBD during the study period were retrospectively reviewed. The mean incidence rate for IBD in 2002-2010 was 7.6 per 100,000 children and adolescents per year, 4.5 for Crohn's disease (CD), 2.9 for ulcerative colitis (UC), and 0.2 for IBD-unclassified, respectively. The incidence rate increased from 5.8 per 100,000 per year in 2002-2004 to 8.6 in 2005-2007 and remained stable afterwards. Statistically significant difference in the incidence rate between the Northeastern and Southwestern parts of the country was observed (p = 0.025). This nationwide study demonstrates that Slovenia is among the European countries with the highest PIBD incidence. During the study period a substantial rise of PIBD incidence was observed during the first half of the study and it seems to have stabilized in the second half. The significant difference in PIBD incidence between Northeastern and Southwestern parts of the country merits further exploration of the possible environmental factors.

  8. Incidence Rate of Concomitant Systemic Diseases in the Aging Population with Postmenopausal Osteoporosis

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    Selçuk Sayılır

    2016-08-01

    Full Text Available Objective: To evaluate the concomitant systemic diseases with postmenopausal osteoporosis and to investigate the points to be considered in treatment approach of patients with osteoporosis. Materials and Methods: The study included 110 female patients admitted to our clinic and followed up after postmenopausal osteoporosis diagnosis. Besides the demographic data; the concomitant diseases of the patients such as hypertension, hypo-hyperthyroidism, diabetes mellitus, Alzheimer’s disease, malignancy, osteoarthritis, gastrointestinal system diseases, chronic obstructive pulmonary disease (COPD- asthma and depression were also recorded. Results: The mean age of the patients included in our study was 65.9±9.8 years. When the concomitant systemic diseases were examined; 40 patients had hypertension, 32 patients had osteoarthritis, 24 patients had gastrointestinal tract problems, 22 patients had thyroid disease, 21 patients had depression, 15 patients had hyperlipidemia, 12 patients had diabetes mellitus, 10 patients had COPD - asthma, 7 patients had cardiac diseases, 5 patients had malignancy and 2 patients had Alzheimer disease. Conclusion: Osteoporosis is a common disease in the geriatric population. As a chronic disease with an increasing incidence with aging; it can cause many health problems, prevalently pathological bone fractures, in our country and all over the world. Constitutively, prophylaxis of osteoporosis should be the first step. Because systemic diseases with increasing incidence with aging may affect the severity of osteoporosis and impair the treatment; it is important for both clinicians and the society to have sufficient information about osteoporosis.

  9. Gardening can induce pulmonary failure: Aspergillus ARDS in an immunocompetent patient, a case report.

    Science.gov (United States)

    Jung, Nina; Mronga, Silke; Schroth, Susanne; Vassiliou, Timon; Sommer, Frank; Walthers, Eduard; Aepinus, Christian; Jerrentrup, Andreas; Vogelmeier, Claus; Holland, Angelique; Koczulla, Rembert

    2014-11-26

    Acute Aspergillus fumigatus infection in immunocompetent patients is rare. This is the first known case of a patient who survived Aspergillus sepsis after being treated early with veno-venous extracorporeal membrane (ECMO) and antifungal therapy. An immunocompetent 54-year-old woman was exposed to plant mulch during gardening and subsequently developed pulmonary failure that progressed to sepsis with multiorgan failure. Owing to her severe clinical condition, she was treated for acute respiratory distress syndrome (ARDS) with veno-venous ECMO. Empiric antifungal therapy comprising voriconazole was also initiated owing to her history and a previous case report of aspergillosis after plant mulch exposure, though there was no microbiological proof at the time. A. fumigatus was later cultured and detected on antibody testing. The patient recovered, and ECMO was discontinued 1 week later. After 7 days of antifungal treatment, Aspergillus antibodies were undetectable. In cases of sepsis that occur after gardening, clinicians should consider Aspergillus inhalation as an aetiology, and early antimycotic therapy is recommended.

  10. Evaluation of the impact of disease prevention measures: a methodological note on defining incidence rates

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    Yin-Bun Cheung

    2017-04-01

    Full Text Available Abstract Background In studies of recurrent events, it is common to consider a person who has suffered a disease episode and received curative treatment to be not at risk of suffering a new episode for a duration of time. It is a common practice to deduct this duration from the person’s observation time in the statistical analysis of the incidence data. Methods We examined the concepts of incidence and protective efficacy from a real life point of view. We developed simple formulae to show the relationship between the incidence rate and protective efficacy between analyses with and without deducting the curative treatment time from the observation time. We used a malaria chemoprevention and a malaria vaccine study, both previously published, to illustrate the differences. Results Applying the formulae we derived to a range of disease incidence that covered the two case studies, we demonstrated the divergence of the two sets of estimates when incidence rate is approximately 1 per person-year or higher. In the malaria chemoprevention study, incidence was 5.40 per person-year after the deduction of curative treatment time from observation time but 4.48 per person-year without the deduction. The chemoprevention offered 56.6 and 50.7% protection calculated with and without the deduction, respectively. In the malaria vaccine study, where disease incidence was much lower than one, the results between the two ways of analysis were similar. For answering real life questions about disease burden in the population in a calendar year and the reduction that may be achieved if an intervention is implemented, the definition without deduction of curative treatment time should be used. Conclusions The practice of deducting curative treatment time from observation time is not wrong, but it is not always the best approach. Investigators should consider the appropriateness of the two analytic procedures in relation to the specific research aims and the intended

  11. Detection of human papillomavirus in nonmelanoma skin cancer lesions and healthy perilesional skin in kidney transplant recipients and immunocompetent patients.

    Science.gov (United States)

    Bernat-García, J; Morales Suárez-Varela, M; Vilata-Corell, J J; Marquina-Vila, A

    2014-04-01

    The influence of human papillomavirus (HPV) on the development of nonmelanoma skin cancer (NMSC) is a topic of debate. HPV types from the beta genus (HPV-β) have been most frequently associated with the development of skin cancer. To analyze the prevalence and range of HPV types in NMSC lesions and healthy perilesional skin in immunodepressed and immunocompetent patients and to evaluate the influence of various clinical factors on the prevalence of HPV in skin cancer. Nested polymerase chain reaction and sequencing were used to detect HPV in 120 NMSC samples obtained by biopsy from 30 kidney transplant recipients and 30 immunocompetent patients. In all cases, a sample was taken from the tumor site and the surrounding healthy skin. Potential confounders were assessed and the data analyzed by multivariate logistic regression. HPV DNA was detected in 44 (73.3%) of the 60 samples from immunodepressed patients and in 32 (53.3%) of the 60 samples from immunocompetent patients (adjusted odds ratio, 3.4; 95% CI, 1.2-9.6). In both groups of patients, HPV was more common in healthy perilesional skin than in lesional skin. HPV-β was the most common type isolated. We found a wide range of HPV types (mostly HPV-β) in the skin of kidney transplant recipients and immunocompetent patients with skin cancer. Copyright © 2013 Elsevier España, S.L. and AEDV. All rights reserved.

  12. Incident impulse control disorder symptoms and dopamine transporter imaging in Parkinson disease.

    Science.gov (United States)

    Smith, Kara M; Xie, Sharon X; Weintraub, Daniel

    2016-08-01

    To describe the incidence of, and clinical and neurobiological risk factors for, new-onset impulse control disorder (ICD) symptoms and related behaviours in early Parkinson disease (PD). The Parkinson's Progression Markers Initiative is an international, multicenter, prospective study of de novo patients with PD untreated at baseline and assessed annually, including serial dopamine transporter imaging (DAT-SPECT) and ICD assessment (Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease short form, QUIP). Participants were included if they screened negative on the QUIP at baseline. Kaplan-Meier curves and generalised estimating equations examined frequency and predictors of incident ICD symptoms. Participants were seen at baseline (n=320), year 1 (n=284), year 2 (n=217) and year 3 (n=96). Estimated cumulative incident rates of ICD symptoms and related behaviours were 8% (year 1), 18% (year 2) and 25% (year 3) and increased each year in those on dopamine replacement therapy (DRT) and decreased in those not on DRT. In participants on DRT, risk factors for incident ICD symptoms were younger age (OR=0.97, p=0.05), a greater decrease in right caudate (OR=4.03, p=0.01) and mean striatal (OR=6.90, p=0.04) DAT availability over the first year, and lower right putamen (OR=0.06, p=0.01) and mean total striatal (OR=0.25, p=0.04) DAT availability at any post-baseline visit. The rate of incident ICD symptoms increases with time and initiation of DRT in early PD. In this preliminary study, a greater decrease or lower DAT binding over time increases risk of incident ICD symptoms, conferring additional risk to those taking DRT. NCT01141023. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Carbohydrate moieties of microsporidian polar tube proteins are targeted by immunoglobulin G in immunocompetent individuals

    NARCIS (Netherlands)

    Peek, Ron; Delbac, Frédéric; Speijer, Dave; Polonais, Valérie; Greve, Sophie; Wentink-Bonnema, Ellen; Ringrose, Jeffrey; van Gool, Tom

    2005-01-01

    Microsporidia of the Encephalitozoon species are frequently found as opportunistic pathogens of immuno-compromised patients, but very little is known about the prevalence and significance of Encephalitozoon infection in immunocompetent individuals. It was reported previously that 8% of Dutch blood

  14. Spatial variability of disease incidence and mortality in the sea fan Gorgonia ventalina in Puerto Rico (Alcyonacea: Goorgoniidae

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    Anabella Zuluaga-Montero

    2012-06-01

    Full Text Available Populations of the common sea fan (Gorgonia ventalina were decimated by an aspergillosis outbreak throughout the Caribbean two decades ago. Since then, aspergillosis has been considered as the principal cause of mortality in sea fans. However, prevalence and presumably incidence of this disease have been declining in the Caribbean since the mid 1990s. Incidence indicates new cases of disease in previously healthy colonies, while prevalence indicates percent of diseased colonies at a given sample. Most coral disease studies use prevalence rather than incidence to assess the temporal dynamics of diseases. Nevertheless, conclusions based only on prevalence should be handled carefully to avoid misinterpretation. This study was carried out at six reefs in Eastern Puerto Rico. We monitored a total of 448 colonies to (1 obtain estimates of incidence and prevalence of disease and other types of lesions, and (2 to determine causes of sea fan mortality plus their spatial and temporal variation. Three transects (10x1m were haphazardly placed at each study site. At each transect, every colony was numbered and photographed and its height measured to the nearest cm. Transects were monitored at six months intervals and health status of the colonies was recorded. Also, the colonies were divided into height classes (small, medium and large for incidence, prevalence and mortality analyses. Incidence and prevalence of disease were low in all reefs, suggesting that disease currently plays a minor role in the regulation of sea fans populations. Detachment was the main cause of mortality, and size structure data suggest that recruitment may compensate for mortality rates in two of the reefs. Spatial differences in size structure and density may be related to environmental and physical characteristics at the reef scale that allow sea fans to reach a safe colony size. Rev. Biol. Trop. 60 (2: 517-526. Epub 2012 June 01.

  15. Incidence of cardiovascular and cerebrovascular disease in Danish men and women with a prolonged heavy alcohol intake

    DEFF Research Database (Denmark)

    Hvidtfeldt, Ulla Arthur; Frederiksen, M.E.; Thygesen, L.C.

    2008-01-01

    significant higher incidence rates than would be expected in a standard population were observed for cardiovascular diseases (e.g., ischemic heart diseases, men: SIR = 1.76; 95% CI 1.69-1.83; women: SIR = 2.44; 95% CI 2.19-2.73) and cerebrovascular diseases (e.g., hemorrhagic stroke, men: SIR = 2.71; 95% CI 2...... rates of cardio- and cerebrovascular diseases than the population in general. METHODS: The cohort comprised 19,185 subjects (15,368 men and 3,817 women) who attended outpatient clinics for alcohol abusers within the Copenhagen Hospital Corporation (1954 to 1992). Incidence rates were standardized (SIR......) according to sex, age and calendar time to compare subjects' cardio- and cerebrovascular incidence with that of the general population of Copenhagen. RESULTS: During the period 1977 to 2001 a total of 9,397 events of cardio- and cerebrovascular disease were observed. In both men and women, statistically...

  16. Perceived job insecurity as a risk factor for incident coronary heart disease

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Nyberg, Solja T; Batty, George David

    2013-01-01

    OBJECTIVE: To determine the association between self reported job insecurity and incident coronary heart disease. DESIGN: A meta-analysis combining individual level data from a collaborative consortium and published studies identified by a systematic review. DATA SOURCES: We obtained individual....... REVIEW METHODS: Prospective cohort studies that reported risk estimates for clinically verified incident coronary heart disease by the level of self reported job insecurity. Two independent reviewers extracted published data. Summary estimates of association were obtained using random effects models...... versus low job insecurity was 1.32 (95% confidence interval 1.09 to 1.59). The relative risk of job insecurity adjusted for sociodemographic and risk factors was 1.19 (1.00 to 1.42). There was no evidence of significant differences in this association by sex, age (

  17. Low incidence but poor prognosis of complicated coeliac disease: a retrospective multicentre study.

    Science.gov (United States)

    Biagi, Federico; Gobbi, Paolo; Marchese, Alessandra; Borsotti, Edoardo; Zingone, Fabiana; Ciacci, Carolina; Volta, Umberto; Caio, Giacomo; Carroccio, Antonio; Ambrosiano, Giuseppe; Mansueto, Pasquale; Corazza, Gino R

    2014-03-01

    Coeliac disease is a chronic enteropathy characterized by an increased mortality caused by its complications, mainly refractory coeliac disease, small bowel carcinoma and abdominal lymphoma. Aim of the study was to study the epidemiology of complications in patients with coeliac disease. Retrospective multicenter case-control study based on collection of clinical and laboratory data. The incidence of complicated coeliac disease was studied among coeliac patients directly diagnosed in four Italian centres. Patients referred to these centres after a diagnosis of coeliac disease and/or complicated coeliac disease in other hospitals were therefore excluded. Between 1/1999 and 10/2011, 1840 adult coeliac patients were followed up for 7364.3 person-years. Fourteen developed complications. Since five patients died, at the end of the observation period (10/2011), the prevalence of complicated coeliac disease was 9/1835 (1/204, 0.49%, 95% CI 0.2-0.9%). The annual incidence of complicated coeliac disease in the study period was 14/7364 (0.2%, 95% CI 0.1-0.31%). Although complications tend to occur soon after the diagnosis of coeliac disease, Kaplan-Meier curve analysis showed that they can actually occur at any time after the diagnosis of coeliac disease. Complications of coeliac disease in our cohort were quite rare, though characterised by a very high mortality. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  18. Primary central nervous system lymphoma with lymphomatosis cerebri in an immunocompetent child: MRI and 18F-FDG PET-CT findings.

    Science.gov (United States)

    Jain, Tarun K; Sharma, Punit; Suman, Sudhir K C; Faizi, Nauroze A; Bal, Chandrasekhar; Kumar, Rakesh

    2013-01-01

    Primary central nervous system lymphoma (PCNSL) is extremely rare in immunocompetent children. We present the magnetic resonance imaging (MRI) and (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography-computed tomography (PET-CT) findings of such a case in a 14-year old immunocompetent boy. In this patient, PCNSL was associated with lymphomatosis cerebri. Familiarity with the findings of this rare condition will improve the diagnostic confidence of the nuclear radiologist and avoid misdiagnosis. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  19. A case of infective endocarditis along with a ruptured valve caused by Streptococcus agalactiae in an immunocompetent man.

    Science.gov (United States)

    Suzuki, Kiyozumi; Hirai, Yuji; Morita, Fujiko; Uehara, Yuki; Oshima, Hiroko; Mitsuhashi, Kazunori; Amano, Atsushi; Naito, Toshio

    2016-01-01

    Streptococcus agalactiae ( S. agalactiae ) is a major cause of invasive disease in neonates and pregnant women, but has also recently been observed among non-pregnant adults, especially elderly persons or persons with underlying chronic disease. S. agalactiae is also a rare cause of infective endocarditis, and most cases require early surgery. We report the case of a 43-year-old previously healthy man who experienced rapid progressive culture-negative infective endocarditis with aortic valve vegetation and severe aortic regurgitation, which was complicated by lumbar spondylodiscitis. Emergency aortic valve replacement was performed on the day of his admission, which revealed a congenital bicuspid aortic valve was ruptured by the vegetation. The resected aortic valve specimen was submitted for 16S ribosomal RNA gene sequencing, which revealed that the pathogen was S. agalactiae . Therefore, S. agalactiae should be considered a potentially causative pathogen in cases of rapid progressive infective endocarditis, even if it occurs in a non-pregnant immunocompetent adult.

  20. Radiological diagnostic in cat stratch disease and bone lesions - a case report

    International Nuclear Information System (INIS)

    Abreu, Marcelo Rodrigues de

    1999-01-01

    Cat scratch disease is not a common disease in immunocompetent patients. Its association with bone lesions is rare. A patient with bone complain and radiologic alterations of bone lesion must be investigated for this disease. A simple story can make the differential diagnosis with more complex disease like Ewing sarcoma or eosinophilic granuloma. (author)

  1. Rhizopus-associated soft tissue infection in an immunocompetent air-conditioning technician after a road traffic accident: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Nada B. Rabie

    2012-02-01

    Full Text Available Summary: Rhinocerebral or sinopulmonary mucromycosis is a well-recognized human fungal infection found among immunocompromised and diabetic patients. However, the infection is rare among immunocompetent hosts. We are reporting the case of an adult immunocompetent male patient working as an air-conditioning technician. The patient was a victim of a road traffic accident (RTA and sustained multiple fractures in the proximal part of the left tibia, distal femur, and scapula. Two weeks postoperatively, Rhizopus microspores were isolated from an infected traumatic wound over the distal femur. Surgical debridement was performed, and the patient was started on amphotericin B. Occupational exposure history and workplace environmental sanitation are crucial for the prevention of this potentially fatal yet preventable infection. Keywords: Rhizopus, Immunocompetent, Air conditioning

  2. Effectiveness of BPMC Application against Bemisia tabaci (Gennadius Population and CMMV Disease Incidence on Soybean

    Directory of Open Access Journals (Sweden)

    Wartono Wartono

    2015-09-01

    Full Text Available Control of whitefly (Bemisia tabaci (Gennadius is the starting point in suppressing the CMMV disease (cowpea mild mottle virus. This study aims to determine the influence of applications BPMC (500 g a.i./l against B. tabaci populations and disease incidence of CMMV on soybean plants. Research was conducted in the field with randomized complete block design consisting of 5 treatments i.e. five concentration levels: 0.75, 1.50,2.25, and 3.00 ml/l including control (untreated with 5 replications. The results showed that BPMC is effective in suppressing the adult population of B. tabaci and disease incidence of CMMV.

  3. Simulation of limiting dilution technique in determination of immunocompetent cells frequency in irradiated cell cultures

    International Nuclear Information System (INIS)

    Martini Filho, R.J.; Barlette, V.E.; Goes, E.G.; Covas, D.T.; Orellana, M.

    2001-01-01

    Limiting dilution techniques (LDA) dose-response data have been used to detect immunocompetent T-Cells in microcultures. In this work, LDA frequencies estimates was obtained using χ2 minimization for irradiated cells in a range of 500 to 1,500 cGy. (author)

  4. Long-term exposure to ambient ultrafine particles and respiratory disease incidence in in Toronto, Canada: a cohort study.

    Science.gov (United States)

    Weichenthal, Scott; Bai, Li; Hatzopoulou, Marianne; Van Ryswyk, Keith; Kwong, Jeffrey C; Jerrett, Michael; van Donkelaar, Aaron; Martin, Randall V; Burnett, Richard T; Lu, Hong; Chen, Hong

    2017-06-19

    Little is known about the long-term health effects of ambient ultrafine particles (respiratory disease incidence. In this study, we examined the relationship between long-term exposure to ambient UFPs and the incidence of lung cancer, adult-onset asthma, and chronic obstructive pulmonary disease (COPD). Our study cohort included approximately 1.1 million adults who resided in Toronto, Canada and who were followed for disease incidence between 1996 and 2012. UFP exposures were assigned to residential locations using a land use regression model. Random-effect Cox proportional hazard models were used to estimate hazard ratios (HRs) describing the association between ambient UFPs and respiratory disease incidence adjusting for ambient fine particulate air pollution (PM 2.5 ), NO 2 , and other individual/neighbourhood-level covariates. In total, 74,543 incident cases of COPD, 87,141 cases of asthma, and 12,908 cases of lung cancer were observed during follow-up period. In single pollutant models, each interquartile increase in ambient UFPs was associated with incident COPD (HR = 1.06, 95% CI: 1.05, 1.09) but not asthma (HR = 1.00, 95% CI: 1.00, 1.01) or lung cancer (HR = 1.00, 95% CI: 0.97, 1.03). Additional adjustment for NO 2 attenuated the association between UFPs and COPD and the HR was no longer elevated (HR = 1.01, 95% CI: 0.98, 1.03). PM 2.5 and NO 2 were each associated with increased incidence of all three outcomes but risk estimates for lung cancer were sensitive to indirect adjustment for smoking and body mass index. In general, we did not observe clear evidence of positive associations between long-term exposure to ambient UFPs and respiratory disease incidence independent of other air pollutants. Further replication is required as few studies have evaluated these relationships.

  5. Incidence of low back pain related occupational diseases in the Netherlands

    NARCIS (Netherlands)

    Miedema, H. S.; van der Molen, H. F.; Kuijer, P. P. F. M.; Koes, B. W.; Burdorf, A.

    2014-01-01

    BackgroundUntil recently, no evidence-based criteria were available to determine the work-relatedness of low back pain (LBP) in an individual worker. Incidence figures for LBP that can be qualified as occupational disease (OD) are scarce. We studied the trend in the number of OD notifications due to

  6. Increasing prevalence and high incidence of celiac disease in elderly people: A population-based study

    Directory of Open Access Journals (Sweden)

    Vilppula Anitta

    2009-06-01

    Full Text Available Abstract Background Celiac disease may emerge at any age, but little is known of its appearance in elderly people. We evaluated the prevalence of the condition in individuals over 55 years of age, and determined the incidence of biopsy-proven celiac disease (CDb and celiac disease including seropositive subjects for anti-tissue transglutaminase antibodies (CDb+s. Methods The study based on prevalence figures in 2815 randomly selected subjects who had undergone a clinical examination and serologic screening for celiac disease in 2002. A second screening in the same population was carried out in 2005, comprising now 2216 individuals. Positive tissue transglutaminase antibodies were confirmed with small bowel biopsy. Results Within three years the prevalence of CDb increased from 2.13 to 2.34%, and that of CDb+s from 2.45 to 2.70%. Five new cases were found among patients previously seronegative; two had minor abdominal symptoms and three were asymptomatic. The incidence of celiac disease in 2002–2005 was 0.23%, giving an annual incidence of 0.08% in this population. Conclusion The prevalence of celiac disease was high in elderly people, but the symptoms were subtle. Repeated screening detected five biopsy-proven cases in three years, indicating that the disorder may develop even in the elderly. Increased alertness to the disorder is therefore warranted.

  7. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies.

    Science.gov (United States)

    Ng, Siew C; Shi, Hai Yun; Hamidi, Nima; Underwood, Fox E; Tang, Whitney; Benchimol, Eric I; Panaccione, Remo; Ghosh, Subrata; Wu, Justin C Y; Chan, Francis K L; Sung, Joseph J Y; Kaplan, Gilaad G

    2018-12-23

    Inflammatory bowel disease is a global disease in the 21st century. We aimed to assess the changing incidence and prevalence of inflammatory bowel disease around the world. We searched MEDLINE and Embase up to and including Dec 31, 2016, to identify observational, population-based studies reporting the incidence or prevalence of Crohn's disease or ulcerative colitis from 1990 or later. A study was regarded as population-based if it involved all residents within a specific area and the patients were representative of that area. To be included in the systematic review, ulcerative colitis and Crohn's disease needed to be reported separately. Studies that did not report original data and studies that reported only the incidence or prevalence of paediatric-onset inflammatory bowel disease (diagnosis at age incidence (119 studies) and prevalence (69 studies) of Crohn's disease and ulcerative colitis. We used temporal trend analyses to report changes as an annual percentage change (APC) with 95% CI. We identified 147 studies that were eligible for final inclusion in the systematic review, including 119 studies of incidence and 69 studies of prevalence. The highest reported prevalence values were in Europe (ulcerative colitis 505 per 100 000 in Norway; Crohn's disease 322 per 100 000 in Germany) and North America (ulcerative colitis 286 per 100 000 in the USA; Crohn's disease 319 per 100 000 in Canada). The prevalence of inflammatory bowel disease exceeded 0·3% in North America, Oceania, and many countries in Europe. Overall, 16 (72·7%) of 22 studies on Crohn's disease and 15 (83·3%) of 18 studies on ulcerative colitis reported stable or decreasing incidence of inflammatory bowel disease in North America and Europe. Since 1990, incidence has been rising in newly industrialised countries in Africa, Asia, and South America, including Brazil (APC for Crohn's disease +11·1% [95% CI 4·8-17·8] and APC for ulcerative colitis +14·9% [10·4-19·6]) and Taiwan (APC

  8. A severe transmissible Majocchi's granuloma in an immunocompetent returned traveler

    Directory of Open Access Journals (Sweden)

    James G. Gallo

    2017-12-01

    Full Text Available Severe dermatophyte infection is rare in immunocompetent adults. Recently cases have been described in travelers returning from South East Asia (Luchsinger et al., 2015 [1]. These may be sexually transmitted and can have permanent sequelae. We describe the first reported case of Majocchi's granuloma (MG in an Australian returned traveler and its subsequent transmission via sexual contact. Both patients were successfully treated with systemic antifungals. MG should be considered in patients with severe rash after travel to South East Asia. Keywords: Trichophyton interdigitale, Majocchi's granuloma, Dermatophyte infection, Tinea corporis

  9. Economic consequences of incident disease: the effect on loss of annual income

    DEFF Research Database (Denmark)

    Rayce, Signe L; Christensen, Ulla; Hougaard, Charlotte Ø

    2008-01-01

    AIMS: To estimate the effect of incident disease on loss of annual income on an individual level, to analyse whether loss of job mediates the effect on loss of annual income, to analyse whether an association is modified by socioeconomic position, and to determine whether the effect on annual inc...... on annual income. This might be interpreted as a buffering effect of the welfare policies in relation to the more discriminating demands of the labour market.......AIMS: To estimate the effect of incident disease on loss of annual income on an individual level, to analyse whether loss of job mediates the effect on loss of annual income, to analyse whether an association is modified by socioeconomic position, and to determine whether the effect on annual...... with an increased and equally strong risk for experiencing a loss of annual income corresponding to one income decile (>25,000 DKK) in the year following disease (odds ratio (OR) from 1.37 (95% confidence interval (CI) 1.09-1.72) to 1.57 (95% CI 1.21-2.04)). No significant effect of female AMI was found...

  10. Identification of opportunistic enteric parasites among immunocompetent patients with diarrhoea from Northern India and genetic characterisation of Cryptosporidium and Microsporidia.

    Science.gov (United States)

    Ghoshal, U; Dey, A; Ranjan, P; Khanduja, S; Agarwal, V; Ghoshal, U C

    2016-01-01

    Enteric parasitic infestation is a major public health problem in developing countries. Parasites such as Cryptosporidium spp., Cyclospora spp., Cystoisospora spp. and Microsporidia may cause severe diarrhoea among immunocompromised patients. There is scanty data on their frequency among immunocompetent patients. Accordingly, we studied the frequency of enteric opportunistic parasites among immunocompetent patients with diarrhoea from northern India; we also performed genetic characterisation of Cryptosporidia and Microsporidia among them. Stool samples from 80 immunocompetent patients with diarrhoea, and 110 healthy controls were examined. Parasites were detected by direct microscopy, modified acid-fast (Kinyoun's) and modified trichrome stain. Polymerase chain reaction--restriction fragment length polymorphism was used for genetic characterisation of selected species such as Cryptosporidia and Microsporidia. Enteric parasites were detected in 16/80 (20%) patients (mean age 28.8±20 years, 45, 56% males) and in 2/110 (1.8%) healthy controls (P=0.00007). Parasites detected were Cryptosporidium spp. (8/16, 50.0%), Cystoisospora spp. (4/16, 25%), Microsporidia (1/16, 6.25%), Cyclospora spp. (1/16, 6.25%) and Giardia spp. (1/16, 6.25%). One patient had mixed infection with Cystoisospora spp. and Giardia spp. The species of Cryptosporidia and Microsporidia detected were Cryptosporidium hominis and Enterocytozoon bieneusi, respectively. Parasites were more often detected in younger patients (≤20 years of age) than in older. Most of the parasite infected patients presented with chronic diarrhoea. Opportunistic enteric parasitic infestation was more common among immunocompetent patients with diarrhoea than healthy subjects. Special staining as well as molecular methods are essential for appropriate diagnosis of these parasites.

  11. Isolated endogenous Fusarium endophthalmitis in an immunocompetent adult after a thorn prick to the hand.

    Science.gov (United States)

    Milligan, Alice L; Gruener, Anna M; Milligan, Iain D; O'Hara, Geraldine A; Stanford, Miles R

    2017-06-01

    To report the case of an immunocompetent adult presenting with endogenous Fusarium endophthalmitis. A woman in her thirties presented with symptoms and signs of a unilateral anterior uveitis. After initial improvement with topical corticosteroids, she continued to develop a panuveitis with an associated drop in vision to counting fingers. A vitreous biopsy confirmed Fusarium solani by 18S rRNA fungal gene detection and PCR sequencing. Despite treatment with pars plana vitrectomy, intravitreal amphotericin B and systemic voriconazole her visual outcome was poor. Detailed review of her antecedent history revealed the route of acquisition to be a thorn prick to the hand two weeks prior to presentation. This patient's endophthalmitis most likely resulted from cutaneous inoculation of Fusarium solani with subsequent hematogenous spread. Endogenous Fusarium endophthalmitis is well recognized in the immunocompromised but is very rarely seen in the immunocompetent. This case highlights the importance of thorough history-taking and consideration of fungal endophthalmitis in the differential diagnosis of a treatment-refractory uveitis.

  12. Review article: the incidence and prevalence of colorectal cancer in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Munkholm, P

    2003-01-01

    Although colorectal cancer (CRC), complicating ulcerative colitis and Crohn's disease, only accounts for 1-2% of all cases of CRC in the general population, it is considered a serious complication of the disease and accounts for approximately 15% of all deaths in inflammatory bowel disease (IBD...... of symptoms, and extent of the disease, with pancolitis having a more severe inflammation burden and risk of the dysplasia-carcinoma cascade. Considering the chronic nature of the disease, it is remarkable that there is such a low incidence of CRC in some of the population-based studies, and possible...... in Crohn's disease, the number was significantly increased in relation to the expected number....

  13. Survival of human mesenchymal stromal cells from bone marrow and adipose tissue after xenogenic transplantation in immunocompetent mice

    DEFF Research Database (Denmark)

    Niemeyer, P; Vohrer, J; Schmal, H

    2008-01-01

    of the current paper was to evaluate the survival of undifferentiated and osteogenically induced human MSC from different origins after transplantation in immunocompetent mice. METHODS: Human MSC were isolated from bone marrow (BMSC) and adipose tissue (ASC). After cultivation on mineralized collagen, MSC were......INTRODUCTION: Mesenchymal stromal cells (MSC) represent an attractive cell population for tissue engineering purposes. As MSC are described as immunoprivileged, non-autologous applications seem possible. A basic requirement is the survival of MSC after transplantation in the host. The purpose...... transplanted subcutaneously into immunocompetent mice (n=12). Undifferentiated MSC (group A) were compared with osteogenic-induced MSC (group B). Human-specific in situ hybridization and anti-vimentin staining was used to follow MSC after transplantation. Quantitative evaluation of lymphocytes and macrophages...

  14. Incidence of sarcopenia and dynapenia according to stage in patients with idiopathic Parkinson's disease.

    Science.gov (United States)

    Yazar, Tamer; Yazar, Hülya Olgun; Zayimoğlu, Emel; Çankaya, Soner

    2018-05-12

    In this study, the aim was to identify the incidence of sarcopenia and dynapenia according to disease stage among idiopathic Parkinson's disease (IPD) patients and collect data to illuminate precautions related to reducing the disease load. The study was completed with 166 patients divided by stage according to modified Hoehn and Yahr (HYR) criteria and 249 healthy volunteers aged from 18 to 39 and 68 to 75 years met the inclusion criteria. In our prospective and cross-sectional study, patients with IPD according to "UK Brain Bank" diagnostic criteria had the Unified Parkinson's Disease Rating Scale (UPDRS) and HYR scales applied. The patient and control groups had skeletal muscle mass index (SMMI), muscle power, and physical performance assessed. Diagnosis of sarcopenia used the European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic criteria. In our study, in parallel with the increase in disease stage among IPD patients, the incidence of sarcopenia (led by severe sarcopenia) and dynapenia was high compared to that among the control group of the same age. In the early stages of chronic progressive diseases like IPD, identification of sarcopenia and dynapenia is important considering the limitations of disease-preventive effects in treatments applied after diagnosis.

  15. Cutaneous zygomycosis due to Saksenaea vasiformis in an immunocompetent host

    Directory of Open Access Journals (Sweden)

    Baradkar V

    2009-01-01

    Full Text Available Saksenaea vasiformis is an emerging zygomycete species, most often associated with cutaneous, subcutaneous and rhino- orbito-cerebral infections. Herein, we report a case of cutaneous zygomycosis of face caused by Saksenaea vasiformis in a 54-year-old immunocompetent female. The diagnosis was carried out by microscopy using KOH mount, Gram staining, Gomori′s methenamine silver staining, hemotoxylin and eosin staining and culture on Sabouraud′s Dextrose agar without actidione. Slide cultures were put up on Czapek Dox agar, which showed typical flask-shaped sporangium with rhizoids. The patient was treated successfully with intravenous amphotericin B.

  16. Incidence and Pattern of Dental Erosion in Gastroesophageal Reflux Disease Patients.

    Science.gov (United States)

    Ramachandran, Anupama; Raja Khan, Sulthan Ibrahim; Vaitheeswaran, Nandinee

    2017-11-01

    Gastroesophageal reflux disease (GERD) is a very common condition whose consequences of are localized not only in the esophagus; extra-esophageal involvement has frequently been reported. The aim of the study is to examine the incidence and pattern of dental erosion in GERD patients. A total of 50 patients were recruited in this study (control -25 and GERD -25). All participants diagnosed having GERD by the endoscopic examination by their gastroenterologist are included. The patients were examined for dental erosion and will be quantified using Basic erosive wear examination index. The results showed that the incidence of dental erosion was 88% as compared to 32% in the control group which was found to be statistically significant.

  17. Relation between the geochemical environment and disease incidence rate. A case study the Island Krk in the Adriatic Sea, Croatia

    International Nuclear Information System (INIS)

    Kutle, A.; Obhodas, J.; Valkovic, V.

    2006-01-01

    It has been observed that among the seven municipalities of the Island of Krk the three in the central part of the island have increased disease incidence rates for the five groups of diseases: (a) neoplasm, (b) diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism, (c) endocrine, nutritional and metabolic diseases, (d) mental and behavioral disorders and (e) diseases of the circulatory system. One of the etiological factors is assumed to be the influence of the geochemical environment. The average element concentration values of six trace elements (Mn, Fe, Ni, Cu, Zn and As) for the geochemical environment in the individual municipalities were determined by XRF analyses of soil, plant, potable water and hair samples. The data on disease incidence rates for the individual municipalities, from 1997 to 2001, have been obtained from the Public Health Institution in charge of monitoring population health on the island. Diseases' groups have been defined by the WHO methodology. The GPS-GIS methodology was used to obtain maps of trace elements in different matrices and disease incidence distributions. Data analyses were performed by multivariate statistical methods (principal component analysis and cluster analysis). It has been shown that the concentration levels of the elements could be related to disease incidence rates. (author)

  18. Late-onset Alzheimer's risk variants in memory decline, incident mild cognitive impairment, and Alzheimer's disease.

    Science.gov (United States)

    Carrasquillo, Minerva M; Crook, Julia E; Pedraza, Otto; Thomas, Colleen S; Pankratz, V Shane; Allen, Mariet; Nguyen, Thuy; Malphrus, Kimberly G; Ma, Li; Bisceglio, Gina D; Roberts, Rosebud O; Lucas, John A; Smith, Glenn E; Ivnik, Robert J; Machulda, Mary M; Graff-Radford, Neill R; Petersen, Ronald C; Younkin, Steven G; Ertekin-Taner, Nilüfer

    2015-01-01

    We tested association of nine late-onset Alzheimer's disease (LOAD) risk variants from genome-wide association studies (GWAS) with memory and progression to mild cognitive impairment (MCI) or LOAD (MCI/LOAD) in older Caucasians, cognitively normal at baseline and longitudinally evaluated at Mayo Clinic Rochester and Jacksonville (n>2000). Each variant was tested both individually and collectively using a weighted risk score. APOE-e4 associated with worse baseline memory and increased decline with highly significant overall effect on memory. CLU-rs11136000-G associated with worse baseline memory and incident MCI/LOAD. MS4A6A-rs610932-C associated with increased incident MCI/LOAD and suggestively with lower baseline memory. ABCA7-rs3764650-C and EPHA1-rs11767557-A associated with increased rates of memory decline in subjects with a final diagnosis of MCI/LOAD. PICALM-rs3851179-G had an unexpected protective effect on incident MCI/LOAD. Only APOE-inclusive risk scores associated with worse memory and incident MCI/LOAD. The collective influence of the nine top LOAD GWAS variants on memory decline and progression to MCI/LOAD appears limited. Discovery of biologically functional variants at these loci may uncover stronger effects on memory and incident disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Hepatosplenic actinomycosis in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Hua-Kung Wang

    2012-04-01

    Full Text Available Hepatosplenic abscess caused by Actinomyces is rare and often misdiagnosed as malignancy. Herein, we report a case of hepatosplenic actinomycosis in a 37-year-old immunocompetent man with a 2-month clinical history of intermittent fever and upper left abdominal pain. Physical examination revealed a mildly ill-appearing man with a low-grade fever (38°C and upper left quadrant abdominal tenderness. Abdominal sonographic examination showed the presence of a 6.3 cm × 6.5 cm heterogeneous abscess with a hypoechoic center and honeycomb appearance in an enlarged spleen (8 cm × 5 cm. Computerized tomography of the abdomen revealed a multiloculated splenic lesion, and laparotomy showed multiple hepatic nodules and a splenic abscess. Histopathological examination of the biopsy revealed filamentous branching bacilli and sulfur granules in the hepatosplenic abscess. The patient successfully underwent splenectomy accompanied by intravenous and oral penicillin treatment. Proper and prompt diagnosis of hepatosplenic actinomycosis is important because the therapeutic plan and prognosis of this pathogen are quite different from other microorganisms and malignancies.

  20. Cutaneous injuries of complicated herpes zoster in an elderly immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Luis Arthur Brasil Gadelha Farias

    2017-10-01

    Full Text Available A 81-years-old caucasian man presented with acute burning pain in external auricular region and inside the auditory canal of right ear, associated with vesicular lesions on face, jugal and lingual mucosa. Physical examination revealed vesicular lesions in external auricular region and inside the auditory canal. Red blood cell count, leukocytes and platelets were normal. Presented HIV-1 and 2 both negative. Patient denied previous history of Diabetes and Hypertension. Treatment was initiated with Ceftriaxone 2g, Acyclovir 250mg, Prednisone 60mg and Bicarbonate Water for rinsing. After eight days of hospitalization, patient reported hearing loss in the right ear, chewing difficulty and mild pain in face. Auditory hearing loss and hypoacusis may suggest involvement of vestibulocochlear nerve. Figure 1 shows cicatricial crusted lesions following trigeminal nerve mandibular branch trajetory. Figure 2 reveals cicatricial crusted lesions following trigeminal nerve maxilar branch, trigeminal branch and erythematous scarring lesions in tongue, hypoglossal nerve region. Figure 3 reveals small crusted lesions following the trigeminal ophthalmic branch. Herpes zoster is caused by Varicella zoster virus (VZV reactivation in individuals who had Varicella in childhood or who were vaccinated. The presence of more than one dermatome affected is rare in immunocompetent individuals, being more prevalent in immunosuppressed individuals such as HIV positive and transplanted patients.1Disseminated herpes zoster can occur in any immunocompetent patient but predominates in elderly due to factors that compromise cellular immune response. 2,3

  1. Dynamic effects of smoking cessation on disease incidence, mortality and quality of life: The role of time since cessation

    Directory of Open Access Journals (Sweden)

    Boshuizen Hendriek C

    2008-01-01

    Full Text Available Abstract Background To support health policy makers in setting priorities, quantifying the potential effects of tobacco control on the burden of disease is useful. However, smoking is related to a variety of diseases and the dynamic effects of smoking cessation on the incidence of these diseases differ. Furthermore, many people who quit smoking relapse, most of them within a relatively short period. Methods In this paper, a method is presented for calculating the effects of smoking cessation interventions on disease incidence that allows to deal with relapse and the effect of time since quitting. A simulation model is described that links smoking to the incidence of 14 smoking related diseases. To demonstrate the model, health effects are estimated of two interventions in which part of current smokers in the Netherlands quits smoking. To illustrate the advantages of the model its results are compared with those of two simpler versions of the model. In one version we assumed no relapse after quitting and equal incidence rates for all former smokers. In the second version, incidence rates depend on time since cessation, but we assumed still no relapse after quitting. Results Not taking into account time since smoking cessation on disease incidence rates results in biased estimates of the effects of interventions. The immediate public health effects are overestimated, since the health risk of quitters immediately drops to the mean level of all former smokers. However, the long-term public health effects are underestimated since after longer periods of time the effects of past smoking disappear and so surviving quitters start to resemble never smokers. On balance, total health gains of smoking cessation are underestimated if one does not account for the effect of time since cessation on disease incidence rates. Not taking into account relapse of quitters overestimates health gains substantially. Conclusion The results show that simulation models are

  2. Seasonal incidence of Haemoprotozoal diseases in crossbred cattle and buffalo in Kaira and Anand districts of Gujarat, India

    Directory of Open Access Journals (Sweden)

    S P Vahora

    2012-08-01

    Full Text Available Seasonal incidence of haemoprotozoal diseases in crossbred cattle and buffalo was studied by examining 3152 and 1129 blood smears respectively, received from various veterinary sub centres located in Anand and Kaira districts of Gujarat during period from April 2009 to March 2010. The present study has recorded higher incidence of haemoprotozoal diseases in crossbred cattle and buffalo from June to September and June to August, respectively. In crossbred cattle, 1172 (37% out of 3152 blood smears were positive for haemoprotozoal infection while in buffalo, 191 (17% out of 1129 blood smears were positive for haemoprotozoal infection. In both the species, higher incidence of Theileriosis was recorded during monsoon season as compared to other protozoan diseases. [Vet. World 2012; 5(4.000: 223-225

  3. Estimating the incidence of connective tissue diseases and vasculitides in a defined population in Northern Savo area in 2010.

    Science.gov (United States)

    Elfving, P; Marjoniemi, O; Niinisalo, H; Kononoff, A; Arstila, L; Savolainen, E; Rutanen, J; Kaipiainen-Seppänen, O

    2016-07-01

    Objective of the study was to evaluate the annual incidence and distribution of autoimmune connective tissue diseases and vasculitides during 2010. All units practicing rheumatology in the Northern Savo area, Finland, participated in the study by collecting data on newly diagnosed adult patients with autoimmune connective tissue disease or vasculitis over 1-year period. Seventy-two cases with autoimmune connective tissue disease were identified. The annual incidence rates were as follows: systemic lupus erythematosus 3.4/100,000 (95 % CI 1.4-7.0), idiopathic inflammatory myopathies 1.9 (0.5-5.0), systemic sclerosis 4.4 (2.0-8.3), mixed connective tissue disease 1.0 (0.1-3.5), Sjögren's syndrome 10.7 (6.7-16.1) and undifferentiated connective tissue disease 13.6 (9.0-19.6). The annual incidence rates among vasculitis category were as follows: antineutrophil cytoplasmic antibody-associated vasculitis 1.5/100,000 (95 % CI 0.3-4.3), central nervous system vasculitis 0.5 (0-2.7) and Henoch-Schönlein purpura 1.5 (0.3-4.3). The annual incidence of giant cell arteritis in the age group of 50 years or older was 7.5/100,000 (95 % CI 3.2-14.8). The longest delay from symptom onset to diagnosis occurred in systemic sclerosis. The incidences of autoimmune connective tissue diseases and vasculitides were comparable with those in published literature. The present study showed female predominance in all connective tissue diseases, excluding idiopathic inflammatory muscle diseases and mean age at onset of disease around 50 years of age. Despite improved diagnostic tools, diagnostic delay is long especially among patients with systemic sclerosis.

  4. Coronary heart disease incidence among non-Western immigrants compared to Danish-born people

    DEFF Research Database (Denmark)

    Bo, Anne; Zinckernagel, Line; Krasnik, Allan

    2014-01-01

     = 229,918). First-time CHD incidence was identified from 1 January 1993–31 December 2007. Incidence ratios for 11 immigrant groups were estimated using Cox regression analysis. Results: Immigrants from Afghanistan, Iraq, Turkey, Eastern Europe and Central Asia, South Asia, the Former Yugoslavia......Background: Increasing global migration has made immigrants’ health an important topic worldwide. We examined the effect of country of birth, migrant status (refugee/family-reunified) and income on coronary heart disease (CHD) incidence. Design: This was a historical prospective register......, and the Middle East and North Africa had significantly higher incidences of CHD (hazard ratio (HR) = 1.36; 95% confidence interval (CI): 1.05–1.75 to HR = 2.86; 95% CI: 2.01–4.08) compared with Danish-born people. Immigrants from Somalia, South and Middle America, Sub-Saharan Africa and women from East Asia...

  5. Trends in Modifiable Risk Factors Are Associated With Declining Incidence of Hospitalized and Nonhospitalized Acute Coronary Heart Disease in a Population.

    Science.gov (United States)

    Mannsverk, Jan; Wilsgaard, Tom; Mathiesen, Ellisiv B; Løchen, Maja-Lisa; Rasmussen, Knut; Thelle, Dag S; Njølstad, Inger; Hopstock, Laila Arnesdatter; Bønaa, Kaare Harald

    2016-01-05

    Few studies have used individual person data to study whether contemporary trends in the incidence of coronary heart disease are associated with changes in modifiable coronary risk factors. We identified 29 582 healthy men and women ≥25 years of age who participated in 3 population surveys conducted between 1994 and 2008 in Tromsø, Norway. Age- and sex-adjusted incidence rates were calculated for coronary heart disease overall, out-of-hospital sudden death, and hospitalized ST-segment-elevation and non-ST-segment-elevation myocardial infarction. We measured coronary risk factors at each survey and estimated the relationship between changes in risk factors and changes in incidence trends. A total of 1845 participants had an incident acute coronary heart disease event during 375 064 person-years of follow-up from 1994 to 2010. The age- and sex-adjusted incidence of total coronary heart disease decreased by 3% (95% confidence interval, 2.0-4.0; Pcoronary risk factors accounted for 66% (95% confidence interval, 48-97; Pcoronary heart disease. Favorable changes in cholesterol contributed 32% to the decline, whereas blood pressure, smoking, and physical activity each contributed 14%, 13%, and 9%, respectively. We observed a substantial decline in the incidence of coronary heart disease that was driven by reductions in out-of-hospital sudden death and hospitalized ST-segment-elevation myocardial infarction. Changes in modifiable coronary risk factors accounted for 66% of the decline in coronary heart disease events. © 2015 American Heart Association, Inc.

  6. Mediterranean Style Diet and 12-Year Incidence of Cardiovascular Diseases: The Epic-NL Cohort Stusy

    NARCIS (Netherlands)

    Hoevenaar-Blom, M.P.; Nooyens, A.J.C.; Kromhout, D.; Spijkerman, A.M.W.; Beulens, W.J.; Schouw, van der Y.T.; Bueno-de-Mesquita4, B.; Verschuren, W.M.M.

    2012-01-01

    Background: A recent meta-analysis showed that a Mediterranean style diet may protect against cardiovascular diseases (CVD). Studies on disease-specific associations are limited. We evaluated the Mediterranean Diet Score (MDS) in relation to incidence of total and specific CVDs. Methods: The EPIC-NL

  7. Vitamin D status and incident cardiovascular disease and all-cause mortality

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Pisinger, Charlotta

    2013-01-01

    Low vitamin D status has been associated with cardiovascular disease (CVD) and mortality primarily in selected groups, smaller studies, or with self-reported vitamin D intake. We investigated the association of serum vitamin D status with the incidence of a registry-based diagnosis of ischemic...... heart disease (IHD), stroke, and all-cause mortality in a large sample of the general population. A total of 9,146 individuals from the two population-based studies, Monica10 and Inter99, were included. Measurements of serum 25-hydroxyvitamin D at baseline were carried out using the IDS ISYS immunoassay...

  8. Incidence of Pest and Diseases of Acha at Badeggi in the Southern ...

    African Journals Online (AJOL)

    Incidence of Pest and Diseases of Acha at Badeggi in the Southern Guinea Savanna Zone of Nigeria. ... Nigeria Agricultural Journal ... Studies were carried out on nine accessions of Acha (Digitaria exilis Stapf and Digitaria Iburua Stapf to evaluate them for their susceptibility to insect pests, fungi, weeds, birds and rodents.

  9. Lymphadenopathic kaposi's sarcoma in an immunocompetent adult

    International Nuclear Information System (INIS)

    David, O.S.; Sani, I.M.

    2012-01-01

    Kaposi's sarcomas (KS) are vascular lesions which usually originate from multiple sites in the mid-dermis extending to the dermis. The aetiology is unknown, but infection from human herpes virus type 8 has been suggested. Several reports of KS had come from Africa initially and from worldwide later due to the close association with HIV/AIDS. Prior to this however, KS was very frequent in Eastern Europe, Italy and the United States where it existed in an indolent form in the elderly men of Jewish ancestry. KS may also be due to iatrogenic immune suppression from chronic use of steroids, elevated degree of expression of numerous cytokines and angiogenic growth factors including TNF alpha, IL-6, bFGF, HIV-tat protein and oncostatin M. Lymphadenopathic KS involves the lymph-nodes, viscera and the gastrointestinal tract and may run a disseminated and aggressive course. We are reporting one such case in an immunocompetent male. (author)

  10. Cystic change in pulmonary tuberculosis in an immunocompetent adult: a case report

    International Nuclear Information System (INIS)

    Ko, Sung Min; Seo, Soo Ji; Choi, Won Il; Jeon, Young June

    2008-01-01

    Cystic change associated with pulmonary tuberculosis is rarely encountered, and few reports are available on the radiologic findings of pulmonary tuberculosis presenting as multiple cystic lesions associated with consolidation or bronchohematogenous nodules. The cystic lesions in our pulmonary tuberculosis patient occurred during steroid treatment without antituberculous chemotherapy and progressively increased in size, but subsequently became smaller after the initiation of antituberculous chemotherapy. Herein, we report the chest radiographic and computed tomographic findings of cystic change in pulmonary tuberculosis in an immunocompetent adult

  11. Density of calcium in the ascending thoracic aorta and risk of incident cardiovascular disease events.

    Science.gov (United States)

    Thomas, Isac C; McClelland, Robyn L; Michos, Erin D; Allison, Matthew A; Forbang, Nketi I; Longstreth, W T; Post, Wendy S; Wong, Nathan D; Budoff, Matthew J; Criqui, Michael H

    2017-10-01

    The volume and density of coronary artery calcium (CAC) both independently predict cardiovascular disease (CVD) beyond standard risk factors, with CAC density inversely associated with incident CVD after accounting for CAC volume. We tested the hypothesis that ascending thoracic aorta calcium (ATAC) volume and density predict incident CVD events independently of CAC. The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective cohort study of participants without clinical CVD at baseline. ATAC and CAC were measured from baseline cardiac computed tomography (CT). Cox regression models were used to estimate the associations of ATAC volume and density with incident coronary heart disease (CHD) events and CVD events, after adjustment for standard CVD risk factors and CAC volume and density. Among 6811 participants, 234 (3.4%) had prevalent ATAC and 3395 (49.8%) had prevalent CAC. Over 10.3 years, 355 CHD and 562 CVD events occurred. One-standard deviation higher ATAC density was associated with a lower risk of CHD (HR 0.48 [95% CI 0.29-0.79], pdensity was inversely associated with incident CHD and CVD after adjustment for CVD risk factors and CAC volume and density. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Changing incidence of diverticular disease of the colon in the Koreans: a radiological study

    International Nuclear Information System (INIS)

    Chung, Soo Kyo; Sohn, Hyung Sun; Lee, Soon Kyu; Bahk, Young Whee

    1979-01-01

    Diverticular disease of the colon is the commonest pathological process in the large bowel in the aged caucasians, but this is rare in oriental races.In Korea, diverticular disease of the colon was known to be rare as reported by Kim in 1964. Since then, however, we have had an impression that the diverticular disease of the colon is not so rare as was reported by Kim previously from our department. The present study has been undertaken to substantiate our impression. We received 1,143 consecutive cases of double-contrast barium performed at the Department of radiology, St. Mary's Hospital, Catholic Medical College during the past 7 years to analyzed diverticular disease patterns of the colon in the Koreans. 1. The present study revealed 29 patients of diverticular disease of the colon, an incidence of 2.5%. The age distribution was shown in Table 1. 2. The mean number of diverticular were 9 and the mean size as follows: the cecum, 6.4 mm; the proximal 1/3 of the ascending colon, 5.6 mm, The mid 1/3 of ascending colon, 4.9 mm; and the distal 1/3 of the ascending colon, 4.4 mm. 3. The average age of patients with diverticular disease of the colon was 49.5 years. Chief complaints were change of bowel habit (31.6%), abdominal pain (28.9%) and indigestion (18.4%). 4. The associated radiological findings of diverticular disease of the colon were: (1) spasm in 16 cases (46%); (2) a marginal irregularity in 16 cases (25%); and (3) asymmetrical haustra in 16 cases (30%). In 13 cases no associated signs seen. We have found that incidence of the diverticular disease of the colon in the present series is very significantly higher than that of the previous report from our department (Kim, 1964). We postulate that the possible factors operational in such increase in the incidence of the clonic diverticular disease in the last decade are: (1) changing dietary pattern characterized by high-protein and high refined-sugar consumption, and (2) routine use of the double contrast

  13. Changing incidence of diverticular disease of the colon in the Koreans: a radiological study

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Soo Kyo; Sohn, Hyung Sun; Lee, Soon Kyu; Bahk, Young Whee [St. Mary' s Hospital., Catholic Medical College, Seoul (Korea, Republic of)

    1979-06-15

    Diverticular disease of the colon is the commonest pathological process in the large bowel in the aged caucasians, but this is rare in oriental races.In Korea, diverticular disease of the colon was known to be rare as reported by Kim in 1964. Since then, however, we have had an impression that the diverticular disease of the colon is not so rare as was reported by Kim previously from our department. The present study has been undertaken to substantiate our impression. We received 1,143 consecutive cases of double-contrast barium performed at the Department of radiology, St. Mary's Hospital, Catholic Medical College during the past 7 years to analyzed diverticular disease patterns of the colon in the Koreans. 1. The present study revealed 29 patients of diverticular disease of the colon, an incidence of 2.5%. The age distribution was shown in Table 1. 2. The mean number of diverticular were 9 and the mean size as follows: the cecum, 6.4 mm; the proximal 1/3 of the ascending colon, 5.6 mm, The mid 1/3 of ascending colon, 4.9 mm; and the distal 1/3 of the ascending colon, 4.4 mm. 3. The average age of patients with diverticular disease of the colon was 49.5 years. Chief complaints were change of bowel habit (31.6%), abdominal pain (28.9%) and indigestion (18.4%). 4. The associated radiological findings of diverticular disease of the colon were: (1) spasm in 16 cases (46%); (2) a marginal irregularity in 16 cases (25%); and (3) asymmetrical haustra in 16 cases (30%). In 13 cases no associated signs seen. We have found that incidence of the diverticular disease of the colon in the present series is very significantly higher than that of the previous report from our department (Kim, 1964). We postulate that the possible factors operational in such increase in the incidence of the clonic diverticular disease in the last decade are: (1) changing dietary pattern characterized by high-protein and high refined-sugar consumption, and (2) routine use of the double contrast

  14. Epidemiological features of and changes in incidence of infectious diseases in China in the first decade after the SARS outbreak: an observational trend study.

    Science.gov (United States)

    Yang, Shigui; Wu, Jie; Ding, Cheng; Cui, Yuanxia; Zhou, Yuqing; Li, Yiping; Deng, Min; Wang, Chencheng; Xu, Kaijin; Ren, Jingjing; Ruan, Bing; Li, Lanjuan

    2017-07-01

    The model of infectious disease prevention and control changed significantly in China after the outbreak in 2003 of severe acute respiratory syndrome (SARS), but trends and epidemiological features of infectious diseases are rarely studied. In this study, we aimed to assess specific incidence and mortality trends of 45 notifiable infectious diseases from 2004 to 2013 in China and to investigate the overall effectiveness of current prevention and control strategies. Incidence and mortality data for 45 notifiable infectious diseases were extracted from a WChinese public health science data centre from 2004 to 2013, which covers 31 provinces in mainland China. We estimated the annual percentage change in incidence of each infectious disease using joinpoint regression. Between January, 2004, and December, 2013, 54 984 661 cases of 45 infectious diseases were reported (average yearly incidence 417·98 per 100 000). The infectious diseases with the highest yearly incidence were hand, foot, and mouth disease (114·48 per 100 000), hepatitis B (81·57 per 100 000), and tuberculosis (80·33 per 100 000). 132 681 deaths were reported among the 54 984 661 cases (average yearly mortality 1·01 deaths per 100 000; average case fatality 2·4 per 1000). Overall yearly incidence of infectious disease was higher among males than females and was highest among children younger than 10 years. Overall yearly mortality was higher among males than females older than 20 years and highest among individuals older than 80 years. Average yearly incidence rose from 300·54 per 100 000 in 2004 to 483·63 per 100 000 in 2013 (annual percentage change 5·9%); hydatid disease (echinococcosis), hepatitis C, and syphilis showed the fastest growth. The overall increasing trend changed after 2009, and the annual percentage change in incidence of infectious disease in 2009-13 (2·3%) was significantly lower than in 2004-08 (6·2%). Although the overall incidence of infectious

  15. Persistent Neutrophilic Meningitis in an Immunocompetent Patient after Basilar Skull Fracture: Case Report

    Directory of Open Access Journals (Sweden)

    Uslan Daniel Z

    2011-05-01

    Full Text Available Abstract Background Persistent neutrophilic meningitis is an unusual form of chronic meningitis that is defined as clinical meningitis with a neutrophilic pleocytosis that persists for greater than 7 days despite empiric antimicrobial therapy. Although numerous disease processes can cause this syndrome, the majority of cases are due to opportunistic pathogens infecting immunocompromised hosts. Case Presentation A 47 year-old female presented after basilar skull fracture with persistent neutrophilic meningitis unresponsive to empiric broad-spectrum antibiotics. After more than weeks of intensive therapy, 4 hospitalizations and 3 relapses, Nocardia cyriacigeorgica was identified from cerebral spinal fluid. Induction therapy was begun with Ceftriaxone and trimethoprim-sulfamethoxazole (TMP-SMX for 6 weeks followed by therapy with TMP-SMX and doxycycline for one year. The patient made a complete recovery without sequelae. Conclusions Due to the difficulty in obtaining a microbiologic diagnosis, appropriate treatment in cases of persistent neutrophilic meningitis is often delayed leading to morbidity, This case highlights a number of the unique features of Nocardia meningitis and the importance of considering Nocardia infection as a cause of persistent neutrophilic meningitis even in immunocompetent patients.

  16. The association of coffee intake with liver cancer incidence and chronic liver disease mortality in male smokers.

    Science.gov (United States)

    Lai, G Y; Weinstein, S J; Albanes, D; Taylor, P R; McGlynn, K A; Virtamo, J; Sinha, R; Freedman, N D

    2013-09-03

    Coffee intake is associated with reduced risk of liver cancer and chronic liver disease as reported in previous studies, including prospective ones conducted in Asian populations where hepatitis B viruses (HBVs) and hepatitis C viruses (HCVs) are the dominant risk factors. Yet, prospective studies in Western populations with lower HBV and HCV prevalence are sparse. Also, although preparation methods affect coffee constituents, it is unknown whether different methods affect disease associations. We evaluated the association of coffee intake with incident liver cancer and chronic liver disease mortality in 27,037 Finnish male smokers, aged 50-69, in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, who recorded their coffee consumption and were followed up to 24 years for incident liver cancer or chronic liver disease mortality. Multivariate relative risks (RRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazard models. Coffee intake was inversely associated with incident liver cancer (RR per cup per day=0.82, 95% CI: 0.73-0.93; P-trend across categories=0.0007) and mortality from chronic liver disease (RR=0.55, 95% CI: 0.48-0.63; P-trendcoffee. These findings suggest that drinking coffee may have benefits for the liver, irrespective of whether coffee was boiled or filtered.

  17. Change in Reported Lyme Disease Incidence in the Northeast and Upper Midwest, 1991-2014

    Data.gov (United States)

    U.S. Environmental Protection Agency — This indicator shows how reported Lyme disease incidence has changed by state since 1991, based on the number of new cases per 100,000 people. The total change has...

  18. Diagnostic difficulties of Lactobacillus casei bacteraemia in immunocompetent patients: A case report

    Directory of Open Access Journals (Sweden)

    Tommasi Chiara

    2008-09-01

    Full Text Available Abstract Introduction Lactobacilli are currently proposed as probiotic agents in several dietary products. In blood cultures, they are usually considered as contaminants, but in recent years they have been recognized as causal infectious agents of endocarditis, urinary tract infections, meningitis, intra-abdominal infections and bacteraemia. Case presentation We report a case of Lactobacillus casei bacteraemia in a 66-year-old immunocompetent man with a history of fever of unknown origin. Leuconostoc bacteraemia was demonstrated by blood culture, but a later polymerase chain reaction analysis with sequencing of 16S ribosomal RNA identified Lactobacillus casei and a successful antibiotic therapy was performed. Conclusion Bacteraemia caused by probiotic organisms is rare but underestimated, since they are normally regarded as contaminants and their role as primary invaders is not always easily established. Although the consumption of probiotic products cannot be considered a risk factor in the development of diseases caused by usually non-pathogenic bacteria, specific individual clinical histories should be taken into account. This report should alert both clinicians and microbiologists to the possibility of unusual pathogens causing serious illnesses and to the use of 16S ribosomal RNA sequencing for molecular identification as a powerful tool in confirming the diagnosis of infrequent pathogens.

  19. Osteomyelitis of the Mandible after Dental Implants in an Immunocompetent Patient

    Directory of Open Access Journals (Sweden)

    Matthieu Balanger

    2017-01-01

    Full Text Available Dental implants are now broadly used to replace missing teeth, and the presence of infectious complications is rising. Dental implant therapy as a local risk factor for the onset of osteomyelitis and its management have not been widely explored. Here, we report an unusual case of mandibular suppurative osteomyelitis caused by Streptococcus intermedius in a healthy and immunocompetent patient secondary to mandibular implants. We describe how surgery combined with systemic application of antibiotics allowed conservation of the dental implants in the mandibular bone, discuss the probable source of contamination, and present the follow-up of the osteomyelitis.

  20. Polyarticular Septic Arthritis Caused by Haemophilus influenzae Serotype f in an 8-Month-Old Immunocompetent Infant: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Raheel Ahmed Ali

    2015-01-01

    Full Text Available Background. The standard use of vaccinations against pathogens has resulted in a decreased incidence of musculoskeletal infections caused by these previously common bacterial pathogens. Consequently, the incidence of infections caused by atypical bacteria is rising. This report presents a case of septic arthritis caused by non-type b H. influenzae in a pediatric patient. Methods. We report a case of an infant with polyarticular septic arthritis caused by H. influenzae serotype f. A literature review was conducted with the inclusion criteria of case reports and studies published between 2004 and 2013 addressing musculoskeletal H. influenzae infections. Results. An 8-month-old female presented with pain and swelling in her right ankle and left elbow. The patient was diagnosed with septic arthritis and underwent incision and drainage. Wound and blood cultures were positive for Haemophilus influenzae serotype f. In addition to treatment with IV antibiotics, the patient underwent immunocompetency studies, which were normal. Subsequent follow-up revealed eradication of the infection. Conclusions. Haemophilus influenzae non-type b may cause serious invasive infections such as sepsis or septic arthritis in children with or without predisposing factors such as immunodeficiency or asplenia. Optimal treatment includes surgical management, culture driven IV antibiotics, and an immunologic workup.

  1. Cholestasis in neonates with red cell alloimmune hemolytic disease: incidence, risk factors and outcome.

    Science.gov (United States)

    Smits-Wintjens, Vivianne E H J; Rath, Mirjam E A; Lindenburg, Irene T M; Oepkes, Dick; van Zwet, Erik W; Walther, Frans J; Lopriore, Enrico

    2012-01-01

    Etiology of cholestatic liver disease in neonates with hemolytic disease of the newborn (HDN) has been associated with iron overload due to intrauterine red cell transfusions (IUTs). Data on the incidence and severity of cholestasis in neonates with HDN are scarce, and little is known about pathogenesis, risk factors, neonatal management and outcome. To evaluate incidence, risk factors, management and outcome of cholestasis in neonates with red cell alloimmune hemolytic disease. All (near-) term neonates with HDN due to red cell alloimmunization admitted to our center between January 2000 and July 2010 were included in this observational study. Liver function tests (including conjugated bilirubin) were routinely performed in the neonatal period. We recorded the presence of cholestasis, investigated several potential risk factors and evaluated the management and outcome in affected neonates. A total of 313 infants with red cell alloimmune hemolytic disease treated with or without IUTs were included. The incidence of cholestasis was 13% (41/313). Two risk factors were independently associated with cholestasis: treatment with at least one IUT (OR 5.81, 95% CI 1.70-19.80, p = 0.005) and rhesus D type of alloimmunization (OR 4.66, 95% CI 1.05-20.57, p = 0.042). Additional diagnostic tests to investigate possible causes of cholestasis were all negative. In 5 infants (12%), supportive medical and nutritional therapy was started, and one neonate required iron chelation therapy. Cholestasis occurs in 13% of neonates with HDN due to red cell alloimmunization, and it is independently associated with IUT treatment and rhesus D type of alloimmunization. Copyright © 2012 S. Karger AG, Basel.

  2. [A case of liver abscess caused by Fusobacterium nucleatum in a patient with recurrent periodontal diseases].

    Science.gov (United States)

    Kim, Yong Hwan; Yoon, Hee Jung; Park, Chan Woong; Kim, Jung Ho; Lee, Min Kyung; Kim, Ki Bang; Na, Dong Jib; Kim, Ji Myung

    2011-01-01

    Fusobacteria are anaerobic gram-negative, non-spore forming bacilli found in normal flora of the oral cavity, urogenital tract, and gastrointestinal tract. Fusobacterium nucleatum has been seldom reported as a cause of liver abscess, particularly in immunocompetent hosts. A 55-year-old man with frequent periodontal disease visited our hospital with intermittent fever and headache for 2 months. Abdominal CT scan revealed an 8.2 × 6 cm mass in the right hepatic lobe with central low density. Abscess culture revealed F. nucleatum as the causative organism. Percutaneous abscess drainage and intravenous administration of antibiotics for 4 weeks improved symptoms and decreased the abscess size. We report a rare case of liver abscess due to F. nucleatum in an immunocompetent man with periodontal disease.

  3. Studies on Lyme disease incidence rates in selected groups of forestry workers in West Pomerania, 2005–2014

    Directory of Open Access Journals (Sweden)

    Tomasz Stawicki

    2017-04-01

    Full Text Available Background: The data collected by sanitary-epidemiological stations in 2005–2014 were analyzed to determine the incidence rates of borreliosis Lyme disease in the West Pomerania group of workers exposed to tick bites. Material and Methods: It was assumed that an adequate comparison of official epidemiological data with the data concerning the number of exposed people, is an indispensable condition for assessing properly the trend in Lyme disease incidence rates, concerning at the same time a real scale of occupational exposure. The study covered a selected group of forestry workers, i.e., white-collar staff employed in different units of the State Forests National Forest Holding with their seats in West Pomerania. The aim of the research was to process and analyze the data on workers employed in the forest sector and their positions, requested from district sanitary-epidemiological stations. Results: In the years concerned 282 cases of the occupational disease were recorded mainly in the groups of forest rangers, junior foresters and forest service inspectors. The values of the incidence factor exhibit high variability with the major share of cases recorded in the years 2008–2010 that accounted for 61.8% of the total occurrences concerned. The incidence in the years 2008, 2009 and 2010 amounted to 2418, 2828 and 2646 cases per 100 000 employees, respectively. Conclusions: The results show that previously published information about the incidence of Lyme disease in the agriculture, forestry and hunting sector, did not fully illustrate a real scale of occupational risk. Med Pr 2017;68(2:211–220

  4. Controle químico da cigarrinha-do-milho e incidência dos enfezamentos causados por molicutes Chemical control of corn leafhopper and incidence of corn stunting diseases caused by mollicutes

    Directory of Open Access Journals (Sweden)

    Charles Martins de Oliveira

    2007-03-01

    Full Text Available O objetivo deste trabalho foi verificar a eficiência do tratamento inseticida de sementes de milho no controle de Dalbulus maidis e na redução da incidência de enfezamentos em viveiro telado e em campo. Foram realizados dois experimentos; no experimento 1, em viveiro telado, sementes de milho foram tratadas com imidacloprid e thiamethoxan e, nessas plantas, cigarrinhas sadias, cigarrinhas infectantes com fitoplasma ou com espiroplasma foram confinadas. Avaliaram-se eficiência de controle, incidência de plantas com enfezamentos, altura das plantas e produção de grãos. No experimento 2, em campo, imidacloprid e thiamethoxan foram utilizados em tratamento de sementes e pulverizações aos 10 e 20 dias após a semeadura. A incidência de enfezamentos e a produção de grãos foram avaliadas. Em viveiro telado, os produtos imidacloprid e thiamethoxan proporcionaram controle de adultos de D. maidis acima de 50%, até o trigésimo dia, e reduziram a incidência de doenças e danos no crescimento e produção das plantas infectadas expostas às cigarrinhas infectantes aos dois dias após a emergência. Em campo, não foi constatada redução na incidência de enfezamentos ou ganho em produção, possivelmente devido ao fluxo migratório de cigarrinhas infectantes.The objective of this work was to verify the efficiency of maize seed treatment on Dalbulus maidis control, and its effect on corn stunting diseases incidence, at screenhouse and at field. Two experiments were carried out. In the experiment 1 ( screenhouse, maize seeds were treated with imidacloprid or with thiamethoxan. Healthy leafhoppers, phytoplasma infective leafhoppers, and spiroplasma infective leafhoppers were confined in plants. Efficiency of control, incidence of plants with corn stunting diseases, plant height, and grain production were evaluated. In the experiment 2 (field imidacloprid and thiamethoxan were used for seed treatment and sprayed at 10 and 20 days after sowing

  5. Thyroid hormone levels and incident chronic kidney disease in euthyroid individuals: the Kangbuk Samsung Health Study.

    Science.gov (United States)

    Zhang, Yiyi; Chang, Yoosoo; Ryu, Seungho; Cho, Juhee; Lee, Won-Young; Rhee, Eun-Jung; Kwon, Min-Jung; Pastor-Barriuso, Roberto; Rampal, Sanjay; Han, Won Kon; Shin, Hocheol; Guallar, Eliseo

    2014-10-01

    Overt and subclinical hypothyroidism are associated with higher levels of serum creatinine and with increased risk of chronic kidney disease (CKD). The prospective association between thyroid hormones and kidney function in euthyroid individuals,however, is largely unexplored. We conducted a prospective cohort study in 104 633 South Korean men and women who were free of CKD and proteinuria at baseline and had normal thyroid hormone levels and no history of thyroid disease or cancer. At each annual or biennial follow-up visit, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxin (FT4) levels were measured by radioimmunoassay. The study outcome was incident CKD, defined as an estimated glomerular filtration rate (eGFR)<60 ml/min/1.73 m2 based on the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. After a median follow-up of 3.5 years, 1032 participants developed incident CKD.There was a positive association between high-normal levels of TSH and increased risk of incident CKD. In fully-adjusted models including baseline eGFR, the hazard ratio comparing the highest vs the lowest quintiles of TSH was 1.26 [95% confidence interval (CI) 1.02 to 1.55; P for linear trend=0.03]. In spline models, FT3 levels below 3 pg/ml were also associated with increased risk of incident CKD. There was no association between FT4 levels and CKD. In a large cohort of euthyroid men and women, high levels of TSH and low levels of FT3, even within the normal range, were modestly associated with an increased risk of incident CKD.

  6. Ocular surface disease incidence in patients with open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Radenković Marija

    2016-01-01

    Full Text Available Introduction. Ocular surface disease (OSD is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbances, tear film instability with potential damage to the ocular surface, accompanied by increased tear film osmolarity and inflammation of the ocular surface. It is a consequence of disrupted homeostasis of lacrimal functional unit. The main pathogenetic mechanism stems from tear hyperosmolarity and tear film instability. The etiological classification is hyposecretory (Sy-Sjögren and non-Sjögren and evaporative (extrinsic and intrinsic form. Delphi panel classification grades disease stages. Antiglaucoma topical therapy causes exacerbation or occurrence of symptoms of dry eye due to main ingredients or preservatives (benzalkonium chloride - BAK, which are dose- and time-dependent. BAK reduces the stability of the lipid layer of tears, the number of goblet cells, induces apoptosis and inflammatory infiltration. Objective. The aim of this study was the analysis of the OSD incidence in open-angle glaucoma patients caused by topical medicamentous therapy. Methods. Retrospective analysis of examined patients with open-angle glaucoma was used. Results. Increased incidence of moderate and advanced OSD Index degrees in the group of primary open-angle glaucoma (POAG and pseudoexfoliative glaucoma. According to the Delphi Panel Scale the most common grade is IIb (POAG and pseudoexfoliative glaucoma. Evaporative form of OSD prevailed in all treatment groups. High percentage of dry eye in patients with higher concentrations of preservatives applied was noticed. Conclusion. OSD should be timely diagnosed and treated. Dry eye has an impact on surgical outcome and postoperative visual acuity, and in order to improve patient compliance and quality of life, symptoms of dry eye should be addressed and medications with lower concentrations of preservatives should be applied.

  7. Ocular surface disease incidence in patients with open-angle glaucoma.

    Science.gov (United States)

    Radenković, Marija; Stanković-Babić, Gordana; Jovanović, Predrag; Djordjević-Jocić, Jasmina; Trenkić-Božinović, Marija

    2016-01-01

    Ocular surface disease (OSD) is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbances, tear film instability with potential damage to the ocular surface, accompanied by increased tear film osmolarity and inflammation of the ocular surface. It is a consequence of disrupted homeostasis of lacrimal functional unit. The main pathogenetic mechanism stems from tear hyperosmolarity and tear film instability. The etiological classification is hyposecretory (Sy-Sjögren and non-Sjögren) and evaporative (extrinsic and intrinsic) form. Delphi panel classification grades disease stages. Antiglaucoma topical therapy causes exacerbation or occurrence of symptoms of dry eye due to main ingredients or preservatives (benzalkonium chloride – BAK), which are dose- and time-dependent. BAK reduces the stability of the lipid layer of tears, the number of goblet cells, induces apoptosis and inflammatory infiltration. The aim of this study was the analysis of the OSD incidence in open-angle glaucoma patients caused by topical medicamentous therapy. Retrospective analysis of examined patients with open-angle glaucoma was used. Increased incidence of moderate and advanced OSD Index degrees in the group of primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma. According to the Delphi Panel Scale the most common grade is IIb (POAG and pseudoexfoliative glaucoma). Evaporative form of OSD prevailed in all treatment groups. High percentage of dry eye in patients with higher concentrations of preservatives applied was noticed. OSD should be timely diagnosed and treated. Dry eye has an impact on surgical outcome and postoperative visual acuity, and in order to improve patient compliance and quality of life, symptoms of dry eye should be addressed and medications with lower concentrations of preservatives should be applied.

  8. Global stability for infectious disease models that include immigration of infected individuals and delay in the incidence

    Directory of Open Access Journals (Sweden)

    Chelsea Uggenti

    2018-03-01

    Full Text Available We begin with a detailed study of a delayed SI model of disease transmission with immigration into both classes. The incidence function allows for a nonlinear dependence on the infected population, including mass action and saturating incidence as special cases. Due to the immigration of infectives, there is no disease-free equilibrium and hence no basic reproduction number. We show there is a unique endemic equilibrium and that this equilibrium is globally asymptotically stable for all parameter values. The results include vector-style delay and latency-style delay. Next, we show that previous global stability results for an SEI model and an SVI model that include immigration of infectives and non-linear incidence but not delay can be extended to systems with vector-style delay and latency-style delay.

  9. Association of Parkinson's disease with industry sectors: a French nationwide incidence study.

    Science.gov (United States)

    Vlaar, Tim; Kab, Sofiane; Schwaab, Yannick; Fréry, Nadine; Elbaz, Alexis; Moisan, Frédéric

    2018-05-05

    In order to identify working environments at risk for Parkinson's disease (PD), we investigated the relation between the importance of industry sectors, used as a surrogate for occupational exposures, and PD incidence in French cantons. The number of incident PD cases (2010-2014) in 3689 cantons of metropolitan France was determined using drug claims from French National Health Insurance databases. The proportions of workers in 38 industry sectors in 2006 were calculated for each canton. Associations between the proportions of workers in industry sectors and PD age/sex-standardized incidence ratios were examined using incidence rate ratios (IRR) and 95% confidence intervals (CI) estimated with multilevel negative binomial regressions with a random intercept at the canton-level and adjusted for smoking, deprivation index, and density of neurologists. We then used two-step semi-Bayes hierarchical regression (HR) to include prior information about exposure to pesticides, metals, and solvents in each industry sector. We identified 112,625 incident cases. PD incidence was higher in areas characterized by high proportions of workers in "Agriculture, forestry and fishing" (IRR HR  = 1.042; CI 95% = 1.014-1.070; p-Trend HR  = 0.004), "Manufacture of textiles, wearing apparel, leather and related products" (IRR HR  = 1.024; CI 95% = 1.005-1.044; p-Trend HR  = 0.010), and "Manufacture of basic metals and fabricated metal products, except machinery and equipment" (IRR HR  = 1.024; CI 95% = 1.003-1.046; p-Trend HR  = 0.071). This nationwide study, based on a comprehensive analysis of industry sectors, shows significant associations between high proportions of workers in specific industry sectors (agriculture, metallurgy, textile) and PD incidence that may be targeted in further epidemiological studies to replicate and better understand these associations.

  10. Evidence of immunocompetence reduction induced by cadmium exposure in honey bees (Apis mellifera).

    Science.gov (United States)

    Polykretis, P; Delfino, G; Petrocelli, I; Cervo, R; Tanteri, G; Montori, G; Perito, B; Branca, J J V; Morucci, G; Gulisano, M

    2016-11-01

    In the last decades a dramatic loss of Apis mellifera hives has been reported in both Europe and USA. Research in this field is oriented towards identifying a synergy of contributing factors, i.e. pathogens, pesticides, habitat loss and pollution to the weakening of the hive. Cadmium (Cd) is a hazardous anthropogenic pollutant whose effects are proving to be increasingly lethal. Among the multiple damages related to Cd contamination, some studies report that it causes immunosuppression in various animal species. The aim of this paper is to determine whether contamination by Cd, may have a similar effect on the honey bees' immunocompetence. Our results, obtained by immune challenge experiments and confirmed by structural and ultrastructural observations show that such metal causes a reduction in immunocompetence in 3 days Cd exposed bees. As further evidence of honey bee response to Cd treatment, Energy Dispersive X-ray Spectroscopy (X-EDS) has revealed the presence of zinc (Zn) in peculiar electron-dense granules in fat body cells. Zn is a characteristic component of metallothioneins (MTs), which are usually synthesized as anti-oxidant and scavenger tools against Cd contamination. Our findings suggest that honey bee colonies may have a weakened immune system in Cd polluted areas, resulting in a decreased ability in dealing with pathogens. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Peptic Ulcer Disease Risk in Chronic Kidney Disease: Ten-Year Incidence, Ulcer Location, and Ulcerogenic Effect of Medications

    Science.gov (United States)

    Liang, Chih-Chia; Muo, Chih-Hsin; Wang, I-Kuan; Chang, Chiz-Tzung; Chou, Che-Yi; Liu, Jiung-Hsiun; Yen, Tzung-Hai; Huang, Chiu-Ching; Chung, Chi-Jung

    2014-01-01

    Objectives We aimed at determining peptic ulcer disease (PUD) incidence among chronic kidney disease (CKD) patients during 1998–2008, compared to patients without CKD, and at examining associations between CKD and PUD. Methods Data for 1998–2008 were extracted from the National Health Insurance Research Database in Taiwan. The annual PUD incidence (cases per thousand persons per year) was calculated separately for patients with and without CKD. Characteristics of patients with newly diagnosed PUD (n = 16322) were compared to those of a control group without PUD (n = 32644). The 2 groups were matched for age, sex, and index year. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression. Results Over the 10-year period, the PUD incidence was ∼10–12 times higher in CKD patients than in those without CKD. Its incidence in elderly CKD patients increased rapidly over time. For CKD patients, most PUD events (>95%) were managed during hospitalization. Peptic ulcer risk, adjusted for all potential confounders, was much higher in CKD patients undergoing hemodialysis (adjusted OR, 9.74; 95% CI, 7.11–13.31). Maintenance hemodialysis patients were 2 times more likely to have gastric ulcers than duodenal ulcers, while CKD patients not on dialysis had similar risks for both. There were no significant interactions between medications and CKD status on the peptic ulcer risk. Unlike CKD patients on nonsteroidal anti-inflammatory drugs and clopidogrel, those on aspirin did not have a higher peptic ulcer risk (adjusted OR, 0.88; 95% CI, 0.44–1.77). Conclusions CKD patients have a substantially increased PUD risk, and the majority of CKD patients with PUD require hospital management. Further, peptic ulcer risk is affected by hemodialysis therapy, patient status (inpatient vs. outpatient), and ulcerogenic medications. PMID:24498412

  12. Effective testing for pulmonary tuberculosis using Xpert MTB/RIF assay for stool specimens in immunocompetent Pakistani children

    Directory of Open Access Journals (Sweden)

    Zahra Hasan

    2016-01-01

    Conclusion: Use of Xpert MTB/RIF assay for stool-based diagnosis of pulmonary TB in immunocompetent children is useful in a resource poor setting. This is a valuable and noninvasive diagnostic alternative for the diagnosis of childhood TB and can be adapted by pediatric arms of national TB programs.

  13. The inverse association of incident cardiovascular disease with plasma bilirubin is unaffected by adiponectin

    NARCIS (Netherlands)

    Dullaart, Robin P. F.; Boersema, Jeltje; Lefrandt, Joop D.; Wolffenbuttel, Bruce H. R.; Bakker, Stephan J. L.

    Objective: Bilirubin may protect against atherosclerotic cardiovascular disease (CVD). The heme oxygenase pathway is crucial for bilirubin generation, and is stimulated by adiponectin. We tested the relationship of plasma bilirubin with adiponectin, and determined whether the association of incident

  14. An unusual outcome in a child with hepatosplenic cat-scratch disease.

    Science.gov (United States)

    Vukelić, Dalibor; Benić, Branka; Bozinović, Dragomir; Vuković, Branka; Dakovic Rode, Oktavija; Culig, Zdravka; Vuković, Jurica; Batinica, Stipe; Visnjić, Stjepan; Puljiz, Ivan

    2006-10-01

    Typical cat-scratch disease (Bartonella henselae infection) in an immunocompetent child is usually associated with a history of scratch, bite or intimate contact with a cat. Most patients develop a non-tender papule in the scratch line after three to ten days. This may persist for only a few days or as long as two to three weeks. During the next two weeks or more, regional lymph nodes that drain the area gradually enlarge and then slowly resolve in more than 10% of patients. The nodes develop overlying erythema and may suppurate. Atypical forms of cat-scratch disease occur in a minority of cases and are characterized by ocular or neurological manifestations, hepatosplenic involvement, vertebral osteomyelitis, endocarditis etc. Immunocompromised individuals with B. henselae infection may develop bacillary angiomatosis, bacillary peliosis, and relapsing bacteremia. There have been several reports of hepatosplenic granulomas caused by B. henselae in immunocompetent children. We report a case of a 6-year-old boy with the hepatosplenic form of cat-scratch disease. Despite early diagnosis and long-term antimicrobial treatment, splenectomy could not be avoided.

  15. Incidence of Interval Colorectal Cancer Among Inflammatory Bowel Disease Patients Undergoing Regular Colonoscopic Surveillance

    NARCIS (Netherlands)

    Mooiweer, Erik; van der Meulen-de Jong, Andrea E.; Ponsioen, Cyriel Y.; van der Woude, C. Janneke; van Bodegraven, Ad A.; Jansen, Jeroen M.; Mahmmod, Nofel; Kremer, Willemijn; Siersema, Peter D.; Oldenburg, Bas

    2015-01-01

    Surveillance is recommended for patients with long-term inflammatory bowel disease because they have an increased risk of colorectal cancer (CRC). To study the effectiveness of surveillance, we determined the incidence of CRC after negative findings from surveillance colonoscopies (interval CRC).

  16. Incidence of Interval Colorectal Cancer Among Inflammatory Bowel Disease Patients Undergoing Regular Colonoscopic Surveillance

    NARCIS (Netherlands)

    Mooiweer, E.; Maulen- de Jong, A.E. van der; Ponsioen, C.Y.; Woude, C.J. van der; Bodegraven, A.A. van; Jansen, J.M.; Mahmmod, N.; Kremer, W.; Siersema, P.D.; Oldenburg, B.

    2015-01-01

    BACKGROUND & AIMS: Surveillance is recommended for patients with long-term inflammatory bowel disease because they have an increased risk of colorectal cancer (CRC). To study the effectiveness of surveillance, we determined the incidence of CRC after negative findings from surveillance colonoscopies

  17. Financial and Health Literacy Predict Incident Alzheimer's Disease Dementia and Pathology.

    Science.gov (United States)

    Yu, Lei; Wilson, Robert S; Schneider, Julie A; Bennett, David A; Boyle, Patricia A

    2017-01-01

    Domain specific literacy is a multidimensional construct that requires multiple resources including cognitive and non-cognitive factors. We test the hypothesis that domain specific literacy is associated with Alzheimer's disease (AD) dementia and AD pathology after controlling for cognition. Participants were community-based older persons who completed a baseline literacy assessment, underwent annual clinical evaluations for up to 8 years, and agreed to organ donation after death. Financial and health literacy was measured using 32 questions and cognition was measured using 19 tests. Annual diagnosis of AD dementia followed standard criteria. AD pathology was examined postmortem by quantifying plaques and tangles. Cox models examined the association of literacy with incident AD dementia. Performance of model prediction for incident AD dementia was assessed using indices for integrated discrimination improvement and continuous net reclassification improvement. Linear regression models examined the independent association of literacy with AD pathology in autopsied participants. All 805 participants were free of dementia at baseline and 102 (12.7%) developed AD dementia during the follow-up. Lower literacy was associated with higher risk for incident AD dementia (p literacy measure had better predictive performance than the one with demographics and cognition only. Lower literacy also was associated with higher burden of AD pathology after controlling for cognition (β= 0.07, p = 0.035). Literacy predicts incident AD dementia and AD pathology in community-dwelling older persons, and the association is independent of traditional measures of cognition.

  18. Haemophilus influenzae Type a Meningitis in Immunocompetent Child, Oman, 2015.

    Science.gov (United States)

    Sawardekar, Kiran P

    2017-07-01

    Meningitis caused by Haemophilus influenzae type b (Hib) was eliminated in Oman after the introduction of Hib vaccine in 2001. However, a case of H. influenzae type a meningitis was diagnosed in a child from Oman in 2015, which highlights the need to monitor the incidence of invasive non-Hib H. influenzae disease.

  19. Incidence of root rot diseases of soybean in Multan Pakistan and its management by the use of plant growth promoting rhizobacteria

    International Nuclear Information System (INIS)

    Haq, M.I.; Tahir, M.I.; Mahmood, S.

    2012-01-01

    Eight villages in Multan district were surveyed to record incidence of disease and losses of soybean (Glycine max L.) caused by root rot fungi. The root incidence ranged 10-17% and losses ranged 6.75-15.5%. The evaluation of four PGPR isolates was used in combination with organic amendment for the management of root-rot disease incidence and to reduce the population of root pathogenic fungi and to increase the yield in field. This study demonstrated effective biological control by the PGPR isolates tested, thereby indicating the possibility of application of rhizobacteria for control of soil bor ne diseases of soybean in Pakistan and other countries. (author)

  20. Abdominal tuberculosis with periportal lymph node involvement mimicking pancreatic malignancy in an immunocompetent adolescent

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yeoun Joo; Park, Su-Eun [Pusan National University, Department of Pediatrics, Pusan National University Children' s Hospital, School of Medicine, Yangsan (Korea, Republic of); Hwang, Jae-Yeon; Kim, Yong-Woo; Lee, Jun Woo [Pusan National University, Department of Radiology, Pusan National University Yangsan Hospital, School of Medicine, Yangsan (Korea, Republic of)

    2014-11-15

    Abdominal tuberculosis manifesting as isolated lymphadenopathy is rare, particularly in children. Tuberculous involvement of the pancreatic head and peripancreatic area can simulate a neoplasm of the pancreatic head. To our knowledge, obstructive jaundice caused by tuberculous lymphadenopathy has not been reported in children or adolescents. Here we present radiologic findings in a case of tuberculous lymphadenopathy that mimicked malignancy of the pancreatic head and caused obstructive jaundice in an immunocompetent adolescent. (orig.)

  1. Abdominal tuberculosis with periportal lymph node involvement mimicking pancreatic malignancy in an immunocompetent adolescent

    International Nuclear Information System (INIS)

    Lee, Yeoun Joo; Park, Su-Eun; Hwang, Jae-Yeon; Kim, Yong-Woo; Lee, Jun Woo

    2014-01-01

    Abdominal tuberculosis manifesting as isolated lymphadenopathy is rare, particularly in children. Tuberculous involvement of the pancreatic head and peripancreatic area can simulate a neoplasm of the pancreatic head. To our knowledge, obstructive jaundice caused by tuberculous lymphadenopathy has not been reported in children or adolescents. Here we present radiologic findings in a case of tuberculous lymphadenopathy that mimicked malignancy of the pancreatic head and caused obstructive jaundice in an immunocompetent adolescent. (orig.)

  2. Trends in incidence of end-stage renal disease among persons with diagnosed diabetes--Puerto Rico, 1996-2010.

    Science.gov (United States)

    Burrows, Nilka Rios; Hora, Israel; Williams, Desmond E; Geiss, Linda S

    2014-03-07

    During 2010, approximately 6,091 persons aged ≥18 years in Puerto Rico were living with end-stage renal disease (ESRD) (i.e., kidney failure that requires regular dialysis or kidney transplantation for survival). This included 1,462 persons who began treatment for ESRD in 2010. Diabetes is the leading cause of ESRD in Puerto Rico, accounting for 66% of new cases in adults, followed by hypertension, which accounts for 15% of the cases. Although the number of adults initiating ESRD treatment (i.e., dialysis or kidney transplantation) in Puerto Rico each year who have diabetes listed as a primary cause (ESRD-D) has increased since 1996, ESRD-D incidence among adults with diagnosed diabetes has not shown a consistent trend. To assess recent trends in ESRD-D incidence among adults aged ≥18 years in Puerto Rico with diagnosed diabetes and to further examine trends by age group and sex, CDC analyzed 1996-2010 data from the U.S. Renal Data System (USRDS) and the Behavioral Risk Factor Surveillance System (BRFSS). After increasing in the late 1990s, ESRD-D incidence decreased during the 2000s among adult men and among persons aged 18-44 years with diagnosed diabetes in Puerto Rico. Throughout the period, ESRD-D incidence among adult women and among persons aged 45-64 and ≥75 years with diagnosed diabetes did not show a consistent trend, and ESRD-D incidence among persons aged 65-74 years with diagnosed diabetes increased. Increased awareness of the risk factors for kidney disease and implementation of effective interventions to prevent or delay kidney disease among persons with diagnosed diabetes might decrease ESRD incidence in Puerto Rico, particularly among women and older persons.

  3. Epidemiology of inflammatory bowel disease in Málaga: incidence rate and follow-up of a cohort diagnosed between 2007-2008.

    Science.gov (United States)

    Cueto Torreblanca, Ignacio; Camargo Camero, Raquel; Andrade Bellido, Raúl; Romero Pérez, Eduardo; Alcaín Martínez, Guillermo

    2017-08-01

    The incidence of inflammatory bowel disease (IBD) in Spain has been traditionally lower than in Northern European countries. Recent epidemiological studies have found that these differences are diminishing. This study estimates the incidence of IBD in Málaga (Spain), a city in Southern Spain and relates its results to those found in our neighboring countries. This was a prospective study designed to collect new cases diagnosed during the period from 2007-2008 and follow up these patients. Incidence is expressed as number of patients per 100,000 population per year. The population distribution found in the European Collaborative Study was used to standardize incidence rates. The gross incidence rate of IBD in Málaga is 9/105, the standardized incidence rate is 12.3/105 (9.7-15.6). These data are similar to those found in our surroundings, although a higher incidence rate for Crohn's disease (CD) as compared to ulcerative colitis (UC) was found. The clinical characteristics and outcomes of our patients do not differ significantly from those described for other populations.

  4. Aetiology-Specific Estimates of the Global and Regional Incidence and Mortality of Diarrhoeal Diseases Commonly Transmitted through Food

    DEFF Research Database (Denmark)

    Pires, Sara Monteiro; Fischer-Walker, Christa L; Lanata, Claudio F

    2015-01-01

    Diarrhoeal diseases are major contributors to the global burden of disease, particularly in children. However, comprehensive estimates of the incidence and mortality due to specific aetiologies of diarrhoeal diseases are not available. The objective of this study is to provide estimates of the gl...

  5. Effects of different irrigation methods on pepper yield and soilborne diseases incidence

    Directory of Open Access Journals (Sweden)

    Seral YÜCEL

    2013-12-01

    Full Text Available In this study, the effect of different irrigation strategies and irrigation methods on yields and the incidence of wilt (Fusarium oxysporum and root rot (Fusarium solani and Macrophomina phaseolina diseases causing significant yield losses on field grown processing red pepper is determined. Experiments were carried out at Topçu Station of the Soil and Water Resources Research Institute of Tarsus in 2010 and 2011. Karaisalı processing pepper (Capsicum annuum L. was used in the experiments. Three furrows and five drip irrigation treatments were used in the study. The disease incidence rates were found 8.0-18.2% in furrow irrigation plots and 4.5-10.0% in drip irrigation plots in 2010, while it was 3.4-9.7% in furrow irrigation plots and 2.2-4.5% in drip irrigation plots in 2011. Pepper yields ranged from 3 416 to 4 417 kg da-1 and 3 376 to 4 779 kg da-1 in drip irrigated plots in 2010 and 2011, respectively. However, yields varied between 3 172-3 559 kg da-1 and 2 932-4 150 kg da-1 in furrow irrigated plots in 2010 and 2011 growing seasons.

  6. The immunocompetence handicap hypothesis in two sexually dimorphic pinniped species - there a sex difference in immunity during early development?

    NARCIS (Netherlands)

    Hall, A.J.; Engelhard, G.H.; Brasseur, S.M.J.M.; Vecchione, A.; Burton, H.R.; Reijnders, P.J.H.

    2003-01-01

    The 'immunocompetence handicap hypothesis' predicts that highly sexually dimorphic and polygynous species will exhibit sex differences in immunity. We tested this hypothesis in southern elephant and grey seals during their early development by measuring the following parameters: leucocyte counts,

  7. Effects of egg storage on hatchability, chick quality, performance and immunocompetence parameters of broiler chickens.

    Science.gov (United States)

    Goliomytis, Michael; Tsipouzian, Theofania; Hager-Theodorides, Ariadne L

    2015-09-01

    Pre-incubation egg storage is a necessity for the poultry industry. This study evaluated the effects of pre-incubation storage length of broiler eggs on hatchability, 1-day-old chick quality, subsequent performance, and immunocompetence. To this end, a total of 360 hatching eggs were stored for 4, 12, or 16 d prior to incubation. Hatchability and chick quality were assessed at hatch, and growth performance and immunocompetence parameters were assessed during a 35 d rearing period. Hatchability of set and fertile eggs, and embryonic mortality, were not affected by egg storage. On the contrary, 1-day-old chick BW and length were linearly negatively correlated with egg storage length (P-linearegg weight prior to setting was unaffected, and corrected chick length was positively affected by storage length. One-day-old chick Tona score, navel quality, and post-hatch growth performance (BW at 7 and 35 d, cumulative feed intake, and feed conversion ratio at 35 d) were unaffected by egg storage (P, P-linear>0.05). Lymphoid organ weights at 2 and 35 d, the titre of maternal anti-NDV antibodies, most of the thymocyte subpopulations defined by CD3, CD4, and CD8 cell surface expression in the thymus of 2-d-old chicks, cellular responses to the PHA skin test, humoral responses to primary SRBC, and NDV immunizations were also not influenced by length of storage (P, P-linear>0.05). On the contrary, the length of egg storage was found to negatively influence the abundance of CD3+CD4-CD8- thymocytes that represent the majority of γδ-T cells in the thymus of 2-day-old chicks, as well as the humoral response to booster NDV immunization of the birds. In brief, pre-incubation storage of broiler hatching eggs for up to 16 d did not affect most developmental and growth parameters investigated, except for BW and length at hatch. Egg storage was found to suppress some aspects of the immunocompetence of the birds, particularly aspects of acquired immunity. © 2015 Poultry Science

  8. Incidence of Interval Colorectal Cancer Among Inflammatory Bowel Disease Patients Undergoing Regular Colonoscopic Surveillance

    NARCIS (Netherlands)

    Mooiweer, Erik; van der Meulen-de Jong, Andrea E.; Ponsioen, Cyriel Y.; van der Woude, C. Janneke; van Bodegraven, Ad A.; Jansen, Jeroen M.; Mahmmod, Nofel; Kremer, Willemijn; Siersema, Peter D.; Oldenburg, Bas

    2015-01-01

    Surveillance is recommended for patients with long-term inflammatory bowel disease because they have an increased risk of colorectal cancer (CRC). To study the effectiveness of surveillance, we determined the incidence of CRC after negative findings from surveillance colonoscopies (interval CRC). We

  9. Incidence and predictors of end-stage renal disease in outpatients with systolic heart failure

    DEFF Research Database (Denmark)

    Bosselmann, Helle; Gislason, Gunnar; Gustafsson, Finn

    2013-01-01

    Background- Renal dysfunction is an important prognostic factor in heart failure (HF), but whether this dysfunction progresses to end-stage renal disease (ESRD) is unknown. Therefore, we examined incidence and predictors of ESRD in outpatients with HF. Methods and Results- Patients with systolic ...

  10. Vitamin D status, liver enzymes, and incident liver disease and mortality

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Borglykke, Anders

    2014-01-01

    , alcohol consumption, smoking, physical activity, dietary habits, education, body mass index, and ALT). The risk of having a high level of ALT, AST, or GGT tended to be higher for lower vitamin D levels, although not statistically significant. In this general population study, vitamin D status...... was inversely associated with incident liver disease. Further studies are needed to determine whether patients in risk of developing impaired liver function should be screened for vitamin D deficiency for preventive purposes....

  11. Incidence of congenital heart disease among neonates in a neonatal unit of a tertiary care hospital

    International Nuclear Information System (INIS)

    Hussain, S.; Sabir, M.U.

    2014-01-01

    Objectives: To determine the incidence and pattern of various congenital heart disease in a neonatal unit of a tertiary care hospital. Methods: The prospective study was carried out in the neonatal unit of Combined Military Hospital, Rawalpindi, from September 2008 to August 2011. All 5800 neonates admitted with gestational age of >28 weeks irrespective of birthweight were included in the study. Neonatologist/Paediatrician carried out the neonatal examination during the first 12 hours of life. Neonates suspected of having congenital heart disease were further evaluated by pulse oxymetry, X-ray chest and echocardiography to ascertain final diagnosis and type of lesion. Data was collected on a predesigned proforma containing information regarding gender, mode of delivery, gestational age, weight at birth, family history, and associated malformations. SPSS 16 was used for statistical analysis. Results: Of the 5800 neonates, 87 (1.5%) were found to have congenital heart disease with an incidence of 15/1000. There was a male preponderance. Most common lesion was ventricular septal defect 27(31.3%), followed by atrial septal defect 20 (22.9%), patent ductus arteriosus 13 (14.94%), tetralogy of fallot 06 (6.89%), transposition of great arteries 04 (4.59%), Pulmonary stenosis 05 (5.79%) and 03(3.44%) had atrioventricular canal defects. Conclusion: Congenital heart disease is a common congenital anomaly. Its incidence varies from centre to centre due to different factors like nature of the sample, method of detection and early examination by a neonatologist/paediatrician. In this study a higher incidence is reported because it was carried out in a tertiary care unit, which is a referral hospital and all the neonates admitted in the unit were included in the study. (author)

  12. INCIDENCE OF STUNTING AND ITS RELATIONSHIP WITH FOOD INTAKE, INFECTIOUS DISEASES, AND ECONOMIC STATUS IN KENDARI, SOUTHEAST SULAWESI, INDONESIA

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    Akhmad

    2016-12-01

    Full Text Available Background: Stunting is characterized by inhibition of growth in children that lead to failure in getting normal heights and healthy child's age. It is a public health problem in the working area of Public Health Center of Mata, Kelurahan Mangga Dua in Kendari in 2016. Objective: This study aims to examine the relationship between food intake, infectious diseases, economic status and the incidence of stunting in Kendari, Southeast Sulawesi, Indonesia Methods: This was a descriptive cross sectional study with retrospective approach. This research was conducted in Public Health Center of Mata. There were 41 respondents were selected as the samples. Data were collected by questionnaires, observation, and documentation. Data were analyzed using Chi-Square test. Results: The results showed that there were significant associations between food intake (p= 0.001, infectious diseases (p= 0.000, economic status (p= 0.000, and the incidence of stunting in infants. Conclusions: It can be concluded that there is a relationship between food intake, infectious diseases and economic status with the incidence of stunting in children aged 2-4 years in the working area of Public Health Center of Mata, Kendari. Therefore, good food intake is needed for the growth and development of the child. Moreover, changing the behavior of parents by doing the healthy and clean behavior in the household to prevent infectious diseases in children infectious diseases is also very important. Economic status however also plays key role in the incidence of stunting in children

  13. Hyperthyroidism incidence fluctuates widely in and around pregnancy and is at variance with some other autoimmune diseases: a Danish population-based study.

    Science.gov (United States)

    Andersen, Stine Linding; Olsen, Jørn; Carlé, Allan; Laurberg, Peter

    2015-03-01

    Hyperthyroidism in women of reproductive age is predominantly caused by Graves' disease. Pregnancy associated changes in the immune system may influence the onset of disease, but population-based incidence rates in and around pregnancy have not been reported. The objective of the study was to estimate the incidence of maternal hyperthyroidism (defined by redeemed prescription of antithyroid drugs) in and around pregnancy and to compare this with the incidence of other autoimmune diseases such as rheumatoid arthritis (RA) and inflammatory bowel disease (IBD). This was a population-based cohort study. The study used the Danish nationwide registers. The participants were women who gave birth to singleton liveborn children in Denmark from 1999 to 2008 (n = 403,958). Incidence rates (IR) of maternal hyperthyroidism during a 4-year period beginning 2 years before and ending 2 years after the date when the mother was giving birth for the first time in the study period were measured. Altogether 3673 women (0.9%) were identified with an onset of hyperthyroidism from 1997 to 2010, and the overall IR of maternal hyperthyroidism was 65.0/100,000/year. The IR of hyperthyroidism in and around pregnancy varied widely and was high in the first 3 months of pregnancy [incidence rate ratio (IRR) vs the remaining study period: 1.50 (95% CI 1.09-2.06)), very low in the last 3 months of pregnancy (0.26 (0.15-0.44)], and reached the highest level 7-9 months postpartum [3.80 (2.88-5.02)]. The incidence variation in and around pregnancy was different for RA and IBD. These are the first population-based data on the incidence of hyperthyroidism in and around pregnancy. The incidence of hyperthyroidism was high in early pregnancy and postpartum, whereas such particular pattern was not observed for other diseases of autoimmune origin.

  14. Incidence and phylogenetic analyses of Armillaria spp. associated with root disease in peach orchards in the State of Mexico, Mexico

    Science.gov (United States)

    R. D. Elias-Roman; R. A. Guzman-Plazola; N. B. Klopfenstein; D. Alvarado-Rosales; G. Calderon-Zavala; J. A. Mora-Aguilera; M.-S. Kim; R. Garcia-Espinosa

    2013-01-01

    Incidence of peach [Prunus persica (L.) Batsch] tree mortality attributed to Armillaria root disease was assessed from 2009 to 2011 in 15 orchards in the State of Mexico, Mexico. Incidence increased gradually every year of assessment, reaching average values of 9.7, 15.3 and 20.3% tree mortality and 23.2, 24.7 and 28.3% disease-impacted area of the orchards during 2009...

  15. Low incidence of lymphoproliferative disease post kidney transplantation with prevalent use of alemtuzumab

    Directory of Open Access Journals (Sweden)

    John Fredy Nieto-Ríos

    2014-01-01

    Full Text Available Introduction: It is well known that the incidence of malignancy is significantly higher in transplanted patients than in general population. The incidence of lymphoproliferative disease post-transplantation (PTLD is approximately of 1% to 2% in kidney transplantation recipients. Objective: The main objective of this study was to evaluate the PTLD incidence when monitoring kidney transplanted patients between the years 2005 and 2010. Methods: Kidney transplanted patients’ data was retrospectively taken between the years 2005 to 2010 in order to determine the number of PTLD cases according to the inductor scheme used. Results: 425 patients were transplanted between 2005 and 2010. They received alemtuzumab 76.2%, daclizumab 10.7%, basiliximab 3.6% and thymoglobulin 2.4%. The 7% did not receive antibody induction. During this period 2 cases of PTLD ocurred: One with multiple myeloma and the other with lymphoma. One of them had been treated with alemtuzumab and the other with thymoglobulin. Conclusions: The PTLD incidence in our group, where alemtuzumab was used predominantly as inductor, was very low; this might suggest that alemtuzumab is a medication that does not increase the risk of this kind of neoplasia.

  16. Changing incidence of diverticular disease of the colon in Korea : a serial radiologic study (report III)

    Energy Technology Data Exchange (ETDEWEB)

    Kwoen, Young Teck; Han, Sung Il; Chung, Soo Kyo; Bahk, Yong Whee [Catholic University Medical College, Seoul (Korea, Republic of)

    1988-10-15

    Diverticular disease of the colon (DDC), the most common affliction in developed countries, increases in incidence. It is an acquired disease where overactivity of smooth muscle of the colon causes mucosa and sub mucosa to herniate through the muscle layer of the bowel. Starting from 1964, we have periodically carried out radiologic survey to acertain the tendency of DDC to gradually increase in the Koreans. Initially Kim reported the incidence to be 0.2% in 1964 but the incidence in 1979 increased to 2.5% as reported by Chung et al. As the third survey on the series of the study on DDC, we have recently reviewed 1,859 consecutive new cases of double contrast barium enemas performed at the department of radiology, Kangnam St. Mary's Hospital, Catholic University Medical College during the 5 year's period from Feb. 1983 to May 1987. The results were as follows. 1. The present study revealed an incidence 6.0% of DDC, 7.2% in male and 5.0% in female. 2. The distribution of diverticular was 37.0% in cecum, 39.0% in ascending colon, 13.6% in transverse colon, 6.2% in descending colon, 3.7% in sigmoid colon. 3. The mean number of diverticular was 5. 4. The average age of patients with DDC was 50.5 years. From the present study, it has emerged that the diverticular disease of the colon in the Koreans is definitely on gradual increase with a significant change in the site of predominant involvement from the right to the left colon.

  17. Changing incidence of diverticular disease of the colon in Korea : a serial radiologic study (report III)

    International Nuclear Information System (INIS)

    Kwoen, Young Teck; Han, Sung Il; Chung, Soo Kyo; Bahk, Yong Whee

    1988-01-01

    Diverticular disease of the colon (DDC), the most common affliction in developed countries, increases in incidence. It is an acquired disease where overactivity of smooth muscle of the colon causes mucosa and sub mucosa to herniate through the muscle layer of the bowel. Starting from 1964, we have periodically carried out radiologic survey to acertain the tendency of DDC to gradually increase in the Koreans. Initially Kim reported the incidence to be 0.2% in 1964 but the incidence in 1979 increased to 2.5% as reported by Chung et al. As the third survey on the series of the study on DDC, we have recently reviewed 1,859 consecutive new cases of double contrast barium enemas performed at the department of radiology, Kangnam St. Mary's Hospital, Catholic University Medical College during the 5 year's period from Feb. 1983 to May 1987. The results were as follows. 1. The present study revealed an incidence 6.0% of DDC, 7.2% in male and 5.0% in female. 2. The distribution of diverticular was 37.0% in cecum, 39.0% in ascending colon, 13.6% in transverse colon, 6.2% in descending colon, 3.7% in sigmoid colon. 3. The mean number of diverticular was 5. 4. The average age of patients with DDC was 50.5 years. From the present study, it has emerged that the diverticular disease of the colon in the Koreans is definitely on gradual increase with a significant change in the site of predominant involvement from the right to the left colon.

  18. Life-Threatening Hypercalcemia During Prodrome of Pneumocystis jiroveci Pneumonia in an Immunocompetent Infant

    Directory of Open Access Journals (Sweden)

    Judith Sebestyen VanSickle MD

    2017-04-01

    Full Text Available Severe hypercalcemia in infants is usually attributed to genetic etiologies and less commonly to acquired ones. An 8-week-old girl presented with failure to thrive, mild respiratory distress, and life-threatening hypercalcemia (23.5 mg/dL. Serum 1,25(OH2-vitamin D (1,25(OH2-D level was elevated and parathyroid hormone undetectable. Evaluation for genetic mutations and malignant etiologies of hypercalcemia was negative. Treatment with intravenous hydration, loop diuretic, and calcitonin failed to correct the hypercalcemia, which was subsequently controlled with bisphosphonate therapy. Due to progressive respiratory deterioration, a bronchopulmonary lavage was done on day 17 of her hospitalization disclosing Pneumocystis jiroveci infection. The subsequent immunological investigation showed no abnormalities. She was treated with trimethoprim/sulfamethoxazole resulting in gradual clearing of her lungs and normalization of serum 1,25(OH2-D level. A year later, she remains healthy with normal biochemical parameters of mineral metabolism. We conclude that in a child with hypercalcemia with suppressed parathyroid hormone and elevated 1,25(OH2-D, once the genetic etiology for elevated 1,25(OH2-D and malignancy are ruled out, one should investigate closely for a chronic granulomatous disease. Among the latter Pneumocystis jiroveci pneumonia infection should be considered even in an immunocompetent child.

  19. [Pneumococcal vaccine recommendations in chronic respiratory diseases].

    Science.gov (United States)

    Casas Maldonado, F; Alfageme Michavila, I; Barchilón Cohen, V S; Peis Redondo, J I; Vargas Ortega, D A

    2014-09-01

    Community-acquired pneumonia is an acute respiratory infectious disease which has an incidence of 3-8 cases/1,000 inhabitants, and increases with age and comorbidities. The pneumococcus is the organism most frequently involved in community-acquired pneumonia in the adult (30-35%). Around 40% of patients with community-acquired pneumonia require hospital admission, and around 10% need to be admitted to an intensive care unit. The most serious forms of pneumococcal infection include invasive pneumococcal disease (IPD), which covers cases of bacteremia (associated or not to pneumonia), meningitis, pleuritis, arthritis, primary peritonitis and pericarditis. Currently, the biggest problem with the pneumococcus is the emergence of resistance to antimicrobial agents, and its high morbimortality, despite the use of appropriate antibiotics and proper medical treatment. Certain underlying medical conditions increase the risk of IPD and its complications, especially, from the respiratory diseases point of view, smoking and chronic respiratory diseases. Pneumococcal disease, according to the WHO, is the first preventable cause of death worldwide in children and adults. Among the strategies to prevent IPD is vaccination. WHO considers that its universal introduction and implementation against pneumococcus is essential and a priority in all countries. There are currently 2 pneumococcal vaccines for adults: the 23 serotypes polysaccharide and conjugate 13 serotypes. The scientific societies represented here have worked to develop some recommendations, based on the current scientific evidence, regarding the pneumococcal vaccination in the immunocompetent adult with chronic respiratory disease and smokers at risk of suffering from IPD. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  20. Men's and Women's Health Beliefs Differentially Predict Coronary Heart Disease Incidence in a Population-Based Sample

    Science.gov (United States)

    Korin, Maya Rom; Chaplin, William F.; Shaffer, Jonathan A.; Butler, Mark J.; Ojie, Mary-Jane; Davidson, Karina W.

    2013-01-01

    Objective: To examine gender differences in the association between beliefs in heart disease preventability and 10-year incidence of coronary heart disease (CHD) in a population-based sample. Methods: A total of 2,688 Noninstitutionalized Nova Scotians without prior CHD enrolled in the Nova Scotia Health Study (NSHS95) and were followed for 10…

  1. Onychomycosis due to Cunninghamella bertholletiae in an Immunocompetent Male from Central India

    Directory of Open Access Journals (Sweden)

    Karuna Tadepalli

    2015-01-01

    Full Text Available Onychomycosis is a fungal infection of nails seen frequently in immune competent and immune compromised patients due to dermatophytes, Candida spp., Fusarium spp., Scopulariopsis brevicaulis, Penicillium spp., and Aspergillus spp. We report a case of onychomycosis in a young immunocompetent male who presented onycholysis of a solitary nail without inflammation. The etiological agent was diagnosed to be Cunninghamella bertholletiae, a fungus pertaining to the order Mucorales (subdivision Mucoromycotina and known for some of the invasive lesions among immunocompromised patients. This case demonstrates the association of onychomycosis with Cunninghamella bertholletiae in an immune competent individual, not reported so far.

  2. Microsporidial keratoconjunctivitis in an immunocompetent patient with a past history of laser in situ keratomilieusis surgery

    Directory of Open Access Journals (Sweden)

    M L Bommala

    2011-01-01

    Full Text Available Ocular infection with microsporidia has been documented in both immunocompetent and immunocompromised patients. Sources and mode of human infection with microsporidia have been difficult to ascertain although exposure to water may be an important risk factor. Of four genera that have been reported in human disease, only the genera Nosema, Encephalitozoon and Septata are documented to cause ocular infection. Here, in our case a healthy 30-year-old man who had undergone bilateral laser in situ keratomilieusis surgery two and half years back presented with a 10-day history of redness and 4-day history of blurring of vision in the right eye. On presentation, his best-corrected visual acuity was 20/20 partial in both eyes. Slit lamp examination revealed multiple pin head shaped infiltrates in the right cornea. Examination of the left eye was unremarkable. Based on microscopic demonstration of numerous microsporidial spores in the corneal scrapings, a diagnosis of microsporidial keratitoconjunctivitis was made. On treatment with oral albendazole, the cornea became clear with complete resolution of symptoms and signs within two weeks.

  3. Optimized oral cholera vaccine distribution strategies to minimize disease incidence: A mixed integer programming model and analysis of a Bangladesh scenario.

    Science.gov (United States)

    Smalley, Hannah K; Keskinocak, Pinar; Swann, Julie; Hinman, Alan

    2015-11-17

    In addition to improved sanitation, hygiene, and better access to safe water, oral cholera vaccines can help to control the spread of cholera in the short term. However, there is currently no systematic method for determining the best allocation of oral cholera vaccines to minimize disease incidence in a population where the disease is endemic and resources are limited. We present a mathematical model for optimally allocating vaccines in a region under varying levels of demographic and incidence data availability. The model addresses the questions of where, when, and how many doses of vaccines to send. Considering vaccine efficacies (which may vary based on age and the number of years since vaccination), we analyze distribution strategies which allocate vaccines over multiple years. Results indicate that, given appropriate surveillance data, targeting age groups and regions with the highest disease incidence should be the first priority, followed by other groups primarily in order of disease incidence, as this approach is the most life-saving and cost-effective. A lack of detailed incidence data results in distribution strategies which are not cost-effective and can lead to thousands more deaths from the disease. The mathematical model allows for what-if analysis for various vaccine distribution strategies by providing the ability to easily vary parameters such as numbers and sizes of regions and age groups, risk levels, vaccine price, vaccine efficacy, production capacity and budget. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Cognition and Incident Coronary Heart Disease in Late Midlife: The Whitehall II Study

    Science.gov (United States)

    Singh-Manoux, Archana; Sabia, Severine; Kivimaki, Mika; Shipley, Martin J.; Ferrie, Jane E.; Marmot, Michael G.

    2009-01-01

    The purpose of this study was to investigate whether cognitive function in midlife predicts incident coronary heart disease (CHD), followed up over 6 years. Data on 5292 (28% women, mean age 55) individuals free from CHD at baseline were drawn from the British Whitehall II study. We used Cox regression to model the association between cognition…

  5. Fulminant Invasive Pulmonary Aspergillosis After a Near-Drowning Accident in an Immunocompetent Patient.

    Science.gov (United States)

    Ratermann, Kelley L; Ereshefsky, Benjamin J; Fleishaker, Elise L; Thornton, Alice C; Buch, Ketan P; Martin, Craig A

    2014-09-01

    To report on invasive aspergillosis infection in an immunocompetent adult after a near-drowning event, which allowed this pathogen to easily gain access to the human respiratory system and result in rapid, severe infection. A 51-year-old female developed severe pneumonia after a near-drowning accident. Two days after admission, a bronchial alveolar lavage (BAL) was performed and was positive for Aspergillus fumigatus. After a 30-day hospital course, multiple antifungals, and various routes of administration, the patient expired. Pneumonia is particularly common because of the aspiration of contaminated water. Whereas pneumococci, staphylococci, and Gram-negative bacteria are all common pathogens for this type of infection, fungi such as Aspergillus spp can also be involved and may be life threatening. Typically, these cases are reported in individuals with an immunodeficiency such as from receipt of myelosuppressive chemotherapy, bone marrow transplants, or lung transplants. Despite initiation of an appropriate empirical antifungal regimen, the rapid recovery of A fumigatus from pulmonary alveolar lavage and BAL samples as well as extremely elevated levels of galactomannan and (1→3)-β-D glucan may have indicated an invasive fungal infection (IFI). IFIs are uncommon in immunocompetent adults, but in the event of a near-drowning accident, environmental fungi can gain access to the human respiratory system and result in rapid, severe infection. Based on this case and the others described, it appears that near-drowning patients need an early initial evaluation for IFI. © The Author(s) 2014.

  6. Incidence, risk factors and treatment of diarrhoea among Dutch travellers: reasons not to routinely prescribe antibiotics.

    Science.gov (United States)

    Belderok, Sanne-Meike; van den Hoek, Anneke; Kint, Joan A; Schim van der Loeff, Maarten F; Sonder, Gerard Jb

    2011-10-29

    Travellers' diarrhoea (TD) is the most common infectious disease among travellers. In the Netherlands, stand-by or prophylactic antibiotics are not routinely prescribed to travellers. This study prospectively assessed the incidence rate, risk factors, and treatment of TD among immunocompetent travellers. Persons who attended the travel clinic of the Public Health Service Amsterdam in 2006-2007 before short-term travel to tropical and subtropical countries were invited to answer a questionnaire regarding sociodemographics and travel purpose; they were also asked to keep a daily structured travel diary, recording their itinerary, symptoms, and self-medication or consultation with a doctor. Diarrhoea episodes containing blood or mucous were considered severe. Of 1202 travellers, the median age was 38 years, and the median travel duration 3 weeks. Of all episodes, 96% were mild. The median duration of TD was 2 days and significantly shorter in subsequent episodes compared to first episodes (p sex, a Western country of birth, and tourism as the purpose of travel. The lowest risk was in travellers to South America. An independent risk factor for subsequent episodes was female sex. In total, 5% of travellers used antibiotics; of those, 92% had mild diarrhoea, and 53% received antibiotics over the counter. TD is common among travellers, but the overall course is mild, not requiring treatment. The incidence rates for first and second episodes are comparable. Female sex is a risk factor for the first episode, as well as subsequent ones. Prescription antibiotics are not needed in short-term healthy travellers.

  7. Incidence and Prevalence of Celiac Disease and Dermatitis Herpetiformis in the UK Over Two Decades: Population-Based Study

    Science.gov (United States)

    West, Joe; Fleming, Kate M; Tata, Laila J; Card, Timothy R; Crooks, Colin J

    2014-01-01

    OBJECTIVES: Few studies have quantified the incidence and prevalence of celiac disease (CD) and dermatitis herpetiformis (DH) nationally and regionally by time and age groups. Understanding this epidemiology is crucial for hypothesizing about causes and quantifying the burden of disease. METHODS: Patients with CD or DH were identified in the Clinical Practice Research Datalink between 1990 and 2011. Incidence rates and prevalence were calculated by age, sex, year, and region of residence. Incidence rate ratios (IRR) adjusted for age, sex, and region were calculated with Poisson regression. RESULTS: A total of 9,087 incident cases of CD and 809 incident cases of DH were identified. Between 1990 and 2011, the incidence rate of CD increased from 5.2 per 100,000 (95% confidence interval (CI), 3.8–6.8) to 19.1 per 100,000 person-years (95% CI, 17.8–20.5; IRR, 3.6; 95% CI, 2.7–4.8). The incidence of DH decreased over the same time period from 1.8 per 100,000 to 0.8 per 100,000 person-years (average annual IRR, 0.96; 95% CI, 0.94–0.97). The absolute incidence of CD per 100,000 person-years ranged from 22.3 in Northern Ireland to 10 in London. There were large regional variations in prevalence for CD but not DH. CONCLUSIONS: We found a fourfold increase in the incidence of CD in the United Kingdom over 22 years, with large regional variations in prevalence. This contrasted with a 4% annual decrease in the incidence of DH, with minimal regional variations in prevalence. These contrasts could reflect differences in diagnosis between CD (serological diagnosis and case finding) and DH (symptomatic presentation) or the possibility that diagnosing and treating CD prevents the development of DH. PMID:24667576

  8. [Chronic renal disease in Puerto Rico: incidence, prevalence, and mortality in 2000-2008].

    Science.gov (United States)

    Rodríguez Ortiz, Ylene D; Miranda, Glenda; Burgos Calderón, Rafael; Depine, Santos; Ojo, Otegbola

    2011-01-01

    End-Stage Renal Disease (ESRD) is a global public health problem. Although there are strategies for its prevention, the number of cases has increased. In order to understand current situation in Puerto Rico (PR) we review available data, which is presented in a descriptive report of the incidence, prevalence and mortality of ESRD during the period 2000-2008. In addition, we compare the incidence and prevalence rates with regard to other countries. We used 2000-2008 USRDS statistics and the QIRN3 for patients on dialysis. Transplanted patients were excluded. Crude rates of incidence and prevalence in PR were calculated for comparison with the United States and other countries. Percentages were calculated to describe the demographic characteristics and primary diagnosis in 2008. During the period 2000-2008 the incidence rate increased by 21.6 percent; from 286.8 to 348.7 pmp. The prevalence rate increased by 27.3 percent; from 861.2 to 1096.2 pmp. The average annual growth in the incidence and prevalence was 2.4 percent and 3.0 percent respectively. During the same period, diabetes mellitus was the leading cause of ESRD reaching 67.4 percent of total new cases in 2008, while in the U.S. was 44.4 percent. Unadjusted mortality decreased slightly in 2008 to 18.5 percent. PR is the fifth country with the highest incidence of patient on dialysis and the first with ESRD due to diabetes mellitus. ESRD is becoming more common and prevalent in PR. We should be more aggressive in establishing public health strategies to reduce ESRD.

  9. Incidence and severity of coronary artery disease in patients with atrial fibrillation undergoing first-time coronary angiography.

    Directory of Open Access Journals (Sweden)

    Stefan Kralev

    Full Text Available In standard reference sources, the incidence of coronary artery disease (CAD in patients with atrial fibrillation (AF ranged between 24 and 46.5%. Since then, the incidence of cardiovascular risk factors (CRF has increased and modern treatment strategies ("pill in the pocket" are only applicable to patients without structural heart disease. The aim of this study was to investigate the incidence and severity of CAD in patients with AF.From January 2005 until December 2009, we included 261 consecutive patients admitted to hospital with paroxysmal, persistent or permanent AF in this prospective study. All patients underwent coronary angiography and the Framingham risk score (FRS was calculated. Patients with previously diagnosed or previously excluded CAD were excluded.The overall incidence of CAD in patients presenting with AF was 34%; in patients >70 years, the incidence of CAD was 41%. The incidence of patients undergoing a percutaneous coronary intervention (PCI or coronary artery bypass graft (CABG was 21%. Patients with CAD were older (73±8 years vs 68±10 years, p = 0.001, had significantly more frequent hypercholesterolemia (60% vs 30%, p<0.001, were more frequent smokers (26% vs 13%, p = 0.017 and suffered from angina more often (37% vs 2%, p<0.001. There was a significant linear trend among the FRS categories in percentage and the prevalence of CAD and PCI/CABG (p<0.0001.The overall incidence of CAD in patients presenting with AF was relatively high at 34%; the incidence of PCI/CABG was 21%. Based upon increasing CRF in the western world, we recommend a careful investigation respecting the FRS to either definitely exclude or establish an early diagnosis of CAD--which could contribute to an early and safe therapeutic strategy considering type Ic antiarrhythmics and oral anticoagulation.

  10. The immunocompetence handicap hypothesis in two sexually dimorphic pinniped species - is there a sex difference in immunity during early development?

    NARCIS (Netherlands)

    Hall, AJ; Englehard, GH; Brasseur, SMJM; Vecchione, A; Burton, HR; Reijnders, PJH

    2003-01-01

    The 'immunocompetence handicap hypothesis' predicts that highly sexually dimorphic and polygynous species will exhibit sex differences in immunity. We tested this hypothesis in southern elephant and grey seals during their early development by measuring the following parameters: leucocyte counts,

  11. REDUCTION OF EGP-2-POSITIVE PULMONARY METASTASES BY BISPECIFIC-ANTIBODY-REDIRECTED T-CELLS IN AN IMMUNOCOMPETENT RAT MODEL

    NARCIS (Netherlands)

    KROESEN, BJ; HELFRICH, W; BAKKER, A; WUBBENA, AS; BAKKER, H; KAL, HB; THE, TH; DELEIJ, L

    1995-01-01

    Effectiveness of bispecific-monoclonal-antibody (B5MAb)-mediated cellular anti-tumour activity was evaluated in vitro and in vivo in relation to the additional need for T-cell activation in a new immunocompetent rat tumour model. L37 tumour cells, derived from a squamous-cell carcinoma of the lung

  12. Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden

    International Nuclear Information System (INIS)

    McGale, Paul; Darby, Sarah C.; Hall, Per; Adolfsson, Jan; Bengtsson, Nils-Olof; Bennet, Anna M.; Fornander, Tommy; Gigante, Bruna; Jensen, Maj-Britt; Peto, Richard; Rahimi, Kazem; Taylor, Carolyn W.; Ewertz, Marianne

    2011-01-01

    Purpose: To study incidence of radiation-related heart disease in a large population of breast cancer patients followed for up to 30 years. Material and methods: 72,134 women diagnosed with breast cancer in Denmark or Sweden during 1976-2006 and followed prospectively. Radiation-related risk was studied by comparing women with left-sided and right-sided tumours. Results: 34,825 women (48%) received radiotherapy. Among unirradiated women tumour laterality had little relevance to heart disease. Among irradiated women mean dose to the whole heart was 6.3 Gy for left-sided tumours and 2.7 Gy for right-sided tumours. Mortality was similar in irradiated women with left-sided and right-sided tumours, but incidence ratios, left-sided versus right-sided, were raised: acute myocardial infarction 1.22 (95% CI 1.06-1.42), angina 1.25 (1.05-1.49), pericarditis 1.61 (1.06-2.43), valvular heart disease 1.54 (1.11-2.13). Incidence ratios for all heart disease were as high for women irradiated since 1990 (1.09 [1.00-1.19]) as for women irradiated during 1976-1989 (1.08 [0.99-1.17]), and were higher for women diagnosed with ischaemic heart disease prior to breast cancer than for other women (1.58 [1.19-2.10] versus 1.08 [1.01-1.15], p for difference = 0.01). Conclusions: Breast cancer radiotherapy has, at least until recently, increased the risk of developing ischaemic heart disease, pericarditis and valvular disease. Women with ischaemic heart disease before breast cancer diagnosis may have incurred higher risks than others.

  13. Predicting the incidence of hand, foot and mouth disease in Sichuan province, China using the ARIMA model.

    Science.gov (United States)

    Liu, L; Luan, R S; Yin, F; Zhu, X P; Lü, Q

    2016-01-01

    Hand, foot and mouth disease (HFMD) is an infectious disease caused by enteroviruses, which usually occurs in children aged ARIMA) model to forecast HFMD incidence in Sichuan province, China. HFMD infection data from January 2010 to June 2014 were used to fit the ARIMA model. The coefficient of determination (R 2), normalized Bayesian Information Criterion (BIC) and mean absolute percentage of error (MAPE) were used to evaluate the goodness-of-fit of the constructed models. The fitted ARIMA model was applied to forecast the incidence of HMFD from April to June 2014. The goodness-of-fit test generated the optimum general multiplicative seasonal ARIMA (1,0,1) × (0,1,0)12 model (R 2 = 0·692, MAPE = 15·982, BIC = 5·265), which also showed non-significant autocorrelations in the residuals of the model (P = 0·893). The forecast incidence values of the ARIMA (1,0,1) × (0,1,0)12 model from July to December 2014 were 4103-9987, which were proximate forecasts. The ARIMA model could be applied to forecast HMFD incidence trend and provide support for HMFD prevention and control. Further observations should be carried out continually into the time sequence, and the parameters of the models could be adjusted because HMFD incidence will not be absolutely stationary in the future.

  14. Intrathecal spinal abscesses due to Candida albicans in an immunocompetent man.

    Science.gov (United States)

    Crane, John K

    2018-03-27

    Infections of the central nervous system due to Candida albicans are uncommon and are usually only observed in special circumstances, such as following neurosurgery or penetrating head trauma, in immunosuppressed patients, premature infants or in patients with ventriculoperitoneal shunts. The author reports a case of an immunocompetent man who presented with a thoracic intraspinal abscess due to C. albicans Despite surgical drainage and 6 weeks of high-dose fluconazole therapy, the abscess extended and recurred in the cervical spine, requiring a second operation to arrest the infection. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Review of the Series "Disease of the Year 2011: Toxoplasmosis" Pathophysiology of Toxoplasmosis

    NARCIS (Netherlands)

    Subauste, C.S.; Ajzenberg, D.; Kijlstra, A.

    2011-01-01

    Toxoplasma gondii is a major cause of chronic parasitic infection in the world. This protozoan can cause retino-choroiditis in newborns and in adults, both immunocompetent and immunodeficient. This disease tends to be recurrent and can lead to severe visual impairment. The authors review current

  16. Computed tomography findings of community-acquired Stenotrophomonas Maltophilia pneumonia in an immunocompetent patient: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Yoon Ki; Kim, Jeung Sook; Park, Seong Yeon; Oh, Jin Young; Kwon, Jae Hyun [Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang (Korea, Republic of)

    2016-11-15

    Stenotrophomonas maltophilia (S. maltophilia) is a rare, but globally emerging gram-negative multiple-drug-resistant organism usually found in a nosocomial setting in immunocompromised patients. To our best knowledge, computed tomography (CT) features of community-acquired S. maltophilia pneumonia have not been previously reported in an immunocompetent patient. Herein, we presented the CT findings of a previous healthy 56-year-old male with S. maltophilia pneumonia.

  17. Diabetic retinopathy is associated with mortality and cardiovascular disease incidence: the EURODIAB prospective complications study

    NARCIS (Netherlands)

    van Hecke, M.V.; Dekker, J.M.; Stehouwer, C.D.A.; Polak, B.C.P.; Fuller, J.H.; Sjolie, A.K.; Kofinis, A.; Rottiers, R.; Porta, M.; Chaturvedi, N.

    2005-01-01

    OBJECTIVE - To study the relationship of nonproliferative and proliferative retinopathy with all-cause mortality and cardiovascular disease (CVD) incidence in type 1 diabetic patients and, additionally, the role of cardiovascular risk factors in these associations. RESEARCH DESIGN AND METHODS - This

  18. The impact of unrecognized autoimmune rheumatic diseases on the incidence of preeclampsia and fetal growth restriction: a longitudinal cohort study.

    Science.gov (United States)

    Spinillo, Arsenio; Beneventi, Fausta; Locatelli, Elena; Ramoni, Vèronique; Caporali, Roberto; Alpini, Claudia; Albonico, Giulia; Cavagnoli, Chiara; Montecucco, Carlomaurizio

    2016-10-18

    The burden of pregnancy complications associated with well defined, already established systemic rheumatic diseases preexisting pregnancy such as rheumatoid arthritis, systemic lupus erythematosus or scleroderma is well known. Systemic rheumatic diseases are characterized by a long natural history with few symptoms, an undifferentiated picture or a remitting course making difficult a timely diagnosis. It has been suggested that screening measures for these diseases could be useful but the impact of unrecognized systemic rheumatic disorders on pregnancy outcome is unknown. The objective of the study was to evaluate the impact of previously unrecognized systemic autoimmune rheumatic on the incidence of preeclampsia and fetal growth restriction (FGR). A longitudinal cohort-study with enrolment during the first trimester of pregnancy of women attending routine antenatal care using a two-step approach with a self-reported questionnaire, autoantibody detection and clinical evaluation of antibody-positive subjects. The incidence of FGR and preeclampsia in subjects with newly diagnosed rheumatic diseases was compared to that of selected negative controls adjusting for potential confounders by logistic regression analysis. The prevalence of previously unrecognized systemic rheumatic diseases was 0.4 % for rheumatoid arthritis (19/5232), 0.25 % (13/5232) for systemic lupus erythematosus, 0.31 % (16/5232) for Sjögren's syndrome, 0.3 % for primary antiphospholipid syndrome (14/5232) and 0.11 % (6/5232) for other miscellaneous diseases. Undifferentiated connective tissue disease was diagnosed in an additional 131 subjects (2.5 %). The incidence of either FGR or preeclampsia was 6.1 % (36/594) among controls and 25.3 % (50/198) in subjects with unrecognized rheumatic diseases (excess incidence = 3.9 % (95 % CI = 2.6-9.6) or 34 % (95 % CI = 22-44) of all cases of FGR/preeclampsia). The incidence of small for gestational age infant (SGA) was higher among

  19. Occupational exposure to dusts, gases, and fumes and incidence of chronic obstructive pulmonary disease in the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults

    NARCIS (Netherlands)

    Mehta, A.J.; Miedinger, D.; Keidel, D.; Bettschart, R.; Bircher, A.; Bridevaux, P.O.; Curjuric, I; Kromhout, H.; Rochat, T.; Rothe, T.; Russi, E.W.; Schikowski, T.; Schindler, C.; Schwartz, J.; Turk, A.; Vermeulen, R.; Probst-Hensch, N.; Künzli, N.

    2012-01-01

    RATIONALE There is limited evidence from population-based studies demonstrating incidence of spirometric-defined chronic obstructive pulmonary disease (COPD) in association with occupational exposures. OBJECTIVES We evaluated the association between occupational exposures and incidence of COPD in

  20. Serum uric acid to creatinine ratio: A predictor of incident chronic kidney disease in type 2 diabetes mellitus patients with preserved kidney function.

    Science.gov (United States)

    Gu, Liubao; Huang, Liji; Wu, Haidi; Lou, Qinglin; Bian, Rongwen

    2017-05-01

    Serum uric acid has shown to be a predictor of renal disease progression in most but not all studies. This study aims to test whether renal function-normalized serum uric acid is superior to serum uric acid as the predictor of incident chronic kidney disease in type 2 diabetes mellitus patients. In this study, 1339 type 2 diabetes mellitus patients with estimated glomerular filtration rate ⩾60 mL/min/1.73 m 2 and normouricemia were included. Renal function-normalized serum uric acid was calculated using serum uric acid/creatinine. Cox regression analysis was used to estimate the association between serum uric acid, renal function-normalized serum uric acid and incident chronic kidney disease. In total, 74 (5.53%) patients developed to chronic kidney disease 3 or greater during a median follow-up of 4 years, with older ages, longer diabetes duration and lower estimated glomerular filtration rate at baseline. The decline rate of estimated glomerular filtration rate was positively correlated with serum uric acid/creatinine ( r = 0.219, p uric acid ( r = 0.005, p = 0.858). Moreover, multivariate analysis revealed that serum uric acid was not an independent risk factor for incident chronic kidney disease ( p = 0.055), whereas serum uric acid to creatinine ratio was significantly associated with incident chronic kidney disease independently of potential confounders including baseline estimated glomerular filtration rate. serum uric acid to creatinine ratio might be a better predictor of incident chronic kidney disease in type 2 diabetes mellitus patients.

  1. Fungal endophthalmitis caused by Paecilomyces variotii, in an immunocompetent patient, following intraocular lens implantation

    Directory of Open Access Journals (Sweden)

    Anita K

    2010-01-01

    Full Text Available We report the case of a 70-year-old man who was admitted for anterior endophthalmitis following an intraocular lens implantation. He had developed a fluffy growth resembling a fungal mass on the iris of the right eye. The mass was removed and sent for fungal studies to our department. Direct microscopy revealed hyphae. Further studies helped identify the fungus to belong to genus Paecilomyces. This is a rare case of fungal endophthalmitis caused by Paecilomyces variotii in an immunocompetent person.

  2. [Clinical and biological manifestations in primary parvovirus B19 infection in immunocompetent adult: a retrospective study of 26 cases].

    Science.gov (United States)

    Parra, D; Mekki, Y; Durieu, I; Broussolle, C; Sève, P

    2014-05-01

    Parvovirus B19 causes erythema infectiosum in children, transient aplastic anemia in patients with hemoglobinopathies, pur red cell aplasia in immunocompromised persons and hydrops fetalis in pregnancy. The spectrum of clinical and biological manifestations in immunocompetent adult continues to grow up. We report on a case series of 26 patients with primary parvovirus B19 infection in immunocompetent adults. This is a retrospective study over the period 2000 to 2010 in two departments of internal medecine. The diagnostic was clinical, serological or molecular. There was a female predominance (sex-ratio 3.33/1). Median patient age at diagnostic was 38.8 years (range: 18-68). The predominant symptoms were fever (65%), peripheral and symmetrical polyarthralgia (62%) and skin rash (58%). Two patients had neurological manifestations (sixth cranial nerve palsy, distal paresthesia) and one patient had myocarditis. Abnormal laboratory values included increased acute phase reactants (73%), thrombocytopenia (43%), lymphopenia (38%) and elevated liver enzymes (37%). Antinuclear (19%), anti-DNA (28%) and anti-phospholipids antibodies (14%), and hypocomplementemia (32%) were observed. False reaction with anti-CMV and anti-EBV IgM positivity was documented in 27% of cases. Two patients had persistent parvovirus B19 infection. The diversity of the clinical manifestations of parvovirus B19 infection may be misleading for the clinician. However, the diagnosis should be suspected in immunocompetent adults to limit the risk of transmission to the patients who could develop a severe infection such as pregnant women or immunocompromised patients. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  3. Change in Reported Lyme Disease Incidence in the Northeast and Upper Midwest, 1991-2014

    Science.gov (United States)

    This indicator shows how reported Lyme disease incidence has changed by state since 1991, based on the number of new cases per 100,000 people. The total change has been estimated from the average annual rate of change in each state. This map is limited to the 14 states where Lyme disease is most common, where annual rates are consistently above 10 cases per 100,000. Connecticut, New York, and Rhode Island had too much year-to-year variation in reporting practices to allow trend calculation. For more information: www.epa.gov/climatechange/science/indicators

  4. Executive function, but not memory, associates with incident coronary heart disease and stroke

    DEFF Research Database (Denmark)

    Rostamian, Somayeh; van Buchem, Mark A; Westendorp, Rudi G J

    2015-01-01

    OBJECTIVE: To evaluate the association of performance in cognitive domains executive function and memory with incident coronary heart disease and stroke in older participants without dementia. METHODS: We included 3,926 participants (mean age 75 years, 44% male) at risk for cardiovascular diseases...... from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) with Mini-Mental State Examination score ≥24 points. Scores on the Stroop Color-Word Test (selective attention) and the Letter Digit Substitution Test (processing speed) were converted to Z scores and averaged into a composite...... executive function score. Likewise, scores of the Picture Learning Test (immediate and delayed memory) were transformed into a composite memory score. Associations of executive function and memory were longitudinally assessed with risk of coronary heart disease and stroke using multivariable Cox regression...

  5. Rhodotorula mucilaginosa Fungemia and Pleural Tuberculosis in an Immunocompetent Patient: An Uncommon Association.

    Science.gov (United States)

    Pereira, Cláudia; Ribeiro, Sofia; Lopes, Virgínia; Mendonça, Teresa

    2016-02-01

    We report an atypical case of Rhodotorula mucilaginosa fungemia coexisting with pleural tuberculosis, in an immunocompetent host. The patient was an inhaled drug abuser and worked in a fruit market. The diagnosis of Rhodotorula mucilaginosa infection was established by the isolation of the yeast in two blood cultures followed by a good response to amphotericin B treatment. Persistent evening fever and pleural effusion led to the second diagnosis-pleural tuberculosis. In the last 5 years, this was the only case of Rhodotorula mucilaginosa fungemia in our hospital and the first case in the literature that documents Rhodotorula mucilaginosa fungemia associated with pleural tuberculosis.

  6. First report of tertiary syphilis presenting as lipoatrophic panniculitis in an immunocompetent patient.

    Science.gov (United States)

    Drago, Francesco; Ciccarese, Giulia; Tomasini, Carlo F; Calamaro, Paola; Boggio, Maurizio; Rebora, Alfredo; Parodi, Aurora

    2017-03-01

    We describe herein a woman who developed subcutaneous gummas in her trochanteric regions, bilaterally, although she had been treated for syphilis two decades earlier. Evidence of Treponema pallidum latent late infection was the presence of IgG antibodies against T. pallidum and the positive non-treponemal and treponemal tests. Moreover, immunohistochemical staining for T. pallidum detected some spirochetes close to the atrophic adipocytes allowing the diagnosis of lypo-atrophic panniculitis tertiary syphilis. This is the first case of tertiary syphilis presenting as panniculitis in an immunocompetent patient, demonstrating that subcutaneous fat may be another organ infected in tertiary syphilis.

  7. Effect of radiotherapy on the immunocompetence in patients with bronchogenic carcinoma and laryngeal cancer

    International Nuclear Information System (INIS)

    Oshitani, Takashi

    1981-01-01

    We evaluated the immunocompetence of 80 patients with bronchogenic carcinoma and 17 patients with laryngeal cancer undergoing radiotherapy, using collectively many types of immunological parameters. In patients with bronchogenic carcinoma, no significant difference was seen with PHA and PPD skin tests, but the reactivity of PHA skin tests gradually decreased in the course of treatment. It was assumed that radiotherapy might not interfere with the recognition of antigen. Lymphocyte blastoid transformations with PHA, Con A and PWM were all inhibited significantly. Since these three mitogens can stimulate the different groups of lymphocyte, the inhibition to the proliferative function of lymphocyte due to radiotherapy would seem to cover a wide area, including T and B lymphocyte. Concerning the comparative radiosensitivity of T and B lymphocyte, no significant result was obtained. However, in the dose of 20Gy the percentage of T lymphocyte decreased, while the percentage of B lymphocyte increased. The percentage of early rosetts, one subset of T cell, decreased more sensitively than that of T cell, but there was no significant difference. Immunocompetence of cases in stage III, which was significantly high before treatment, decreased to the same level as those in stage IV according to the treatment. In patients with laryngeal cancer, lymphocyte counts and reactivity of PHA skin tests were not influenced by radiotherapy, and then reactivity of PPD skin tests and lymphocyte blastoid transformations with PHA and Con A tended to increase instead. (J.P.N.)

  8. Comparative Incidence of Conformational, Neurodegenerative Disorders.

    Directory of Open Access Journals (Sweden)

    Jesús de Pedro-Cuesta

    Full Text Available The purpose of this study was to identify incidence and survival patterns in conformational neurodegenerative disorders (CNDDs.We identified 2563 reports on the incidence of eight conditions representing sporadic, acquired and genetic, protein-associated, i.e., conformational, NDD groups and age-related macular degeneration (AMD. We selected 245 papers for full-text examination and application of quality criteria. Additionally, data-collection was completed with detailed information from British, Swedish, and Spanish registries on Creutzfeldt-Jakob disease (CJD forms, amyotrophic lateral sclerosis (ALS, and sporadic rapidly progressing neurodegenerative dementia (sRPNDd. For each condition, age-specific incidence curves, age-adjusted figures, and reported or calculated median survival were plotted and examined.Based on 51 valid reported and seven new incidence data sets, nine out of eleven conditions shared specific features. Age-adjusted incidence per million person-years increased from ≤1.5 for sRPNDd, different CJD forms and Huntington's disease (HD, to 1589 and 2589 for AMD and Alzheimer's disease (AD respectively. Age-specific profiles varied from (a symmetrical, inverted V-shaped curves for low incidences to (b those increasing with age for late-life sporadic CNDDs and for sRPNDd, with (c a suggested, intermediate, non-symmetrical inverted V-shape for fronto-temporal dementia and Parkinson's disease. Frequently, peak age-specific incidences from 20-24 to ≥90 years increased with age at onset and survival. Distinct patterns were seen: for HD, with a low incidence, levelling off at middle age, and long median survival, 20 years; and for sRPNDd which displayed the lowest incidence, increasing with age, and a short median disease duration.These results call for a unified population view of NDDs, with an age-at-onset-related pattern for acquired and sporadic CNDDs. The pattern linking age at onset to incidence magnitude and survival might

  9. Comparative Incidence of Conformational, Neurodegenerative Disorders

    Science.gov (United States)

    de Pedro-Cuesta, Jesús; Rábano, Alberto; Martínez-Martín, Pablo; Ruiz-Tovar, María; Alcalde-Cabero, Enrique; Almazán-Isla, Javier; Avellanal, Fuencisla; Calero, Miguel

    2015-01-01

    Background The purpose of this study was to identify incidence and survival patterns in conformational neurodegenerative disorders (CNDDs). Methods We identified 2563 reports on the incidence of eight conditions representing sporadic, acquired and genetic, protein-associated, i.e., conformational, NDD groups and age-related macular degeneration (AMD). We selected 245 papers for full-text examination and application of quality criteria. Additionally, data-collection was completed with detailed information from British, Swedish, and Spanish registries on Creutzfeldt-Jakob disease (CJD) forms, amyotrophic lateral sclerosis (ALS), and sporadic rapidly progressing neurodegenerative dementia (sRPNDd). For each condition, age-specific incidence curves, age-adjusted figures, and reported or calculated median survival were plotted and examined. Findings Based on 51 valid reported and seven new incidence data sets, nine out of eleven conditions shared specific features. Age-adjusted incidence per million person-years increased from ≤1.5 for sRPNDd, different CJD forms and Huntington's disease (HD), to 1589 and 2589 for AMD and Alzheimer's disease (AD) respectively. Age-specific profiles varied from (a) symmetrical, inverted V-shaped curves for low incidences to (b) those increasing with age for late-life sporadic CNDDs and for sRPNDd, with (c) a suggested, intermediate, non-symmetrical inverted V-shape for fronto-temporal dementia and Parkinson's disease. Frequently, peak age-specific incidences from 20–24 to ≥90 years increased with age at onset and survival. Distinct patterns were seen: for HD, with a low incidence, levelling off at middle age, and long median survival, 20 years; and for sRPNDd which displayed the lowest incidence, increasing with age, and a short median disease duration. Interpretation These results call for a unified population view of NDDs, with an age-at-onset-related pattern for acquired and sporadic CNDDs. The pattern linking age at onset to

  10. Major Depression, C-Reactive Protein, and Incident Ischemic Heart Disease in Healthy Men and Women

    NARCIS (Netherlands)

    Surtees, Paul G.; Wainwright, Nicholas W. J.; Boekholdt, S. Matthijs; Luben, Robert N.; Wareham, Nicholas J.; Khaw, Kay-Tee

    2008-01-01

    Objective: To investigate how C-reactive protein (CRP) and major depressive disorder (MDD) relate to each other and to incident ischemic heart disease (IHD). Studies have shown that both depression and raised CRP concentration predict IHD and that elevated CRP is linked with increased risk of

  11. Incident diabetes mellitus, hypertension, and cardiovascular disease risk in exercising hypercholesterolemic patients.

    Science.gov (United States)

    Williams, Paul T; Franklin, Barry A

    2015-11-15

    Exercise may be an important treatment for hypercholesterolemic patients, particularly in statin users who are at increased diabetes risk. We therefore used Cox proportional hazard analyses to compare running and walking dose (metabolic equivalent hours/day [MET-h/d]) to diabetes, hypertension, and cardiovascular disease (CVD) risk in hypercholesterolemic patients. There were 60 diabetic- and 373 CVD-related deaths during a 10.1-year mortality surveillance of 6,688 hypercholesterolemic patients. In addition, there were 177 incident nonfatal diabetes, 815 incident nonfatal hypertensions, and 323 incident nonfatal CVD events during a 6.4-year follow-up of 6,971 hypercholesterolemic patients who supplied follow-up questionnaires. Fatal and nonfatal diabetes risk decreased 26% (p = 0.002) and 19% (p ≤0.0001) per MET-h/d, respectively, and relative to hypertension risk decreased 4% (p = 0.01) per MET-h/d, and relative to diabetes, hypertension, and CVD risk in hypercholesterolemic patients and should more than compensate for the purported 9% increase in diabetes risk from statin use. By preventing morbidity and mortality for a specific existing medical condition, some exercise expenses may qualify for flexible spending account expenditures in hypercholesterolemic patients when prescribed by a physician. Published by Elsevier Inc.

  12. Udder diseases in dairy cows — field observations on incidence, somatic and environmental factors, and control

    Directory of Open Access Journals (Sweden)

    Hannu Saloniemi

    1980-03-01

    Full Text Available The incidence of udder diseases and the predisposing factors were examined in 32 herds, in a total of 500 cows. During a 3-year-period 0.32 cases of clinical mastitis occurred per cow per annum. Subclinical mastitis was detected in 61.2 % of the cows during one year. The average incidence based on a single sampling was 36.5 %. In order to obtain reliable information on the udder health of a herd the occurrence of both clinical and subclinical mastitis must be followed. Clinical cases, both those treated by a veterinarian on a farm visit and those treated by the owner according to phone prescription must be filed statistically. In this study the incidence of mastitis as reported by owner was only half of that actually detected. The incidence of teat injuries requiring veterinary treatment was 0.03 cases per cow per annum. The diagnosis »presence of bacteria» obtained from a milk sample examination using Nordic methods means according to this study in most cases the probable occurrence of infection and mastitis. Scoring of observations made from udder health, and indexes based on these scores prove to be good tools when studying relationships between udder diseases and predisposing factors. Of the somatic factors the age of the cow, stage of lactation, the distance of the rear teats from the stall floor and the position of the teats influence the incidence of mastitis. Therefore, these factors must be taken into consideration in preventive work, especially in the culling of cows. Neither teat shape nor milkability had any connection with the incidence of udder diseases. With regard to the factors in the production environment the incidence of clinical mastitis was influenced especially by the function of the milking machine. Diurnal changes in temperature, when exceeding5 degrees centigrade, increased the occurrence of mastitis. The use of a thermohygrograph is proposed in preventive work. Because of the small number of the herds only in few

  13. Female bluethroats enhance offspring immunocompetence through extra-pair copulations.

    Science.gov (United States)

    Johnsen, A; Andersen, V; Sunding, C; Lifjeld, J T

    2000-07-20

    Female birds frequently copulate with extra-pair males, but the adaptive value of this behaviour is poorly understood. Some studies have suggested that 'good genes' may be involved, where females seek to have their eggs fertilized by high-quality males without receiving any material benefits from them. Nevertheless, it remains to be shown that a genetic benefit is passed on to offspring. Here we report that nestling bluethroats, Luscinia svecica, sired by extra-pair males had a higher T-cell-mediated immune response than their maternal half-siblings raised in the same nest. The difference could not be attributed to nestling body mass, sex or hatching order, but may be an effect of paternal genotype. Extra-pair young were also more immunocompetent than their paternal half-sibs raised in the genetic father's own nest, which indicates an additional effect of maternal genotype. Our results are consistent with the idea that females engage in extra-pair copulations to obtain compatible viability genes, rather than 'good genes' per se.

  14. Comparative study on the immunocompetent activity of three different kinds of Peh-Hue-Juwa-Chi-Cao, Hedyotis diffusa, H. corymbosa and Mollugo pentaphylla after sublethal whole body X-irradiation

    International Nuclear Information System (INIS)

    Yang JenqJer; Hsu HsueYin; Ho YauHui; Lin ChunChing

    1997-01-01

    This brief communication describes the immunocompetent activity of the Chinese folk-medicinal herbs, Hedyotis corymbosa, H. diffusa and Mollugo pentaphylla in mice after moderate whole body x-irradiation. These antitumour drugs, given at doses of 500 and 1000 mg/kg/day for 7 consecutive days before x-irradiation protected ICR strain mice from the sublethal effects of radiation at a dose of 4 Gy, especially for the dose at 1000 mg/kg. Prior administration of H. corymbosa and H. diffusa ameliorated the leukopenia and splenic cellular decrease induced by sublethal irradiation, and slightly increased the immunocompetence of splenic cells after being stimulated by mitogens. However, administration of M. pentaphylla before x-irradiation exerted a less protective effect on ameliorating leukopenia and on splenic cellular immunocompetence. These findings suggest that some types of Peh-Hue-Juwa-Chi-Caoi (PHJCC) may also be effective in the prevention of haematopoietic damage when used in combination with radiotherapy. (author)

  15. Comparative study on the immunocompetent activity of three different kinds of Peh-Hue-Juwa-Chi-Cao, Hedyotis diffusa, H. corymbosa and Mollugo pentaphylla after sublethal whole body X-irradiation

    Energy Technology Data Exchange (ETDEWEB)

    JenqJer, Yang; HsueYin, Hsu; YauHui, Ho; ChunChing, Lin [School of Pharmacy, Kaohsiung Medical College, Kaohsiung, Taiwan (China)

    1997-07-01

    This brief communication describes the immunocompetent activity of the Chinese folk-medicinal herbs, Hedyotis corymbosa, H. diffusa and Mollugo pentaphylla in mice after moderate whole body x-irradiation. These antitumour drugs, given at doses of 500 and 1000 mg/kg/day for 7 consecutive days before x-irradiation protected ICR strain mice from the sublethal effects of radiation at a dose of 4 Gy, especially for the dose at 1000 mg/kg. Prior administration of H. corymbosa and H. diffusa ameliorated the leukopenia and splenic cellular decrease induced by sublethal irradiation, and slightly increased the immunocompetence of splenic cells after being stimulated by mitogens. However, administration of M. pentaphylla before x-irradiation exerted a less protective effect on ameliorating leukopenia and on splenic cellular immunocompetence. These findings suggest that some types of Peh-Hue-Juwa-Chi-Caoi (PHJCC) may also be effective in the prevention of haematopoietic damage when used in combination with radiotherapy. (author)

  16. Is drinking water a risk factor for endemic cryptosporidiosis? A case-control study in the immunocompetent general population of the San Francisco Bay Area

    Directory of Open Access Journals (Sweden)

    Nadle Joelle

    2003-03-01

    Full Text Available Abstract Background Cryptosporidiosis, caused by Cryptosporidium, is an enteric illness that has received much attention as an infection of immunocompromised persons as well as in community outbreaks (frequently waterborne. There are, however, no studies of the risk factors for sporadic community-acquired cryptosporidiosis in the immunocompetent US population. We undertook a case-control study in the San Francisco Bay Area as part of a national study sponsored by the Centers for Disease Control and Prevention to ascertain the major routes of transmission for endemic cryptosporidiosis, with an emphasis on evaluating risk from drinking water. Methods Cases were recruited from a population-based, active surveillance system and age-matched controls were recruited using sequential random-digit dialing. Cases (n = 26 and controls (n = 62 were interviewed by telephone using a standardized questionnaire that included information about the following exposures: drinking water, recreational water, food items, travel, animal contact, and person-to-person fecal contact, and (for adults sexual practices. Results In multivariate conditional logistic regression analyses no significant association with drinking water was detected. The major risk factor for cryptosporidiosis in the San Francisco Bay Area was travel to another country (matched odds ratio [95% confidence interval]: 24.1 [2.6, 220]. Conclusion The results of this study do not support the hypothesis that drinking water is an independent risk factor for cryptosporidiosis among the immunocompetent population. These findings should be used to design larger studies of endemic cryptosporidiosis to elucidate the precise mechanisms of transmission, whether waterborne or other.

  17. Incidence of invasive salmonella disease in sub-Saharan Africa: a multicentre population-based surveillance study.

    Science.gov (United States)

    Marks, Florian; von Kalckreuth, Vera; Aaby, Peter; Adu-Sarkodie, Yaw; El Tayeb, Muna Ahmed; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Biggs, Holly M; Bjerregaard-Andersen, Morten; Breiman, Robert F; Campbell, James I; Cosmas, Leonard; Crump, John A; Espinoza, Ligia Maria Cruz; Deerin, Jessica Fung; Dekker, Denise Myriam; Fields, Barry S; Gasmelseed, Nagla; Hertz, Julian T; Van Minh Hoang, Nguyen; Im, Justin; Jaeger, Anna; Jeon, Hyon Jin; Kabore, Leon Parfait; Keddy, Karen H; Konings, Frank; Krumkamp, Ralf; Ley, Benedikt; Løfberg, Sandra Valborg; May, Jürgen; Meyer, Christian G; Mintz, Eric D; Montgomery, Joel M; Niang, Aissatou Ahmet; Nichols, Chelsea; Olack, Beatrice; Pak, Gi Deok; Panzner, Ursula; Park, Jin Kyung; Park, Se Eun; Rabezanahary, Henintsoa; Rakotozandrindrainy, Raphaël; Raminosoa, Tiana Mirana; Razafindrabe, Tsiriniaina Jean Luco; Sampo, Emmanuel; Schütt-Gerowitt, Heidi; Sow, Amy Gassama; Sarpong, Nimako; Seo, Hye Jin; Sooka, Arvinda; Soura, Abdramane Bassiahi; Tall, Adama; Teferi, Mekonnen; Thriemer, Kamala; Warren, Michelle R; Yeshitela, Biruk; Clemens, John D; Wierzba, Thomas F

    2017-03-01

    Available incidence data for invasive salmonella disease in sub-Saharan Africa are scarce. Standardised, multicountry data are required to better understand the nature and burden of disease in Africa. We aimed to measure the adjusted incidence estimates of typhoid fever and invasive non-typhoidal salmonella (iNTS) disease in sub-Saharan Africa, and the antimicrobial susceptibility profiles of the causative agents. We established a systematic, standardised surveillance of blood culture-based febrile illness in 13 African sentinel sites with previous reports of typhoid fever: Burkina Faso (two sites), Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar (two sites), Senegal, South Africa, Sudan, and Tanzania (two sites). We used census data and health-care records to define study catchment areas and populations. Eligible participants were either inpatients or outpatients who resided within the catchment area and presented with tympanic (≥38·0°C) or axillary temperature (≥37·5°C). Inpatients with a reported history of fever for 72 h or longer were excluded. We also implemented a health-care utilisation survey in a sample of households randomly selected from each study area to investigate health-seeking behaviour in cases of self-reported fever lasting less than 3 days. Typhoid fever and iNTS disease incidences were corrected for health-care-seeking behaviour and recruitment. Between March 1, 2010, and Jan 31, 2014, 135 Salmonella enterica serotype Typhi (S Typhi) and 94 iNTS isolates were cultured from the blood of 13 431 febrile patients. Salmonella spp accounted for 33% or more of all bacterial pathogens at nine sites. The adjusted incidence rate (AIR) of S Typhi per 100 000 person-years of observation ranged from 0 (95% CI 0-0) in Sudan to 383 (274-535) at one site in Burkina Faso; the AIR of iNTS ranged from 0 in Sudan, Ethiopia, Madagascar (Isotry site), and South Africa to 237 (178-316) at the second site in Burkina Faso. The AIR of iNTS and typhoid

  18. Association of UV radiation with Parkinson disease incidence: A nationwide French ecologic study

    International Nuclear Information System (INIS)

    Kravietz, Adam; Kab, Sofiane; Wald, Lucien; Dugravot, Aline; Singh-Manoux, Archana; Moisan, Frédéric; Elbaz, Alexis

    2017-01-01

    Background: Vitamin D is thought to contribute to brain health, but it is unclear whether low vitamin D levels are associated with increased incidence of Parkinson's disease (PD). Using ultraviolet B (UV-B) as a surrogate for vitamin D levels, we conducted a nationwide ecologic study in France in order to examine the association of UV-B with PD incidence. Methods: We used French national drug claims databases to identify PD cases using a validated algorithm. UV-B data from the solar radiation database were derived from satellite images. We estimated PD incidence (2010–2012) at the canton level (small administrative French unit) and used multilevel Poisson regression to examine its association with UV-B (2005 annual average), after adjustment for age, sex, deprivation index, density of neurologists, smoking, proportion of agricultural land, and vitamin D supplementation. Results: Analyses are based on 69,010 incident PD patients. The association between UV-B and PD incidence was quadratic (P<0.001) and modified by age (P<0.001). Below 70y, incidence was higher in the bottom quintile (relative risk, RR Q1:45-49y =1.18, 95% CI=1.08–1.29) compared with the middle UV-B quintile, and lower in the top quintile (RR Q5:45-49y =0.85 [0.77–0.94]). An opposite pattern was observed in older subjects (RR Q1:85-89y =0.92 [0.89–0.96]; RR Q5:85-89y =1.06 [1.02–1.11]). Analysis based on continuous UV-B yielded similar conclusions. Conclusions: In this nationwide study, there was an age-dependent quadratic association between UV-B and PD incidence. This study suggests that reasonable UV-B exposure is associated with lower PD risk in younger persons and that future studies should examine dose-response relations and take age into account. - Highlights: • There is an age-dependent quadratic association between UV-B and PD incidence. • Reasonable UV-B exposure is beneficial in younger persons for the risk of PD. • Our findings are consistent with a role of vitamin D

  19. The association of atopy with incidence of ischemic heart disease, stroke, and diabetes

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Thuesen, Betina Heinsbæk

    2015-01-01

    analyzed by Cox regression analyses with age as underlying time axis and adjusted for study cohort, gender, education, body mass index, alcohol intake, smoking habits, physical activity during leisure time, serum lipids, and blood pressure. The prevalence of atopy was 26.9 % (n = 3,994). There were 1......Allergy is a systemic inflammatory disease that could theoretically affect the risk of cardiovascular disease (CVD) and diabetes through inflammatory pathways or mast cell-induced coronary spasm. Whether allergy is associated with an increased risk of CVD and diabetes is largely unknown. We......-specific IgE positivity to inhalant allergens. The Danish National Diabetes Register enabled identification of incident diabetes. Likewise, the Danish Registry of Causes of Death and the Danish National Patient Register provided information on fatal and non-fatal ischemic heart disease and stroke. Data were...

  20. Computational Modelling and Optimal Control of Ebola Virus Disease with non-Linear Incidence Rate

    Science.gov (United States)

    Takaidza, I.; Makinde, O. D.; Okosun, O. K.

    2017-03-01

    The 2014 Ebola outbreak in West Africa has exposed the need to connect modellers and those with relevant data as pivotal to better understanding of how the disease spreads and quantifying the effects of possible interventions. In this paper, we model and analyse the Ebola virus disease with non-linear incidence rate. The epidemic model created is used to describe how the Ebola virus could potentially evolve in a population. We perform an uncertainty analysis of the basic reproductive number R 0 to quantify its sensitivity to other disease-related parameters. We also analyse the sensitivity of the final epidemic size to the time control interventions (education, vaccination, quarantine and safe handling) and provide the cost effective combination of the interventions.

  1. Healthy lifestyles reduce the incidence of chronic diseases and dementia: evidence from the Caerphilly cohort study.

    Directory of Open Access Journals (Sweden)

    Peter Elwood

    Full Text Available BACKGROUND: Healthy lifestyles based on non-smoking, an acceptable BMI, a high fruit and vegetable intake, regular physical activity, and low/moderate alcohol intake, are associated with reductions in the incidence of certain chronic diseases, but to date there is limited evidence on cognitive function and dementia. METHODS: In 1979 healthy behaviours were recorded on 2,235 men aged 45-59 years in Caerphilly, UK. During the following 30 years incident diabetes, vascular disease, cancer and death were recorded, and in 2004 cognitive state was determined. FINDINGS: Men who followed four or five of the behaviours had an odds ratio (OR and confidence intervals (CI for diabetes, corrected for age and social class, of 0.50 (95% CI: 0.19, 1.31; P for trend with increasing numbers of healthy behaviours <0.0005. For vascular disease the OR was 0.50 (95% CI: 0.30, 0.84; P for trend <0.0005, and there was a delay in vascular disease events of up to 12 years. Cancer incidence was not significantly related to lifestyle although there was a reduction associated with non-smoking (OR: 0.65; 95% CI: 0.54, 0.79. All-cause mortality was reduced in men following four or five behaviours (OR 0.40; 95% CI: 0.24, 0.67; P for trend <0.005. After further adjustment for NART, the OR for men following four or five healthy behaviours was 0.36 (95% CI: 0.12, 1.09; P for trend <0.001 for cognitive impairment, and 0.36 (95% CI: 0.07, 1.99; P for trend <0.02 for dementia. The adoption of a healthy lifestyle by men was low and appears not to have changed during the subsequent 30 years, with under 1% of men following all five of the behaviours and 5% reporting four or more in 1979 and in 2009. INTERPRETATION: A healthy lifestyle is associated with increased disease-free survival and reduced cognitive impairment but the uptake remains low.

  2. Periodontal Disease and Incident Lung Cancer Risk: A Meta-Analysis of Cohort Studies.

    Science.gov (United States)

    Zeng, Xian-Tao; Xia, Ling-Yun; Zhang, Yong-Gang; Li, Sheng; Leng, Wei-Dong; Kwong, Joey S W

    2016-10-01

    Periodontal disease is linked to a number of systemic diseases such as cardiovascular diseases and diabetes mellitus. Recent evidence has suggested periodontal disease might be associated with lung cancer. However, their precise relationship is yet to be explored. Hence, this study aims to investigate the association of periodontal disease and risk of incident lung cancer using a meta-analytic approach. PubMed, Scopus, and ScienceDirect were searched up to June 10, 2015. Cohort and nested case-control studies investigating risk of lung cancer in patients with periodontal disease were included. Hazard ratios (HRs) were calculated, as were their 95% confidence intervals (CIs) using a fixed-effect inverse-variance model. Statistical heterogeneity was explored using the Q test as well as the I(2) statistic. Publication bias was assessed by visual inspection of funnel plots symmetry and Egger's test. Five cohort studies were included, involving 321,420 participants in this meta-analysis. Summary estimates based on adjusted data showed that periodontal disease was associated with a significant risk of lung cancer (HR = 1.24, 95% CI = 1.13 to 1.36; I(2) = 30%). No publication bias was detected. Subgroup analysis indicated that the association of periodontal disease and lung cancer remained significant in the female population. Evidence from cohort studies suggests that patients with periodontal disease are at increased risk of developing lung cancer.

  3. Reduced plant nutrition under elevated CO2 depresses the immunocompetence of cotton bollworm against its endoparasite

    OpenAIRE

    Yin, Jin; Sun, Yucheng; Ge, Feng

    2014-01-01

    Estimating the immunocompetence of herbivore insects under elevated CO2 is an important step in understanding the effects of elevated CO2 on crop-herbivore-natural enemy interactions. Current study determined the effect of elevated CO2 on the immune response of Helicoverpa armigera against its parasitoid Microplitis mediator. H. armigera were reared in growth chambers with ambient or elevated CO2, and fed wheat grown in the concentration of CO2 corresponding to their treatment levels. Our res...

  4. TUBERCULOSIS INFECTION MIGHT INCREASE THE RISK OF INVASIVE CANDIDIASIS IN AN IMMUNOCOMPETENT PATIENT

    Directory of Open Access Journals (Sweden)

    Xiao-Hua CHEN

    2015-06-01

    Full Text Available Deep Candida infections commonly occur in immunosuppressed patients. A rare case of a multiple deep organ infection with Candida albicans and spinal tuberculosis was reported in a healthy young man. The 19-year-old man complained of month-long fever and lower back pain. He also had a history of scalded mouth syndrome. Coinfection with Mycobacterium tuberculosis and Candida albicans was diagnosed using the culture of aspirates from different regions. Symptoms improved considerably after antifungal and antituberculous therapy. This case illustrates that infection with tuberculosis might impair the host's immune system and increase the risk of invasive candidiasis in an immunocompetent patient.

  5. Incidence and outcome of patients starting renal replacement therapy for end-stage renal disease due to multiple myeloma or light-chain deposit disease: an ERA-EDTA Registry study

    DEFF Research Database (Denmark)

    Tsakiris, D.J.; Stel, V.S.; Finne, P.

    2010-01-01

    Background. Information on demographics and survival of patients starting renal replacement therapy (RRT) for end-stage renal disease (ESRD) due to multiple myeloma (MM) or light-chain deposit disease (LCDD) is scarce. The aim of this study was to describe the incidence, characteristics, causes...... causes (non-MM) was observed overtime. Patient survival on RRT was examined, unadjusted and adjusted for age and gender. Results. Of the 159 637 patients on RRT, 2453 (1.54%) had MM or LCDD. The incidence of RRT for ESRD due to MM or LCDD, adjusted for age and gender, increased from 0.70 pmp in 1986...

  6. The incidence of chromosome abnormalities in neonates with structural heart disease.

    Science.gov (United States)

    Dykes, John C; Al-mousily, Mohammad F; Abuchaibe, Eda-Cristina; Silva, Jennifer N; Zadinsky, Jennifer; Duarte, Daniel; Welch, Elizabeth

    2016-04-01

    This study was conducted to determine the prevalence of chromosomal anomalies in newborns with structural heart disease admitted to the cardiac intensive care unit (CICU) at Nicklaus Children's Hospital (NCH). A retrospective review identified newborns age 30 days or less admitted to NCH CICU between 2004 and 2010. Patients with structural heart disease who required admission to our CICU and received karyotype or karyotype and fluorescent in situ hybridization (FISH) testing were included in the study. All patients were examined for the presence of dysmorphic features. Four hundred and eighty-two patients met the criteria for the study; 405 (84%) received both karyotype and FISH. Chromosome abnormalities were present in 86 (17.8%) patients. Syndromes accounted for 20 (5.1%) of those with normal chromosomes. Dysmorphic features were seen in 79.1% of patients with abnormal chromosomes and 25.5% of those with normal chromosomes. All patients with syndromes were dysmorphic. Race and gender did not significantly affect the incidence of genetic abnormalities. Chromosome abnormalities, including syndromes, are prevalent in newborns with congenital heart disease. Further research is needed to evaluate the utility of cytogenetic screening in all children with congenital heart disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Decreasing fertility rate correlates with the chronological increase and geographical variation in incidence of Kawasaki disease in Japan.

    Directory of Open Access Journals (Sweden)

    Yoshiro Nagao

    Full Text Available BACKGROUND: Kawasaki disease (KD is a common cause of acquired paediatric heart disease in developed countries. KD was first identified in the 1960s in Japan, and has been steadily increasing since it was first reported. The aetiology of KD has not been defined, but is assumed to be infection-related. The present study sought to identify the factor(s that mediate the geographical variation and chronological increase of KD in Japan. METHODS AND FINDINGS: Based upon data reported between 1979 and 2010 from all 47 prefectures in Japan, the incidence and mean patient age at the onset of KD were estimated. Using spatial and time-series analyses, incidence and mean age were regressed against climatic/socioeconomic variables. Both incidence and mean age of KD were inversely correlated with the total fertility rate (TFR; i.e., the number of children that would be born to one woman. The extrapolation of a time-series regressive model suggested that KD emerged in the 1960s because of a dramatic decrease in TFR in the 1940s through the 1950s. CONCLUSIONS: Mean patient age is an inverse surrogate for the hazard of contracting the aetiologic agent. Therefore, the observed negative correlation between mean patient age and TFR suggests that a higher TFR is associated with KD transmission. This relationship may be because a higher TFR facilitates sibling-to-sibling transmission. Additionally, the observed inverse correlation between incidence and TFR implies a paradoxical "negative" correlation between the incidence and the hazard of contracting the aetiologic agent. It was hypothesized that a decreasing TFR resulted in a reduced hazard of contracting the agent for KD, thereby increasing KD incidence.

  8. Incidence of hypothyroidism following small doses of 131I in the treatment of Graves' disease

    International Nuclear Information System (INIS)

    McCullagh, F.P.; Jelden, G.L.; Rodriguez-Antunez, A.

    1976-01-01

    In a group of 147 patients treated with 131 I in doses of 3.0 millicuries or less for Graves' disease, the incidence of hypothyroidism was calculated 10 to 17 years after treatment. This paper emphasizes the frequency of hypothyroidism after treatment with 131 I in small doses, if sufficient time lapse is considered

  9. Incidence of chronic obstructive pulmonary disease in a cohort of young adults according to the presence of chronic cough and phlegm

    NARCIS (Netherlands)

    de Marco, Roberto; Accordini, Simone; Cerveri, Isa; Corsico, Angelo; Anto, Josep M.; Kunzli, Nino; Janson, Christer; Sunyer, Jordi; Jarvis, Deborah; Chinn, Susan; Vermeire, Paul; Svanes, Cecilie; Ackermann-Liebrich, Ursula; Gislason, Thorarinn; Heinrich, Joachim; Leynaert, Benedicte; Neukirch, Francoise; Schouten, Jan P.; Wjst, Matthias; Burney, Peter

    2007-01-01

    Rationale: The few prospective studies aimed at assessing the incidence of chronic obstructive pulmonary disease (COPD) in relation to the presence of chronic cough/phlegm have produced contrasting results. Objectives: To assess the incidence of COPD in a cohort of young adults and to test whether

  10. Effort–Reward Imbalance at Work and Incident Coronary Heart Disease

    Science.gov (United States)

    Siegrist, Johannes; Nyberg, Solja T.; Lunau, Thorsten; Fransson, Eleonor I.; Alfredsson, Lars; Bjorner, Jakob B.; Borritz, Marianne; Burr, Hermann; Erbel, Raimund; Fahlén, Göran; Goldberg, Marcel; Hamer, Mark; Heikkilä, Katriina; Jöckel, Karl-Heinz; Knutsson, Anders; Madsen, Ida E. H.; Nielsen, Martin L.; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H.; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Schupp, Jürgen; Singh-Manoux, Archana; Steptoe, Andrew; Theorell, Töres; Vahtera, Jussi; Westerholm, Peter J. M.; Westerlund, Hugo; Virtanen, Marianna; Zins, Marie; Batty, G. David; Kivimäki, Mika

    2017-01-01

    Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease. Methods: This multicohort study (the “IPD-Work” consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort–reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis. Results: At baseline, 31.7% of study members reported effort–reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00–1.35) was observed for effort–reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01–1.34) for having either effort–reward imbalance or job strain and 1.41 (1.12–1.76) for having both these stressors compared to having neither effort–reward imbalance nor job strain. Conclusions: Individuals with effort–reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress. PMID:28570388

  11. Geographic Variation of Chronic Kidney Disease Prevalence: Correlation with the Incidence of Renal Cell Carcinoma or Urothelial Carcinoma?

    Science.gov (United States)

    Yap, Yit-Sheung; Chuang, Kai-Wen; Chiang, Chun-Ju; Chuang, Hung-Yi; Lu, Sheng-Nan

    2015-01-01

    The aim of this study is to evaluate whether geographic variations in the prevalence of late-stage chronic kidney disease (CKD) exist and are associated with incidence rates of renal cell carcinoma (RCC), upper tract urothelial carcinoma (UTUC), or lower tract urothelial carcinoma (LTUC). Prevalence rates of late-stage CKD for 366 townships (n > 30) in Taiwan were calculated for 1,518,241 and 1,645,151 subjects aged 40 years or older in years 2010 and 2009, respectively. Late-stage CKD prevalence in year 2010 was used as a training set and its age-adjusted standardized morbidity rates (ASMR) were divided into three groups as defined ASMR ASMR of late-stage CKD in years 2010 and 2009 were 1.76%, and 2.09%, respectively. Geographic variations were observed, with notably higher rates of disease in areas of the central, southwestern mountainside, and southeastern seaboard. There were no significant differences among different combined risk groups of RCC, UTUC, and LTUC incidence. The substantial geographic variations in the prevalence of late-stage CKD exist, but are not correlated with RCC, UTUC, or LTUC incidence.

  12. Mathematical modeling of zika virus disease with nonlinear incidence and optimal control

    Science.gov (United States)

    Goswami, Naba Kumar; Srivastav, Akhil Kumar; Ghosh, Mini; Shanmukha, B.

    2018-04-01

    The Zika virus was first discovered in a rhesus monkey in the Zika Forest of Uganda in 1947, and it was isolated from humans in Nigeria in 1952. Zika virus disease is primarily a mosquito-borne disease, which is transmitted to human primarily through the bite of an infected Aedes species mosquito. However, there is documented evidence of sexual transmission of this disease too. In this paper, a nonlinear mathematical model for Zika virus by considering nonlinear incidence is formulated and analyzed. The equilibria and the basic reproduction number (R0) of the model are found. The stability of the different equilibria of the model is discussed in detail. When the basic reproduction number R0 1, we have endemic equilibrium which is locally stable under some restriction on parameters. Further this model is extended to optimal control model and is analyzed by using Pontryagin’s Maximum Principle. It has been observed that optimal control plays a significant role in reducing the number of zika infectives. Finally, numerical simulation is performed to illustrate the analytical findings.

  13. Association of UV radiation with Parkinson disease incidence: A nationwide French ecologic study

    Energy Technology Data Exchange (ETDEWEB)

    Kravietz, Adam [University of Miami Miller School of Medicine, Miami, Florida (United States); Kab, Sofiane [Santé publique France, Direction santé travail, F-94415 Saint-Maurice (France); CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805 Villejuif (France); Wald, Lucien [MINES ParisTech, PSL Research University, Sophia Antipolis (France); Dugravot, Aline [CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805 Villejuif (France); Singh-Manoux, Archana [CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805 Villejuif (France); Department of Epidemiology and Public Health, University College London, London (United Kingdom); Moisan, Frédéric [Santé publique France, Direction santé travail, F-94415 Saint-Maurice (France); Elbaz, Alexis, E-mail: alexis.elbaz@inserm.fr [Santé publique France, Direction santé travail, F-94415 Saint-Maurice (France); CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805 Villejuif (France)

    2017-04-15

    Background: Vitamin D is thought to contribute to brain health, but it is unclear whether low vitamin D levels are associated with increased incidence of Parkinson's disease (PD). Using ultraviolet B (UV-B) as a surrogate for vitamin D levels, we conducted a nationwide ecologic study in France in order to examine the association of UV-B with PD incidence. Methods: We used French national drug claims databases to identify PD cases using a validated algorithm. UV-B data from the solar radiation database were derived from satellite images. We estimated PD incidence (2010–2012) at the canton level (small administrative French unit) and used multilevel Poisson regression to examine its association with UV-B (2005 annual average), after adjustment for age, sex, deprivation index, density of neurologists, smoking, proportion of agricultural land, and vitamin D supplementation. Results: Analyses are based on 69,010 incident PD patients. The association between UV-B and PD incidence was quadratic (P<0.001) and modified by age (P<0.001). Below 70y, incidence was higher in the bottom quintile (relative risk, RR{sub Q1:45-49y}=1.18, 95% CI=1.08–1.29) compared with the middle UV-B quintile, and lower in the top quintile (RR{sub Q5:45-49y}=0.85 [0.77–0.94]). An opposite pattern was observed in older subjects (RR{sub Q1:85-89y}=0.92 [0.89–0.96]; RR{sub Q5:85-89y}=1.06 [1.02–1.11]). Analysis based on continuous UV-B yielded similar conclusions. Conclusions: In this nationwide study, there was an age-dependent quadratic association between UV-B and PD incidence. This study suggests that reasonable UV-B exposure is associated with lower PD risk in younger persons and that future studies should examine dose-response relations and take age into account. - Highlights: • There is an age-dependent quadratic association between UV-B and PD incidence. • Reasonable UV-B exposure is beneficial in younger persons for the risk of PD. • Our findings are consistent with a

  14. Variation in sex pheromone emission does not reflect immunocompetence but affects attractiveness of male burying beetles-a combination of laboratory and field experiments.

    Science.gov (United States)

    Chemnitz, Johanna; Bagrii, Nadiia; Ayasse, Manfred; Steiger, Sandra

    2017-08-01

    Life history theory predicts a trade-off between male sexual trait expression and immunocompetence. Using burying beetles, Nicrophorus vespilloides, as a model, we investigated the relationship between male immune function, sex pheromone emission, and attractiveness under field conditions. In the first experiment, we tested whether there is a positive correlation between immune capacity, sex pheromone characteristics (quantity, relative composition, and time invested in pheromone emission), and male attractiveness. As a measurement of immune capacity, we used an individual's encapsulation ability against a novel antigen. In the second experiment, we specifically examined whether a trade-off between chemical trait expression and immune function existed. To this end, we challenged the immune system and measured the subsequent investment in sex pheromone emission and the attractiveness of the male under field conditions. We found that a male's immunocompetence was neither related to the emission of the male's sex pheromone nor to its attractiveness in the field. Furthermore, none of the immune-challenge treatments affected the subsequent investment in pheromone emission or number of females attracted. However, we showed that the same males that emitted a high quantity of their sex pheromone in the laboratory were able to attract more females in the field. Our data suggest that the chemical signal is not a reliable predictor of a male's immunocompetence but rather is a general important fitness-related trait, with a higher emission of the sex pheromone measured in the laboratory directly affecting the attractiveness of a male under field conditions.

  15. Variation in sex pheromone emission does not reflect immunocompetence but affects attractiveness of male burying beetles—a combination of laboratory and field experiments

    Science.gov (United States)

    Chemnitz, Johanna; Bagrii, Nadiia; Ayasse, Manfred; Steiger, Sandra

    2017-08-01

    Life history theory predicts a trade-off between male sexual trait expression and immunocompetence. Using burying beetles, Nicrophorus vespilloides, as a model, we investigated the relationship between male immune function, sex pheromone emission, and attractiveness under field conditions. In the first experiment, we tested whether there is a positive correlation between immune capacity, sex pheromone characteristics (quantity, relative composition, and time invested in pheromone emission), and male attractiveness. As a measurement of immune capacity, we used an individual's encapsulation ability against a novel antigen. In the second experiment, we specifically examined whether a trade-off between chemical trait expression and immune function existed. To this end, we challenged the immune system and measured the subsequent investment in sex pheromone emission and the attractiveness of the male under field conditions. We found that a male's immunocompetence was neither related to the emission of the male's sex pheromone nor to its attractiveness in the field. Furthermore, none of the immune-challenge treatments affected the subsequent investment in pheromone emission or number of females attracted. However, we showed that the same males that emitted a high quantity of their sex pheromone in the laboratory were able to attract more females in the field. Our data suggest that the chemical signal is not a reliable predictor of a male's immunocompetence but rather is a general important fitness-related trait, with a higher emission of the sex pheromone measured in the laboratory directly affecting the attractiveness of a male under field conditions.

  16. Rhizopus-associated soft tissue infection in an immunocompetent air-conditioning technician after a road traffic accident: a case report and review of the literature.

    Science.gov (United States)

    Rabie, Nada B; Althaqafi, Abdulhakeem O

    2012-03-01

    Rhinocerebral or sinopulmonary mucromycosis is a well-recognized human fungal infection found among immunocompromised and diabetic patients. However, the infection is rare among immunocompetent hosts. We are reporting the case of an adult immunocompetent male patient working as an air-conditioning technician. The patient was a victim of a road traffic accident (RTA) and sustained multiple fractures in the proximal part of the left tibia, distal femur, and scapula. Two weeks postoperatively, Rhizopus microspores were isolated from an infected traumatic wound over the distal femur. Surgical debridement was performed, and the patient was started on amphotericin B. Occupational exposure history and workplace environmental sanitation are crucial for the prevention of this potentially fatal yet preventable infection. Copyright © 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  17. Incidence and Clinical Outcomes of Inflammatory Bowel Disease in South Korea, 2011-2014: A Nationwide Population-Based Study.

    Science.gov (United States)

    Jung, Yoon Suk; Han, Minkyung; Kim, Won Ho; Park, Sohee; Cheon, Jae Hee

    2017-08-01

    The incidence of inflammatory bowel disease (IBD) is increasing in East Asia; however, population-based data from this region are lacking. We conducted a nationwide, population-based study to examine the incidence and disease course of IBD in South Korea. Using the National Health Insurance claims data, we collected data on patients diagnosed with IBD [10,049 with ulcerative colitis (UC) and 5595 with Crohn's disease (CD)] from 2011 to 2014. During the study period, the average annual incidence of UC was 5.0 per 10 5 , while that of CD was 2.8 per 10 5 . Among patients with UC, the cumulative rates of surgery 1 and 4 years after diagnosis were 1.0 and 2.0%; those among patients with CD were 9.0 and 13.9%, respectively. The 1- and 4-year cumulative rates of moderate- to high-dose corticosteroid use were, respectively, 26.6 and 45.2% among patients with UC, and 29.9 and 50.8% among those with CD. Similarly, the 1- and 4-year cumulative rates of immunomodulator use were 14.1 and 26.4% among patients with UC, and 58.3 and 76.1% among those with CD, respectively. With regard to biologic use, the 1- and 4-year cumulative rates were 3.0 and 9.0% among patients with UC, and 11.1 and 31.7% among those with CD, respectively. The recent incidence of IBD in South Korea has been the highest in East Asia. Patients who had been diagnosed recently with IBD showed lower rates of surgery and higher rates of immunomodulator and biologic use compared to those reported ever in South Korea.

  18. Quantitative prediction of shrimp disease incidence via the profiles of gut eukaryotic microbiota.

    Science.gov (United States)

    Xiong, Jinbo; Yu, Weina; Dai, Wenfang; Zhang, Jinjie; Qiu, Qiongfen; Ou, Changrong

    2018-04-01

    One common notion is emerging that gut eukaryotes are commensal or beneficial, rather than detrimental. To date, however, surprisingly few studies have been taken to discern the factors that govern the assembly of gut eukaryotes, despite growing interest in the dysbiosis of gut microbiota-disease relationship. Herein, we firstly explored how the gut eukaryotic microbiotas were assembled over shrimp postlarval to adult stages and a disease progression. The gut eukaryotic communities changed markedly as healthy shrimp aged, and converged toward an adult-microbiota configuration. However, the adult-like stability was distorted by disease exacerbation. A null model untangled that the deterministic processes that governed the gut eukaryotic assembly tended to be more important over healthy shrimp development, whereas this trend was inverted as the disease progressed. After ruling out the baseline of gut eukaryotes over shrimp ages, we identified disease-discriminatory taxa (species level afforded the highest accuracy of prediction) that characteristic of shrimp health status. The profiles of these taxa contributed an overall 92.4% accuracy in predicting shrimp health status. Notably, this model can accurately diagnose the onset of shrimp disease. Interspecies interaction analysis depicted how the disease-discriminatory taxa interacted with one another in sustaining shrimp health. Taken together, our findings offer novel insights into the underlying ecological processes that govern the assembly of gut eukaryotes over shrimp postlarval to adult stages and a disease progression. Intriguingly, the established model can quantitatively and accurately predict the incidences of shrimp disease.

  19. Maternally acquired runt disease.

    Science.gov (United States)

    Beer, A E; Billingham, R E

    1973-01-19

    Without altering the structural integrity of the placenta by irradiation or drugs, we have shown that it is possible to immunize females both adoptively and actively against the paternally inherited transplantation antigens of their fetuses. Such immunization causes a high incidence of runt disease among the litters. Although the putative chimeric status of the affected offspring has yet to be confirmed, the results of our experiments support the thesis that runt disease is caused by the activities of "unwanted" immigrant lymphocytes from the maternal circulation. Our results suggest that immunologically activated cells are more likely to cross the placenta than normal cells and that this greater mobility may not be related to the immunologic specificity of the activated cells. Two factors may have contributed to the apparent failure of numerous previous attempts to demonstrate the capacity of transplantation immunity to affect the well-being of a fetus or, more correctly, its placenta, in the way that might be expected of a homograft. (i) Investigators were preoccupied with obtaining a classic type of rejection, in utero, analogous to the rejection of an orthotopic skin homograft. The birth of consistently healthy-looking litters, interpreted as a failure of the experiment, convinced the investigators of the efficacy of nature's solution of the homograft problem and there was no reason for them to suspect its possible limitations. Observation of the litters for several weeks might have uncovered the phenomenon of maternally induced runt disease. (ii) Most investigators resorted to hyperimmunization of the mothers. This would have facilitated the synthesis of protective isoantibodies capable of interfering with the expression of the potentially harmful cellular immune response (6). Ever since the abnormalities of runt disease were first described they have repeatedly been compared to those observed in patients with certain lymphomas (17). Various theories have been

  20. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits.

    Science.gov (United States)

    Labrador Velandia, Sonia; Di Lauro, Salvatore; Alonso-Alonso, Maria Luz; Tabera Bartolomé, Soraya; Srivastava, Girish Kumar; Pastor, José Carlos; Fernandez-Bueno, Ivan

    2018-01-01

    To evaluate the feasibility, safety, and biocompatibility of intravitreal injection of human mesenchymal stem cells (MSCs) in immunocompetent pigmented rabbits. Thirty-two pigmented rabbits (24 females, 8 males; Chinchilla-New Zealand White) were divided into 8 groups of 4 animals. Commercially prepared human MSCs were injected (0.05 ml) into the post-lens vitreous of the right eyes. Groups 1 and 4 received isotonic medium (Ringer lactate-based), groups 2, 5, 7, and 8 received a low dose of 15 × 10 6 cells/ml. Groups 3 and 6 received a high dose of 30 × 10 6 cells/ml. Clinical signs were evaluated and scored before MSCs injection and weekly for 2 or 6 weeks. Animals were sacrificed at 2 or 6 weeks after injection. Eyes, liver, spleen, and gonads were assessed by histology and by fluorescent in situ hybridization to evaluate survival and extraocular migration of MSCs. There were no relevant clinical findings between control and MSC-injected rabbit eyes at any time point. There were also no relevant histological findings between control and MSC-injected rabbits related to ocular, liver, spleen, or gonad tissues modifications. MSCs survived intravitreally for at least 2 weeks after injection. Extraocular migration of MSCs was not detected. MSCs are safe and well-tolerated when administered intravitreally at a dose of 15 × 10 6 cells/ml in pigmented rabbits. These findings enable future research to explore the intravitreal use of commercially prepared allogenic human MSCs in clinical trials of retinal diseases.

  1. Dietary Protein Sources and Risk for Incident Chronic Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Study.

    Science.gov (United States)

    Haring, Bernhard; Selvin, Elizabeth; Liang, Menglu; Coresh, Josef; Grams, Morgan E; Petruski-Ivleva, Natalia; Steffen, Lyn M; Rebholz, Casey M

    2017-07-01

    Dietary protein restriction is recommended for patients with moderate to severe renal insufficiency. Long-term data on the relationship between dietary protein sources and risk for incident kidney disease in individuals with normal kidney function are largely missing. This study aimed to assess the association between dietary protein sources and incident chronic kidney disease (CKD). Prospective cohort. Atherosclerosis Risk in Communities study participants from 4 US communities. A total of 11,952 adults aged 44-66 years in 1987-1989 who were free of diabetes mellitus, cardiovascular disease, and had an estimated glomerular filtration rate (eGFR) ≥ 60 mL/minute/1.73 m 2 . A 66-item food frequency questionnaire was used to assess food intake. CKD stage 3 was defined as a decrease in eGFR of ≥25% from baseline resulting in an eGFR of less than 60 mL/minute/1.73 m 2 ; CKD-related hospitalization; CKD-related death; or end-stage renal disease. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression. During a median follow-up of 23 years, there were 2,632 incident CKD cases. Red and processed meat consumption was associated with increased CKD risk (HR Q5 vs. Q1 : 1.23, 95% CI: 1.06-1.42, p trend  = 0.01). In contrast, higher dietary intake of nuts, legumes, and low-fat dairy products was associated with lower CKD risk (nuts: HR Q5 vs. Q1 : 0.81, 95% CI: 0.72-0.92, p trend protein sources with risk of incident CKD; with red and processed meat being adversely associated with CKD risk; and nuts, low-fat dairy products, and legumes being protective against the development of CKD. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  2. Cardiovascular disease incidence in adolescent and young adult cancer survivors: a retrospective cohort study.

    Science.gov (United States)

    Keegan, Theresa H M; Kushi, Lawrence H; Li, Qian; Brunson, Ann; Chawla, X; Chew, Helen K; Malogolowkin, Marcio; Wun, Ted

    2018-06-01

    Few population-based studies have focused on cardiovascular disease (CVD) risk in adolescent and young adult (AYA; 15-39 years) cancer survivors and none have considered whether CVD risk differs by sociodemographic factors. Analyses focused on 79,176 AYA patients diagnosed with 14 first primary cancers in 1996-2012 and surviving > 2 years after diagnosis with follow-up through 2014. Data were obtained from the California Cancer Registry and State hospital discharge data. CVD included coronary artery disease, heart failure, and stroke. The cumulative incidence of developing CVD accounted for the competing risk of death. Multivariable Cox proportional hazards regression evaluated factors associated with CVD and the impact of CVD on mortality. Overall, 2249 (2.8%) patients developed CVD. Survivors of central nervous system cancer (7.3%), acute lymphoid leukemia (6.9%), acute myeloid leukemia (6.8%), and non-Hodgkin lymphoma (4.1%) had the highest 10-year CVD incidence. In multivariable models, African-Americans (hazard ratio (HR) = 1.55, 95% confidence interval (CI) = 1.33-1.81; versus non-Hispanic Whites), those with public/no health insurance (HR = 1.78, 95% CI = 1.61-1.96; versus private) and those who resided in lower socioeconomic status neighborhoods had a higher CVD risk. These sociodemographic differences in CVD incidence were apparent across most cancer sites. The risk of death was increased by eightfold or higher among AYAs who developed CVD. While cancer therapies are known to increase the risk of CVD, this study additionally shows that CVD risk varies by sociodemographic factors. The identification and mitigation of CVD risk factors in these subgroups may improve long-term patient outcomes.

  3. Within-Colony Variation in the Immunocompetency of Managed and Feral Honey Bees (Apis mellifera L.) in Different Urban Landscapes.

    Science.gov (United States)

    Appler, R Holden; Frank, Steven D; Tarpy, David R

    2015-10-29

    Urbanization has the potential to dramatically affect insect populations worldwide, although its effects on pollinator populations are just beginning to be understood. We compared the immunocompetency of honey bees sampled from feral (wild-living) and managed (beekeeper-owned) honey bee colonies. We sampled foragers from feral and managed colonies in rural, suburban, and urban landscapes in and around Raleigh, NC, USA. We then analyzed adult workers using two standard bioassays for insect immune function (encapsulation response and phenoloxidase activity). We found that there was far more variation within colonies for encapsulation response or phenoloxidase activity than among rural to urban landscapes, and we did not observe any significant difference in immune response between feral and managed bees. These findings suggest that social pollinators, like honey bees, may be sufficiently robust or variable in their immune responses to obscure any subtle effects of urbanization. Additional studies of immune physiology and disease ecology of social and solitary bees in urban, suburban, and natural ecosystems will provide insights into the relative effects of changing urban environments on several important factors that influence pollinator productivity and health.

  4. Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study.

    Science.gov (United States)

    Wada, Masaoki; Takeshima, Taro; Nakamura, Yosikazu; Nagasaka, Shoichiro; Kamesaki, Toyomi; Oki, Hiroshi; Kajii, Eiji

    2015-01-01

    Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD) is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. This was an observational study. Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic) in Japan. The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%). During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo) and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6-232.6) per 1,000 person-years and 115.7 (95% confidence interval: 92.2-142.6) per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of benign paroxysmal positional vertigo, and three of Meniere's disease among the 76 PVD patients. We reported the incidence of dizziness/vertigo among Japanese primary care clinic patients, which was higher than that usually observed in the general population. Furthermore, we described the incidence of PVD and found that it was a major cause of dizziness/vertigo.

  5. Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study

    Science.gov (United States)

    Wada, Masaoki; Takeshima, Taro; Nakamura, Yosikazu; Nagasaka, Shoichiro; Kamesaki, Toyomi; Oki, Hiroshi; Kajii, Eiji

    2015-01-01

    Objective Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD) is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. Design This was an observational study. Setting and participants Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic) in Japan. Outcome The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. Results The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%). During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo) and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6–232.6) per 1,000 person-years and 115.7 (95% confidence interval: 92.2–142.6) per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of benign paroxysmal positional vertigo, and three of Meniere’s disease among the 76 PVD patients. Conclusion We reported the incidence of dizziness/vertigo among Japanese primary care clinic patients, which was higher than that usually observed in the general population. Furthermore, we described the incidence of PVD and found that it was a major cause of dizziness/vertigo. PMID:25931828

  6. Community-Acquired Pneumonia and Empyema Caused by Citrobacter koseri in an Immunocompetent Patient

    Directory of Open Access Journals (Sweden)

    Miguel Angel Ariza-Prota

    2015-01-01

    Full Text Available Citrobacter species, belonging to the family Enterobacteriaceae, are environmental organisms commonly found in soil, water, and the intestinal tracts of animals and humans. Citrobacter koseri is known to be an uncommon but serious cause of both sporadic and epidemic septicemia and meningitis in neonates and young infants. Most cases reported have occurred in immunocompromised hosts. The infections caused by Citrobacter are difficult to treat with usual broad spectrum antibiotics owing to rapid generation of mutants and have been associated with high death rates in the past. We believe this is the first case described in the literature of a community-acquired pneumonia and empyema caused by Citrobacter koseri in an immunocompetent adult patient.

  7. Serum urate gene associations with incident gout, measured in the Framingham Heart Study, are modified by renal disease and not by body mass index.

    Science.gov (United States)

    Reynolds, Richard J; Vazquez, Ana I; Srinivasasainagendra, Vinodh; Klimentidis, Yann C; Bridges, S Louis; Allison, David B; Singh, Jasvinder A

    2016-02-01

    We hypothesized that serum urate-associated SNPs, individually or collectively, interact with BMI and renal disease to contribute to risk of incident gout. We measured the incidence of gout and associated comorbidities using the original and offspring cohorts of the Framingham Heart Study. We used direct and imputed genotypes for eight validated serum urate loci. We fit binomial regression models of gout incidence as a function of the covariates, age, type 2 diabetes, sex, and all main and interaction effects of the eight serum urate SNPs with BMI and renal disease. Models were also fit with a genetic risk score for serum urate levels which corresponds to the sum of risk alleles at the eight SNPs. Model covariates, age (P = 5.95E-06), sex (P = 2.46E-39), diabetes (P = 2.34E-07), BMI (P = 1.14E-11) and the SNPs, rs1967017 (P = 9.54E-03), rs13129697 (P = 4.34E-07), rs2199936 (P = 7.28E-03) and rs675209 (P = 4.84E-02) were all associated with incident gout. No BMI by SNP or BMI by serum urate genetic risk score interactions were statistically significant, but renal disease by rs1106766 was statistically significant (P = 6.12E-03). We demonstrated that minor alleles of rs1106766 (intergenic, INHBC) were negatively associated with the risk of incident gout in subjects without renal disease, but not for individuals with renal disease. These analyses demonstrate that a significant component of the risk of gout may involve complex interplay between genes and environment.

  8. Upper-gastrointestinal bleeding secondary to peptic ulcer disease: incidence and outcomes.

    Science.gov (United States)

    Quan, Samuel; Frolkis, Alexandra; Milne, Kaylee; Molodecky, Natalie; Yang, Hong; Dixon, Elijah; Ball, Chad G; Myers, Robert P; Ghosh, Subrata; Hilsden, Robert; van Zanten, Sander Veldhuyzen; Kaplan, Gilaad G

    2014-12-14

    To evaluate the incidence, surgery, mortality, and readmission of upper gastrointestinal bleeding (UGIB) secondary to peptic ulcer disease (PUD). Administrative databases identified all hospitalizations for UGIB secondary to PUD in Alberta, Canada from 2004 to 2010 (n = 7079) using the International Classification of Diseases Codes (ICD-10). A subset of the data was validated using endoscopy reports. Positive predictive value and sensitivity with 95% confidence intervals (CI) were calculated. Incidence of UGIB secondary to PUD was calculated. Logistic regression was used to evaluate surgery, in-hospital mortality, and 30-d readmission to hospital with recurrent UGIB secondary to PUD. Co-variants accounted for in our logistic regression model included: age, sex, area of residence (i.e., urban vs rural), number of Charlson comorbidities, presence of perforated PUD, undergoing upper endoscopy, year of admission, and interventional radiological attempt at controlling bleeding. A subgroup analysis (n = 6356) compared outcomes of patients with gastric ulcers to those with duodenal ulcers. Adjusted estimates are presented as odds ratios (OR) with 95%CI. The positive predictive value and sensitivity of ICD-10 coding for UGIB secondary to PUD were 85.2% (95%CI: 80.2%-90.2%) and 77.1% (95%CI: 69.1%-85.2%), respectively. The annual incidence between 2004 and 2010 ranged from 35.4 to 41.2 per 100000. Overall risk of surgery, in-hospital mortality, and 30-d readmission to hospital for UGIB secondary to PUD were 4.3%, 8.5%, and 4.7%, respectively. Interventional radiology to control bleeding was performed in 0.6% of patients and 76% of these patients avoided surgical intervention. Thirty-day readmission significantly increased from 3.1% in 2004 to 5.2% in 2010 (OR = 1.07; 95%CI: 1.01-1.14). Rural residents (OR rural vs urban: 2.35; 95%CI: 1.83-3.01) and older individuals (OR ≥ 65 vs ulcers had higher odds of dying (OR = 1.27; 95%CI: 1.05-1.53), requiring surgery (OR = 1.73; 95

  9. Number of recent stressful life events and incident cardiovascular disease: Moderation by lifetime depressive disorder.

    Science.gov (United States)

    Berntson, Jessica; Patel, Jay S; Stewart, Jesse C

    2017-08-01

    We investigated whether number of recent stressful life events is associated with incident cardiovascular disease (CVD) and whether this relationship is stronger in adults with a history of clinical depression. Prospective data from 28,583 U.S. adults (mean age=45years) initially free of CVD who participated in Waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Number of past-year stressful life events (Wave 1), lifetime depressive disorder (Wave 1), and incident CVD (Wave 2) were determined by structured interviews. There were 1069 cases of incident CVD. Each additional stressful life event was associated with a 15% increased odds of incident CVD [Odds Ratio (OR)=1.15, 95% Confidence Interval (CI): 1.11, 1.19]. As hypothesized, a stressful life events by lifetime depressive disorder interaction was detected (P=0.003). Stratified analyses indicated that stressful life events had a stronger association with incident CVD among adults with (OR=1.18, 95% CI: 1.10, 1.27, n=4908) versus without (OR=1.10, 95% CI: 1.07, 1.14, n=23,675) a lifetime depressive disorder. Our findings suggest that a greater number of recent stressful life events elevate the risk of new-onset CVD and that this risk is potentiated in adults with a history of clinical depression. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon Toxoplasmosis diseminada en un paciente inmunocompetente procedente de la Amazonía peruana

    Directory of Open Access Journals (Sweden)

    Juan Nunura

    2010-04-01

    Full Text Available We report a case of severe toxoplasmosis in an immunocompetent patient, characterized by pneumonia, retinochoroiditis, hepatitis and myositis. Diagnosis was confirmed by serology, T. gondii in thick blood smear and presence of bradyzoites in muscle biopsy. Treatment with pyrimethamine plus sulfadoxine was successful but visual acuity and hip extension were partially recovered. This is the first case report of severe toxoplasmosis in an immunocompetent patient from Peru.Reportamos un caso de toxoplasmosis severa en un paciente inmunocompetente caracterizado por neumonía, retinocoroiditis, hepatitis y miositis. El diagnóstico fue confirmado por serología, el hallazgo de T. gondii en gota gruesa y la presencia de bradizoitos en biopsia muscular. El tratamiento con pirimetamina mas sulfadoxina fue exitoso pero solo hubo una parcial recuperación de la agudeza visual y de la capacidad de extensión de la cadera. Este es el primer reporte de un caso de toxoplasmosis severa en el Perú.

  11. Identification and characterization of 20 immunocompetent patients with simultaneous varicella zoster and herpes simplex virus infection.

    Science.gov (United States)

    Giehl, K A; Müller-Sander, E; Rottenkolber, M; Degitz, K; Volkenandt, M; Berking, C

    2008-06-01

    It has been shown that varicella zoster virus (VZV) and herpes simplex virus (HSV) can co-localize to the same sensory ganglion. However, only a few case reports on VZV/HSV co-infections exist. Objective To identify and characterize patients with concurrent VZV and HSV infection at the same body site. In 1718 patients, the presence of VZV and HSV in suspicious skin lesions was investigated by polymerase chain reaction analysis. Clinical characteristics of co-infected patients were compared with matched control patients infected with either VZV or HSV. The data are discussed in the context of an extensive review of the literature. Twenty (1.2%) of 1718 patients were infected with both VZV and HSV at the same body site. The mean age was 54 years (range, 2-83). The clinical diagnosis was zoster in 65%, herpes simplex in 20%, varicella in 10% and erythema multiforme in 5% of cases. The trigeminus region was affected in 60% and the trunk in 25%. Involvement of the head was most commonly associated with a severe course of disease and with older age. Simultaneous VZV/HSV infection is rare but can occur in immunocompetent patients, which is often overlooked. The majority of cases is localized to the trigeminus region and affects elderly people.

  12. Risk of Incident Liver Disease in Patients with Psoriasis, Psoriatic Arthritis, and Rheumatoid Arthritis: A Population-Based Study.

    Science.gov (United States)

    Ogdie, Alexis; Grewal, Sungat K; Noe, Megan H; Shin, Daniel B; Takeshita, Junko; Chiesa Fuxench, Zelma C; Carr, Rotonya M; Gelfand, Joel M

    2018-04-01

    Relatively little is known about the risk for incident liver disease in psoriasis (PsO), psoriatic arthritis (PsA), and rheumatoid arthritis (RA). We performed a cohort study among patients with PsO, PsA, or RA and matched controls in The Health Improvement Network from 1994 to 2014. Outcomes of interest were any liver disease, nonalcoholic fatty liver disease, and cirrhosis (any etiology). Among patients with PsO (N = 197,130), PsA (N = 12,308), RA (N = 54,251), and matched controls (N = 1,279,754), the adjusted hazard ratios for any liver disease were elevated among patients with PsO (without systemic therapy [ST] 1.37; with ST 1.97), PsA (without ST 1.38; with ST 1.67), and RA without an ST (1.49) but not elevated in patients with RA prescribed an ST (0.96). Incident nonalcoholic fatty liver disease was highest in patients with PsO prescribed an ST (2.23) and PsA with an ST (2.11). The risk of cirrhosis was highest among patients with PsO with an ST (2.62) and PsA without an ST (3.15). Additionally, the prevalence of liver disease and cirrhosis increased in a stepwise fashion with increasing body surface area affected by PsO (P for trend <0.001). More so than RA, PsO and PsA are associated with liver disease, particularly nonalcoholic fatty liver disease and cirrhosis, and this was true even among patients without ST exposure. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  13. Photodynamic therapy for actinic keratosis in organ transplant patients

    DEFF Research Database (Denmark)

    Basset-Seguin, N; Baumann Conzett, K; Gerritsen, M J P

    2013-01-01

    Background The incidence of actinic keratoses (AK) and non-melanoma skin cancer (NMSC) in organ transplant recipients (OTRs) is significantly higher than in immunocompetent patients. Rates of progression and recurrence following treatment are higher too, in part due to the effects of the immunosu......Background The incidence of actinic keratoses (AK) and non-melanoma skin cancer (NMSC) in organ transplant recipients (OTRs) is significantly higher than in immunocompetent patients. Rates of progression and recurrence following treatment are higher too, in part due to the effects...... investigate induced immunosuppression with PDT in healthy volunteers....

  14. Syndrome of rapid onset end stage renal disease in incident Mayo Clinic chronic hemodialysis patient

    Directory of Open Access Journals (Sweden)

    M. A. C. Onuigbo

    2014-01-01

    Full Text Available Despite decades of research, a full understanding of chronic kidney disease (CKD-end stage renal disease (ESRD progression remains elusive. The common consensus is a predictable, linear, progressive and time-dependent decline of CKD to ESRD. Acute kidney injury (AKI on CKD is usually assumed to be transient, with recovery as the expected outcome. AKI-ESRD association in current nephrology literature is blamed on the so-called "residual confounding." We had previously described a relationship between AKI events and rapid onset yet irreversible ESRD happening in a continuum in a high-risk CKD cohort. However, the contribution of the syndrome of rapid onset-ESRD (SORO-ESRD to incident United States ESRD population remained conjectural. In this retrospective analysis, we analyzed serum creatinine trajectories of the last 100 consecutive ESRD patients in 4 Mayo Clinic chronic hemodialysis units to determine the incidence of SORO-ESRD. Excluding 9 patients, 31 (34% patients, including two renal transplant recipients, had SORO-ESRD: 18 males and 13 females age 72 (range 50-92 years. Precipitating AKI followed pneumonia (8, acutely decompensated heart failure (7, pyelonephritis (4, post-operative (5, sepsis (3, contrast-induced nephropathy (2, and others (2. Time to dialysis was shortest following surgical procedures. Concurrent renin angiotensin aldosterone system blockade was higher with SORO-ESRD - 23% versus 5%, P = 0.0113. In conclusion, SORO-ESRD is not uncommon among the incident general US ESRD population. The implications for ESRD care planning, AV-fistula-first programs, general CKD care and any associations with renal ageing/senescence warrant further study.

  15. [The estimated incidence and case fatality rate of ischemic and hemorrhagic cerebrovascular disease in 2002 in Catalonia].

    Science.gov (United States)

    Marrugat, Jaume; Arboix, Adrià; García-Eroles, Lluís; Salas, Teresa; Vila, Joan; Castell, Conxa; Tresserras, Ricard; Elosua, Roberto

    2007-06-01

    The aim of this study was to obtain an estimate of the incidence of cerebrovascular disease (CVD) in the Spanish population in 2002. The study involved data on patients aged over 24 years for the year 2002 contained in both the death register and the Minimum Basic Data Set from 65 of the 84 Catalan general hospitals (i.e., 90.7% of all acute hospital beds in Catalonia). Total and age-adjusted mortality rates, cumulative incidence, and hospitalization rates, and the 28-day case fatality rate for CVD in the Catalan population were calculated after cases of traumatic and transient disease had been excluded. The unadjusted CVD mortality rate per 100,000 population aged over 24 years in Catalonia was 92 in men and 119 in women. The age-adjusted rates were 58 (95% confidence interval or CI, 56-61) and 43 (95% CI, 41-44), respectively. The cumulative incidence of CVD per 100,000 population was 218 (95% CI, 214-221) in men and 127 (95% CI, 125-128) in women. The unadjusted 28-day case fatality rate in the population was 36.2%: 30.3% in men and 42.0% in women. Some 62.5% of patients (57.2% of men and 66.4% of women) died from CVD outside hospital. These findings indicate that CVD mortality and incidence rates in Catalonia are among the lowest in developed countries. More than half of the deaths that took place within 28 days after the onset of symptoms occurred outside hospital.

  16. Primary Intraventricular Leiomyoma in an Immunocompetent Patient: First Case Report and Review of the Literature.

    Science.gov (United States)

    Garces, Juanita; Mathkour, Mansour; Valle-Giler, Edison; Scullen, Tyler; Berry, J Franklin; Smith, Roger D

    2016-06-01

    Primary intracranial leiomyoma is an extremely rare occurrence of a low-grade mesenchymal tumor characterized by a proliferation of smooth muscle cells. When present, these lesions predominantly occur in immunocompromised patients in the setting of infection or transplant and have not been known to involve the ventricular system of the brain. In this report, we describe a case of primary leiomyoma of the lateral ventricle in an immunocompetent patient. A 30-year-old man with no medical history presented with progressive diplopia and occipital headaches. Magnetic resonance imaging of the brain revealed a homogenously enhancing mass of the left lateral ventricle with associated cerebral edema. The patient underwent interhemispheric transcallosal craniotomy for resection for symptom alleviation and surgical diagnosis. Histopathology and immunohistochemistry was subsequently consistent with that of leiomyoma. Genetic probing for Epstein-Barr virus was negative. Computed tomography of the chest and abdomen failed to uncover a primary tumor. The patient did well postoperatively and was discharged 3 days after resection. At a two-and-a-half year follow-up, there continued to be no radiologic or clinical evidence of recurrence. To date and to our knowledge, there are fewer than 25 reported cases of primary intracranial leiomyoma, with only 13 occurring in immunocompetent individuals. We believe this is the first report of this tumor type occurring within the ventricular system of the brain. As such, leiomyoma should be considered as a rare etiology in the differential diagnosis of intraventricular lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Road traffic noise, air pollution and incident cardiovascular disease: A joint analysis of the HUNT, EPIC-Oxford and UK Biobank cohorts.

    Science.gov (United States)

    Cai, Yutong; Hodgson, Susan; Blangiardo, Marta; Gulliver, John; Morley, David; Fecht, Daniela; Vienneau, Danielle; de Hoogh, Kees; Key, Tim; Hveem, Kristian; Elliott, Paul; Hansell, Anna L

    2018-05-01

    This study aimed to investigate the effects of long-term exposure to road traffic noise and air pollution on incident cardiovascular disease (CVD) in three large cohorts: HUNT, EPIC-Oxford and UK Biobank. In pooled complete-case sample of the three cohorts from Norway and the United Kingdom (N = 355,732), 21,081 incident all CVD cases including 5259 ischemic heart disease (IHD) and 2871 cerebrovascular cases were ascertained between baseline (1993-2010) and end of follow-up (2008-2013) through medical record linkage. Annual mean 24-hour weighted road traffic noise (Lden) and air pollution (particulate matter with aerodynamic diameter ≤ 10 μm [PM10], ≤2.5 μm [PM2.5] and nitrogen dioxide [NO2]) exposure at baseline address was modelled using a simplified version of the Common Noise Assessment Methods in Europe (CNOSSOS-EU) and European-wide Land Use Regression models. Individual-level covariate data were harmonised and physically pooled across the three cohorts. Analysis was via Cox proportional hazard model with mutual adjustments for both noise and air pollution and potential confounders. No significant associations were found between annual mean Lden and incident CVD, IHD or cerebrovascular disease in the overall population except that the association with incident IHD was significant among current-smokers. In the fully adjusted models including adjustment for Lden, an interquartile range (IQR) higher PM10 (4.1 μg/m3) or PM2.5 (1.4 μg/m3) was associated with a 5.8% (95%CI: 2.5%-9.3%) and 3.7% (95%CI: 0.2%-7.4%) higher risk for all incident CVD respectively. No significant associations were found between NO2 and any of the CVD outcomes. We found suggestive evidence of a possible association between road traffic noise and incident IHD, consistent with current literature. Long-term particulate air pollution exposure, even at concentrations below current European air quality standards, was significantly associated with incident CVD. Copyright

  18. Cryptococcal meningitis in an immunocompetent child: a case report and literature review.

    Science.gov (United States)

    Othman, Norlijah; Abdullah, Nor Atiqah Ng; Wahab, Zubaidah Abdul

    2004-12-01

    An immunocompetent 5 year-old girl presented with pyrexia of unknown origin associated with headache. Initial investigations showed leukocytosis and an increased erythrocyte sedimentation rate. A Widal-Weil Felix test, blood film for malarial parasites, mycoplasma IgM antibody, cultures from blood and urine, full blood picture, Mantoux test, and chest x-ray were all negative. A lumbar puncture was done as part of a work-up for pyrexia of unknown origin. Cryptococcus neoformans was seen on India ink examination and confirmed on culture. She was treated with 10 weeks of intravenous amphotericin B and 8 weeks of fluconazole. Further immunological tests did not reveal any defect in the cell-mediated immune system. C. neoformans meningitis may present with non-specific symptoms and should be considered in a work-up for pyrexia of unknown origin.

  19. "Glowing head" mice: a genetic tool enabling reliable preclinical image-based evaluation of cancers in immunocompetent allografts.

    Directory of Open Access Journals (Sweden)

    Chi-Ping Day

    Full Text Available Preclinical therapeutic assessment currently relies on the growth response of established human cell lines xenografted into immunocompromised mice, a strategy that is generally not predictive of clinical outcomes. Immunocompetent genetically engineered mouse (GEM-derived tumor allograft models offer highly tractable preclinical alternatives and facilitate analysis of clinically promising immunomodulatory agents. Imageable reporters are essential for accurately tracking tumor growth and response, particularly for metastases. Unfortunately, reporters such as luciferase and GFP are foreign antigens in immunocompetent mice, potentially hindering tumor growth and confounding therapeutic responses. Here we assessed the value of reporter-tolerized GEMs as allograft recipients by targeting minimal expression of a luciferase-GFP fusion reporter to the anterior pituitary gland (dubbed the "Glowing Head" or GH mouse. The luciferase-GFP reporter expressed in tumor cells induced adverse immune responses in wildtype mouse, but not in GH mouse, as transplantation hosts. The antigenicity of optical reporters resulted in a decrease in both the growth and metastatic potential of the labeled tumor in wildtype mice as compared to the GH mice. Moreover, reporter expression can also alter the tumor response to chemotherapy or targeted therapy in a context-dependent manner. Thus the GH mice and experimental approaches vetted herein provide concept validation and a strategy for effective, reproducible preclinical evaluation of growth and response kinetics for traceable tumors.

  20. ASSOCIATION OF SEBORRHEIC KERATOSIS AND HUMAN PAPILLOMA VIRUS IN IMMUNE-SUPPRESSED AND IMMUNOCOMPETENT PATIENTS: A COMPARISON STUDY

    Directory of Open Access Journals (Sweden)

    V. A. Molochkov

    2014-01-01

    Full Text Available Aim: To study an association between seborrheic keratosis and human papilloma virus (HPV using quantitative analysis of viral desoxyribonucleic acid (DNA; to assess prevalence of different phenotypes of beta-HPV. Materials and methods: We examined 60 renal transplant recipients (20 of them had multiple seborrheic keratosis and 22 immunocompetent patients with seborrheic keratosis. Control group included 49 healthy subjects. Burr biopsy samples (micro-samples were collected in sterile conditions. After sample procession and DNA isolation using DNK-sorb-C kit (Central Research Institute for Epidemiology – CRIE, polymerase chain reaction for HPV was performed with real-time fluorescent hybridization detection. For DNA amplification and detection we used RotorGene 3000 analyzer (Corbett Research, Australia. In the beta-HPV assay, recombinant plasmids were used as positive controls and control human beta-globin gene fragments (CRIE. 4 oligo-nucleotide systems (group-specific primers and probes were used for the detection of beta-HPV DNA. Results: Keratotic lesions of open and covered skin regions were common in renal transplant recipients. Beta-HPV DNA was more frequent in seborrheis keratomas and intact skin (81% and 55% of renal transplant recipients compared to healthy donors (47%. Conclusion: HPV DNA was frequently detected in keratotic lesions and intact skin of renal transplant recipients. In immunocompetent patients prevalence of HPV DNA in keratotic lesions was significantly higher compared to intact skin.

  1. Diagnostic value of kinetic analysis using dynamic FDG PET in immunocompetent patients with primary CNS lymphoma

    International Nuclear Information System (INIS)

    Nishiyama, Yoshihiro; Yamamoto, Yuka; Monden, Toshihide; Sasakawa, Yasuhiro; Satoh, Katashi; Ohkawa, Motoomi; Kawai, Nobuyuki

    2007-01-01

    The purpose of this study was to investigate the accumulation of FDG in immunocompetent patients with primary central nervous system (CNS) lymphoma using qualitative and quantitative PET images and to compare baseline with follow-up PET after therapy. Twelve immunocompetent patients with CNS lymphoma were examined. Dynamic emission data were acquired for 60 min immediately following injection of FDG. In seven patients, repeated PET studies were performed after treatment. Applying a three-compartment five-parameter model, K 1 , k 2 , k 3 , k 4 , vascular fraction (V B ) and cerebral metabolic rate of glucose (CMR Glc ) were obtained. We evaluated the FDG uptake visually using qualitative and parametric images and quantitatively using parametric images. A total of 12 lesions were identified in ten patients with newly diagnosed CNS lymphoma. On visual analysis, ten lesions showed an increase on qualitative images, eight showed an increase on K 1 images, 12 showed an increase on k 3 images and ten showed an increase on CMR Glc images. On quantitative analysis, k 2 , k 3 and CMR Glc values of the lesion were significantly different from those of the normal grey matter (p 3 and CMR Glc images. The K 1 , k 2 , k 3 and CMR Glc values after treatment were significantly different from those obtained before treatment (p 3 , using dynamic FDG PET might be helpful for diagnosis of CNS lymphoma and for monitoring therapeutic assessment. (orig.)

  2. Piracetam for reducing the incidence of painful sickle cell disease crises.

    Science.gov (United States)

    Al Hajeri, Amani; Fedorowicz, Zbys

    2016-02-12

    Sickle cell disease is one of the most common genetic disorders. Sickle cell crises in which irregular and dehydrated cells contribute to blocking of blood vessels are characterised by episodes of pain. Treatment is mainly supportive and symptomatic. In vitro studies with piracetam indicate that it has the potential for inhibition and a reversal of the process of sickling of erythrocytes. This is an update of a previously published Cochrane review. To assess the effectiveness of piracetam for reducing the incidence of painful sickle cell disease crises. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register which comprises of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Last search of the Group's Haemoglobinopathies Trials Register: 21 September 2015. Randomised controlled trials comparing orally administered piracetam to placebo or standard care in people, of all ages and both sexes, with sickle cell disease. Two authors independently assessed trial quality and extracted data. Trial authors were contacted for additional information. Adverse effects data were collected from the trials. Three trials involving 169 participants were included in the review. A limited amount of data addressing some of the primary and some of the secondary outcomes were provided, but data were incomplete and based on un-validated assumptions used in the evaluation of outcomes. One trial reported a reduction in the number of pain crises and their severity with active intervention than placebo but presented no data to confirm these results. A second trial presented a monthly global pain score based on the number of sickle cell crises and severity of pain but included no separate data for these primary outcomes. Although there was no significant difference between the piracetam and placebo periods for the number of days of

  3. [Incidence of non-communicable diseases and health risks due to potable water quality].

    Science.gov (United States)

    Skudarnov, S E; Kurkatov, S V

    2011-01-01

    Iron and fluorine concentrations and water mineralization and hardness, which exceeded the maximum allowable concentrations, were found to cause an increase in overall morbidity and morbidity from skeletal-and-muscular, urogenital, and digestive system involvement in the population of the Krasnoyarsk Region. A quantitative relationship were found between the concentrations of iron, the hardness and dry residue of water and the incidence rates of urogenital, skeletal-and-muscular and digestive diseases. The consumption of potable water contaminated with chloroform and methane tetrachloride presents unacceptable carcinogenic risks to the population of the Krasnoyarsk Region.

  4. Incidence and phenotype of inflammatory bowel disease based on results from the Asia-pacific Crohn's and colitis epidemiology study.

    Science.gov (United States)

    Ng, Siew C; Tang, Whitney; Ching, Jessica Y; Wong, May; Chow, Chung Mo; Hui, A J; Wong, T C; Leung, Vincent K; Tsang, Steve W; Yu, Hon Ho; Li, Mo Fong; Ng, Ka Kei; Kamm, Michael A; Studd, Corrie; Bell, Sally; Leong, Rupert; de Silva, H Janaka; Kasturiratne, Anuradhani; Mufeena, M N F; Ling, Khoon Lin; Ooi, Choon Jin; Tan, Poh Seng; Ong, David; Goh, Khean L; Hilmi, Ida; Pisespongsa, Pises; Manatsathit, Sathaporn; Rerknimitr, Rungsun; Aniwan, Satimai; Wang, Yu Fang; Ouyang, Qin; Zeng, Zhirong; Zhu, Zhenhua; Chen, Min Hu; Hu, Pin Jin; Wu, Kaichun; Wang, Xin; Simadibrata, Marcellus; Abdullah, Murdani; Wu, Justin Cy; Sung, Joseph J Y; Chan, Francis K L

    2013-07-01

    Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia-Pacific Crohn's and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. We performed a prospective, population-based study of IBD incidence in predefined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture. We identified 419 new cases of IBD (232 of ulcerative colitis [UC], 166 of Crohn's disease [CD], and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25-1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46-29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4-15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P = .001), and a family history of IBD was less common in Asia (3% vs 17%; P incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

  5. Prospective population-based study of the association between vitamin D status and incidence of autoimmune disease

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Thuesen, Betina Heinsbæk

    2015-01-01

    Beside its traditional role in skeletal health, vitamin D is believed to have multiple immunosuppressant properties, and low vitamin D status has been suggested to be a risk factor in the development of autoimmune disease. We investigated the association between vitamin D status and development...... of autoimmune disease. We included a total of 12,555 individuals from three population-based studies with measurements of vitamin D status (25-hydroxy vitamin D). We followed the participants by linkage to the Danish National Patient Register (median follow-up time 10.8 years). Relative risks of autoimmune...... disease were estimated by Cox regression and expressed as hazard ratios, HRs (95 % confidence intervals CIs). There were 525 cases of incident autoimmune disease. The risk for a 10 nmol/l higher vitamin D was: for any autoimmune disease (HR = 0.94 % CI 0.90, 0.98); thyrotoxicosis (HR = 0.83, 95 % CI 0...

  6. Falciparum malaria infection with invasive pulmonary aspergillosis in immunocompetent host – case report

    Science.gov (United States)

    Andriyani, Y.

    2018-03-01

    Invasive pulmonary aspergillosis is an extraordinary rare in the immunocompetent host. Falciparum malaria contributes to high morbidity and mortality of malaria infection cases in the world. The impairments of both humoral and cellular immunity could be the reason of invasive pulmonary aspergillosis in falciparum malaria infection. Forty-nine years old patient came with fever, jaundice, pain in the right abdomen, after visiting a remote area in Africa about one month before admission. Blood films and rapid test were positive for Plasmodium falciparum. After malaria therapy in five days, consciousness was altered into somnolence and intubated with respiratory deterioration. Invasive pulmonary aspergillosis after falciparum malaria infection is life-threatening. There should be awareness of physicians of invasive pulmonary aspergillosis in falciparum malaria infection.

  7. Distribution, incidence and severity of yam (Dioscorea spp

    African Journals Online (AJOL)

    toualy

    2014-01-15

    Jan 15, 2014 ... incidence, severity of viral diseases, and viruses associated with the infected plants. Incidence and severity of the viral diseases were estimated based on symptoms. Enzyme-linked immunosorbent assay. (ELISA) and polymerase chain reaction (PCR)-based techniques were used for the detection of Yam.

  8. Progesterone Alleviates Endometriosis via Inhibition of Uterine Cell Proliferation, Inflammation and Angiogenesis in an Immunocompetent Mouse Model

    Science.gov (United States)

    Kannan, Athilakshmi; Davila, Juanmahel; Zhao, Yuechao; Nowak, Romana A.; Bagchi, Milan K.; Bagchi, Indrani C.; Li, Quanxi

    2016-01-01

    Endometriosis, defined as growth of the endometrial cells outside the uterus, is an inflammatory disorder that is associated with chronic pelvic pain and infertility in women of childbearing age. Although the estrogen-dependence of endometriosis is well known, the role of progesterone in development of this disease remains poorly understood. In this study, we developed a disease model in which endometriosis was induced in the peritoneal cavities of immunocompetent female mice, and maintained with exogenous estrogen. The endometriosis-like lesions that were identified at a variety of ectopic locations exhibited abundant blood supply and extensive adhesions. Histological examination revealed that these lesions had a well-organized endometrial architecture and fibrotic response, resembling those recovered from clinical patients. In addition, an extensive proliferation, inflammatory response, and loss of estrogen receptor alpha (ERα) and progesterone receptor (PR) expression were also observed in these lesions. Interestingly, administration of progesterone before, but not after, lesion induction suppressed lesion expansion and maintained ERα and PR expressions. These progesterone-pretreated lesions exhibited attenuation in KI67, CD31, and pro-inflammatory cytokine expression as well as macrophage infiltration, indicating that progesterone ameliorates endometriosis progression by inhibiting cell proliferation, inflammation and neovascularization. Our studies further showed that suppression of global DNA methylation by application of DNA methyltransferase inhibitor to female mice bearing ectopic lesions restrained lesion expansion and restored ERα and PR expression in eutopic endometrium and ectopic lesions. These results indicate that epigenetic regulation of target gene expression via DNA methylation contributes, at least in part, to progesterone resistance in endometriosis. PMID:27776183

  9. Progesterone Alleviates Endometriosis via Inhibition of Uterine Cell Proliferation, Inflammation and Angiogenesis in an Immunocompetent Mouse Model.

    Directory of Open Access Journals (Sweden)

    Yanfen Li

    Full Text Available Endometriosis, defined as growth of the endometrial cells outside the uterus, is an inflammatory disorder that is associated with chronic pelvic pain and infertility in women of childbearing age. Although the estrogen-dependence of endometriosis is well known, the role of progesterone in development of this disease remains poorly understood. In this study, we developed a disease model in which endometriosis was induced in the peritoneal cavities of immunocompetent female mice, and maintained with exogenous estrogen. The endometriosis-like lesions that were identified at a variety of ectopic locations exhibited abundant blood supply and extensive adhesions. Histological examination revealed that these lesions had a well-organized endometrial architecture and fibrotic response, resembling those recovered from clinical patients. In addition, an extensive proliferation, inflammatory response, and loss of estrogen receptor alpha (ERα and progesterone receptor (PR expression were also observed in these lesions. Interestingly, administration of progesterone before, but not after, lesion induction suppressed lesion expansion and maintained ERα and PR expressions. These progesterone-pretreated lesions exhibited attenuation in KI67, CD31, and pro-inflammatory cytokine expression as well as macrophage infiltration, indicating that progesterone ameliorates endometriosis progression by inhibiting cell proliferation, inflammation and neovascularization. Our studies further showed that suppression of global DNA methylation by application of DNA methyltransferase inhibitor to female mice bearing ectopic lesions restrained lesion expansion and restored ERα and PR expression in eutopic endometrium and ectopic lesions. These results indicate that epigenetic regulation of target gene expression via DNA methylation contributes, at least in part, to progesterone resistance in endometriosis.

  10. High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves' disease in the young in a high iodine intake area

    DEFF Research Database (Denmark)

    Laurberg, P; Pedersen, K M; Vestergaard, H

    1991-01-01

    Little is known about the optimum level of iodine intake for iodine supplementation programmes, or about the effects of the high levels of iodine intake that are found in some countries. We compared the incidence of different types of hyperthyroidism in East-Jutland Denmark with a low average...... that even mild iodine deficiency has a significant effect on population health, since it leads to a high incidence of autonomous thyroid nodules with hyperthyroidism in the elderly population. However, population iodine intake probably should not exceed a level much higher than that necessary to avoid...... iodine intake but no endemic goitre, and the incidence in Iceland with a relatively high iodine intake. Hyperthyroidism was more common in East-Jutland than in Iceland, due to a much higher incidence of multinodular toxic goitre and also of single toxic adenoma. Most of the patients with these diseases...

  11. Incidence and completeness of notification of Legionnaires' disease in The Netherlands: covariate capture–recapture analysis acknowledging regional differences.

    NARCIS (Netherlands)

    N.A.H. van Hest; C.J.P.A. Hoebe (Christian); J.W. Boer, den; J.K. Vermunt (Jeroen); E.P.F. IJzerman (Ed); W.G. Boersma (Wim); J.H. Richardus (Jan Hendrik)

    2008-01-01

    textabstractTo estimate incidence and completeness of notification of Legionnaires' disease (LD) in The Netherlands in 2000 and 2001, we performed a capture–recapture analysis using three registers: Notifications, Laboratory results and Hospital admissions. After record-linkage, 373 of the 780 LD

  12. Circumcision status and incident herpes simplex virus type 2 infection, genital ulcer disease, and HIV infection

    Science.gov (United States)

    Mehta, Supriya D.; Moses, Stephen; Parker, Corette B.; Agot, Kawango; Maclean, Ian; Bailey, Robert C.

    2013-01-01

    Objective We assessed the protective effect of medical male circumcision (MMC) against HIV, herpes simplex virus type 2 (HSV-2), and genital ulcer disease (GUD) incidence. Design Two thousand, seven hundred and eighty-seven men aged 18–24 years living in Kisumu, Kenya were randomly assigned to circumcision (n=1391) or delayed circumcision (n =1393) and assessed by HIV and HSV-2 testing and medical examinations during follow-ups at 1, 3, 6, 12, 18, and 24 months. Methods Cox regression estimated the risk ratio of each outcome (incident HIV, GUD, HSV-2) for circumcision status and multivariable models estimated HIV risk associated with HSV-2, GUD, and circumcision status as time-varying covariates. Results HIV incidence was 1.42 per 100 person-years. Circumcision was 62% protective against HIV [risk ratio =0.38; 95% confidence interval (CI) 0.22–0.67] and did not change when controlling for HSV-2 and GUD (risk ratio =0.39; 95% CI 0.23–0.69). GUD incidence was halved among circumcised men (risk ratio =0.52; 95% CI 0.37–0.73). HSV-2 incidence did not differ by circumcision status (risk ratio =0.94; 95% CI 0.70–1.25). In the multivariable model, HIV seroconversions were tripled (risk ratio =3.44; 95% CI 1.52–7.80) among men with incident HSV-2 and seven times greater (risk ratio =6.98; 95% CI 3.50–13.9) for men with GUD. Conclusion Contrary to findings from the South African and Ugandan trials, the protective effect of MMC against HIV was independent of GUD and HSV-2, and MMC had no effect on HSV-2 incidence. Determining the causes of GUD is necessary to reduce associated HIV risk and to understand how circumcision confers protection against GUD and HIV PMID:22382150

  13. Cancer incidence and thyroid disease among Estonian Chernobyl clean-up workers

    Energy Technology Data Exchange (ETDEWEB)

    Auvinen, A; Salomaa, S [eds.; Radiation and Nuclear Safety Authority, Helsinki (Finland); Rahu, M; Veidebaum, T; Tekkel, M [eds.; Inst. of Experimental and Clinical Medicine, Tallinn (Estonia); Hakulinen, T [ed.; Finnish Cancer Registry, Helsinki (Finland); Boice, Jr, J D [ed.; Int. Epidemiology Inst., MD (United States)

    1998-09-01

    The report describes the development and summarizes the results of the project Cancer incidence and thyroid disease among Estonian Chernobyl clean-up workers. One of the goals of the report is to give research protocols and questionnaires for researchers involved in other studies. Eight previously published articles are also included summarizing the results. The development of the collaboration work of the project is described in the introduction of the report. Epidemiological methods are described in an article complemented by the protocol and English version of the questionnaire administered to all cleanup workers, as well as the data collection form of the thyroid study. The results from biological biodosimetry using both glycophorin A and FISH methods have shown that the radiation doses received by the Chernobyl cleanup workers were relatively low. Thyroid nodularity was not associated with any radiation exposure characteristic in the thyroid screening study. Estonian Chernobyl cleanup workers were followed up for cancer incidence through the Estonian Cancer Registry. No cases of leukemia or thyroid cancer were observed by the end of 1993. It is too early to observe possible effect on other types of cancer. However, mortality from suicides was increased compared with general population. Further follow-up and the extension to other Baltic countries in the future will undoubtedly strengthen the study. There are also plans for future projects covering areas from psychosocial factors to radiation biology

  14. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015

    DEFF Research Database (Denmark)

    Truelsen, Thomas Clement

    2016-01-01

    common in adults. For the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015), we estimated the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015. METHODS: We estimated...... incidence and prevalence by age, sex, cause, year, and geography with a wide range of updated and standardised analytical procedures. Improvements from GBD 2013 included the addition of new data sources, updates to literature reviews for 85 causes, and the identification and inclusion of additional studies...... causes of years lived with disability (YLDs) on a global basis. NCDs accounted for 18 of the leading 20 causes of age-standardised YLDs on a global scale. Where rates were decreasing, the rate of decrease for YLDs was slower than that of years of life lost (YLLs) for nearly every cause included in our...

  15. Characterizing heterogeneity of disease incidence in a spatial hierarchy: a case study from a decade of observations of fusarium head blight of wheat.

    Science.gov (United States)

    Kriss, A B; Paul, P A; Madden, L V

    2012-09-01

    A multilevel analysis of heterogeneity of disease incidence was conducted based on observations of Fusarium head blight (caused by Fusarium graminearum) in Ohio during the 2002-11 growing seasons. Sampling consisted of counting the number of diseased and healthy wheat spikes per 0.3 m of row at 10 sites (about 30 m apart) in a total of 67 to 159 sampled fields in 12 to 32 sampled counties per year. Incidence was then determined as the proportion of diseased spikes at each site. Spatial heterogeneity of incidence among counties, fields within counties, and sites within fields and counties was characterized by fitting a generalized linear mixed model to the data, using a complementary log-log link function, with the assumption that the disease status of spikes was binomially distributed conditional on the effects of county, field, and site. Based on the estimated variance terms, there was highly significant spatial heterogeneity among counties and among fields within counties each year; magnitude of the estimated variances was similar for counties and fields. The lowest level of heterogeneity was among sites within fields, and the site variance was either 0 or not significantly greater than 0 in 3 of the 10 years. Based on the variances, the intracluster correlation of disease status of spikes within sites indicated that spikes from the same site were somewhat more likely to share the same disease status relative to spikes from other sites, fields, or counties. The estimated best linear unbiased predictor (EBLUP) for each county was determined, showing large differences across the state in disease incidence (as represented by the link function of the estimated probability that a spike was diseased) but no consistency between years for the different counties. The effects of geographical location, corn and wheat acreage per county, and environmental conditions on the EBLUP for each county were not significant in the majority of years.

  16. Serum IgG antibody levels to periodontal microbiota are associated with incident Alzheimer disease.

    Directory of Open Access Journals (Sweden)

    James M Noble

    Full Text Available Periodontitis and Alzheimer disease (AD are associated with systemic inflammation. This research studied serum IgG to periodontal microbiota as possible predictors of incident AD.Using a case-cohort study design, 219 subjects (110 incident AD cases and 109 controls without incident cognitive impairment at last follow-up, matched on race-ethnicity, were drawn from the Washington Heights-Inwood Columbia Aging Project (WHICAP, a cohort of longitudinally followed northern Manhattan residents aged >65 years. Mean follow-up was five years (SD 2.6. In baseline sera, serum IgG levels were determined for bacteria known to be positively or negatively associated with periodontitis (Porphyromonas gingivalis, Tannerella forsythia, Actinobacillus actinomycetemcomitans Y4, Treponema denticola, Campylobacter rectus, Eubacterium nodatum, and Actinomyces naeslundii genospecies-2. In all analyses, we used antibody threshold levels shown to correlate with presence of moderate-severe periodontitis.Mean age was 72 years (SD 6.9 for controls, and 79 years (SD 4.6 for cases (p640 ng/ml, present in 10% of subjects was associated with increased risk of AD (HR = 2.0, 95%CI: 1.1-3.8. This association was stronger after adjusting for other significant titers (HR = 3.1, 95%CI: 1.5-6.4. In this model, high anti-E. nodatum IgG (>1755 ng/ml; 19% of subjects was associated with lower risk of AD (HR = 0.5, 95%CI: 0.2-0.9.Serum IgG levels to common periodontal microbiota are associated with risk for developing incident AD.

  17. Grey Incidence analyze of Environment Monitoring Data and Research on the Disease Prevention Measures of Longmen Grottoes

    Science.gov (United States)

    LeiLei, Zheng; XueZhi, Fu; Fei, Chu

    2018-05-01

    Longmen Grottoes was afflicted with many diseases for a long period such as weathering, seepage water and organism growth. Those adverse factors were threatening to preserve cultural relic. Longmen Grottoes conservation and restoration project being put into effect by UNESCO in 2002. The Longmen Grottoes area environmental monitoring system was built in order to comprehensively master the distribution law of environmental factors over the Longmen Grottoes. The monitoring items contains temperature, humidity, wind direction, wind speed, precipitation, light intensity,water content in soil, the rock surface temperature and so on. At the same time, monitoring three experiment caves, monitoring the inside temperature, humidity, seepage water and the wall face temperature etc. So as to analyze the relationship between cave environment and regional environment. We statistical and arrange the data using Excel software, Kgraph software and DPS software. Through the grey incidence analyze, the incidence matrix and the correlation degree of the environmental factors was obtained[1]. The main environment factors for the formation of the disease had been researched. Based on the existing environmental monitor data, the relevance of seepage water and fracture displacement with other environmental factors had been studied, and the relational order was obtained. Corresponding preventive measures were put forward by the formation mechanism analyze of the disease.

  18. Incidence, clearance, and disease progression of genital human papillomavirus infection in heterosexual men.

    Science.gov (United States)

    Moreira, Edson Duarte; Giuliano, Anna R; Palefsky, Joel; Flores, Carlos Aranda; Goldstone, Stephen; Ferris, Daron; Hillman, Richard J; Moi, Harald; Stoler, Mark H; Marshall, Brooke; Vuocolo, Scott; Guris, Dalya; Haupt, Richard M

    2014-07-15

    In this analysis, we examine the incidence and clearance of external genital human papillomavirus (HPV) infection among heterosexual males aged 16-24 years. A total of 1732 males aged 16-24 years old in the placebo arm of a quadrivalent HPV vaccine trial were included in this analysis. Participants were enrolled from 18 countries in Africa, the Asia-Pacific region, Europe, Latin America, and North America. Subjects underwent anogenital examinations and sampling of the penis, scrotum, and perineal/perianal regions. The incidence rate of any HPV DNA genotype 6, 11, 16, and/or 18 detection was 9.0 cases per 100 person-years. Rates of HPV DNA detection were highest in men from Africa. Median time to clearance of HPV genotypes 6, 11, 16, and 18 DNA was 6.1, 6.1, 7.7, and 6.2 months, respectively. Median time to clearance of persistently detected HPV 6, 11, 16, and 18 DNA was 6.7, 3.2, 9.2, and 4.7 months, respectively. The study results suggest that the acquisition of HPV 6, 11, 16, and/or 18 in males is common and that many of these so-called infections are subsequently cleared, similar to findings for women. Nevertheless, given the high rate of HPV detection among young men, HPV vaccination of males may reduce infection in men and reduce the overall burden of HPV-associated disease in the community. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Pediatric inflammatory bowel disease: Increasing incidence, decreasing surgery rate, and compromised nutritional status: A prospective population-based cohort study 2007-2009

    DEFF Research Database (Denmark)

    Jakobsen, Christian; Paerregaard, Anders; Munkholm, Pia

    2011-01-01

    Background: The aim was to evaluate the incidence, treatment, surgery rate, and anthropometry at diagnosis of children with inflammatory bowel disease (IBD). Methods: Patients diagnosed between January 1, 2007 to December 31, 2009 in Eastern Denmark, Funen, and Aarhus were included from a backgro......Background: The aim was to evaluate the incidence, treatment, surgery rate, and anthropometry at diagnosis of children with inflammatory bowel disease (IBD). Methods: Patients diagnosed between January 1, 2007 to December 31, 2009 in Eastern Denmark, Funen, and Aarhus were included from...... a background population of 668,056 children evaluation of incidence, treatment, and surgery rate, a subcohort from Eastern Denmark was extracted for comparison with a previously published population-based cohort from the same geographical area (1998–2006). Results: In all, 130 children...... in the rate of initiating immunomodulators (IM) within the first year (29.0/100 person-years versus 69.2, P nutritional status at diagnosis compared with the general...

  20. “Glowing Head” Mice: A Genetic Tool Enabling Reliable Preclinical Image-Based Evaluation of Cancers in Immunocompetent Allografts

    Science.gov (United States)

    Day, Chi-Ping; Carter, John; Ohler, Zoe Weaver; Bonomi, Carrie; El Meskini, Rajaa; Martin, Philip; Graff-Cherry, Cari; Feigenbaum, Lionel; Tüting, Thomas; Van Dyke, Terry; Hollingshead, Melinda; Merlino, Glenn

    2014-01-01

    Preclinical therapeutic assessment currently relies on the growth response of established human cell lines xenografted into immunocompromised mice, a strategy that is generally not predictive of clinical outcomes. Immunocompetent genetically engineered mouse (GEM)-derived tumor allograft models offer highly tractable preclinical alternatives and facilitate analysis of clinically promising immunomodulatory agents. Imageable reporters are essential for accurately tracking tumor growth and response, particularly for metastases. Unfortunately, reporters such as luciferase and GFP are foreign antigens in immunocompetent mice, potentially hindering tumor growth and confounding therapeutic responses. Here we assessed the value of reporter-tolerized GEMs as allograft recipients by targeting minimal expression of a luciferase-GFP fusion reporter to the anterior pituitary gland (dubbed the “Glowing Head” or GH mouse). The luciferase-GFP reporter expressed in tumor cells induced adverse immune responses in wildtype mouse, but not in GH mouse, as transplantation hosts. The antigenicity of optical reporters resulted in a decrease in both the growth and metastatic potential of the labeled tumor in wildtype mice as compared to the GH mice. Moreover, reporter expression can also alter the tumor response to chemotherapy or targeted therapy in a context-dependent manner. Thus the GH mice and experimental approaches vetted herein provide concept validation and a strategy for effective, reproducible preclinical evaluation of growth and response kinetics for traceable tumors. PMID:25369133

  1. Coronary heart disease events in Aboriginal Australians: incidence in an urban population.

    Science.gov (United States)

    Bradshaw, Pamela J; Alfonso, Helman S; Finn, Judith C; Owen, Julie; Thompson, Peter L

    2009-05-18

    To determine the incidence of coronary heart disease (CHD) events in an urban Aboriginal population. Cohort study of 906 Aboriginal people without CHD from 998 who had undergone risk-factor assessment in the Perth Aboriginal Atherosclerosis Risk Study (PAARS) in 1998-1999. PAARS cohort data were electronically linked to a range of databases that included Western Australian hospital morbidity data and death registry data. We analysed data from January 1980 to December 2006 to identify previous admissions for CHD from 1980 to baseline (1998-1999) and new events from baseline to 2006. First CHD event (hospital admission or death). There were 891 linked records for the 906 participants without previous CHD. The event rate was 12.6/1000 person-years (95% CI, 10.2-15.6/1000 person-years). Annual CHD event rates ranged from 8 to 18/1000 person-years. After adjustment for age (sex was not associated with the risk factors assessed), factors associated with risk of a CHD event in the PAARS cohort were a history of diabetes, overweight or obesity (indicated by body mass index), smoking, and hypertension, but not waist circumference. People with these risk factors were 1.9-2.7 times more likely to experience a CHD event. Compared with previously published information from a remote Aboriginal community in the Northern Territory, the incidence of CHD events among urban-dwelling Aboriginal people was not significantly different (P > 0.05 overall and for subgroups defined by age and sex). City-dwelling Aboriginal Australians have an incidence of CHD events comparable to that of Aboriginal people living in remote northern Australia.

  2. Concomitant Mycobacterium avium infection and Hodgkin's disease in a lymph node from an HIV-negative child.

    Science.gov (United States)

    de Armas, Yaxsier; Capó, Virginia; González, Ida; Mederos, Lilian; Díaz, Raúl; de Waard, Jacobus H; Rodríguez, Alberto; García, Yarmila; Cabanas, Ricardo

    2011-03-01

    We report a case of an immunocompetent child with simultaneously an infection with Mycobacterium avium and Hodgkin's disease in a cervical lymph node. A positive PCR result for M. avium on a biopsy of the lymph node directed the definitive diagnosis for both etiologies and avoided a possible dissemination of this infection after chemotherapy was started.

  3. Within-Colony Variation in the Immunocompetency of Managed and Feral Honey Bees (Apis mellifera L.) in Different Urban Landscapes

    OpenAIRE

    Appler, R.; Frank, Steven; Tarpy, David

    2015-01-01

    Urbanization has the potential to dramatically affect insect populations worldwide, although its effects on pollinator populations are just beginning to be understood. We compared the immunocompetency of honey bees sampled from feral (wild-living) and managed (beekeeper-owned) honey bee colonies. We sampled foragers from feral and managed colonies in rural, suburban, and urban landscapes in and around Raleigh, NC, USA. We then analyzed adult workers using two standard bioassays for insect imm...

  4. [Downscaling research of spatial distribution of incidence of hand foot and mouth disease based on area-to-area Poisson Kriging method].

    Science.gov (United States)

    Wang, J X; Hu, M G; Yu, S C; Xiao, G X

    2017-09-10

    Objective: To understand the spatial distribution of incidence of hand foot and mouth disease (HFMD) at scale of township and provide evidence for the better prevention and control of HFMD and allocation of medical resources. Methods: The incidence data of HFMD in 108 counties (district) in Shandong province in 2010 were collected. Downscaling interpolation was conducted by using area-to-area Poisson Kriging method. The interpolation results were visualized by using geographic information system (GIS). The county (district) incidence was interpolated into township incidence to get the distribution of spatial distribution of incidence of township. Results: In the downscaling interpolation, the range of the fitting semi-variance equation was 20.38 km. Within the range, the incidence had correlation with each other. The fitting function of scatter diagram of estimated and actual incidence of HFMD at country level was y =1.053 1 x , R (2)=0.99. The incidences at different scale were consistent. Conclusions: The incidence of HFMD had spatial autocorrelation within 20.38 km. When HFMD occurs in one place, it is necessary to strengthen the surveillance and allocation of medical resource in the surrounding area within 20.38 km. Area to area Poisson Kriging method based downscaling research can be used in spatial visualization of HFMD incidence.

  5. Effects of plant conduction systems and organic fertilizer management on disease incidence and severity in ‘Osiana’ and ‘Carola’ roses

    Directory of Open Access Journals (Sweden)

    Márcia de Nazaré Oliveira Ribeiro

    2015-04-01

    Full Text Available Conventional pruning is a very common practice for pruning rose cultivars in Brazil. However, few Brazilian producers known any other efficient plant training method for roses, namely “lateral stem bending” or “arching technique”, which involves bending the branches of the rosebush in order to increase the photosynthetic rate of the plant. As well as plant training, the use of fertilizers must also be done carefully in order to obtain high quality roses. Biofertilizers are recommended because of their multiple effects: fertilizer, protein synthesis stimulant, insect repellent, and disease controller. The aim of this study was to assess the plant training system and management of organic fertilizer on the incidence and severity of disease in the ‘Osiana’ and ‘Carola’ roses. The ‘Osiana’ rosebushes received three concentrations (0%, 5%, and 15% of foliar biofertilizer applied monthly to the leaves together with two plant conduction methods (conventional pruning and lateral stem bending. ‘Carola’ roses were treated with three types of fertilizer (chemical fertilizer on the soil + bokashi on the soil, chemical fertilizer on the soil + foliar FishfertilÒand chemical fertilization on the soil without applying organic fertilizers every two weeks, together with 2 plant conduction systems (conventional pruning and lateral stem bending. The additional treatments in ‘Carola’ roses were composed of two organic fertilizers (Bokashi and foliar Fishfertil® and chemical fertilization with lateral pruning. The incidence and severity of disease in these plants during the experiment were assessed over 5 months. For the ‘Osiana’ rose, the incidence and severity of disease were not influenced by fertilizer management or plant training methods. For the ‘Carola’ roses, the different types of fertilizer caused different responses according to the plant training system used, with the biofertilizer Fishfertil® reducing the incidence

  6. Within-Colony Variation in the Immunocompetency of Managed and Feral Honey Bees (Apis mellifera L. in Different Urban Landscapes

    Directory of Open Access Journals (Sweden)

    R. Holden Appler

    2015-10-01

    Full Text Available Urbanization has the potential to dramatically affect insect populations worldwide, although its effects on pollinator populations are just beginning to be understood. We compared the immunocompetency of honey bees sampled from feral (wild-living and managed (beekeeper-owned honey bee colonies. We sampled foragers from feral and managed colonies in rural, suburban, and urban landscapes in and around Raleigh, NC, USA. We then analyzed adult workers using two standard bioassays for insect immune function (encapsulation response and phenoloxidase activity. We found that there was far more variation within colonies for encapsulation response or phenoloxidase activity than among rural to urban landscapes, and we did not observe any significant difference in immune response between feral and managed bees. These findings suggest that social pollinators, like honey bees, may be sufficiently robust or variable in their immune responses to obscure any subtle effects of urbanization. Additional studies of immune physiology and disease ecology of social and solitary bees in urban, suburban, and natural ecosystems will provide insights into the relative effects of changing urban environments on several important factors that influence pollinator productivity and health.

  7. Evaluation of bovine coronavirus antibody levels, virus shedding, and respiratory disease incidence throughout the beef cattle production cycle

    Science.gov (United States)

    Objective- Determine how levels of serum antibody to bovine coronavirus (BCV) are related to virus shedding patterns and respiratory disease incidence in beef calves at various production stages. Animals- 890 crossbred beef calves from four separately managed herds at the U.S. Meat Animal Research C...

  8. Incidence of Atrophic Lesions in Stargardt Disease in the Progression of Atrophy Secondary to Stargardt Disease (ProgStar) Study: Report No. 5.

    Science.gov (United States)

    Strauss, Rupert W; Muñoz, Beatriz; Ho, Alex; Jha, Anamika; Michaelides, Michel; Mohand-Said, Saddek; Cideciyan, Artur V; Birch, David; Hariri, Amir H; Nittala, Muneeswar G; Sadda, SriniVas; Scholl, Hendrik P N

    2017-07-01

    Outcome measures that are sensitive to disease progression are needed as clinical end points for future treatment trials in Stargardt disease. To examine the incidence of atrophic lesions of the retinal pigment epithelium in patients with Stargardt disease as determined by fundus autofluorescence imaging. In this retrospective multicenter cohort study, 217 patients 6 years and older at baseline at tertiary referral centers in Europe, the United States, and the United Kingdom who were harboring disease-causing variants in the adenosine triphosphate (ATP)-binding cassette subfamily A member 4 (ABCA4) gene and who met the following criteria were enrolled: (1) at least 1 well-demarcated area of atrophy with a minimum diameter of 300 µm, with the total area of all atrophic lesions being less than or equal to 12 mm2 in at least 1 eye at the most recent visit, and (2) fundus autofluorescence images for at least 2 visits with a minimum of 6 months between at least 2 visits. Data were collected between August 22, 2013, and December 12, 2014. Data analysis was performed from March 15, 2015, through January 31, 2017. Images were evaluated by staff at a central reading center. Areas of definitely decreased autofluorescence (DDAF) and questionably decreased autofluorescence (QDAF) were outlined and quantified. Lesion-free survival rates were estimated using Kaplan-Meier survival curves. Incidence of atrophic lesions as determined by fundus autofluorescence. The 217 patients (mean [SD] age, 21.8 [13.3] years; 127 female [57.5%]; 148 white [68.2%]) contributed 390 eyes for which the mean (SD) follow-up time was 3.9 (1.6) years (range, 0.7-12.1 years). Among eyes without DDAF at first visit, the median time to develop a DDAF lesion was 4.9 years (95% CI, 4.3-5.6 years). Among eyes without QDAF, the median time to develop a QDAF lesion was 6.3 years (95% CI, 5.6-9.7 years). Eyes with a lesion of DDAF at the first visit were less likely to develop a QDAF lesion compared with eyes

  9. Sexual ornamentation and parasite infection in males of common bream (Abramis brama): a reflection of immunocompetence status or simple cost of reproduction?

    Czech Academy of Sciences Publication Activity Database

    Ottová, E.; Šimková, A.; Jurajda, Pavel; Dávidová, M.; Ondračková, Markéta; Pečínková, M.; Gelnar, M.

    2005-01-01

    Roč. 7, č. 4 (2005), s. 581-593 ISSN 1522-0613 R&D Projects: GA ČR(CZ) GA524/04/1128; GA ČR(CZ) GP524/03/P108 Institutional research plan: CEZ:AV0Z60930519 Keywords : cost of reproduction * immunocompetence * sexual ornamentation Subject RIV: EG - Zoology Impact factor: 1.614, year: 2005

  10. Incidence and Predictors of Bacterial infection in Febrile Children with Sickle Cell Disease.

    Science.gov (United States)

    Morrissey, Benita J; Bycroft, Thomas P; Almossawi, Ofran; Wilkey, Olufunke B; Daniels, Justin G

    2015-01-01

    Children with sickle cell disease are at increased risk of developing bacteremia and other serious bacterial infections. Fever is a common symptom in sickle cell disease and can also occur with sickle cell crises and viral infections. We aimed to evaluate the incidence and predictors of bacteremia and bacterial infection in children with sickle cell disease presenting with fever to a district hospital and sickle cell center in London. A retrospective analysis was performed on all attendances of children (aged under 16 years) with sickle cell disease presenting with a fever of 38.5 °C or higher over a 1-year period. Confirmed bacterial infection was defined as bacteremia, bacterial meningitis, urinary tract infection (UTI), pneumonia, osteomyelitis or other bacterial infection with positive identification of organism. Children were defined as having a suspected bacterial infection if a bacterial infection was suspected clinically, but no organism was identified. Over a 1-year period there were 88 episodes analyzed in 59 children. Bacteremia occurred in 3.4% of episodes and confirmed bacterial infection in 7.0%. Suspected bacterial infection occurred in 33.0%. One death occurred from Salmonella typhirium septicemia. C-reactive protein (CRP) level and white blood cell (WBC) count were both significantly associated with bacterial infection (p = 0.004 and 0.02, respectively.) In conclusion, bacterial infections continue to be a significant problem in children with sickle cell disease. C-reactive protein was significantly associated with bacterial infections, and could be included in clinical risk criteria for febrile children with sickle cell disease.

  11. Morbidade em creche de Brasília: estudo longitudinal de incidência de enfermidades no ano de 1977 Morbidity in a Brasilia day care center: a longitudinal study of disease incidence in 1977

    Directory of Open Access Journals (Sweden)

    Ana Maria Low

    1980-12-01

    Full Text Available Foi feito estudo longitudinal de morbidade em creche de Brasília (Brasil freqüentada por crianças com bom estado nutricional. Foram admitidas na creche durante o ano de 1977 o total de 67 crianças (34 do sexo masculino e 33 do sexo feminino, com idade entre 3 e 21 meses. Infecções de vias aéreas superiores (25,4%, diarréia (23,6% e febre não esclarecida (18,4% representaram dois terços dos diagnósticos. A seguir, em ordem de freqüência, apareceram conjuntivite (15,5%, viroses da infância (7,9%, doenças de pele (3,8%, pequenos acidentes (2,6%, hepatite (2,6% e meningococcemia (0,3%. Houve um total de 343 episódios agudos, dando uma taxa de incidência de 14 enfermidades por criança por ano, independente de sexo e idade.A longitudinal morbidity study was carried out in a day care center in Brasilia (Brazil on a sample of 67 (34 male and 33 female, 3 to 21 months of age well-fed children from middle-class families. A pediatrician was on duty daily in the center. The incidence of disease was: upper respiratory, 25.4%; diarrhea, 23.6%; and undetermined fever, 18.4%. These represented 2/3 of the diagnoses. The other diseases found (and here listed in order of frequency were: conjunctivitis, 15.5%; childhood infections, 7.9%; skin diseases, 3.8%; accidents, 2.6%; hepatitis, 2.6%; and meningitis, 0.3%. There were a total of 343 acute illnesses, giving a mean incidence rate of 14 illnesses per child per year, independent of sex and age. Perhaps the incidence of illnesses would have been lower if the children had not been attending the center, a natural factor in the dissemination of communicable diseases.

  12. Serum IgG antibody levels to periodontal microbiota are associated with incident Alzheimer disease.

    Science.gov (United States)

    Noble, James M; Scarmeas, Nikolaos; Celenti, Romanita S; Elkind, Mitchell S V; Wright, Clinton B; Schupf, Nicole; Papapanou, Panos N

    2014-01-01

    Periodontitis and Alzheimer disease (AD) are associated with systemic inflammation. This research studied serum IgG to periodontal microbiota as possible predictors of incident AD. Using a case-cohort study design, 219 subjects (110 incident AD cases and 109 controls without incident cognitive impairment at last follow-up), matched on race-ethnicity, were drawn from the Washington Heights-Inwood Columbia Aging Project (WHICAP), a cohort of longitudinally followed northern Manhattan residents aged >65 years. Mean follow-up was five years (SD 2.6). In baseline sera, serum IgG levels were determined for bacteria known to be positively or negatively associated with periodontitis (Porphyromonas gingivalis, Tannerella forsythia, Actinobacillus actinomycetemcomitans Y4, Treponema denticola, Campylobacter rectus, Eubacterium nodatum, and Actinomyces naeslundii genospecies-2). In all analyses, we used antibody threshold levels shown to correlate with presence of moderate-severe periodontitis. Mean age was 72 years (SD 6.9) for controls, and 79 years (SD 4.6) for cases (pthe sample. In a model adjusting for baseline age, sex, education, diabetes mellitus, hypertension, smoking, prior history of stroke, and apolipoprotein E genotype, high anti-A. naeslundii titer (>640 ng/ml, present in 10% of subjects) was associated with increased risk of AD (HR = 2.0, 95%CI: 1.1-3.8). This association was stronger after adjusting for other significant titers (HR = 3.1, 95%CI: 1.5-6.4). In this model, high anti-E. nodatum IgG (>1755 ng/ml; 19% of subjects) was associated with lower risk of AD (HR = 0.5, 95%CI: 0.2-0.9). Serum IgG levels to common periodontal microbiota are associated with risk for developing incident AD.

  13. Incidence, adherence, and antibiotic resistance of coagulase-negative Staphylococcus species causing human disease.

    Science.gov (United States)

    Needham, C A; Stempsey, W

    1984-09-01

    Fifty-two isolates of coagulase-negative Staphylococcus species recovered from the blood or intravenous catheters of patients with clinically significant disease were compared to 60 similar isolates from patients who were presumably colonized. All isolates were identified and evaluated for ability to adhere to smooth surfaces, and resistance to anti-staphylococcal penicillins. S. epidermidis, S. hominis, and S. haemolyticus were the most frequently occurring species, representing 65%, 15%, and 10%, respectively, of disease isolates and 57%, 25%, and 8% of colonizers. The seven other species recovered accounted for only 10% of the total in both groups. Differences in isolation rates of each species within the two groups were not significant and were reflective of their reported incidence in the normal flora. All species of coagulase-negative Staphylococcus (except S. capitis and S. cohnii, which were isolated in very small numbers) were capable of adhering to smooth surfaces. S. hominis disease isolates were all capable of adherence, and the difference between the disease isolates and colonizers was statistically significant (p less than 0.02). This was not true for any other species that was analyzed nor for all isolates considered as a whole. Resistance to anti-staphylococcal penicillins was documented for all coagulase-negative Staphylococcus species, and was more frequent in S. epidermidis disease isolates than colonizers (p less than 0.05). No correlation was found between resistance to antistaphylococcal penicillins and ability to adhere.

  14. Estimating a population cumulative incidence under calendar time trends

    DEFF Research Database (Denmark)

    Hansen, Stefan N; Overgaard, Morten; Andersen, Per K

    2017-01-01

    BACKGROUND: The risk of a disease or psychiatric disorder is frequently measured by the age-specific cumulative incidence. Cumulative incidence estimates are often derived in cohort studies with individuals recruited over calendar time and with the end of follow-up governed by a specific date....... It is common practice to apply the Kaplan-Meier or Aalen-Johansen estimator to the total sample and report either the estimated cumulative incidence curve or just a single point on the curve as a description of the disease risk. METHODS: We argue that, whenever the disease or disorder of interest is influenced...

  15. Glitazone Treatment and Incidence of Parkinson's Disease among People with Diabetes: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Ruth Brauer

    2015-07-01

    Full Text Available Recent in vitro and animal experiments suggest that peroxisome proliferation-activated receptor gamma (PPARɣ agonist medications, such as antidiabetic glitazone (GTZ drugs, are neuroprotective in models of Parkinson's disease (PD. These findings have not been tested in humans. We hypothesized that individuals prescribed GTZ drugs would have a lower incidence of PD compared to individuals prescribed other treatments for diabetes.Using primary care data from the United Kingdom Clinical Practice Research Datalink (CPRD, we conducted a retrospective cohort study in which individuals with diabetes who were newly prescribed GTZ (GTZ-exposed group were matched by age, sex, practice, and diabetes treatment stage with up to five individuals prescribed other diabetes treatments (other antidiabetic drug-exposed group. Patients were followed up from 1999 until the first recording of a PD diagnosis, end of observation in the database, or end of the study (1 August 2013. An incidence rate ratio (IRR was calculated using conditional Poisson regression, adjusted for possible confounders. 44,597 GTZ exposed individuals were matched to 120,373 other antidiabetic users. 175 GTZ-exposed individuals were diagnosed with PD compared to 517 individuals in the other antidiabetic drug-exposed group. The incidence rate (IR of PD in the GTZ-exposed group was 6.4 per 10,000 patient years compared with 8.8 per 10,000 patient years in those prescribed other antidiabetic treatments (IRR 0.72, 95% confidence interval [CI] 0.60-0.87. Adjustments for potential confounding variables, including smoking, other medications, head injury, and disease severity, had no material impact (fully adjusted IRR 0.75, 0.59-0.94. The risk was reduced in those with current GTZ prescriptions (current GTZ-exposed IRR 0.59, 0.46-0.77 but not reduced among those with past prescriptions (past GTZ-exposed IRR 0.85, 0.65-1.10. Our study only included patients with diabetes who did not have a PD

  16. Incidence of gallstone disease and complications

    DEFF Research Database (Denmark)

    Shabanzadeh, Daniel Mønsted

    2018-01-01

    PURPOSE OF REVIEW: The purpose of this review was to describe the epidemiology of gallstone disease in the era of ultrasound screening and laparoscopic cholecystectomy. RECENT FINDINGS: Recent general population cohorts, including ultrasound screenings, have contributed to our understanding...... of formation and clinical course of gallstone disease. Cohorts of symptomatic gallstone disease have been informative about symptom recurrence and need of treatment. Preventive targets for gallstone formation may include obesity and the associated metabolic changes. The presence of gallstone disease is best...... described as a continuum from asymptomatic to symptomatic disease, with the latter including both pain attacks and complicated disease. Symptomatic disease causes a persistent high risk of symptom recurrence and need of cholecystectomy. The majority of gallstone carriers will remain asymptomatic and about...

  17. The incidence of Trichomonas vaginalis infection in women attending nine sexually transmitted diseases clinics in the USA.

    Science.gov (United States)

    Alcaide, Maria L; Feaster, Daniel J; Duan, Rui; Cohen, Stephanie; Diaz, Chanelle; Castro, Jose G; Golden, Matthew R; Henn, Sarah; Colfax, Grant N; Metsch, Lisa R

    2016-02-01

    Trichomoniasis (TV) is associated with an increased risk of acquisition of sexually transmitted diseases (STDs) and HIV. The purpose of this study is to evaluate factors associated with incidence TV among female STD clinic attendees in the USA. Data were collected from women participating in a randomised controlled trial evaluating brief risk reduction counselling at the time of HIV testing to reduce sexually transmitted infections (STIs) incidence in STD clinics. Participants recruited from STD clinics underwent STI testing at baseline and 6-month follow-up. TV testing was performed using Nucleic Acid Amplification Test. 1704 participants completed study assessments. Prevalence of TV was 14.6%, chlamydia 8.6%, gonorrhoea 3.0%, herpes simplex virus 2 44.7% and HIV 0.4%. Cumulative 6-month incidence of TV was 7.5%. Almost 50% of the incident TV cases had TV at baseline and had received treatment. Factors associated with incidence of TV were having chlamydia, TV and HIV at baseline: TV relative risk (RR)=3.37 (95% CI 2.35 to 4.83, pTV is common among STD clinic attendees; and baseline TV is the main risk factor for incident TV, suggesting high rates of reinfection or treatment failures. This supports the importance of rescreening women after treatment for TV, evaluating current treatment regimens and programmes to ensure treatment of sexual partners. NCT01154296. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  18. A new, accurate predictive model for incident hypertension

    DEFF Research Database (Denmark)

    Völzke, Henry; Fung, Glenn; Ittermann, Till

    2013-01-01

    Data mining represents an alternative approach to identify new predictors of multifactorial diseases. This work aimed at building an accurate predictive model for incident hypertension using data mining procedures.......Data mining represents an alternative approach to identify new predictors of multifactorial diseases. This work aimed at building an accurate predictive model for incident hypertension using data mining procedures....

  19. Incidence of hyperthyroidism in Slovenia since improved iodine supply

    International Nuclear Information System (INIS)

    Zaletel, K.; Gaberscek, S.; Pirnat, E.; Hojker, S.

    2002-01-01

    Full text: Since the year 1953, when iodine prophylaxis was introduced in Slovenia, several epidemiological studies confirmed the existence of mild iodine deficiency on the whole territory of Slovenia. In January 1999 the implementation of higher iodine content (25 mg of KI or 32 mg of KIO 3 ) was recommended and since then the increased incidence of thyrotoxicosis was observed. Here we present 5-year follow-up data of the incidence of hyperthyroidism due to thyroid autonomy and Graves' disease. We estimated incidence rates from 1997 to 2001 for hyperthyroidism due to thyroid autonomy and Graves' disease among 1000000 people, living in the area of Ljubljana. We assumed that most cases were seen and treated in the Outpatient Department for thyroid diseases of Department for Nuclear Medicine of University Medical Centre Ljubljana. Immediately after correction of iodine deficiency, the incidence of hyperthyroidism due to thyroid autonomy rose almost twice in 1999 (320 cases in 1999 compared to 173 cases in 1997), but afterwards the incidence slightly decreased (240 cases in 2000). Similarly, the incidence of Graves' disease rose in 1999 (267 cases in 1999 compared to 237 in 1997) and in contrast to thyroid autonomy the incidence further increased in the following years (337 in 2000 and 246 in the first half of 2001). The increased incidence of hyperthyroidism due to thyroid autonomy and Graves' disease after elevation of iodine prophylaxis in Slovenia is comparable with data in some other endemic areas. Those data indicate that stepwise supplementation is preferable to immediate corrections. However, we believe that iodine prophylaxis is reasonable and justified and to reassess the iodine nutrition status we plan a follow up evaluation in year 2002. (author)

  20. Unmodifiable variables related to thyroid cancer incidence

    Directory of Open Access Journals (Sweden)

    Cornelia Nitipir

    2018-04-01

    Full Text Available The incidence of thyroid cancer is significantly different between male and female patients. Thyroid cancer is also the only form of cancer where age can be considered a staging variable. Identifying biological prognostic factors such as age or sex is important as it helps select an optimal personalized therapy. The present analysis is an observational, prospective study that enrolled all patients with thyroid disease who were operated upon at a single center. The study aimed to determine the most frequent age at presentation, the predominance of one sex over the other, the incidence of malignant thyroid disease, and the relative risk for each sex to develop thyroid carcinoma. The incidence of thyroid carcinoma was higher for women than for men, with a higher relative risk in the female subgroup. Incidence was also highest in the 50-60-year-old group. Given that studies show better survival for women and for younger patients, even when presenting with advanced disease, compared with older, male patients, such prognostic indicators should be a factor in the treatment decision.

  1. Latent Microsporidiosis Caused by Encephalitozoon cuniculi in Immunocompetent Hosts: A Murine Model Demonstrating the Ineffectiveness of the Immune System and Treatment with Albendazole

    Science.gov (United States)

    Kotkova, Michaela; Sak, Bohumil; Kvetonova, Dana; Kvac, Martin

    2013-01-01

    Background Microsporidia are obligate intracellular parasites causing severe infections with lethal outcome in immunocompromised hosts. However, these pathogens are more frequently reported as latent infections in immunocompetent individuals and raises questions about the potential risk of reactivation following induced immunosuppression. Aims To evaluate the possibility latent microsporidiosis, efficacy or albendazole, and reactivation, the authors monitored the course of E. cuniculi infection in immunocompetent BALB/c mice and immunodeficient SCID mice using molecular methods. Methods Mice were per orally infected with 107 spores of E. cuniculi. Selected groups were treated with albendazole, re-infected or chemically immunosuppressed by dexamethasone. The presence of microsporidia in the host’s organs and feces were determined using PCR methods. Changes in numbers of lymphocytes in blood and in spleen after induction of immunosuppression were confirmed using flow cytometry analysis. Results Whereas E. cuniculi caused lethal microsporidiosis in SCID mice, the infection in BABL/c mice remained asymptomatic despite parasite dissemination into many organs during the acute infection phase. Albendazole treatment led to microsporidia elimination from organs in BALB/c mice. In SCID mice, however, only a temporary reduction in number of affected organs was observed and infection re-established post-treatment. Dexamethasone treatment resulted in a chronic microsporidia infection disseminating into most organs in BALB/c mice. Although the presence of E. cuniculi in organs of albendazole- treated mice was undetectable by PCR, it was striking that infection was reactivated by immunosuppression treatment. Conclusion Our results demonstrated that microsporidia can successfully survive in organs of immunocompetent hosts and are able to reactivate from undetectable levels and spread within these hosts after induction of immunosuppression. These findings stress the danger of

  2. Latent microsporidiosis caused by Encephalitozoon cuniculi in immunocompetent hosts: a murine model demonstrating the ineffectiveness of the immune system and treatment with albendazole.

    Directory of Open Access Journals (Sweden)

    Michaela Kotkova

    Full Text Available BACKGROUND: Microsporidia are obligate intracellular parasites causing severe infections with lethal outcome in immunocompromised hosts. However, these pathogens are more frequently reported as latent infections in immunocompetent individuals and raises questions about the potential risk of reactivation following induced immunosuppression. AIMS: To evaluate the possibility latent microsporidiosis, efficacy or albendazole, and reactivation, the authors monitored the course of E. cuniculi infection in immunocompetent BALB/c mice and immunodeficient SCID mice using molecular methods. METHODS: Mice were per orally infected with 10(7 spores of E. cuniculi. Selected groups were treated with albendazole, re-infected or chemically immunosuppressed by dexamethasone. The presence of microsporidia in the host's organs and feces were determined using PCR methods. Changes in numbers of lymphocytes in blood and in spleen after induction of immunosuppression were confirmed using flow cytometry analysis. RESULTS: Whereas E. cuniculi caused lethal microsporidiosis in SCID mice, the infection in BABL/c mice remained asymptomatic despite parasite dissemination into many organs during the acute infection phase. Albendazole treatment led to microsporidia elimination from organs in BALB/c mice. In SCID mice, however, only a temporary reduction in number of affected organs was observed and infection re-established post-treatment. Dexamethasone treatment resulted in a chronic microsporidia infection disseminating into most organs in BALB/c mice. Although the presence of E. cuniculi in organs of albendazole- treated mice was undetectable by PCR, it was striking that infection was reactivated by immunosuppression treatment. CONCLUSION: Our results demonstrated that microsporidia can successfully survive in organs of immunocompetent hosts and are able to reactivate from undetectable levels and spread within these hosts after induction of immunosuppression. These findings

  3. Geographic Variation of Chronic Kidney Disease Prevalence: Correlation with the Incidence of Renal Cell Carcinoma or Urothelial Carcinoma?

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    Yit-Sheung Yap

    2015-01-01

    Full Text Available Background. The aim of this study is to evaluate whether geographic variations in the prevalence of late-stage chronic kidney disease (CKD exist and are associated with incidence rates of renal cell carcinoma (RCC, upper tract urothelial carcinoma (UTUC, or lower tract urothelial carcinoma (LTUC. Methods. Prevalence rates of late-stage CKD for 366 townships (n>30 in Taiwan were calculated for 1,518,241 and 1,645,151 subjects aged 40 years or older in years 2010 and 2009, respectively. Late-stage CKD prevalence in year 2010 was used as a training set and its age-adjusted standardized morbidity rates (ASMR were divided into three groups as defined <1.76%, 1.76% ≤ ASMR < 2.64%, and ≥2.64%, respectively. Year 2009, defined as the validation set, was used to validate the results. Results. The ASMR of late-stage CKD in years 2010 and 2009 were 1.76%, and 2.09%, respectively. Geographic variations were observed, with notably higher rates of disease in areas of the central, southwestern mountainside, and southeastern seaboard. There were no significant differences among different combined risk groups of RCC, UTUC, and LTUC incidence. Conclusion. The substantial geographic variations in the prevalence of late-stage CKD exist, but are not correlated with RCC, UTUC, or LTUC incidence.

  4. Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study

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    Wada M

    2015-04-01

    Full Text Available Masaoki Wada,1,2 Taro Takeshima,1 Yosikazu Nakamura,3 Shoichiro Nagasaka,4 Toyomi Kamesaki,1 Hiroshi Oki,2 Eiji Kajii1 1Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan; 2Oki Clinic, Ibaraki, Japan; 3Department of Public Health, Jichi Medical University, Tochigi, Japan; 4Department of Internal Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Tochigi, Japan Objective: Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. Design: This was an observational study. Setting and participants: Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic in Japan. Outcome: The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. Results: The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%. During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6–232.6 per 1,000 person-years and 115.7 (95% confidence interval: 92.2–142.6 per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of

  5. Age-specific incidence rates for dementia and Alzheimer disease in NIA-LOAD/NCRAD and EFIGA families: National Institute on Aging Genetics Initiative for Late-Onset Alzheimer Disease/National Cell Repository for Alzheimer Disease (NIA-LOAD/NCRAD) and Estudio Familiar de Influencia Genetica en Alzheimer (EFIGA).

    Science.gov (United States)

    Vardarajan, Badri N; Faber, Kelley M; Bird, Thomas D; Bennett, David A; Rosenberg, Roger; Boeve, Bradley F; Graff-Radford, Neill R; Goate, Alison M; Farlow, Martin; Sweet, Robert A; Lantigua, Rafael; Medrano, Martin Z; Ottman, Ruth; Schaid, Daniel J; Foroud, Tatiana M; Mayeux, Richard

    2014-03-01

    Late-onset Alzheimer disease (LOAD), defined as onset of symptoms after age 65 years, is the most common form of dementia. Few reports investigate incidence rates in large family-based studies in which the participants were selected for family history of LOAD. To determine the incidence rates of dementia and LOAD in unaffected members in the National Institute on Aging Genetics Initiative for Late-Onset Alzheimer Disease/National Cell Repository for Alzheimer Disease (NIA-LOAD/NCRAD) and Estudio Familiar de Influencia Genetica en Alzheimer (EFIGA) family studies. Families with 2 or more affected siblings who had a clinical or pathological diagnosis of LOAD were recruited as a part of the NIA-LOAD/NCRAD Family Study. A cohort of Caribbean Hispanics with familial LOAD was recruited in a different study at the Taub Institute for Research on Alzheimer's Disease and the Aging Brain in New York and from clinics in the Dominican Republic as part of the EFIGA study. Age-specific incidence rates of LOAD were estimated in the unaffected family members in the NIA-LOAD/NCRAD and EFIGA data sets. We restricted analyses to families with follow-up and complete phenotype information, including 396 NIA-LOAD/NCRAD and 242 EFIGA families. Among the 943 at-risk family members in the NIA-LOAD/NCRAD families, 126 (13.4%) developed dementia, of whom 109 (86.5%) met criteria for LOAD. Among 683 at-risk family members in the EFIGA families, 174 (25.5%) developed dementia during the study period, of whom 145 (83.3%) had LOAD. The annual incidence rates of dementia and LOAD in the NIA-LOAD/NCRAD families per person-year were 0.03 and 0.03, respectively, in participants aged 65 to 74 years; 0.07 and 0.06, respectively, in those aged 75 to 84 years; and 0.08 and 0.07, respectively, in those 85 years or older. Incidence rates in the EFIGA families were slightly higher, at 0.03 and 0.02, 0.06 and 0.05, 0.10 and 0.08, and 0.10 and 0.07, respectively, in the same age groups. Contrasting these

  6. Tolerance, immunocompetence, and secondary disease in fully allogeneic radiation chimeras

    International Nuclear Information System (INIS)

    Rayfield, L.S.; Brent, L.

    1983-01-01

    The aim of this study was to ascertain the extent to which secondary disease and mortality in fully allogeneic chimeras (C57BL leads to CBA) is caused (if at all) by a delayed graft-versus-host reaction. Adult CBA males were thymectomized, irradiated, and reconstituted with T-lymphocyte-depleted C57BL or CBA bone marrow cells (BMC), followed three weeks after irradiation by implantation under the kidney capsule of thymic lobes from C57BL or CBA fetal or adult donors. These mice were observed for the development of secondary disease for periods in excess of 250 days, and they were examined at 5 weeks or 4 months for T lymphocyte reactivity and tolerance to alloantigens, using the cell-mediated lympholysis assay (CML). The following results were obtained. First, removal of T lymphocytes with anti-Thy 1 antibody and complement from allogeneic bone marrow did not prevent wasting and eventual death, although it prolonged the lifespan of mice substantially. Second, T lymphocytes generated from bone marrow-derived precursor cells became tolerant of the histocompatibility antigens of the thymus donor strain but remained normally reactive to third-party antigens. Third, allogeneic radiation chimeras did not survive as well as animals reconstituted with syngeneic cells, even when they were demonstrably tolerant in CML. Fourth, C57BL BMC maturing in a CBA host equipped with a C57BL thymus graft did not become tolerant of host antigens, indicating that extra-thymic tolerance does not occur in fully allogeneic--as opposed to semiallogeneic--chimeras. It is argued that the function of B lymphocytes and/or accessory cells is impaired in fully allogeneic radiation chimeras, and that the mortality observed was directly related to the resulting immunodeficiency. The relevance of the results described in this paper to clinical bone marrow transplantation is discussed

  7. Combined central retinal artery and vein occlusion with optic perineuritis following herpes zoster dermatitis in an immunocompetent child.

    Science.gov (United States)

    Bansal, Reema; Singh, Ramandeep; Takkar, Aastha; Lal, Vivek

    2017-11-01

    A 15-year-old healthy boy developed acute, rapidly progressing visual loss in left eye following herpes zoster dermatitis, with a combined central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO), along with optic perineuritis. Laboratory tests were negative. Despite an empirical, intensive antiviral treatment with systemic corticosteroids, and vision could not be restored in the affected eye. Herpes zoster dermatitis, in an immunocompetent individual, may be associated with a combined CRAO and CRVO along with optic perineuritis, leading to profound visual loss.

  8. Effects of road salt on larval amphibian susceptibility to parasitism through behavior and immunocompetence.

    Science.gov (United States)

    Milotic, Dino; Milotic, Marin; Koprivnikar, Janet

    2017-08-01

    Large quantities of road salts are used for de-icing in temperate climates but often leach into aquatic ecosystems where they can cause harm to inhabitants, including reduced growth and survival. However, the implications of road salt exposure for aquatic animal susceptibility to pathogens and parasites have not yet been examined even though infectious diseases can significantly contribute to wildlife population declines. Through a field survey, we found a range of NaCl concentrations (50-560mg/L) in ponds known to contain larval amphibians, with lower levels found in sites close to gravel- rather than hard-surfaced roads. We then investigated how chronic exposure to environmentally-realistic levels of road salt (up to 1140mg/L) affected susceptibility to infection by trematode parasites (helminths) in larval stages of two amphibian species (Lithobates sylvaticus - wood frogs, and L. pipiens - northern leopard frogs) by considering effects on host anti-parasite behavior and white blood cell profiles. Wood frogs exposed to road salt had higher parasite loads, and also exhibited reduced anti-parasite behavior in these conditions. In contrast, infection intensity in northern leopard frogs had a non-monotonic response to road salts even though lymphocytes were only elevated at the highest concentration. Our results indicate the potential for chronic road salt exposure to affect larval amphibian susceptibility to pathogenic parasites through alterations of behavior and immunocompetence, with further studies needed at higher concentrations, as well as that of road salts on free-living parasite infectious stages. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Educational class inequalities in the incidence of coronary heart disease in Europe

    DEFF Research Database (Denmark)

    Veronesi, Giovanni; Ferrario, Marco M; Kuulasmaa, Kari

    2016-01-01

    compared with the most educated, respectively. These figures corresponded to 48% and 71% of the average event rates in each gender group. Inequalities in CHD mortality were mainly driven by incidence in the Nordic countries, Scotland and Lithuania, and by 28-day case-fatality in the remaining central....... Conclusions: Social inequalities in CHD are still widespread in Europe. Since the major determinants of inequalities followed geographical and gender-specific patterns, European-level interventions should be tailored across different European regions.......Objective: To estimate the burden of social inequalities in coronary heart disease (CHD) and to identify their major determinants in 15 European populations. Methods: The MORGAM (MOnica Risk, Genetics, Archiving and Monograph) study comprised 49 cohorts of middle-aged European adults free of CHD...

  10. The fate of mesenchymal stem cells transplanted into immunocompetent neonatal mice: implications for skeletal gene therapy via stem cells.

    Science.gov (United States)

    Niyibizi, Christopher; Wang, Sujing; Mi, Zhibao; Robbins, Paul D

    2004-06-01

    To explore the feasibility of skeletal gene and cell therapies, we transduced murine bone marrow-derived mesenchymal stem cells (MSCs) with a retrovirus carrying the enhanced green fluorescent protein and zeocin-resistance genes prior to transplantation into 2-day-old immunocompetent neonatal mice. Whole-body imaging of the recipient mice at 7 days post-systemic cell injection demonstrated a wide distribution of the cells in vivo. Twenty-five days posttransplantation, most of the infused cells were present in the lung as assessed by examination of the cells cultured from the lungs of the recipient mice. The cells persisted in lung and maintained a high level of gene expression and could be recovered from the recipient mice at 150 days after cell transplantation. A significant number of GFP-positive cells were also present in the bones of the recipient mice at 35 days post-cell transplantation. Recycling of the cells recovered from femurs of the recipient mice at 25 days posttransplantation by repeated injections into different neonatal mice resulted in the isolation of a clone of cells that was detected in bone and cartilage, but not in lung and liver after systemic injection. These data demonstrate that MSCs persist in immunocompetent neonatal mice, maintain a high level of gene expression, and may participate in skeletal growth and development of the recipient animals.

  11. Effect of cardiovascular prevention strategies on incident coronary disease hospitalisation rates in Spain; an ecological time series analysis.

    Science.gov (United States)

    Medrano, María José; Alcalde-Cabero, Enrique; Ortíz, Cristina; Galán, Iñaki

    2014-02-17

    To assess the overall population impact of primary prevention strategies (promotion of healthy lifestyles, prevention of smoking and use of vascular risk drug therapy) of coronary disease in Spain. Ecological time series analysis, 1982-2009. All public and private hospitals in Spain. General population. Incident coronary disease hospitalisation as derived from official hospital discharge data. Annual hospitalisation rates were modelled according to nationwide use of statins, antihypertensive, antidiabetic and antiplatelet drugs, and prevalences of smoking, obesity and overweight. Additive generalised models and mixed Poisson regression models were used for the purpose, taking year as the random-effect variable and adjusting for age, sex, prevalence of vascular risk factors and the number of hospital beds in intensive and coronary care units. Across 28 years and 671.5 million person-years of observation, there were 2 986 834 hospitalisations due to coronary disease; of these, 1 441 980 (48.28%) were classified as incident. Hospitalisation rates increased from 1982 to 1996, with an inflection point in 1997 and a subsequent 52% decrease until 2009. Prevalences of smoking, obesity, overweight and use of vascular risk drug therapy were significantly associated with hospitalisation rates (pcrisis. Future strategies ought to lay special stress on excessive body weight prevention.

  12. Triglyceride-to-high-density-lipoprotein-cholesterol ratio is an index of heart disease mortality and of incidence of type 2 diabetes mellitus in men.

    Science.gov (United States)

    Vega, Gloria Lena; Barlow, Carolyn E; Grundy, Scott M; Leonard, David; DeFina, Laura F

    2014-02-01

    High triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) impart risk for heart disease. This study examines the relationships of TG/HDL-C ratio to mortality from all causes, coronary heart disease (CHD), or cardiovascular disease (CVD). Survival analysis was done in 39,447 men grouped by TG/HDL-C ratio cut point of 3.5 and for metabolic syndrome. National Death Index International Classification of Diseases (ICD-9 and ICD-10) codes were used for CVD and CHD deaths occurring from 1970 to 2008. Incidence of type 2 diabetes mellitus (DM) according to ratio was estimated in 22,215 men. Triglyceride/HDL-C ratio and cross-product of TG and fasting blood glucose (TyG index) were used in analysis. Men were followed up for 581,194 person-years. Triglyceride/HDL-C ratio predicted CHD, CVD, and all-cause mortality after adjustment for established risk factors and non-HDL-C. Mortality rates were higher in individuals with a high ratio than in those with a low ratio. Fifty-five percent of men had metabolic syndrome that was also predictive of CHD, CVD, and all-cause mortality. Annual incidence of DM was 2 times higher in men with high TG/HDL-C ratio than in those with a low ratio. Individuals with high TG/HDL-C ratio had a higher incidence of DM than those with a low ratio. The TyG index was not equally predictive of causes of mortality to TG/HDL-C, but both were equally predictive of diabetes incidence. Triglyceride/HDL-C ratio predicts CHD and CVD mortality as well as or better than do metabolic syndrome in men. Also, a high ratio predisposes to DM. The TyG index does not predict CHD, CVD, or all-cause mortality equally well, but like TG/HDL-C ratio, it predicts DM incidence.

  13. The Incidence of End-Stage Renal Disease in the Diabetic (Compared to the Non-Diabetic) Population: A Systematic Review

    Science.gov (United States)

    Narres, Maria; Claessen, Heiner; Droste, Sigrid; Kvitkina, Tatjana; Koch, Michael; Kuss, Oliver; Icks, Andrea

    2016-01-01

    End-stage renal disease (ESRD) in diabetes is a life threatening complication resulting in a poor prognosis for patients as well as high medical costs. The aims of this systematic review were (1) to evaluate the incidence of ESRD due to all causes and due to diabetic nephropathy in the diabetic population and differences between incidences of ESRD with respect to sex, ethnicity, age and regions, (2) to compare incidence rates in the diabetic and non-diabetic population, and (3) to investigate time trends. The systematic review was conducted according to the PRISMA group guidelines by performing systematic literature searches in the biomedical databases until January 3rd 2015; thirty-two studies were included. Among patients with incident type 1 diabetes the 30-year cumulative incidence ranged from 3.3% to 7.8%. Among patients with prevalent diabetes, incidence rates of ESRD due to all causes ranged from 132.0 to 167.0 per 100,000 person-years, whereas incidence rates of ESRD due to diabetic nephropathy varied from 38.4 to 804.0 per 100,000 person-years. The incidence of ESRD in the diabetic population was higher compared to the non-diabetic population, and relative risks varied from 6.2 in the white population to 62.0 among Native Americans. The results regarding time trends were inconsistent. The review conducted demonstrates the considerable variation of incidences of ESRD among the diabetic population. Consistent findings included an excess risk when comparing the diabetic to the non-diabetic population and ethnic differences. We recommend that newly designed studies should use standardized methods for the determination of ESRD and population at risk. PMID:26812415

  14. Incidence of sickle cell disease and other hemoglobin variants in 10,095 Lebanese neonates.

    Directory of Open Access Journals (Sweden)

    Evelyne Khoriaty

    Full Text Available Hemoglobinopathies are highly prevalent diseases and impose a public health burden. Early diagnosis and treatment can ameliorate the course of these diseases and improve survival. Despite purported high incidence of hemoglobinopathies in Lebanon, there are no nationwide screening programs. In this study, newborn screening utilizing high pressure liquid chromatography was executed in all public hospitals across Lebanon between 2010 and 2013. All newborns with an abnormal hemoglobin (Hb were offered genetic counseling and all those with disease were enrolled in comprehensive hemoglobinopathy clinics. Among newborns, 2.1% were found to have an abnormal Hb variant with sickle Hb being the most common while 0.1% were found to have sickle cell disease (SCD. The majority of those with SCD had non-Lebanese origins. The most common causes of hospitalizations in infants with SCD were acute splenic sequestration and pain crises. No bacteremia or other life threatening infections were noted. At a median follow up 14 months (follow up range 7 to 34 months, all children with disease are alive and compliant with treatment. Systematic screening for SCD and other Hb variants was shown to be feasible, cost effective, and of accurate predictive value. This program was also clinically effective because it led to the identification of babies with disease and to providing them with free early multidisciplinary care. Conclusively, a newborn screening program should be implemented across Lebanon to detect hemoglobinopathies and initiate early therapeutic and preventive strategies and genetic counseling.

  15. Longitudinal Patterns of Change in Systolic Blood Pressure and Incidence of Cardiovascular Disease: The Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Petruski-Ivleva, Natalia; Viera, Anthony J; Shimbo, Daichi; Muntner, Paul; Avery, Christy L; Schneider, Andrea L C; Couper, David; Kucharska-Newton, Anna

    2016-06-01

    Elevated blood pressure in midlife contributes significantly to the risk of cardiovascular disease. However, patterns of blood pressure increase may differ among individuals and may result in differential risk. Our goal was to examine the contribution of longitudinal patterns of blood pressure change to incidence of heart failure, coronary heart disease, stroke, and cardiovascular disease mortality. Latent class growth models were used to identify patterns of change in blood pressure across 4 clinical examinations (1987-1998) among 9845 Atherosclerosis Risk in Communities (ARIC) cohort participants (mean age, 53.7 [SD 5.7] years). Patterns of change in systolic blood pressure included slowly and steeply increasing, a decreasing and a sustained elevated blood pressure. Changes in diastolic and mid-blood pressure (½ systolic+½ diastolic) were less pronounced. The association of blood pressure pattern group membership with incidence of clinical outcomes was examined in follow-up from the fourth clinical examination (1996-1998) to December 31, 2011, using Poisson regression models adjusted for demographic and metabolic characteristics, and hypertension medication use. A gradient of rates of all events was observed across the identified patterns. Associations were attenuated after adjustment for covariates. Cumulative systolic blood pressure load, rather than the temporal pattern of change in systolic blood pressure itself, plays a role in determining the risk of cardiovascular disease, in particular, of heart failure and cardiovascular disease mortality, independent of blood pressure level measured at one point in time. © 2016 American Heart Association, Inc.

  16. Antifungal Prevention of Systemic Candidiasis in Immunocompetent ICU Adults: Systematic Review and Meta-Analysis of Clinical Trials.

    Science.gov (United States)

    Dupont, Hervé; Mahjoub, Yazine; Chouaki, Taieb; Lorne, Emmanuel; Zogheib, Elie

    2017-11-01

    The aim of this study was to identify the impact of antifungal prevention in critically ill immunocompetent adult patients on mortality and subsequent infection. A systematic review and meta-analysis of randomized controlled trials comparing any antifungal use versus placebo to prevent candidiasis in ICU patients were performed. Searches were performed on PubMed, Embase, Scopus, main conference proceedings, and ClinicalTrials.gov, as well as reference lists. The primary outcomes were mortality and invasive candidiasis. The secondary outcome was the rate of Candida albicans and nonalbicans strains after treatment. A random effect model was used, and sensitivity analysis was performed for both outcomes. Results are expressed as risk ratios and their 95% CIs. Nineteen trials (10 with fluconazole, four with ketoconazole, one with itraconazole, three with micafungin, and one with caspofungin) including 2,792 patients were identified. No individual trial showed a decreased mortality rate. Combined analysis showed that preventive antifungal did not decrease mortality (risk ratio, 0.88; 95% CI, 0.74-1.04; p = 0.14) but significantly decreased secondary fungal infections by 50% (risk ratio, 0.49; 95% CI, 0.35-0.68; p = 0.0001). No shift across nonalbicans strains was observed during treatment (risk ratio, 0.62; 95% CI, 0.19-1.97; p = 0.42). However, publication biases preclude any definite conclusions for prevention of infection. Antifungal prevention of systemic candidiasis in immunocompetent critically ill adults did not reduce mortality and may have decreased secondary fungal infection rates. However, significant publication bias was present.

  17. A review of clinical trials in dietary interventions to decrease the incidence of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Miettinen Tatu A

    2001-04-01

    Full Text Available Abstract Of the associations between dietary elements and coronary artery disease (CAD, the greatest body of evidence deals with the beneficial effect of reducing the dietary intake of saturated fatty acids and cholesterol. Furthermore, it is well established, on the basis of convincing evidence, that reduction in serum total cholesterol results in reduction in coronary morbidity and mortality, as well as in regression of other atherosclerotic manifestations.In fact, dietary intervention studies revealed that it is possible to reduce the incidence of coronary death and nonfatal myocardial infarction, as well as manifestations of atherosclerosis in cerebral and peripheral arteries, by reducing dietary intake of saturated fat and cholesterol. In two recently reported dietary interventions the incidence of coronary events, especially coronary mortality, and total mortality were reduced by increased intake of n-3 long-chain polyunsaturated fatty acids and by a modification of the diet toward a Mediterranean-type diet (rich in α-linolenic acid. In addition to those findings, the potential efficacy of the dietary newcomers phytostanol and phytosterol esters on reducing coronary incidence is discussed in the present review.

  18. Nontuberculous Mycobacterial (NTM) Disease in Immunocompetent Patients: Expanding Image Findings on Chest CT

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hyo Hyun; Seon, Hyun Ju; Kim, Mok Hee; Choi, Song; Song, Sang Gook; Shin, Sang Soo; Kim, Yun Hyeon; Park, Jin Gyoon [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2010-04-15

    The aim of this study was to evaluate the chest CT features of nontuberculous mycobacterial (NTM) disease regardless of the specific organisms. This study included 74 consecutive patients (35 men, 39 women; mean age, 63 years; age range, 25-89 years) who were diagnosed with NTM disease according to the American Thoracic Society Guidelines (1997 and 2007) between January 2005 and July 2007. Chest CT images were randomly reviewed by two radiologists with consensus. The most common organism associated with NTM disease is M. avium-intracellulare complex (87.8%), followed by M. abscesses, M. kansasii, and M. chelonae. The most common chest CT finding was a nodular bronchiectatic lesion (n = 35, 46.7%), followed by a cavitary lesion of the upper lobe (n = 21, 28.0%), combined lesions of two prior subtypes (n = 6, 8.0%), consolidative lesion (s) (n = 5, 6.7%), a bronchogenic spreading pulmonary tuberculosis-like lesion (n = 5, 6.7%), a cavitary mass lesion with small satellite nodules (n = 2, 2.7%), and a miliary nodular lesion (n = 1, 1.3%). More than 5 segments were involved in 60 cases (81.1%). The nodular bronchiectatic lesion or cavitary lesion of upper lobe presents with multi-segmental involvement and the occurrence of combined consolidation is indicative of NTM disease

  19. Effects of Ganoderma lucidum on cellular immunocompetence in gamma-irradiated mice

    Energy Technology Data Exchange (ETDEWEB)

    WangChi, Chen; DouMong, Hau [Institute of Radiation Biology, National Tsing Hua University, Hsinchu (China)

    1995-07-01

    We have investigated the effects on mice treated with Ganoderma lucidum (Gl) when the whole body was exposed to 400 rad gamma-irradiation. The mice were divided into five groups. Group A was the normal control; group B, the experimental control, was treated with GI; group C was the radiation control (RT); group D was treated with RT and Gl; group E was treated with Gl, RT and Gl. The results revealed that the relative spleen weight had increased significantly in groups B and E on day 7 and increased in all experimental groups on day, 28 after irradiation. The leukocyte counts decreased obviously in groups C, D and E on day 7, and recovered in groups D and E was faster than that in group C on day 28. The blastogenic response of splenocytes to LPS, Con A and PHA in groups administered GI were higher than that in group C on days 7and 28. Therefore, Gl seemed to assist the recovery of cellular immunocompetence in gamma-irradiated mice. (author)

  20. Effects of Ganoderma lucidum on cellular immunocompetence in gamma-irradiated mice

    International Nuclear Information System (INIS)

    Chen WangChi; Hau DouMong

    1995-01-01

    We have investigated the effects on mice treated with Ganoderma lucidum (Gl) when the whole body was exposed to 400 rad gamma-irradiation. The mice were divided into five groups. Group A was the normal control; group B, the experimental control, was treated with GI; group C was the radiation control (RT); group D was treated with RT and Gl; group E was treated with Gl, RT and Gl. The results revealed that the relative spleen weight had increased significantly in groups B and E on day 7 and increased in all experimental groups on day, 28 after irradiation. The leukocyte counts decreased obviously in groups C, D and E on day 7, and recovered in groups D and E was faster than that in group C on day 28. The blastogenic response of splenocytes to LPS, Con A and PHA in groups administered GI were higher than that in group C on days 7and 28. Therefore, Gl seemed to assist the recovery of cellular immunocompetence in gamma-irradiated mice. (author)

  1. Fatal disseminated toxoplasmosis in an immunocompetent cat

    Directory of Open Access Journals (Sweden)

    Susanna S. Nagel

    2013-02-01

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

  2. Fatal disseminated toxoplasmosis in an immunocompetent cat.

    Science.gov (United States)

    Nagel, Susanna S; Williams, June H; Schoeman, Johannes P

    2013-02-14

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

  3. A prospective study of the cumulative incidence and course of restless legs syndrome in de novo patients with Parkinson's disease during chronic dopaminergic therapy.

    Science.gov (United States)

    Marchesi, Elena; Negrotti, Anna; Angelini, Monica; Goldoni, Matteo; Abrignani, Giorgia; Calzetti, Stefano

    2016-03-01

    The authors report the cumulative incidence of Restless Legs Syndrome (RLS) over a 3 years follow-up period in 92 de novo Parkinson's disease patients under chronic dopaminergic therapy and the clinical course of the sensory-motor disorder over 12 months as from its onset. The overall cumulative incidence of RLS was found by 15.3%, i.e. 14 incident cases, and by 11.9%, i.e. 11 incident cases, after the exclusion of possible "secondary" forms of the disorder. These figures are higher than those reported in general population in Germany (Study of Health in Pomerania), confirming our previous findings of incidence rate of the disorder. At the end of the 3 years follow-up period the prevalence of "current" RLS was significantly higher than that previously found in drug naïve Parkinson's disease patients and in controls, supporting the view that RLS emerging in the course of chronic dopaminergic therapy is the main determinant of the co-morbid association with Parkinson's disease. During the 12 months period of observation the RLS showed a frequency of occurrence of 6.08 episodes per month on average and a remittent clinical course was prevailing in the 11 incident cases, with a significant frequency decrease in the second as compared to the first 6 months, i.e. 3.26 versus 8.9 episodes per month, and none of the patients developed augmentation in the same period. It is hypothesized that the remittent course could be due to long-term adaptation (downregulation) of the hypersensitive post-synaptic dopamine receptors in the spinal cord to a continuous dopaminergic stimulation, possibly coupled with compensatory up-regulation of pre-synaptic dopamine re-uptake mechanism, in the patients in which the hypothalamic A11 area, site of origin of the dopamine-mediated diencephalo-spinal pathway, is involved in the neurodegenerative process.

  4. A spatiotemporal mixed model to assess the influence of environmental and socioeconomic factors on the incidence of hand, foot and mouth disease

    Directory of Open Access Journals (Sweden)

    Lianfa Li

    2018-02-01

    Full Text Available Abstract Background As a common infectious disease, hand, foot and mouth disease (HFMD is affected by multiple environmental and socioeconomic factors, and its pathogenesis is complex. Furthermore, the transmission of HFMD is characterized by strong spatial clustering and autocorrelation, and the classical statistical approach may be biased without consideration of spatial autocorrelation. In this paper, we propose to embed spatial characteristics into a spatiotemporal additive model to improve HFMD incidence assessment. Methods Using incidence data (6439 samples from 137 monitoring district for Shandong Province, China, along with meteorological, environmental and socioeconomic spatial and spatiotemporal covariate data, we proposed a spatiotemporal mixed model to estimate HFMD incidence. Geo-additive regression was used to model the non-linear effects of the covariates on the incidence risk of HFMD in univariate and multivariate models. Furthermore, the spatial effect was constructed to capture spatial autocorrelation at the sub-regional scale, and clusters (hotspots of high risk were generated using spatiotemporal scanning statistics as a predictor. Linear and non-linear effects were compared to illustrate the usefulness of non-linear associations. Patterns of spatial effects and clusters were explored to illustrate the variation of the HFMD incidence across geographical sub-regions. To validate our approach, 10-fold cross-validation was conducted. Results The results showed that there were significant non-linear associations of the temporal index, spatiotemporal meteorological factors and spatial environmental and socioeconomic factors with HFMD incidence. Furthermore, there were strong spatial autocorrelation and clusters for the HFMD incidence. Spatiotemporal meteorological parameters, the normalized difference vegetation index (NDVI, the temporal index, spatiotemporal clustering and spatial effects played important roles as predictors in

  5. Timing of initiation of enzyme replacement therapy after diagnosis of type 1 Gaucher disease: effect on incidence of avascular necrosis

    Science.gov (United States)

    Mistry, Pramod K; Deegan, Patrick; Vellodi, Ashok; Cole, J Alexander; Yeh, Michael; Weinreb, Neal J

    2009-01-01

    Data from the International Collaborative Gaucher Group Gaucher Registry were analysed to assess the relationship between enzyme replacement therapy with imiglucerase (ERT) and incidence of avascular necrosis (AVN) in type 1 Gaucher disease (GD1), and to determine whether the time interval between diagnosis and initiation of ERT influences the incidence rate of AVN. All patients with GD1 enrolled in the Gaucher Registry who received ERT and did not report AVN prior to starting therapy (n = 2700) were included. The incidence rate of AVN following initiation of ERT was determined. An incidence rate of AVN of 13·8 per 1000 person-years was observed in patients receiving ERT. Patients who initiated ERT within 2 years of diagnosis had an incidence rate of 8·1 per 1000 person-years; patients who started ERT ≥2 years after diagnosis had an incidence rate of 16·6 per 1000 person-years. The adjusted incidence rate ratio was 0·59 [95% confidence interval (CI) 0·36–0·96, P = 0·0343]. Splenectomy was an independent risk factor for AVN (adjusted incidence rate ratio 2·23, 95% CI 1·61–3·08, P < 0·0001). In conclusion, the risk of AVN was reduced among patients who initiated ERT within 2 years of diagnosis, compared to initiating treatment ≥2 years after diagnosis. A higher risk of AVN was observed among patients who had previously undergone splenectomy. PMID:19732054

  6. Prevalence and incidence of peptic ulcer disease in a Danish County--a prospective cohort study.

    OpenAIRE

    Rosenstock, S J; Jørgensen, T

    1995-01-01

    Peptic ulcer prevalence and five year incidence were assessed in a sex and age stratified population sample of 3608 Danish subjects aged 30-60 years. Statements of peptic ulcer disease obtained from questionnaires were scrutinised by reviewing medical records. Life time ulcer prevalence (95% confidence intervals) was 5.6 (4.9-6.4) per cent. Male to female prevalence ratio was 2.2:1, and duodenal to gastric ulcer prevalence ratio was 3.8:1. Thirty two participants with no previous history of p...

  7. Bilateral symmetrical herpes zoster in an immunocompetent patient (herpes zoster duplex symmetricus)

    International Nuclear Information System (INIS)

    Arfan-ul-bari; Iftikhar, N.; Rahman, S. B.

    2003-01-01

    Herpes zoster is a common disease of adulthood. Its incidence is low in childhood and adolescence. Certain risk factors like hematological malignancies or immunosuppression due to any cause may lead to onset at an early age. There is a unilateral appearance of grouped vesicular eruption on an erythematous background which may involve contiguous dermatomes. Rarely the lesions may occur bilaterally in an otherwise healthy individual. We present a case of herpes zoster, with lesions having atypical distribution involving bilaterally symmetrical dermatomes over the lower chest.(author)

  8. Effect of medicinal plants extracts on the incidence of mosaic disease caused by cucumber mosaic virus and growth of chili

    Science.gov (United States)

    Hamidson, H.; Damiri, N.; Angraini, E.

    2018-01-01

    This research was conducted to study the effect of the application of several extracts of medicinal plants on the incidence of mosaic disease caused by Cucumber Mosaic Virus infection on the chili (Capsicum annuum L.) plantation. A Randomized Block Design with eight treatments including control was used throughout the experiment. Treatments consisted of Azadiracta indica (A), Piper bitle (B), Cymbopogon citrates (C), Curcuma domestica (D), Averroa bilimbi (E), Datura stramonium (F), Annona Muricata (G) and control (H). Each treatment consist of three replications. The parameters observed were the incidence of mosaic attack due to CMV, disease severity, plant height, wet and dry weight and production (number of fruits and the weight of total fruits) each plant. Results showed that the application of medicinal plant extracts reduced the disease severity due to CMV. Extracts of Annona muricata and Datura stramonium were most effective in suppressing disease severity caused by the virus as they significantly different from control and from a number of treatment. The plants medicinal extracts were found to have increased the plant height and total weight of the plant, fruit amount and fruit weight. Extracts of Curcuma domestica, Piper bitle and Cymbopogon citrates were the third highest in fruit amount and weight and significantly different from the control.

  9. Periodontal Disease and Incident Cancer Risk among Postmenopausal Women: Results from the Women's Health Initiative Observational Cohort.

    Science.gov (United States)

    Nwizu, Ngozi N; Marshall, James R; Moysich, Kirsten; Genco, Robert J; Hovey, Kathleen M; Mai, Xiaodan; LaMonte, Michael J; Freudenheim, Jo L; Wactawski-Wende, Jean

    2017-08-01

    Background: Periodontal pathogens have been isolated from precancerous and cancerous lesions and also shown to promote a procarcinogenic microenvironment. Few studies have examined periodontal disease as a risk factor for total cancer, and none have focused on older women. We examined whether periodontal disease is associated with incident cancer among postmenopausal women in the Women's Health Initiative Observational Study. Methods: Our prospective cohort study comprised 65,869 women, ages 54 to 86 years. Periodontal disease information was obtained via self-report questionnaires administered between 1999 and 2003, whereas ascertainment of cancer outcomes occurred through September 2013, with a maximum follow-up period of 15 years. Physician-adjudicated incident total cancers were the main outcomes and site-specific cancers were secondary outcomes. HRs and 95% confidence intervals (CI) were calculated using Cox proportional hazards regression. All analyses were conducted two-sided. Results: During a mean follow-up of 8.32 years, 7,149 cancers were identified. Periodontal disease history was associated with increased total cancer risk (multivariable-adjusted HR, 1.14; 95% CI, 1.08-1.20); findings were similar in analyses limited to 34,097 never-smokers (HR, 1.12; 95% CI, 1.04-1.22). Associations were observed for breast (HR, 1.13; 95% CI, 1.03-1.23), lung (HR, 1.31; 95% CI, 1.14-1.51), esophagus (HR, 3.28; 95% CI, 1.64-6.53), gallbladder (HR, 1.73; 95% CI, 1.01-2.95), and melanoma skin (HR, 1.23; 95% CI, 1.02-1.48) cancers. Stomach cancer was borderline (HR, 1.58; 95% CI, 0.94-2.67). Conclusions: Periodontal disease increases risk of total cancer among older women, irrespective of smoking, and certain anatomic sites appear to be vulnerable. Impact: Our findings support the need for further understanding of the effect of periodontal disease on cancer outcomes. Cancer Epidemiol Biomarkers Prev; 26(8); 1255-65. ©2017 AACR . ©2017 American Association for Cancer

  10. Association between circulating specific leukocyte types and incident chronic kidney disease: the Atherosclerosis Risk in Communities (ARIC) study.

    Science.gov (United States)

    Tian, Niu; Penman, Alan D; Manning, R Davis; Flessner, Michael F; Mawson, Anthony R

    2012-01-01

    Progressive renal fibrosis is a characteristic of all the diseases that cause renal failure and is invariably accompanied by a prominent leukocyte infiltration in the kidney. The goal of this study was to determine the association between the circulating specific leukocyte types and incident chronic kidney disease (CKD). In a cohort of 10,056 middle-aged white and African American adults, levels of circulating neutrophils, lymphocytes, and monocytes were measured at baseline; blood pressure (BP) and serum creatinine were measured and estimated glomerular filtration rate (eGFR) was calculated at baseline and 3 and 9 years later; and surveillance for first hospitalization or death with CKD was carried out over a mean follow-up of 7.4 years (maximum, 11.9 years). Increased neutrophil levels and decreased lymphocyte levels were significantly associated with greater CKD incidence after adjustment for covariates. African Americans tended to have similar but stronger patterns of association between circulating leukocytes and CKD incidence than whites, although the differences between race groups were not statistically significant. We also found that eGFR and BP were higher at each visit in African Americans than whites between ages 45 and 65. These findings support a potential role for circulating specific leukocytes in the pathogenesis of kidney dysfunction, especially in African Americans, indicating the leukocyte-related renal mechanism of essential hypertension (HT). Copyright © 2012 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  11. The Next Generation of Orthotopic Thyroid Cancer Models: Immunocompetent Orthotopic Mouse Models of BRAFV600E-Positive Papillary and Anaplastic Thyroid Carcinoma

    Science.gov (United States)

    Vanden Borre, Pierre; McFadden, David G.; Gunda, Viswanath; Sadow, Peter M.; Varmeh, Shohreh; Bernasconi, Maria; Jacks, Tyler

    2014-01-01

    Background: While the development of new treatments for aggressive thyroid cancer has advanced in the last 10 years, progress has trailed headways made with other malignancies. A lack of reliable authenticated human cell lines and reproducible animal models is one major roadblock to preclinical testing of novel therapeutics. Existing xenograft and orthotopic mouse models of aggressive thyroid cancer rely on the implantation of highly passaged human thyroid carcinoma lines in immunodeficient mice. Genetically engineered models of papillary and undifferentiated (anaplastic) thyroid carcinoma (PTC and ATC) are immunocompetent; however, slow and stochastic tumor development hinders high-throughput testing. Novel models of PTC and ATC in which tumors arise rapidly and synchronously in immunocompetent mice would facilitate the investigation of novel therapeutics and approaches. Methods: We characterized and utilized mouse cell lines derived from PTC and ATC tumors arising in genetically engineered mice with thyroid-specific expression of endogenous BrafV600E/WT and deletion of either Trp53 (p53) or Pten. These murine thyroid cancer cells were transduced with luciferase- and GFP-expressing lentivirus and implanted into the thyroid glands of immunocompetent syngeneic B6129SF1/J mice in which the growth characteristics were assessed. Results: Large locally aggressive thyroid tumors form within one week of implantation. Tumors recapitulate their histologic subtype, including well-differentiated PTC and ATC, and exhibit CD3+, CD8+, B220+, and CD163+ immune cell infiltration. Tumor progression can be followed in vivo using luciferase and ex vivo using GFP. Metastatic spread is not detected at early time points. Conclusions: We describe the development of the next generation of murine orthotopic thyroid cancer models. The implantation of genetically defined murine BRAF-mutated PTC and ATC cell lines into syngeneic mice results in rapid and synchronous tumor formation. This

  12. High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves' disease in the young in a high iodine intake area

    DEFF Research Database (Denmark)

    Laurberg, P; Pedersen, K M; Vestergaard, H

    1991-01-01

    that even mild iodine deficiency has a significant effect on population health, since it leads to a high incidence of autonomous thyroid nodules with hyperthyroidism in the elderly population. However, population iodine intake probably should not exceed a level much higher than that necessary to avoid...... iodine deficiency, otherwise Graves' disease may be induced in the young population.......Little is known about the optimum level of iodine intake for iodine supplementation programmes, or about the effects of the high levels of iodine intake that are found in some countries. We compared the incidence of different types of hyperthyroidism in East-Jutland Denmark with a low average...

  13. Incidence, progression and intensity of Bud Rot in Elaeis guineensis Jacq. in San Lorenzo, Ecuador

    Directory of Open Access Journals (Sweden)

    Fernando Rivas Figueroa

    2017-01-01

    Full Text Available BUD rot (BR is the most serious disease of oil palm in Latin America; in Equator has caused more than 150 million USD of losses. The aim of this work was to determine the incidence, progression and disease intensity of BR in E. guineensis. Incidence and disease progression was determined from data of oil palm enterprises: Palesema, PDA, Palpailón, Energy & Palma y Alespalma during 2006-2013. Disease intensity was determined at 2013. Incidence was 66.75 % and disease intensity was 46 %. Based on projections of accumulative incidence a polynomial equation was built that predicted 78.30 % of cumulative incidence for 2014, indicating exponential growth of BR from 2009 to 2013. Magnitude of damages based on incidence, disease progression and infection index indicated the occurrence of a lethal form of BR in San Lorenzo, province of Esmeraldas, Equator.

  14. Incidência de doenças e necessidade de controle em cultivo protegido de videira Incidence of diseases and needs of control in overhead covered grapes

    Directory of Open Access Journals (Sweden)

    Geraldo Chavarria

    2007-01-01

    ência de podridão ácida (-77,10% e a severidade de podridão-da-uva-madura (-89,47%, podridão-cinzenta-da-uva (-57,56% e podridão ácida (-84,54% em função da cobertura plástica. De modo geral, as condições microclimáticas do cultivo protegido não permitiram o estabelecimento de míldio e diminuíram a incidência e severidade de podridões de cacho reduzindo as exigências e os custos com controle fitossanitário. Portanto, essa tecnologia pode apresentar-se como uma possibilidade de cultivo com menores impactos de contaminação para o ambiente, produtor e consumidor, desde que sejam consideradas as reduções de tratamentos fitossanitários. Isso fica evidente com os dados de acúmulo residual de fungicidas, que foi maior no cultivo protegido comparado ao convencional, de forma que o manejo fitossanitário deve ser diferenciado em relação ao cultivo convencional.The plastic overhead cover (POC of grapes is increasing in Brazilian vineyards aiming to reduce physical and biological damages. The objectives of this work had been to characterize the incidence and severity of diseases, and, consequently, the needs of control, as well as to evaluate the residues of fungicides in POC conditions. The experiment was installed in 2005/2006, in Flores da Cunha-RS, in a vineyard cv. Moscato Giallo, led in "Y Shape", with impermeable plastic covering (160µm, in 12 rows with 35m, being left 5 rows without covering (control. In both areas, the microclimate was evaluated with relationship to the presence of free water ( visual register , temperature (T, relative humidity (UR of the air, photosynthetically active radiation (PAR and wind speed (WS close to the leaves and clusters. In the covered area were only applied fungicides when necessary. In the control plants sprays were accomplished by calendar. Incidence and severity of downy mildew (Plasmopara viticola, powdery mildew (Uncinula necator, botrytis (Botrytis cinerea, rip rot (Glomerella cingulata and sour rot

  15. RISK FACTORS AFFECTING THE INCIDENCE OF CORONARY HEART DISEASE AT THE DR. WAHIDIN SUDIROHUSODO GENERAL HOSPITAL IN MAKASSAR IN 2010

    OpenAIRE

    arsin, A. Arsunan

    2011-01-01

    Dipresentasikan pada kegiatan " The 43rd APACPH Conference" di Graduate School of Public Health, Yonsei University, Korea. pada tanggal 20-22 Oktober 2011 RISK FACTORS AFFECTING THE INCIDENCE OF CORONARY HEART DISEASE AT THE DR. WAHIDIN SUDIROHUSODO GENERAL HOSPITAL IN MAKASSAR IN 2010 A. Arsunan Arsin, Wiwik, Ridwan Amiruddin Hasanuddin University, Indonesia Coronary heart disease is the first cause of death in the world and the fifth cause of death in all hospitals in Indonesi...

  16. Adult health study report 7. noncancer disease incidence in the atomic-bomb survivors, 1958-86 (examination cycles 1-14)

    International Nuclear Information System (INIS)

    Wong F, Lennie; Yamada, Michiko; Sasaki, Hideo; Kodama, Kazunori; Akiba, Suminori; Shimaoka, Katsutaro; Hosoda, Yutaka.

    1993-08-01

    Using the longitudinal data of the Adult Health Study (AHS) cohort collected during 1958-86, we examined for the first time the relationship between exposure to ionizing radiation and the incidence of 19 selected nonmalignant disorders. Diagnoses of the diseases were based on general laboratory tests, physical examinations, and histories taken during the biennial AHS examinations. The outcomes were encoded as three-digit International Classification of Diseases codes in the AHS data base, which served as the basis for case ascertainment. Statistically significant excess risk was detected for myoma uteri, chronic hepatitis and liver cirrhosis, and thyroid disease, defined broadly as the presence of one or more of certain noncancerous thyroid conditions. The finding for myoma uteri might be additional evidence indicating that benign tumor growths are possible effects of radiation exposure. An age-at-exposure effect was detected in nonmalignant thyroid disease, with increased risk for those exposed at ages ≤ 20 yr, but not for older persons. Thus, the AHS data also suggest that the thyroid gland in young persons is more radiosensitive not only to the development of thyroid malignancies, as shown in the most recent LSS report on cancer incidence, but also possibly to the development of nonmalignant disorders. Our findings hold independent of the dose effects observed for thyroid malignancies. No significant dose-response relationships were detected in any of our cardiovascular disease endpoints. Our analysis also suggests that new occurrences of lens opacity during 1958-86 are not increased with radiation dose among the AHS participants. Our results emphasize the utility and importance of the AHS in searching for the effects of acute exposure to ionizing radiation in noncancer diseases. (J.P.N.)

  17. The association between changes in lifestyle behaviors and the incidence of chronic kidney disease (CKD) in middle-aged and older?men

    OpenAIRE

    Michishita, Ryoma; Matsuda, Takuro; Kawakami, Shotaro; Tanaka, Satoshi; Kiyonaga, Akira; Tanaka, Hiroaki; Morito, Natsumi; Higaki, Yasuki

    2017-01-01

    Background: This study was designed to evaluate whether changes in lifestyle behaviors are correlated with the incidence of chronic kidney disease (CKD). Methods: The subjects consisted of 316 men without a history of cardiovascular disease, stroke, or renal dysfunction or dialysis treatment. The following lifestyle behaviors were evaluated using a standardized self-administered questionnaire: habitual moderate exercise, daily physical activity, walking speed, eating speed, late-night din...

  18. Behcet's disease in acquired immune deficiency syndrome

    Directory of Open Access Journals (Sweden)

    Beenish Siddiqui

    2016-01-01

    Full Text Available HIV/AIDS patients often present with orogenital ulcers. In the immunocompromised patient diagnosis of these ulcers pose a challenge, as there is a myriad of etiologies. We present a case of an HIV/AIDS patient with recurrent orogenital aphthosis that was confirmed to have concomitant diagnosis of Behcet's disease. Proper awareness of the causes of these ulcers is essential for prompt and effective treatment. While rare causes may be at the bottom of a differential list in an immunocompetent host, when HIV/AIDS is involved these rare causes often percolate to the top.

  19. Psychiatric aspects of herpes simplex encephalitis, tick-borne encephalitis and herpes zoster encephalitis among immunocompetent patients.

    Science.gov (United States)

    Więdłocha, Magdalena; Marcinowicz, Piotr; Stańczykiewicz, Bartłomiej

    2015-01-01

    The psychopathological symptoms occurring in the course of diseases associated with infections are often initially isolated and non-characteristic, and may cause diagnostic difficulties. Moreover, such disorders tend to be less responsive to psychiatric management. Among possible causes such as trauma, neoplasm and vascular changes, inflammatory changes of the brain as a result of a viral infection should also be considered. There were 452 registered cases of viral encephalitis in Poland in 2010, and although not very prevalent they remain a severe and life-threatening condition. What is more, the frequently occurring neurological and psychiatric complications of viral encephalitis often result in permanent disabilities, causing a significant decrease in the quality of life. This article presents the three types of encephalitis that are most prevalent among immunocompetent patients in Poland, i.e. herpes simplex encephalitis (HSE), tick-borne encephalitis (TBE) and herpes zoster encephalitis (HZE). The psychopathology of the acute phase of the infection, the residual symptoms, features apparent in imaging studies and some neuropathological aspects are also presented. The paper also focuses on psychiatric aspects of the diagnostics and treatment of the described conditions. The clinical pictures of these infections are quite specific, although they cover a wide range of symptoms, and these characteristic features are described. The aim of this review is also to show the significance of thorough diagnostics and a multidisciplinary approach to patients with viral CNS infections.

  20. Incidence of stroke and coronary heart disease in the adult health study sample, 1958 - 78

    International Nuclear Information System (INIS)

    Kodama, Kazunori; Shimizu, Yukiko; Sawada, Hisao; Kato, Hiroo.

    1986-04-01

    Approximately 16,000 study subjects in the Adult Health Study sample who had received examination at least once during the 20 years (1958 - 78) in Hiroshima or Nagasaki and were found to have neither stroke nor coronary heart disease (CHD) at the initial examination were studied for the incidence of stroke and CHD and the relationship of these to atomic bomb radiation exposure. Their secular trends were also studied. Findings suggestive of a relationship between stroke and radiation exposure among Hiroshima females were first discovered for the years 1969 - 73, that is, 24 - 28 years after A-bomb exposure. In general, this association is supported by the present analysis. Stroke incidence continued to decrease during the present report's period of observation. Analysis by type showed that cerebral infarction and cerebral hemorrhage both decreased, but the decrease of the latter is especially remarkable. The trend to decrease is observed in both sexes and in both cities. A relationship between CHD and radiation exposure was, as noted for stroke, first observed only in Hiroshima females for the years 1969 - 73, but from this analysis it appears that the trend began earlier and the association is getting stronger with the passage of time. Analysis by type showed myocardial infarction (MI), but not angina pectoris, to be related to radiation exposure. The incidence rate for CHD, especially for MI, was almost constant during the observation period, it being 1.2/1,000 person-years on the average. Comparing by sex, the incidence rate was constant in males. In females, the pattern varied with time. There appear to be no between-city differences in secular trends - essentially constant. (author)

  1. Incidence of lactase deficiency (LD) in gastroduodenal ulcer and gastric carcinoma

    International Nuclear Information System (INIS)

    Bahk, Yong Whee; Ahn, Kwan Shik; Kim, Chung Ja

    1974-01-01

    Lactase deficiency (LD) has been described in associated with peptic ulcer disease of the upper gastrointestinal tract, but little has been known as to the incidence of LD in the patients with ulcer disease of the upper GI tract or with gastric carcinoma. The purpose of the present study is to investigate the incidence of LD in gastric and/or duodenal ulcer disease and in gastric carcinoma, and to hypothesize the possible effect of these diseases on LD. Clinical materials consisted of 40 cases of active duodenal ulcer disease, 19 cases of benign gastric ulcer, 5 cases of multiple ulcers both in the stomach and duodenum, and 32 cases of gastric carcinoma. We used the lactose-barium test in diagnosing LD. X-ray findings were assessed according to the criteria described by Laws et al. and Preger and Amberg in the small-bowel film obtained at 30 minutes after the ingestion of some 200 ml of lactose-barium meal which contained 50 gm of lactose. Our clinical study revealed that the incidence of LD in duodenal ulcer was 50%, in gastric ulcer 57.9%, in gastric and duodenal ulcer 60%, and in gastric carcinoma 46.9%. The difference of incidence between each disease were statistically not significant, but the difference between the disease group and normal control was highly significant. The incidence of LD in disease group was nearly twice as high as that of normal control (27.7%). It is speculated that high incidence of LD in peptic ulcer disease of upper GI tract in particular may be associated with high acidity, the analog of which is found in Zollinger-Ellison syndrome. But high acidity is not a prominent feature in gastric carcinoma which is attended by almost equally high incidence of LD. It is therefore likely that the intolerability to lactose is caused by much complicated mechanism of versatile factors

  2. Incidence of lactase deficiency (LD) in gastroduodenal ulcer and gastric carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Yong Whee; Ahn, Kwan Shik; Kim, Chung Ja [St. Mary' s Hospital, Catholic Medical College, Seoul (Korea, Republic of)

    1974-04-15

    Lactase deficiency (LD) has been described in associated with peptic ulcer disease of the upper gastrointestinal tract, but little has been known as to the incidence of LD in the patients with ulcer disease of the upper GI tract or with gastric carcinoma. The purpose of the present study is to investigate the incidence of LD in gastric and/or duodenal ulcer disease and in gastric carcinoma, and to hypothesize the possible effect of these diseases on LD. Clinical materials consisted of 40 cases of active duodenal ulcer disease, 19 cases of benign gastric ulcer, 5 cases of multiple ulcers both in the stomach and duodenum, and 32 cases of gastric carcinoma. We used the lactose-barium test in diagnosing LD. X-ray findings were assessed according to the criteria described by Laws et al. and Preger and Amberg in the small-bowel film obtained at 30 minutes after the ingestion of some 200 ml of lactose-barium meal which contained 50 gm of lactose. Our clinical study revealed that the incidence of LD in duodenal ulcer was 50%, in gastric ulcer 57.9%, in gastric and duodenal ulcer 60%, and in gastric carcinoma 46.9%. The difference of incidence between each disease were statistically not significant, but the difference between the disease group and normal control was highly significant. The incidence of LD in disease group was nearly twice as high as that of normal control (27.7%). It is speculated that high incidence of LD in peptic ulcer disease of upper GI tract in particular may be associated with high acidity, the analog of which is found in Zollinger-Ellison syndrome. But high acidity is not a prominent feature in gastric carcinoma which is attended by almost equally high incidence of LD. It is therefore likely that the intolerability to lactose is caused by much complicated mechanism of versatile factors.

  3. Worldwide Incidence of Colorectal Cancer, Leukemia, and Lymphoma in Inflammatory Bowel Disease: An Updated Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Chelle L. Wheat

    2016-01-01

    Full Text Available Background/Aims. Inflammatory bowel disease (IBD is associated with an increased risk of colorectal cancer (CRC. In addition, there may be an association between leukemia and lymphoma and IBD. We conducted a systematic review and meta-analysis of the IBD literature to estimate the incidence of CRC, leukemia, and lymphoma in adult IBD patients. Methods. Studies were identified by a literature search of PubMed, Cochrane Library, Medline, Web of Science, Scopus, EMBASE, and ProQuest Dissertations and Theses. Pooled incidence rates (per 100,000 person-years [py] were calculated through use of a random effects model, unless substantial heterogeneity prevented pooling of estimates. Several stratified analyses and metaregression were performed to explore potential study heterogeneity and bias. Results. Thirty-six articles fulfilled the inclusion criteria. For CRC, the pooled incidence rate in CD was 53.3/100,000 py (95% CI 46.3–60.3/100,000. The incidence of leukemia was 1.5/100,000 py (95% CI −0.06–3.0/100,000 in IBD, 0.3/100,000 py (95% CI −1.0–1.6/100,000 in CD, and 13.0/100,000 py (95% CI 5.8–20.3/100,000 in UC. For lymphoma, the pooled incidence rate in CD was 0.8/100,000 py (95% CI −0.4–2.1/100,000. Substantial heterogeneity prevented the pooling of other incidence estimates. Conclusion. The incidence of CRC, leukemia, and lymphoma in IBD is low.

  4. Scrub Typhus Incidence Modeling with Meteorological Factors in South Korea.

    Science.gov (United States)

    Kwak, Jaewon; Kim, Soojun; Kim, Gilho; Singh, Vijay P; Hong, Seungjin; Kim, Hung Soo

    2015-06-29

    Since its recurrence in 1986, scrub typhus has been occurring annually and it is considered as one of the most prevalent diseases in Korea. Scrub typhus is a 3rd grade nationally notifiable disease that has greatly increased in Korea since 2000. The objective of this study is to construct a disease incidence model for prediction and quantification of the incidences of scrub typhus. Using data from 2001 to 2010, the incidence Artificial Neural Network (ANN) model, which considers the time-lag between scrub typhus and minimum temperature, precipitation and average wind speed based on the Granger causality and spectral analysis, is constructed and tested for 2011 to 2012. Results show reliable simulation of scrub typhus incidences with selected predictors, and indicate that the seasonality in meteorological data should be considered.

  5. Scrub Typhus Incidence Modeling with Meteorological Factors in South Korea

    Directory of Open Access Journals (Sweden)

    Jaewon Kwak

    2015-06-01

    Full Text Available Since its recurrence in 1986, scrub typhus has been occurring annually and it is considered as one of the most prevalent diseases in Korea. Scrub typhus is a 3rd grade nationally notifiable disease that has greatly increased in Korea since 2000. The objective of this study is to construct a disease incidence model for prediction and quantification of the incidences of scrub typhus. Using data from 2001 to 2010, the incidence Artificial Neural Network (ANN model, which considers the time-lag between scrub typhus and minimum temperature, precipitation and average wind speed based on the Granger causality and spectral analysis, is constructed and tested for 2011 to 2012. Results show reliable simulation of scrub typhus incidences with selected predictors, and indicate that the seasonality in meteorological data should be considered.

  6. Spatial variability of disease incidence and mortality in the sea fan Gorgonia ventalina in Puerto Rico (Alcyonacea: Goorgoniidae

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    Anabella Zuluaga-Montero

    2012-06-01

    Full Text Available Populations of the common sea fan (Gorgonia ventalina were decimated by an aspergillosis outbreak throughout the Caribbean two decades ago. Since then, aspergillosis has been considered as the principal cause of mortality in sea fans. However, prevalence and presumably incidence of this disease have been declining in the Caribbean since the mid 1990s. Incidence indicates new cases of disease in previously healthy colonies, while prevalence indicates percent of diseased colonies at a given sample. Most coral disease studies use prevalence rather than incidence to assess the temporal dynamics of diseases. Nevertheless, conclusions based only on prevalence should be handled carefully to avoid misinterpretation. This study was carried out at six reefs in Eastern Puerto Rico. We monitored a total of 448 colonies to (1 obtain estimates of incidence and prevalence of disease and other types of lesions, and (2 to determine causes of sea fan mortality plus their spatial and temporal variation. Three transects (10x1m were haphazardly placed at each study site. At each transect, every colony was numbered and photographed and its height measured to the nearest cm. Transects were monitored at six months intervals and health status of the colonies was recorded. Also, the colonies were divided into height classes (small, medium and large for incidence, prevalence and mortality analyses. Incidence and prevalence of disease were low in all reefs, suggesting that disease currently plays a minor role in the regulation of sea fans populations. Detachment was the main cause of mortality, and size structure data suggest that recruitment may compensate for mortality rates in two of the reefs. Spatial differences in size structure and density may be related to environmental and physical characteristics at the reef scale that allow sea fans to reach a safe colony size. Rev. Biol. Trop. 60 (2: 517-526. Epub 2012 June 01.Las poblaciones de abanicos de mar (Gorgonia

  7. Mortality incidence estimation using federal death certificate and natality data with an application to Tay-Sachs disease.

    Science.gov (United States)

    Jalal, Kabir; Carter, Randy L

    2015-09-01

    For confidentiality reasons, US federal death certificate data are incomplete with regards to the dates of birth and death for the decedents, making calculation of total lifetime of a decedent impossible and thus estimation of mortality incidence difficult. This paper proposes the use of natality data and an imputation-based method to estimate age-specific mortality incidence rates in the face of this missing information. By utilizing previously determined probabilities of birth, a birth date and death date are imputed for every decedent in the dataset. Thus, the birth cohort of each individual is imputed, and the total on-study time can be calculated. This idea is implemented in two approaches for estimation of mortality incidence rates. The first is an extension of a person-time approach, while the second is an extension of a life table approach. Monte Carlo simulations showed that both approaches perform well in comparison to the ideal complete data methods, but that the person-time method is preferred. An application to Tay-Sachs disease is demonstrated. It is concluded that the imputation methods proposed provide valid estimates of the incidence of death from death certificate data without the need for additional assumptions under which usual mortality rates provide valid estimates. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Chronic diarrhea caused by Blastocystis hominis and Cryptosporidium sp. in immunocompetent patient-a case report

    Science.gov (United States)

    Andriyani, Y.; Rozi, M. F.; Saragih, R. H.; Darlan, D. M.

    2018-03-01

    Blastocystis hominis and Cryptosporidium sp. are commonly associated with immunocompromised patients. Severe clinical manifestation can be produced by this organism. It varies according to immune status, and subtype of this organism. Unfortunately, we found an immunocompetent patient with chronic diarrhea caused by this organism. A 38- year old male was admitted to Adam Malik General Hospital because of watery diarrhea since four days ago. Administration of fluid replacement was done to this patient, but the frequency of diarrhea did not decrease. Loperamide as anti-spasmodic was also given in each episode of diarrhea. Surprisingly, fecal smear examination revealed that this patient positive for Blastocystis hominis and Cryptosporidium sp. Thus, diarrhea was resolved for four days without giving any anti-parasitic drugs to the patient.

  9. Incidence of cassava mosaic disease and associated whitefly vectors in South West and North Central Nigeria: Data exploration.

    Science.gov (United States)

    Eni, Angela O; Efekemo, Oghenevwairhe P; Soluade, Mojisola G; Popoola, Segun I; Atayero, Aderemi A

    2018-08-01

    Cassava mosaic disease (CMD) is one of the most economically important viral diseases of cassava, an important staple food for over 800 million people in the tropics. Although several Cassava mosaic virus species associated with CMD have been isolated and characterized over the years, several new super virulent strains of these viruses have evolved due to genetic recombination between diverse species. In this data article, field survey data collected from 184 cassava farms in 12 South Western and North Central States of Nigeria in 2015 are presented and extensively explored. In each State, one cassava farm was randomly selected as the first farm and subsequent farms were selected at 10 km intervals, except in locations were cassava farms are sporadically located. In each selected farm, 30 cassava plants were sampled along two diagonals and all selected plant was scored for the presence or absence of CMD symptoms. Cassava mosaic disease incidence and associated whitefly vectors in South West and North Central Nigeria are explored using relevant descriptive statistics, box plots, bar charts, line graphs, and pie charts. In addition, correlation analysis, Analysis of Variance (ANOVA), and multiple comparison post-hoc tests are performed to understand the relationship between the numbers of whiteflies counted, uninfected farms, infected farms, and the mean of symptom severity in and across the States under investigation. The data exploration provided in this data article is considered adequate for objective assessment of the incidence and symptom severity of cassava mosaic disease and associated whitefly vectors in farmers' fields in these parts of Nigeria where cassava is heavily cultivated.

  10. Alternative male reproductive tactics and the immunocompetence handicap in the Azorean rock-pool blenny, Parablennius parvicornis

    Science.gov (United States)

    Ros, Albert F.H; Bouton, Niels; Santos, Ricardo S; Oliveira, Rui F

    2006-01-01

    In the Azorean rock-pool blenny (Parablennius parvicornis) reproductively active males display alternative morphotypes, which differ in the expression of secondary sexual characters (SSC). Males expressing SSC, the M+ morphotype, have high androgen levels and compete for crevices that will be visited by females to spawn. M+ males holding nests court females and care for the eggs. Males with low expression of SSC, the M− morphotype, have low levels of androgens and reproduce by stealing fertilizations from the M+ males. Based on the hypothesis that androgens are immunosuppressive, we expected these morphotypes to differ in immunocompetence. To test this hypothesis, we conducted a field study in which we collected repeated blood samples to monitor leukocyte populations (blood smears), and to measure the primary antibody response of males that were experimentally challenged with a foreign non-pathogenic antigen (sheep red blood cells). Circulating levels of 11-ketotestosterone and testosterone were higher in M+ males than in M− males. Neither granulocyte nor thrombocyte counts did covariate with androgens or male tactic. In contrast, lymphocyte counts and humoral antibody response were negatively correlated with body size, and as expected, both were lower in M+ than in M− males. Interestingly, in M+ males androgen levels decreased after immunization, and this was less in nest-holder males than in M+ males that were floating around in the pools. Within each morphotype we found no relationship between androgens and immunocompetence. The latter result is not supportive for androgen regulated immunosuppression in M+ males. A possible alternative is enhancement of immunity in M− males. These males had relatively high levels of injuries in comparison with M+ males. High immunity might be a consequence of high infection rate because of such injuries. PMID:16627274

  11. Antibiotics in early life alter the gut microbiome and increase disease incidence in a spontaneous mouse model of autoimmune insulin-dependent diabetes.

    Science.gov (United States)

    Candon, Sophie; Perez-Arroyo, Alicia; Marquet, Cindy; Valette, Fabrice; Foray, Anne-Perrine; Pelletier, Benjamin; Milani, Christian; Milani, Cristian; Ventura, Marco; Bach, Jean-François; Chatenoud, Lucienne

    2015-01-01

    Insulin-dependent or type 1 diabetes is a prototypic autoimmune disease whose incidence steadily increased over the past decades in industrialized countries. Recent evidence suggests the importance of the gut microbiota to explain this trend. Here, non-obese diabetic (NOD) mice that spontaneously develop autoimmune type 1 diabetes were treated with different antibiotics to explore the influence of a targeted intestinal dysbiosis in the progression of the disease. A mixture of wide spectrum antibiotics (i.e. streptomycin, colistin and ampicillin) or vancomycin alone were administered orally from the moment of conception, treating breeding pairs, and during the postnatal and adult life until the end of follow-up at 40 weeks. Diabetes incidence significantly and similarly increased in male mice following treatment with these two antibiotic regimens. In NOD females a slight yet not significant trend towards an increase in disease incidence was observed. Changes in gut microbiota composition were assessed by sequencing the V3 region of bacterial 16S rRNA genes. Administration of the antibiotic mixture resulted in near complete ablation of the gut microbiota. Vancomycin treatment led to increased Escherichia, Lactobacillus and Sutterella genera and decreased members of the Clostridiales order and Lachnospiraceae, Prevotellaceae and Rikenellaceae families, as compared to control mice. Massive elimination of IL-17-producing cells, both CD4+TCRαβ+ and TCRγδ+ T cells was observed in the lamina propria of the ileum and the colon of vancomycin-treated mice. These results show that a directed even partial ablation of the gut microbiota, as induced by vancomycin, significantly increases type 1 diabetes incidence in male NOD mice thus prompting for caution in the use of antibiotics in pregnant women and newborns.

  12. Periostite metacarpiana dorsal: incidência e fatores pré-disponentes

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    Flávio Gomes de Oliveira

    2006-04-01

    Full Text Available Forty two 2-year-old thoroughbreds were examined clinically at intervals of 15 days during their training for the first race to determine the incidence and the predisposing factors of dorsal metacarpal disease. During the first year 25 horses were followed during 2 months and in the second year the follow up was done for 4 months in 17 . Horses' data like gender, average speed, speed exercise work and trainer were also collected. Dorsal metacarpal disease was diagnosed in 28% and 70,6% of the 2 year-old thoroughbreds in the first and second year of the study, respectively. Total incidence was 45%. The incidence and average speed was not affected by gender. The average speed achieved by affected and none affected horses remained between 16 and 18m/s. On 500 and 700m speed exercise, the average speed of affected horses was higher than of none affected ones (p<0,05. Ten out of 19 horses showed dorsal metacarpal disease signs at the distance of 700m. There was significant difference between trainers regarding the incidence of dorsal metacarpal disease and average speed of their horses. 2-year-olds under care of trainers whose horses had the highest incidence o dorsal metacarpal disease also were the fastest one's. Therefore, fast speed associated with longer distances (700m and trainer are factors that predispose young horses to dorsal metacarpal disease.

  13. Parvovirus B19 in an Immunocompetent Adult Patient with Acute Liver Failure: An Underdiagnosed Cause of Acute Non-A-E Viral Hepatitis

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    J Kee Ho

    2005-01-01

    Full Text Available There are occasional pediatric reports of parvovirus B19-associated transient acute hepatitis and hepatic failure. A case of a 34-year-old immunocompetent woman who developed severe and prolonged but self-limited acute hepatitis and myelosuppression following acute parvovirus B19 infection is reported. Parvovirus B19 may be the causative agent in some adult cases of acute non-A-E viral hepatitis and acute liver failure.

  14. Baseline and post-stress seasonal changes in immunocompetence and redox state maintenance in the fishing bat Myotis vivesi

    Science.gov (United States)

    Ibáñez-Contreras, Alejandra; Miranda-Labra, Roxana U.; Flores-Martínez, José Juan

    2018-01-01

    Little is known of how the stress response varies when animals confront seasonal life-history processes. Antioxidant defenses and damage caused by oxidative stress and their link with immunocompetence are powerful biomarkers to assess animal´s physiological stress response. The aim of this study was A) to determine redox state and variation in basal (pre-acute stress) immune function during summer, autumn and winter (spring was not assessed due to restrictions in collecting permit) in the fish-eating Myotis (Myotis vivesi; Chiroptera), and B) to determine the effect of acute stress on immunocompetence and redox state during each season. Acute stress was stimulated by restricting animal movement for 6 and 12 h. The magnitude of the cellular immune response was higher during winter whilst that of the humoral response was at its highest during summer. Humoral response increased after 6 h of movement restriction stress and returned to baseline levels after 12 h. Basal redox state was maintained throughout the year, with no significant changes in protein damage, and antioxidant activity was modulated mainly in relation to variation to environment cues, increasing during high temperatures and decreasing during windy nights. Antioxidant activity increased after the 6 h of stressful stimuli especially during summer and autumn, and to a lesser extent in early winter, but redox state did not vary. However, protein damage increased after 12 h of stress during summer. Prolonged stress when the bat is engaged in activities of high energy demand overcame its capacity to maintain homeostasis resulting in oxidative damage. PMID:29293551

  15. Ethnic differences in Colon and Rectal Cancer incidence in Nigeria ...

    African Journals Online (AJOL)

    If moving from a location of low colorectal cancer incidence to one of high colorectal cancer incidence predisposes one to develop the disease, could not the converse apply and those with a predisposition to developing the disease experience some protection when they live or interact with those with negligible ...

  16. Chromoblastomycosis associated with bone and central nervous involvement system in an immunocompetent child caused by exophiala spinifera

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    Sahana M Srinivas

    2016-01-01

    Full Text Available Chromoblastomycosis is a chronic granulomatous infection of the skin and subcutaneous tissue caused by specific group of dematiaceous fungi. The infection results from traumatic injury and is seen more commonly on feet and lower legs. It is rarely seen in children and metastatic spread to other systems is exceptionally rare. We report a 12-year-old immunocompetent male child diagnosed with chromoblastomycosis on the lower leg, who in a span of few months developed osteomyelitis and left hemiparesis. Fungal culture showed growth of Exophiala spinifera. Child showed good improvement with voriconazole and itraconazole after 1 year of treatment. Skin lesions healed with minimal scarring and his power improved.

  17. Higher plasma soluble Receptor for Advanced Glycation End Products (sRAGE) levels are associated with incident cardiovascular disease and all-cause mortality in type 1 diabetes

    DEFF Research Database (Denmark)

    Nin, Johanna W M; Jorsal, Anders; Ferreira, Isabel

    2010-01-01

    To investigate the associations of plasma levels of soluble receptor for advanced glycation end products (sRAGE) with incident cardiovascular disease (CVD) and all-cause mortality in type 1 diabetes and the extent to which any such associations could be explained by endothelial and renal dysfunct......To investigate the associations of plasma levels of soluble receptor for advanced glycation end products (sRAGE) with incident cardiovascular disease (CVD) and all-cause mortality in type 1 diabetes and the extent to which any such associations could be explained by endothelial and renal...

  18. Dietary Inflammatory Index and Incidence of Cardiovascular Disease in the PREDIMED Study

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    Ana Garcia-Arellano

    2015-05-01

    Full Text Available Previous studies have reported an association between a more pro-inflammatory diet profile and various chronic metabolic diseases. The Dietary Inflammatory Index (DII was used to assess the inflammatory potential of nutrients and foods in the context of a dietary pattern. We prospectively examined the association between the DII and the incidence of cardiovascular disease (CVD: myocardial infarction, stroke or cardiovascular death in the PREDIMED (Prevención con Dieta Mediterránea study including 7216 high-risk participants. The DII was computed based on a validated 137-item food frequency questionnaire. Multivariate-adjusted hazard ratios (HR and 95% confidence intervals of CVD risk were computed across  quartiles of the DII where the lowest (most anti-inflammatory quartile is the referent. Risk increased across the quartiles (i.e., with increasing inflammatory potential: HRquartile2 = 1.42 (95%CI = 0.97–2.09;  HRquartile3 = 1.85 (1.27–2.71; and HRquartile4 = 1.73 (1.15–2.60. When fit as continuous the multiple-adjusted hazard ratio for each additional standard deviation of the DII was 1.22 (1.06–1.40. Our results provide direct prospective evidence that a pro-inflammatory diet is associated with a higher risk of cardiovascular clinical events.

  19. Midgut microbiota and host immunocompetence underlie Bacillus thuringiensis killing mechanism

    Science.gov (United States)

    Caccia, Silvia; Di Lelio, Ilaria; La Storia, Antonietta; Marinelli, Adriana; Varricchio, Paola; Franzetti, Eleonora; Banyuls, Núria; Tettamanti, Gianluca; Casartelli, Morena; Giordana, Barbara; Ferré, Juan; Gigliotti, Silvia; Pennacchio, Francesco

    2016-01-01

    Bacillus thuringiensis is a widely used bacterial entomopathogen producing insecticidal toxins, some of which are expressed in insect-resistant transgenic crops. Surprisingly, the killing mechanism of B. thuringiensis remains controversial. In particular, the importance of the septicemia induced by the host midgut microbiota is still debated as a result of the lack of experimental evidence obtained without drastic manipulation of the midgut and its content. Here this key issue is addressed by RNAi-mediated silencing of an immune gene in a lepidopteran host Spodoptera littoralis, leaving the midgut microbiota unaltered. The resulting cellular immunosuppression was characterized by a reduced nodulation response, which was associated with a significant enhancement of host larvae mortality triggered by B. thuringiensis and a Cry toxin. This was determined by an uncontrolled proliferation of midgut bacteria, after entering the body cavity through toxin-induced epithelial lesions. Consequently, the hemolymphatic microbiota dramatically changed upon treatment with Cry1Ca toxin, showing a remarkable predominance of Serratia and Clostridium species, which switched from asymptomatic gut symbionts to hemocoelic pathogens. These experimental results demonstrate the important contribution of host enteric flora in B. thuringiensis-killing activity and provide a sound foundation for developing new insect control strategies aimed at enhancing the impact of biocontrol agents by reducing the immunocompetence of the host. PMID:27506800

  20. Incidence, risk factors and clinical epidemiology of melioidosis: a complex socio-ecological emerging infectious disease in the Alor Setar region of Kedah, Malaysia

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    Vijayalakshmi Natesan

    2010-10-01

    Full Text Available Abstract Background Melioidosis, a severe and fatal infectious disease caused by Burkholderia pseudomallei, is believed to an emerging global threat. However, data on the natural history, risk factors, and geographic epidemiology of the disease are still limited. Methods We undertook a retrospective analysis of 145 confirmed cases extracted from a hospital-based Melioidosis Registry set up from 2005 in Hospital Sultanah Bahiyah, Alor Setar, Kedah state, Malaysia, in order to provide a first description of the contemporary incidence, risk factors, and clinical epidemiology of the disease in this putatively high risk region of the country. Results The incidence of melioidosis in Alor Setar is remarkably high at 16.35 per 100,000 population per year. The mean age of patients was 50.40 years, with infection varying nonlinearly with age. Males (75.2%; P 2 = 30.57, P Conclusions Melioidosis represents a complex socio-ecological public health problem in Kedah, being strongly related with age, occupation, rainfall and predisposing chronic diseases, such as diabetes mellitus. Among cases, bacteremic patients were associated with significantly high mortality despite provision of the recommended antibacterial therapy. The burden of this disease is likely to grow in this region unless better informed interventions targeted at high-risk groups and associated diseases are urgently implemented.

  1. Incidence and Determinants of Ventilation Tubes in Denmark.

    Science.gov (United States)

    Pedersen, Tine Marie; Mora-Jensen, Anna-Rosa Cecilie; Waage, Johannes; Bisgaard, Hans; Stokholm, Jakob

    2016-01-01

    Many children are treated for recurrent acute otitis media and middle ear effusion with ventilation tubes (VT). The objectives are to describe the incidence of VT in Denmark during 1997-2011 from national register data, furthermore, to analyze the determinants for VT in the Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010) birth cohort. The incidence of VT in all children under 16 years from 1997-2011 were calculated in the Danish national registries. Determinants of VT were studied in the COPSAC2010 birth cohort of 700 children. Nationwide the prevalence of VT was 24% in children aged 0 to 3 three years, with a significant increase over the study period. For all children 0-15 years, the incidence of VT was 35/1,000. In the VT population, 57% was male and 43% females. In the COPSAC2010 birth cohort, the prevalence of VT during the first 3 years of life was 29%. Determinants of VT were: maternal history of middle ear disease; aHR 2.07, 95% CI [1.45-2.96] and siblings history of middle ear disease; aHR 3.02, [2.11-4.32]. Paternal history of middle ear disease, presence of older siblings in the home and diagnosis of persistent wheeze were significant in the univariate analysis but the association did not persist after adjustment. The incidence of VT is still increasing in the youngest age group in Denmark, demonstrating the highest incidence recorded in the world. Family history of middle ear disease and older siblings are the main determinants for VT.

  2. Emerging Vector-Borne Diseases - Incidence through Vectors.

    Science.gov (United States)

    Savić, Sara; Vidić, Branka; Grgić, Zivoslav; Potkonjak, Aleksandar; Spasojevic, Ljubica

    2014-01-01

    Vector-borne diseases use to be a major public health concern only in tropical and subtropical areas, but today they are an emerging threat for the continental and developed countries also. Nowadays, in intercontinental countries, there is a struggle with emerging diseases, which have found their way to appear through vectors. Vector-borne zoonotic diseases occur when vectors, animal hosts, climate conditions, pathogens, and susceptible human population exist at the same time, at the same place. Global climate change is predicted to lead to an increase in vector-borne infectious diseases and disease outbreaks. It could affect the range and population of pathogens, host and vectors, transmission season, etc. Reliable surveillance for diseases that are most likely to emerge is required. Canine vector-borne diseases represent a complex group of diseases including anaplasmosis, babesiosis, bartonellosis, borreliosis, dirofilariosis, ehrlichiosis, and leishmaniosis. Some of these diseases cause serious clinical symptoms in dogs and some of them have a zoonotic potential with an effect to public health. It is expected from veterinarians in coordination with medical doctors to play a fundamental role at primarily prevention and then treatment of vector-borne diseases in dogs. The One Health concept has to be integrated into the struggle against emerging diseases. During a 4-year period, from 2009 to 2013, a total number of 551 dog samples were analyzed for vector-borne diseases (borreliosis, babesiosis, ehrlichiosis, anaplasmosis, dirofilariosis, and leishmaniasis) in routine laboratory work. The analysis was done by serological tests - ELISA for borreliosis, dirofilariosis, and leishmaniasis, modified Knott test for dirofilariosis, and blood smear for babesiosis, ehrlichiosis, and anaplasmosis. This number of samples represented 75% of total number of samples that were sent for analysis for different diseases in dogs. Annually, on average more then half of the samples

  3. Effect of Associated Autoimmune Diseases on Type 1 Diabetes Mellitus Incidence and Metabolic Control in Children and Adolescents

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    Aleksandra Krzewska

    2016-01-01

    Full Text Available Type 1 diabetes mellitus (T1DM is one of the most common chronic diseases developing in childhood. The incidence of the disease in children increases for unknown reasons at a rate from 3 to 5% every year worldwide. The background of T1DM is associated with the autoimmune process of pancreatic beta cell destruction, which leads to absolute insulin deficiency and organ damage. Complex interactions between environmental and genetic factors contribute to the development of T1DM in genetically predisposed patients. The T1DM-inducing autoimmune process can also affect other organs, resulting in development of additional autoimmune diseases in the patient, thereby impeding diabetes control. The most common T1DM comorbidities include autoimmune thyroid diseases, celiac disease, and autoimmune gastritis; additionally, diabetes can be a component of PAS (Polyglandular Autoimmune Syndrome. The aim of this review is to assess the prevalence of T1DM-associated autoimmune diseases in children and adolescents and their impact on the course of T1DM. We also present suggestions concerning screening tests.

  4. INCIDENCE OF AMPUTATION IN EMERGENCY

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    K. Rojaramani Kumbha

    2016-08-01

    Full Text Available Advanced Technology and early detection of disease by recent improvements in investigation modalities lead to decreased incidents of amputations while Road Traffic Accidents (RTA increase. Furthermore, it leads to variation and decreased morbidity, mortality and accidents (crush injuries, and better equipped and trained staff, specialist services, diabetic food, rehabilitation centres, and giving good support physically and psychologically for Amputated patients. OBJECTIVE To know incidence rates of Emergency Amputation who attended causality with advanced disease and severe Trauma. METHODOLOGY The study is done over a period of one year i.e. between June 2015 to June 2016 who attended causality with advanced and severe disease affecting the limbs either due to diabetes, trauma or vascular diseases. RESULTS During one-year period, total 6,371 patients attended for general surgery OP. In those, 187 patients needed emergency surgery which included both major and minor operations. Among those, 81 patients were amputated. CONCLUSION As per our available records and observation, even though there is increased literacy and access to advanced technology, there is still increased incidence of patients undergoing amputations due to diseases. Therefore, there is a need to improve awareness and importance of early detection of diabetes, hazards of smoking, and regular general health checkups for patients at root level. With that we can treat diabetes and/or any disease in time. So there must be awareness in peripheral health staff i.e. PHC, subcentres, and community health centres about early detection of disease which in turn improves the quality of life of the patient. Due to diabetes slight injury to the glucose laden tissue may cause chronic infection and ulcer formation.(1 The tumours are seen commonly in the age group of 20-40 years after bone fusion, bones affected commonly are those around the knee (lower end of knee, upper end of tibia. A lytic

  5. Incidence of and risk factors for Motor Neurone Disease in UK women: a prospective study

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    Doyle Pat

    2012-05-01

    Full Text Available Abstract Background Motor neuron disease (MND is a severe neurodegenerative disease with largely unknown etiology. Most epidemiological studies are hampered by small sample sizes and/or the retrospective collection of information on behavioural and lifestyle factors. Methods 1.3 million women from the UK Million Women Study, aged 56 years on average at recruitment, were followed up for incident and/or fatal MND using NHS hospital admission and mortality data. Adjusted relative risks were calculated using Cox regression models. Findings During follow-up for an average of 9·2 years, 752 women had a new diagnosis of MND. Age-specific rates increased with age, from 1·9 (95% CI 1·3 – 2·7 to 12·5 (95% CI 10·2 – 15·3 per 100,000 women aged 50–54 to 70–74, respectively, giving a cumulative risk of diagnosis with the disease of 1·74 per 1000 women between the ages of 50 and 75 years. There was no significant variatio