Full Text Available The coexistence of rheumatoid arthritis (RA and familial Mediterranean fever (FMF has been rarely seen in case reports in the literature. Herein, we wanted to present a patient who had been followed up and treated as RA, but on investigation we concluded that he really had FMF and its joint complaints associated with sacroiliitis. Recovery was achieved by etanercept administered as if he was an RA patient.
Erken, Ertugrul; Goruroglu Ozturk, Ozlem; Kudas, Ozlem; Arslan Tas, Didem; Demirtas, Ahmet; Kibar, Filiz; Dinkci, Suzan; Erken, Eren
BACKGROUND Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disease predominantly affecting Mediterranean populations. The gene associated with FMF is the MEFV gene, which encodes for a protein called pyrin. Mutations of pyrin lead to uncontrolled attacks of inflammation, and subclinical inflammation continues during attack-free intervals. Killer cell immunoglobulin-like receptor (KIR) genes encode HLA class I receptors expressed by NK cells. The aim this study was to look for immunogenetic determinants in the pathogenesis of FMF and find out if KIR are related to susceptibility to disease or complications like renal amyloidosis. MATERIAL AND METHODS One hundred and five patients with FMF and 100 healthy individuals were involved in the study. Isolated DNA from peripheral blood was amplified by sequence specific PCR probes and analyzed by Luminex for KIR genotypes. Fisher Exact test was used to evaluate the variation of KIR gene distribution. RESULTS All patients and healthy controls expressed the framework genes. An activator KIR gene, KIR2DS2, was significantly more frequent in FMF patients (p=0.036). Renal amyloidosis and presence of arthritis were not associated with KIR genes and genotype. KIR3DL1 gene was more common in patients with high serum CRP (p=0.016). CONCLUSIONS According to our findings, we suggest that presence of KIR2DS2, which is an activator gene for NK cell functions, might be related to the autoinflammation in FMF. The potential effect of KIR genes on amyloidosis and other clinical features requires studies with larger sample sizes.
Korenstein, A.; Avivi, L. [Tel-Avivi University (Israel); Ravia, Y. [Sheba Medical Center, Tel-Hashomer (Israel)
Uniparental disomy (UPD), an altered mode of Mendelian inheritance, may reveal expression of recessive alleles due to the loss of heterozygosity, as well as imprinted genes. The mechanism causing UPD can be best elucidated in offsprings of individuals at high risk for chromosomal non-disjunction. Such individuals are Familial Mediterranean Fever (FMF) patients, who are routinely treated with the antimitotic agent colchicine, and, therefore, are expected to be at an increased risk for aneuploidy. A dominant mode of inheritance was observed in four FMF offsprings having one parent exhibiting the FMF phenotype (homozygote recessive) while the other was free of the mutant allele (as assumed from his ethnic background). Out of these, two exhibited UPD of chromosome 16, which carries the FMF gene, as judged from four different RFLP markers along this chromosome. Since in both case the UPD was of maternal origin, it is suggested that the colchicine-treated FMF mothers contributed two doses of chromosome 16, presumably due to meiotic non-disjunction, followed by a somatic loss of the paternal chromosome 16 in the embryo. The somatic chromosome loss is also assumed to be caused by the antimitotic drug since the mother continued to receive it during pregnancy. Whether the UPD arises from the colchicine treatment, from the high tendency of chromosome 16 to maternal non-disjunction or from both remains to be elucidated. Our results highlighted the importance of taking UPD into account when counseling individuals who are either treated with antimitotic agents or are carriers of recessive mutant alleles which are mapped to chromosomes prone to aneuploidy.
Alsarah, Ahmad; Alsara, Osama; Laird-Fick, Heather S.
Familial Mediterranean fever (FMF) is autoinflammatory disorder characterized by sporadic attacks of fever, peritonitis, pleuritis, and arthritis. It is mainly seen in patients from Mediterranean origins, but it is now reported more frequently in Europe and North America due to immigration. To analyze the data on the cardiovascular manifestations in FMF patients, we searched PubMed using the terms “Familial Mediterranean Fever” or “FMF” in combination with other key words including “cardiovas...
Sarı, İsmail; Birlik, Merih; Kasifoğlu, Timuçin
Familial Mediterranean Fever (FMF) is a hereditary autoinflammatory disorder characterised by acute attacks of fever and serosal inflammation. FMF primarily affects Jewish, Armenian, Turkish, and Arab populations. The disease is accompanied by a marked decrease in quality of life due to the effects of attacks and subclinical inflammation in the attack-free periods. Untreated or inadequately treated patients run the risk of amyloidosis, which is an important cause of morbidity and mortality. In this review, the current information available on FMF is summarised. PMID:27708867
Familial Mediterranean fever (FMF) is the most common hereditary inflammatory periodic disease, characterized by recurrent episodes of fever, abdominal pain, synovitis and pleurisy. The aim of this study was to determine the frequency and distri- bution of Mediterranean fever (MEFV) gene mutations and to investigate the ...
Kosker, Mustafa; Arslan, Nese; Alp, Muhammed Yunus; Ozisler, Cem; Acar, Mutlu; Dogan, Aysun Sanal; Yesilyurt, Ahmet; Gurdal, Canan
To evaluate the association between familial Mediterranean fever (FMF) and keratoconus (KC). This retrospective case-control study was performed to compare the prevalence of KC in patients with FMF with the corresponding prevalence in control patients without FMF referred to Genetic Diagnostic Center at Diskapi Yildirim Beyazit Training and Research Hospital from June 2012 to June 2015. We included all 100 patients with FMF. Each FMF-affected patient was matched to 3 controls. None of the patients in the control group (0%, 0/300) had KC, whereas 4 of 100 patients with FMF (4%) had KC (P < 0.004). Three of 33 patients with a homozygous mutation (9.1%) (M694V/M694V in 2 cases and M680I/M680I in 1 case) and 1 of the 46 patients with a compound heterozygous mutation (2.2%) (M694V/M680I) had KC, whereas none of the 21 patients with a heterozygous mutation (0%) had KC. All patients with KC were women, and mean age was 40.8 years (range, 30-51). Although 1 of the 4 patients with KC had hypertension and type 2 diabetes mellitus, the other 3 patients did not have any systemic illness except FMF. When we compared the prevalence of KC in patients with FMF (4%) with the highest prevalence of KC reported in the literature (0.2%), FMF was a predisposing factor to develop KC [odds ratio: 18.1 (95% CI: 11.9-27.5)] especially in patients with a homozygous mutation [odds ratio: 43.4 (95% CI: 28.6-65.7)]. Mediterranean fever (MEFV) gene mutations, particularly in homozygous mutations of the MEFV gene, may be a predisposing factor in the development of KC.
Oct 2, 2006 ... Touitou I (1998). Phenotype-genotype correlation in Jewish patients suffering from familial Mediterranean fever (FMF). Eur. J. Hum. Genet. 6: 95-7. Kogan A, Shinar Y, Lidar M, Revivo A, Langevitz P, Padeh S, Pras M,. Livneh A. (2001). Common MEFV mutations among Jewish ethnic groups in Israel: High ...
Abstract Familial Mediterranean fever (FMF) is an autosomal recessive disease which is charac- terized by recurrent fever and inflammation of serous membranes. A Chilean FMF patient was investigated for MEFV mutations. After DNA extraction, exons 3, 5, 10 and 30UTR region of. MEFV gene were analyzed by DNA ...
Familial Mediterranean fever (FMF) is an autosomal recessive disease which is characterized by recurrent fever and inflammation of serous membranes. A Chilean FMF patient was investigated for MEFV mutations. After DNA extraction, exons 3, 5, 10 and 30UTR region of MEFV gene were analyzed by DNA sequencing ...
Portincasa, Piero; Scaccianoce, Giuseppe; Palasciano, Giuseppe
Familial Mediterranean fever (FMF) is a rare inherited autosomal recessive autoinflammatory disorder characterized by recurrent and self-limited episodes of fever and painful serositis, lasting 1-3 days. FMF occurs almost exclusively among ethnic groups of the Mediterranean basin, although cases have also been found in Japan and Korean populations. Diagnosis is based on clinical features, response to colchicine and genetic analysis. Novel drugs are emerging, allowing better management of colchicine-resistant/colchicine-intolerant patients. This review aims to attract the attention of the readers on differential diagnosis and management of patients with FMF. The current state-of-the-art on FMF is outlined, with respect to epidemiological, genetic, pathophysiological and therapeutic characteristics, based on critical analysis of solid scientific literature. FMF is more frequent than it was thought before. The phenotypic expression of M694V is more severe than that of V726A. Patients with M694V/M694V homozygosity are exposed to a higher risk of developing renal amyloidosis, arthritis, dermatologic and oral lesions, higher fever and more frequent painful attacks. Life-long therapy with colchicine (1·0-2·4 mg/day) is effective and safe to prevent recurrent attacks and renal amyloidosis and to reverse proteinuria. In nonresponder patients, alternative novel approaches include interleukin-1 receptor antagonist anakinra and the interleukin-1 decoy receptor rilonacept. The prognosis of FMF is normal if AA amyloidosis is prevented. Colchicine remains the first-line therapy to treat pain and prevent amyloidosis. A follow-up should include clinical evaluation, therapeutic adjustments, measurement of serum amyloid A and proteinuria. © 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.
Full Text Available Familial Mediterranean Fever is an autosomal recessive inherited disease with a course of autoinflammation, which is characterized by the episodes of fever and serositis. It affects the populations from Mediterranean basin. Genetic mutation of the disease is on MEFV gene located on short arm of Chromosome 16. The disease is diagnosed based on clinical evaluation. Amyloidosis is the most important complication. The only agent that decreases the development of amyloidosis and the frequency and severity of the episodes is colchicine, which has been used for about 40 years. In this review, we aimed to discuss especially the most recent advances about Familial Mediterranean Fever which is commonly seen in our population.
Makay, Balahan; Kiliçaslan, Serdar Kamer; Anik, Ahmet; Bora, Elçin; Bozkaya, Özlem; Çankaya, Tufan; Ünsal, Erbil
This study aimed to investigate sleep patterns, sleep disturbances and possible factors that are associated with sleep disturbances among children with familial Mediterranean fever (FMF). Fifty-one patients with FMF and 84 age- and sex-matched healthy controls were enrolled in the study. The patients who had an attack during the last 2 weeks were not included. Demographic data, FMF symptoms, disease duration, dose of colchicine, disease severity score, number of attacks in the last year, MEFV mutation and serum C-reactive protein (CRP) levels were recorded for each patient. A Children's Sleep Habits Questionnaire was performed. The total sleep scores of the patients with FMF were significantly higher than the control group. Total sleep durations were similar between FMF patients and controls. Children with FMF had significantly higher scores regarding sleep-onset delay, sleep anxiety, night wakings and sleep-disordered breathing when compared to healthy controls. There was a significant positive correlation between number of attacks in the last year and sleep onset delay, night wakings and sleep disordered-breathing. Disease severity score and CRP levels were not associated with any of the subscale scores. The patients with exertional leg pain had significantly higher total sleep scores than the ones without. Furthermore, patients with exertional leg pain had significantly higher subscale scores regarding sleep onset delay, parasomnias and sleep-disordered breathing. This study showed for the first time that children with FMF had more sleep disturbances than their healthy peers. Higher numbers of attacks and exertional leg pain were associated with poor sleep quality. In conclusion, this study underlines the need to assess and manage sleep problems in children with FMF. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.
Full Text Available Background: Familial Mediterranean fever (FMF is an autosomal recessive genetic disorder characterized by recurrent episodes of self-limited fever and serosal tissues inflammation. Methods: To evaluate clinical symptoms and common genetic mutations in southwestern Iranian patients with FMF, 20 unrelated patients were enrolled in this study based on clinical criteria. A panel of 12 common MEFV gene mutations was tested. Results: The most frequent clinical presentations of the patients were fever, colicky abdominal pain and arthritis. Eighteen patients responded completely to colchicine therapy. MEFV gene mutations were detected in only 40% of the patients. The most common mutation was E148Q, detected in five patients (25%. The V726A, M694V and P369S mutations were each observed in one patient. Conclusions: Although none of the 12 mutations we included in our test panel was detected in 60% of our patients, all of them had FMF symptoms and responded well to colchicine. MEFV full gene sequencing analysis in these patients may lead to finding new mutations in southwestern Iranian FMF patients which would be helpful in designing a local diagnostic kit.
Full Text Available Familial Mediterranean fever is an autosomal recessive,short, acute, self-limiting disease characterized by attacksof fever and polyserositis, which is common in countriesaround the Mediterranean. Inflammatory bowel diseaseis a term used to describe Ulcerative colitis and Crohn’sdisease that associated with chronic idiopathic inflammatory.The patient had FMF but she had been well untilapproximately 20 days before admission, when malaise,fever, abdominal pain, right knee and ankle edema developed.She was taking colchicine. The patient diagnosedas Crohn Disease by endoscopy and histopathology. Thiscase report is presented to emphasize the association oftwo diseases.Key words: Familial Mediterranean Fever, inflammatorybowel disease, Crohn’s disease, childhood
Full Text Available Familial Mediterranean fever (FMF is the most common hereditary auto-inflammatory (periodic fever syndrome, and usually successfully treated with colchicine. However, nearly 5-10% of FMF cases are resistant or intolerant to colchicine and treatment options are highly restricted in these cases. Biologics including anakinra, canakinumab, rilonacept, etanercept, infliximab, interferon-alpha, and tocilizumab are shown to have efficacy to control FMF attacks. Tofacitinib, a Janus kinase (JAK inhibitor, is an orally administered non-biologic disease modifying anti-rheumatic drug for the treatment of rheumatoid arthritis (RA. Herein we report a female patient with coexisting RA and colchicine resistant FMF whose FMF attacks and disease activity were completely controlled after treatment with tofacitinib, a small-molecule JAK3 inhibitor.
Semerdjian Ronald J
Full Text Available Abstract Background Familial Mediterranean fever (FMF is an autosomal recessive disease characterized by inflammatory serositis (fever, peritonitis, synovitis and pleuritis. The gene locus responsible for FMF was identified in 1992 and localized to the short arm of chromosome 16. In 1997, a specific FMF gene locus, MEFV, was discovered to encode for a protein, pyrin that mediates inflammation. To date, more than forty missense mutations are known to exist. The diversity of mutations identified has provided insight into the variability of clinical presentation and disease progression. Case Report We report an individual heterozygous for the M680I gene mutation with a clinical diagnosis of FMF using the Tel-Hashomer criteria. Subsequently, the patient developed nephrotic syndrome with biopsy-confirmed fibrillary glomerulonephritis (FGN. Further diagnostic studies were unremarkable with clinical workup negative for amyloidosis or other secondary causes of nephrotic syndrome. Discussion Individuals with FMF are at greater risk for developing nephrotic syndrome. The most serious etiology is amyloidosis (AA variant with renal involvement, ultimately progressing to end-stage renal disease. Other known renal diseases in the FMF population include IgA nephropathy, IgM nephropathy, Henoch-Schönlein purpura as well as polyarteritis nodosa. Conclusion To our knowledge, this is the first association between FMF and the M680I mutation later complicated by nephrotic syndrome and fibrillary glomerulonephritis.
Barut, Kenan; Sahin, Sezgin; Adrovic, Amra; Sinoplu, Ada Bulut; Yucel, Gozde; Pamuk, Gizem; Aydın, Aslı Kirectepe; Dasdemir, Selcuk; Turanlı, Eda Tahir; Buyru, Nur; Kasapcopur, Ozgur
The aim of this study is to present demographic and clinical features, MEFV mutation variations, and treatment response of a large number of pediatric familial Mediterranean fever (FMF) patients from a single tertiary centre. Moreover, we aimed to investigate the current outcome of FMF, namely frequency of amyloidosis in children with FMF. We evaluated 708 FMF patients who were followed up in our clinic and who were under colchicine treatment for at least 6 months. The data were recorded from patient records and also verified by negotiations with patients and parents. The male/female proportion of the cohort was 1.05/1 (n = 362/346). Abdominal pain (89.5%, n = 634) was the most common manifestation of FMF episodes, followed by fever (88.8%, n = 629) and arthritis (40.7%, n = 288). However, arthritis in 23 (8%) of the 288 cases was not self-limited; and they subsequently diagnosed with juvenile idiopathic arthritis in addition to FMF. Homozygote or heterozygote M694V mutation was more frequent in patients with arthritis (63.2%) and chronic arthritis (69.6%) than the whole cohort (53.8%). Erythrocyte sedimentation rate and CRP level were in high levels even during attack-free period in 13.9% (n = 97/697) and 11% (n = 78/670) of the patients, respectively. Proteinuria was found in ten patients (1.4%). Amyloidosis was confirmed by renal biopsy in only two of these cases who were homozygous for M694V and compound heterozygous for M694V/M680I. 47 (6.6%) subjects were considered as colchicine resistant. Homozygote M694V mutation was the most frequent mutation in those resistant cases (63.8%, n = 30), followed by compound heterozygote mutation of M694V/M680I (6.3%, n = 3). Homozygous M694V mutation are still the most frequent mutation and associated with the most severe clinical picture and the worst outcome in Turkish children. M694V genotype seems to be more frequently associated with arthritis as well as with chronic arthritis than other genotypes
Full Text Available Familial Mediterranean Fever is an autosomal recessive disease. Major symptoms of disease are recurrent fever accompanied by serositis attacks. The disease is usually diagnosed before 20 years of age. Symptoms related to FMF are noted when children become more verbal, usually after 2 years of age. In this case report, the youngest patient with the diagnosis of FMF is presented. She was consulted to pediatric rheumatology for the high acute phase response and fever. It was learned that her mother had recurrent swelling of her ankle joints. Mutation analysis was performed and two homozygous mutations (M694V and R202Q were identified. She was diagnosed as FMF at 3 months of age and colchicine was started. She responded to colchicine. Her uncontrolled acute phase response declined gradually. This case was reported to point out the importance of early remembrance of autoinflammatory diseases even at very early ages especially at endemic countries.
Sánchez Ferrer, F; Martinez Villar, M; Fernández Bernal, A; Martín de Lara, I; Paya Elorza, I
Familial Mediterranean fever (FMF) is a hereditary disease characterized by brief, recurring and self-limited episodes of fever and pain with inflammation, of one or several serous (peritoneum, pleura, pericardium, synovial or vaginal tunic of the testicle). Amyloidosis is its more important complication and the principal reason of death in the cases in which it appears. Diagnosis is based on the clinic and is confirmed by genetic tests. The treatment with Colchicine (0,02-0,03 mg/kg/day) prevents the recurrence of FMF attacks and the development of secondary (AA) amyloidosis. We report a case of a 13-year-old child in which FMF was diagnosed after several coincidental episodes with fever, pericarditis and cardiac tamponade. The genetic confirmation showed an autosomal dominant inheritance that is less frecuent than the recesive form, in this disease. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.
Leukopenia is a blood disease in which the number of circulating white blood cells diminishes. All underlying causes of leukopenia are not yet known. The subjects of this study are 15 leukopenic patients who were assessed by a systemic workup, including physical examination, blood tests, and molecular analysis. A common and unusual cause was revealed in all patients. This cause was a disorder with a laboratory characteristic of leukocytosis, namely familial Mediterranean fever (FMF). It was discussed that leukopenia arising in the context of FMF is mainly due to autophagy and apoptosis processes. These two pathophysiological characteristics of FMF were thought to explain the particular (episodic and self-limited) leukopenia in this disorder. Based on the results of this study in conjunction with the currently existing literature data, we suggest that FMF causes leukopenia. Leukopenic cases should be investigated for FMF, particularly if the leukopenia is episodic in nature. Early recognition of FMF would help to skip unnecessary invasive procedures and to prevent the development of amyloidosis, the devastating complication of FMF.
Jéru, Isabelle; Hentgen, Véronique; Cochet, Emmanuelle; Duquesnoy, Philippe; Le Borgne, Gaëlle; Grimprel, Emmanuel; Stojanovic, Katia Stankovic; Karabina, Sonia; Grateau, Gilles; Amselem, Serge
Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disorder due to MEFV mutations and one of the most frequent Mediterranean genetic diseases. The observation of many heterozygous patients in whom a second mutated allele was excluded led to the proposal that heterozygosity could be causal. However, heterozygosity might be coincidental in many patients due to the very high rate of mutations in Mediterranean populations. To better delineate the pathogenicity of heterozygosity in order to improve genetic counselling and disease management. Complementary statistical approaches were used: estimation of FMF prevalence at population levels, genotype comparison in siblings from 63 familial forms, and genotype study in 557 patients from four Mediterranean populations. At the population level, we did not observe any contribution of heterozygosity to disease prevalence. In affected siblings of patients carrying two MEFV mutations, 92% carry two mutated alleles, whereas 4% are heterozygous with typical FMF diagnosis. We demonstrated statistically that patients are more likely to be heterozygous than healthy individuals, as shown by the higher ratio heterozygous carriers/non carriers in patients (pclassical Mendelian FMF per se, but constitutes a susceptibility factor for clinically-similar multifactorial forms of the disease. We also provide a first estimate of the risk for heterozygotes to develop FMF.
Ozen, Seza; Demirkaya, Erkan; Amaryan, Gayane
BACKGROUND AND AIM: Familial Mediterranean fever (FMF) is an autoinflammatory disease caused by mutations of the MEFV gene. We analyse the impact of ethnic, environmental and genetic factors on the severity of disease presentation in a large international registry. METHODS: Demographic, genetic....../year and more frequent arthritis, pericarditis, chest pain, abdominal pain and vomiting compared to the other two groups. Multivariate analysis showed that the variables independently associated with severity of disease presentation were country of residence, presence of M694V mutation and positive family...
Full Text Available Protracted febrile myalgia (PFM is a rare form of vasculitic disease which is an uncommon dramatic manifestation of familial Mediterranean fever (FMF, characterized by severe crippling myalgia and high fever. We describe a 14-year-old boy who presented with fever, abdominal pain and severe myalgia in all his muscles for 5 days. The diagnosis of PFM was considered based on the presence of fever, paralyzing myalgia with normal CPK, elevated CRP and ESR. Thus, we started prednisolone treatment and his symptoms disappeared and acute-phase reactants declined rapidly. Mutational analysis of the MEFV gene demonstrated homozygote M694V mutation. Thus, he was diagnosed as PFM and FMF. In this report, we present a child with PFM as the sole feature preceding the diagnosis of FMF, and draw attention to the PFM for the diagnosis of FMF even the patient does not fulfill the criteria for the clinical diagnosis.
Özer, Samet; Bozkurt, Hasan; Yılmaz, Resul; Sönmezgöz, Ergün; Bütün, Ilknur
The aim of the present study was to investigate neuropsychological test performance in children and adolescents with familial Mediterranean fever (FMF). A total of 88 children and adolescents aged 8 to 17 years were included, 52 with FMF and 36 healthy controls. After the participants were administered the Children Depression Inventory (CDI) and the Screen for Child Anxiety Related Emotional Disorders (SCARED), they completed the battery tests of the Central Nervous System Vital Signs (CNSVS), a neurocognitive test battery, via computer. The battery calculates seven domain scores (Memory, Psychomotor Speed, Processing Speed, Reaction Time, Complex Attention, Executive Function, and Cognitive Flexibility) and a summary score (Neurocognition Index [NCI]). A statistically significant difference between the FMF and control groups was found in six out of seven domains, where the scores of the participants with FMF were found to be significantly lower than those of the control participants (p .05). The mean CDI and SCARED scores of the participants with FMF were found to be significantly higher than those of the control participants (p < .05). Low scores in the Processing Speed and Psychomotor Speed domains of the CNSVS were significantly correlated with higher SCARED scores (r = -.37, p = .01). Impaired cognitive functions should be taken into consideration in children and adolescents with FMF when assessing and managing this population.
Buades, J; Ben-Chetrit, E; Levy, M
The aim of our study was to compare the features of familial Mediterranean fever (FMF) in Mallorcan "Chuetas" with those in non-Ashkenazi Jews in Israel. The clinical and laboratory data of FMF were evaluated in a recently identified cluster of 50 FMF patients from Mallorca (the Chuetas) and 45 patients from Israel. We found that the prevalence and clinical manifestations of FMF were similar among the Chuetas and the Israeli group. Furthermore, in contrast to other ethnic groups with FMF, joint involvement was quite common in both the Chuetas (70%) and the Israeli group (75%). The Chuetas are descendants of Mallorcan Jews who emigrated from Spain to the island in the 12th century. The non-Ashkenazi Jews originated mainly in North Africa and are descendants of refugees who escaped from Spain as a result of the Inquisition in the 15th century. We suggest that the non-Ashkenazi Jews and the Chuetas may have a common gene defect for FMF.
Familial Mediterranean fever (FMF) is the most common form of monogenic autoinflammatory conditions, and response to colchicine has been considered as one of its distinctive features among other hereditary periodic fever disorders. Prophylactic colchicine has been shown to be effective in the prevention of inflammatory attacks and development of amyloidosis. However, the highest tolerable doses of colchicine may not be adequate enough to manage these goals in approximately 5% of FMF patients. Inadequate response to colchicine in fully compliant FMF patients may be associated with genetic and/or environmental factors affecting disease severity and colchicine bioavailability. Clarification of the molecular pathogenic mechanisms of FMF has revealed that interleukin-1 beta (IL-1β) cytokine is the most likely target to attack, and several case reports and case series have already documented the efficacy and safety of available anti-IL-1 agents, such as anakinra, rilonacept, and canakinumab in those patients inadequately responding to colchicine. Characterization and early identification of those FMF patients with uncontrolled inflammatory activity have become more important after the availability of new treatment options for the prevention of disease-associated complications and permanent damages. Copyright Â© 2016 Elsevier Ltd. All rights reserved.
Lunge, Snehal Balvant; Patil, Vaibhav; Ambar, Sameer; Naik, Vishwas
Fever with rash is one of the most common causes of referral to a dermatologist. A plethora of conditions need to be considered in the differential diagnosis. They may be broadly classified into infectious causes, drug reactions, and autoimmune disorders. Here we present a rare case of rickettsial fever with cardiac involvement in an elderly male patient with no comorbidities.
Sevillano, Ángel M; Hernandez, Eduardo; Gonzalez, Esther; Mateo, Isabel; Gutierrez, Eduardo; Morales, Enrique; Praga, Manuel
Renal amyloidosis is one of the most severe complications of familial Mediterranean fever (FMF). Colchicine has reduced the incidence of this complication, which now only appears in untreated, under-treated and resistant patients, but it is usually ineffective in patients with advanced amyloidosis. Here we report a patient with FMF and biopsy-proven amyloidosis who presented with nephrotic syndrome despite colchicine treatment. Anakinra (an interleukin-1β inhibitor) was started and a dramatic complete remission of nephrotic syndrome was observed in the following months. Anakinra can be an effective treatment for FMF patients with severe secondary amyloidosis. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.
... people of Mediterranean origin — including Sephardic Jews, Arabs, Greeks, Italians, Armenians and Turks. But it may affect ... attacks, you'll likely feel normal. Symptom-free periods may be as short as a few days ...
Tanyıldız, Burak; Tezcan, Mehmet Engin; Kandemir, Baran; Günaydın, Nesrin Tutaş; Göktaş, Eren; Tangılntız, Aise; Arsan, Aysu Karatay
The purpose of this study is to investigate whether oral colchicine has an effect on peripapillary retinal nerve fiber layer (pRNFL) thickness of familial Mediterranean fever (FMF) patients. We conducted a cross sectional study by comparing pRNFL thickness of FMF patients on colchicine (treated group), newly diagnosed colchicine naïve FMF patients (untreated group) and healthy controls. The study included 66 FMF patients and 32 healthy control subjects. Treated FMF patients were grouped according to colchicine use, duration of use and dosage. pRNFL thickness of the patients and controls were measured by using optical coherence tomography and the measurements were compared. No statistically significant difference was found between the pRNFL thickness in untreated group, treated group and the healthy control group (all p > 0.05). No statistically significant difference was found between pRNFL thickness in the healthy control group and FMF patients grouped according to duration or dosage of colchicine use (all p > 0.05). According to our study, FMF and oral colchicine use had no statistically significant effect on pRNFL thickness.
Hala M. Lofty
Full Text Available Background and Objectives. SAA is an acute-phase reactant detected during an FMF attack or other inflammatory conditions. High SAA levels may increase the risk of amyloidosis. The aim of the study is to measure the serum amyloid A (SAA level in a group of Egyptian children with familial Mediterranean fever (FMF and study its various correlates, if any. Methods. The study enrolled seventy-one children with FMF. Results. SAA level was high in 78.9% of the studied patients with a mean of 81.62±31.6 mg/L, and CRP was positive in 31% of patients. There was no significant releation between SAA level and any demographic or clinical manifestation. High SAA was more frequent in V726A allele (16.9% followed by M694V allele (12.3%. Elevated SAA levels were more frequent in patients on low colchicine doses. Forty-five percent (45% of patients have low adherence to colchicine therapy. Interpretation and Conclusion. High SAA levels were detected two weeks after last FMF attack in a large percentage of Egyptian FMF children. This indicates that subclinical inflammation continues during attack-free periods, and SAA could be used as a marker of it.
Full Text Available Aim: Familial Mediterranean Fever (FMF is the most common hereditary monogenic auto-inflammatory disease. Studies suggest that inflammation persists even in attack-free periods in FMF patients. In this study, we aim to investigate the potential of simple blood parameters including neutrophil to lymphocyte ratio (NLR, platelet to lymphocyte ratio (PLR, lymphocyte/monocyte ratio (LMR, mean platelet volume (MPV, and platelet distributed width (PDW as emerging inflammatory markers to identify chronic inflammations during symptom-free periods in a group of pregnant patients with FMF. Material and Method: A total of consecutive 65 singleton pregnancies, 33 with FMF and the other 32 healthy women, were followed from the first trimester to the end of the pregnancies. Blood samples for biochemical analyses (C-reactive protein, fibrinogen and a complete blood count were obtained at 11-13 weeks and at 16-19 weeks following a detailed examination. Results: While the mean, NLR, PLR, PDW, fibrinogen, and LMR values were comparable between the groups, the mean hs-CRP levels were significantly higher and MPV values were significantly lower in the FMF group compared with the control group at both the first and second trimester. There was a significant negative correlation between hs-CRP levels with MPV at second trimester (r= -0.375 p=0.003. Discussion: Since all of our FMF patients had already been on regular colchicine therapy on admission, we admit, at least theoretically, that the anti-inflammatory and potential effects of colchicine on platelets could have altered our results. Otherwise, MPV may be used as a negative acute-phase reactant in pregnant patients with FMF.
Full Text Available Background and Objectives : Familial Mediterranean Fever, an autosomal recessive disorder, is the most common and well known periodical fevers syndrome. Disease is mainly prevalent among non-Ashkenazi Jews, Arabs, Turks and Armenia. According to the geographical location of North-West of Iran, neighboring with two high risk FMF population (Turkey and Armenia, the prevalence of FMF in this region of Iran is not unlikely. The aim of this study was to estimate the carriers rate of FMF common mutations in healthy control people. Results can be potentially useful to estimate prevalence of disease. Methods : Randomly 200 samples from healthy people [non-FMF] from North-West of Iran selected. After taking consent, DNA was extracted from blood samples of these groups. Then mutations were evaluated using ARMS-PCR and RFLP-PCR techniques. Results : from 400 studied alleles, 44 and 7 mutant alleles were found for E148Q and V726A respectively. For 2 other mutations, no mutant alleles were found. The total allelic frequency for these four common mutations was 0.132. The carriers rate was 23.4%. Conclusion : This study showed that E148Q has high mutation frequency relative to other mutations in North-West of Iran.
Güncan, Sabri; Bilge, N. Şule Y.; Cansu, Döndü Üsküdar; Kaşifoğlu, Timuçin; Korkmaz, Cengiz
Objective This study aimed to investigate the frequency in which familial Mediterranean fever (FMF) coexists with other diseases and determine whether Mediterranean fever (MEFV) gene mutations are involved in such coexistence. Material and Methods In total, 142 consecutive patients with FMF investigated for MEFV mutation were enrolled in this study [Female: 87; Male: 55, mean age 32±12 years (11–62)]. All the patients were questioned for the presence of concurrent disorders, and the medical records of these patients were revised retrospectively. A previous diagnosis of inflammatory disorder other than FMF was considered true if it met the relevant criteria. MEFV mutations were divided into 2 groups, namely M694V and its subgroup (homozygous or heterozygous) (Group I) and others (Group II). Compound heterozygosity for M694V mutation was included in Group II to form a homogeneous group for Group I. Group I and Group II were compared according to phenotypical features. The presence of MEFV mutation was investigated in exons 2, 3, 5, and 10 by the multiplex-PCR reverse hybridization method. Results Concomitant disorders were found in 17 of 73 patients with FMF (23%) in Group I and 5 of 56 patients (8.9%) in Group II (p=0.04). Concomitant disorders in Group I were as follows: 7 cases of amyloidosis, 2 cases of Behcet’s disease (BD), 4 cases of ankylosing spondylitis (AS), 1 case of antiphospholipid syndrome, 1 case of Henoch–Schonlein purpura (HSP), 1 case of combination of psoriatic arthritis, HSP, and membranoproliferative glomerulonephritis, and 1 case of AS and amyloidosis. In Group II, the following disorders were found: 1 case of amyloidosis, 1 case of BD, 1 case of AS, 1 case of ulcerative colitis, and 1 case of vitiligo. Conclusion The presence of M694V mutation may predispose patients with FMF to developing other inflammatory disorders. PMID:27733942
Full Text Available Objective. To investigate ovarian reserves in attack-free familial Mediterranean fever (AF-FMF patients at the reproductive age by anti-Müllerian hormone (AMH, antral follicle count (AFC, ovarian volume, and hormonal parameters. Methods. Thirty-three AF-FMF patients aging 18–45 years and 34 healthy women were enrolled and FSH, LH, E2, PRL, and AMH levels were measured in the morning blood samples at 2nd–4th days of menstruation by ELISA. Concomitant pelvic ultrasonography was performed to calculate AFC and ovarian volumes. Results. In FMF patient group, median AMH levels were statistically significantly lower in the M69V mutation positive group than in the negative ones (P=0.018. There was no statistically significant difference in median AMH levels between E148Q mutation positive patients and the negative ones (P=0.920. There was also no statistically significant difference in median AMH levels between M680I mutation positive patients and the negative ones (P=0.868. No statistically significant difference was observed in median AMH levels between patients who had at least one mutation and those with no mutations (P=0.868. We realized that there was no difference in comparisons between ovarian volumes, number of follicles, and AMH levels ovarian reserves when compared with FMF patients and healthy individuals. Conclusions. Ovarian reserves of FMF pateints were similar to those of healthy subjects according to AMH. However, AMH levels were lower in FMF patients with M694V mutation.
Full Text Available Hereditary periodic fever syndromes are Mendelian inherited single gene diseases which are also known as hereditary autoinflammatory syndromes, are characterized by recurrent attacks of fever and inflammation. Familial Mediterranean Fever and Hyperimmunoglobulinemia D syndrome are prototypes and are inherited autosomal recessively. The diagnosis is based on clinical course, family history and is confirmed with genetic mutation analysis. We describe a 5- year-old boy who had recurrent attacks of fever, skin rash, and cervical lymphadenopathy since he was 2 years old. His genetic analysis revealed homozygous M694V and V377I for MEFV and MVK gene respectively. Due to our knowledge, this is the first report of a patient who has both HIDS and FMF clinical and genetic features.
Kriegshäuser, Gernot; Enko, Dietmar; Hayrapetyan, Hasmik; Atoyan, Stepan; Oberkanins, Christian; Sarkisian, Tamara
PurposeThis work aimed at investigating demographic, clinical, and genetic characteristics of individuals experiencing their first familial Mediterranean fever (FMF) attack at age ≥40 years in a very large cohort of Armenian FMF patients.MethodsIn total, 10,370 Armenian patients diagnosed with FMF based on the Tel Hashomer criteria and carrying at least one MEFV mutant allele were included in this study.ResultsA total of 354 (3.40%) patients had late-onset FMF. Of these, 194 (54.80%) were female and 160 (45.20%) were male. The following genotypes were significantly associated with the late-onset variant: M680I/E148Q (P = 0.004), M694V/E148Q (P group, whereas arthritis, proteinuria, and amyloidosis did not differ significantly between the two groups.ConclusionOur data suggest that late-onset FMF is more prevalent in women and is of greater clinical as well as genetic heterogeneity than previously reported.GENETICS in MEDICINE advance online publication, 15 March 2018; doi:10.1038/gim.2018.46.
Full Text Available Background: Blood neutrophil to lymphocyte ratio (NLR and mean platelet volume (MPV both have been used as a simple marker of inflammation in many disorders. Here, we aimed to investigate the relationship between NLR, MPV, and familial Mediterranean fever (FMF. Materials and Methods: In this retrospective study, the files of FMF patients in pediatric rheumatology outpatient clinic were reviewed. There were 160 participants (68.4% in the FMF patient group and 74 participants (31.6% in the control group. Ninety of patients were in attack-free period, and 70 were in attack period. Results: The highest values of NLR were found in the patients at attack period. Patients in attack-free period and the participants in control group had similar levels of NLR (1.71 ± 0.83 and 1.91 ± 1.86 respectively (P = 0.457, and they had lower ratios than the patients did at attack period (4.10 ± 3.11 (P < 0.001 for both. There was no significant difference between MPV values of attack patients (8.35 ± 4.91 and attack-free patients (8.43 ± 1.15 (P = 0.074. MPV values of attack patients and attack-free patients were significantly higher than control group (7.99 ± 0.81 (P < 0.001 for both. Conclusion: NLR ratio may indicate FMF attack period. Since there was no significant difference between attack-free patients and control groups, NLR ratio cannot be used as a subclinical inflammation marker. However, NLR could be a useful predictor of inflammation in FMF patients. On the other hand, since our attack and attack-free patients have similar MPV values and both had greater MPV values than control group, we suggest that MPV may be used to show subclinical inflammation.
Oct 2, 2006 ... childhood and adolescence. A typical attack of disease consists of fever and serositis lasting for 1- 3 days, with a spontaneous recovery. Between attacks FMF patients are usually free of symptoms. The severity and frequency of the attacks varies between patients and the male to female ratio is considered ...
Cohen, Oren; Locketz, Garrett; Hershko, Alon Y; Gorshtein, Alexander; Levy, Yair
Chronic administration of colchicine remains a mainstay of therapy for patients with Familial Mediterranean Fever (FMF). As this medication is a strong CYP3A4 inhibitor, it has the potential to interact with many routinely used medications. One such medication is clarithromycin, itself a strong inhibitor of the same enzyme, and a typical choice for triple therapy eradication of H. pylori. Various sequelae of colchicine-clarithromycin interaction have been documented and can be expected by prescribing physicians, with rhabdomyolysis, though rare, being among the most serious. Review of cases from a tertiary academic medical center and full PubMed/MEDLINE literature review. Despite the prevalence of diseases treated with clarithromycin and the expected drug interaction with colchicine, only two cases in the literature document clinical rhabdomyolysis due to colchicine-clarithromycin interaction. In neither case, however, were patients undergoing treatment for FMF. Herein, we describe the first two cases in the literature of clinical rhabdomyolysis in FMF patients under colchicine therapy after administration of clarithromycin as part of therapy treating H. pylori infection.
Full Text Available Abstract Background Familial Mediterranean fever is a recessive autoinflammatory disease frequently encountered in Armenians, Jews, Arabs and Turks. The MEFV gene is responsible for the disease. It encodes a protein called pyrin/marenostrin involved in the innate immune system. A large number of clinically diagnosed FMF patients carry only one MEFV mutation. This study aims at studying the MEFV gene splicing pattern in heterozygous FMF patients and healthy individuals, in an attempt to understand the mechanism underlying the disease in these patients. Methods RNA was extracted from peripheral blood leucocytes of 41 FMF patients and 34 healthy individuals. RT-PCR was then performed, and the amplified products were migrated on a polyacrylamide electrophoresis gel, characterized by gel extraction of the corresponding bands followed by sequencing. Results Five novel splicing events were observed in both patients and controls deleting either exons 3, 4 (del34, or exons 2, 3, 4 (del234, or exons 2, 3, 4, 5 (del2345 or exon7 (del7 or exons 7 and 8 (del78. Conclusions The observation of such qualitative variability in the expression of the MEFV gene suggests a complex transcriptional regulation. However, the expression of these novel transcripts in both patients and controls is not in favour of a severe pathogenic effect.
Majeed, Hasan A; El-Khateeb, Mohammed; El-Shanti, Hatem; Rabaiha, Zaid Abu; Tayeh, Marwan; Najib, Dana
To identify the frequency and distribution of familial Mediterranean fever (FMF) gene (MEFV) mutations in Arab patients. The study was performed in the pediatric FMF clinic of Jordan University Hospital over a period of 4 years. Patients were referred by their physicians for diagnosis, management, genetic study, and counseling. A diagnosis of FMF was made according to published criteria. Screening for 5 mutations, namely M694V, V726A, M694I, M680I, and E148Q, was performed by amplification refractory mutation system (ARMS) for the first 4 and by restriction endonuclease testing for E148Q. Of the 407 unrelated patients investigated, 239 (59%) had 1 or 2 mutations and 168 (41%) had none of the studied mutations detected. Of those with mutations, 92 were homozygous, 53 were compound heterozygotes, 3 had complex alleles, and 91 patients had only 1 identifiable mutation. Of the mutations, M694V, V726A, M694I, M680I, and E148Q accounted for 38, 26, 14, 10 and 13%, respectively. Twelve of our patients developed the protracted febrile myalgia syndrome (PFMS) of whom 5 (42%) were homozygous for M694V. Only 2 developed chronic renal failure, both of whom were homozygous for M694V and were not on colchicine prophylaxis. However, 43 patients had a family history of chronic renal failure, and 15 (35%) were homozygous for M694V. Our data indicate that the 5 MEFV mutations are well distributed in Arabs. They also show that M694V is the most common mutation in Arab patients with FMF and seems to have an association with the development of amyloidosis and the PFMS. The high frequency of V726A, and the unique high frequency of M694I in Arabs compared with 3 other ethnic groups, are confirmed.
Becel, Sinan; Sezgin, Yılmaz; Akçay, Fatih
In this study, we evaluated the effectiveness of acupuncture therapy based on Verbal Pain Scale (VPS) scores in familial Mediterranean fever (FMF) patients admitted to the emergency department with attacks of abdominal pain. This observational study was conducted in Erzurum Regional Training and Research Hospital between August 2014 and December 2014. Twenty patients admitted to the emergency department with FMF attacks were included in the study. Acupuncture therapy was applied to three points including LI4 (Hegu), ST25 (Tianshu), and Ren12 (Zhongwan). The VPS test was applied to the patients before and after the treatment. Average VPS scores were found to be 8.45±0.75 before the treatment and 2.10±0.85 after the treatment. The difference of the VPS scores before and after treatment was statistically significant (p=0.001). To our knowledge, this is the first study evaluating the effectiveness of acupuncture therapy in the treatment of FMF attacks. Our results suggest that acupuncture therapy can be used as an effective treatment method in patients with FMF attacks. Copyright © 2016. Published by Elsevier B.V.
International Retrospective Chart Review of Treatment Patterns in Severe Familial Mediterranean Fever, Tumor Necrosis Factor Receptor-Associated Periodic Syndrome, and Mevalonate Kinase Deficiency/Hyperimmunoglobulinemia D Syndrome.
Ozen, Seza; Kuemmerle-Deschner, Jasmin B; Cimaz, Rolando; Livneh, Avi; Quartier, Pierre; Kone-Paut, Isabelle; Zeft, Andrew; Spalding, Steve; Gul, Ahmet; Hentgen, Veronique; Savic, Sinisa; Foeldvari, Ivan; Frenkel, Joost; Cantarini, Luca; Patel, Dony; Weiss, Jeffrey; Marinsek, Nina; Degun, Ravi; Lomax, Kathleen G; Lachmann, Helen J
Periodic fever syndrome (PFS) conditions are characterized by recurrent attacks of fever and localized inflammation. This study examined the diagnostic pathway and treatments at tertiary centers for familial Mediterranean fever (FMF), tumor necrosis factor receptor-associated periodic syndrome (TRAPS), and mevalonate kinase deficiency (MKD)/hyperimmunoglobulinemia D syndrome (HIDS). PFS specialists at medical centers in the US, the European Union, and the eastern Mediterranean participated in a retrospective chart review, providing de-identified data in an electronic case report form. Patients were treated between 2008 and 2012, with at least 1 year of followup; all had clinical and/or genetically proven disease and were on/eligible for biologic treatment. A total of 134 patients were analyzed: FMF (n = 49), TRAPS (n = 47), and MKD/HIDS (n = 38). Fever was commonly reported as severe across all indications. Other frequently reported severe symptoms were serositis for FMF patients and elevated acute-phase reactants and gastrointestinal upset for TRAPS and MKD/HIDS. A long delay from disease onset to diagnosis was seen within TRAPS and MKD/HIDS (5.8 and 7.1 years, respectively) compared to a 1.8-year delay in FMF patients. An equal proportion of TRAPS patients first received anti-interleukin-1 (anti-IL-1) and anti-tumor necrosis factor (anti-TNF) biologic agents, whereas IL-1 blockade was the main choice for FMF patients resistant to colchicine and MKD/HIDS patients. For TRAPS patients, treatment with anakinra versus anti-TNF treatments as first biologic agent resulted in significantly higher clinical and biochemical responses (P = 0.03 and P patterns and diagnostic delays highlight the need for greater awareness and improved diagnostics for PFS. This real-world treatment assessment supports the need for further refinement of treatment practices. © 2016, American College of Rheumatology.
Full Text Available Objective: The aim of this study was to compare acutephase reactant (AFR levels at attack period and attackfreeperiod under colchicine treatment in children with FamilialMediterranean Fever (FMF.Methods: The diagnosis of FMF was done based on clinicalcriteria and patients were prospectively followed upfor average of 1.2 years. Symptom-onset age, age at diagnosis,clinical symptoms and features of FMF attackswere recorded. MEFV gene mutations were detected byreverse hybridization (strip assay method. Peripheralblood leukocyte count, erythrocyte sedimentation rate(ESR, C-reactive protein (CRP and blood fibrinogen levelswere measured by standard methods, both at attackperiod and during attack-free period.Results: Totally 105 (55 girls, 50 boys children with FMFwere included. The mean age was 8.9±3.2 years, meansymptom onset age was 5.9 years and mean age at diagnosiswas 8.1 years. MEFV gene mutations were asfollows: E148Q (29.2%, M694V (24.8%, R761H (15.3%and V726A (13.1%. The mean AFR values were overnormal values in attack period and there was at least onehigh AFR level in 80.0% of patients. In attack-free period,although the mean values of all AFRs were within normallimits, 31.4% of patients had at least one high AFR level.Conclusion: Based on these data, one-third of FMF childrenhad a high AFR level, which may be a marker of subclinicalinflammation. In children with continuous inflammationduring attack-free period, a new anti-inflammatorydrug additional to colchicine can be considered in order toprevent complications of chronic inflammation. J Clin ExpInvest 2013; 4 (2: 213-218Key words: Familial Mediterranean Fever, acute phasereactants, children, attack period, attack-free period
Baş, Firdevs; Kabataş-Eryilmaz, Sema; Günöz, Hülya; Darendeliler, Feyza; Küçükemre, Banu; Bundak, Rüveyde; Saka, Nurçin
It is known that type 1 diabetes mellitus (type 1 DM) may be associated with other autoimmune diseases. Recently, a patient with an association of type 1 DM and familial Mediterranean fever (FMF) was reported in the medical literature. A 10.5-year-old boy was brought to our clinic with complaints of polydipsia, polyuria and weight loss and was diagnosed as diabetic ketoacidosis due to autoimmune type 1 DM. Insulin therapy was started. Elevated thyroid antibodies associated with diffuse goiter and hypothyroidism led to the diagnosis of autoimmune thyroid disease (ATD), and elevated antiendomysial antibodies and abnormal intestinal biopsy findings led to the diagnosis of celiac disease (CD). L-thyroxine therapy and gluten-free diet were initiated accordingly. At the third-year of follow-up, acute attacks of fever, abdominal pain and chest pain developed. Laboratory investigations, which were normal between the attacks, revealed elevated erythrocyte sedimentation rate, fibrinogen, white blood cell count and pleural effusion on chest X-ray during the attacks. Molecular analysis for FMF revealed compound heterozygous M694I and V726A. The patient responded well to colchicine therapy started at a dose of 1.5 mg/day. We present the second patient with type 1 DM associated with FMF who also had ATD and CD.
Kosmidis, Christophoros; Anthimidis, Georgios; Varsamis, Nikolaos; Makedou, Fotini; Georgakoudi, Eleni; Efthimiadis, Christophoros
Differential diagnosis of acute abdomen in pregnant patients is one of the greatest challenges for the clinician. Occurrence of Familial Mediterranean Fever (FMF) paroxysm of peritonitis and acute cholecystitis during pregnancy is a unique clinical entity that leads to serious diagnostic and therapeutic dilemmas. We present the case of a 33-year-old Armenian patient at 16 weeks' gestational age with a history of FMF, who was admitted twice within 1 month with acute abdomen. The first episode was attributed to FMF and successfully treated conservatively with colchicine. The second episode was diagnosed as acute cholecystitis and led to emergent laparoscopic cholecystectomy and lysis of peritoneal adhesions from previous FMF attacks. The patient presented an uneventful postoperative clinical course and had a normal delivery of a healthy infant at the 39th week of gestation. Pregnant patients with acute abdomen should be evaluated with open mind. To the best of our knowledge, this is the first published report of the coexistence of 2 different causes of acute abdomen during pregnancy. Meticulous history and thorough physical, laboratory, and radiologic examination are the keys to reach a correct diagnosis. Treatment of pregnant patients with acute abdomen should be individualized. Administration of colchicine should be continued during conception, pregnancy, and lactation in patients with FMF history. Laparoscopic intervention in pregnant patients with surgical abdomen such as acute cholecystitis is the optimal method of treatment.
Yalçinkaya, F; Cakar, N; Acar, B; Tutar, E; Güriz, H; Elhan, A H; Oztürk, S; Kansu, A; Ince, E; Atalay, S; Girgin, N; Doğru, U; Aysev, D; Ekim, M
In order to determine the role of levels of acute phase proteins (APPs) for the development of amyloidosis in familial Mediterranean fever (FMF) patients, the levels of serum amyloid A (SAA), C reactive protein (CRP), fibrinogen and erythrocyte sedimentation rate were measured in paired sera of 36 FMF patients during and in between acute attacks, 39 of their healthy parents (obligate heterozgotes), and 15 patients with FMF associated amyloidosis. To compare the levels of APPs, 39 patients with chronic infections or inflammatory diseases who may develop secondary amyloidosis, 20 patients with acute infections who are known to have elevated acute phase response but will never develop amyloidosis and 19 healthy controls were included. The median levels of all APPs are increased in the patients with FMF during attacks and a significant decrease was observed after the attack was over. The level of SAA was above reference range in all FMF patients during the attack free period and the level of at least one other APP was also above normal in 64% of the patients. Both CRP and SAA levels were found to be higher in obligate heterozygotes compared to controls. The levels of SAA in patients with FMF during the attack-free period, obligate heterozygotes and patients with FMF-amyloidosis were found to be similar. The levels in each group were found to be higher than SAA levels found in healthy controls yet lower than the levels measured in the patients with acute infections and patients with chronic inflammation or chronic infections. In conclusion, our results show that SAA level reflects subclinical inflammation with high sensitivity but its value for the prediction of amyloid formation process seems to be low.
Kushnir, T.; Eshed, I.; Heled, Y.; Livneh, A.; Langevitz, P.; Ben Zvi, I.; Konen, E.; Lidar, M.
Aim: To evaluate the effect of physical activity on the structural, morphological, and metabolic characteristics of the gastrocnemius muscle in familial Mediterranean fever (FMF) patients, utilizing quantitative 31 P magnetic resonance spectroscopy (MRS), in order to elucidate the mechanism of their exertional leg pain. Materials and methods: Eleven FMF patients suffering from exertional leg pain (eight male, three female; mean age 33 years) and six healthy individuals (three male, three female; mean age 39 years) constituted the control group. All of the participants underwent magnetic resonance imaging (MRI) and non-selective 31 P MRS (3 T) of the leg muscles before and after graded exercise on a treadmill. Phosphocreatine (PCr):inorganic phosphate (Pi), PCr:adenosine triphosphate (ATP) ratios and the intracellular pH of the leg muscles were measured using 31 P MRS. Results: For both groups, normal muscle mass with no signal alterations was observed on the MRI images after exercise. The normal range of pre- and post- exercise MRS muscle parameters was observed in both groups. However, the intracellular pH post-exercise, was significantly higher (less acidic) in the FMF group compared to the control group [pH (FMF) = 7.03 ± 0.02; pH (control) 7.00 ± 0.02; p < 0.0006]. Conclusions: The finding of a less prominent, post-exercise acidification of the gastrocnemius muscle in this FMF patient group suggests a forme fruste of glycogenosis. This preliminary observation should be further investigated in a future, larger-scale study
Girisgen, Ilknur; Sonmez, Ferah; Koseoglu, Kutsi; Erisen, Seda; Yilmaz, Dilek
Familial Mediterranean fever is an autosomal recessive disease characterized by recurrent self-limited attacks of fever accompanied by peritonitis, pleuritis, and arthritis. Approximately 5% of individuals with familial Mediterranean fever have been reported to have Henoch-Schonlein purpura and about 1% to have polyarteritis nodosa. A 7-year-old girl presenting with complaints of purpuric rash, abdominal pain, arthritis, hematuria, and proteinuria and having IgA depositions on renal biopsy was diagnosed as Henoch-Schönlein nephritis. She had a history of recurrent fever, abdominal and joint pain and M694 V compound homozygote mutation. Colchicine treatment was started for the diagnosis of FMF. When constitutional symptoms such as myalgia, weight loss, fatigue, fever, and hypertension were added to the clinical picture, the diagnosis of polyarteritis nodosa HSP was thought and confirmed by the demonstration of microaneurisms on renal arteries. There was no response to corticosteroid and cyclophosphamide treatments; however, the symptoms were rapidly and dramatically reduced after the administration of intravenous immunoglobulin. In conclusion, polyarteritis nodosa and Henoch-Schonlein purpura can be seen together with familial Mediterranean fever. It is also suggested that IVIG might be an important adjunct therapy in selected patients with polyarteritis nodosa, especially in the lack of response to steroids and immunsuppressive drugs.
Sari, Ismail; Simsek, Ismail; Tunca, Yusuf; Kisacik, Bunyamin; Erdem, Hakan; Pay, Salih; Cay, Hasan Fatih; Gul, Davut; Dinc, Ayhan
Gouty arthritis and familial Mediterranean fever (FMF) share some clinical and pathological features such as being classified as auto inflammatory disease, association with inflammasome, short-lived intermittent arthritis, and good response to colchicine and anti-interleukin-1 treatments. As Mediterranean fever (MEFV) gene is the causative factor of FMF, we aimed to investigate the prevalence of MEFV gene mutations and their effect on disease manifestations in Turkish gouty arthritis patients. Ninety-seven patients diagnosed with primary gouty arthritis (93M and 4 F, 54 [37-84] years) and 100 healthy controls (94M and 6 F, 57 [37-86] years) included in the study. All subjects were genotyped for the MEFV variations. Number of gout attacks, diuretic use, and history of nephrolithiasis and presence of tophus were also recorded. The carriage rate of MEFV mutations for patients and controls were 22.7% (n=22) and 24% (n=24) respectively. The comparison of the patient and control groups yielded no significant difference in terms of the MEFV mutations carriage rate (p=0.87). The allelic frequencies of the MEFV mutations in patients were 11.9% (n=23) and 14% (n=28) in controls (p=0.55). The presence of MEFV variants did not show any association with clinical features of gouty arthritis. The subgroup analysis of patients revealed that gouty arthritis patients with mutations had similar frequencies of tophus, history of nephrolithiasis and podogra compared to the ones without mutations (p>0.05). This study does not provide support for a major role of MEFV mutations in Turkish gouty arthritis patients. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.
Uslu, Ali Ugur; Yonem, Ozlem; Aydin, Bahattin; Uncu, Tunahan; Seven, Dogan; Balta, Sevket; Cicekli, Emre
Systematic inflammation, enhanced oxidative stress, and endothelial dysfunction are important for evolution and progression of renal damage, and they cause an increase in red cell distribution width (RDW). Familial Mediterranean fever (FMF) patients who are in the attack-free period and its relation with albuminuria and performance on assessment of microalbuminuria. One hundred and seventy-seven patients who had been diagnosed in accordance with Tel-hoshmer criteria and were in the attack-free period, and 143 age- and sex-matched healthy individuals were enrolled in our study. RDW values of FMF patients were higher compared with those of the controls (13.85 ± 1.07 and 13.15 ± 0.91, respectively; p albuminuria (r = 0.185, p = 0.014). When assessing microalbuminuria with RDW in the patients, a cutoff value of 13.85 with sensitivity of 60%, specificity of 62%, and p = 0.002 (area under curve: 0.651, 95% confidence interval 0.563-0.738), was observed according to receiver-operating characteristic curve analysis. Among the various variables associated with albuminuria in multivariate logistic regression analyses, RDW remained an independent predictor of albuminuria (95% confidence interval 0.479-0.942, p = 0.021). RDW may be associated with albuminuria in FMF patients and it can be a predictor of microalbuminuria. Copyright © 2016. Published by Elsevier Taiwan.
Pitigoi, Daniela; Olaru, Ioana D; Badescu, Daniela; Rafila, Alexandru; Arama, Victoria; Hristea, Adriana
Although cases of Mediterranean spotted fever (MSF) have been reported for decades in southeastern Romania, there are few published data. We retrospectively studied 339 patients, diagnosed with MSF at the National Institute of Infectious Diseases "Prof. Dr. Matei Bals" between 2000 and 2011, in order to raise awareness about MSF in certain regions of Romania. According to the Raoult diagnostic criteria 171 (50.4%) had a score >25 points. Mean age was 52.5 years. One hundred and fifty-five (90.6%) patients were from Bucharest and the surrounding region. Almost all patients presented with fever (99.4%) and rash (98.2%), and 57.9% had evidence of a tick bite. There were no recorded deaths. Serologic diagnosis was made by indirect immunofluorescence assay. Of the 171 patients, serology results for R. conorii were available in 147. One hundred and twenty-three (83.7%) of them had a titer IgG ≥1:160 or a fourfold increase in titer in paired samples. MSF is endemic in southeastern Romania and should be considered in patients with fever and rash even in the absence of recognized tick exposure. Since the disease is prevalent in areas highly frequented by tourists, travel-associated MSF should be suspected in patients with characteristic symptoms returning from the endemic area.
Full Text Available Although cases of Mediterranean spotted fever (MSF have been reported for decades in southeastern Romania, there are few published data. We retrospectively studied 339 patients, diagnosed with MSF at the National Institute of Infectious Diseases “Prof. Dr. Matei Bals” between 2000 and 2011, in order to raise awareness about MSF in certain regions of Romania. According to the Raoult diagnostic criteria 171 (50.4% had a score >25 points. Mean age was 52.5 years. One hundred and fifty-five (90.6% patients were from Bucharest and the surrounding region. Almost all patients presented with fever (99.4% and rash (98.2%, and 57.9% had evidence of a tick bite. There were no recorded deaths. Serologic diagnosis was made by indirect immunofluorescence assay. Of the 171 patients, serology results for R. conorii were available in 147. One hundred and twenty-three (83.7% of them had a titer IgG ≥1 : 160 or a fourfold increase in titer in paired samples. MSF is endemic in southeastern Romania and should be considered in patients with fever and rash even in the absence of recognized tick exposure. Since the disease is prevalent in areas highly frequented by tourists, travel-associated MSF should be suspected in patients with characteristic symptoms returning from the endemic area.
Dechtman, Ido-David; Grossman, Chagai; Shinar, Yael; Cohen, Rinat; Nachum, Eyal; Raanani, Ehud; Livneh, Avi; Ben-Zvi, Ilan
Postpericardiotomy syndrome (PPS) is characterized by pleuro-pericardial inflammation, which occurs in patients undergoing surgical procedures involving the pleura, pericardium, or both. The syndrome is considered to be immune mediated. However, its pathogenesis is not fully understood. It has previously been demonstrated that the Mediterranean Fever (MEFV) gene, which is associated with familial Mediterranean fever (FMF), has a role in the activation and expression of several inflammatory diseases. To investigate whether carriage of the MEFV mutation may precipitate PPS or affect its phenotype. The study population included 45 patients who underwent cardiac surgery and developed PPS. The control group was comprised of 41 patients who did not develop PPS. Clinical and demographic data was collected. The severity of PPS was evaluated. Genetic analysis to determine the carriage of one the three most common MEFV gene mutations (M694V, V726A, E148Q) was performed. The carriage rate of MEFV mutations in patients with and without PPS was compared. Association between MEFV mutation carriage and severity of PPS was evaluated. The rate of mutation carriage in the MEFV gene was similar in patients with and without PPS (15.6% in the study groups vs. 29.3% in the control group, P = 0.1937). The rate of mutation carriage in the MEFV gene was significantly lower among patients with severe PPS as compared to patients with mild-moderate PPS (4.8% vs. 25%, P PPS; however, it may affect PPS severity.
Full Text Available Ankylosing spondylitis (AS is a common inflammatory rheumatic disease. Mediterranean fever (MEFV gene, which has already been identified as being responsible for familial Mediterranean fever (FMF, is also a suspicious gene for AS because of the clinical association of these two diseases. The aim of this study was to explore the frequency and clinical significance of MEFV gene mutations (M694V, M680I, V726A, E148Q and P369S in a cohort of Turkish patients with AS. Genomic DNAs of 103 AS patients and 120 controls were isolated and genotyped using polymerase chain reaction (PCR and restriction fragment length polymorphism (RFLP methods. There was a statistically significant difference of the MEFV gene mutation carrier rates between AS patients and healthy controls (p = 0.004, OR: 2.5, 95% CI: 1.32–4.76. This association was also observed in allele frequencies (p = 0.005, OR: 2.3, 95% CI: 1.27–4.2. A relatively higher frequency was observed for M694V mutation in AS patients than controls (10.7% versus 4.2% , p = 0.060. There were no significant differences between MEFV mutation carriers and non-carriers with respect to the clinical and demographic characteristics. The results of this study suggest that MEFV gene mutations are positively associated with a predisposition to develop AS.
Giese, A; Ornek, A; Kurucay, M; Kilic, L; Şendur, S N; Münker, A; Puchstein, C; Lainka, E; Wittkowski, H; Henning, B F
Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by bouts of fever and serositis. Morbidity caused by bouts as well as self-medication were assessed among patients of Turkish ancestry living in Germany (D) or Turkey (T) in order to evaluate current analgetic concepts from a patient's perspective. D and T were asked about the 3 months preceding the interview. A total of 40 D and 40 T were included; 35/40 D and 40/40 T were on colchicine. In the last 3 months, 61.3 % had ≥ 1 bout and suffered from peritonitis (87.8 %), fever (61.2 %), myalgia (45 %), pleuritis (42.8 %), arthralgia (36.7 %), and cephalgia (32.6 %). Of the patients, 65.3 % were bedridden during bouts, 61.2 % sought the attention of a physician, 53.1 % were unable to work or attend school, and 38.8 % were hospitalized. The following drugs were taken: NSAIDs (45.6 %), NSAIDs and paracetamol (42.6 %), and combinations of NSAIDs with other analgesics. NSAIDs (58.6 %) and paracetamol (20.7 %) were considered the most potent substances. FMF inflicts substantial morbidity. Patients most commonly rely on NSAIDs and paracetamol to relieve symptoms of FMF bouts.
Eroglu, Fehime Kara; Beşbaş, Nesrin; Topaloglu, Rezan; Ozen, Seza
Familial Mediterranean fever (FMF) is the most common autoinflammatory disease worldwide. Approximately 5-10 % of patients are unresponsive to colchicine. Aim of this study was to determine the short- and long-term efficacy and safety of anti-interleukin 1 (anti-IL1) and anti-tumor necrosis factor agents in colchicine-resistant FMF cases in Turkish children and adolescents. This is a single-center retrospective case series of colchicine-resistant FMF patients. The included patients were treated with biologics for either colchicine resistance or because of one of the following: (1) amyloidosis, (2) recurrent prolonged febrile myalgia and frequent need of steroid and (3) persistent arthritis. Colchicine resistance was defined as at least one attack per month for three consecutive months and elevated erythrocyte sedimentation rate or C-reactive protein or serum amyloid A in-between attacks despite taking adequate dose of colchicine. Response to biologicals was evaluated by the Autoinflammatory Diseases Activity Index (AIDAI) score sheet, patients/parents'/physicians' global assessment of disease severity and laboratory parameters every 3-6 months. Fourteen patients were included in the study. Three patients were treated with etanercept for median 7 months (range 3-11 months), and all patients had to be switched to anti-IL1 treatment because of adverse effects and/or partial response. Eleven patients were treated with anakinra with a median duration of 8 months (4-60 months). Nine patients responded to treatment at the third month, but four of them switched to canakinumab because of noncompliance, local side effects and active arthritis. Nine patients were treated with canakinumab, all responded. At follow-up, in two patients the dose had to be increased, and on the other hand, in three patients the interval was increased to every 12-16 weeks. In three patients, anti-IL1 treatment could be stopped and they are fine with colchicine. This case series describes the
Full Text Available Familial Mediterranean fever (FMF is a periodic autoinflammatory disease characterized by chronic inflammation. This study investigated the relationship between acute-phase reactants and gene mutations in attack-free periods of childhood FMF. Patients diagnosed with FMF were divided into four groups based on genetic features: no mutation, homozygous, heterozygous, and compound heterozygous. These groups were monitored for 2 years, and blood samples were collected every 6 months during attack-free periods. Erythrocyte sedimentation rate, C-reactive protein, fibrinogen, and white blood cell count were measured. A disease severity score was determined for each patient. Mean values for erythrocyte sedimentation rate and fibrinogen were significantly different in the homozygous group. White blood cell count and C-reactive protein were similar between the groups. Disease severity score was higher in patients with the M694V mutation than in individuals without the mutation, as well as in those with other mutation groups. Periodic follow-up of patients with FMF MEFV mutations in subjects with acute-phase reactants may be useful in the prevention of morbidity.
Kosan, C; Cayir, A; Turan, M I
Familial Mediterranean fever (FMF) is a periodic autoinflammatory disease characterized by chronic inflammation. This study investigated the relationship between acute-phase reactants and gene mutations in attack-free periods of childhood FMF. Patients diagnosed with FMF were divided into four groups based on genetic features: no mutation, homozygous, heterozygous, and compound heterozygous. These groups were monitored for 2 years, and blood samples were collected every 6 months during attack-free periods. Erythrocyte sedimentation rate, C-reactive protein, fibrinogen, and white blood cell count were measured. A disease severity score was determined for each patient. Mean values for erythrocyte sedimentation rate and fibrinogen were significantly different in the homozygous group. White blood cell count and C-reactive protein were similar between the groups. Disease severity score was higher in patients with the M694V mutation than in individuals without the mutation, as well as in those with other mutation groups. Periodic follow-up of patients with FMF MEFV mutations in subjects with acute-phase reactants may be useful in the prevention of morbidity.
Kosan, C. [Department of Pediatric Nephrology, Faculty of Medicine, Ataturk University, Erzurum (Turkey); Cayir, A.; Turan, M.I. [Department of Pediatrics, Faculty of Medicine, Ataturk University, Erzurum (Turkey)
Familial Mediterranean fever (FMF) is a periodic autoinflammatory disease characterized by chronic inflammation. This study investigated the relationship between acute-phase reactants and gene mutations in attack-free periods of childhood FMF. Patients diagnosed with FMF were divided into four groups based on genetic features: no mutation, homozygous, heterozygous, and compound heterozygous. These groups were monitored for 2 years, and blood samples were collected every 6 months during attack-free periods. Erythrocyte sedimentation rate, C-reactive protein, fibrinogen, and white blood cell count were measured. A disease severity score was determined for each patient. Mean values for erythrocyte sedimentation rate and fibrinogen were significantly different in the homozygous group. White blood cell count and C-reactive protein were similar between the groups. Disease severity score was higher in patients with the M694V mutation than in individuals without the mutation, as well as in those with other mutation groups. Periodic follow-up of patients with FMF MEFV mutations in subjects with acute-phase reactants may be useful in the prevention of morbidity.
Ben-Chetrit, Eldad; Yazici, Hasan
Henoch-Schönlein purpura is a relatively common vasculitis mainly affecting children. It is characterized by purpuric skin rash, abdominal cramping, and haematuria. Skin biopsies taken from Henoch-Schönlein purpura lesions disclose perivascular IgA deposits. FMF is an autoinflammatory disease characterized by recurrent attacks of fever lasting 2-3 days which resolve spontaneously. Typical manifestations of the disease are peritonitis, pleuritis, pericarditis, arthritis and erysipelas-like erythema usually affecting the lower limbs. Over the years many reviews emphasized the clinical impression that Henoch-Schönlein purpura is more common among FMF patients than in healthy control population. In this review we summarize these reports and show that sometimes Henoch-Schönlein purpura associated with FMF differs from typical isolated Henoch-Schönlein purpura, and this is also the case with polyarteritis nodosa and SpA associated with FMF. It is suggested that these clinical manifestations (polyarteritis nodosa, Henoch-Schönlein purpura and SpA) should be considered to be associated with FMF as part of what we call FMF rather than as co-existing additional separate clinical entities. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Ktsoyan, Zhanna A.; Beloborodova, Natalia V.; Sedrakyan, Anahit M.; Osipov, George A.; Khachatryan, Zaruhi A.; Manukyan, Gayane P.; Arakelova, Karine A.; Hovhannisyan, Alvard I.; Arakelyan, Arsen A.; Ghazaryan, Karine A.; Zakaryan, Magdalina K.; Aminov, Rustam I.
In our previous works we established that in an autoinflammatory condition, familial Mediterranean fever (FMF), the gut microbial diversity is specifically restructured, which also results in the altered profiles of microbial long chain fatty acids (LCFAs) present in the systemic metabolome. The mainstream management of the disease is based on oral administration of colchicine to suppress clinical signs and extend remission periods and our aim was to determine whether this therapy normalizes the microbial LCFA profiles in the metabolome as well. Unexpectedly, the treatment does not normalize these profiles. Moreover, it results in the formation of new distinct microbial LCFA clusters, which are well separated from the corresponding values in healthy controls and FMF patients without the therapy. We hypothesize that the therapy alters the proinflammatory network specific for the disease, with the concomitant changes in gut microbiota and the corresponding microbial LCFAs in the metabolome. PMID:23373011
Erer, Burak; Demirkaya, Erkan; Ozen, Seza; Kallinich, Tilmann
The most dreaded complication of familial Mediterranean fever (FMF) is amyloidosis; controversy exists as to what acute phase reactant (APR) should be monitored in these patients. To analyze the best acute phase reactant for FMF follow-up to help guide physicians to decide on what APR parameter to use, we also attempted to define the best APR in predicting the complications of FMF, specifically the development of amyloidosis. Systematic review based on a sensitive search to capture studies that: (1) included FMF patients; (2) measured serum amyloid A (SAA), CRP (C-reactive protein), proteinuria, or ESR (erythrocyte sedimentation rate); (3) amyloidosis were the outcome measure; (4) sensitivity, specificity, predictive value, and other performance parameters could be calculated; and (5) had a longitudinal design. Of 1905 captured items, 26 were selected for detailed review, of which only two finally met the criteria, and the quality was only moderate; the articles did not analyzed the performance by means of sensitivity and specificity to predict, or even detect, amyloidosis, and thus had to be calculated based on text. The 26 screened studies were very heterogeneous in designs, parameters measured, and results, despite being set from research questions similar to ours. They were mainly descriptive, and it was very difficult to interpret the true performance of the tests. The correlation between the various APR is low. The evidence supporting the monitoring of FMF with any APR over the others is limited. Well designed longitudinal studies with a mixture of outcomes should be undertaken. Until them, recommending an APR over other would be based on expert opinion and indirect evidence.
Philip J. Hashkes
Full Text Available Objective. To examine the effect of rilonacept on the health-related quality of life (HRQoL in patients with poorly controlled familial Mediterranean fever (FMF. Methods. As part of a randomized, double-blinded trial comparing rilonacept and placebo for the treatment of FMF, patients/parents completed the modified Child Health Questionnaire (CHQ at baseline, and at the start and end of each of 4 treatment courses, 2 each with rilonacept and placebo. Results. Fourteen subjects were randomized; mean age was 24.4 ± 11.8 years. At baseline the physical HRQoL score was significantly less (24.2 ± 49.5 but the psychosocial score was similar to the population norm (49.5 ± 10.0. There were significant improvements in most HRQoL concepts after rilonacept but not placebo. Significant differences between rilonacept and placebo were found in the physical (33.7 ± 16.4 versus 23.7 ± 14.5, P=0.021 but not psychosocial scores (51.4 ± 10.3 versus 49.8 ± 12.4, P=0.42. The physical HRQoL was significantly impacted by the treatment effect and patient global assessment. Conclusion. Treatment with rilonacept had a beneficial effect on the physical HRQoL in patients with poorly controlled FMF and was also significantly related to the patient global assessment. This trial is registered with ClinicalTrials.gov Identifier NCT00582907.
Supplementary data: Frequency of mutations in Mediterranean fever gene, with gender and genotype–phenotype correlations in a Turkish population. Salih Coskun, Serkan Kurtgöz, Ece Keskin, Ferah Sönmez and Gökay Bozkurt. J. Genet. 94, 629–635. Table 1. Whole data of genotype–phenotype correlations of M694V ...
Raquel Sousa Almeida
Full Text Available Mediterranean spotted fever is a tick-borne zoonotic disease caused by Rickettsia conorii. It is transmitted by the dog tick Rhipicephalus sanguineus. It usually presents as a benign self-limited disease characterized by a skin rash, high fever, and, sometimes, a characteristic ulcer at the tick bite site called tache noir. The course of this disease is usually benign, although severe manifestations have been previously described, mainly in adults. Neurological manifestations are very unusual. We present a case of Mediterranean spotted fever with encephalitis to highlight the importance of clinical suspicion, mainly in endemic areas, the potential severity of this disease, and the need of early initiation of therapy in order to prevent severe complications.
Talaat Hala Salah El-Din
Full Text Available Abstract Background Familial Mediterranean fever (FMF is an autosomal recessive disease characterized by self-limiting recurrent attacks of fever and serosal inflammation, leading to abdominal, thoracic or articular pain. Objective To detect variable clinical presentations and genotypic distribution of different groups of FMF patients and the efficacy of colchicine therapy in treatment of these groups of FMF after one year. Methods A cross-sectional study was conducted on 70 patients already diagnosed with FMF and following-up at the Rheumatology Clinic, Children's Hospital - Cairo University. Diagnosis of FMF was determined according to Tel Hashomer criteria for FMF. All patients were subjected to a questionnaire including detailed history with emphasis on clinical manifestations and colchicine dose to control attacks. Mutational analysis was performed for all study subjects covering 12 mutations in the MEFV gene: E148Q, P369S, F479L, M680I (G/C, M680I (G/A, I692del, M694V, M694I, K695R, V726A, A744S and R761H. Response to colchicine treatment was evaluated as complete, incomplete and unresponsive. Results Out of the 70 patients- 40 males and 30 females- fever was the most common presenting feature, followed by abdominal pain, and arthritis; documented in 95.7%, 94.3%, and 77.1% of cases respectively. Mutational analysis detected gene mutation on both alleles in 20 patients (homozygotes, on only 1 allele in 40 patients (heterozygotes, and on none of the alleles (uncharacterized cases. Mild to moderate disease severity score (according to Tel Hashomer key to severity score was detected in a significant proportion of heterozygotes and the uncharacterized group than the homozygotes. All patients received colchicine therapy; 22.9% of them showed complete response, 74.3% showed incomplete response and 2.9% showed no response to therapy. The colchicine dose needed to control attacks was significantly lower in heterozygotes than the homozygotes(P=0
Manukyan, Gayane; Aminov, Rustam; Hakobyan, Gagik
not revealed any conventional mechanisms contributing to the enhanced apoptotic rate of neutrophils in FMF. Although the exact molecular mechanisms of accelerated neutrophil apoptosis in FMF remain unknown, it may provide a protection against excessive inflammation and tissue damage due to a massive...... of systemic neutrophil apoptosis as well as the levels of proteins involved in apoptosis were investigated ex vivo in patients with FMF using flow cytometry and RT-qPCR. The freshly collected neutrophils from the patients in FMF remission displayed a significantly larger number of cells spontaneously entering...... apoptosis compared to control (6.27 ± 2.14 vs. 1.69 ± 0.18%). This elevated ratio was retained after 24 h incubation of neutrophils in the growth medium (32.4 ± 7.41 vs. 7.65 ± 1.32%). Correspondingly, the mRNA level for caspase-3 was also significantly increased under these conditions. In response...
Cherqaoui, Bilade; Rossi-Semerano, Linda; Georgin-Lavialle, Sophie; Dusser, Perrine; Galeotti, Caroline; Piram, Maryam; Hentgenb, Véronique; Touitou, Isabelle; Koné-Paut, Isabelle
Children with Familial Mediterranean fever may suffer from musculoskeletal involvement, somewhat difficult to distinguish from juvenile spondyloarthritis. The association of these two diseases has been scarcely reported in children. Objective of this work was to define the association of familial Mediterranean fever and juvenile spondyloarthritis in France. Three cohorts of children with familial Mediterranean fever, juvenile spondyloarthritis, familial Mediterranean fever related juvenile spondyloarthritis, were retrospectively identified in the French reference center of auto-inflammatory diseases. Familial Mediterranean fever was defined according to Tel-Hashomer or Turkish pediatric criteria with at least one exon-10 MEFV-gene mutation. Juvenile spondyloarthritis was defined according to ILAR criteria. Patients with familial Mediterranean fever or juvenile spondyloarthritis were respectively compared to familial Mediterranean fever related juvenile spondyloarthritis patients. Sixteen children were identified as having familial Mediterranean fever related juvenile spondyloarthritis. The male/female-ratio was 0.6, with median age at spondyloarthritis onset of 7.5years (3-16years). All carried at least one M694V variant in MEFV gene; 16.7% were HLA-B27-carriers. Compared to 83 familial Mediterranean fever patients, familial Mediterranean fever related juvenile spondyloarthritis patients had less frequently fever (PMediterranean fever related juvenile spondyloarthritis patients less often received non-steroidal anti-inflammatory drugs (PMediterranean fever may be associated with typical pattern of juvenile spondyloarthritis. These patients, with less response to colchicine, should be diagnosed earlier and treated as for jSpA. Copyright © 2018 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.
Full Text Available In our previous works we established that in an autoinflammatory condition, familial Mediterranean fever, the gut microbial diversity is specifically restructured, which also results in the altered profiles of microbial long chain fatty acids (LCFAs present in the systemic metabolome. The mainstream management of the disease is based on oral administration of colchicine to suppress clinical signs and extend remission periods and our aim was to determine whether this therapy normalizes the microbial LCFA profiles in the metabolome as well. Unexpectedly, the treatment does not normalize these profiles. Moreover, it results in the formation of new distinct microbial LCFA clusters, which are well separated from the corresponding values in healthy controls and FMF patients without the therapy. We hypothesize that the therapy alters the proinflammatory network specific for the disease, with the concomitant changes in gut microbiota and the corresponding microbial LCFAs in the metabolome.
Full Text Available Familial Mediterranean fever, an autosomal recessive disorder, is a member of the periodic fever syndromes, and considered to be the most common cause of recurrent febrile episodes in children. It is important to understand the disorder as familial Mediterranean fever falls on a spectrum of various presentations; the recurrent episodes of familial Mediterranean fever may be so severe that the quality of life may be affected in such patients. Therefore, physicians should not delay the evaluation in such cases and promptly initiate treatment to not only improve quality of life but to also avoid complications, such as amyloidosis. This study reports two different cases of familial Mediterranean fever, with varying clinical presentations, and established diagnosis via genetic testing as well as cessation of symptoms with a trial of therapy. Furthermore, this study discusses the various manifestations of familial Mediterranean fever, laboratory findings, and current therapies available for management.
Chappey, O; Niel, E; Dervichian, M; Wautier, J L; Scherrmann, J M; Cattan, D
Free and total plasma, granulocyte and mononuclear cell colchicine concentrations were measured by radioimmunoassay in 30 patients with familial Mediterranean fever treated with colchicine 0.5 to 2 mg day-1. Colchicine concentrations showed a large intersubject variability in plasma (0.13-1.75 ng ml-1), granulocytes (4 to 64 ng/10(9) cells), and mononuclear cells (11.4 to 57.6 ng/10(9) cells). Whereas unbound and total plasma colchicine concentrations were well correlated, no correlation was ...
Also, the most common symptoms were vomiting, fatigue and anorexia, which were not included as Tel–Hashomer criteria (Livneh et al. 1997). Anorexia was especially common in children. Frequencies of. FMF clinical features in previous studies from other ethnic groups (Armenians, Jews and Arabs) have been reported.
Full Text Available Background Familial Mediterranean Fever and celiac disease are both related to auto-inflammation and/or auto-immunity and they share some common clinical features such as abdominal pain, diarrhea, bloating and flatulence. Objectives We aimed to determine the association of these two diseases, if present. Methods Totally 112 patients diagnosed with Familial Mediterranean Fever and 32 cases as healthy control were included in the study. All participants were examined for the evidence of celiac disease, with serum tissue transglutaminase IgA levels (tTG IgA. Results Totally 144 cases, 112 with Familial Mediterranean Fever and 32 healthy control cases were included in the study. tTG IgA positivity was determined in three cases with Familial Mediterranean Fever and in one case in control group. In that aspect there was no significant difference regarding the tTG IgA positivity between groups (P=0.81. Duodenum biopsy was performed to the tTG IgA positive cases and revealed Marsh Type 3b in two Familial Mediterranean Fever cases and Marsh Type 3c in the other one while the biopsy results were of the only tTG IgA positive case in control group was Marsh Type 3b. In HLA evaluation of the celiac cases; HLA DQ2 was present in two celiac cases of the Familial Mediterranean Fever group and in the only celiac case of the control group while HLA DQ8 was present in one celiac case of the Familial Mediterranean Fever group. Conclusions We did not determine an association of Familial Mediterranean Fever with celiac disease. Larger studies with subgroup analysis are warranted to determine the relationship of these two diseases.
biallelic mutations in the MEFV gene could be associated with a risk of migraine in the Turkish population. Moreover, MEFV mutations could be related to increased frequency and short durations of migraine attacks (P=0.043 and P=0.021, respectively. Future studies in larger groups and expression analysis of MEFV are required to clarify the role of the MEFV gene in migraine susceptibility. Keywords: MEFV gene, headache, Familial Mediterranean fever (FMF, biallelic mutations, pyrin (or marenostrin, aura, single nucleotide polymorphisms
Polat, Adem; Acikel, Cengizhan; Sozeri, Betul; Dursun, Ismail; Kasapcopur, Ozgur; Gulez, Nesrin; Simsek, Dogan; Saldir, Mehmet; Dokurel, Ipek; Poyrazoglu, Hakan; Bakkaloglu, Sevcan; Delibas, Ali; Ekinci, Zelal; Ayaz, Nuray A; Kandur, Yasar; Peru, Harun; Kurt, Yasemin G; Polat, Safiye R; Unsal, Erbil; Makay, Balahan; Gok, Faysal; Ozen, Seza; Demirkaya, Erkan
In this study, we examined the efficacy and safety of a once-daily dosage schema of colchicine compared with a twice-daily dosage schema in pediatric patients with familial Mediterranean fever (FMF). In this 24-week, multicenter, randomized controlled noninferiority trial, pediatric patients newly diagnosed with FMF carrying a homozygous or compound heterozygous mutation and not receiving any treatment were included. Patients were randomly assigned using a block randomization method to receive treatment with a once- or twice-daily dosage. Clinical and laboratory characteristics and medication side effects were recorded and compared between groups. The study was carried out in compliance with Good Clinical Practice and the Consolidated Standards for Reporting of Trials (CONSORT) statement. A total of 92 patients were selected, and 79 patients completed the study. There were 42 patients in the once-daily dosage group and 37 in the twice-daily dosage group. The results indicated that the once-daily dosage was not inferior to the twice-daily dosage regarding decrease in attack frequency and duration as well as improvement in clinical findings and Mor severity scores. Alterations in laboratory findings indicating inflammation, such as erythrocyte sedimentation rate, C-reactive protein, and serum amyloid A, were similar in both groups. The rates of drug side effects were similar between the once- and twice-daily dosage groups, implying comparable safety of colchicine, with the exception of diarrhea, which was slightly higher in the once-daily dosage group. Using colchicine with either a once- or twice-daily dosage provides similar clinical and laboratory improvements. Considering both efficacy and safety, colchicine can be prescribed with a once-daily dosage. ClinicalTrials.gov identifier NCT02602028 . Registered 5 November 2015.
Full Text Available Abstract Introduction Familial Mediterranean fever is an autosomal recessive disease that predominantly affects people of the Mediterranean coast. One of the most frequent complications of the disease is amyloidosis. This clinical entity is known as secondary (also called AA amyloidosis. Case presentation In this report, we describe the case of a 33-year-old Turkish man with familial Mediterranean fever and chronic renal insufficiency. He was admitted to our clinic with symptoms of suprarenal insufficiency. The patient died three months later as a result of cardiac arrest. Conclusion Our aim is to make a contribution to the literature by reporting a case of combined insufficiency due to the accumulation of renal and adrenal amyloid in a patient with familial Mediterranean fever, which has very rarely been described in the literature. We hope that adrenal insufficiency, which becomes fatal if not diagnosed and treated rapidly, will come to mind as easily as chronic renal failure in clinical practice.
Full Text Available Mirella Alpa, Dario Roccatello Centro di Ricerche di Immunopatologia e Documentazione su Malattie Rare (CMID, Struttura Complessa Direzione Universitaria di Immunologia Clinica, Università di Torino e Ospedale G Bosco, Torino, ItalyAbstract: Familial Mediterranean fever is an autosomal recessive autoinflammatory disorder mainly affecting Mediterranean populations, which is associated with mutations of the MEFV gene that encodes pyrin. Functional studies suggest that pyrin is implicated in the maturation and secretion of interleukin-1 (IL-1. The IL-1 receptor antagonist or anti-IL-1 monoclonal antibody may therefore represent a rational approach for the treatment of the rare patients who are refractory to conventional therapy. We report the case of a young female affected by familial Mediterranean fever who proved to be resistant to colchicine and was successfully treated with canakinumab.Keyword: interleukin-1, colchicine, familial Mediterranean fever, anti-IL-1 treatment, biologic agents
Ugurlu, Serdal; Hacioglu, Aysa; Adibnia, Yasaman; Hamuryudan, Vedat; Ozdogan, Huri
There is no established treatment of AA amyloidosis, a long-term complication of various chronic inflammatory diseases associated with increased mortality, such as familial Mediterranian fever (FMF). Recently there are few reports pointing out that tocilizumab(TCZ), an anti IL-6 agent may be effective in AA amyloidosis resistant to conventional treatments. We report our data on the effect of TCZ in patients with FMF complicated with AA amyloidosis. FMF patients with histologically proven AA amyloidosis, treated with TCZ (8 mg/kg per month) were followed monthly and the changes in creatinine, creatinine clearance, the amount of 24-hour urinary protein, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were noted throughout the treatment period. Adverse effects of the treatment were closely monitored. TCZ was given to 12 patients (6 F, 6 M) who also continued to receive colchicine (1.9 ± 0.4 mg/day). Coexisting diseases were ankylosing spondylitis(4) and Crohn's disease(1). The mean age was 35.2 ± 10.0 years and the mean follow-up on TCZ was 17.5 ± 14.7 months. The renal functions remained stable (mean creatinine from 1.1 ± 0.9 mg/dl to 1.0 ± 0.6 mg/dl), while a significant decrease in acute phase response (the mean CRP from 18.1 ± 19.5 mg/L to 5.8 ± 7.1 mg/L and ESR from 48.7 ± 31.0 mm/h to 28.7 ± 28.3 mm/h) was observed and the mean 24-hour urinary protein excretion reduced from 6537.6 ± 6526.0 mg/dl to 4745.5 ± 5462.7 mg/dl. Two patients whose renal functions were impaired prior to TCZ therapy improved significantly on this regimen. No infusion reaction was observed. None of the patients experienced any FMF attack under TCZ treatment with the exception of 2, one of whom had less frequent attacks while the other had episodes of erysipelas-like erythema. CONCLUSıON: Tocilizumab improved the acute phase response and the renal function in this group of patients and was generally well
Tawhida Y. Abdel Ghaffar
Colchicine;. Familial Mediterranean fever. Abstract Crohn's disease and familial Mediterranean fever are both inflammatory diseases char- ... the same chronic relapsing behavior, infil- tration by neutrophils at the site of injury, and abnormal ... moglobin was 9.6 g/dl); white blood cells and platelets were within normal ranges.
Crohn's disease and familial Mediterranean fever are both inflammatory diseases characterized by similar clinical manifestations. The concurrence of the two diseases may pose a challenge to diagnosis and treatment. In this report, we present a child with familial Mediterranean fever and undiagnosed Crohn's disease ...
Egritaş Gürkan, Ödül; Ünlüsoy Aksu, Aysel; Demirtaş, Zeliha; Dalgıç, Buket
Considering the etiology of cyclic vomiting syndrome (CVS) in childhood, a variety of underlying organic causes has been clearly identified in the literature. The aim of this study was to emphasize that endoscopic evaluation in the first step may help diagnosis and treatment in patients with CVS, unlike the CVS-related "North American Society for Pediatric Gastroenterology, Hepatology and Nutrition" (NASPGHAN) consensus statement in 2008. The medical files of patients with vomiting complaints admitted to our tertiary center between the years 2007 and 2012 were analyzed retrospectively. Patients were identified according to the International Classification of Diseases (ICD) codes at their initial presentation, including vomiting. A total of 815 patients with vomiting complaints were evaluated. Of the 379 patients who presented with vomiting only, 336 patients were already being followed for chronic vomiting. Cyclic vomiting was detected in 31 out of 336 patients. In our series, familial Mediterranean fever (FMF), cavernous transformation of the portal vein, and Helicobacter pylori (HP) gastritis presented with CVS for the first time in the pediatric age group. We emphasize that endoscopic evaluation in patients with CVS should be performed as the first step for appropriate diagnosis and treatment.
Gudiol, F; Pallares, R; Carratala, J; Bolao, F; Ariza, J; Rufi, G; Viladrich, P F
A study of 43 patients with Mediterranean spotted fever showed that a 2-day course of ciprofloxacin or a 2-day course of doxycycline may be an effective mode of therapy. All patients in both arms of the study were cured; however, doxycycline produced a more rapid defervescence.
Full Text Available The familial Mediterranean fever (FMF gene (MEFV encodes pyrin, a major regulator of the inflammasome platform controlling caspase-1 activation and IL-1beta processing. Pyrin has been shown to interact with the gene product of NLRP3, NALP3/cryopyrin, also an important active member of the inflammasome. The NLRP3 region was recently reported to be associated with Crohn's disease (CD susceptibility. We therefore sought to evaluate MEFV as an inflammatory bowel disease (IBD susceptibility gene.MEFV colonic mucosal gene expression was significantly increased in experimental colitis mice models (TNBS p<0.0003; DSS p<0.006, in biopsies from CD (p<0.02 and severe ulcerative colitis (UC patients (p<0.008. Comprehensive genetic screening of the MEFV region in the Belgian exploratory sample set (440 CD trios, 137 UC trios, 239 CD cases, 96 UC cases, and 107 healthy controls identified SNPs located in the MEFV 5' haplotype block that were significantly associated with UC (rs224217; p = 0.003; A allele frequency: 56% cases, 45% controls, while no CD associations were observed. Sequencing and subsequent genotyping of variants located in this associated haplotype block identified three synonymous variants (D102D/rs224225, G138G/rs224224, A165A/rs224223 and one non-synonymous variant (R202Q/rs224222 located in MEFV exon 2 that were significantly associated with UC (rs224222: p = 0.0005; A allele frequency: 32% in cases, 23% in controls. No consistent associations were observed in additional Canadian (256 CD trios, 91 UC trios and Scottish (495 UC, 370 controls sample sets. We note that rs224222 showed marginal association (p = 0.012; G allele frequency: 82% in cases, 70% in controls in the Canadian sample, but with a different risk allele. None of the NLRP3 common variants were associated with UC in the Belgian-Canadian UC samples and no significant interactions were observed between NLRP3 and MEFV that could explain the observed flip-flop of the rs224222 risk
Peces, Ramón; Afonso, Sara; Peces, Carlos; Nevado, Julián; Selgas, Rafael
Familial Mediterranean fever is an autosomal recessive disease characterized by recurrent episodes of fever and polyserositis and by the onset of reactive amyloid-associated amyloidosis. Amyloidosis due to familial Mediterranean fever can lead to end-stage renal disease, culminating in kidney transplantation for some patients. In this study, we report the clinical outcome of two brothers with familial Mediterranean fever who were the inadvertent donor and recipient, respectively, of a kidney. Subsequently, they were diagnosed with renal amyloidosis secondary to familial Mediterranean fever and were successfully treated with anakinra and colchicine. Two brothers with familial Mediterranean fever and renal amyloidosis were the inadvertent donor and recipient, respectively, of a kidney. The recipient had presented recurrent acute febrile episodes of familial Mediterranean fever, developed nephrotic syndrome secondary to amyloidosis and needed bilateral nephrectomy and chronic dialysis. His elder brother, in apparent good health, donated his left kidney to his brother. Immediately after the kidney transplantation, both the donor and recipient presented massive proteinuria, impaired renal function and elevated serum amyloid A levels. Biopsies of the brothers' kidneys showed amyloidosis. Genetic studies thereafter revealed a homozygous variant for the MEFV gene (NM_000243.2.c.2082G > A; p.M694I) in both brothers. At this point, both the donor and recipient were treated with colchicine and anakinra, resulting in improved renal function, decreased proteinuria, undetectable serum amyloid A levels and stable renal function at 62 months of follow-up and no major adverse effects. In familial Mediterranean fever, analyses of the MEFV gene should be performed in potential live kidney donors from a direct family member (either between siblings or between parents and children). In addition, genetic studies are required when consanguinity is suspected between members involved in
Apr 3, 2009 ... becomes arrested in perithecial development regardless of whether the mutant participates in the cross as the male or female parent. We localized ... role in mating pheromone signalling in Neurospora, then protoperithecia in an fmf-1 × fmf-1. + ... The female and male fertility-1 (fmf-1) mutant of Neurospora.
Gunes, Muhammed; Cekic, Sukru; Kilic, Sara Sebnem
Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome is the most frequent repetitive fever syndrome in childhood. It is characterized by fever episodes lasting for approximately 3-6 days, once every 3-8 weeks. Clinical and laboratory data for PFAPA syndrome patients between January 2010 and December 2014 followed up at a tertiary pediatric care hospital were reviewed. Four hundred children (256 male, 144 female; mean age at diagnosis, 4.2 ± 2.2 years), were enrolled in the study. During the episodes, mean leukocyte number was high (12 725/mm 3 ) with predominant neutrophils. The mean number of monocytes was 1256/mm 3 , and 90.2% had monocytosis. Serum amyloid A and C-reactive protein were high in 84.6% and in 77.8% of the patients, respectively. Mediterranean fever (MEFV) gene heterozygous mutation was identified in 57 of the 231 patients (24.7%) in whom genetic analysis had been performed. The most frequent mutation was heterozygous M694V (10%, n = 23). Extension of between-episode interval following prophylaxis was noted in 85% of those on regular colchicine treatment (n = 303). In the colchicine group, between-episode interval was prolonged from 18.8 ± 7.9 days (before colchicine treatment) to 49.5 ± 17.6 days on prophylactic colchicine therapy; also, prophylactic treatment was more effective in reducing episode frequency in patients with MEFV gene variant (n = 54, 96%) than in those without (n = 122, 80%; P = 0.003). This study has involved the largest number of PFAPA syndrome patients in the literature. It is particularly important to assess and to demonstrate the high rate of response to colchicine prophylaxis in PFAPA syndrome patients, especially those with MEFV variant. On blood screening, neutrophilia associated with monocytosis and low procalcitonin could contribute to diagnosis. © 2017 Japan Pediatric Society.
Partial sequencing of this segment revealed a point mutation in the gene NCU 09387.1, a homologue of the Schizosaccharomyces pombe ste11+ regulator of sexual development. The fmf-1 mutation did not complement a NCU 09387.1 deletion mutation, and transformation with wild-type NCU 09387.1 complemented fmf-1.
REPORT TYPE 3. DATES COVERED 00-00-2008 to 00-00-2008 4. TITLE AND SUBTITLE CSC Curriculum That Meets the Needs of the FMF 5a. CONTRACT NUMBER 5b...8-98) Prescribed by ANSI Std Z39-18 ii EXECUTIVE SUMMARY TITLE: CSC CURRICULUM THAT MEETS THE NEEDS OF THE FMF I. Theme: That the CSC
Angelakis, Emmanouil; Botelho, Elizabeth; Socolovschi, Cristina; Sobas, Chantal Roure; Piketty, Christophe; Parola, Philippe; Raoult, Didier
Travelers are exposed to a variety of health risks in unfamiliar environments and fever is a common problem in patients returning from travel abroad. Rickettsial diseases are increasingly frequently being reported among international travelers. Here we present cases of Rickettsia typhi infection, the agent of murine typhus, that were identified in our laboratory the last year, in travelers from Tunisia. For each patient we tested an acute-phase serum sample and for one patient we tested a convalescent-phase serum sample. IgG and IgM antibody titers were estimated with use of the microimmunofluorescence (MIF) assay. Western blot (WB) assay was performed for all the patients. We identified three cases of murine typhus after a travel in Tunisia. All cases were observed during late summer and early autumn and patients were suffering by persistent fever. None of them presented rash or inoculation eschar. MIF was positive for Rickettsia sp. in the acute-phase serum samples of two patients. In one patient, two acute-phase serum samples were Rickettsia sp. negative whereas a third convalescent-phase serum sample that was obtained 2 weeks after was Rickettsia sp. positive. By WB assay we identified infection by R typhi. A treatment was immediately started and patients became apyretic. In the countries of North Europe, although autochthones cases of murine typhus have not been described, sporadic cases of R typhi infection are identified in travelers who visited murine typhus endemic areas. Murine typhus should be considered in the diagnosis of febrile illness without rash in travelers returning from disease endemic areas, like the south Mediterranean area. © 2010 International Society of Travel Medicine.
Cito, F; Narcisi, V; Danzetta, M L; Iannetti, S; Sabatino, D D; Bruno, R; Carvelli, A; Atzeni, M; Sauro, F; Calistri, P
West Nile virus (WNV) and Rift Valley fever virus (RVFV) represent an important group of viral agents responsible for vector-borne zoonotic diseases constituting an emerging sanitary threat for the Mediterranean Basin and the neighbouring countries. WNV infection is present in several Mediterranean countries, whereas RVF has never been introduced into Europe, but it is considered a major threat for North African countries. Being vector-borne diseases, they cannot be prevented only through an animal trade control policy. Several approaches are used for the surveillance of WNV and RVFV. With the aim of assessing the surveillance systems in place in Mediterranean countries, two disease-specific questionnaires (WNV, RVFV) have been prepared and submitted to Public Health and Veterinary Authorities of six EU countries. This study presents the information gathered through the questionnaires and describes some critical points in the prevention and surveillance of these diseases as emerged by the answers received. © 2013 Blackwell Verlag GmbH.
... ear infections , sinus infections , mononucleosis , bronchitis , pneumonia , and tuberculosis Urinary tract infections Viral gastroenteritis and bacterial gastroenteritis Children may have a low-grade fever for 1 ...
Zerkaoui, Maria; Laarabi, Fatima Zahra; Ajhoun, Yousra; Chkirate, Bouchra; Sefiani, Abdelaziz
Familial Mediterranean fever is an autoinflammatory disease of unknown etiology, characterized clinically by recurrent attacks of sudden-onset fever with arthralgia and/or thoracoabdominal pain and pathogenetically by autosomal recessive inheritance due to a mutation in the MEFV gene. Behçet's disease is an inflammatory disease characterized by recurrent oral and genital aphthous ulcerations, uveitis, and skin lesions. Preliminarily, our literature review suggested that patients with familial Mediterranean fever who also have Behçet's disease have only a single mutated familial Mediterranean fever gene. The MEFV gene mutation responsible for familial Mediterranean fever is probably a susceptibility factor for Behçet's disease, particularly for patients with vascular involvement, and both disorders can occur concurrently in a patient, as in the present case. A 10-year-old girl of Moroccan origin presented to our institution for genetic consultation for genetic testing of the MEFV gene. She had fever associated with abdominal and diffuse joint pain in addition to headache. These symptoms have oriented pediatricians to familial Mediterranean fever. The evolution was marked by Behçet's syndrome symptoms. Sanger sequencing followed by complete exome sequencing analysis of the MEFV gene for the proband mutation revealed a novel variant. We conclude that the novel single variant c.2078 T > A (p.Met693Lys) could be responsible for the association of familial Mediterranean fever and Behçet's disease. To the best of our knowledge, this is the first report of a new variant in exon 10 of the MEFV gene in a Moroccan family. This novel variant should be listed in the MEFV sequence variant databases.
Dzhndoian, Z T
The determination of serum myeloid-related protein MRP 8/14 (calprotectin) in Armenian patients with FMF before and after treatment with colchicine (including colchicine-resistant patients who don't respond to 2 mg of colchicine; t patients who don't respond to 1,5 mg of colchicine, and also responders to different dose of colchicine) and estimation of the response to antiinflammatory therapy. MRP 8/14 serum levels were measured in 80 FMF patients before and after treatment with colchicine and in healthy individuals (n = 11) and patients with rheumatoid arthritis RA (n=11) as a control group. Serum MRP 8/14 concentration was measured by ELISA (Enzyme Linked-Immuno-Sorbent-Assay) method using "Buhlmann" kit (Switzerland) in the laboratory with modern equipment. Serum MRP 8/14 concentrations were within a normal ranges in healthy individuals and elevated in patients with FMF and RA. MRP 8/14 serum levels in FMF patients were higher than in RA patients. Serum MRP 8/14 concentrations in FMF patients before colchicines therapy were higher than after treatment. The findings of our study indicate that myeloid-related protein MRP 8/14 is a very sensitive marker of the disease activity and response to antiinflammatory therapy in FMF.
Neurospora crassa fmf-1 encodes the homologue of the. Schizosaccharomyces pombe Ste11p regulator of sexual development. Srividhya V. Iyer, Mukund Ramakrishnan and Durgadas P. Kasbekar. J. Genet. 88, 33–39. Figure 1. Sequence at the junction of the proximal breakpoint of T(AR173) has homology with Cen-VII ...
Soylemezoglu, Oguz; Kandur, Yasar; Duzova, Ali; Ozkaya, Ozan; Kasapcopur, Ozgür; Baskin, Esra; Fidan, Kibriya; Yalcinkaya, Fatos
Presence of common MEFV gene mutations strengthened the diagnosis of FMF in addition to the typical clinical characteristics of FMF. However, there are also rare mutations. P369S, A744S, R761H, K695R, F479L are the main rare mutations in Turkish population. We aimed to evaluate FMF patients with a single allele MEFV mutation and to compare patients with common and rare mutations. We retrospectively reviewed the medical records of FMF patients with a single allele mutation who were followed up between 2008 and 2013 in six centres. We compared the patients with rare and common mutations for disease severity score, frequent exacerbations ( >1 attack per month), long attack period (>3 day), symptoms, age at the onset of symptoms, gender, consanguinity, and family history. Two hundred and seventeen patients (M/F=101/116) with the diagnosis of FMF and single mutation were included. Heterozygote mutations were defined as common (M694V, V726A, M68OI) and rare mutations (A744S, P369S, K695R, R761H, F479L). Sixty-seven patients (27 males, 40 females) had one single rare mutation and 150 (74 males, 76 females) had one single common mutation. No difference was found between the rare and common mutations with respect to the disease severity score. There was no significant difference between common and rare heterozygote form of mutations in terms of disease severity. Patients with typical characteristics of FMF, with some rare mutations (A744S, P369S) should be treated in the same manner as patients with a common mutation.
Maeda, Koji; Nagamine, Tsuyoshi; Nakamura, Yasuo; Mitsugi, Takeshi; Matsumoto, Shinichiro
The remote handling technique has been developed and demonstrated by Fuel Monitoring Facility (FMF) operated by Japan Nuclear Cycle Development Institute (JNC). In particular, the reassembling of irradiated fuels has been successfully performed, and reassembled irradiation vehicles were reinserted to Japanese experimental fast reactor 'JOYO'. This paper describes following four items; (A) Irradiation vehicle, (B) Disassembling and interim examination, (C) Decontamination of fuel pin or capsule, (D) Reassembling machine, which are necessary for the reinsertion. (J.P.N.)
Piram, Maryam; Koné-Paut, Isabelle; Lachmann, Helen J; Frenkel, Joost; Ozen, Seza; Kuemmerle-Deschner, Jasmin; Stojanov, Silvia; Simon, Anna; Finetti, Martina; Sormani, Maria Pia; Martini, Alberto; Gattorno, Marco; Ruperto, Nicolino
Objectives To validate the Auto-Inflammatory Diseases Activity Index (AIDAI) in the four major hereditary recurrent fever syndromes (HRFs): familial Mediterranean fever (FMF), mevalonate kinase deficiency (MKD), tumour necrosis factor receptor-associated periodic syndrome (TRAPS) and cryopyrin-associated periodic syndromes (CAPS). Methods In 2010, an international collaboration established the content of a disease activity tool for HRFs. Patients completed a 1-month prospective diary with 12 yes/no items before a clinical appointment during which their physician assessed their disease activity by a questionnaire. Eight international experts in auto-inflammatory diseases evaluated the patient's disease activity by a blinded web evaluation and a nominal group technique consensus conference, with their consensus judgement considered the gold standard. Sensitivity/specificity/accuracy measures and the ability of the score to discriminate active from inactive patients via the best cut-off score were calculated by a receiver operating characteristic analysis. Results Consensus was achieved for 98/106 (92%) cases (39 FMF, 35 CAPS, 14 TRAPS and 10 MKD), with 26 patients declared as having inactive disease and 72 as having active disease. The median total AIDAI score was 14 (range=0–175). An AIDAI cut-off score ≥9 discriminated active from inactive patients, with sensitivity/specificity/accuracy of 89%/92%/90%, respectively, and an area under the curve of 98% (95% CI 96% to 100%). Conclusions The AIDAI score is a valid and simple tool for assessing disease activity in FMF/MKD/TRAPS/CAPS. This tool is easy to use in clinical practice and has the potential to be used as the standard efficacy measure in future clinical trials. PMID:24026675
Klymchuk, M D; Lezhentsev, B M; Andrukhiv, I Iu
In the paper, new data are submitted on natural focality of Marseilles fever in the territory of the Crimean Peninsula. Identified in the above territory was a high activity of previously unknown natural foci that manifested themselves by an epidemic outbreak (Saki, 1996) and by sporadic diseases in people. A clinical-and-epidemiological characterization is given of rickettsiosis in the Crimea Autonomous Republic.
Full Text Available Rift Valley fever (RVF is a mosquito-borne viral zoonosis which affects humans and a wide range of domestic and wild ruminants. The large spread of RVF in Africa and its potential to emerge beyond its geographic range requires the development of surveillance strategies to promptly detect the disease outbreaks in order to implement efficient control measures, which could prevent the widespread of the virus to humans. The Animal Health Mediterranean Network (REMESA linking some Northern African countries as Algeria, Egypt, Libya, Mauritania, Morocco, Tunisia with Southern European ones as France, Italy, Portugal and Spain aims at improving the animal health in the Western Mediterranean Region since 2009. In this context, a first assessment of the diagnostic capacities of the laboratories involved in the RVF surveillance was performed. The first proficiency testing (external quality assessment--EQA for the detection of the viral genome and antibodies of RVF virus (RVFV was carried out from October 2013 to February 2014. Ten laboratories participated from 6 different countries (4 from North Africa and 2 from Europe. Six laboratories participated in the ring trial for both viral RNA and antibodies detection methods, while four laboratories participated exclusively in the antibodies detection ring trial. For the EQA targeting the viral RNA detection methods 5 out of 6 laboratories reported 100% of correct results. One laboratory misidentified 2 positive samples as negative and 3 positive samples as doubtful indicating a need for corrective actions. For the EQA targeting IgG and IgM antibodies methods 9 out of the 10 laboratories reported 100% of correct results, whilst one laboratory reported all correct results except one false-positive. These two ring trials provide evidence that most of the participating laboratories are capable to detect RVF antibodies and viral RNA thus recognizing RVF infection in affected ruminants with the diagnostic methods
Monaco, Federica; Cosseddu, Gian Mario; Doumbia, Baba; Madani, Hafsa; El Mellouli, Fatiha; Jiménez-Clavero, Miguel Angel; Sghaier, Soufien; Marianneau, Philippe; Cetre-Sossah, Catherine; Polci, Andrea; Lacote, Sandra; Lakhdar, Magtouf; Fernandez-Pinero, Jovita; Sari Nassim, Chabane; Pinoni, Chiara; Capobianco Dondona, Andrea; Gallardo, Carmina; Bouzid, Taoufiq; Conte, Annamaria; Bortone, Grazia; Savini, Giovanni; Petrini, Antonio; Puech, Lilian
Rift Valley fever (RVF) is a mosquito-borne viral zoonosis which affects humans and a wide range of domestic and wild ruminants. The large spread of RVF in Africa and its potential to emerge beyond its geographic range requires the development of surveillance strategies to promptly detect the disease outbreaks in order to implement efficient control measures, which could prevent the widespread of the virus to humans. The Animal Health Mediterranean Network (REMESA) linking some Northern African countries as Algeria, Egypt, Libya, Mauritania, Morocco, Tunisia with Southern European ones as France, Italy, Portugal and Spain aims at improving the animal health in the Western Mediterranean Region since 2009. In this context, a first assessment of the diagnostic capacities of the laboratories involved in the RVF surveillance was performed. The first proficiency testing (external quality assessment—EQA) for the detection of the viral genome and antibodies of RVF virus (RVFV) was carried out from October 2013 to February 2014. Ten laboratories participated from 6 different countries (4 from North Africa and 2 from Europe). Six laboratories participated in the ring trial for both viral RNA and antibodies detection methods, while four laboratories participated exclusively in the antibodies detection ring trial. For the EQA targeting the viral RNA detection methods 5 out of 6 laboratories reported 100% of correct results. One laboratory misidentified 2 positive samples as negative and 3 positive samples as doubtful indicating a need for corrective actions. For the EQA targeting IgG and IgM antibodies methods 9 out of the 10 laboratories reported 100% of correct results, whilst one laboratory reported all correct results except one false-positive. These two ring trials provide evidence that most of the participating laboratories are capable to detect RVF antibodies and viral RNA thus recognizing RVF infection in affected ruminants with the diagnostic methods currently
Chebaane, Saleh; Fathallah, Habib; Seleem, Hussein; Machhout, Mohsen
Dispersion management in few mode fiber (FMF) technology is crucial to support the upcoming standard that reaches 400 Gbps and Terabit/s per wavelength. Recently in Chebaane et al. (2016), we defined two potential differential mode delay (DMD) management strategies, namely sawtooth and triangular. Moreover we proposed a novel parametric refractive index profile for FMF, referred as raised cosine (RC) profile. In this article, we improve and optimize the RC profile design by including additional shaping parameters, in order to obtain much more attractive dispersion characteristics. Our improved design enabled to obtain a zero DMD (z-DMD), strong positive DMD (p-DMD) and near-zero DMD (nz-DMD) for six-mode fiber, all appropriate for dispersion management in FMF system. In addition, we propose a positive DMD (p-DMD) fiber designs for both, four-mode fiber (4-FMF) and six-mode fiber (6-FMF), respectively, having particularly attractive dispersion characteristics.
Knieper, Anne-Marie; Klotsche, Jens; Lainka, Elke; Berger, Thomas; Dressler, Frank; Jansson, Annette F; Rietschel, Christoph; Oommen, Prasad T; Berendes, Rainer; Niehues, Tim; Neudorf, Ulrich; Foell, Dirk; Wittkowski, Helmut; Kallinich, Tilmann
The aim was to analyse factors influencing the individual colchicine dose in children with FMF, to evaluate the impact of dose adjustment on the clinical course and inflammation and to identify clinical parameters and biomarkers that predict dose increase in the near future. Data from 409 paediatric FMF patients (4566 visits) derived from the national auto-inflammatory diseases registry were analysed. Serum concentrations of S100 molecules were determined by ELISA. The age-dependent colchicine dose is influenced by the present genotype. The body surface area is the anthropometric parameter that correlates best with the applied dosages. Colchicine introduction and dose increase lead to significant reduction of clinical symptoms and inflammation. During established colchicine therapy, an increase of one single biomarker increases the likelihood of a dose increment in the next 12 months with a factor of 1.62-1.94. A combination of biomarkers including S100 molecules increases this odds ratio up to 4.66 when analysing all patients and up to 7.27 when analysing patients with a high risk of severe disease. Colchicine therapy is currently guided mainly by the occurrence of clinical symptoms and serological inflammation. Other factors, such as the genotype, the body surface area and biomarkers, will help to manage colchicine therapy in a more individualized fashion. The additional analysis of S100 molecules as sensitive biomarkers will help to identify patients at risk for dose increases in the near future. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: email@example.com
Zhang, Chuanbiao; Ning, Tigang; Zheng, Jingjing; Gao, Xuekai; Lin, Heng; Li, Jing; Pei, Li; Wen, Xiaodong
We proposed and experimentally demonstrated a miniature optical fiber temperature sensor consisting of a seven core fiber (SCF) and a few mode fiber (FMF). The device is fabricated by splicing a section of FMF with a segment of SCF to form a FMF-SCF based sensing structure, and during the FMF region, few modes can be excited and will propagate within the SCF. In experiment, the proposed device has good quality interferometric spectra, and the highest extinction ratio of 27 dB was achieved. When the temperature increases from room temperature to 110 °C, the temperature response properties of the sensor have been investigated, the wavelength sensitivity of about 91.8 pm/°C and the amplitude sensitivity of about 1.57 × 10-2 a.u./°C are obtained, respectively. Due to its easy and controllable fabrication, the sensor can be a suitable candidate in temperature sensing applications.
Price, M.H.; Frantz, T.R.
The post irradiation examination test cell of the Fuel Monitoring Facility (FMF-2) presents a challenging operational environment of high radiation and operation temperatures in an inert gas atmosphere. Extensive computer integration of analytical instruments and fuel handling equipment is incorporated into the facility design. Two fully programmable overhead type robot systems will be used in the test hot cell for transfer of spent fuel pin magazines. FMF-2 represents the application of remote handling and robotic technology to a hazardous operational environment. Manned entry into the hot cells for equipment maintenance is impossible after that start of operations. In-cell conditions require that the robotic systems be hardened and remotely maintainable. FMF-2 also demonstrates the integration of diverse remote handling system technologies including robots, electromechanical manipulators and in-cell cranes. Similar design techniques may have applicability in design of future US spent fuel handling facilities
channel provides better quality transmission at greater speed and is the preferred method when available. 135 D. COMMUNICATIONS AFLOAT Deployed FMF...Discussion----------------------------------61 3. Recommendation------------------------------63 K. QUALITY OF DISKETTES----------------------------63...Computers------------------------- 71 4. Deployed FASC’s----------------------------- 71 S. CDPA Concept--------------------------------71 6. Programming
Dragsted, U B; Eugen-Olsen, J; Mathiesen, L R
Familial Mediterranean Fever (FMF) is a recessive trait mainly affecting Jews, Turks and Arabs. FMF is characterized by recurrent episodes of painful serositis and fever leaving no sequelae. Involvement of the peritoneum is the most common clinical form. In 1997 the gene that causes FMF (MEFV-gen...
Seif S. Al-Abri
Full Text Available Crimean-Congo haemorrhagic fever (CCHF is the most widespread, tick-borne viral disease affecting humans. The disease is endemic in many regions, such as Africa, Asia, Eastern and Southern Europe, and Central Asia. Recently, the incidence of CCHF has increased rapidly in the countries of the World Health Organization Eastern Mediterranean Region (WHO EMR, with sporadic human cases and outbreaks of CCHF being reported from a number of countries in the region. Despite the rapidly growing incidence of the disease, there are currently no accurate data on the burden of the disease in the region due to the different surveillance systems used for CCHF in these countries. In an effort to increase our understanding of the epidemiology and risk factors for the transmission of the CCHF virus (CCHFV; a Nairovirus of the family Bunyaviridae in the WHO EMR, and to identify the current knowledge gaps that are hindering effective control interventions, a sub-regional meeting was organized in Muscat, Oman, from December 7 to 9, 2015. This article summarizes the current knowledge of the disease in the region, identifies the knowledge gaps that present challenges for the prevention and control of CCHFV, and details a strategic framework for research and development activities that would be necessary to curb the ongoing and new threats posed by CCHFV.
Al-Abri, Seif S; Abaidani, Idris Al; Fazlalipour, Mehdi; Mostafavi, Ehsan; Leblebicioglu, Hakan; Pshenichnaya, Natalia; Memish, Ziad A; Hewson, Roger; Petersen, Eskild; Mala, Peter; Nhu Nguyen, Tran Minh; Rahman Malik, Mamunur; Formenty, Pierre; Jeffries, Rosanna
Crimean-Congo haemorrhagic fever (CCHF) is the most widespread, tick-borne viral disease affecting humans. The disease is endemic in many regions, such as Africa, Asia, Eastern and Southern Europe, and Central Asia. Recently, the incidence of CCHF has increased rapidly in the countries of the World Health Organization Eastern Mediterranean Region (WHO EMR), with sporadic human cases and outbreaks of CCHF being reported from a number of countries in the region. Despite the rapidly growing incidence of the disease, there are currently no accurate data on the burden of the disease in the region due to the different surveillance systems used for CCHF in these countries. In an effort to increase our understanding of the epidemiology and risk factors for the transmission of the CCHF virus (CCHFV; a Nairovirus of the family Bunyaviridae) in the WHO EMR, and to identify the current knowledge gaps that are hindering effective control interventions, a sub-regional meeting was organized in Muscat, Oman, from December 7 to 9, 2015. This article summarizes the current knowledge of the disease in the region, identifies the knowledge gaps that present challenges for the prevention and control of CCHFV, and details a strategic framework for research and development activities that would be necessary to curb the ongoing and new threats posed by CCHFV. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.
... attack your body by mistake. Autoinflammatory diseases can cause fever, rash, swelling of joints and other tissues, and ... symptoms include: Familial Mediterranean Fever (FMF), which can cause: Fever that comes and goes. Stomach pain. Arthritis. Chest ...
Muliar, Olena; Usuga Castaneda, Mario A.; Rottwitt, Karsten
), commonly used in a MDM scenario. This experimental technique requires the use of a Mach-Zehnder interferometer, where the reference's path length is controlled by an optical delay line. The interference between the output beams of reference and fiber under test (FUT) is recorded on a CCD camera...... or optical modes. Mode division multiplexing (MDM) appears in this context as a promising and viable solution for such capacity increase, since it utilizes multiple spatial modes of an optical fiber as individual communication channels for data transmission. In order to evaluate its performance, a MDM system...... requires advanced characterization methods with regard to the modal content of its photonics components and in particular of the fibers involved for data transmission. In this contribution we present a time-domain interferometric technique for a full modal characterization of few mode fibers (FMF...
Nursal, Ayse Feyda; Kaya, Süheyla; Sezer, Ozlem; Karakus, Nevin; Yigit, Serbulent
Methylenetetrahydrofolate reductase (MTHFR) is a crucial enzyme in homocysteine (Hcy) metabolism. We aimed to evaluate a possible relationship between MTHFR gene C677T (rs 1801133), A1298C (rs 1801131) variants and susceptibility to FMF in a Turkish cohort. This case-control study included 198 Turkish FMF patients and 100 healthy subjects as controls. MTHFR C677T and A1298C were analyzed by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) methods. The genotype distribution and allele frequency of the MTHFR C677T were statistically different between the patients and the control group (P=.006, P=.001, respectively). The frequency of the TT genotype and T allele of MTHFR C677T was significantly higher in the patients than in the controls. The genotype distribution of MTHFR A1298C variant did not show any statistically significant difference between the patients and the controls (P›.05). The patients had statistically different frequencies in allele C of MTHFR A1298C variant compared with the control (P=.032). We also examined the risk associated with inheriting the combined genotypes for the two MTHFR variants. According to these results, individuals who were CC homozygous at C677T locus and AA homozygous at A1298C locus have a lower risk of developing FMF (P=.002). Individuals who were TT homozygous at C677T locus and AC heterozygous at A1298C locus have higher risk of developing FMF (P=.033). Our findings clearly showed there was an association the MTHFR C677T/A1298C variants and susceptibility to FMF in the Turkish sample. © 2017 Wiley Periodicals, Inc.
Familial Mediterranean fever (FMF) has traditionally been considered as a monogenic autosomal recessive disorder caused by mutations in the MEFV gene with highest incidence among Mediterranean populations. In a considerable number of patients with typical FMF, only one MEFV mutation was identified and the ...
... can trigger a type of allergy called hay fever. Symptoms can include Sneezing, often with a runny ... eyes Your health care provider may diagnose hay fever based on a physical exam and your symptoms. ...
Valley Fever is a disease caused by a fungus (or mold) called Coccidioides. The fungi live in the soil ... from person to person. Anyone can get Valley Fever. But it's most common among older adults, especially ...
Rheumatic fever is still common in countries that have a lot of poverty and poor health systems. It does not often occur in the United States and other developed countries. When rheumatic fever does occur in the United ...
... It is characterized by repeated episodes of fever. Causes Relapsing fever is an infection caused by several species of ... death of very large numbers of borrelia bacteria causes shock) Weakness Widespread bleeding ... health care provider right away if you develop a fever after returning from a trip. Possible infections need ...
... time, can lead to congestive heart failure. What causes rheumatic fever? Rheumatic fever is not an infection itself, but ... If the antibodies attack your heart, they can cause your heart valves to swell, which can ... is at risk for rheumatic fever? Fewer than 0.3% of people who have ...
White, Lindsey; Ybarra, Michael
Fever is a common presenting complaint among adult or pediatric patients in the emergency department setting. Although fever in healthy individuals does not necessarily indicate severe illness, fever in patients with neutropenia may herald a life-threatening infection. Therefore, prompt recognition of patients with neutropenic fever is imperative. Serious bacterial illness is a significant cause of morbidity and mortality for neutropenic patients. Neutropenic fever should trigger the initiation of a rapid work-up and the administration of empiric systemic antibiotic therapy to attenuate or avoid the progression along the spectrum of sepsis, severe sepsis, septic shock syndrome, and death. Copyright © 2017 Elsevier Inc. All rights reserved.
Introduction. Dengue fever is caused by dengue viruses. (DENV). Transmission of DENV has increased dramatically in the past two decades making DENV the most important human pathogens among arthropod-borne viruses (1). About 50-. 100 million dengue fever infections occur every year in tropical and subtropical.
Hemorrhagic dengue; Dengue shock syndrome; Philippine hemorrhagic fever; Thai hemorrhagic fever; Singapore hemorrhagic fever ... Four different dengue viruses are known to cause dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when a person is bitten by ...
Sasaki, S.; Abe, K.; Nagamine, T.; Matsumoto, S.
In the place adjacent to the Fuel Monitoring Facility (FMF) in the O-arai Engineering Center, FMF-Extension was constructed to examine large subassemblies irradiated in the prototype fast breeder reactor 'MONJU' and so on. Until now, in order to confirm the performances of subassembly vertical examination machine, which is one of main apparatus installed in FMF-Extension, it has been experimentally conducted to measure six subassemblies irradiated in the experimental fast reactor 'JOYO'. This machine has multi-functions such appearance inspection, various size measurements and dismantling a subassembly. As to the size measurements, it is possible to measure subassembly length, hexagonal wrapper tube face-to-face distance, corner-to-corner distance, bowing and twisting automatically. Furthermore, this machine has a function of grasping the cross section form of hexagonal wrapper tube, using a new special tool. The results measured by this machine were compared with the data of the same subassemblies with the exiting machine in FMF, which was calibrated already. For the data of subassembly length, hexagonal wrapper tube face-to-face distance and corner-to-corner distance, the difference of both machines was within a measurement error. In some results of bowing, the difference was over 1mm. It was thought that the difference was not a considerable error when taking into account the characteristics of these machines that the error was easy to propagate. The results of cross section form of hexagonal wrapper tube newly introduced in this machine were in a good agreement within a measurement error, compared with the data calculated on the basis of size measurement results. The existing machine in FMF could not treat this cross section form measurement. (author)
... loss Headache Valley fever Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...
... disease is common in South America and in sub-Saharan Africa. Anyone can get yellow fever, but older people ... by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is ...
... page: //medlineplus.gov/ency/patientinstructions/000110.htm Mediterranean diet To use the sharing features on this page, ... and other health problems. How to Follow the Diet The Mediterranean diet is based on: Plant-based ...
Streptobacillary fever; Streptobacillosis; Haverhill fever; Epidemic arthritic erythema; Spirillary fever; Sodoku ... Rat-bite fever can be caused by either of 2 different bacteria, Streptobacillus moniliformis or Spirillum minus. Both of these are ...
Garg A, Garg J, Rao YK et al. Prevalence of dengue. 8. among clinically suspected febrile episodes at a teaching hospital in North India. Journal of Infectious Diseases and. Immunity 2011; 3 (5): 85 – 89. Reiter P. Yellow fever and dengue: a threat to Europe? 9. Euro Surveill 2010; 15 (10): 11 – 16. Gibbons RV, Vaughn DW.
Exotic, captivating, and seductive, orchids have long fascinated plant lovers. They first attracted the attention of Westerners in the 17th century, when explorers brought back samples from South America and Asia. By the mid-1800s, orchid collecting had reached a fever pitch, not unlike that of the Dutch tulip craze of the 1630s, with rich (and…
... of DHF, which is a medical emergency. To treat severe cases of dengue fever at a hospital, doctors will give intravenous (IV) fluids and electrolytes (salts) to replace those lost through vomiting or ... enough to effectively treat the disease. In more advanced cases, doctors may ...
Katherine Fleming-Dutra, pediatrician, discusses scarlet fever, its cause, how to treat it, and how to prevent its spread. Created: 6/9/2011 by National Center for Immunization and Respiratory Diseases (NCIRD). Date Released: 6/9/2011.
D, Pradeepa H; Rao, Sathish B; B, Ganaraj; Bhat, Gopalakrishna; M, Chakrapani
Dengue fever is an acute febrile illness with a duration of 2-12 days. Our observational study observed the 24-h continuous tympanic temperature pattern of 15 patients with dengue fever and compared this with 26 others with fever due to a non-dengue aetiology. A tri-phasic fever pattern was seen among two-thirds of dengue fever patients, but in only one with an inflammatory disease. One-third of dengue fever patients exhibited a single peak temperature. Continuous temperature monitoring and temperature pattern analysis in clinical settings can aid in the early differentiation of dengue fever from non-dengue aetiology.
Wain, John; Hendriksen, Rene S.; Mikoleit, Matthew L.
, especially those in Africa. The main barriers to control are vaccines that are not immunogenic in very young children and the development of multidrug resistance, which threatens efficacy of antimicrobial chemotherapy. Clinicians, microbiologists, and epidemiologists worldwide need to be familiar...... cause of enteric fever, but now S Typhi is being displaced by infections with drug-resistant S enterica serovar Paratyphi A. New conjugate vaccines are imminent and new treatments have been promised, but the engagement of local medical and public health institutions in endemic areas is needed to allow...... with shifting trends in enteric fever. This knowledge is crucial, both to control the disease and to manage cases. Additionally, salmonella serovars that cause human infection can change over time and location. In areas of Asia, multidrug-resistant Salmonella enterica serovar Typhi (S Typhi) has been the main...
Infectious complications following delivery were, in the past, attributed to "milk fever": these were milk congestion, milk deposits, rancid milk, etc., that were held responsible. The milk was reabsorbed into the blood of the patient and settled in the peritoneum ("milk peritonitis"), in the broad ligaments (pelvic abscess), in the thighs (phlebitis) and also in the breasts (breast abscess). This belief, originated by Aristotle, was accepted by excellent authors like Andre Levret (1703-1780), one of the most famous French obstetricians and Nicolas Puzos, at the same time. More recently, authors alluded to it and blamed "milk fever" for being at the origin of dramatic pictures which they described in their novels, like Victor Hugo and Guy de Maupassant, for instance.
... familial Mediterranean fever (FMF; an inborn condition that causes episodes of fever, pain, and swelling of the stomach area, lungs, ... emergency room immediately. Taking too much colchicine may cause death.Symptoms ... sore throat, fever, chills, and other signs of infection paleness or ...
Wain, John; Hendriksen, Rene S; Mikoleit, Matthew L; Keddy, Karen H; Ochiai, R Leon
Control of typhoid fever relies on clinical information, diagnosis, and an understanding for the epidemiology of the disease. Despite the breadth of work done so far, much is not known about the biology of this human-adapted bacterial pathogen and the complexity of the disease in endemic areas, especially those in Africa. The main barriers to control are vaccines that are not immunogenic in very young children and the development of multidrug resistance, which threatens efficacy of antimicrobial chemotherapy. Clinicians, microbiologists, and epidemiologists worldwide need to be familiar with shifting trends in enteric fever. This knowledge is crucial, both to control the disease and to manage cases. Additionally, salmonella serovars that cause human infection can change over time and location. In areas of Asia, multidrug-resistant Salmonella enterica serovar Typhi (S Typhi) has been the main cause of enteric fever, but now S Typhi is being displaced by infections with drug-resistant S enterica serovar Paratyphi A. New conjugate vaccines are imminent and new treatments have been promised, but the engagement of local medical and public health institutions in endemic areas is needed to allow surveillance and to implement control measures. Copyright © 2015 Elsevier Ltd. All rights reserved.
Fenga, Concettina; Pugliese, Michela
The Mediterranean is historically considered an area of high concentration of zoonoses. Mediterranean countries socio-economic features have favoured, over time, the onset of different types of zoonosis. Many of these may affect many occupational categories, first of all farmers, people working in abattoirs and processing products of animal origin. New farming activities and technologies have generated new occupational and zoonotic risks. These changes have influenced zoonosis epidemiology and have led to a gradual decrease in the number of diseases and to a reduction of some biological risks. However, brucellosis, Q fever, bovine tuberculosis cystic echinococcosis remain a strong example of zoonosis and a real risk, in the Mediterranean area especially. Therefore, an interdisciplinary collaboration between Veterinary Service, Public Health and Occupational medicine is necessary in order to plan territorial prevention.
Papa, Riccardo; Doglio, Matteo; Lachmann, Helen J; Ozen, Seza; Frenkel, Joost; Simon, Anna; Neven, Bénédicte; Kuemmerle-Deschner, Jasmin; Ozgodan, Huri; Caorsi, Roberta; Federici, Silvia; Finetti, Martina; Trachana, Maria; Brunner, Jurgen; Bezrodnik, Liliana; Pinedo Gago, Mari Carmen; Maggio, Maria Cristina; Tsitsami, Elena; Al Suwairi, Wafaa; Espada, Graciela; Shcherbina, Anna; Aksu, Guzide; Ruperto, Nicolino; Martini, Alberto; Ceccherini, Isabella; Gattorno, Marco
Hereditary recurrent fevers (HRF) are a group of rare monogenic diseases leading to recurrent inflammatory flares. A large number of variants has been described for the four genes associated with the best known HRF, namely MEFV, NLRP3, MVK, TNFRSF1A. The Infevers database ( http://fmf.igh.cnrs.fr/ISSAID/infevers ) is a large international registry collecting variants reported in these genes. However, no genotype-phenotype associations are provided, but only the clinical phenotype of the first patient(s) described for each mutation. The aim of this study is to develop a registry of genotype-phenotype associations observed in patients with HRF, enrolled and validated in the Eurofever registry. Genotype-phenotype associations observed in all the patients with HRF enrolled in the Eurofever registry were retrospectively analyzed. For autosomal dominant diseases (CAPS and TRAPS), all mutations were individually analyzed. For autosomal recessive diseases (FMF and MKD), homozygous and heterozygous combinations were described. Mean age of onset, disease course (recurrent or chronic), mean duration of fever episodes, clinical manifestations associated with fever episodes, atypical manifestations, complications and response to treatment were also studied. Data observed in 751 patients (346 FMF, 133 CAPS, 114 MKD, 158 TRAPS) included in the Eurofever registry and validated by experts were summarized in Tables. A total of 149 variants were described: 46 TNFRSF1A and 27 NLRP3 variants, as well as various combinations of 48 MVK and 28 MEFV variants were available. We provide a potentially useful tool for physicians dealing with HRF, namely a registry of genotype-phenotype associations for patients enrolled in the Eurofever registry. This tool is complementary to the Infevers database and will be available at the Eurofever and Infevers websites.
Martínez de Salazar, Pablo; Suy, Anna; Sánchez-Montalvá, Adrián; Rodó, Carlota; Salvador, Fernando; Molina, Israel
Zika fever is an arboviral systemic disease that has recently become a public health challenge of global concern after its spread through the Americas. This review highlights the current understanding on Zika virus epidemiology, its routes of transmission, clinical manifestations, diagnostic tests, and the current management, prevention and control strategies. It also delves the association between Zika infection and complications, such as microencephaly or Guillem-Barré syndrome. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.
... Library ▸ Allergy Library ▸ Hay Fever Medications Share | Hay Fever and Allergy Medications This article has been reviewed ... MD, FAAAAI Seasonal allergic rhinitis known as hay fever symptoms range from being mildly annoying to seriously ...
Dengue fever, or West Nile fever, is a mild viral illness transmitted by mosquitoes which causes fever, rashes and muscle and joint aches. Treatment includes rehydration and recovery is expected. A second exposure to the virus can result in Dengue ...
... Educators Search English Español A Kid's Guide to Fever KidsHealth / For Kids / A Kid's Guide to Fever ... change into some lighter-weight pajamas. Fighting a Fever For almost all kids, fevers aren't a ...
Şahan, Berna; Tatlıpınar, Sinan; Marangoz, Deniz; Çiftçi, Ferda
Dengue fever is a flavivirus infection transmitted through infected mosquitoes, and is endemic in Southeast Asia, Central and South America, the Pacific, Africa and the Eastern Mediterranean region. A 41-year-old male patient had visual impairment after travelling to Thailand, which is one of the endemic areas. Cotton wool spots were observed on fundus examination. Fundus fluorescein angiography showed minimal vascular leakage from areas near the cotton wool spots and dot hemorrhages in the macula. Dengue fever should be considered in patients with visual complaints who traveled to endemic areas of dengue fever.
Background: Familial Mediterranean fever (FMF) which is an autosomal recessive condition that primarily affect population of the Mediterranean basin. If undiagnosed effectively and treated with colchicine for life it may lead to serious consequences in terms of renal amyloidosis and renal failure. Objectives: We aim to check ...
Learning is always a joyful experience for any human being and must always remain so. Children are happiest when they learn through play. The philosophy of my life is to keep encouraging children to think beyond they could achieve easily. I understand children are adaptive to change and take things with an open mind. They are ready to experiment new things and dare to dream big. I am fortunate to be a teacher by profession and thus I always attempt experimenting, observing and participating with other children and adults. Education is not about moulding children the way you think they should be. It is about organizing the natural longing in a human being to know. From birth children are active participants in building their own understanding. I always prepare the environment to help each child build on what they already know. It is such a great pleasure to observe every young kid become excited and curious to know when we teach them. Std 8 Geography the students are very excited to learn about this continent, with the help of Videos and a wall map the Political map of Europe with its countries shown I introduced the topic by asking 'If given a chance which place they would like to visit in Europe' , students are familiar with the countries of their favourite football players and happily pointed out their destination. The Mediterranean Region is a paradise the scenic beauty, the climate, the food along with a variety of fruits which are totally different from Asia increased the curiosity among the students. With the help of case study of the Mediterranean Sea the students were able to research and present the history, the adventure sports the aquatic life and the twenty three beautiful islands located in the Mediterranean Sea. Photos and videos helped me to explain the Mediterranean Sea The Formation of the Mediterranean Sea ( Youtube Video) which is otherwise completely enclosed by land. (The evaporating Mediterranean Sea - BBC (Video) Gibraltar Breach.mov . The
Full Text Available Colchicine is frequently used in the treatment of familial Mediterranean fever (FMF. First symptoms of colchicine intoxication are gastrointestinal disturbances, such as abdominal cramps, diarrhea, pancytopenia and so on. Herein, we report a female FMF patient with pancytopenia and hemophagocytic lymphohitiocytosis (HLH, following colchicine intoxication for committing suicide. To our knowledge, this is the first reported case of a patient with HLH associated with colchicine intoxication.
... fever, dengue, Omsk haemorrhagic fever, Kyasanur forest disease). Ebola virus disease outbreak in West Africa in 2014-2015 All information on Ebola virus disease Ebola features map Dashboard - Progress update ...
... spread by domestic and wild animals and ticks. Causes Q fever is caused by the bacteria Coxiella burnetii , which ... Prevention Pasteurization of milk destroys the bacteria that cause early Q fever. Domestic animals should be inspected for signs of ...
Koch, Anders; Svendsen, Claus Bo; Christensen, Jens Jorgen
We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection.......We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection....
... Español Text Size Email Print Share Rat Bite Fever Page Content Article Body Rat-bite fever is a disease that occurs in humans who ... ingestion of contaminated food or milk products (Haverhill fever). Most cases in the United States are caused ...
Suprakash Chaudhury; Biswajit Jagtap; Deepak Kumar Ghosh
An 18-year-old male student developed abnormal behavior while undergoing treatment for dengue fever. He was ill-kempt, irritable and had auditory and visual hallucinations and vague persecutory delusions in clear sensorium with impaired insight. The psychotic episode had a temporal correlation with dengue fever. Psychiatric comorbidities of dengue fever including mania, anxiety, depression, and catatonia are mentioned in literature but the literature on the psychosis following dengue is spars...
Full Text Available This paper presents the modeling and design of ultra high capacity Space Division Multiplexing (SDM transmission system. Polarization Division Multiplexing (PDM and Dense Wavelength Division Multiplexing (DWDM techniques are also proposed in this system to increase total system data rate. For the ultra-high capacity need of SDM, Few Mode Fiber (FMF was proposed as SDM best technology for obtaining ultra-high bit rates with long haul transmission. The description and design of 8-DWDM channels over 7 modes SDM/PDM system was explored as future of ultra-high capacity optical network. A long-haul transmission of 1080 Km recorded for 8-WDM channels-7modes-SDM/PDM system by using QPSK modulation format. The total bit rate achieved by our designed system is 4.48 Tb/s at 40Gb/s. Channel estimation techniques were proposed to enable the transmitter pre-shaping design for the linear effects mitigation by using different DSP algorithms. The presence of linear and nonlinear losses limits the acceptable range of input power that produce the required BER for our proposed system from -4dBm to 4dBm.
Bleeker-Rovers, C.P.; Meer, J.W.M. van der; Oyen, W.J.G.
Fever of unknown origin (FUO) often is defined as a fever greater than 38.3 degrees C on several occasions during at least 3 weeks with uncertain diagnosis after a number of obligatory tests. In general, infection accounts for approximately one-fourth of cases of FUO, followed by neoplasm and
Fabiansen, Christian; Thybo, Søren
A case of fatal hemorrhagic Rift Valley fever during an epidemic in Kenya's North Eastern Province in January 2007 is described.......A case of fatal hemorrhagic Rift Valley fever during an epidemic in Kenya's North Eastern Province in January 2007 is described....
Johansen, Jakob Aaquist; Thybo, Søren
The incident of spotted fever imported to Denmark is unknown. We present a classic case of African Tick Bite Fever (ATBF) to highlight a disease, which frequently infects wildlife enthusiasts and hunters on vacation in South Africa. ATBF has a good prognosis and is easily treated with doxycyclin...
Gaastra, W.; Boot, R.G.A.; Ho, H.; Lipman, L.J.A.
Rat bite fever (RBF) is a bacterial zoonosis for which two causal bacterial species have been identified: Streptobacillis moniliformis and Spirillum minus. Haverhill fever (HF) is a form of S. moniliformis infection believed to develop after ingestion of contaminated food or water. Here the
Brett-Major, David M; Claborn, David M
Sand fly fever has severely impacted military missions in southern Europe and the Middle East for hundreds of years. After a brief respite following the malaria eradication programs of World War II, it has returned as a significant disease among residents in and travelers to the Mediterranean rim. It is a more severe disease now, with potential vectors in the United States. Sand fly fever is discussed in terms of its viruses, vectors, disease, control, and potential domestic impact.
N. N. Zvereva
Full Text Available Currently in Russia number of cases of dengue fever in adults grows up, whereas in endemic areas, due to the wide spread of the disease is more common in children, which symptoms has its own characteristics. In the article is reviewed a clinical case of girl living in Moscow who has been returned from the Thailand vacation — the first registered case of dengue fever in childhood. In the article were discussed the problems of diagnostics of the disease, an algorithm for diagnosis of dengue fever.
Full Text Available Dengue fever, also known as break bone fever, is a mosquito-borne infection that causes a severe flu-like illness. During the last few years, there had been increasing reports of dengue fever with unusual manifestations, primarily with neurological symptoms. Psychiatric morbidity during acute dengue infection has rarely been reported. There has not been any systemic study mentioning the prevalence and pattern of psychiatric sequelae. We report a 28-year-old male who after an acute dengue infection developed an episode of mania which was successfully treated.
Odio, W T; Mangalaboyi, L J; M'Belepe, M R; Ditu, M S
The causes of fever were attempted to identify in a prospective study on 300 adult in- and outpatients with fever at Kinshasa Teaching Hospital, Zaire. Infection was by far the primary cause of fever (87%). Tuberculosis occurred in 15% of the inpatients. Malaria was the most frequent febrile disease: one fever in two was malaria. Connective tissue diseases and neoplasms were rare.
Giaccaria, P.; Minca, C.
This paper is a critical review of Italian and French Mediterranean studies from a postcolonial and geographical perspective. It claims that the relationship between contemporary Mediterranean geographies and mainstream European modernities has been overlooked by the Mediterraneanist literature, a
Ikegami, Tetsuro; Makino, Shinji
Rift Valley fever virus (RVFV), which belongs to the genus Phlebovirus, family Bunyaviridae, is a negative-stranded RNA virus carrying a tripartite RNA genome. RVFV is transmitted by mosquitoes and causes large outbreaks among ruminants and humans in Africa and the Arabian Peninsula. Human patients develop an acute febrile illness, followed by a fatal hemorrhagic fever, encephalitis or ocular diseases, whereas ruminants experience abortions during outbreak. Effective vaccination of both human...
Torreggiani, Sofia; Filocamo, Giovanni; Esposito, Susanna
Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time.
We describe a case of Rickettsia conorii that was complicated with hearing loss and did not respond to specific treatment. Hearing loss is a rare event, but clinicians should be aware of this complication.
Anorexia. 2 (14.3). 9 (13.8). 12 (12.5). 0.965. 0.851. 0.803. Chest pain. 2 (14.3). 12 (18.5). 12 (12.5). 0.988. 0.851. 0.297. Headache. 2 (14.3). 8 (12.3). 9 (9.4). 0.839. 0.630. 0.552. Myalgia. 2 (14.3). 11 (16.9). 4 (4.2). 0.809. 0.168. 0.014. Splenomegaly. 2 (14.3). 2 (3.1). 2 (2.1). 0.142. 0.078. 0.691. Family history of renal failure.
... Department of Medical Genetics, Süleyman Demirel University, 32260 Isparta, Turkey; Department of Medical Genetics, Süleymaniye Education and Training Hospital, 34116 Istanbul, Turkey; Department of Medical Genetics, Süleyman Demirel University, 32260 Isparta, Turkey; Medical Faculty, Department of Pediatrics, ...
Chu, David I; Lipkin, Michael E; Wang, Agnes J
OBJECTIVE: To compare the risks of fever from different lithotrites after percutaneous nephrolithotomy (PNL). MATERIALS AND METHODS: The Clinical Research Office of the Endourological Society (CROES) PNL database is a prospective, multi-institutional, international PNL registry. Of 5,803 total...... patients, 4,968 received preoperative antibiotics, were supplied with complete information and included in this analysis. The lithotrites assessed included no fragmentation, ultrasonic, laser, pneumatic and combination ultrasonic/pneumatic. Risk of fever was estimated using multivariate logistic regression...... with adjustment for diabetes, steroid use, a history of positive urine culture, the presence of staghorn calculi or preoperative nephrostomy, stone burden and lithotrite. RESULTS: The overall fever rate was 10%. Pneumatic lithotrites were used in 43% of the cohort, followed by ultrasonic (24%), combination...
... Read MoreDepression in Children and TeensRead MoreBMI Calculator Fever in Infants and ChildrenBecause young children are not ... Facial Swelling Feeding Problems in Infants and Children Fever Fever in Infants and Children Foot Problems Genital ...
... YFV transmission is present,” as defined by the World Health Organization, are countries or areas where “yellow fever has ... this table are not contained on the official World Health Organization list of countries with risk of YFV transmission ( ...
McDermott, MF; Frenkel, J
Hereditary periodic fever syndromes are defined by recurrent attacks of generalised inflammation for which no infectious or auto-immune cause can be identified. For most of these disorders, the molecular basis has recently been elucidated. This has opened the prospect of novel therapeutic
Dr. Duc Vugia, chief of the Infectious Diseases Branch in the California Department of Public Health, discusses Valley Fever. Created: 2/4/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 2/5/2014.
... Safe Videos for Educators Search English Español Seasonal Allergies (Hay Fever) KidsHealth / For Parents / Seasonal Allergies (Hay ... español Alergia estacional (fiebre del heno) About Seasonal Allergies "Achoo!" It's your son's third sneezing fit of ...
Tomas, Carmen; Sanchez Sanchez, Juan Jose; Barbaro, A.
genetically from the rest of the populations in the Mediterranean area. This result supports the hypothesis of a low incidence of the south-north genetic interchange at the western shores of the Mediterranean basin. A low genetic distance was found between populations in the Middle East and the western part...
Syert Luidolf Nienhuis
Full Text Available Introduction. FMF (Familial Mediterranean Fever is characterized by recurrent attacks of fever and articular pain. Enthesitis is the hallmark of pain in spondyloarthropathy. Literature suggests association of M694V mutation and enthesitis. We report a case of a 16-year-old boy with enthesitis and FMF. Case Presentation. A 16-year-old boy of Turkish origin with a history of FMF presented with localized tenderness of the heel and severe disability. MRI showed an enthesitis of the plantar fascia. Standard treatment of FMF and enthesitis was not successful. After referral to a university hospital and expert opinion of a professor in rheumatology, this enthesitis should be treated as an enthesitis related arthritis. With this treatment, our patient fully recovered 8 months after the onset of the disease symptoms. Conclusion. M694V mutation related enthesitis should be considered in FMF patients with enthesitis. We would suggest treatment for enthesitis related arthritis in similar cases. This is of clinical importance because the treatment is different from treatment of enthesitis or articular pain caused by FMF.
Horcada, M Loreto; Díaz-Calderón, Carlos; Garrido, Laura
Chikungunya fever is a viral disease caused by an alphavirus belonging to the Togaviridae family, transmitted by several species of Aedes mosquitoes: Aedes aegypti and Aedes albopictus (A. albopictus). It is endemic in Africa and Asia with recurrent outbreaks. It is an emerging disease and cases in Europe transmitted by A. albopictus have been established in Mediterranean areas. The first autochthonous cases detected on the Caribbean islands suppose a serious threat of spreading disease to America, which so far has been disease free. Clinical symptoms begin abruptly with fever, skin rash and polyarthritis. Although mortality is low, a high percentage of patients develop a chronic phase defined by persistent arthritis for months or even years. A severe immune response is responsible for joint inflammation. The absence of specific treatment and lack of vaccine requires detailed studies about its immunopathogenesis in order to determine the most appropriate target. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Feldmann, Heinz; Geisbert, Thomas W
Ebola viruses are the causative agents of a severe form of viral haemorrhagic fever in man, designated Ebola haemorrhagic fever, and are endemic in regions of central Africa. The exception is the species Reston Ebola virus, which has not been associated with human disease and is found in the Philippines. Ebola virus constitutes an important local public health threat in Africa, with a worldwide effect through imported infections and through the fear of misuse for biological terrorism. Ebola virus is thought to also have a detrimental effect on the great ape population in Africa. Case-fatality rates of the African species in man are as high as 90%, with no prophylaxis or treatment available. Ebola virus infections are characterised by immune suppression and a systemic inflammatory response that causes impairment of the vascular, coagulation, and immune systems, leading to multiorgan failure and shock, and thus, in some ways, resembling septic shock. PMID:21084112
Rajapakse, Senaka; Rodrigo,Chaturaka; Rajapakse,Anoja Chamarie
Senaka Rajapakse,1,2 Chaturaka Rodrigo,1 Anoja Rajapakse31Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka; 2Lincoln County Hospital, United Lincolnshire NHS Trust, Lincoln, UK; 3Kings Mill Hospital, Sherwood Forest NHS Foundation Trust, Mansfield, UKAbstract: The endemic area for dengue fever extends over 60 countries, and approximately 2.5 billion people are at risk of infection. The incidence of dengue has multiplied many times over the last five decad...
Full Text Available Coxiella burnetii is the bacterium that causes Q fever. Human infection is mainly transmitted from cattle, goats and sheep. The disease is usually self-limited. Pneumonia and hepatitis are the most common clinical manifestations. In this study, we present a case of Q fever from the western part of Turkey mimicking Crimean-Congo haemorrhagic fever (CCHF in terms of clinical and laboratory findings.
Pasikhova, Yanina; Ludlow, Steven; Baluch, Aliyah
The definition of fever is flexible and depends on the clinical context. Fever is frequently observed in patients with cancer. Infectious and noninfectious causes of fever in patients with various oncological and hematological malignancies and the usefulness of biomarkers are discussed. To treat patients in a timely manner and to minimize morbidity and mortality, it is paramount that health care professionals determine the cause of fever. The usefulness of biomarkers in febrile patients with cancer continues to be controversial. Fever is frequently seen in patients with cancer and can be associated with a variety of infectious and noninfectious causes. The utility of acute-phase reactants, such as erythrocyte sedimentation rate, C-reactive protein, and procalcitonin, along with a nonsteroidal anti-inflammatory drug challenge should be further evaluated as adjunct tools for the workup of fever in patients with cancer.
Cattle fever tick, Rhipicephalus annulatus (CFT), is a hard tick native to the Mediterranean region that is invasive in the southwestern USA. The tick is known to develop on cattle and white tailed deer, and it transmits two lethal diseases, piroplasmosis and babesiosis. Extensive use of acaricides...
Gubler, Duane J.
Dengue fever, a very old disease, has reemerged in the past 20 years with an expanded geographic distribution of both the viruses and the mosquito vectors, increased epidemic activity, the development of hyperendemicity (the cocirculation of multiple serotypes), and the emergence of dengue hemorrhagic fever in new geographic regions. In 1998 this mosquito-borne disease is the most important tropical infectious disease after malaria, with an estimated 100 million cases of dengue fever, 500,000...
0.05) comparing to HC group. However, there were no statistically significant differences between the groups in terms of antioxidant vitamin levels. Conclusions: Our study demonstrated increased oxidative stress in patients with FMF during AP.
Wing, Robyn; Dor, Maya R; McQuilkin, Patricia A
Fever is the most common reason that children and infants are brought to emergency departments. Emergency physicians face the challenge of quickly distinguishing benign from life-threatening conditions. The management of fever in children is guided by the patient's age, immunization status, and immune status as well as the results of a careful physical examination and appropriate laboratory tests and radiographic views. In this article, the evaluation and treatment of children with fevers of known and unknown origin are described. Causes of common and dangerous conditions that include fever in their manifestation are also discussed. Copyright © 2013 Elsevier Inc. All rights reserved.
Burnett, Mark W
Ebola hemorrhagic fever is an often-fatal disease caused by a virus of the Filoviridae family, genus Ebolavirus. Initial signs and symptoms of the disease are nonspecific, often progressing on to a severe hemorrhagic illness. Special Operations Forces Medical Providers should be aware of this disease, which occurs in sporadic outbreaks throughout Africa. Treatment at the present time is mainly supportive. Special care should be taken to prevent contact with bodily fluids of those infected, which can transmit the virus to caregivers. 2014.
Objective: To study the incidence of tick borne relapsing fever (TBRF) during the last 50 years, once like malaria an endemic disease in Sengerema, Tanzania. Design: By analyzing the annual reports, focusing on the number of admissions, maternal deaths, blood smears of patients with fever for Borrelia.
M.E. Fenn; E.B. Allen; L.H. Geiser
The Mediterranean California ecoregion (CEC 1997; Fig 2.2) encompasses the greater Central Valley, Sierra foothills, and central coast ranges of California south to Mexico and is bounded by the Pacific Ocean, Sierra Nevada Mountains and Mojave Desert.
... Cardiovascular Conditions What About My Child and Rheumatic Fever? Rheumatic fever is an inflammatory reaction that can occur after ... strep throat infections don’t lead to rheumatic fever. When they do, the time between the strep ...
Ter Haar, Nienke; Lachmann, Helen; Özen, Seza
diseases were included: familial Mediterranean fever (FMF), cryopyrin-associated periodic syndromes (CAPS), tumour necrosis factor (TNF)-receptor associated periodic syndrome (TRAPS), mevalonate kinase deficiency (MKD), pyogenic arthritis pustulosis acne (PAPA) syndrome, deficiency of interleukin-1...... on demand probably represent a valid therapeutic strategy for PFAPA, but also for MKD and TRAPS. Patients with poorly controlled MKD, TRAPS, PAPA or FMF may benefit from IL-1 blockade; anti-TNF treatment may represent a possible valuable alternative. CONCLUSIONS: In the absence of high-grade evidence...
Pedro Fernando da Costa Vasconcelos
Full Text Available A febre amarela é doenca infecciosa não-contagiosa causada por um arbovírus mantido em ciclos silvestres em que macacos atuam como hospedeiros amplificadores e mosquitos dos gêneros Aedes na África, e Haemagogus e Sabethes na América, são os transmissores. Cerca de 90% dos casos da doença apresentam-se com formas clínicas benignas que evoluem para a cura, enquanto 10% desenvolvem quadros dramáticos com mortalidade em torno de 50%. O problema mostra-se mais grave em África onde ainda há casos urbanos. Nas Américas, no período de 1970-2001, descreveram-se 4.543 casos. Os países que mais diagnosticaram a doença foram o Peru (51,5%, a Bolívia (20,1% e o Brasil (18,7%. Os métodos diagnósticos utilizados incluem a sorologia (IgM, isolamento viral, imunohistoquímica e RT-PCR. A zoonose não pode ser erradicada, mas, a doença humana é prevenível mediante a vacinação com a amostra 17D do vírus amarílico. A OMS recomenda nova vacinação a cada 10 anos. Neste artigo são revistos os principais conceitos da doença e os casos de mortes associados à vacina.Yellow fever is an infectious and non-contagious disease caused by an arbovirus, the yellow fever virus. The agent is maintained in jungle cycles among primates as vertebrate hosts and mosquitoes, especially Aedes in Africa, and Haemagogus and Sabethes in America. Approximately 90% of the infections are mild or asymptomatic, while 10% course to a severe clinical picture with 50% case-fatality rate. Yellow fever is largely distributed in Africa where urban epidemics are still reported. In South America, between 1970-2001, 4,543 cases were reported, mostly from Peru (51.5%, Bolivia (20.1% and Brazil (18.7%. The disease is diagnosed by serology (detection of IgM, virus isolation, immunohistochemistry and RT-PCR. Yellow fever is a zoonosis and cannot be eradicated, but it is preventable in man by using the 17D vaccine. A single dose is enough to protect an individual for at least
Azevedo, Raimunda S.S.; Silva, Eliana V.P.; Carvalho, Valéria L.; Rodrigues, Sueli G.; Neto, Joaquim P. Nunes; Monteiro, Hamilton A.O.; Peixoto, Victor S.; Chiang, Jannifer O.; Nunes, Márcio R.T.
In February 2008, a Mayaro fever virus (MAYV) outbreak occurred in a settlement in Santa Barbara municipality, northern Brazil. Patients had rash, fever, and severe arthralgia lasting up to 7 days. Immunoglobulin M against MAYV was detected by ELISA in 36 persons; 3 MAYV isolates sequenced were characterized as genotype D. PMID:19891877
Sarih, M’hammed; Garnier, Martine; Boudebouch, Najma; Bouattour, Ali; Rihani, Abdelaziz; Hassar, Mohammed; Gern, Lise; Postic, Danièle
We found that 20.5% of patients with an unexplained fever in northwestern Morocco had tick-borne relapsing fever. Molecular detection specific for the 16S rRNA gene identified Borrelia hispanica. The noncoding intergenic spacer sequence domain showed high sensitivity and good resolution for this species. PMID:19861058
The experiments reported here were carried on in the main with passage strains of Bartonella bacilliformis, and the results indicate that the virulence of the organism has been considerably enhanced by passage through susceptible animals. While the animals of the earlier experimental series showed no anemia, some of the present group manifested a definite reduction in the number of red cells and in hemoglobin, and in one instance (M. rhesus 25) anemia was of the extreme type so often associated with Oroya fever in man. The anemic condition appeared to be secondary in character, however, nucleated red cells being few in number. In this animal also Bartonella bacilliformis was readily demonstrated in the erythrocytes by means of stained smears, though the number of cells invaded by the parasites was by no means so great as in the human infection. In most instances of experimental Bartonella infection so far induced the demonstration of the parasites by ordinary routine examination of stained film preparations is possible only when the titer of the blood exceeds 1:1,000. Prolonged search of many slides has not been attempted, however. The number of microorganisms in the blood, as shown by culture tests of ascending dilutions, was in most instances highest (1:100,000 to 1:10,000,000) during the early period of the infection coincident usually with the period of highest fever, falling to a titer of 1:10 during the last half of the disease. In one of the fatally infected monkeys, however, the titer increased from 1:10 on the 4th day to 1:1,000,000 on the 24th day. The titer of the blood was equally great in Monkeys 5 and 6, although the former was inoculated locally, the other intravenously and intraperitoneally. The largest proportion of infected red cells was found in Monkey 25, while the blood titer, as shown by culture test, was highest in Monkey 7. The febrile reaction varied in the animals of this series from a severe continuous fever of 104–105°F., lasting 2 to
This Forum aims to uncover the socio-politics of the ‘migration crisis’ in the Mediterranean. The contributions explore the idea of the ‘migration crisis’ or ‘refugee crisis’ in the Mediterranean from the starting point that as scholars of the Mediterranean we can do two things: one, we can look at
Verma, Rajesh; Bharti, Kavita; Mehta, Mannan; Bansod, Amrit
Dengue infection is gradually disseminating throughout the world in alarming proportions. It is a arbovirus infection,transmitted by aedes mosquitoes. It is a multi-systemic disorder associated with varied neurological complications. There is increased trend of development of neurological complications in dengue fever. The neurological complications arising due to dengue infection can be categorized into central and neuromuscular complications. The central nervous system disorders reported with dengue fever are encephalopathy,encephalitis and myelitis.Here we report a case of rhombencephalitis associated with dengue fever. The literature does not mention rhombencephalitis occurring with dengue illness. Copyright © 2016 Elsevier B.V. All rights reserved.
Martin, V; Chevalier, V; Ceccato, P; Anyamba, A; De Simone, L; Lubroth, J; de La Rocque, S; Domenech, J
Climate change is likely to change the frequency of extreme weather events, such as tropical cyclones, floods, droughts and hurricanes, and may destabilise and weaken the ecosystem services upon which human society depends. Climate change is also expected to affect animal, human and plant health via indirect pathways: it is likely that the geography of infectious diseases and pests will be altered, including the distribution of vector-borne diseases, such as Rift Valley fever, yellow fever, malaria and dengue, which are highly sensitive to climatic conditions. Extreme weather events might then create the necessary conditions for Rift Valley fever to expand its geographical range northwards and cross the Mediterranean and Arabian seas, with an unexpected impact on the animal and human health of newly affected countries. Strengthening global, regional and national early warning systems is crucial, as are co-ordinated research programmes and subsequent prevention and intervention measures.
My school (1o EPAL Ymittos -Athens, Greece) is a technical school of secondary education and throughout this school year being drafted a program of environmental education. The main theme is the Mediterranean Sea, the biggest closed sea extending between three continents. Topics studied: 1. Biodiversity and the risks threat. 2. The geophysics that characterize (earthquakes, volcanoes explosions, etc). 3. The Mediterranean Sea as environment anthropogenesis, a mosaic of other cultures and even place current notions of social phenomena (refugees). Pedagogical Objectives: Cognitive/Enviromental: 1. To investigate and understand the biodiversity of the Mediterranean Sea and the risks to threaten and phenomena that characterize. 2. To understand the position of the Mediterranean Sea in the land and the role of the historical, cultural and social human environment. 3. To come in contact with texts literary, social, articles on the Mediterranean. Psychomotor: 1. To work together and collect information for the Mediterranean Sea. 2. Experiential approach to the natural environment. 3. Develop critical thinking. 4. Undertake responsibilities for the presentation of the program. Emotional: 1. To feel joy from participation in the program. 2. Being sensitized and configure attitudes and actions of respect towards the environment. Methodology implementation: Teamwork. Interdisciplinary - holistic to dissemination of program recordings to courses curriculum. Study in the field. Gathering information from newspapers, magazines, internet, maps, and photographs. Experiential method- Project. Assessment methods and self-assessment. Fields of courses: Greek language- History- Biology- Chemistry- Technology Dissemination of results: Make a page of social media (facebook), a blog, enhancing environmental awareness via video, make an electronic poster.
The EU and 12 countries of the Middle East and North Africa (MENA) engaged in 1995 in the Euro-Mediterranean Partnership (EMP) in political, economic and cultural matters with the aim to foster cooperation, stability and prosperity around the Mediterranean Basin. The Economic and Financial...... Partnership (EFP) plays a central role in the EMP design and implementation, which is centered on economic and trade integration as a starting point for and an anchor of socio-economic development in the MENA region. Against this background, this paper reviews the situation in the MENA partner countries...
MRC Symposium (1977).Thorax, 32, 653-663. Humidifier fever. In enclosed environments, it may be necessary to regulate temperature, ventilation, and humidity to maintain comfortable working conditions. Several systems can be used although in terms of installation and running costs a simple radiator system is far more economical than air conditioning with complete temperature and humidity control. Humidity control requires the introduction of water into a moving current of air, and in such a system baffle plates are often used to eliminate large droplets; also any unused water is usually recirculated. Organic dust drawn into the system and settling on the baffle plates and in the mixing chamber may be utilised by micro-organisms introduced from the atmosphere and from the water supply, and a biomass builds up. Microbial material is then voided into the working atmosphere by the ventilation system. Under appropriate exposure conditions susceptible individuals may succumb to an episode of humidifier fever, an influenza-like illness with pyrexia and malaise as the main symptoms, but cough, chest tightness, dyspnoea and weight loss may also be seen. The episodes usually occur after absence from work for a few days and have been termed `Monday sickness'. Individuals are often able to return to work the next day and appear refractory to further exposure. The disease is of the winter months probably due to the larger amount (up to 90%) of fresh air drawn into the humidifier during the summer. In the blood of exposed subjects precipitins are usually present to extracts of baffle plate material and recirculating water although they are not necessarily indicative of disease. Skin tests may be positive and inhalation challenge has reproduced the disease in susceptible individuals. Many organisms may be isolated from baffle plates and recirculating water but only amoeba extracts have produced consistently positive reactions with sera from affected individuals. Remedial actions
Full Text Available Senaka Rajapakse,1,2 Chaturaka Rodrigo,1 Anoja Rajapakse31Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka; 2Lincoln County Hospital, United Lincolnshire NHS Trust, Lincoln, UK; 3Kings Mill Hospital, Sherwood Forest NHS Foundation Trust, Mansfield, UKAbstract: The endemic area for dengue fever extends over 60 countries, and approximately 2.5 billion people are at risk of infection. The incidence of dengue has multiplied many times over the last five decades at an alarming rate. In the endemic areas, waves of infection occur in epidemics, with thousands of individuals affected, creating a huge burden on the limited resources of a country's health care system. While the illness passes off as a simple febrile episode in many, a few have a severe illness marked by hypovolemic shock and bleeding. Iatrogenic fluid overload in the management may further complicate the picture. In this severe form dengue can be fatal. Tackling the burden of dengue is impeded by several issues, including a lack of understanding about the exact pathophysiology of the infection, inability to successfully control the vector population, lack of specific therapy against the virus, and the technical difficulties in developing a vaccine. This review provides an overview on the epidemiology, natural history, management strategies, and future directions for research on dengue, including the potential for development of a vaccine.Keywords: dengue, treatment, fluid resuscitation
I am a science teacher at a primary school and my students are very interested in science. Through this year I will work with my students, organizing several workshops and or results will be presented on poster. I will work with several groups (4-6) students 8th grade. In this poster all activities will be presented, showing how science is easy to learn even in a classroom. 1. Workshop > Chemical characteristic of sea water Using school laboratory each group of students will analyze the physical and chemical characteristic of sea water and they have to explain the results to younger student's 5th and 6th grade. The final result will be presented on poster. 2. Workshop> Meet the Mediterranean life During this workshop students will work in different groups. The aim of the workshop is to meet lots of species that we can find in Mediterranean using movies, phone applications, internet explorer, science books and school collections of invertebrates … 3. Workshop>Stop the pollution Several groups of students have to debate about causes of pollution and possibilities for prevention. At the end of workshop we will organize a quiz. Student's answers and suggestions will be shown on the poster. 4. Workshop> How we see the Mediterranean During this workshop students will make models of Mediterranean in 2d and 3d perspective, using different materials. They can show on models parts of Mediterranean area, country, sea... After making models students need to visit 5th and 6th grade classes, to show them and explain the final results. Few models will be presented on poster
Dayal, Rajeshwar; Agarwal, Dipti
Fever is the most common symptom in children and can be classified as fever with or without focus. Fever without focus can be less than 7 d and is subclassified as fever without localizing signs and fever of unknown origin (FUO). FUO is defined as a temperature greater than 38.3 °C, for more than 3 wk or failure to reach a diagnosis after 1 wk of inpatient investigations. The most common causes of FUO in children are infections, connective tissue disorders and neoplasms. Infectious diseases most commonly implicated in children with FUO are salmonellosis, tuberculosis, malaria and rickettsial diseases. Juvenile rheumatic arthritis is the connective tissue disease frequently associated with FUO. Malignancy is the third largest group responsible for FUO in children. Diagnostic approach of FUO includes detailed history and examination supported with investigations. Age, history of contact, exposure to wild animals and medications should be noted. Examination should include, apart from general appearance, presence of sweating, rashes, tonsillitis, sinusitis and lymph node enlargement. Other signs such as abdominal tenderness and hepatosplenomegly should be looked for. The muscles and bones should be carefully examined for connective tissue disorders. Complete blood count, blood smear examination and level of acute phase reactants should be part of initial investigations. Radiological imaging is useful aid in diagnosing FUO. Trials of antimicrobial agents should not be given as they can obscure the diagnosis of the disease in FUO.
Date, Kashmira A; Bentsi-Enchill, Adwoa; Marks, Florian; Fox, Kimberley
Typhoid vaccination is an important component of typhoid fever prevention and control, and is recommended for public health programmatic use in both endemic and outbreak settings. We reviewed experiences with various vaccination strategies using the currently available typhoid vaccines (injectable Vi polysaccharide vaccine [ViPS], oral Ty21a vaccine, and injectable typhoid conjugate vaccine [TCV]). We assessed the rationale, acceptability, effectiveness, impact and implementation lessons of these strategies to inform effective typhoid vaccination strategies for the future. Vaccination strategies were categorized by vaccine disease control strategy (preemptive use for endemic disease or to prevent an outbreak, and reactive use for outbreak control) and vaccine delivery strategy (community-based routine, community-based campaign and school-based). Almost all public health typhoid vaccination programs used ViPS vaccine and have been in countries of Asia, with one example in the Pacific and one experience using the Ty21a vaccine in South America. All vaccination strategies were found to be acceptable, feasible and effective in the settings evaluated; evidence of impact, where available, was strongest in endemic settings and in the short- to medium-term. Vaccination was cost-effective in high-incidence but not low-incidence settings. Experience in disaster and outbreak settings remains limited. TCVs have recently become available and none are WHO-prequalified yet; no program experience with TCVs was found in published literature. Despite the demonstrated success of several typhoid vaccination strategies, typhoid vaccines remain underused. Implementation lessons should be applied to design optimal vaccination strategies using TCVs which have several anticipated advantages, such as potential for use in infant immunization programs and longer duration of protection, over the ViPS and Ty21a vaccines for typhoid prevention and control. Copyright © 2015. Published by
Xie, Yingda; Pope, Bailey A; Hunter, Alan J
Fever and leukocytosis have many possible etiologies in injection drug users. We present a case of a 22-year-old woman with fever and leukocytosis that were presumed secondary to cotton fever, a rarely recognized complication of injection drug use, after an extensive workup. Cotton fever is a benign, self-limited febrile syndrome characterized by fevers, leukocytosis, myalgias, nausea and vomiting, occurring in injection drug users who filter their drug suspensions through cotton balls. While this syndrome is commonly recognized amongst the injection drug user population, there is a paucity of data in the medical literature. We review the case presentation and available literature related to cotton fever.
Martins, Reinaldo M.; Maia, Maria de Lourdes S.; Farias, Roberto Henrique G.; Camacho, Luiz Antonio B.; Freire, Marcos S.; Galler, Ricardo; Yamamura, Anna Maya Yoshida; Almeida, Luiz Fernando C.; Lima, Sheila Maria B.; Nogueira, Rita Maria R.; Sá, Gloria Regina S.; Hokama, Darcy A.; de Carvalho, Ricardo; Freire, Ricardo Aguiar V.; Filho, Edson Pereira; Leal, Maria da Luz Fernandes; Homma, Akira
Objective: To verify if the Bio-Manguinhos 17DD yellow fever vaccine (17DD-YFV) used in lower doses is as immunogenic and safe as the current formulation. Results: Doses from 27,476 IU to 587 IU induced similar seroconversion rates and neutralizing antibodies geometric mean titers (GMTs). Immunity of those who seroconverted to YF was maintained for 10 mo. Reactogenicity was low for all groups. Methods: Young and healthy adult males (n = 900) were recruited and randomized into 6 groups, to receive de-escalating doses of 17DD-YFV, from 27,476 IU to 31 IU. Blood samples were collected before vaccination (for neutralization tests to yellow fever, serology for dengue and clinical chemistry), 3 to 7 d after vaccination (for viremia and clinical chemistry) and 30 d after vaccination (for new yellow fever serology and clinical chemistry). Adverse events diaries were filled out by volunteers during 10 d after vaccination. Volunteers were retested for yellow fever and dengue antibodies 10 mo later. Seropositivity for dengue was found in 87.6% of volunteers before vaccination, but this had no significant influence on conclusions. Conclusion: In young healthy adults Bio-Manguinhos/Fiocruz yellow fever vaccine can be used in much lower doses than usual. International Register ISRCTN 38082350. PMID:23364472
This fact , coupled with the continued operatir%._l interest there, makes the issuance of an up-date to the Atie .7orthwhile. (U) In order to serve the...characteristics from wind conditions has long interested wave theoreticians and forecasters. These specialists have developed various graphs, tables, and...the Mediterranean. Under the proper environmental conditions, micro- scopic and larger protozoans, crustaceans, and jellyfishes responsible for
Full Text Available Phleboviruses transmitted by sandflies are endemic in the Mediterranean area. The last decade has witnessed the description of an accumulating number of novel viruses. Although, the risk of exposure of vertebrates is globally assessed, detailed geographic knowledge is poor even in Greece and Cyprus where sandfly fever has been recognized for a long time and repeatedly. A total of 1,250 dogs from mainland Greece and Greek archipelago on one hand and 422 dogs from Cyprus on the other hand have been sampled and tested for neutralising antibodies against Toscana virus (TOSV, Sandfly fever Sicilian virus (SFSV, Arbia virus, and Adana virus i.e. four viruses belonging to the 3 sandfly-borne serocomplexes known to circulate actively in the Mediterranean area. Our results showed that (i SFSV is highly prevalent with 71.9% (50.7-84.9% depending on the region in Greece and 60.2% (40.0-72.6% in Cyprus; (ii TOSV ranked second with 4.4% (0-15.4% in Greece and 8.4% (0-11.4% in Cyprus; (iii Salehabad viruses (Arbia and Adana displayed also substantial prevalence rates in both countries with values ranging from 0-22.6% depending on the region and on the virus strain used in the test. These results demonstrate that circulation of viruses transmitted by sand flies can be estimated qualitatively using dog sera. As reported in other regions of the Mediterranean, these results indicate that it is time to shift these viruses from the "neglected" status to the "priority" status in order to stimulate studies aiming at defining and quantifying their medical and veterinary importance and possible public health impact. Specifically, viruses belonging to the Sandfly fever Sicilian complex should be given careful consideration. This calls for implementation of direct and indirect diagnosis in National reference centers and in hospital microbiology laboratories and systematic testing of unelucidated febrile illness and central and peripheral nervous system febrile
About 9% of the world's oil refining capacity is on the Mediterranean: some of the world's biggest and most advanced refineries are on Sicily and Sardinia. The Mediterranean refineries are important suppliers to southern Europe and N. Africa. The article discusses commercial refining in the Mediterranean under the headings of (i) historic development, (ii) product demand, (iii) refinery configurations, (iv) refined product trade, (v) financial performance and (vi) future outlook. Although some difficulties are foreseen, refining in the Mediterranean is likely to continue to be important well into the 21st century. (UK)
Seetharam, K A; Sridevi, K; Vidyasagar, P
Chikungunya fever, a re-emerging RNA viral infection produces different cutaneous manifestations in children compared to adults. 52 children with chikungunya fever, confirmed by positive IgM antibody test were seen during 2009-2010. Pigmentary lesions were common (27/52) followed by vesiculobullous lesions (16/52) and maculopapular lesions (14/52). Vesiculobullous lesions were most common in infants, although rarely reported in adults. Psoriasis was exacerbated in 4 children resulting in more severe forms. In 2 children, guttate psoriasis was observed for the first time.
Özkale, Yasemin; Özkale, Murat; Kiper, Pinar; Çetinkaya, Bilin; Erol, İlknur
Sandfly fever, also known as ‘three-day fever’ or ‘pappataci fever’ or ‘Phlebotomus fever’ is a viral infection that causes self-limited influenza-like symptoms and characterized by a rapid onset. The disease occurs commonly in endemic areas in summer months and especially in August during which sandflies are active. In this article, two siblings who presented with high fever, redness in the eyes, headache, weakness, malaise and inability to walk, who were found to have increased liver functi...
Dengue fever is a common tropical infection. This acute febrile illness can be a deadly infection in cases of severe manifestation, causing dengue hemorrhagic shock. In this brief article, I will summarize and discuss the diagnosis and treatment of this disease. For diagnosis of dengue, most tropical doctors make use of presumptive diagnosis; however, the definite diagnosis should be based on immunodiagnosis or viral study. Focusing on treatment, symptomatic and supportive treatment is the main therapeutic approach. The role of antiviral drugs in the treatment of dengue fever has been limited, but is currently widely studied.
Apr 1, 2013 ... Increase of gold mining, improved local economy, housing and standards of living after the nineties ... countries, Central Asia, the Middle East and the. Americas, tick borne relapsing fever is rare. It is often ... ten miles and 30% from over 10 miles, but inside the district. Figure 1. Admission. 30000. 25000.
Classical swine fever is a contagious often fatal disease of pigs clinically characterized by high body temperature, lethargy, yellowish diarrhea, vomits and purple skin discoloration of ears, lower abdomen and legs. It was first described in the early 19th century in the USA. Later, a condition i...
... Library ▸ Allergy Library ▸ Rhinitis TTR Share | Rhinitis (Hay Fever) Do you suffer from frequent sneezing, congestion or ... Triggers Seasonal allergic rhinitis, commonly known as hay fever, is triggered by outdoor allergens such as pollen ...
... Submit What's this? Submit Button Past Emails Scarlet Fever: A Group A Streptococcal Infection Language: English (US) ... and 15 years old. People Can Spread Scarlet Fever Germs to Others Group A strep bacteria can ...
Salerno, Giuseppe G.; Sellitto, Pasquale; Corradini, Stefano; Di Sarra, Alcide Giorgio; Merucci, Luca; Caltabiano, Tommaso; La Spina, Alessandro
Emissions of volcanic gases and particles can have profound impacts on terrestrial environment, atmospheric composition, climate forcing, and then on human health at various temporal and spatial scales. Volcanic emissions have been identified as one of the largest sources of uncertainty in our understanding of recent climate change trends. In particular, a primary role is acted by sulphur dioxide emission due to its conversion to volcanic sulphate aerosol via atmospheric oxidation. Aerosols may play a key role in the radiative budget and then in photochemistry and tropospheric composition. Mt. Etna is one of the most prodigious and persistent emitters of gasses and particles on Earth, accounting for about 10% of global average volcanic emission of CO2 and SO2. Its sulphur emissions stand for 0.7 × 106 t S/yr9 and then about 10 times bigger than anthropogenic sulphur emissions in the Mediterranean area. Centrepiece of the SMED project is to advance the understanding of volcanogenic sulphur dioxide and sulphate aerosol particles dispersion and radiative impact on the downwind Mediterranean region by an integrated approach between ground- and space-based observations and modelling. Research is addressed by exploring the potential relationship between proximal SO2 flux and aerosol measured remotely in the volcanic plume of Mt. Etna between 2000 and 2014 and distal aerosol ground-based measurements in Lampedusa, Greece, and Malta from AERONET network. Ground data are combined with satellite multispectral polar and geostationary imagers able to detect and retrieve volcanic ash and SO2. The high repetition time of SEVIRI (15 minutes) will ensure the potential opportunity to follow the entire evolution of the volcanic cloud, while, the higher spatial resolution of MODIS (1x1 km2), are exploited for investigating the probability to retrieve volcanic SO2 abundances from passive degassing. Ground and space observations are complemented with atmospheric Lagrangian model
Kaur, Paramjit; Kaur, Gagandeep
Dengue fever has emerged as a global public health problem in the recent decades. The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. The disease is characterized by increased capillary permeability, thrombocytopenia and coagulopathy. Thrombocytopenia with hemorrhagic manifestations warrants platelet transfusions. There is lack of evidence-based guidelines for transfusion support in patients with dengue fever. This contributes t...
Heilman, James M; Wolff, Jacob De; Beards, Graham M; Basden, Brian J
Dengue fever, also known as breakbone fever, is a mosquito-borne infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles. In a small proportion of cases, the disease develops into life-threatening dengue hemorrhagic fever, which results in bleeding, thrombocytopenia, and leakage of blood plasma, or into dengue shock syndrome, in which dangerously low blood pressure occurs. Treat...
Rekha; Sumangala; Ishwarya
BACKGROUND: In recent days fever with Thrombocytopenia is a common clinical presentation in the medical wards. This study has been undertaken to know the modes of clinical presentations and possible causes of fever with Thrombocytopenia. OBJECTIVE: 1. To determine possible infective etiology for fever with Thrombocytopenia. 2. To correlate clinical features, laboratory studies and infective etiology. METHODS: Case record analysis of fever with Thrombocytopenia admitted to ...
Gillow, Sabreena J; Ouyang, Bichun; Lee, Vivien H; John, Sayona
Fever is common in patients with intracerebral hemorrhage (ICH). We sought to identify predictors of fever in patients hospitalized with ICH, and compare infectious fever with noninfectious fever. A retrospective review on consecutive spontaneous ICH patients from April 2009 to March 2010 was performed. Fever was defined as temperature 100.9°F or higher and attributed to infectious versus noninfectious etiology, based upon the National Healthcare Safety Network criteria. Univariate analysis and multivariable logistic regression model were used to determine factors associated with fever and with infection. Among the 351 ICH patients, 136 (39%) developed fever. Factors associated with fever included mean ICH volume, intraventricular hemorrhage (IVH), external ventricular drain (EVD) placement or surgical evacuation, positive microbial cultures, longer length of stay (LOS), and higher in-hospital mortality. Among patients with fever, 96 (71%) were noninfectious and 40 (29%) were infectious. Infectious fever was associated with higher LOS. Noninfectious fever was associated with higher in-hospital mortality. In multivariable analysis, ICH volume (OR = 1.01, P = .04), IVH (OR = 2.0, P = .03), EVD (OR = 3.7, P fever. Infectious fever (OR = 5.26, P = .004), EVD (OR = 4.86, P = .01), and surgical evacuation (OR = 4.77, P = .04) correlated with prolonged LOS when dichotomized using a median of 15 days. Fever is common in ICH patients and is not associated with a clear infectious etiology in the majority of patients. Patients with noninfectious fever have higher in-hospital mortality, but survivors have shorter LOS. Further studies are warranted to better understand fevers in ICH. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
touching their forehead, while 21 (13.9%) used thermometer. Commonest action taken when there was fever was to administer Paracetamol (107 (70.9%)). Commonest identified complication of fever was convulsion (86(67.7%)). Conclusion: Knowledge of fever is good amongst mothers in Port Harcourt; however there is ...
Rahman, Mahbubur; Rahman, Khalilur; Siddque, A. K.; Shoma, Shereen; Kamal, A. H. M.; Ali, K. S.; Nisaluk, Ananda; Breiman, Robert F.
During the first countrywide outbreak of dengue hemorrhagic fever in Bangladesh, we conducted surveillance for dengue at a hospital in Dhaka. Of 176 patients, primarily adults, found positive for dengue, 60.2% had dengue fever, 39.2% dengue hemorrhagic fever, and 0.6% dengue shock syndrome. The Dengue virus 3 serotype was detected in eight patients.
Onyango, Clayton O.; Grobbelaar, Antoinette A.; Gibson, Georgina V.F.; Sang, Rosemary C.; Sow, Abdourahmane; Swanepoel, Robert
In May 2003, an outbreak of fatal hemorrhagic fever, caused by yellow fever virus, occurred in southern Sudan. Phylogenetic analysis showed that the virus belonged to the East African genotype, which supports the contention that yellow fever is endemic in East Africa with the potential to cause large outbreaks in humans. PMID:15498174
Mar 2, 1991 ... A. C. EVANS, D. J. MARTIN, B. D. GINSBURG. Summary. Katayama fever or acute schistosomiasis probably occurs more commonly than is recorded. Interviews with a 3-man scuba diving team who had had contact with a large dam in an·endemic area of the eastern Transvaal Lowveld at the same time ...
Davis, Nelson C.
1. Saimiri sciureus has been infected with yellow fever virus, both by the inoculation of infectious blood and by the bites of infective mosquitoes. Some of the monkeys have died, showing lesions, including hepatic necrosis, suggesting yellow fever as seen in human beings and in rhesus monkeys. Virus has been transferred back to M. rhesus from infected Saimiri both by blood inoculation and by mosquito bites. The virus undoubtedly has been maintained through four direct passages in Saimiri. Reinoculations of infectious material into recovered monkeys have not given rise to invasion of the blood stream by virus. Sera from recovered animals have protected M. rhesus against the inoculation of virus. 2. It has been possible to pass the virus to and from Ateleus ater by the injection of blood or liver and by the bites of mosquitoes. The livers from two infected animals have shown no necrosis. The serum from one recovered monkey proved to be protective for M. rhesus. 3. Only three out of twelve Lagothrix lagotricha have reacted to yellow fever virus by a rise in temperature. Probably none have died as a result of the infection. In only one instance has the virus been transferred back to M. rhesus. The sera of recovered animals have had a protective action against yellow fever virus. PMID:19869721
Roy, S. K.; Speelman, P.; Butler, T.; Nath, S.; Rahman, H.; Stoll, B. J.
To study the pathogenesis of diarrhea occurring with typhoid fever, we selected 42 patients with diarrhea and blood cultures positive for Salmonella typhi or Salmonella paratyphi A, but without diarrheal copathogens, for measurement of stool output and examination of fecal composition. The mean
Zaferatos, Nicholas C.
This article presents the findings of a collaborative investigation by six nongovernment organisations (NGOs) from five European-Mediterranean countries to identify a framework for reversing rural marginalisation in Mediterranean communities through sustainable forms of community-based agricultural development. The project brought together…
DeWitt, Sarah; Chavez, Summer A; Perkins, Jack; Long, Brit; Koyfman, Alex
Fever is one of the most common complaints in the emergency department (ED) and is more complex than generally appreciated. The broad differential diagnosis of fever includes numerous infectious and non-infectious etiologies. An essential skill in emergency medicine is recognizing the pitfalls in fever evaluation. This review provides an overview of the complaint of fever in the ED to assist the emergency physician with a structured approach to evaluation. Fever can be due to infectious or non-infectious etiology and results from the body's natural response to a pyrogen. Adjunctive testing including C-reactive protein, erythrocyte sedimentation rate, and procalcitonin has been evaluated in the literature, but these tests do not have the needed sensitivity and specificity to definitively rule in a bacterial cause of fever. Blood cultures should be obtained in septic shock or if the results will change clinical management. Fever may not be always present in true infection, especially in elderly and immunocompromised patients. Oral temperatures suffer from poor sensitivity to diagnose fever, and core temperatures should be utilized if concern for fever is present. Consideration of non-infectious causes of elevated temperature is needed based on the clinical situation. Any fever evaluation must rigorously maintain a broad differential to avoid pitfalls that can have patient care consequences. Fever is complex and due to a variety of etiologies. An understanding of the pathophysiology, causes, and assessment is important for emergency physicians. Published by Elsevier Inc.
Dengue fever (DF) is endemic in tropical and subtropical zones and the prevalence is increasing across South-east Asia, Africa, the Western Pacific and the Americas. In recent years, the spread of unplanned urbanisation, with associated substandard housing, overcrowding and deterioration in water, sewage and waste management systems, has created ideal conditions for increased transmission of the dengue virus in tropical urban centres. While dengue infection has traditionally been considered a...
Full Text Available The Mediterranean area have a special concept of competitiveness topic. Normally is that region not so industrial and knowledge based oriented as a North Europe.That countries can't reach the same development level as the north one. Lisbon's and Goethenburg's strategies create the main framework of development programme. Mediterranean programme is such a case. European internal market has forced the EU countries to increase competitiveness. The economic prosperity of countries is associated with their ability to generate or attract economic activities which are able to increase income by performing well on themarket. Financial crisis in the EU has changed the look on the competitiveness research. Economy in the main countries has to find way of recovery. Former giants of the financial world have found themselves suddenly facing bankruptcy.Inevitably, the crisis is also having an effect on households and businesses - economic growth has slowed sharply and in some EU countries unemployment has begun to increase for the first time in several years. Form that perspective we have to find the right solution of European competitiveness.
Richi Alberti, Patricia; Steiner, Martina; Illera Martín, Óscar; Alcocer Amores, Patricia; Cobo Ibáñez, Tatiana; Muñoz Fernández, Santiago
Chikungunya Fever is a mosquito-transmitted viral disease that causes fever, rash and musculoskeletal complaints. The latest may persist for several months, or even years or developed a relapsing course, that deserve an adequate treatment. Due to the large outbreak declared in the Caribbean in 2013, imported cases of Chikungunya as well as the risk of autochthonous transmission in case of available vectors have increased in non-endemic countries, like Spain. We described four cases of Chikungunya treated in our clinic. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.
Julander, Justin G.
A number of viruses in the family Flaviviridae are the focus of efforts to develop effective antiviral therapies. Success has been achieved with inhibitors for the treatment of hepatitis C, and there is interest in clinical trials of drugs against dengue fever. Antiviral therapies have also been evaluated in patients with Japanese encephalitis and West Nile encephalitis. However, no treatment has been developed against the prototype flavivirus, yellow fever virus (YFV). Despite the availability of the live, attenuated 17D vaccine, thousands of cases of YF continue to occur each year in Africa and South America, with a significant mortality rate. In addition, a small number of vaccinees develop severe systemic infections with the 17D virus. This paper reviews current efforts to develop antiviral therapies, either directly targeting the virus or blocking detrimental host responses to infection. PMID:23237991
Saijo, Masayuki; Moriikawa, Shigeru; Kurane, Ichiro
Crimean-Congo hemorrhagic fever (CCHF) is an acute infectious disease caused by CCHF virus (CCHFV), a member of the family Bunyaviridae, genus Nairovirus. The case fatality rate of CCHF ranges from 10-40%. Because CCHF is not present in Japan, many Japanese virologists and clinicians are not very familiar with this disease. However, there remains the possibility of an introduction of CCHFV or other hemorrhagic fever viruses into Japan from surrounding endemic areas. Development of diagnostic laboratory capacity for viral hemorrhagic fevers is necessary even in countries without these diseases. At the National Institute of Infectious Diseases, Tokyo, Japan, laboratory-based systems such as recombinant protein-based antibody detection, antigen-capture and pathological examination have been developed. In this review article, epidemiologic and clinical data on CCHF in the Xinjiang Uygur Autonomous Region, compiled through field investigations and diagnostic testing utilizing the aforementioned laboratory systems, are presented. CCHFV infections are closely associated with the environmental conditions, life styles, religion, occupation, and human economic activities. Based on these data, preventive measures for CCHFV infections are also discussed.
Orientation toward Mecca has been compulsory for Muslims in all time periods and in all places. In fact, mosques were built in such a way as to help believers to pray toward the right direction. Nevertheless, the alignment of the sacred buildings was not always exact, and many did not actually face the Kaaba. There are many reasons for this "mistake", the main one being that at the time of the construction of the most important mosques, the astronomical and geographical knowledge needed to make accurate calculations was lacking. In the Mediterranean area, the scholars who were most involved in this task were the fuqahā' (experts in Islamic jurisprudence) who were sometimes well versed in astronomical knowledge or, at least, were skilled in the practice of popular astronomy. The combination of astronomy and religion, mixed with the political and topographical conditions, produces a unique area of study which remains controversial today.
Korzeniewski, Krzysztof; Gaweł, Bartłomiej; Krankowska, Dagny; Wasilczuk, Katarzyna
The aim of the article is to discuss issues associated with the occurrence of febrile illnesses in leisure and business travellers, with a particular emphasis on fevers of unknown origin (FUO). FUO, apart from diarrhoeas, respiratory tract infections and skin lesions, are one of the most common health problems in travellers to tropical and subtropical countries. FUO are manifestations of various diseases, typically of infectious or invasive aetiology. In one out of 3 cases, the cause of a fever in travellers returning from the hot climate zone is malaria, and therefore diagnostic tests should first aim at ruling out this specific disease entity. Other illnesses with persistent fever include dengue, enteric fever, viral hepatitis A, bacterial diarrhoeas and rickettsioses. Fever may also occur in travellers suffering from diseases of non-tropical origin, e.g. cosmopolitan respiratory tract or urinary tract infections, also, fever may coexist with other illnesses or injuries (skin rashes, bites, burns).
Laupland, Kevin B
Fever, commonly defined by a temperature of >or=38.3 degrees C (101 degrees F), occurs in approximately one half of patients admitted to intensive care units. Fever may be attributed to both infectious and noninfectious causes, and its development in critically ill adult medical patients is associated with an increased risk for death. Although it is widespread and clinically accepted practice to therapeutically lower temperature in patients with hyperthermic syndromes, patients with marked hyperpyrexia, and selected populations such as those with neurologic impairment, it is controversial whether most medical patients with moderate degrees of fever should be treated with antipyretic or direct cooling therapies. Although treatment of fever may improve patient comfort and reduce metabolic demand, fever is a normal adaptive response to infection and its suppression is potentially harmful. Clinical trials specifically comparing fever management strategies in neurologically intact critically ill medical patients are needed.
Full Text Available ' classifications of plant forms and formations, categories implicitly based on their intuitive views of convergence. Because of the striking similarities in plant form among the small, widely-separated Mediterranean ecosystems (Figure 1), biogeographical concepts...
Full Text Available This study provides a systematic account of the hydrozoan species collected up to now in the Mediterranean Sea. All species are described, illustrated and information on morphology and distribution is given for all of them. This work is the most complete fauna of hydrozoans made in the Mediterranean. The fauna includes planktonic hydromedusae, benthic polyps stages and the siphonophores. The Hydrozoa are taken as an example of inconspicuous taxa whose knowledge has greatly progressed in the last decades due to the scientific research of some specialists in the Mediterranean area. The number of species recorded in the Mediterranean almost doubled in the last thirty years and the number of new records is still increasing. The 457 species recorded in this study represents the 12% of the world known species. The fauna is completed with classification keys and a glossary of terms with the main purpose of facilitating the identification of all Meditrranean hydrozoan species
Elvira Sánchez Mateos
Full Text Available In the last decade, the WEU, NATO and specially the European Union (in the framework of the Barcelona process initiated security dialogues with countries East and South of the Mediterranean Basin. Those processes are far to achieve significant progress. Some arguments help to explain the present situation: on the one hand, European countries and organizations lack clear strategic goals and consistent policies. On the other, difficulties to create a security dialogue in the Mediterranean, which is a precondition to generateboth a common language and security culture, are the result of differences between the European and the Arab security cultures. Nevertheless, the geopolitical environment, the Euro-Mediterranean process itself and the development of the European Union demanda strategic revision on how to implement the objectives of the Barcelona Declaration, reformulating the idea of Euro-Mediterranean Partnership towards a new concept of shared security that integrates Southern interests and concerns.
U.S. Department of Health & Human Services — NNDSS - Table II. Salmonellosis (excluding typhoid fever and paratyphoid fever) to Shigellosis - 2018. In this Table, provisional cases of selected notifiable...
Korkmaz D. T.
Full Text Available Familial Mediterranean fever (FMF is an autosomal recessive disorder characterized by fever and serosal inflammation. The reasons for the disorder are mutations in the Mediterranean fever (MEFV gene; the most common of which are M694V, M680I, M694I and V726A. In this study, we aimed to screen these common mutations of the MEFV gene and then determine the prevalence of FMF according to these mutations in Adıyaman, Southeast Anatolia, Turkey. Seven hundred and sixty-seven healthy individuals from the region of Adıyaman participated in the study. Polymerase chain reaction-amplification refractory mutation system (PCR-ARMS methods were used to determine the common mutations of the MEFV gene. Twenty-six (3.9% individuals had only one mutation in the MEFV gene, 25 individuals were heterozygous and one person was homozygous for the V726A mutation (0.15%. In the present study, the V726A mutation (50.0% was the most frequent, followed by M694V (38.5%, M680I (7.7% and M694I (3.8%. It was seen that the carrier rate was very low and the prevalence of FMF was 0.15%, according to the common mutations of the MEFV gene in Adıyaman, Southeast Anatolia, Turkey.
Mitraka, Elvira; Topalis, Pantelis; Dritsou, Vicky; Dialynas, Emmanuel; Louis, Christos
Background Ontologies represent powerful tools in information technology because they enhance interoperability and facilitate, among other things, the construction of optimized search engines. To address the need to expand the toolbox available for the control and prevention of vector-borne diseases we embarked on the construction of specific ontologies. We present here IDODEN, an ontology that describes dengue fever, one of the globally most important diseases that are transmitted by mosquitoes. Methodology/Principal Findings We constructed IDODEN using open source software, and modeled it on IDOMAL, the malaria ontology developed previously. IDODEN covers all aspects of dengue fever, such as disease biology, epidemiology and clinical features. Moreover, it covers all facets of dengue entomology. IDODEN, which is freely available, can now be used for the annotation of dengue-related data and, in addition to its use for modeling, it can be utilized for the construction of other dedicated IT tools such as decision support systems. Conclusions/Significance The availability of the dengue ontology will enable databases hosting dengue-associated data and decision-support systems for that disease to perform most efficiently and to link their own data to those stored in other independent repositories, in an architecture- and software-independent manner. PMID:25646954
Dengue fever (DF) is endemic in tropical and subtropical zones and the prevalence is increasing across South-east Asia, Africa, the Western Pacific and the Americas. In recent years, the spread of unplanned urbanisation, with associated substandard housing, overcrowding and deterioration in water, sewage and waste management systems, has created ideal conditions for increased transmission of the dengue virus in tropical urban centres. While dengue infection has traditionally been considered a paediatric disease, the age distribution of dengue has been rising and more cases have been observed in adolescents and adults. Furthermore, the development of tourism in the tropics has led to an increase in the number of tourists who become infected, most of whom are adults. Symptoms and risk factors for dengue haemorrhagic fever (DHF) and severe dengue differ between children and adults, with co-morbidities and incidence in more elderly patients associated with greater risk of mortality. Treatment options for DF and DHF in adults, as for children, centre round fluid replacement (either orally or intravenously, depending on severity) and antipyretics. Further data are needed on the optimal treatment of adult patients.
Ratnam, Irani; Leder, Karin; Black, Jim; Torresi, Joseph
Dengue is a leading public health problem with an expanding global burden. Dengue virus is also a significant cause of illness in international travelers with an increasing number of cases of dengue fever identified in travelers returning from dengue-endemic countries. This review focuses on the clinical illness of dengue infection in international travelers and provides a summary of the risk of infection for travelers, clinical features of infection, and an overview of dengue vaccines and their potential applicability to travelers. Four prospective studies of travelers to dengue-endemic destinations have shown that the dengue infection incidence ranges from 10.2 to 30 per 1,000 person-months. This varies according to travel destination and duration and season of travel. Dengue is also a common cause of fever in returned travelers, accounting for up to 16% of all febrile illnesses in returned travelers. Although the majority of infections are asymptomatic, a small proportion of travelers develop dengue hemorrhagic fever. The diagnosis of dengue in travelers requires a combination of serological testing for IgG and IgM together with either nucleic acid or NS1 antigen testing. Several vaccine candidates have now entered into clinical trials including ChimeriVax Dengue, which is currently in phase 3 trials, live-attenuated chimeric vaccines (DENV-DENV Chimera, Inviragen), live-attenuated viral vaccines, recombinant protein subunit vaccines, and DNA vaccines. Dengue infection in international travelers is not infrequent and may be associated with substantial morbidity. Furthermore, an accurate diagnosis of dengue in travelers requires the use of a combination of diagnostic tests. Although a vaccine is not yet available a number of promising candidates are under clinical evaluation. For now travelers should be provided with accurate advice regarding preventive measures when visiting dengue-endemic areas. © 2013 International Society of Travel Medicine.
Seimenis, Aristarhos M
Great concern is being expressed at the international level on the emergence and re-emergence of certain infectious diseases, many of which are zoonoses, e.g. Rift Valley fever, highly pathogenic avian influenza, etc. Many aspects of globalisation, i.e. the movements of populations, increased urbanisation, greater production and trade in animals and animal products, close interaction between humans and animals, environmental degradation, inappropriate waste disposal, etc., are all determining factors in the prevalence of zoonoses. The Mediterranean and Middle East share similar ecological and epidemiological conditions and are affected by almost the same zoonoses (brucellosis, rabies, echinococcosis, leishmaniosis, salmonellosis, etc.). National control programmes have given partial results or have failed due to weak infrastructures, insufficient financial resources, inadequate intersectoral collaboration and coordination, a lack of public health education, etc. There is an urgent need for the firm commitment of all parties involved on regional, national and international levels to ensure the success of zoonoses prevention and control programmes.
I Wayan Putu Sutirta-Yasa
Full Text Available The incidence and geographical distribution of dengue has gradually increased during the past decade. Today, dengue is considered one of the most important arthropod-borne viral diseasases in humans in term of morbidity and mortality. Dengue infection a potential life-threatening dengue hemorrhagic fever (DHF / dengue shock syndrome(DSS, characterized by thrombocytopenia and increased vascular permiability. Thrombocytopenia causes bleeding, but in DHF patients with thrombocytopenia do not always develop bleeding manifestation. The pathogenesis of thrombocytopenia are not cleared. Multiple factors may be involved in the machanisms leading to thrombocytopenia in DHF/DSS patients.
. Public Health Education should be implemented in order to enlighten caregivers on fever and advocate for the use of a clinical thermometer to monitor fever at home. INTRODUCTION. Fever is controlled increase in body ...
... Hay fever and pollen counts Share | Controlling Hay Fever Symptoms with Accurate Pollen Counts This article has ... MD, FAAAAI Seasonal allergic rhinitis known as hay fever is caused by pollen carried in the air ...
... Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea Ear Problems Elimination Problems Elimination Problems in Infants and Children Eye Problems Facial Swelling Feeding Problems in Infants ...
... your children to do the same, especially before eating, after using the toilet, after spending time in a crowd or around someone who's sick, after petting animals, and during travel on public transportation. Show your ...
Saragih, R. H.; Purba, G. C. F.
Typhoid fever (enteric fever) remains a burden in developing countries and a major health problem in Southern and Southeastern Asia. Salmonella typhi (S. typhi), the causative agent of typhoid fever, is a gram-negative, motile, rod-shaped, facultative anaerobe and solely a human pathogen with no animal reservoir. Infection of S. typhi can cause fever, abdominal pain and many worsenonspecific symptoms, including gastrointestinal symptoms suchas nausea, vomiting, constipation, and diarrhea. Chloramphenicol, ampicillin,and cotrimoxazole were the first-recommended antibiotics in treating typhoid fever. In the last two decades though, these three traditional drugs started to show resistance and developed multidrug resistance (MDR) S. typhi strains. In many parts of the world, the changing modes ofpresentation and the development of MDR have made typhoid fever increasingly difficult to treat.The use of first-line antimicrobials had been recommended to be fluoroquinolone as a replacement. However, this wassoonfollowedbyreportsof isolates ofS. typhi showing resistancetofluoroquinolones as well. These antimicrobial resistance problems in typhoid fever have been an alarming situation ever since and need to be taken seriously or else typhoid fever will no longer be taken care completely by administering antibiotics.
Oct 15, 2008 ... Vaccines or antiviral drugs are not available for dengue viruses; the only effective way to prevent epidemic degure fever/dengue haemorrhagic fever (DF/DHF) is to control the mosquito vector, Aedes aegypti and prevent its bite. This country has few virus laboratories and some of them have done excellent ...
From 2007-2010, during the recent Q fever epidemic in the Netherlands, over 4000 cases of acute Q fever were registered, which is an underestimation of the total amount of Coxiella burnetii infections due to a high amount of asymptomatic primary infections. In the literature it is stated that 1-5%
Q fever is an infection caused by the bacterium Coxiella burnetii. A large outbreak of Q fever occurred in the Netherlands between 2007 and 2010, in which infected goats and sheep were the source of human infections. In some people, so-called ‘chronic Q fever’ develops, which mainly manifests as
... valley fever, but it is not contagious between animals and people. Valley fever in dogs is similar to valley ... Via Growth on Fomites. An Epidemic Involving Six Persons. Am Rev Respir Dis. ... aspects of coccidioidomycosis in animals and humans. Ann N Y Acad Sci. 2007 ...
El Mamy, Ahmed B O; Baba, Mohamed Ould; Barry, Yahya; Isselmou, Katia; Dia, Mamadou L; El Kory, Mohamed O B; Diop, Mariam; Lo, Modou Moustapha; Thiongane, Yaya; Bengoumi, Mohammed; Puech, Lilian; Plee, Ludovic; Claes, Filip; de La Rocque, Stephane; Doumbia, Baba
During September-October 2010, an unprecedented outbreak of Rift Valley fever was reported in the northern Sahelian region of Mauritania after exceptionally heavy rainfall. Camels probably played a central role in the local amplification of the virus. We describe the main clinical signs (hemorrhagic fever, icterus, and nervous symptoms) observed during the outbreak.
Sow, Abdourahmane; Faye, Ousmane; Ba, Yamar; Ba, Hampathé; Diallo, Diawo; Faye, Oumar; Loucoubar, Cheikh; Boushab, Mohamed; Barry, Yahya; Diallo, Mawlouth; Sall, Amadou Alpha
After a period of heavy rainfall, an outbreak of Rift Valley fever occurred in southern Mauritania during September-November 2012. A total of 41 human cases were confirmed, including 13 deaths, and 12 Rift Valley fever virus strains were isolated. Moudjeria and Temchecket Departments were the most affected areas.
... In addition to the rash, the infection can cause fever, chills, muscle aches, vomiting, and nausea. Typically, RMSF ... But with late or no treatment, RMSF can cause serious health problems. If your child has fever, achiness, stiff neck, or rash and has or ...
Risager, Peter Christian; Belsham, Graham J.; Rasmussen, Thomas Bruun
Classical swine fever virus (CSFV) is the etiologic agent of the severe porcine disease, classical swine fever. Unraveling the molecular determinants of efficient replication is crucial for gaining proper knowledge of the pathogenic traits of this virus. Monitoring the replication competence within...
Recently there has been a public panic about an increase in cases of typhoid fever. Typhoid fever caused by salmonella typhi is common and constitutes a major public health problem in developing countries including sub-Saharan Africa, South America and parts of Asia. Its clinical features are non-specific and available ...
Full Text Available This paper examines the influence of educational fever on the development of the Republic of Korea education and economy in the context of the cultural history of this country. In order to examine this study, the author explains the concept of educational fever and discusses the relation between Confucianism and education zeal. Educational fever and human capitalization in South Korean higher education are analyzed from a comparative viewpoint. The study evaluates the effects and problems of education fever this country’s current higher education, and it concludes that Koreans’ educational fever has been a core factor by which to achieve the development of the national economy as well as the rapid expansion of higher education.
Heilman, James M; De Wolff, Jacob; Beards, Graham M; Basden, Brian J
Dengue fever, also known as breakbone fever, is a mosquito-borne infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles. In a small proportion of cases, the disease develops into life-threatening dengue hemorrhagic fever, which results in bleeding, thrombocytopenia, and leakage of blood plasma, or into dengue shock syndrome, in which dangerously low blood pressure occurs. Treatment of acute dengue fever is supportive, with either oral or intravenous rehydration for mild or moderate disease and use of intravenous fluids and blood transfusion for more severe cases. Along with attempts to eliminate the mosquito vector, work is ongoing to develop a vaccine and medications targeted directly at the virus.
Thilsing-Hansen, T; Jørgensen, R J; Østergaard, S
Three main preventive principles against milk fever were evaluated in this literature review, and the efficacy of each principle was estimated from the results of controlled investigations. Oral calcium drenching around calving apparently has a mean efficacy of 50%-60% in terms of milk fever...... prevention as well as prevention of milk fever relapse after intravenous treatment with calcium solutions. However, some drenches have been shown to cause lesions in the forestomacs. When using the DCAD (dietary cation-anion difference) principle, feeding rations with a negative DCAD (measured as (Na + K......)-(Cl + S)) significantly reduce the milk fever incidence. Calculating the relative risk (RR) of developing milk fever from controlled experiments results in a mean RR between 0.19 and 0.35 when rations with a negative versus positive DCAD are compared. The main drawback from the DCAD principle...
Dengue fever and dengue hemorrhagic fever are re-emerging diseases that are endemic in the Tropics. The global prevalence of dengue cases has increased in South-East Asia, Africa, the Western Pacific, and the Americas. The increasingly widespread distribution and the rising incidence of dengue virus infections are related to increased distribution of Aedes aegypti, an increasingly urban population, and increasing air travel. Several Southeast Asian countries show that the age of the reported dengue cases has increased from 5-9 years, to older children and young adults. Dengue infection in adolescents and adults has also been recognized as a potential hazard to international travelers returning from endemic areas, especially SoutheastAsia. Dengue is one disease entity with different clinical presentations; often with unpredictable clinical evolutions and outcomes. Bleeding manifestations in adult patients, including petechiae and menorrhagia were also frequently found; however, massive hematemesis may occur in adult patients because of peptic ulcer disease and may not be associated with profound shock as previously reported in children. Although shock and plasma leakage seem to be more prevalent as age decreases, the frequency of internal hemorrhage rises as age increases. Increase in liver enzymes found in both children and adults indicated liver involvement during dengue infections. Pre-existing liver diseases in adults such as chronic hepatitis, alcoholic cirrhosis, and hemoglobinopathies may aggravate the liver impairment in dengue infection. Fulminant hepatitis is a rare but well described problem in adult patients with dengue infection. Currently, no specific therapeutic agent exists for dengue. The early recognition of dengue infection, bleeding tendency, and signs of circulatory collapse would reduce mortality rates in adult patients with dengue infection.
Georgoulis, Michael; Kontogianni, Meropi D.; Yiannakouris, Nikos
The aim of the present review is to examine current scientific knowledge on the association between the Mediterranean diet and diabetes mellitus (mostly type 2 diabetes). A definition of the Mediterranean diet and the tools widely used to evaluate adherence to this traditional diet (Mediterranean diet indices) are briefly presented. The review focuses on epidemiological data linking adherence to the Mediterranean diet with the risk of diabetes development, as well as evidence from interventi...
KATSANEVAKIS, S.; ACAR, Ü.; AMMAR, I.; BALCI, B. A.; BEKAS, P.; BELMONTE, M.; CHINTIROGLOU, C. C.; CONSOLI, P.; DIMIZA, M.; FRYGANIOTIS, K.; GEROVASILEIOU, V.; GNISCI, V.; GÜLŞAHIN, N.; HOFFMAN, R.; ISSARIS, Y.
The Collective Article ‘New Mediterranean Biodiversity Records’ of the Mediterranean Marine Science journal offers the means to publish biodiversity records in the Mediterranean Sea. The current article is divided in two parts, for records of alien and native species respectively. The new records of alien species include: the red alga Asparagopsis taxiformis (Crete and Lakonicos Gulf) (Greece); the red alga Grateloupia turuturu (along the Israeli Mediterranean shore); the mantis shrimp Clorid...
Kampschreur, Linda M.; Delsing, Corine E.; Groenwold, Rolf H. H.; Wegdam-Blans, Marjolijn C. A.; Bleeker-Rovers, Chantal P.; de Jager-Leclercq, Monique G. L.; Hoepelman, Andy I. M.; van Kasteren, Marjo E.; Buijs, Jacqueline; Renders, Nicole H. M.; Nabuurs-Franssen, Marrigje H.; Oosterheert, Jan Jelrik; Wever, Peter C.
Coxiella burnetii causes Q fever, a zoonosis, which has acute and chronic manifestations. From 2007 to 2010, the Netherlands experienced a large Q fever outbreak, which has offered a unique opportunity to analyze chronic Q fever cases. In an observational cohort study, baseline characteristics and clinical characteristics, as well as mortality, of patients with proven, probable, or possible chronic Q fever in the Netherlands, were analyzed. In total, 284 chronic Q fever patients were identifi...
Full Text Available Many studies have presented virus sequences which suggest the existence of a variety of putative new phleboviruses transmitted by sandflies in the Old World. However, in most of these studies, only partial sequences in the polymerase or the nucleoprotein genes were characterised. Therefore to further our understand of the presence and potential medical importance of sandfly-borne phleboviruses that circulate in southern Anatolia, we initiated field campaigns in 2012 and 2013 designed to identify, isolate and characterise phleboviruses in sandflies in this region.An entomological investigation encompassing 8 villages in Adana, Mediterranean Turkey was performed in August and September 2012 and 2013. A total of 11,302 sandflies were collected and grouped into 797 pools which were tested for the presence of phleboviruses using specific primers for RT-PCR analysis and also cell culture methods for virus isolation. Seven pools were PCR positive, and viruses were isolated from three pools of sandflies, resulting in the identification of two new viruses that we named Zerdali virus and Toros virus. Phylogenetic analysis based on full-length genomic sequence showed that Zerdali virus was most closely related with Tehran virus (and belongs to the Sandfly fever Naples species, whereas Toros virus was closest to Corfou virus.The results indicate that a variety of phleboviruses are co-circulating in this region of southern Anatolia. Based on our studies, these new viruses clearly belong to genetic groups that include several human pathogens. However, whether or not Toros and Zerdali viruses can infect humans and cause diseases such as sandfly fever remains to be investigated.
Seimenis, Aristarco; Morelli, Daniela; Mantovani, Adriano
The Mediterranean and Middle East Region (MME) is considered the most important area for the historical development and concentration of zoonoses. Besides the classical Mediterranean pattern, an urbanised pattern has emerged which is strongly influenced by globalisation. Both patterns co-exist and have many peculiarities affecting the life cycles of zoonoses and their social impact. The features of those zoonoses which are now most relevant in the MME (brucellosis, rabies, cystic echinococcosis, leishmaniasis, food-borne zoonoses) are discussed. Besides other relevant activities, the World Health Organization has established, since 1979, a specialised programme with a unit coordinating and managing activities: i.e. the Mediterranean Zoonoses Control Centre, operating from Athens, Greece.
One of the most fatal diseases encountered by mankind so far is Ebola fever. Ebola fever is caused by a highly pathogenic virus from the Filoviridae family which is found in nature in four different sub-types which differ among others also by their pathogenicity for man. The hitherto detected EBO sub-types are stable do not change in the course of an epidemic nor in the course of the patient's illness, nor during passage of the virus from one subject to another. The author presents a historical review of epidemics, nosocomial and laboratory infections, spread and epizoonosis caused by the Ebola virus. The author presents a detailed clinical picture describing the frequency and evolution of different clinical symptoms and signs based on the observation of 103 patients infected with the Ebola virus in Kikwit, Zaire (nowadays Democratic Republic of Congo) in 1995. In the laboratory diagnosis individual tests are mentioned assessing the presence of the virus, viral antigens and antibodies, incl. the most recent immunohistochemical test. The author mentions the problem of patient care and his therapy, incl. available antiviral drugs and passive immunotherapy. He also discusses the possibility and probability of spread of the Ebola virus into our environment. He mentions principles for transport of subjects with suspected disease, demands for their strict isolation and maximum protection of the attending staff incl. barrier nursing technique. The author discusses also principles of epidemiological work, detection and isolation of sources, identification and follow up of contacts and epidemiological supervision of affected areas. Past epidemics made it possible to assemble many scientific findings and practical experience. These make it possible to cope nowadays with any attack of the Ebola virus not only in areas of its epizootic occurrence.
Ahmed, S.; Illyas, M.
To determine the frequency of dengue as a cause of fever and compare the clinical and haematological characteristics of Dengue-probable and Dengue-proven cases. All patients with age above 14 years, who were either hospitalized or treated in medical outdoor clinic due to acute febrile illness, were evaluated for clinical features of Dengue Fever (DF), Dengue haemorrhagic fever (DHF) and Dengue Shock Syndrome (DSS). Patients showing typical clinical features and haematological findings suggestive of Dengue fever (As per WHO criteria) were evaluated in detail for comparison of probable and confirmed cases of Dengue fever. All other cases of acute febrile illness, not showing clinical features or haematological abnormalities of Dengue fever, were excluded. The clinical and laboratory features were recorded on SPSS 11.0 programme and graded where required, for descriptive and statistical analysis. Out of 5200 patients with febrile illness, 107 (2%) presented with typical features of DF, 40/107 (37%) were Dengue-proven while 67/107 (63%) were Dengue-probable. Out of Dengue-proven cases, 38 were of DF and 2 were of DHF. Day 1 temperature ranged from 99-105 degreeC (mean 101 degree C). Chills and rigors were noticed in 86 (80%), myalgia in 67%, headache in 54%, pharyngitis in 35%, rash in 28%, and bleeding manifestations in 2% cases. Hepatomegaly in 1(0.5%), lymphadenopathy in 1 (0.5%) and splenomegaly in 12 (11.2%) cases. Leucopoenia (count 40 U/L in 57% cases. Frequency of clinically suspected dengue virus infection was 107 (2%), while confirmed dengue fever cases were 40 (0.8%) out of 5200 fever cases. Fever with chills and rigors, body aches, headache, myalgia, rash, haemorrhagic manifestations, platelet count, total leukocyte count, and ALT, are parameters to screen the cases of suspected dengue virus infection, the diagnosis cannot be confirmed unless supported by molecular studies or dengue specific IgM. (author)
Effa, Emmanuel E; Lassi, Zohra S; Critchley, Julia A; Garner, Paul; Sinclair, David; Olliaro, Piero L; Bhutta, Zulfiqar A
Typhoid and paratyphoid are febrile illnesses, due to a bacterial infection, which remain common in many low- and middle-income countries. The World Health Organization (WHO) currently recommends the fluoroquinolone antibiotics in areas with known resistance to the older first-line antibiotics. To evaluate fluoroquinolone antibiotics for treating children and adults with enteric fever. We searched The Cochrane Infectious Disease Group Specialized Register (February 2011); Cochrane Central Register of Controlled Trials (CENTRAL), published in The Cochrane Library (2011, Issue 2); MEDLINE (1966 to February 2011); EMBASE (1974 to February 2011); and LILACS (1982 to February 2011). We also searched the metaRegister of Controlled Trials (mRCT) in February 2011. Randomized controlled trials examining fluoroquinolone antibiotics, in people with blood, stool or bone marrow culture-confirmed enteric fever. Two authors independently assessed the trial's methodological quality and extracted data. We calculated risk ratios (RR) for dichotomous data and mean difference for continuous data with 95% confidence intervals (CI).Comparative effectiveness has been interpreted in the context of; length of treatment, dose, year of study, known levels of antibiotic resistance, or proxy measures of resistance such as the failure rate in the comparator arm. Twenty-six studies, involving 3033 patients, are included in this review.Fluoroquinolones versus older antibiotics (chloramphenicol, co-trimoxazole, amoxicillin and ampicillin)In one study from Pakistan in 2003-04, high clinical failure rates were seen with both chloramphenicol and co-trimoxazole, although resistance was not confirmed microbiologically. A seven-day course of either ciprofloxacin or ofloxacin were found to be superior. Older studies of these comparisons failed to show a difference (six trials, 361 participants).In small studies conducted almost two decades ago, the fluoroquinolones were demonstrated to have fewer
Ramakrishnan, Reshma; Shrivastava, Saurabh; Deshpande, Shrikant; Patkar, Priyanka
Dengue fever is caused by a flavivirus. This infection is endemic in the tropics and warm temperate regions of the world. Ocular manifestations of dengue fever include subconjunctival, vitreous, and retinal haemorrhages; posterior uveitis; optic neuritis; and maculopathies, haemorrhage, and oedema. However anterior ischemic optic neuropathy is a rare presentation. Optic nerve ischemia most frequently occurs at the optic nerve head, where structural crowding of nerve fibers and reduction of the vascular supply may combine to impair perfusion to a critical degree and produce optic disc oedema. Here we present a case of anterior ischemic optic neurapathy associated with dengue fever.
Ferguson, R; Feeney, C; Chirurgi, V A
Cotton fever is usually a benign febrile, leukocytic syndrome of unknown etiology seen in intravenous narcotic abusers. Cotton and cotton plants are heavily colonized with Enterobacter agglomerans. We report a case of cotton fever associated with E agglomerans in which the organism was first isolated from the patient's blood and secondarily from cotton that he had used to filter heroin. Enterobacter agglomerans is with most probability the causal agent of cotton fever. Patients presenting with the classic history should have blood cultures performed and should be started on a regimen of empiric antibiotic therapy.
Full Text Available Dengue viral infections have become one of major emerging infectious diseases in the tropics. Acute abdomen occurring in dengue viral infection is not uncommon. The spectrums of acute surgical emergencies which raise suspicion of an abdominal catastrophe in patients presenting with dengue fever include acute pancreatitis, acute acalculous cholecystitis, non-specific peritonitis and very rarely acute appendicitis. The presence of low white cell count and platelet count can raise suspicion of a diagnosis of dengue in a patient presenting with acute abdominal pain, during a dengue epidemic. We herein report three patients with dengue fever who had appendicular perforation during the course of their viral fever.
Sharpe, Emily E; Arendt, Katherine W
Women receiving an epidural for labor analgesia are at increased risk for intrapartum fever. This relationship has been supported by observational, before and after, and randomized controlled trials. The etiology is not well understood but is likely a result of noninfectious inflammation as studies have found women with fever have higher levels of inflammatory markers. Maternal pyrexia may change obstetric management and women are more likely to receive antibiotics or undergo cesarean delivery. Maternal pyrexia is associated with adverse neonatal outcomes. With these consequences, understanding and preventing maternal fever is imperative.
Keeley, Jon E.; Fotheringham, Connie J.; Rundel, Philip W.
This study compares postfire regeneration and diversity patterns in fire-prone chaparral shrublands from mediterranean (California) and non-mediterranean-type climates (Arizona). Vegetation sampling was conducted in tenth hectare plots with nested subplots for the first two years after fire. Floras in the two regions were compared with Jaccard's Index and importance of families and genera compared with dominance-diversity curves. Although there were 44 families in common between the two regions, the dominant families differed; Poaceae and Fabaceae in Arizona and Hydrophyllaceae and Rosaceae in California. Dominance diversity curves indicated in the first year a more equable distribution of families in Arizona than in California. Woody plants were much more dominant in the mediterranean climate and herbaceous plants more dominant in the bimodal rainfall climate. Species diversity was comparable in both regions at the lowest spatial scales but not at the tenth hectare scale. Due to the double growing season in the non-mediterranean region, the diversity for the first year comprised two different herbaceous floras in the fall and spring growing seasons. The Mediterranean climate in California, in contrast, had only a spring growing season and thus the total diversity for the first year was significantly greater in Arizona than in California for both annuals and herbaceous perennials. Chaparral in these two climate regimes share many dominant shrub species but the postfire communities are very different. Arizona chaparral has both a spring and fall growing season and these produce two very different postfire floras. When combined, the total annual diversity was substantially greater in Arizona chaparral.
Delsing, Corine E.; Groenwold, Rolf H. H.; Wegdam-Blans, Marjolijn C. A.; Bleeker-Rovers, Chantal P.; de Jager-Leclercq, Monique G. L.; Hoepelman, Andy I. M.; van Kasteren, Marjo E.; Buijs, Jacqueline; Renders, Nicole H. M.; Nabuurs-Franssen, Marrigje H.; Oosterheert, Jan Jelrik; Wever, Peter C.
Coxiella burnetii causes Q fever, a zoonosis, which has acute and chronic manifestations. From 2007 to 2010, the Netherlands experienced a large Q fever outbreak, which has offered a unique opportunity to analyze chronic Q fever cases. In an observational cohort study, baseline characteristics and clinical characteristics, as well as mortality, of patients with proven, probable, or possible chronic Q fever in the Netherlands, were analyzed. In total, 284 chronic Q fever patients were identified, of which 151 (53.7%) had proven, 64 (22.5%) probable, and 69 (24.3%) possible chronic Q fever. Among proven and probable chronic Q fever patients, vascular infection focus (56.7%) was more prevalent than endocarditis (34.9%). An acute Q fever episode was recalled by 27.0% of the patients. The all-cause mortality rate was 19.1%, while the chronic Q fever-related mortality rate was 13.0%, with mortality rates of 9.3% among endocarditis patients and 18% among patients with a vascular focus of infection. Increasing age (P = 0.004 and 0.010), proven chronic Q fever (P = 0.020 and 0.002), vascular chronic Q fever (P = 0.024 and 0.005), acute presentation with chronic Q fever (P = 0.002 and P fever (P = 0.025 and P fever-related mortality, respectively. PMID:24599987
Georgoulis, Michael; Kontogianni, Meropi D.; Yiannakouris, Nikos
The aim of the present review is to examine current scientific knowledge on the association between the Mediterranean diet and diabetes mellitus (mostly type 2 diabetes). A definition of the Mediterranean diet and the tools widely used to evaluate adherence to this traditional diet (Mediterranean diet indices) are briefly presented. The review focuses on epidemiological data linking adherence to the Mediterranean diet with the risk of diabetes development, as well as evidence from interventional studies assessing the effect of the Mediterranean diet on diabetes control and the management of diabetes-related complications. The above mentioned data are explored on the basis of evaluating the Mediterranean diet as a whole dietary pattern, rather than focusing on the effect of its individual components. Possible protective mechanisms of the Mediterranean diet against diabetes are also briefly discussed. PMID:24714352
... usually have to be hospitalized. Yellow fever can cause: • fever and flu-like symptoms • jaundice (yellow skin or ... vaccine? fromyellow A vaccine, like any medicine, could cause a ... problems Yellow fever vaccine has been associated with fever, and with ...
Features to distinguish Malaria from Typhoid fever. These can be discerned from a good and detailed clinical history, in addition to a thorough physical examination. The following would help. The paroxysms of malaria fever as against the step ladder pattern fever of typhoid fever. The prominence of headaches in typhoid ...
Alkan, Cigdem; Erisoz Kasap, Ozge; Alten, Bulent; de Lamballerie, Xavier; Charrel, Rémi N.
initiated field campaigns in 2012 and 2013 designed to identify, isolate and characterise phleboviruses in sandflies in this region Methodology/Principal Findings An entomological investigation encompassing 8 villages in Adana, Mediterranean Turkey was performed in August and September 2012 and 2013. A total of 11,302 sandflies were collected and grouped into 797 pools which were tested for the presence of phleboviruses using specific primers for RT-PCR analysis and also cell culture methods for virus isolation. Seven pools were PCR positive, and viruses were isolated from three pools of sandflies, resulting in the identification of two new viruses that we named Zerdali virus and Toros virus. Phylogenetic analysis based on full-length genomic sequence showed that Zerdali virus was most closely related with Tehran virus (and belongs to the Sandfly fever Naples species), whereas Toros virus was closest to Corfou virus. Conclusions/Significance The results indicate that a variety of phleboviruses are co-circulating in this region of southern Anatolia. Based on our studies, these new viruses clearly belong to genetic groups that include several human pathogens. However, whether or not Toros and Zerdali viruses can infect humans and cause diseases such as sandfly fever remains to be investigated. PMID:27007326
José M. Lou-Bonafonte
Full Text Available The Mediterranean diet has been proven to be highly effective in the prevention of cardiovascular diseases. Paraoxonase 1 (PON1 has been implicated in the development of those conditions, especially atherosclerosis. The present work describes a systematic review of current evidence supporting the influence of Mediterranean diet and its constituents on this enzyme. Despite the differential response of some genetic polymorphisms, the Mediterranean diet has been shown to exert a protective action on this enzyme. Extra virgin olive oil, the main source of fat, has been particularly effective in increasing PON1 activity, an action that could be due to low saturated fatty acid intake, oleic acid enrichment of phospholipids present in high-density lipoproteins that favor the activity, and increasing hepatic PON1 mRNA and protein expressions induced by minor components present in this oil. Other Mediterranean diet constituents, such as nuts, fruits and vegetables, have been effective in modulating the activity of the enzyme, pomegranate and its compounds being the best characterized items. Ongoing research on compounds isolated from all these natural products, mainly phenolic compounds and carotenoids, indicates that some of them are particularly effective, and this may enhance the use of nutraceuticals and functional foods capable of potentiating PON1 activity.
Lou-Bonafonte, José M.; Gabás-Rivera, Clara; Navarro, María A.; Osada, Jesús
The Mediterranean diet has been proven to be highly effective in the prevention of cardiovascular diseases. Paraoxonase 1 (PON1) has been implicated in the development of those conditions, especially atherosclerosis. The present work describes a systematic review of current evidence supporting the influence of Mediterranean diet and its constituents on this enzyme. Despite the differential response of some genetic polymorphisms, the Mediterranean diet has been shown to exert a protective action on this enzyme. Extra virgin olive oil, the main source of fat, has been particularly effective in increasing PON1 activity, an action that could be due to low saturated fatty acid intake, oleic acid enrichment of phospholipids present in high-density lipoproteins that favor the activity, and increasing hepatic PON1 mRNA and protein expressions induced by minor components present in this oil. Other Mediterranean diet constituents, such as nuts, fruits and vegetables, have been effective in modulating the activity of the enzyme, pomegranate and its compounds being the best characterized items. Ongoing research on compounds isolated from all these natural products, mainly phenolic compounds and carotenoids, indicates that some of them are particularly effective, and this may enhance the use of nutraceuticals and functional foods capable of potentiating PON1 activity. PMID:26024295
da Vico, Letizia; Agostini, Susanna; Brazzo, Silvia; Biffi, Barbara; Masini, Maria Luisa
The proposal of a Mediterranean way of life is much more than advise how to eat. The Mediterranean Diet, a model of Sustainable Diet, is an example of how to combine personal choices, economic, social and cultural rights, protective of human health and the ecosystem. There is in fact fundamental interdependence between dietary requirements, nutritional recommendations, production and consumption of food. In literature studies and nutritional and epidemiological monitoring activities at national and international level have found a lack of adherence to this lifestyle, due to the spread of the economy, lifestyles of the Western type and globalization of the production and consumption. To encourage the spread of a culture and a constant practice of the Mediterranean Diet, there are some tools that are presented in this article. The Mediterranean Diet Pyramid in addition to the recommendations on the frequency and portions of food, focuses on the choice of how to cook and eat food. The "Double Food Pyramid" encourages conscious food choices based on "healthy eating and sustainability. All the nutrition professionals and dietitians in particular should be constantly striving to encourage the adoption of a sustainable and balanced nutrition.
Andrei, G; De Clercq, E
Viruses causing hemorrhagic fevers in man belong to the following virus groups: togavirus (Chikungunya), flavivirus (dengue, yellow fever, Kyasanur Forest disease, Omsk hemorrhagic fever), arenavirus (Argentinian hemorrhagic fever, Bolivian hemorrhagic fever, Lassa fever), filovirus (Ebola, Marburg), phlebovirus (Rift Valley fever), nairovirus (Crimian-Congo hemorrhagic fever) and hantavirus (hemorrhagic fever with renal syndrome, nephropathic epidemia). Hemorrhagic fever virus infections can be approached by different therapeutic strategies: (i) vaccination; (ii) administration of high-titered antibodies; and (iii) treatment with antiviral drugs. Depending on the molecular target of their interaction, antiviral agents could be classified as follows: IMP dehydrogenase inhibitors (i.e., ribavirin and its derivatives); OMP decarboxylase inhibitors (i.e., pyrazofurin); CTP synthetase inhibitors (i.e., cyclopentylcytosine and cyclopentenylcytosine); SAH hydrolase inhibitors (i.e., neplanocin A); polyanionic substances (i.e., sulfated polymers); interferon and immunomodulators.
Geoffrey C. Buckle
Full Text Available Typhoid and paratyphoid fever remain important causes of morbidity worldwide. Accurate disease burden estimates are needed to guide policy decisions and prevention and control strategies.
Kaur, Paramjit; Kaur, Gagandeep
Dengue fever has emerged as a global public health problem in the recent decades. The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. The disease is characterized by increased capillary permeability, thrombocytopenia and coagulopathy. Thrombocytopenia with hemorrhagic manifestations warrants platelet transfusions. There is lack of evidence-based guidelines for transfusion support in patients with dengue fever. This contributes to inappropriate use of blood components and blood centers constantly face the challenge of inventory management during dengue outbreaks. The current review is aimed to highlight the role of platelets and other blood components in the management of dengue. The review was performed after searching relevant published literature in PubMed, Science Direct, Google scholar and various text books and journal articles.
Full Text Available Ebola haemorrhagic fever is a viral infection causing a major health problem worldwide. In this short article, the authors briefly review and discuss on the nutritional management (energy, protein, fat and micronutrient in management of Ebola infection.
Mayxay, Mayfong; Sengvilaipaseuth, Onanong; Chanthongthip, Anisone; Dubot-Pérès, Audrey; Rolain, Jean-Marc; Parola, Philippe; Craig, Scott B; Tulsiani, Suhella; Burns, Mary-Anne; Khanthavong, Maniphone; Keola, Siamphay; Pongvongsa, Tiengkham; Raoult, Didier; Dittrich, Sabine; Newton, Paul N
The etiology of fever in rural Lao People's Democratic Republic (Laos) has remained obscure until recently owing to the lack of laboratory facilities. We conducted a study to determine the causes of fever among 229 patients without malaria in Savannakhet Province, southern Laos; 52% had evidence of at least one diagnosis (45% with single and 7% with apparent multiple infections). Among patients with only one diagnosis, dengue (30.1%) was the most common, followed by leptospirosis (7.0%), Japanese encephalitis virus infection (3.5%), scrub typhus (2.6%), spotted fever group infection (0.9%), unspecified flavivirus infection (0.9%), and murine typhus (0.4%). We discuss the empirical treatment of fever in relation to these findings. © The American Society of Tropical Medicine and Hygiene.
Cattle fever ticks (CFT) Rhipicephalus microplus and Rhipicephalus annulatus are invasive livestock pests that are endemic to Mexico and invasive along the Texas – Mexico border. Acaricide resistance, alternate wildlife hosts, and pathogenic landscape forming weeds present challenges for sustainable...
Maity, Pranab; Roy, Pinaki; Basu, Arindam; Das, Biman; Ghosh, U S
Chikungunya most often is a self-limiting febrile illness with polyarthritis and the virus is not known to be neurotropic. We are reporting a case of chikugunya fever presenting as acute demyelinating encephalomyelitis(ADEM) which is very rare.
Khetarpal, Niyati; Khanna, Ira
Dengue is a highly endemic infectious disease of the tropical countries and is rapidly becoming a global burden. It is caused by any of the 4 serotypes of dengue virus and is transmitted within humans through female Aedes mosquitoes. Dengue disease varies from mild fever to severe conditions of dengue hemorrhagic fever and shock syndrome. Globalization, increased air travel, and unplanned urbanization have led to increase in the rate of infection and helped dengue to expand its geographic and...
Kumar, Kalenahalli Jagadish; Chandrashekar, Anitha; Basavaraja, Chetak Kadabasal; Kumar, Halasahalli Chowdegowda Krishna
Dengue infection can have spectrum of manifestations, often with an unpredictable clinical progression and outcome. There have been increasing reports of atypical manifestations. Abdominal pain or tenderness and persistent vomiting (warning signs) are present in the majority of cases with severe dengue prior to clinical deterioration. We report a 10-year-old child who presented with fever, persistent vomiting, and abdominal pain. A diagnosis of acute pancreatitis was made. This is a very infrequently reported complication of dengue hemorrhagic fever.
Foggo, Vanessa; Cavenagh, Jamie
The presence of fever in malignancy usually indicates infection, though transfusion, thrombosis and drugs are also culprits. However, particularly in some tumour types, fever can also be a paraneoplastic syndrome, caused by the malignancy itself. This can be a difficult diagnosis to establish and presents a therapeutic challenge to the physician when the underlying malignancy is not easily treated. © Royal College of Physicians 2015. All rights reserved.
Davis, Nelson C.; Shannon, Raymond C.
Yellow fever virus from M. rhesus has been inoculated into a South American monkey (Cebus macrocephalus) by blood injection and by bites of infected mosquitoes. The Cebus does not develop the clinical or pathological signs of yellow fever. Nevertheless, the virus persists in the Cebus for a time as shown by the typical symptoms and lesions which develop when the susceptible M. rhesus is inoculated from a Cebus by direct transfer of blood or by mosquito (A. aegypti) transmission. PMID:19869607
Veloso Henrique Horta
Full Text Available Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.
Augustin C. Dima
Full Text Available 49 year-old man presented to our clinic for pain in the right hypochondrium, diarrhea, and fever. The clinical examination highlights a tumoral formation in the right side of the abdomen, with firm consistency, poorly defined margins, and present mobility in the deep structures. On biological exams, leukocytosis with neutrophilia, inflammatory syndrome, and hypoalbuminaemia were identified. The first computed tomography exam described parietal thickening of the ascending colon, with infiltrative aspect, and multiple local adenopathies, lomboaortic and interaortocave. Moreover, four nodular liver tumors, with hypodense image in native examination, were identified. The lab tests for infectious diseases were all inconclusives: three hemocultures, three stool samples, and three coproparasitological exams were all negatives. Interdisciplinary examinations, internal medicine and infectious diseases, sustained the diagnosis of colonic neoplasm with peritumoral abscess and liver pseudo-tumoral masses. The colonoscopy did not revealed any bowel lesions relevant for neoplasia. This result as well as the bio-clinical context imposed abstention from surgical intervention. Wide spectrum antibiotics and symptomatic treatment were initiated. But, ten days after hospitalization, the second computed tomography exam showed reduction of the ascending colon wall thickness associated with significant increases of the liver tumors is so revealed. The investigations for other possible etiologies were so continued.
Digoutte, J P
In the early 20th century, when it was discovered that the yellow fever virus was transmitted in its urban cycle by Aedes aegypti, measures of control were introduced leading to its disappearance. Progressive neglect of the disease, however, led to a new outbreak in 1927 during which the etiological agent was isolated; some years later a vaccine was discovered and yellow fever disappeared again. In the 1960s, rare cases of encephalitis were observed in young children after vaccination and the administration of the vaccine was forbidden for children under 10 years. Five years later, a new outbreak of yellow fever in Diourbel, Senegal, was linked to the presence of Aedes aegypti. In the late 1970s, the idea of a selvatic cycle for yellow fever arose. Thanks to new investigative techniques in Senegal and Côte d'Ivoire, the yellow fever virus was isolated from the reservoir of virus and vectors. The isolated virus was identified in monkeys and several vectors: Aedes furcifer, Aedes taylori, Aedes luteocephalus. Most importantly, the virus was isolated in male mosquitoes. Until recently, the only known cycle had been that of Haddow in East Africa. The virus circulate in the canopea between monkeys and Aedes africanus. These monkeys infect Aedes bromeliae when they come to eat in banana plantations. This cycle does not occur in West Africa. Vertical transmission is the main method of maintenance of the virus through the dry season. "Reservoirs of virus" are often mentioned in medical literature, monkeys having a short viremia whereas mosquitoes remain infected throughout their life cycle. In such a selvatic cycle, circulation can reach very high levels and no child would be able to escape an infecting bite and yet no clinical cases of yellow fever have been reported. The virulence--as it affects man--of the yellow fever virus in its wild cycle is very low. In areas where the virus can circulate in epidemic form, two types of circulation can be distinguished
Galil, B.S.; Spanier, E.; Ferguson, W.W.
Seven species of Scyphomedusae are reported from the Mediterranean coast of Israel. Two of these, Rhopilema nomadica spec. nov. and Phyllorhiza punctata von Lendenfeld, 1884, are Lessepsian migrants new to the Mediterranean.
Kampschreur, L.M.; Delsing, C.E.; Groenwold, R.H.; Wegdam-Blans, M.C.; Bleeker-Rovers, C.P.; Jager-Leclercq, M.G. De; Hoepelman, A.I.; Kasteren, M.E.E. van; Buijs, J.; Renders, N.H.; Nabuurs-Franssen, M.H.; Oosterheert, J.J.; Wever, P.C.
Coxiella burnetii causes Q fever, a zoonosis, which has acute and chronic manifestations. From 2007 to 2010, the Netherlands experienced a large Q fever outbreak, which has offered a unique opportunity to analyze chronic Q fever cases. In an observational cohort study, baseline characteristics and
Price, J F; Baringer, M O; Lueck, R G; Johnson, G C; Ambar, I; Parrilla, G; Cantos, A; Kennelly, M A; Sanford, T B
The Mediterranean Sea produces a salty, dense outflow that is strongly modified by entrainment as it first begins to descend the continental slope in the eastern Gulf of Cadiz. The current accelerates to 1.3 meters per second, which raises the internal Froude number above 1, and is intensely turbulent through its full thickness. The outflow loses about half of its density anomaly and roughly doubles its volume transport as it entrains less saline North Atlantic Central water. Within 100 kilometers downstream, the current is turned by the Coriolis force until it flows nearly parallel to topography in a damped geostrophic balance. The mixed Mediterranean outflow continues westward, slowly descending the continental slope until it becomes neutrally buoyant in the thermocline where it becomes an important water mass.
Stahlschmidt, Z. R.; Adamo, S. A.
Fever can reduce mortality in infected animals. Yet, despite its fitness-enhancing qualities, fever often varies among animals. We used several approaches to examine this variation in insects. Texas field crickets ( Gryllus texensis) exhibited a modest fever (1 °C increase in preferred body temperature, T pref) after injection of prostaglandin, which putatively mediates fever in both vertebrates and invertebrates, but they did not exhibit fever during chronic exposure to heat-killed bacteria. Further, chronic food limitation and mating status did not affect T pref or the expression of behavioural fever, suggesting limited context dependency of fever in G. texensis. Our meta-analysis of behavioural fever studies indicated that behavioural fever occurs in many insects, but it is not ubiquitous. Thus, both empirical and meta-analytical results suggest that the fever response in insects `is widespread, although certainly not inevitable' (Moore 2002). We highlight the need for future work focusing on standardizing an experimental protocol to measure behavioural fever, understanding the specific mechanism(s) underlying fever in insects, and examining whether ecological or physiological costs often outweigh the benefits of fever and can explain the sporadic nature of fever in insects.
Goyal, Jyoti; Jha, Rakesh; Bhatia, Paramjeet; Mani, Raj Kumar
A case of cervical spinal cord injury and quadriparesis with prolonged fever is being described. Initially, the patient received treatment for well-documented catheter-related bloodstream infection. High spiking fever returned and persisted with no obvious evidence of infection. The usual non-infectious causes too were carefully excluded. QUAD fever or fever due to spinal cord injury itself was considered. The pathogenetic basis of QUAD fever is unclear but could be attributed to autonomic dysfunction and temperature dysregulation. Awareness of this little known condition could help in avoiding unnecessary antimicrobial therapy and in more accurate prognostication. Unlike several previous reported cases that ended fatally, the present case ran a relatively benign course. The spectrum of presentations may therefore be broader than hitherto appreciated. © 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.
Eichhorst, Werner; Neder, Franziska
In all Mediterranean countries youth unemployment has reached alarming record levels. This paper analyses the current situation in France, Greece, Italy, Portugal, and Spain. In all countries school dropout rates are high, returns to education are low and the transition from education to work is problematic and difficult. This is due to a poor working vocational training system, the dualization of the labor market and minimum wages that are set too high. The Great Recession deteriorated the s...
In its examination of wind energy potential in the Mediterranean Basin, this paper provides brief notes on the Basin's geography; indicates power production and demand; describes the area's wind characteristics and wind monitoring activities; illustrates wind velocity distributions; estimates local wind power production potential; reviews the Basin's wind energy marketing situation and each bordering country's wind energy programs; surveys installed wind energy farms; and assesses national research and commercialization efforts
Rizza, W; De Gara, L; Antonelli Incalzi, R; Pedone, C
To investigate the evolution of the Mediterranean Diet (MD) in a delimited area of Southern Italy, by comparing the diet adopted 60-70 years ago (Prototypical Mediterranean Diet, PMD) with the contemporary one (Contemporary Mediterranean Diet, CMD), and to verify to what extent they fitted the recommendations of the Italian and the USDA dietary guidelines. We recruited a total of 106 participants, divided in two groups. PMD group included 52 women aged >80 years, with a good cognitive function and full independence in basic and instrumental activities of daily living. CMD group included 20 men and 34 women aged 50-60 years. Food intake was assessed by administering the EPIC food frequency questionnaire to each participant, and an additional survey to the PMD subjects only. Both PMD and CMD showed adequate intakes of macronutrients, although some deficiencies related to micronutrient requirements were evident. CMD showed a slightly greater use of animal products, processed and sugary foods, and higher intakes of simple sugars, animal proteins (49.6 vs 28.3 g/day), animal lipids (37.8 vs 20.1 g/day), saturated fats (25.0 vs 15.8 g/day) and cholesterol (305.0 vs 258.5 g/day). PMD showed many similarities to the original version of the MD in terms of macronutrients distribution and food choices. The documented evolution of the dietary habits over a 70 years timespan suggests that nowadays Mediterranean regions adhere less strictly to the original MD, although nutrients intakes are adequate to LARN and USDA recommendations. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
Blank, Norbert; Hegenbart, Ute; Dietrich, Sascha; Brune, Maik; Beimler, Jörg; Röcken, Christoph; Müller-Tidow, Carsten; Lorenz, Hanns-Martin; Schönland, Stefan O
To investigate obesity as susceptibility factor in patients with idiopathic AA amyloidosis. Clinical, biochemical and genetic data were obtained from 146 patients with AA amyloidosis. Control groups comprised 40 patients with long-standing inflammatory diseases without AA amyloidosis and 56 controls without any inflammatory disease. Patients with AA amyloidosis had either familial Mediterranean fever (FMF) or long-standing rheumatic diseases as underlying inflammatory disease (n = 111, median age 46 years). However, in a significant proportion of patients with AA amyloidosis no primary disease was identified (idiopathic AA; n = 37, median age 60 years). Patients with idiopathic AA amyloidosis were more obese and older than patients with AA amyloidosis secondary to FMF or rheumatic diseases. Serum leptin levels correlated with the body mass index (BMI) in all types of AA amyloidosis. Elevated leptin levels of more than 30 µg/l were detected in 18% of FMF/rheumatic + AA amyloidosis and in 40% of patients with idiopathic AA amyloidosis (p = .018). Finally, the SAA1 polymorphism was confirmed as a susceptibility factor for AA amyloidosis irrespective of the type of the disease. Obesity, age and the SAA1 polymorphism are susceptibility factors for idiopathic AA amyloidosis. Recent advances in treatment of FMF and rheumatic disorders will decrease the incidence of AA amyloidosis due to these diseases. Idiopathic AA, however, might be an emerging problem in the ageing and increasingly obese population.
Full Text Available This study details mercury pollution within the food chain of the Mediterranean by analysing the most comprehensive mercury dataset available for biota and water measurements. In this study we computed a bioaccumulation factor (BAF for datasets in the existing mercury-related scientific literature, in on-going programs, and in past measurement campaigns. Preliminary results indicate a major lack of information, making the outcome of any assessment very uncertain. Importantly, not all marine eco-regions are (or have ever been covered by measurement campaigns. Most lacking is information associated with the South-Eastern part of the Mediterranean, and in several eco-regions it is still impossible to reconstruct a trophic net, as the required species were not accounted for when mercury measurements were taken. The datasets also have additional temporal sampling problems, as species were often not sampled systematically (but only sporadically during any given sampling period. Moreover, datasets composed of mercury concentrations in water also suffer from similar geographic limitations, as they are concentrated in the North-Western Mediterranean. Despite these concerns, we found a very clear bioaccumulation trend in 1999, the only year where comprehensive information on both methylmercury concentrations in water and biota was available.
Hoffman, Richard; Gerber, Mariette
.... It discusses the Mediterranean diet in the light of recent developments in nutritional biochemistry, disease mechanisms and epidemiological studies, and also provides advice on nutrition policies...
.... The new security concerns in the southern Mediterranean region terrorism, economic disparities, demographic imbalances, the potential for social and political instability, and the proliferation...
Hinson, Holly E; Rowell, Susan; Morris, Cynthia; Lin, Amber L; Schreiber, Martin A
Fever is strongly associated with poor outcome after traumatic brain injury (TBI). We hypothesized that early fever is a direct result of brain injury and thus would be more common in TBI than in patients without brain injury and associated with inflammation. We prospectively enrolled patients with major trauma with and without TBI from a busy Level I trauma center intensive care unit (ICU). Patients were assigned to one of four groups based on their presenting Head Abbreviated Injury Severity Scale scores: multiple injuries: head Abbreviated Injury Scale (AIS) score greater than 2, one other region greater than 2; isolated head: head AIS score greater than 2, all other regions less than 3; isolated body: one region greater than 2, excluding head/face; minor injury: no region with AIS greater than 2. Early fever was defined as at least one recorded temperature greater than 38.3°C in the first 48 hours after admission. Outcome measures included neurologic deterioration, length of stay in the ICU, hospital mortality, discharge Glasgow Outcome Scale-Extended, and plasma levels of seven key cytokines at admission and 24 hours (exploratory). Two hundred sixty-eight patients were enrolled, including subjects with multiple injuries (n = 59), isolated head (n = 97), isolated body (n = 100), and minor trauma (n = 12). The incidence of fever was similar in all groups irrespective of injury (11-24%). In all groups, there was a significant association between the presence of early fever and death in the hospital (6-18% vs. 0-3%), as well as longer median ICU stays (3-7 days vs. 2-3 days). Fever was significantly associated with elevated IL-6 at admission (50.7 pg/dL vs. 16.9 pg/dL, p = 0.0067) and at 24 hours (83.1 pg/dL vs. 17.1 pg/dL, p = 0.0025) in the isolated head injury group. Contrary to our hypothesis, early fever was not more common in patients with brain injury, though fever was associated with longer ICU stays and death in all groups. Additionally, fever was
Durrani, A.B.; Shaikh, M.; Khan, Z.
To observe the pattern and mortality of Congo-Crimean Hemorrhagic Fever (CCHF) in Balochistan. Two hundred and twenty-six febrile patients with bleeding of sudden onset, with initial signs and symptoms including headache, high fever, back pain, joint pain, stomach pain, vomiting, red eyes, flushed face, red throat and petechiae on the palate of both sexes were screened for CCHF over a period of 10 years. Clinical criteria for initial diagnosis directed the subsequent diagnostic work-up. The ages of these patients ranged from 7 years to 74 years. Sixty-three percent of these patients were positive for CCHF. Males were 68% of the total patients. Over the years, CCHF showed a gradual increase ranging from 43% to 80%. Total mortality was 15%, all being secondary cases. Death was not observed in primary CCHF cases. In this study, suspicion of viral hemorrhagic fever was raised in 62% cases at the time of admission and the patients were immediately isolated, noninvasive procedures were instigated and barrier nursing was implemented. None of the family and hospital staff members who had close contact with the patient became ill, while those who were not suspected initially (38%) infected the health care workers and the family members. Although CCHF is rare, this study stresses the need for proper health facilities in Pakistan and to include VHF (viral hemorrhagic fevers) in the differential diagnosis of unexplained fever with hemorrhagic tendencies of sudden onset. (author)
Kenneth J. Hsü
Full Text Available The Earth is a self-organizing system liking a living organism. Lovelock proposed Gaia as a metaphor to designate the check and balance ofterrestrial temperatures: the Earth is never too hot so that the ocean could boil, and the Earth is never too cold that the ocean could freeze from top to bottom. Hsü proposed that Gaia is endothermic because the life on Earth has been alternate successions of air-conditioners and heaters which evolved and deactivate or reinforce the terrestial greenhouse of carbon dioxide in atmosphere. When Earth was heating up too much, the air-conditioneers, such as anaerobic bacteria, cyanobacteria, skeletal organisms and trees, and finally calcareous plankton, went to work to bring the terrestrial temperature down. When the Earth was freezing at times of continental glaciation, heaters went to work, such as methanogenic bacteria, Ediacaran faunas, tundra and desert plants, and now Homo sapiens. Gaia has to have other organs to keep the self-organizing system vital. This paper presents a postulate that the Miocene Mediterranean Sea acted as Gaia´s kidney. The steady influx of dissolved ions and debris into the ocean causes inevitable increase of ocean´s salinity. The fossil and geochemicl records indicate that the ocean has never been too saline nor too brackish for the survival of normal marine organisms: the salinity ranged from about 32 to 36 pro mil during the last billion years. Ocean-drilling cruises to the Mediterranean discovered a very large salt formation, deposited during some 5 million years ago when the Mediterranean dried up. A study of the geochemical balance of the oceans indicates that the deposition of very large salt bodies in isolated basins such as the Miocene Mediterranean every 100 million years or so. The saline giants have the function of Gaia´s kidney. With periodical removals of the salt ions and the heavy metals from seawater, the world´s ocean have been rendered forever habitable. Gaia
Dorsett, Chasity; Oh, Hyunju; Paulemond, Marie Laura; Rychtář, Jan
Dengue fever is one of the most important vector-borne diseases. It is transmitted by Aedes Stegomyia aegypti, and one of the most effective strategies to combat the disease is the reduction of exposure to bites of these mosquitoes. In this paper, we present a game-theoretical model in which individuals choose their own level of protection against mosquito bites in order to maximize their own benefits, effectively balancing the cost of protection and the risk of contracting the dengue fever. We find that even when the usage of protection is strictly voluntary, as soon as the cost of protection is about 10,000 times less than the cost of contracting dengue fever, the optimal level of protection will be within 5 % of the level needed for herd immunity.
Full Text Available A 24-year-old previously healthy girl presented with persistent fever, headache, and jaundice. Rapid-test anti-dengue virus IgM antibody was positive but anti-dengue IgG was nonreactive, which is suggestive of primary dengue infection. There was clinical deterioration during empiric antibiotic and symptomatic therapy. Bone marrow examination demonstrated the presence of hemophagocytosis. Diagnosis of dengue fever with virus-associated hemophagocytic syndrome was made according to the diagnostic criteria of the HLH 2004 protocol of the Histiocyte Society. The patient recovered with corticosteroid therapy. A review of literature revealed only a handful of case reports that showed the evidence that this syndrome is caused by dengue virus. Our patient is an interesting case of hemophagocytic syndrome associated with classic dengue fever and contributes an additional case to the existing literature on this topic. This case highlights the need for increased awareness even in infections not typically associated with hemophagocytic syndrome.
Runge, John S
In the 19th century, yellow fever thrived in the tropical, urban trade centers along the American Gulf Coast. Industrializing and populated, New Orleans and Memphis made excellent habitats for the yellow fever-carrying Aedes aegypti mosquitoes and the virulence they imparted on their victims. Known for its jaundice and black, blood-filled vomit, the malady terrorized the region for decades, sometimes claiming tens of thousands of lives during the near annual summertime outbreaks. In response to the failing medical community, a small, pronounced population of sick and healthy laypeople openly criticized the efforts to rid the Gulf region of yellow jack. Utilizing newspapers and cartoons to vocalize their opinions, these critics doubted and mocked the medical community, contributing to the regional and seasonal dilemma yellow fever posed for the American South. These sentient expressions prove to be an early example of patient distrust toward caregivers, a current problem in clinical heath care.
Yong, Benny; Samat, Nor Azah
In recent years, political figures begin to utilize social media as one of alternative to engage in communication with their supporters. Publics referred to Jokowi, one of the candidates in Indonesia presidential election in 2014, as the first politician in Indonesia to truly understand the power of social media. Social media is very important in shaping public opinion. In this paper, effect of social media on the Jokowi-fever model in a closed population will be discussed. Supporter population is divided into three class sub-population, i.e susceptible supporters, Jokowi infected supporters, and recovered supporters. For case no positive media, there are two equilibrium points; the Jokowi-fever free equilibrium point in which it locally stable if basic reproductive ratio less than one and the Jokowi-fever endemic equilibrium point in which it locally stable if basic reproductive ratio greater than one. For case no negative media, there is only the Jokowi-fever endemic equilibrium point in which it locally stable if the condition is satisfied. Generally, for case positive media proportion is positive, there is no Jokowi-fever free equilibrium point. The numerical result shows that social media gives significantly effect on Jokowi-fever model, a sharp increase or a sharp decrease in the number of Jokowi infected supporters. It is also shown that the boredom rate is one of the sensitive parameters in the Jokowi-fever model; it affects the number of Jokowi infected supporters.
Staszewska-Jakubik, Ewa; Czarkowski, Mirosław P; Kondej, Barbara
Assessment of the epidemiological situation of scarlet fever in Poland in 2014. The evaluation was performed by reviewing surveillance data published in the bulletin “Infectious diseases and poisonings in Poland in 2014” as well as in previous bulletins, and unpublished data collected under Statistical survey program of official statistics. These data relate to cases of scarlet fever registered by health sanitary inspection on the basis of statutory notification of scarlet fever reported by physicians. In 2014, annual, incidence rate of scarlet fever in Poland was about 9% lower in comparison to previous year. There were 22 855 cases all over the country and the incidence was 59.5 per 100,000 population; depending on the voivodeship ranged from 19.5 in podkarpackie to 93.2 in pomorskie. The highest incidence was noted among 4-year-old children (981.4) and 5-year-old children (971.0). However the incidence among children and young people up to 15 years accounted for 95.7% of all cases. The incidence among men (67.2) was higher by 28.5% than incidence among women (52.3). Incidence rate in urban areas, in any size town, was higher than in rural areas. Overall incidence in urban areas was 66.4; in rural areas - 49.0. 1,11% of patients were hospitalized. There were no reported deaths related to scarlet fever. In the surveillance of scarlet fever it is necessary to ensure that the collected data will be valid and reliable. Very low specificity of this surveillance may not only impinge on the assessment of epidemiological situation of this disease in Poland but also overshadow the situation of other diseases, including diseases under elimination program (rubella, measles). This is one of the greatest challenges facing sanitary inspection in the coming years.
Full Text Available A 21-year-old female patient with abdominal pain, vomiting and constipation was admitted to the hospital with the possible diagnosis of diabetic ketoacidosis. Due to increased abdominal pain and constipation the patient underwent a surgery with the diagnosis of ileus. However, no pathological findings were found in the abdominal organs apart from serous fluid in the abdominal cavity. The patient became hypertensive, tachycardic and had an episode of seizures postoperatively. Neurological manifestations with unexplained abdominal pain indicated a diagnosis of acute intermittent porphyria (AIP. Acute intermittent porphyria diagnosis is based on elevated urinary δ-aminolevulinic acid (ALA and porphobilinogen (PBG levels as well as hydroxymethylbilane synthase (HMBS IVS13-2 A>G heterozygous mutation. Familial Mediterranean Fever (FMF gene mutations were not confirmed. Porphyria should be considered in the differential diagnosis of patients with recurrent abdominal pain, neurological symptoms and lack of FMF gene polymorphism.
Kinohshita, Tomomi; Matsushima, Akira; Satoh, Shunichi; Hoshi, Kenichi; Kishida, Dai; Yahikozawa, Hiroyuki
A 66-year-old woman was admitted to our hospital with recurrent meningitis. She presented with 10 episodes of meningitis in 10 months. Examination of cerebrospinal fluid demonstrated pleocytosis, with neutrophils dominant at the early stage, and lymphocytes dominant at the late stage. Mollaret cells were found and the level of IL-6 was increased in cerebrospinal fluid. Several antibiotics and antiviral agents failed to prevent relapse. However, colchicine therapy successfully prevented the recurrence of meningitis. Genetic testing for familial Mediterranean fever (FMF) showed a mutation in the MEFV gene. It is difficult to diagnose the cause of Mollaret's meningitis in some patients. FMF, neuro-Behçet's disease, and neuro-Sweet disease should be included in the differential diagnosis of recurrent meningitis. In addition, colchicine therapy can prevent the relapse of meningitis in such cases.
Al-Araimi, Hanaa; Al-Jabri, Amal; Mehmoud, Arshad; Al-Abri, Seif
We describe a case of a 38 year-old Sri Lankan female who was referred to the surgeon on call with a picture of acute abdomen. She presented with a three-day history of fever, headache, abdominal pain and diarrhoea; however, the physical examination was not consistent with acute abdomen. Her platelet count was 22 ×109/L. A diagnosis of dengue haemorrhagic fever (DHF) was made and dengue serology was positive. Dengue epidemics have been associated with a variety of gastrointestinal symptoms an...
Maalouly, C; Cecere, N; Wilmes, D; Demoulin, N; Morelle, J
Bartonella henselae infections are among the most common causes of fever and lymphadenopathies, but can lead to severe complications in immunocompromised hosts; early recognition of these infections is of paramount importance in immunocompromised patients. Here we report the case of a renal transplant recipient who presented with fever, lymphadenopathies, and a splenic abscess secondary to Bartonella henselae infection, successfully treated with doxycycline. We discuss the various clinical presentations of Bartonella henselae infections in immunocompromised patients and the available diagnostic tools for this potentially severe complication.
Full Text Available Chikungunya fever is a tropical vector-borne disease that has been spreading rapidly around the world during the last 10 years, and which has been usually misdiagnosed as dengue. Nowadays, this disease is increasing in Mexico, mainly in the southern and central zones of the country, being significantly more common in women, children and young adults (28% in < 20 years of age. The classical presentation includes fever, arthralgia, polyarthritis, back-pain, and skin rashes. Although symptoms and treatment are similar to those for dengue, there are key clinical features to differentiate these two diseases.
Full Text Available Three main preventive principles against milk fever were evaluated in this literature review, and the efficacy of each principle was estimated from the results of controlled investigations. Oral calcium drenching around calving apparently has a mean efficacy of 50%–60% in terms of milk fever prevention as well as prevention of milk fever relapse after intravenous treatment with calcium solutions. However, some drenches have been shown to cause lesions in the forestomacs. When using the DCAD (dietary cation-anion difference principle, feeding rations with a negative DCAD (measured as (Na + K – (Cl + S significantly reduce the milk fever incidence. Calculating the relative risk (RR of developing milk fever from controlled experiments results in a mean RR between 0.19 and 0.35 when rations with a negative versus positive DCAD are compared. The main drawback from the DCAD principle is a palatability problem. The principle of feeding rations low in calcium is highly efficient in milk fever prevention provided the calcium intake in the dry period is kept below 20 g per day. Calculating the relative risk (RR of developing milk fever from controlled experiments results in a very low mean RR (between 0 and 0.20 (daily calcium intake below versus above 20 g/d. The main problem in implementing the low-Ca principle is difficulties in formulating rations sufficiently low in calcium when using commonly available feeds. The use of large doses of vitamin D metabolites and analogues for milk fever prevention is controversial. Due to toxicity problems and an almost total lack of recent studies on the subject this principle is not described in detail. A few management related issues were discussed briefly, and the following conclusions were made: It is important to supply the periparturient cow with sufficient magnesium to fulfil its needs, and to prevent the dry cows from being too fat. Available information on the influence of carbohydrate intake, and on the
Debora; Rendy; Rahmi
Dengue fever is an endemic disease that is transmitted through the Aedes aegypti mosquito vector. The disease is present in more than 100 countries in America, Africa, and Asia, especially tropical countries. Differential equations can be used to represent the spread of dengue virus occurring in time intervals and model in the form of mathematical models. The mathematical model in this study tries to represent the spread of dengue fever based on the data obtained and the assumptions used. The mathematical model used is a mathematical model consisting of Susceptible (S), Infected (I), Viruses (V) subpopulations. The SIV mathematical model is then analyzed to see the solution behaviour of the system.
McGregor, Alastair C; Moore, David A
The causes of fever of unknown origin (FUO) are changing because advances in clinical practice and diagnostics have facilitated the identification of some infections. A variety of bacterial infections can cause FUO, and these can be divided into those that are easy to identify using culture and those that require serological or molecular tests for identification. A number of viral, parasitic and fungal infections can also cause prolonged fever. This article summarises the clinical features and diagnostic strategy of these infections. © Royal College of Physicians 2015. All rights reserved.
Peña-Irún, Á; González Santamaría, A R; Munguía Rozadilla, F; Herrero González, J L
Q fever is a zoonosis of global distribution with an incidence of 3 cases per 100,000 inhabitants/year. A variety of animals can be the coxiella reservoir which always must be taken into account when faced with a fever process in a compatible context. Rapid diagnosis and treatment are essential to improve the prognosis, and prevent the development of chronic infection or other potential complications associated with the coxelliosis. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.
Vallejos-Parás, Alfonso; Cabrera-Gaytán, David Alejandro
Dengue virus three, Chikunguya and Zika have entered the national territory through the south of the country. Cases and outbreaks of yellow fever have now been identified in the Americas where it threatens to expand. Although Mexico has a robust epidemiological surveillance system for vector-borne diseases, our country must be alert in case of its possible introduction into the national territory. This paper presents theoretical assumptions based on factual data on the behavior of yellow fever in the Americas, as well as reflections on the epidemiological surveillance of vector-borne diseases.
Zhioua, Elyes; Moureau, Grégory; Chelbi, Ifhem; Ninove, Laetitia; Bichaud, Laurence; Derbali, Mohamed; Champs, Mylène; Cherni, Saifeddine; Salez, Nicolas; Cook, Shelley; de Lamballerie, Xavier; Charrel, Remi N
Sandflies are widely distributed around the Mediterranean Basin. Therefore, human populations in this area are potentially exposed to sandfly-transmitted diseases, including those caused by phleboviruses. Whilst there are substantial data in countries located in the northern part of the Mediterranean basin, few data are available for North Africa. In this study, a total of 1489 sandflies were collected in 2008 in Tunisia from two sites, bioclimatically distinct, located 235 km apart, and identified morphologically. Sandfly species comprised Phlebotomus perniciosus (52.2%), Phlebotomus longicuspis (30.1%), Phlebotomus papatasi (12.0%), Phlebotomus perfiliewi (4.6%), Phlebotomus langeroni (0.4%) and Sergentomyia minuta (0.5%). PCR screening, using generic primers for the genus Phlebovirus, resulted in the detection of ten positive pools. Sequence analysis revealed that two pools contained viral RNA corresponding to a novel virus closely related to sandfly fever Naples virus. Virus isolation in Vero cells was achieved from one pool. Genetic and phylogenetic characterization based on sequences in the three genomic segments showed that it was a novel virus distinct from other recognized members of the species. This novel virus was provisionally named Punique virus. Viral sequences in the polymerase gene corresponding to another phlebovirus closely related to but distinct from sandfly fever Sicilian virus were obtained from the eight remaining positive pools.
Estofolete, Cássia Fernanda; Mota, Mânlio Tasso Oliveira; Vedovello, Danila; Góngora, Delzi Vinha Nunes de; Maia, Irineu Luiz; Nogueira, Maurício Lacerda
Arboviruses impose a serious threat to public health services. We report a case of a patient returning from a work trip to the Amazon basin with myalgia, arthralgia, fever, and headache. During this travel, the patient visited riverside communities. Both dengue and Chikungunya fevers were first suspected, tested for, and excluded. Mayaro fever was then confirmed by reverse transcription polymerase chain reaction followed by next-generation sequencing and phylogenetic reconstruction. The increased awareness of physicians and consequent detection of Mayaro virus in this case was only possible due a previous surveillance program with specific health personnel training about these neglected arboviruses.
Bouzid, Maha; Colón-González, Felipe J; Lung, Tobias; Lake, Iain R; Hunter, Paul R
Dengue fever is the most prevalent mosquito-borne viral disease worldwide. Dengue transmission is critically dependent on climatic factors and there is much concern as to whether climate change would spread the disease to areas currently unaffected. The occurrence of autochthonous infections in Croatia and France in 2010 has raised concerns about a potential re-emergence of dengue in Europe. The objective of this study is to estimate dengue risk in Europe under climate change scenarios. We used a Generalized Additive Model (GAM) to estimate dengue fever risk as a function of climatic variables (maximum temperature, minimum temperature, precipitation, humidity) and socioeconomic factors (population density, urbanisation, GDP per capita and population size), under contemporary conditions (1985-2007) in Mexico. We then used our model estimates to project dengue incidence under baseline conditions (1961-1990) and three climate change scenarios: short-term 2011-2040, medium-term 2041-2070 and long-term 2071-2100 across Europe. The model was used to calculate average number of yearly dengue cases at a spatial resolution of 10 × 10 km grid covering all land surface of the currently 27 EU member states. To our knowledge, this is the first attempt to model dengue fever risk in Europe in terms of disease occurrence rather than mosquito presence. The results were presented using Geographical Information System (GIS) and allowed identification of areas at high risk. Dengue fever hot spots were clustered around the coastal areas of the Mediterranean and Adriatic seas and the Po Valley in northern Italy. This risk assessment study is likely to be a valuable tool assisting effective and targeted adaptation responses to reduce the likely increased burden of dengue fever in a warmer world.
Cêtre-Sossah, Catherine; Zeller, Hervé; Grandadam, Marc; Caro, Valérie; Pettinelli, François; Bouloy, Michèle; Cardinale, Eric; Albina, Emmanuel
As further confirmation of a first human case of Rift Valley fever in 2007 in Comoros, we isolated Rift Valley fever virus in suspected human cases. These viruses are genetically closely linked to the 2006-2007 isolates from Kenya.
... To Your Health: NLM update Transcript Dengue fever vaccines : 03/12/2018 To use the sharing features ... decision to curtail the availability of an approved vaccine for dengue fever is a setback against the ...
... For Consumers Home For Consumers Consumer Updates Reducing Fever in Children: Safe Use of Acetaminophen Share Tweet ... re in the drug store, looking for a fever-reducing medicine for your children. They range in ...
Morillas, Laura; Leuning, Ray; Villagarcia, Luis
measurements from eddy covariance systems located in two functionally different sparsely vegetated drylands sites: a littoral Mediterranean semiarid steppe and a dry-subhumid Mediterranean montane site. The method providing the best results in both areas was fdrying (mean absolute error of 0.17 mm day−1) which...
in the Mediterranean, Malta: Mediterranean Academy of Diplomatic Studies, University of Malta, 1998; and Eberhard Rhein, " Globalisation of the Economy...peace, more marked by internal conflicts (opposing terrorisms, urban guerrillas, social inequalities ) than by the great armoured and air battles. Iraq is
2015 14. ABSTRACT Sandfly fever group viruses in the genus Phlebovirus (family Bunyaviridae) are widely distributed across the globe and are a cause ...Sandfly fever group viruses in the genus Phlebovirus (family Bunyaviridae) are widely distributed across the globe and are a cause of disease in... causes sporadic epidemics of Pappataci fevers in humans (Brett-Major and Claborn 1997). Rift Valley fever virus and Arumowot virus are transmitted by
Suaria, Giuseppe; Avio, Carlo G.; Mineo, Annabella; Lattin, Gwendolyn L.; Magaldi, Marcello G.; Belmonte, Genuario; Moore, Charles J.; Regoli, Francesco; Aliani, Stefano
The Mediterranean Sea has been recently proposed as one of the most impacted regions of the world with regards to microplastics, however the polymeric composition of these floating particles is still largely unknown. Here we present the results of a large-scale survey of neustonic micro- and meso-plastics floating in Mediterranean waters, providing the first extensive characterization of their chemical identity as well as detailed information on their abundance and geographical distribution. All particles >700 μm collected in our samples were identified through FT-IR analysis (n = 4050 particles), shedding for the first time light on the polymeric diversity of this emerging pollutant. Sixteen different classes of synthetic materials were identified. Low-density polymers such as polyethylene and polypropylene were the most abundant compounds, followed by polyamides, plastic-based paints, polyvinyl chloride, polystyrene and polyvinyl alcohol. Less frequent polymers included polyethylene terephthalate, polyisoprene, poly(vinyl stearate), ethylene-vinyl acetate, polyepoxide, paraffin wax and polycaprolactone, a biodegradable polyester reported for the first time floating in off-shore waters. Geographical differences in sample composition were also observed, demonstrating sub-basin scale heterogeneity in plastics distribution and likely reflecting a complex interplay between pollution sources, sinks and residence times of different polymers at sea.
Objective: Severe Lassa fever with high mortality among health care providers is usually a human to human infection that requires high index of suspicion to diagnose. This case report is to describe a peculiar case of Lassa fever among health worker. Result: A severe form of Lassa fever was diagnosed early in a healthcare ...
Background: A mother's knowledge and perception of fever may determine the degree of her anxiety and fear, and reflect on the way the fever is managed at home. This study was carried out to determine the knowledge, perception and practice towards childhood fevers among mothers at the University of Nigeria Teaching ...
Frenkel, J.; Houten, S. M.; Waterham, H. R.; Wanders, R. J.; Rijkers, G. T.; Kimpen, J. L.; Duran, R.; Poll-The, B. T.; Kuis, W.
Dutch type periodic fever (DPF) is an autosomal recessive hereditary fever syndrome. Cases have been reported worldwide, the majority from France and The Netherlands. From infancy the patients suffer fever attacks that recur every 2-8 weeks, often precipitated by immunizations, infections or
The participants were asked questions about sociodemographic data, the definition and measurement of fever, antipyretics, and other interventions used to reduce fever before presenting to the primary care center. Results: A total of 205 parents participated in this study. Ninety‑four parents (45.8%) measured fever with a ...
disease, typhoid fever was included in the differential diagnosis of only about half of the cases. Typhoid fever should always be borne in mind when a patient from an endemic area presents with a pyrexial illness. Typhoid fever is endemic in the area served by Edendale. Hospital. It is common experience that this disease is ...
.... APHIS-2012-0069] Texas (Splenetic) Fever in Cattle AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Final rule. SUMMARY: We are amending the Texas (Splenetic) Fever regulations by updating... Fever Tick Eradication Program Manager, VS, APHIS, 4700 River Road Unit 39, Riverdale, MD 20737-1231...
Background: Fever is a common problem in childhood. Most febrile episodes are managed at home before consultation in a health facility. Caregivers' response to fever will depend on their perception of its cause and knowledge of its management. This study aimed to evaluate mothers' perceptions of fever and its ...
Jan 22, 2013 ... 30.3% of caregivers could cor- rectly describe what fever was. The most frequently utilised fever detection method was tactile as- sessment. Only 3.2% of the care- givers used a thermometer to de- tect fever. Social class, maternal age and religion significantly in- fluenced the decision to use ther- mometers.
This cross-sectional study sought to estimate the direct medical cost of Lassa fever treatment on patients in South-South Nigeria. All the 73 confirmed Lassa fever cases admitted in the isolation ward of the Institute Of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital (ISTH) Irrua, in Edo State, Nigeria, ...
Full Text Available The Mediterranean is one of the most cyclogenetic regions in the world. The cyclones are concentrated along its northern coasts and their tracks are oriented more or less west-east, with several secondary tracks connecting them to Europe and to North Africa. The aim of this study is to examine scenarios in the development of Mediterranean cyclones, based on five selected winter seasons (October–March. We detected the cyclones subjectively using 6-hourly Sea-Level Pressure maps, based on the NCAR/NCEP reanalysis archive.
HMSO (1962 has shown that most Mediterranean cyclones (58% enter the Mediterranean from the Atlantic Ocean (through Biscay and Gibraltar, and from the south-west, the Sahara Desert, while the rest are formed in the Mediterranean Basin itself. Our study revealed that only 13% of the cyclones entered the Mediterranean, while 87% were generated in the Mediterranean Basin. The entering cyclones originate in three different regions: the Sahara Desert (6%, the Atlantic Ocean (4%, and Western Europe (3%.
The cyclones formed within the Mediterranean Basin were found to generate under the influence of external cyclonic systems, i.e. as "daughter cyclones" to "parent cyclones" or troughs. These parent systems are located in three regions: Europe (61%, North Africa and the Red Sea (34.5% and the Mediterranean Basin itself (4.5%. The study presents scenarios in the development of Mediterranean cyclones during the winter season, emphasizing the cyclogenesis under the influence of various external forcing.
The large difference with respect to the findings of HMSO (1962 is partly explained by the dominance of spring cyclones generating in the Sahara Desert, especially in April and May that were not included in our study period.
El-Bahnasawy, Mamdouh M; Megahed, Laila Abdel-Mawla; Abdalla Saleh, Hala Ahmed; Morsy, Tosson A
Viral hemorrhagic fevers (VHFs) typically manifest as rapidly progressing acute febrile syndromes with profound hemorrhagic manifestations and very high fatality rates. Lassa fever, an acute hemorrhagic fever characterized by fever, muscle aches, sore throat, nausea, vomiting, diarrhea and chest and abdominal pain. Rodents are important reservoirs of rodent-borne zoonosis worldwide. Transmission rodents to humans occur by aerosol spread, either from the genus Mastomys rodents' excreta (multimammate rat) or through the close contact with infected patients (nosocomial infection). Other rodents of the genera Rattus, Mus, Lemniscomys, and Praomys are incriminated rodents hosts. Now one may ask do the rodents' ectoparasites play a role in Lassa virus zoonotic transmission. This paper summarized the update knowledge on LHV; hopping it might be useful to the clinicians, nursing staff, laboratories' personals as well as those concerned zoonoses from rodents and rodent control.
Barten, D.G.; Delsing, C.E.; Keijmel, S.P.; Sprong, T.; Timmermans, J.; Oyen, W.J.G.; Nabuurs-Franssen, M.H.; Bleeker-Rovers, C.P.
BACKGROUND: Chronic Q fever usually presents as endocarditis or endovascular infection. We investigated whether 18F-FDG PET/CT and echocardiography were able to detect the localization of infection. Also, the utility of the modified Duke criteria was assessed. METHODS: Fifty-two patients, who had an
Auguste, Albert J; Lemey, Philippe; Bergren, Nicholas A; Giambalvo, Dileyvic; Moncada, Maria; Morón, Dulce; Hernandez, Rosa; Navarro, Juan-Carlos; Weaver, Scott C
Phylogenetic analysis of yellow fever virus (YFV) strains isolated from Venezuela strongly supports YFV maintenance in situ in Venezuela, with evidence of regionally independent evolution within the country. However, there is considerable YFV movement from Brazil to Venezuela and between Trinidad and Venezuela.
This podcast looks at the epidemiologic characteristics of Alkhurma Hemorrhagic Fever in humans in Najran City, Saudi Arabia. CDC epidemiologist Dr. Adam MacNeil discusses the severity and risk factors for the illness. Created: 10/28/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 11/17/2010.
Sissoko, Daouda; Giry, Claude; Gabrie, Philippe; Tarantola, Arnaud; Pettinelli, François; Collet, Louis; D'Ortenzio, Eric; Renault, Philippe; Pierre, Vincent
After the 2006-2007 epidemic wave of Rift Valley fever (RVF) in East Africa and its circulation in the Comoros, laboratory case-finding of RVF was conducted in Mayotte from September 2007 through May 2008. Ten recent human RVF cases were detected, which confirms the indigenous transmission of RFV virus in Mayotte.
Barrett, Freja Cecille; Knudsen, Jenny Dahl; Johansen, Isik Somuncu
Typhoid fever is a systemic illness which in high-income countries mainly affects travellers. The incidence is particularly high on the Indian subcontinent. Travellers who visit friends and relatives (VFR) have been shown to have a different risk profile than others. We wished to identify main ch...
Based on the feeding pattern in a 24-hour feeding recall by mothers, infants were classified into exclusive and nonexclusive breastfeeding groups. Each of the infant's mothers was provided with a digital thermometer and instructed on how to measure the temperature of her infant. The information about the incidence of fever ...
... to Yosemite FAQ: Non-U.S. Visitors to Yosemite History of HPS Related Links Prevent Rodent Infestations Cleaning Up After Rodents Diseases From Rodent Hemorrhagic Fever with Renal Syndrome (HFRS) Recommend on Facebook Tweet Share Compartir On This Page What is ...
Dr. Smita Sulackshana Devi Goorah
Full Text Available Chikungunya fever, an emerging mosquito-borne viral disease, has affected Mauritius with two recent outbreaks in 2005 and 2006 respectively. A study was carried out in 2007 to describe the clinical complications post-Chikungunya infection. Ethical clearance was obtained for this study. Data collection was carried out in February and March 2007 on a sample of people who had suffered from Chikungunya fever by means of a comprehensive questionnaire. Participants comprised 77 people; there were 41 males and 36 females. Participants ranged from 6 to 69 years. 70 participants experienced persisting joint pains for at least 6 months following the acute phase. Of these, 35 had residual joint complaints after 6 months. 44 participants suffered from psychological sequelae. 10 participants had dermatological sequelae, 6 had iatrogenic complications due to non-steroidal anti-inflammatory drug (NSAID-induced gastritis, and 3 participants with serologically confirmed Chikungunya fever had neurological manifestations and changes on CT/MRI which could correspond to demyelination. Statistical analysis demonstrated that there was a weak linear relationship between the number of complications and increasing age; there was a significant difference in the number of complications according to gender, females being more affected than males; participants with co-morbidities had more complications and psychological sequelae than previously healthy participants. This study highlights that Chikungunya fever, which causes a significant impact on health in the acute phase, can have significant sequelae months afterwards and this includes psychological sequelae.
Faye, Ousmane; Ba, Hampathé; Ba, Yamar; Freire, Caio C M; Faye, Oumar; Ndiaye, Oumar; Elgady, Isselmou O; Zanotto, Paolo M A; Diallo, Mawlouth; Sall, Amadou A
A Rift Valley fever (RVF) outbreak in humans and animals occurred in Mauritania in 2010. Thirty cases of RVF in humans and 3 deaths were identified. RVFV isolates were recovered from humans, camels, sheep, goats, and Culex antennatus mosquitoes. Phylogenetic analysis of isolates indicated a virus origin from western Africa.
de Jong, H.K.
This thesis focuses on host-pathogen interactions in Salmonella Typhi and Burkholderia pseudomallei infections and explores the interplay between these bacteria and the innate immune system. Typhoid fever is one of the most common causes of bacterial infection in low-income countries. With adequate
Rift Valley fever (RVF) is a serious viral disease of animals and humans in Africa and the Middle East that is transmitted by mosquitoes. First isolated in Kenya during an outbreak in 1930, subsequent outbreaks have had a significant impact on animal and human health, as well as national economies. ...
Zaki, Syed Ahmed; Karande, Sunil
Multidrug-resistant typhoid fever (MDRTF) is defined as typhoid fever caused by Salmonella enterica serovar Typhi strains (S. Typhi), which are resistant to the first-line recommended drugs for treatment such as chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole. Since the mid-1980s, MDRTF has caused outbreaks in several countries in the developing world, resulting in increased morbidity and mortality, especially in affected children below five years of age and those who are malnourished. Two methods were used to gather the information presented in this article. First PubMed was searched for English language references to published relevant articles. Secondly, chapters on typhoid fever in standard textbooks of paediatric infectious diseases and preventive and social medicine were reviewed. Although there are no pathognomonic clinical features of MDRTF at the onset of the illness, high fever ( > 104°F), toxaemia, abdominal distension, abdominal tenderness, hepatomegaly and splenomegaly are often reported. The gold standard for the diagnosis of MDRTF is bacterial isolation of the organism in blood cultures. Ciprofloxacin and ceftriaxone are the drugs most commonly used for treatment of MDRTF and produce good clinical results. MDRTF remains a major public health problem, particularly in developing countries. Mass immunization in endemic areas with either the oral live attenuated Typhi 21a or the injectable unconjugated Vi typhoid vaccine, rational use of antibiotics, improvement in public sanitation facilities, availability of clean drinking water, promotion of safe food handling practices and public health education are vital in the prevention of MDRTF.
Giry, Claude; Gabrie, Philippe; Tarantola, Arnaud; Pettinelli, François; Collet, Louis; D’Ortenzio, Eric; Renault, Philippe; Pierre, Vincent
After the 2006–2007 epidemic wave of Rift Valley fever (RVF) in East Africa and its circulation in the Comoros, laboratory case-finding of RVF was conducted in Mayotte from September 2007 through May 2008. Ten recent human RVF cases were detected, which confirms the indigenous transmission of RFV virus in Mayotte. PMID:19331733
Aug 6, 2013 ... Abstract. Objective: To deter- mine the incidence of fever after vaccination with the first dose of diphtheria-pertussis-tetanus. (DPT) among exclusively breast- fed and non-exclusively breastfed infants in Ibadan, Nigeria. Methods: A prospective study was conducted on a cohort of 710 in- fants who received ...
Background : A unique feature of previous Ebola outbreaks has been the relative sparing of children. For the first time, an out break of an unusual illness-Ebola haemorrhagic fever occurred in Northern Uganda - Gulu district. Objectives : To describe the epidemiologic and clinical aspects of hospitalised children and ...
South Sudan Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2012) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Dengue fever. Milada Tavodova. Abstract. No Abstract ...
Full Text Available Introduction. Dengue fever is a mosquito-borne disease caused by dengue virus, endemic in tropical and subtropical regions, where it is mostly imported from. The most common clinical form is classic dengue fever. We presented the first dengue case microbiologically confirmed in Serbia. Case report. A 34-year-old male got classic dengue fever after arrival from Cuba. The disease occurred suddenly with fever, myalgias, skin rash, hepatosplenomegaly, cytopenia, abnormal aminotransferase and creatine kinase levels. The diagnosis was confirmed with virological diagnostic methods. Significant leukopenia and thrombocytopenia as well as elevation of serum creatine kinase activity were recorded from the very beginning of hospitalization, but were gradually normalized. The whole duration of hospitalization was accompanied by laboratory signs of liver lesion. The disease had favourable outcome. At hospital discharge, the patient was afebrile, asymptomatic, with discrete erythematous rash on torso and arms, normal hemathological values and creatine kinase level and moderately elevated alanine-aminotransferase level. Conclusion. Considering global climate changes and growing international traffic, our health care service needs to be ready for possible massive outbreaks of dengue and other tropical infectious diseases in forthcoming years.
Vaccines or antiviral drugs are not available for dengue viruses; the only effective way to prevent epidemic degure fever/dengue haemorrhagic .... After the World War II, rapid urbanization in Southeast Asia led to ... epidemic of the DHF occurred in 1953–1954 in Philippines followed by a quick global spread of epidemics of ...
Dr. Amesh Adalja, an associate at the Center for Biosecurity and clinical assistant professor at the University of Pittsburgh School, of Medicine, discusses dengue fever outbreaks in the United States. Created: 4/9/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 4/16/2012.
Codina-García, Marina; Militão, Teresa; Moreno, Javier; González-Solís, Jacob
Plastic debris is often ingested by marine predators and can cause health disorders and even death. We present the first assessment of plastic ingestion in Mediterranean seabirds. We quantified and measured plastics accumulated in the stomach of 171 birds from 9 species accidentally caught by longliners in the western Mediterranean from 2003 to 2010. Cory's shearwaters (Calonectris diomedea) showed the highest occurrence (94%) and large numbers of small plastic particles per affected bird (on average N = 15.3 ± 24.4 plastics and mass = 23.4 ± 49.6 mg), followed by Yelkouan shearwaters (Puffinus yelkouan, 70%, N = 7.0 ± 7.9, 42.1 ± 100.0 mg), Balearic shearwaters (Puffinus mauretanicus, 70%, N = 3.6 ± 2.9, 5.5 ± 9.7 mg) and the rest of species (below 33%, N = 2.7, 113.6 ± 128.4 mg). Plastic characteristics did not differ between sexes and were not related to the physical condition of the birds. Our results point out the three endemic and threatened shearwater species as being particularly exposed to plastic accumulation.
Bilardo, U.; Mureddu, G.
The Mediterranean Sea represents only about 0.7% of the planet's total water surface area, yet it is host to as much as one-quarter of the world's total maritime oil traffic. Statistics indicate that from 47 to 77,000 tonnes of crude oil are now being released annually into the Sea through accidental spills; and over the last decade, its tourism dependent coastlines have been fouled by the highest levels of tar contamination in the world. Oil carrier traffic, routed within the Sea's already overcrowded shipping lanes, is intense and this traffic is expected to increase, as a result of rises in world energy demand, to levels of from 7 to 8 million barrels a day. It has been estimated that, at the end of 1992, 90% of all large tankers operating in this area, will have reached a service life of 15-16 years which is very close to the average recommended life cycle limit of 15-20 years. Only 20% of the world's 3,000 tankers are currently equipped with double bottomed hulls. This paper uses these and other facts and figures to argue that the risks of future severe oil tanker accidents in the Mediterranean Sea are high, and that these must be countered with the development of a new set of stricter marine traffic safety regulations at the Italian, national, as well as, European level
United Nations Environmental Program (UNEP) studies on forecasted greenhouse climatic effects on the Mediterranean coastal and marine ecosystems and regional socio-economic framework have indicated the need for a concerted plan of protective and remedial action. The studies considered rises of 1.5 degrees in ambient temperature and 20 centimeters in sea level occurring before the year 2025. A regional, as opposed to a global area, study approach was adopted since the severity of climatic effects is expected to vary greatly from one part of the world to another. The specific areas investigated were the Po River Delta and Venezia Lagoon in Italy, the Nile Delta, Camargue, the Ebro Delta, the Tunisian National Park area, and the Thermaicos Gulf in Greece. The rise in average temperature is expected to negatively effect Mediterranean agricultural production and the coastal and marine ecosystems due to prolonged periods of drought and exceptional rainfall. It is suggested that a system of dikes be constructed to protect the coastal areas which are heavily dependent on tourism and agriculture
Elfving, Karin; Olsen, Björn; Bergström, Sven; Waldenström, Jonas; Lundkvist, Ake; Sjöstedt, Anders; Mejlon, Hans; Nilsson, Kenneth
Migratory birds are known to play a role as long-distance vectors for many microorganisms. To investigate whether this is true of rickettsial agents as well, we characterized tick infestation and gathered ticks from 13,260 migratory passerine birds in Sweden. A total of 1127 Ixodes spp. ticks were removed from these birds and the extracted DNA from 957 of them was available for analyses. The DNA was assayed for detection of Rickettsia spp. using real-time PCR, followed by DNA sequencing for species identification. Rickettsia spp. organisms were detected in 108 (11.3%) of the ticks. Rickettsia helvetica, a spotted fever rickettsia associated with human infections, was predominant among the PCR-positive samples. In 9 (0.8%) of the ticks, the partial sequences of 17kDa and ompB genes showed the greatest similarity to Rickettsia monacensis, an etiologic agent of Mediterranean spotted fever-like illness, previously described in southern Europe as well as to the Rickettsia sp.IrITA3 strain. For 15 (1.4%) of the ticks, the 17kDa, ompB, gltA and ompA genes showed the greatest similarity to Rickettsia sp. strain Davousti, Rickettsia japonica and Rickettsia heilongjiangensis, all closely phylogenetically related, the former previously found in Amblyomma tholloni ticks in Africa and previously not detected in Ixodes spp. ticks. The infestation prevalence of ticks infected with rickettsial organisms was four times higher among ground foraging birds than among other bird species, but the two groups were equally competent in transmitting Rickettsia species. The birds did not seem to serve as reservoir hosts for Rickettsia spp., but in one case it seems likely that the bird was rickettsiemic and that the ticks had acquired the bacteria from the blood of the bird. In conclusion, migratory passerine birds host epidemiologically important vector ticks and Rickettsia species and contribute to the geographic distribution of spotted fever rickettsial agents and their diseases.
Aristarhos M. Seimenis
Full Text Available Great concern is being expressed at the international level on the emergence and re-emergence of certain infectious diseases, many of which are zoonoses, e.g. Rift Valley fever, highly pathogenic avian influenza, etc. Many aspects of globalisation, i.e. the movements of populations, increased urbanisation, greater production and trade in animals and animal products, close interaction between humans and animals, environmental degradation, inappropriate waste disposal, etc., are all determining factors in the prevalence of zoonoses. The Mediterranean and Middle East share similar ecological and epidemiological conditions and are affected by almost the same zoonoses (brucellosis, rabies, echinococcosis, leishmaniosis, salmonellosis, etc.. National control programmes have given partial results or have failed due to weak infrastructures, insufficient financial resources, inadequate intersectoral collaboration and coordination, a lack of public health education, etc. There is an urgent need for the firm commitment of all parties involved on regional, national and international levels to ensure the success of zoonoses prevention and control programmes.
Kumar, Lovekesh; Singh, Mahendra; Saxena, Ashish; Kolhe, Yuvraj; Karande, Snehal K; Singh, Narendra; Venkatesh, P; Meena, Rambabu
Dengue fever is the most important arbovirus illness with an estimated incidence of 50-100 million cases per year. The common symptoms of dengue include fever, rash, malaise, nausea, vomiting, and musculoskeletal pain. Dengue fever may present as acute abdomen leading to diagnostic dilemma. The acute surgical complications of dengue fever include acute pancreatitis, acute acalculous cholecystitis, nonspecific peritonitis, and acute appendicitis. We report a case of dengue fever that mimicked acute appendicitis leading to unnecessary appendectomy. A careful history examination for dengue-related signs, and serial hemogram over the first 3-4 days of disease may prevent unnecessary appendectomy.
Sharma, Anurag; Bhatia, Sonia; Singh, Rajendra Pratap; Malik, Gaurav
Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the Dengue virus. It is associated with a number of complications, which are well documented. However, Dengue fever associated with rectus sheath hematoma (RSH) is a very rare complication. Only one case report has been published prior supporting the association of Dengue fever with RSH. We report a case of Dengue fever who presented with RSH and was successfully treated conservatively. RSH is also an uncommon cause of acute abdominal pain. It is accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear.
Maria Paula Gomes Mourão
Full Text Available Dengue fever is the world's most important viral hemorrhagic fever disease, the most geographically wide-spread of the arthropod-born viruses, and it causes a wide clinical spectrum of disease. We report a case of dengue hemorrhagic fever complicated by acute hepatitis. The initial picture of classical dengue fever was followed by painful liver enlargement, vomiting, hematemesis, epistaxis and diarrhea. Severe liver injury was detected by laboratory investigation, according to a syndromic surveillance protocol, expressed in a self-limiting pattern and the patient had a complete recovery. The serological tests for hepatitis and yellow fever viruses were negative. MAC-ELISA for dengue was positive.
Full Text Available Q fever is a bacterial infection affecting mainly the lungs, liver, and heart. It is found around the world and is caused by the bacteria Coxiella burnetii. The bacteria affects sheep, goats, cattle, dogs, cats, birds, rodents, and ticks. Infected animals shed this bacteria in birth products, feces, milk, and urine. Humans usually get Q fever by breathing in contaminated droplets released by infected animals and drinking raw milk. People at highest risk for this infection are farmers, laboratory workers, sheep and dairy workers, and veterinarians. Chronic Q fever develops in people who have been infected for more than 6 months. It usually takes about 20 days after exposure to the bacteria for symptoms to occur. Most cases are mild, yet some severe cases have been reported. Symptoms of acute Q fever may include: chest pain with breathing, cough, fever, headache, jaundice, muscle pains, and shortness of breath. Symptoms of chronic Q fever may include chills, fatigue, night sweats, prolonged fever, and shortness of breath. Q fever is diagnosed with a blood antibody test. The main treatment for the disease is with antibiotics. For acute Q fever, doxycycline is recommended. For chronic Q fever, a combination of doxycycline and hydroxychloroquine is often used long term. Complications are cirrhosis, hepatitis, encephalitis, endocarditis, pericarditis, myocarditis, interstitial pulmonary fibrosis, meningitis, and pneumonia. People at risk should always: carefully dispose of animal products that may be infected, disinfect any contaminated areas, and thoroughly wash their hands. Pasteurizing milk can also help prevent Q fever.
ALESSANDRO SERAFINI SAULI
Full Text Available In Rome both meadows of CentraI-European affinity and Mediterranean dry grasslands are presento We studied a site (Parco Regionale Urbano de] Pineto in Rome with very diverse vegetation, where species belonging to both coenologica] groups oceur. Wc fertilized a grassland with a combination of phosphorus (P and nitrogen (N. After fertilization diagDostie species of Helianthemetea guttati (Thcrophytes dccrease while species of MolinioArrhenatheretea (Hemicriptophytes increase. In a climate as that of Rome, transition between Mediterranean (with summer drought and Central European (without summer drought, nutrients availability modulates the distribution of vegetation Classes with respectively Mediterranean or Central-Europe affinities.
before the advent of colchicine as therapy for FMF, a devel- opment that has changed the course of the disease for ... PXE is an autosomal recessive systemic dis- ease of connective tissue, primarily affecting the ... the large ATP-dependent transmembrane transporter family, expressed predominantly in the liver and kidney ( ...
Fever of unknown origin (FUO) was originally defined as recurrent fever of 38.2 C or higher, lasting 2-3 weeks or longer, and undiagnosed after 1 week of hospital evaluation. The last criterion has undergone modification and is now generally interpreted as no diagnosis after appropriate inpatient or outpatient evaluation. The three major categories that account for the majority of fever of unknown origin (FUO) are infections, malignancies and non infectious inflammatory diseases. In this respect FOU in its original definition is clearly separated from nosocomial, post-operative and neutropenic fever, where acute infection is more common. Although in-vitro- or in-vivo-labelled white blood cells (WBCs) have a high diagnostic accuracy in the detection and exclusion of granulocytic pathology, these methods are only of limited value in patients with 'classic' FUO in establishing the final diagnosis due to the low prevalence of acute infection in this group. Labelled WBCs therefore seem to be more useful in patients with nosocomial, post-operative and neutropenic fever. 67 Ga citrate is the only commercially available gamma emitter in imaging acute, chronic, granulomatous and autoimmune inflammation and also various malignant diseases. Therefore 67 Ga citrate was for a long time considered to be the tracer of choice in the diagnostic work-up of FUO. The number of 67 Ga scans contributing to the final diagnosis was found to be higher than it has been reported for labelled WBCs. The positron emitter [ 18 F]-2-fluoro-2'-deoxy-D-glucose (FDG) have been systematically evaluated in the context of classic FUO by several groups within last 5 years. This data, although limited, indicate that FDG-imaging should considered as the most promising procedure in patients with undetermined fever. FDG-PT seems to be more sensitive than other techniques, offers a more rapid diagnosis without an increase of the patients radioactive burden. It is expected that the PET/CT technology will
Lieberman, E; Lang, J; Richardson, D K; Frigoletto, F D; Heffner, L J; Cohen, A
Much of fever during term labor may not be infectious but rather a consequence of the use of epidural analgesia. Therefore, we investigated the association of elevated maternal intrapartum temperature with neonatal outcome when the infant does not develop an infection. We studied 1218 nulliparous women with singleton, term pregnancies in a vertex presentation and spontaneous labor. Women were excluded if their temperature was >99.5 degrees F at admission for delivery, if they were diabetic or had an active genital herpes infection or if their infant developed a neonatal infection, had a congenital infection, or had a major malformation. Maximum intrapartum temperature was categorized as: 101 degrees F. During labor, 123 women (10.1%) developed a fever >100.4 degrees F; 62 (5.1%) women had a maximum temperature of 100.5 degrees F to 101 degrees F and 61 (5.0%) women had a maximum temperature >101 degrees F. Of febrile women, 97.6% had received epidural analgesia for pain relief. Infants of women developing a fever >100.4 degrees F were more likely to have a 1-minute Apgar score 100.4 degrees F vs 8.0% for afebrile) and to be hypotonic after delivery (4.8% for >100.4 degrees F vs.5% for afebrile). Compared with infants of afebrile women, infants whose mothers' maximum temperature was >101 degrees F were more likely to require bag and mask resuscitation (11.5% vs 3.0%) and to be given oxygen therapy in the nursery (8.2% vs 1.3%). We also found a higher rate of neonatal seizure with fever (3.3% vs.2%), but the number of infants with seizure was small (n = 4). All associations remained essentially the same after controlling for confounding in logistic regression analyses. Intrapartum maternal fever, particularly if >101 degrees F, was associated with a number of apparently transient adverse effects in the newborn. Larger studies are needed to investigate the association of intrapartum fever with neonatal seizures and to determine whether any lasting injury to the fetus
Full Text Available Autoinflammatory diseases (AID are characterized by seemingly unprovoked self-limited attacks of fever and systemic inflammation potentially leading to amyloidosis. Familial Mediterranean fever (FMF is the most common AID and therefore the most studied. Besides FMF, the other main hereditary AID are tumor necrosis factor-associated periodic fever syndrome (TRAPS, mevalonate kinase deficiency (MKD, and cryopyrin-associated periodic fever syndrome (CAPS. These hereditary diseases result from a mutant gene that is involved in the regulation of inflammation, resulting in a characteristic clinical phenotype. The differential diagnosis of AID can be challenging due to a wide overlap in clinical manifestations. Moreover, a considerable proportion of patients present with autoinflammatory symptoms but without a pathogenetic variant on genetic analysis. Furthermore, non-hereditary AID, such as the periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA syndrome, which is the most common AID in children worldwide, must be excluded in certain circumstances. Herein we shall review the main AID and describe a practical approach to diagnosis in a patient with a clinical suspicion of AID.
On the occasion of CERN's 50th anniversary, the French Association for the Advancement of Science (AFAS) is organising a conference at CERN on 6 - 7 May on the subject of "Sharing Knowledge across the Mediterranean". The full program can be found at http://www.avancement-sciences.org. For those wishing to attend, advanced registration is mandatory. Follow the instructions at: http://lpsc.in2p3.fr/congres/CERN/index.htm The conference fee is 50 euro. It includes attendance at the official dinner on Thursday 6 May and a copy of the conference proceedings. Special conditions for CERN: registration is free, but does not include the dinner. CERN people wishing to receive the proceedings will be charged 10 euro.
On the occasion of CERN's 50th anniversary, the French Association for the Advancement of Science (AFAS) is organising a conference at CERN on 6 - 7 May on the subject of "Sharing Knowledge across the Mediterranean". The full program can be found at http://www.avancement-sciences.org. For those wishing to attend, advanced registration is mandatory. Follow the instructions at: http://lpsc.in2p3.fr/congres/CERN/index.htm The conference fee is 50 euro. It includes attendance at the official dinner on Thursday 6 May and a copy of the conference proceedings. Special conditions for CERN: registration is free, but does not include the dinner. CERN people wishing to receive the proceedings will be charged 10 euro.
Full Text Available Secondary grasslands are one of the most common vegetation types worldwide. In Europe, and in the Mediterranean basin, human activities have transformed many woodlands into secondary grasslands. Despite their recognized role in the global carbon cycle, very few data are available for estimating the biomass of Mediterranean grasslands. We developed linear regression models in order to predict the biomass of two native Mediterranean grasses (Ampelodesmos mauritanicus and Hyparrhenia hirta and an invasive alien grass (Pennisetum setaceum. Ampelodesmos mauritanicus is very common throughout the Mediterranean basin, mostly on north-facing slopes, H. hirta characterizes thermo-xeric grasslands, while P. setaceum is an alien species that is rapidly spreading along coastal areas. The measured morphometric attributes of individual plants as potential predictors were considered. The validation results corroborate the ability of the established models to predict above ground and total biomass of A. mauritanicus and P. setaceum. We also evaluated the total biomass per hectare for each species. The highest biomass per hectare was found for A. mauritanicus, whereas biomass was higher for H. hirta than for P. setaceum. The replacement of H. hirta by P. setaceum may reduce the total carbon storage in the ecosystem; however, P. setaceum allocates more resources to the roots, thus increasing the more stable and durable pool of carbon in grasslands.Los pastizales secundarios son uno de los tipos de vegetación más comunes en todo el mundo. En Europa y en la cuenca mediterránea, las actividades humanas han transformado muchos bosques en pastizales secundarios. A pesar de su reconocido papel en el ciclo global del carbono, hay muy pocos datos disponibles para la estimación de la biomasa de los pastizales mediterráneos. Hemos desarrollado modelos de regresión lineal con el fin de predecir la biomasa de dos gramíneas nativas del Mediterráneo (Ampelodesmos
Ghai, Rohit; Hernandez, Claudia Mella; Picazo, Antonio; Mizuno, Carolina Megumi; Ininbergs, Karolina; Díez, Beatriz; Valas, Ruben; DuPont, Christopher L; McMahon, Katherine D; Camacho, Antonio; Rodriguez-Valera, Francisco
Coastal lagoons, both hypersaline and freshwater, are common, but still understudied ecosystems. We describe, for the first time, using high throughput sequencing, the extant microbiota of two large and representative Mediterranean coastal lagoons, the hypersaline Mar Menor, and the freshwater Albufera de Valencia, both located on the south eastern coast of Spain. We show there are considerable differences in the microbiota of both lagoons, in comparison to other marine and freshwater habitats. Importantly, a novel uncultured sulfur oxidizing Alphaproteobacteria was found to dominate bacterioplankton in the hypersaline Mar Menor. Also, in the latter prokaryotic cyanobacteria were almost exclusively comprised by Synechococcus and no Prochlorococcus was found. Remarkably, the microbial community in the freshwaters of the hypertrophic Albufera was completely in contrast to known freshwater systems, in that there was a near absence of well known and cosmopolitan groups of ultramicrobacteria namely Low GC Actinobacteria and the LD12 lineage of Alphaproteobacteria.
Martínez-González, Miguel Ángel; Hershey, Maria Soledad; Zazpe, Itziar; Trichopoulou, Antonia
Substantial evidence has verified the Mediterranean diet's (MedDiet) nutritional adequacy, long-term sustainability, and effectiveness for preventing hard clinical events from cardiovascular disease (CVD), as well as increasing longevity. This article includes a cumulative meta-analysis of prospective studies supporting a strong inverse association between closer adherence to the MedDiet and the incidence of hard clinical events of CVD. The MedDiet has become an increasingly popular topic of interest when focusing on overall food patterns rather than single nutrient intake, not only in Mediterranean countries, but also globally. However, several myths and misconceptions associated with the traditional Mediterranean diet should be clearly addressed and dispelled, particularly those that label as "Mediterranean" an eating pattern that is not in line with the traditional Mediterranean diet. The transferability of the traditional MedDiet to the non-Mediterranean populations is possible, but it requires a multitude of changes in dietary habits. New approaches for promoting healthy dietary behavior consistent with the MedDiet will offer healthful, sustainable, and practical strategies at all levels of public health. The following article presents practical resources and knowledge necessary for accomplishing these changes.
Wang, Sheng-Fan; Wang, Wen-Hung; Chang, Ko; Chen, Yen-Hsu; Tseng, Sung-Pin; Yen, Chia-Hung; Wu, Deng-Chyang; Chen, Yi-Ming Arthur
Dengue fever (DF) is a vector-borne disease caused by dengue viruses (DENVs). Epidemic dengue occurs intermittently in Taiwan. In 2014, Taiwan experienced its largest DF outbreak. There were 15,732 DF cases reported. There were a total of 136 dengue hemorrhagic fever (DHF) cases, of which 20 resulted in death. Most DF cases were reported in southern Taiwan. A total of 15,043 (96%) cases were from Kaohsiung, a modern city in southern Taiwan. This report reviews DF epidemics in Taiwan during 2005–2014. The correlation between DF and DHF along with temperature and precipitation were conjointly examined. We conclude that most dengue epidemics in Taiwan resulted from imported DF cases. Results indicate three main factors that may have been associated with this DF outbreak in Kaohsiung: an underground pipeline explosion combined with subsequent rainfall and higher temperature. These factors may have enhanced mosquito breeding activity, facilitating DENV transmission. PMID:26572871
N Raabe Vanessa
Full Text Available Breaking the human-to-human transmission cycle remains the cornerstone of infection control during filoviral (Ebola and Marburg hemorrhagic fever outbreaks. This requires effective identification and isolation of cases, timely contact tracing and monitoring, proper usage of barrier personal protection gear by health workers, and safely conducted burials. Solely implementing these measures is insufficient for infection control; control efforts must be culturally sensitive and conducted in a transparent manner to promote the necessary trust between the community and infection control team in order to succeed. This article provides a review of the literature on infection control during filoviral hemorrhagic fever outbreaks focusing on outbreaks in a developing setting and lessons learned from previous outbreaks. The primary search database used to review the literature was PUBMED, the National Library of Medicine website.
Ofula, Victor O.; Sang, Rosemary C.; Konongoi, Samson L.; Sow, Abdourahmane; De Cock, Kevin M.; Tukei, Peter M.; Okoth, Fredrick A.; Swanepoel, Robert; Burt, Felicity J.; Waters, Norman C.; Coldren, Rodney L.
In May 2003, the World Health Organization received reports about a possible outbreak of a hemorrhagic disease of unknown cause in the Imatong Mountains of southern Sudan. Laboratory investigations were conducted on 28 serum samples collected from patients in the Imatong region. Serum samples from 13 patients were positive for immunoglobulin M antibody to flavivirus, and serum samples from 5 patients were positive by reverse transcription–polymerase chain reaction with both the genus Flavivirus–reactive primers and yellow fever virus–specific primers. Nucleotide sequencing of the amplicons obtained with the genus Flavivirus oligonucleotide primers confirmed yellow fever virus as the etiologic agent. Isolation attempts in newborn mice and Vero cells from the samples yielded virus isolates from five patients. Rapid and accurate laboratory diagnosis enabled an interagency emergency task force to initiate a targeted vaccination campaign to control the outbreak. PMID:15207058
Sprigg, W. A.
Advances in satellite Earth observation systems, numerical weather prediction, and dust storm modeling yield new tools for public health warnings, advisories and epidemiology of illnesses associated with airborne desert dust. Valley Fever, endemic from California through the US/Mexico border region into Central and South America, is triggered by inhalation of soil-dwelling fungal spores. The path from fungal growth to airborne threat depends on environmental conditions observable from satellite. And space-based sensors provide initial conditions for dust storm forecasts and baselines for the epidemiology of Valley Fever and other dust-borne aggravation of respiratory and cardiovascular disease. A new Pan-American Center for the World Meteorological Organization Sand and Dust Storm Warning Advisory and Assessment System creates an opportunity to advance Earth science applications in public health.
Wang, Sheng-Fan; Wang, Wen-Hung; Chang, Ko; Chen, Yen-Hsu; Tseng, Sung-Pin; Yen, Chia-Hung; Wu, Deng-Chyang; Chen, Yi-Ming Arthur
Dengue fever (DF) is a vector-borne disease caused by dengue viruses (DENVs). Epidemic dengue occurs intermittently in Taiwan. In 2014, Taiwan experienced its largest DF outbreak. There were 15,732 DF cases reported. There were a total of 136 dengue hemorrhagic fever (DHF) cases, of which 20 resulted in death. Most DF cases were reported in southern Taiwan. A total of 15,043 (96%) cases were from Kaohsiung, a modern city in southern Taiwan. This report reviews DF epidemics in Taiwan during 2005-2014. The correlation between DF and DHF along with temperature and precipitation were conjointly examined. We conclude that most dengue epidemics in Taiwan resulted from imported DF cases. Results indicate three main factors that may have been associated with this DF outbreak in Kaohsiung: an underground pipeline explosion combined with subsequent rainfall and higher temperature. These factors may have enhanced mosquito breeding activity, facilitating DENV transmission. © The American Society of Tropical Medicine and Hygiene.
Nava-Frías, Margarita; Searcy-Pavía, Ricardo Efrén; Juárez-Contreras, Carina Aurora; Valencia-Bautista, Anayeli
Chikungunya fever is a tropical vector-borne disease that has been spreading rapidly around the world during the last 10 years, and which has been usually misdiagnosed as dengue. Nowadays, this disease is increasing in Mexico, mainly in the southern and central zones of the country, being significantly more common in women, children and young adults (28% in<20 years of age). The classical presentation includes fever, arthralgia, polyarthritis, back-pain, and skin rashes. Although symptoms and treatment are similar to those for dengue, there are key clinical features to differentiate these two diseases. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.
Davis, Nelson C.; Shannon, Raymond C.
1. Batches of Aëdes (Stegomyia) aegypti which had fed on monkeys in the early febrile stage of yellow fever and which has subsequently passed the usually accepted extrinsic incubation period for the virus, failed to transmit the disease to normal monkeys in approximately fifty per cent of the experiments. During the same time over eighty per cent of blood transfers were successful. 2. The monkeys which failed to show fever following mosquito bites later proved resistant to the inoculation of blood or tissues containing virus. 3. The incubation, or afebrile, period in monkeys following the bites of infected mosquitoes varied from less than twenty-four hours to fifteen days. It averaged somewhat longer in non-fatal than in fatal infections. PMID:19869665
Full Text Available Abstract Background Dengue, a mosquito-borne flavivirus infection, is endemic in Southeast Asia. Currently, the incidence has been increasing among adults. Case presentation A 26-year-old Thai woman, G1P0 31 weeks pregnancy, presented with epigastric pain for 1 day. She also had a high-grade fever for 4 days. The physical examination, complete blood counts as well as serology confirmed dengue fever. The patient was under conservative treatment despite severe thrombocytopenia. She was well at the 3rd day of discharge and 1-week follow-up. The pregnancy continued until term without any complication and she delivered vaginally a healthy female baby. Conclusions More cases of dengue infection in pregnancy can be found due to the increasing incidence during adulthood. It should be suspected when a pregnant woman presents with symptoms and signs like in a non-pregnant. Conservative treatment should be conducted unless there are any complications.
Mohite, Abhijit Anand; Agius-Fernandez, Adriana
Chikungunya fever is a vector borne virus that typically causes a self-limiting systemic illness with fever, skin rash and joint aches 2 weeks after infection. We present the case of a 69-year-old woman presenting with an acute unilateral optic neuropathy as a delayed complication of Chikungunya virus (CHIKV) infection contracted during a recent trip to the West Indies. She presented to our ophthalmology department with acute painless visual field loss in the right eye and a recent flu-like illness. She was found to have a right relative afferent pupillary defect (RAPD) with unilateral optic disc swelling. Serology confirmed recent CHIKV infection. Treatment with intravenous methylprednisolone was delayed while awaiting MRI scans and serology results. At 5-month follow-up, there was a persistent right RAPD and marked optic atrophy with a corresponding inferior scotoma in the visual field. 2015 BMJ Publishing Group Ltd.
Ye. M. Shifman
Full Text Available Objective: to study the incidence of labor fever under epidural analgesia (EA and to evaluate its impact on the courses of puerperium and early neonatality. Subjects and methods. The paper presents the data of a prospective study of the course of labor, puerperium, and early neonatality in 397 women in whom labors occurred at the Republican Peritoneal Center in 2006. A study group included 324 parturients in whom labor pain was relieved by EA. A comparison group comprised 55 parturients in whom no analgesics were used at labor. Results. There were no significant statistical differences between the groups in the incidence of labor fever and complicated puerperium and in that of neonatal pyoseptic diseases. Key words: labor hyperthermia, epidural analgesia, labor pain relief.
Al-Tikriti, S. K.; Al-Ani, F.; Jurji, F. J.; Tantawi, H.; Al-Moslih, M.; Al-Janabi, N.; Mahmud, M. I. A.; Al-Bana, A.; Habib, H.; Al-Munthri, H.; Al-Janabi, Sh.; Al-Jawahry, K.; Yonan, M.; Hassan, F.; Simpson, D. I. H.
Congo/Crimean haemorrhagic fever was recognized for the first time in Iraq in 1979. The first case was reported on 3 September 1979 and since then a further 9 patients have been investigated. Eight patients gave a history of previous contact with sheep or cattle, while 2 patients, a resident doctor and an auxiliary nurse, acquired their infections in hospital by direct contact with patients. The causal virus was isolated from patients' blood and postmortem liver specimens. The virus isolates were found to be closely related if not identical serologically to members of the Congo/Crimean haemorrhagic fever virus group. Eight of the patients had no epidemiological relationship to one another and lived in widely separated areas around Baghdad and Ramadi (110 km to the west of Baghdad). ImagesFig. 1 PMID:6790183
Full Text Available In being at the base of the marine food web, phytoplankton is particularly important for marine ecosystem functioning (e.g., biodiversity. Strong anthropization, over-exploitation of natural resources, and climate change affect the natural amount of phytoplankton and, therefore, represent a continuous threat to the biodiversity in marine waters. In particular, a concerning risks for coastal waters is the increase in nutrient inputs of terrestrial/anthropogenic origin that can lead to undesirable modifications of phytoplankton concentration (i.e., eutrophication. Monitoring chlorophyll (Chl concentration, which is a proxy of phytoplankton biomass, is an efficient tool for recording and understanding the response of the marine ecosystem to human pressures and thus for detecting eutrophication. Here, we compute Chl trends over the Mediterranean Sea by using satellite data, also highlighting the fact that remote sensing may represent an efficient and reliable solution to synoptically control the "good environmental status" (i.e., the Marine Directive to achieve Good Environmental Status of EU marine waters by 2020 and to assess the application of international regulations and environmental directives. Our methodology includes the use of an ad hoc regional (i.e., Mediterranean algorithm for Chl concentration retrieval, also accounting for the difference between offshore (i.e., Case I and coastal (i.e., Case II waters. We apply the Mann-Kendall test and the Sens's method for trend estimation to the Chl concentration de-seasonalized monthly time series, as obtained from the X-11 technique. We also provide a preliminary analysis of some particular trends by evaluating their associated inter-annual variability. The high spatial resolution of our approach allows a clear identification of intense trends in those coastal waters that are affected by river outflows. We do not attempt to attribute the observed trends to specific anthropogenic events. However
Colella, Simone; Falcini, Federico; Rinaldi, Eleonora; Sammartino, Michela; Santoleri, Rosalia
In being at the base of the marine food web, phytoplankton is particularly important for marine ecosystem functioning (e.g., biodiversity). Strong anthropization, over-exploitation of natural resources, and climate change affect the natural amount of phytoplankton and, therefore, represent a continuous threat to the biodiversity in marine waters. In particular, a concerning risks for coastal waters is the increase in nutrient inputs of terrestrial/anthropogenic origin that can lead to undesirable modifications of phytoplankton concentration (i.e., eutrophication). Monitoring chlorophyll (Chl) concentration, which is a proxy of phytoplankton biomass, is an efficient tool for recording and understanding the response of the marine ecosystem to human pressures and thus for detecting eutrophication. Here, we compute Chl trends over the Mediterranean Sea by using satellite data, also highlighting the fact that remote sensing may represent an efficient and reliable solution to synoptically control the "good environmental status" (i.e., the Marine Directive to achieve Good Environmental Status of EU marine waters by 2020) and to assess the application of international regulations and environmental directives. Our methodology includes the use of an ad hoc regional (i.e., Mediterranean) algorithm for Chl concentration retrieval, also accounting for the difference between offshore (i.e., Case I) and coastal (i.e., Case II) waters. We apply the Mann-Kendall test and the Sens's method for trend estimation to the Chl concentration de-seasonalized monthly time series, as obtained from the X-11 technique. We also provide a preliminary analysis of some particular trends by evaluating their associated inter-annual variability. The high spatial resolution of our approach allows a clear identification of intense trends in those coastal waters that are affected by river outflows. We do not attempt to attribute the observed trends to specific anthropogenic events. However, the trends
Fenech, Dominic; Pace, Michelle
Ideas about what the Mediterranean is, was or is imagined to be abound, and the debate over definition continues to intrigue scholars more than ever, especially as the region’s heightened newsworthiness in recent years has forced the protagonists of world affairs to turn their attention to it....... Historically the status of the Mediterranean has changed over and over again, in terms of unity and cohesion, or lack thereof, but also of the region’s shifting place in the global hierarchy of power. The post-Cold War era rekindled or exposed a host of historically-engrained problems and developments...... that brought the Mediterranean back into the limelight, as Europe first and then other world players recognized that the region’s concerns were also their own. Looking at the contemporary Mediterranean the authors see in it a scale-model of world affairs, a concentration of intense political situations...
Manzoni, Giancarlo; Cova, Bruno; Pincella, Claudio; Rebolini, Massimo; Ricci, Paolo
The technology evolution of direct current energy transmission offer new perspectives for the exchange of energy with South side of Mediterranean Area: for Italy are new opportunity for energy import [it
The first part of this report presents the Mediterranean Solar Plan (MSP) as an ambitious political initiative which aims at creating a better context for the Northern (Mediterranean) countries which are looking for a secure energy supply, and for the Southern and Eastern (Mediterranean) countries where demand is strongly increasing. It highlights the fact that the cost of this plan is indeed important but still limited regarding the regional scale. Its success therefore needs projects with sufficient profitability to attract investors and to be realised within an adapted law environment. The report also outlines that the plan needs a regional vision and a cooperative approach between North and South, that it will have a strong impact of electric interconnections all around the Mediterranean Sea, and that its governance needs to be clarified to maintain the political momentum created by its co-presidents
Rohr, Marie; Wagner, Noémie
Prolonged fevers in children are a regular challenge for the paediatrician or any physician caring for these children (emergency physicians, pediatric infectious diseases specialists). The causes are multiple, classified into three major families : infectious, inflammatory and oncological. Infectious causes are the most common and account for more than 50 % of cases. The objective of this review is to guide physicians in charge of these patients throughout their management by focusing on the quest of infectious causes.
Nedjadi, Taoufik; El-Kafrawy, Sherif; Sohrab, Sayed S.; Despr?s, Philippe; Damanhouri, Ghazi; Azhar, Esam
According to recent statistics, 96 million apparent dengue infections were estimated worldwide in 2010. This figure is by far greater than the WHO prediction which indicates the rapid spread of this disease posing a growing threat to the economy and a major challenge to clinicians and health care services across the globe particularly in the affected areas. This article aims at bringing to light the current epidemiological and clinical status of the dengue fever. The relationship between gene...
Anderson, K; Watt, A D; Sinclair, D; Lewis, C; McSharry, C P; Boyd, G
Two summer outbreaks of humidifier fever (HF) are described in a microprocessor factory (factory A) and a printing factory (factory B). The air in each factory was humidified intermittently and controlled by present humidistats operating to maintain a relative humidity of 45% by an air handler incorporating a spray humidifier in factory A and two ceiling mounted spray humidifiers in factory B. Questionnaire data from each workforce suggested that although symptoms apparently occurred most com...
This podcast describes the emergence of the first human cases of Crimean-Congo Hemorrhagic Fever in Sudan in 2008. CDC epidemiologist Dr. Stuart Nichol discusses how the disease was found in Sudan and how it spread in a hospital there. Created: 4/15/2010 by National Center for Emerging and Zoonotic Infections (proposed). Date Released: 4/15/2010.
Al-Tikriti, S. K.; Al-Ani, F.; Jurji, F. J.; Tantawi, H.; Al-Moslih, M.; Al-Janabi, N.; Mahmud, M. I. A.; Al-Bana, A.; Habib, H.; Al-Munthri, H.; Al-Janabi, Sh.; Al-Jawahry, K.; Yonan, M.; Hassan, F.; Simpson, D. I. H.
Congo/Crimean haemorrhagic fever was recognized for the first time in Iraq in 1979. The first case was reported on 3 September 1979 and since then a further 9 patients have been investigated. Eight patients gave a history of previous contact with sheep or cattle, while 2 patients, a resident doctor and an auxiliary nurse, acquired their infections in hospital by direct contact with patients. The causal virus was isolated from patients' blood and postmortem liver specimens. The virus isolates ...
Full Text Available Abstract Background South Hungary is being monitored for the northward spreading of thermophilic ixodid species, therefore ticks were collected from cattle and wild ruminants (red, fallow and roe deer in the autumn of 2011. Findings Besides indigenous species (1185 Dermacentor reticulatus and 976 Ixodes ricinus, two Hyalomma marginatum rufipes males were found on two cows, in September eight days apart. Conclusions This is the northernmost autochthonous infestation of the type host (cattle with H. m. rufipes, vector of Crimean-Congo haemorrhagic fever virus. The present findings are suggestive of the moulting success of this Afro-Mediterranean tick species in a continental climate in Central Europe.
Full Text Available Aim: To evaluate demographic,clinical and laboratory characteristics, causes, MEFV gene mutations, and mortality rates of patients with secondary amyloidosis. Material and Method: 61 patients who had been diagnosed with secondary amyloidosis by renal and rectal biopsy between 2007 and 2013 in the nephrology clinic of Cumhuriyet University, Faculty of Medicine, were included in the study. Demographic characteristics, causes of secondary amyloidosis, MEFV gene mutations, end-stage renal failure (ESRF, renal transplantation, and mortality rates were examined retrospectively. Results: In etiological terms, Familial Mediterranean Fever (FMF occurrence was 62.2% (38, bronchiectasis and emphysema 9.8% (6, tuberculosis 4.9% (3, coexistence of FMF and ankylosing spondylitis 3.2% (2, coexistence of FMF and rheumatoid arthritis 1.6% (1, coexistence of FMF and systemic lupus erythematosus (SLE 1.6% (1, osteomyelitis 1.6% (1, septic arthritis 1.6% (1, Crohn%u2019s disease 1.6% (1, colon cancer 1.6% (1, coexistence of bronchiectasis and tuberculosis 1.6% (1, rheumatoid arthritis 1.6% (1, and idiopathic cases 6.5% (4. Proteinuria was determined at nephrotic level among 68% (32 of 47 patients who had secondary amyloidosis. MEFV gene mutation of 45 patients with secondary amyloidosis was assessed. Most patients had M694V gene mutation. Surprisingly, we detected heterozygous E148Q mutation in 3 cases. 12 cases died; of these, 9 had ESRF. Five cases with ESRF underwent renal transplantation. Discussion: We found FMF as the most common cause for secondary AA amyloidosis in this study. Further studies should be done with larger or multicenter cohorts.
We reported a case of acute pancreatitis as the complication of dengue hemorrhagic fever (DHF). This complication can cause more severe fatal condition, and difficulties in treatment, although it is rare. Dengue hemorrhagic fever (DHF) is one of the endemic diseases and often come as an outbreak event in South East Asia including Indonesia. Dengue hemorrhagic fever (DHF) is a global public health problem, because until now there has been no medicine to eradicate the dengue virus, no dengue vaccine and difficult to eradicate the mosquitoes as the contagious vector. Diagnosis and treatment of acute pancreatitis as early as possible is important to improve the patient's condition and survival. The patient was a 59 year old male and had been treated conservatively. The patient was admitted to the hospital, oral fasting until the fourth day, given parenteral nutrition, antibiotic and other intravenous medicines. Initial oral liquid diet was given on the fifth day of hospitalization and changed gradually according to the condition. The patient was then improved and discharged from the hospital.
Moore, Ann Hudson; Carrigan, Julie Dagenhart; Solomon, David M; Tart, Rebecca Creech
This research investigated effectiveness of temporal artery thermometry (TAT) to detect high rectal fever in children ≥ 91 days and ≤ 4 years old. Rectal temperature was initially evaluated immediately followed by TAT. As expected, the difference between mean rectal (38.05 ± .99 °C) and mean TA (37.55 ± .8 °C) temperatures in subjects (N = 239) was significant (p thermometry with greater frequency at higher temperatures. This observation provides probable explanation for the disparity between these thermometry methods. A TAT sensitivity of 75% and specificity of 85% were determined for detecting high fever (39 °C)-a finding clinically unacceptable. In contrast, among the small number of injured subjects enrolled, TAT detected high rectal fever with 100% sensitivity and specificity. This finding, if confirmed, suggests TAT screening for well and injured children has potential for clinical practice by diminishing rectal measurements and their associated risks in the acute care and/or ambulatory practice setting. © The Author(s) 2014.
Mehler, Mark F; Purpura, Dominick P
Some children with autism spectrum disorders (ASD) exhibit improved behaviors and enhanced communication during febrile episodes. We hypothesize that febrigenesis and the behavioral-state changes associated with fever in autism depend upon selective normalization of key components of a functionally impaired locus coeruleus-noradrenergic (LC-NA) system. We posit that autistic behaviors result from developmental dysregulation of LC-NA system specification and neural network deployment and modulation linked to the core behavioral features of autism. Fever transiently restores the modulatory functions of the LC-NA system and ameliorates autistic behaviors. Fever-induced reversibility of autism suggests preserved functional integrity of widespread neural networks subserving the LC-NA system and specifically the subsystems involved in mediating the cognitive and behavioral repertoires compromised in ASD. Alterations of complex gene-environmental interactions and associated epigenetic mechanisms during seminal developmental critical periods are viewed as instrumental in LC-NA dysregulation as emphasized by the timing and severity of prenatal maternal stressors on autism prevalence. Our hypothesis has implications for a rational approach to further interrogate the interdisciplinary etiology of ASD and for designing novel biological detection systems and therapeutic agents that target the LC-NA system's diverse network of pre- and postsynaptic receptors, intracellular signaling pathways and dynamic epigenetic remodeling processes involved in their regulation and functional plasticity.
Seasonal allergic rhinitis (hay fever) is common and can considerably reduce the quality of life of sufferers. Despite the wide everyday application and promising results with homeopathy, scientific evidence of its effectiveness for most ailments is scarce. The assessment of the clinical effectiveness of homeopathic remedies in the alleviation of hay fever symptoms in a typical clinical setting. We performed a clinical observational study of eight patients in the treatment of hay fever symptoms over a two-year period (2012 and 2013) using Measure Yourself Medical Outcome Profile (MYMOP) self-evaluation questionnaires at baseline and again after two weeks and four weeks of homeopathic treatment. The individualized prescription - either a single remedy or multiple remedies - was based on the totality of each patient's symptoms. The average MYMOP scores for the eyes, nose, activity and wellbeing had improved significantly after two and four weeks of homeopathic treatment. The overall average MYMOP profile score at baseline was 3.83 (standard deviation, SD, 0.78). After 14 and 28 days of treatment the average score had fallen to 1.14 (SD, 0.36; PHomeopathy. Published by Elsevier Ltd. All rights reserved.
The recent onset of epidemics caused by viruses such as Ebola, Marburg, Nipah, Lassa, coronavirus, West-Nile encephalitis, Saint Louis encephalitis, human immunodeficiency virus, dengue, yellow fever and Venezuelan hemorrhagic fever alerts about the risk these agents represent for the global health. Chikungunya virus represents a new threat. Surged from remote African regions, this virus has become endemic in the Indic ocean basin, the Indian subcontinent and the southeast of Asia, causing serious epidemics in Africa, Indic Ocean Islands, Asia and Europe. Due to their epidemiological and biological features and the global presence of their vectors, chikungunya represents a serious menace and could become endemic in the Americas. Although chikungunya infection has a low mortality rate, its high attack ratio may collapse the health system during epidemics affecting a sensitive population. In this paper, we review the clinical and epidemiological features of chikungunya fever as well as the risk of its introduction into the Americas. We remark the importance of the epidemiological control and mosquitoes fighting in order to prevent this disease from being introduced into the Americas. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Igor S. Lukashevich
Full Text Available Lassa virus (LASV is the most prominent human pathogen of the Arenaviridae. The virus is transmitted to humans by a rodent reservoir, Mastomys natalensis, and is capable of causing lethal Lassa Fever (LF. LASV has the highest human impact of any of the viral hemorrhagic fevers (with the exception of Dengue Fever with an estimated several hundred thousand infections annually, resulting in thousands of deaths in Western Africa. The sizeable disease burden, numerous imported cases of LF in non-endemic countries, and the possibility that LASV can be used as an agent of biological warfare make a strong case for vaccine development. Presently there is no licensed vaccine against LF or approved treatment. Recently, several promising vaccine candidates have been developed which can potentially target different groups at risk. The purpose of this manuscript is to review the LASV pathogenesis and immune mechanisms involved in protection. The current status of pre-clinical development of the advanced vaccine candidates that have been tested in non-human primates will be discussed. Major scientific, manufacturing, and regulatory challenges will also be considered.
The enlargement of the European community to include Portugal and Spain has focussed public attention on the EC's relations with certain other states bordering the Mediterranean; Israel, Morocco, Tunisia and Cyprus in particular fear that the competitiveness of their exports to the European market will be prejudiced. In view of this and other threats to the EC's ties to her Southern neighbours the future of the EC's external Mediterranean policy is at stake.
C?zar, Andr?s; Sanz-Mart?n, Marina; Mart?, Elisa; Gonz?lez-Gordillo, J. Ignacio; Ubeda, B?rbara; G?lvez, Jos? ?.; Irigoien, Xabier; Duarte, Carlos M.
Copyright: © 2015 Cózar et al. Concentrations of floating plastic were measured throughout the Mediterranean Sea to assess whether this basin can be regarded as a great accumulation region of plastic debris. We found that the average density of plastic (1 item per 4 m2), as well as its frequency of occurrence (100% of the sites sampled), are comparable to the accumulation zones described for the five subtropical ocean gyres. Plastic debris in the Mediterranean surface waters was dominated by ...
Turati, Federica; Carioli, Greta; Bravi, Francesca; Ferraroni, Monica; Serraino, Diego; Montella, Maurizio; Giacosa, Attilio; Toffolutti, Federica; Negri, Eva; Levi, Fabio; La Vecchia, Carlo
The Mediterranean diet has been related to a reduced risk of several common cancers but its role on breast cancer has not been quantified yet. We investigated the association between adherence to the Mediterranean diet and breast cancer risk by means of a hospital-based case-control study conducted in Italy and Switzerland. 3034 breast cancer cases and 3392 controls admitted to the same network of hospitals for acute, non-neoplastic and non-gynaecologic diseases were studied. Adherence to the Mediterranean diet was quantitatively measured through a Mediterranean Diet Score (MDS), summarizing the major characteristics of the Mediterranean dietary pattern and ranging from 0 (lowest adherence) to 9 (highest adherence). We estimated the odds ratios (ORs) of breast cancer for the MDS using multiple logistic regression models, adjusting for several covariates. Compared to a MDS of 0-3, the ORs for breast cancer were 0.86 (95% confidence interval, CI, 0.76-0.98) for a MDS of 4-5 and 0.82 (95% CI, 0.71-0.95) for a MDS of 6-9 ( p for trend = 0.008). The exclusion of the ethanol component from the MDS did not materially modify the ORs (e.g., OR = 0.81, 95% CI, 0.70-0.95, for MDS ≥ 6). Results were similar in pre- and post-menopausal women. Adherence to the Mediterranean diet was associated with a reduced breast cancer risk.
Chikungunya fever (CHIK-F) has been increasingly documented among Western travelers returning from areas with chikungunya virus transmission, which are also popular tourist sites. We present three Israeli travelers who developed fever, maculopapular rash and long-standing arthralgias while visiting northern Indian states not known to be involved in the chikungunya fever epidemic. We also present an epidemiological review of the chikungunya epidemic over the past decades. Rare systemic manifestations of this disorder, like catastrophic antiphospholipid syndrome (CAPS) and adult-onset Still's syndrome, are discussed. The present era of international travel poses a new diagnostic and epidemiologic challenge that demands increased awareness to the possibility of an exotic tropical infectious disease.
O'Mara, Susan K
Postoperative fever after cardiac surgery is a common occurrence. Most fevers are benign and self-limiting resulting from inflammation caused by surgical trauma and blood contact with cardiopulmonary bypass circuit resulting in the release of cytokines. Only a small percentage of time is postoperative fever due to an infection complicating surgery. The presence of fever frequently triggers a battery of diagnostic tests that are costly, could expose the patient to unnecessary risks, and can produce misleading or inconclusive results. It is therefore important that fever be evaluated in a systematic, prudent, clinically appropriate, and cost-effective manner. This article focuses on the current evidence regarding pathophysiology, incidence, causes, evaluation, and management of fever in postoperative adult cardiac surgical patients.
Al-Tawfiq, Jaffar A; Memish, Ziad A
Dengue fever is a global disease with a spectrum of clinical manifestation ranging from mild febrile disease to a severe disease in the form of dengue hemorrhagic fever and dengue shock syndrome. Dengue virus is one viral hemorrhagic fever that exists in the Kingdom of Saudi Arabia in addition to Alkhurma (Alkhurma) Hemorrhagic Fever, Chikungunya virus, Crimean-Congo Hemorrhagic Fever, and Rift Valley Fever. The disease is limited to the Western and South-western regions of Saudi Arabia, where Aedes aegypti exists. The majority of the cases in Saudi Arabia had mild disease and is related to serotypes 1-3 but not 4. The prospect for Dengue virus control relies on vector control, health education, and possibly vaccine use. Despite extensive collaborative efforts between multiple governmental sectors, including Ministry of Health, Ministry of Municipalities and Rural Affairs, and Ministry of Water, dengue remains a major public health concern in the regions affected.
Marventano, Stefano; Godos, Justyna; Platania, Alessio; Galvano, Fabio; Mistretta, Antonio; Grosso, Giuseppe
A decline in adherence to the Mediterranean dietary pattern has been observed over the last years. The aim of this study was to assess the level of adherence to the Mediterranean diet and possible determinants in the Mediterranean healthy Eating, Aging and Lifestyle (MEAL) study cohort. Demographic and dietary data of 1937 individuals were collected in 2014-2015 from the general population of Catania, Sicily (Italy). Food frequency questionnaires and the MEDI-LITE score were used to assess adherence to the Mediterranean diet. The score well characterised consumption of major food groups, micro- and macro-nutrients. The cohort had a general good adherence, but only a minority was highly adherent. High adherence was directly associated with education, non-smoking and physical activity and inversely with high occupational status. In conclusions, Mediterranean diet is still followed in Sicily; however, nutrition education campaigns should promote healthy traditional dietary patterns in certain groups of individuals.
Ali, Syed Ahsan; Ahmed, Sara; Riaz, Mehmood
Hemorrhagic manifestations are fairly common in Dengue hemorrhagic fever and are associated with increased mortality. During last few decades there have been increasing reports of Dengue infection with unusual manifestations. Here we present a case of dengue hemorrhagic fever complicated by spontaneous rupture of an intercostal artery leading to a large hematoma which was treated successfully with angio-embolization. To the authors' knowledge this is a first case of dengue hemorrhagic fever complicated by spontaneous intercostal artery hemorrhage.
Romano, Alessandro Pecego Martins; Costa, Zouraide Guerra Antunes; Ramos, Daniel Garkauskas; Andrade, Maria Auxiliadora; Jayme, Valéria de Sá; de Almeida, Marco Antônio Barreto; Vettorello, Kátia Campomar; Mascheretti, Melissa; Flannery, Brendan
Author Summary Yellow fever is a viral hemorrhagic disease transmitted by mosquitos, endemic in tropical regions of Africa and South America. Large urban outbreaks of yellow fever have been eliminated in the Americas, where most yellow fever cases result from human exposure to jungle or forested environments. Vaccination is effective but carries a risk of potentially fatal adverse events in a small number of vaccinees. In a large country such as Brazil, vaccination is recommended only in area...
Boopathy, Vinoth; Periyasamy, Sivakumar; Alexander, Thomas; Balasubramanian, Padhmini
Typhoid fever is caused by enteroinvasive Gram-negative organism Salmonella typhi. The well-known complications of typhoid fever are intestinal haemorrhage and perforation. In the pre-antibiotic era, these complications were quite common, but in the current antibiotic era the incidence of these complications is on the decline. We report a case of a patient with typhoid fever who developed haematochezia during the hospital stay and was found to have caecal ulcer with an adherent clot on colono...
Ehrhardt, A.; Schnabel, M.; Damm, V.
The Eratosthenes Seamount forms a prominent landmark in the Eastern Mediterranean. It is located south of Cyprus with the Levantine Basin on its eastern side, the Herodotus Basin on its western side and the Nile Cone south of the seamount. The Eratosthenes Seamount rises up to 750 m below sea surface and is about 1200 m higher than the surrounding seafloor of the Levantine Basin and the Nile Cone sediments. The Eratosthenes Seamount is considered as a continental fragment of the former African-Nubian Plate that was rifted to its present position relative to Africa during the formation of the Tethyan Ocean. In 2010 a detailed geophysical survey was carried out in the area of the Eratosthenes Seamount by the Federal Institute for Geosciences and Natural Resources of Germany including multichannel seismic (MCS), refraction seismics, magnetic, gravity and magnetotelluric data acquisition. First results show a highly deformed seamount, with a plateau-like top that is impacted by west-east trending graben formation. The slopes of the seamount are eroded showing deep incised ripple patterns and recent submarine landslides. The Eratosthenes Seamount produces also a prominent magnetic and gravity anomaly, both supporting its uniqueness in the area of the Eastern Mediterranean. Velocity information by refraction seismic modeling, as well as the models of the magnetic and gravity data show evidence for a volcanic core of the seamount with carbonate layers on top of the volcanic core. The slopes of the seamount terminate against a conspicuous rim-like escarpment that forms in addition the northern and western termination of the Messinian Evaporites in the study area. The MCS and refraction seismic data show a very deep Levantine Basin with maximum acoustic basement depths of 12 to 14 km very close to the slope of the Eratosthenes Seamount. The deepest sediments resolved by the MCS data are of Lower Cretaceous to Jurassic age. The refraction seismic model shows a 14 km thick
Bang, Peter Fibiger
Historie, Mediterranean pre-industrial history, The Mediterranean, Ecological History, Economic History, Pre-industrial History, Finley, Ancient trade, Mediterranean unity......Historie, Mediterranean pre-industrial history, The Mediterranean, Ecological History, Economic History, Pre-industrial History, Finley, Ancient trade, Mediterranean unity...
Carmoi, T; Grateau, G; Billhot, M; Dumas, G; Biale, L; Perrot, G; Algayres, J-P
Early studies on prolonged fever date back to the 1960s. Fifty years later, prolonged unexplained fever remains a diagnostic challenge to the general internists. Although the aetiologies of prolonged fevers have not changed much in the general population, the distribution between the various causes is not the same anymore. A regular decrease in infectious and neoplastic causes is noticed whatever the age. Prolonged fevers related to inflammatory disorders and fevers that remain of unknown origin still represent approximately 30 to 50% of the cases. In the young adult population, as in the older patients, prolonged fevers can be attributed to four groups: infection, inflammation, neoplasic and other aetiologies (including drug-related fevers). In the young adult population, the management of prolonged fever presents some specific issues that are the purpose of this review coupled with our own experience. The prognosis of undiagnosed prolonged fever is usually favourable, as a life-threatening aetiology is exceptionally diagnosed during the follow-up if the initial management was complete and accurate. Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.
Syafruddin, S.; Noorani, M. S. M.
In this paper, we study a system of differential equations that models the population dynamics of SEIR vector transmission of dengue fever. The model studied breeding value based on the number of reported cases of dengue fever in Selangor because the state had the highest case in Malaysia. The model explains that maximum level of human infection rate of dengue fever achieved in a very short period. It is also revealed that there existed suitability result between theoretical and empirical calculation using the model. The result of SEIR model will hopefully provide an insight into the spread of dengue fever in Selangor Malaysia and basic form for modeling this area.
Nakamura, Masayuki; Ikeda, Shuntaro; Nagahara, Hiroyuki; Hitsumoto, Tatsurou; Matsui, Shogo; Kadota, Hisaki; Shimizu, Hideaki; Ohshima, Kiyotaka; Yakushiji, Naoki; Hamada, Mareomi
A 16-year-old boy stayed in Tokyo near Yoyogi Park for extracurricular high school activities. After returning home, he experienced an episode of fever and visited our emergency outpatient unit. He initially exhibited symptoms of leukopenia, thrombocytopenia and concomitant rhabdomyolysis and after admission simultaneously developed a biphasic fever and systemic erythema. Based on the results of reverse transcription polymerase chain reaction testing, he was finally diagnosed with dengue fever. After an absence of 70 years, dengue fever has reemerged as a domestic infection. Awareness of this trend led to our diagnosis.
Miguel Ángel Martínez-González
Full Text Available Substantial evidence has verified the Mediterranean diet’s (MedDiet nutritional adequacy, long-term sustainability, and effectiveness for preventing hard clinical events from cardiovascular disease (CVD, as well as increasing longevity. This article includes a cumulative meta-analysis of prospective studies supporting a strong inverse association between closer adherence to the MedDiet and the incidence of hard clinical events of CVD. The MedDiet has become an increasingly popular topic of interest when focusing on overall food patterns rather than single nutrient intake, not only in Mediterranean countries, but also globally. However, several myths and misconceptions associated with the traditional Mediterranean diet should be clearly addressed and dispelled, particularly those that label as “Mediterranean” an eating pattern that is not in line with the traditional Mediterranean diet. The transferability of the traditional MedDiet to the non-Mediterranean populations is possible, but it requires a multitude of changes in dietary habits. New approaches for promoting healthy dietary behavior consistent with the MedDiet will offer healthful, sustainable, and practical strategies at all levels of public health. The following article presents practical resources and knowledge necessary for accomplishing these changes.
Martínez-González, Miguel Ángel; Hershey, Maria Soledad; Zazpe, Itziar
Substantial evidence has verified the Mediterranean diet’s (MedDiet) nutritional adequacy, long-term sustainability, and effectiveness for preventing hard clinical events from cardiovascular disease (CVD), as well as increasing longevity. This article includes a cumulative meta-analysis of prospective studies supporting a strong inverse association between closer adherence to the MedDiet and the incidence of hard clinical events of CVD. The MedDiet has become an increasingly popular topic of interest when focusing on overall food patterns rather than single nutrient intake, not only in Mediterranean countries, but also globally. However, several myths and misconceptions associated with the traditional Mediterranean diet should be clearly addressed and dispelled, particularly those that label as “Mediterranean” an eating pattern that is not in line with the traditional Mediterranean diet. The transferability of the traditional MedDiet to the non-Mediterranean populations is possible, but it requires a multitude of changes in dietary habits. New approaches for promoting healthy dietary behavior consistent with the MedDiet will offer healthful, sustainable, and practical strategies at all levels of public health. The following article presents practical resources and knowledge necessary for accomplishing these changes. PMID:29117146
Marcos, Raül; Turco, Marco; Bedía, Joaquín; Llasat, Maria Carmen; Provenzale, Antonello
Each year approximately 500000 hectares burn in Europe. Most of them are consequence of Mediterranean summer fires that lead to damages to the natural environment causing important economic and life losses. In order to allow the preparedness of adequate prevention measures in European Mediterranean regions, a better understanding of the summer fire predictability is crucial. Climate is a primary driver of the interannual variability of fires in Mediterranean-type ecosystems, controlling fuel flammability and fuel structure [1, 2]. That is, summer fires are linked to current-year climate values (proxies for the climatic factors that affect fuel flammability) and to antecedent climate variables (proxies for the climatic factors influencing fine fuel availability and connectivity). In our contribution we explore the long-term predictability of wildfires in a Mediterranean region (NE Spain), driving a multiple linear regression model with observed antecedent climate variables and with predicted variables from the ECMWF System-4 seasonal forecast. The approaches are evaluated through a leave-one-out cross-validation over the period 1983-2010. While the ECMWF System-4 proved of limited usefulness due to its limited skill, the model driven with antecedent climate variables alone allowed for satisfactory long-term prediction of above-normal fire activity, suggesting the feasibility of successful seasonal prediction of summer fires in Mediterranean-type regions. *References  M. Turco, M. C. Llasat, J. von Hardenberg, and A. Provenzale. Impact of climate variability on summer fires in a mediterranean environment (northeastern iberian peninsula). Climatic Change, 116:665-678, 2013.  M. Turco, M. C. Llasat, J. von Hardenberg, and A. Provenzale. Climate change impacts on wildfires in a Mediterranean environment. Climatic Change, 125: 369-380, 2014.
Full Text Available Salinization is increasingly affecting world's agricultural land causing serious yield loss and soil degradation. Understanding how we could improve crop productivity in salinized environments is therefore critical to meet the challenging goal of feeding 9.3 billion people by 2050. Our comprehension of fundamental physiological mechanisms in plant salt stress adaptation has greatly advanced over the last decades. However, many of these mechanisms have been linked to salt tolerance in simplified experimental systems whereas they have been rarely functionally proven in real agricultural contexts. In-depth analyses of specific crop-salinity interactions could reveal important aspects of plant salt stress adaptation as well as novel physiological/agronomic targets to improve salinity tolerance. These include the developmental role of root vs. shoot systems respect to water-ion homeostasis, morphological vs. metabolic contributions to stress adaptation, developmental processes vs. seasonal soil salinity evolution, residual effects of saline irrigation in non-irrigated crops, critical parameters of salt tolerance in soil-less systems and controlled environments, response to multiple stresses. Finally, beneficial effects of salinization on qualitative parameters such as stress-induced accumulation of high nutritional value secondary metabolites should be considered, also. In this short review we attempted to highlight the multifaceted nature of salinity in Mediterranean agricultural systems by summarizing most experimental activity carried out at the Department of Agricultural Engineering and Agronomy of University of Naples Federico II in the last few years.
Lika, Konstadia; Kooijman, Sebastiaan A. L. M.; Papandroulakis, Nikos
Larval stages are considered the most critical of fish development. During a very short period of time (2 to 3 months), larvae undergo major morphoanatomical and functional changes in order to transform into juveniles while remaining functioning (developing, eating, surviving). Depending on species and environmental conditions, patterns in larval development may vary. We study the patterns of larval development for nine fish species of Perciformes reared under aquaculture conditions and compare them in terms of species-specific parameters derived from DEB theory. We extended the standard DEB model to include metabolic acceleration during the larval period, where maximum specific assimilation and energy conductance increase with length between birth and metabolic metamorphosis. Metabolic acceleration has as a consequence that larvae initially grow slower than juveniles and adults. Our results indicate that the species with higher acceleration have lower growth rates at birth and they also suggest that metabolic acceleration is related to spawning season. High metabolic acceleration of demersal species is associated with summer-autumn spawning in the Mediterranean, where temperature is high and food availability is low.
Full Text Available The present Atlas contains a detailed study, based in scanning electron microscopy (SEM observations, of living coccolithophores from NW Mediterranean waters. The study contains 103 figures with 411 micrographs, which correspond to 168 coccolithophores (including different taxonomic and morphotypic entities. The figured specimens were collected during different cruises carried out from 1995 to 1999.Classification of the organisms follows modern taxonomy of living calcareous nannoplankton. Measures of the specimens and notes on their taxonomy are given in addition to abridged descriptions of the studied taxa. The atlas contains a large number of previously undescribed forms, specially in the genera Syracosphaera, Papposphaera, Polycrater, Anthosphaera, Corisphaera and Sphaerocalyptra. Several species never illustrated in the literature are presented here for the first time. Coccospheres having coccoliths of different recognized species are presented. These combination coccospheres are nowadays considered as transitional steps between different phases in the cellular life-cycle. An introduction with a brief overview of the actual coccolithophore knowledge and an abridged glossary with figures of the basic terminology are included.
Xavier Medina, F
The aim of the present article is to discuss the role of the Mediterranean diet as a part of Human Culture and Intangible Cultural Heritage. Until the present, Mediterranean diet has been observed as a healthy model of medical behaviour. After its proposal as a Cultural Heritage of the Humanity at UNESCO (United Nations Educational, Scientific and Cultural Organization), Mediterranean diet is actually being observed as a part of Mediterranean culture and starting its concept as an equivalent of Mediterranean Cultural Food System or Mediterranean Culinary System. At the candidacy of Mediterranean diet as a World Cultural Intangible Heritage to be presented at UNESCO in 2008, this new conception is making sense. A new point of view that will be capital in the future discussions about the Mediterranean diet, their challenges and their future perspectives.
O'Toole, Sam M; Pathak, Neha; Toms, Graham C; Gelding, Susan V; Sivaprakasam, Venkat
Leptospirosis is an uncommon infectious disease that has protean clinical manifestations ranging from an innocuous 'flu-like' illness to potentially life-threatening multi-organ failure. Here we describe a case of Weil's disease that presented on the acute medical take with fever, jaundice and acute renal failure. We highlight the importance of careful history taking at the time of admission and how understanding the epidemiology and pathophysiology of leptospirosis enables a definitive diagnosis to be reached. © 2015 Royal College of Physicians.
Srikiatkhachorn, Anon; Kelley, James F
Therapies to prevent or reverse endothelial dysfunction and vascular leak found in dengue hemorrhagic fever (DHF) have not been identified. In this review we summarize dengue viruses and the spectrum of human disease and highlight evidence of endothelial cell dysfunction in DHF based on studies in patients and mouse and tissue culture models. Evidence suggests that both virus antigen and host immune response, can cause endothelial cell dysfunction and weaken endothelial barrier integrity. We suggest possible therapeutic interventions and highlight how therapies targeting altered endothelial function might be evaluated in animal models and in patients with DHF. Copyright © 2014 Elsevier B.V. All rights reserved.
Thilsing-Hansen, T; Jørgensen, R J; Østergaard, S
(between 0 and 0.20) (daily calcium intake below versus above 20 g/d). The main problem in implementing the low-Ca principle is difficulties in formulating rations sufficiently low in calcium when using commonly available feeds. The use of large doses of vitamin D metabolites and analogues for milk fever...... with sufficient magnesium to fulfil its needs, and to prevent the dry cows from being too fat. Available information on the influence of carbohydrate intake, and on the effect of the length of the dry period and prepartum milking, is at present insufficient to include these factors in control programmes....
Full Text Available BACKGROUND Dengue fever (DF is a viral haemorrhagic fever causing severe morbidity and mortality in affected patients. The aim of the study is to describe the role of ultrasonography (USG in the assessment of patients with Dengue fever, and its complications and to prove ultrasound is useful in the diagnosis during an epidemic. MATERIALS AND METHODS It is a prospective study was conducted in 2016 comprising of 178 patients who were serologically positive for dengue, radiological investigations were conducted in all cases. RESULTS Out of 178 patients Males (N=117 are more effected subjects in the study. female: Male ratio is 1:2. Hepatomegaly 74.1% which is most common findings in study, 113 (63.4% had GB wall thickening 98 had ascites (55%, 32 had pleural effusion (17.9%. most commonly seen in the age group of 20-39 years. Hepatomegaly was the most common finding noted in 67 patients (37.6%, followed by GB wall thickening in 65 patients (36.1%. Hepatomegaly was more common in 0-19 is 56 patients with 31.4% years age group Ascites in >40 years age group (16.8%. Hepatomegaly was seen in most of the patients whose platelet count was <40,000. (94.7%. GB wall thickening (88.5% common findings seen in patients whose platelet count was <40,000. In patients with platelet count of 40,000-80,000, Ascites is most common finding (87.5%, followed by Splenomegaly (60.7%. In patients whose platelet count was 80,000-150,000, Ascites (50% was more common than Splenomegaly (45.8%. In three patients with platelet count more than 150,000, no sonological abnormality was detected. CONCLUSIONS Ultrasound findings of hepatic changes, GB wall oedema, splenomegaly, ascites and pleural effusion in patients presenting with signs and symptoms of Dengue fever during an epidemic are diagnostic. Contributing in the differential diagnosis with other causes of febrile disease.
Harter, Katherine R; Bhatt, Sanjay; Kim, Hyung T; Mallon, William K
We report the case of a 33-year-old woman returning from Haiti, presenting to our emergency department (ED) with fever, rash and arthralgia. Following a broad workup that included laboratory testing for dengue and malaria, our patient was diagnosed with Chikungunya virus, which was then reported to the Centers for Disease Control and Prevention for initiation of infection control. This case demonstrates the importance of the ED for infectious disease case identification and initiation of public health measures. This case also addresses public health implications of Chikungunya virus within the United States, and issues related to the potential for local spread and autochthonous cases.
It is not given to everyone to have his maladies made the subject-matter of a published book. Not so Grand Master Perellos (1697 1720) who lived to see a 104-page volume about his recalcitrant fevers printed in his lifetime.1 It all started with a letter written on February 15, 1708, by Malta's protomedico (Chief Government Medical Officer) Dr Arcangelo Grech2 at the instance of the Grand Master, addressed to the most eminent physician in Sicily, indirectly asking for guidance about the def...
In Mediterranean basin, woodlands grazing still continue to be important commercial owners' benefits. These owners manage woodlands vegetations as if they were not at risk of degradation and declining. Frequently, no temporally grazing set-aside is taken into account to avoid overgrazing of annual and perennial vegetations. Although less common, in the northern shore of Mediterranean basin undergrazing might increase the frequency and the number of catastrophic forest fires. This under/over grazing regime occurs in the Mediterranean basin woodlands with contrasted differences on land property rights, local economies and government livestock policy incentives. Spain and Tunisia are examples of these Mediterranean livestock contrasts. Most of Spanish Mediterranean woodlands and livestock herds are large private ownerships and owners could maintain their lands and livestock herds properties on the basis of moderate cash-income compensation against land revaluation and exclusive amenity self-consumption. The later is less tangible benefit and it could include family land legacy, nature enjoyment, country stile of life development, social status and so on. In public woodlands, social and environmental goals -as they are cultural heritage, biodiversity loss mitigation, soil conservation and employment- could maintain market unprofitable woodlands operations. Last three decades Spanish Mediterranean woodlands owners have increased the livestock herds incentivized by government subsidies. As result, grazing rent is pending on the level of European Union and Spanish government livestock subsidies. In this context, Spanish Mediterranean woodlands maintain a high extensive livestock stoking population, which economy could be called fragile and environmentally unsustainable because forest degradation and over/under grazing practices. Tunisian Mediterranean woodlands are state properties and livestock grazing is practice as a free private regimen. Livestock herds are small herd
Full Text Available This contribution forms part of a series of collective articles published regularly in Mediterranean Marine Science that report on new biodiversity records from the Mediterranean basin. The current article presents 51 geographically distinct records for 21 taxa belonging to 6 Phyla, extending from the western Mediterranean to the Levantine. The new records, per country, are as follows: Spain: the cryptogenic calcareous sponge Paraleucilla magna is reported from a new location in the Alicante region. Algeria: the rare Atlanto-Mediterranean bivalve Cardium indicum is reported from Annaba. Tunisia: new distribution records for the Indo-Pacific lionfish Pterois miles from Zembra Island and Cape Bon. Italy: the ark clam Anadara transversa is reported from mussel cultures in the Gulf of Naples, while the amphipod Caprella scaura and the isopods Paracerceis sculpta and Paranthura japonica are reported as associated to the –also allochthonous–bryozoan Amathia verticillata in the Adriatic Sea; in the latter region, the cosmopolitan Atlantic tripletail Lobotes surinamensisis also reported, a rare finding for the Mediterranean. Slovenia: a new record of the non-indigenous nudibranch Polycera hedgpethi in the Adriatic. Greece: several new reports of the introduced scleractinian Oculina patagonica, the fangtooth moray Enchelycore anatina, the blunthead puffer Sphoeroides pachygaster (all Atlantic, and the lionfish Pterois miles (Indo-Pacific suggest their ongoing establishment in the Aegean Sea; the deepest bathymetric record of the invasive alga Caulerpa cylindracea in the Mediterranean Sea is also registered in the Kyklades, at depths exceeding 70 m. Turkey: new distribution records for two non indigenous crustaceans, the blue crab Callinectes sapidus (Atlantic origin and the moon crab Matuta victor (Indo-Pacific origin from the Bay of Izmir and Antalya, respectively; in the latter region, the Red Sea goatfish Parupeneus forsskali, is also reported
Thais Cunha Matos
Full Text Available CONTEXT: Autoinflammatory syndromes are diseases manifested by recurrent episodes of fever and inflammation in multiple organs. There is no production of autoantibodies, but interleukins play an important role and acute-phase reactants show abnormalities. Our aim was to report on three cases of autoinflammatory syndromes that are considered to be rare entities. CASE REPORTS: The authors describe the clinical features of three patients whose diagnosis were the following: tumor necrosis factor receptor-associated periodic syndrome (TRAPS, chronic infantile neurological cutaneous articular (CINCA syndrome and familial Mediterranean fever (FMF. All of the patients presented fever, joint or bone involvement and increased acute phase reactants. The genetic analysis confirmed the diagnoses of two patients. The great diversity of manifestations and the difficulties in genetic analyses make the diagnosing of these diseases a challenge.
clinical features are exudative pharyngitis, fever and bright red exanthema. Otitis media, pneumonia, septicaemia, osteomyelitis, rheumatic fever and acute glomerulonephritis are the common complications associated with scarlet fever. However, hepatitis and vasculitis are other rare complications described in the literature.
Zhang, Yong-Zhen; He, Yong-Wen; Dai, Yong-An; Xiong, Yanwen; Zheng, Han; Zhou, Dun-Jin; Li, Juan; Sun, Qiangzheng; Luo, Xue-Lian; Cheng, Yu-Li; Qin, Xin-Cheng; Tian, Jun-Hua; Chen, Xiao-Ping; Yu, Bin; Jin, Dong; Guo, Wen-Ping; Li, Wei; Wang, Wen; Peng, Jin-Song; Zhang, Guo-Bin; Zhang, Shaomin; Chen, Xiao-Min; Wang, Yan; Li, Ming-Hui; Li, Zhenjun; Lu, Shan; Ye, Changyun; de Jong, Menno D.; Xu, Jianguo
Background. Hemorrhagic fever-like illness caused by a novel Bunyavirus, Huaiyangshan virus (HYSV, also known as Severe Fever with Thrombocytopenia virus [SFTSV] and Fever, Thrombocytopenia and Leukopenia Syndrome [FTLS]), has recently been described in China. Methods. Patients with
Dorhout Mees, Sanne M.; Luitse, Merel J. A.; van den Bergh, Walter M.; Rinkel, Gabriel J. E.
BACKGROUND AND PURPOSE: Fever after aneurysmal subarachnoid hemorrhage is associated with poor outcome. Because hydrocephalus and extravasated blood may influence thermoregulation, we determined whether these factors increase the risk for fever after subarachnoid hemorrhage. METHODS: Fever within 14
Full Text Available Dengue is a highly endemic infectious disease of the tropical countries and is rapidly becoming a global burden. It is caused by any of the 4 serotypes of dengue virus and is transmitted within humans through female Aedes mosquitoes. Dengue disease varies from mild fever to severe conditions of dengue hemorrhagic fever and shock syndrome. Globalization, increased air travel, and unplanned urbanization have led to increase in the rate of infection and helped dengue to expand its geographic and demographic distribution. Dengue vaccine development has been a challenging task due to the existence of four antigenically distinct dengue virus serotypes, each capable of eliciting cross-reactive and disease-enhancing antibody response against the remaining three serotypes. Recently, Sanofi Pasteur’s chimeric live-attenuated dengue vaccine candidate has been approved in Mexico, Brazil, and Philippines for usage in adults between 9 and 45 years of age. The impact of its limited application to the public health system needs to be evaluated. Simultaneously, the restricted application of this vaccine candidate warrants continued efforts in developing a dengue vaccine candidate which is additionally efficacious for infants and naïve individuals. In this context, alternative strategies of developing a designed vaccine candidate which does not allow production of enhancing antibodies should be explored, as it may expand the umbrella of efficacy to include infants and naïve individuals.
Khetarpal, Niyati; Khanna, Ira
Dengue is a highly endemic infectious disease of the tropical countries and is rapidly becoming a global burden. It is caused by any of the 4 serotypes of dengue virus and is transmitted within humans through female Aedes mosquitoes. Dengue disease varies from mild fever to severe conditions of dengue hemorrhagic fever and shock syndrome. Globalization, increased air travel, and unplanned urbanization have led to increase in the rate of infection and helped dengue to expand its geographic and demographic distribution. Dengue vaccine development has been a challenging task due to the existence of four antigenically distinct dengue virus serotypes, each capable of eliciting cross-reactive and disease-enhancing antibody response against the remaining three serotypes. Recently, Sanofi Pasteur's chimeric live-attenuated dengue vaccine candidate has been approved in Mexico, Brazil, and Philippines for usage in adults between 9 and 45 years of age. The impact of its limited application to the public health system needs to be evaluated. Simultaneously, the restricted application of this vaccine candidate warrants continued efforts in developing a dengue vaccine candidate which is additionally efficacious for infants and naïve individuals. In this context, alternative strategies of developing a designed vaccine candidate which does not allow production of enhancing antibodies should be explored, as it may expand the umbrella of efficacy to include infants and naïve individuals.
Thompson, Corinne N; Kama, Mike; Acharya, Shrish; Bera, Una; Clemens, John; Crump, John A; Dawainavesi, Aggie; Dougan, Gordon; Edmunds, W John; Fox, Kimberley; Jenkins, Kylie; Khan, M Imran; Koroivueta, Josefa; Levine, Myron M; Martin, Laura B; Nilles, Eric; Pitzer, Virginia E; Singh, Shalini; Raiwalu, Ratu Vereniki; Baker, Stephen; Mulholland, Kim
The country of Fiji, with a population of approximately 870 000 people, faces a growing burden of several communicable diseases including the bacterial infection typhoid fever. Surveillance data suggest that typhoid has become increasingly common in rural areas of Fiji and is more frequent amongst young adults. Transmission of the organisms that cause typhoid is facilitated by faecal contamination of food or water and may be influenced by local behavioural practices in Fiji. The Fijian Ministry of Health, with support from Australian Aid, hosted a meeting in August 2012 to develop comprehensive control and prevention strategies for typhoid fever in Fiji. International and local specialists were invited to share relevant data and discuss typhoid control options. The resultant recommendations focused on generating a clearer sense of the epidemiology of typhoid in Fiji and exploring the contribution of potential transmission pathways. Additionally, the panel suggested steps such as ensuring that recommended ciprofloxacin doses are appropriate to reduce the potential for relapse and reinfection in clinical cases, encouraging proper hand hygiene of food and drink handlers, working with water and sanitation agencies to review current sanitation practices and considering a vaccination policy targeting epidemiologically relevant populations. © 2014 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.
Dengue is a highly endemic infectious disease of the tropical countries and is rapidly becoming a global burden. It is caused by any of the 4 serotypes of dengue virus and is transmitted within humans through female Aedes mosquitoes. Dengue disease varies from mild fever to severe conditions of dengue hemorrhagic fever and shock syndrome. Globalization, increased air travel, and unplanned urbanization have led to increase in the rate of infection and helped dengue to expand its geographic and demographic distribution. Dengue vaccine development has been a challenging task due to the existence of four antigenically distinct dengue virus serotypes, each capable of eliciting cross-reactive and disease-enhancing antibody response against the remaining three serotypes. Recently, Sanofi Pasteur's chimeric live-attenuated dengue vaccine candidate has been approved in Mexico, Brazil, and Philippines for usage in adults between 9 and 45 years of age. The impact of its limited application to the public health system needs to be evaluated. Simultaneously, the restricted application of this vaccine candidate warrants continued efforts in developing a dengue vaccine candidate which is additionally efficacious for infants and naïve individuals. In this context, alternative strategies of developing a designed vaccine candidate which does not allow production of enhancing antibodies should be explored, as it may expand the umbrella of efficacy to include infants and naïve individuals. PMID:27525287
Alpert, P.; Price, C.; Krichak, S.; Saaroni, H.; Osetinsky, I.; Barkan, J.; Kishcha, P.; Ziv, B.
Some strong natural fluctuations of climate in the Eastern Mediterranean (EM) region are shown to be connected to the major tropical systems, e.g., El Ni no Southern Oscillation, South Asian Monsoon and hurricanes. Modelling of the severe floods suggests a relation to tropical hurricanes. For a specific event, high-resolution modelling of the severe flood on December 3-5, 2001 in Israel suggests a relation to hurricane Olga. In order to understand the factors governing the Eastern Mediterranean climate variability in the summer season, the relationship between extreme summer temperatures and the South Asian Monsoon was examined. Other tropical factors, like the Red Sea Trough system and the Saharan dust, also contribute to the Mediterranean climate variability
Full Text Available Cyclonic storms that closely resemble tropical cyclones in satellite images occasionally form over the Mediterranean Sea. Synoptic and mesoscale analyses of such storms show small, warm-core structure and surface winds sometimes exceeding 25ms-1 over small areas. These analyses, together with numerical simulations, reveal that in their mature stages, such storms intensify and are maintained by a feedback between surface enthalpy fluxes and wind, and as such are isomorphic with tropical cyclones. In this paper, I demonstrate that a cold, upper low over the Mediterranean can produce strong cyclogenesis in an axisymmetric model, thereby showing that baroclinic instability is not necessary during the mature stages of Mediterranean hurricanes.
Panza, G.F.; Raykova, R.; Carminati, E.; Doglioni, C.
Two cross-sections of the western Mediterranean Neogene-to-present backarc basin are presented, in which geological and geophysical data of the Transmed project are tied to a new shear-wave tomography. Major results are i) the presence of a well stratified upper mantle beneath the older African continent, with a marked low-velocity layer between 130-200 km of depth; ii) the dilution of this layer within the younger western Mediterranean backarc basin to the north, and iii) the easterly raising of a shallower low-velocity layer from about 140 km to about 30 km in the Tyrrhenian active part of the backarc basin. These findings suggest upper mantle circulation in the western Mediterranean backarc basin, mostly easterly-directed and affecting the boundary between upper asthenosphere (LVZ) and lower asthenosphere, which undulates between about 180 km and 280 km. (author)
Full Text Available Human activities in the Mediterranean determine, to a large extent, the availability of food and breeding sites for seabirds, the two most important ecological requirements for breeding seabirds. Food availability is highly dependent on fisheries activities and the availability of breeding sites is largely related with tourism pressure. Conservation plans necessarily need to incorporate the fact that Mediterranean seabirds and human activities are forced partners. However, solutions are complex because fishing policies are not commonly designed by environmental agencies and also because seabirds are organized in metapopulations which do not coincide with administrative borders. In this monographic volume, several authors describe the main characteristics of the Mediterranean seabird community, identify its conservation problems and suggest a number of technical solutions.
Benlhabib, O.; Yazar, A.; Qadir, M.
In the Mediterranean region, crop productivity and food security are closely linked to the adaptation of cropping systems to multiple abiotic stresses. Limited and unpredictable rainfall and low soil fertility have reduced agricultural productivity and environmental sustainability. For this reason......, crop management technologies have been developed, with a special focus on the Mediterranean region, to enhance crop production by increasing land productivity and sustaining soil fertility under influence of climate changes and population increases. The main objective of this study was to analyse...... dryland Mediterranean cropping systems, and to discuss and recommend sustainable cropping technologies that could be used at the small-scale farm level. Four crop management practices were evaluated: crop rotations, reduced tillage, use of organic manure, and supplemental and deficit irrigation. Among...
Skarsoulis, E. K.; Send, U.; Piperakis, G.; Testor, P.
Ocean acoustic tomography is used to obtain heat-content estimates for the western Mediterranean basin. Travel-time data from 13 tomography sections of the Thetis-2 experiment (January-October 1994) are analyzed with a matched-peak inversion approach. The underlying analysis involves the use of peak arrivals and nonlinear model relations between travel-time and sound-speed variations. Slice inversion results are combined with temperature covariance functions for the western Mediterranean to obtain heat-content estimates for the basin. These estimates compare favorably with ECMWF data over the nine-month period of the Thetis-2 experiment. Furthermore, estimates for the basin-average temperature of the western Mediterranean deep water are obtained.
Full Text Available Forest fires are a serious environmental hazard in southern Europe. Quantitative assessment of recent trends in fire statistics is important for assessing the possible shifts induced by climate and other environmental/socioeconomic changes in this area. Here we analyse recent fire trends in Portugal, Spain, southern France, Italy and Greece, building on a homogenized fire database integrating official fire statistics provided by several national/EU agencies. During the period 1985-2011, the total annual burned area (BA displayed a general decreasing trend, with the exception of Portugal, where a heterogeneous signal was found. Considering all countries globally, we found that BA decreased by about 3020 km2 over the 27-year-long study period (i.e. about -66% of the mean historical value. These results are consistent with those obtained on longer time scales when data were available, also yielding predominantly negative trends in Spain and France (1974-2011 and a mixed trend in Portugal (1980-2011. Similar overall results were found for the annual number of fires (NF, which globally decreased by about 12600 in the study period (about -59%, except for Spain where, excluding the provinces along the Mediterranean coast, an upward trend was found for the longer period. We argue that the negative trends can be explained, at least in part, by an increased effort in fire management and prevention after the big fires of the 1980's, while positive trends may be related to recent socioeconomic transformations leading to more hazardous landscape configurations, as well as to the observed warming of recent decades. We stress the importance of fire data homogenization prior to analysis, in order to alleviate spurious effects associated with non-stationarities in the data due to temporal variations in fire detection efforts.
Cêtre-Sossah, Catherine; Pédarrieu, Aurélie; Guis, Hélène; Defernez, Cédric; Bouloy, Michèle; Favre, Jacques; Girard, Sébastien; Cardinale, Eric; Albina, Emmanuel
Rift Valley fever threatens human and animal health. After a human case was confirmed in Comoros in 2007, 4 serosurveys among ruminants in Mayotte suggested that Rift Valley fever virus had been circulating at low levels since 2004, although no clinical cases occurred in animals. Entomologic and ecologic studies will help determine outbreak potential.
Postema, Pieter G.
This editorial refers to the study of Adler, Viskin and colleagues, in which it appears that a Brugada syndrome ECG is much more prevalent in patients with fever than in afebrile patients. This does not yet warrant a widespread diagnostic effort in patients with fever but may be relevant for certain
McFarlane, M E C; Plummer, J M; Leake, P A; Powell, L; Chand, V; Chung, S; Tulloch, K
Dengue fever is an acute viral disease, which usually presents as a mild febrile illness. Patients with severe disease present with dengue haemorrhagic fever or dengue toxic shock syndrome. Rarely, it presents with abdominal symptoms mimicking acute appendicitis. We present a case of a male patient presenting with right iliac fossa pain and suspected acute appendicitis that was later diagnosed with dengue fever following a negative appendicectomy. A 13-year old male patient presented with fever, localized right-sided abdominal pain and vomiting. Abdominal ultrasound was not helpful and appendicectomy was performed due to worsening abdominal signs and an elevated temperature. A normal appendix with enlarged mesenteric nodes was found at surgery. Complete blood count showed thrombocytopenia with leucopenia. Dengue fever was now suspected and confirmed by IgM enzyme-linked immunosorbent assay against dengue virus. This unusual presentation of dengue fever mimicking acute appendicitis should be suspected during viral outbreaks and in patients with atypical symptoms and cytopenias on blood evaluation in order to prevent unnecessary surgery. This case highlights the occurrence of abdominal symptoms and complications that may accompany dengue fever. Early recognition of dengue fever mimicking acute appendicitis will avoid non-therapeutic operation and the diagnosis may be aided by blood investigations indicating a leucopenia, which is uncommon in patients with suppurative acute appendicitis. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.
Ammann, Roland A.; Tissing, Wim J. E.; Phillips, Bob
Purpose of review Fever in neutropenia is the most frequent potentially life-threatening complication of chemotherapy in children and adolescents with cancer. This review summarizes recent studies that refine our knowledge of how to manage pediatric fever in neutropenia, and their implications for
African swine fever (ASF) is a highly lethal and economically significant disease of domestic pigs in Uganda where outbreaks regularly occur. There is neither a vaccine nor treatment available for ASF control. Twenty two African swine fever virus (ASFV) genotypes (I - XXII) have been identified based on partial sequencing ...
Vollaard, A.M.; Ali, S.; Asten, H.A.G.H. van; Widjaja, S.; Visser, L.G.; Surjadi, C.; Dissel, J.T. van
CONTEXT: The proportion of paratyphoid fever cases to typhoid fever cases may change due to urbanization and increased dependency on food purchased from street vendors. For containment of paratyphoid a different strategy may be needed than for typhoid, because risk factors for disease may not
Background: Rift Valley fever (RVF) is a mosquito-borne viral zoonotic disease. Rift Valley fever virus (RVFV) has been isolated from more than 40 species of mosquitoes from eight genera. This study was conducted to determine the abundance of potential mosquito vectors and their RVFV infection status in Ngorongoro ...
Cattle Fever Ticks (CFT), Rhipicephalus annulatus and R. microplus, have been a threat to the livestock industry for many years. These ticks are vectors of cattle fever, a disease produced by the hemoparasite Babesia bovis and B. bigemina. Laboratory research on CFT larval survival has shown that co...
Vollaard, A.M.; Ali, S.; Asten, H.A.G.H. van; Widjaja, S.; Visser, L.G.; Surjadi, C.; Dissel, J.T. van
CONTEXT: The proportion of paratyphoid fever cases to typhoid fever cases may change due to urbanization and increased dependency on food purchased from street vendors. For containment of paratyphoid a different strategy may be needed than for typhoid, because risk factors for disease may not
Background: Fever remains a common clinical indicator of disease, accounting alone for over 25% of paediatric emergency rooms consultations. Perception of this important sign is a crucial prelude and determinant of outcome in febrile children. The aim was to determine knowledge and attitudes of parents regarding fever ...
A mathematical model for the dynamics of Lassa fever is presented. Contributions from regular contact with the species of rats that carry the virus that cause Lassa fever and infectious contact with those suffering from the disease is seen as significant in the spread of the disease. Steady states of the model are examined for ...
Young Min Hong
Full Text Available Hemorrhagic fever with renal syndrome (HFRS is an acute viral disease with fever, hemorrhage and renal failure caused by hantavirus infection. Hantavirus induces HFRS or hantavirus pulmonary syndrome (HPS. HPS progression to a life-threatening pulmonary disease is found primarily in the USA and very rarely in South Korea. Here, we report a case of HFRS and coexisting HPS.
Background: Fever is one of the most common complaints presented to the Paediatric Emergency Unit (PEU). It is a sign that there is an underlying pathologic process, the most common being infection. Many childhood illnesses are accompanied by fever, many of which are treated at home prior to presentation to hospital.
Patients at all levels of the health care system will often have a fever on initial presentation. The cause may be obvious; most will have a simple viral upper respiratory tract infection (URTI) and others will have signs and symptoms pointing to the site and aeti- ology of the fever. Sometimes, however, a patient will present.
Dr Oboro VO
Key Words: Lassa fever, Lassa Virus and Epidemic. INTRODUCTION. Nigeria is .... rats as in those who do not, and deafness (an effect of Lassa fever) .... treatment is available and the effects may be transitory or often permanent. The auditory patterns and clinical course resemble idiopathic nerve deafness (16). The clinical ...
Shamim, M.; Naqvi, S.Z.G.
Scrotal oedema associated with dengue fever is a rare and self limiting condition resolving in a few days without any complication or sequelae. This is a report of two cases of dengue fever associated with acute scrotal and penile oedema. (author)
With the exception of a vaccine for yellow fever and ribavirin, which is used for treatment of some arenaviral infections, no specific chemotherapy for viral hemorrhagic fever exists. Only supportive treatment is possible The filoviruses, Marburg virus (MARV) and Ebola virus (EBOV), have been associated with hemorrhagic ...
Patient was managed for hyperglycemic crisis with intravenous normal saline and soluble insulin. She was also commenced on Ribavirin but died of complications of lassa fever. Lassa fever should be included as a precipitant of hyperglycemic crisis in endemic countries. Key words: Hyperosmolar hyperglycemic state, ...
The public health importance of Lassa fever can not be over emphasized if one considers the high infectivity and mortality rates associated with the disease. This study dealt extensively on the epidemiology, clinical features and current management of Lassa fever through literature review. The aim of this study is to sensitise ...
Kampschreur, L.M.; Wegdam-Blans, M.C.; Wever, P.C.; Renders, N.H.; Delsing, C.E.; Sprong, T.; Kasteren, M.E. van; Bijlmer, H.; Notermans, D.; Oosterheert, J.J.; Stals, F.S.; Nabuurs-Franssen, M.H.; Bleeker-Rovers, C.P.
Chronic Q fever, caused by Coxiella burnetii, has high mortality and morbidity rates if left untreated. Controversy about the diagnosis of this complex disease has emerged recently. We applied the guideline from the Dutch Q Fever Consensus Group and a set of diagnostic criteria proposed by Didier
Kampschreur, Linda M.; Wegdam-Blans, Marjolijn C. A.; Weyer, Peter C.; Renders, Nicole H. M.; Delsing, Corine E.; Sprong, Tom; van Kasteren, Marjo E. E.; BijImer, Henk; Notermans, Daan; Oosterheert, Jan Jelrik; Stals, Frans S.; Nabuurs-Franssen, Marrigje H.; Bleeker-Rovers, Chantal P.
Chronic Q fever, caused by Coxiella burnetii, has high mortality and morbidity rates if left untreated. Controversy about the diagnosis of this complex disease has emerged recently. We applied the guideline from the Dutch Q Fever Consensus Group and a set of diagnostic criteria proposed by Didier
The paper presents the principles of thermometry in children, interpretation of the measurement results, as well as the biological mechanisms of fever and the principles of its treatment. It is shown that the drug of choice in the symptomatic treatment of fever in children is ibuprofen (Nurofen for children).
Kallinich, T.; Gattorno, M.; Grattan, C.E.; Koning, H.D. de; Traidl-Hoffmann, C.; Feist, E.; Krause, K.; Lipsker, D.; Navarini, A.A.; Maurer, M.; Lachmann, H.J.; Simon, A.
Recurrent fever can be the sole or leading manifestation of a variety of diseases including malignancies, autoimmune diseases and infections. Because the differential diagnoses are manifold, no formal guidelines for the approach of patients with recurrent fever exists. The newly recognized group of
Based on the results of these findings, vis a vis the proportion of individuals negative for both malaria and typhoid fevers, clinicians should revisit causes of febrile illnesses other than malaria or typhoid and hence the need to include other tests for the detection of other causes. Keywords: Malaria diagnosis, Typhoid fever, ...
Results: A total of 2804 households were surveyed to estimate larval indices and man-vector contacts of potential vectors of viral haemorrhagic fevers such as Yellow fever and Dengue. Over 56% households in each study site were positive for Aedes larvae. Relatively higher Breteaux index (BI) and Container index (CI) ...
Hamer, Davidson H; Angelo, Kristina; Caumes, Eric; van Genderen, Perry J J; Florescu, Simin A; Popescu, Corneliu P; Perret, Cecilia; McBride, Angela; Checkley, Anna; Ryan, Jenny; Cetron, Martin; Schlagenhauf, Patricia
Yellow fever virus is a mosquito-borne flavivirus that causes yellow fever, an acute infectious disease that occurs in South America and sub-Saharan Africa. Most patients with yellow fever are asymptomatic, but among the 15% who develop severe illness, the case fatality rate is 20%-60%. Effective live-attenuated virus vaccines are available that protect against yellow fever (1). An outbreak of yellow fever began in Brazil in December 2016; since July 2017, cases in both humans and nonhuman primates have been reported from the states of São Paulo, Minas Gerais, and Rio de Janeiro, including cases occurring near large urban centers in these states (2). On January 16, 2018, the World Health Organization updated yellow fever vaccination recommendations for Brazil to include all persons traveling to or living in Espírito Santo, São Paulo, and Rio de Janeiro states, and certain cities in Bahia state, in addition to areas where vaccination had been recommended before the recent outbreak (3). Since January 2018, 10 travel-related cases of yellow fever, including four deaths, have been reported in international travelers returning from Brazil. None of the 10 travelers had received yellow fever vaccination.
Gefenaite, G.; Munster, J. M.; van Houdt, R.; Hak, E.
In the Netherlands, the number of notified human Q fever cases showed a steep increase over the last three years and is not expected to disappear in the next few years. Since vaccination might be an option to prevent Q fever cases in the general population, evidence is needed about its
Coetzee, Peter; Mubemba, Benjamin; Nhambirre, Ofélia; Neves, Luis; Coetzer, J.A.W.; Venter, Estelle H.
In early 2014, abortions and death of ruminants were reported on farms in Maputo and Gaza Provinces, Mozambique. Serologic analysis and quantitative and conventional reverse transcription PCR confirmed the presence of Rift Valley fever virus. The viruses belonged to lineage C, which is prevalent among Rift Valley fever viruses in southern Africa. PMID:27869589
Autoimmune haemolytic anaemia and fever of undetermined origin as presenting manifestations of Hodgkin disease: A case report. ... Subjects and Methods: We report a 14 year-old male adolescent who presented with protracted recurrent fever, as well as clinical and laboratory findings suggestive of autoimmune ...
The authors present a comprehensive review of the possible pathogenetic mechanisms, pathophysiology and therapeutic options of blackwater fever. The review points out some salient controversies from several studies concerning this disorder. It is concluded that despite these controversies in literature, blackwater fever ...
Q fever is caused by Coxiella burnetii, a Gram-negative and intracellular bacterium. From 2007 to 2010, the Netherlands was confronted with the world’s largest Q fever outbreak. Dairy goats were identified to be the source. At the end of 2009, the outbreak expanded enormously (with 1000 patients in
Khan, Mohammad Enayet Hossain
In conclusion, the data presented herein show that no single clinical or paraclinical parameter is reliable in arriving at a correct clinical diagnosis of typhoid fever and that bacteriologic confirmation is necessary for the diagnosis of typhoid fever. Patients ’ age and sex influence the clinical
To assess the accuracy of tactile examination bymothers as amethod of fever determination in their children and thus determine the reliability of mothers' history about the presence or absence of fever in their children. A descriptive cross-sectional study conducted in four health centers randomly selected in ...