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.
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.
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.
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 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.
... 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 ...
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 ...
U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2017. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the...
U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2014.In this Table, all conditions with a 5-year average annual national total of more than or equals...
U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2017. In this Table, provisional cases of selected notifiable diseases (â¥1,000 cases reported during...
U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2015.In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the...
U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2016. In this Table, provisional* cases of selected† notifiable diseases (≥1,000 cases reported during...
... 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 ...
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
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 ...
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 ...
Álvarez-Hernández, Gerardo; Roldán, Jesús Felipe González; Milan, Néstor Saúl Hernández; Lash, R Ryan; Behravesh, Casey Barton; Paddock, Christopher D
Rocky Mountain spotted fever, a tick-borne zoonosis caused by Rickettsia rickettsii, is among the most lethal of all infectious diseases in the Americas. In Mexico, the disease was first described during the early 1940s by scientists who carefully documented specific environmental determinants responsible for devastating outbreaks in several communities in the states of Sinaloa, Sonora, Durango, and Coahuila. These investigators also described the pivotal roles of domesticated dogs and Rhipicephalus sanguineus sensu lato (brown dog ticks) as drivers of epidemic levels of Rocky Mountain spotted fever. After several decades of quiescence, the disease re-emerged in Sonora and Baja California during the early 21st century, driven by the same environmental circumstances that perpetuated outbreaks in Mexico during the 1940s. This Review explores the history of Rocky Mountain spotted fever in Mexico, current epidemiology, and the multiple clinical, economic, and social challenges that must be considered in the control and prevention of this life-threatening illness. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Adult Still's Disease was first described in 1971 by Bywaters in fourteen adult female patients who presented with symptoms indistinguishable from that of classic childhood Still's Disease (Bywaters, 1971. George Still in 1896 first recognized this triad of quotidian (daily fevers, evanescent rash, and arthritis in children with what later became known as juvenile inflammatory arthritis (Still, 1990. Adult Onset Still's Disease (AOSD is an inflammatory condition of unknown etiology characterized by an evanescent rash, quotidian fevers, and arthralgias. Numerous infectious agents have been associated with its presentation. This case is to our knowledge the first presentation of AOSD in the setting of Rocky Mountain Spotted Fever. Although numerous infectious agents have been suggested, the etiology of this disorder remains elusive. Nevertheless, infection may in fact play a role in triggering the onset of symptoms in those with this disorder. Our case presentation is, to our knowledge, the first case of Adult Onset Still's Disease associated with Rocky Mountain spotted fever (RMSF.
Persad, Paul; Patel, Rajendrakumar; Patel, Niki
Adult Still's Disease was first described in 1971 by Bywaters in fourteen adult female patients who presented with symptoms indistinguishable from that of classic childhood Still's Disease (Bywaters, 1971). George Still in 1896 first recognized this triad of quotidian (daily) fevers, evanescent rash, and arthritis in children with what later became known as juvenile inflammatory arthritis (Still, 1990). Adult Onset Still's Disease (AOSD) is an inflammatory condition of unknown etiology characterized by an evanescent rash, quotidian fevers, and arthralgias. Numerous infectious agents have been associated with its presentation. This case is to our knowledge the first presentation of AOSD in the setting of Rocky Mountain Spotted Fever. Although numerous infectious agents have been suggested, the etiology of this disorder remains elusive. Nevertheless, infection may in fact play a role in triggering the onset of symptoms in those with this disorder. Our case presentation is, to our knowledge, the first case of Adult Onset Still's Disease associated with Rocky Mountain spotted fever (RMSF). PMID:20811570
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.
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 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 ...
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...
Milagres, Bruno S.; Padilha, Amanda F.; Montandon, Carlos E.; Freitas, Renata N.; Pacheco, Richard; Walker, David H.; Labruna, Marcelo B.; Mafra, Cláudio L.; Galvão, Márcio A. M.
We investigated the humoral immune response against different species of Rickettsia in serum samples from small rodents collected in two areas of a silent focus for Brazilian spotted fever in the eastern region of Minas Gerais State, Brazil. Sera samples were analyzed by indirect immunofluorescence assay using antigens from Rickettsia species of the spotted fever, ancestral, and transition groups. Titers ≥ 1:64 were considered positive. In Santa Cruz do Escalvado, 94% (30 of 32) of the samples collected from Rattus rattus, 22% (5 of 23) from Nectomys squamipes, and 80% (4 of 5) from Akodon sp., reacted by indirect immunofluorescence assay with Rickettsia antigens of the spotted fever group. In the municipality of Pingo D'Água, 84% (26 of 31) of the samples collected from R. rattus, 86% (6 of 7) of the samples from Oryzomys subflavus, 86% (6 of 7) from N. squamipes, and 100% (1 of 1) from Bolomys sp. contained antibodies that reacted with rickettsial antigens of the spotted fever group. These results demonstrated the previous exposure of small rodents to spotted fever group Rickettsia, suggesting the participation of these animals in the natural history of these rickettsiae in this region. PMID:23509125
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 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.
U.S. Department of Health & Human Services — NNDSS - Table II. Spotted fever rickettsiosis to Syphilis, primary and secondary - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000...
Jiang, Ju; Blair, Patrick J; Felices, Vidal; Moron, Cecilia; Cespedes, Manuel; Anaya, Elizabeth; Schoeler, George B; Sumner, John W; Olson, James G; Richards, Allen L
...) collected from two domestic horses living in two separate locations in northern Peru (Coletas and Naranjo) was conducted to more clearly characterize this recently reported novel spotted fever group...
U.S. Department of Health & Human Services — NNDSS - Table II. Spotted fever rickettsiosis to Syphilis, primary and secondary - 2018. In this Table, provisional cases of selected notifiable diseases (â¥1,000...
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.
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.
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.
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
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
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.
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
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.
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 ...
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.
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.
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.
Khalid El Karkouri
Full Text Available Arthropod-borne Rickettsia species are obligate intracellular bacteria which are pathogenic for humans. Within this genus, Rickettsia slovaca and Rickettsia conorii cause frequent and potentially severe infections, whereas Rickettsia raoultii and Rickettsia massiliae cause rare and milder infections. All four species belong to spotted fever group (SFG rickettsiae. However, R. slovaca and R. raoultii cause scalp eschar and neck lymphadenopathy (SENLAT and are mainly associated with Dermacentor ticks, whereas the other two species cause Mediterranean spotted fever (MSF and are mainly transmitted by Rhipicephalus ticks. To identify the potential genes and protein profiles and to understand the evolutionary processes that could, comprehensively, relate to the differences in virulence and pathogenicity observed between these four species, we compared their genomes and proteomes. The virulent and milder agents displayed divergent phylogenomic evolution in two major clades, whereas either SENLAT or MSF disease suggests a discrete convergent evolution of one virulent and one milder agent, despite their distant genetic relatedness. Moreover, the two virulent species underwent strong reductive genomic evolution and protein structural variations, as well as a probable loss of plasmid(s, compared to the two milder species. However, an abundance of mobilome genes was observed only in the less pathogenic species. After infecting Xenopus laevis cells, the virulent agents displayed less up-regulated than down-regulated proteins, as well as less number of identified core proteins. Furthermore, their similar and distinct protein profiles did not contain some genes (e.g., ompA/B and rickA known to be related to rickettsial adhesion, motility and/or virulence, but may include other putative virulence-, antivirulence-, and/or disease-related proteins. The identified evolutionary forces herein may have a strong impact on intracellular expressions and strategies in
Londoño, Andrés F; Acevedo-Gutiérrez, Leidy Y; Marín, Diana; Contreras, Verónica; Díaz, Francisco J; Valbuena, Gustavo; Labruna, Marcelo B; Hidalgo, Marylin; Arboleda, Margarita; Mattar, Salim; Solari, Sergio; Rodas, Juan D
In February 2006, an outbreak of human rickettsiosis occurred in the municipality of Necoclí Colombia, with 35% of lethality. This episode was, followed by two more, one in the municipality of Los Cordobas in 2007 with a 54% of lethality and the other one in the municipality of Turbo in 2008 with 27% of lethality. The aim of this study was to perform serological tests in healthy persons to determine the seroprevalence of antibodies against spotted fever group (SFG) rickettsiae and develop a survey to study some infection risk-related factors. A cross-sectional study was performed in 2011 and 2012. A blood sample and survey of associated factors was performed in healthy persons. A prevalence of 32%-41% was found in healthy people. From the multivariate analysis, we found that people living more than 16 years in these sites had a 79% higher risk of being seropositive and a 46% higher risk when they reported having birds in their houses if the variable of having a horse was included in the model. In conclusion, this study shows endemicity of at least one spotted fever group Rickettsia in the study zone. Copyright © 2017 Elsevier GmbH. All rights reserved.
Full Text Available Objective. Characterize clinical manifestations and predictors of mortality in children hospitalized for spotted fever. Materials and methods. Cross-sectional study in 210 subjects with a diagnosis of Rocky Mountain spotted fever (RMSF in a pediatric hospital in Sonora, from January 1st, 2004 to June 30th, 2015. Data were analyzed using descriptive statistics and multivariate logistic regression. Results. An upward trend was observed in RMSF morbidity and mortal- ity. Fatality rate was 30%. Three predictors were associated with risk of death: delay ≥ 5 days at the start of doxycycline (ORa = 2.95, 95% CI 1.10-7.95, acute renal failure ((ORa = 8.79, 95% CI 3.46-22.33 and severe sepsis (ORa = 3.71, 95% CI 1.44-9.58. Conclusions. RMSF causes high mortality in children, which can be avoided with timely initiation of doxycycline. Acute renal failure and severe sepsis are two independent predictors of death in children with RMSF.
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.
Full Text Available Ticks were obtained from dogs from February to September of 1999 at weekly intervals, in the County of Piraí, State of Rio de Janeiro. Four hundred seventy four ixodids were taxonomically identified, 103 Amblyomma cajennense, seven Amblyomma ovale, 209 Rhipicephalus sanguineus, and 155 Amblyomma sp. An hemolymph test associated with Giemsa's stain revealed two specimens in 163 ticks tested (R. sanguineus and Amblyomma sp, containing rickettsia-like organisms. Direct immunofluorescence verified the presence of spotted fever group rickettsia in one specimen of R. sanguineus. Considering the limited information on rickettsiosis in Brazil, principally in relation to the vectors involved in perpetuating it in foci, these preliminary results give us an idea on the importance of infection in ticks, allowing to expand our knowledge on this zoonosis.
Nasser, Jeanette Trigo; Lana, Rafael César; Silva, Claudia Maria dos Santos; Lourenço, Roberto Wagner; da Cunha e Silva, Darllan Collins; Donalísio, Maria Rita
Brazilian spotted fever is an emerging zoonosis notified mainly in the Southeast of Brazil, especially due to its high level of lethality. To analyze the epidemiological and spatial pattern of the disease in the municipality of Valinhos (106,793 inhabitants), São Paulo, Southeastern region of Brazil, in the period between 2001 and 2012. All laboratory-confirmed cases with likely site of infection in the city (n = 49) notified in the Brazilian Case Registry Database were studied. Sites were geocoded using the cartographic base of the city and Google Earth (geographic coordinates) with correction according to the Brazilian Geodetic System. We used the Kernel estimator to analyze the density of the cases on the map. Land cover and distance to basins of all cases were analyzed. Information about tick species and primary hosts were obtained from reports of the Superintendence of Control of Endemic Diseases. Seasonality of the disease was observed with the highest incidence from June to November, and in 2005 and 2011. The most affected groups were men (79.6%) aged 20-49 years old (49%). Lethality was found to be 42.9%. Maps showed the progressive registration of cases in the urban area. Capybaras were reported as the main primary host, and Amblyomma cajennense was identified in probable sites of infection during field investigation. The likely sites of infection were mostly located near basins, dirty pastures, and bordering woods. The transmission pattern of Brazilian spotted fever in Valinhos is similar to that in other cities in the region, where capybara is the main primary host and an amplifier of R. rickettsii. Over the years, a higher occurrence of cases has been identified in the urban area of the city.
Szabó, Matias P. J.; Pinter, Adriano; Labruna, Marcelo B.
Spotted-fever-caused Rickettsia rickettsii infection is in Brazil the major tick-borne zoonotic disease. Recently, a second and milder human rickettsiosis caused by an agent genetically related to R. parkeri was discovered in the country (Atlantic rainforest strain). Both diseases clearly have an ecological background linked to a few tick species and their environment. Capybaras (Hydrochoerus hydrochaeris) and Amblyomma cajennense ticks in urban and rural areas close to water sources are the main and long-known epidemiological feature behind R. rickettsii-caused spotted-fever. Unfortunately, this ecological background seems to be increasing in the country and disease spreading may be foreseen. Metropolitan area of São Paulo, the most populous of the country, is embedded in Atlantic rainforest that harbors another important R. rickettsii vector, the tick Amblyomma aureolatum. Thus, at the city–forest interface, dogs carry infected ticks to human dwellings and human infection occurs. A role for R. rickettsii vectoring to humans of a third tick species, Rhipicephalus sanguineus in Brazil, has not been proven; however, there is circumstantial evidence for that. A R. parkeri-like strain was found in A. ovale ticks from Atlantic rainforest and was shown to be responsible for a milder febrile human disease. Rickettsia-infected A. ovale ticks are known to be spread over large areas along the Atlantic coast of the country, and diagnosis of human infection is increasing with awareness and proper diagnostic tools. In this review, ecological features of the tick species mentioned, and that are important for Rickettsia transmission to humans, are updated and discussed. Specific knowledge gaps in the epidemiology of such diseases are highlighted to guide forthcoming research. PMID:23875178
Koetsveld, Joris; Tijsse-Klasen, Ellen; Herremans, Tineke; Hovius, Joppe W. R.; Sprong, Hein
Only a few reported cases indicate that Rickettsia helvetica and Rickettsia monacensis can cause disease in humans. Exposure to these two spotted fever group (SFG) rickettsiae occurs through bites of Ixodes ricinus, also the primary vector of Lyme borreliosis in Europe. To date, it is unclear how
Kubelová, M.; Papoušek, I.; Bělohlávek, T.; Goüy de Bellocq, Joëlle; Baird, Stuart J. E.; Široký, P.
Roč. 6, č. 6 (2015), s. 711-714 ISSN 1877-959X Institutional support: RVO:68081766 Keywords : Spotted fever group rickettsiae * Rickettsia monacensis * Rickettsia helvetica * Ixodes ricinus * Lacerta schreiberi Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 2.690, year: 2015
Thomas, N.J.; Bunikis, J.; Barbour, A.G.; Wolcott, M.J.
Acute septicemic spirochetosis was diagnosed in an adult male northern spotted owl (Strix occidentalis caurina) found dead in Kittitas County, Washington, USA. Gross necropsy findings included marked enlargement of the liver and spleen and serofibrinous deposits on the serous membranes lining the body cavities and the pericardial and perihepatic sacs. Microscopic observations included macrophage infiltration in the liver and spleen with mild thrombosis and multifocal necrosis, as well as hemorrhage and acute inflammation in the choroid plexus of the brain. No viruses or pathogenic bacteria were isolated from brain, liver, or spleen, and no parasites were found in blood smears or impression smears of the liver. Chlamydial culture attempts were unsuccessful and no chlamydial antibodies were detected in serum. In silver-stained microscopic sections and by transmission electron microscopy of liver, numerous long, thin, spiral-shaped bacteria were seen in the liver, spleen, cerebral ventricles, and within blood vessels in many organs. The organism was identified as a member of the Borrelia genus by sequence analysis of the PCR-amplified 16S rRNA gene. The most closely related species is B. hermsii, an agent of relapsing fever in humans in the western United States. This is the first report of a relapsing fever-related Borrelia in a wild bird.
Thomas, Nancy J; Bunikis, Jonas; Barbour, Alan G; Wolcott, Mark J
Acute septicemic spirochetosis was diagnosed in an adult male northern spotted owl (Strix occidentalis caurina) found dead in Kittitas County, Washington, USA. Gross necropsy findings included marked enlargement of the liver and spleen and serofibrinous deposits on the serous membranes lining the body cavities and the pericardial and perihepatic sacs. Microscopic observations included macrophage infiltration in the liver and spleen with mild thrombosis and multifocal necrosis, as well as hemorrhage and acute inflammation in the choroid plexus of the brain. No viruses or pathogenic bacteria were isolated from brain, liver, or spleen, and no parasites were found in blood smears or impression smears of the liver. Chlamydial culture attempts were unsuccessful and no chlamydial antibodies were detected in serum. In silver-stained microscopic sections and by transmission electron microscopy of liver, numerous long, thin, spiral-shaped bacteria were seen in the liver, spleen, cerebral ventricles, and within blood vessels in many organs. The organism was identified as a member of the Borrelia genus by sequence analysis of the PCR-amplified 16S rRNA gene. The most closely related species is B. hermsii, an agent of relapsing fever in humans in the western United States. This is the first report of a relapsing fever-related Borrelia in a wild bird.
Moysidis, Stavros N; Koulisis, Nicole; Patel, Vivek R; Kashani, Amir H; Rao, Narsing A; Humayun, Mark S; Rodger, Damien C
To describe a case of small retinal vessel vasculopathy postvaccination. We report the case of a 41-year-old white man who presented with a "second blind spot," describing a nasal scotoma in the right eye that started 4 days after vaccinations against Neisseria meningitidis and the yellow fever virus, and after a 2-month period of high stress and decreased sleep. Clinical examination, Humphrey visual field testing, and multimodal imaging with fundus photographs, autofluorescence, fluorescein angiography, and spectral domain optical coherence tomography and angiography were performed. Clinical examination revealed a well-circumscribed, triangular area of retinal graying of about 1-disk diameter in size, located at the border of the temporal macula. This corresponded to a deep scotoma similar in size to the physiologic blind spot on Humphrey visual field 24-2 testing. There was mild hypoautofluoresence of this lesion on autofluorescence, hypofluorescence on fluorescein angiography, and focal attenuation of a small artery just distal to the bifurcation of an artery supplying the involved area. Spectral domain optical coherence tomography through the lesion conveyed hyperreflectivity most prominent in the inner and outer plexiform layers, with extension of the hyperreflectivity into the ganglion cell and inner nuclear layers. Spectral domain optical coherence tomography angiography demonstrated arteriolar and capillary dropout, more pronounced in the superficial retinal layer compared to the deeper retinal layer. At 1-month follow-up, his scotoma improved with monitoring, with reduction from -32 dB to -7 dB on Humphrey visual field testing. There was clinical resolution of the area of graying and decreased hyperreflectivity on spectral domain optical coherence tomography, with atrophy of the inner retina. Spectral domain optical coherence tomography angiography showed progression of arteriolar and capillary dropout, more so in the superficial than in the deep capillary
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.
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.
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.
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.
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
Matias, Jaqueline; Garcia, Marcos Valério; Cunha, Rodrigo Casquero; Aguirre, André de Abreu Rangel; Barros, Jacqueline Cavalvante; Csordas, Bárbara Guimarães; Andreotti, Renato
Rickettsia infection of each tick was evaluated by the hemolymph test and polymerase chain reaction (PCR) targeting gltA and ompA genes. All hemolymph tests were negative and PCR of one A. dubitatum detected both Rickettsia genes. Sequence of ompA exhibited a 99% identity with Rickettsia parkeri and R. africae and a 98% identity with R. sibirica. Rickettsia of the spotted fever group in A. dubitatum is described for the first time in an urban area within the municipality of Campo Grande in the state of Mato Grosso do Sul (MS), Brazil. This finding reinforces the importance of more detailed studies to determine the role of A. dubitatum in the transmission of spotted fever agents. Copyright © 2014 Elsevier GmbH. All rights reserved.
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.
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.
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.
Chen, Chien-Chou; Teng, Yung-Chu; Lin, Bo-Cheng; Fan, I-Chun; Chan, Ta-Chien
Cases of dengue fever have increased in areas of Southeast Asia in recent years. Taiwan hit a record-high 42,856 cases in 2015, with the majority in southern Tainan and Kaohsiung Cities. Leveraging spatial statistics and geo-visualization techniques, we aim to design an online analytical tool for local public health workers to prospectively identify ongoing hot spots of dengue fever weekly at the village level. A total of 57,516 confirmed cases of dengue fever in 2014 and 2015 were obtained from the Taiwan Centers for Disease Control (TCDC). Incorporating demographic information as covariates with cumulative cases (365 days) in a discrete Poisson model, we iteratively applied space-time scan statistics by SaTScan software to detect the currently active cluster of dengue fever (reported as relative risk) in each village of Tainan and Kaohsiung every week. A village with a relative risk >1 and p value dengue fever transmission on a weekly basis at the village level by using the routine surveillance data.
Do Thi Thanh Toan
Full Text Available Introduction: Dengue fever (DF in Vietnam remains a serious emerging arboviral disease, which generates significant concerns among international health authorities. Incidence rates of DF have increased significantly during the last few years in many provinces and cities, especially Hanoi. The purpose of this study was to detect DF hot spots and identify the disease dynamics dispersion of DF over the period between 2004 and 2009 in Hanoi, Vietnam. Methods: Daily data on DF cases and population data for each postcode area of Hanoi between January 1998 and December 2009 were obtained from the Hanoi Center for Preventive Health and the General Statistic Office of Vietnam. Moran's I statistic was used to assess the spatial autocorrelation of reported DF. Spatial scan statistics and logistic regression were used to identify space–time clusters and dispersion of DF. Results: The study revealed a clear trend of geographic expansion of DF transmission in Hanoi through the study periods (OR 1.17, 95% CI 1.02–1.34. The spatial scan statistics showed that 6/14 (42.9% districts in Hanoi had significant cluster patterns, which lasted 29 days and were limited to a radius of 1,000 m. The study also demonstrated that most DF cases occurred between June and November, during which the rainfall and temperatures are highest. Conclusions: There is evidence for the existence of statistically significant clusters of DF in Hanoi, and that the geographical distribution of DF has expanded over recent years. This finding provides a foundation for further investigation into the social and environmental factors responsible for changing disease patterns, and provides data to inform program planning for DF control.
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.
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.
Alexander Welker Biondo
Full Text Available Brazilian spotted fever (BSF is caused by bacteria Rickettsia rickettsii, highly pathogenic for humans and dogs, and has the Amblyomma cajennense tick as its main vector. Dogs maybe have a significantly participation on the BSF epidemiology, particularly in urban areas, due to the close contact with human beings. Several serologic studies in dogs from different Brazilian regions have indicated a previous contact of these animals with the R. rickettsii, and they are even considered as sentinels for the bacteria distribution. Although dogs are susceptible to R. rickettsii infection, the clinical disease in dogs has been very recently described in Brazil. Common signs of infection may include fever, depression, anorexia, ocular lesions, hemorrhagic petechiaes, anemia and thrombocytopenia, which also may appear in other diseases, such as the canine monocytic ehrlichiosis, considered the most common disease in dogs transmitted by ticks in Brazil. Thus, BSF clinical diagnosis in dogs may be confused by other diseases, causing its sub-notification. The aim of the present review article on BSF in dogs was to describe epidemiologic, clinical and diagnosis aspects, including also the main alternatives for its treatment and control.A febre maculosa brasileira (FMB é causada pela bactéria Rickettsia rickettsii, cuja patogenicidade é conhecida para seres humanos e cães, e o carrapato Amblyomma cajennense é tido como seu principal vetor. Os cães podem ter um papel significativo na epidemiologia da FMB devido ao próximo contato com seres humanos. Vários estudos sorológicos em cães em diferentes estados brasileiros indicaram um contato prévio destes animais com a R. rickettsii, sendo inclusive considerados sentinelas para a circulação da bactéria. Apesar de serem susceptíveis à infecção por R. rickettsii, a doença clínica em cães foi relatada apenas recentemente no Brasil, onde observaram-se sinais comuns da infecção, como febre, anorexia
... 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 ...
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.
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.
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.
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.
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.
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.
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.
... from eating raw infected fish. Table 3-18. Classification, primary vector, and reservoir occurrence of rickettsiae known ... within 1–2 weeks of infection include fever, headache, malaise, rash, nausea, and vomiting. Many rickettsioses are ...
Full Text Available Abstract Background Cases of dengue fever have increased in areas of Southeast Asia in recent years. Taiwan hit a record-high 42,856 cases in 2015, with the majority in southern Tainan and Kaohsiung Cities. Leveraging spatial statistics and geo-visualization techniques, we aim to design an online analytical tool for local public health workers to prospectively identify ongoing hot spots of dengue fever weekly at the village level. Methods A total of 57,516 confirmed cases of dengue fever in 2014 and 2015 were obtained from the Taiwan Centers for Disease Control (TCDC. Incorporating demographic information as covariates with cumulative cases (365 days in a discrete Poisson model, we iteratively applied space–time scan statistics by SaTScan software to detect the currently active cluster of dengue fever (reported as relative risk in each village of Tainan and Kaohsiung every week. A village with a relative risk >1 and p value <0.05 was identified as a dengue-epidemic area. Assuming an ongoing transmission might continuously spread for two consecutive weeks, we estimated the sensitivity and specificity for detecting outbreaks by comparing the scan-based classification (dengue-epidemic vs. dengue-free village with the true cumulative case numbers from the TCDC’s surveillance statistics. Results Among the 1648 villages in Tainan and Kaohsiung, the overall sensitivity for detecting outbreaks increases as case numbers grow in a total of 92 weekly simulations. The specificity for detecting outbreaks behaves inversely, compared to the sensitivity. On average, the mean sensitivity and specificity of 2-week hot spot detection were 0.615 and 0.891 respectively (p value <0.001 for the covariate adjustment model, as the maximum spatial and temporal windows were specified as 50% of the total population at risk and 28 days. Dengue-epidemic villages were visualized and explored in an interactive map. Conclusions We designed an online analytical tool for
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.
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.
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.
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.
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.
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 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.
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.
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 Tick-borne rickettsioses are caused by obligate intracellular bacteria belonging to the spotted fever group (SFG rickettsiae. Although Spotted Fever is prevalent in the Middle East, no reports for the presence of tick-borne pathogens are available or any studies on the epidemiology of this disease in the West Bank. We aimed to identify the circulating hard tick vectors and genetically characterize SFG Rickettsia species in ixodid ticks from the West Bank-Palestinian territories.A total of 1,123 ixodid ticks belonging to eight species (Haemaphysalis parva, Haemaphysalis adleri, Rhipicephalus turanicus, Rhipicephalus sanguineus, Rhipicephalus bursa, Hyalomma dromedarii, Hyalomma aegyptium and Hyalomma impeltatum were collected from goats, sheep, camels, dogs, a wolf, a horse and a tortoise in different localities throughout the West Bank during the period of January-April, 2014. A total of 867 ticks were screened for the presence of rickettsiae by PCR targeting a partial sequence of the ompA gene followed by sequence analysis. Two additional genes, 17 kDa and 16SrRNA were also targeted for further characterization of the detected Rickettsia species. Rickettsial DNA was detected in 148 out of the 867 (17% tested ticks. The infection rates in Rh. turanicus, Rh. sanguineus, H. adleri, H. parva, H. dromedarii, and H. impeltatum ticks were 41.7, 11.6, 16.7, 16.2, 11.8 and 20%, respectively. None of the ticks, belonging to the species Rh. bursa and H. aegyptium, were infected. Four SFG rickettsiae were identified: Rickettsia massiliae, Rickettsia africae, Candidatus Rickettsia barbariae and Candidatus Rickettsia goldwasserii.The results of this study demonstrate the geographic distribution of SFG rickettsiae and clearly indicate the presence of at least four of them in collected ticks. Palestinian clinicians should be aware of emerging tick-borne diseases in the West Bank, particularly infections due to R. massiliae and R. africae.
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.
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.
Balayeva, N M; Demkin, V V; Rydkina, E B; Ignatovich, V F; Artemiev, M I; Lichoded LYa; Genig, V A
A strain of rickettsiae, designated Crimea-108, was isolated from ticks Dermacentor marginatus in the Crimea in 1977. Its immunobiological characteristics involve low pathogenicity for experimental animals, moderate infectivity for chick embryos, and antigenic relatedness to spotted fever group (SFG) rickettsiae (R. sibirica, R. conorii, R. akari), especially to R. sibirica. The genotypic characterization of the strain Crimea-108 was carried out in comparison with SFG and typhus group rickettsiae by using restriction fragment length polymorphism (RFLP) analysis and DNA-probe hybridization. The marked similarity was detected between DNA restriction patterns of the strains Crimea-108, R. sibirica and R. conorii, but each of them besides comigrating fragments had specific ones. Genotypic analysis of the strain Crimea-108, the SFG and typhus group rickettsiae by three independent DNA probes, based on R. prowazekii DNA, gave unique hybridization patterns for the Crimea-108 strain with all probes. The obtained data show that the Crimea-108 isolate does not belong to the species of R. sibirica, R. conorii, R. akari. The strain Crimea-108 is a novel strain of SFG rickettsiae for the Crimea region.
Renvoisé, Aurélie; Delaunay, Pascal; Blanchouin, Elea; Cannavo, Isabelle; Cua, Eric; Socolovschi, Cristina; Parola, Philippe; Raoult, Didier
Here, we report an epidemiological and entomological investigation of a cluster of cases of spotted fever group (SFG) rickettsiosis occurring in southern France. A family of 3 (husband, wife, and their son) presented with symptoms compatible with SFG rickettsiosis. For 2 patients, serum samples presented increased levels of IgM and IgG for SFG Rickettsia. The patients' home was investigated, and Rhipicephalus sanguineus ticks were collected from the floor from behind the furniture. Of 22 ticks collected, 20 tested positive for Rickettsia. As Rh. sanguineus serves as a vector for both Rickettsia conorii and Ri. massiliae in southern France, all Rh. sanguineus isolates were tested by real-time PCR and conventional PCR to detect the 2 species. Nine ticks tested positive for Ri. conorii subsp. caspia (marking the first documentation of this subspecies in France), 7 tested positive for Ri. massiliae, and 4 tested positive for both rickettsiae. This study is the first report of coinfection of Rh. sanguineus ticks with Ri. conorii and Ri. massiliae in southern France. Copyright © 2012 Elsevier GmbH. All rights reserved.
Levin, Michael L; Snellgrove, Alyssa N; Zemtsova, Galina E
The definitive diagnosis of spotted fever group (SFG) rickettsioses in humans is challenging due to the retrospective nature and cross reactivity of the serological methods and the absence of reliable and consistent samples for molecular diagnostics. Existing data indicate the transient character of bacteremia in experimentally infected animals. The ability of arthropod vectors to acquire rickettsial infection from the laboratory animals in the absence of systemic infection and known tropism of rickettsial agents to endothelial cells of peripheral blood vessels underline the importance of local infection and consequently the diagnostic potential of skin samples. In order to evaluate the diagnostic sensitivity of rickettsial DNA detection in blood and skin samples, we compared results of PCR testing in parallel samples collected from model laboratory animals infected with Rickettsia rickettsii, Rickettsia parkeri and Rickettsia slovaca-like agent at different time points after infection. Skin samples were collected from ears - away from the site of tick placement and without eschars. Overall, testing of skin samples resulted in a higher proportion of positive results than testing of blood samples. Presented data from model animals demonstrates that testing of skin samples from sites of rickettsial proliferation can provide definitive molecular diagnosis of up to 60-70% of tick-borne SFG rickettsial infections during the acute stage of illness. Detection of pathogen DNA in cutaneous samples is a valuable alternative to blood-PCR at least in model animals. Published by Elsevier GmbH.
Ram K Raghavan
Full Text Available This study aims to examine the spatio-temporal dynamics of Rocky Mountain spotted fever (RMSF prevalence in four contiguous states of Midwestern United States, and to determine the impact of environmental and socio-economic factors associated with this disease. Bayesian hierarchical models were used to quantify space and time only trends and spatio-temporal interaction effect in the case reports submitted to the state health departments in the region. Various socio-economic, environmental and climatic covariates screened a priori in a bivariate procedure were added to a main-effects Bayesian model in progressive steps to evaluate important drivers of RMSF space-time patterns in the region. Our results show a steady increase in RMSF incidence over the study period to newer geographic areas, and the posterior probabilities of county-specific trends indicate clustering of high risk counties in the central and southern parts of the study region. At the spatial scale of a county, the prevalence levels of RMSF is influenced by poverty status, average relative humidity, and average land surface temperature (>35°C in the region, and the relevance of these factors in the context of climate-change impacts on tick-borne diseases are discussed.
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.
Mărcuţan, Ioan-Daniel; Kalmár, Zsuzsa; Ionică, Angela Monica; D'Amico, Gianluca; Mihalca, Andrei Daniel; Vasile, Cozma; Sándor, Attila D
Birds are important hosts and dispersers of parasitic arthropods and vector-borne zoonotic pathogens. Particularly migratory species may carry these parasites over long distances in short time periods. Migratory hotspots present ideal conditions to get a snapshot of parasite and pathogen diversity of birds migrating between continents. The aim of this study was to investigate the presence and diversity of Rickettsia spp. in ticks collected from birds at a migratory hot-spot in the Danube Delta, Romania, eastern Europe. DNA was extracted from ticks that were collected from migratory birds in the Danube Delta during migratory seasons in 2011-2012. Two 360 bp fragments of the 16S ribosomal RNA gene and a 381 bp fragment Gene gltA were PCR amplified and analyzed by sequence analysis (performed at Macrogen Europe, Amsterdam, The Netherlands). Nucleotide sequences were compared to reference sequences available in the GenBank database, using Basic Local Alignment Search Tool. Four hundred ticks of four different species were found on 11 bird species. The prevalence of Rickettsia spp. infection was 14 % (56/400, CI: 11.7-29.1), with significantly more nymphs hosting rickettsial infection compared to larvae (48 vs 7; P birds migrating through eastern Europe may carry ticks infected with a high diversity of rickettsial pathogens, with four Rickettsia spp. recorded. Migratory direction was important for pathogen burden, with seasonal differences in the occurrence of individual Rickettsia species. Here we report the first individual records of different Rickettsia spp. in H. concinna (R. monacensis), I. arboricola (R. helvetica, R. massiliae) and I. redikorzevi (R. helvetica) and also the first geographical record of occurrence of R. massiliae in Romania, representing the easternmost observation on the continent.
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.
Barradas, Patrícia F; Vilhena, Hugo; Oliveira, Ana Cristina; Granada, Sara; Amorim, Irina; Ferreira, Paula; Cardoso, Luís; Gärtner, Fátima; de Sousa, Rita
Infections with tick-borne rickettsiae can cause diseases well known in humans but still not so well characterized in dogs. Susceptibility to infection depends on the virulence of Rickettsia spp. and only a few of them have been described to cause disease in dogs. The aim of this study was to investigate the exposure to Rickettsia spp. among a group of pet dogs from Luanda, Angola. Out of 103 dogs included in the study, 62 (60.2%) were infested with ticks. Plasma specimens tested for serology by an immunofluorescence assay (IFA) revealed that six (5.8%) dogs had detectable immunoglobulin G (IgG) antibodies to spotted fever group Rickettsia (SFGR), with endpoint titers of 64 for two dogs, 128 for three dogs and 1024 for one dog. From the seropositive group of dogs, five (83%) of them were males, with their age ranging from 1 to 8 years old. Among the seropositive dogs, four (66.7%) were parasitized with ticks and no breed (or cross) was found to be associated with specific antibodies. Rickettsia spp. DNA was detected by nested-polymerase chain reaction (PCR) in two (1.9%) dogs that were found to be seronegative. Seroprevalence and molecular detection of Rickettsia spp. infection in this group of pet dogs from Luanda is low compared with other studies performed in the same type of hosts in other areas. Although many dogs were parasitized with ticks, a low prevalence of Rickettsia spp. could be related with the hypothesis of a low rickettsial prevalence in the infesting ticks. This study provides evidence that dogs in Luanda are exposed to Rickettsia spp., but further studies are needed to better characterize the bacterial infections in dogs and in their ectoparasites.
Bruce H Noden
Full Text Available The role of pathogen-mediated febrile illness in sub-Saharan Africa is receiving more attention, especially in Southern Africa where four countries (including Namibia are actively working to eliminate malaria. With a high concentration of livestock and high rates of companion animal ownership, the influence of zoonotic bacterial diseases as causes of febrile illness in Namibia remains unknown.The aim of the study was to evaluate exposure to Coxiella burnetii, spotted fever and typhus group rickettsiae, and Bartonella henselae using IFA and ELISA (IgG in serum collected from 319 volunteer blood donors identified by the Blood Transfusion Service of Namibia (NAMBTS. Serum samples were linked to a basic questionnaire to identify possible risk factors. The majority of the participants (64.8% had extensive exposure to rural areas or farms. Results indicated a C. burnetii prevalence of 26.1% (screening titre 1∶16, and prevalence rates of 11.9% and 14.9% (screening titre 1∶100 for spotted fever group and typhus group rickettsiae, respectively. There was a significant spatial association between C. burnetii exposure and place of residence in southern Namibia (P0.012, especially cattle (P>0.006, were also significantly associated with C. burnetii exposure. Males were significantly more likely than females to have been exposed to spotted fever (P<0.013 and typhus (P<0.011 group rickettsiae. Three (2.9% samples were positive for B. henselae possibly indicating low levels of exposure to a pathogen never reported in Namibia.These results indicate that Namibians are exposed to pathogenic fever-causing bacteria, most of which have flea or tick vectors/reservoirs. The epidemiology of febrile illnesses in Namibia needs further evaluation in order to develop comprehensive local diagnostic and treatment algorithms.
Full Text Available Salih Coşkun,1 Sefer Varol,2 Hasan H Özdemir,2 Sercan Bulut Çelik,3 Metin Balduz,4 Mehmet Akif Camkurt,5 Abdullah Çim,1 Demet Arslan,2 Mehmet Uğur Çevik2 1Department of Medical Genetics, 2Department of Neurology, Faculty of Medicine, Dicle University, Diyarbakir, 3Family Health Center, Batman, 4Department of Neurology, Şanlıurfa Education and Research Hospital, Şanlıurfa, 5Department of Psychiatry, Afsin State Hospital, Kahramanmaraş, Turkey Abstract: Migraine pathogenesis involves a complex interaction between hormones, neurotransmitters, and inflammatory pathways, which also influence the migraine phenotype. The Mediterranean fever gene (MEFV encodes the pyrin protein. The major role of pyrin appears to be in the regulation of inflammation activity and the processing of the cytokine pro-interleukin-1β, and this cytokine plays a part in migraine pathogenesis. This study included 220 migraine patients and 228 healthy controls. Eight common missense mutations of the MEFV gene, known as M694V, M694I, M680I, V726A, R761H, K695R, P369S, and E148Q, were genotyped using real-time polymerase chain reaction with 5' nuclease assays, which include sequence specific primers, and probes with a reporter dye. When mutations were evaluated separately among the patient and control groups, only the heterozygote E148Q carrier was found to be significantly higher in the control group than in the patient group (P=0.029, odds ratio [95% confidence interval] =0.45 [0.21–0.94]. In addition, the frequency of the homozygote and the compound heterozygote genotype carrier was found to be significantly higher in patients (n=8, 3.6% than in the control group (n=1, 0.4% (P=0.016, odds ratio [95% confidence interval] =8.57 [1.06–69.07]. However, there was no statistically significant difference in the allele frequencies of MEFV mutations between the patients and the healthy control group (P=0.964. In conclusion, the results of the present study suggest that
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
Full Text Available Spotted fever group rickettsioses are a group of tick-borne zoonotic diseases caused by intracellular bacteria of the genus Rickettsia. The diseases are widely reported amongst international travellers returning from most sub-Saharan Africa with fever, yet their importance in local populations largely remains unknown. Although this has started to change and recently there have been increasing reports of the diseases in livestock, ticks and humans in Kenya, they have not been investigated in wildlife. We examined the presence, prevalence and species of Rickettsia present in wildlife in two regions of Kenya with a unique human–wildlife–livestock interface. For this purpose, 79 wild animals in Laikipia County and 73 in Maasai Mara National Reserve were sampled. DNA extracted from blood was tested using the polymerase chain reaction (PCR to amplify the intergenic spacer rpmE-tRNAfMet and the citrate synthase-encoding gene gltA. Rickettsial DNA was detected in 2 of the 79 (2.5% animals in Laikipia and 4 of the 73 (5.5% in Maasai Mara. The PCR-positive amplicons of the gltA gene were sequenced to determine the detected Rickettsia species. This revealed Rickettsia sibirica in a Topi (Damaliscus lunatus ssp. jimela. This is the first report of spotted fever group rickettsioses in wildlife and the first to report R. sibirica in Kenya. The finding demonstrates the potential role of wild animals in the circulation of the diseases.
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.
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.
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.
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... that may be done include: Antibody titer by complement fixation or immunofluorescence Complete blood count (CBC) Kidney ... Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of ...
von Fricken, Michael E; Lkhagvatseren, Sukhbaatar; Boldbaatar, Bazartseren; Nymadawa, Pagbajab; Weppelmann, Thomas A; Baigalmaa, Bekh-Ochir; Anderson, Benjamin D; Reller, Megan E; Lantos, Paul M; Gray, Gregory C
To better understand the epidemiology of tick-borne disease in Mongolia, a comprehensive seroprevalence study was conducted investigating exposure to Anaplasma spp. and spotted fever group (SFG) Rickettsia spp. in nomadic herders and their livestock across three provinces from 2014 to 2015. Blood was collected from 397 herders and 2370 livestock, including sheep, goats, cattle, horses and camels. Antibodies against Anaplasma spp. and SFG Rickettsia were determined by indirect immunofluorescence using commercially available slides coated with Anaplasma phagocytophilum and Rickettsia rickettsii antigens. Logistic regression was used to determine if the odds of previous exposure differed by gender, location, and species, with or without adjustment for age. To examine the association between seroprevalence and environmental variables we used ArcGIS to circumscribe the five major clusters where human and animal data were collected. Anaplasma spp. exposure was detected in 37.3% (136/365) of humans and 47.3% (1120/2370) of livestock; SFG Rickettsia exposure was detected in 19.5% (73/374) humans and 20.4% (478/2342) livestock. Compared to the southern province (aimag) of Dornogovi, located in the Gobi Desert, humans were significantly more likely to be exposed to Anaplasma spp. and SFG Rickettsia in the northern provinces of Tov (OR=7.3, 95% CI: 3.5, 15.1; OR=3.3, 95% CI: 1.7, 7.5), and Selenge (OR=6.9, 95% CI: 3.4, 14.0; OR=2.2, 95% CI: 1.1, 4.8). The high seroprevalence of Anaplasma spp. and SFG Rickettsia in humans and livestock suggests that exposure to tick-borne pathogens may be common in herders and livestock in Mongolia, particularly in the more northern regions of the country. Until more is known about these pathogens in Mongolia, physicians and veterinarians in the countryside should consider testing for Anaplasma and SFG Rickettsia infections and treating clinically compatible cases, while public health authorities should expand surveillance efforts for these
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
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
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 The first record of the A. dactylomela from the Mediterranean Sea, in the Strait of Sicily waters was reported in 2002 (Trainito, 2003. Some reports of the A. dactylomela are given in the Mediterranean Sea in Table 1. A specimen of spotted sea hare was seen in a rock pool which was covered with algea. It was first recorded from Yeşilovacık Bay in 2017. Previous record of the species was noted in the Hatay coast of Turkey (Çinar et al. 2006. The present rapid communication reported the first record of A. dactylomela from the Yeşilovacık Bay. One specimen of A. dactylomela was photographed at the infralittoral zone of the Bay on 26 March, 2017, at a depth of 1 m in a rock pool togetter with Padina pavonica (Linnaeus and other algea.
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
Milagres, Bruno S.; Padilha, Amanda F.; Barcelos, Rafael M.; Gomes, Gabriel G.; Montandon, Carlos E.; Pena, Dárlen C. H.; Nieri Bastos, Fernanda A.; Silveira, Iara; Pacheco, Richard; Labruna, Marcelo B.; Bouyer, Donald H.; Freitas, Renata N.; Walker, David H.; Mafra, Cláudio L.; Galvao, Márcio A. M.
The aim of this study was to understand the current epidemiology of rickettsial diseases in two rickettsial-endemic regions in Brazil. In the municipalities of Pingo D'Agua and Santa Cruz do Escalvado, among serum samples obtained from horses and dogs, reactivity by immunofluorescent assay against spotted fever group rickettsiae was verified. In some serum samples from opossums (Didelphis aurita) captured in Santa Cruz do Escalvado, serologic response against rickettsiae was also verified. Polymerase chain reaction identified rickettsiae only in ticks and fleas obtained in Santa Cruz do Escalvado. Rickettsiae in samples had 100% sequence homology with Rickettsia felis. These results highlight the importance of marsupials in maintenance of the sylvatic cycle of rickettsial disease and potential integration with the domestic cycle. Our data also support the importance of horses and dogs as sentinels in monitoring circulation of rickettsiae in an urban area. PMID:21118939
Full Text Available Se comunica un caso de fiebre manchada por rickettsia autóctono del delta del Paraná correspondiente a la provincia de Buenos Aires. Luego de cinco días de haber permanecido en una región cercana a la localidad de ingeniero Otamendi, partido de Campana, el paciente presentó un síndrome febril agudo caracterizado por hipertermia con escalofríos y sudoración, mialgias, cefalea, astenia y discreta odinofagia, seguido a las 72 horas por un exantema maculopapuloso congestivo con elementos purpúricos, de distribución universal. En la región preauricular izquierda se observaba una lesión papuloerosiva, producida cinco días antes de iniciada la fiebre por una garrapata adquirida en el lugar. El cuadro clínico remitió rápidamente con la administración de doxiciclina. Por inmunofluorescencia indirecta se identificaron anticuerpos reactivos contra el grupo de rickettsias causantes de fiebres manchadas (CDC, Atlanta, EE.UU.. Se realizan consideraciones sobre la especie de rickettsia, el vector involucrado y la posibilidad que la enfermedad fuera debida a Rickettsia parkeri.We describe a case of rickettsial spotted fever in the Paraná Delta region of Buenos Aires province in Argentina. The patient developed an acute febrile syndrome characterized by myalgias, headache, asthenia and moderate odynophagia, followed by a diffuse macular, papular, and purpuric exanthema. The patient had been bitten recently by a tick on the left preauricular region and an erosive papular lesion was evident at the bite site. An indirect immunofluorescence antibody assay identified antibodies reactive with spotted fever group rickettsiae in the patient's serum. The patient improved rapidly with doxycycline. Several considerations relating to the identity of the rickettsial species and tick vector are discussed, including the possibility that this patient's illness may have been caused by Rickettsia parkeri.
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.
Full Text Available The tiger beetle fauna of the Maghreb region is one of the richest in the Palaearctic, including 22 species and 5 subspecies and 19% of all Palaearctic species of Cicindelinae. Assembled to their chorotypes, the Maghreb tiger beetles fall into eight different groups that include Maghreb endemics (26% of fauna, Mediterranean (7%, West Mediterranean (40%, North African (4%, Mediterranean-Westturanian (4%, West Palaearctic (4%, Afrotropico-Indo-Mediterranean (4%, and Saharian (11% species. The Mediterranean Sclerophyl and Atlas Steppe are the Maghreb biogeographical provinces with the highest species richness, while the Sahara Desert has the lowest Cicindelinae diversity. Twenty-five cicindelid species and subspecies (93% of Maghreb fauna are restricted to only one or two habitat types in lowland areas. Only Calomera littoralis littoralis and Lophyra flexuosa flexuosa are recognized as eurytopic species and occur in three types of habitat. The highest tiger beetle diversity characterizes salt marshes and river banks (in both cases 11 species and subspecies or 41% of Maghreb fauna. Approximately 85% of all Maghreb tiger beetle species and subspecies are found in habitats potentially endangered by human activity.
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
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.
Page-Sharp, Madhu; Coward, Jonathan; Moore, Brioni R; Salman, Sam; Marshall, Lewis; Davis, Timothy M E; Batty, Kevin T; Manning, Laurens
Rheumatic heart disease (RHD) remains an important global health challenge. Administration of benzathine penicillin (BPG) every 3 to 4 weeks is recommended as a secondary prophylaxis to prevent recurrent episodes of acute rheumatic fever and subsequent RHD. Following intramuscular injection, BPG is hydrolyzed to penicillin G (benzylpenicillin). However, little is known of the pharmacokinetics (PK) of BPG in pediatric populations at high risk of RHD or of the pharmacokinetic-pharmacodynamic relationship between penicillin exposure and clinically relevant outcomes. Dried blood spot (DBS) assays can facilitate PK studies in situations where frequent venous blood sampling is logistically difficult. A liquid chromatography-mass spectroscopy assay for penicillin G in plasma and DBS was developed and validated. Application of the DBS assay for PK studies was confirmed using samples from adult patients receiving penicillin as part of an infection management plan. The limit of quantification for penicillin G in DBS was 0.005 mg/liter. Penicillin G is stable in DBS for approximately 12 h at room temperature (22°C), 6 days at 4°C, and >1 month at -20°C. Plasma and DBS penicillin G concentrations for patients receiving BPG and penicillin G given via bolus doses correlated well and had comparable time-concentration profiles. There was poor correlation for patients receiving penicillin via continuous infusions, perhaps as a result of the presence of residual penicillin in the peripherally inserted central catheter, from which the plasma samples were collected. The present DBS penicillin G assay can be used as a surrogate for plasma concentrations to provide valid PK data for studies of BPG and other penicillin preparations developed to prevent rheumatic fever and RHD. Copyright © 2017 American Society for Microbiology.
Elba R.S. de Lemos
Full Text Available Ticks were collected from vegetation and animals at monthly intervals during one year (1993-1994 in an endemic area of Brazilian spotted fever in the County of Pedreira, State of São Paulo. Six species of ticks were identified Amblyomma cajennense, Amblyomma cooperi, Amblyomma triste, Anocentor nitens, Rhipicephalus sanguineus and Boophilus microplus. Only the first species was sufficiently numerous to permit a quantitative study with seasonal activity, although the distribution and source of capture of other species were observed and are reported. This information is correlated with the epidemiology of tick-borne rickettsiosis.Carrapatos de vegetação e de animais foram coletados mensalmente durante o período de um ano (1993-1994 em uma área endêmica de febre maculosa brasileira no município de Pedreira, São Paulo. Seis espécies de carrapatos foram identificadas Amblyomma cajennense, Amblyomma cooperi, Amblyomma triste, Anocentor nitens, Rhipicephalus sanguineus e Boophilus microplus. Somente a primeira espécie foi suficientemente abundante para permitir um estudo quantitativo com atividade sazonal, embora a distribuição e fonte de captura de outras espécies fossem observadas e aqui relatadas. Estas informações são correlacionadas com a epidemiologia da rickettsiose transmitida por carrapato.
Movila, Alexandru; Reye, Anna L; Dubinina, Helen V; Tolstenkov, Oleg O; Toderas, Ion; Hübschen, Judith M; Muller, Claude P; Alekseev, Andrey N
To reveal the prevalence of spotted fever group (SFG) rickettsiae and Babesia sp. in Ixodes ricinus (L.) ticks from migratory birds, 236 specimens represented 8 species of Passeriformes and were collected at Curonian Spit in Kaliningrad enclave of North-Western Russia. The ticks (total 126) being detached from four bird species, Turdus philomelos, Fringilla coelebs, Parus major, and Sturnus vulgaris, were investigated by PCR using the primers Rp CS.877p/Rp CS.1258n for the detection of Rickettsia and BJ1/BN2 for Babesia spp. Babesia spp. were detected in 2 of 126 (1.6%) ticks. The partial sequence of 18S rDNA had 100% similarity to human pathogenic Babesia sp. EU1. The SFG rickettsiae were detected in 19 of 126 (15.1%) ticks collected from the above-mentioned bird species. BLAST analysis of SFG rickettsia gltA assigned sequences to human pathogenic Rickettsia helvetica (10.3%), Rickettsia monacensis (3.9%), and Rickettsia japonica (0.8%) with 98%-100% sequence similarity. The SFG rickettsiae and Babesia sp. EU1 in ticks collected from the passerines in Russia were detected for the first time. The survey indicates that migratory birds may become a reservoir for Babesia spp. and SFG rickettsiae. Future investigations need to characterize the role of birds in the epidemiology of these human pathogens in the region.
Monospot test; Heterophile antibody test; Heterophile agglutination test; Paul-Bunnell test; Forssman antibody test ... The mononucleosis spot test is done when symptoms of mononucleosis are ... Fatigue Fever Large spleen (possibly) Sore throat Tender ...
Full Text Available Rocky Mountain spotted fever (RMSF transmitted by the brown dog tick (Rhipicephalus sanguineus sensu lato has emerged as a significant public health risk on American Indian reservations in eastern Arizona. During 2003-2012, more than 250 RMSF cases and 19 deaths were documented among Arizona's American Indian population. The high case fatality rate makes community-level interventions aimed at rapid and sustained reduction of ticks urgent. Beginning in 2012, a two year pilot integrated tick prevention campaign called the RMSF Rodeo was launched in a ∼ 600-home tribal community with high rates of RMSF. During year one, long-acting tick collars were placed on all dogs in the community, environmental acaricides were applied to yards monthly, and animal care practices such as spay and neuter and proper tethering procedures were encouraged. Tick levels, indicated by visible inspection of dogs, tick traps and homeowner reports were used to monitor tick presence and evaluate the efficacy of interventions throughout the project. By the end of year one, <1% of dogs in the RMSF Rodeo community had visible tick infestations five months after the project was started, compared to 64% of dogs in Non-Rodeo communities, and environmental tick levels were reduced below detectable levels. The second year of the project focused on use of the long-acting collar alone and achieved sustained tick control with fewer than 3% of dogs in the RMSF Rodeo community with visible tick infestations by the end of the second year. Homeowner reports of tick activity in the domestic and peridomestic setting showed similar decreases in tick activity compared to the non-project communities. Expansion of this successful project to other areas with Rhipicephalus-transmitted RMSF has the potential to reduce brown dog tick infestations and save human lives.
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...
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.
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.
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.
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.
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.
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.
Canu, Donata; Rosati, Ginevra
The Marano-Grado Lagoon (MGL) is extensively contaminated by mercury (Hg) from local sources and long-term (500 years) tidally delivered inputs from the Idrija Hg mine (Slovenia) through Isonzo River suspended loads. A multibox WASP-7 (Water Analysis Simulation Program) model was used to simulate the long-term dynamics of the mercury cycle in the MGL. Scenario simulations were used to compute changes in the system over 100 years. Present and future Hg concentrations in water, sediment, and Hg budgets were compared, including evasion and MeHg inputs to the Mediterranean Sea, based on climate changes and mercury capping in tributary rivers. Using the Ref baseline scenario, the model computes a general decrease in HgT of 13% in the water column and of 80% in sediment and a strong MeHg increase in sediment (+73%). The net sea export of HgT decreases by 57% to up to 48 kg/y while MeHg increases by 10% to up to 0.63 kg/y. The lagoon sediment recovery time of HgT up to a target level of 0.3 mg/kg is computed over 570 years for surface sediments (1750 for subsurface sediments). When removing Hg from boundaries, the same target value for surface sediments is reached within 110 years.
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
Full Text Available Albedo plays an important role in snow evolution modeling quantifying the amount of solar radiation absorbed and reflected by the snowpack, especially in mid-latitude regions with semiarid conditions. Satellite remote sensing is the most extensive technique to determine the variability of snow albedo over medium to large areas; however, scale effects from the pixel size of the sensor source may affect the results of snow models, with different impacts depending on the spatial resolution. This work presents the evaluation of snow albedo values retrieved from (1 Landsat images, L (16-day frequency with 30 × 30 m pixel size and (2 SPOT VEGETATION albedo products, SV (10-day frequency with 1 × 1 km pixel size in the Sierra Nevada mountain range in South Spain, a Mediterranean site representative of highly heterogeneous conditions. Daily snow albedo map series were derived from both sources, and used as input for the snow module in the WiMMed (Watershed Integrated Management in Mediterranean Environment hydrological model, which was operational at the study area for snow monitoring for two hydrological years, 2011–2012 and 2012–2013, in the Guadalfeo river basin in Sierra Nevada. The results showed similar albedo trends in both data sources, but with different values, the shift between both sources being distributed in space according to the altitude. This difference resulted in lower snow cover fraction values in the SV-simulations that affected the rest of snow variables included in the simulation. This underestimation, mainly due to the effects of mixed pixels composed by both snow and snow-free areas, produced higher divergences from both sources during the melting periods when the evapo-sublimation and melting fluxes are more relevant. Therefore, the selection of the albedo data source in these areas, where snow evapo-sublimation plays a very important role and the presence of snow-free patches is very frequent, can condition the final
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.
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.
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.
Do Thi Thanh, Toan; Hu, WenBiao; Pham Quang, Thai; Luu Ngoc, Hoat; Wright, P; Martens, P
Introduction: Dengue fever (DF) in Vietnam remains a serious emerging arboviral disease, which generates significant concerns among international health authorities. Incidence rates of DF have increased significantly during the last few years in many provinces and cities, especially Hanoi. The
Virgília Luna Castor de Lima
Full Text Available A febre maculosa brasileira foi detectada pela primeira vez no Estado de São Paulo em 1929. No entanto, não há registro sistemático de casos neste Estado. Em 1985 ocorreram três casos desta doença no Município de Pedreira, situado na região de Campinas, que fica no nordeste do Estado de São Paulo, Brasil, correspondendo à 5ª Região Administrativa, e compreendendo 88 municípios. Alguns estudos foram realizados no Município de Pedreira, mas a falta de registro de casos foi um obstáculo encontrado. Com a finalidade de recuperar o histórico da doença, resolveu-se pesquisar e registrar as ocorrências de febre maculosa na região no período de 1985 a 2000 e analisar o seu comportamento. Foram recuperados todos os registros da doença nos diversos serviços de saúde pública. Observou-se uma ampliação da área de transmissão e a ocorrência de um aumento dos casos suspeitos a partir de 1996, ano em que a doença foi determinada como de notificação compulsória na região. Esta doença foi causa de óbito na maioria dos anos do período de estudo. Conclui-se que a febre maculosa está em ascensão na região e estudos bioecológicos complementares estão sendo desenvolvidos para melhor compreensão da epidemiologia dessa doença, que é mundialmente reconhecida como um problema emergente de saúde pública.Brazilian spotted fever was detected for the first time in the State of São Paulo in 1929. However, there is no systematic reporting of the disease in the State. In 1985, three cases of the disease occurred in the municipality of Pedreira, located in the Campinas Region, belonging to the 5th Administrative Region, in the Northeast part of the State, including 88 municipalities. An investigation was conducted at the time, but the lack of case registry limited its scope. The present study was undertaken with the aim of recovering the history of the disease in the Region. Data recovered from several public health services for
Manoella Campostrini Barreto Vianna
Full Text Available The present study investigated the infection by spotted fever rickettsia in an endemic area for Brazilian spotted fever (BSF; caused by Rickettsia rickettsii in Minas Gerais State, Brazil. Human, canine and equine sera samples, and Amblyomma cajennense adult ticks collected in a rural area of Itabira City, Minas Gerais State were tested for rickettsial infection. Through Immunofluorescence Assay (IFA we demonstrated the presence of antibodies anti-R. rickettsii in 8.2%, 81.3% and 100% of the human, canine and equine sera, respectively. None of the 356 tick specimens analyzed were positive for Rickettsia by the hemolymph test or Polymerase Chain Reaction technique (PCR for the htrA and the gltA genes. Our serological results on horses and dogs (sentinels for BSF appoint for the circulation of a SFG Rickettsia in the study area, however in a very low infection rate among the A. cajennense tick population.O presente estudo investigou a infecção por rickéttsias do grupo da febre maculosa (GFM em área endêmica para febre maculosa brasileira (FMB; causada por Rickettsia rickettsii no Estado de Minas Gerais, Brasil. Amostras de soros de humanos, cães e eqüídeos, e carrapatos Amblyomma cajennense adultos colhidos em um povoado rural em Itabira, Minas Gerais foram testados para infecção por Rickettsia. Pela Reação de Imunofluorescência Indireta (RIFI foram detectados anticorpos anti-R. rickettsii em 8,2% dos soros humanos, 81,3% dos cães e em 100% dos eqüídeos. Nenhum dos 356 carrapatos se mostrou positivo para Rickettsia no teste de hemolinfa e na reação em cadeia pela polimerase (PCR objetivando amplificar fragmentos de DNA dos genes htrA and the gltA. Os resultados sorológicos em eqüinos e cães (sentinelas para FMB apontam para a circulação de uma rickéttsia do GFM na área do estudo, porém, numa freqüência de infecção muito baixa na população do carrapato A. cajennense.
Tchouassi David P
Full Text Available Abstract Background Mosquitoes’ response to artificial lights including color has been exploited in trap designs for improved sampling of mosquito vectors. Earlier studies suggest that mosquitoes are attracted to specific wavelengths of light and thus the need to refine techniques to increase mosquito captures following the development of super-bright light-emitting diodes (LEDs which emit narrow wavelengths of light or very specific colors. Therefore, we investigated if LEDs can be effective substitutes for incandescent lamps used in CDC light traps for mosquito surveillance, and if so, determine the best color for attraction of important Rift Valley Fever (RFV vectors. Methods The efficiency of selected colored LED CDC light traps (red, green, blue, violet, combination of blue-green-red (BGR to sample RVF vectors was evaluated relative to incandescent light (as control in a CDC light trap in two RVF hotspots (Marigat and Ijara districts in Kenya. In field experiments, traps were baited with dry ice and captures evaluated for Aedes tricholabis, Ae. mcintoshi, Ae. ochraceus, Mansonia uniformis, Mn. africana and Culex pipiens, following Latin square design with days as replicates. Daily mosquito counts per treatment were analyzed using a generalized linear model with Negative Binomial error structure and log link using R. The incidence rate ratios (IRR that mosquito species chose other treatments instead of the control, were estimated. Results Seasonal preference of Ae.mcintoshi and Ae. ochraceus at Ijara was evident with a bias towards BGR and blue traps respectively in one trapping period but this pattern waned during another period at same site with significantly low numbers recorded in all colored traps except blue relative to the control. Overall results showed that higher captures of all species were recorded in control traps compared to the other LED traps (IRR Conclusion Based on our trapping design and color, none of the LEDs
Zribi, Mehrez; Dridi, Ghofrane; Amri, Rim; Lili-Chabaane, Zohra
In semi-arid regions, and northern Africa in particular, the scarcity of rainfall and the occurrence of long periods of drought, represent one of the main environmental factors having a negative effect on agricultural productivity. This is the case in Central Tunisia, where the monitoring of agricultural and water resources is of prime importance. Vegetation cover is a key parameter to analyse this problem. Remote sensing has shown in the last decades a high potential to estimate these surface parameters. This study is based on two satellite products: SPOT-VGT (1998-2012) and TERRA-MODIS (2001-2012) NDVI products. They are used to study the dynamics of vegetation and land use. Different behaviors linked to drought periods have been observed. A strong agreement is observed between products proposed by the two sensors. Low spatial resolution SPOT-VGT and TERRA-MODIS NDVI images were used to map the land into three characteristic classes: olive trees, annual agriculture and pastures. An analysis of vegetation behaviour for dry years is proposed using the Windowed Fourier Transform (WTF). The Fourier Transform is able to analyze the frequency content of a signal in the time domain by decomposing the signal as the superposition of sine and cosine basis functions. Analysis for annual agricultural areas demonstrates a combined effect between climate and farmers behaviours. In these areas, bare soils show a high increasing for drought years. Highest percent of bare soil is retrieved with TERRA-MODIS than with SPOT-VGT. This could be explained by the spatial resolution of the two sensors. The temporal series of optical images are finally used to calculate a drought index, namely the VAI (Vegetation Anomaly Index), on the plain of Kairouan (Amri et al., 2011). This index shows a high correlation with precipitation statistics.
... 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.
Shreadah, Mohamed A; Shobier, Aida H; Ghani, Safaa A Abdel; El Zokm, Gehan M; Said, Tarek O
The major constituents and trace metals in the surface sediments collected from the Western Harbor and El-Mex Bay along the Egyptian Mediterranean Coast were studied. The concentrations of major constituents decreased in the following order: Ca > Si > Mg > Na > K for the Western Harbor and El-Mex Bay. Additionally, the ranking order of trace metals was Fe > Al > Pb > Zn > Mn > Cu > Sn > V > As > Cd > Se for the Western Harbor. For El-Mex Bay, the decreasing order was Fe > Al > Mn > Sn > Pb > Zn > Cu > V > As > Cd > Se. Fe, Al, Zn, Pb, Cu, V, Cd and Sn in the Western Harbor occurred in higher concentrations than in El-Mex Bay. A higher concentration of Mn was observed in El-Mex Bay. Two pollution indicators, enrichment factor (EF) and metal pollution index (MPI), and several sediment quality guidelines (SQGs) were used to evaluate the status of metal pollution. Based on the mean EF values of the studied metals, surface sediments of the Western Harbor and El-Mex Bay revealed that they are enriched with metals from anthropogenic sources. An analysis of variance (ANOVA) test showed that the mean measurements for all metals across the Western Harbor and El-Mex Bay are significantly different at a 0.05 significance level. Principal components analysis (PCA) was applied in result interpretation. The spatial distribution of the different parameters was illustrated.
Ricket . Diseases. Jan - yolk sac 132P. i Isolated from Tatera, in Sialkot, Pakistan 10/3/64. j Obtained from Walter Reed, Dept. of Ricket . Diseases...purified C, burneti was obtained from Dr. Oswald Baca, University of New Mexico , Albuquerque. The DNA was purified by a combination of enzyme digestions
... tick Diseases transmitted by ticks More Statistics and Epidemiology Recommend on Facebook Tweet Share Compartir Rocky Mountain ... lower case fatality rate observed in recent decades. Epidemiology Figure 1 – Reported incidence and case fatality of ...
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.
Febre maculosa das Montanhas Rochosas: ensaios negativos de transmissão experimental do virus por Triatomideos Rocky Mountain spotted fever: failure of Triatomid bugs to transmit the virus experimentally
Cornelius B. Philip
das Montanhas Rochosas, ou retel-o em seu organismo, em estado virulento, por mais de 2 a 4 dias.1. - The following species of blood-sucking triatomids failed to transmit the virus of Rocky Mountain spotted fever to susceptible guinea pigs by feeding at the following respective time intervals after the infective feeding: Eutriatoma uhleri, 33, 47, 75, and 141 days (one bug; Triatoma protracta, 15 and 37 days (one bug; T. infestans, 8 days (15 bugs; and Rhodnius prolixus, 2 days (1 bug. The last was shown to contain virus. 2. - Mechanical transmission tests by undelayed, interrupted feedings of 3 species, T. protracta and R. prolixus, were also negative. One insect of the former species accepted 2 infective and 2 normal (test feedings, while 22 bugs of the latter species accepted alternate blood-meals one to 3 times each on infected and normal guinea pigs. 3. - Fecal droplets collected from one R. prolixus 2 days after an infected feeding failed to infect when injected into a susceptible guinea pig, although virus was shown to be present inthe bug by subsequent injection of the viscera into another test animal. 4. - The period of survival of the virus in the bugs was determined by injection of gut contents at various short intervals after infected feedings. T. infestans: Positive once a 24 hours and twice at 48 hours; negative twice at 72, 96, 120 and 192 hours each. Panstrongylus megistus: Positive 3 times at 24 hours, twice at 48 hours, and once at 72 hours; negative once each at 72 and 96 hours; tests doubtful or valueless once at 48 hours, and twice each at 72, 96 and 144 hours. R. prolixus: Positive once each at 24, 48 and 72 hours, and negative at 96 hours. 5. - From these data, involving species of 4 genera of the Triatomidae, it appears unlikely that triatomids can either transmit Rocky Mountain spotted fever by their bites, or retain virulent virus within their bodies for longer than 2 to 4 days.
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 ...
... 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 ...
... for Every Season How to Choose the Best Skin Care Products In This Section Dermatologic Surgery What is dermatologic ... for Every Season How to Choose the Best Skin Care Products Age Spots Treatment Options Learn more about treatment ...
... 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 ...
A Spacecraft Position Optimal Tracking (SPOT) program was developed to process Global Positioning System (GPS) data, sent via telemetry from a spacecraft, to generate accurate navigation estimates of the vehicle position and velocity (state vector) using a Kalman filter. This program uses the GPS onboard receiver measurements to sequentially calculate the vehicle state vectors and provide this information to ground flight controllers. It is the first real-time ground-based shuttle navigation application using onboard sensors. The program is compact, portable, self-contained, and can run on a variety of UNIX or Linux computers. The program has a modular objec-toriented design that supports application-specific plugins such as data corruption remediation pre-processing and remote graphics display. The Kalman filter is extensible to additional sensor types or force models. The Kalman filter design is also strong against data dropouts because it uses physical models from state and covariance propagation in the absence of data. The design of this program separates the functionalities of SPOT into six different executable processes. This allows for the individual processes to be connected in an a la carte manner, making the feature set and executable complexity of SPOT adaptable to the needs of the user. Also, these processes need not be executed on the same workstation. This allows for communications between SPOT processes executing on the same Local Area Network (LAN). Thus, SPOT can be executed in a distributed sense with the capability for a team of flight controllers to efficiently share the same trajectory information currently being computed by the program. SPOT is used in the Mission Control Center (MCC) for Space Shuttle Program (SSP) and International Space Station Program (ISSP) operations, and can also be used as a post -flight analysis tool. It is primarily used for situational awareness, and for contingency situations.
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.
Dark spots (left) and 'fans' appear to scribble dusty hieroglyphics on top of the Martian south polar cap in two high-resolution Mars Global Surveyor, Mars Orbiter Camera images taken in southern spring. Each image is about 3-kilometers wide (2-miles).
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.
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.
Lima, Luiz H; Vianello, Silvana; Pimentel, Sérgio; Costa de Andrade, Gabriel; Zett, Claudio; Muller, Léo; Farah, Michel E; Belfort, Rubens
To report the fundus manifestations and spectral-domain optical coherence tomographic (SD-OCT) features of dengue fever presenting as Purtscher-like retinopathy. Retrospective review of two cases of dengue fever. Color fundus photograph revealed the presence of cotton-wool spots in a Purtscher-like configuration in the posterior pole of all study eyes. SD-OCT demonstrated increased reflectivity signal in the inner retinal layers, and after a variable follow-up period, there was complete disappearance of cotton-wool spots and persistence of the hyperreflectivity signal. We report two unique cases of dengue fever associated with retinal lesions in a configuration of Purtscher-like retinopathy.
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.
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.
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.
Full Text Available Mongolian spots (MS are birthmarks that are present at birth and their most common location is sacrococcygeal or lumbar area. Lesions may be single or multiple and usually involve < 5% total body surface area. They are macular and round, oval or irregular in shape. The color varies from blue to greenish, gray, black or a combination of any of the above. The size varies from few to more than 20 centimetres. Pigmentation is most intense at the age of one year and gradually fades thereafter. It is rarely seen after the age of 6 years. Aberrant MS over occiput, temple, mandibular area, shoulders and limbs may be confused with other dermal melanocytoses and bruises secondary to child abuse, thus necessitating documentation at birth. Although regarded as benign, recent data suggest that MS may be associated with inborn errors of metabolism and neurocristopathies. Mongolian spots usually resolve by early childhood and hence no treatment is generally needed if they are located in the sacral area. However, sometimes it may be required for extrasacral lesions for cosmesis.
... 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 ...
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.
Study of infection by Rickettsiae of the spotted fever group in humans and ticks in an urban park located in the City of Londrina, State of Paraná, Brazil Estudo da infecção por Rickettsias do grupo da febre maculosa em humanos e carrapatos de um parque urbano na Cidade de Londrina, Estado do Paraná
Roberta Santos Toledo
Full Text Available INTRODUCTION: Spotted fevers are emerging zoonoses caused by Rickettsia species in the spotted fever group (SFG. Rickettsia rickettsii is the main etiologic agent of Brazilian spotted fever (BSF and it is transmitted by Amblyomma spp. ticks. METHODS: The study aimed to investigate SFG rickettsiae in the Arthur Thomas Municipal Park in Londrina, PR, by collecting free-living ticks and ticks from capybaras and blood samples from personnel working in these areas. Samples from A. dubitatum and A. cajennense were submitted for PCR in pools to analyze the Rickettsia spp. gltA (citrate synthase gene. RESULTS: All the pools analyzed were negative. Human sera were tested by indirect immunofluorescence assay with R. rickettsii and R. parkeri as antigens. Among the 34 sera analyzed, seven (20.6% were reactive for R. rickettsii: four of these had endpoint titers equal to 64, 2 titers were 128 and 1 titer was 256. None of the samples were reactive for R. parkeri. An epidemiological questionnaire was applied to the park staff, but no statistically significant associations were identified. CONCLUSIONS: The serological studies suggest the presence of Rickettsiae related to SFG that could be infecting the human population studied; however, analysis of the ticks collected was unable to determine which species may be involved in transmission to humans.INTRODUÇÃO: A febre maculosa é uma zoonose emergente causada por espécies de Rickettsia do grupo febre maculosa (GFM. Rickettsia rickettsii é o principal agente etiológico da febre maculosa brasileira (FMB e é transmitida por Amblyomma spp. MÉTODOS: Com o objetivo de obter informações sobre GFM Rickettsiae no Parque Municipal Arthur Thomas em Londrina, PR, carrapatos de vida livre e de capivaras foram coletados, assim como amostras de sangue das pessoas que trabalham no parque. A. dubitatum e A. cajennense foram submetidos à PCR em pools para analises de Rickettsia spp. gltA (citrate synthase gene
Serosurvey of Rickettsia spp. in dogs and humans from an endemic area for Brazilian spotted fever in the State of São Paulo, Brazil Sorologia para Rickettsia spp. em cães e humanos de uma área endêmica para febre maculosa brasileira no Estado de São Paulo, Brasil
Full Text Available The present study provides a rickettsial serosurvey in 25 dogs and 35 humans in an endemic area for Brazilian spotted fever in the State of São Paulo, where the tick Amblyomma aureolatum is the main vector. Testing canine and human sera by indirect immunofluorescence against four Rickettsia antigens (R. rickettsii, R. parkeri, R. felis and R. bellii showed that 16 (64% of canine sera and 1 (2.8% of human sera reacted to at least one of these rickettsial antigens with titers ³ 64. Seven canine sera and the single reactive human serum showed titers to R. rickettsii at least four times those of any of the other three antigens. The antibody titers in these 7 animals and 1 human were attributed to stimulation by R. rickettsii infection. No positive canine or human serum was attributed to stimulation by R. parkeri, R. felis, or R. bellii. Our serological results showed that dogs are important sentinels for the presence of R. rickettsii in areas where the tick A. aureolatum is the main vector of Brazilian spotted fever.Este estudo avaliou a ocorrência de anticorpos anti-Rickettsia em 25 cães e 35 humanos, em uma área endêmica para a febre maculosa brasileira no Estado de São Paulo, onde o principal vetor é o carrapato Amblyomma aureolatum. Soros dos cães e humanos foram testados pela técnica de imunofluorescência indireta contra quatro antígenos de riquétsias (R. rickettsii, R. parkeri, R. felis, R. bellii, mostrando que soros de 16 (64% cães e 1 (2,8% humano reagiram com títulos ³ 64 para pelo menos um dos antígenos de riquétsias. Sete soros caninos e o único soro humano reativo demonstraram títulos para R. rickettsii no mínimo quatro vezes maior do que aqueles para os outros antígenos de riquétsias. Os títulos de anticorpos nesses cães e um humano foram considerados homólogos a R. rickettsii, enquanto que nenhum soro de cão ou humano foi considerado reativamente homólogo para R. parkeri, R. felis ou R. bellii. Os
... 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 ...
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
... 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 ...
Epidemiological aspects of the Brazilian spotted fever: serological survey of dogs and horses in an endemic area in the State of São Paulo, Brazil Aspectos epidemiológicos da febre maculosa brasileira: inquérito sorológico em cães e equinos em uma área endêmica no estado de São Paulo, Brasil
Elba R.S. de Lemos
Full Text Available In order to obtain information on Brazilian spotted fever, a study in domestic animals was performed in the County of Pedreira, State of São Paulo, Brazil, where 17 human cases had been notified. Serum samples obtained from animals were tested by indirect immunofluorescence for detectable antibodies to spotted fever-group rickettsiae. Seropositivity was revealed in 12 (36.4% of 33 dogs and seven (77.8% of nine horses from the endemic area. For comparison, blood samples from dogs and horses from non endemic area were tested and four (12.9% of 31 dogs and three (27.3% of 11 horses were positive. The highest titers of antibodies by IFA (IgG > 1:1024 were found only in three dogs and six horses from endemic area. The results suggest that dogs as horses may serve as environmental sentinels for estabilishing the prevalence of foci of spotted fever in Brazil.Com o objetivo de obter informações sobre a febre maculosa brasileira, um estudo em animais domésticos foi conduzido no município de Pedreira, São Paulo, Brasil, onde 17 casos humanos foram notificados. Amostras de soro obtidas de animais foram testadas pelo teste de imunofluorescência indireta para detecção de anticorpos para rickettsia do grupo da febre maculosa. Soro reatividade foi observada em 12 (36,4% dos 33 cães e sete (77,8% dos nove eqüinos procedentes da área endêmica. Para comparação, amostras de sangue de cães e de eqüinos procedentes de área não endêmica foram testadas e quatro (12,9% dos 31 cães e três dos 10 eqüinos foram positivos. Somente três cães e seis eqüinos procedentes da área endêmica tinham títulos de anticorpos imunofluorescentes elevados (> 1:1024. Os resultados obtidos sugerem que além dos cães, os eqüinos poderiam servir também como animal sentinela na febre maculosa brasileira
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 ...
Kaulakiene, Dalia; Thomsen, Christian; Pedersen, Torben Bach
by Amazon Web Services (AWS). The users aiming for the spot market are presented with many instance types placed in multiple datacenters in the world, and thus it is difficult to choose the optimal deployment. In this paper, we propose the framework SpotADAPT (Spot-Aware (re-)Deployment of Analytical...... execution within boundaries). Moreover, during the execution of the workload, SpotADAPT suggests a redeployment if the current spot instance gets terminated by Amazon or a better deployment becomes possible due to fluctuations of the spot prices. The approach is evaluated using the actual execution times...
Randall J. Nett
Full Text Available We describe the case of a man presumptively diagnosed and treated for Rocky Mountain spotted fever following exposure to multiple ticks while riding horses. The laboratory testing of acute and convalescent serum specimens led to laboratory confirmation of acute Q fever as the etiology. This case represents a potential tickborne transmission of Coxiella burnetii and highlights the importance of considering Q fever as a possible diagnosis following tick exposures.
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...
Nadolny, Robyn M; Wright, Chelsea L; Sonenshine, Daniel E; Hynes, Wayne L; Gaff, Holly D
The incidence of tick-borne rickettsial disease in the southeastern United States has been rising steadily through the past decade, and the range expansions of tick species and tick-borne infectious agents, new and old, has resulted in an unprecedented mix of vectors and pathogens. The results of an ongoing 4-year surveillance project describe the relative abundance of questing tick populations in southeastern Virginia. Since 2009, more than 66,000 questing ticks of 7 species have been collected from vegetation in a variety of habitats, with Amblyomma americanum constituting over 95% of ticks collected. Other species represented included Ixodes scapularis, Dermacentor variabilis, Amblyomma maculatum, Ixodes affinis, Haemaphysalis leporispalustris, and Ixodes brunneus. We found that 26.9-54.9% of A. americanum ticks tested were positive for Rickettsia amblyommii, a non-pathogenic symbiont of this tick species. We also found no evidence of R. rickettsii in D. variabilis ticks, although they did show low infection rates of R. montanensis (1.5-2.0%). Rickettsia parkeri and Candidatus R. andeanae were found in 41.8-55.7% and 0-1.5% A. maculatum ticks, respectively. The rate of R. parkeri in A. maculatum ticks is among the highest in the literature and has increased in the 2 years since R. parkeri and A. maculatum were first reported in southeastern Virginia. We conclude that tick populations in southeastern Virginia have recently undergone dramatic changes in species and abundance and that these populations support a variety of rickettsial agents with the potential for increased risk to human health. Copyright © 2013 Elsevier GmbH. All rights reserved.
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....
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.
The spot market is always quoted for the price of uranium because little information is available about long-term contracts. A review of the development of spot market prices shows the same price curve swings that occur with all raw materials. Future long-term contracts will probably be lower to reflect spot market prices, which are currently in the real-value range of $30-$35. An upswing in the price of uranium could come in the next few months as utilities begin making purchases and trading from stockpiles. The US, unlike Europe and Japan, has already reached a supply and demand point where the spot market share is increasing. Forecasters cannot project the market price, they can only predict the presence of an oscillating spot or a secondary market. 5 figures
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...
Carrapatos do gênero amblyomma (acari: ixodidae e suas relações com os hospedeiros em área endêmica para febre maculosa no Estado de São Paulo Ticks of genus Amblyomma (Acari: Ixodidae and their relationship with hosts in endemic area for spotted fever in the state of São Paulo
Carlos Alberto Perez
vulture (Cathartidae had the heaviest infestation (69.9% followed by species of the Thamnophilidae and Turdidae families. Adult ticks collected on capybaras were A. cajennense (80.8% and A. dubitatum (19.2%. Both tick species were also found on opossums corresponding to 72.4% and 27.6%, respectively. Due to easy capture and attractiveness for ticks, opossums could be used as bioindicators in Brazilian zoonotic areas with spotted fever. Considering the prevalence and also abundance of ticks, host attractiveness, proliferation and susceptibly for R. rickettsi infection, capybaras and opossums are the main amplifying hosts for this microorganism at the ESALQ/Campus, while horses, black vultures and stray cats act as secondary hosts.
Reller, Megan E; Chikeka, Ijeuru; Miles, Jeremy J; Dumler, J Stephen; Woods, Christopher W; Mayorga, Orlando; Matute, Armando J
Rickettsial infections and Q fever present similarly to other acute febrile illnesses, but are infrequently diagnosed because of limited diagnostic tools. Despite sporadic reports, rickettsial infections and Q fever have not been prospectively studied in Central America. We enrolled consecutive patients presenting with undifferentiated fever in western Nicaragua and collected epidemiologic and clinical data and acute and convalescent sera. We used ELISA for screening and paired sera to confirm acute (≥4-fold rise in titer) spotted fever and typhus group rickettsial infections and Q fever as well as past (stable titer) infections. Characteristics associated with both acute and past infection were assessed. We enrolled 825 patients and identified acute rickettsial infections and acute Q fever in 0.9% and 1.3%, respectively. Clinical features were non-specific and neither rickettsial infections nor Q fever were considered or treated. Further study is warranted to define the burden of these infections in Central America.
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.
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.
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, ...
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...
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...
Brown, G C; Brown, M M; Hiller, T; Fischer, D; Benson, W E; Magargal, L E
A series of 24 consecutive patients presenting with a fundus picture characterized by a predominance of cotton-wool spots, or a single cotton-wool spot, is reported. Excluded were patients with known diabetes mellitus. Etiologic conditions found included previously undiagnosed diabetes mellitus in five patients, systemic hypertension in five patients, cardiac valvular disease in two patients, radiation retinopathy in two patients, and severe carotid artery obstruction in two patients. Dermatomyositis, systemic lupus erythematosus, polyarteritis nodosa, leukemia, AIDS, Purtscher's retinopathy, metastatic carcinoma, intravenous drug abuse, partial central retinal artery obstruction, and giant cell arteritis were each found in one patient. In only one patient did a systemic workup fail to reveal an underlying cause. The presence of even one cotton-wool spot in an otherwise normal fundus necessitates an investigation to ascertain systemic etiologic factors.
... 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...
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
Among the patients with AIDS, 32 (17%) had retinal microangiopathy manifest by cotton wool spots; one (0.5%) had signs of active cytomegalovirus (CMV) retinitis. The presence of microangiopathy was not related to TB. Conclusions. In Malawian patients with TB presenting acutely with fever, choroidal granulomas were ...
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...
Cheewangkoon, R.; Groenewald, J.Z.; Hyde, K.D.; To-anun, C.; Crous, P.W.
Chocolate Spot leaf disease of Eucalyptus is associated with several Heteroconium-like species of hyphomycetes that resemble Heteroconium s.str. in morphology. They differ, however, in their ecology, with the former being plant pathogenic, while Heteroconium s.str. is a genus of sooty moulds. Results of molecular analyses, inferred from DNA sequences of the large subunit (LSU) and internal transcribed spacers (ITS) region of nrDNA, delineated four Heteroconium-like species on Eucalyptus, name...
Full Text Available l spot político tiene durante la campaña un objetivo final inequívoco: la consecución del voto favorable. Se dirige al cuerpo electoral a través de la televisión y de Internet, y presenta, en muchos casos, un planteamiento negativo, albergando mensajes destinados a la crítica frontal contra el adversario, más que a la exposición de propuestas propias. Este artículo se centra en el análisis del spot electoral negativo, en aquellas producciones audiovisuales construidas sin más causa que la reprobación del contrincante. Se trata de vídeos que, lejos de emplearse en difundir las potencialidades de la organización y las virtudes de su candidato –además de su programa electoral–, consumen su tiempo en descalificar al oponente mediante la transmisión de mensajes, muchas veces, ad hominem. Repasamos el planteamiento negativo del spot electoral desde su primera manifestación, que en España data de 1996, año de emisión del conocido como vídeo del dóberman, sin olvidar otros ejemplos que completan el objeto de estudio.
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...
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.
Full Text Available In wildfire science, spotting refers to non-local creation of new fires, due to downwind ignition of brands launched from a primary fire. Spotting is often mentioned as being one of the most difficult problems for wildfire management, because of its unpredictable nature. Since spotting is a stochastic process, it makes sense to talk about a probability distribution for spotting, which we call the spotting distribution. Given a location ahead of the fire front, we would like to know how likely is it to observe a spot fire at that location in the next few minutes. The aim of this paper is to introduce a detailed procedure to find the spotting distribution. Most prior modelling has focused on the maximum spotting distance, or on physical subprocesses. We will use mathematical modelling, which is based on detailed physical processes, to derive a spotting distribution. We discuss the use and measurement of this spotting distribution in fire spread, fire management and fire breaching. The appendix of this paper contains a comprehensive review of the relevant underlying physical sub-processes of fire plumes, launching fire brands, wind transport, falling and terminal velocity, combustion during transport, and ignition upon landing.
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 ...
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
Totz, Sonja; Tziperman, Eli; Coumou, Dim; Pfeiffer, Karl; Cohen, Judah
The European climate is changing under global warming, and especially the Mediterranean region has been identified as a hot spot for climate change with climate models projecting a reduction in winter rainfall and a very pronounced increase in summertime heat waves. These trends are already
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
A brief review of spot curing technology was presented. The process which a spot of energy of a specific wavelength bandwidth and irradiance is used to cause a coating, encapsulant or adhesive to change from a liquid to a solid state
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.
Cao, Zheng; Liu, Tao; Li, Xing; Wang, Jin; Lin, Hualiang; Chen, Lingling; Wu, Zhifeng; Ma, Wenjun
Background : Large spatial heterogeneity was observed in the dengue fever outbreak in Guangzhou in 2014, however, the underlying reasons remain unknown. We examined whether socio-ecological factors affected the spatial distribution and their interactive effects. Methods : Moran's I was applied to first examine the spatial cluster of dengue fever in Guangzhou. Nine socio-ecological factors were chosen to represent the urbanization level, economy, accessibility, environment, and the weather of the 167 townships/streets in Guangzhou, and then the geographical detector was applied to analyze the individual and interactive effects of these factors on the dengue outbreak. Results : Four clusters of dengue fever were identified in Guangzhou in 2014, including one hot spot in the central area of Guangzhou and three cold spots in the suburban districts. For individual effects, the temperature ( q = 0.33) was the dominant factor of dengue fever, followed by precipitation ( q = 0.24), road density ( q = 0.24), and water body area ( q = 0.23). For the interactive effects, the combination of high precipitation, high temperature, and high road density might result in increased dengue fever incidence. Moreover, urban villages might be the dengue fever hot spots. Conclusions : Our study suggests that some socio-ecological factors might either separately or jointly influence the spatial distribution of dengue fever in Guangzhou.
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
Honeycomb structures are used to prepare meals water jet cutting machines for textile. These honeycomb structures are made of stainless steel sheet thickness of 0.1-0.2 mm. Corrugated sheet metal strips are between two gears with special tooth profile. Hexagonal cells for obtaining these strips are welded points between them. Spot welding device is three electrodes in the upper part, which carries three welding points across the width of the strip of corrugated sheet metal. Spot welding device filled with press and advance mechanisms. The paper presents the values of the regime for spot welding.
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
Full Text Available 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 native and alien species respectively. The new records of native fish species include: the slender sunfish Ranzania laevis and the scalloped ribbonfish Zu cristatus in Calabria; the Azores rockling Gaidropsarus granti in Calabria and Sicily; the agujon needlefish Tylosurus acus imperialis in the Northern Aegean; and the amphibious behaviour of Gouania willdenowi in Southern Turkey. As regards molluscs, the interesting findings include Ischnochiton usticensis in Calabria and Thordisa filix in the bay of Piran (Slovenia. The stomatopod Parasquilla ferussaci was collected from Lesvos island (Greece; the isopod Anilocra frontalis was observed parasitizing the alien Pteragogus trispilus in the Rhodes area. The asteroid Tethyaster subinermis and the butterfly ray Gymnura altavela were reported from several localities in the Greek Ionian and Aegean Seas. The new records of alien species include: the antenna codlet Bregmaceros atlanticus in Saronikos Gulf; three new fish records and two decapods from Egypt; the establishment of the two spot cardinal fish Cheilodipterus novemstriatus and the first record of the Indo-Pacific marble shrimp Saron marmoratus in semi-dark caves along the Lebanese coastline; the finding of Lagocephalus sceleratus, Sargocentron rubrum, Fistularia commersonii and Stephanolepis diaspros around Lipsi island (Aegean Sea, Greece; the decapod Penaeus hathor in Aegean waters; the decapod Penaeus aztecus and the nudibranch Melibe viridis in the Dodecanese islands; the finding of Pinctada imbricata radiata in the Mar Grande of Taranto (Ionian Sea, Italy and the Maliakos Gulf (Greece.
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
Di Paola, Arianna; Valentini, Riccardo; Paparella, Francesco
The Mediterranean region is one of the hot spots of climate change. This study aims at understanding what are the conditions sustaining tree diversity in Mediterranean wet forests under future scenarios of altered hydrological regimes. The core of the work is a quantitative, dynamic model describing the coexistence of different Mediterranean tree species, typical of arid or semi-arid wetlands. Two kind of species, i.e. Hygrophilous (drought sensitive, flood resistant) and Non-hygrophilous (drought resistant, flood sensitive), are broadly defined according to the distinct adaptive strategies of trees against water stress of summer drought and winter flooding. We argue that at intermediate levels of water supply the dual role of water (resource and stress) results in the coexistence of the two kind of species. A bifurcation analysis allows us to assess the effects of climate change on the coexistence of the two species in order to highlight the impacts of predicted climate scenarios on tree diversity. Specifically, the model has been applied to Mediterranean coastal swamp forests of Central Italy located at Castelporziano Estate and Circeo National Park. Our results show that there are distinct rainfall thresholds beyond which stable coexistence becomes impossible. Regional climatic projections show that the lower rainfall threshold may be approached or crossed during the XXI century, calling for an urgent adaptation and mitigation response to prevent biodiversity losses. PMID:23077484
Trusov, V.; Shaklein, A.
The Udmurt Republic is the natural focus and the hot spot of the haemorrhagic fever with the nephritic syndrome (HFNS). The acute renal failure (ARF), by our data, is being developed from 24 up to 49 % of the HFNS diseased persons, at the severe forms of which, side by side with the medicamental therapy, the hemodialysis is being used. In the last years, the efferent therapy new methods such, as the hemofiltration, the hemodyafiltration (HDF) are being used for the ARF medical treatment.
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
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Spot audit. 149.4 Section 149.4... LIVESTOCK IMPROVEMENT VOLUNTARY TRICHINAE CERTIFICATION PROGRAM § 149.4 Spot audit. (a) In addition to regularly scheduled site audits, certified production sites will be subject to spot audits. (1) Random spot...
Mount Wilson sunspot drawings from 1966 through 1980 were used in conjunction with Hα filtergrams from Big Bear Solar Observatory to examine the origin of delta spots, spots with bipolar umbrae within one penumbra. Of the six cases we studied, five were formed by the union of non-paired spots. They are either shoved into one another by two neighboring growing bipoles or by a new spot born piggy-back style on an existing spot of opposite polarity. Proper motions of the growing spots take on curvilinear paths around one another to avoid a collision. This is the shear motion observed in delta spots (Tanaka, 1979). In the remaining case, the delta spot was formed by spots that emerged as a pair. Our findings indicate no intrinsic differences in the formation or the behavior between delta spots of normal magnetic configuration. (orig.)
Full Text Available Abstract Background Classical swine fever virus (CSFV belongs to the genus Pestivirus within the family Flaviviridae. Virulent strains of classical swine fever virus (CSFV cause severe disease in pigs characterized by immunosuppression, thrombocytopenia and disseminated intravascular coagulation, which causes significant economic losses to the pig industry worldwide. Methods To reveal proteomic changes in swine serum during the acute stage of lethal CSFV infection, 5 of 10 pigs were inoculated with the virulent CSFV Shimen strain, the remainder serving as uninfected controls. A serum sample was taken at 3 days post-infection from each swine, at a stage when there were no clinical symptoms other than increased rectal temperatures (≥40°C. The samples were treated to remove serum albumin and immunoglobulin (IgG, and then subjected to two-dimension differential gel electrophoresis. Results Quantitative intensity analysis revealed 17 protein spots showing at least 1.5-fold quantitative alteration in expression. Ten spots were successfully identified by MALDI-TOF MS or LTQ MS. Expression of 4 proteins was increased and 6 decreased in CSFV-infected pigs. Functions of these proteins included blood coagulation, anti-inflammatory activity and angiogenesis. Conclusion These proteins with altered expression may have important implications in the pathogenesis of classical swine fever and provide a clue for identification of biomarkers for classical swine fever early diagnosis.
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
Moreno, Aranzazu; Fereres, Alberto
Lettuce is frequently attacked by several viruses causing disease epidemics and considerable yield losses along the Mediterranean basin. Aphids are key pests and the major vectors of plant viruses in lettuce fields. Lettuce mosaic virus (LMV) is probably the most important because it is seed-transmitted in addition to be transmissible by many aphid species that alight on the crop. Tomato spotted wilt virus (TSWV) is another virus that causes severe damage since the introduction of its major vector, the thrips Frankliniella occidentalis. In regions with heavy and humid soils, Lettuce Mirafiori big-vein virus (LMBVV) can also produce major yield losses. Copyright © 2012 Elsevier Inc. All rights reserved.
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.
Jonietz, Florian; Myrach, Philipp; Rethmeier, Michael; Suwala, Hubert; Ziegler, Mathias
Spot welding is one of the most important joining technologies, especially in the automotive industry. Hitherto, the quality of spot welded joints is tested mainly by random destructive tests. A nondestructive testing technique offers the benefit of cost reduction of the testing procedure and optimization of the fabrication process, because every joint could be examined. This would lead to a reduced number of spot welded joints, as redundancies could be avoided. In the procedure described here, the spot welded joint between two zinc-coated steel sheets (HX340LAD+Z100MB or HC340LA+ZE 50/50) is heated optically on one side. Laser radiation and flash light are used as heat sources. The melted zone, the so called "weld nugget" provides the mechanical stability of the connection, but also constitutes a thermal bridge between the sheets. Due to the better thermal contact, the spot welded joint reveals a thermal behavior different from the surrounding material, where the heat transfer between the two sheets is much lower. The difference in the transient thermal behavior is measured with time resolved thermography. Hence, the size of the thermal contact between the two sheets is determined, which is directly correlated to the size of the weld nugget, indicating the quality of the spot weld. The method performs well in transmission with laser radiation and flash light. With laser radiation, it works even in reflection geometry, thus offering the possibility of testing with just one-sided accessibility. By using heating with collimated laser radiation, not only contact-free, but also remote testing is feasible. A further convenience compared to similar thermographic approaches is the applicability on bare steel sheets without any optical coating for emissivity correction. For this purpose, a proper way of emissivity correction was established.
Choe, Won Sick; Lee, Yu Kyung; Lee, Min Kyung; Hwang, Kyung Hoon [Gachon University Gil Hospital, Incheon (Korea, Republic of)
The authors report brain images of 18F-FDG-PET in a case of schizophrenia. The images showed strikingly increased bilateral uptake in the locus ceruleum. The locus ceruleum is called the blue spot and known to be a center of the norepinephrinergic system.
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
Bonaccio, Marialaura; Iacoviello, Licia; de Gaetano, Giovanni; Moli-Sani Investigators
There is a substantial body of evidence linking Mediterranean Diet to cardiovascular risk reduction and prevention of the major chronic diseases. Nevertheless Mediterranean societies are rapidly withdrawing from this eating pattern orienting their food choices toward products typical of the Western diet pattern, which is rich in refined grains, animal fats, sugars, processed meat but are quite poor in legumes, cereals, fruits and vegetables. The reasons people keep on shifting from healthy to unhealthy dietary habits remain open to several interpretations. Social changes appear to have consistently contributed to radical reversal in dietary habits in European Mediterranean societies even though developing Countries are somewhat turning into westernized diets as well. Among possible causes, increasing prices of some of the major food items of Mediterranean pyramid seem to have led people to give up this eating pattern in favor of less expensive products which allow to save money but are definitively unhealthy. Many studies suggest that diet quality follows a socio-economic gradient highlighting how disadvantaged people present higher rates of obesity, diabetes, cardiovascular disease and some types of cancer. Recent studies have shown a linear relationship between food cost and adherence to eating patterns and obesity. In addition to financial crisis, during the last decades the Mediterranean Diet has been put on the spot because of its alcohol -in- moderation component. Does it make any sense to blame a whole philosophy, which turned out to have beneficial effects on human health, just because, in some Countries, there is a misuse of alcoholic beverages? Copyright © 2011 Elsevier Ltd. All rights reserved.
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.
Full Text Available The purpose of this research was to determine whether there are significant differences in terms of carcass weight, forequarters, hindquarters and the dressing percentage among Romanian Spotted breed steers and first generation crossbreed obtained between Romanian Spotted and Holstein at slaughter age of 12 and 17 months respectively. Study was done on Romanian Spotted breed steer aged 12 months (36 heads and 17 months (19 heads; Romanian Spotted x Holstein first generation crossbreed of aged 12 months (29 heads and 17 months (20 heads. The Romanian Spotted breed steer, show superiority in terms of carcass weight compared to crossbreed of Romanian Spotted x Holstein, therefore this breed has a better suitability for fattening for meat. Regarding dressing percentage is higher in crossbreed of Romanian Spotted x Holstein compared with Romanian Spotted breed steers, but the difference is insignificant.
Henwood, C; Henwood, J; Robinson, R
An autosomal dominant white spotting mutant is described for the Chinese hamster. The mutant gene is designated as dominant spot (symbol Ds). The homozygote DsDs is a prenatal lethal while the heterozygote Ds + displays white spotting. The expression of white is variable, ranging from a white forehead spot to extensive white on the body. The venter is invariably white. Growth appears to be normal and the fertility of both sizes shows no impairment.
Elleman, D. D.; Allen, J. L.; Lee, M. C.
Laser pyrometer makes temperature map by scanning measuring spot across target. Scanning laser pyrometer passively measures radiation emitted by scanned spot on target and calibrated by similar passive measurement on blackbody of known temperature. Laser beam turned on for active measurements of reflectances of target spot and reflectance standard. From measurements, temperature of target spot inferred. Pyrometer useful for non-contact measurement of temperature distributions in processing of materials.
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
Full Text Available Geographies of cultural contact within the cosmopolitan city: Mediterranean cities looking for new identities. Contemporary society stresses its multicultural and multiethnic character. The comings and goings of humankind are becoming more important than ever before, affecting cities and metropolises, exposing them to global risk and causing them to search for nervous and confused responses to the global challenge. In order to understand this current transmutation, it is necessary first to adopt a cosmopolitan outlook and to perform “sopralluoghi” ( over-places. In other words, it is necessary to go beyond the methodological nationalism which is a constituent of the social sciences, and, by using on-the-spot inspections, to detect the places of contact where the present cosmopolitan processes are manifesting themselves. Mediterranean cities are, in this sense, the best places to explore this phenomenon, because new cultures and identities continue to spring up there, thanks to the duration and the intensity of human mobility, the frequency of contacts, the variety of cultures and the stratification of a shared cultural heritage.Keywords: Geographies; Cultural contacts (in between; Cosmopolitan view; Mediterranean cities
Coll, Marta; Piroddi, Chiara; Steenbeek, Jeroen; Kaschner, Kristin; Ben Rais Lasram, Frida; Aguzzi, Jacopo; Ballesteros, Enric; Bianchi, Carlo Nike; Corbera, Jordi; Dailianis, Thanos; Danovaro, Roberto; Estrada, Marta; Froglia, Carlo; Galil, Bella S.; Gasol, Josep M.; Gertwagen, Ruthy; Gil, João; Guilhaumon, François; Kesner-Reyes, Kathleen; Kitsos, Miltiadis-Spyridon; Koukouras, Athanasios; Lampadariou, Nikolaos; Laxamana, Elijah; López-Fé de la Cuadra, Carlos M.; Lotze, Heike K.; Martin, Daniel; Mouillot, David; Oro, Daniel; Raicevich, Saša; Rius-Barile, Josephine; Saiz-Salinas, Jose Ignacio; San Vicente, Carles; Somot, Samuel; Templado, José; Turon, Xavier; Vafidis, Dimitris; Villanueva, Roger; Voultsiadou, Eleni
The Mediterranean Sea is a marine biodiversity hot spot. Here we combined an extensive literature analysis with expert opinions to update publicly available estimates of major taxa in this marine ecosystem and to revise and update several species lists. We also assessed overall spatial and temporal patterns of species diversity and identified major changes and threats. Our results listed approximately 17,000 marine species occurring in the Mediterranean Sea. However, our estimates of marine diversity are still incomplete as yet—undescribed species will be added in the future. Diversity for microbes is substantially underestimated, and the deep-sea areas and portions of the southern and eastern region are still poorly known. In addition, the invasion of alien species is a crucial factor that will continue to change the biodiversity of the Mediterranean, mainly in its eastern basin that can spread rapidly northwards and westwards due to the warming of the Mediterranean Sea. Spatial patterns showed a general decrease in biodiversity from northwestern to southeastern regions following a gradient of production, with some exceptions and caution due to gaps in our knowledge of the biota along the southern and eastern rims. Biodiversity was also generally higher in coastal areas and continental shelves, and decreases with depth. Temporal trends indicated that overexploitation and habitat loss have been the main human drivers of historical changes in biodiversity. At present, habitat loss and degradation, followed by fishing impacts, pollution, climate change, eutrophication, and the establishment of alien species are the most important threats and affect the greatest number of taxonomic groups. All these impacts are expected to grow in importance in the future, especially climate change and habitat degradation. The spatial identification of hot spots highlighted the ecological importance of most of the western Mediterranean shelves (and in particular, the Strait of
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.
Ayaki, Toshikazu; Yoshikawa, Isao; Niikawa, Norio; Hoshi, Masaharu.
A Drosophila wing spot test system was used to investigate the effects of low doses of X-rays, gamma rays, and both 2.3 and 14.1 MeV neutrons on somatic chromosome mutation (SCM) induction. The incidence of SCM was significantly increased with any type of radiation, with evident linear dose-response relationship within the range of 3 to 20 cGy. It was estimated that relative biological effectiveness value for SCM induction of 2.3 MeV neutrons to X-rays and gamma rays is much higher than that of 14.1 MeV neutrons to those photons (2.4 vs 8.0). The Drosophila wing spot test system seems to become a promising in vivo experimental method for higher animals in terms of the lack of necessity for a marvelously large number of materials required in conventional test system. (Namekawa, K.)
Thompson, Michael; Tsui, Stella; Leung, Chi Fan
A sweet spot is referred to in sport as the perfect place to strike a ball with a racquet or bat. It is the point of contact between bat and ball where maximum results can be produced with minimal effort from the hand of the player. Similar physics can be applied to the less inspiring examples of door stops; the perfect position of a door stop is…
Pittarello, Andrea; Leib, Margarita; Gordon-Hecker, Tom; Shalvi, Shaul
To some extent, unethical behavior results from people's limited attention to ethical considerations, which results in an ethical blind spot. Here, we focus on the role of ambiguity in shaping people's ethical blind spots, which in turn lead to their ethical failures. We suggest that in ambiguous settings, individuals' attention shifts toward tempting information, which determines the magnitude of their lies. Employing a novel ambiguous-dice paradigm, we asked participants to report the outcome of the die roll appearing closest to the location of a previously presented fixation cross on a computer screen; this outcome would determine their pay. We varied the value of the die second closest to the fixation cross to be either higher (i.e., tempting) or lower (i.e., not tempting) than the die closest to the fixation cross. Results of two experiments revealed that in ambiguous settings, people's incorrect responses were self-serving. Tracking participants' eye movements demonstrated that people's ethical blind spots are shaped by increased attention toward tempting information. © The Author(s) 2015.
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.
Full Text Available This paper presents an analysis of the properties of resistance spot welds between low carbon steel and austenitic CrNi stainless steel. The thickness of the welded dissimilar materials was 2 mm. A DeltaSpot welding gun with a process tape was used for welding the dissimilar steels. Resistance spot welds were produced with various welding parameters (welding currents ranging from 7 to 8 kA. Light microscopy, microhardness measurements across the welded joints, and EDX analysis were used to evaluate the quality of the resistance spot welds. The results confirm the applicability of DeltaSpot welding for this combination of materials.
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...
16 July 2004 Astronomers using ESA’s X-ray observatory XMM-Newton have detected a small, bright ‘hot spot’ on the surface of the neutron star called Geminga, 500 light-years away. The hot spot is the size of a football field and is caused by the same mechanism producing Geminga’s X-ray tails. This discovery identifies the missing link between the X-ray and gamma-ray emission from Geminga. hi-res Size hi-res: 1284 kb Credits: ESA, P. Caraveo (IASF, Milan) Geminga's hot spot This figure shows the effects of charged particles accelerated in the magnetosphere of Geminga. Panel (a) shows an image taken with the EPIC instrument on board the XMM-Newton observatory. The bright tails, made of particles kicked out by Geminga’s strong magnetic field, trail the neutron star as it moves about in space. Panel (b) shows how electrically charged particles interact with Geminga’s magnetic field. For example, if electrons (blue) are kicked out by the star, positrons (in red) hit the star’s magnetic poles like in an ‘own goal’. Panel (c) illustrates the size of Geminga’s magnetic field (blue) compared to that of the star itself at the centre (purple). The magnetic field is tilted with respect to Geminga’s rotation axis (red). Panel (d) shows the magnetic poles of Geminga, where charged particles hit the surface of the star, creating a two-million degrees hot spot, a region much hotter than the surroundings. As the star spins on its rotation axis, the hot spot comes into view and then disappears, causing the periodic colour change seen by XMM-Newton. An animated version of the entire sequence can be found at: Click here for animated GIF [low resolution, animated GIF, 5536 KB] Click here for AVI [high resolution, AVI with DIVX compression, 19128 KB] hi-res Size hi-res: 371 kb Credits: ESA, P. Caraveo (IASF, Milan) Geminga's hot spot, panel (a) Panel (a) shows an image taken with the EPIC instrument on board the XMM-Newton observatory. The bright tails, made of
Ulman, Aylin; Ferrario, Jasmine; Occhpinti-Ambrogi, Anna; Arvanitidis, Christos; Bandi, Ada; Bertolino, Marco; Bogi, Cesare; Chatzigeorgiou, Giorgos; Çiçek, Burak Ali; Deidun, Alan; Ramos-Esplá, Alfonso; Koçak, Cengiz; Lorenti, Maurizio; Martinez-Laiz, Gemma; Merlo, Guenda; Princisgh, Elisa; Scribano, Giovanni; Marchini, Agnese
The Mediterranean Sea is home to over 2/3 of the world's charter boat traffic and hosts an estimated 1.5 million recreational boats. Studies elsewhere have demonstrated marinas as important hubs for the stepping-stone transfer of non-indigenous species (NIS), but these unique anthropogenic, and typically artificial habitats have largely gone overlooked in the Mediterranean as sources of NIS hot-spots. From April 2015 to November 2016, 34 marinas were sampled across the following Mediterranean countries: Spain, France, Italy, Malta, Greece, Turkey and Cyprus to investigate the NIS presence and richness in the specialized hard substrate material of these marina habitats. All macroinvertebrate taxa were collected and identified. Additionally, fouling samples were collected from approximately 600 boat-hulls from 25 of these marinas to determine if boats host diverse NIS not present in the marina. Here, we present data revealing that Mediterranean marinas indeed act as major hubs for the transfer of marine NIS, and we also provide evidence that recreational boats act as effective vectors of spread. From this wide-ranging geographical study, we report here numerous new NIS records at the basin, subregional, country and locality level. At the basin level, we report three NIS new to the Mediterranean Sea ( Achelia sawayai sensu lato , Aorides longimerus , Cymodoce aff. fuscina ), and the re-appearance of two NIS previously known but currently considered extinct in the Mediterranean ( Bemlos leptocheirus, Saccostrea glomerata ). We also compellingly update the distributions of many NIS in the Mediterranean Sea showing some recent spreading; we provide details for 11 new subregional records for NIS ( Watersipora arcuata , Hydroides brachyacantha sensu lato and Saccostrea glomerata now present in the Western Mediterranean; Symplegma brakenhielmi , Stenothoe georgiana , Spirobranchus tertaceros sensu lato , Dendostrea folium sensu lato and Parasmittina egyptiaca now present in
tn~::.ifo n ’ Davis, California; Instituto Veterinario de Investtgacrones Troptcales y de Altura , lquttos, P~ru, US. Naval Me~ Silver...email@example.com. Hugo Galvez, Instituto Veterinario de Investigaciones Tropicales y de Altura , lquitos, Peru, E-mail: firstname.lastname@example.org
Fernanda Aparecida Nieri-Bastos
Full Text Available Adult ticks of the species Amblyomma parvum were collected from the vegetation in the Pantanal biome (state of Mato Grosso do Sul and from horses in the Cerrado biome (state of Piauí in Brazil. The ticks were individually tested for rickettsial infection via polymerase chain reaction (PCR targeting three rickettsial genes, gltA, ompA and ompB. Overall, 63.5% (40/63 and 66.7% (2/3 of A. parvum ticks from Pantanal and Cerrado, respectively, contained rickettsial DNA, which were all confirmed by DNA sequencing to be 100% identical to the corresponding fragments of the gltA, ompA and ompB genes of Candidatus Rickettsia andeanae. This report is the first to describe Ca. R. andeanae in Brazil.
Nieri-Bastos, Fernanda Aparecida; Lopes, Marcos Gomes; Cançado, Paulo Henrique Duarte; Rossa, Giselle Ayres Razera; Faccini, João Luiz Horácio; Gennari, Solange Maria; Labruna, Marcelo Bahia
Adult ticks of the species Amblyomma parvum were collected from the vegetation in the Pantanal biome (state of Mato Grosso do Sul) and from horses in the Cerrado biome (state of Piauí) in Brazil. The ticks were individually tested for rickettsial infection via polymerase chain reaction (PCR) targeting three rickettsial genes, gltA, ompA and ompB. Overall, 63.5% (40/63) and 66.7% (2/3) of A. parvum ticks from Pantanal and Cerrado, respectively, contained rickettsial DNA, which were all confirmed by DNA sequencing to be 100% identical to the corresponding fragments of the gltA, ompA and ompB genes of Candidatus Rickettsia andeanae. This report is the first to describe Ca. R. andeanae in Brazil.
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.
Reed, Alastair; Filler, TomáÅ.¡; Falkenstern, Kristyn; Bai, Yang
In January 2014, Digimarc announced Digimarc® Barcode for the packaging industry to improve the check-out efficiency and customer experience for retailers. Digimarc Barcode is a machine readable code that carries the same information as a traditional Universal Product Code (UPC) and is introduced by adding a robust digital watermark to the package design. It is imperceptible to the human eye but can be read by a modern barcode scanner at the Point of Sale (POS) station. Compared to a traditional linear barcode, Digimarc Barcode covers the whole package with minimal impact on the graphic design. This significantly improves the Items per Minute (IPM) metric, which retailers use to track the checkout efficiency since it closely relates to their profitability. Increasing IPM by a few percent could lead to potential savings of millions of dollars for retailers, giving them a strong incentive to add the Digimarc Barcode to their packages. Testing performed by Digimarc showed increases in IPM of at least 33% using the Digimarc Barcode, compared to using a traditional barcode. A method of watermarking print ready image data used in the commercial packaging industry is described. A significant proportion of packages are printed using spot colors, therefore spot colors needs to be supported by an embedder for Digimarc Barcode. Digimarc Barcode supports the PANTONE spot color system, which is commonly used in the packaging industry. The Digimarc Barcode embedder allows a user to insert the UPC code in an image while minimizing perceptibility to the Human Visual System (HVS). The Digimarc Barcode is inserted in the printing ink domain, using an Adobe Photoshop plug-in as the last step before printing. Since Photoshop is an industry standard widely used by pre-press shops in the packaging industry, a Digimarc Barcode can be easily inserted and proofed.
. 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 ...
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... 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 ...
In the last decade, the oil futures market has risen to prominence and has become a major factor in influencing oil market psychology and the crude oil market. On a normal day, over 92 thousand contracts, the equivalent of 92 million barrels per day, change hands on the New York Mercantile Exchange, NYMEX. This market has provided a vehicle for hedging against risk. At the same time, it has also created opportunities for speculation. Those who previously were unable to participate in oil market transactions can now become involved through the futures market. The large number of participants in the future market and the availability of information has made this market more efficient and transparent, relative to the crude oil market. While there has been considerable in-depth analysis of other future markets, relatively little theoretical attention has focused on that of oil. This paper looks at the following issues. First, what is the relationship between futures and spot oil prices? And secondly, are futures prices a good predictor of spot crude prices in the future? (author)
Full Text Available Background: glucose-6-phosphate dehydrogenase (G6PD deficiency is the most common genetic defects in the world, so that more than 400 million people in worldwide are affected with it, but its prevalence varies from 1-65% in different populations. Clinical manifestation of this defect is acute hemolytic anemia, neonatal hyperbilirubinemia and chronic nonspherocytic haemolytic anaemia. So far, almost 140 mutations have been identified in the gene of G6PD enzyme. Mediterranean is the most common mutation. The purpose of this study is to determine the prevalence of G6PD Mediterranean mutation in the deficient people in the city of Zahedan.Materials and Methods: In this descriptive cross-sectional study, blood samples of 1440 male individuals, who were referred to Zahedan Reference Laboratory for premarital testing, were examined for G6PD deficiency using fluorescent spot test. Genomic DNA from blood of people with G6PD deficiency was extracted by DNA extraction kit. Mediterranean mutation was identified using PCR-RFLP method.Results: 101 out of 1440 subjects had G6PD deficiency. Therefore prevalence of G6PD deficiency in Zahedan city was estimated about 7%. Mediterranean mutation frequency in patients with defect of G6PD was estimated 84.2% (85 out of 101 patients and 15.8% (16 out of 101 patients did not have mutation Mediterranean. The frequency of G6PD deficiency was expressed as a percentage of total cases and Mediterranean mutation prevalence was expressed as a percentage of total impaired individuals.Conclusion: The result of this study showed that the frequency of G6PD deficiency in Zahedan city is lower than other cities of sistan and baluchestan province. Dominant mutation in present study was Mediterranean type and its frequency was very similar with prevalence of this mutation in other parts of Iran.
John E Fa
Full Text Available Wild animals are a primary source of protein (bushmeat for people living in or near tropical forests. Ideally, the effect of bushmeat harvests should be monitored closely by making regular estimates of offtake rate and size of stock available for exploitation. However, in practice, this is possible in very few situations because it requires both of these aspects to be readily measurable, and even in the best case, entails very considerable time and effort. As alternative, in this study, we use high-resolution, environmental favorability models for terrestrial mammals (N = 165 in Central Africa to map areas of high species richness (hot spots and hunting susceptibility. Favorability models distinguish localities with environmental conditions that favor the species' existence from those with detrimental characteristics for its presence. We develop an index for assessing Potential Hunting Sustainability (PHS of each species based on their ecological characteristics (population density, habitat breadth, rarity and vulnerability, weighted according to restrictive and permissive assumptions of how species' characteristics are combined. Species are classified into five main hunting sustainability classes using fuzzy logic. Using the accumulated favorability values of all species, and their PHS values, we finally identify weak spots, defined as high diversity regions of especial hunting vulnerability for wildlife, as well as strong spots, defined as high diversity areas of high hunting sustainability potential. Our study uses relatively simple models that employ easily obtainable data of a species' ecological characteristics to assess the impacts of hunting in tropical regions. It provides information for management by charting the geography of where species are more or less likely to be at risk of extinction from hunting.
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.
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.
Gilarranz, Luis J; Sabatino, Malena; Aizen, Marcelo A; Bascompte, Jordi
Incorporating interactions into a biogeographical framework may serve to understand how interactions and the services they provide are distributed in space. We begin by simulating the spatiotemporal dynamics of realistic mutualistic networks inhabiting spatial networks of habitat patches. We proceed by comparing the predicted patterns with the empirical results of a set of pollination networks in isolated hills of the Argentinian Pampas. We first find that one needs to sample up to five times as much area to record interactions as would be needed to sample the same proportion of species. Secondly, we find that peripheral patches have fewer interactions and harbour less nested networks - therefore potentially less resilient communities - compared to central patches. Our results highlight the important role played by the structure of dispersal routes on the spatial distribution of community patterns. This may help to understand the formation of biodiversity hot spots. © 2014 The Authors. Journal of Animal Ecology © 2014 British Ecological Society.
Courtois, Hélène M.; Graziani, Romain; Dupuy, Alexandra [University of Lyon, UCB Lyon 1, CNRS/IN2P3, IPN, Lyon (France); Tully, R. Brent [Institute for Astronomy, University of Hawaii, 2680 Woodlawn Drive, Honolulu, HI 96822 (United States); Hoffman, Yehuda [Racah Institute of Physics, Hebrew University, Jerusalem, 91904 (Israel); Pomarède, Daniel [Institut de Recherche sur les Lois Fondamentales de l’Univers, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette (France)
The three-dimensional gravitational velocity field within z ∼ 0.1 has been modeled with the Wiener filter methodology applied to the Cosmicflows-3 compilation of galaxy distances. The dominant features are a basin of attraction and two basins of repulsion. The major basin of attraction is an extension of the Shapley concentration of galaxies. One basin of repulsion, the Dipole Repeller, is located near the anti-apex of the cosmic microwave background dipole. The other basin of repulsion is in the proximate direction toward the “Cold Spot” irregularity in the cosmic microwave background. It has been speculated that a vast void might contribute to the amplitude of the Cold Spot from the integrated Sachs–Wolfe effect.
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)
Hazardous wastes contaminated with radionuclides, chemicals, and explosives exist across the Department of Energy complex and need to be remediated due to environmental concerns. Currently, an opportunity is being developed to dramatically reduce remediation costs and to assist in the acceleration of schedules associated with these wastes by deploying a Hot Spot Removal System. Removing the hot spot from the waste site will remove risk driver(s) and enable another, more cost effective process/option/remedial alternative (i.e., capping) to be applied to the remainder of the site. The Hot Spot Removal System consists of a suite of technologies that will be utilized to locate and remove source terms. Components of the system can also be used in a variety of other cleanup activities. This Hot Spot Removal System Description document presents technologies that were considered for possible inclusion in the Hot Spot Removal System, technologies made available to the Hot Spot Removal System, industrial interest in the Hot Spot Removal System''s subsystems, the schedule required for the Hot Spot Removal System, the evaluation of the relevant technologies, and the recommendations for equipment and technologies as stated in the Plan section
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
... 7 Agriculture 2 2010-01-01 2010-01-01 false Low Middling Light Spotted Color. 28.415 Section 28... Spotted Color. Low Middling Light Spotted Color is color which in spot or color, or both, is between Low Middling Color and Low Middling Spotted Color. ...
... 7 Agriculture 2 2010-01-01 2010-01-01 false Good Middling Light Spotted Color. 28.411 Section 28... Light Spotted Color. Good Middling Light Spotted Color is color which in spot or color, or both, is between Good Middling Color and Good Middling Spotted Color. ...
... 7 Agriculture 2 2010-01-01 2010-01-01 false Middling Light Spotted Color. 28.413 Section 28.413... Spotted Color. Middling Light Spotted Color is color which in spot or color, or both, is between Middling Color and Middling Spotted Color. ...
... 7 Agriculture 2 2010-01-01 2010-01-01 false Strict Middling Light Spotted Color. 28.412 Section 28... Light Spotted Color. Strict Middling Light Spotted Color is color which in spot or color, or both, is between Strict Middling Color and Strict Middling Spotted Color. ...
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.
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.
Gonzalez, Jean-Paul; Souris, Marc; Valdivia-Granda, Willy
As successive epidemics have swept the world, the scientific community has quickly learned from them about the emergence and transmission of communicable diseases. Epidemics usually occur when health systems are unprepared. During an unexpected epidemic, health authorities engage in damage control, fear drives action, and the desire to understand the threat is greatest. As humanity recovers, policy-makers seek scientific expertise to improve their "preparedness" to face future events.Global spread of disease is exemplified by the spread of yellow fever from Africa to the Americas, by the spread of dengue fever through transcontinental migration of mosquitos, by the relentless influenza virus pandemics, and, most recently, by the unexpected emergence of Ebola virus, spread by motorbike and long haul carriers. Other pathogens that are remarkable for their epidemic expansions include the arenavirus hemorrhagic fevers and hantavirus diseases carried by rodents over great geographic distances and the arthropod-borne viruses (West Nile, chikungunya and Zika) enabled by ecology and vector adaptations. Did we learn from the past epidemics? Are we prepared for the worst?The ultimate goal is to develop a resilient global health infrastructure. Besides acquiring treatments, vaccines, and other preventive medicine, bio-surveillance is critical to preventing disease emergence and to counteracting its spread. So far, only the western hemisphere has a large and established monitoring system; however, diseases continue to emerge sporadically, in particular in Southeast Asia and South America, illuminating the imperfections of our surveillance. Epidemics destabilize fragile governments, ravage the most vulnerable populations, and threaten the global community.Pandemic risk calculations employ new technologies like computerized maintenance of geographical and historical datasets, Geographic Information Systems (GIS), Next Generation sequencing, and Metagenomics to trace the
NASA's Hubble Space Telescope has discovered a new great dark spot, located in the northern hemisphere of the planet Neptune. Because the planet's northern hemisphere is now tilted away from Earth, the new feature appears near the limb of the planet. The spot is a near mirror-image to a similar southern hemisphere dark spot that was discovered in 1989 by the Voyager 2 probe. In 1994, Hubble showed that the southern dark spot had disappeared. Like its predecessor, the new spot has high altitude clouds along its edge, caused by gasses that have been pushed to higher altitudes where they cool to form methane ice crystal clouds. The dark spot may be a zone of clear gas that is a window to a cloud deck lower in the atmosphere. Planetary scientists don t know how long lived this new feature might be. Hubble's high resolution will allow astronomers to follow the spot's evolution and other unexpected changes in Neptune's dynamic atmosphere. The image was taken on November 2, 1994 with Hubble's Wide Field Planetary Camera 2, when Neptune was 2.8 billion miles (4.5 billion kilometers) from Earth. Hubble can resolve features as small as 625 miles (1,000 kilometers) across in Neptune's cloud tops. Credit: H. Hammel (Massachusetts Institute of Technology) and NASA
Navarro-Pérez, M L; López, J; Rodríguez-Riaño, T; Bacchetta, G; de Miguel Gordillo, C; Ortega-Olivencia, A
Both bird and mixed vertebrate-insect (MVI) pollination systems are very rare in Europe and the Mediterranean region. Because MVI can ensure reproduction over a wider range of environmental conditions than when insects are the sole pollinators, under certain circumstances such systems are highly advantageous to plants. Here, we investigated the pollination and some reproductive traits of the Tyrrhenian Scrophularia trifoliata, the only species of the genus possessing two showy dark spots inside the corolla, for which MVI pollination system had been inferred on the basis of limited censuses. We conducted field experiments to study MVI pollination and some reproductive traits and elucidate the role of corolla spots, analysing their ultraviolet pattern, histology and pigments versus the rest of the corolla. The primary pollinators were wasps and passerine birds. Corolla spots absorb UV light, present abundant anthocyanins and are histologically identical to the rest of the corolla. Control flowers had higher visitation frequency than flowers without spots. S. trifoliata is self-compatible, with efficient intrafloral protogyny and herkogamy that prevent self-pollination but not geitonogamy. We confirmed the existence of a mixed bird-insect pollination system in S. trifoliata. This system is found in three other Scrophularia species with large, showy flowers - two Mediterranean (S. grandiflora and S. sambucifolia) and one Macaronesian (S. calliantha). Unlike those species, S. trifoliata has two large spots inside the corolla. These likely operate as nectar guides and their dark colouration is related to abundant anthocyanin content. © 2017 German Botanical Society and The Royal Botanical Society of the Netherlands.
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
Petel, Roy; Fuks, Anna
Pink spots in teeth were first described by Mummery in 1920, and were related to resorption. Resorption is a pathologic process that often eludes the clinician with its varied etiologic factors and diverse clinical presentations. Resorption can be generally classified as internal and external resorption. Internal resorption has been described as a rare occurrence as compared to external resorption. This article describes a pink spot that was diagnosed as a progressing resorption process. Early diagnosis enabled a successful management of the lesion. Early diagnosis and treatment of an internal resorption, clinically seen as a pink spot, in a primary central incisor may prevent its fast progress and subsequent loss.
Totz, Sonja; Tziperman, Eli; Coumou, Dim; Pfeiffer, Karl; Cohen, Judah
The European climate is changing under global warming, and especially the Mediterranean region has been identified as a hot spot for climate change with climate models projecting a reduction in winter rainfall and a very pronounced increase in summertime heat waves. These trends are already detectable over the historic period. Hence, it is beneficial to forecast seasonal droughts well in advance so that water managers and stakeholders can prepare to mitigate deleterious impacts. We developed a new cluster-based empirical forecast method to predict precipitation anomalies in winter. This algorithm considers not only the strength but also the pattern of the precursors. We compare our algorithm with dynamic forecast models and a canonical correlation analysis-based prediction method demonstrating that our prediction method performs better in terms of time and pattern correlation in the Mediterranean and European regions.
Boncourt, Maite de
The wave of deep offshore and unconventional gas and oil exploration projects, rendered economically feasible by relatively high prices and new technologies, has reached the shores of the Mediterranean. Levantine countries, including Cyprus, Israel, Palestinian Territories, Lebanon, Syria, have new offshore gas potentials. A few years ago, the East Mediterranean energy situation looked gloomy. East Mediterranean countries, struggling to feed their growing domestic energy consumption, were forced to depend on neighbours like Egypt whose export gas pipeline kept on blowing or Syria which was unable to fulfil the export contracts it signed and they meanwhile had to buy LNG at world markets high spot prices or fuel their power stations with highly priced fuel oil or diesel. Long term prospects did not look good either as the ability of Egypt -the main regional supplier- to maintain gas export's volumes is being challenged by rising domestic demand. Israel in particular, given its tense relations with energy rich Arab countries was finding itself in a difficult situation to secure its supplies. The discoveries of giant gas fields offshore Israel, now followed by its neighbours who all started to explore their offshore, has changed the picture. Gas fields have provided these countries a great feeling of blessing as expected economic benefits will be massive and energy security improved - a major concern after Arab Revolutions have shaken established energy routes. The road leading to a change of energy paradigm in the East Mediterranean is however long and bumpy. Before these countries will be able to tap benefits from these deep water gas (and oil) resources, these countries will actually have to overcome significant geopolitical, regulatory and commercial hurdles. Energy laws and clear and attractive legal frameworks for exploration and production activities, will need to be set up, and sometimes from scratch. Infrastructures -so far almost inexistent- will have to be
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.
Hodgson, Erin W.; Drost, Dan
Asparagus beetle, Crioceris asparagi, and spotted asparagus beetle, C. duodecimpunctata are leaf beetles in the family Chrysomelidae. These beetles feed exclusively on asparagus and are native to Europe. Asparagus beetle is the more economically injurious of the two species.
T. S. Ajay
Full Text Available Safety remains a top concern for automobile industries and new-car shoppers. Detection of Blind Spots is a major concern for safety issues. So automobiles have been constantly updating their products with new technologies to detect blind spots so that they can add more safety to the vehicle and also reduce the road accidents. Almost 1.5 million people die in road accidents each year. Blind spot of an automobile is the region of the vehicle which cannot be observed properly while looking either through side or rear mirror view. To meet the above requirements this paper describes detecting blind spot by using ultrasonic sensor and controlling the direction of car by automatic steering. The technology embedded in the system is capable of automatically steer the vehicle away from an obstacle if the system determines that a collision is impending or if the vehicle is in the vicinity of our car.
Reed, Kristine M.
Describes first grade students' mathematical investigation of the number of spots on a cheetah. The exploration of counting and estimation strategies that grew from the investigation gives evidence that mathematicians come in all ages. (ASK)
Lesnjak, A.; Tusek, J.
Plasma spot wedding of ferritic stainless steels studied. The study was focused on welding parameters, plasma and shieldings and the optimum welding equipment. Plasma-spot welded overlap joints on a 0.8 mm thick ferritic stainless steel sheet were subjected to a visual examination and mechanical testing in terms of tension-shear strength. Several macro specimens were prepared Plasma spot welding is suitable to use the same gas as shielding gas and as plasma gas , i. e. a 98% Ar/2% H 2 gas mixture. Tension-shear strength of plasma-spot welded joint was compared to that of resistance sport welded joints. It was found that the resistance welded joints withstand a somewhat stronger load than the plasma welded joints due to a large weld sport diameter of the former. Strength of both types of welded joints is approximately the same. (Author) 32 refs
associated fish in South Africa was investigated by conducting a tracking experiment on spotted grunter Pomadasys commersonnii in the East Kleinemonde Estuary. The telemetry equipment comprised two VEMCO V8 transmitters and a ...
Fry, David A [Los Alamos National Laboratory
Measurement of microfocus spot size can be important for several reasons: (1) Quality assurance during manufacture of microfocus tubes; (2) Tracking performance and stability of microfocus tubes; (3) Determining magnification (especially important for digital radiography where the native spatial resolution of the digital system is not adequate for the application); (4) Knowledge of unsharpness from the focal spot alone. The European Standard EN 12543-5 is based on a simple geometrical method of calculating focal spot size from unsharpness of high magnification film radiographs. When determining microfocus focal spot dimensions using unsharpness measurements both signal-to-noise (SNR) and magnification can be important. There is a maximum accuracy that is a function of SNR and therefore an optimal magnification. Greater than optimal magnification can be used but it will not increase accuracy.
Pury, T.; Tsen, M.L.S.; Gray, F.L.; Stehr, R.E.; Konle, R.L.
Improvements are described in an X-ray spot film device which is used in conjunction with an X-ray table to make a selected number of radiographic exposures on a single film and to perform fluoroscopic examinations. To date, the spot film devices consist of two X-ray field defining masks, one of which is moved manually. The present device is more convenient to use and speeds up the procedure. (U.K.)
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.
Stuart, Anthony J.; Lister, Adrian M.
The extirpation of spotted hyaena, Crocuta crocuta, in northern Eurasia can be seen as part of the late Quaternary megafaunal extinction event. The radiocarbon record for this species is less substantial than for other megafaunal species, but with the addition of new dates we have significantly increased the tally to approximately 100 reliable direct dates. These suggest extirpation at ca 40 ka (calendar years) in Central Europe and Russia, and ca 31 ka in north-west and southern Europe, so that the species was probably restricted to the Mediterranean and the Atlantic seaboard after 40 ka. Previous records suggesting Lateglacial or even Holocene survival (especially in eastern Asia) are not substantiated. The current estimate of 31 ka for extirpation of the spotted hyaena in northern Eurasia is close to the estimated extinction date of cave bear (Ursus spelaeus), suggesting a possible common cause. Factors likely to have impacted the spotted hyaena include, in particular, physiological cold intolerance in the face of deteriorating climate, as well as reduction of prey abundance driven by depressed vegetational productivity, and increased competition for food or space with lions, bears and people, possibly exacerbated by the arrival of modern humans.
Bastos, A.; Gouveia, C. M.; Trigo, R. M.; DaCamara, C. C.
Mediterranean ecosystems have evolved along with fire, adapting to quick recovering following wildfire events. However, vegetation species respond differently to the changes in fire regimes that have been observed in the past decades in the Mediterranean. These changes, which occurred mainly due to socio-economic and climatic changes, led to dramatic modifications of landscape composition and structure (Malkinson et al., 2011). Post-fire vegetation recovery depends on environmental factors such as landscape features and climatic variables and on specific plant traits; however it also depends on the differentiated response of each species to the characteristics of fire regimes, such as recurrence, severity and extent. The complexity of the interactions between these factors emphasizes the importance of assessing quantitatively post-fire recovery as well as the role of driving factors of regeneration over different regions in the Mediterranean. In 2006, Spain experienced the fire season with larger fires, restricted to a relatively small region of the province of Galicia, that represents more than 60% of total burned area of this fire season (92000ha out of 148827 ha). The 2007 fire season in Greece was remarkably severe, registering the highest value of burnt area (225734 ha) since 1980. Finally, in 2010 a very large wildfire of about 5000 ha occurred in Mount Carmel, Israel, with major social and environmental impacts. The work relies on monthly NDVI data from SPOT/VEGETATION at 1km spatial resolution over the period from September 1998 - August 2011 for Spain, Greece and Israel. Here we have applied the same sequential methodology developed at our laboratory, starting by the identification of very large burnt scars by means of a spatial cluster analysis followed by the application of the monoparametric model (Gouveia et al., 2010; Bastos et al., 2011) in order to study post-fire vegetation dynamics. Post-fire recovery times were estimated for burnt scars from each
A novel "Flying Spot" infrared camera for nondestructive evaluation (NDE) and nondestructive characterization is presented. The camera scans the focal point of an unmodulated heating laser beam across the sample in a raster. The detector of the camera tracks the heating spot in the same raster, but with a time delay. The detector is thus looking at the "thermal wake" of the heating spot. The time delay between heating and detection is determined by the speed of the laser spot and the distance between it and the detector image. Since this time delay can be made arbitrarily small, the camera is capable of making thermal wave images of phenomena which occur on a very short time scale. In addition, because the heat source is a very small spot, the heat flow is fully three-dimensional. This makes the camera system sensitive to features, like tightly closed vertical cracks, which are invisible to imaging systems which employ full-field heating. A detailed theory which relates the temperature profile around the heating spot to the sample thermal properties is also described. The camera represents a potentially useful tool for measuring thermal diffusivities of materials by means of fitting the recorded temperature profiles to the theoretical curves with the diffusivity as a fitting parameter.
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.
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
Tests of caprolactam in the mouse spot test showed that treatment with this compound increased the frequency of color spots among animals treated in utero. The nature of these spots suggests that caprolactam may induce spots through the induction of mitotic recombination.
... 7 Agriculture 2 2010-01-01 2010-01-01 false Middling Spotted Color. 28.423 Section 28.423... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Spotted Cotton § 28.423 Middling Spotted Color. Middling Spotted Color is color which is within the range represented by a set of samples in the custody of...
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.
Suhail Sufi M
Full Text Available Abstract Background Worldwide there is a need to develop simple effective predictors that can distinguish whether a patient will progress from dengue fever (DF to life threatening dengue hemorrhagic (DHF or dengue shock syndrome (DSS. We explored whether proteinuria could be used as such a marker. Methods We included patients admitted to hospital with suspected dengue fever. Starting at enrollment until discharge, each patient's daily spot urine protein creatinine ratio (UPCR was measured. We classified those with confirmed dengue infection as DF or DHF (including DSS based on WHO criteria. Peak and day of onset of proteinuria was compared between both groups. Results Compared to those with DF, patients with DHF had significantly higher median peak proteinuria levels (0.56 versus 0.08 g/day; p Conclusions Peak UPCR could potentially predict DHF in patients with dengue requiring close monitoring and treatment.
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.
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
Koivisto, Emilia A.; Andrews, David L.; Gordon, Richard G.
Rates of inter-hot spot motion have been debated for decades. Herein we present updated predictions for the tracks of the Tristan da Cunha, Réunion, and Iceland hot spots assuming them to be fixed relative to Pacific hot spots. Uncertainties in Pacific hot spot rotations, which include uncertainties in the current locations of hot spots of 100-200 km, are combined with uncertainties in relative plate motions accumulated through the plate circuit to obtain the final uncertainty in the predicted positions (including uncertainties of 150-200 km in the current locations of the Indo-Atlantic hot spots). Improvements to reconstruction methods, to relative plate reconstructions, to age dates along the tracks, and to the geomagnetic reversal timescale lead to significant changes from prior results. When compared with the observed tracks, the predicted tracks indicate nominal rates of motion of only 2-6 mm a-1 of these Indo-Atlantic hot spots relative to Pacific hot spots over the past 48 Ma. Within the uncertainties, the rates range from no motion to rates as high as 8-13 mm a-1. For reconstructions prior to 48 Ma B.P., however, the apparent rates of inter-hot spot motion are much larger, 46-55 ± 20 mm a-1, if the motion occurred entirely between 68 Ma B.P. and 48 Ma B.P. Either hot spots moved rapidly before 48 Ma B.P., and slowed drastically at ≈ 48 Ma B.P., or global plate circuits through Antarctica become less reliable as one goes increasingly further into the past. Most paleomagnetic data favor the latter explanation.
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
Morris, Brett M.; Agol, Eric; Davenport, James R. A.; Hawley, Suzanne L.
Astrometry from Gaia will measure the positions of stellar photometric centroids to unprecedented precision. We show that the precision of Gaia astrometry is sufficient to detect starspot-induced centroid jitter for nearby stars in the Tycho-Gaia Astrometric Solution (TGAS) sample with magnetic activity similar to the young G-star KIC 7174505 or the active M4 dwarf GJ 1243, but is insufficient to measure centroid jitter for stars with Sun-like spot distributions. We simulate Gaia observations of stars with 10 year activity cycles to search for evidence of activity cycles, and find that Gaia astrometry alone likely can not detect activity cycles for stars in the TGAS sample, even if they have spot distributions like KIC 7174505. We review the activity of the nearby low-mass stars in the TGAS sample for which we anticipate significant detections of spot-induced jitter.
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.
Ibe, Masahiro; Kitano, Ryuichiro
Sweet spot supersymmetry is a phenomenologically and cosmologically perfect framework to realize a supersymmetric world at short distance. We discuss a class of dynamical models of supersymmetry breaking and its mediation whose low-energy effective description falls into this framework. Hadron fields in the dynamical models play a role of the messengers of the supersymmetry breaking. As is always true in the models of the sweet spot supersymmetry, the messenger scale is predicted to be 10 5 GeV ∼ mess ∼ 10 GeV. Various values of the effective number of messenger fields N mess are possible depending on the choice of the gauge group
This article is the September 1994 uranium market summary. Volume in the spot concentrates market fell below 1 million lbs U3O8. In total, twelve deals took place compared to 28 deals in August. Of the twelve deals, three took place in the spot concentrates market, two took place in the medium and long-term market, three in the conversion market, and four in the enrichment market. Restricted prices weakened, but unrestricted prices firmed slightly. The enrichment price range narrowed a bit
Full Text Available In the paper, we present a system designed for detecting keywords in telephone speech. We focus not only on achieving high accuracy but also on very short processing time. The keyword spotting system can run in three modes: a an off-line mode requiring less than 0.1xRT, b an on-line mode with minimum (2 s latency, and c a repeated spotting mode, in which pre-computed values allow for additional acceleration. Its performance is evaluated on recordings of Czech spontaneous telephone speech using rather large and complex keyword lists.
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
Wu, Xiaohua; Moin, Parviz; Wallace, James M.; Skarda, Jinhie; Lozano-Durán, Adrián; Hickey, Jean-Pierre
Two observations drawn from a thoroughly validated direct numerical simulation of the canonical spatially developing, zero-pressure gradient, smooth, flat-plate boundary layer are presented here. The first is that, for bypass transition in the narrow sense defined herein, we found that the transitional–turbulent spot inception mechanism is analogous to the secondary instability of boundary-layer natural transition, namely a spanwise vortex filament becomes a Λ vortex and then, a hairpin packet. Long streak meandering does occur but usually when a streak is infected by a nearby existing transitional–turbulent spot. Streak waviness and breakdown are, therefore, not the mechanisms for the inception of transitional–turbulent spots found here. Rather, they only facilitate the growth and spreading of existing transitional–turbulent spots. The second observation is the discovery, in the inner layer of the developed turbulent boundary layer, of what we call turbulent–turbulent spots. These turbulent–turbulent spots are dense concentrations of small-scale vortices with high swirling strength originating from hairpin packets. Although structurally quite similar to the transitional–turbulent spots, these turbulent–turbulent spots are generated locally in the fully turbulent environment, and they are persistent with a systematic variation of detection threshold level. They exert indentation, segmentation, and termination on the viscous sublayer streaks, and they coincide with local concentrations of high levels of Reynolds shear stress, enstrophy, and temperature fluctuations. The sublayer streaks seem to be passive and are often simply the rims of the indentation pockets arising from the turbulent–turbulent spots. PMID:28630304
Wu, Xiaohua; Moin, Parviz; Wallace, James M; Skarda, Jinhie; Lozano-Durán, Adrián; Hickey, Jean-Pierre
Two observations drawn from a thoroughly validated direct numerical simulation of the canonical spatially developing, zero-pressure gradient, smooth, flat-plate boundary layer are presented here. The first is that, for bypass transition in the narrow sense defined herein, we found that the transitional-turbulent spot inception mechanism is analogous to the secondary instability of boundary-layer natural transition, namely a spanwise vortex filament becomes a [Formula: see text] vortex and then, a hairpin packet. Long streak meandering does occur but usually when a streak is infected by a nearby existing transitional-turbulent spot. Streak waviness and breakdown are, therefore, not the mechanisms for the inception of transitional-turbulent spots found here. Rather, they only facilitate the growth and spreading of existing transitional-turbulent spots. The second observation is the discovery, in the inner layer of the developed turbulent boundary layer, of what we call turbulent-turbulent spots. These turbulent-turbulent spots are dense concentrations of small-scale vortices with high swirling strength originating from hairpin packets. Although structurally quite similar to the transitional-turbulent spots, these turbulent-turbulent spots are generated locally in the fully turbulent environment, and they are persistent with a systematic variation of detection threshold level. They exert indentation, segmentation, and termination on the viscous sublayer streaks, and they coincide with local concentrations of high levels of Reynolds shear stress, enstrophy, and temperature fluctuations. The sublayer streaks seem to be passive and are often simply the rims of the indentation pockets arising from the turbulent-turbulent spots.
Wu, Xiaohua; Moin, Parviz; Wallace, James M.; Skarda, Jinhie; Lozano-Durán, Adrián; Hickey, Jean-Pierre
Two observations drawn from a thoroughly validated direct numerical simulation of the canonical spatially developing, zero-pressure gradient, smooth, flat-plate boundary layer are presented here. The first is that, for bypass transition in the narrow sense defined herein, we found that the transitional-turbulent spot inception mechanism is analogous to the secondary instability of boundary-layer natural transition, namely a spanwise vortex filament becomes a ΛΛ vortex and then, a hairpin packet. Long streak meandering does occur but usually when a streak is infected by a nearby existing transitional-turbulent spot. Streak waviness and breakdown are, therefore, not the mechanisms for the inception of transitional-turbulent spots found here. Rather, they only facilitate the growth and spreading of existing transitional-turbulent spots. The second observation is the discovery, in the inner layer of the developed turbulent boundary layer, of what we call turbulent-turbulent spots. These turbulent-turbulent spots are dense concentrations of small-scale vortices with high swirling strength originating from hairpin packets. Although structurally quite similar to the transitional-turbulent spots, these turbulent-turbulent spots are generated locally in the fully turbulent environment, and they are persistent with a systematic variation of detection threshold level. They exert indentation, segmentation, and termination on the viscous sublayer streaks, and they coincide with local concentrations of high levels of Reynolds shear stress, enstrophy, and temperature fluctuations. The sublayer streaks seem to be passive and are often simply the rims of the indentation pockets arising from the turbulent-turbulent spots.
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 The Mediterranean Sea is home to over 2/3 of the world’s charter boat traffic and hosts an estimated 1.5 million recreational boats. Studies elsewhere have demonstrated marinas as important hubs for the stepping-stone transfer of non-indigenous species (NIS, but these unique anthropogenic, and typically artificial habitats have largely gone overlooked in the Mediterranean as sources of NIS hot-spots. From April 2015 to November 2016, 34 marinas were sampled across the following Mediterranean countries: Spain, France, Italy, Malta, Greece, Turkey and Cyprus to investigate the NIS presence and richness in the specialized hard substrate material of these marina habitats. All macroinvertebrate taxa were collected and identified. Additionally, fouling samples were collected from approximately 600 boat-hulls from 25 of these marinas to determine if boats host diverse NIS not present in the marina. Here, we present data revealing that Mediterranean marinas indeed act as major hubs for the transfer of marine NIS, and we also provide evidence that recreational boats act as effective vectors of spread. From this wide-ranging geographical study, we report here numerous new NIS records at the basin, subregional, country and locality level. At the basin level, we report three NIS new to the Mediterranean Sea (Achelia sawayai sensu lato, Aorides longimerus, Cymodoce aff. fuscina, and the re-appearance of two NIS previously known but currently considered extinct in the Mediterranean (Bemlos leptocheirus, Saccostrea glomerata. We also compellingly update the distributions of many NIS in the Mediterranean Sea showing some recent spreading; we provide details for 11 new subregional records for NIS (Watersipora arcuata, Hydroides brachyacantha sensu lato and Saccostrea glomerata now present in the Western Mediterranean; Symplegma brakenhielmi, Stenothoe georgiana, Spirobranchus tertaceros sensu lato, Dendostrea folium sensu lato and Parasmittina egyptiaca now
Gomberg, Joan; Prejean, Stephanie
To better understand what controls fault slip along plate boundaries, we have exploited the abundance of seismic and geodetic data available from the richly varied tectonic environments composing Alaska. A search for tremor triggered by 11 large earthquakes throughout all of seismically monitored Alaska reveals two tremor “sweet spots”—regions where large-amplitude seismic waves repeatedly triggered tremor between 2006 and 2012. The two sweet spots locate in very different tectonic environments—one just trenchward and between the Aleutian islands of Unalaska and Akutan and the other in central mainland Alaska. The Unalaska/Akutan spot corroborates previous evidence that the region is ripe for tremor, perhaps because it is located where plate-interface frictional properties transition between stick-slip and stably sliding in both the dip direction and laterally. The mainland sweet spot coincides with a region of complex and uncertain plate interactions, and where no slow slip events or major crustal faults have been noted previously. Analyses showed that larger triggering wave amplitudes, and perhaps lower frequencies (sweet spots also does not occur during slow slip events visually detectable in GPS data, although slow slip below the detection threshold may have facilitated tremor triggering.
Mcewen, A. S.
The thesis is that extensional tectonics and low-angle detachment faults probably occur on Io in association with the hot spots. These processes may occur on a much shorter timescale on Ion than on Earth, so that Io could be a natural laboratory for the study of thermotectonics. Furthermore, studies of heat and detachment in crustal extension on Earth and the other terresrial planets (especially Venus and Mars) may provide analogs to processes on Io. The geology of Io is dominated by volcanism and hot spots, most likely the result of tidal heating. Hot spots cover 1 to 2% of Io's surface, radiating at temperatures typically from 200 to 400 K, and occasionally up to 700K. Heat loss from the largest hot spots on Io, such as Loki Patera, is about 300 times the heat loss from Yellowstone, so a tremendous quantity of energy is available for volcanic and tectonic work. Active volcanism on Io results in a resurfacing rate as high as 10 cm per year, yet many structural features are apparent on the surface. Therefore, the tectonics must be highly active.
Simon, A. A.; Wong, M. H.; Rogers, J. H.; Orton, G. S.; de Pater, I.; Asay-Davis, X.; Carlson, R. W.; Marcus, P. S.
Jupiter's Great Red Spot (GRS) is one of its most distinct and enduring features, having been continuously observed since the 1800's. It currently spans the smallest latitude and longitude size ever recorded. Here we show analyses of 2014 Hubble spectral imaging data to study the color, structure and internal dynamics of this long-live storm.
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.
Lauria, V; Gristina, M; Attrill, M J; Fiorentino, F; Garofalo, G
Commercial fisheries have dramatically impacted elasmobranch populations worldwide. With high capture and bycatch rates, the abundance of many species is rapidly declining and around a quarter of the world's sharks and rays are threatened with extinction. At a regional scale this negative trend has also been evidenced in the central Mediterranean Sea, where bottom-trawl fisheries have affected the biomass of certain rays (e.g. Raja clavata) and sharks (e.g. Mustelus spp.). Detailed knowledge of elasmobranch habitat requirements is essential for biodiversity conservation and fisheries management, but this is often hampered by a poor understanding of their spatial ecology. Habitat suitability models were used to investigate the habitat preference of nine elasmobranch species and their overall diversity (number of species) in relation to five environmental predictors (i.e. depth, sea surface temperature, surface salinity, slope and rugosity) in the central Mediterranean Sea. Results showed that depth, seafloor morphology and sea surface temperature were the main drivers for elasmobranch habitat suitability. Predictive distribution maps revealed different species-specific patterns of suitable habitat while high assemblage diversity was predicted in deeper offshore waters (400-800 m depth). This study helps to identify priority conservation areas and diversity hot-spots for rare and endangered elasmobranchs in the Mediterranean Sea.
Shive, J.P.; Pilliod, D.S.; Peterson, C.R.
Wildlife managers increasingly are using remotely sensed imagery to improve habitat delineations and sampling strategies. Advances in remote sensing technology, such as hyperspectral imagery, provide more information than previously was available with multispectral sensors. We evaluated accuracy of high-resolution hyperspectral image classifications to identify wetlands and wetland habitat features important for Columbia spotted frogs (Rana luteiventris) and compared the results to multispectral image classification and United States Geological Survey topographic maps. The study area spanned 3 lake basins in the Salmon River Mountains, Idaho, USA. Hyperspectral data were collected with an airborne sensor on 30 June 2002 and on 8 July 2006. A 12-year comprehensive ground survey of the study area for Columbia spotted frog reproduction served as validation for image classifications. Hyperspectral image classification accuracy of wetlands was high, with a producer's accuracy of 96 (44 wetlands) correctly classified with the 2002 data and 89 (41 wetlands) correctly classified with the 2006 data. We applied habitat-based rules to delineate breeding habitat from other wetlands, and successfully predicted 74 (14 wetlands) of known breeding wetlands for the Columbia spotted frog. Emergent sedge microhabitat classification showed promise for directly predicting Columbia spotted frog egg mass locations within a wetland by correctly identifying 72 (23 of 32) of known locations. Our study indicates hyperspectral imagery can be an effective tool for mapping spotted frog breeding habitat in the selected mountain basins. We conclude that this technique has potential for improving site selection for inventory and monitoring programs conducted across similar wetland habitat and can be a useful tool for delineating wildlife habitats. ?? 2010 The Wildlife Society.