Fatal Deer Tick Virus Infection in Maine.

PubMed

Cavanaugh, Catherine E; Muscat, Paul L; Telford, Sam R; Goethert, Heidi; Pendlebury, William; Elias, Susan P; Robich, Rebecca; Welch, Margret; Lubelczyk, Charles B; Smith, Robert P

2017-09-15

Deer tick virus (DTV), a genetic variant (lineage II) of Powassan virus, is a rare cause of encephalitis in North America. We report a fatal case of DTV encephalitis following a documented bite from an Ixodes scapularis tick and the erythema migrans rash associated with Lyme disease. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Acquisition and loss of virulence-associated factors during genome evolution and speciation in three clades of Bordetella species

USDA-ARS?s Scientific Manuscript database

Bacteria in the genus Bordetella include nine species that are important pathogens. B. pertussis causes whooping cough, a serious and sometimes fatal disease in infants and in elderly people. Some strains of B. parapertussis also cause whooping cough-like disease in children while others cause pn...

A fatal case of Brazilian spotted fever in a non-endemic area in Brazil: the importance of having health professionals who understand the disease and its areas of transmission.

PubMed

Oliveira, Stefan Vilges de; Caldas, Eduardo Pacheco de; Colombo, Silvia; Gazeta, Gilberto Salles; Labruna, Marcelo Bahia; Santos, Fabiana Cristina Pereira Dos; Angerami, Rodrigo Nogueira

2016-01-01

Brazilian spotted fever (BSF) is caused by the bacterium Rickettsia rickettsii. Because of its high case-fatality rate and apparent increase in areas of transmission, it is considered to be the rickettsial illness of primary public health interest. Cases of this disease have historically occurred in Southeastern Brazil. This article reports the first fatal case of BSF in Southern Brazil. This case high lights the importance of BSF to be considered as a differential diagnosis for acute hemorrhagic fever in areas where cases of BSF may not be expected.

The effects of diabetes on the risks of major cardiovascular diseases and death in the Asia-Pacific region.

PubMed

Woodward, M; Zhang, X; Barzi, F; Pan, W; Ueshima, H; Rodgers, A; MacMahon, S

2003-02-01

To provide reliable age- and region-specific estimates of the associations between diabetes and major cardiovascular diseases and death in populations from the Asia-Pacific region. Twenty-four cohort studies from Asia, Australia, and New Zealand (median follow-up, 5.4 years) provided individual participant data from 161,214 people (58% from Asia) of whom 4,873 had a history of diabetes at baseline. The associations of diabetes with the risks of coronary heart disease, stroke, and cause-specific mortality during follow-up were estimated using time-dependent Cox models, stratified by study cohort and sex and adjusted for age at risk. In all, 9,277 deaths occurred (3,635 from cardiovascular disease). The hazard ratio (95% CI) associated with diabetes was 1.97 (1.72-2.25) for fatal cardiovascular disease; there were similar hazard ratios for fatal coronary heart disease, fatal stroke, and composites of fatal and nonfatal outcomes. For all cardiovascular outcomes, hazard ratios were similar in Asian and non-Asian populations and in men and women, but were greater in younger than older individuals. For noncardiovascular death, the hazard ratio was 1.56 (1.38-1.77), with separately significant increases in the risks of death from renal disease, cancer, respiratory infections, and other infective causes. The hazard ratio for all-causes mortality was 1.68 (1.55-1.84), with similar ratios in Asian and non-Asian populations, but with significantly higher ratios in younger than older individuals. The relative effect of diabetes on the risks of cardiovascular disease and death in Asian populations is much the same as that in the largely Caucasian populations of Australia and New Zealand. Hazard ratios were severalfold greater in younger people than older people. The rapidly growing prevalence of diabetes in Asia heralds a large increase in the incidence of diabetes-related death in the coming decades.

Detecting and quantifying prions: Mass spectrometry-based approaches

USDA-ARS?s Scientific Manuscript database

Prions are novel pathogens that cause a set of rare fatal neurological diseases know as transmissible spongiform encephalopathies. Examples of these diseases include Creutzfeldt-Jakob disease, scrapie and chronic wasting disease. Prions are able to recruit a normal cellular prion protein and convert...

Identification of new molecular alterations in Fatal Familial Insomnia.

USDA-ARS?s Scientific Manuscript database

Fatal familial insomnia (FFI) is an autosomal dominant prion disease caused by a D178N mutation in PRNP in combination with methionine (Met) at codon 129 in the mutated allele of the same gene (D178N-129M haplotype). The present study analyzes pathological and molecular features in seven FFI cases c...

It's Open Season on Ticks

MedlinePlus

... potentially fatal diseases like Lyme disease, ehrlichiosis and tularemia. Many of these illnesses can be treated effectively ... which can carry the organisms that cause ehrlichiosis, tularemia and the Southern Tick-Associated Rash Illness (STARI)), ...

Case report: Co-infection of Rickettsia rickettsii and Streptococcus pyogenes: is fatal Rocky Mountain spotted fever underdiagnosed?

PubMed

Raczniak, Gregory A; Kato, Cecilia; Chung, Ida H; Austin, Amy; McQuiston, Jennifer H; Weis, Erica; Levy, Craig; Carvalho, Maria da Gloria S; Mitchell, Audrey; Bjork, Adam; Regan, Joanna J

2014-12-01

Rocky Mountain spotted fever, a tick-borne disease caused by Rickettsia rickettsii, is challenging to diagnose and rapidly fatal if not treated. We describe a decedent who was co-infected with group A β-hemolytic streptococcus and R. rickettsii. Fatal cases of Rocky Mountain spotted fever may be underreported because they present as difficult to diagnose co-infections. © The American Society of Tropical Medicine and Hygiene.

Characteristics of fatal abusive head trauma among children in the USA: 2003-2007: an application of the CDC operational case definition to national vital statistics data.

PubMed

Parks, Sharyn E; Kegler, Scott R; Annest, Joseph L; Mercy, James A

2012-06-01

In March of 2008, an expert panel was convened at the Centers for Disease Control and Prevention to develop code-based case definitions for abusive head trauma (AHT) in children under 5 years of age based on the International Classification of Diseases, 10th Revision (ICD-10) nature and cause of injury codes. This study presents the operational case definition and applies it to US death data. National Center for Health Statistics National Vital Statistics System data on multiple cause-of-death from 2003 to 2007 were examined. Inspection of records with at least one ICD-10 injury/disease code and at least one ICD-10 cause code from the AHT case definition resulted in the identification of 780 fatal AHT cases, with 699 classified as definite/presumptive AHT and 81 classified as probable AHT. The fatal AHT rate was highest among children age <1 year with a peak in incidence that occurred at 1-2 months of age. Fatal AHT incidence rates were higher for men than women and were higher for non-Hispanic African-Americans compared to other racial/ethnic groups. Fatal AHT incidence was relatively constant across seasons. This report demonstrates that the definition can help to identify population subgroups at higher risk for AHT defined by year and month of death, age, sex and race/ethnicity. This type of definition may be useful for various epidemiological applications including research and surveillance. These activities can in turn inform further development of prevention activities, including educating parents about the dangers of shaking and strategies for managing infant crying.

Measuring the Burden of Hospitalization in Patients with Parkinson´s Disease in Spain.

PubMed

Gil-Prieto, Ruth; Pascual-Garcia, Raquel; San-Roman-Montero, Jesus; Martinez-Martin, Pablo; Castrodeza-Sanz, Javier; Gil-de-Miguel, Angel

2016-01-01

This epidemiological survey estimates the hospitalization burden related to Parkinson´s Disease in Spain. This observational retrospective survey was performed by reviewing data from the National Surveillance System for Hospital Data, which includes more than 98% of Spanish hospitals. All hospitalizations of patients with Parkinson´s disease that were reported from 1997-2012 were analyzed. Codes were selected using the 9th International Classification of Diseases: ICD-9-CM: 332.0. A total of 438,513 hospital discharges of patients with Parkinson´s Disease were reported during the study period. The annual hospitalization rate was 64.2 cases per 100,000. The average length of hospital stay was 10 days. The trend for the annual hospitalization rate differed significantly depending on whether Parkinson´s disease was the main cause of hospitalization (n = 23,086, 1.14% annual increase) or was not the main cause of hospitalization (n = 415,427, 15.37% annual increase). The overall case-fatality rate among hospitalized patients was 10%. The case fatality rate among patient´s hospitalized with Parkinson´s disease as the main cause of hospitalization was 2.5%. The hospitalization rate and case-fatality rate significantly increased with age. The primary causes of hospitalization when Parkinson´s disease was not coded as the main cause of hospitalization were as follows: respiratory system diseases (24%), circulatory system diseases (19%), injuries and poisoning, including fractures (12%), diseases of the digestive system (10%) and neoplasms (5%). The annual average cost for National Health Care System was € 120 M, with a mean hospitalization cost of €4,378. Parkinson´s disease poses a significant health threat in Spain, particularly in the elderly. While hospitalizations due to Parkinson´s Disease are relatively stable over time, the number of patients presenting with Parkinson´s disease as an important comorbidity has increased dramatically. Medical staff must be specifically trained to treat the particular needs of hospitalized patients suffering from Parkinson´s disease as an important comorbidity.

Measuring the Burden of Hospitalization in Patients with Parkinson´s Disease in Spain

PubMed Central

Gil-Prieto, Ruth; Pascual-Garcia, Raquel; San-Roman-Montero, Jesus; Martinez-Martin, Pablo; Castrodeza-Sanz, Javier; Gil-de-Miguel, Angel

2016-01-01

Introduction This epidemiological survey estimates the hospitalization burden related to Parkinson´s Disease in Spain. Methods This observational retrospective survey was performed by reviewing data from the National Surveillance System for Hospital Data, which includes more than 98% of Spanish hospitals. All hospitalizations of patients with Parkinson´s disease that were reported from 1997–2012 were analyzed. Codes were selected using the 9th International Classification of Diseases: ICD-9-CM: 332.0. Results A total of 438,513 hospital discharges of patients with Parkinson´s Disease were reported during the study period. The annual hospitalization rate was 64.2 cases per 100,000. The average length of hospital stay was 10 days. The trend for the annual hospitalization rate differed significantly depending on whether Parkinson´s disease was the main cause of hospitalization (n = 23,086, 1.14% annual increase) or was not the main cause of hospitalization (n = 415,427, 15.37% annual increase). The overall case-fatality rate among hospitalized patients was 10%. The case fatality rate among patient´s hospitalized with Parkinson´s disease as the main cause of hospitalization was 2.5%. The hospitalization rate and case-fatality rate significantly increased with age. The primary causes of hospitalization when Parkinson´s disease was not coded as the main cause of hospitalization were as follows: respiratory system diseases (24%), circulatory system diseases (19%), injuries and poisoning, including fractures (12%), diseases of the digestive system (10%) and neoplasms (5%). The annual average cost for National Health Care System was € 120 M, with a mean hospitalization cost of €4,378. Conclusions Parkinson´s disease poses a significant health threat in Spain, particularly in the elderly. While hospitalizations due to Parkinson´s Disease are relatively stable over time, the number of patients presenting with Parkinson´s disease as an important comorbidity has increased dramatically. Medical staff must be specifically trained to treat the particular needs of hospitalized patients suffering from Parkinson´s disease as an important comorbidity. PMID:26977930

Human respiratory syncytial virus Memphis 37 grown in HEp-2 cells causes more severe disease in lambs than virus grown in vero cells

USDA-ARS?s Scientific Manuscript database

Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis in infants and young children. A small percentage of these individuals develop severe and even fatal disease. To better understand the pathogenesis of severe disease and develop therapies unique to the less-developed infan...

In situ immune response and mechanisms of cell damage in central nervous system of fatal cases microcephaly by Zika virus.

PubMed

Azevedo, Raimunda S S; de Sousa, Jorge R; Araujo, Marialva T F; Martins Filho, Arnaldo J; de Alcantara, Bianca N; Araujo, Fernanda M C; Queiroz, Maria G L; Cruz, Ana C R; Vasconcelos, Beatriz H Baldez; Chiang, Jannifer O; Martins, Lívia C; Casseb, Livia M N; da Silva, Eliana V; Carvalho, Valéria L; Vasconcelos, Barbara C Baldez; Rodrigues, Sueli G; Oliveira, Consuelo S; Quaresma, Juarez A S; Vasconcelos, Pedro F C

2018-01-08

Zika virus (ZIKV) has recently caused a pandemic disease, and many cases of ZIKV infection in pregnant women resulted in abortion, stillbirth, deaths and congenital defects including microcephaly, which now has been proposed as ZIKV congenital syndrome. This study aimed to investigate the in situ immune response profile and mechanisms of neuronal cell damage in fatal Zika microcephaly cases. Brain tissue samples were collected from 15 cases, including 10 microcephalic ZIKV-positive neonates with fatal outcome and five neonatal control flavivirus-negative neonates that died due to other causes, but with preserved central nervous system (CNS) architecture. In microcephaly cases, the histopathological features of the tissue samples were characterized in three CNS areas (meninges, perivascular space, and parenchyma). The changes found were mainly calcification, necrosis, neuronophagy, gliosis, microglial nodules, and inflammatory infiltration of mononuclear cells. The in situ immune response against ZIKV in the CNS of newborns is complex. Despite the predominant expression of Th2 cytokines, other cytokines such as Th1, Th17, Treg, Th9, and Th22 are involved to a lesser extent, but are still likely to participate in the immunopathogenic mechanisms of neural disease in fatal cases of microcephaly caused by ZIKV.

Pulmonary and central nervous system pathology in fatal cases of hand foot and mouth disease caused by enterovirus A71 infection.

PubMed

Wang, Zijun; Nicholls, John M; Liu, Fengfeng; Wang, Joshua; Feng, Zijian; Liu, Dongge; Sun, Yanni; Zhou, Cheng; Li, Yunqian; Li, Hai; Qi, Shunxiang; Huang, Xueyong; Sui, Jilin; Liao, Qiaohong; Peiris, Malik; Yu, Hongjie; Wang, Yu

2016-04-01

In the past 17 years, neurological disease associated with enterovirus A71 (EV-A71) has increased dramatically in the Asia-Pacific region with a high fatality rate in young infants, often due to pulmonary oedema, however the mechanism of this oedema remains obscure. We analysed the brainstem, heart and lungs of 15 fatal cases of confirmed EV-A71 infection in order to understand the pathophysiological mechanism of death and pulmonary oedema. In keeping with other case studies, the main cause of death was neurogenic pulmonary oedema. In the brainstem, 11 cases showed inflammation and all cases showed parenchymal inflammation with seven cases showing moderate or severe clasmatodendrosis. No viral antigen was detected in sections of the brainstem in any of the cases. All fatal cases showed evidence of pulmonary oedema; however, there was absence of direct pulmonary viral damage or myocarditis-induced damage and EV-A71 viral antigen staining was negative. Though there was no increase in staining for Na/K-ATPase, 11 of the 15 cases showed a marked reduction in aquaporin-4 staining in the lung, and this reduction may contribute to the development of fatal pulmonary oedema. Copyright © 2016. Published by Elsevier B.V.

Hepcidin-25 is related to cardiovascular events in chronic haemodialysis patients.

PubMed

van der Weerd, Neelke C; Grooteman, Muriel P C; Bots, Michiel L; van den Dorpel, Marinus A; den Hoedt, Claire H; Mazairac, Albert H A; Nubé, Menso J; Penne, E Lars; Wetzels, Jack F M; Wiegerinck, Erwin T; Swinkels, Dorine W; Blankestijn, Peter J; Ter Wee, Piet M

2013-12-01

The development of atherosclerosis may be enhanced by iron accumulation in macrophages. Hepcidin-25 is a key regulator of iron homeostasis, which downregulates the cellular iron exporter ferroportin. In haemodialysis (HD) patients, hepcidin-25 levels are increased. Therefore, it is conceivable that hepcidin-25 is associated with all-cause mortality and/or fatal and non-fatal cardiovascular (CV) events in this patient group. The aim of the current analysis was to study the relationship between hepcidin-25 and all-cause mortality and both fatal and non-fatal CV events in chronic HD patients. Data from 405 chronic HD patients included in the CONvective TRAnsport STudy (NCT00205556) were studied (62% men, age 63.7 ± 13.9 years [mean ± SD]). The median (range) follow-up was 3.0 (0.8-6.6) years. Hepcidin-25 was measured with mass spectrometry. The relationship between hepcidin-25 and all-cause mortality or fatal and non-fatal CV events was investigated with multivariate Cox proportional hazard models. Median (interquartile range) hepcidin-25 level was 13.8 (6.6-22.5) nmol/L. During follow-up, 158 (39%) patients died from any cause and 131 (32%) had a CV event. Hepcidin-25 was associated with all-cause mortality in an unadjusted model [hazard ratio (HR) 1.14 per 10 nmol/L, 95% CI 1.03-1.26; P = 0.01], but not after adjustment for all confounders including high-sensitive C-reactive protein (HR 1.02 per 10 nmol/L, 95% CI 0.87-1.20; P = 0.80). At the same time, hepcidin-25 was significantly related to fatal and non-fatal CV events in a fully adjusted model (HR 1.24 per 10 nmol/L, 95% CI 1.05-1.46, P = 0.01). Hepcidin-25 was associated with fatal and non-fatal CV events, even after adjustment for inflammation. Furthermore, inflammation appears to be a significant confounder in the relation between hepcidin-25 and all-cause mortality. These findings suggest that hepcidin-25 might be a novel determinant of CV disease in chronic HD patients.

Scrapie

USDA-ARS?s Scientific Manuscript database

Prion diseases are a heterogeneous group of transmissible spongiform encephalopathies (TSEs) that affect a variety of mammals, causing a slowly progressive and ultimately fatal, degenerative disease of the brain. Classical scrapie, commonly just referred to as ‘scrapie’, is a naturally transmissibl...

Do failures in non-technical skills contribute to fatal medical accidents in Japan? A review of the 2010-2013 national accident reports.

PubMed

Uramatsu, Masashi; Fujisawa, Yoshikazu; Mizuno, Shinya; Souma, Takahiro; Komatsubara, Akinori; Miki, Tamotsu

2017-02-16

We sought to clarify how large a proportion of fatal medical accidents can be considered to be caused by poor non-technical skills, and to support development of a policy to reduce number of such accidents by making recommendations about possible training requirements. Summaries of reports of fatal medical accidents, published by the Japan Medical Safety Research Organization, were reviewed individually. Three experienced clinicians and one patient safety expert conducted the reviews to determine the cause of death. Views of the patient safety expert were given additional weight in the overall determination. A total of 73 summary reports of fatal medical accidents were reviewed. These reports had been submitted by healthcare organisations across Japan to the Japan Medical Safety Research Organization between April 2010 and March 2013. The cause of death in fatal medical accidents, categorised into technical skills, non-technical skills and inevitable progress of disease were evaluated. Non-technical skills were further subdivided into situation awareness, decision making, communication, team working, leadership, managing stress and coping with fatigue. Overall, the cause of death was identified as non-technical skills in 34 cases (46.6%), disease progression in 33 cases (45.2%) and technical skills in two cases (5.5%). In two cases, no consensual determination could be achieved. Further categorisation of cases of non-technical skills were identified as 14 cases (41.2%) of problems with situation awareness, eight (23.5%) with team working and three (8.8%) with decision making. These three subcategories, or combinations of them, were identified as the cause of death in 33 cases (97.1%). Poor non-technical skills were considered to be a significant cause of adverse events in nearly half of the fatal medical accidents examined. Improving non-technical skills may be effective for reducing accidents, and training in particular subcategories of non-technical skills may be especially relevant. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Francisella tularensis Molecular Typing Using Differential Insertion Sequence Amplification

DTIC Science & Technology

2011-08-01

16 May 2011 Tularemia is a potentially fatal disease that is caused by the highly infectious and zoonotic pathogen Francisella tularensis. Despite...and characterizations of tularemia source outbreaks. Francisella tularensis is a facultative intracellular bacterium and the causative agent of the...zoonotic disease tularemia ( 10). This Gram-negative microbe is highly infectious, with as few as 10 organisms being capable of causing disease in

Should the chickenpox vaccine be included in the National Immunization Schedule in India?

PubMed

Verma, Ramesh; Bairwa, Mohan; Chawla, Suraj; Prinja, Shankar; Rajput, Meena

2011-08-01

Varicella (chickenpox) is an acute, highly contagious viral disease with worldwide distribution. The highest prevalence occurs in the 4-10 year age group but tends to be more severe in adults. It may be fatal in neonates, immunocompromised persons, and normal adults, especially smokers. Varicella is usually a benign childhood disease, and rarely rated as an important public health problem, but this can be severe and even fatal in otherwise healthy children (< 1 out of every 10,000 cases). Chickenpox can cause pneumonia (23 out of every 10,000 cases), and is an important risk factor for developing severe invasive "strep" (group A streptococcal disease). Complications of varicella include bacterial infections (up to 5% of cases), decreased platelets, arthritis, hepatitis, pneumonia (more commonly in adults) or encephalitis (1 in 10,000 cases), which may cause a failure of muscular coordination, sometimes resulting in persistent sequelae or death. Varicella is the leading cause of vaccine-preventable death in children. Universal vaccination can cause a dramatic reduction in the incidence of varicella, associated complications, hospitalizations and fatality rates. In India, due to the high cost of the vaccine, it would be difficult to vaccinate a large percentage of the children. The government of India should consider the inclusion of varicella vaccine in the National Immunization Schedule with the help of International agencies.

Diminished Disease-Free Survival After Lobectomy: Screening Implications.

PubMed

Reich, Jerome M; Kim, Jong S; Asaph, James W

2015-09-01

The aim of this study was to estimate the effect of lobectomy on life expectancy in healthy smokers and consider the implications for lung cancer screening. In a retrospective cohort study that provided a minimum of 15 years of follow-up, we analyzed lung cancer survival, all-cause survival, and fatality (1-survival) of 261 persons with stage I non-small-cell lung cancer who underwent lobectomy at Portland Providence Medical Center between 1978 and 1994. We: (1) compared 5-year disease-free fatality (non-lung-cancer fatality) with lung cancer fatality; and (2) based on actuarial data that demonstrated life expectancy equivalence of the healthiest smokers (whom we assumed would be comparable with subjects judged eligible for lobectomy) in the US population, we compared their long-term, disease-free survival (our primary end point) with actuarial expectations by computing the Kaplan-Meier survival function of the differences between lifetimes since surgery in disease-free persons versus matched, expected remaining lifetimes in the US population. (1) Five-year disease-free fatality (16.1%) was 58% as high as 5-year lung cancer fatality (27.6%); (2) disease-free survival was reduced by 6.9-years (95% confidence interval, 5.5-8.3), 41% of actuarial life expectancy (17 years). The divergence from expected survival took place largely after 6 years of follow-up. Lobectomy materially diminishes long-term disease-free survival in the healthiest smokers--persons judged healthy enough to tolerate major surgery and to have sufficient pulmonary reserve to sustain loss of one-fifth of their lung tissue. In screened populations, diminished survival in overdiagnosed persons will offset, to an undetermined extent, the mortality benefit imparted by preemption of advanced lung cancer. Copyright © 2015 Elsevier Inc. All rights reserved.

Mass spectrometric approaches to detecting prions and protein conformers

USDA-ARS?s Scientific Manuscript database

Transmissible spongiform encephalopathies (TSEs) can cause substantial economic damage to agriculture. These diseases have characteristically long incubation periods, comparatively short symptomatic intervals, and are invariably fatal. Early detection is important in controlling these diseases. Howe...

Statins for the primary prevention of cardiovascular disease

PubMed Central

Taylor, Fiona; Ward, Kirsten; Moore, Theresa HM; Burke, Margaret; Smith, George Davey; Casas, Juan P; Ebrahim, Shah

2014-01-01

Background Reducing high blood cholesterol, a risk factor for cardiovascular disease (CVD) events in people with and without a past history of coronary heart disease (CHD) is an important goal of pharmacotherapy. Statins are the first-choice agents. Previous reviews of the effects of statins have highlighted their benefits in people with coronary artery disease. The case for primary prevention, however, is less clear. Objectives To assess the effects, both harms and benefits, of statins in people with no history of CVD. Search methods To avoid duplication of effort, we checked reference lists of previous systematic reviews. We searched the Cochrane Central Register of Controlled Trials (Issue 1, 2007), MEDLINE (2001 to March 2007) and EMBASE (2003 to March 2007). There were no language restrictions. Selection criteria Randomised controlled trials of statins with minimum duration of one year and follow-up of six months, in adults with no restrictions on their total low density lipoprotein (LDL) or high density lipoprotein (HDL) cholesterol levels, and where 10% or less had a history of CVD, were included. Data collection and analysis Two authors independently selected studies for inclusion and extracted data. Outcomes included all cause mortality, fatal and non-fatal CHD, CVD and stroke events, combined endpoints (fatal and non-fatal CHD, CVD and stroke events), change in blood total cholesterol concentration, revascularisation, adverse events, quality of life and costs. Relative risk (RR) was calculated for dichotomous data, and for continuous data pooled weighted mean differences (with 95% confidence intervals) were calculated. Main results Fourteen randomised control trials (16 trial arms; 34,272 participants) were included. Eleven trials recruited patients with specific conditions (raised lipids, diabetes, hypertension, microalbuminuria). All-cause mortality was reduced by statins (RR 0.84, 95% CI 0.73 to 0.96) as was combined fatal and non-fatal CVD endpoints (RR 0.70, 95% CI 0.61 to 0.79). Benefits were also seen in the reduction of revascularisation rates (RR 0.66, 95% CI 0.53 to 0.83). Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects. There was no clear evidence of any significant harm caused by statin prescription or of effects on patient quality of life. Authors’ conclusions Reductions in all-cause mortality, major vascular events and revascularisations were found with no excess of cancers or muscle pain among people without evidence of cardiovascular disease treated with statins. Other potential adverse events were not reported and some trials included people with cardiovascular disease. Only limited evidence showed that primary prevention with statins may be cost effective and improve patient quality of life. Caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk. PMID:21249663

Risk factors for fatal outcome from rocky mountain spotted Fever in a highly endemic area-Arizona, 2002-2011.

PubMed

Regan, Joanna J; Traeger, Marc S; Humpherys, Dwight; Mahoney, Dianna L; Martinez, Michelle; Emerson, Ginny L; Tack, Danielle M; Geissler, Aimee; Yasmin, Seema; Lawson, Regina; Williams, Velda; Hamilton, Charlene; Levy, Craig; Komatsu, Ken; Yost, David A; McQuiston, Jennifer H

2015-06-01

Rocky Mountain spotted fever (RMSF) is a disease that now causes significant morbidity and mortality on several American Indian reservations in Arizona. Although the disease is treatable, reported RMSF case fatality rates from this region are high (7%) compared to the rest of the nation (<1%), suggesting a need to identify clinical points for intervention. The first 205 cases from this region were reviewed and fatal RMSF cases were compared to nonfatal cases to determine clinical risk factors for fatal outcome. Doxycycline was initiated significantly later in fatal cases (median, day 7) than nonfatal cases (median, day 3), although both groups of case patients presented for care early (median, day 2). Multiple factors increased the risk of doxycycline delay and fatal outcome, such as early symptoms of nausea and diarrhea, history of alcoholism or chronic lung disease, and abnormal laboratory results such as elevated liver aminotransferases. Rash, history of tick bite, thrombocytopenia, and hyponatremia were often absent at initial presentation. Earlier treatment with doxycycline can decrease morbidity and mortality from RMSF in this region. Recognition of risk factors associated with doxycycline delay and fatal outcome, such as early gastrointestinal symptoms and a history of alcoholism or chronic lung disease, may be useful in guiding early treatment decisions. Healthcare providers should have a low threshold for initiating doxycycline whenever treating febrile or potentially septic patients from tribal lands in Arizona, even if an alternative diagnosis seems more likely and classic findings of RMSF are absent. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Avian botulism: geographic expansion of a historic disease

USGS Publications Warehouse

Locke, Louis N.; Friend, Milton

1989-01-01

Avian botulism is a paralytic, often fatal disease of birds resulting from ingestion of toxin produced by the bacterium Clostridium botulinum. Waterfowl die-offs from the botulism are usually caused by type C toxin; sporadic die-offs among fish-eating birds, such as common loons (Gavia immer) and gulls, have been caused by type E toxin.

Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular events.

PubMed

Squizzato, Alessandro; Bellesini, Marta; Takeda, Andrea; Middeldorp, Saskia; Donadini, Marco Paolo

2017-12-14

Aspirin is the prophylactic antiplatelet drug of choice for people with cardiovascular disease. Adding a second antiplatelet drug to aspirin may produce additional benefit for people at high risk and people with established cardiovascular disease. This is an update to a previously published review from 2011. To review the benefit and harm of adding clopidogrel to aspirin therapy for preventing cardiovascular events in people who have coronary disease, ischaemic cerebrovascular disease, peripheral arterial disease, or were at high risk of atherothrombotic disease, but did not have a coronary stent. We updated the searches of CENTRAL (2017, Issue 6), MEDLINE (Ovid, 1946 to 4 July 2017) and Embase (Ovid, 1947 to 3 July 2017) on 4 July 2017. We also searched ClinicalTrials.gov and the WHO ICTRP portal, and handsearched reference lists. We applied no language restrictions. We included all randomised controlled trials comparing over 30 days use of aspirin plus clopidogrel with aspirin plus placebo or aspirin alone in people with coronary disease, ischaemic cerebrovascular disease, peripheral arterial disease, or at high risk of atherothrombotic disease. We excluded studies including only people with coronary drug-eluting stent (DES) or non-DES, or both. We collected data on mortality from cardiovascular causes, all-cause mortality, fatal and non-fatal myocardial infarction, fatal and non-fatal ischaemic stroke, major and minor bleeding. The overall treatment effect was estimated by the pooled risk ratio (RR) with 95% confidence interval (CI), using a fixed-effect model (Mantel-Haenszel); we used a random-effects model in cases of moderate or severe heterogeneity (I 2 ≥ 30%). We assessed the quality of the evidence using the GRADE approach. We used GRADE profiler (GRADE Pro) to import data from Review Manager to create a 'Summary of findings' table. The search identified 13 studies in addition to the two studies in the previous version of our systematic review. Overall, we included data from 15 trials with 33,970 people. We completed a 'Risk of bias' assessment for all studies. The risk of bias was low in four trials because they were at low risk of bias for all key domains (random sequence generation, allocation concealment, blinding, selective outcome reporting and incomplete outcome data), even if some of them were funded by the pharmaceutical industry.Analysis showed no difference in the effectiveness of aspirin plus clopidogrel in preventing cardiovascular mortality (RR 0.98, 95% CI 0.88 to 1.10; participants = 31,903; studies = 7; moderate quality evidence), and no evidence of a difference in all-cause mortality (RR 1.05, 95% CI 0.87 to 1.25; participants = 32,908; studies = 9; low quality evidence).There was a lower risk of fatal and non-fatal myocardial infarction with clopidogrel plus aspirin compared with aspirin plus placebo or aspirin alone (RR 0.78, 95% CI 0.69 to 0.90; participants = 16,175; studies = 6; moderate quality evidence). There was a reduction in the risk of fatal and non-fatal ischaemic stroke (RR 0.73, 95% CI 0.59 to 0.91; participants = 4006; studies = 5; moderate quality evidence).However, there was a higher risk of major bleeding with clopidogrel plus aspirin compared with aspirin plus placebo or aspirin alone (RR 1.44, 95% CI 1.25 to 1.64; participants = 33,300; studies = 10; moderate quality evidence) and of minor bleeding (RR 2.03, 95% CI 1.75 to 2.36; participants = 14,731; studies = 8; moderate quality evidence).Overall, we would expect 13 myocardial infarctions and 23 ischaemic strokes be prevented for every 1000 patients treated with the combination in a median follow-up period of 12 months, but 9 major bleeds and 33 minor bleeds would be caused during a median follow-up period of 10.5 and 6 months, respectively. The available evidence demonstrates that the use of clopidogrel plus aspirin in people at high risk of cardiovascular disease and people with established cardiovascular disease without a coronary stent is associated with a reduction in the risk of myocardial infarction and ischaemic stroke, and an increased risk of major and minor bleeding compared with aspirin alone. According to GRADE criteria, the quality of evidence was moderate for all outcomes except all-cause mortality (low quality evidence) and adverse events (very low quality evidence).

Risk Factors for Fatal Outcome From Rocky Mountain Spotted Fever in a Highly Endemic Area—Arizona, 2002–2011

PubMed Central

Regan, Joanna J.; Traeger, Marc S.; Humpherys, Dwight; Mahoney, Dianna L.; Martinez, Michelle; Emerson, Ginny L.; Tack, Danielle M.; Geissler, Aimee; Yasmin, Seema; Lawson, Regina; Williams, Velda; Hamilton, Charlene; Levy, Craig; Komatsu, Ken; Yost, David A.; McQuiston, Jennifer H.

2016-01-01

Background Rocky Mountain spotted fever (RMSF) is a disease that now causes significant morbidity and mortality on several American Indian reservations in Arizona. Although the disease is treatable, reported RMSF case fatality rates from this region are high (7%) compared to the rest of the nation (<1%), suggesting a need to identify clinical points for intervention. Methods The first 205 cases from this region were reviewed and fatal RMSF cases were compared to nonfatal cases to determine clinical risk factors for fatal outcome. Results Doxycycline was initiated significantly later in fatal cases (median, day 7) than nonfatal cases (median, day 3), although both groups of case patients presented for care early (median, day 2). Multiple factors increased the risk of doxycycline delay and fatal outcome, such as early symptoms of nausea and diarrhea, history of alcoholism or chronic lung disease, and abnormal laboratory results such as elevated liver aminotransferases. Rash, history of tick bite, thrombocytopenia, and hyponatremia were often absent at initial presentation. Conclusions Earlier treatment with doxycycline can decrease morbidity and mortality from RMSF in this region. Recognition of risk factors associated with doxycycline delay and fatal outcome, such as early gastrointestinal symptoms and a history of alcoholism or chronic lung disease, may be useful in guiding early treatment decisions. Healthcare providers should have a low threshold for initiating doxycycline whenever treating febrile or potentially septic patients from tribal lands in Arizona, even if an alternative diagnosis seems more likely and classic findings of RMSF are absent. PMID:25697742

[Morphological findings in fatal cases of hantavirus cardiopulmonary syndrome. Report of 7 autopsies].

PubMed

Guzmán G, Pablo; Tapia E, Oscar; Villaseca H, Miguel; Araya O, Juan; Antonio P, Lilia; Lee O, Bolívar; Roa S, Juan

2010-10-01

Hantavirus cardiopulmonary syndrome (HCPS) is an acute infectious disease characterized by sudden cardiorespiratory failure and high mortality, caused by a RNA virus of the genus Hantavirus, family Bunyaviridae, 15% of Chilean cases have been detected in the Araucania Region. To determine in fatal cases of HCPS, clinical and morphological characteristics. Descriptive-retrospective analysis of seven fatal cases with postmortem study of HCPS, attended between 1997 and 2009 at the Hospital of Temuco, Chile. Cases were young patients from rural areas, and presented as an illness of progressive respiratory failure, with leukocytosis, thrombocytopenia and bilateral interstitial pulmonary infiltrates. Main morphological findings were marked intersticial and intraalveolar pulmonary edema, with minimal epithelial injury and mononuclear cell intersticial infiltrate and mild edematous intersticial inflamatory process. Epidemiological, clinical and laboratory background allow to suspect HCPS. In fatal cases, the autopsy makes possible to discard other similar pathologies and provide tissue for confirmation of the disease.

Resting heart rate is a risk factor for mortality in chronic obstructive pulmonary disease, but not for exacerbations or pneumonia.

PubMed

Warnier, Miriam J; Rutten, Frans H; de Boer, Anthonius; Hoes, Arno W; De Bruin, Marie L

2014-01-01

Although it is known that patients with chronic obstructive pulmonary disease (COPD) generally do have an increased heart rate, the effects on both mortality and non-fatal pulmonary complications are unclear. We assessed whether heart rate is associated with all-cause mortality, and non-fatal pulmonary endpoints. A prospective cohort study of 405 elderly patients with COPD was performed. All patients underwent extensive investigations, including electrocardiography. Follow-up data on mortality were obtained by linking the cohort to the Dutch National Cause of Death Register and information on complications (exacerbation of COPD or pneumonia) by scrutinizing patient files of general practitioners. Multivariable cox regression analysis was performed. During the follow-up 132 (33%) patients died. The overall mortality rate was 50/1000 py (42-59). The major causes of death were cardiovascular and respiratory. The relative risk of all-cause mortality increased with 21% for every 10 beats/minute increase in heart rate (adjusted HR: 1.21 [1.07-1.36], p = 0.002). The incidence of major non-fatal pulmonary events was 145/1000 py (120-168). The risk of a non-fatal pulmonary complication increased non-significantly with 7% for every 10 beats/minute increase in resting heart rate (adjusted HR: 1.07 [0.96-1.18], p = 0.208). Increased resting heart rate is a strong and independent risk factor for all-cause mortality in elderly patients with COPD. An increased resting heart rate did not result in an increased risk of exacerbations or pneumonia. This may indicate that the increased mortality risk of COPD is related to non-pulmonary causes. Future randomized controlled trials are needed to investigate whether heart-rate lowering agents are worthwhile for COPD patients.

EARS2 mutations cause fatal neonatal lactic acidosis, recurrent hypoglycemia and agenesis of corpus callosum.

PubMed

Danhauser, Katharina; Haack, Tobias B; Alhaddad, Bader; Melcher, Marlen; Seibt, Annette; Strom, Tim M; Meitinger, Thomas; Klee, Dirk; Mayatepek, Ertan; Prokisch, Holger; Distelmaier, Felix

2016-06-01

Mitochondrial aminoacyl tRNA synthetases are essential for organelle protein synthesis. Genetic defects affecting the function of these enzymes may cause pediatric mitochondrial disease. Here, we report on a child with fatal neonatal lactic acidosis and recurrent hypoglycemia caused by mutations in EARS2, encoding mitochondrial glutamyl-tRNA synthetase 2. Brain ultrasound revealed agenesis of corpus callosum. Studies on patient-derived skin fibroblasts showed severely decreased EARS2 protein levels, elevated reactive oxygen species (ROS) production, and altered mitochondrial morphology. Our report further illustrates the clinical spectrum of the severe neonatal-onset form of EARS2 mutations. Moreover, in this case the live-cell parameters appeared to be more sensitive to mitochondrial dysfunction compared to standard diagnostics, which indicates the potential relevance of fibroblast studies in children with mitochondrial diseases.

[Cause of death related to medical disputes in Yancheng area: a study of 60 autopsy cases].

PubMed

Peng, Ming-Qi; Chen, Rong-Yu; Zhou, Lan; Zhang, Kai-Qiao; Shi, Jian-Song

2014-04-01

To summarize the pattern and main characteristics of fatal cases related to medical disputes in Yancheng area. Sixty fatal cases of medical disputes were retrospectively analyzed to elucidate the annual incidence, characters of distribution of hospitals, gender and age of the decedents, types of diseases, and cause of death. Among 60 fatal cases, most cases happened in health clinics of county, township and village. There were more males than females. The major medical specialties involved included internal medicine, surgery, gynecology and pediatrics, with the internal medicine specialty having the highest incidence. Police institutions have advantages in investigation of these cases in their jurisdictions, which could enhance the ability of local medicolegal examination.

Two faces of death: fatalities from disease and combat in America's principal wars, 1775 to present.

PubMed

Cirillo, Vincent J

2008-01-01

Throughout America's first 145 years of war, far more of the country's military personnel perished from infectious diseases than from enemy action. This enduring feature of war was finally reversed in World War II, chiefly as a result of major medical advances in prevention (vaccines) and treatment (antibiotics). Safeguarding the health of a command is indispensable for the success of any campaign. Wars are lost by disease, which causes an enormous drain on the military's resources and affects both strategy and tactics. Disease and combat mortality data from America's principal wars (1775-present) fall into two clearly defined time periods: the Disease Era (1775-1918), during which infectious diseases were the major killer of America's armed forces, and the Trauma Era (1941-present), in which combat-related fatalities predominated. The trend established in World War II continues to the present day. Although there are currently more than 3,400 U.S. military fatalities in Iraq, the disease-death toll is so low that it is exceeded by the number of suicides.

Screening for coronary artery disease in patients with type 2 diabetes: a meta-analysis and trial sequential analysis

PubMed Central

Leitão, Cristiane B; Gross, Jorge L

2017-01-01

Objective To evaluate the efficacy of coronary artery disease screening in asymptomatic patients with type 2 diabetes and assess the statistical reliability of the findings. Methods Electronic databases (MEDLINE, EMBASE, Cochrane Library and clinicaltrials.org) were reviewed up to July 2016. Randomised controlled trials evaluating coronary artery disease screening in asymptomatic patients with type 2 diabetes and reporting cardiovascular events and/or mortality were included. Data were summarised with Mantel-Haenszel relative risk. Trial sequential analysis (TSA) was used to evaluate the optimal sample size to detect a 40% reduction in outcomes. Main outcomes were all-cause mortality and cardiac events (non-fatal myocardial infarction and cardiovascular death); secondary outcomes were non-fatal myocardial infarction, myocardial revascularisations and heart failure. Results One hundred thirty-five references were identified and 5 studies fulfilled the inclusion criteria and totalised 3315 patients, 117 all-cause deaths and 100 cardiac events. Screening for coronary artery disease was not associated with decrease in risk for all-cause deaths (RR 0.95(95% CI 0.66 to 1.35)) or cardiac events (RR 0.72(95% CI 0.49 to 1.06)). TSA shows that futility boundaries were reached for all-cause mortality and a relative risk reduction of 40% between treatments could be discarded. However, there is not enough information for firm conclusions for cardiac events. For secondary outcomes no benefit or harm was identified; optimal sample sizes were not reached. Conclusion Current available data do not support screening for coronary artery disease in patients with type 2 diabetes for preventing fatal events. Further studies are needed to assess the effects on cardiac events. PROSPERO CRD42015026627. PMID:28490559

Disease patterns and causes of death of hospitalized HIV-positive adults in West Africa: a multicountry survey in the antiretroviral treatment era.

PubMed

Lewden, Charlotte; Drabo, Youssoufou J; Zannou, Djimon M; Maiga, Moussa Y; Minta, Daouda K; Sow, Papa S; Akakpo, Jocelyn; Dabis, François; Eholié, Serge P

2014-01-01

We aimed to describe the morbidity and mortality patterns in HIV-positive adults hospitalized in West Africa. We conducted a six-month prospective multicentre survey within the IeDEA West Africa collaboration in six adult medical wards of teaching hospitals in Abidjan, Ouagadougou, Cotonou, Dakar and Bamako. From April to October 2010, all newly hospitalized HIV-positive patients were eligible. Baseline and follow-up information until hospital discharge was recorded using standardized forms. Diagnoses were reviewed by a local event validation committee using reference definitions. Factors associated with in-hospital mortality were studied with a logistic regression model. Among 823 hospitalized HIV-positive adults (median age 40 years, 58% women), 24% discovered their HIV infection during the hospitalization, median CD4 count was 75/mm(3) (IQR: 25-177) and 48% had previously received antiretroviral treatment (ART). The underlying causes of hospitalization were AIDS-defining conditions (54%), other infections (32%), other diseases (8%) and non-specific illness (6%). The most frequent diseases diagnosed were: tuberculosis (29%), pneumonia (15%), malaria (10%) and cerebral toxoplasmosis (10%). Overall, 315 (38%) patients died during hospitalization and the underlying cause of death was AIDS (63%), non-AIDS-defining infections (26%), other diseases (7%) and non-specific illness or unknown cause (4%). Among them, the most frequent fatal diseases were: tuberculosis (36%), cerebral toxoplasmosis (10%), cryptococcosis (9%) and sepsis (7%). Older age, clinical WHO stage 3 and 4, low CD4 count, and AIDS-defining infectious diagnoses were associated with hospital fatality. AIDS-defining conditions, primarily tuberculosis, and bacterial infections were the most frequent causes of hospitalization in HIV-positive adults in West Africa and resulted in high in-hospital fatality. Sustained efforts are needed to integrate care of these disease conditions and optimize earlier diagnosis of HIV infection and initiation of ART.

Newcastle disease virus detection and differentiation from avian influenza

USDA-ARS?s Scientific Manuscript database

Newcastle disease (ND) is a contagious and often fatal disease that affects over 250 bird species worldwide, and is caused by infection with virulent strains of avian paramyxovirus-1 (APMV-1) of the family Paramyxoviridae, genus Avulavirus. Infections of poultry with virulent strains of APMV-1 (New...

The most important parasites in Serbia involving the foodborne route of transmission

NASA Astrophysics Data System (ADS)

Petrović, J. M.; Prodanov-Radulović, J. Z.; Vasilev, S. D.

2017-09-01

Food can be an important route for transmission of parasites to humans. Compared to other foodborne pathogens in Serbia, foodborne (or potentially foodborne) parasites do not get the attention they undoubtedly deserve. The aim of this article is to give an overview of the most important parasitic pathogens that can be transmitted by food, and that cause disease in humans: Echinococcus, Trichinella, Taenia solium and Toxoplasma gondii. For each of these pathogens, the severity of human diseases they cause, incidence, mortality and case fatality rate among humans in Serbia as well as their prevalence in animal species in Serbia are described. Some of the described foodborne parasites can induce severe disease symptoms in humans associated with high case fatality rates, while others can cause massive outbreaks. All of the aforementioned parasites occur throughout Serbia and cause both severe public health problems and substantial economic losses in livestock production. In conclusion, the control measures of foodborne parasites certainly need to include education of farmers and improvement of veterinary sanitary measures in animal farming and animal waste control.

Mutation of NLRC4 causes a syndrome of enterocolitis and autoinflammation

PubMed Central

Nelson-Williams, Carol; Stiegler, Amy L; Loring, Erin; Choi, Murim; Overton, John; Meffre, Eric; Khokha, Mustafa K; Huttner, Anita J; West, Brian; Podoltsev, Nikolai A; Boggon, Titus J; Kazmierczak, Barbara I; Lifton, Richard P

2014-01-01

Upon detection of pathogen-associated molecular patterns, innate immune receptors initiate inflammatory responses. These receptors include cytoplasmic NOD-like receptors (NLRs), whose stimulation recruits and proteolytically activates caspase-1 within the inflammasome, a multi-protein complex. Caspase-1 mediates the production of interleukin-1 family cytokines (IL1FCs), leading to fever, and inflammatory cell death (pyroptosis)1,2. Mutations that constitutively activate these pathways underlie several autoinflammatory diseases with diverse clinical features3. We describe a family with a previously unreported syndrome featuring neonatal-onset enterocolitis, periodic fever, and fatal/near-fatal episodes of autoinflammation caused by a de novo gain-of-function mutation (p.V341A) in the HD1 domain of NLRC4 that co-segregates with disease. Mutant NLRC4 causes constitutive Interleukin-1 family cytokine production and macrophage cell death. Infected patient macrophages are polarized toward pyroptosis and exhibit abnormal staining for inflammasome components. These findings describe and reveal the cause of a life-threatening but treatable autoinflammatory disease that underscores the divergent roles of the NLRC4 inflammasome. PMID:25217960

Jane Austen's lifelong health problems and final illness: New evidence points to a fatal Hodgkin's disease and excludes the widely accepted Addison's.

PubMed

Upfal, A

2005-06-01

Jane Austen is typically described as having excellent health until the age of 40 and the onset of a mysterious and fatal illness, initially identified by Sir Zachary Cope in 1964 as Addison's disease. Her biographers, deceived both by Cassandra Austen's destruction of letters containing medical detail, and the cheerful high spirits of the existing letters, have seriously underestimated the extent to which illness affected Austen's life. A medical history reveals that she was particularly susceptible to infection, and suffered unusually severe infective illnesses, as well as a chronic conjunctivitis that impeded her ability to write. There is evidence that Austen was already suffering from an immune deficiency and fatal lymphoma in January 1813, when her second and most popular novel, Pride and Prejudice, was published. Four more novels would follow, written or revised in the shadow of her increasing illness and debility. Whilst it is impossible now to conclusively establish the cause of her death, the existing medical evidence tends to exclude Addison's disease, and suggests there is a high possibility that Jane Austen's fatal illness was Hodgkin's disease, a form of lymphoma.

A Case of Fatal Serotonin Syndrome-Like Human Rabies Caused by Tricolored Bat-Associated Rabies Virus.

PubMed

Regunath, Hariharan; Chinnakotla, Bhavana; Rojas-Moreno, Christian; Salzer, William; Hughes, Natalie J; Sangha, Harbaksh

2016-06-01

Human rabies is a fatal disease, transmitted by saliva of infected animals, and the diagnosis requires a high index of suspicion. Very few cases are reported annually in the United States. We present a case of human rabies without a clear exposure history that masqueraded as serotonin syndrome. © The American Society of Tropical Medicine and Hygiene.

Anticipating Viral Species Jumps: Bioinformatics and Data Needs

DTIC Science & Technology

2011-06-01

FIELD SAMPLING PLAN There are historical examples of viral species jumps that have profoundly affected human society, the most recent being the...Henipaviruses are an important group of emerging zoonotic RNA viruses whose primary hosts are large fruit bats of the genus Pteropus. Henipaviruses...2008). Hendra viruses from Australian fruit bats have caused small, isolated fatal disease outbreaks among horses and fatal spillover cases among

Porcine models of muscular dystrophy

USDA-ARS?s Scientific Manuscript database

Duchenne muscular dystrophy is a progressive, fatal, X-linked disease caused by a failure to accumulate the cytoskeletal protein, dystrophin. This disease is modeled by a variety of animal models including several fish models, mice, rats, and dogs. While these models have contributed substantially t...

Protothecosis in hematopoietic stem cell transplantation: case report and review of previous cases.

PubMed

Macesic, N; Fleming, S; Kidd, S; Madigan, V; Chean, R; Ritchie, D; Slavin, M

2014-06-01

Prototheca species are achlorophyllus algae. Prototheca wickerhamii and Prototheca zopfii cause human disease. In immunocompetent individuals, they cause soft tissue infections and olecranon bursitis, but in transplant recipients, these organisms can cause disseminated disease. We report a fatal case of disseminated P. zopfii infection in an hematopoietic stem cell transplant (HSCT) recipient with bloodstream infection and involvement of multiple soft tissue sites. We review all previous cases of protothecosis in HSCT reported in the literature. Protothecosis is uncommon after HSCT, but has a disseminated presentation that is frequently fatal. It is commonly misidentified as a yeast. Tumor necrosis factor-alpha inhibitors and contamination of central venous catheters may contribute to development of protothecosis. Optimal treatment approaches are yet to be defined. New agents such as miltefosine may be possible future therapies. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Sapstreak disease of sugar maple

Treesearch

James W. Walters

1992-01-01

Sapstreak is a fatal disease of sugar maple that usually enters the tree through basal trunk scars or root wounds. The disease most often affects large, wounded trees left after logging. The fungus causing sapstreak readily infects stumps or cut logs during the summer months. So, wounding sugar maples during this time will increase the potential for disease spread. In...

Unraveling the Mystery of an Environmental Disease

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grollman, Arthur

For many years, residents of farming villages along the Danube River basin suffered from a fatal kidney disease and an associated urinary tract cancer. The cause of the disease remained a mystery for more than 50 years. Recently, however, Arthur Grollman and his colleagues have determined that home-baked bread is implicated in the disease, known as Balkan endemic nephropathy.

Interferon gamma responses to proteome-determined specific recombinant proteins: Potential as diagnostic markers for ovine Johne's disease

USDA-ARS?s Scientific Manuscript database

Johne’s disease (JD), or paratuberculosis is a fatal chronic granulomatous enteritis of animals caused by infection with Mycobacterium avium subspecies paratuberculosis (Map). A long subclinical phase may ensue during which time the animal shows no signs of clinical disease. Diagnosis of JD is probl...

Serological survey of dogs from Egypt for antibodies to Leishmania spp.

USDA-ARS?s Scientific Manuscript database

Leishmaniasis is an insect-transmitted parasitic disease with worldwide distribution. Leishmania spp. infections cause a broad spectrum of clinical signs ranging from skin lesions to fatal visceral disease. Dogs are a major reservoir host for visceral leishmaniasis in humans. Leishmaniasis is endemi...

Cytokines as biomarkers of Crimean-Congo hemorrhagic fever.

PubMed

Papa, Anna; Tsergouli, Katerina; Çağlayık, Dilek Yağcı; Bino, Silvia; Como, Najada; Uyar, Yavuz; Korukluoglu, Gulay

2016-01-01

Crimean-Congo hemorrhagic fever (CCHF) is a potentially severe disease caused by CCHF virus. As in other viral hemorrhagic fevers, it is considered that the course and outcome of the disease depend on the viral load and the balance among the immune response mediators, and that a fatal outcome is the result of a "cytokine storm." The level of 27 cytokines was measured in serum samples taken from 29 patients during the acute phase of the disease. Two cases were fatal. Among survivors, significant differences between severe and non-severe cases were observed in the levels of IP-10, and MCP-1, while the levels of IL-1b, IL-5, IL-6, IL-8, IL-9, IL-10, IL-15, IP-10, MCP-1, TNF-α, and RANTES differed significantly between fatal and non-fatal cases (P < 0.05). RANTES was negatively correlated with the outcome of the disease. A striking similarity with the cytokine patterns seen in Ebola virus disease was observed. A weak Th1 immune response was seen. The viral load was positively correlated with IL-10, IP-10, and MCP-1 levels, and negatively correlated with the ratio IL-12/IL-10. Especially IP-10 and MCP-1 were significantly associated with the viral load, the severity and outcome of the disease, and they could act as biomarkers and, probably, as potential targets for treatment strategies design. © 2015 Wiley Periodicals, Inc.

New arenavirus isolated in Brazil

PubMed Central

Coimbra, Terezinha Lisieux M; Nassar, Elza S; Burattini, Marcelo N; de Souza, Luiza Terezinha Madia; Ferreira, Ivani B; Rocco, Iray M; Travassos da Rosa, Amelia P A; Vasconcelos, Pedro F C; Pinheiro, Francisco P; LeDuc, James W; Rico-Hesse, Rebeca; Gonzalez, Jean-Paul; Jahrling, Peter B

2012-01-01

A new arenavirus, called Sabiá, was isolated in Brazil from a fatal case of haemorrhagic fever initially thought to be yellow fever. Antigenic and molecular characterisation indicated that Sabiá virus is a new member of the Tacaribe complex. A laboratory technician working with the agent was also infected and developed a prolonged, non-fatal influenza-like illness. Sabiá virus is yet another arenavirus causing human disease in South America. PMID:7905555

Natural history of coronary heart disease and heart disease of uncertain etiology: Findings from a 50-year population study.

PubMed

Puddu, Paolo Emilio; Menotti, Alessandro

2015-10-15

To describe the natural history of common heart disease incidence on a population study. A sample of 1712 men aged 40-59 was enrolled in 1960 and followed-up for 50years. Coronary heart disease (CHD) was categorized if manifested as sudden death, fatal and non-fatal myocardial infarction and other acute coronary syndromes, and as Heart Disease of Uncertain Etiology (HDUE) if manifested as heart failure, chronic arrhythmia, blocks, diagnoses of chronic CHD or hypertensive heart disease. Their characteristics and prognosis in terms of age at event, mortality and expectancy of life up to 50years were analyzed. Incidence of first CHD and HDUE event or diagnosis was of 26.9 and 20.6%, respectively. First events were equally manifested as fatal or non-fatal occurrences among CHD, while non-fatal occurrences were almost always observed among HDUE. Cases of HDUE presented at a more advanced age and also average age at death was significantly more advanced than in CHD, respectively around 79 and 76years. Expectancy of life was significantly longer for HDUE (30.7years) than for CHD (27.6years). Strokes were more frequently ascertained among HDUE (14%) while 14% of death causes were due to cancer in both CHD and HDUE. Cancers were much higher (40%) among those never diagnosed CHD or HDUE who also had more stroke-due deaths (17%). This is the first investigation to report heart disease incidence and its natural history in a quasi-extinction cohort data from Italy in a pre-cardiac surgery era. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Salmonella, Shigella, and Yersinia

PubMed Central

Dekker, John; Frank, Karen

2015-01-01

Synopsis Salmonella, Shigella, and Yersinia cause a well-characterized spectrum of disease in humans, ranging from asymptomatic carriage to hemorrhagic colitis and fatal typhoidal fever. These pathogens are responsible for millions of cases of food-borne illness in the U.S. each year, with substantial costs measured in hospitalizations and lost productivity. In the developing world, illness caused by these pathogens is not only more prevalent, but is also associated with a greater case-fatality rate. Classical methods for identification rely on selective media and serology, but newer methods based on mass spectrometry and PCR show great promise for routine clinical testing. PMID:26004640

Vaccination of Ferrets for Rabies and Distemper.

PubMed

Wade, Laura L

2018-01-01

Companion ferrets need to be vaccinated against 2 viral diseases that cause neurologic illness: canine distemper and rabies. Although not common in ferrets, both viruses are fatal in ferrets and rabies virus is also fatal in humans. In this article, we provide a basic review of the 2 diseases, highlighting key neurologic concerns. We also review and update current vaccine concerns from a practitioner's perspective, including available vaccines, vaccine schedule recommendations, vaccine reactions, and risk assessment. Last, we mention the ferret and its use in cutting-edge vaccine development. Copyright © 2017 Elsevier Inc. All rights reserved.

Clinical manifestations and management of four children with Pearson syndrome.

PubMed

Tumino, Manuela; Meli, Concetta; Farruggia, Piero; La Spina, Milena; Faraci, Maura; Castana, Cinzia; Di Raimondo, Vincenzo; Alfano, Marivana; Pittalà, Annarita; Lo Nigro, Luca; Russo, Giovanna; Di Cataldo, Andrea

2011-12-01

Pearson marrow-pancreas syndrome is a fatal disorder mostly diagnosed during infancy and caused by mutations of mitochondrial DNA. We hereby report on four children affected by Pearson syndrome with hematological disorders at onset. The disease was fatal to three of them and the fourth one, who received hematopoietic stem cell transplantation, died of secondary malignancy. In this latter patient transplantation corrected hematological and non-hematological issues like metabolic acidosis, and we therefore argue that it could be considered as a useful option in an early stage of the disease. Copyright © 2011 Wiley Periodicals, Inc.

Pupil - white spots

MedlinePlus

... a white pupil or cloudy cornea needs immediate attention, preferably from an eye specialist. It is important to get diagnosed early if the problem is caused by retinoblastoma since this disease can be fatal.

Gas gangrene (image)

MedlinePlus

Gas gangrene is a severe form of gangrene (tissue death) caused by the bacterium Clostridium perfringens. Patients with ... vascular diseases are more prone to spontaneously develop gas gangrene, which is rapidly progressive and often fatal.

Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

PubMed

Vos, Theo; Flaxman, Abraham D; Naghavi, Mohsen; Lozano, Rafael; Michaud, Catherine; Ezzati, Majid; Shibuya, Kenji; Salomon, Joshua A; Abdalla, Safa; Aboyans, Victor; Abraham, Jerry; Ackerman, Ilana; Aggarwal, Rakesh; Ahn, Stephanie Y; Ali, Mohammed K; Alvarado, Miriam; Anderson, H Ross; Anderson, Laurie M; Andrews, Kathryn G; Atkinson, Charles; Baddour, Larry M; Bahalim, Adil N; Barker-Collo, Suzanne; Barrero, Lope H; Bartels, David H; Basáñez, Maria-Gloria; Baxter, Amanda; Bell, Michelle L; Benjamin, Emelia J; Bennett, Derrick; Bernabé, Eduardo; Bhalla, Kavi; Bhandari, Bishal; Bikbov, Boris; Bin Abdulhak, Aref; Birbeck, Gretchen; Black, James A; Blencowe, Hannah; Blore, Jed D; Blyth, Fiona; Bolliger, Ian; Bonaventure, Audrey; Boufous, Soufiane; Bourne, Rupert; Boussinesq, Michel; Braithwaite, Tasanee; Brayne, Carol; Bridgett, Lisa; Brooker, Simon; Brooks, Peter; Brugha, Traolach S; Bryan-Hancock, Claire; Bucello, Chiara; Buchbinder, Rachelle; Buckle, Geoffrey; Budke, Christine M; Burch, Michael; Burney, Peter; Burstein, Roy; Calabria, Bianca; Campbell, Benjamin; Canter, Charles E; Carabin, Hélène; Carapetis, Jonathan; Carmona, Loreto; Cella, Claudia; Charlson, Fiona; Chen, Honglei; Cheng, Andrew Tai-Ann; Chou, David; Chugh, Sumeet S; Coffeng, Luc E; Colan, Steven D; Colquhoun, Samantha; Colson, K Ellicott; Condon, John; Connor, Myles D; Cooper, Leslie T; Corriere, Matthew; Cortinovis, Monica; de Vaccaro, Karen Courville; Couser, William; Cowie, Benjamin C; Criqui, Michael H; Cross, Marita; Dabhadkar, Kaustubh C; Dahiya, Manu; Dahodwala, Nabila; Damsere-Derry, James; Danaei, Goodarz; Davis, Adrian; De Leo, Diego; Degenhardt, Louisa; Dellavalle, Robert; Delossantos, Allyne; Denenberg, Julie; Derrett, Sarah; Des Jarlais, Don C; Dharmaratne, Samath D; Dherani, Mukesh; Diaz-Torne, Cesar; Dolk, Helen; Dorsey, E Ray; Driscoll, Tim; Duber, Herbert; Ebel, Beth; Edmond, Karen; Elbaz, Alexis; Ali, Suad Eltahir; Erskine, Holly; Erwin, Patricia J; Espindola, Patricia; Ewoigbokhan, Stalin E; Farzadfar, Farshad; Feigin, Valery; Felson, David T; Ferrari, Alize; Ferri, Cleusa P; Fèvre, Eric M; Finucane, Mariel M; Flaxman, Seth; Flood, Louise; Foreman, Kyle; Forouzanfar, Mohammad H; Fowkes, Francis Gerry R; Franklin, Richard; Fransen, Marlene; Freeman, Michael K; Gabbe, Belinda J; Gabriel, Sherine E; Gakidou, Emmanuela; Ganatra, Hammad A; Garcia, Bianca; Gaspari, Flavio; Gillum, Richard F; Gmel, Gerhard; Gosselin, Richard; Grainger, Rebecca; Groeger, Justina; Guillemin, Francis; Gunnell, David; Gupta, Ramyani; Haagsma, Juanita; Hagan, Holly; Halasa, Yara A; Hall, Wayne; Haring, Diana; Haro, Josep Maria; Harrison, James E; Havmoeller, Rasmus; Hay, Roderick J; Higashi, Hideki; Hill, Catherine; Hoen, Bruno; Hoffman, Howard; Hotez, Peter J; Hoy, Damian; Huang, John J; Ibeanusi, Sydney E; Jacobsen, Kathryn H; James, Spencer L; Jarvis, Deborah; Jasrasaria, Rashmi; Jayaraman, Sudha; Johns, Nicole; Jonas, Jost B; Karthikeyan, Ganesan; Kassebaum, Nicholas; Kawakami, Norito; Keren, Andre; Khoo, Jon-Paul; King, Charles H; Knowlton, Lisa Marie; Kobusingye, Olive; Koranteng, Adofo; Krishnamurthi, Rita; Lalloo, Ratilal; Laslett, Laura L; Lathlean, Tim; Leasher, Janet L; Lee, Yong Yi; Leigh, James; Lim, Stephen S; Limb, Elizabeth; Lin, John Kent; Lipnick, Michael; Lipshultz, Steven E; Liu, Wei; Loane, Maria; Ohno, Summer Lockett; Lyons, Ronan; Ma, Jixiang; Mabweijano, Jacqueline; MacIntyre, Michael F; Malekzadeh, Reza; Mallinger, Leslie; Manivannan, Sivabalan; Marcenes, Wagner; March, Lyn; Margolis, David J; Marks, Guy B; Marks, Robin; Matsumori, Akira; Matzopoulos, Richard; Mayosi, Bongani M; McAnulty, John H; McDermott, Mary M; McGill, Neil; McGrath, John; Medina-Mora, Maria Elena; Meltzer, Michele; Mensah, George A; Merriman, Tony R; Meyer, Ana-Claire; Miglioli, Valeria; Miller, Matthew; Miller, Ted R; Mitchell, Philip B; Mocumbi, Ana Olga; Moffitt, Terrie E; Mokdad, Ali A; Monasta, Lorenzo; Montico, Marcella; Moradi-Lakeh, Maziar; Moran, Andrew; Morawska, Lidia; Mori, Rintaro; Murdoch, Michele E; Mwaniki, Michael K; Naidoo, Kovin; Nair, M Nathan; Naldi, Luigi; Narayan, K M Venkat; Nelson, Paul K; Nelson, Robert G; Nevitt, Michael C; Newton, Charles R; Nolte, Sandra; Norman, Paul; Norman, Rosana; O'Donnell, Martin; O'Hanlon, Simon; Olives, Casey; Omer, Saad B; Ortblad, Katrina; Osborne, Richard; Ozgediz, Doruk; Page, Andrew; Pahari, Bishnu; Pandian, Jeyaraj Durai; Rivero, Andrea Panozo; Patten, Scott B; Pearce, Neil; Padilla, Rogelio Perez; Perez-Ruiz, Fernando; Perico, Norberto; Pesudovs, Konrad; Phillips, David; Phillips, Michael R; Pierce, Kelsey; Pion, Sébastien; Polanczyk, Guilherme V; Polinder, Suzanne; Pope, C Arden; Popova, Svetlana; Porrini, Esteban; Pourmalek, Farshad; Prince, Martin; Pullan, Rachel L; Ramaiah, Kapa D; Ranganathan, Dharani; Razavi, Homie; Regan, Mathilda; Rehm, Jürgen T; Rein, David B; Remuzzi, Guiseppe; Richardson, Kathryn; Rivara, Frederick P; Roberts, Thomas; Robinson, Carolyn; De Leòn, Felipe Rodriguez; Ronfani, Luca; Room, Robin; Rosenfeld, Lisa C; Rushton, Lesley; Sacco, Ralph L; Saha, Sukanta; Sampson, Uchechukwu; Sanchez-Riera, Lidia; Sanman, Ella; Schwebel, David C; Scott, James Graham; Segui-Gomez, Maria; Shahraz, Saeid; Shepard, Donald S; Shin, Hwashin; Shivakoti, Rupak; Singh, David; Singh, Gitanjali M; Singh, Jasvinder A; Singleton, Jessica; Sleet, David A; Sliwa, Karen; Smith, Emma; Smith, Jennifer L; Stapelberg, Nicolas J C; Steer, Andrew; Steiner, Timothy; Stolk, Wilma A; Stovner, Lars Jacob; Sudfeld, Christopher; Syed, Sana; Tamburlini, Giorgio; Tavakkoli, Mohammad; Taylor, Hugh R; Taylor, Jennifer A; Taylor, William J; Thomas, Bernadette; Thomson, W Murray; Thurston, George D; Tleyjeh, Imad M; Tonelli, Marcello; Towbin, Jeffrey A; Truelsen, Thomas; Tsilimbaris, Miltiadis K; Ubeda, Clotilde; Undurraga, Eduardo A; van der Werf, Marieke J; van Os, Jim; Vavilala, Monica S; Venketasubramanian, N; Wang, Mengru; Wang, Wenzhi; Watt, Kerrianne; Weatherall, David J; Weinstock, Martin A; Weintraub, Robert; Weisskopf, Marc G; Weissman, Myrna M; White, Richard A; Whiteford, Harvey; Wiersma, Steven T; Wilkinson, James D; Williams, Hywel C; Williams, Sean R M; Witt, Emma; Wolfe, Frederick; Woolf, Anthony D; Wulf, Sarah; Yeh, Pon-Hsiu; Zaidi, Anita K M; Zheng, Zhi-Jie; Zonies, David; Lopez, Alan D; Murray, Christopher J L; AlMazroa, Mohammad A; Memish, Ziad A

2012-12-15

Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs). Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis. Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350,000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient -0·37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa. Rates of YLDs per 100,000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Effective and affordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world. Bill & Melinda Gates Foundation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Ground verification of aerial for Port-Orford-cedar root disease in Southwest Oregon.

Treesearch

A. Kanaskie; M. McWilliams; D. Overhulser; J. Prukop; R. Christian; S. Malvitch

2002-01-01

Port-Orford-cedar (POC) (Chamaecyparis lawsoniana) is limited in its natural range to southwest Oregon and northwest California. It is highly susceptible to the introduced root pathogen, Phytophthora lateralis, which causes a fatal root disease throughout most of its range. The disease is transmitted by movement of infested soil and water and is...

[Adult respiratory distress syndrome as a complication of infectious mononucleosis].

PubMed

Storm, W; Jorch, G

1987-09-01

We describe a three-year-old boy with clinical findings of infectious mononucleosis, but no serologic proof in the beginning of his disease. The subsequent course was complicated by fatal pulmonary complications compatible with an adult respiratory distress syndrome (ARDS). Repeat serologic tests for Epstein-Barr virus finally could confirm the diagnosis of infectious mononucleosis. Thus, ARDS has to be added to the possible rare causes of fulminant, fatal cases of infectious mononucleosis.

Interstitial lung disease caused by TS-1: a case of long-term drug retention as a fatal adverse reaction.

PubMed

Park, Joong-Min; Hwang, In Gyu; Suh, Suk-Won; Chi, Kyong-Choun

2011-12-01

TS-1 is an oral anti-cancer agent for gastric cancer with a high response rate and low toxicity. We report a case of long-term drug retention of TS-1 causing interstitial lung disease (ILD) as a fatal adverse reaction. A 65-year-old woman underwent a total gastrectomy with pathologic confirmation of gastric adenocarcinoma. She received 6 cycles of TS-1 and low-dose cisplatin for post-operative adjuvant chemotherapy followed by single-agent maintenance therapy with TS-1. After 8 months, the patient complained of a productive cough with sputum and mild dyspnea. A pulmonary evaluation revealed diffuse ILD in the lung fields, bilaterally. In spite of discontinuing chemotherapy and the administration of corticosteroids, the pulmonary symptoms did not improve, and the patient died of pulmonary failure. TS-1-induced ILD can be caused by long-term drug retention that alters the lung parenchyma irreversibly, the outcome of which can be life-threatening. Pulmonary evaluation for early detection of disease is recommended.

Comparison of Rift Valley fever virus replication in North American livestock and wildlife cell lines

USDA-ARS?s Scientific Manuscript database

Rift Valley fever virus (RVFV) causes outbreaks of endemic disease across Africa and the Arabian Peninsula, resulting in high morbidity and mortality among young domestic livestock, frequent abortions in pregnant animals, and potentially severe or fatal disease in humans. The possibility of RVFV spr...

Cranial Mesenteric Arterial Obstruction Due To Strongylus vulgaris Larvae in a Donkey (Equus asinus).

PubMed

Borji, Hassan; Moosavi, Zahra; Ahmadi, Fatemeh

2014-09-01

Arteritis due to Strongylus vulgaris is a well-known cause of colic in horses and donkeys. The current report describes a fatal incidence of arterial obstruction in cranial mesenteric artery caused by S. vulgaris infection in an adult donkey in which anthelmintic treatment was not regularly administered. Necropsy findings of the abdominal cavity revealed a complete cranial mesenteric arterial obstruction due to larvae of S. vulgaris, causing severe colic. To the authors' knowledge, a complete cranial mesenteric arterial obstruction due to verminous arteritis has rarely been described in horses and donkeys. Based on recent reports of fatal arterial obstruction due to S. vulgaris infection in donkeys, it may be evident to consider acute colic caused by this pathogenic parasite a re-emerging disease in donkeys and horses.

Japanese encephalitis virus infection, diagnosis and control in domestic animals.

PubMed

Mansfield, Karen L; Hernández-Triana, Luis M; Banyard, Ashley C; Fooks, Anthony R; Johnson, Nicholas

2017-03-01

Japanese encephalitis virus (JEV) is a significant cause of neurological disease in humans throughout Asia causing an estimated 70,000 human cases each year with approximately 10,000 fatalities. The virus contains a positive sense RNA genome within a host-derived membrane and is classified within the family Flaviviridae. Like many flaviviruses, it is transmitted by mosquitoes, particularly those of the genus Culex in a natural cycle involving birds and some livestock species. Spill-over into domestic animals results in a spectrum of disease ranging from asymptomatic infection in some species to acute neurological signs in others. The impact of JEV infection is particularly apparent in pigs. Although infection in adult swine does not result in symptomatic disease, it is considered a significant reproductive problem causing abortion, still-birth and birth defects. Infected piglets can display fatal neurological disease. Equines are also infected, resulting in non-specific signs including pyrexia, but occasionally leading to overt neurological disease that in extreme cases can lead to death. Veterinary vaccination is available for both pigs and horses. This review of JEV disease in livestock considers the current diagnostic techniques available for detection of the virus. Options for disease control and prevention within the veterinary sector are discussed. Such measures are critical in breaking the link to zoonotic transmission into the human population where humans are dead-end hosts. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Phobic anxiety and ischaemic heart disease.

PubMed

Haines, A P; Imeson, J D; Meade, T W

1987-08-01

A prospective study of the relation between scores on the six subscales of the Crown-Crisp experiential index and subsequent incidence of ischaemic heart disease was undertaken among participants in the Northwick Park heart study. Results from 1457 white men aged 40-64 at recruitment showed that phobic anxiety was strongly related to subsequent major ischaemic heart disease (fatal and non-fatal events combined) when other associated variables were taken into account. The phobic anxiety score alone remained significantly associated with ischaemic heart disease when scores on all the subscales were included in the analysis. Phobic anxiety seemed to be particularly associated with fatal ischaemic heart disease but was not associated with deaths from other causes and was no higher in those with a pre-existing myocardial infarction at recruitment than in those without. There was a consistent increase in risk of fatal ischaemic heart disease with score on the phobic anxiety subscale. The relative risk for those whose score was 5 and above was 3.77 (95% confidence interval 1.64 to 8.64) compared with those whose score was 0 or 1. The 49 participants with evidence of myocardial infarction at recruitment had higher scores on the subscales for free floating anxiety and functional somatic complaint. The Crown-Crisp experiential index is simple to fill out and acceptable to patients. When the results are combined with other known risk factors it may be of use in defining high risk subjects and in planning strategies for prevention.

Rift valley Fever virus encephalitis is associated with an ineffective systemic immune response and activated T cell infiltration into the CNS in an immunocompetent mouse model.

PubMed

Dodd, Kimberly A; McElroy, Anita K; Jones, Tara L; Zaki, Sherif R; Nichol, Stuart T; Spiropoulou, Christina F

2014-06-01

Rift Valley fever virus (RVFV) causes outbreaks of severe disease in livestock and humans throughout Africa and the Arabian Peninsula. In people, RVFV generally causes a self-limiting febrile illness but in a subset of individuals, it progresses to more serious disease. One manifestation is a delayed-onset encephalitis that can be fatal or leave the afflicted with long-term neurologic sequelae. In order to design targeted interventions, the basic pathogenesis of RVFV encephalitis must be better understood. To characterize the host immune responses and viral kinetics associated with fatal and nonfatal infections, mice were infected with an attenuated RVFV lacking NSs (ΔNSs) that causes lethal disease only when administered intranasally (IN). Following IN infection, C57BL/6 mice developed severe neurologic disease and succumbed 7-9 days post-infection. In contrast, inoculation of ΔNSs virus subcutaneously in the footpad (FP) resulted in a subclinical infection characterized by a robust immune response with rapid antibody production and strong T cell responses. IN-inoculated mice had delayed antibody responses and failed to clear virus from the periphery. Severe neurological signs and obtundation characterized end stage-disease in IN-inoculated mice, and within the CNS, the development of peak virus RNA loads coincided with strong proinflammatory responses and infiltration of activated T cells. Interestingly, depletion of T cells did not significantly alter survival, suggesting that neurologic disease is not a by-product of an aberrant immune response. Comparison of fatal (IN-inoculated) and nonfatal (FP-inoculated) ΔNSs RVFV infections in the mouse model highlighted the role of the host immune response in controlling viral replication and therefore determining clinical outcome. There was no evidence to suggest that neurologic disease is immune-mediated in RVFV infection. These results provide important insights for the future design of vaccines and therapeutic options.

Skin infection caused by Scedosporium apiospermum in immunocompromised patients. Report of two cases.

PubMed

Valenzuela Salas, I; Martinez Peinado, C; Fernandez Miralbell, A; Soto Diaz, Augustin; Nogueras Morillas, P; Martin Castro, A; Tercedor Sanchez, J; Garcia Mellado, V

2013-10-16

Scedosporium apiospermum is a filamentous fungus that can cause cutaneous or extracutaneous disease. A large number of cases have been published over the last decades, mainly in patients immunocompromised as a result of their disease or treatment. These kinds of infections can progress rapidly and become disseminated, leading to very serious or even fatal complications. We report two new cases of skin infection by Scedosporium apiospermum from our hospital.

Urinary tract infection caused by Chromobacterium violaceum.

PubMed

Pant, Narayan Dutt; Sharma, Manisha

2015-01-01

Chromobacterium violaceum, a proteobacterium, is a facultative anaerobe, which is generally present as the normal flora of water and soil in tropical and subtropical regions. The infection due to Chromobacterium violaceum is rare but mostly fatal. It is responsible for causing fatal cases of septicemia, visceral abscesses, skin and soft tissue infections, meningitis, diarrhea, and rarely urinary tract infection. The bacteria has high propensity to spread causing sepsis. Delayed proper treatment due to limited awareness related to the C. violaceum infection is responsible for the high mortality rate. Here, we describe a rare case of urinary tract infection by C. violaceum in a chronic kidney disease patient, which was managed with timely proper antimicrobial therapy as per the culture sensitivity report.

Identification, characterization, and in vitro culture of highly divergent arenaviruses from boa constrictors and annulated tree boas: candidate etiological agents for snake inclusion body disease.

PubMed

Stenglein, Mark D; Sanders, Chris; Kistler, Amy L; Ruby, J Graham; Franco, Jessica Y; Reavill, Drury R; Dunker, Freeland; Derisi, Joseph L

2012-01-01

Inclusion body disease (IBD) is an infectious fatal disease of snakes typified by behavioral abnormalities, wasting, and secondary infections. At a histopathological level, the disease is identified by the presence of large eosinophilic cytoplasmic inclusions in multiple tissues. To date, no virus or other pathogen has been definitively characterized or associated with the disease. Using a metagenomic approach to search for candidate etiologic agents in snakes with confirmed IBD, we identified and de novo assembled the complete genomic sequences of two viruses related to arenaviruses, and a third arenavirus-like sequence was discovered by screening an additional set of samples. A continuous boa constrictor cell line was established and used to propagate and isolate one of the viruses in culture. Viral nucleoprotein was localized and concentrated within large cytoplasmic inclusions in infected cells in culture and tissues from diseased snakes. In total, viral RNA was detected in 6/8 confirmed IBD cases and 0/18 controls. These viruses have a typical arenavirus genome organization but are highly divergent, belonging to a lineage separate from that of the Old and New World arenaviruses. Furthermore, these viruses encode envelope glycoproteins that are more similar to those of filoviruses than to those of other arenaviruses. These findings implicate these viruses as candidate etiologic agents of IBD. The presence of arenaviruses outside mammals reveals that these viruses infect an unexpectedly broad range of species and represent a new reservoir of potential human pathogens. Inclusion body disease (IBD) is a common infectious disease of captive snakes. IBD is fatal and can cause the loss of entire animal collections. The cause of the disease has remained elusive, and no treatment exists. In addition to being important to pet owners, veterinarians, breeders, zoological parks, and aquariums, the study of animal disease is significant since animals are the source of virtually every emerging infectious human disease. We searched for candidate causative agents in snakes diagnosed with IBD and found a group of novel viruses distantly related mainly to arenaviruses but also to filoviruses, both of which can cause fatal hemorrhagic fevers when transmitted from animals to humans. In addition to providing evidence that strongly suggests that these viruses cause snake IBD, this discovery reveals a new and unanticipated domain of virus biology and evolution.

Comparison of the injury severity and medical history of disease-related versus trauma-related bicyclist fatalities.

PubMed

Hitosugi, Masahito; Koseki, Takeshi; Miyama, Genta; Furukawa, Satoshi; Morita, Satomu

2016-01-01

The objective of this study was to clarify the relationship between injury severity and mechanism of death in bicycle fatalities resulting from trauma compared with those resulting from disease, to propose effective measures to prevent fatal bicyclist accidents. Autopsy and accident records were reviewed for bicyclist fatalities who had undergone forensic autopsy at the Dokkyo Medical University School of Medicine between September 1999 and March 2014. Victims' health histories, blood alcohol levels, causes of death, mechanisms of injury, Abbreviated Injury Scale (AIS) scores and Injury Severity Scores (ISSs) were determined. Fifty-five bicyclists (43 male and 12 female) with a mean age of 62.5±17.3 years were included in this study. Sixteen victims had driven under the influence of alcohol (mean blood concentration of 1.8±0.7 mg/ml). Mean ISS was 32.4 and the chest had the highest mean AIS score (2.6), followed by the head (2.1) and the neck (1.8). Thirty-nine victims (70.9%) had died of trauma and 16 had died of disease. The disease-death victims had significantly higher prevalence of having diabetes mellitus, hyperlipidemia, hypertension, heart disease or cerebrovascular diseases (50.0% vs. 22.2%, p=0.03) and a lower rate of drunk driving (6.3% vs. 41.0%, p=0.01) than the trauma-death group. All victims who were affected by disease, and 33.3% of trauma-death victims, had fallen on the road without a vehicle collision (p<0.001). The mean ISS of the trauma-death group was significantly higher than that of the disease-death group (44.0 vs. 4.2, p<0.001). Except for facial injuries, the AIS scores were significantly higher in trauma-death victims than in the disease-death group (p<0.005). To effectively reduce bicyclist fatalities, the authors strongly advocate efforts that will increase compliance with drunk driving prohibitions. For victims of fatal bicycle accidents with a medical history of diseases, a forensic autopsy should be performed to establish a disease-related death while bicycle riding. We must also put into effect preventative safety measures, which take into consideration the physical condition of bicyclists, to reduce the incidence of these types of accidents. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A fatal case of necrotizing fasciitis caused by Serratia marcescens.

PubMed

Curtis, Christopher E; Chock, Stefan; Henderson, Terrance; Holman, Michael J

2005-03-01

A patient with a history of type II diabetes mellitus (DM), end stage renal disease (ESRD), and congestive heart failure (CHF) developed necrotizing fasciitis caused by Serratia marcescens after scraping his leg on rocks in a river while fishing. Aggressive management with surgical debridement, antibiotics, and pressure support was unsuccessful.

Molecular approaches to detecting and discriminating among prions, a class of pathogenic molecules(Abstract)

USDA-ARS?s Scientific Manuscript database

Prions (PrPSc)are the pathogens that cause a set of fatal neurological diseases that include scrapie and chronic wasting disease (CWD). They are composed solely of protein and unlike viral, bacterial, or fungal pathogens, the information necessary to convert the normal cellular prion protein (PrPC) ...

An unusual case of fatal pulmonary hemorrhage in pregnancy.

PubMed

Dissanayake, N L A; Madegedara, Dushantha

2011-07-01

Rickettsial diseases are common in Srilanka. The spotted fever group of rickettsiae presents in many ways, including very severe disease causing significant morbidity and mortality. A regional variation of the Rickettsia conorii subspecies and differences in clinical presentations are reported. This case describes disseminated Rickettsia conorii infection in a pregnant woman presenting with endocarditis.

AIDS: Are Children at Risk? ERIC Digest 16.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Teacher Education, Washington, DC.

Lack of knowledge and misinformation about Acquired Immune Deficiency Syndrome (AIDS), a fatal disease with no cure or vaccine, has caused widespread public concern. Education is an effective way to reduce fears and prevent the spread of the disease. Public school personnel must have accurate information about AIDS in order to make suitable…

Association of the host immune response with protection using a live attenuated African swine fever virus model

USDA-ARS?s Scientific Manuscript database

African swine fever virus (ASFV) causes a lethal disease of swine. Infection with attenuated strains protect against challenge but there is limited knowledge of the immune mechanisms generating that protection. ASFV Pret4 produces a fatal disease, while its derivative, lacking virulence-associated g...

Dietary patterns are associated with disease risk among participants in the women's health initiative observational study

USDA-ARS?s Scientific Manuscript database

Coronary heart disease (CHD) is the leading cause of death in women. A nested case-control study tested whether dietary patterns predicted CHD events among 1224 participants in the Women’s Health Initiative-Observational Study (WHI-OS) with centrally confirmed CHD, fatal or nonfatal myocardial infar...

Atypical fatal sarcocystosis associated with Sarcocystis neurona in a white-nosed coati (Nasua narica molaris)

USDA-ARS?s Scientific Manuscript database

The protozoan parasite Sarcocystis neurona is an important cause of disease in horses (equine protozoal myeloencephalitis, EPM) and in marine mammals. Isolated reports of clinical EPM-like disease have also been documented in a zebra, raccoon, domestic cat, domestic dog, ferret, skunk, mink, lynx, R...

Foodborne Disease Epidemiologist

ERIC Educational Resources Information Center

Sullivan, Megan

2005-01-01

The Centers for Disease Control and Prevention estimates that 76 million cases of foodborne illness occur in the U.S. each year; 5,000 are fatal. Most of these illnesses are caused by a variety of bacteria, viruses, and parasites and the remaining are poisonings triggered by harmful toxins or chemicals. To Jack Guzewich, a foodborne disease…

Brain micro-inflammation at specific vessels dysregulates organ-homeostasis via the activation of a new neural circuit

PubMed Central

Arima, Yasunobu; Ohki, Takuto; Nishikawa, Naoki; Higuchi, Kotaro; Ota, Mitsutoshi; Tanaka, Yuki; Nio-Kobayashi, Junko; Elfeky, Mohamed; Sakai, Ryota; Mori, Yuki; Kawamoto, Tadafumi; Stofkova, Andrea; Sakashita, Yukihiro; Morimoto, Yuji; Kuwatani, Masaki; Iwanaga, Toshihiko; Yoshioka, Yoshichika; Sakamoto, Naoya; Yoshimura, Akihiko; Takiguchi, Mitsuyoshi; Sakoda, Saburo; Prinz, Marco; Kamimura, Daisuke; Murakami, Masaaki

2017-01-01

Impact of stress on diseases including gastrointestinal failure is well-known, but molecular mechanism is not understood. Here we show underlying molecular mechanism using EAE mice. Under stress conditions, EAE caused severe gastrointestinal failure with high-mortality. Mechanistically, autoreactive-pathogenic CD4+ T cells accumulated at specific vessels of boundary area of third-ventricle, thalamus, and dentate-gyrus to establish brain micro-inflammation via stress-gateway reflex. Importantly, induction of brain micro-inflammation at specific vessels by cytokine injection was sufficient to establish fatal gastrointestinal failure. Resulting micro-inflammation activated new neural pathway including neurons in paraventricular-nucleus, dorsomedial-nucleus-of-hypothalamus, and also vagal neurons to cause fatal gastrointestinal failure. Suppression of the brain micro-inflammation or blockage of these neural pathways inhibited the gastrointestinal failure. These results demonstrate direct link between brain micro-inflammation and fatal gastrointestinal disease via establishment of a new neural pathway under stress. They further suggest that brain micro-inflammation around specific vessels could be switch to activate new neural pathway(s) to regulate organ homeostasis. DOI: http://dx.doi.org/10.7554/eLife.25517.001 PMID:28809157

Avian botulism

USGS Publications Warehouse

Rocke, T.E.; Friend, M.

1999-01-01

Avian botulism is a paralytic, often fatal, disease of birds that results when they ingest toxin produced by the bacterium, Clostridium botulinum. Seven distinct types of toxin designated by the letters A to G have been identified (Table 38.1). Waterfowl die-offs due to botulism are usually caused by type C toxin; sporadic die-offs among fish-eating birds, such as common loons and gulls, have been caused by type E toxin. Type A botulinum toxin has also caused disease in birds, most frequently in domestic chickens. Types B, D, F, and G are not known to cause avian botulism in North America.

Vaccines against viral hemorrhagic fevers: non-human primate models.

PubMed

Carrion, Ricardo; Patterson, Jean L

2011-06-01

Viral hemorrhagic fevers are a group of disease syndromes caused by infection with certain RNA viruses. The disease is marked by a febrile response, malaise, coagulopathy and vascular permeability culminating in death. Case fatality rates can reach 90% depending on the etiologic agent. Currently, there is no approved antiviral treatment. Because of the high case fatality, risk of importation and the potential to use these agents as biological weapons, development of countermeasures to these agents is a high priority. The sporadic nature of disease outbreaks and the ethical issues associated with conducting a human trial for such diseases make human studies impractical; therefore, development of countermeasures must occur in relevant animal models. Non-human primates are superior models to study infectious disease because their immune system is similar to humans and they are good predictors of efficacy in vaccine development and other intervention strategies. This review article summarizes viral hemorrhagic fever non-human primate models.

Dietary α-Linolenic Acid, Marine ω-3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study.

PubMed

Sala-Vila, Aleix; Guasch-Ferré, Marta; Hu, Frank B; Sánchez-Tainta, Ana; Bulló, Mònica; Serra-Mir, Mercè; López-Sabater, Carmen; Sorlí, Jose V; Arós, Fernando; Fiol, Miquel; Muñoz, Miguel A; Serra-Majem, Luis; Martínez, J Alfredo; Corella, Dolores; Fitó, Montserrat; Salas-Salvadó, Jordi; Martínez-González, Miguel A; Estruch, Ramón; Ros, Emilio; B

2016-01-26

Epidemiological evidence suggests a cardioprotective role of α-linolenic acid (ALA), a plant-derived ω-3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω-3 fatty acids (long-chain n-3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all-cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long-chain n-3 polyunsaturated fatty acids (≥500 mg/day). We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable-adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9-y follow-up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56-0.92) for all-cause mortality and 0.95 (95% CI 0.58-1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long-chain n-3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67-1.05) for all-cause mortality, 0.61 (95% CI 0.39-0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29-0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22-1.01) for sudden cardiac death. The highest reduction in all-cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45-0.87]). In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all-cause mortality, whereas protection from cardiac mortality is limited to fish-derived long-chain n-3 polyunsaturated fatty acids. URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Seasonality and Coronary Heart Disease Deaths in United States Firefighters

PubMed Central

Mbanu, Ibeawuchi; Wellenius, Gregory A.; Mittleman, Murray A.; Peeples, Lynne; Stallings, Leonard A.; Kales, Stefanos N.

2013-01-01

United States firefighters have a high on-duty fatality rate and coronary heart disease is the leading cause. Seasonality affects the incidence of cardiovascular events in the general population, but its effects on firefighters are unknown. We statistically examined the seasonal and annual variation of all on-duty coronary heart disease deaths among US firefighters between 1994 and 2004 using the chi-square distribution and Poisson regression model of the monthly fatality counts. We also examined the effect of ambient temperature (apparent as well as wind chill temperature) on coronary heart disease fatalities during the study span using a time-stratified, case-crossover study design. When grouped by season, we observed the distribution of the 449 coronary heart disease fatalities to show a relative peak in winter (32%) and relative nadir in spring (21%). This pattern was significantly different (p=0.005) from the expected distribution under the null hypothesis where season has no effect. The pattern persisted in additional analyses, stratifying the deaths by the type of duty in which the firefighters were engaged at the time of their deaths. In the Poisson regression model of the monthly fatality counts, the overall goodness-of-fit between the actual and predicted case counts was excellent ( χ42 = 16.63; p = 0.002). Two distinct peaks were detected, one in January-February and the other in August-September. Overall, temperature was not associated with increased risk of on-duty death. After allowing for different effects of temperature in mild/hot versus cold periods, a 1°C increase was not protective in cold weather, nor did it increase the risk of death in warmer weather. The findings of this study reveal statistical evidence for excess coronary heart disease deaths among firefighters during winter; however, the temporal pattern coronary heart disease deaths was not linked to temperature variation. We also found the seasonal pattern to be independent of duty-related risks. PMID:17701682

Transmissible Spongiform Encephalopathy and Meat Safety

NASA Astrophysics Data System (ADS)

Ward, Hester J. T.; Knight, Richard S. G.

Prion diseases or transmissible spongiform encephalopathies (TSEs) comprise a wide-ranging group of neurodegenerative diseases found in animals and humans. They have diverse causes and geographical distributions, but have similar pathological features, transmissibility and, are ultimately, fatal. Central to all TSEs is the presence of an abnormal form of a normal host protein, namely the prion protein. Because of their potential transmissibility, these diseases have wide public health ramifications.

Parasitic diseases as the cause of death of prisoners of war during the Korean War (1950-1953).

PubMed

Huh, Sun

2014-06-01

To determine the cause of death of prisoners of war during the Korean War (1950-1953), death certificates or medical records were analyzed. Out of 7,614 deaths, 5,013 (65.8%) were due to infectious diseases. Although dysentery and tuberculosis were the most common infectious diseases, parasitic diseases had caused 14 deaths: paragonimiasis in 5, malaria in 3, amoebiasis in 2, intestinal parasitosis in 2, ascariasis in 1, and schistosomiasis in 1. These results showed that paragonimiasis, malaria, and amoebiasis were the most fatal parasitic diseases during the early 1950s in the Korean Peninsula. Since schistosomiasis is not endemic to Korea, it is likely that the infected private soldier moved from China or Japan to Korea.

Update: Multinational listeriosis outbreak due to 'Quargel', a sour milk curd cheese, caused by two different L. monocytogenes serotype 1/2a strains, 2009-2010.

PubMed

Fretz, R; Pichler, J; Sagel, U; Much, P; Ruppitsch, W; Pietzka, A T; Stöger, A; Huhulescu, S; Heuberger, S; Appl, G; Werber, D; Stark, K; Prager, R; Flieger, A; Karpísková, R; Pfaff, G; Allerberger, F

2010-04-22

We previously reported an outbreak of listeriosis in Austria and Germany due to consumption of Quargel cheese. It comprised 14 cases (including five fatalities) infected by a serotype 1/2a Listeria monocytogenes (clone 1), with onset of illness from June 2009 to January 2010. A second strain of L. monocytogenes serotype 1/2a (clone 2) spread by this product could be linked to further 13 cases in Austria (two fatal), six in Germany (one fatal) and one case in the Czech Republic, with onset of disease from December 2009 to end of February 2010.

Work related mortality among merchant seafarers employed in UK Royal Fleet Auxillary shipping from 1976 to 2005.

PubMed

Roberts, Stephen E; Marlow, Peter B

2006-01-01

Over 2300 merchant seafarers are currently employed on board UK Royal Fleet Auxiliary (RFA) ships. However, little is known about work related mortality among these seafarers, and whether it is lower than among seafarers in merchant fleets. To establish the causes and circumstances of all work related deaths among seafarers who were employed in RFA ships from 1976 to 2005, to compare mortality rates with those in other merchant fleets, and to identify implications for maritime health. A population based study of work related mortality over 30 years. A total of 60 deaths among seafarers in RFA ships were caused by disease (30), accidents (19), suicide (6), homicide (one), and inconclusive causes (4). Six of the 19 fatal accidents were directly related to work duties (occupational accidents), 12 occurred during off-duty time and one resulted from a shipping disaster. The fatal accident rate was about one half, and the fatal work related accident rate was about one quarter, of corresponding rates in UK merchant shipping from 1976-2002; and they were much lower than those in merchant fleets internationally. The fatal accident rate in RFA shipping also fell by about 80% over the 30 year study period. The lower fatal accident rates in RFA shipping, particularly for work related accidents, presumably reflect a lower incidence of hazardous working practices, arising from better training and career pathways for seafarers in RFA shipping, as well as better maintained ships with higher manning levels than in merchant shipping.

Rocky Mountain spotted fever.

PubMed

Dantas-Torres, Filipe

2007-11-01

Rocky Mountain spotted fever (RMSF) is a life-threatening disease caused by Rickettsia rickettsii, an obligately intracellular bacterium that is spread to human beings by ticks. More than a century after its first clinical description, this disease is still among the most virulent human infections identified, being potentially fatal even in previously healthy young people. The diagnosis of RMSF is based on the patient's history and a physical examination, and often presents a dilemma for clinicians because of the non-specific presentation of the disease in its early course. Early empirical treatment is essential to prevent severe complications or a fatal outcome, and treatment should be initiated even in unconfirmed cases. Because there is no vaccine available against RMSF, avoidance of tick-infested areas is still the best way to prevent the infection.

Prognostic models for stable coronary artery disease based on electronic health record cohort of 102 023 patients.

PubMed

Rapsomaniki, Eleni; Shah, Anoop; Perel, Pablo; Denaxas, Spiros; George, Julie; Nicholas, Owen; Udumyan, Ruzan; Feder, Gene Solomon; Hingorani, Aroon D; Timmis, Adam; Smeeth, Liam; Hemingway, Harry

2014-04-01

The population with stable coronary artery disease (SCAD) is growing but validated models to guide their clinical management are lacking. We developed and validated prognostic models for all-cause mortality and non-fatal myocardial infarction (MI) or coronary death in SCAD. Models were developed in a linked electronic health records cohort of 102 023 SCAD patients from the CALIBER programme, with mean follow-up of 4.4 (SD 2.8) years during which 20 817 deaths and 8856 coronary outcomes were observed. The Kaplan-Meier 5-year risk was 20.6% (95% CI, 20.3, 20.9) for mortality and 9.7% (95% CI, 9.4, 9.9) for non-fatal MI or coronary death. The predictors in the models were age, sex, CAD diagnosis, deprivation, smoking, hypertension, diabetes, lipids, heart failure, peripheral arterial disease, atrial fibrillation, stroke, chronic kidney disease, chronic pulmonary disease, liver disease, cancer, depression, anxiety, heart rate, creatinine, white cell count, and haemoglobin. The models had good calibration and discrimination in internal (external) validation with C-index 0.811 (0.735) for all-cause mortality and 0.778 (0.718) for non-fatal MI or coronary death. Using these models to identify patients at high risk (defined by guidelines as 3% annual mortality) and support a management decision associated with hazard ratio 0.8 could save an additional 13-16 life years or 15-18 coronary event-free years per 1000 patients screened, compared with models with just age, sex, and deprivation. These validated prognostic models could be used in clinical practice to support risk stratification as recommended in clinical guidelines.

FATE AND TRANSPORT OF PRIONS FROM CHRONIC WASTING DISEASE (CWD) WASTE IN MUNICIPAL SOLID WASTE LANDFILLS

EPA Science Inventory

CWD is a fatal neurologic disease of deer and elk caused by an infectious abnormal protein called a prion. Infected free-ranging or captive deer and elk have been found in several states including Wisconsin, Illinois and Minnesota in Region 5. The management of CWD may call for...

Detecting and discriminating among pathogenic protein conformers(prions), using mass spectrometry-based and antibody-based approaches(Abstract)

USDA-ARS?s Scientific Manuscript database

A set of fatal neurological diseases that includes scrapie and chronic wasting disease (CWD) are caused by a pathological protein referred to as a prion (PrPSc). A prion propagates an infection by converting a normal cellular protein (PrPC) into a prion. Unlike viral, bacterial, or fungal pathogens,...

Morphologic and phenotypic characteristics of myocarditis in two pigs infected by foot-and mouth disease virus strains of serotypes O or A

USDA-ARS?s Scientific Manuscript database

Myocarditis is often cited as the cause of fatalities associated with foot-and-mouth disease virus (FMDV) infection; however the pathogenesis of FMDV-associated myocarditis has not been described in detail. The current report describes substantial quantities of FMDV in association with a marked mono...

An unusual case of fatal pulmonary hemorrhage in pregnancy

PubMed Central

Dissanayake, N. L. A; Madegedara, Dushantha

2011-01-01

Rickettsial diseases are common in Srilanka. The spotted fever group of rickettsiae presents in many ways, including very severe disease causing significant morbidity and mortality. A regional variation of the Rickettsia conorii subspecies and differences in clinical presentations are reported. This case describes disseminated Rickettsia conorii infection in a pregnant woman presenting with endocarditis. PMID:21886958

Fatal Enterococcus durans aortic valve endocarditis: a case report and review of the literature

PubMed Central

Vijayakrishnan, Rajakrishnan; Rapose, Alwyn

2012-01-01

Most enterococcal endocarditis is caused by Enterococcus faecalis and Enterococcus faecium. Enterococcus durans is a rare member of non-faecalis, non-faecium enterococcal species and is found in the intestines of animals. E durans endocarditis is a very rare infection—only two cases of endocarditis in humans have been reported in the literature—and usually associated with good outcomes when treated with appropriate antibiotics. We report the first case of fatal E durans endocarditis. This patient had end-stage liver disease with associated compromised immune status that likely contributed to the progression of disease in spite of appropriate antibiotic coverage and clearance of bacteraemia. PMID:22684831

Deaths, late deaths, and role of infecting dose in Ebola virus disease in Sierra Leone: retrospective cohort study.

PubMed

Bower, Hilary; Smout, Elizabeth; Bangura, Mohamed S; Kamara, Osman; Turay, Cecilia; Johnson, Sembia; Oza, Shefali; Checchi, Francesco; Glynn, Judith R

2016-05-17

 To assess the frequency of fatal recrudescence from Ebola virus disease after discharge from treatment centres, and explore the influence of infecting dose on case fatality rates.  Retrospective cohort study.  Western Area, Sierra Leone.  151 survivors treated for Ebola virus disease at the Kerry Town treatment centre and discharged. Survivors were followed up for a vital status check at four to nine months after discharge, and again at six to 13 months after discharge. Verbal autopsies were conducted for four survivors who had died since discharge (that is, late deaths). Survivors still living in Western Area were interviewed together with their household members. Exposure level to Ebola virus disease was ascertained as a proxy of infecting dose, including for those who died.  Risks and causes of late death; case fatality rates; odds ratios of death from Ebola virus disease by age, sex, exposure level, date, occupation, and household risk factors.  Follow-up information was obtained on all 151 survivors of Ebola virus disease, a mean of 10 months after discharge. Four deaths occurred after discharge, all within six weeks: two probably due to late complications, one to prior tuberculosis, and only one after apparent full recovery, giving a maximum estimate of recrudescence leading to death of 0.7%. In these households, 395 people were reported to have had Ebola virus disease, of whom 227 died. A further 53 people fulfilled the case definition for probable disease, of whom 11 died. Therefore, the case fatality rate was 57.5% (227/395) for reported Ebola virus disease, or 53.1% (238/448) including probable disease. Case fatality rates were higher in children aged under 2 years and adults older than 30 years, in larger households, and in infections occurring earlier in the epidemic in Sierra Leone. There was no consistent trend of case fatality rate with exposure level, although increasing exposure increased the risk of Ebola virus disease.  In this study of survivors in Western Area, Sierra Leone, late recrudescence of severe Ebola virus disease appears to be rare. There was no evidence for an effect of infecting dose (as measured by exposure level) on the severity of disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Naturally occurring reassortants of infectious bursal disease virus - A review].

PubMed

Qi, Xiaole; Gao, Li; Wang, Xiaomei

2016-05-04

Infectious bursal disease virus (IBDV) is an important representative of Birnaviridae, which causes infectious bursal disease (IBD), one important immuno-suppressive and fatal disease threatening the poultry husbandry. The naturally occurring reassortants of IBDV induced new risks to disease prevention and control. Here, we reviewed the main types of the genome segments reassortants and intragenic recombination, the inherent mechanism and the biological significances were analyzed, which would give us new insights into the virus genetic evolution research and the disease control strategy.

Childhood pesticide poisoning in Zhejiang, China: a retrospective analysis from 2006 to 2015.

PubMed

Yimaer, Aziguli; Chen, Guangdi; Zhang, Meibian; Zhou, Lifang; Fang, Xinglin; Jiang, Wei

2017-06-28

Pesticide poisoning in children has been a serious public health issue around the world, especially in the developing countries where agriculture is still one of the largest economic sectors. The purpose of this study was to analyze epidemiological characteristics of acute pesticide poisoning in children from Zhejiang province, China. The pesticide poisoning cases for children were retrieved from Occupational Disease Surveillance and Reporting System, Zhejiang Provincial Center for Disease Control and Prevention, China. The incident cases, deaths, and fatality rate of child pesticide poisoning from 2006 through 2015 were calculated. During the study period, totally 2952 children were poisoned by pesticides, with 66 deaths, resulting in a fatality rate of 2.24%. Among them, there were 1607 male cases with 28 deaths, and 1345 female cases with 38 deaths. Most of the cases occurred in preschool children (1349) and adolescent age group (1269). Organophosphate and carbamate insecticides were the cause of most poisonings (1130), leading to 34 deaths. The highest fatality rate (3.13%) was due to poisoning by herbicides and fungicides, causing 14 deaths out of 448 cases. Poisoning occurred mostly in rural areas (78%). And most pesticide poisoning occurred in the summer (896) and fall (811), while fewest poisoning cases in the winter (483) but with the highest fatality rate (3.52%). This study shows that pesticide poisoning of children is a major health problem in Zhejiang, suggesting preventive strategies should be conducted to control childhood pesticide poisoning.

Acute-on-chronic and Decompensated Chronic Liver Failure: Definitions, Epidemiology, and Prognostication.

PubMed

Olson, Jody C

2016-07-01

Chronic liver disease is the fifth leading cause of death worldwide and represents a major burden for the health care community. Cirrhosis is a progressive disease resulting in end-stage liver failure, which in the absence of liver transplantation is fatal. Acute-on-chronic liver failure carries high short-term mortality but is potentially reversible. Viral hepatitis, alcohol, and nonalcoholic fatty liver disease remain the principal causes of liver disease. Though treatments exist for hepatitis B and C, they remain unavailable to many with these diseases. This article reviews the epidemiology of advanced liver disease and the concept of acute-on-chronic liver failure. Copyright © 2016 Elsevier Inc. All rights reserved.

An Analysis of 332 Fatalities Infected with Pandemic 2009 Influenza A (H1N1) in Argentina

PubMed Central

Balanzat, Ana M.; Hertlein, Christian; Apezteguia, Carlos; Bonvehi, Pablo; Cámera, Luis; Gentile, Angela; Rizzo, Oscar; Gómez-Carrillo, Manuel; Coronado, Fatima; Azziz-Baumgartner, Eduardo; Chávez, Pollyanna R.; Widdowson, Marc-Alain

2012-01-01

Background The apparent high number of deaths in Argentina during the 2009 pandemic led to concern that the influenza A H1N1pdm disease was different there. We report the characteristics and risk factors for influenza A H1N1pdm fatalities. Methods We identified laboratory-confirmed influenza A H1N1pdm fatalities occurring during June-July 2009. Physicians abstracted data on age, sex, time of onset of illness, medical history, clinical presentation at admission, laboratory, treatment, and outcomes using standardize questionnaires. We explored the characteristics of fatalities according to their age and risk group. Results Of 332 influenza A H1N1pdm fatalities, 226 (68%) were among persons aged <50 years. Acute respiratory failure was the leading cause of death. Of all cases, 249 (75%) had at least one comorbidity as defined by Advisory Committee on Immunization Practices. Obesity was reported in 32% with data and chronic pulmonary disease in 28%. Among the 40 deaths in children aged <5 years, chronic pulmonary disease (42%) and neonatal pathologies (35%) were the most common co-morbidities. Twenty (6%) fatalities were among pregnant or postpartum women of which only 47% had diagnosed co-morbidities. Only 13% of patients received antiviral treatment within 48 hours of symptom onset. None of children aged <5 years or the pregnant women received antivirals within 48 h of symptom onset. As the pandemic progressed, the time from symptom-onset to medical care and to antiviral treatment decreased significantly among case-patients who subsequently died (p<0.001). Conclusion Persons with co-morbidities, pregnant and who received antivirals late were over-represented among influenza A H1N1pdm deaths in Argentina, though timeliness of antiviral treatment improved during the pandemic. PMID:22506006

Reversal of the Progression of Fatal Coronavirus Infection in Cats by a Broad-Spectrum Coronavirus Protease Inhibitor

PubMed Central

Kim, Yunjeong; Liu, Hongwei; Galasiti Kankanamalage, Anushka C.; Weerasekara, Sahani; Hua, Duy H.; Groutas, William C.; Chang, Kyeong-Ok; Pedersen, Niels C.

2016-01-01

Coronaviruses infect animals and humans causing a wide range of diseases. The diversity of coronaviruses in many mammalian species is contributed by relatively high mutation and recombination rates during replication. This dynamic nature of coronaviruses may facilitate cross-species transmission and shifts in tissue or cell tropism in a host, resulting in substantial change in virulence. Feline enteric coronavirus (FECV) causes inapparent or mild enteritis in cats, but a highly fatal disease, called feline infectious peritonitis (FIP), can arise through mutation of FECV to FIP virus (FIPV). The pathogenesis of FIP is intimately associated with immune responses and involves depletion of T cells, features shared by some other coronaviruses like Severe Acute Respiratory Syndrome Coronavirus. The increasing risks of highly virulent coronavirus infections in humans or animals call for effective antiviral drugs, but no such measures are yet available. Previously, we have reported the inhibitors that target 3C-like protease (3CLpro) with broad-spectrum activity against important human and animal coronaviruses. Here, we evaluated the therapeutic efficacy of our 3CLpro inhibitor in laboratory cats with FIP. Experimental FIP is 100% fatal once certain clinical and laboratory signs become apparent. We found that antiviral treatment led to full recovery of cats when treatment was started at a stage of disease that would be otherwise fatal if left untreated. Antiviral treatment was associated with a rapid improvement in fever, ascites, lymphopenia and gross signs of illness and cats returned to normal health within 20 days or less of treatment. Significant reduction in viral titers was also observed in cats. These results indicate that continuous virus replication is required for progression of immune-mediated inflammatory disease of FIP. These findings may provide important insights into devising therapeutic strategies and selection of antiviral compounds for further development for important coronaviruses in animals and humans. PMID:27027316

CD8+ T Cells Induce Fatal Brainstem Pathology during Cerebral Malaria via Luminal Antigen-Specific Engagement of Brain Vasculature

PubMed Central

Swanson, Phillip A.; Hart, Geoffrey T.; Russo, Matthew V.; Nayak, Debasis; Yazew, Takele; Peña, Mirna; Khan, Shahid M.; Pierce, Susan K.; McGavern, Dorian B.

2016-01-01

Cerebral malaria (CM) is a severe complication of Plasmodium falciparum infection that results in thousands of deaths each year, mostly in African children. The in vivo mechanisms underlying this fatal condition are not entirely understood. Using the animal model of experimental cerebral malaria (ECM), we sought mechanistic insights into the pathogenesis of CM. Fatal disease was associated with alterations in tight junction proteins, vascular breakdown in the meninges / parenchyma, edema, and ultimately neuronal cell death in the brainstem, which is consistent with cerebral herniation as a cause of death. At the peak of ECM, we revealed using intravital two-photon microscopy that myelomonocytic cells and parasite-specific CD8+ T cells associated primarily with the luminal surface of CNS blood vessels. Myelomonocytic cells participated in the removal of parasitized red blood cells (pRBCs) from cerebral blood vessels, but were not required for the disease. Interestingly, the majority of disease-inducing parasite-specific CD8+ T cells interacted with the lumen of brain vascular endothelial cells (ECs), where they were observed surveying, dividing, and arresting in a cognate peptide-MHC I dependent manner. These activities were critically dependent on IFN-γ, which was responsible for activating cerebrovascular ECs to upregulate adhesion and antigen-presenting molecules. Importantly, parasite-specific CD8+ T cell interactions with cerebral vessels were impaired in chimeric mice rendered unable to present EC antigens on MHC I, and these mice were in turn resistant to fatal brainstem pathology. Moreover, anti-adhesion molecule (LFA-1 / VLA-4) therapy prevented fatal disease by rapidly displacing luminal CD8+ T cells from cerebrovascular ECs without affecting extravascular T cells. These in vivo data demonstrate that parasite-specific CD8+ T cell-induced fatal vascular breakdown and subsequent neuronal death during ECM is associated with luminal, antigen-dependent interactions with cerebrovasculature. PMID:27907215

Associations of mortality and cardiovascular disease risks with diabetes and albuminuria in urban Indigenous Australians: the DRUID follow-up study.

PubMed

Barr, E L M; Cunningham, J; Tatipata, S; Dunbar, T; Kangaharan, N; Guthridge, S; Li, S Q; Condon, J R; Shaw, J E; O'Dea, K; Maple-Brown, L J

2017-07-01

To assess the relationships of diabetes and albuminuria with all-cause mortality and cardiovascular disease outcomes in a population without prior cardiovascular disease using data from the Darwin Region Urban Indigenous Diabetes (DRUID) study. We conducted a prospective cohort study of 706 participants (aged 15-81 years, 68% women) without prior cardiovascular disease who underwent a 75-g oral glucose tolerance test. Deaths and fatal or non-fatal cardiovascular disease were determined over 7 years, and hazard ratios with 95% CIs and population attributable risks were estimated for baseline glycaemia and albuminuria. Compared with normoglycaemia and after adjustment for age, sex, hypertension, dyslipidaemia and smoking, known diabetes was associated with an adjusted hazard ratio of 4.8 (95% CI 1.5-14.7) for all-cause mortality and 5.6 (95% CI 2.1-15.2) for cardiovascular disease. Compared with normoalbuminuria, the respective adjusted risks for macroalbuminuria were 10.9 (95% CI 3.7-32.1) and 3.9 (95% CI 1.4-10.8). The Adjusted all-cause mortality and cardiovascular disease estimated population attributable risks for diabetes were 27% and 32%, and for albuminuria they were 32% and 21%, respectively. In our study population, the burden of mortality and cardiovascular disease was largely driven by diabetes and albuminuria. This finding on the influence of diabetes and albuminuria is consistent with reports in other high-risk Indigenous populations and should be better reflected in risk scores and intervention programmes. © 2017 Diabetes UK.

Aspergillosis

USGS Publications Warehouse

Friend, M.

1999-01-01

Aspergillosis is a respiratory tract infection caused by fungi of the genus Aspergillus, of which A. fumigatus is the primary species responsible for infections in wild birds (Fig. 13.1). Aspergillosis is not contagious (it will not spread from bird to bird), and it may be an acute, rapidly fatal disease or a more chronic disease. Both forms of the disease are commonly seen in free-ranging birds, but the acute form is generally responsible for large-scale mortality events in adult birds and for brooder pneumonia in hatching birds. Aspergillus sp. also produce aflatoxins (see Chapter 37, Mycotoxins), but the significance of those toxins in the ability of the fungus to cause disease in birds is unknown.

Effects of acarbose on cardiovascular and diabetes outcomes in patients with coronary heart disease and impaired glucose tolerance (ACE): a randomised, double-blind, placebo-controlled trial.

PubMed

Holman, Rury R; Coleman, Ruth L; Chan, Juliana C N; Chiasson, Jean-Louis; Feng, Huimei; Ge, Junbo; Gerstein, Hertzel C; Gray, Richard; Huo, Yong; Lang, Zhihui; McMurray, John J; Rydén, Lars; Schröder, Stefan; Sun, Yihong; Theodorakis, Michael J; Tendera, Michal; Tucker, Lynne; Tuomilehto, Jaakko; Wei, Yidong; Yang, Wenying; Wang, Duolao; Hu, Dayi; Pan, Changyu

2017-11-01

The effect of the α-glucosidase inhibitor acarbose on cardiovascular outcomes in patients with coronary heart disease and impaired glucose tolerance is unknown. We aimed to assess whether acarbose could reduce the frequency of cardiovascular events in Chinese patients with established coronary heart disease and impaired glucose tolerance, and whether the incidence of type 2 diabetes could be reduced. The Acarbose Cardiovascular Evaluation (ACE) trial was a randomised, double-blind, placebo-controlled, phase 4 trial, with patients recruited from 176 hospital outpatient clinics in China. Chinese patients with coronary heart disease and impaired glucose tolerance were randomly assigned (1:1), in blocks by site, by a centralised computer system to receive oral acarbose (50 mg three times a day) or matched placebo, which was added to standardised cardiovascular secondary prevention therapy. All study staff and patients were masked to treatment group allocation. The primary outcome was a five-point composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, hospital admission for unstable angina, and hospital admission for heart failure, analysed in the intention-to-treat population (all participants randomly assigned to treatment who provided written informed consent). The secondary outcomes were a three-point composite outcome (cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke), death from any cause, cardiovascular death, fatal or non-fatal myocardial infarction, fatal or non-fatal stroke, hospital admission for unstable angina, hospital admission for heart failure, development of diabetes, and development of impaired renal function. The safety population comprised all patients who received at least one dose of study medication. This trial is registered with ClinicalTrials.gov, number NCT00829660, and the International Standard Randomised Controlled Trial Number registry, number ISRCTN91899513. Between March 20, 2009, and Oct 23, 2015, 6522 patients were randomly assigned and included in the intention-to-treat population, 3272 assigned to acarbose and 3250 to placebo. Patients were followed up for a median of 5·0 years (IQR 3·4-6·0) in both groups. The primary five-point composite outcome occurred in 470 (14%; 3·33 per 100 person-years) of 3272 acarbose group participants and in 479 (15%; 3·41 per 100 person-years) of 3250 placebo group participants (hazard ratio 0·98; 95% CI 0·86-1·11, p=0·73). No significant differences were seen between treatment groups for the secondary three-point composite outcome, death from any cause, cardiovascular death, fatal or non-fatal myocardial infarction, fatal or non-fatal stroke, hospital admission for unstable angina, hospital admission for heart failure, or impaired renal function. Diabetes developed less frequently in the acarbose group (436 [13%] of 3272; 3·17 per 100 person-years) compared with the placebo group (513 [16%] of 3250; 3·84 per 100 person-years; rate ratio 0·82, 95% CI 0·71-0·94, p=0·005). Gastrointestinal disorders were the most common adverse event associated with drug discontinuation or dose changes (215 [7%] of 3263 patients in the acarbose group vs 150 [5%] of 3241 in the placebo group [p=0·0007]; safety population). Numbers of non-cardiovascular deaths (71 [2%] of 3272 vs 56 [2%] of 3250, p=0·19) and cancer deaths (ten [<1%] of 3272 vs 12 [<1%] of 3250, p=0·08) did not differ between groups. In Chinese patients with coronary heart disease and impaired glucose tolerance, acarbose did not reduce the risk of major adverse cardiovascular events, but did reduce the incidence of diabetes. Bayer AG. Copyright © 2017 Elsevier Ltd. All rights reserved.

Parasitic Diseases as the Cause of Death of Prisoners of War during the Korean War (1950-1953)

PubMed Central

2014-01-01

To determine the cause of death of prisoners of war during the Korean War (1950-1953), death certificates or medical records were analyzed. Out of 7,614 deaths, 5,013 (65.8%) were due to infectious diseases. Although dysentery and tuberculosis were the most common infectious diseases, parasitic diseases had caused 14 deaths: paragonimiasis in 5, malaria in 3, amoebiasis in 2, intestinal parasitosis in 2, ascariasis in 1, and schistosomiasis in 1. These results showed that paragonimiasis, malaria, and amoebiasis were the most fatal parasitic diseases during the early 1950s in the Korean Peninsula. Since schistosomiasis is not endemic to Korea, it is likely that the infected private soldier moved from China or Japan to Korea. PMID:25031479

Alphaviral equine encephalomyelitis (Eastern, Western and Venezuelan).

PubMed

Aréchiga-Ceballos, N; Aguilar-Setién, A

2015-08-01

Summary Alphaviral equine encephalomyelitis is a mosquito-borne infection that causes severe neurological disease and fatalities in horses and humans in the Americas. Consequently, the equine alphaviruses (Eastern, Western and Venezuelan) are of considerable concern worldwide and are notifiable to the World Organisation for Animal Health. In addition, these diseases are considered a potent potential biological weapon, emphasising the need to develop an effective vaccine. Alphaviral equine encephalomyelitis is caused by Eastern equine encephalomyelitis virus (EEEV), Western equine encephalomyelitis virus (WEEV) or Venezuelan equine encephalomyelitis virus (VEEV), which are related members of the Alphavirus genus in the Togaviridae family. Although related, the three viruses are genetically and antigenically distinct. The disease is characterised by fever, anorexia, depression and clinical signs of encephalomyelitis, and may be fatal in up to 90% of cases, for both humans and horses, particularly in the case of EEE. Surviving horses develop lifelong immunity but may have permanent neuropathology. The aim of this paper is to analyse the scientific information available on the evolution of EEE, WEE and VEE, and any potential vaccines.

Fatal coinfection with Legionella pneumophila serogroup 8 and Aspergillus fumigatus.

PubMed

Guillouzouic, Aurélie; Bemer, Pascale; Gay-Andrieu, Françoise; Bretonnière, Cédric; Lepelletier, Didier; Mahé, Pierre-Joachim; Villers, Daniel; Jarraud, Sophie; Reynaud, Alain; Corvec, Stéphane

2008-02-01

Legionella pneumophila is an important cause of community-acquired and nosocomial pneumonia. We report on a patient who simultaneously developed L. pneumophila serogroup 8 pneumonia and Aspergillus fumigatus lung abscesses. Despite appropriate treatments, Aspergillus disease progressed with metastasis. Coinfections caused by L. pneumophila and A. fumigatus remain exceptional. In apparently immunocompetent patients, corticosteroid therapy is a key risk factor for aspergillosis.

Hantavirus pulmonary syndrome in the Atlantic Argentinean Patagonia region.

PubMed

Baccaro, Fernando G; Rovasio, Jose Luis; Laguardia, Silvia; Framarini, Silvia

2010-03-01

The hantavirus causes a hemorrhagic disease and in 1993 was responsible for an outbreak of a pulmonary syndrome in the south of the United States of America. The disease is endemic in the north of Argentina where the Oran strain is prevalent. A fatal case of the Hanta Pulmonary Syndrome (HPS) occurring in a migrant agricultural worker is reported.

Warfarin compared with aspirin for older Chinese patients with stable coronary heart diseases and atrial fibrillation complications.

PubMed

Liu, Xinbing; Huang, Hongman; Yu, Jianhua; Cao, Guoliang; Feng, Liuliu; Xu, Qitan; Zhang, Shufu; Zhou, Mingcheng; Li, Yigang

2014-06-01

To compare the therapeutic warfarin and aspirin efficacies for treatments of atrial fibrillation (AF) complicated with stable coronary heart disease particularly in older Chinese patients. In our prospective study 101 patients with AF and stable coronary heart disease older than 80 years were randomized into two groups. One group (n = 51) basically received 1.25 mg/day warfarin per os, followed by addition of 0.5 - 1.0 mg/day from day 3 - 5 if the international normalized ratio (INR) was initially < 1.5 and in order to achieve a maintained INR between 1.6 and 2.5 (warfarin group). The second group (n = 50) received 100 mg aspirin per day (control group). All patients were medicated and monitored for a period of 2 years. The primary endpoint was the occurrence of ischemic stroke or systemic embolism, and the composite secondary endpoint was non-fatal myocardial infarction and all causes of death. For safety evaluation, the hemorrhage rates were recorded. The warfarin medication was superior regarding the overall occurrence of ischemic stroke or systemic embolism as well as non-fatal myocardial infarction and all causes of death outcomes compared to aspirin administration during the 2 years of medication (17.6% vs. 36.0%, p = 0.03), while there was no significant difference of mild (5 vs. 4), severe (2 vs. 1), and fatal (1 vs. 1) hemorrhage incidences between the warfarin and aspirin groups (p > 0.05). Warfarin was found to be more efficacious than aspirin for an anticoagulation therapy of older Chinese patients with AF and stable coronary heart disease.

Epidemiological dynamics of Ebola outbreaks

PubMed Central

House, Thomas

2014-01-01

Ebola is a deadly virus that causes frequent disease outbreaks in the human population. In this study, we analyse its rate of new introductions, case fatality ratio, and potential to spread from person to person. The analysis is performed for all completed outbreaks and for a scenario where these are augmented by a more severe outbreak of several thousand cases. The results show a fast rate of new outbreaks, a high case fatality ratio, and an effective reproductive ratio of just less than 1. DOI: http://dx.doi.org/10.7554/eLife.03908.001 PMID:25217532

Changing epidemiology of melioidosis? A case of acute pulmonary melioidosis with fatal outcome imported from Brazil.

PubMed Central

Aardema, H.; Luijnenburg, E. M.; Salm, E. F.; Bijlmer, H. A.; Visser, C. E.; Van't Wout, J. W.

2005-01-01

Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is endemic in South East Asia and tropical regions of Northern Australia. Sporadic cases have been described elsewhere. In this article we present a case of acute pulmonary melioidosis with fatal outcome imported from Brazil. The most common pathogen causing severe community-acquired pneumonia in Brazil is Streptococcus pneumoniae. Other possible pathogens include Legionella spp., Mycoplasma pneumonia, Gram-negative rods and viruses. There are few reports of melioidosis in the Americas. This article represents the second known human case of melioidosis from Brazil. Recognition of melioidosis as a possible cause of severe pneumonia, even if a patient has not been travelling in a highly endemic area, is important because of the therapeutic consequences. The epidemiology of melioidosis will be reviewed. PMID:16181507

Malignant catarrhal fever: understanding molecular diagnostics in context of epidemiology

USDA-ARS?s Scientific Manuscript database

Malignant catarrhal fever (MCF) is a frequently fatal disease, primarily of ruminants, caused by a group of gammaherpesviruses. Due to complexities of pathogenesis and epidemiology in various species which are either clinically-susceptible or reservoir hosts, veterinary clinicians face significant ...

Prototheca wickerhamii mimicking yeast: a cautionary tale.

PubMed

McMullan, B; Muthiah, K; Stark, D; Lee, L; Marriott, D

2011-08-01

Prototheca spp. are environmental algae that may cause serious infection in the immunocompromised patient. Clinical manifestations may mimic other diseases. We present a case of fatal infection in a 78-year-old cardiac transplant recipient and discuss pitfalls in the clinical and laboratory diagnoses.

Chalkbrood re-examined

USDA-ARS?s Scientific Manuscript database

Chalkbrood is an invasive mycosis in honey bees (Apis mellifera L.) produced by Ascosphaera apis fungus. Although fatal to individual larvae, the disease does not usually destroy an entire bee colony. However, it can cause significant losses in terms of both bee numbers and colony productivity. Chal...

AGING OF CRYPTOSPORIDIUM PARVUUM OOCYSTS STUDIED BY MALDI-TOF MS

EPA Science Inventory

Cryptosporidium parvum is a protozoan parasite, and it causes a potentially fatal gastrointestinal illness. This water borne pathogen has been the subject of several high profile disease outbreaks in the US and abroad. C. parvum presents challenges for both compliance monitorin...

AGING OF CRYPTOSPORIDIUM PARVUM OOCYSTS STUDIED BY MALDI-TOF MS

EPA Science Inventory

Cryptosporidium parvum is a protozoan parasite, and it causes a potentially fatal gastrointestinal illness. This water borne pathogen has been the subject of several high profile disease outbreaks in the US and abroad. C. parvum presents challenges for both compliance monitoring ...

A treatment for and vaccine against the deadly Hendra and Nipah viruses.

PubMed

Broder, Christopher C; Xu, Kai; Nikolov, Dimitar B; Zhu, Zhongyu; Dimitrov, Dimiter S; Middleton, Deborah; Pallister, Jackie; Geisbert, Thomas W; Bossart, Katharine N; Wang, Lin-Fa

2013-10-01

Hendra virus and Nipah virus are bat-borne paramyxoviruses that are the prototypic members of the genus Henipavirus. The henipaviruses emerged in the 1990s, spilling over from their natural bat hosts and causing serious disease outbreaks in humans and livestock. Hendra virus emerged in Australia and since 1994 there have been 7 human infections with 4 case fatalities. Nipah virus first appeared in Malaysia and subsequent outbreaks have occurred in Bangladesh and India. In total, there have been an estimated 582 human cases of Nipah virus and of these, 54% were fatal. Their broad species tropism and ability to cause fatal respiratory and/or neurologic disease in humans and animals make them important transboundary biological threats. Recent experimental findings in animals have demonstrated that a human monoclonal antibody targeting the viral G glycoprotein is an effective post-exposure treatment against Hendra and Nipah virus infection. In addition, a subunit vaccine based on the G glycoprotein of Hendra virus affords protection against Hendra and Nipah virus challenge. The vaccine has been developed for use in horses in Australia and is the first vaccine against a Biosafety Level-4 (BSL-4) agent to be licensed and commercially deployed. Together, these advances offer viable approaches to address Hendra and Nipah virus infection of livestock and people. Published by Elsevier B.V.

Hendra Virus and Nipah Virus Animal Vaccines

PubMed Central

Weir, Dawn L.; Reid, Peter A.

2016-01-01

Hendra virus (HeV) and Nipah virus (NiV) are zoonotic viruses that emerged in the mid to late 1990s causing disease outbreaks in livestock and people. HeV appeared in Queensland, Australia in 1994 causing a severe respiratory disease in horses along with a human case fatality. NiV emerged a few years later in Malaysia and Singapore in 1998-99 causing a large outbreak of encephalitis with high mortality in people and also respiratory disease in pigs which served as amplifying hosts. The key pathological elements of HeV and NiV infection in several species of mammals, and also in people, are a severe systemic and often fatal neurologic and/or respiratory disease. In people, both HeV and NiV are also capable of causing relapsed encephalitis following recovery from an acute infection. The known reservoir hosts of HeV and NiV are several species of pteropid fruit bats. Spillovers of HeV into horses continue to occur in Australia and NiV has caused outbreaks in people in Bangladesh and India nearly annually since 2001, making HeV and NiV important transboundary biological threats. NiV in particular possesses several features that underscore its potential as a pandemic threat, including its ability to infect humans directly from natural reservoirs or indirectly from other susceptible animals, along with a capacity of limited human-to-human transmission. Several HeV and NiV animal challenge models have been developed which have facilitated an understanding of pathogenesis and allowed for the successful development of both active and passive immunization countermeasures. PMID:27154393

Hendra virus and Nipah virus animal vaccines.

PubMed

Broder, Christopher C; Weir, Dawn L; Reid, Peter A

2016-06-24

Hendra virus (HeV) and Nipah virus (NiV) are zoonotic viruses that emerged in the mid to late 1990s causing disease outbreaks in livestock and people. HeV appeared in Queensland, Australia in 1994 causing a severe respiratory disease in horses along with a human case fatality. NiV emerged a few years later in Malaysia and Singapore in 1998-1999 causing a large outbreak of encephalitis with high mortality in people and also respiratory disease in pigs which served as amplifying hosts. The key pathological elements of HeV and NiV infection in several species of mammals, and also in people, are a severe systemic and often fatal neurologic and/or respiratory disease. In people, both HeV and NiV are also capable of causing relapsed encephalitis following recovery from an acute infection. The known reservoir hosts of HeV and NiV are several species of pteropid fruit bats. Spillovers of HeV into horses continue to occur in Australia and NiV has caused outbreaks in people in Bangladesh and India nearly annually since 2001, making HeV and NiV important transboundary biological threats. NiV in particular possesses several features that underscore its potential as a pandemic threat, including its ability to infect humans directly from natural reservoirs or indirectly from other susceptible animals, along with a capacity of limited human-to-human transmission. Several HeV and NiV animal challenge models have been developed which have facilitated an understanding of pathogenesis and allowed for the successful development of both active and passive immunization countermeasures. Published by Elsevier Ltd.

Non-fatal disease burden for subtypes of depressive disorder: population-based epidemiological study.

PubMed

Biesheuvel-Leliefeld, Karolien E M; Kok, Gemma D; Bockting, Claudi L H; de Graaf, Ron; Ten Have, Margreet; van der Horst, Henriette E; van Schaik, Anneke; van Marwijk, Harm W J; Smit, Filip

2016-05-12

Major depression is the leading cause of non-fatal disease burden. Because major depression is not a homogeneous condition, this study estimated the non-fatal disease burden for mild, moderate and severe depression in both single episode and recurrent depression. All estimates were assessed from an individual and a population perspective and presented as unadjusted, raw estimates and as estimates adjusted for comorbidity. We used data from the first wave of the second Netherlands-Mental-Health-Survey-and-Incidence-Study (NEMESIS-2, n = 6646; single episode Diagnostic and Statistical Manual (DSM)-IV depression, n = 115; recurrent depression, n = 246). Disease burden from an individual perspective was assessed as 'disability weight * time spent in depression' for each person in the dataset. From a population perspective it was assessed as 'disability weight * time spent in depression *number of people affected'. The presence of mental disorders was assessed with the Composite International Diagnostic Interview (CIDI) 3.0. Single depressive episodes emerged as a key driver of disease burden from an individual perspective. From a population perspective, recurrent depressions emerged as a key driver. These findings remained unaltered after adjusting for comorbidity. The burden of disease differs between the subtype of depression and depends much on the choice of perspective. The distinction between an individual and a population perspective may help to avoid misunderstandings between policy makers and clinicians.

Cathelicidin Insufficiency in Patients with Fatal Leptospirosis.

PubMed

Lindow, Janet C; Wunder, Elsio A; Popper, Stephen J; Min, Jin-Na; Mannam, Praveen; Srivastava, Anup; Yao, Yi; Hacker, Kathryn P; Raddassi, Khadir; Lee, Patty J; Montgomery, Ruth R; Shaw, Albert C; Hagan, Jose E; Araújo, Guilherme C; Nery, Nivison; Relman, David A; Kim, Charles C; Reis, Mitermayer G; Ko, Albert I

2016-11-01

Leptospirosis causes significant morbidity and mortality worldwide; however, the role of the host immune response in disease progression and high case fatality (>10-50%) is poorly understood. We conducted a multi-parameter investigation of patients with acute leptospirosis to identify mechanisms associated with case fatality. Whole blood transcriptional profiling of 16 hospitalized Brazilian patients with acute leptospirosis (13 survivors, 3 deceased) revealed fatal cases had lower expression of the antimicrobial peptide, cathelicidin, and chemokines, but more abundant pro-inflammatory cytokine receptors. In contrast, survivors generated strong adaptive immune signatures, including transcripts relevant to antigen presentation and immunoglobulin production. In an independent cohort (23 survivors, 22 deceased), fatal cases had higher bacterial loads (P = 0.0004) and lower anti-Leptospira antibody titers (P = 0.02) at the time of hospitalization, independent of the duration of illness. Low serum cathelicidin and RANTES levels during acute illness were independent risk factors for higher bacterial loads (P = 0.005) and death (P = 0.04), respectively. To investigate the mechanism of cathelicidin in patients surviving acute disease, we administered LL-37, the active peptide of cathelicidin, in a hamster model of lethal leptospirosis and found it significantly decreased bacterial loads and increased survival. Our findings indicate that the host immune response plays a central role in severe leptospirosis disease progression. While drawn from a limited study size, significant conclusions include that poor clinical outcomes are associated with high systemic bacterial loads, and a decreased antibody response. Furthermore, our data identified a key role for the antimicrobial peptide, cathelicidin, in mounting an effective bactericidal response against the pathogen, which represents a valuable new therapeutic approach for leptospirosis.

Dendritic Cells Endocytose Bacillus Anthracis Spores: Implications for Anthrax Pathogenesis

DTIC Science & Technology

2005-02-15

29. Horwitz, M. A. 1984. Phagocytosis of the Legionnaires ’ disease bacterium (Le- gionella pneumophila) occurs by a novel mechanism: engulfment within...Journal of Immunology, 2005, 174: 5545–5552. I nhalational anthrax, a disease that was exploited for bioter-rorism (1), is most often fatal and causes...them out of the lungs. However, mice that were chemically depleted of macrophages and infected with spores by aerosol nev- ertheless experienced disease

Fatalities from occupational diseases in Connecticut.

PubMed

Morse, T; Storey, E

1999-08-01

Occupational diseases in Connecticut were identified using reports to the Workers' Compensation Commission, Connecticut OSHA, Vital Statistics, and the Tumor Registry. There were 93 identified fatalities from occupational disease in 1995, and 90 in 1994, approximately three times the number of traumatic occupational fatalities. Identified fatalities were predominantly from asbestos-related diseases, including mesothelioma and asbestosis. Most occupational diseases are not readily identifiable with current reporting mechanisms. Based on national estimates, these figures are considered to be an underestimate of the true burden of occupational disease. Increased awareness and reporting of occupational diseases is needed to properly identify and prevent these common conditions.

Heart rate is a prognostic risk factor for myocardial infarction: a post hoc analysis in the PERFORM (Prevention of cerebrovascular and cardiovascular Events of ischemic origin with teRutroban in patients with a history oF ischemic strOke or tRansient ischeMic attack) study population.

PubMed

Fox, Kim; Bousser, Marie-Germaine; Amarenco, Pierre; Chamorro, Angel; Fisher, Marc; Ford, Ian; Hennerici, Michael G; Mattle, Heinrich P; Rothwell, Peter M

2013-10-09

Elevated resting heart rate is known to be detrimental to morbidity and mortality in cardiovascular disease, though its effect in patients with ischemic stroke is unclear. We analyzed the effect of baseline resting heart rate on myocardial infarction (MI) in patients with a recent noncardioembolic cerebral ischemic event participating in PERFORM. We compared fatal or nonfatal MI using adjusted Cox proportional hazards models for PERFORM patients with baseline heart rate <70 bpm (n=8178) or ≥70 bpm (n=10,802). In addition, heart rate was analyzed as a continuous variable. Other cerebrovascular and cardiovascular outcomes were also explored. Heart rate ≥70 bpm was associated with increased relative risk for fatal or nonfatal MI (HR 1.32, 95% CI 1.03-1.69, P=0.029). For every 5-bpm increase in heart rate, there was an increase in relative risk for fatal and nonfatal MI (11.3%, P=0.0002). Heart rate ≥70 bpm was also associated with increased relative risk for a composite of fatal or nonfatal ischemic stroke, fatal or nonfatal MI, or other vascular death (excluding hemorrhagic death) (P<0001); vascular death (P<0001); all-cause mortality (P<0001); and fatal or nonfatal stroke (P=0.04). For every 5-bpm increase in heart rate, there were increases in relative risk for fatal or nonfatal ischemic stroke, fatal or nonfatal MI, or other vascular death (4.7%, P<0.0001), vascular death (11.0%, P<0.0001), all-cause mortality (8.0%, P<0.0001), and fatal and nonfatal stroke (2.4%, P=0.057). Elevated heart rate ≥70 bpm places patients with a noncardioembolic cerebral ischemic event at increased risk for MI. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

hTERT-immortalized ovine microglia propagate natural scrapie isolates

USDA-ARS?s Scientific Manuscript database

Scrapie is a transmissible fatal neurodegenerative disease of sheep that is caused by a novel infectious agent called a prion. The study of prions under controlled culture conditions is crucial to advancing knowledge regarding prion processes of replication and accumulation within cells. Unfortunate...

CWDPRNP: A tool for cervid prion sequence analysis in program R

USGS Publications Warehouse

Miller, William L.; Walter, W. David

2017-01-01

Chronic wasting disease is a fatal, neurological disease caused by an infectious prion protein, which affects economically and ecologically important members of the family Cervidae. Single nucleotide polymorphisms within the prion protein gene have been linked to differential susceptibility to the disease in many species. Wildlife managers are seeking to determine the frequencies of disease-associated alleles and genotypes and delineate spatial genetic patterns. The CWDPRNP package, implemented in program R, provides a unified framework for analyzing prion protein gene variability and spatial structure.

Study design of ASPirin in Reducing Events in the Elderly (ASPREE): a randomized, controlled trial.

PubMed

2013-11-01

Cost-effective strategies to maintain healthy active lifestyle in aging populations are required to address the global burden of age-related diseases. ASPREE will examine whether the potential primary prevention benefits of low dose aspirin outweigh the risks in older healthy individuals. Our primary hypothesis is that daily oral 100 mg enteric-coated aspirin will extend a composite primary endpoint termed 'disability-free life' including onset of dementia, total mortality, or persistent disability in at least one of the Katz Activities of Daily Living in 19,000 healthy participants aged 65 years and above ('US minorities') and 70 years and above (non-'US minorities'). ASPREE is a double-blind, randomized, placebo-controlled trial of oral 100mg enteric-coated acetyl salicylic acid (ASA) or matching placebo being conducted in Australian and US community settings on individuals free of dementia, disability and cardiovascular disease (CVD) events. Secondary endpoints are all-cause and cause specific mortality, fatal and non-fatal cardiovascular events, fatal and non-fatal cancer (excluding non-melanoma skin cancer), dementia, mild cognitive impairment, depression, physical disability, and clinically significant bleeding. To 20 September 2013 14,383 participants have been recruited. Recruitment and study completion are anticipated in July 2014 and December 2018 respectively. In contrast to other aspirin trials that have largely focused on cardiovascular endpoints, ASPREE has a unique composite primary endpoint to better capture the overall risk and benefit of aspirin to extend healthy independent lifespan in older adults in the US and Australia. © 2013. Published by Elsevier Inc. All rights reserved.

Graphical fault tree analysis for fatal falls in the construction industry.

PubMed

Chi, Chia-Fen; Lin, Syuan-Zih; Dewi, Ratna Sari

2014-11-01

The current study applied a fault tree analysis to represent the causal relationships among events and causes that contributed to fatal falls in the construction industry. Four hundred and eleven work-related fatalities in the Taiwanese construction industry were analyzed in terms of age, gender, experience, falling site, falling height, company size, and the causes for each fatality. Given that most fatal accidents involve multiple events, the current study coded up to a maximum of three causes for each fall fatality. After the Boolean algebra and minimal cut set analyses, accident causes associated with each falling site can be presented as a fault tree to provide an overview of the basic causes, which could trigger fall fatalities in the construction industry. Graphical icons were designed for each falling site along with the associated accident causes to illustrate the fault tree in a graphical manner. A graphical fault tree can improve inter-disciplinary discussion of risk management and the communication of accident causation to first line supervisors. Copyright © 2014 Elsevier Ltd. All rights reserved.

Susceptibility to Phytophthora ramorum in California bay laurel, a key foliar host of sudden oak death

Treesearch

Brian L. Anacker; Nathan E. Rank; Daniel Hüberli; Matteo Garbelotto; Sarah Gordon; Rich Whitkus; Tami Harnik; Matthew Meshriy; Lori Miles; Ross K. Meentemeyer

2008-01-01

Sudden oak death, caused by the water mold Phytophthora ramorum, is a plant disease responsible for the death of hundreds of thousands of oak and tanoak trees. Some foliar hosts play a major role in the epidemiology of this disease. Upon infection by P. ramorum, these foliar hosts express non-fatal leaf lesions from which large...

Erosive-throat with rash (scarlet fever), an investigation on its brief history.

PubMed

Yu, Y

1998-07-01

Being a kind of epidemic contagious disease in modern time, erosive-throat with rash was a fatal disease causing numerous victims. High attention was paid to by traditional medical professionals through various fields, theoretical and clinical. A correct conclusion was reached claiming that TCM did make contributions to its prevention and treatment before effective treatment in western medicine appeared in China.

Escherichia coli O157:H7: Recent Advances in Research on Occurrence, Transmission, and Control in Cattle and the Production Environment

USDA-ARS?s Scientific Manuscript database

Escherichia coli O157:H7 is a zoonotic pathogen that is an important cause of human food- and waterborne disease, with a spectrum of illnesses ranging from asymptomatic carriage and diarrhea to the sometimes fatal hemolytic uremic syndrome. Outbreaks of E. coli O157:H7 disease are frequently associ...

Worldwide Report: Epidemiology.

DTIC Science & Technology

1985-07-17

BANGLADESH Toxoplasmosis Found for First Time in Bangladesh (THE NEW NATION, 27 May 85) 56 Briefs Cattle Disease Epidemic 57 Fatal Cattle...Harare FINANCIAL GAZETTE in English 31 May 85 "Farming Gazette" Supplement p 32] GSO: 5400/158 55 TOXOPLASMOSIS FOUND FOR FIRST TIME IN...34 toxoplasmosis " in Bangladesh, says a press release. Toxoplasmosis is a ubiqui- tous disease affecting all species; of animals including man, caused by

Passively Administered Pooled Human Immunoglobulins Exert IL-10 Dependent Anti-Inflammatory Effects that Protect against Fatal HSV Encephalitis

PubMed Central

Ramakrishna, Chandran; Newo, Alain N. S.; Shen, Yueh-Wei; Cantin, Edouard

2011-01-01

HSV-1 is the leading cause of sporadic encephalitis in humans. HSV infection of susceptible 129S6 mice results in fatal encephalitis (HSE) caused by massive inflammatory brainstem lesions comprising monocytes and neutrophils. During infection with pathogenic microorganisms or autoimmune disease, IgGs induce proinflammatory responses and recruit innate effector cells. In contrast, high dose intravenous immunoglobulins (IVIG) are an effective treatment for various autoimmune and inflammatory diseases because of potent anti-inflammatory effects stemming in part from sialylated IgGs (sIgG) present at 1–3% in IVIG. We investigated the ability of IVIG to prevent fatal HSE when given 24 h post infection. We discovered a novel anti-inflammatory pathway mediated by low-dose IVIG that protected 129S6 mice from fatal HSE by modulating CNS inflammation independently of HSV specific antibodies or sIgG. IVIG suppressed CNS infiltration by pathogenic CD11b+ Ly6Chigh monocytes and inhibited their spontaneous degranulation in vitro. FcγRIIb expression was required for IVIG mediated suppression of CNS infiltration by CD45+ Ly6Clow monocytes but not for inhibiting development of Ly6Chigh monocytes. IVIG increased accumulation of T cells in the CNS, and the non-sIgG fraction induced a dramatic expansion of FoxP3+ CD4+ T regulatory cells (Tregs) and FoxP3− ICOS+ CD4+ T cells in peripheral lymphoid organs. Tregs purified from HSV infected IVIG treated, but not control, mice protected adoptively transferred mice from fatal HSE. IL-10, produced by the ICOS+ CD4+ T cells that accumulated in the CNS of IVIG treated, but not control mice, was essential for induction of protective anti-inflammatory responses. Our results significantly enhance understanding of IVIG's anti-inflammatory and immunomodulatory capabilities by revealing a novel sIgG independent anti-inflammatory pathway responsible for induction of regulatory T cells that secrete the immunosuppressive cytokine IL-10 and further reveal the therapeutic potential of IVIG for treating viral induced inflammatory diseases. PMID:21655109

Neglecting safety precautions may lead to trenching fatalities.

PubMed

Deatherage, J Harold; Furches, Lisa K; Radcliffe, Mike; Schriver, William R; Wagner, John P

2004-06-01

Trench collapses ranked as the seventh leading cause of the possible twenty-nine causes of OSHA-inspected fatal construction events during the period 1991-2001. This study aims to examine why these fatalities occurred. Forty-four case files from OSHA inspections of fatal trench collapses were reviewed. Improper protection of the excavation site where work was taking place was the leading fatality cause. Several organizational or physical conditions were present at many fatal sites; the most frequent was that no training had been provided for trenching. Presence of a competent, diligent person at the site would have prohibited most fatalities. The top cited violation was lack of protection, that is, benching, shoring, sloping, trench boxes, etc. (29 CFR 1926.652 (a) (1)). Copyright 2004 Wiley-Liss, Inc.

The expanding universe of prion diseases.

PubMed

Watts, Joel C; Balachandran, Aru; Westaway, David

2006-03-01

Prions cause fatal and transmissible neurodegenerative disease. These etiological infectious agents are formed in greater part from a misfolded cell-surface protein called PrP(C). Several mammalian species are affected by the diseases, and in the case of "mad cow disease" (BSE) the agent has a tropism for humans, with negative consequences for agribusiness and public health. Unfortunately, the known universe of prion diseases is expanding. At least four novel prion diseases--including human diseases variant Creutzfeldt-Jakob disease (vCJD) and sporadic fatal insomnia (sFI), bovine amyloidotic spongiform encephalopathy (BASE), and Nor98 of sheep--have been identified in the last ten years, and chronic wasting disease (CWD) of North American deer (Odocoileus Specis) and Rocky Mountain elk (Cervus elaphus nelsoni) is undergoing a dramatic spread across North America. While amplification (BSE) and dissemination (CWD, commercial sourcing of cervids from the wild and movement of farmed elk) can be attributed to human activity, the origins of emergent prion diseases cannot always be laid at the door of humankind. Instead, the continued appearance of new outbreaks in the form of "sporadic" disease may be an inevitable outcome in a situation where the replicating pathogen is host-encoded.

Prototheca wickerhamii Mimicking Yeast: a Cautionary Tale ▿

PubMed Central

McMullan, B.; Muthiah, K.; Stark, D.; Lee, L.; Marriott, D.

2011-01-01

Prototheca spp. are environmental algae that may cause serious infection in the immunocompromised patient. Clinical manifestations may mimic other diseases. We present a case of fatal infection in a 78-year-old cardiac transplant recipient and discuss pitfalls in the clinical and laboratory diagnoses. PMID:21653770

Particles Alter Diesel Exhaust Gases-Induced Hypotension, Cardiac Arrhythmia,Conduction Disturbance, and Autonomic Imbalance in Heart Failure-Prone Rats

EPA Science Inventory

Epidemiologic studies indicate that acute exposures to vehicular traffic and particulate matter (PM) air pollution are key causes of fatal cardiac arrhythmia, especially in those with preexisting cardiovascular disease. Researchers point to electrophysiologic dysfunction and auto...

A multi-state collaborative effort to conserve butternut Ex Situ

Treesearch

M.V. Coggeshall; S.M. Hoban; A. Flickinger; T.J. Hall; P. O’Connor; B. Schultz; S.A. Anagnostakis; J. Romero-Severson

2017-01-01

Butternut (Juglans cinerea), a native riparian forest tree, has suffered significant decline throughout most of its range due to a fatal fungal disease, butternut canker (caused by Sirococcus clavigignenti-juglandacearum). It has also been subject to natural hybridization pressures from Japanese walnut (J. ailantifolia), first...

Ebola hemorrhagic Fever.

PubMed

Burnett, Mark W

2014-01-01

Ebola hemorrhagic fever is an often-fatal disease caused by a virus of the Filoviridae family, genus Ebolavirus. Initial signs and symptoms of the disease are nonspecific, often progressing on to a severe hemorrhagic illness. Special Operations Forces Medical Providers should be aware of this disease, which occurs in sporadic outbreaks throughout Africa. Treatment at the present time is mainly supportive. Special care should be taken to prevent contact with bodily fluids of those infected, which can transmit the virus to caregivers. 2014.

To Live Like a Pig and Die Like a Dog: Environmental Implications for World War I in East Africa

DTIC Science & Technology

2009-12-03

held decisive advantages including greater numbers of troops, more robust logistics, and unchallenged control of the sea lines of communications...The Center for Disease Control defines malaria as “a serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of...malaria parasites that can infect humans, Plasmodium falciparum remains indigenous to east 32 Center for Disease Control, “Malaria Home > Frequently

Treatment and recovery.

PubMed

Raia, Susan

2005-01-01

Addiction is a chronic, progressive, fatal disease. It is a primary disease, not caused by any other disease process. It has recognizable symptoms that if left untreated, can lead to premature death, deterioration of physical conditions, social withdrawal and disintegration of all support systems. The family and co-workers are affected as well. There is no cure, but we know that treatment works! Don't stand by while someone you care about needs help. Nurses helping nurses, let's take care of our own.

The “First” Case of Cholera in Haiti: Lessons for Global Health

PubMed Central

Ivers, Louise C.; Walton, David A.

2012-01-01

Cholera is an acute watery diarrheal disease caused by infection with Vibrio cholerae. The disease has a high fatality rate when untreated and outbreaks of cholera have been increasing globally in the past decade, most recently in Haiti. We present the case of a 28-year-old Haitian male with a history of severe untreated mental health disorder that developed acute fatal watery diarrhea in mid-October 2010 in central Haiti after drinking from the local river. We believe he is the first or among the first cases of cholera in Haiti during the current epidemic. By reviewing his case, we extracted lessons for global health on the importance of mental health for overall health, the globalization of diseases in small communities, and the importance of a comprehensive approach to the health of communities when planning services in resource-poor settings. PMID:22232448

Fatal Primary Capillary Leak Syndrome in a Late Preterm Newborn.

PubMed

Kulihova, Katarina; Prochazkova, Martina; Semberova, Jana; Janota, Jan

2016-10-01

Primary capillary leak syndrome is a rare disease of unknown etiology, characterized by episodes of vascular collapse and plasma extravasation, which may lead to multiple organ failure. Primary capillary leak is extremely rare in children. The authors report a case of a late preterm newborn with fatal capillary leak syndrome of unknown etiology, manifesting as hypotension unresponsive to treatment, extravasation leading to generalised edema, disseminated intravascular coagulation and finally, multiple organ dysfunction syndrome. Aggressive volumotherapy and a combination of inotropes and high doses of terlipressin did not influence systemic vascular collapse and plasma extravasation. The newborn developed multiple organ failure and died on day 27 of life. Investigations performed failed to reveal any specific cause of capillary leak. This is the first report of a fatal primary capillary leak syndrome in a newborn.

Musical Instrument-Associated Health Issues and Their Management.

PubMed

Okoshi, Kae; Minami, Taro; Kikuchi, Masahiro; Tomizawa, Yasuko

2017-09-01

Playing musical instruments can bring joy to people, but can also cause a wide variety of health issues that range from mild disorders to potentially fatal conditions. Although sports medicine is an established medical subspecialty, relatively few studies have investigated the health issues associated with musical instruments. Here we present an overview of these health issues. These include infections due to microorganisms, allergic reactions, as well as mechanical injuries from sustained high pressures within the oral, mediastinal, thoracic, and abdominal cavities. For example, wind instruments can potentially harbor thousands of pathogenic organisms. If several players share the same instrument, these instruments present potential hazards in the spread of infections. A fatal case of hypersensitivity pneumonitis in a bagpiper is particularly noteworthy. Similarly, a case of gastrointestinal anthrax in an animal-hide drummer is a reminder of this rare but highly fatal disease. Although not fatal, hearing-related disorders, neuromuscular issues, musculoskeletal problems, and contact dermatitis are also very common among instrumentalists. This review aims to illuminate these under-recognized health issues by highlighting both the common conditions and the rare but fatal cases.

Fatal cervical spine injuries: a Finnish nationwide register-based epidemiologic study on data from 1987 to 2010.

PubMed

Thesleff, Tuomo; Niskakangas, Tero; Luoto, Teemu M; Öhman, Juha; Ronkainen, Antti

2016-08-01

The number of cervical spine injuries (CSIs) is increasing. Cervical spine injuries are associated with high morbidity and mortality. Identifying those who are at risk for CSI-related death can help develop national and international interventions and policies to reduce mortality. This study aimed to determine the trends in the incidence and the characteristics of fatal CSIs in Finland over a 24-year study period from 1987 to 2010. A large nationwide, retrospective, register-based study was carried out. The population-based sample was collected from death certificates issued in Finland between 1987 and 2010. The death certificates were obtained from the official Cause-of-Death Register, coordinated by Statistics Finland, which covers all deaths occurring in Finland. Sociodemographics and injury- and death-related data were used for outcome measures. All death certificates issued in Finland (1987-2010) containing a CSI as the cause of death were carefully reviewed. A total of 2,041 fatal CSIs were identified. These constituted 0.17% of all deaths in Finland within the study period. The average annual incidence of fatal CSIs was 16.5 per million (range: 12.5-21.2). The majority of the victims were male (72.9%) and had concurrent spinal cord injury (83.0%). Traffic accidents (40.1%) and falls (45.0%) were the most common injury mechanisms. Almost one-third (29.8%) of the deaths were alcohol-related. Among the young victims (<60 years) with upper CSI (C0-C2), the majority (91.8%) died within 24 hours post-injury. One-third of elderly victims' (≥60 years) CSI-related deaths occurred after 1 week post-injury and were mostly (74.2%) caused by respiratory and circulatory system diseases. Within the 24-year period, the incidence of fatal CSIs (+2/million), as well as the average age of sustaining a fatal CSI (+13.5 years), increased markedly. Fall-induced accidents among elderly males were the most prominently increasing subpopulation of fatal CSI victims. In recent decades, fatal CSI incidence (death certificate-based) has increased, being 18.6 per million in Finland in 2010. Victims of fatal CSIs tend to be older than in the past, and for a substantial number of males, low-energy falls lead to cervical trauma and death. Copyright © 2015 Elsevier Inc. All rights reserved.

[Cause of death after liver transplantation: an analysis of 41 cases in 382 patients].

PubMed

Rayes, N; Bechstein, W O; Keck, H; Blumhardt, G; Lohmann, R; Neuhaus, P

1995-01-01

The aim of this study was to analyse the causes of death after liver transplantation in order to find and to avoid preventable fatal complications if possible. Between September 1988 and September 1993 415 orthotopic liver transplantations in 382 patients were performed at the Rudolf Virchow University Hospital in Berlin. During the same interval 41 (10.7%) of these patients died. Their clinical records were reviewed. The main cause of death was infection (29.3%), followed by recurrent malignancy (21.9%). Less patients died because of hepatitis B-reinfection (14.6%), chronic rejection (7.3%), hemorrhage (7.3%), cardiac failure (7.3%), trauma (4.8%), hypoxia (4.8%) and recurrence of alcoholic liver disease (4.8%). There was a wide spectrum of opportunistic infectious agents with CMV and Pneumocystis carinii being the most important pathogenic organisms. Only one isolated bacterial infection as principle cause of death was found. In all fatal infections the lung was the primary site of infection, 7 patients additionally developed sepsis. Altogether 75 patients (19.6%) with hepatitis B-cirrhosis were transplanted. Six of them (8%) developed a fatal hepatitis B-reinfection. Malignancy was the indication for OLT in 41 patients (10.7%). Six of these patients (14.6%) died because of recurrent tumor. Regarding the whole series, most deaths occurred four to twelve months (58.5%) and only five (12.2%) during the first month after OLT. Recurrence of primary disease is an important factor regarding total mortality. Therefore it is necessary to practise a careful selection of liver transplant recipients. In the future more attention needs to be drawn towards prevention, identification and management of opportunistic infections.

The Aβ oligomer hypothesis for synapse failure and memory loss in Alzheimer's diseas

PubMed Central

Ferreira, Sergio T; Klein, William L

2015-01-01

Alzheimer's disease is the 3rd most costly disease and is estimated to be the 6th leading cause of death. Alzheimer's disease (AD) is fatal and affected individuals can sometimes linger many years. Current treatments are palliative and transient, not disease modifying. This article reviews progress in the search to identify the primary AD-causing toxins. We summarize the shift from an initial focus on amyloid plaques to the contemporary concept that AD memory failure is caused by small soluble oligomers of the Aβ peptide, toxins that target and disrupt particular synapses. Evidence is presented that links Aβ oligomers to pathogenesis in animal models and humans, with reference to seminal discoveries from cell biology and new ideas concerning pathogenic mechanisms. These findings have established the oligomer hypothesis as a new molecular basis for the cause, diagnosis, and treatment of AD. PMID:21914486

Is diabetes mellitus a heart disease equivalent in women? Results from an international study of postmenopausal women in the Raloxifene Use for the Heart (RUTH) Trial.

PubMed

Daniels, Lori B; Grady, Deborah; Mosca, Lori; Collins, Peter; Mitlak, Bruce H; Amewou-Atisso, Messan G; Wenger, Nanette K; Barrett-Connor, Elizabeth

2013-03-01

Several studies have concluded that diabetes mellitus and heart disease carry similar risk for future cardiovascular disease (CVD). Most of these studies were too small to quantify independent risks specific to women. The purpose of this study was to determine whether diabetes mellitus is a coronary heart disease (CHD) risk equivalent for prediction of future CHD and CVD events in women. The Raloxifene Use for the Heart (RUTH) trial was an international, multicenter, double-blind, randomized, placebo-controlled trial of raloxifene and CVD outcomes in 10 101 postmenopausal women selected for high CHD risk. Of these, 3672 had a history of diabetes mellitus without known CHD, and 3265 had a history of CHD without known diabetes mellitus. Cox proportional hazard models were used to compare cardiovascular outcomes in these 2 groups. Mean age at baseline was 67.5 years; median follow-up was 5.6 years. There were 725 deaths, including 450 cardiovascular deaths. In age-adjusted analyses, diabetic women had an increased risk of all-cause mortality compared with women with CHD. Although the overall risk of CHD and CVD was lower in diabetic women compared with women with CHD, the risk of fatal CHD, fatal CVD, and all-cause mortality was similar (hazard ratio [95% confidence interval]: 0.85 [0.65-1.12], 0.99 [0.78-1.25], and 1.18 [0.98-1.42], respectively, after adjusting for age, lifestyle factors, CHD risk factors, statin use, and treatment assignment). In the RUTH trial, diabetes mellitus was a CHD risk equivalent in women for fatal, but not nonfatal, CHD and CVD.

Risk of fatal amebic meningoencephalitis from waterborne Naegleria fowleri

NASA Astrophysics Data System (ADS)

Hallenbeck, William H.; Brenniman, Gary R.

1989-03-01

Primary amebic meningoencephalitis (PAM) is a fatal disease of the central nervous system caused primarily by the free-living ameba, Naegleria fowleri. PAM is primarily associated with swimming in various types of fresh water. World literature was reviewed in order to derive a risk analysis model that would be helpful in the management of PAM. The management of PAM risk is difficult, and the prevention of PAM is almost impossible. However, it is reassuring that the cases and risks estimated by the risk model are usually small, with individual annual risk on the order of 10-6.

Camouflage and misdirection: the full-on assault of ebola virus disease.

PubMed

Misasi, John; Sullivan, Nancy J

2014-10-23

Ebolaviruses cause a severe hemorrhagic fever syndrome that is rapidly fatal to humans and nonhuman primates. Ebola protein interactions with host cellular proteins disrupt type I and type II interferon responses, RNAi antiviral responses, antigen presentation, T-cell-dependent B cell responses, humoral antibodies, and cell-mediated immunity. This multifaceted approach to evasion and suppression of innate and adaptive immune responses in their target hosts leads to the severe immune dysregulation and "cytokine storm" that is characteristic of fatal ebolavirus infection. Here, we highlight some of the processes by which Ebola interacts with its mammalian hosts to evade antiviral defenses.

Fatal anaphylaxis registries data support changes in the who anaphylaxis mortality coding rules.

PubMed

Tanno, Luciana Kase; Simons, F Estelle R; Annesi-Maesano, Isabella; Calderon, Moises A; Aymé, Ségolène; Demoly, Pascal

2017-01-13

Anaphylaxis is defined as a severe life-threatening generalized or systemic hypersensitivity reaction. The difficulty of coding anaphylaxis fatalities under the World Health Organization (WHO) International Classification of Diseases (ICD) system is recognized as an important reason for under-notification of anaphylaxis deaths. On current death certificates, a limited number of ICD codes are valid as underlying causes of death, and death certificates do not include the word anaphylaxis per se. In this review, we provide evidences supporting the need for changes in WHO mortality coding rules and call for addition of anaphylaxis as an underlying cause of death on international death certificates. This publication will be included in support of a formal request to the WHO as a formal request for this move taking the 11 th ICD revision.

The prevalence and burden of mental and substance use disorders in Australia: Findings from the Global Burden of Disease Study 2015.

PubMed

Ciobanu, Liliana G; Ferrari, Alize J; Erskine, Holly E; Santomauro, Damian F; Charlson, Fiona J; Leung, Janni; Amare, Azmeraw T; Olagunju, Andrew T; Whiteford, Harvey A; Baune, Bernhard T

2018-05-01

Timely and accurate assessments of disease burden are essential for developing effective national health policies. We used the Global Burden of Disease Study 2015 to examine burden due to mental and substance use disorders in Australia. For each of the 20 mental and substance use disorders included in Global Burden of Disease Study 2015, systematic reviews of epidemiological data were conducted, and data modelled using a Bayesian meta-regression tool to produce prevalence estimates by age, sex, geography and year. Prevalence for each disorder was then combined with a disorder-specific disability weight to give years lived with disability, as a measure of non-fatal burden. Fatal burden was measured as years of life lost due to premature mortality which were calculated by combining the number of deaths due to a disorder with the life expectancy remaining at the time of death. Disability-adjusted life years were calculated by summing years lived with disability and years of life lost to give a measure of total burden. Uncertainty was calculated around all burden estimates. Mental and substance use disorders were the leading cause of non-fatal burden in Australia in 2015, explaining 24.3% of total years lived with disability, and were the second leading cause of total burden, accounting for 14.6% of total disability-adjusted life years. There was no significant change in the age-standardised disability-adjusted life year rates for mental and substance use disorders from 1990 to 2015. Global Burden of Disease Study 2015 found that mental and substance use disorders were leading contributors to disease burden in Australia. Despite several decades of national reform, the burden of mental and substance use disorders remained largely unchanged between 1990 and 2015. To reduce this burden, effective population-level preventions strategies are required in addition to effective interventions of sufficient duration and coverage.

Severe pandemic 2009 H1N1 influenza disease due to pathogenic immune complexes

PubMed Central

Monsalvo, Ana Clara; Batalle, Juan P.; Lopez, M. Florencia; Krause, Jens C.; Klemenc, Jennifer; Zea, Johanna; Maskin, Bernardo; Bugna, Jimena; Rubinstein, Carlos; Aguilar, Leandro; Dalurzo, Liliana; Libster, Romina; Savy, Vilma; Baumeister, Elsa; Aguilar, Liliana; Cabral, Graciela; Font, Julia; Solari, Liliana; Weller, Kevin P.; Johnson, Joyce; Echavarria, Marcela; Edwards, Kathryn M.; Chappell, James D.; Crowe, James E.; Williams, John V.; Melendi, Guillermina A.; Polack, Fernando P.

2010-01-01

Pandemic influenza viruses often cause severe disease in middle-aged adults without preexistent co-morbidities. The mechanism of illness associated with severe disease in this age group is not well understood1–10. Here, we demonstrate preexisting serum antibody that cross-reacts with, but does not protect against 2009 H1N1 influenza virus in middle-aged adults. Non-protective antibody is associated with immune complex(IC)-mediated disease after infection. High titers of serum antibody of low avidity for H1-2009 antigen, and low avidity pulmonary ICs against the same protein were detected in severely ill patients. Moreover, C4d deposition - a sensitive marker of complement activation mediated by ICs- was present in lung sections of fatal cases. Archived lung sections from adults with confirmed fatal influenza 1957 H2N2 infection revealed a similar mechanism of illness. These observations provide a novel biological mechanism for the unusual age distribution of severe cases during influenza pandemics. PMID:21131958

Ten Genome Sequences of Human and Livestock Isolates of Bacillus anthracis from the Country of Georgia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khmaladze, Ekaterine; Dzavashvili, Giorgi; Chanturia, Gvantsa

Bacillus anthracis causes the acute fatal disease anthrax, is a proven biological weapon, and is endemic in Georgia, where human and animal cases are reported annually. Furthermore, we present whole-genome sequences of 10 historical B. anthracis strains from Georgia.

Perinatal consumption of thiamin-fortified fish sauce in rural Cambodia: a randomized controlled efficacy trial

USDA-ARS?s Scientific Manuscript database

Importance: Infantile beriberi, a potentially fatal disease caused by thiamin deficiency, remains a public health concern in Cambodia and regions where B-vitamin poor, polished white rice is a staple food. Low maternal thiamin intake reduces breast milk thiamin concentrations, placing breastfed infa...

Sarcocystis neurona retinochoroiditis in a sea otter (Enhydra lutris kenyoni)

USDA-ARS?s Scientific Manuscript database

Sarcocystis neurona is an important cause of fatal disease in sea otters in the USA. Encephalitis is the predominant lesion and parasites are confined to the central nervous system and muscles. Here we report retinochoroiditis in a sea otter (Enhydra lutris kenyoni) found dead on Copalis Beach, WA, ...

Ten Genome Sequences of Human and Livestock Isolates of Bacillus anthracis from the Country of Georgia

DOE PAGES

Khmaladze, Ekaterine; Dzavashvili, Giorgi; Chanturia, Gvantsa; ...

2017-05-11

Bacillus anthracis causes the acute fatal disease anthrax, is a proven biological weapon, and is endemic in Georgia, where human and animal cases are reported annually. Furthermore, we present whole-genome sequences of 10 historical B. anthracis strains from Georgia.

Safety in numbers : using statistics to make the transportation system safer : safety data action plan

DOT National Transportation Integrated Search

2000-09-13

Deaths and injuries are a major cost in transportation. Transportation fatalities rank third as the cause of lost years of life in the U.S. (behind heart disease and cancer. But the Department of Transportation has not yet responded to this public he...

Development and Characterization of a Mouse Model for Marburg Hemorrhagic Fever

DTIC Science & Technology

2009-07-01

Microbiology. All Rights Reserved. Development and Characterization of a Mouse Model for Marburg Hemorrhagic Fever Kelly L. Warfield,* Steven B...mouse model has hampered an understanding of the pathogenesis and immunity of Marburg hemorrhagic fever (MHF), the disease caused by marburgvirus (MARV...cause severe hemorrhagic fevers in humans and non- human primates (27). The incubation time is estimated to be 3 to 21 days, with human case fatality

Otomastoiditis caused by Candida auris: Case report and literature review.

PubMed

Choi, Hyoung Il; An, Jin; Hwang, Jae Joon; Moon, Soo-Youn; Son, Jun Seong

2017-08-01

Fungal otomastoiditis is a rare disease, but can be fatal for immunocompromised patients. Recently, there have been increasing cases of otologic infection caused by Candida auris. Candida auris can be easily misdiagnosed for other species and treatment is difficult due to multidrug resistance. Clinician should be aware of this rare pathogen, and it should be treated with appropriate antifungal agent with surgical debridement. © 2017 Blackwell Verlag GmbH.

Whole-Genome Sequence of a Suid Herpesvirus-1 Strain Isolated from the Brain of a Hunting Dog in Italy

PubMed Central

Pizzurro, Federica; Mangone, Iolanda; Zaccaria, Guendalina; De Luca, Eliana; Malatesta, Daniela; Innocenti, Marco; Carmine, Irene; Cito, Francesca; Marcacci, Maurilia; Di Sabatino, Daria

2016-01-01

Suid herpesvirus-1 (SHV-1), a DNA virus of the family Herpesviridae, causes a severe and fatal disease in a wide range of mammals. Here, we report the whole-genome sequence of an SHV-1 isolated in Italy in 2014 from the brain of a hunting dog that suffered from an acute and severe disease. PMID:27908993

Distribution and load of elephant endotheliotropic herpesviruses in tissues from associated fatalities of Asian elephants.

PubMed

Seilern-Moy, Katharina; Darpel, Karin; Steinbach, Falko; Dastjerdi, Akbar

2016-07-15

Elephant Endotheliotropic Herpesviruses (EEHVs) are the cause of a highly fatal haemorrhagic disease in elephants primarily affecting young Asian elephants (Elephas maximus) in both captivity and in the wild. The viruses have emerged as a significant threat to Asian elephant conservation, critically affecting overall sustainability of their population. So far insight into the pathogenesis of EEHV infections has been restricted to examination of EEHV-infected tissues. However, little is known about distribution and burden of the viruses within the organs of fatal cases, crucial elements in the understanding of the virus pathogenesis. This study was therefore undertaken to assess the extent of organ and cell involvement in fatal cases of EEHV-1A, 1B and 5 using a quantitative real-time PCR. EEHV-1 and 5 DNA were detectable in all the tissues examined, albeit with substantial differences in the viral DNA load. The highest EEHV-1A DNA load was observed in the liver, followed by the heart, thymus and tongue. EEHV-1B and 5 showed the highest DNA load in the heart, followed by tongue and liver. This study provides new insights into EEHV pathogenicity and has implications in choice of sample type for disease investigation and virus isolation. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Lung pathology and infectious agents in fatal feedlot pneumonias and relationship with mortality, disease onset, and treatments.

PubMed

Fulton, Robert W; Blood, K Shawn; Panciera, Roger J; Payton, Mark E; Ridpath, Julia F; Confer, Anthony W; Saliki, Jeremiah T; Burge, Lurinda T; Welsh, Ronald D; Johnson, Bill J; Reck, Amy

2009-07-01

This study charted 237 fatal cases of bovine respiratory disease (BRD) observed from May 2002 to May 2003 in a single Oklahoma feed yard. Postmortem lung samples were used for agent identification and histopathology. Late in the study, 94 skin samples (ear notches) were tested for Bovine viral diarrhea virus (BVDV) by immunohistochemistry (IHC). Bovine respiratory disease morbidity was 14.7%, and the mortality rate of all causes was 1.3%, with more than half (53.8%) attributed to BRD (0.7% total of all causes). The agents isolated were the following: Mannheimia haemolytica (25.0%), Pasteurella multocida (24.5%), Histophilus somni (10.0%), Arcanobacterium pyogenes (35.0%), Salmonella spp. (0.5%), and Mycoplasma spp. (71.4%). Viruses recovered by cell culture were BVDV-1a noncytopathic (NCP; 2.7%), BVDV-1a cytopathic (CP) vaccine strain (1.8%), BVDV-1b NCP (2.7%), BVDV-2a NCP (3.2%), BVDV-2b CP (0.5%), and Bovine herpesvirus 1 (2.3%). Gel-based polymerase chain reaction (PCR) assays were 4.6% positive for Bovine respiratory syncytial virus and 10.8% positive for Bovine coronavirus. Bovine viral diarrhea virus IHC testing was positive in 5.3% of the animals. The mean values were determined for the treatment data: fatal disease onset (32.65 days), treatment interval (29.15 days), number of antibiotic treatments (2.65), number of different antibiotics (1.89), and day of death (61.81 days). Lesions included the following: 1) duration: acute (21%), subacute (15%), chronic (40.2%), healing (2.8%), normal (18.1%), and autolyzed (2.8%); 2) type of pneumonia: lobar bronchopneumonia (LBP; 27.1%), LBP with pleuritis (49.1%), interstitial pneumonia (5.1%), bronchointerstitial pneumonia (1.4%), septic (0.9%), embolic foci (0.5%), other (2.8%), normal (10.3%), and autolyzed (2.8%); and 3) bronchiolar lesions: bronchiolitis obliterans (39.7%), bronchiolar necrosis (26.6%), bronchiolitis obliterans/bronchiolar necrosis (1.4%), other bronchiolar lesions (6.5%), and bronchiolar lesion negative (25.7%). Statistically significant relationships were present among the agents, lesions, and the animal treatment, disease onset, and mortality data. Clinical illnesses observed in this study were lengthier than those reported 16-20 years ago, based on fatal disease onset, treatment interval, and day of death.

The Expanding Universe of Prion Diseases

PubMed Central

Watts, Joel C; Balachandran, Aru; Westaway, David

2006-01-01

Prions cause fatal and transmissible neurodegenerative disease. These etiological infectious agents are formed in greater part from a misfolded cell-surface protein called PrPC. Several mammalian species are affected by the diseases, and in the case of “mad cow disease” (BSE) the agent has a tropism for humans, with negative consequences for agribusiness and public health. Unfortunately, the known universe of prion diseases is expanding. At least four novel prion diseases—including human diseases variant Creutzfeldt-Jakob disease (vCJD) and sporadic fatal insomnia (sFI), bovine amyloidotic spongiform encephalopathy (BASE), and Nor98 of sheep—have been identified in the last ten years, and chronic wasting disease (CWD) of North American deer (Odocoileus Specis) and Rocky Mountain elk (Cervus elaphus nelsoni) is undergoing a dramatic spread across North America. While amplification (BSE) and dissemination (CWD, commercial sourcing of cervids from the wild and movement of farmed elk) can be attributed to human activity, the origins of emergent prion diseases cannot always be laid at the door of humankind. Instead, the continued appearance of new outbreaks in the form of “sporadic” disease may be an inevitable outcome in a situation where the replicating pathogen is host-encoded. PMID:16609731

Predictive Factors for Fatal Tick-Borne Spotted Fever in Brazil.

PubMed

de Oliveira, S V; Willemann, M C A; Gazeta, G S; Angerami, R N; Gurgel-Gonçalves, R

2017-11-01

In Brazil, two pathogenic Rickettsia species have been identified causing tick-borne spotted fever (SF). The aetiological agent Rickettsia rickettsii causes serious illness, particularly in the south-eastern region of the country. Moreover, the Rickettsia sp. strain Atlantic Rainforest cause milder clinical manifestations in south-eastern, south and north-east regions. This study has sought to analyse predictive factors for fatal SF. A case-control study was performed using disease notification records in Brazil. The cases included were individuals with laboratory confirmation and fatal progression of SF, while the controls included individuals with SF who were cured. A total of 386 cases and 415 controls were identified (1 : 1.1), and the cases and controls were similar in age. The factors identified as being protective against death were reported presence of ticks (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.41-0.88), residing in urban areas (OR, 0.47, 95% CI, 0.31-0.74) and presenting lymphadenopathy (OR, 0.43; 95% CI, 0.23-0.82). Males exhibited a greater chance of death (OR, 1.57; 95% CI, 1.13-2.18), as did patients who were hospitalized (OR, 10.82; 95% CI, 6.38-18.35) and who presented hypotension or shock (OR, 10.80; 95% CI, 7.33-15.93), seizures (OR, 11.24; 95% CI, 6.49-19.45) and coma (OR of 15.16; 95% CI, 8.51-27.02). The study demonstrates the severity profile of the SF cases, defined either as the frequency of hospitalization (even in cases that were cured) or as the increased frequency of the clinical complications typically found in critical patients. Opportune clinical diagnosis, a careful evaluation of the epidemiological aspects of the disease and adequate care for patients are determining factors for reducing SF fatality rates. © 2017 Blackwell Verlag GmbH.

Ebola viral disease outbreak--West Africa, 2014.

PubMed

Dixon, Meredith G; Schafer, Ilana J

2014-06-27

On March 21, 2014, the Guinea Ministry of Health reported the outbreak of an illness characterized by fever, severe diarrhea, vomiting, and a high case-fatality rate (59%) among 49 persons. Specimens from 15 of 20 persons tested at Institut Pasteur in Lyon, France, were positive for an Ebola virus by polymerase chain reaction. Viral sequencing identified Ebola virus (species Zaïre ebolavirus), one of five viruses in the genus Ebolavirus, as the cause. Cases of Ebola viral disease (EVD) were initially reported in three southeastern districts (Gueckedou, Macenta, and Kissidougou) of Guinea and in the capital city of Conakry. By March 30, cases had been reported in Foya district in neighboring Liberia (1), and in May, the first cases identified in Sierra Leone were reported. As of June 18, the outbreak was the largest EVD outbreak ever documented, with a combined total of 528 cases (including laboratory-confirmed, probable, and suspected cases) and 337 deaths (case-fatality rate = 64%) reported in the three countries. The largest previous outbreak occurred in Uganda during 2000-2001, when 425 cases were reported with 224 deaths (case-fatality rate = 53%). The current outbreak also represents the first outbreak of EVD in West Africa (a single case caused by Taï Forest virus was reported in Côte d'Ivoire in 1994 [3]) and marks the first time that Ebola virus transmission has been reported in a capital city.

Transplantation of organs from deceased donors with meningitis and encephalitis: a UK registry analysis.

PubMed

Trotter, Patrick B; Robb, Matthew; Hulme, William; Summers, Dominic M; Watson, Christopher J E; Bradley, J Andrew; Neuberger, James

2016-12-01

Deceased organ donors, where the cause of death is meningitis or encephalitis, are a potential concern because of the risks of transmission of a potentially fatal infection to recipients. Using the UK Transplant Registry, a retrospective cohort analysis of deceased organ donors in the UK was undertaken to better understand the extent to which organs from deceased donors with meningitis and/or encephalitis (M/E) (of both known and unknown cause) have been used for transplantation, and to determine the associated recipient outcomes. Between 2003 and 2015, 258 deceased donors with M/E were identified and the causative agent was known in 188 (72.9%). These donors provided 899 solid organs for transplantation (455 kidneys and 444 other organs). The only recorded case of disease transmission was from a donor with encephalitis of unknown cause at time of transplantation who transmitted a fatal nematode infection to 2 kidney transplant recipients. A further 3 patients (2 liver and 1 heart recipient) died within 30 days of transplantation from a neurological cause (cerebrovascular accident) with no suggestion of disease transmission. Overall, patient and graft survival in recipients of organs from donors with M/E were similar to those for all other types of deceased organ donor. Donors dying with M/E represent a valuable source of organs for transplantation. The risk of disease transmission is low but, where the causative agent is unknown, caution is required. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Occupational health and safety in small animal veterinary practice: Part I--nonparasitic zoonotic diseases.

PubMed

Weese, J S; Peregrine, A S; Armstrong, J

2002-08-01

Zoonotic diseases are an ever-present concern in small animal veterinary practice and are often overlooked. A variety of nonparasitic zoonotic diseases may be encountered in small animal practice, including cat scratch disease (bartonellosis), cat bite abscesses, rabies, leptospirosis, methicillin-resistant Staphylococcus aureus, Clostridium difficile-associated diarrhea, salmonellosis, avian chlamydiosis, campylobacteriosis, dermatophytosis, and blastomycosis. These may cause human disease ranging from mild and self-limiting to fatal. The risk of development of a zoonotic disease can be lessened by early recognition of infected animals, proper animal handling, basic biosecurity precautions, and, most importantly, personal hygiene.

Pediatric Invasive Pneumococcal Disease in Guatemala City: Importance of Serotype 2.

PubMed

Gaensbauer, James T; Asturias, Edwin J; Soto, Monica; Holt, Elizabeth; Olson, Daniel; Halsey, Neal A

2016-05-01

To inform estimations of the potential impact of recently introduced pneumococcal conjugate vaccine (PCV), we report results of 11 years of pre-PCV surveillance for invasive pneumococcal disease (IPD) among children in Guatemala City. Cases of IPD in children younger than 5 years were identified by active surveillance at 3 referral hospitals in Guatemala City from October 1996 through 2007. Clinical and demographic data were obtained, and isolates of Streptococcus pneumoniae from normally sterile sites were serotyped using latex agglutination and confirmed by Quellung reaction. Four hundred fifty-two cases of IPD were identified with a case fatality rate of 21%. Meningitis was the most common cause of death (77% of all deaths) and occurred more often in infancy (median age 5 months) than other clinical syndromes. Of the 137 isolates serotyped, type 1 (26 cases, 17%), type 2 (25 cases, 16%) and type 5 (18 cases, 12%) were the most common. Serotype 2 was associated with a higher case fatality rate (28%), higher rate of meningitis (68%) and occurred in younger infants (median age, 3.5 months) than other common serotypes. Recently introduced PCV13 includes 73% of observed serotypes in the study. Infants with IPD presented at a young age. Serotype 2, rarely reported as a significant cause of IPD and not included in available PCVs, was a common cause of disease in this population. PCV13 introduction in Guatemala, begun in 2013, may not have as great an impact in disease reduction as has been observed in other countries.

Medical knowledge related to Rocky Mountain spotted fever in Sonora, Mexico.

PubMed

Alvarez-Hernandez, Gerardo; Ernst, Kacey; Acuña-Melendrez, Natalia Haydee; Vargas-Ortega, Anabel Patricia; Candia-Plata, Maria Del Carmen

2018-03-01

Rocky Mountain spotted fever (RMSF) is a tick-borne disease with a high case-fatality rate unless diagnosed promptly and treated timely with doxycycline. Physician knowledge about presentation and treatment can improve outcomes of RMSF in endemic regions, such as Sonora in northern Mexico, where RMSF has caused 1348 non-fatal cases and 247 deaths from 2003 to 2016. A cross-sectional study was conducted with 343 physicians working in medical facilities in Sonora, Mexico. A 25-item questionnaire explored physician knowledge of clinical, epidemiological and preventive aspects of RMSF. Only 62% of physicians agreed that doxycycline should be used as the first choice treatment for children under 8 years with suspected RMSF. Additionally, 40% of primary care physicians correctly identified the time to initiate doxycycline, and 32% correctly identified the case-fatality rate of untreated RMSF in all patients. Inadequate medical knowledge may adversely affect how patients infected with Rickettsia rickettsii are diagnosed and treated. Educational programs that improve the risk perception and medical knowledge about RMSF should be targeted at physicians most likely to have initial contact with diseased patients.

Impact of yellow fever on the developing world.

PubMed

Tomori, O

1999-01-01

Yellow fever (YF) has remained a disease of public health importance since it was first described in the fifteenth century. At different periods in human history, YF has caused untold hardship and indescribable misery among populations in the Americas, Europe, and Africa. It brought economic disaster in its wake, constituting a stumbling block to development. Yellow fever is an arboviral infection with three epidemiological transmission cycles between monkeys, mosquitoes, and humans. It is an acute infectious disease characterized by sudden onset, with two phases of development separated by a short period of remission. The clinical spectrum of YF varies from a very mild, nonspecific, febrile illness to a fulminating, sometimes fatal disease with pathognomonic features. In severe cases, jaundice and bleeding diathesis with hepatorenal involvement are common. The fatality rate of severe YF is 50% or higher. Despite landmark achievements in the understanding of the epidemiology of YF and the availability of a safe, efficacious vaccine, YF remains a major public health problem in both Africa and South America, where annually the disease affects an estimated 200,000 persons, causing an estimated 30,000 deaths. Since the 1980s epidemics of YF in Africa have affected predominantly children under the age of 15 years. The failure to control YF arises from a misapplication of public health strategies and insufficient political commitment by governments in YF endemic areas, especially in Africa, to control the disease.

Inclusion body disease in snakes: a review and description of three cases in boa constrictors in Belgium.

PubMed

Vancraeynest, D; Pasmans, F; Martel, A; Chiers, K; Meulemans, G; Mast, J; Zwart, P; Ducatelle, R

2006-06-03

Inclusion body disease, a fatal disorder in Boidae, is reviewed, and three cases in boa constrictors, the first reported cases in Belgium, are described. The snakes showed nervous signs, and numerous eosinophilic intracytoplasmic inclusions, which are considered to be characteristic of the disease, were found in the liver and pancreas. The disease is suspected to be caused by a retrovirus, but transmission electron microscopic examinations of several tissues from one of the snakes did not reveal particles with a typical retroviral morphology.

Type-1 angiotensin receptor signaling in central nervous system myeloid cells is pathogenic during fatal alphavirus encephalitis in mice.

PubMed

Blakely, Pennelope K; Huber, Amanda K; Irani, David N

2016-08-25

Alphaviruses can cause fatal encephalitis in humans. Natural infections occur via the bite of infected mosquitos, but aerosol transmissibility makes some of these viruses potential bioterrorism agents. Central nervous system (CNS) host responses contribute to alphavirus pathogenesis in experimental models and are logical therapeutic targets. We investigated whether reactive oxygen species (ROS) generated by nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (Nox) activity within the CNS contributes to fatal alphavirus encephalitis in mice. Infected animals were treated systemically with the angiotensin receptor-blocking drug, telmisartan, given its ability to cross the blood-brain barrier, selectively block type-1 angiotensin receptors (AT1R), and inhibit Nox-derived ROS production in vascular smooth muscle and other extraneural tissues. Clinical, virological, biochemical, and histopathological outcomes were followed over time. The importance of the angiotensin II (Ang II)/AT1R axis in disease pathogenesis was confirmed by demonstrating increased Ang II levels in the CNS following infection, enhanced disease survival when CNS Ang II production was suppressed, increased AT1R expression on microglia and tissue-infiltrating myeloid cells, and enhanced disease survival in AT1R-deficient mice compared to wild-type (WT) controls. Systemic administration of telmisartan protected WT mice from lethal encephalitis caused by two different alphaviruses in a dose-dependent manner without altering virus replication or exerting any anti-inflammatory effects in the CNS. Infection triggered up-regulation of multiple Nox subunits in the CNS, while drug treatment inhibited local Nox activity, ROS production, and oxidative neuronal damage. Telmisartan proved ineffective in Nox-deficient mice, demonstrating that this enzyme is its main target in this experimental setting. Nox-derived ROS, likely arising from CNS myeloid cells triggered by AT1R signaling, are pathogenic during fatal alphavirus encephalitis in mice. Systemically administered telmisartan at non-hypotensive doses targets Nox activity in the CNS to exert a neuroprotective effect. Disruption of this pathway may have broader implications for the treatment of related infections as well as for other CNS diseases driven by oxidative injury.

External cause-specific summaries of occupational fatal injuries. Part II: an analysis of years of potential life lost.

PubMed

Bailer, A John; Bena, James F; Stayner, Leslie T; Halperin, William E; Park, Robert M

2003-03-01

Fatal injury surveillance data provide an opportunity to assess the impact of occupational injuries and may indicate which industries or occupations are appreciably more hazardous than others, and thus should be given priority in public health intervention. Fatalities from the National Traumatic Occupational Fatality surveillance system served as the basis for examining external cause (E-code) specific impact summaries. Years of potential life lost (YPLL) were calculated for fatal injuries in the years 1983-1994. Industries and occupations were compared with respect to frequency of fatal injuries. In addition, injuries in categories of external causes are examined across all industries and occupations. Machinery, electric current, homicide, falls, and transportation-related are the external cause groups highlighted by high frequency/rate of occurrence. Electric current event groups are also characterized by high average YPLL. Poisoning, conflagration, and lightning were also identified in several occupations as having high associated average YPLL. The external-cause-specific analysis of average YPLL identified industries and occupations where, on average, younger workers were dying in fatal injuries. Noteworthy in this assessment were homicides and falls. The YPLL measure coupled with more commonly employed indices (e.g., rates) may provide a fuller description of the impact of occupational fatal injuries.

The changing epidemiology of invasive Haemophilus influenzae disease: Emergence and global presence of serotype a strains that may require a new vaccine for control.

PubMed

Tsang, Raymond S W; Ulanova, Marina

2017-07-24

More than two decades after the implementation of the Hib conjugate vaccine in North America, Haemophilus influenzae serotype a (Hia) has emerged as a significant cause of invasive disease in Indigenous communities. However, little is known about the global presence of this pathogen. We interrogated the H. influenzae Multi-Locus Sequence Typing (MLST) website (https://pubmlst.org/hinfluenzae/) by selecting for serotype a records. We also updated our previous literature review on this subject matter. Hia has been reported from at least 35 countries on six major continents. However, most Hia diseases were associated with Indigenous communities. Clonal analysis identified two clonal populations with one typified as ST-23 responsible for most invasive disease in North America and being the predominant clone described on the H. influenzae MLST website. Incidence of invasive Hia disease in Indigenous communities in North America are similar to the rates of Hib disease reported prior to the Hib conjugate vaccine era. Hia causes severe clinical diseases, such as meningitis, septicaemia, pneumonia, and septic arthritis with case-fatality rates between 5.6% and 33% depending on the age of the patient and the genetic makeup of the Hia strain. Although invasive Hia disease can be found globally, the current epidemiological data suggest that this infection predominantly affects Indigenous communities in North America. The clinical disease of Hia and the clonal nature of the bacteria resemble that of Hib. The high incidence of invasive Hia disease in Indigenous communities, along with potential fatality and severe sequelae causing long-term disability in survivors, may support the development of a new Hia conjugate vaccine for protection against this infection similar in design to the one introduced in the 1990s to control invasive Hib disease. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Resetting the transcription factor network reverses terminal chronic hepatic failure

PubMed Central

Nishikawa, Taichiro; Bell, Aaron; Brooks, Jenna M.; Setoyama, Kentaro; Melis, Marta; Han, Bing; Fukumitsu, Ken; Handa, Kan; Tian, Jianmin; Kaestner, Klaus H.; Vodovotz, Yoram; Locker, Joseph; Soto-Gutierrez, Alejandro; Fox, Ira J.

2015-01-01

The cause of organ failure is enigmatic for many degenerative diseases, including end-stage liver disease. Here, using a CCl4-induced rat model of irreversible and fatal hepatic failure, which also exhibits terminal changes in the extracellular matrix, we demonstrated that chronic injury stably reprograms the critical balance of transcription factors and that diseased and dedifferentiated cells can be returned to normal function by re-expression of critical transcription factors, a process similar to the type of reprogramming that induces somatic cells to become pluripotent or to change their cell lineage. Forced re-expression of the transcription factor HNF4α induced expression of the other hepatocyte-expressed transcription factors; restored functionality in terminally diseased hepatocytes isolated from CCl4-treated rats; and rapidly reversed fatal liver failure in CCl4-treated animals by restoring diseased hepatocytes rather than replacing them with new hepatocytes or stem cells. Together, the results of our study indicate that disruption of the transcription factor network and cellular dedifferentiation likely mediate terminal liver failure and suggest reinstatement of this network has therapeutic potential for correcting organ failure without cell replacement. PMID:25774505

Global earthquake fatalities and population

USGS Publications Warehouse

Holzer, Thomas L.; Savage, James C.

2013-01-01

Modern global earthquake fatalities can be separated into two components: (1) fatalities from an approximately constant annual background rate that is independent of world population growth and (2) fatalities caused by earthquakes with large human death tolls, the frequency of which is dependent on world population. Earthquakes with death tolls greater than 100,000 (and 50,000) have increased with world population and obey a nonstationary Poisson distribution with rate proportional to population. We predict that the number of earthquakes with death tolls greater than 100,000 (50,000) will increase in the 21st century to 8.7±3.3 (20.5±4.3) from 4 (7) observed in the 20th century if world population reaches 10.1 billion in 2100. Combining fatalities caused by the background rate with fatalities caused by catastrophic earthquakes (>100,000 fatalities) indicates global fatalities in the 21st century will be 2.57±0.64 million if the average post-1900 death toll for catastrophic earthquakes (193,000) is assumed.

Estimation of the Long-term Cardiovascular Events Using UKPDS Risk Engine in Metabolic Syndrome Patients.

PubMed

Shivakumar, V; Kandhare, A D; Rajmane, A R; Adil, M; Ghosh, P; Badgujar, L B; Saraf, M N; Bodhankar, S L

2014-03-01

Long-term cardiovascular complications in metabolic syndrome are a major cause of mortality and morbidity in India and forecasted estimates in this domain of research are scarcely reported in the literature. The aim of present investigation is to estimate the cardiovascular events associated with a representative Indian population of patients suffering from metabolic syndrome using United Kingdom Prospective Diabetes Study risk engine. Patient level data was collated from 567 patients suffering from metabolic syndrome through structured interviews and physician records regarding the input variables, which were entered into the United Kingdom Prospective Diabetes Study risk engine. The patients of metabolic syndrome were selected according to guidelines of National Cholesterol Education Program - Adult Treatment Panel III, modified National Cholesterol Education Program - Adult Treatment Panel III and International Diabetes Federation criteria. A projection for 10 simulated years was run on the engine and output was determined. The data for each patient was processed using the United Kingdom Prospective Diabetes Study risk engine to calculate an estimate of the forecasted value for the cardiovascular complications after a period of 10 years. The absolute risk (95% confidence interval) for coronary heart disease, fatal coronary heart disease, stroke and fatal stroke for 10 years was 3.79 (1.5-3.2), 9.6 (6.8-10.7), 7.91 (6.5-9.9) and 3.57 (2.3-4.5), respectively. The relative risk (95% confidence interval) for coronary heart disease, fatal coronary heart disease, stroke and fatal stroke was 17.8 (12.98-19.99), 7 (6.7-7.2), 5.9 (4.0-6.6) and 4.7 (3.2-5.7), respectively. Simulated projections of metabolic syndrome patients predict serious life-threatening cardiovascular consequences in the representative cohort of patients in western India.

Influenza A (H10N7) Virus Causes Respiratory Tract Disease in Harbor Seals and Ferrets.

PubMed

van den Brand, Judith M A; Wohlsein, Peter; Herfst, Sander; Bodewes, Rogier; Pfankuche, Vanessa M; van de Bildt, Marco W G; Seehusen, Frauke; Puff, Christina; Richard, Mathilde; Siebert, Ursula; Lehnert, Kristina; Bestebroer, Theo; Lexmond, Pascal; Fouchier, Ron A M; Prenger-Berninghoff, Ellen; Herbst, Werner; Koopmans, Marion; Osterhaus, Albert D M E; Kuiken, Thijs; Baumgärtner, Wolfgang

2016-01-01

Avian influenza viruses sporadically cross the species barrier to mammals, including humans, in which they may cause epidemic disease. Recently such an epidemic occurred due to the emergence of avian influenza virus of the subtype H10N7 (Seal/H10N7) in harbor seals (Phoca vitulina). This epidemic caused high mortality in seals along the north-west coast of Europe and represented a potential risk for human health. To characterize the spectrum of lesions and to identify the target cells and viral distribution, findings in 16 harbor seals spontaneously infected with Seal/H10N7 are described. The seals had respiratory tract inflammation extending from the nasal cavity to bronchi associated with intralesional virus antigen in respiratory epithelial cells. Virus infection was restricted to the respiratory tract. The fatal outcome of the viral infection in seals was most likely caused by secondary bacterial infections. To investigate the pathogenic potential of H10N7 infection for humans, we inoculated the seal virus intratracheally into six ferrets and performed pathological and virological analyses at 3 and 7 days post inoculation. These experimentally inoculated ferrets displayed mild clinical signs, virus excretion from the pharynx and respiratory tract inflammation extending from bronchi to alveoli that was associated with virus antigen expression exclusively in the respiratory epithelium. Virus was isolated only from the respiratory tract. In conclusion, Seal/H10N7 infection in naturally infected harbor seals and experimentally infected ferrets shows that respiratory epithelial cells are the permissive cells for viral replication. Fatal outcome in seals was caused by secondary bacterial pneumonia similar to that in fatal human cases during influenza pandemics. Productive infection of ferrets indicates that seal/H10N7 may possess a zoonotic potential. This outbreak of LPAI from wild birds to seals demonstrates the risk of such occasions for mammals and thus humans.

Perinatal consumption of thiamine-fortified fish sauce in rural Cambodia. A randomized clinical trial

USDA-ARS?s Scientific Manuscript database

Infantile beriberi, a potentially fatal disease caused by thiamine deficiency, is a public health concern in Cambodia and regions where thiamine-poor white rice is a staple food. Low maternal thiamine intake reduces breast milk thiamine placing breastfed infants at risk of beriberi. The objective wa...

Development of a Rift Valley fever virus viremia challenge model in sheep and goats

USDA-ARS?s Scientific Manuscript database

Rift valley fever virus (RVFV), a member of the family Bunyaviridae, causes severe to fatal disease in newborn ruminants, as well as abortions in pregnant animals; both preventable by vaccination. Availability of a challenge model is a pre-requisite for vaccine efficacy trials. Several modes of ino...

AIDS: Education's New Dilemma.

ERIC Educational Resources Information Center

Freeland, D. Kay; Faber, Charles F.

The acquired immune deficiency syndrome (AIDS) is an incurable, fatal disease that is caused by a virus that eventually destroys the body's immune system. While AIDS is contagious, the risk of contracting AIDS through casual contact is said to be negligible. A review of the court cases involving students with AIDS reveals that the precedent has…

Rapid microfluidic assay for the detection of botulinum neurotoxin in animal sera

USDA-ARS?s Scientific Manuscript database

The potent botulinum neurotoxins (BoNTs) represent a threat to public health and safety. Botulism is a disease caused by BoNT intoxication that results in muscle paralysis that can be fatal. Sensitive assays capable of detecting BoNTs from different substrates and settings are essential to limit f...

Inhibiting oral intoxication of botulinum neurotoxin A by carbohydrate receptor mimics

USDA-ARS?s Scientific Manuscript database

Botulinum neurotoxins (BoNTs) cause the disease botulism manifested by flaccid paralysis that could be fatal to humans and animals. Oral ingestion of the toxin with contaminated food is one of the most common routes of BoNT intoxication, where BoNT assembles with several auxiliary proteins to surviv...

Absolute quantification of the host-to-parasite DNA ratio in theileria parva-infected lymphocyte cell lines

USDA-ARS?s Scientific Manuscript database

Theileria parva is a tick-transmitted intracellular apicomplexan pathogen of cattle in sub-Saharan Africa that causes East Coast fever (ECF). ECF is an acute fatal disease that kills over one million cattle annually, imposing a tremendous burden on African small-holder cattle farmers. The pathology ...

Scrapie resistant goats: Keep your herd healthy and help your business with a new gene test

USDA-ARS?s Scientific Manuscript database

Classical scrapie is an infectious disease of goats and sheep that causes slowly progressive but ultimately fatal degeneration of the brain, with advanced cases often hindering their ability to move properly. Currently, a single diagnosis of classical scrapie results in permanent quarantine or eutha...

First Report of Peronospora digitalidis causing downy mildew disease on foxglove in Oregon

USDA-ARS?s Scientific Manuscript database

Foxglove (Digitalis purpurea) is a biennial plant in the Plantaginaceae family. Widely cultivated as a striking flowering ornamental plant, foxglove is also a source of toxic cardiac glycosides that may be fatal if ingested at high doses, or used pharmaceutically to treat human heart failure. In the...

A review of oak wilt management: a summary of treatment options and their efficacy

Treesearch

Karrie A. Koch; Gina L. Quiram; Robert C. Venette

2010-01-01

Oak wilt, caused by the invasive fungal pathogen Ceratocystis fagacearum (Bretz) Hunt, is a serious and fatal disease of oaks, Quercus spp., with red oaks (section Lobatae) generally being more susceptible than white oaks (section Quercus). Oak wilt was first recognized in North America in 1944...

An analysis of the causes of compressed-gas diving fatalities in Australia from 1972-2005.

PubMed

Lippmann, John; Baddeley, Adrian; Vann, Richard; Walker, Douglas

2013-01-01

In order to investigate causative factors, root cause analysis (RCA) was applied to 351 Australian compressed-gas diving fatalities from 1972-2005. Each case was described by four sequential events (trigger, disabling agent, disabling injury, cause of death) that were assessed for frequency, trends, and dive and diver characteristics. The average age increased by 16 years, with women three years younger than men annually. For the entire 34-year period, the principal disabling injuries were asphyxia (49%), cerebral arterial gas embolism (CAGE; 25%), and cardiac (19%). There was evidence of a long-term decline in the rate of asphyxia and a long-term increase in CAGE and cardiac disabling injuries. Asphyxia was associated with rough water, buoyancy trouble, equipment trouble, and gas supply trouble. CAGE was associated with gas supply trouble and ascent trouble, while cardiac cases were associated with exertion, cardiovascular disease, and greater age. Exertion was more common in younger cardiac deaths than in older deaths. Asphyxia became less common with increasing age. Equipment-related problems were most common during the late 1980s and less so in 2005. Buoyancy-related deaths usually involved loss of buoyancy on the surface but decreased when buoyancy control devices were used. Countermeasures to reduce fatalities based on these observations will require validation by active surveillance.

Avalanche Accidents Causing Fatalities: Are They Any Different in the Summer?

PubMed

Pasquier, Mathieu; Hugli, Olivier; Kottmann, Alexandre; Techel, Frank

2017-03-01

Pasquier, Mathieu, Olivier Hugli, Alexandre Kottmann, and Frank Techel. Avalanche accidents causing fatalities: are they any different in the summer? High Alt Med Biol. 18:67-72, 2017. This retrospective study investigated the epidemiology of summer avalanche accidents that occurred in Switzerland and caused at least one fatality between 1984 and 2014. Summer avalanche accidents were defined as those that occurred between June 1st and October 31st. Summer avalanches caused 21 (4%) of the 482 avalanches with at least one fatality occurring during the study period, and 40 (6%) of the 655 fatalities. The number of completely buried victims per avalanche and the proportion of complete burials among trapped people were lower in summer than in winter. Nevertheless, the mean number of fatalities per avalanche was higher in summer than in winter: 1.9 ± 1.2 (standard deviation; range 1-6) versus 1.3 ± 0.9 (range 1-7; p < 0.001). Trauma was the presumed cause of death in 94% (33 of 35) in summer avalanche accidents. Sixty-five percent of fully buried were found due to visual clues at the snow surface. Fatal summer avalanche accidents caused a higher mean number of fatalities per avalanche than winter avalanches, and those deaths resulted mostly from trauma. Rescue teams should anticipate managing polytrauma for victims in summer avalanche accidents rather than hypothermia or asphyxia; they should be trained in prehospital trauma life support and equipped accordingly to ensure efficient patient care.

Camouflage and Misdirection: The Full-On Assault of Ebola Virus Disease

PubMed Central

Misasi, John; Sullivan, Nancy J.

2014-01-01

Ebolaviruses cause a severe hemorrhagic fever syndrome that is rapidly fatal to humans and non-human primates. Ebola protein interactions with host cellular proteins disrupt Type I and Type II interferon responses, RNAi anti-viral responses, antigen presentation, T-cell mediated antibody responses, humoral antibodies and cell mediated immunity. This multifaceted approach to evasion and suppression of innate and adaptive immune responses in their target hosts leads to the severe immune dysregulation and “cytokine storm” that is characteristic of fatal ebolavirus infection. Here we highlight some of the processes by which Ebola interacts with its mammalian hosts to evade anti-viral defenses. PMID:25417101

The burden of childhood injuries and evidence based strategies developed using the injury surveillance system in Pasto, Colombia.

PubMed

Espitia-Hardeman, Victoria; Borse, Nagesh N; Dellinger, Ann M; Betancourt, Carmen Elena; Villareal, Alba Nelly; Caicedo, Luz Diana; Portillo, Carlos

2011-02-01

This article characterises the burden of childhood injuries and provides examples of evidence-based injury prevention strategies developed using a citywide injury surveillance system in Pasto, Colombia. Fatal (2003-2007) and non-fatal (2006-2007) childhood injury data were analysed by age, sex, cause, intent, place of occurrence, and disposition. Boys accounted for 71.5% of fatal and 64.9% of non-fatal injuries. The overall fatality rate for all injuries was 170.8 per 100,000 and the non-fatal injury rate was 4,053 per 100,000. Unintentional injuries were the leading causes of fatal injuries for all age groups, except for those 15-19 years whose top four leading causes were violence-related. Among non-fatal injuries, falls was the leading mechanism in the group 0-14 years. Interpersonal violence with a sharp object was the most important cause for boys aged 15-19 years. Home was the most frequent place of occurrence for both fatal and non-fatal injuries for young children 0-4 years old. Home, school and public places became an important place for injuries for boys in the age group 5-15 years. The highest case-fatality rate was for self-inflicted injuries (8.9%). Although some interventions have been implemented in Pasto to reduce injuries, it is necessary to further explore risk factors to better focus prevention strategies and their evaluation. We discuss three evidence-based strategies developed to prevent firework-related injuries during festival, self-inflicted injuries, and road traffic-related injuries, designed and implemented based on the injury surveillance data.

Liver transplant in ethylmalonic encephalopathy: a new treatment for an otherwise fatal disease.

PubMed

Dionisi-Vici, Carlo; Diodato, Daria; Torre, Giuliano; Picca, Stefano; Pariante, Rosanna; Giuseppe Picardo, Sergio; Di Meo, Ivano; Rizzo, Cristiano; Tiranti, Valeria; Zeviani, Massimo; De Ville De Goyet, Jean

2016-04-01

Ethylmalonic encephalopathy is a fatal, rapidly progressive mitochondrial disorder caused by ETHE1 mutations, whose peculiar clinical and biochemical features are due to the toxic accumulation of hydrogen sulphide and of its metabolites, including thiosulphate. In mice with ethylmalonic encephalopathy, liver-targeted adeno-associated virus-mediated ETHE1 gene transfer dramatically improved both clinical course and metabolic abnormalities. Reasoning that the same achievement could be accomplished by liver transplantation, we performed living donor-liver transplantation in an infant with ethylmalonic encephalopathy. Unlike the invariably progressive deterioration of the disease, 8 months after liver transplantation, we observed striking neurological improvement with remarkable achievements in psychomotor development, along with dramatic reversion of biochemical abnormalities. These results clearly indicate that liver transplantation is a viable therapeutic option for ETHE1 disease. © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Blastomycosis in northwestern Ontario, 2004 to 2014

PubMed Central

Dalcin, Daniel; Ahmed, Syed Zaki

2015-01-01

Blastomycosis is an invasive fungal disease caused by Blastomyces dermatitidis and the recently discovered Blastomyces gilchristii. The medical charts of 64 patients with confirmed cases of blastomycosis in northwestern Ontario during a 10-year period (2004 to 2014) were retrospectively reviewed. The number of patients diagnosed with blastomycosis in Ontario was observed to have increased substantially compared with before 1990, when blastomycosis was removed from the list of reportable diseases. Aboriginals were observed to be disproportionately represented in the patient population. Of the patients whose smoking status was known, 71.4% had a history of smoking. 59.4% of patients had underlying comorbidities and a higher comorbidity rate was observed among Aboriginal patients. The case-fatality rate from direct complications of blastomycosis disease was calculated to be 20.3%; this case-fatality rate is the highest ever to be reported in Canada and more than double that of previously published Canadian studies. The clinical characteristics of 64 patients diagnosed with blastomycosis are summarized. PMID:26600814

[Invasive meningococcal disease in the Czech Republic - analysis of the epidemiological situation and vaccination strategy recommendations].

PubMed

Křížová, Pavla; Vacková, Zuzana; Musílek, Martin; Kozáková, Jana

2013-12-01

Analysis of invasive meningococcal disease (IMD) surveillance data including molecular epidemio-logy data. Vaccination strategy recommendations based on the current epidemiological situation of IMD in the Czech Republic and availability of meningococcal vaccines. IMD surveillance data are compiled by the National Reference Laboratory for Meningococcal Disease (NRL) from routinely reported data and NRL data after clearing out duplicate data. Neisseria meningitidis (N.m.) isolates referred to the NRL are confirmed and characterized in detail according to internationally validated methods. The current epidemiological situation of IMD is relatively favourable - the incidence rates have been below 1/100,000 population for several years, but show a slightly upward trend over more than 40-year period (1970-2012). A return to the typical prevalence of serogroup B accounting for up to 75% of cases has recently been shown. In this context, the upward trend in IMD caused by serogroup Y associated with a high case fatality rate in the Czech Republic cannot be overseen or even underestimated. The hypervirulent clonal complex cc11 characteristic of N.m.C:2a:P1.2,5 prevailed in this country between 1993 and 2004, but decreased in the following years and currently, hypervirulent clonal complexes characteristic of N.m.B (cc18, cc32, cc41/44, and cc269) are the most common in the Czech Republic. The average overall case fatality rate in the Czech Republic is 10%, but varies between causative serogroups: the highest case fatality rate has been caused by serogroup Y (16.7% ), followed by serogroup C (12.3%), and serogroup W135 (11.7%), while serogroup B only accounts for a case fatality rate of 7.8%. In the age group under one year, the incidence of IMD caused by serogroup B remains three to five times as high as in the age groups 1-4 years and 15-19 years throughout the surveillance period. The highest numbers of IMD cases caused by serogroup B have been reported in 3-7-month-olds. Based on the IMD surveillance data from the Czech Republic, the NRL recommends a vaccination strategy to provide an adequate protection to individuals. To induce an immune response as wide as possible, the tetravalent meningococcal conjugate vaccine A,C,Y,W135 in combination with the newly registered MenB vaccine designed by reverse vaccinology should be given. To maintain immunity, subsequent booster doses are required at intervals depending on the primary vaccination age.

Haemophilus influenzae serotype a as a cause of serious invasive infections.

PubMed

Ulanova, Marina; Tsang, Raymond S W

2014-01-01

Haemophilus influenzae, particularly H influenzae serotype b (Hib), is an important pathogen that causes serious diseases like meningitis and septicaemia. Since the introduction of Hib conjugate vaccines in the 1990s, the epidemiology of invasive H influenzae disease has changed substantially, with most infections now caused by non-Hib strains. We discuss the importance of H influenzae serotype a (Hia) as a cause of serious morbidity and mortality and its global epidemiology, clinical presentation, microbiology, immunology, prevention, and control. Much like Hib, the capsule of Hia is an important virulence factor contributing to the development of invasive disease. Molecular typing of Hia has identified distinct clonal groups, with some linked to severe disease and high case-fatality rates. Similarities between Hia and Hib capsules, their clinical presentation, and immunology of infection suggest that a bivalent Hia-Hib capsular polysaccharide-protein conjugate vaccine could offer protection against these two important serotypes of H influenzae. Copyright © 2014 Elsevier Ltd. All rights reserved.

Autonomic deficit not the cause of death in West Nile virus neurological disease.

PubMed

Wang, Hong; Siddharthan, Venkatraman; Hall, Jeffery O; Morrey, John D

2014-02-01

Some West Nile virus (WNV)-infected patients have been reported to manifest disease signs consistent with autonomic dysfunction. Moreover, WNV infection in hamsters causes reduced electromyography amplitudes of the gastrointestinal tract and diaphragm, and they have reduced heart rate variability (HRV), a read-out for the parasympathetic autonomic function. HRV was measured in both hamsters and mice using radiotelemetry to identify autonomic deficits. To identify areas of WNV infection within the medulla oblongata mapping to the dorsal motor nucleus of vagus (DMNV) and the nucleus ambiguus (NA), fluorogold dye was injected into the cervical trunk of the vagus nerve of hamsters. As a measurement of the loss of parasympathetic function, tachycardia was monitored contiguously over the time course of the disease. Decrease of HRV did not occur in all animals that died, which is not consistent with autonomic function being the mechanism of death. Fluorogold-stained cells in the DMNV were not stained for WNV envelope protein. Fourteen percent of WNV-stained cells were co-localized with fluorogold-stained cells in the NA. These data, however, did not suggest a fatal loss of autonomic functions because tachycardia was not observed in WNV-infected hamsters. Parasympathetic autonomic function deficit was not a likely mechanism of death in WNV-infected rodents and possibly in human patients with fatal WN neurological disease.

Animal models of disease shed light on Nipah virus pathogenesis and transmission

PubMed Central

de Wit, Emmie; Munster, Vincent J.

2014-01-01

Nipah virus is an emerging virus infection that causes yearly disease outbreaks with high case fatality rates in Bangladesh. Nipah virus causes encephalitis and systemic vasculitis, sometimes in combination with respiratory disease. Pteropus species fruit bats are the natural reservoir of Nipah virus and zoonotic transmission can occur directly or via an intermediate host; human-to-human transmission occurs regularly. In this review we discuss the current state of knowledge on the pathogenesis and transmission of Nipah virus, focusing on dissemination of the virus through its host, known determinants of pathogenicity and routes of zoonotic and human-to-human transmission. Since data from human cases are sparse, this knowledge is largely based on the results of studies performed in animal models that recapitulate Nipah virus disease in humans. PMID:25229234

Exercise and Genetic Rescue of SCA1 via the Transcriptional Repressor Capicua*

PubMed Central

Fryer, John D.; Yu, Peng; Kang, Hyojin; Mandel-Brehm, Caleigh; Carter, Angela N.; Crespo-Barreto, Juan; Gao, Yan; Flora, Adriano; Shaw, Chad; Orr, Harry T.; Zoghbi, Huda Y.

2011-01-01

Spinocerebellar ataxia type 1 (SCA1) is a fatal neurodegenerative disease caused by expansion of a translated CAG repeat in Ataxin-1 (ATXN1). To determine the long-term effects of exercise, we implemented a mild exercise regimen in a mouse model of SCA1 and found a considerable improvement in survival accompanied by upregulation of epidermal growth factor and consequential downregulation of Capicua, an ATXN1 interactor. Offspring of Capicua mutant mice bred to SCA1 mice showed significant improvement of all disease phenotypes. Although polyglutamine-expanded Atxn1 caused some loss of Capicua function, further reducing Capicua levels, either genetically or by exercise, mitigated the disease phenotypes. Thus, exercise might have long-term beneficial effects in other ataxias and neurodegenerative diseases. PMID:22053053

Cross-species transmission of CWD prions.

PubMed

Kurt, Timothy D; Sigurdson, Christina J

2016-01-01

Prions cause fatal neurodegenerative diseases in humans and animals and can be transmitted zoonotically. Chronic wasting disease (CWD) is a highly transmissible prion disease of wild deer and elk that affects cervids over extensive regions of the United States and Canada. The risk of cross-species CWD transmission has been experimentally evaluated in a wide array of mammals, including non-human primates and mouse models expressing human cellular prion protein. Here we review the determinants of cross-species CWD transmission, and propose a model that may explain a structural barrier for CWD transmission to humans.

Chernobyl Accident Fatalities and Causes

DTIC Science & Technology

1990-06-01

TI FLE CY N Defense Nuclear Agency Alexandria, VA 22310-3398 SWES% Ot DNA-TR-89-45 Chernobyl Accident Fatalities and Causes A. Laupa G. H. Anno...0104 Chernobyl Accident Fatalities and Causes PE - 62715H PR - RM 6 AUTHOR(S) TA -RH A. Laupa: G. H. Anno WU - DH026130 7 PERFORMING ORGANIZATION NAME(S...vi 1 INTRODUCTION .......................................... 1I DATA SOURCES ON CHERNOBYL VICTIMS ............... 3 CHERNOBYL

Syrian hamsters (Mesocricetus auratus) oronasally inoculated with a Nipah virus isolate from Bangladesh or Malaysia develop similar respiratory tract lesions.

PubMed

Baseler, L; de Wit, E; Scott, D P; Munster, V J; Feldmann, H

2015-01-01

Nipah virus is a paramyxovirus in the genus Henipavirus, which has caused outbreaks in humans in Malaysia, India, Singapore, and Bangladesh. Whereas the human cases in Malaysia were characterized mainly by neurological symptoms and a case fatality rate of ∼40%, cases in Bangladesh also exhibited respiratory disease and had a case fatality rate of ∼70%. Here, we compared the histopathologic changes in the respiratory tract of Syrian hamsters, a well-established small animal disease model for Nipah virus, inoculated oronasally with Nipah virus isolates from human cases in Malaysia and Bangladesh. The Nipah virus isolate from Bangladesh caused slightly more severe rhinitis and bronchointerstitial pneumonia 2 days after inoculation in Syrian hamsters. By day 4, differences in lesion severity could no longer be detected. Immunohistochemistry demonstrated Nipah virus antigen in the nasal cavity and pulmonary lesions; the amount of Nipah virus antigen present correlated with lesion severity. Immunohistochemistry indicated that both Nipah virus isolates exhibited endotheliotropism in small- and medium-caliber arteries and arterioles, but not in veins, in the lung. This correlated with the location of ephrin B2, the main receptor for Nipah virus, in the vasculature. In conclusion, Nipah virus isolates from outbreaks in Malaysia and Bangladesh caused a similar type and severity of respiratory tract lesions in Syrian hamsters, suggesting that the differences in human disease reported in the outbreaks in Malaysia and Bangladesh are unlikely to have been caused by intrinsic differences in these 2 virus isolates. © The Author(s) 2014.

Non-traumatic and spontaneous hemothorax in the setting of forensic medical examination: a systematic literature survey.

PubMed

Janik, Martin; Straka, Lubomir; Krajcovic, Jozef; Hejna, Petr; Hamzik, Julian; Novomesky, Frantisek

2014-03-01

Spontaneous hemothorax is a well-known yet seldom-reported entity in forensic literature. While trauma-related hemothorax is frequently encountered in a medicolegal setting, non-traumatic and spontaneous hemothorax are relatively uncommon entities. The wide range of causes that can trigger fatal intrathoracic bleeding include thoracic aortic dissection, followed by vascular malformations, various oncological diseases, and connective tissue abnormalities. In rare instances, extramedullary hematopoiesis, ectopic pregnancy, congenital heart defects, amyloidosis, or parasitic diseases may constitute a source of bleeding. This etiological heterogeneity may, as a result, cause diagnostic difficulties during post-mortem elucidation of hemothorax. It should be borne in mind that hemothorax after low-energy trauma does not exclusively indicate traumatic hemorrhage, hence, the non-traumatic origin of bleeding must be taken into consideration. In this paper, we present a systematic review of the relevant literature enriched by the results of our observations to investigate the etiologies and recommendations for the post-mortem diagnosis of spontaneous hemothorax in an attempt to better delineate the possible medicolegal considerations. It is important that forensic pathologist as well as clinicians are aware of the diseases that could potentially give rise to fatal hemothorax. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Two novel mutations in thymidine kinase-2 cause early onset fatal encephalomyopathy and severe mtDNA depletion.

PubMed

Lesko, Nicole; Naess, Karin; Wibom, Rolf; Solaroli, Nicola; Nennesmo, Inger; von Döbeln, Ulrika; Karlsson, Anna; Larsson, Nils-Göran

2010-03-01

Deficiency of thymidine kinase-2 (TK2) has been described in children with early onset fatal skeletal myopathy. TK2 is a mitochondrial deoxyribonucleoside kinase required for the phosphorylation of deoxycytidine and deoxythymidine and hence is vital for the maintenance of a balanced mitochondrial dNTP pool in post-mitotic tissues. We describe a patient with two novel TK2 mutations, which caused disease onset shortly after birth and death at the age of three months. One mutation (219insCG) generated an early stop codon, thus preventing the synthesis of a functional protein. The second mutation (R130W) resulted in an amino acid substitution, which caused a severe reduction (<3%) of TK2 enzyme activity. These two novel TK2 mutations cause an extremely severe phenotype with overwhelming central nervous system symptoms not commonly seen in patients with TK2-deficiency. We conclude that the severe clinical presentation in this patient was due to a virtual lack of mitochondrial TK2 activity. Copyright 2009 Elsevier B.V. All rights reserved.

Low-dose aspirin for prevention of cardiovascular disease in patients on hemodialysis: A 5-y prospective cohort study.

PubMed

Liu, Jun; Pan, Yu; Chen, Lei; Qiao, Qing Yan; Wang, Jing; Pan, Li Hua; Gu, Yan Hong; Gu, Hui Fang; Fu, Shun Kun; Jin, Hui Min

2016-10-01

Introduction Aspirin is an effective antiplatelet drug for preventing cardiovascular events in high-risk subjects. However, for patients with chronic kidney disease and undergoing hemodialysis (HD), its preventive efficacy remains controversial. The present study aimed to determine whether aspirin therapy reduces the risk of cardiovascular disease (CVD) and all-cause mortality in patients on HD. Methods We conducted a 5-y prospective cohort study involving patients on HD. Major exposure variables included prescription of aspirin (100 mg/d) and no aspirin (nonaspirin). The primary outcomes included all-cause death, cardiovascular events, hemorrhage, and ischemic stroke. The secondary outcome included bleeding events defined by the requirement of hospitalization. Findings In this study, 406 patients on regular HD were involved during a 5-y follow-up. Among these, 152 and 254 propensity-matched patients were enrolled in the aspirin and nonaspirin cohort, respectively. The cumulative survival rate was not significantly higher in the aspirin than in the nonaspirin users (log rank χ 2  = 1.080, P = 0.299). Aspirin use was not significantly associated with reduced all-cause mortality, fatal and nonfatal congestive heart failure, as well as acute myocardial infarction and ischemic stroke. The risk of fatal cerebral hemorrhage was not significantly increased in the aspirin users (HR = 1.795, 95% CI 0.666-4.841, P = 0.174). After adjustment for other confounders, aspirin use was also not associated with decreased risk of all-cause mortality and CVD. Discussion The present prospective cohort study suggests that low-dose aspirin use is not associated with a significant decrease in the risks of all-cause mortality, CVD, and stroke in population undergoing HD (ClinicalTrials.gov number, NCT02261025). © 2016 International Society for Hemodialysis.

Aspergillus and aspergilloses in wild and domestic animals: a global health concern with parallels to human disease.

PubMed

Seyedmousavi, Seyedmojtaba; Guillot, Jacques; Arné, Pascal; de Hoog, G Sybren; Mouton, Johan W; Melchers, Willem J G; Verweij, Paul E

2015-11-01

The importance of aspergillosis in humans and various animal species has increased over the last decades. Aspergillus species are found worldwide in humans and in almost all domestic animals and birds as well as in many wild species, causing a wide range of diseases from localized infections to fatal disseminated diseases, as well as allergic responses to inhaled conidia. Some prevalent forms of animal aspergillosis are invasive fatal infections in sea fan corals, stonebrood mummification in honey bees, pulmonary and air sac infection in birds, mycotic abortion and mammary gland infections in cattle, guttural pouch mycoses in horses, sinonasal infections in dogs and cats, and invasive pulmonary and cerebral infections in marine mammals and nonhuman primates. This article represents a comprehensive overview of the most common infections reported by Aspergillus species and the corresponding diseases in various types of animals. © The Author 2015. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Isolation of an agent causing bilirubinemia and jaundice in raccoons

USGS Publications Warehouse

Kilham, L.; Herman, C.M.

1954-01-01

An infectious agent, which appears to be a virus (RJV) has been isolated from the liver of a wild raccoon which has led to a highly fatal type of disease characterized by conjunctivitis and an elevated serum bilirubin frequently accompanied by jaundice on inoculation of raccoons. Ferrets also appear to be susceptible to infections with this agent.

Relationships between PrPSc stability and incubation time for United States scrapie strains in a natural host system

USDA-ARS?s Scientific Manuscript database

Transmissible spongiform encephalopathies (TSEs), including scrapie in sheep (Ovis aries), are fatal neurodegenerative diseases caused by the misfolding of the cellular prion protein (PrP**C) into a beta-rich conformer (PrP**Sc) that accumulates into higher-order structures in the brain and other ti...

Influence of selection versus lifestyle on risk of fatal cancer and cardiovascular disease among Seventh-day Adventists.

PubMed

Phillips, R L; Kuzma, J W; Beeson, W L; Lotz, T

1980-08-01

The authors examine the influence of selection versus life-style on mortality from various causes for a population of 23,000 California Seventh-Day Adventists. The data are compared with data from a control group of 112,726 other Californians. The selective factors considered include education, occupation, and marital status

Classical scrapie prions in ovine blood are associated with B lymphocytes and platelets-rich plasma

USDA-ARS?s Scientific Manuscript database

Classical scrapie is a naturally occurring fatal brain disease of sheep and goats which is caused by prions, a novel class of infectious agent, and is accompanied by the accumulation of abnormal isoforms of prion protein (PrP-Sc) in certain neural and lymphoid tissues. Although collection of a blood...

Accumulation of PrP-Sc in hemal nodes of naturally and experimentally scrapie-infected sheep

USDA-ARS?s Scientific Manuscript database

Classical scrapie is a naturally occurring fatal disease of sheep and goats which is caused by prions, a novel class of infectious agent. Infection is accompanied by accumulation of abnormal isoforms of the prion protein (PrP-Sc) in certain neural and lymphoid tissues. Hemal nodes, which are unique ...

Identification of an NTPase motif in classical swine fever virus NS4B protein

USDA-ARS?s Scientific Manuscript database

Classical swine fever (CSF) is a highly contagious and often fatal disease of swine caused by CSF virus (CSFV), a positive sense single-stranded RNA virus in the genus Pestivirus of the Flaviviridae family. Here, we have identified, within CSFV non-structural (NS) protein NS4B, conserved sequence el...

Canker Stain Affects Delaware Sycamores Pest Alert

Treesearch

Alan Iskra; Gary Schwetz; Michael Valenti

2001-01-01

An often fatal disease of American sycamore (Platanus occidentalis), known as canker stain, is caused by the fungus, Ceratocystis fimbriata f.sp. platani. This fungus, indigenous to the United States, occurs in urban and forested areas from New Jersey to Georgia and west to Missouri and Louisiana. Other trees affected are the Oriental plane (Platanus orientalis) and...

Development of therapeutics for treatment of Ebola virus infection.

PubMed

Li, Haoyang; Ying, Tianlei; Yu, Fei; Lu, Lu; Jiang, Shibo

2015-02-01

Ebola virus infection can cause Ebola virus disease (EVD). Patients usually show severe symptoms, and the fatality rate can reach up to 90%. No licensed medicine is available. In this review, development of therapeutics for treatment of Ebola virus infection and EVD will be discussed. Copyright © 2014 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

Lymphocytes and macrophages are infected by theileria equi, but T cells and B cells are not required to establish infection in vivo

USDA-ARS?s Scientific Manuscript database

Theileria equi has a biphasic life cycle in horses, with a period of intraleukocyte development followed by patent erythrocytic parasitemia that causes acute and sometimes fatal hemolytic disease. Unlike Theileria spp. that infect cattle (Theileria parva and Theileria annulata), the intraleukocyte s...

Comparison of Rift Valley fever virus and MP-12 replication in domestic livestock and North American wildlife cell lines.

USDA-ARS?s Scientific Manuscript database

Rift Valley fever virus (RVFV) is a mosquito-transmitted pathogen that primarily affects livestock, but can also cause mild to fatal disease in humans. Currently, there is no approved vaccine for use in the United States if it were introduced. Domestic goats, sheep and cattle are susceptible hosts ...

Pneumonia and New Methicillin-resistant Staphylococcus aureus Clone

PubMed Central

Tristan, Anne; François, Bruno; Etienne, Jerome; Delage-Corre, Manuella; Martin, Christian; Liassine, Nadia; Wannet, Wim; Denis, François; Ploy, Marie-Cécile

2006-01-01

Necrotizing pneumonia caused by Staphylococcus aureus strains carrying the Panton-Valentin leukocidin gene is a newly described disease entity. We report a new fatal case of necrotizing pneumonia. An S. aureus strain with an agr1 allele and of a new sequence type 377 was recovered, representing a new, emerging, community-acquired methicillin-resistant clone. PMID:16704793

Leading causes of death from injury and poisoning by age, sex and urban/rural areas in Tianjin, China 1999-2006.

PubMed

Jiang, Guohong; Choi, Bernard C K; Wang, Dezheng; Zhang, Hui; Zheng, Wenlong; Wu, Tongyu; Chang, Gai

2011-05-01

Injury and poisoning are a growing public health concern in China due to rapid economic growth, which has resulted in many cases with an injury-prone environment, such as overcrowded traffic, booming construction, and work-related stress. This study investigates the distribution and trends of deaths from injury and poisoning in Tianjin, China, by age, sex and urban/rural status, from 1999 to 2006. The study used data from the all-cause mortality surveillance system maintained by the Tianjin Centers for Disease Control and Prevention (CDC). Each death certificate recorded 53 variables. Cause of death was coded using the International Classification of Diseases (ICD). Standardized mortality rates and proportions of deaths were analyzed. Traffic accidents, suicide, poisoning, drowning and fall were the leading causes of fatal injuries in Tianjin from 1999 to 2006. Injury mortality rates were high in males, in rural areas, and in the older age groups. Despite low injury mortality rates, injury accounted for close to 50% of all deaths amongst the 5-29 year age group. Traffic accident mortality rates increased, although not significantly so, during the period from 1999 to 2006. Injury prevention and control is a high public health priority in Tianjin. Our detailed table on the number of deaths by causes of fatal injuries and by age group provides important information to set prevention strategies in the nurseries, schools, workplace and seniors homes. 2009 Elsevier Ltd. All rights reserved.

Prognostic Value of Dehydroepiandrosterone Sulfate for Patients With Cardiovascular Disease: A Systematic Review and Meta-Analysis.

PubMed

Wu, Ting-Ting; Chen, Yuan; Zhou, Yun; Adi, Dilare; Zheng, Ying-Ying; Liu, Fen; Ma, Yi-Tong; Xie, Xiang

2017-05-05

The aim of the present study was to estimate the impact of dehydroepiandrosterone sulfate (DHEAS) on the prognosis of patients with cardiovascular disease by performing a systematic review and meta-analysis. The Embase, PubMed, Web of Science, CNKI, and WanFang databases were searched up to September 5, 2016, to identify eligible studies. The quality of each study was assessed using the Newcastle-Ottawa Scale. The association between DHEAS, either on admission or at discharge, and cardiovascular disease outcomes were reviewed. The overall risk ratio for the effect of DHEAS on all-cause mortality and fatal and nonfatal cardiovascular events was pooled using a fixed-effects or a random-effects model. The publication bias was evaluated using funnel plots. Twenty-five studies were included for systematic review. The follow-up duration ranged from 1 to 19 years. Eighteen studies were included in the meta-analysis. We found that lower DHEAS levels indicated a significant increased risk for all-cause mortality (risk ratio, 1.47; 95% CI, 1.38-1.56 [ P <0.00001]), fatal cardiovascular event (risk ratio, 1.58; 95% CI, 1.30-1.91 [ P <0.00001]), and nonfatal cardiovascular event (risk ratio, 1.42; 95% CI, 1.24-1.62 [ P <0.0001]) in patients with cardiovascular disease. Patients with cardiovascular disease who have lower DHEAS levels may have poorer prognosis than those with higher DHEAS levels. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Current and Future Burden of Chronic Nonmalignant Liver Disease.

PubMed

Udompap, Prowpanga; Kim, Donghee; Kim, W Ray

2015-11-01

Disease burden is an important indicator of the state of health of a population. It can be measured as the frequency (eg, incidence and prevalence) of a condition or its effects including fatal and non-fatal health loss from disease (eg, disability-adjusted life years) as well as the financial costs (eg, direct healthcare costs and indirect healthcare expenditures related to lost income because of premature death). Accurate disease burden information is essential for policy-making such as prioritization of health interventions and allocation of resources. Chronic liver disease (CLD) causes substantial health and economic burden in the United States, where nearly 2 million deaths annually are attributable to CLD. In the recent past, overall mortality rate of CLD has been increasing. Viral hepatitis and alcoholic liver disease are thought to be the most common etiologies of chronic liver diseases. More recently, the prevalence of nonalcoholic fatty liver disease is rapidly increasing, and nonalcoholic steatohepatitis has become a leading indication for liver transplantation. In this article, we assemble available data on the burden of CLD in the United States, focusing on nonmalignant complications, whereas the impact on mortality and healthcare expenses of hepatocellular carcinoma, an important consequence of CLD, is discussed elsewhere. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

Vaccines for leishmaniasis: from proteome to vaccine candidates.

PubMed

Schroeder, Juliane; Aebischer, Toni

2011-01-01

Leishmania spp. cause a wide spectrum of tropical diseases which are threatening an estimated 350 million people around the globe. While in most cases non-fatal, the disease is associated with high morbidity, social stigmata and poverty. However, the most severe form visceral leishmaniasis can be fatal if left untreated. Chemotherapeutics are available but show high toxicity, costs and are prone to resistance development due to prolonged treatment periods. Healing is associated with a life-long resistance to re-infection and this argues for the feasibility of vaccination. However, despite much effort, no such vaccine has become available yet. Here, the status of vaccine development in this field is briefly summarized before the focus is set on the promise of reverse vaccinology for anti-Leishmania vaccine development in the post-genomic era. We report on our own experience with this approach using an instructive example of successful candidate vaccine antigen identification.

Serotonin toxicity involving MDMA (ecstasy) and moclobemide.

PubMed

Pilgrim, J L; Gerostamoulos, D; Woodford, N; Drummer, Olaf H

2012-02-10

The use of MDMA (ecstasy) in Australia is a widespread and growing problem, promoting acute toxicity and disease which can lead to premature death in users. We report four cases of fatal serotonin toxicity caused by the combination of MDMA and moclobemide, a reversible MAO-A inhibitor with potent serotonergic activity. Despite the highly reported toxicity of this drug combination, there are very few reports of fatalities attributed to a MDMA and moclobemide interaction. Pathology and toxicology reports, initial police reports and coroners' findings were examined to determine the circumstances of the deaths. Symptoms of some of the four cases as reported by paramedics and medical staff included hyperthermia, hyperkalemia, profuse sweating, twitching and shaking. Two cases involved moclobemide concentrations consistent with common prescribed doses, while the other two cases involved much higher concentrations often associated with toxicity. Three of these cases presented with some form of heart disease. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Melioidosis and glanders modulation of the innate immune system: barriers to current and future vaccine approaches.

PubMed

Aschenbroich, Sophie A; Lafontaine, Eric R; Hogan, Robert J

2016-09-01

Burkholderia pseudomallei and Burkholderia mallei are pathogenic bacteria causing fatal infections in animals and humans. Both organisms are classified as Tier 1 Select Agents owing to their highly fatal nature, potential/prior use as bioweapons, severity of disease via respiratory exposure, intrinsic resistance to antibiotics, and lack of a current vaccine. Disease manifestations range from acute septicemia to chronic infection, wherein the facultative intracellular lifestyle of these organisms promotes persistence within a broad range of hosts. This ability to thrive intracellularly is thought to be related to exploitation of host immune response signaling pathways. There are currently considerable gaps in our understanding of the molecular strategies employed by these pathogens to modulate these pathways and evade intracellular killing. A better understanding of the specific molecular basis for dysregulation of host immune responses by these organisms will provide a stronger platform to identify novel vaccine targets and develop effective countermeasures.

Oxidative stress and mitochondrial dysfunction-linked neurodegenerative disorders.

PubMed

Islam, Md Torequl

2017-01-01

Reactive species play an important role in physiological functions. Overproduction of reactive species, notably reactive oxygen (ROS) and nitrogen (RNS) species along with the failure of balance by the body's antioxidant enzyme systems results in destruction of cellular structures, lipids, proteins, and genetic materials such as DNA and RNA. Moreover, the effects of reactive species on mitochondria and their metabolic processes eventually cause a rise in ROS/RNS levels, leading to oxidation of mitochondrial proteins, lipids, and DNA. Oxidative stress has been considered to be linked to the etiology of many diseases, including neurodegenerative diseases (NDDs) such as Alzheimer diseases, Amyotrophic lateral sclerosis, Friedreich's ataxia, Huntington's disease, Multiple sclerosis, and Parkinson's diseases. In addition, oxidative stress causing protein misfold may turn to other NDDs include Creutzfeldt-Jakob disease, Bovine Spongiform Encephalopathy, Kuru, Gerstmann-Straussler-Scheinker syndrome, and Fatal Familial Insomnia. An overview of the oxidative stress and mitochondrial dysfunction-linked NDDs has been summarized in this review.

First report of fatal disseminated microsporidiosis in two inland bearded dragons Pogona vitticeps in Japan.

PubMed

Shibasaki, Kojiro; Tokiwa, Toshihiro; Sukegawa, Akihiro; Kondo, Hirotaka; Tamukai, Kenichi; Haga, Yumiko; Ike, Kazunori

2017-04-01

Introduction. Encephalitozoon pogonae is a newly described pathogen belonging to the phylum Microsporidia. In Austria and the USA, this species has been isolated from fatal and disseminated cases of captive-bred inland bearded dragons. Here, we report the case of fatal disseminated microsporidiosis caused by E. pogonae in two bearded dragons in Japan. Case Presentation. The two lizards from different private households in Tokyo, Japan, had been brought to an animal hospital for examination. In both cases, the animal presented with a history of weight loss for several weeks. There were no improvements in clinical symptoms and the lizards deteriorated and finally died. Histopathological examination demonstrated necrotizing granulomatous inflammation attributed to disseminated microsporidian infection. Nucleotide sequencing of the nuclear ribosomal internal transcribed spacer region identified the microsporidian as E. pogonae with sequence identity of 100 %. Conclusion. We report the first case, to our knowledge, of disseminated microsporidiosis caused by E. pogonae in inland bearded dragons in Japan. Although it is difficult to diagnose prenatally since the signs are nonspecific, the disease should be considered in the differential diagnosis of chronic infections that do not respond to antibiotics.

First report of fatal disseminated microsporidiosis in two inland bearded dragons Pogona vitticeps in Japan

PubMed Central

Sukegawa, Akihiro; Kondo, Hirotaka; Tamukai, Kenichi; Haga, Yumiko; Ike, Kazunori

2017-01-01

Introduction. Encephalitozoon pogonae is a newly described pathogen belonging to the phylum Microsporidia. In Austria and the USA, this species has been isolated from fatal and disseminated cases of captive-bred inland bearded dragons. Here, we report the case of fatal disseminated microsporidiosis caused by E. pogonae in two bearded dragons in Japan. Case Presentation. The two lizards from different private households in Tokyo, Japan, had been brought to an animal hospital for examination. In both cases, the animal presented with a history of weight loss for several weeks. There were no improvements in clinical symptoms and the lizards deteriorated and finally died. Histopathological examination demonstrated necrotizing granulomatous inflammation attributed to disseminated microsporidian infection. Nucleotide sequencing of the nuclear ribosomal internal transcribed spacer region identified the microsporidian as E. pogonae with sequence identity of 100 %. Conclusion. We report the first case, to our knowledge, of disseminated microsporidiosis caused by E. pogonae in inland bearded dragons in Japan. Although it is difficult to diagnose prenatally since the signs are nonspecific, the disease should be considered in the differential diagnosis of chronic infections that do not respond to antibiotics. PMID:29026616

Using alternatives to the car and risk of all-cause, cardiovascular and cancer mortality.

PubMed

Panter, Jenna; Mytton, Oliver; Sharp, Stephen; Brage, Søren; Cummins, Steven; Laverty, Anthony A; Wijndaele, Katrien; Ogilvie, David

2018-05-21

To investigate the associations between using alternatives to the car which are more active for commuting and non-commuting purposes, and morbidity and mortality. We conducted a prospective study using data from 3 58 799 participants, aged 37-73 years, from UK Biobank. Commute and non-commute travel were assessed at baseline in 2006-2010. We classified participants according to whether they relied exclusively on the car or used alternative modes of transport that were more active at least some of the time. The main outcome measures were incident cardiovascular disease (CVD) and cancer, and CVD, cancer and all-cause mortality. We excluded events in the first 2 years and conducted analyses separately for those who regularly commuted and those who did not. In maximally adjusted models, regular commuters with more active patterns of travel on the commute had a lower risk of incident (HR 0.89, 95% CI 0.79 to 1.00) and fatal (HR 0.70, 95% CI 0.51 to 0.95) CVD. Those regular commuters who also had more active patterns of non-commute travel had an even lower risk of fatal CVD (HR 0.57, 95% CI 0.39 to 0.85). Among those who were not regular commuters, more active patterns of travel were associated with a lower risk of all-cause mortality (HR 0.92, 95% CI 0.86 to 0.99). More active patterns of travel were associated with a reduced risk of incident and fatal CVD and all-cause mortality in adults. This is an important message for clinicians advising people about how to be physically active and reduce their risk of disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Monochloramine use for prevention of Legionella in hospital water systems.

PubMed

Kandiah, Sheetal; Yassin, Mohamed H; Stout, Janet

2013-06-01

Eradication of Legionella species from water distribution systems especially in hospital settings has proven to be challenging. Legionella species causes Legionnaire's disease that is a potentially fatal respiratory disease often acquired through the aerosolization of contaminated water. Monochloramine has been used successfully in the municipal water systems to eradicate Legionella and there is currently limited data to support its use in the hospital setting. This technology appears to be affordable, safe and effective at penetrating biofilm in water distribution systems.

Clinical Neurogenetics: Amyotrophic Lateral Sclerosis

PubMed Central

Harms, Matthew B.; Baloh, Robert H.

2013-01-01

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease, about which our understanding is expanding rapidly as its genetic causes are uncovered. The pace of new gene discovery over the last 5 years has accelerated, providing new insights into the pathogenesis of disease and highlighting biological pathways for target for therapeutic development. This article reviews our current understanding of the heritability of ALS, provides an overview of each of the major ALS genes, highlighting their phenotypic characteristics and frequencies as a guide for clinicians evaluating patients with ALS. PMID:24176417

A Systematic Review of the Incidence, Risk Factors and Case Fatality Rates of Invasive Nontyphoidal Salmonella (iNTS) Disease in Africa (1966 to 2014)

PubMed Central

Uche, Ifeanyi Valentine; MacLennan, Calman A.

2017-01-01

This study systematically reviews the literature on the occurrence, incidence and case fatality rate (CFR) of invasive nontyphoidal Salmonella (iNTS) disease in Africa from 1966 to 2014. Data on the burden of iNTS disease in Africa are sparse and generally have not been aggregated, making it difficult to describe the epidemiology that is needed to inform the development and implementation of effective prevention and control policies. This study involved a comprehensive search of PubMed and Embase databases. It documents the geographical spread of iNTS disease over time in Africa, and describes its reported incidence, risk factors and CFR. We found that Nontyphoidal Salmonella (NTS) have been reported as a cause of bacteraemia in 33 out of 54 African countries, spanning the five geographical regions of Africa, and especially in sub-Saharan Africa since 1966. Our review indicates that NTS have been responsible for up to 39% of community acquired blood stream infections in sub-Saharan Africa with an average CFR of 19%. Salmonella Typhimurium and Enteritidis are the major serovars implicated and together have been responsible for 91%% of the cases of iNTS disease, (where serotype was determined), reported in Africa. The study confirms that iNTS disease is more prevalent amongst Human Immunodeficiency Virus (HIV)-infected individuals, infants, and young children with malaria, anaemia and malnutrition. In conclusion, iNTS disease is a substantial cause of community-acquired bacteraemia in Africa. Given the high morbidity and mortality of iNTS disease in Africa, it is important to develop effective prevention and control strategies including vaccination. PMID:28056035

Burden of disease attributed to ambient air pollution in Thailand: A GIS-based approach.

PubMed

Pinichka, Chayut; Makka, Nuttapat; Sukkumnoed, Decharut; Chariyalertsak, Suwat; Inchai, Puchong; Bundhamcharoen, Kanitta

2017-01-01

Growing urbanisation and population requiring enhanced electricity generation as well as the increasing numbers of fossil fuel in Thailand pose important challenges to air quality management which impacts on the health of the population. Mortality attributed to ambient air pollution is one of the sustainable development goals (SDGs). We estimated the spatial pattern of mortality burden attributable to selected ambient air pollution in 2009 based on the empirical evidence in Thailand. We estimated the burden of disease attributable to ambient air pollution based on the comparative risk assessment (CRA) framework developed by the World Health Organization (WHO) and the Global Burden of Disease study (GBD). We integrated geographical information systems (GIS)-based exposure assessments into spatial interpolation models to estimate ambient air pollutant concentrations, the population distribution of exposure and the concentration-response (CR) relationship to quantify ambient air pollution exposure and associated mortality. We obtained air quality data from the Pollution Control Department (PCD) of Thailand surface air pollution monitoring network sources and estimated the CR relationship between relative risk (RR) and concentration of air pollutants from the epidemiological literature. We estimated 650-38,410 ambient air pollution-related fatalities and 160-5,982 fatalities that could have been avoided with a 20 reduction in ambient air pollutant concentrations. The summation of population-attributable fraction (PAF) of the disease burden for all-causes mortality in adults due to NO2 and PM2.5 were the highest among all air pollutants at 10% and 7.5%, respectively. The PAF summation of PM2.5 for lung cancer and cardiovascular disease were 16.8% and 14.6% respectively and the PAF summations of mortality attributable to PM10 was 3.4% for all-causes mortality, 1.7% for respiratory and 3.8% for cardiovascular mortality, while the PAF summation of mortality attributable to NO2 was 7.8% for respiratory mortality in Thailand. Mortality due to ambient air pollution in Thailand varies across the country. Geographical distribution estimates can identify high exposure areas for planners and policy-makers. Our results suggest that the benefits of a 20% reduction in ambient air pollution concentration could prevent up to 25% of avoidable fatalities each year in all-causes, respiratory and cardiovascular categories. Furthermore, our findings can provide guidelines for future epidemiological investigations and policy decisions to achieve the SDGs.

Fatal injuries in the slums of Nairobi and their risk factors: results from a matched case-control study.

PubMed

Ziraba, Abdhalah Kasiira; Kyobutungi, Catherine; Zulu, Eliya Msiyaphazi

2011-06-01

Injuries contribute significantly to the rising morbidity and mortality attributable to non-communicable diseases in the developing world. Unfortunately, active injury surveillance is lacking in many developing countries, including Kenya. This study aims to describe and identify causes of and risk factors for fatal injuries in two slums in Nairobi city using a demographic surveillance system framework. The causes of death are determined using verbal autopsies. We used a nested case-control study design with all deaths from injuries between 2003 and 2005 as cases. Two controls were randomly selected from the non-injury deaths over the same period and individually matched to each case on age and sex. We used conditional logistic regression modeling to identity individual- and community-level factors associated with fatal injuries. Intentional injuries accounted for about 51% and unintentional injuries accounted for 49% of all injuries. Homicides accounted for 91% of intentional injuries and 47% of all injury-related deaths. Firearms (23%) and road traffic crashes (22%) were the leading single causes of deaths due to injuries. About 15% of injuries were due to substance intoxication, particularly alcohol, which in this community comes from illicit brews and is at times contaminated with methanol. Results suggest that in the pervasively unsafe and insecure environment that characterizes the urban slums, ethnicity, residence, and area level factors contribute significantly to the risk of injury-related mortality.

Systematic Review and Meta-Analysis of Randomised Trials to Ascertain Fatal Gastrointestinal Bleeding Events Attributable to Preventive Low-Dose Aspirin: No Evidence of Increased Risk

PubMed Central

Dolwani, Sunil; Graziano, J. Michael; Lanas, Angel; Longley, Marcus; Phillips, Ceri J.; Roberts, Stephen E.; Soon, Swee S.; Steward, Will

2016-01-01

Background Aspirin has been shown to lower the incidence and the mortality of vascular disease and cancer but its wider adoption appears to be seriously impeded by concerns about gastrointestinal (GI) bleeding. Unlike heart attacks, stroke and cancer, GI bleeding is an acute event, usually followed by complete recovery. We propose therefore that a more appropriate evaluation of the risk-benefit balance would be based on fatal adverse events, rather than on the incidence of bleeding. We therefore present a literature search and meta-analysis to ascertain fatal events attributable to low-dose aspirin. Methods In a systematic literature review we identified reports of randomised controlled trials of aspirin in which both total GI bleeding events and bleeds that led to death had been reported. Principal investigators of studies in which fatal events had not been adequately described were contacted via email and asked for further details. A meta-analyses was then performed to estimate the risk of fatal gastrointestinal bleeding attributable to low-dose aspirin. Results Eleven randomised trials were identified in the literature search. In these the relative risk (RR) of ‘major’ incident GI bleeding in subjects who had been randomised to low-dose aspirin was 1.55 (95% CI 1.33, 1.83), and the risk of a bleed attributable to aspirin being fatal was 0.45 (95% CI 0.25, 0.80). In all the subjects randomised to aspirin, compared with those randomised not to receive aspirin, there was no significant increase in the risk of a fatal bleed (RR 0.77; 95% CI 0.41, 1.43). Conclusions The majority of the adverse events caused by aspirin are GI bleeds, and there appears to be no valid evidence that the overall frequency of fatal GI bleeds is increased by aspirin. The substantive risk for prophylactic aspirin is therefore cerebral haemorrhage which can be fatal or severely disabling, with an estimated risk of one death and one disabling stroke for every 1,000 people taking aspirin for ten years. These adverse effects of aspirin should be weighed against the reductions in vascular disease and cancer. PMID:27846246

Global trend according to estimated number of occupational accidents and fatal work-related diseases at region and country level.

PubMed

Hämäläinen, Päivi; Leena Saarela, Kaija; Takala, Jukka

2009-01-01

Although occupational accidents and work-related diseases have been of interest for a long time, due to lack of proper recording and notification systems the official numbers of occupational accidents and work-related diseases are missing for many countries. Presently, the demand for effectiveness and an interest in the economic aspects of accidents have increased prevention activities at company and country levels. Occupational accident data of selected countries and of World Health Organization regional divisions together with the global burden of disease were used in estimating global occupational accidents and fatal work-related diseases. The trend of global occupational accidents and work-related diseases is presented at region and country levels. The years 1998, 2001, and 2003 are compared in the case of occupational accidents and the years 2000 and 2002 in the case of work-related diseases. The total number of occupational accidents and fatal work-related diseases has increased, but the fatality rates per 100,000 workers have decreased. There were almost 360,000 fatal occupational accidents in 2003 and almost 2 million fatal work-related diseases in 2002. Every day more than 960,000 workers get hurt because of accidents. Each day 5,330 people die because of work-related diseases. Information on occupational accidents and work-related diseases is needed so that countries may understand better the importance of occupational health and safety at country and company level. Especially companies in developing countries are not familiar with occupational safety and health. Statistical data is essential for accident prevention; it is a starting point for the safety work.

An Emerging Tick-Borne Disease of Humans Is Caused by a Subset of Strains with Conserved Genome Structure

PubMed Central

Barbet, Anthony F.; Al-Khedery, Basima; Stuen, Snorre; Granquist, Erik G.; Felsheim, Roderick F.; Munderloh, Ulrike G.

2013-01-01

The prevalence of tick-borne diseases is increasing worldwide. One such emerging disease is human anaplasmosis. The causative organism, Anaplasma phagocytophilum, is known to infect multiple animal species and cause human fatalities in the U.S., Europe and Asia. Although long known to infect ruminants, it is unclear why there are increasing numbers of human infections. We analyzed the genome sequences of strains infecting humans, animals and ticks from diverse geographic locations. Despite extensive variability amongst these strains, those infecting humans had conserved genome structure including the pfam01617 superfamily that encodes the major, neutralization-sensitive, surface antigen. These data provide potential targets to identify human-infective strains and have significance for understanding the selective pressures that lead to emergence of disease in new species. PMID:25437207

Novel epitopes identified by Anti-PrP monoclonal antibodies produced following immunization of Prnp0/0 Balb/cJ mice with purified scrapie prions

USDA-ARS?s Scientific Manuscript database

Prions, or infectious proteins, cause a class of uniformly fatal neurodegenerative diseases. Prions are composed solely of an aberrantly folded isoform(PrPSc)of a normal cellular protein (PrPC). Shared sequence identity of PrPSc with PrPC has limited the detection sensitivity of immunochemical assay...

Cell surface expression of PrP-c and the presence of scrapie prions in the blood of goats

USDA-ARS?s Scientific Manuscript database

Classical scrapie is a naturally occurring fatal brain disease of goats and sheep which is caused by prions, a novel class of infectious agent, and is accompanied by the accumulation of abnormal isoforms of prion protein (PrP-Sc) in certain neural and lymphoid tissues. Although collection of a blood...

Development and characterization of six monoclonal antibodies to hemagglutinin-70 (HA70) of Clostridium botulinum and their application in a sandwich ELISA

USDA-ARS?s Scientific Manuscript database

Botulinum neurotoxins (BoNT),produced by Clostridium botulinum, cause severe neuroparalytic disease that if not treated quickly is often fatal. The toxin is synthesized as a 150 kDa precursor protein (holotoxin), which is then enzymatically cleaved to form two subunit chains linked by a single disul...

Stable transfection of babesia bigemina and babesia bovis using a single plasmid containing homologous and heterologous insertion and gene regulatory sequences

USDA-ARS?s Scientific Manuscript database

Bovine babesiosis caused by Babesia bovis and B. bigemina is a severe, often fatal, tick-borne disease of cattle for which improved methods for control are urgently needed. One of our long term goals is to develop effective vaccines based on genetically modfied B. bigemina and B. bovis parasites. Al...

Clonal Clusters and Virulence Factors of Group C and G Streptococcus Causing Severe Infections, Manitoba, Canada, 2012-2014.

PubMed

Lother, Sylvain A; Demczuk, Walter; Martin, Irene; Mulvey, Michael; Dufault, Brenden; Lagacé-Wiens, Philippe; Keynan, Yoav

2017-07-01

The incidence of group C and G Streptococcus (GCGS) bacteremia, which is associated with severe disease and death, is increasing. We characterized clinical features, outcomes, and genetic determinants of GCGS bacteremia for 89 patients in Winnipeg, Manitoba, Canada, who had GCGS bacteremia during 2012-2014. Of the 89 patients, 51% had bacteremia from skin and soft tissue, 70% had severe disease features, and 20% died. Whole-genome sequencing analysis was performed on isolates derived from 89 blood samples and 33 respiratory sample controls: 5 closely related genetic lineages were identified as being more likely to cause invasive disease than non-clade isolates (83% vs. 57%, p = 0.002). Virulence factors cbp, fbp, speG, sicG, gfbA, and bca clustered clonally into these clades. A clonal distribution of virulence factors may account for severe and fatal cases of bacteremia caused by invasive GCGS.

Fatal pneumonia epizootic in musk ox (Ovibos moschatus) in a period of extraordinary weather conditions.

PubMed

Ytrehus, Bjørnar; Bretten, Tord; Bergsjø, Bjarne; Isaksen, Ketil

2008-06-01

The musk ox is adapted to extreme cold and regarded as vulnerable to the impacts of climate change. Population decline is proposed to occur due to changes in forage availability, insect harassment, parasite load, and habitat availability, while the possible role of infectious diseases has not been emphasized. The goal of the present article is to describe an outbreak of fatal pasteurellosis that occurred in the introduced musk ox population of Dovrefjell, Norway in 2006, causing the death of a large proportion of the animals. The epizootic coincided with extraordinary warm and humid weather, conditions that often are associated with outbreaks of pasteurellosis. The description is based on long series of data from the surveillance of the musk ox population, weather data from a closely located meteorological station, and pathoanatomical investigation of the diseased animals. It is concluded that the weather conditions likely were the decisive factors for the outbreak. It is suggested that such epizootics may occur increasingly among cold-adapted animals if global warming results in increased occurrence of heat waves and associated extreme weather events, thereby causing population declines and possibly extinctions.

Primary Amoebic Meningoencephalitis: Neurochemotaxis and Neurotropic Preferences of Naegleria fowleri.

PubMed

Baig, Abdul Mannan

2016-08-17

Naegleria fowleri causes one of the most devastating necrotic meningoencephalitis in humans. The infection caused by this free-living amoeba is universally fatal within a week of onset of the signs and symptoms of the disease called primary amoebic meningoencephalitis (PAM). In all the affected patients, there is always a history of entry of water into the nose. Even though the diagnostic and treatment protocols have been revised and improved, the obstinate nature of the disease can be gauged by the fact that the mortality rate has persisted around ∼95% over the past 60 years. Some of the unanswered questions regarding PAM are is there a neurochemical basis of the chemotaxis of N. fowleri to the brain? What immune evasion means occurs preceding the neurotropic invasion? What is the contribution of the acute inflammatory response in the fatal cases? Can a combination of anti-amoebic drugs with antagonism of the acute inflammation help save the patient's life? As prevention remains the most valuable safeguard against N. fowleri, a quicker diagnosis, better understanding of the pathogenesis of PAM coupled with testing of newer and safer drugs could improve the chances of survival in patients affected with PAM.

Retrospective Study on Fatal Melioidosis in Captive Zoo Animals in Thailand.

PubMed

Kasantikul, T; Sommanustweechai, A; Polsrila, K; Kongkham, W; Chaisongkram, C; Sanannu, S; Kongmakee, P; Narongwanichgarn, W; Bush, M; Sermswan, R W; Banlunara, W

2016-10-01

Melioidosis is caused by Burkholderia pseudomallei and is an important zoonotic infectious disease causing high mortality from fulminant septicaemia in humans and a wide variety of animal species. The incidence of fatal melioidosis in zoo animals has been significant in many Thai zoos. A total number of 32 cases were evaluated throughout the Thai zoo animal populations. The highest prevalence of disease has been reported from the north-eastern region followed by the zoos in the southern part of the country, approximately 47% and 38%, respectively, while the other zoos reported sporadic infections. Herbivores and non-human primates were the most commonly affected animals with incidences of 59% and 28%, respectively. This appears to be a seasonal correlation with the highest incidence of melioidosis in zoo animals reported in the rainy season (44%) or subdivided monthly in June (19%) followed by September and November (16% and 12%, respectively). The route of infection and the incubation period still remain unclear. This retrospective study examined the clinical presentation in various zoo species, pathological findings and epidemiological data as well as conducting an in depth literature review. © 2015 Blackwell Verlag GmbH.

Fatal traumatic brain injury in older adults in Austria 1980-2012: an analysis of 33 years.

PubMed

Brazinova, Alexandra; Mauritz, Walter; Majdan, Marek; Rehorcikova, Veronika; Leitgeb, Johannes

2015-05-01

traumatic brain injury (TBI) is a significant public health problem. Developed countries report a significant increase of TBI in older adults in the past decades. The objective of this study was to investigate the changes in TBI-related mortality in older Austrians (65 years or older) between 1980 and 2012 (33 years) and to identify possible causes for these changes. data from Statistics Austria on mortality in Austria between 1980 and 2012 were screened and data on TBI-related mortality in adults aged 65 and older were extracted and analysed, based on the diagnostic codes of the International Classification of Diseases, 10th and 9th revision. Mortality rates were calculated for 5-year age groups; standardized mortality rates were calculated for the total. Mechanism of injury was analysed for all events, both sexes and individual age groups. between 1980 and 2012, 16,204 people aged 65 or older died from TBI in Austria; 61% of these were male. Fatal TBI cases and mortality rates increased in the oldest age groups (80 years or older). Half of the fatal TBI cases were caused by falls, 22% by traffic accidents and 17% by suicides. Rate of fall-related fatal TBI increased and rate of traffic accident-related fatal TBI decreased with age. preventive measures introduced in the past decades in the developed countries have contributed to a decrease in traffic injuries. However, falls in the older population are on the rise, mainly due to ageing of the population, throughout the reported period. It is important to take preventive measures to stop the epidemics of fall-related TBIs and fatalities in older adults. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Hantavirus infection as the cause of haemorrhagic fever with renal syndrome].

PubMed

Redal-Baigorri, Belén; Chen Nielsen, Xiaohui; Martin-Iguacel, Raquel

2012-10-29

Hantavirus is an RNA virus that can cause potentially fatal pulmonary and renal diseases in humans. Infections with Hantaviruses occur through inhalation of aerosol from rodent faeces, urine or saliva. The predominant virus type in Denmark is the Puumala virus, which causes the mildest form of haemorrhagic fever with renal syndrome, the so-called nephropathia epidemica (NE) with good prognosis (mortality 0.1-0.4%). The incidence of Hantavirus-infection in Denmark is about ten cases a year. The diagnosis of Hantavirus-infection is based on serology and/or polymerase chain reaction in blood or urine.

Infective endocarditis and meningitis due to Scedosporium prolificans in a renal transplant recipient.

PubMed

Uno, Kenji; Kasahara, Kei; Kutsuna, Satoshi; Katanami, Yuichi; Yamamoto, Yoshifumi; Maeda, Koichi; Konishi, Mitsuru; Ogawa, Taku; Yoneda, Tatsuo; Yoshida, Katsunori; Kimura, Hiroshi; Mikasa, Keiichi

2014-02-01

Scedosporium prolificans is a ubiquitous filamentous fungi that may cause disseminated diseases in neutropenic patients with hematological malignancies. We report a fatal case of renal transplant recipient who developed both infective endocarditis and meningitis due to S. prolificans during treatment with micafungin and itraconazole for chronic necrotizing aspergillosis. Breakthrough Scedosporium infection should be considered among differential diagnosis of invasive fungal diseases in patients with renal transplant recipients receiving antifungal agents. Copyright © 2013 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Emergence of Streptococcus pyogenes emm102 causing toxic shock syndrome in Southern Taiwan during 2005-2012.

PubMed

Lin, Jiun-Nong; Chang, Lin-Li; Lai, Chung-Hsu; Lin, Hsi-Hsun; Chen, Yen-Hsu

2013-01-01

Streptococcal toxic shock syndrome (STSS) is an uncommon but life-threatening disease caused by Streptococcus pyogenes. To understand the clinical and molecular characteristics of STSS, we analyzed clinical data and explored the emm types, superantigen genes, and pulsed-field gel electrophoresis of causative S. pyogenes isolates obtained between 2005 and 2012. In total, 53 patients with STSS were included in this study. The median age of the patients was 57 years (range: 9-83 years), and 81.1% were male. The most prevalent underlying disease was diabetes mellitus (45.3%). Skin and soft-tissue infection accounted for 86.8% of STSS. The overall mortality rate was 32.1%. Underlying diseases had no statistical impact on mortality. A total of 19 different emm types were identified. The most prevalent emm type was emm102 (18.9%), followed by emm11 (17%), emm1 (11.3%), emm87 (9.4%), and emm89 (7.5%). There was no statistically significant association between emm type and a fatal outcome. Among the superantigen genes, speB was the most frequently detected one (92.5%), followed by smeZ (90.6%), speG (81.1%), speC (39.6%), and speF (39.6%). The majority of emm102 strains were found to have speB, speC, speG, and smeZ. The presence of speG was negatively associated with a fatal outcome (P = 0.045). Our surveillance revealed the emergence of uncommon emm types, particularly emm102, causing STSS in southern Taiwan. Characterization of clinical, epidemiological, and molecular characteristics of STSS will improve our understanding of this life-threatening disease.

Emergence of Streptococcus pyogenes emm102 Causing Toxic Shock Syndrome in Southern Taiwan during 2005–2012

PubMed Central

Lin, Jiun-Nong; Chang, Lin-Li; Lai, Chung-Hsu; Lin, Hsi-Hsun; Chen, Yen-Hsu

2013-01-01

Background Streptococcal toxic shock syndrome (STSS) is an uncommon but life-threatening disease caused by Streptococcus pyogenes. Methods To understand the clinical and molecular characteristics of STSS, we analyzed clinical data and explored the emm types, superantigen genes, and pulsed-field gel electrophoresis of causative S. pyogenes isolates obtained between 2005 and 2012. Results In total, 53 patients with STSS were included in this study. The median age of the patients was 57 years (range: 9–83 years), and 81.1% were male. The most prevalent underlying disease was diabetes mellitus (45.3%). Skin and soft-tissue infection accounted for 86.8% of STSS. The overall mortality rate was 32.1%. Underlying diseases had no statistical impact on mortality. A total of 19 different emm types were identified. The most prevalent emm type was emm102 (18.9%), followed by emm11 (17%), emm1 (11.3%), emm87 (9.4%), and emm89 (7.5%). There was no statistically significant association between emm type and a fatal outcome. Among the superantigen genes, speB was the most frequently detected one (92.5%), followed by smeZ (90.6%), speG (81.1%), speC (39.6%), and speF (39.6%). The majority of emm102 strains were found to have speB, speC, speG, and smeZ. The presence of speG was negatively associated with a fatal outcome (P = 0.045). Conclusions Our surveillance revealed the emergence of uncommon emm types, particularly emm102, causing STSS in southern Taiwan. Characterization of clinical, epidemiological, and molecular characteristics of STSS will improve our understanding of this life-threatening disease. PMID:24349115

Avian influenza viruses in humans.

PubMed

Malik Peiris, J S

2009-04-01

Past pandemics arose from low pathogenic avian influenza (LPAI) viruses. In more recent times, highly pathogenic avian influenza (HPAI) H5N1, LPAI H9N2 and both HPAI and LPAI H7 viruses have repeatedly caused zoonotic disease in humans. Such infections did not lead to sustained human-to-human transmission. Experimental infection of human volunteers and seroepidemiological studies suggest that avian influenza viruses of other subtypes may also infect humans. Viruses of the H7 subtype appear to have a predilection to cause conjunctivitis and influenza-like illness (ILI), although HPAI H7N7 virus has also caused fatal respiratory disease. Low pathogenic H9N2 viruses have caused mild ILI and its occurrence may be under-recognised for this reason. In contrast, contemporary HPAI H5N1 viruses are exceptional in their virulence for humans and differ from human seasonal influenza viruses in their pathogenesis. Patients have a primary viral pneumonia progressing to acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome. Over 380 human cases have been confirmed to date, with an overall case fatality of 63%. The zoonotic transmission of avian influenza is a rare occurrence, butthe greater public health concern is the adaptation of such viruses to efficient human transmission, which could lead to a pandemic. A better understanding of the ecology of avian influenza viruses and the biological determinants of transmissibility and pathogenicity in humans is important for pandemic preparedness.

Prediction of Pan-Specific B-Cell Epitopes From Nucleocapsid Protein of Hantaviruses Causing Hantavirus Cardiopulmonary Syndrome.

PubMed

Kalaiselvan, Sagadevan; Sankar, Sathish; Ramamurthy, Mageshbabu; Ghosh, Asit Ranjan; Nandagopal, Balaji; Sridharan, Gopalan

2017-08-01

Hantaviruses are emerging viral pathogens that causes hantavirus cardiopulmonary syndrome (HCPS) in the Americas, a severe, sometimes fatal, respiratory disease in humans with a case fatality rate of ≥50%. IgM and IgG-based serological detection methods are the most common approaches used for laboratory diagnosis of hantaviruses. Such emerging viral pathogens emphasizes the need for improved rapid diagnostic devices and vaccines incorporating pan-specific epitopes of genotypes. We predicted linear B-cell epitopes for hantaviruses that are specific to genotypes causing HCPS in humans using in silico prediction servers. We modeled the Andes and Sin Nombre hantavirus nucleocapsid protein to locate the identified epitopes. Based on the mean percent prediction probability score, epitope IMASKSVGS/TAEEKLKKKSAF was identified as the best candidate B-cell epitope specific for hantaviruses causing HCPS. Promiscuous epitopes were identified in the C-terminal of the protein. Our study for the first time has reported pan-specific B-cell epitopes for developing immunoassays in the detection of antibodies to hantaviruses causing HCPS. Identification of epitopes with pan-specific recognition of all genotypes causing HCPS could be valuable for the development of immunodiagnositic tools toward pan-detection of hantavirus antibodies in ELISA. J. Cell. Biochem. 118: 2320-2324, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Causes of Nonbattle Injury Fatalities Among U.S. Army Soldiers During Operation Enduring Freedom and Operation Iraqi Freedom, 2001-2006

DTIC Science & Technology

2008-07-28

SUPPLEMENTARY NOTES 14. ABSTRACT As with previous military conflicts, nonbattle injuries ( NBls ) are a major cause of mortality in Operations...Enduring (OEF) and Iraqi Freedom (OIF). The purpose of this retrospective analysis was to 1) describe the incidence and rate of fatal NBls in OEF and OIF...from their beginning through December 2006, 2) describe the causes and circumstances of fatal NBls , and 3) compare two Army data systems that report

Discontinuation of penicillamine in the absence of alternative orphan drugs (trientine-zinc): a case of decompensated liver cirrhosis in Wilson's disease.

PubMed

Ping, C C; Hassan, Y; Aziz, N A; Ghazali, R; Awaisu, A

2007-02-01

To report a case of early-decompensated liver cirrhosis secondary to discontinuation of penicillamine therapy in a patient with Wilson's disease. A 33-year-old Chinese female patient was diagnosed with Wilson's disease, for which penicillamine 250 mg p.o. once daily was prescribed. However, the patient developed intolerance and penicillamine was discontinued without alternative treatment. Five months later, she developed decompensated liver cirrhosis with hepatic encephalopathy. Eventually, the patient died because of the complications of sepsis and decompensated liver failure. Chelating agent is the mainstay of treatment in Wilson's disease, which is an inherited disorder of hepatic copper metabolism. Therapy must be instituted and continued for life once diagnosis is confirmed. Interruption of therapy can be fatal or cause irreversible relapse. Penicillamine given orally is the chelating agent of first choice. However, its unfavourable side-effects profile leads to discontinuation of therapy in 20-30% of patients. In most case reports, cessation of penicillamine without replacement treatment causes rapid progression to fulminant hepatitis, which is fatal unless liver transplantation is performed. In this, we highlight a case of discontinuation of penicillamine in a patient with Wilson's disease without substitution with alternative regimen. This was caused by unavailability of the alternative agents such as trientine in our country. Consequently, the patient progressed to decompensated liver cirrhosis with encephalopathy and eventually passed-away within 5 months. One recent study supports a combination of trientine and zinc in treating patient with decompensated liver cirrhosis. This combination is capable of reversing liver failure and prevents the need of liver transplantation. Both trientine and zinc are not registered in Malaysia. Therefore, liver transplantation was probably the only treatment option for this patient. Hence, non-availability of orphan drugs in clinical practice is certainly a subject of serious concern. Systems for better management of patients with rare diseases need to be instituted by all the institutions concerned.

Snake fungal disease: An emerging threat to wild snakes

USGS Publications Warehouse

Lorch, Jeffrey M.; Knowles, Susan N.; Lankton, Julia S.; Michell, Kathy; Edwards, Jaime L.; Kapfer, Joshua M.; Staffen, Richard A.; Wild, Erik R.; Schmidt, Katie Z.; Ballmann, Anne; Blodgett, Doug; Farrell, Terence M.; Glorioso, Brad M.; Last, Lisa A.; Price, Steven J.; Schuler, Krysten L.; Smith, Christopher; Wellehan, James F. X.; Blehert, David S.

2016-01-01

Since 2006, there has been a marked increase in the number of reports of severe and often fatal fungal skin infections in wild snakes in the eastern USA. The emerging condition, referred to as snake fungal disease (SFD), was initially documented in rattlesnakes, where the infections were believed to pose a risk to the viability of affected populations. The disease is caused byOphidiomyces ophiodiicola, a fungus recently split from a complex of fungi long referred to as the Chrysosporium anamorph of Nannizziopsis vriesii (CANV). Here we review the current state of knowledge about O. ophiodiicola and SFD. In addition, we provide original findings which demonstrate that O. ophiodiicola is widely distributed in eastern North America, has a broad host range, is the predominant cause of fungal skin infections in wild snakes and often causes mild infections in snakes emerging from hibernation. This new information, together with what is already available in the scientific literature, advances our knowledge of the cause, pathogenesis and ecology of SFD. However, additional research is necessary to elucidate the factors driving the emergence of this disease and develop strategies to mitigate its impacts.

Role of carriers in the transmission of pneumonia in bighorn sheep (Ovis canadensis)

PubMed Central

Raghavan, Bindu; Erickson, Kayla; Kugadas, Abirami; Batra, Sai A.; Call, Douglas R.; Davis, Margaret A.; Foreyt, William J.

2016-01-01

ABSTRACT In the absence of livestock contact, recurring lamb mortality in bighorn sheep (Ovis canadensis) populations previously exposed to pneumonia indicates the likely presence of carriers of pneumonia-causing pathogens, and possibly inadequate maternally derived immunity. To investigate this problem we commingled naïve, pregnant ewes (n=3) with previously exposed rams (n=2). Post-commingling, all ewes and lambs born to them acquired pneumonia-causing pathogens (leukotoxin-producing Pasteurellaceae and Mycoplasma ovipneumoniae), with subsequent lamb mortality between 4-9 weeks of age. Infected ewes became carriers for two subsequent years and lambs born to them succumbed to pneumonia. In another experiment, we attempted to suppress the carriage of leukotoxin-producing Pasteurellaceae by administering an antibiotic to carrier ewes, and evaluated lamb survival. Lambs born to both treatment and control ewes (n=4 each) acquired pneumonia and died. Antibody titers against leukotoxin-producing Pasteurellaceae in all eight ewes were ‘protective’ (>1:800 and no apparent respiratory disease); however their lambs were either born with comparatively low titers, or with high (but non-protective) titers that declined rapidly within 2-8 weeks of age, rendering them susceptible to fatal disease. Thus, exposure to pneumonia-causing pathogens from carrier ewes, and inadequate titers of maternally derived protective antibodies, are likely to render bighorn lambs susceptible to fatal pneumonia. PMID:27185269

QIL1 mutation causes MICOS disassembly and early onset fatal mitochondrial encephalopathy with liver disease

PubMed Central

Guarani, Virginia; Jardel, Claude; Chrétien, Dominique; Lombès, Anne; Bénit, Paule; Labasse, Clémence; Lacène, Emmanuelle; Bourillon, Agnès; Imbard, Apolline; Benoist, Jean-François; Dorboz, Imen; Gilleron, Mylène; Goetzman, Eric S; Gaignard, Pauline; Slama, Abdelhamid; Elmaleh-Bergès, Monique; Romero, Norma B; Rustin, Pierre; Ogier de Baulny, Hélène; Paulo, Joao A; Harper, J Wade; Schiff, Manuel

2016-01-01

Previously, we identified QIL1 as a subunit of mitochondrial contact site (MICOS) complex and demonstrated a role for QIL1 in MICOS assembly, mitochondrial respiration, and cristae formation critical for mitochondrial architecture (Guarani et al., 2015). Here, we identify QIL1 null alleles in two siblings displaying multiple clinical symptoms of early-onset fatal mitochondrial encephalopathy with liver disease, including defects in respiratory chain function in patient muscle. QIL1 absence in patients’ fibroblasts was associated with MICOS disassembly, abnormal cristae, mild cytochrome c oxidase defect, and sensitivity to glucose withdrawal. QIL1 expression rescued cristae defects, and promoted re-accumulation of MICOS subunits to facilitate MICOS assembly. MICOS assembly and cristae morphology were not efficiently rescued by over-expression of other MICOS subunits in patient fibroblasts. Taken together, these data provide the first evidence of altered MICOS assembly linked with a human mitochondrial disease and confirm a central role for QIL1 in stable MICOS complex formation. DOI: http://dx.doi.org/10.7554/eLife.17163.001 PMID:27623147

Laguna Negra Virus Infection Causes Hantavirus Pulmonary Syndrome in Turkish Hamsters (Mesocricetus brandti).

PubMed

Hardcastle, K; Scott, D; Safronetz, D; Brining, D L; Ebihara, H; Feldmann, H; LaCasse, R A

2016-01-01

Laguna Negra virus (LNV) is a New World hantavirus associated with severe and often fatal cardiopulmonary disease in humans, known as hantavirus pulmonary syndrome (HPS). Five hamster species were evaluated for clinical and serologic responses following inoculation with 4 hantaviruses. Of the 5 hamster species, only Turkish hamsters infected with LNV demonstrated signs consistent with HPS and a fatality rate of 43%. Clinical manifestations in infected animals that succumbed to disease included severe and rapid onset of dyspnea, weight loss, leukopenia, and reduced thrombocyte numbers as compared to uninfected controls. Histopathologic examination revealed lung lesions that resemble the hallmarks of HPS in humans, including interstitial pneumonia and pulmonary edema, as well as generalized infection of endothelial cells and macrophages in major organ tissues. Histologic lesions corresponded to the presence of viral antigen in affected tissues. To date, there have been no small animal models available to study LNV infection and pathogenesis. The Turkish hamster model of LNV infection may be important in the study of LNV-induced HPS pathogenesis and development of disease treatment and prevention strategies. © The Author(s) 2015.

[Epidemiology of the meningococcal disease in Catalonia before and after vaccination against serogroup C].

PubMed

Martínez, Ana I; Domínguez, Angela; Oviedo, Manuel; Minguell, Sofía; Jansà, Josep M; Codina, Gemma; Vázquez, Julio A

2009-01-01

Meningococcal disease remains a serious public health problem worldwide. In Catalonia, after implementing the vaccination program, there has been a significant decrease in cases caused by meningococcus C. Reported cases of meningococcal disease between 1997 and 2008 were analyzed to determine the evolution after the introduction of a conjugated vaccine in Catalonia. In < 6 years, the incidence rate of serogroup C fell from 7.6 to 0.6 per 100,000 persons/year in the periods before (1997-2000) and after (2001-2007) the introduction of the conjugate vaccine. In serogroup B, the reduction was from 15.4 to 11.1. In < 20 years case-fatality-rate increased only in serogroup B (3% and 7.4%). Serosubtype P1.15was the most frequent in serogroup B (31%), mainly associated with serotype 4 (80%), and in serogroup C subtype P1.5 (36%), with serotype 2a (86%). During 2008, 5 apparently unrelated cases of B:2a:P1.5 were identified in the same geographic area, with a case-fatality-rate of 80%. Exhaustive surveillance of circulating meningococcal strains is essential.

Immune response of T cells during herpes simplex virus type 1 (HSV-1) infection.

PubMed

Zhang, Jie; Liu, Huan; Wei, Bin

Herpes simplex virus type 1 (HSV-1), a neurotropic member of the alphaherpes virus family, is among the most prevalent and successful human pathogens. HSV-1 can cause serious diseases at every stage of life including fatal disseminated disease in newborns, cold sores, eye disease, and fatal encephalitis in adults. HSV-1 infection can trigger rapid immune responses, and efficient inhibition and clearance of HSV-1 infection rely on both the innate and adaptive immune responses of the host. Multiple strategies have been used to restrict host innate immune responses by HSV-1 to facilitate its infection in host cells. The adaptive immunity of the host plays an important role in inhibiting HSV-1 infections. The activation and regulation of T cells are the important aspects of the adaptive immunity. They play a crucial role in host-mediated immunity and are important for clearing HSV-1. In this review, we examine the findings on T cell immune responses during HSV-1 infection, which hold promise in the design of new vaccine candidates for HSV-1.

Immune response of T cells during herpes simplex virus type 1 (HSV-1) infection*

PubMed Central

Zhang, Jie; Liu, Huan; Wei, Bin

2017-01-01

Herpes simplex virus type 1 (HSV-1), a neurotropic member of the alphaherpes virus family, is among the most prevalent and successful human pathogens. HSV-1 can cause serious diseases at every stage of life including fatal disseminated disease in newborns, cold sores, eye disease, and fatal encephalitis in adults. HSV-1 infection can trigger rapid immune responses, and efficient inhibition and clearance of HSV-1 infection rely on both the innate and adaptive immune responses of the host. Multiple strategies have been used to restrict host innate immune responses by HSV-1 to facilitate its infection in host cells. The adaptive immunity of the host plays an important role in inhibiting HSV-1 infections. The activation and regulation of T cells are the important aspects of the adaptive immunity. They play a crucial role in host-mediated immunity and are important for clearing HSV-1. In this review, we examine the findings on T cell immune responses during HSV-1 infection, which hold promise in the design of new vaccine candidates for HSV-1. PMID:28378566

Elevated PGC-1α activity sustains mitochondrial biogenesis and muscle function without extending survival in a mouse model of inherited ALS.

PubMed

Da Cruz, Sandrine; Parone, Philippe A; Lopes, Vanda S; Lillo, Concepción; McAlonis-Downes, Melissa; Lee, Sandra K; Vetto, Anne P; Petrosyan, Susanna; Marsala, Martin; Murphy, Anne N; Williams, David S; Spiegelman, Bruce M; Cleveland, Don W

2012-05-02

The transcriptional coactivator PGC-1α induces multiple effects on muscle, including increased mitochondrial mass and activity. Amyotrophic lateral sclerosis (ALS) is a progressive, fatal, adult-onset neurodegenerative disorder characterized by selective loss of motor neurons and skeletal muscle degeneration. An early event is thought to be denervation-induced muscle atrophy accompanied by alterations in mitochondrial activity and morphology within muscle. We now report that elevation of PGC-1α levels in muscles of mice that develop fatal paralysis from an ALS-causing SOD1 mutant elevates PGC-1α-dependent pathways throughout disease course. Mitochondrial biogenesis and activity are maintained through end-stage disease, accompanied by retention of muscle function, delayed muscle atrophy, and significantly improved muscle endurance even at late disease stages. However, survival was not extended. Therefore, muscle is not a primary target of mutant SOD1-mediated toxicity, but drugs increasing PGC-1α activity in muscle represent an attractive therapy for maintaining muscle function during progression of ALS. Copyright © 2012 Elsevier Inc. All rights reserved.

Moving beyond teen crash fatality statistics : the go-team study.

DOT National Transportation Integrated Search

2013-04-08

Despite a trend of decreasing teen fatalities due to motor vehicle crashes over the past decade, they remain the leading cause : of adolescent fatalities in Iowa. The purpose of this study was to create detailed case studies of each fatal motor vehic...

Proapoptotic Bak and Bax guard against fatal systemic and organ-specific autoimmune disease

PubMed Central

Mason, Kylie D.; Lin, Ann; Robb, Lorraine; Josefsson, Emma C.; Henley, Katya J.; Gray, Daniel H. D.; Kile, Benjamin T.; Roberts, Andrew W.; Strasser, Andreas; Huang, David C. S.; Waring, Paul; O’Reilly, Lorraine A.

2013-01-01

Dysregulation of the “intrinsic” apoptotic pathway is associated with the development of cancer and autoimmune disease. Bak and Bax are two proapoptotic members of the Bcl-2 protein family with overlapping, essential roles in the intrinsic apoptotic pathway. Their activity is critical for the control of cell survival during lymphocyte development and homeostasis, best demonstrated by defects in thymic T-cell differentiation and peripheral lymphoid homeostasis caused by their combined loss. Because most bak−/−bax−/− mice die perinatally, the roles of Bax and Bak in immunological tolerance and prevention of autoimmune disease remain unclear. We show that mice reconstituted with a Bak/Bax doubly deficient hematopoietic compartment develop a fatal systemic lupus erythematosus-like autoimmune disease characterized by hypergammaglobulinemia, autoantibodies, lymphadenopathy, glomerulonephritis, and vasculitis. Importantly, these mice also develop a multiorgan autoimmune disease with autoantibodies against most solid glandular structures and evidence of glandular atrophy and necrotizing vasculitis. Interestingly, similar albeit less severe pathology was observed in mice containing a hematopoietic compartment deficient for only Bak, a phenotype reminiscent of the disease seen in patients with point mutations in BAK. These studies demonstrate a critical role for Bak and an ancillary role for Bax in safeguarding immunological tolerance and prevention of autoimmune disease. This suggests that direct activators of the intrinsic apoptotic pathway, such as BH3 mimetics, may be useful for treatment of diverse autoimmune diseases. PMID:23349374

Fatal degenerative neurologic illnesses in men who participated in wild game feasts--Wisconsin, 2002.

PubMed

2003-02-21

Creutzfeldt-Jakob disease (CJD) is a fatal neurologic disorder in humans. CJD is one of a group of conditions known as transmissible spongiform encephalopathies (TSEs), or prion diseases, that are believed to be caused by abnormally configured, host-encoded prion proteins that accumulate in the central nervous tissue. CJD has an annual incidence of approximately 1 case per million population in the United States and occurs in three forms: sporadic, genetically determined, and acquired by infection. In the latter form, the incubation period is measured typically in years. Recent evidence that prion infection can cross the species barrier between humans and cattle has raised increasing public health concerns about the possible transmission to humans of a TSE among deer and elk known as chronic wasting disease (CWD). During 1993-1999, three men who participated in wild game feasts in northern Wisconsin died of degenerative neurologic illnesses. This report documents the investigation of these deaths, which was initiated in August 2002 and which confirmed the death of only one person from CJD. Although no association between CWD and CJD was found, continued surveillance of both diseases remains important to assess the possible risk for CWD transmission to humans.

Cytophagic histiocytic panniculitis and hemophagocytic lymphohistiocytosis: an overview.

PubMed

Aronson, Iris K; Worobec, Sophie M

2010-01-01

Cytophagic histiocytic panniculitis (CHP) is a rare panniculitis that is associated with systemic features including fevers, hepatosplenomegaly, lymphadenopathy, pancytopenia, hepatic abnormalities, hypertriglyceridemia, and coagulopathy without an elevated erythrocyte sedimentation rate. The panniculitis lesions show adipose tissue lymphocytic and histiocytic infiltration along with hemophagocytosis, which may also appear in bone marrow, spleen, lymph nodes, and liver. Patients may have a rapidly fatal disease course, a longer disease course with intermittent remissions and exacerbations for many years prior to death, or a nonfatal acute or intermittent course responsive to treatment. The cytophagocytic disorder in these patients is a hemophagocytic lymphohistiocytosis (HLH), similar to the infection-activated reaction associated with perforin mutations found in familial hemophagocytic lymphohistiocytosis. HLH is a group of autoinflammatory disorders, which include macrophage activation syndrome and infection-associated hemophagocytic syndrome, which if not treated rapidly, can be fatal. The relationship of CHP and HLH is discussed. CHP associated diseases include: subcutaneous panniculitis-like T cell lymphomas; infections, connective tissue diseases, other malignancies, and the molecular disorders that cause HLH. Treatment of CHP includes: glucocorticoids in combination with cyclosporine, combined chemotherapeutic medications and most recently, anakinra, an Interleukin-1 receptor antagonist; along with supportive care, search for underlying malignancies and treatment thereof, and control of associated infections.

Global Burden of Skin Disease: Inequities and Innovations.

PubMed

Seth, Divya; Cheldize, Khatiya; Brown, Danielle; Freeman, Esther F

2017-09-01

We review the current understanding of the burden of dermatological disease through the lens of the Global Burden of Disease project, evaluate the impact of skin disease on quality of life in a global context, explore socioeconomic implications, and finally summarize interventions towards improving quality of dermatologic care in resource-poor settings. The Global Burden of Disease project has shown that skin diseases continue to be the 4 th leading cause of nonfatal disease burden world-wide. However, research efforts and funding do not match with the relative disability of skin diseases. International and national efforts, such as the WHO List of Essential Medicines, are critical towards reducing the socioeconomic burden of skin diseases and increasing access to care. Recent innovations such as teledermatology, point-of-care diagnostic tools, and task-shifting help to provide dermatological care to underserved regions in a cost-effective manner. Skin diseases cause significant non-fatal disability worldwide, especially in resource-poor regions. Greater impetus to study the burden of skin disease in low resource settings and policy efforts towards delivering high quality care are essential in improving the burden of skin diseases.

Structure of sulfamidase provides insight into the molecular pathology of mucopolysaccharidosis IIIA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sidhu, Navdeep S.; University of Göttingen, Tammannstrasse 4, 37077 Göttingen; Schreiber, Kathrin

2014-05-01

Mucopolysaccharidosis IIIA is a fatal neurodegenerative disease that typically manifests itself in childhood and is caused by mutations in the gene for the lysosomal enzyme sulfamidase. The first structure of this enzyme is presented, which provides insight into the molecular basis of disease-causing mutations, and the enzymatic mechanism is proposed. Mucopolysaccharidosis type IIIA (Sanfilippo A syndrome), a fatal childhood-onset neurodegenerative disease with mild facial, visceral and skeletal abnormalities, is caused by an inherited deficiency of the enzyme N-sulfoglucosamine sulfohydrolase (SGSH; sulfamidase). More than 100 mutations in the SGSH gene have been found to reduce or eliminate its enzymatic activity. However,more » the molecular understanding of the effect of these mutations has been confined by a lack of structural data for this enzyme. Here, the crystal structure of glycosylated SGSH is presented at 2 Å resolution. Despite the low sequence identity between this unique N-sulfatase and the group of O-sulfatases, they share a similar overall fold and active-site architecture, including a catalytic formylglycine, a divalent metal-binding site and a sulfate-binding site. However, a highly conserved lysine in O-sulfatases is replaced in SGSH by an arginine (Arg282) that is positioned to bind the N-linked sulfate substrate. The structure also provides insight into the diverse effects of pathogenic mutations on SGSH function in mucopolysaccharidosis type IIIA and convincing evidence for the molecular consequences of many missense mutations. Further, the molecular characterization of SGSH mutations will lay the groundwork for the development of structure-based drug design for this devastating neurodegenerative disorder.« less

The prognostic value of dobutamine stress echocardiography amongst British Indian Asian and Afro-Caribbean patients: a comparison with European white patients.

PubMed

O'Driscoll, Jamie M; Rossato, Claire; Gargallo-Fernandez, Paula; Araco, Marco; Giannoglou, Dimitrios; Sharma, Sanjay; Sharma, Rajan

2015-08-06

The incidence of cardiovascular disease is considerably disparate among different racial and ethnic populations. While dobutamine stress echocardiography (DSE) has been shown to be useful in Caucasian patients, its role among ethnic minority groups remains unclear. This study aimed to investigate the prognostic importance of DSE in three ethnic groups in the UK. DSE was performed on 6231 consecutive patients. After exclusions, 5329 patients formed the study (2676 [50.2%] Indian Asian, 2219 [41.6%] European white and 434 [8.1%] Afro-Caribbean). Study outcome measures were non-fatal cardiac events (NFCE) and all-cause mortality. There were 849 (15.9%) NFCE and 1365 (25.6%) deaths over a median follow-up period of 4.6 years. In total 1174 (22%) patients had inducible myocardial ischaemia during DSE, 859 (16.1%) had fixed wall motion abnormalities and 3645 (68.4%) patients had a normal study. Ethnicity did not predict events. Among the three ethnic groups, ischaemia on DSE was associated with 2 to 2.5 times the risk of non-fatal cardiac events and 1.2 to 1.4 times the risk of all-cause mortality. Peak wall motion score index was the strongest independent predictor of non-fatal cardiac events and all-cause mortality in all groups. The C statistic for the prediction of NFCE and all-cause mortality were significantly higher when DSE parameters were added to the standard risk factors for all ethnic groups. DSE is a strong predictor of NFCE and all-cause mortality and provides predictive information beyond that provided by standard risk factors in three major racial and ethnic groups. No major differences among racial and ethnic groups in the predictive value of DSE was detected.

THE BURDEN OF INVASIVE NEONATAL GROUP B STREPTOCOCCAL (GBS) DISEASE IN THAILAND AND THE PHILIPPINES.

PubMed

Villanueva-Uy, Ma Esterlita; Wongsiridej, Pimol; Sangtawesin, Varaporn; Chiu, Vivina; Tallo, Veronica; Nazaire-Bermal, Nancy; Bock, Hans; Cunnington, Marianne; Nan, Cassandra; Boudville, Irving

2015-07-01

Group B Streptococcus (GBS) is a leading cause of meningitis and sepsis in infancy, but burden of disease data are scarce for Asia. We performed two hospital-based, prospective, descriptive, observational studies using similar protocols in the Philippines and Thailand to evaluate neonatal GBS disease epidemiology. Infants aged <90 days with a GBS-positive culture from normally sterile sites using routine microbiological standards were eligible for inclusion. Awareness of GBS symptoms was raised by informing all women at delivery and follow-up for 90 days post-delivery. Infections were classified as early onset disease (EOD) if they occurred within 6 days of birth and late Onset disease (LOD) if they occurred 7-89 days after birth. Due to ethical requirements in Thailand, consent for study participation, including periodic post-discharge telephone calls, was obtained at delivery. Parents in the Philippines gave consent for study participation at case identification. The clinical outcomes of GBS infections were recorded. During the 6-month study period, two cases (one fatal) of EOD were identified among 8,409 live births at the study hospitals in Thailand and three cases (two fatal) of EOD were identified among 11,768 live births reported at the study hospitals in the Philippines. Incidence rates per 1,000 live births were 0.2 (95% CI: 0.0-0.8) and 0.3 (95% CI: 0.1-0.8) in Thailand and the Philippines, respectively. There were no cases of reported LOD. The low number of cases precluded analysis of serotype distribution and case fatality rates. Large epidemiological studies are needed to better understand the factors influencing GBS infection incidence in Asia.

Isolation and molecular characterization of Toxoplasma gondii in a colony of captive black-capped squirrel monkeys (Saimiri boliviensis).

PubMed

Pardini, L; Dellarupe, A; Bacigalupe, D; Quiroga, M A; Moré, G; Rambeaud, M; Basso, W; Unzaga, J M; Schares, G; Venturini, M C

2015-12-01

Toxoplasmosis is commonly asymptomatic; however, it can be a fatal multisystemic disease in some animal species, such as New World monkeys. An outbreak of acute fatal toxoplasmosis was reported in a colony of black-capped squirrel monkeys (Saimiri boliviensis) from the zoo of La Plata, Argentina. Post-mortem examination of two monkeys revealed macroscopical and microscopical lesions compatible with acute toxoplasmosis. The presence of Toxoplasma gondii was confirmed by immunohistochemistry on monkey tissues, bioassay in mice and PCR using the specific primers B22-B23. By PCR-RFLP analysis, T. gondii isolated in mice, deriving from both monkeys, showed the same restriction pattern, with most markers showing a type III restriction pattern, except for C22-8 (type II) and C29-2 (type I). To our knowledge this is the first report of fatal toxoplasmosis in S. boliviensis caused by a non-canonical or atypical genotype of T. gondii. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Fatal aviation accidents in Lower Saxony from 1979 to 1996.

PubMed

Ast, F W; Kernbach-Wighton, G; Kampmann, H; Koops, E; Püschel, K; Tröger, H D; Kleemann, W J

2001-06-01

So far no national or regional studies have been published in Germany regarding the number of fatal aviation accidents and results of autopsy findings. Therefore, we evaluated all fatal aviation accidents occurring in Lower Saxony from 1979 to 1996. A total of 96 aviation accidents occurred in this period involving 73 aeroplanes. The crashes resulted in the death of 154 people ranging in age from 19 to 68 years. The greatest number of victims in a single crash of an aircraft was (n=7). Other types of fatal accidents were crashes of aircraft and helicopter while on the ground (n=5), hot-air balloons (n=2), parachutes (n=10), hang glider accidents (n=5) and the striking of a bystander by a model airplane. Autopsies were performed on 68 of the 154 victims (44.2%), including 39 of the 73 pilots (53.4%). Some of the autopsies yielded findings relevant to the cause of the accident: gunshot wounds, the presence of alcohol or drugs in blood and preexisting diseases. Our findings emphasize the need for autopsy on all aviation accident victims, especially pilots, as this is the only reliable method to uncover all factors contributing to an accident.

Trying to understand routine stroke outcome data: the need for adequate casemix adjustment and some practical considerations.

PubMed

Weir, N U; Signorini, D F; Dennis, M S; Murdoch, P S

2000-07-01

To determine how far the difference in published stroke case fatality between the Western General Hospital (WGH), Edinburgh and the Falkirk and District Royal Infirmary (FDRI) for the period 1990-93 can be explained by adjusting more fully for casemix. The cases were ascertained and followed prospectively at the WGH and retrospectively at the FDRI; casemix correction was performed using a validated logistic regression model. The WGH is a teaching hospital and the FDRI a district general hospital. Four hundred and thirty seven patients with a verified acute stroke at the WGH; 471 patients assigned a cerebrovascular disease discharge diagnostic code at the FDRI. Thirty day case fatality. About half of the difference in the two hospitals' published stroke case fatality could be accounted for by variation in measured casemix. The residual difference in adjusted case fatality might have been due to differences in the structure of stroke care or simply to remaining differences in casemix. Full investigation of the cause was prevented by the destruction of the deceased patients records. Comparisons of routinely collected stroke outcomes will remain difficult to interpret unless casemix is properly accounted for and deceased patients' records stored for several years.

Highlights of the 11th International Bordetella Symposium: from Basic Biology to Vaccine Development

PubMed Central

Wirsing von König, Carl Heinz; Lan, Ruiting; Cotter, Peggy A.; Deora, Rajendar; Merkel, Tod J.; van Els, Cécile A.; Locht, Camille; Hozbor, Daniela; Rodriguez, Maria E.

2016-01-01

Pertussis is a severe respiratory disease caused by infection with the bacterial pathogen Bordetella pertussis. The disease affects individuals of all ages but is particularly severe and sometimes fatal in unvaccinated young infants. Other Bordetella species cause diseases in humans, animals, and birds. Scientific, clinical, public health, vaccine company, and regulatory agency experts on these pathogens and diseases gathered in Buenos Aires, Argentina from 5 to 8 April 2016 for the 11th International Bordetella Symposium to discuss recent advances in our understanding of the biology of these organisms, the diseases they cause, and the development of new vaccines and other strategies to prevent these diseases. Highlights of the meeting included pertussis epidemiology in developing nations, genomic analysis of Bordetella biology and evolution, regulation of virulence factor expression, new model systems to study Bordetella biology and disease, effects of different vaccines on immune responses, maternal immunization as a strategy to prevent newborn disease, and novel vaccine development for pertussis. In addition, the group approved the formation of an International Bordetella Society to promote research and information exchange on bordetellae and to organize future meetings. A new Bordetella.org website will also be developed to facilitate these goals. PMID:27655886

Hyperinfection with Strongyloides in a HIV-negative elderly male

PubMed Central

Girija, S; Kannan, Suresh; Jeyakumari, D; Gopal, R

2012-01-01

Strongyloides stercoralis is an intestinal nematode producing mild infection in the immunocompetent and fatal hyperinfection syndrome in the immunocompromised. An elderly HIV-negative male presented with symptoms of chronic respiratory disease and vague abdominal symptoms. Examination of sputum and stools showed larvae of S. stercoralis. Bacterial and fungal causes of respiratory infections were ruled out. The patient responded to oral ivermectin. PMID:23508878

Subacute Sclerosing Panencephalitis in a Child with Human Immunodeficiency Virus Co-Infection

PubMed Central

Maurya, Pradeep Kumar; Thakkar, Mayur Deepak; Kulshreshtha, Dinkar; Singh, Ajai Kumar; Thacker, Anup Kumar

2016-01-01

Subacute sclerosing panencephalitis is a fatal infectious disease of childhood caused by persistence of the measles virus in the brain. The effect of human immunodeficiency virus (HIV) co-infection on subacute sclerosing panencephalitis remains elusive and rare. We report a child who developed subacute sclerosing panencephalitis following a short latency period and a rapidly progressive course with HIV co-infection. PMID:27777245

Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin’s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis

PubMed Central

Gallo, Maria Teresa; Di Domenico, Enea Gino; Toma, Luigi; Marchesi, Francesco; Pelagalli, Lorella; Manghisi, Nicola; Ascenzioni, Fiorentina; Prignano, Grazia; Mengarelli, Andrea; Ensoli, Fabrizio

2016-01-01

Campylobacter jejuni (C. jejuni) bacteremia is difficult to diagnose in individuals with hematological disorders undergoing chemotherapy. The cause can be attributed to the rarity of this infection, to the variable clinical presentation, and to the partial overlapping symptoms underlying the disease. Here, we report a case of a fatal sepsis caused by C. jejuni in a 76-year-old Caucasian man with non-Hodgkin’s lymphoma. After chemotherapeutic treatment, the patient experienced fever associated with severe neutropenia and thrombocytopenia without hemodynamic instability, abdominal pain, and diarrhea. The slow growth of C. jejuni in the blood culture systems and the difficulty in identifying it with conventional biochemical phenotyping methods contributed to the delay of administering a targeted antimicrobial treatment, leading to a fatal outcome. Early recognition and timely intervention are critical for the successful management of C. jejuni infection. Symptoms may be difficult to recognize in immunocompromised patients undergoing chemotherapy. Thus, it is important to increase physician awareness regarding the clinical manifestations of C. jejuni to improve therapeutic efficacy. Moreover, the use of more aggressive empirical antimicrobial treatments with aminoglycosides and/or carbapenems should be considered in immunosuppressed patients, in comparison to those currently indicated in the guidelines for cancer-related infections supporting the use of cephalosporins as monotherapy. PMID:27077849

Fatal disseminated Rasamsonia infection in cystic fibrosis post-lung transplantation.

PubMed

Hong, Gina; White, Marissa; Lechtzin, Noah; West, Natalie E; Avery, Robin; Miller, Heather; Lee, Richard; Lovari, Robert J; Massire, Christian; Blyn, Lawrence B; Liang, Xinglun; Sutton, Deanna A; Fu, Jianmin; Wickes, Brian L; Wiederhold, Nathan P; Zhang, Sean X

2017-03-01

Disseminated fungal infections are a known serious complication in individuals with cystic fibrosis (CF) following orthotopic lung transplantation. Aspergillus fumigatus and Scedosporium species are among the more common causes of invasive fungal infection in this population. However, it is also important for clinicians to be aware of other emerging fungal species which may require markedly different antifungal therapies. We describe the first laboratory-documented case of a fatal disseminated fungal infection caused by Rasamsonia aegroticola in a 21-year-old female CF patient status post-bilateral lung transplantation, which was only identified post-mortem. Molecular analysis revealed the presence of the identical Rasamsonia strains in the patient's respiratory cultures preceding transplantation. We propose that the patient's disseminated fungal disease and death occurred as a result of recrudescence of Rasamsonia infection from her native respiratory system in the setting of profound immunosuppression post-operatively. Since Rasamsonia species have been increasingly recovered from the respiratory tract of CF patients, we further review the literature on these fungi and discuss their association with invasive fungal infections in the CF lung transplant host. Our report suggests Rasamsonia species may be important fungal pathogens that may have fatal consequences in immunosuppressed CF patients after solid organ transplantation. Copyright © 2017 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Ebola virus disease: Report from the task force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine.

PubMed

Richards, Guy A; Baker, Tim; Amin, Pravin

2018-02-01

Ebola virus is a filovirus that can cause fatal hemorrhagic fever (HF) and five distinct species exist that vary in terms of geographical distribution and virulence. Once the more virulent forms enter the human population, transmission occurs primarily through direct contact with infected body fluids and may result in significant outbreaks. The devastating has been the recent West African outbreak. Clinically, signs and symptoms are similar to those of the other VHFs [4]. The incubation period is 2-21days, followed by fever, headache, myalgia, diarrhoea, vomiting and dehydration; thereafter, there may be recovery or deterioration with collapse, neurological manifestations and bleeding, that can lead to a fatal outcome. Elevated hepatic transaminases is common and severe hepatitis is more common in fatal cases and frequently there is associated fluid depletion. Real time reverse transcription-PCR (RT-PCR) techniques on blood specimens are the gold standard for diagnosis [6]. Management is discussed and is essentially supportive with strict attention to infection control and prevention. None of the pharmacological interventions have shown conclusive benefit and future management of epidemics should centre around prevention and containment, specifically isolation, hygiene, and vaccination. Copyright © 2017 Elsevier Inc. All rights reserved.

Thrombotic thrombocytopenic purpura possibly triggered by Graves’ disease

PubMed Central

Chitnis, Saurabh D; Mene-Afejuku, Tuoyo O; Aujla, Amandeep; Shady, Ahmed; Gil, Gaby S; Cativo, Eder Hans; Popescu-Martinez, Andrea

2017-01-01

Abstract Thrombotic thrombocytopenic purpura (TTP) is a part of a spectrum of thrombotic microangiopathy syndromes which are mainly characterized by platelet aggregation causing microangiopathic hemolytic anemia, thrombocytopenia and microvascular occlusion. In literature, very few cases expressing a direct association between pre-existing Grave’s disease and TTP have been described. A 37-year-old African–American woman with past medical history of Grave’s disease and polysubstance abuse who presented with complaints of dyspnoea at rest and chest pain was diagnosed to have TTP on further evaluation. Patient also showed severely elevated thyroid hormones and suppressed thyroid stimulating hormone levels indicating severe thyrotoxicosis. Initiation of prompt management of TTP and thyrotoxicosis led to a favorable patient outcome. In conclusion, patients presenting with thyrotoxicosis, thrombocytopenia and microangioapthic hemolytic anemia without an alternative cause should be treated and screened for TTP due to the high fatality associated with untreated or untimely detection of this disease. PMID:29744115

Livestock Drugs and Disease: The Fatal Combination behind Breeding Failure in Endangered Bearded Vultures

PubMed Central

Blanco, Guillermo; Lemus, Jesús A.

2010-01-01

There is increasing concern about the impact of veterinary drugs and livestock pathogens as factors damaging wildlife health, especially of threatened avian scavengers feeding upon medicated livestock carcasses. We conducted a comprehensive study of failed eggs and dead nestlings in bearded vultures (Gypaetus barbatus) to attempt to elucidate the proximate causes of breeding failure behind the recent decline in productivity in the Spanish Pyrenees. We found high concentrations of multiple veterinary drugs, primarily fluoroquinolones, in most failed eggs and nestlings, associated with multiple internal organ damage and livestock pathogens causing disease, especially septicaemia by swine pathogens and infectious bursal disease. The combined impact of drugs and disease as stochastic factors may result in potentially devastating effects exacerbating an already high risk of extinction and should be considered in current conservation programs for bearded vultures and other scavenger species, especially in regards to dangerous veterinary drugs and highly pathogenic poultry viruses. PMID:21152405

Animal models of disease shed light on Nipah virus pathogenesis and transmission.

PubMed

de Wit, Emmie; Munster, Vincent J

2015-01-01

Nipah virus is an emerging virus infection that causes yearly disease outbreaks with high case fatality rates in Bangladesh. Nipah virus causes encephalitis and systemic vasculitis, sometimes in combination with respiratory disease. Pteropus species fruit bats are the natural reservoir of Nipah virus and zoonotic transmission can occur directly or via an intermediate host; human-to-human transmission occurs regularly. In this review we discuss the current state of knowledge on the pathogenesis and transmission of Nipah virus, focusing on dissemination of the virus through its host, known determinants of pathogenicity and routes of zoonotic and human-to-human transmission. Since data from human cases are sparse, this knowledge is largely based on the results of studies performed in animal models that recapitulate Nipah virus disease in humans. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Injury Deaths Among U.S. Females: CDC Resources and Programs

PubMed Central

Mack, Karin A.; Peterson, Cora; Zhou, Chao; MacConvery, Elliane; Wilkins, Natalie

2017-01-01

Injury death rates are lower for women than for men at all ages, but we have a long way to go in understanding the circumstances of injury fatalities among females. This article presents resources that can be used to examine the most recent data on injury fatalities among females and highlights activities of CDC’s Injury Center. The National Center for Injury Prevention and Control’s (NCIPC’s) Web-based Injury Statistics Query and Reporting System, an online surveillance database, can be used to examine injury deaths. We present examples that show the 2015 number of female fatal injuries by age group and injury cause and method, as well as a 2008–2014 county-level map of female fatal injury rates. In 2015, there were 68,572 injury fatalities of females of age ≥1 year, equivalent to 1 death every 7 minutes. Injuries were the leading cause of death for females of ages 1–41 years and the sixth-ranked cause of female death overall. Falls were the leading cause of injury death overall (and for women ≥70 years), unintentional poisonings were second, and motor vehicle traffic injuries were third. NCIPC funds national organizations, state health agencies, and other groups to develop, implement, and promote effective injury and violence prevention and control practices. Five key programs are discussed. Presenting data on injury fatalities is an essential element in identifying meaningful prevention efforts. Further investigation of the causes and impact of female injury fatalities can refine the public health approach to reduce this injury burden. PMID:28294691

Temporal trends in motor vehicle fatalities in the United States, 1968 to 2010 - a joinpoint regression analysis.

PubMed

Bandi, Priti; Silver, Diana; Mijanovich, Tod; Macinko, James

2015-12-01

In the past 40 years, a variety of factors might have impacted motor vehicle (MV) fatality trends in the US, including public health policies, engineering innovations, trauma care improvements, etc. These factors varied in their timing across states/localities, and many were targeted at particular population subgroups. In order to identify and quantify differential rates of change over time and differences in trend patterns between population subgroups, this study employed a novel analytic method to assess temporal trends in MV fatalities between 1968 and 2010, by age group and sex. Cause-specific MV fatality data from traffic injuries between 1968 and 2010, based on death certificates filed in the 50 states, and DC were obtained from Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER). Long-term (1968 to 2010) and short-term (log-linear piecewise segments) trends in fatality rates were compared for males and females overall and in four separate age groups using joinpoint regression. MV fatalities declined on average by 2.4% per year in males and 2.2% per year in females between 1968 and 2010, with significant declines observed in all age groups and in both sexes. In males overall and those 25 to 64 years, sharp declines between 1968 and mid-to-late 1990s were followed by a stalling until the mid-2000s, but rates in females experienced a long-term steady decline of a lesser magnitude than males during this time. Trends in those aged <1 to 14 years and 15 to 24 years were mostly steady over time, but males had a larger decline than females in the latter age group between 1968 and the mid-2000s. In ages 65+, short-term trends were similar between sexes. Despite significant long-term declines in MV fatalities, the application of Joinpoint Regression found that progress in young adult and middle-aged adult males stalled in recent decades and rates in males declined relatively more than in females in certain age groups. Future research is needed to establish the causes of these observed trends, including the potential role of contemporaneous MV-related policies and their repeal. Such research is needed in order to better inform the design and evaluation of future population interventions addressing MV fatalities nationally.

Line of duty firefighter fatalities: an evolving trend over time.

PubMed

Kahn, Steven A; Woods, Jason; Rae, Lisa

2015-01-01

Between 1990 and 2012, 2775 firefighters were killed in the line of duty. Myocardial infarction (MI) was responsible for approximately 40% of these mortalities, followed by mechanical trauma, asphyxiation, and burns. Protective gear, safety awareness, medical care, and the age of the workforce have evolved since 1990, possibly affecting the nature of mortality during this 22-year time period. The purpose of this study is to determine whether the causes of firefighter mortality have changed over time to allow a targeted focus in prevention efforts. The U.S. Fire Administration fatality database was queried for all-cause on-duty mortality between 1990 to 2000 and 2002 to 2012. The year 2001 was excluded due to inability to eliminate the 347 deaths that occurred on September 11. Data collected included age range at the time of fatality (exact age not included in report), type of duty (on-scene fire, responding, training, and returning), incident type (structure fire, motor vehicle crash, etc), and nature of fatality (MI, trauma, asphyxiation, cerebrovascular accident [CVA], and burns). Data were compared between the two time periods with a χ test. Between 1990 and 2000, 1140 firefighters sustained a fatal injury while on duty, and 1174 were killed during 2002 to 2012. MI has increased from 43% to 46.5% of deaths (P = .012) between the 2 decades. CVA has increased from 1.6% to 3.7% of deaths (P = .002). Asphyxiation has decreased from 12.1% to 7.9% (P = .003) and burns have decreased from 7.7% to 3.9% (P = .0004). Electrocution is down from 1.8% to 0.5% (P = .004). Death from trauma was unchanged (27.8 to 29.6%, P = .12). The percentage of fatalities of firefighters over age 40 years has increased from 52% to 65% (P = .0001). Fatality by sex was constant at 3% female. Fatalities during training have increased from 7.3% to 11.2% of deaths (P = .00001). The nature of firefighter mortality has evolved over time. In the current decade, line-of-duty mortality is more likely to occur during training. Mortality from burns, asphyxiation, and electrocution has decreased; but death from MI and CVA has increased, particularly in older firefighters. Outreach and education should be targeted toward vehicle safety, welfare during training, and cardiovascular disease prevention in the firefighter population.

[Ebola virus disease].

PubMed

Nazimek, Katarzyna; Bociaga-Jasik, Monika; Bryniarski, Krzysztof; Gałas, Aleksander; Garlicki, Aleksander; Gawda, Anna; Gawlik, Grzegorz; Gil, Krzysztof; Kosz-Vnenchak, Magdalena; Mrozek-Budzyn, Dorota; Olszanecki, Rafał; Piatek, Anna; Zawilińska, Barbara; Marcinkiewicz, Janusz

2014-01-01

Ebola is one of the most virulent zoonotic RNA viruses causing in humans haemorrhagic fever with fatality ratio reaching 90%. During the outbreak of 2014 the number of deaths exceeded 8.000. The "imported" cases reported in Western Europe and USA highlighted the extreme risk of Ebola virus spreading outside the African countries. Thus, haemorrhagic fever outbreak is an international epidemiological problem, also due to the lack of approved prevention and therapeutic strategies. The editorial review article briefly summarizes current knowledge on Ebola virus disease epidemiology, etiology, pathogenesis, clinical presentation, diagnosis as well as possible prevention and treatment.

First evidence of asymptomatic infection related to the Araucaria (Juquitiba-like) hantavirus.

PubMed

de Borba, Luana; Delfraro, Adriana; Raboni, Sonia M; dos Santos, Claudia Nunes Duarte

2013-08-05

Hantavirus pulmonary syndrome (HPS) is a severe disease, transmitted to humans by inhalation of virus-contaminated aerosols from rodent excreta. Epidemiological, clinical and laboratory data confirmed a fatal HPS case and an asymptomatic infection in a household contact, both caused by Araucaria hantavirus, which has previously been found only in patients with HPS. This is the first report of asymptomatic infection related to a pathogenic hantavirus genotype, highlighting the need for additional studies on characterisation of viral and genetic mechanisms associated with this disease.

[«All of a sudden…» preventability and priorities of construction fatalities: an experience in Piedmont].

PubMed

Pasqualini, Osvaldo; Libener, Marcello; Farina, Elena; Bena, Antonella

2011-01-01

To examine the usefulness for prevention of the National Surveillance System on occupational fatalities, which is based on the narrative description of the work accident collected by OSH inspectors and on the subsequent classification of the injury dynamics by means of a standardized model of analysis. The system ability of providing useful recommendations for prevention was evaluated on one hand by analyzing the effectiveness of inspections in preventing fatalities, on the other hand by identifying the most frequent accident mechanisms. Data analyzed consisted of investigation reports of construction fatalities occurred during 2002-2008 in the Piedmont Region, collected by surveillance system. The injury narrative description was used to assess whether the fatality would have been preventable by an inspection hypothetically conducted the day before the event; injuries were classified as probably preventable, probably not preventable, and uncertain. A standardized model of classification of injury dynamics was employed to identify mechanisms and circumstances related to the construction fatalities, and particularly those caused by falls from height. Among 122 construction fatalities occurred, 25%were considered probably preventable and 60%probably not preventable. Half of the construction fatalities was caused by fall from height, most of which were caused by sudden breaking of a surface walkway, and almost 20% by fall of objects, including burial. The analysis of the preventability of construction fatalities in Piedmont seems partly to rebut the assumption that more inspections are necessarily associated with a reduction in fatalities. The interpretation of the injury narrative descriptions, which are implemented by OHS inspectors as part of their usual activity, through a standardized model of analysis allows to identify the breaking of surface walkways as the most important mechanism of fatality among falls from height.

Classification scheme and prevention measures for caught-in-between occupational fatalities.

PubMed

Chi, Chia-Fen; Lin, Syuan-Zih

2018-04-01

The current study analyzed 312 caught-in-between fatalities caused by machinery and vehicles. A comprehensive and mutually exclusive coding scheme was developed to analyze and code each caught-in-between fatality in terms of age, gender, experience of the victim, type of industry, source of injury, and causes for these accidents. Boolean algebra analysis was applied on these 312 caught-in-between fatalities to derive minimal cut set (MCS) causes associated with each source of injury. Eventually, contributing factors and common accident patterns associated with (1) special process machinery including textile, printing, packaging machinery, (2) metal, woodworking, and special material machinery, (3) conveyor, (4) vehicle, (5) crane, (6) construction machinery, and (7) elevator can be divided into three major groups through Boolean algebra and MCS analysis. The MCS causes associated with conveyor share the same primary causes as those of the special process machinery including textile, printing, packaging and metal, woodworking, and special material machinery. These fatalities can be eliminated by focusing on the prevention measures associated with lack of safeguards, working on a running machine or process, unintentional activation, unsafe posture or position, unsafe clothing, and defective safeguards. Other precise and effective intervention can be developed based on the identified groups of accident causes associated with each source of injury. Copyright © 2017 Elsevier Ltd. All rights reserved.

The biology of pulmonary aspergillus infections.

PubMed

Warris, Adilia

2014-11-01

Pulmonary aspergillus infections are mainly caused by Aspergillus fumigatus and can be classified based on clinical syndromes into saphrophytic infections, allergic disease and invasive disease. Invasive pulmonary aspergillosis, occurring in immunocompromised patients, reflects the most serious disease with a high case-fatality rate. Patients with cystic fibrosis and severe asthma might develop allergic bronchopulmonary aspergillosis, while saphrophytic infections are observed in patients with lung cavities mainly due to tuberculosis. Histopathologically, a differentiation can be made into angio-invasive and airway-invasive disease. If the host response is too weak or too strong, Aspergillus species are able to cause disease characterized either by damage from the fungus itself or through an exaggerated inflammatory response of the host, in both situations leading to overt disease associated with specific clinical signs and symptoms. The unraveling of the specific host - Aspergillus interaction has not been performed to a great extent and needs attention to improve the management of those clinical syndromes. Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

[A fatal case series of Rocky Mountain spotted fever in Sonora, México].

PubMed

Delgado-De la Mora, Jesús; Licona-Enríquez, Jesús David; Leyva-Gastélum, Marcia; Delgado-De la Mora, David; Rascón-Alcantar, Adela; Álvarez-Hernández, Gerardo

2018-03-15

Rocky Mountain spotted fever is a highly lethal infectious disease, particularly if specific treatment with doxycycline is given belatedly. To describe the clinical profile of fatal Rocky Mountain spotted fever cases in hospitalized patients in the state of Sonora, México. We conducted a cross-sectional study on a series of 47 deaths caused by Rickettsia rickettsii from 2013 to 2016. The diagnosis of Rocky Mountain spotted fever was confirmed in a single blood sample by polymerase chain reaction (PCR) or by a four-fold increase in immunoglobulin G measured in paired samples analyzed by indirect immunofluorescence. Clinical and laboratory characteristics were compared stratifying subjects into two groups: pediatric and adult. There were no differences in clinical characteristics between groups; petechial rash was the most frequent sign (96%), followed by headache (70%) and myalgia (67%). Although that doxycycline was administered before the fifth day from the onset of symptoms, death occurred in 55% of patients. In clinical laboratory, thrombocytopenia, and biomarkers of liver acute failure and acute kidney failure were the most frequent. Rocky Mountain spotted fever remains as one of the most lethal infectious diseases, which may be related not only to the lack of diagnostic suspicion and delayed administration of doxycycline, but to genotypic characteristics of Rickettsia rickettsii that may play a role in the variability of the fatality rate that has been reported in other geographical regions where the disease is endemic.

Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature

PubMed Central

Abayazeed, Aly; Hayman, Emily; Moghadamfalahi, Mana; Cain, Darren

2014-01-01

Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In 70% of cases, vascular rupture or dissection, gastrointestinal perforation, or organ rupture is a presenting sign. We present a case of genetically proven vascular Ehlers-Danlos with fatal recurrent retroperitoneal hemorrhages secondary to a ruptured right common iliac artery dissection in a 30-year-old male. This case highlights the need to suspect collagen vascular disorders when a young adult presents with unexplained retroperitoneal hemorrhage, even without family history of such diseases. PMID:24967021

Distribution of Clostridium perfringens epsilon toxin in the brains of acutely intoxicated mice and its effect upon glial cells.

PubMed

Soler-Jover, Alex; Dorca, Jonatan; Popoff, Michel R; Gibert, Maryse; Saura, Josep; Tusell, Josep Maria; Serratosa, Joan; Blasi, Juan; Martín-Satué, Mireia

2007-09-15

Epsilon toxin (epsilon-toxin), produced by Clostridium perfringens types B and D, causes fatal enterotoxaemia in livestock. The disease is principally manifested as severe and often fatal neurological disturbance. Oedema of several organs, including the brain, is also a clinical sign related to microvascular damage. Recombinant epsilon-toxin-green fluorescence protein (epsilon-toxin-GFP) and epsilon-prototoxin-GFP have already been characterised as useful tools to track their distribution in intravenously injected mice, by means of direct fluorescence microscopy detection. The results shown here, using an acutely intoxicated mouse model, strongly suggest that epsilon-toxin-GFP, but not epsilon-prototoxin-GFP, not only causes oedema but is also able to cross the blood-brain barrier and accumulate in brain tissue. In some brain areas, epsilon-toxin-GFP is found bound to glial cells, both astrocytes and microglia. Moreover, cytotoxicity assays, performed with mixed glial primary cultures, demonstrate the cytotoxic effect of epsilon-toxin upon both astrocytes and microglial cells.

An Outbreak of Yersinia enterocolitica in a Captive Colony of African Green Monkeys (Chlorocebus aethiops sabaeus) in the Caribbean

PubMed Central

Soto, Esteban; Griffin, Matt; Verma, Ashutosh; Castillo-Alcala, Fernanda; Beierschmitt, Amy; Beeler-Marfisi, Janet; Arauz, Maziel; Illanes, Oscar

2013-01-01

Yersinia enterocolitica is a zoonotic gram-negative pathogen that causes mesenteric lymphadenitis, terminal ileitis, acute gastroenteritis, and septicemia in domestic animals and primates. In 2012, 46 captive African green monkeys (Chlorocebus aethiops sabaeus) died during an outbreak of acutely fatal enteric disease over a period of 1 mo on the island of St Kitts. The affected monkeys presented with a history of mucohemorrhagic diarrhea, marked dehydration, and depression. Fifteen bacterial isolates were recovered from the spleen, liver, and lungs of affected monkeys. All isolates were identified as Y. enterocolitica by biochemical analysis and sequence comparison of the 16S rRNA gene. Phenotypic and genotypic analysis of the recovered isolates revealed homogeneity among the recovered bacteria, and all isolates gave a random amplified polymorphic DNA pattern resembling that given by genotype D under serotypes O:7,8. This outbreak represents the first isolation and characterization of Y. enterocolitica as the causative agent of fatal enteric disease in primates in the Caribbean. PMID:24210021

Natural hazard fatalities in Switzerland from 1946 to 2015

NASA Astrophysics Data System (ADS)

Andres, Norina; Badoux, Alexandre; Techel, Frank

2017-04-01

Switzerland, located in the middle of the Alps, is prone to several different natural hazards which regularly cause fatalities. To explore temporal trends as well as demographic and spatial patterns in the number of natural hazard fatalities, a database comprising all natural hazard events causing fatalities was compiled for the years 1946 until 2015. The new database includes avalanche, flood, lightning, windstorm, landslide, debris flow, rockfall, earthquake and ice avalanche processes. Two existing databases were incorporated and the resulting dataset extended by a comprehensive newspaper search. In total the database contains 635 natural hazard events causing 1023 fatalities. The database does not include victims which exposed themselves to an important danger on purpose (e.g. high risk sports). The most common causes of death were snow avalanches (37 %), followed by lightning (16 %), floods (12 %), windstorms (10 %), rockfall (8 %), landslides (7 %) and other processes (9 %). Around 14.6 fatalities occurred on average each year. A distinct decrease of natural hazard fatalities could be shown over the last 70 years, which was mostly due to the decline in the number of avalanche and lightning fatalities. Thus, nearly three times as many people were killed by natural hazard processes from 1946 to 1980 than from 1981 to 2015. Normalisation of fatality data by population resulted in a clearly declining annual crude mortality rate: 3.9 deaths per million persons for the first 35 years and 1.1 deaths per million persons for the second 35 years of the study period. The average age of the victims was approximately 36 years and about 75% were males. Most people were killed in summer (JJA, 42%) and winter (DJF, 32 %). Furthermore, almost two-thirds of the fatalities took place in the afternoon and evening. The spatial distribution of the natural hazard fatalities over Switzerland was quite homogeneous. However, mountainous parts of the country (Prealps, Alps) were somewhat more prone to fatal events compared to the Swiss Plateau and the Jura. It appears that the overall natural hazard mortality rate in Switzerland over the past 70 years has been relatively low in comparison to rates in other countries or rates of other types of fatal accidents in Switzerland. Nevertheless, the collected data provides a valuable base for analysis and helps authorities to better identify higher risk demographic groups and regions, and accordingly target these to reduce the number of victims.

Efficacy of Angiotensin-Converting Enzyme Inhibitors and Angiotensin-Receptor Blockers in Coronary Artery Disease without Heart Failure in the Modern Statin Era: a Meta-Analysis of Randomized-Controlled Trials.

PubMed

Hoang, Vu; Alam, Mahboob; Addison, Daniel; Macedo, Francisco; Virani, Salim; Birnbaum, Yochai

2016-04-01

Current practice guidelines support the use of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin-receptor blockers (ARBs) in patients with coronary artery disease (CAD) without heart failure (HF). However, a number of cited trials were performed prior to the era of prevalent statin use. Our objective was to evaluate the effectiveness of ACEi and ARBs in reducing cardiovascular events as well as the impact of statin therapy. We searched the MEDLINE and EMBASE databases for randomized-controlled trials (1/1/1980 - 8/31/2015) with ACEi or ARBs as the single intervention for patients with CAD without HF. We assessed the outcomes of non-fatal myocardial infarction (MI), stroke, cardiovascular mortality and all-cause mortality. The relationship between these outcomes and the percentages of patients on statin therapy was evaluated using meta-regression analysis. A total of ten ACEi trials and five ARB trials were included for analysis, with 78,761 patients followed for a mean of 36 months. Treatment with ACEi was associated with decreased non-fatal MI (RR 0.83; 95 % CI 0.75-0.91), stroke (RR 0.76; 95 % CI 0.68-0.86), cardiovascular mortality (RR 0.83; 95 % CI 0.72-0.95), and all-cause mortality (RR 0.86; 95 % CI 0.80-0.93). Treatment with ARBs was associated only with a decreased incidence of stroke (RR 0.92; 95 % CI 0.87-0.98). When adjusted for statin use, there was a trend towards an attenuated effect of ACEi in reducing cardiovascular mortality with increased use of statins (p-value = 0.063). In CAD patients without HF, ACEi, but not ARBs decreases the risk of non-fatal MI, cardiovascular mortality and all-cause mortality, while both ACEi and ARBs decrease the risk of stroke.

A record linkage study of outcomes in patients with mild primary hyperparathyroidism: the Parathyroid Epidemiology and Audit Research Study (PEARS).

PubMed

Yu, Ning; Donnan, Peter T; Leese, Graham P

2011-08-01

Primary hyperparathyroidism (PHPT) is a common endocrine disorder, but the majority of cases are perceived to be mild and remain untreated. To determine the risk of mortality and morbidities in patients with mild PHPT. Tayside, Scotland, 1997-2006. A historical, prospective, record-linkage, population-based, matched cohort study. All patients with diagnosed but untreated, mild PHPT. METHOD AND OUTCOME MEASURES: Each patient with PHPT was matched with five population-based comparators, by age, gender and calendar year of PHPT diagnosis, selected from the general population. Primary outcomes were all-cause mortality, fatal and nonfatal cardiovascular disease (CVD). Secondary outcomes were cancer-related deaths and other hospital admitted morbidities, including cerebrovascular disease, fractures, hypertension, psychiatric disease, renal complications, cancer and diabetes. The risk was assessed using the Cox proportional hazards model, adjusting for confounding factors of pre-existing co-morbidities, previous prescription of bisphosphonates, socio-economic deprivation score and the probability of having a calcium check. Compared to the matched cohort, the risk of all cause mortality, fatal and nonfatal CVD was increased in patients with asymptomatic PHPT: adjusted hazard ratios (HR) 1·64 (95% CI: 1·43-1·87), 1·64 (95% CI: 1·32-2·04) and 2·48 (95% CI: 2·13-2·89), respectively. The risk was also increased in all secondary outcomes, with the risk of renal failure and renal stones being the highest, adjusted HRs being 13·83 (95% CI: 10·41-18·37) and 5·15 (95% CI: 2·69-9·83), respectively. Patients with mild PHPT had an increased risk of mortality, fatal and nonfatal CVD, and the risk of developing other co-morbidities was also increased. © 2011 Blackwell Publishing Ltd.

Brief communication: Loss of life due to Hurricane Harvey

NASA Astrophysics Data System (ADS)

Jonkman, Sebastiaan N.; Godfroy, Maartje; Sebastian, Antonia; Kolen, Bas

2018-04-01

An analysis was made of the loss of life caused by Hurricane Harvey. Information was collected for 70 fatalities that occurred due to the event and were recovered within the first 2 weeks after landfall. Most fatalities occurred due to drowning (81 %), particularly in and around vehicles. Males (70 %) and people over 50 years old (56 %) were overrepresented in the dataset. More than half of the fatalities occurred in the greater Houston area (n = 37), where heavy rainfall and dam releases caused unprecedented urban flooding. The majority of fatalities were recovered outside the designated 100- and 500-year flood hazard areas.

Considerably decreased risk of cardiovascular disease with combined reductions in HbA1c, blood pressure and blood lipids in type 2 diabetes: Report from the Swedish National Diabetes Register.

PubMed

Eeg-Olofsson, Katarina; Zethelius, Björn; Gudbjörnsdottir, Soffia; Eliasson, Björn; Svensson, Ann-Marie; Cederholm, Jan

2016-07-01

Assess the effect of risk factors changes on risk for cardiovascular disease and mortality in patients with type 2 diabetes selected from the Swedish National Diabetes Register. Observational study of 13,477 females and males aged 30-75 years, with baseline HbA1c 41-67 mmol/mol, systolic blood pressure 122-154 mmHg and ratio non-HDL:HDL 1.7-4.1, followed for mean 6.5 years until 2012. Four groups were created: a reference group (n = 6757) with increasing final versus baseline HbA1c, systolic blood pressure and non-HDL:HDL cholesterol during the study period, and three groups with decreasing HbA1c (n = 1925), HbA1c and systolic blood pressure (n = 2050) or HbA1c and systolic blood pressure and non-HDL:HDL (n = 2745). Relative risk reduction for fatal/nonfatal cardiovascular disease was 35% with decrease in HbA1c only (mean 6 to final 49 mmol/mol), 56% with decrease in HbA1c and systolic blood pressure (mean 12 to final 128 mmHg) and 75% with combined decreases in HbA1c, systolic blood pressure and non-HDL:HDL (mean 0.8 to final 2.1), all p < 0.001 adjusting for clinical characteristics, other risk factors, treatments and previous cardiovascular disease. Similar risk reductions were found for fatal/nonfatal coronary heart disease, fatal cardiovascular disease, all-cause mortality and also in a subgroup of 3038 patients with albuminuria. Considerable risk reductions for cardiovascular disease and mortality were seen with combined long-term risk factor improvement. © The Author(s) 2016.

Harnessing Functional Genomics to Reverse Chemoresistance in Breast Cancer

DTIC Science & Technology

2008-10-01

lymphoproliferative syndrome This is a rare immunodeficiency disease characterized by fatal or near-fatal Epstein–Barr virus-induced infectious ... mononucleosis in childhood, subsequent hypogammaglob- ulinaemia and a markedly increased risk of lymphoma or other lymphoproliferative diseases

Bilateral panuveitis associated with Whipple disease - case report.

PubMed

Lisboa, Maria; Domingues, Isabel; Pamplona, Jaime; Barata, Pedro; Morgado, Joana; Brotas, Vítor

2014-01-01

To describe a clinical case and literature review of Whipple disease. A 65-year-old male with bilateral decreased visual acuity for 3 weeks as well as bilateral hypoacusia, vertigo, disequilibrium, headache and decreased strength in the right upper limb for 4 months. The clinical work-up revealed a bilateral panuveitis and an ischemic cerebellar stroke. The diagnosis of Whipple disease was confirmed by histopathological analysis of adenopathy. The patient was treated with cortico-antibiotic therapy with significant clinical improvement. Although rare, Whipple disease is potentially fatal if left untreated, it must be always be taken into consideration before any panuveitis of an unknown cause, even in the absence of gastrointestinal symptoms.

1998 railroad employee fatalities : an analytical study

DOT National Transportation Integrated Search

2003-11-01

"1998 Railroad Employee Fatalities: An Analytical Study," is designed to promote and enhance awareness of many unsafe behaviors and conditions that typically contribute to railroad employee fatalities. By furthering our understanding of the causes of...

Clinical profile and predictors of fatal Rocky Mountain spotted fever in children from Sonora, Mexico.

PubMed

Alvarez-Hernandez, Gerardo; Murillo-Benitez, Coral; Candia-Plata, Maria del Carmen; Moro, Manuel

2015-02-01

Rocky Mountain spotted fever (RMSF) is an increasingly important cause of preventable mortality in children in Sonora, Mexico. Although early treatment with tetracycline has shown to prevent fatal outcome, the disease remains a life-threatening condition, particularly for children. This study describes the clinical factors associated with pediatric mortality due to RMSF in Sonora, in order to guide healthcare practices. This is a retrospective analysis of 104 children consecutively hospitalized at the major pediatric hospital of Sonora, diagnosed with RMSF between January 2004 and December 2013. Descriptive statistics and multiple logistic regression were used to identify risk factors for fatal outcome. The case fatality ratio in this cohort was 20.2%. Children were hospitalized after a median of 6 days from onset of symptoms including fever (100%), rash involving palms and soles (88.5%) and headache (79.8%); 90.4% of fatal cases had low platelet counts (<50,000/μL) and 33.3% showed serum creatinine concentrations above the normal value. Acute kidney injury increased mortality, odds ratio (OR(adj)) = 4.84, 95% confidence interval (CI): 1.2-16.2, as well as delay in treatment (≥ 5th day from onset) with doxycycline, OR(adj) = 2.62, 95% CI: 1.24-5.52 and hemorrhage, OR(adj) = 6.11, 95% CI: 1.89-19.69. RMSF is a public health problem in Sonora. Clinically, fatal cases differ from non-fatal cases in renal function and hemorrhagic manifestations, although these findings may occur too late for a timely intervention. First-line providers must be educated to harbor a timely suspicion of RMSF, and should provide empiric treatment with doxycycline when febrile patients first present for care.

Increasing Trend of Fatal Falls in Older Adults in the United States, 1992 to 2005: Coding Practice or Reporting Quality?

PubMed

Kharrazi, Rebekah J; Nash, Denis; Mielenz, Thelma J

2015-09-01

To investigate whether changes in death certificate coding and reporting practices explain part or all of the recent increase in the rate of fatal falls in adults aged 65 and older in the United States. Trends in coding and reporting practices of fatal falls were evaluated under mortality coding schemes for International Classification of Diseases (ICD), Ninth Revision (1992-1998) and Tenth Revision (1999-2005). United States, 1992 to 2005. Individuals aged 65 and older with falls listed as the underlying cause of death (UCD) on their death certificates. The primary outcome was annual fatal falls rates per 100,000 U.S. residents aged 65 and older. Coding practice was assessed through analysis of trends in rates of specific UCD fall ICD e-codes over time. Reporting quality was assessed by examining changes in the location on the death certificate where fall e-codes were reported, in particular, the percentage of fall e-codes recorded in the proper location on the death certificate. Fatal falls rates increased over both time periods: 1992 to 1998 and 1999 to 2005. A single falls e-code was responsible for the increasing trend of fatal falls overall from 1992 to 1998 (E888, other and unspecified fall) and from 1999 to 2005 (W18, other falls on the same level), whereas trends for other falls e-codes remained stable. Reporting quality improved steadily throughout the study period. Better reporting quality, not coding practices, contributed to the increasing rate of fatal falls in older adults in the United States from 1992 to 2005. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Risk of cardiovascular events and death in the life after aneurysmal subarachnoid haemorrhage: a nationwide study.

PubMed

Nieuwkamp, Dennis J; Vaartjes, Ilonca; Algra, Ale; Rinkel, Gabriel J E; Bots, Michiel L

2014-12-01

The increased mortality rates of survivors of aneurysmal subarachnoid haemorrhage have been attributed to an increased risk of cardiovascular events in a registry study in Sweden. Swedish registries have however not been validated for subarachnoid haemorrhage and Scandinavian incidences of cardiovascular disease differ from that in Western European countries. We assessed risks of vascular disease and death in subarachnoid haemorrhage survivors in the Netherlands. From the Dutch hospital discharge register, we identified all patients with subarachnoid haemorrhage admission between 1997 and 2008. We determined the accuracy of coding of the diagnosis subarachnoid haemorrhage for patients admitted to our centre. Conditional on survival of three-months after the subarachnoid haemorrhage, we calculated standardized incidence and mortality ratios for fatal or nonfatal vascular diseases, vascular death, and all-cause death. Cumulative risks were estimated with survival analysis. The diagnosis of nontraumatic subarachnoid haemorrhage was correct in 95·4% of 1472 patients. Of 11,263 admitted subarachnoid haemorrhage patients, 6999 survived more than three-months. During follow-up (mean 5·1 years), 874 (12·5%) died. The risks of death were 3·3% within one-year, 11·3% within five-years, and 21·5% within 10 years. The standardized mortality ratio was 3·4 (95% confidence interval: 3·1 to 3·7) for vascular death and 2·2 (95% confidence interval: 2·1 to 2·3) for all-cause death. The standardized incidence ratio for fatal or nonfatal vascular diseases was 2·7 (95% confidence interval: 2·6 to 2·8). Dutch hospital discharge and cause of death registries are a valid source of data for subarachnoid haemorrhage, and show that the increased mortality rate in subarachnoid haemorrhage survivors is explained by increased risks for vascular diseases and death. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Pluripotent stem cells to model Hutchinson-Gilford progeria syndrome (HGPS): Current trends and future perspectives for drug discovery.

PubMed

Lo Cicero, Alessandra; Nissan, Xavier

2015-11-01

Progeria, or Hutchinson-Gilford progeria syndrome (HGPS), is a rare, fatal genetic disease characterized by an appearance of accelerated aging in children. This syndrome is typically caused by mutations in codon 608 (p.G608G) of the LMNA, leading to the production of a mutated form of lamin A precursor called progerin. In HGPS, progerin accumulates in cells causing progressive molecular defects, including nuclear shape abnormalities, chromatin disorganization, damage to DNA and delays in cell proliferation. Here we report how, over the past five years, pluripotent stem cells have provided new insights into the study of HGPS and opened new original therapeutic perspectives to treat the disease. Copyright © 2015 Elsevier B.V. All rights reserved.

Approaching chronic cough

PubMed Central

Poulose, Vijo; Tiew, Pei Yee; How, Choon How

2016-01-01

Chronic cough is one of the most common reasons for referral to a respiratory physician. Although fatal complications are rare, it may cause considerable distress in the patient’s daily life. Western and local data shows that in patients with a normal chest radiograph, the most common causes are postnasal drip syndrome, postinfectious cough, gastro-oesophageal reflux disease and cough variant asthma. Less common causes are the use of angiotensin-converting enzyme inhibitors, smoker’s cough and nonasthmatic eosinophilic bronchitis. A detailed history-taking and physical examination will provide a diagnosis in most patients, even at the primary care level. Some cases may need further investigations or specialist referral for diagnosis. PMID:26892615

[Botulism an a 38-year-old man after ingestion of garlic in chilli oil].

PubMed

Lohse, Nicolai; Kraghede, Poul G; Mølbak, Kåre

2003-07-21

Botulism is a rare but potentially fatal disease caused by toxins produced by Clostridium botulinum. We report a case of botulism in a 38-year-old man after eating canned "garlic in chilli-oil". The patient was treated with antiserum. The diagnosis was confirmed by detection of botulinum B toxin by a bio-assay and growth of Clostridium botulinum from the food left-overs.

Subacute Sclerosing Panencephalitis in a Child with Human Immunodeficiency Virus Co-Infection.

PubMed

Maurya, Pradeep Kumar; Thakkar, Mayur Deepak; Kulshreshtha, Dinkar; Singh, Ajai Kumar; Thacker, Anup Kumar

2016-12-01

Subacute sclerosing panencephalitis is a fatal infectious disease of childhood caused by persistence of the measles virus in the brain. The effect of human immunodeficiency virus (HIV) co-infection on subacute sclerosing panencephalitis remains elusive and rare. We report a child who developed subacute sclerosing panencephalitis following a short latency period and a rapidly progressive course with HIV co-infection. © 2016 Marshfield Clinic.

Burden of disease attributed to ambient air pollution in Thailand: A GIS-based approach

PubMed Central

Pinichka, Chayut; Makka, Nuttapat; Sukkumnoed, Decharut; Chariyalertsak, Suwat; Inchai, Puchong

2017-01-01

Background Growing urbanisation and population requiring enhanced electricity generation as well as the increasing numbers of fossil fuel in Thailand pose important challenges to air quality management which impacts on the health of the population. Mortality attributed to ambient air pollution is one of the sustainable development goals (SDGs). We estimated the spatial pattern of mortality burden attributable to selected ambient air pollution in 2009 based on the empirical evidence in Thailand. Methods We estimated the burden of disease attributable to ambient air pollution based on the comparative risk assessment (CRA) framework developed by the World Health Organization (WHO) and the Global Burden of Disease study (GBD). We integrated geographical information systems (GIS)-based exposure assessments into spatial interpolation models to estimate ambient air pollutant concentrations, the population distribution of exposure and the concentration-response (CR) relationship to quantify ambient air pollution exposure and associated mortality. We obtained air quality data from the Pollution Control Department (PCD) of Thailand surface air pollution monitoring network sources and estimated the CR relationship between relative risk (RR) and concentration of air pollutants from the epidemiological literature. Results We estimated 650–38,410 ambient air pollution-related fatalities and 160–5,982 fatalities that could have been avoided with a 20 reduction in ambient air pollutant concentrations. The summation of population-attributable fraction (PAF) of the disease burden for all-causes mortality in adults due to NO2 and PM2.5 were the highest among all air pollutants at 10% and 7.5%, respectively. The PAF summation of PM2.5 for lung cancer and cardiovascular disease were 16.8% and 14.6% respectively and the PAF summations of mortality attributable to PM10 was 3.4% for all-causes mortality, 1.7% for respiratory and 3.8% for cardiovascular mortality, while the PAF summation of mortality attributable to NO2 was 7.8% for respiratory mortality in Thailand. Conclusion Mortality due to ambient air pollution in Thailand varies across the country. Geographical distribution estimates can identify high exposure areas for planners and policy-makers. Our results suggest that the benefits of a 20% reduction in ambient air pollution concentration could prevent up to 25% of avoidable fatalities each year in all-causes, respiratory and cardiovascular categories. Furthermore, our findings can provide guidelines for future epidemiological investigations and policy decisions to achieve the SDGs. PMID:29267319

Dengue mortality in Colombia, 1985-2012.

PubMed

Chaparro-Narváez, Pablo; León-Quevedo, Willian; Castañeda-Orjuela, Carlos Andrés

2016-02-11

Dengue in Colombia is an important public health problem due to the huge economic and social costs it has caused, especially during the disease outbreaks.  To describe the behavior of dengue mortality in Colombia between 1985 and 2012.  We conducted a descriptive study. Information was obtained from mortality and population projection databases provided by the Departamento Administrativo Nacional de Estadística (DANE) for the 1985-2012 period. Mortality rates, rate ratios, and case fatality rates were estimated.  A total of 1,990 dengue deaths were registered during this period in Colombia. Dengue mortality rates presented an increasing trend with statistical significance between 1985 and 1998. Higher mortality rates were reported in men both younger than 5 years and older than 65 years. Between 1995 and 2012, category 1 to 4 municipalities reported the highest mortality rates. Case fatality rates varied during the period between 0.01% and 0.39%.  Dengue is an avoidable disease that should disappear from mortality statistics as a cause of death. The event is avoidable if the proposed activities from the Estrategia de Gestión Integrada (EGI)-Dengue are implemented and evaluated. We recommend encouraging the development of an informational culture to contribute to decision making and prioritizing resource allocation.

Risk for transmission of Naegleria fowleri from solid organ transplantation.

PubMed

Roy, S L; Metzger, R; Chen, J G; Laham, F R; Martin, M; Kipper, S W; Smith, L E; Lyon, G M; Haffner, J; Ross, J E; Rye, A K; Johnson, W; Bodager, D; Friedman, M; Walsh, D J; Collins, C; Inman, B; Davis, B J; Robinson, T; Paddock, C; Zaki, S R; Kuehnert, M; DaSilva, A; Qvarnstrom, Y; Sriram, R; Visvesvara, G S

2014-01-01

Primary amebic meningoencephalitis (PAM) caused by the free-living ameba (FLA) Naegleria fowleri is a rare but rapidly fatal disease of the central nervous system (CNS) affecting predominantly young, previously healthy persons. No effective chemotherapeutic prophylaxis or treatment has been identified. Recently, three transplant-associated clusters of encephalitis caused by another FLA, Balamuthia mandrillaris, have occurred, prompting questions regarding the suitability of extra-CNS solid organ transplantation from donors with PAM. During 1995-2012, 21 transplant recipients of solid organs donated by five patients with fatal cases of PAM were reported in the United States. None of the recipients developed PAM, and several recipients tested negative for N. fowleri by serology. However, historical PAM case reports and animal experiments with N. fowleri, combined with new postmortem findings from four patients with PAM, suggest that extra-CNS dissemination of N. fowleri can occur and might pose a risk for disease transmission via transplantation. The risks of transplantation with an organ possibly harboring N. fowleri should be carefully weighed for each individual recipient against the potentially greater risk of delaying transplantation while waiting for another suitable organ. In this article, we present a case series and review existing data to inform such risk assessments. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

Risk for Transmission of Naegleria fowleri from Solid Organ Transplantation

PubMed Central

Roy, SL; Metzger, R; Chen, JG; Laham, FR; Martin, M; Kipper, SW; Smith, LE; Lyon, GM; Haffner, J; Ross, JE; Rye, AK; Johnson, W; Bodager, D; Friedman, M; Walsh, DJ; Collins, C; Inman, B; Davis, BJ; Robinson, T; Paddock, C; Zaki, SR; Kuehnert, M; DaSilva, A; Qvarnstrom, Y; Sriram, R; Visvesvara, GS

2015-01-01

Primary amebic meningoencephalitis (PAM) caused by the free-living ameba Naegleria fowleri is a rare but rapidly fatal disease of the central nervous system (CNS) affecting predominantly young, previously healthy persons. No effective chemotherapeutic prophylaxis or treatment has been identified. Recently, three transplant-associated clusters of encephalitis caused by another free-living ameba, Balamuthia mandrillaris, have occurred, prompting questions regarding the suitability of extra-CNS solid organ transplantation from donors with PAM. During 1995–2012, 21 transplant recipients of solid organs donated by five patients with fatal cases of PAM were reported in the United States. None of the recipients developed PAM and several recipients tested negative for N. fowleri by serology. However, historical PAM case reports and animal experiments with N. fowleri, combined with new post-mortem findings from four PAM patients, suggest that extra-CNS dissemination of N. fowleri can occur and might pose a risk for disease transmission via transplantation. The risks of transplantation with an organ possibly harboring N. fowleri should be carefully weighed for each individual recipient against the potentially greater risk of delaying transplantation while waiting for another suitable organ. In this article we present a case series and review existing data to inform such risk assessments. PMID:24279908

Cancer Fatalism, Literacy, and Cancer Information Seeking in the American Public.

PubMed

Kobayashi, Lindsay C; Smith, Samuel G

2016-08-01

Information seeking is an important behavior for cancer prevention and control, but inequalities in the communication of information about the disease persist. Conceptual models have suggested that low health literacy is a barrier to information seeking, and that fatalistic beliefs about cancer may be a mediator of this relationship. Cancer fatalism can be described as deterministic thoughts about the external causes of the disease, the inability to prevent it, and the inevitability of death at diagnosis. This study aimed to examine the associations between these constructs and sociodemographic factors, and test a mediation model using the American population-representative Health Information and National Trends Survey (HINTS 4), Cycle 3 (n = 2,657). Approximately one third (34%) of the population failed to answer 2/4 health literacy items correctly (limited health literacy). Many participants agreed with the fatalistic beliefs that it seems like everything causes cancer (66%), that one cannot do much to lower his or her chances of getting cancer (29%), and that thinking about cancer makes one automatically think about death (58%). More than half of the population had "ever" sought information about cancer (53%). In analyses adjusted for sociodemographic characteristics and family cancer history, people with limited health literacy were less likely to have ever sought cancer information (odds ratio [OR] = 0.63; 0.42-0.95) and more frequently endorsed the belief that "there's not much you can do . . ." (OR = 1.61; 1.05-2.47). This fatalistic belief partially explained the relationship between health literacy and information seeking in the mediation model (14% mediation). Interventions are needed to address low health literacy and cancer fatalism to increase public interest in cancer-related information. © 2015 Society for Public Health Education.

Detection and characterization of viruses causing hand, foot and mouth disease from children in Seri Kembangan, Malaysia.

PubMed

Ling, Beh Poay; Jalilian, Farid Azizi; Harmal, Nabil Saad; Yubbu, Putri; Sekawi, Zamberi

2014-12-01

Hand, foot and mouth disease (HFMD) is a common viral infection among infants and children. The major causative agents of HFMD are enterovirus 71 (EV71) and coxsackievirus A16 (CVA16). Recently, coxsackievirus A6 (CVA6) infections were reported in neighboring countries. Infected infants and children may present with fever, mouth/throat ulcers, rashes and vesicles on hands and feet. Moreover, EV71 infections might cause fatal neurological complications. Since 1997, EV71 caused fatalities in Sarawak and Peninsula Malaysia. The purpose of this study was to identify and classify the viruses which detected from the patients who presenting clinical signs and symptoms of HFMD in Seri Kembangan, Malaysia. From December 2012 until July 2013, a total of 28 specimens were collected from patients with clinical case definitions of HFMD. The HFMD viruses were detected by using semi-nested reverse transcription polymerase chain reaction (snRT-PCR). The positive snRT-PCR products were sequenced and phylogenetic analyses of the viruses were performed. 12 of 28 specimens (42.9%) were positive in snRT-PCR, seven are CVA6 (58.3%), two CVA16 (16.7%) and three EV71 (25%). Based on phylogenetic analysis studies, EV71 strains were identified as sub-genotype B5; CVA16 strains classified into sub-genotype B2b and B2c; CVA6 strains closely related to strains in Taiwan and Japan. In this study, HFMD in Seri Kembangan were caused by different types of Enterovirus, which were EV71, CVA6 and CVA16.

Violence related injuries, deaths and disabilities in the capital of Honduras.

PubMed

Yacoub, Sophie; Arellano, Sergio; Padgett-Moncada, Dennis

2006-05-01

Honduras has the second highest incidence of violence in the Americas. The aim of this study is to explore the number and mechanism of fatal injuries, non-fatal injuries and the sequelae of these injuries due to violence. This is compared with unintentional injuries, in the capital of Honduras for 2001, with a view to better-targeted prevention. Data for non-fatal injuries was retrospectively obtained from medical records of all admissions from the public Emergency Department in Tegucigalpa for 2001. Data on fatal injuries were obtained from the national forensic department. All injuries were reviewed for intention, mechanism and age group. There were 1631 (rate 138/100,000) fatal injuries recorded for 2001 in Tegucigalpa. Of these, 1149 (70.4%) were due to violence, compared to 355 (21.8%) due to unintentional injuries and 127 (7.8%) of unknown intent. Homicides accounted for 1044 (64%), suicides 105 (6.4%) and unintentional deaths 355 (22%). Firearms were the leading cause of death in the homicide group (84.3%). In addition 1592 (rate 235/100,000) non-fatal injuries were documented for people 15 years and above, with 1228 (77.1%) caused by violence, of which 640 (52.1%) were caused by firearms. The age group 15-24 years had the highest rates of fatal and non-fatal injuries due to violence. Twenty percent had permanent sequelae as a result of their injuries. Firearm injuries had the highest proportion of sequelae (28.8%). Violence in Tegucigalpa is a major cause of injury resulting in substantial morbidity, mortality and disability, particularly in young individuals. Firearms are the most common form of violence related injury mechanism and carry the highest associated mortality and permanent disability. Prevention programs are urgently needed to address this devastating problem.

Factors determining case fatality in myocardial infarction "who dies in a heart attack"?

PubMed

Wannamethee, G; Whincup, P H; Shaper, A G; Walker, M; MacFarlane, P W

1995-09-01

To examine the determinants of case fatality in the first major ischaemic heart disease event (heart attack) after screening. Prospective study of 7735 middle aged men drawn from general practices in 24 British towns. During 11.5 years follow up there were 743 major ischaemic heart disease events of which 302 (40.6%) were fatal within 28 days of onset. Previous definite myocardial infarction or stroke and age at time of event were most strongly associated with case fatality. In men with no previous myocardial infarction or stroke, after adjustment for a range of risk factors, antihypertensive treatment (odds ratio (OR) = 1.97, P < 0.05), arrhythmia (OR = 1.93, P = 0.06), increased heart rate (OR = 2.03, P = 0.06), and diabetes (OR = 2.61, P = 0.07) were associated with increased case fatality. High levels of physical activity (OR = 0.53, P < 0.05) and moderate drinking (16-42 units/week) (OR = 0.61, P < 0.05) were associated with lower case fatality, although moderate drinking was not associated with a lower incidence of major ischaemic heart disease events. Current smoking, serum total cholesterol, and systolic blood pressure were not significantly associated with case fatality. In men with previous myocardial infarction or stroke, arrhythmia and to a lesser degree antihypertensive treatment, moderate or heavy drinking, and diabetes were associated with higher case fatality. These findings suggest that physical activity may be an important modifiable factor influencing the incidence of ischaemic heart disease and the chance of survival in men without a previous heart attack or stroke. Arrhythmia, increased heart rate, diabetes, and treatment for hypertension are also areas of concern.

Accidental fatal lung injury by compressed air: a case report.

PubMed

Rayamane, Anand Parashuram; Pradeepkumar, M V

2015-03-01

Compressed air is being used extensively as a source of energy at industries and in daily life. A variety of fatal injuries are caused by improper and ignorant use of compressed air equipments. Many types of injuries due to compressed air are reported in the literature such as colorectal injury, orbital injury, surgical emphysema, and so on. Most of these injuries are accidental in nature. It is documented that 40 pounds per square inch pressure causes fatal injuries to the ear, eyes, lungs, stomach, and intestine. Openings of body are vulnerable to injuries by compressed air. Death due to compressed air injuries is rarely reported. Many cases are treated successfully by conservative or surgical management. Extensive survey of literature revealed no reports of fatal injury to the upper respiratory tract and lungs caused by compressed air. Here, we are reporting a fatal event of accidental death after insertion of compressed air pipe into the mouth. The postmortem findings are corroborated with the history and discussed in detail.

Emerging viral diseases of Southeast Asia and the Western Pacific.

PubMed Central

Mackenzie, J. S.; Chua, K. B.; Daniels, P. W.; Eaton, B. T.; Field, H. E.; Hall, R. A.; Halpin, K.; Johansen, C. A.; Kirkland, P. D.; Lam, S. K.; McMinn, P.; Nisbet, D. J.; Paru, R.; Pyke, A. T.; Ritchie, S. A.; Siba, P.; Smith, D. W.; Smith, G. A.; van den Hurk, A. F.; Wang, L. F.; Williams, D. T.

2001-01-01

Over the past 6 years, a number of zoonotic and vectorborne viral diseases have emerged in Southeast Asia and the Western Pacific. Vectorborne disease agents discussed in this article include Japanese encephalitis, Barmah Forest, Ross River, and Chikungunya viruses. However, most emerging viruses have been zoonotic, with fruit bats, including flying fox species as the probable wildlife hosts, and these will be discussed as well. The first of these disease agents to emerge was Hendra virus, formerly called equine morbillivirus. This was followed by outbreaks caused by a rabies-related virus, Australian bat lyssavirus, and a virus associated with porcine stillbirths and malformations, Menangle virus. Nipah virus caused an outbreak of fatal pneumonia in pigs and encephalitis in humans in the Malay Peninsula. Most recently, Tioman virus has been isolated from flying foxes, but it has not yet been associated with animal or human disease. Of nonzoonotic viruses, the most important regionally have been enterovirus 71 and HIV. PMID:11485641

Mutant SOD1 in cell types other than motor neurons and oligodendrocytes accelerates onset of disease in ALS mice

PubMed Central

Yamanaka, Koji; Boillee, Severine; Roberts, Elizabeth A.; Garcia, Michael L.; McAlonis-Downes, Melissa; Mikse, Oliver R.; Cleveland, Don W.; Goldstein, Lawrence S. B.

2008-01-01

Dominant mutations in ubiquitously expressed superoxide dismutase (SOD1) cause familial ALS by provoking premature death of adult motor neurons. To test whether mutant damage to cell types beyond motor neurons is required for the onset of motor neuron disease, we generated chimeric mice in which all motor neurons and oligodendrocytes expressed mutant SOD1 at a level sufficient to cause fatal, early-onset motor neuron disease when expressed ubiquitously, but did so in a cellular environment containing variable numbers of non-mutant, non-motor neurons. Despite high-level mutant expression within 100% of motor neurons and oligodendrocytes, in most of these chimeras, the presence of WT non-motor neurons substantially delayed onset of motor neuron degeneration, increasing disease-free life by 50%. Disease onset is therefore non-cell autonomous, and mutant SOD1 damage within cell types other than motor neurons and oligodendrocytes is a central contributor to initiation of motor neuron degeneration. PMID:18492803

Invasive Group A Streptococcus Infection among Children, Rural Kenya.

PubMed

Seale, Anna C; Davies, Mark R; Anampiu, Kirimi; Morpeth, Susan C; Nyongesa, Sammy; Mwarumba, Salim; Smeesters, Pierre R; Efstratiou, Androulla; Karugutu, Rosylene; Mturi, Neema; Williams, Thomas N; Scott, J Anthony G; Kariuki, Samuel; Dougan, Gordon; Berkley, James A

2016-02-01

To determine the extent of group A Streptococcus (GAS) infections in sub-Saharan Africa and the serotypes that cause disease, we analyzed surveillance data for 64,741 hospital admissions in Kilifi, Kenya, during 1998-2011. We evaluated incidence, clinical presentations, and emm types that cause invasive GAS infection. We detected 370 cases; of the 369 for which we had data, most were skin and soft tissue infections (70%), severe pneumonia (23%), and primary bacteremia (14%). Overall case-fatality risk was 12%. Incidence of invasive GAS infection was 0.6 cases/1,000 live births among neonates, 101/100,000 person-years among children <1 year of age, and 35/100,000 among children <5 years of age. Genome sequencing identified 88 emm types. GAS causes serious disease in children in rural Kenya, especially neonates, and the causative organisms have considerable genotypic diversity. Benefit from the most advanced GAS type-specific vaccines may be limited, and efforts must be directed to protect against disease in regions of high incidence.

Prognostic value of one-year course of symptoms of anxiety and depression in patients with coronary heart disease: Role of physical activity and unmet medical need.

PubMed

Rothenbacher, Dietrich; Jaensch, Andrea; Mons, Ute; Hahmann, Harry; Becker, Thomas; Koenig, Wolfgang; Brenner, Hermann

2015-09-01

Symptoms of depression and anxiety contribute to determining prognosis of patients with coronary heart disease. We evaluated the association of the one-year course of symptoms of anxiety and depressive symptoms with fatal and non-fatal cardiovascular disease-events during 10-year follow-up and assessed the utilization of anti-depressant and psycholeptic medication. Prospective cohort study in coronary heart disease patients aged 30-70 years with stable coronary heart disease. Symptoms of anxiety and depression were evaluated at baseline and follow-up using the Hospital Anxiety and Depression Scale. Associations with fatal and non-fatal cardiovascular disease events were determined by a Cox-proportional hazards model. Nine hundred and ninety-six patients were included in this study. Of the 862 patients with a normal depression symptom score at baseline 10.3% had an increased score at one-year follow-up. Of those with an elevated symptom score at baseline, 62.7% still had an elevated score after one year. During follow-up (median 8.9 years) fatal and non-fatal cardiovascular disease events were observed in 152 patients. One year course of depressive symptoms was associated with cardiovascular disease events during follow-up (p-value for trend 0.029); for example, patients with an increase of depressive symptoms had a hazard ratio of 1.93 (95% confidence interval 1.08-3.34) compared with patients with a normal score at baseline as well as at one-year follow-up. However, if physical activity was considered as a covariate, the HRs attenuated and the association was no longer statistically significant. The utilization of anti-depressant medication in the overall population was low (overall 2%). The study supports a role of the one year course of symptoms of depression for long-term prognosis of patients with known coronary heart disease, which might be partly mediated by lack of physical activity. © The European Society of Cardiology 2014.

Hospitalised and Fatal Head Injuries in Viti Levu, Fiji: Findings from an Island-Wide Trauma Registry (TRIP 4)

PubMed Central

Kool, Bridget; Raj, Naina; Wainiqolo, Iris; Kafoa, Berlin; McCaig, Eddie; Ameratunga, Shanthi

2012-01-01

Background Globally, head injury is a substantial cause of mortality and morbidity. A disproportionately greater burden is borne by low- and middle-income countries. The incidence and characteristics of fatal and hospitalised head injuries in Fiji are unknown. Methods Using prospective data from the Fiji Injury Surveillance in Hospital system, the epidemiology of fatal and hospitalised head injuries was investigated (2004–2005). Results In total, 226 hospital admissions and 50 fatalities (66% died prior to admission) with a principal diagnosis of head injury were identified (crude annual rates of 34.7 and 7.7/100,000, respectively). Males were more likely to die and be hospitalised as a result of head injury than females. The highest fatality rate was among those in the 30–44-year age group. Road traffic crashes were the leading causes of injuries resulting in death (70%), followed by ‘hit by person or object’ and falls (14% each). Among people admitted to hospital, road traffic crashes (34.5%) and falls (33.2%) were the leading causes of injury. The leading cause of head injuries in children was falls, in 15–29-year-olds road traffic crashes, and in adults aged 30–44 years or 45 years and older ‘hit by person or object’. Among the two major ethnic groups, Fijians had higher rates of falls and ‘hit by person or object’ and Indians higher rates for road traffic crashes. There were no statistically significant differences between the overall rates of head injuries or the fatal and non-fatal rates among Fijians or Indians by gender following age standardisation to the total Fijian national population. Conclusion Despite underestimating the overall burden, this study identified head injury to be a major cause of death and hospitalisation in Fiji. The predominance of males and road traffic-related injuries is consistent with studies on head injuries conducted in other low- and middle-income countries. The high fatality rate among those aged 30–44 years in this study has not been noted previously. The high case fatality rate prior to admission to the hospital requires urgent attention. PMID:22472517

Causes and risk factors for fatal accidents in non-commercial twin engine piston general aviation aircraft.

PubMed

Boyd, Douglas D

2015-04-01

Accidents in twin-engine aircraft carry a higher risk of fatality compared with single engine aircraft and constitute 9% of all general aviation accidents. The different flight profile (higher airspeed, service ceiling, increased fuel load, and aircraft yaw in engine failure) may make comparable studies on single-engine aircraft accident causes less relevant. The objective of this study was to identify the accident causes for non-commercial operations in twin engine aircraft. A NTSB accident database query for accidents in twin piston engine airplanes of 4-8 seat capacity with a maximum certified weight of 3000-8000lbs. operating under 14CFR Part 91 for the period spanning 2002 and 2012 returned 376 accidents. Accident causes and contributing factors were as per the NTSB final report categories. Total annual flight hour data for the twin engine piston aircraft fleet were obtained from the FAA. Statistical analyses employed Chi Square, Fisher's Exact and logistic regression analysis. Neither the combined fatal/non-fatal accident nor the fatal accident rate declined over the period spanning 2002-2012. Under visual weather conditions, the largest number, n=27, (27%) of fatal accidents was attributed to malfunction with a failure to follow single engine procedures representing the most common contributing factor. In degraded visibility, poor instrument approach procedures resulted in the greatest proportion of fatal crashes. Encountering thunderstorms was the most lethal of all accident causes with all occupants sustaining fatal injuries. At night, a failure to maintain obstacle/terrain clearance was the most common accident cause leading to 36% of fatal crashes. The results of logistic regression showed that operations at night (OR 3.7), off airport landings (OR 14.8) and post-impact fire (OR 7.2) all carried an excess risk of a fatal flight. This study indicates training areas that should receive increased emphasis for twin-engine training/recency. First, increased training should be provided on single engine procedures in the event of an engine failure. Second, more focus should be placed on instrument approaches and recovery from unusual aircraft attitude where visibility is degraded. Third, pilots should be made aware of appropriate speed selection for inadvertent flights in convective weather. Finally, emphasizing the importance of conducting night operations under instrument flight rules with its altitude restrictions should lead to a diminished proportion of accidents attributed to failure to maintain obstacle/terrain clearance. Copyright © 2015 Elsevier Ltd. All rights reserved.

Death related to dental treatment: a systematic review.

PubMed

Reuter, Nathan G; Westgate, Philip M; Ingram, Mark; Miller, Craig S

2017-02-01

The aim of this study was to identify factors associated with death in relation to dental care. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Dental and Oral Sciences Source, Web of Science, and the Cochrane database were searched, and the references of all retrieved articles were analyzed. Studies were included if death had occurred within 90 days of the dental appointment, and if the patient's age, procedure, and information regarding cause or time of death were provided. Factors associated with death were assessed by multivariate analyses and logistic regression. Fifty-six publications, including retrospective studies and case reports/series that reported 148 fatalities, were analyzed. On average, 2.6 deaths were reported per year. The leading cause of deaths was anesthesia/sedation/medication-related complications (n = 70). Other causes were cardiovascular events (n = 31), infection (n = 19), airway-respiratory complications (n = 18), bleeding (n = 5), and others (n = 5). Age (P < .0001), disease severity (P < .02), disease stability (P < .006), dental provider characteristics (P < .05), level of consciousness/sedation (P < .02), and drug effects (P < .03) had significant associations with death. Reports of death were rare; however, specific risk factors associated with dentistry were identified. A better understanding of these factors is important for the development of guidelines that help prevent fatalities in dentistry. Copyright © 2016 Elsevier Inc. All rights reserved.

Outbreaks of paralytic poliomyelitis during 1996-2012: the changing epidemiology of a disease in the final stages of eradication.

PubMed

Mach, Ondrej; Tangermann, Rudolf H; Wassilak, Steve G; Singh, Simarjit; Sutter, Roland W

2014-11-01

Despite substantial progress toward eradication of poliomyelitis, the risk of poliomyelitis outbreaks resulting from virus importations into polio-free areas persists. We reviewed the changing epidemiology of outbreaks in the final stages of the eradication initiative. Available literature on outbreaks of poliomyelitis caused by wild polioviruses between 1996 and 2012 was reviewed. During this period, there were 22 outbreaks involving 39 countries. Outbreaks ranged in size from 1 to 1335 cases. These outbreaks caused 4571 cases, representing 21% of all cases reported during this period. Five outbreaks involved multiple countries. In 76% of outbreaks (16/21) with a known age distribution, cases concentrated among children aged <5 years; in 19% (4/21), most cases were among adolescents and adults. The outbreaks among adolescents and adults were associated with higher case-fatality ratios, ranging from 12% in Albania in 1994 to 41% in the Republic of Congo in 2010. The majority of outbreaks were controlled within 6 months with oral poliovirus vaccine. Importations resulting in epidemic transmission of wild poliovirus caused thousands of cases of paralysis often in countries where poliomyelitis had not occurred for many years. The changing epidemiology, with cases and higher case-fatality ratios among adults, increased the severity of these outbreaks. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

R3-R4 deletion in the PRNP gene is associated with Creutzfeldt-Jakob disease (CJD)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cervenakova, L.; Brown, P.; Nagle, J.

1994-09-01

There are conflicting reports on the association of deletions in the PRNP gene on chromosome 20 with CJD, a rapidly progressive fatal spongiform encephalopathy. We accumulated data suggesting that a deletion of R3-R4 type (parts of the third and fourth repeats are deleted from the area of four repeating 24 bp sequences in the 5{prime} region of the gene) is causing CJD. Screening of 129 unaffected control individuals demonstrated presence of a deletion of R2 type in four (1.55% of the studied chromosomes), but none of them had the R3-R4 type. Of 181 screened patients with spongiform encephalopathies, two hadmore » a deletion of R3-R4 type with no other mutations in the coding sequence. Both patients had a classical rapidly progressive dementing disease and diffuse spongiform degeneration, and both cases were apparently sporadic. The same R3-R4 type of deletion was detected in three additional neuropathologically confirmed spongiform encephalopathy patients, of which two had other known pathogenic mutations in the PRNP gene: at codon 178 on the methionine allele exhibiting the phenotype of fatal familial insomnia, and codon 200 causing CJD with severe dementia; the third was a patient with iatrogenic CJD who developed the disease after treatment with growth hormone extracted from cadaveric human pituitary glands. In all cases the deletion coincided with a variant sequence at position 129 coding for methionine.« less

Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias.

PubMed

Rudolf, Frauke; Damkjær, Mads; Lunding, Suzanne; Dornonville de la Cour, Kenn; Young, Alyssa; Brooks, Tim; Sesay, Tom; Salam, Alex P; Mishra, Sharmistha; Storgaard, Merete

2017-04-01

Case-fatality rates in Ebola treatment centers (ETCs) varied widely during the Ebola virus disease (EVD) outbreak in West Africa. We assessed the influence of referral pathway on ETC case-fatality rates with a retrospective cohort of 126 patients treated at the Mathaska ETC in Port Loko, Sierra Leone. The patients consisted of persons who had confirmed EVD when transferred to the ETC or who had been diagnosed onsite. The case-fatality rate for transferred patients was 46% versus 67% for patients diagnosed onsite (p = 0.02). The difference was mediated by Ebola viral load at diagnosis, suggesting a survival selection bias. Comparisons of case-fatality rates across ETCs and clinical management strategies should account for potential survival selection bias.

Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias

PubMed Central

Damkjær, Mads; Lunding, Suzanne; Dornonville de la Cour, Kenn; Young, Alyssa; Brooks, Tim; Sesay, Tom; Salam, Alex P.; Mishra, Sharmistha; Storgaard, Merete

2017-01-01

Case-fatality rates in Ebola treatment centers (ETCs) varied widely during the Ebola virus disease (EVD) outbreak in West Africa. We assessed the influence of referral pathway on ETC case-fatality rates with a retrospective cohort of 126 patients treated at the Mathaska ETC in Port Loko, Sierra Leone. The patients consisted of persons who had confirmed EVD when transferred to the ETC or who had been diagnosed onsite. The case-fatality rate for transferred patients was 46% versus 67% for patients diagnosed onsite (p = 0.02). The difference was mediated by Ebola viral load at diagnosis, suggesting a survival selection bias. Comparisons of case-fatality rates across ETCs and clinical management strategies should account for potential survival selection bias. PMID:28322693

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

PubMed Central

Wills, Pallara Janardhanan; Anjana, Mohan; Nitin, Mohan; Varun, Raghuveeran; Sachidanandan, Parayil; Jacob, Tharaniyil Mani; Lilly, Madhavan; Thampan, Raghava Varman; Karthikeya Varma, Koyikkal

2016-01-01

Lepidopterism is a disease caused by the urticating scales and toxic fluids of adult moths, butterflies or its caterpillars. The resulting cutaneous eruptions and systemic problems progress to clinical complications sometimes leading to death. High incidence of fever epidemics were associated with massive outbreaks of tiger moth Asota caricae adult populations during monsoon in Kerala, India. A significant number of monsoon related fever characteristic to lepidopterism was erroneously treated as infectious fevers due to lookalike symptoms. To diagnose tiger moth lepidopterism, we conducted immunoblots for tiger moth specific IgE in fever patients’ sera. We selected a cohort of patients (n = 155) with hallmark symptoms of infectious fevers but were tested negative to infectious fevers. In these cases, the total IgE was elevated and was detected positive (78.6%) for tiger moth specific IgE allergens. Chemical characterization of caterpillar and adult moth fluids was performed by HPLC and GC-MS analysis and structural identification of moth scales was performed by SEM analysis. The body fluids and chitinous scales were found to be highly toxic and inflammatory in nature. To replicate the disease in experimental model, wistar rats were exposed to live tiger moths in a dose dependant manner and observed similar clinico-pathological complications reported during the fever epidemics. Further, to link larval abundance and fever epidemics we conducted cointegration test for the period 2009 to 2012 and physical presence of the tiger moths were found to be cointegrated with fever epidemics. In conclusion, our experiments demonstrate that inhalation of aerosols containing tiger moth fluids, scales and hairs cause systemic reactions that can be fatal to human. All these evidences points to the possible involvement of tiger moth disease as a major cause to the massive and fatal fever epidemics observed in Kerala. PMID:27073878

Antitrypanosomatid drug discovery: an ongoing challenge and a continuing need

PubMed Central

Field, Mark C.; Horn, David; Fairlamb, Alan H.; Ferguson, Michael A. J.; Gray, David W.; Read, Kevin D.; De Rycker, Manu; Torrie, Leah S.; Wyatt, Paul G.; Wyllie, Susan; Gilbert, Ian H.

2017-01-01

The World Health Organization recognizes human African trypanosomiasis, Chagas’ disease and the leishmaniases as neglected tropical diseases. These diseases are caused by parasitic trypanosomatids and range in severity from mild and self-curing to near invariably fatal. Public health advances have substantially decreased the impact of these diseases in recent decades, but alone will not eliminate these diseases. Here we discuss why new drugs against trypanosomatids are needed, approaches that are under investigation to develop new drugs and why the drug discovery pipeline remains essentially unfilled. Additionally, we consider the important challenges to drug discovery strategies and the new technologies that can address them. The combination of new drugs, new technologies and public health initiatives are essential for the management and hopefully eventual elimination of trypanosomatid diseases from the human population. PMID:28239154

Is Fibroblast growth factor 23 the leading cause of increased mortality among chronic kidney disease patients? A narrative review.

PubMed

Sharaf El Din, Usama A; Salem, Mona M; Abdulazim, Dina O

2017-05-01

The death rate among chronic kidney disease patients is the highest compared to other chronic diseases. 60% of these fatalities are cardiovascular. Cardiovascular calcifications and chronic inflammation affect almost all chronic kidney disease patients and are associated with cardiovascular mortality. Fibroblast growth factor 23 is associated with vascular calcification. Systemic inflammation in chronic kidney disease patients is multifactorial. The role of systemic inflammation in the pathogenesis of vascular calcification was recently reappraised. Fibroblast growth factor 23 was accused as a direct stimulus of left ventricular hypertrophy, uremic inflammation, and impaired neutrophil function. This review will discuss the underlying mechanisms that underlie the link between Fibroblast growth factor 23 and increased mortality encountered among chronic kidney disease patients.

Study of Hydatidosis-Attributed Mortality in Endemic Area

PubMed Central

Belhassen-García, Moncef; Romero-Alegria, Angela; Velasco-Tirado, Virginia; Alonso-Sardón, Montserrat; Lopez-Bernus, Amparo; Alvela-Suarez, Lucia; del Villar, Luis Perez; Carpio-Perez, Adela; Galindo-Perez, Inmaculada; Cordero-Sanchez, Miguel; Pardo-Lledias, Javier

2014-01-01

Background Cystic hydatid disease is still an important health problem in European Mediterranean areas. In spite of being traditionally considered as a “benign” pathology, cystic echinococcosis is an important cause of morbidity in these areas. Nevertheless, there are few analyses of mortality attributed to human hydatidosis. Objective To describe the epidemiology, the mortality rate and the causes of mortality due to E. granulosus infection in an endemic area. Methodology A retrospective study followed up over a period of 14 years (1998–2011). Principal Findings Of the 567 patients diagnosed with hydatid disease over the period 1998–2011, eleven deaths directly related to hydatid disease complications were recorded. Ten patients (90.9%) died due to infectious complications and the remaining one (9.1%) died due to mechanical complications after a massive hemoptysis. We registered a case fatality rate of 1.94% and a mortality rate of 3.1 per 100.000 inhabitants. Conclusions Hydatidosis is still a frequent parasitic disease that causes a considerable mortality. The main causes of mortality in patients with hydatidosis are complications related to the rupture of CE cysts with supurative collangitis. Therefore, an expectant management can be dangerous and it must be only employed in well-selected patients. PMID:24632824

Fatal Tick-Borne Encephalitis Virus Infections Caused by Siberian and European Subtypes, Finland, 2015.

PubMed

Kuivanen, Suvi; Smura, Teemu; Rantanen, Kirsi; Kämppi, Leena; Kantonen, Jonas; Kero, Mia; Jääskeläinen, Anu; Jääskeläinen, Anne J; Sane, Jussi; Myllykangas, Liisa; Paetau, Anders; Vapalahti, Olli

2018-05-01

In most locations except for Russia, tick-borne encephalitis is mainly caused by the European virus subtype. In 2015, fatal infections caused by European and Siberian tick-borne encephalitis virus subtypes in the same Ixodes ricinus tick focus in Finland raised concern over further spread of the Siberian subtype among widespread tick species.

Global and National Burden of Diseases and Injuries Among Children and Adolescents Between 1990 and 2013: Findings From the Global Burden of Disease 2013 Study.

PubMed

Kyu, Hmwe H; Pinho, Christine; Wagner, Joseph A; Brown, Jonathan C; Bertozzi-Villa, Amelia; Charlson, Fiona J; Coffeng, Luc Edgar; Dandona, Lalit; Erskine, Holly E; Ferrari, Alize J; Fitzmaurice, Christina; Fleming, Thomas D; Forouzanfar, Mohammad H; Graetz, Nicholas; Guinovart, Caterina; Haagsma, Juanita; Higashi, Hideki; Kassebaum, Nicholas J; Larson, Heidi J; Lim, Stephen S; Mokdad, Ali H; Moradi-Lakeh, Maziar; Odell, Shaun V; Roth, Gregory A; Serina, Peter T; Stanaway, Jeffrey D; Misganaw, Awoke; Whiteford, Harvey A; Wolock, Timothy M; Wulf Hanson, Sarah; Abd-Allah, Foad; Abera, Semaw Ferede; Abu-Raddad, Laith J; AlBuhairan, Fadia S; Amare, Azmeraw T; Antonio, Carl Abelardo T; Artaman, Al; Barker-Collo, Suzanne L; Barrero, Lope H; Benjet, Corina; Bensenor, Isabela M; Bhutta, Zulfiqar A; Bikbov, Boris; Brazinova, Alexandra; Campos-Nonato, Ismael; Castañeda-Orjuela, Carlos A; Catalá-López, Ferrán; Chowdhury, Rajiv; Cooper, Cyrus; Crump, John A; Dandona, Rakhi; Degenhardt, Louisa; Dellavalle, Robert P; Dharmaratne, Samath D; Faraon, Emerito Jose A; Feigin, Valery L; Fürst, Thomas; Geleijnse, Johanna M; Gessner, Bradford D; Gibney, Katherine B; Goto, Atsushi; Gunnell, David; Hankey, Graeme J; Hay, Roderick J; Hornberger, John C; Hosgood, H Dean; Hu, Guoqing; Jacobsen, Kathryn H; Jayaraman, Sudha P; Jeemon, Panniyammakal; Jonas, Jost B; Karch, André; Kim, Daniel; Kim, Sungroul; Kokubo, Yoshihiro; Kuate Defo, Barthelemy; Kucuk Bicer, Burcu; Kumar, G Anil; Larsson, Anders; Leasher, Janet L; Leung, Ricky; Li, Yongmei; Lipshultz, Steven E; Lopez, Alan D; Lotufo, Paulo A; Lunevicius, Raimundas; Lyons, Ronan A; Majdan, Marek; Malekzadeh, Reza; Mashal, Taufiq; Mason-Jones, Amanda J; Melaku, Yohannes Adama; Memish, Ziad A; Mendoza, Walter; Miller, Ted R; Mock, Charles N; Murray, Joseph; Nolte, Sandra; Oh, In-Hwan; Olusanya, Bolajoko Olubukunola; Ortblad, Katrina F; Park, Eun-Kee; Paternina Caicedo, Angel J; Patten, Scott B; Patton, George C; Pereira, David M; Perico, Norberto; Piel, Frédéric B; Polinder, Suzanne; Popova, Svetlana; Pourmalek, Farshad; Quistberg, D Alex; Remuzzi, Giuseppe; Rodriguez, Alina; Rojas-Rueda, David; Rothenbacher, Dietrich; Rothstein, David H; Sanabria, Juan; Santos, Itamar S; Schwebel, David C; Sepanlou, Sadaf G; Shaheen, Amira; Shiri, Rahman; Shiue, Ivy; Skirbekk, Vegard; Sliwa, Karen; Sreeramareddy, Chandrashekhar T; Stein, Dan J; Steiner, Timothy J; Stovner, Lars Jacob; Sykes, Bryan L; Tabb, Karen M; Terkawi, Abdullah Sulieman; Thomson, Alan J; Thorne-Lyman, Andrew L; Towbin, Jeffrey Allen; Ukwaja, Kingsley Nnanna; Vasankari, Tommi; Venketasubramanian, Narayanaswamy; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Wilkinson, James D; Woldeyohannes, Solomon Meseret; Wolfe, Charles D A; Yano, Yuichiro; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; El Sayed Zaki, Maysaa; Naghavi, Mohsen; Murray, Christopher J L; Vos, Theo

2016-03-01

The literature focuses on mortality among children younger than 5 years. Comparable information on nonfatal health outcomes among these children and the fatal and nonfatal burden of diseases and injuries among older children and adolescents is scarce. To determine levels and trends in the fatal and nonfatal burden of diseases and injuries among younger children (aged <5 years), older children (aged 5-9 years), and adolescents (aged 10-19 years) between 1990 and 2013 in 188 countries from the Global Burden of Disease (GBD) 2013 study. Data from vital registration, verbal autopsy studies, maternal and child death surveillance, and other sources covering 14,244 site-years (ie, years of cause of death data by geography) from 1980 through 2013 were used to estimate cause-specific mortality. Data from 35,620 epidemiological sources were used to estimate the prevalence of the diseases and sequelae in the GBD 2013 study. Cause-specific mortality for most causes was estimated using the Cause of Death Ensemble Model strategy. For some infectious diseases (eg, HIV infection/AIDS, measles, hepatitis B) where the disease process is complex or the cause of death data were insufficient or unavailable, we used natural history models. For most nonfatal health outcomes, DisMod-MR 2.0, a Bayesian metaregression tool, was used to meta-analyze the epidemiological data to generate prevalence estimates. Of the 7.7 (95% uncertainty interval [UI], 7.4-8.1) million deaths among children and adolescents globally in 2013, 6.28 million occurred among younger children, 0.48 million among older children, and 0.97 million among adolescents. In 2013, the leading causes of death were lower respiratory tract infections among younger children (905.059 deaths; 95% UI, 810,304-998,125), diarrheal diseases among older children (38,325 deaths; 95% UI, 30,365-47,678), and road injuries among adolescents (115,186 deaths; 95% UI, 105,185-124,870). Iron deficiency anemia was the leading cause of years lived with disability among children and adolescents, affecting 619 (95% UI, 618-621) million in 2013. Large between-country variations exist in mortality from leading causes among children and adolescents. Countries with rapid declines in all-cause mortality between 1990 and 2013 also experienced large declines in most leading causes of death, whereas countries with the slowest declines had stagnant or increasing trends in the leading causes of death. In 2013, Nigeria had a 12% global share of deaths from lower respiratory tract infections and a 38% global share of deaths from malaria. India had 33% of the world's deaths from neonatal encephalopathy. Half of the world's diarrheal deaths among children and adolescents occurred in just 5 countries: India, Democratic Republic of the Congo, Pakistan, Nigeria, and Ethiopia. Understanding the levels and trends of the leading causes of death and disability among children and adolescents is critical to guide investment and inform policies. Monitoring these trends over time is also key to understanding where interventions are having an impact. Proven interventions exist to prevent or treat the leading causes of unnecessary death and disability among children and adolescents. The findings presented here show that these are underused and give guidance to policy makers in countries where more attention is needed.

Effectiveness of rumble stripes on roadway safety in Mississippi.

DOT National Transportation Integrated Search

2009-12-01

Although traffic deaths are caused by an array of factors, in the United States more than half of all roadway : fatalities are caused by roadway departures [FHWA 2006]. In 2003, there were 25,562 roadway departure : fatalities, accounting for 55 perc...

An Analysis of fatal traffic crashes in Kentucky and recommended countermeasures.

DOT National Transportation Integrated Search

2005-11-01

The objective of this study were analyze fatal traffic crashes in Kentucky to identify patterns and causes of these crashes and to recommend potential countermeasures. The study included the following areas of analysis: 1) trends in fatal collisions,...

Bereaved families and the coronial response to traumatic workplace fatalities: Organizational perspectives.

PubMed

Matthews, Lynda R; Fitzpatrick, Scott J; Quinlan, Michael G; Ngo, Mark; Bohle, Philip

2016-01-01

Work remains a significant source of illness, injury, and death in developed countries. In Australia, for example, over 2,000 people die from work-related causes each year, with heavy social, economic, and personal costs (Safe Work Australia, 2013a ). Most die as a result of work-related disease. However, many die from trauma. In 2012, 223 workers were fatally injured in Australia and in the United States the figure was 4,383 (Bureau of Labor Statistics, 2014 ; Safe Work Australia, 2013b ). Apart from the immediate tragedy of each worker's death, these deaths affect the victim's immediate family, wider family, friends, and co-workers. It has been estimated that, on average, every death has an impact on at least 20 other people (Dyregrov, Nordanger, & Dyregrov, 2003 ), especially when the deceased had several families, which is an increasingly common phenomenon (OECD, 2014 ). Little is known, however, about how regulatory responses following a traumatic workplace fatality meet the needs of surviving families. With a focus on the coronial investigation, this article provides information about the regulatory responses to a traumatic workplace fatality and examines how various organizations involved in the coronial process following the death viewed its ability to accommodate the needs and wishes of surviving families.

Fatal primary amoebic meningoencephalitis in a Norwegian tourist returning from Thailand

PubMed Central

Reiakvam, Olaug Marie; Stensvold, Christen Rune; Hermansen, Nils Olav; Holberg-Petersen, Mona; Antal, Ellen-Ann; Gaustad, Knut; Førde, Ingrid Schage; Heger, Bernt

2016-01-01

Introduction: Primary amoebic meningoencephalitis (PAM) is a rare disease caused by the free-living amoeba Naegleria fowleri. Infection occurs by insufflation of water containing amoebae into the nasal cavity, and is usually associated with bathing in freshwater. Nasal irrigation is a more rarely reported route of infection. Case presentation: A fatal case of PAM in a previously healthy Norwegian woman, acquired during a holiday trip to Thailand, is described. Clinical findings were consistent with rapidly progressing meningoencephalitis. The cause of infection was discovered by chance, owing to the unexpected detection of N. fowleri DNA by a PCR assay targeting fungi. A conclusive diagnosis was established based on sequencing of N. fowleri DNA from brain biopsies, supported by histopathological findings. Nasal irrigation using contaminated tap water is suspected as the source of infection. Conclusion: The clinical presentation of PAM is very similar to severe bacterial meningitis. This case is a reminder that when standard investigations fail to identify a cause of infection in severe meningoencephalitis, it is of crucial importance to continue a broad search for a conclusive diagnosis. PAM should be considered as a diagnosis in patients with symptoms of severe meningoencephalitis returning from endemic areas. PMID:28348761

Fatal primary amoebic meningoencephalitis in a Norwegian tourist returning from Thailand.

PubMed

Stubhaug, Tore Taksdal; Reiakvam, Olaug Marie; Stensvold, Christen Rune; Hermansen, Nils Olav; Holberg-Petersen, Mona; Antal, Ellen-Ann; Gaustad, Knut; Førde, Ingrid Schage; Heger, Bernt

2016-06-01

Primary amoebic meningoencephalitis (PAM) is a rare disease caused by the free-living amoeba Naegleria fowleri . Infection occurs by insufflation of water containing amoebae into the nasal cavity, and is usually associated with bathing in freshwater. Nasal irrigation is a more rarely reported route of infection. A fatal case of PAM in a previously healthy Norwegian woman, acquired during a holiday trip to Thailand, is described. Clinical findings were consistent with rapidly progressing meningoencephalitis. The cause of infection was discovered by chance, owing to the unexpected detection of N. fowleri DNA by a PCR assay targeting fungi. A conclusive diagnosis was established based on sequencing of N. fowleri DNA from brain biopsies, supported by histopathological findings. Nasal irrigation using contaminated tap water is suspected as the source of infection. The clinical presentation of PAM is very similar to severe bacterial meningitis. This case is a reminder that when standard investigations fail to identify a cause of infection in severe meningoencephalitis, it is of crucial importance to continue a broad search for a conclusive diagnosis. PAM should be considered as a diagnosis in patients with symptoms of severe meningoencephalitis returning from endemic areas.

The Pathogenesis of Ebola Virus Disease.

PubMed

Baseler, Laura; Chertow, Daniel S; Johnson, Karl M; Feldmann, Heinz; Morens, David M

2017-01-24

For almost 50 years, ebolaviruses and related filoviruses have been repeatedly reemerging across the vast equatorial belt of the African continent to cause epidemics of highly fatal hemorrhagic fever. The 2013-2015 West African epidemic, by far the most geographically extensive, most fatal, and longest lasting epidemic in Ebola's history, presented an enormous international public health challenge, but it also provided insights into Ebola's pathogenesis and natural history, clinical expression, treatment, prevention, and control. Growing understanding of ebolavirus pathogenetic mechanisms and important new clinical observations of the disease course provide fresh clues about prevention and treatment approaches. Although viral cytopathology and immune-mediated cell damage in ebolavirus disease often result in severe compromise of multiple organs, tissue repair and organ function recovery can be expected if patients receive supportive care with fluids and electrolytes; maintenance of oxygenation and tissue perfusion; and respiratory, renal, and cardiovascular support. Major challenges for managing future Ebola epidemics include establishment of early and aggressive epidemic control and earlier and better patient care and treatment in remote, resource-poor areas where Ebola typically reemerges. In addition, it will be important to further develop Ebola vaccines and to adopt policies for their use in epidemic and pre-epidemic situations.

Alcohol intake in relation to non-fatal and fatal coronary heart disease and stroke: EPIC-CVD case-cohort study.

PubMed

Ricci, Cristian; Wood, Angela; Muller, David; Gunter, Marc J; Agudo, Antonio; Boeing, Heiner; van der Schouw, Yvonne T; Warnakula, Samantha; Saieva, Calogero; Spijkerman, Annemieke; Sluijs, Ivonne; Tjønneland, Anne; Kyrø, Cecilie; Weiderpass, Elisabete; Kühn, Tilman; Kaaks, Rudolf; Sánchez, Maria-Jose; Panico, Salvatore; Agnoli, Claudia; Palli, Domenico; Tumino, Rosario; Engström, Gunnar; Melander, Olle; Bonnet, Fabrice; Boer, Jolanda M A; Key, Timothy J; Travis, Ruth C; Overvad, Kim; Verschuren, W M Monique; Quirós, J Ramón; Trichopoulou, Antonia; Papatesta, Eleni-Maria; Peppa, Eleni; Iribas, Conchi Moreno; Gavrila, Diana; Forslund, Ann-Sofie; Jansson, Jan-Håkan; Matullo, Giuseppe; Arriola, Larraitz; Freisling, Heinz; Lassale, Camille; Tzoulaki, Ioanna; Sharp, Stephen J; Forouhi, Nita G; Langenberg, Claudia; Saracci, Rodolfo; Sweeting, Michael; Brennan, Paul; Butterworth, Adam S; Riboli, Elio; Wareham, Nick J; Danesh, John; Ferrari, Pietro

2018-05-29

To investigate the association between alcohol consumption (at baseline and over lifetime) and non-fatal and fatal coronary heart disease (CHD) and stroke. Multicentre case-cohort study. A study of cardiovascular disease (CVD) determinants within the European Prospective Investigation into Cancer and nutrition cohort (EPIC-CVD) from eight European countries. 32 549 participants without baseline CVD, comprised of incident CVD cases and a subcohort for comparison. Non-fatal and fatal CHD and stroke (including ischaemic and haemorrhagic stroke). There were 9307 non-fatal CHD events, 1699 fatal CHD, 5855 non-fatal stroke, and 733 fatal stroke. Baseline alcohol intake was inversely associated with non-fatal CHD, with a hazard ratio of 0.94 (95% confidence interval 0.92 to 0.96) per 12 g/day higher intake. There was a J shaped association between baseline alcohol intake and risk of fatal CHD. The hazard ratios were 0.83 (0.70 to 0.98), 0.65 (0.53 to 0.81), and 0.82 (0.65 to 1.03) for categories 5.0-14.9 g/day, 15.0-29.9 g/day, and 30.0-59.9 g/day of total alcohol intake, respectively, compared with 0.1-4.9 g/day. In contrast, hazard ratios for non-fatal and fatal stroke risk were 1.04 (1.02 to 1.07), and 1.05 (0.98 to 1.13) per 12 g/day increase in baseline alcohol intake, respectively, including broadly similar findings for ischaemic and haemorrhagic stroke. Associations with cardiovascular outcomes were broadly similar with average lifetime alcohol consumption as for baseline alcohol intake, and across the eight countries studied. There was no strong evidence for interactions of alcohol consumption with smoking status on the risk of CVD events. Alcohol intake was inversely associated with non-fatal CHD risk but positively associated with the risk of different stroke subtypes. This highlights the opposing associations of alcohol intake with different CVD types and strengthens the evidence for policies to reduce alcohol consumption. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Causes of fatal accidents for instrument-certified and non-certified private pilots.

PubMed

Shao, Bob Siyuan; Guindani, Michele; Boyd, Douglas D

2014-11-01

Instrument certification (IFR) enhances a pilot's skills in precisely controlling the aircraft and requires a higher level of standards in maintaining heading and altitude compared with the less stringent private pilot certificate. However, there have been no prior studies to compare fatal accident causes for airmen with, and without, this rating, The NTSB accident database was queried for general aviation fatal accidents for private pilots with, and without IFR certification. Exact Poisson tests were used to calculate whether two rate parameters were equal (ratio of 1), normalized to the number of IFR-rated pilots and flight hours in the given time period. Proportion tests were used to determine whether there were significant differences in fatal accident causes between IFR-certified and non-certified pilots. A logistic regression for log-odds success was used in determining the trend and effect of age on fatal accident rates. IFR certification was associated with a reduced risk of accidents due to failure to maintain obstacle/terrain clearance and spatial disorientation for day and night operations respectively. In contrast, the likelihood of fatal accident due to equipment malfunction during day operations was higher for IFR-certified pilots. The fatal accident rate decreased over the last decade for IFR-certified but not for non-IFR-certified private pilots. However, the overall accident rate for IFR-certified private pilots was more than double that of the cohort lacking this certification. Finally, we found a trend for an increased fatality rate with advancing age for both group of pilots. Our findings informs on where training and/or technology should be focused. Both training for aerodynamic stalls, which causes over a quarter of all fatal accidents, should be intensified for both IFR-certified and non-certified private pilots. Similarly, adherence to minimum safe altitudes for both groups of pilots should be encouraged toward reducing the fatal accidents rate due to failure to maintain obstacle/terrain clearance. For night operations, the high percentage of accidents due to spatial disorientation for non-IFR certified airmen suggests that additional training be required for such operations or such flights carry restrictions for this subset of pilots. Copyright © 2014 Elsevier Ltd. All rights reserved.

Hantavirus pulmonary syndrome.

PubMed

Macneil, Adam; Nichol, Stuart T; Spiropoulou, Christina F

2011-12-01

Hantavirus pulmonary syndrome (HPS) is a severe disease characterized by a rapid onset of pulmonary edema followed by respiratory failure and cardiogenic shock. The HPS associated viruses are members of the genus Hantavirus, family Bunyaviridae. Hantaviruses have a worldwide distribution and are broadly split into the New World hantaviruses, which includes those causing HPS, and the Old World hantaviruses [including the prototype Hantaan virus (HTNV)], which are associated with a different disease, hemorrhagic fever with renal syndrome (HFRS). Sin Nombre virus (SNV) and Andes virus (ANDV) are the most common causes of HPS in North and South America, respectively. Case fatality of HPS is approximately 40%. Pathogenic New World hantaviruses infect the lung microvascular endothelium without causing any virus induced cytopathic effect. However, virus infection results in microvascular leakage, which is the hallmark of HPS. This article briefly reviews the knowledge on HPS-associated hantaviruses accumulated since their discovery, less than 20 years ago. Published by Elsevier B.V.

Encephalitis Surveillance through the Emerging Infections Program, 1997–2010

PubMed Central

Glaser, Carol A.

2015-01-01

Encephalitis is a devastating illness that commonly causes neurologic disability and has a case fatality rate >5% in the United States. An etiologic agent is identified in <50% of cases, making diagnosis challenging. The Centers for Disease Control and Prevention Emerging Infections Program (EIP) Encephalitis Project established syndromic surveillance for encephalitis in New York, California, and Tennessee, with the primary goal of increased identification of causative agents and secondary goals of improvements in treatment and outcome. The project represents the largest cohort of patients with encephalitis studied to date and has influenced case definition and diagnostic evaluation of this condition. Results of this project have provided insight into well-established causal pathogens and identified newer causes of infectious and autoimmune encephalitis. The recognition of a possible relationship between enterovirus D68 and acute flaccid paralysis with myelitis underscores the need for ongoing vigilance for emerging causes of neurologic disease. PMID:26295485

Leishmaniasis: a review.

PubMed

Torres-Guerrero, Edoardo; Quintanilla-Cedillo, Marco Romano; Ruiz-Esmenjaud, Julieta; Arenas, Roberto

2017-01-01

Leishmaniasis is caused by an intracellular parasite transmitted to humans by the bite of a sand fly. It is endemic in Asia, Africa, the Americas, and the Mediterranean region. Worldwide, 1.5 to 2 million new cases occur each year, 350 million are at risk of acquiring the disease, and leishmaniasis causes 70,000 deaths per year. Clinical features depend on the species of Leishmania involved and the immune response of the host. Manifestations range from the localized cutaneous to the visceral form with potentially fatal outcomes. Many drugs are used in its treatment, but the only effective treatment is achieved with current pentavalent antimonials.

Leishmaniasis: a review

PubMed Central

Torres-Guerrero, Edoardo; Quintanilla-Cedillo, Marco Romano; Ruiz-Esmenjaud, Julieta; Arenas, Roberto

2017-01-01

Leishmaniasis is caused by an intracellular parasite transmitted to humans by the bite of a sand fly. It is endemic in Asia, Africa, the Americas, and the Mediterranean region. Worldwide, 1.5 to 2 million new cases occur each year, 350 million are at risk of acquiring the disease, and leishmaniasis causes 70,000 deaths per year. Clinical features depend on the species of Leishmania involved and the immune response of the host. Manifestations range from the localized cutaneous to the visceral form with potentially fatal outcomes. Many drugs are used in its treatment, but the only effective treatment is achieved with current pentavalent antimonials. PMID:28649370

Ocular Manifestations of Ebola Virus Disease: An Ophthalmologist's Guide to Prevent Infection and Panic

PubMed Central

Vingolo, Enzo Maria; Messano, Giuseppe Alessio; Fragiotta, Serena; Petti, Stefano

2015-01-01

Ebola virus disease (EVD—formerly known as Ebola hemorrhagic fever) is a severe hemorrhagic fever caused by lipid-enveloped, nonsegmented, negative-stranded RNA viruses belonging to the genus Ebolavirus. Case fatality rates may reach up to 76% of infected individuals, making this infection a deadly health problem in the sub-Saharan population. At the moment, there are still no indications on ophthalmological clinical signs and security suggestions for healthcare professionals (doctors and nurses or cooperative persons). This paper provides a short but complete guide to reduce infection risks. PMID:26557674

Paracoccidioidomycosis.

PubMed

Ramos-E-Silva, Marcia; Saraiva, Luciana do Espirito Santo

2008-04-01

Paracoccidioidomycosis is a fungal infection that is relatively common in Brazil, Venezuela, Colombia, Ecuador, and Argentina. Sporadic cases can also be seen in some other countries. It is caused by a dimorphic fungus, Paracoccidioides brasiliensis, which affects mainly the skin, lymph nodes, lungs, and oral, nasal, and gastrointestinal mucous membranes. Depending on the specific immunity of the host, the infection can assume many forms and affect single or multiple organs, eventually becoming a severe and even fatal disease. It is very important for dermatologists of all over the world to know about paracoccidioidomycosis because sometimes the disease only manifests many years after the individual has left the endemic area.

Cost-effectiveness analysis of applying the Cholesterol and Recurrent Events (CARE) study protocol in Hong Kong.

PubMed

Chau, J; Cheung, B M; McGhee, S M; Lauder, I J; Lau, C P; Kumana, C R

2001-12-01

To determine the cost-effectiveness of secondary prevention with pravastatin in Hong Kong patients with coronary heart disease and average cholesterol levels. Cost-effectiveness analysis based on published results of the CARE study. Men and women post-myocardial infarction with average cholesterol levels. Cost-effectiveness analysis: cost per life saved, cost per fatal or non-fatal coronary event prevented, cost per procedure prevented, and cost per fatal or non-fatal stroke prevented. Cost-utility analysis: gross cost and net cost per quality-adjusted life year gained calculated using two alternative models. Cost per life saved or death prevented was HK$4,442,350 (non-discounted); cost per fatal or non-fatal cardiac event prevented HK$1,146,413; cost per procedure prevented HK$732,759; and cost per fatal or non-fatal stroke prevented HK$2,961,566. Net cost per quality adjusted life year gained was HK$73,218 and HK$65,280 non-discounted, respectively using the two alternative models. The results of this study can assist in prioritising the use of health care resources in Hong Kong but should be considered alongside the benefits and costs of alternative interventions for coronary heart disease.

The Role of Alcohol Consumption in the Aetiology of Different Cardiovascular Disease Phenotypes: a CALIBER Study

ClinicalTrials.gov

2013-05-28

Chronic Stable Angina; Unstable Angina; Coronary Heart Disease Not Otherwise Specified; Acute Myocardial Infarction; Heart Failure; Ventricular Arrhythmias; Cardiac Arrest; Abdominal Aortic Aneurysm; Peripheral Arterial Disease; Ischaemic Stroke; Subarachnoid Haemorrhagic Stroke; Intracerebral Haemorrhagic Stroke; Stroke Not Otherwise Specified; Sudden Cardiac Death; Unheralded Coronary Death; Mortality; Coronary Heart Disease (CHD); Cardiovascular Disease (CVD); Fatal Cardiovascular Disease (Fatal CVD); ST Elevation Myocardial Infarction (STEMI); Non-ST Elevation Myocardial Infarction (nSTEMI); Myocardial Infarction Not Otherwise Specified (MI NOS)

Hydro-geomorphologic disasters in Portugal: mortality trends in the past 150 years

NASA Astrophysics Data System (ADS)

Pereira, Susana; Zêzere, José L.; Quaresma, Ivânia; Santos, Pedro P.; Santos, Mónica

2015-04-01

For the first time in Portugal, an extensive analysis of the mortality caused by hydro-geomorphological hazards was made, for a long period (1865-2010) using the DISASTER database (Zêzere et al., 2014). This database was built under the assumption that social consequences (including fatalities) of floods and landslides are relevant enough to be reported by newspapers, which were the source for data collection. This database counts 1902 hydro-geomorphologic cases that caused 1248 fatalities, 14 191 evacuated persons and 41 844 homeless persons. Floods correspond to the majority of cases (85.2%) that caused 1012 fatalities. Landslides correspond to 14.8 % of the total hydro-geomorphologic cases and caused 236 fatalities. The exploitation of the DISASTER database allowed: (i) to analyze the frequency and the temporal evolution of fatal floods and landslides; (ii) to analyze the spatio-temporal distribution of fatalities; (iii) to identify the most deadly flood and landslide types; and (iv) to evaluate the individual and societal risk. The obtained results demonstrate the absence of any exponential growth with time of hydro-geomorphologic cases and associated fatalities in Portugal. The highest flood and landslide cases as well as the associated mortality were registered in the period 1935-1969. After this period, flood and landslide mortality decreased, although landslide fatalities remained higher than the registered in the period 1865-1934. These features do not account the exceptional flash flood event occurred in the Lisbon region in November 1967. This outlier event was responsible for 522 fatalities, which corresponds to more than half of the total mortality generated by floods in Portugal in the complete time series (1865 - 2010). Moreover, the 1967 flash flood event was the deadliest natural disaster registered in Portugal after the Lisbon earthquake occurred in 1755, not accounting heat waves. Flood fatalities occurred widespread in the country, with an important cluster in the Lisbon Region and in the Tagus valley, Oporto and Coimbra cities, where simultaneously, natural conditions are favorable to floods and a high number of people are exposed to flood hazard (e.g. residential buildings and economic activities installed in floodplains). The occurrence of landslide fatalities is mostly constrained in the north of the Tagus valley, where geologic and geomorphologic conditions are more landslide-prone than in the southern part of the country. Flash floods caused the majority of fatalities associated with floods, while falls and flows were responsible for the highest frequency of fatalities associated with landslides. The temporal evolution of flood fatalities reflects the implementation of territorial management policies and the improving of early warning systems for floods and the evacuation of people living in floodplain areas prior major flood events, in Portugal in the latest four decades. In the case of landslides, despite the improving in the quality of buildings construction, fatalities generated by landslides are still frequent because buildings are often located in hazardous slopes. In addition, so far no early warning system for landslide was implemented in Portugal. This research was supported by the Portuguese Foundation for Science and Technology (FCT). The first author is a Post-Doc fellow funded by FCT (SFRH/BPD/69002/2010).

Statistical Analysis to Assess Effectiveness of Rumble Stripes on Highway Safety

DOT National Transportation Integrated Search

2011-01-01

Although traffic deaths are caused by an array of factors, in the United States more than half of all roadway fatalities are caused by roadway departures [FHWA 2006]. In 2003, there were 25,562 roadway departure fatalities, accounting for 55 percent ...

Vaccine Development for Biothreat Alpha Viruses

DTIC Science & Technology

2011-09-25

gaviridae, are causative agents of debilitative, acute, and sometimes fatal encephalitis in North, Central, and South America [1]. These viruses are...and can be lyophilized. VEEV was tested as a biowarfare agent during the U.S. offensive program in the 1950’s and 1960’s, and may have been...MD 21702, USA Abstract The majority of alpha virus is non-pathogenic to humans. However, select alpha viruses can cause severe disease in humans

Fusarium proliferatum as an agent of disseminated infection in an immunosuppressed patient.

PubMed Central

Summerbell, R C; Richardson, S E; Kane, J

1988-01-01

Fusarium proliferatum was reported as the agent of a fatal disseminated infection in a child with lymphoblastic leukemia. The fungus has not been reported previously to cause disease in humans, but it is closely related to the known opportunistic pathogen F. verticillioides. It was distinguished by the production of clavate microconidia in chains from proliferating phialides. Resistance to amphotericin B and flucytosine in vitro was shown. Images PMID:3422646

65 mph speed limit : analysis of fatal accident injury severity

DOT National Transportation Integrated Search

1989-11-01

Several studies of the fatality experience in the 38 states that implemented a65 mph speed : limit on Rural Interstate highways in 1987 concluded that the higher speed limit has : caused fatalities to increase. This relationship between the speed lim...

Etiology of Sudden Cardiac Arrest in Patients with Epilepsy: Experience of Tertiary Referral Hospital in Sapporo City, Japan.

PubMed

Miyata, Kei; Ochi, Satoko; Enatsu, Rei; Wanibuchi, Masahiko; Mikuni, Nobuhiro; Inoue, Hiroyuki; Uemura, Shuji; Tanno, Katsuhiko; Narimatsu, Eichi; Maekawa, Kunihiko; Usui, Keiko; Mizobuchi, Masahiro

2016-05-15

It has been reported that epilepsy patients had higher risk of sudden death than that of the general population. However, in Japan, there is very little literature on the observational research conducted on sudden fatal events in epilepsy. We performed a single-center, retrospective study on all the out-of-hospital cardiac arrest (OHCA) patients treated in our emergency department between 2007 and 2013. Among the OHCA patients, we extracted those with a history of epilepsy and then analyzed the characteristics of the fatal events and the background of epilepsy. From 1,823 OHCA patients, a total of 10 cases were enrolled in our study. The median age was 34 years at the time of the incident [9-52 years; interquartile range (IQR), 24-45]. We determined that half of our cases resulted from external causes of death such as drowning and suffocation and the other half were classified as sudden unexpected death in epilepsy (SUDEP). In addition, asphyxia was implicated as the cause in eight cases. Only the two near-drowning patients were immediately resuscitated, but the remaining eight patients died. The median age of first onset of epilepsy was 12 years (0.5-30; IQR, 3-21), and the median disease duration was 25 years (4-38; IQR, 6-32). Patients with active epilepsy accounted for half of our series and they were undergoing poly anti-epileptic drug therapy. The fatal events related to epilepsy tended to occur in the younger adult by external causes. An appropriate therapeutic intervention and a thorough observation were needed for its prevention.

Quality of the record of data on fatal workplace injuries in Brazil

PubMed Central

Galdino, Adriana; Santana, Vilma Sousa; Ferrite, Silvia

2017-01-01

ABSTRACT OBJECTIVE To evaluate the quality of the data on fatal workplace injuries in Brazil, in the Mortality Information System (SIM) and the Information System of Notifiable Diseases (SINAN-AT), analyzing the spatial and temporal distribution between 2007 and 2012. METHODS We identified fields related to fatal workplace injuries, which were examined for completeness and the use of the “ignored” option. From the SIM, we extracted the records of deaths from external causes, which require the completing of the field about their relation with work. From the SINAN, we analyzed the field, which allows us to identify fatal cases among s severe workplace injuries. RESULTS In the SIM, from 469,121 records, the field was left unfilled or filled as ignored in 84.2% of them; the Brazilian region with the highest proportion was the Northeast (79.1%), from which the state of Alagoas (94.4%) had the highest amount. There was a 5.5% decreasing trend between 2007 (86.6%) and 2012 (81.8%). Among the 251,681 records found in the SINAN-AT, 28.3% had unfilled or ignored responses for , varying from 39.7% in 2007 to 23.2% in 2012, a 41.6% decrease. CONCLUSIONS The quality of the records on the fields of interest needed to identify fatal workplace injuries is poor in the SIM, but gradually improving. Recording quality was better for SINAN-AT, which has also been strongly getting better lately. PMID:29236875

Quality of the record of data on fatal workplace injuries in Brazil.

PubMed

Galdino, Adriana; Santana, Vilma Sousa; Ferrite, Silvia

2017-12-11

To evaluate the quality of the data on fatal workplace injuries in Brazil, in the Mortality Information System (SIM) and the Information System of Notifiable Diseases (SINAN-AT), analyzing the spatial and temporal distribution between 2007 and 2012. We identified fields related to fatal workplace injuries, which were examined for completeness and the use of the "ignored" option. From the SIM, we extracted the records of deaths from external causes, which require the completing of the field about their relation with work. From the SINAN, we analyzed the field, which allows us to identify fatal cases among s severe workplace injuries. In the SIM, from 469,121 records, the field was left unfilled or filled as ignored in 84.2% of them; the Brazilian region with the highest proportion was the Northeast (79.1%), from which the state of Alagoas (94.4%) had the highest amount. There was a 5.5% decreasing trend between 2007 (86.6%) and 2012 (81.8%). Among the 251,681 records found in the SINAN-AT, 28.3% had unfilled or ignored responses for , varying from 39.7% in 2007 to 23.2% in 2012, a 41.6% decrease. The quality of the records on the fields of interest needed to identify fatal workplace injuries is poor in the SIM, but gradually improving. Recording quality was better for SINAN-AT, which has also been strongly getting better lately.

Causes of Death Data in the Global Burden of Disease Estimates for Ischemic and Hemorrhagic Stroke.

PubMed

Truelsen, Thomas; Krarup, Lars-Henrik; Iversen, Helle K; Mensah, George A; Feigin, Valery L; Sposato, Luciano A; Naghavi, Mohsen

2015-01-01

Stroke mortality estimates in the Global Burden of Disease (GBD) study are based on routine mortality statistics and redistribution of ill-defined codes that cannot be a cause of death, the so-called 'garbage codes' (GCs). This study describes the contribution of these codes to stroke mortality estimates. All available mortality data were compiled and non-specific cause codes were redistributed based on literature review and statistical methods. Ill-defined codes were redistributed to their specific cause of disease by age, sex, country and year. The reassignment was done based on the International Classification of Diseases and the pathology behind each code by checking multiple causes of death and literature review. Unspecified stroke and primary and secondary hypertension are leading contributing 'GCs' to stroke mortality estimates for hemorrhagic stroke (HS) and ischemic stroke (IS). There were marked differences in the fraction of death assigned to IS and HS for unspecified stroke and hypertension between GBD regions and between age groups. A large proportion of stroke fatalities are derived from the redistribution of 'unspecified stroke' and 'hypertension' with marked regional differences. Future advancements in stroke certification, data collections and statistical analyses may improve the estimation of the global stroke burden. © 2015 S. Karger AG, Basel.

Causes of Death Data in the Global Burden of Disease Estimates for Ischemic and Hemorrhagic Stroke

PubMed Central

Truelsen, Thomas; Krarup, Lars-Henrik; Iversen, Helle; Mensah, George A.; Feigin, Valery; Sposato, Luciano; Naghavi, Mohsen

2015-01-01

Background Stroke mortality estimates in the Global Burden of Disease (GBD) study are based on routine mortality statistics and redistribution of ill-defined codes that cannot be a cause of death, the so-called “garbage codes”. This study describes the contribution of these codes to stroke mortality estimates. Methods All available mortality data were compiled and non-specific cause codes were redistributed based on literature review and statistical methods. Ill-defined codes were redistributed to their specific cause of disease by age, sex, country, and year. The reassignment was done based on the international classification of diseases and the pathology behind each code by checking multiple causes of death and literature review. Results Unspecified stroke, and primary and secondary hypertension are leading contributing “garbage codes” to stroke mortality estimates for intracranial hemorrhagic stroke and ischemic stroke. There were marked differences in the fraction of death assigned to ischemic stroke and hemorrhagic stroke for unspecified stroke and hypertension between GBD regions and between age groups. Conclusions A large proportion of stroke fatalities is derived from the redistribution of “unspecified stroke” and “hypertension” with marked regional differences. Future advancements in stroke certification, data collections, and statistical analyses may improve the estimation of the global stroke burden. PMID:26505189

Cytokine Profiles during Invasive Nontyphoidal Salmonella Disease Predict Outcome in African Children.

PubMed

Gilchrist, James J; Heath, Jennifer N; Msefula, Chisomo L; Gondwe, Esther N; Naranbhai, Vivek; Mandala, Wilson; MacLennan, Jenny M; Molyneux, Elizabeth M; Graham, Stephen M; Drayson, Mark T; Molyneux, Malcolm E; MacLennan, Calman A

2016-07-01

Nontyphoidal Salmonella is a leading cause of sepsis in African children. Cytokine responses are central to the pathophysiology of sepsis and predict sepsis outcome in other settings. In this study, we investigated cytokine responses to invasive nontyphoidal Salmonella (iNTS) disease in Malawian children. We determined serum concentrations of 48 cytokines with multiplexed immunoassays in Malawian children during acute iNTS disease (n = 111) and in convalescence (n = 77). Principal component analysis and logistic regression were used to identify cytokine signatures of acute iNTS disease. We further investigated whether these responses are altered by HIV coinfection or severe malnutrition and whether cytokine responses predict inpatient mortality. Cytokine changes in acute iNTS disease were associated with two distinct cytokine signatures. The first is characterized by increased concentrations of mediators known to be associated with macrophage function, and the second is characterized by raised pro- and anti-inflammatory cytokines typical of responses reported in sepsis secondary to diverse pathogens. These cytokine responses were largely unaltered by either severe malnutrition or HIV coinfection. Children with fatal disease had a distinctive cytokine profile, characterized by raised mediators known to be associated with neutrophil function. In conclusion, cytokine responses to acute iNTS infection in Malawian children are reflective of both the cytokine storm typical of sepsis secondary to diverse pathogens and the intramacrophage replicative niche of NTS. The cytokine profile predictive of fatal disease supports a key role of neutrophils in the pathogenesis of NTS sepsis. Copyright © 2016 Gilchrist et al.

Undocumented Immigration, Drug Problems, and Driving Under the Influence in the United States, 1990-2014.

PubMed

Light, Michael T; Miller, Ty; Kelly, Brian C

2017-09-01

To examine the influence of undocumented immigration in the United States on 4 different metrics of drug and alcohol problems: drug arrests, drug overdose fatalities, driving under the influence (DUI) arrests, and DUI deaths. We combined newly developed state-level estimates of the undocumented population between 1990 and 2014 from the Center for Migration Studies with arrest data from the Federal Bureau of Investigation Uniform Crime Reports and fatality information from the Fatality Analysis Reporting System and the Centers for Disease Control and Prevention Underlying Cause of Death database. We used fixed-effects regression models to examine the longitudinal association between increased undocumented immigration and drug problems and drunk driving. Increased undocumented immigration was significantly associated with reductions in drug arrests, drug overdose deaths, and DUI arrests, net of other factors. There was no significant relationship between increased undocumented immigration and DUI deaths. This study provides evidence that undocumented immigration has not increased the prevalence of drug or alcohol problems, but may be associated with reductions in these public health concerns.

Urban violence is the biggest cause of fatal work-related accidents in Brazil.

PubMed

Cordeiro, Ricardo; Luz, Verônica Gronau; Hennington, Élida Azevedo; Martins, Ana Cláudia Alves; Tófoli, Luís Fernando

2017-12-11

To quantify the occurrence of deaths directly associated with urban violence among fatal work-related accidents. Verbal autopsies were performed with the relatives and coworkers of residents of Campinas, state of São Paulo, Brazil, who died from external causes in 2015. We have also analyzed police reports and reports of the Legal Medical Institute related to these deaths. We have identified 82 fatal work-related accidents in Campinas in 2015, of which 25 were murders, 35 were traffic accidents not directly related to work activities, and three were suicides at work. The proportional mortality rate for homicides, traffic accidents, and suicides among fatal work-related accidents was estimated at 30.5%, 42.7%, and 3.7%, respectively. Urban violence accounted for three-fourths of the fatal work-related accidents recorded in the period studied.

Relevance of pharmacogenetic aspects of mercaptopurine metabolism in the treatment of interstitial lung disease.

PubMed

Bakker, Jaap A; Drent, Marjolein; Bierau, Jörgen

2007-09-01

Mercaptopurine therapy is increasingly important as immunosuppressive therapy in interstitial lung disease. We focus on human mercaptopurine metabolism and the defects in this metabolism causing adverse drug reactions. Defects in mercaptopurine metabolizing enzymes like thiopurine methyltransferase and inosine triphosphate pyrophosphohydrolase lead to severe adverse drug reactions, sometimes with fatal outcome. Other enzymes, still not thoroughly investigated, can give rise to toxic effects or decreased efficacy in mercaptopurine therapy when the activity of these enzymes is altered. Pharmacogenetic screening of potential patients for mercaptopurine therapy is important to avoid adverse drug reactions caused by inherited enzyme deficiencies in these metabolic pathways. Pretreatment screening for deficiencies of mercaptopurine metabolizing enzymes will significantly reduce the number of patients with an adverse drug reaction and concomitantly associated healthcare costs.

A review of the global epidemiology of scrub typhus.

PubMed

Xu, Guang; Walker, David H; Jupiter, Daniel; Melby, Peter C; Arcari, Christine M

2017-11-01

Scrub typhus is a serious public health problem in the Asia-Pacific area. It threatens one billion people globally, and causes illness in one million people each year. Caused by Orientia tsutsugamushi, scrub typhus can result in severe multiorgan failure with a case fatality rate up to 70% without appropriate treatment. The antigenic heterogeneity of O. tsutsugamushi precludes generic immunity and allows reinfection. As a neglected disease, there is still a large gap in our knowledge of the disease, as evidenced by the sporadic epidemiologic data and other related public health information regarding scrub typhus in its endemic areas. Our objective is to provide a systematic analysis of current epidemiology, prevention and control of scrub typhus in its long-standing endemic areas and recently recognized foci of infection.

A review of the global epidemiology of scrub typhus

PubMed Central

Xu, Guang; Jupiter, Daniel; Melby, Peter C.; Arcari, Christine M.

2017-01-01

Scrub typhus is a serious public health problem in the Asia-Pacific area. It threatens one billion people globally, and causes illness in one million people each year. Caused by Orientia tsutsugamushi, scrub typhus can result in severe multiorgan failure with a case fatality rate up to 70% without appropriate treatment. The antigenic heterogeneity of O. tsutsugamushi precludes generic immunity and allows reinfection. As a neglected disease, there is still a large gap in our knowledge of the disease, as evidenced by the sporadic epidemiologic data and other related public health information regarding scrub typhus in its endemic areas. Our objective is to provide a systematic analysis of current epidemiology, prevention and control of scrub typhus in its long-standing endemic areas and recently recognized foci of infection. PMID:29099844

Bordetella bronchiseptica and fatal pneumonia of dogs and cats

USDA-ARS?s Scientific Manuscript database

Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less well-studied. The objectives of this study were to identify the frequency of Bordetella bronchiseptica infection in fatal cases of bronchopneumonia in dogs and cats and to compare the diag...

Dynamic all-red extension at signalized intersection : probabilistic modeling and algorithm.

DOT National Transportation Integrated Search

2011-01-01

Red light running has been a major cause of intersection injuries and fatalities in the United : States. In 2004 alone, there were 8,619 fatal crashes and 848,000 crashes with people injured, all : caused by RLR. Under the U.S. Department of Transpor...

Mortality after hip fracture: regional variations in New Zealand.

PubMed

Walker, N; Norton, R; Vander Hoorn, S; Rodgers, A; MacMahon, S; Clark, T; Gray, H

1999-07-23

To determine the 35-day and one-year mortality rates following a hospital admission for hip fracture, among individuals aged 60 years or older in New Zealand. New Zealand Health Information Service mortality data for the years 1988 to 1992 were examined to determine the case fatality rate among individuals aged 60 years or older admitted to hospital for fractures of the neck of femur (ICD-9 N-code 820). Case fatality rates assessed at 35 days and one year after admission to hospital were examined by age, gender, year of admission, place of residence, area health board region and cause of death. Between 1988 and 1992, the case fatality rate was 8% within 35 days of admission to hospital and 24% within one year of admission. Case fatality rates were found to be twice as high in men compared to women and four to five times higher in individuals aged 85 years and older, compared to people aged between 60 and 64 years. The only regional difference in hip fracture mortality was found in the Canterbury area health board region, which had a 30% higher rate of hip fracture mortality compared to all regions combined. The two main cited underlying causes of death after hip fracture were accidental falls (ICD E880-E888) and ischaemic heart disease (ICD 410-414). Over three-quarters of individuals aged 60 years or older who are hospitalised with a hip fracture in New Zealand survive for at least one year after admission. However, significant variations in mortality exist with age and gender. These data highlight the importance of preventive strategies for hip fracture in older people and the need to identify ways of improving post-admission care.

GM2 Gangliosidosis Variant 0 (Sandhoff Disease) in a Mixed-Breed Dog.

PubMed

Kohyama, Moeko; Yabuki, Akira; Kawasaki, Yasuaki; Kawaguchi, Hiroaki; Miura, Naoki; Kitano, Yoshiaki; Onitsuka, Toshinori; Rahman, Mohammad Mahbubur; Miyoshi, Noriaki; Yamato, Osamu

2015-01-01

GM2 gangliosidosis variant 0 (Sandhoff disease, SD) is a fatal, progressive, neurodegenerative lysosomal storage disease caused by simultaneous deficiencies of acid β-hexosaminidases A and B. Canine SD has so far been identified only in two purebreeds. In this article, we present the case of a 10 mo old, male dog of mixed breed that developed progressive neurological signs including ataxia, postural deficit, and visual deficits and finally died at the age of 21 mo. The dog was diagnosed with SD on the basis of the results of biochemical and histopathological analyses. This is the third report of canine SD and the first time it has been identified in a mixed breed.

Yellow fever: a reemerging threat.

PubMed

Gardner, Christina L; Ryman, Kate D

2010-03-01

Yellow fever (YF) is a viral disease, endemic to tropical regions of Africa and the Americas, which principally affects humans and nonhuman primates and is transmitted via the bite of infected mosquitoes. Yellow fever virus (YFV) can cause devastating epidemics of potentially fatal, hemorrhagic disease. Despite mass vaccination campaigns to prevent and control these outbreaks, the risk of major YF epidemics, especially in densely populated, poor urban settings, both in Africa and South America, has greatly increased. Consequently, YF is considered an emerging, or reemerging disease of considerable importance. This article comprehensively reviews the history, microbiology, epidemiology, clinical presentation, diagnosis, and treatment of YFV, as well as the vaccines produced to combat YF. 2010 Elsevier Inc. All rights reserved.

A statistical analysis of the global historical volcanic fatalities record

USGS Publications Warehouse

Auker, Melanie Rose; Sparks, Robert Stephen John; Siebert, Lee; Crosweller, H. S.; Ewert, John W.

2013-01-01

A new database of volcanic fatalities is presented and analysed, covering the period 1600 to 2010 AD. Data are from four sources: the Smithsonian Institution, Witham (2005), CRED EM-DAT and Munich RE. The data were combined and formatted, with a weighted average fatality figure used where more than one source reports an event; the former two databases were weighted twice as strongly as the latter two. More fatal incidents are contained within our database than similar previous works; approximately 46% of the fatal incidents are listed in only one of the four sources, and fewer than 10% are in all four. 278,880 fatalities are recorded in the database, resultant from 533 fatal incidents. The fatality count is dominated by a handful of disasters, though the majority of fatal incidents have caused fewer than ten fatalities. Number and empirical probability of fatalities are broadly correlated with VEI, but are more strongly influenced by population density around volcanoes and the occurrence and extent of lahars (mudflows) and pyroclastic density currents, which have caused 50% of fatalities. Indonesia, the Philippines, and the West Indies dominate the spatial distribution of fatalities, and there is some negative correlation between regional development and number of fatalities. With the largest disasters removed, over 90% of fatalities occurred between 5 km and 30 km from volcanoes, though the most devastating eruptions impacted far beyond these distances. A new measure, the Volcano Fatality Index, is defined to explore temporal changes in societal vulnerability to volcanic hazards. The measure incorporates population growth and recording improvements with the fatality data, and shows prima facie evidence that vulnerability to volcanic hazards has fallen during the last two centuries. Results and interpretations are limited in scope by the underlying fatalities data, which are affected by under-recording, uncertainty, and bias. Attempts have been made to estimate the extent of these issues, and to remove their effects where possible.The data analysed here are provided as supplementary material. An updated version of the Smithsonian fatality database fully integrated with this database will be publicly available in the near future and subsequently incorporate new data.

Passive immunization with Leptospira LPS-specific agglutinating but not non-agglutinating monoclonal antibodies protect guinea pigs from fatal pulmonary hemorrhages induced by serovar Copenhageni challenge.

PubMed

Challa, Sreerupa; Nally, Jarlath E; Jones, Carroll; Sheoran, Abhineet S

2011-06-15

Leptospira interrogans serovar Copenhageni causes pulmonary hemorrhages with respiratory failure, a major cause of death in leptospirosis patients. Protective immunity to Leptospira is known to correlate with the production of leptospiral lipopolysaccharide (L-LPS)-specific agglutinating antibodies. We generated L-LPS-specific mouse monoclonal antibodies (MAbs) and investigated if these MAbs can protect guinea pigs against fatal pulmonary hemorrhages caused by serovar Copenhageni. The MAbs L8H4 and L9B11 against 22kDa L-LPS agglutinated leptospires and completely protected guinea pigs from the development of fatal pulmonary hemorrhages by serovar Copenhageni, whereas the MAb L4C1 against 8kDa L-LPS neither agglutinated the bacteria nor protected the animals against the fatal pulmonary hemorrhages. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Reduced number of fatal and life-threatening reactions to food. Reporting by the medical profession has resulted in effective measures].

PubMed

Foucard, Tony; Yman, Ingrid Malmheden; Nordvall, Lennart

The results from the Swedish system for reporting severe and fatal reactions caused by food for the period 1993-96 were published in Lakartidningen in 1997. We now report the results for the period 1997-2003. The number of fatal cases has decreased from 1.75 to 0.86 per year and the number of life-threatening cases from 3 to I per year. The most gratifying result was the large decrease in severe reactions caused by soy, from 3 deaths and 6 life-threatening cases during the first 4-year period to just one life-threatening case during the following 7-year period. This reduction is probably largely due to an increased awareness of identified risk persons, but also to a reduced use of soy protein. The ongoing study illustrates the usefulness of a national system for reporting severe and fatal reactions caused by food.

Opioid analgesics stop the development of clostridial gas gangrene.

PubMed

Chakravorty, Anjana; Awad, Milena M; Hiscox, Thomas J; Cheung, Jackie K; Choo, Jocelyn M; Lyras, Dena; Rood, Julian I

2014-08-01

Gas gangrene is a potentially fatal disease that is primarily caused by the ubiquitous, anaerobic bacteria Clostridium perfringens and Clostridium septicum. Treatment is limited to antibiotic therapy, debridement of the infected tissue, and, in severe cases, amputation. The need for new treatment approaches is compelling. Opioid-based analgesics such as buprenorphine and morphine also have immunomodulatory properties, usually leading to faster disease progression. However, here we show that mice pretreated with buprenorphine and morphine do not die from clostridial myonecrosis. Treatment with buprenorphine after the onset of infection also arrested disease development. Protection against myonecrotic disease was specific to C. perfringens-mediated myonecrosis; buprenorphine did not protect against disease caused by C. septicum infection even though infections due to both species are very similar. These data provide the first evidence of a protective role for opioids during infection and suggest that new therapeutic strategies may be possible for the treatment of C. perfringens-mediated myonecrosis. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Exploring Anti-Prion Glyco-Based and Aromatic Scaffolds: A Chemical Strategy for the Quality of Life.

PubMed

Blázquez-Sánchez, María Teresa; de Matos, Ana M; Rauter, Amélia P

2017-05-24

Prion diseases are fatal neurodegenerative disorders caused by protein misfolding and aggregation, affecting the brain progressively and consequently the quality of life. Alzheimer's is also a protein misfolding disease, causing dementia in over 40 million people worldwide. There are no therapeutics able to cure these diseases. Cellular prion protein is a high-affinity binding partner of amyloid β (Aβ) oligomers, the most toxic species in Alzheimer's pathology. These findings motivate the development of new chemicals for a better understanding of the events involved. Disease control is far from being reached by the presently known therapeutics. In this review we describe the synthesis and mode of action of molecular entities with intervention in prion diseases' biological processes and, if known, their role in Alzheimer's. A diversity of structures is covered, based on glycans, steroids and terpenes, heterocycles, polyphenols, most of them embodying aromatics and a structural complexity. These molecules may be regarded as chemical tools to foster the understanding of the complex mechanisms involved, and to encourage the scientific community towards further developments for the cure of these devastating diseases.

Primary amebic meningoencephalitis due to Naegleria fowleri in a South American tapir.

PubMed

Lozano-Alarcón, F; Bradley, G A; Houser, B S; Visvesvara, G S

1997-05-01

Naegleria fowleri, Acanthamoeba spp., and Balamuthia mandrillaris are known to cause fatal central nervous system (CNS) disease in human beings. N. fowleri causes acute, fulminating primary amebic meningoencephalitis (PAM), which generally leads to death within 10 days. Acanthamoeba spp. and B. mandrillaris cause chronic granulomatous amebic encephalitis, which may last for 8 weeks. Acanthamoeba spp. and B. mandrillaris also cause CNS disease in animals. N. fowleri, however, has been described only in human beings. This report is the first of PAM in an animal, a South American tapir. Dry cough, lethargy, and coma developed in the animal, and its condition progressed to death. At necropsy, lesions were seen in the cerebrum, cerebellum, and lungs. The CNS had severe, suppurative meningoencephalitis with many neutrophils, fibrin, plasma cells, and amebas. Amebas were 6.5 microns to 9 microns in diameter and had a nucleus containing a large nucleolus. Amebas in the sections reacted with a monoclonal antibody specific for N. fowleri in the immunofluorescent assay and appeared bright green.

Evaluation of poly-drug use in methadone-related fatalities using segmental hair analysis.

PubMed

Nielsen, Marie Katrine Klose; Johansen, Sys Stybe; Linnet, Kristian

2015-03-01

In Denmark, fatal poisoning among drug addicts is often related to methadone. The primary mechanism contributing to fatal methadone overdose is respiratory depression. Concurrent use of other central nervous system (CNS) depressants is suggested to heighten the potential for fatal methadone toxicity. Reduced tolerance due to a short-time abstinence period is also proposed to determine a risk for fatal overdose. The primary aims of this study were to investigate if concurrent use of CNS depressants or reduced tolerance were significant risk factors in methadone-related fatalities using segmental hair analysis. The study included 99 methadone-related fatalities collected in Denmark from 2008 to 2011, where both blood and hair were available. The cases were divided into three subgroups based on the cause of death; methadone poisoning (N=64), poly-drug poisoning (N=28) or methadone poisoning combined with fatal diseases (N=7). No significant differences between methadone concentrations in the subgroups were obtained in both blood and hair. The methadone blood concentrations were highly variable (0.015-5.3, median: 0.52mg/kg) and mainly within the concentration range detected in living methadone users. In hair, methadone was detected in 97 fatalities with concentrations ranging from 0.061 to 211ng/mg (median: 11ng/mg). In the remaining two cases, methadone was detected in blood but absent in hair specimens, suggesting that these two subjects were methadone-naive users. Extensive poly-drug use was observed in all three subgroups, both recently and within the last months prior to death. Especially, concurrent use of multiple benzodiazepines was prevalent among the deceased followed by the abuse of morphine, codeine, amphetamine, cannabis, cocaine and ethanol. By including quantitative segmental hair analysis, additional information on poly-drug use was obtained. Especially, 6-acetylmorphine was detected more frequently in hair specimens, indicating that regular abuse of heroin was common among the deceased. In conclusion, continuous exposure of methadone provide by segmental hair analysis suggested that reduced tolerance of methadone was not a critical factor among methadone-related fatalities. In contrast, a high abundance of co-ingested CNS depressants suggested that adverse effects from drug-drug interactions were more important risk factors for fatal outcome in these deaths. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Occupational fatalities in Jordan.

PubMed

Al-Abdallat, Emad M; Oqailan, Ahmad Mohammad A; Al Ali, Rayyan; Hudaib, Arwa A; Salameh, Ghada A M

2015-01-01

Occupational fatalities are a worldwide problem. Certain occupations pose a greater risk than others. Recent statistics on global occupational injuries and diseases that might lead to temporary or permanent disability and even worse might lead to death, are staggering. The purpose of this study was to estimate the death rates from occupational injuries in Jordan over a period of four years; to estimate occupational fatality rate that results from accidental injuries and identify the most risky concurrent occupations with the type of injuries, the age and nationality of the victims. A total of 88 work related fatalities were admitted to three hospitals in Amman through 2008-2012 and were examined by a forensic (occupational) physician at the time. They were categorized according to, age, nationality, occupation, type of injury and were all tested for toxic substances. The occupation with the most fatalities was construction (44%); falling from a height was the commonest type of accident (44%) and head injuries were the leading injury type (21.6%); 9.1% of the deaths were positive for alcohol. Moreover, 22.7% of deaths were between ages of 25-29. Consequently, the mean occupational fatality rate was 2 per 100.000 workers during 2008-2012. Constructions and other types of occupations are more extensive problems than what is usually anticipated, especially when safety precautions are not effective or implemented. They may cause injuries and death, which will have a socioeconomic burden on families, society, governments and industries. Not to mention the grief that is associated with the death of a worker at his work site to all concerned parties. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Hantavirus pulmonary syndrome, Southern Chile, 1995-2012.

PubMed

Riquelme, Raúl; Rioseco, María Luisa; Bastidas, Lorena; Trincado, Daniela; Riquelme, Mauricio; Loyola, Hugo; Valdivieso, Francisca

2015-04-01

Hantavirus is endemic to the Region de Los Lagos in southern Chile; its incidence is 8.5 times higher in the communes of the Andean area than in the rest of the region. We analyzed the epidemiologic aspects of the 103 cases diagnosed by serology and the clinical aspects of 80 hospitalized patients during 1995-2012. Cases in this region clearly predominated during winter, whereas in the rest of the country, they occur mostly during summer. Mild, moderate, and severe disease was observed, and the case-fatality rate was 32%. Shock caused death in 75% of those cases; high respiratory frequency and elevated creatinine plasma level were independent factors associated with death. Early clinical suspicion, especially in rural areas, should prompt urgent transfer to a hospital with an intensive care unit and might help decrease the high case-fatality rate.

Fatal Neonatal Herpes Simplex Infection Likely from Unrecognized Breast Lesions.

PubMed

Field, Scott S

2016-02-01

Type 1 herpes simplex virus (HSV-1) is very prevalent yet in rare circumstances can lead to fatal neonatal disease. Genital acquisition of type 2 HSV is the usual mode for neonatal herpes, but HSV-1 transmission by genital or extragenital means may result in greater mortality rates. A very rare scenario is presented in which the mode of transmission was likely through breast lesions. The lesions were seen by nurses as well as the lactation consultant and obstetrician in the hospital after delivery of the affected baby but not recognized as possibly being caused by herpes. The baby died 9 days after birth with hepatic failure and disseminated intravascular coagulation. Peripartum health care workers need to be aware of potential nongenital (including from the breast[s]) neonatal herpes acquisition, which can be lethal. © The Author(s) 2015.

Hantavirus Pulmonary Syndrome , Southern Chile, 1995–2012

PubMed Central

Riquelme, Raúl; Rioseco, María Luisa; Bastidas, Lorena; Trincado, Daniela; Riquelme, Mauricio; Loyola, Hugo; Valdivieso, Francisca

2015-01-01

Hantavirus is endemic to the Region de Los Lagos in southern Chile; its incidence is 8.5 times higher in the communes of the Andean area than in the rest of the region. We analyzed the epidemiologic aspects of the 103 cases diagnosed by serology and the clinical aspects of 80 hospitalized patients during 1995–2012. Cases in this region clearly predominated during winter, whereas in the rest of the country, they occur mostly during summer. Mild, moderate, and severe disease was observed, and the case-fatality rate was 32%. Shock caused death in 75% of those cases; high respiratory frequency and elevated creatinine plasma level were independent factors associated with death. Early clinical suspicion, especially in rural areas, should prompt urgent transfer to a hospital with an intensive care unit and might help decrease the high case-fatality rate. PMID:25816116

Fatal injuries among urban children in South Africa: risk distribution and potential for reduction

PubMed Central

van Niekerk, Ashley; Laflamme, Lucie

2010-01-01

Abstract Objective To determine the leading causes of fatal injury for urban South African children aged 0–14 years, the distribution of those causes and the current potential for safety improvements. Methods We obtained injury surveillance data from the National Injury Mortality Surveillance System 2001–2003 for six major South African cities varying in size, development and sociodemographic composition. We calculated age-adjusted rates, by sex, population group and city, for death from the five leading causes of fatal injury as well as population attributable risks (PARs). Findings The leading causes of fatal injury in childhood included road traffic injuries – among vehicle passengers and especially among pedestrians – drowning, burns and, in some cities, firearm injuries. Large differences in PARs were observed, particularly for population groups and cities. Disparities between cities and between population groups were largest for deaths from pedestrian injuries, while differences between boys and girls were greatest for drowning deaths. Conclusion In the face of the high variability observed between cities and population groups in the rates of the most common types of fatal injuries, a safety agenda should combine safety-for-all countermeasures – i.e. lowering injury rates for all – and targeted countermeasures that help reduce the burden for those at greatest risk. PMID:20431790

The state of the residential fire fatality problem in Sweden: Epidemiology, risk factors, and event typologies.

PubMed

Jonsson, Anders; Bonander, Carl; Nilson, Finn; Huss, Fredrik

2017-09-01

Residential fires represent the largest category of fatal fires in Sweden. The purpose of this study was to describe the epidemiology of fatal residential fires in Sweden and to identify clusters of events. Data was collected from a database that combines information on fatal fires with data from forensic examinations and the Swedish Cause of Death-register. Mortality rates were calculated for different strata using population statistics and rescue service turnout reports. Cluster analysis was performed using multiple correspondence analysis with agglomerative hierarchical clustering. Male sex, old age, smoking, and alcohol were identified as risk factors, and the most common primary injury diagnosis was exposure to toxic gases. Compared to non-fatal fires, fatal residential fires more often originated in the bedroom, were more often caused by smoking, and were more likely to occur at night. Six clusters were identified. The first two clusters were both smoking-related, but were separated into (1) fatalities that often involved elderly people, usually female, whose clothes were ignited (17% of the sample), (2) middle-aged (45-64years old), (often) intoxicated men, where the fire usually originated in furniture (30%). Other clusters that were identified in the analysis were related to (3) fires caused by technical fault, started in electrical installations in single houses (13%), (4) cooking appliances left on (8%), (5) events with unknown cause, room and object of origin (25%), and (6) deliberately set fires (7%). Fatal residential fires were unevenly distributed in the Swedish population. To further reduce the incidence of fire mortality, specialized prevention efforts that focus on the different needs of each cluster are required. Cooperation between various societal functions, e.g. rescue services, elderly care, psychiatric clinics and other social services, with an application of both human and technological interventions, should reduce residential fire mortality in Sweden. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study.

PubMed

Notara, Venetia; Panagiotakos, Demosthenes B; Kogias, Yannis; Stravopodis, Petros; Antonoulas, Antonis; Zombolos, Spyros; Mantas, Yannis; Pitsavos, Christos

2016-07-01

The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated. From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient's educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years). Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed. A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.

Mouse-adapted MERS coronavirus causes lethal lung disease in human DPP4 knockin mice.

PubMed

Li, Kun; Wohlford-Lenane, Christine L; Channappanavar, Rudragouda; Park, Jung-Eun; Earnest, James T; Bair, Thomas B; Bates, Amber M; Brogden, Kim A; Flaherty, Heather A; Gallagher, Tom; Meyerholz, David K; Perlman, Stanley; McCray, Paul B

2017-04-11

The Middle East respiratory syndrome (MERS) emerged in Saudi Arabia in 2012, caused by a zoonotically transmitted coronavirus (CoV). Over 1,900 cases have been reported to date, with ∼36% fatality rate. Lack of autopsies from MERS cases has hindered understanding of MERS-CoV pathogenesis. A small animal model that develops progressive pulmonary manifestations when infected with MERS-CoV would advance the field. As mice are restricted to infection at the level of DPP4, the MERS-CoV receptor, we generated mice with humanized exons 10-12 of the mouse Dpp4 locus. Upon inoculation with MERS-CoV, human DPP4 knockin (KI) mice supported virus replication in the lungs, but developed no illness. After 30 serial passages through the lungs of KI mice, a mouse-adapted virus emerged (MERS MA ) that grew in lungs to over 100 times higher titers than the starting virus. A plaque-purified MERS MA clone caused weight loss and fatal infection. Virus antigen was observed in airway epithelia, pneumocytes, and macrophages. Pathologic findings included diffuse alveolar damage with pulmonary edema and hyaline membrane formation associated with accumulation of activated inflammatory monocyte-macrophages and neutrophils in the lungs. Relative to the parental MERS-CoV, MERS MA viruses contained 13-22 mutations, including several within the spike (S) glycoprotein gene. S-protein mutations sensitized viruses to entry-activating serine proteases and conferred more rapid entry kinetics. Recombinant MERS MA bearing mutant S proteins were more virulent than the parental virus in hDPP4 KI mice. The hDPP4 KI mouse and the MERS MA provide tools to investigate disease causes and develop new therapies.

Reported fatal and non-fatal incidents involving tourists in Hawaii Volcanoes National Park, 1992-2002.

PubMed

Heggie, Travis W

2005-08-01

Objectives. To examine fatal and non-fatal incidents involving tourists in Hawaii Volcanoes National Park. Methods. Official press releases from the public relations office at Hawaii Volcanoes National Park were examined for reports of fatal and non-fatal incidents involving tourists. Results. Between 1992 and 2002 there were 65 press releases reporting 40 fatalities, 45 serious injuries, 53 minor injuries, and 25 no injury events. Severity information was unavailable for four additional tourists. Aircraft and backcountry incidents each accounted for 30% of all incidents followed by road incidents (22%) and frontcountry incidents (17%). Aircraft incidents reported 17 fatalities, backcountry incidents accounted for 10 fatalities, frontcountry incidents reported seven fatalities, and road incidents totaled six fatalities. One fatality was classified as a suicide. Backcountry (23) and road (10) incidents had the highest number of serious incidents. Male tourists (62) were more frequently involved in incidents than female tourists (41) and tourists aged 20-29 years and 40-49 years accounted for the highest number of fatalities and total incidents. Conclusions. Helicopter tours, hiking in areas with active lava flows, falls into steam vents and earthcracks, and driving unfamiliar rental cars in unfamiliar locations are the major activities resulting in death and serious injury. Additional factors such as tourists ignoring warning signs, wandering off-trail or hiking at night, tourists misinformed by guidebooks and other tourists, and tourists with pre-existing heart and asthma conditions are contributing causes in many incidents. The findings of this study provide information that allows prospective tourists, tourism managers, and travel health providers make informed decisions that promote safe tourism and can aid future efforts in developing preventative strategies at tourist destinations with similar environments and activities. However, in order for preventative strategies to be most effective, future research using medical or emergency response records and employing an injury epidemiology framework that identifies the cause of fatal and non-fatal injuries is recommended.

Obesity is associated with fatal coronary heart disease independently of traditional risk factors and deprivation.

PubMed

Logue, Jennifer; Murray, Heather M; Welsh, Paul; Shepherd, James; Packard, Chris; Macfarlane, Peter; Cobbe, Stuart; Ford, Ian; Sattar, Naveed

2011-04-01

The effect of body mass index (BMI) on coronary heart disease (CHD) risk is attenuated when mediators of this risk (such as diabetes, hypertension and hyperlipidaemia) are accounted for. However, there is now evidence of a differential effect of risk factors on fatal and non-fatal CHD events, with markers of inflammation more strongly associated with fatal than non-fatal events. To describe the association with BMI separately for both fatal and non-fatal CHD risk after accounting for classical risk factors and to assess any independent effects of obesity on CHD risk. In the West of Scotland Coronary Prevention Study BMI in 6082 men (mean age 55 years) with hypercholesterolaemia, but no history of diabetes or CVD, was related to the risk of fatal and non-fatal CHD events. After excluding participants with any event in the first 2 years, 1027 non-fatal and 214 fatal CHD events occurred during 14.7 years of follow-up. A minimally adjusted model (age, sex, statin treatment) and a maximally adjusted model (including known CVD risk factors and deprivation) were compared, with BMI 25-27.4 kg/m² as referent. The risk of non-fatal events was similar across all BMI categories in both models. The risk of fatal CHD events was increased in men with BMI 30.0-39.9 kg/m² in both the minimally adjusted model (HR = 1.75 (95% CI 1.12 to 2.74)) and the maximally adjusted model (HR = 1.60 (95% CI 1.02 to 2.53)). These hypothesis generating data suggest that obesity is associated with fatal, but not non-fatal, CHD after accounting for known cardiovascular risk factors and deprivation. Clinical trial registration WOSCOPS was carried out and completed before the requirement for clinical trial registration.

Baylisascaris Larva Migrans

USGS Publications Warehouse

Kazacos, Kevin R.; Abbott, Rachel C.; van Riper, Charles

2016-05-26

SummaryBaylisascaris procyonis, the common raccoon roundworm, is the most commonly recognized cause of clinical larva migrans (LM) in animals, a condition in which an immature parasitic worm or larva migrates in a host animal’s tissues, causing obvious disease. Infection with B. procyonis is best known as a cause of fatal or severe neurologic disease that results when the larvae invade the brain, the spinal cord, or both; this condition is known as neural larva migrans (NLM). Baylisascariasis is a zoonotic disease, that is, one that is transmissible from animals to humans. In humans, B. procyonis can cause damaging visceral (VLM), ocular (OLM), and neural larva migrans. Due to the ubiquity of infected raccoons around humans, there is considerable human exposure and risk of infection with this parasite. The remarkable disease-producing capability of B. procyonis in animals and humans is one of the most significant aspects of the biology of ascarids (large roundworms) to come to light in recent years. Infection with B. procyonis has important health implications for a wide variety of free-ranging and captive wildlife, zoo animals, domestic animals, as well as human beings, on both an individual and population level. This report, eighth in the series of U.S. Geological Survey Circulars on zoonotic diseases, will help us to better understand the routes of Baylisascaris procyonis infections and how best to adequately monitor this zoonotic disease.

A fatal infection caused by sequence type 398 methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin gene: A case report in Japan.

PubMed

Koyama, Hiroshi; Sanui, Masamitsu; Saga, Tomoo; Harada, Sohei; Ishii, Yoshikazu; Tateda, Kazuhiro; Lefor, Alan Kawarai

2015-07-01

Methicillin-resistant Staphylococcus aureus (MRSA) has now been recognized as a common pathogen in the community. Sequence type (ST) 398 MRSA is generally considered as an emerging zoonotic agent spreading among livestock and personnel who have direct contact with animals, mainly in Europe. A 37-year-old Chinese woman receiving steroid therapy for systemic lupus erythematosus with general fatigue and myalgia was brought to the emergency department in critical condition. Her condition deteriorated despite aggressive management and she died on day 7. Her blood culture revealed ST398 MRSA-SCCmec V with Panton-Valentine Leukocidin (PVL) gene. This is the first case report of a fatal infection caused by this lineage. According to the results of molecular analyses, the isolate from this particular patient's blood was genetically close to a lineage detected in China, and is less likely to be related to an animal-associated lineage. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Rapid Laboratory Identification of Neisseria meningitidis Serogroup C as the Cause of an Outbreak - Liberia, 2017.

PubMed

Patel, Jaymin C; George, Josiah; Vuong, Jeni; Potts, Caelin C; Bozio, Catherine; Clark, Thomas A; Thomas, Jerry; Schier, Joshua; Chang, Arthur; Waller, Jessica L; Diaz, Maureen H; Whaley, Melissa; Jenkins, Laurel T; Fuller, Serena; Williams, Desmond E; Redd, John T; Arthur, Ray R; Taweh, Fahn; Vera Walker, Yatta; Hardy, Patrick; Freeman, Maxwell; Katawera, Victoria; Gwesa, Gulu; Gbanya, Miatta Z; Clement, Peter; Kohar, Henry; Stone, Mardia; Fallah, Mosoka; Nyenswah, Tolbert; Winchell, Jonas M; Wang, Xin; McNamara, Lucy A; Dokubo, E Kainne; Fox, LeAnne M

2017-10-27

On April 25, 2017, a cluster of unexplained illness and deaths among persons who had attended a funeral during April 21-22 was reported in Sinoe County, Liberia (1). Using a broad initial case definition, 31 cases were identified, including 13 (42%) deaths. Twenty-seven cases were from Sinoe County (1), and two cases each were from Grand Bassa and Monsterrado counties, respectively. On May 5, 2017, initial multipathogen testing of specimens from four fatal cases using the Taqman Array Card (TAC) assay identified Neisseria meningitidis in all specimens. Subsequent testing using direct real-time polymerase chain reaction (PCR) confirmed N. meningitidis in 14 (58%) of 24 patients with available specimens and identified N. meningitidis serogroup C (NmC) in 13 (54%) patients. N. meningitidis was detected in specimens from 11 of the 13 patients who died; no specimens were available from the other two fatal cases. On May 16, 2017, the National Public Health Institute of Liberia and the Ministry of Health of Liberia issued a press release confirming serogroup C meningococcal disease as the cause of this outbreak in Liberia.

Zoonotic Infection with Pigeon Paramyxovirus Type 1 linked to Fatal Pneumonia.

PubMed

Kuiken, Thijs; Breitbart, Mya; Beer, Martin; Grund, Christian; Höper, Dirk; van den Hoogen, Bernadette; Kerkhoffs, Jean-Louis H; Kroes, Aloys C M; Rosario, Karyna; van Run, Peter; Schwarz, Matthias; Svraka, Sanela; Teifke, Jens; Koopmans, Marion

2018-01-24

The characteristics and risk factors of pigeon paramyxovirus type 1 (PPMV-1) infection in humans are poorly known. We performed virological, pathological and epidemiological analyses of a Dutch case, and compared the results with those of a US case. Both infections occurred in transplant patients under immunosuppressive therapy and caused fatal respiratory failure. Both virus isolates clustered with avian paramyxovirus type 1 (APMV-1) genotype VIb/1, which has pigeons and doves as reservoir. Experimentally inoculated pigeons became infected and transmitted the virus to naïve pigeons. Likely route of transmission to both patients was direct or indirect contact with infected pigeons or doves. Given the large populations of feral pigeons with endemic PPMV-1 infection in cities, increasing urbanisation and a higher proportion of immunocompromised individuals, the risk of severe human PPMV-1 infections may increase. We recommend to test for APMV-1, including PPMV-1, in respiratory disease cases where common respiratory pathogens cannot be identified. © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

[Severe Legionella micdadei pneumonia effectively treated with hemofiltration therapy].

PubMed

Matsubara, S; Akashi, S; Naitoh, K; Nakahara, Y; Hayashi, S

1998-10-01

A 42-year-old man was admitted because of fever, productive cough, and progressive dyspnea. Chest x-ray films and computed tomographic scans disclosed dense consolidation in the left and right lung fields. No pathogenic agent was found despite extensive bacteriological examinations. Based on serological findings, the patient was given a diagnosis of acute pneumonia caused by Legionella micdadei. It has been reported that Legionnaire's disease is easily complicated by fatal systemic illnesses such as disseminated intravascular coagulation (DIC) and multiple organ failure. In fact, the patient suffered from severe hypotension and DIC on admission. Treatments against systemic complications were started together with intravenous administration of antibiotics including erythromycin. Continuous intravenous cathecolamin, however, failed to alleviate the patient's shock. We therefore applied endotoxin eliminating therapy using a polymyxin-B-column (PMX) and continuous hemofiltration (CHF). The patient recovered from critical shock immediately after the start of PMX, which together with CHF, alleviated his systemic complications. Although the factors responsible for fatal systemic complications in Legionnare's disease are not well-documented, our findings suggested that some substances removable by PMX and CHF play an important role in pathogenesis.

Management of Depression in Patients with Coronary Heart Disease: Association, Mechanisms, and Treatment Implications for Depressed Cardiac Patients

PubMed Central

Wang, Jenny T.; Hoffman, Benson; Blumenthal, James A.

2010-01-01

Importance of the field Coronary heart disease (CHD) and depression are two leading causes of death and disability in the United States and worldwide. Depression is especially common in cardiac patients, and there is growing evidence that depression is a risk factor for fatal and non-fatal events in CHD patients. Areas covered in this review This paper reviews current literature of depression as a risk factor for CHD along with pharmacologic and non-pharmacologic treatments for depression in cardiac patients. What the reader will gain Readers will gain knowledge about the importance of depression as a CHD risk factor and learn the results of efforts to treat depressed CHD patients. Take home message Although randomized clinical trials (RCTs) of medication and non-pharmacologic therapies have not demonstrated that treating depression improves survival, there is evidence that treating depressed patients can reduce depressive symptoms and improve quality of life. Additional RCTs are needed, including evaluation of non-pharmacologic therapies such as exercise, to examine the effects of treatment of depression on medical and psychosocial outcomes. PMID:20715885

Urban violence is the biggest cause of fatal work-related accidents in Brazil

PubMed Central

Cordeiro, Ricardo; Luz, Verônica Gronau; Hennington, Élida Azevedo; Martins, Ana Cláudia Alves; Tófoli, Luís Fernando

2017-01-01

ABSTRACT OBJECTIVE To quantify the occurrence of deaths directly associated with urban violence among fatal work-related accidents. METHODS Verbal autopsies were performed with the relatives and coworkers of residents of Campinas, state of São Paulo, Brazil, who died from external causes in 2015. We have also analyzed police reports and reports of the Legal Medical Institute related to these deaths. RESULTS We have identified 82 fatal work-related accidents in Campinas in 2015, of which 25 were murders, 35 were traffic accidents not directly related to work activities, and three were suicides at work. The proportional mortality rate for homicides, traffic accidents, and suicides among fatal work-related accidents was estimated at 30.5%, 42.7%, and 3.7%, respectively. CONCLUSIONS Urban violence accounted for three-fourths of the fatal work-related accidents recorded in the period studied. PMID:29236880

Fatal injuries caused by logs rolling off trucks: Kentucky 1994-1998.

PubMed

Struttmann, T W; Scheerer, A L

2001-02-01

Logging is one of the most hazardous occupations and fatality rates are consistently among the highest of all industries. A review of fatalities caused by logs rolling off trucks is presented. The Kentucky Fatality Assessment and Control Evaluation Project is a statewide surveillance system for occupational fatalities. Investigations are conducted on selected injuries with an emphasis on prevention strategy development. Logging was an area of high priority for case investigation. During 1994-1998, we identified seven incidents in which a worker was killed by a log rolling off a truck at a sawmill, accounting for 15% of the 45 deaths related to logging activities. These cases were reviewed to identify similar characteristics and risk factors. Investigations led to recommendations for behavioral, administrative, and engineering controls. Potential interventions include limiting load height on trucks, installing unloading cages at sawmills and prohibiting overloaded trucks on public roadways. Copyright 2001 Wiley-Liss, Inc.

Cilia-associated bacteria in fatal Bordetella bronchiseptica pneumonia of dogs and cats

USDA-ARS?s Scientific Manuscript database

Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less well-studied. The objectives of this study were to identify the frequency of Bordetella bronchiseptica infection in fatal cases of bronchopneumonia in dogs and cats and to compare the diag...

Construction equipment and motor vehicle related injuries on construction sites in Turkey.

PubMed

Gürcanli, G Emre; Müngen, Ugur; Akad, Murat

2008-08-01

Research on occupational accidents on construction sites in Turkey is very few. Moreover, research on motor vehicle and equipment accidents also do not exist. Investigation in the scope of this study shows that after falls and contact with electricity, accidents involving heavy equipment and motor vehicles rank third and fourth, respectively. This study aims to reveal the characteristics of these types of accidents, deduct the prominent causes that lead to fatalities as well as permanent disabilities using the present data. With the aid of obtained results, recommendations are made for safety experts on how to derive data from insufficient sources in Turkey and to evaluate these data for prevention and mitigation of the risks that construction workers are exposed to. 168 fatal and 38 non-fatal traffic accident-caused incidents as well as 206 fatal and 97 non-fatal construction equipment accidents, which were selected from official statistics and expert reports, were taken into consideration. Analysis and classification of these accidents were done according to the way they happened, the type of construction site and the occupation of the victims. Moreover, the leading causes of fatal and non-fatal injuries, to which drivers, operators and co-operators are exposed, are presented. Critical findings concerning prominent ways of occurrence, type of construction work and occupation are presented; and a number of measures for reducing the present risks are suggested. Some approaches for analysing relevant data are proposed for further research.

Fatal occupational injuries in the Malaysian construction sector–causes and accidental agents

NASA Astrophysics Data System (ADS)

Ayob, A.; Shaari, A. A.; Zaki, M. F. M.; Munaaim, M. A. C.

2018-04-01

The construction sector is associated with various accidents and fatal injuries. These occupational accidents are caused by numerous factors, such as lack of supervision; lack of adherence to safe work technique; failure to wear personal protective equipment; and failure to comply with the safe use of tools, vehicles, and machines. Using 2013–2016 secondary data from the Department of Occupational Safety and Health and Social Security Organization, this study conducted a descriptive exploration survey to identify common fatal occupational injuries associated with the Malaysian construction sector, as well as their causes and accidental agents. Results indicated that construction, followed by manufacturing, agriculture, forestry, logging, and fishery, are the riskiest job sectors in Malaysia. The highest incidences of occupational casualties were reported in Sarawak, Johor, and Selangor. These states accounted for approximately 13.33% to 18.18% of all cases of fatal occupational accidents. In these states, the lack of safety and health regulations and poor execution of risk management increased the risk of occupational accidents. Falls from heights accounted for 46.28% of fatal occupational injuries. Furthermore, being crushed by objects, materials, or vehicles accounted for 9.09% to 17.36% of fatal occupational injuries. Substandard work environment and transportation and lifting equipment, such as scaffolds, are primary accidental agents. Results of this study could enhance the knowledge and awareness of construction workers and management of job-related injuries to decrease the incidence of fatal occupational accidents.

Hypothyroidism and myxedema coma.

PubMed

Finora, Kevin; Greco, Deborah

2007-01-01

Hypothyroidism is a common endocrinopathy in dogs but is rare in cats. Lymphocytic thyroiditis and idiopathic thyroid atrophy are common causes of this condition. Specific thyroid function tests, in conjunction with clinical signs and physical examination findings, are used to help confirm a diagnosis of hypothyroidism. This disease can be managed with synthetic hormone supplementation and has an excellent prognosis. Myxedema coma is a rare and potentially fatal manifestation of severe hypothyroidism that can be successfully treated using intravenous levothyroxine.

Assessing Disease and Mortality among Small Cetaceans Stranded at a World Heritage Site in Southern Brazil

PubMed Central

Domiciano, Isabela G.; Domit, Camila; Broadhurst, Matt K.; Koch, Mariana S.; Bracarense, Ana Paula F. R. L.

2016-01-01

Cetaceans are considered environmental sentinels and their health often reflects either anthropogenic or natural spatio-temporal disturbances. This study investigated the pathological findings and mortality of small cetaceans with the aim of detecting hazards and monitoring health trends in a high-biodiversity area. Between 2007 and 2012, 218 stranded cetaceans were recorded on the Paraná coast, southern Brazil. Fifty-seven (26.1%) of these animals, including 50 Sotalia guianensis, 2 Pontoporia blainvillei, 2 Stenella frontalis, 1 Stenella longirostris, 1 Tursiops truncatus and 1 Globicephala melas were necropsied and samples were collected for histopathology. Causes of death were determined in 46 of the 57 (80.7%) animals and most (30 or 65.2%) were ascribed to anthropogenic activities, including fisheries bycatch (28/30) and trauma (2/30). The remaining 16 fatalities were considered natural, and attributed to pneumonia (10/16), emaciation (3/16), septicemia (1/16), neonatal pathology (1/16) and choking via food obstruction (1/16). Irrespective of the cause, bronchointerstitial pneumonia, associated with parasitism, lymphadenitis and membranous glomerulonephritis were common findings among all fatalities. These results suggest, that while anthropogenic activities are a leading cause of cetacean strandings in Paraná, underlying pre-existing diseases may contribute towards deaths. Although the studied area is considered a biosphere reserve by UNESCO, complex anthropogenic and natural interactions might be occurring, increasing cetacean susceptibility to hazards. This study may help facilitate developing an effective conservation plan for coastal cetaceans focusing on reducing fisheries interactions, habitat degradation and pollution as mechanisms for ultimately increasing species resilience. PMID:26871703

Rebound effect of modern drugs: serious adverse event unknown by health professionals.

PubMed

Teixeira, Marcus Zulian

2013-01-01

Supported in the Hippocratic aphorism primum non nocere, the bioethical principle of non-maleficence pray that the medical act cause the least damage or injury to the health of the patient, leaving it to the doctor to assess the risks of a particular therapy through knowledge of possible adverse events of drugs. Among these, the rebound effect represents a common side effect to numerous classes of modern drugs, may cause serious and fatal disorders in patients. This review aims to clarify the health professionals on clinical and epidemiological aspects of rebound phenomenon. A qualitative, exploratory and bibliographic review was held in the PubMed database using the keywords 'rebound', 'withdrawal', 'paradoxical', 'acetylsalicylic acid', 'anti-inflammatory', 'bronchodilator', 'antidepressant', 'statin', 'proton pump inhibitor' and 'bisphosphonate'. The rebound effect occurs after discontinuation of numerous classes of drugs that act contrary to the disease disorders, exacerbating them at levels above those prior to treatment. Regardless of the disease, the drug and duration of treatment, the phenomenon manifests itself in a small proportion of susceptible individuals. However, it may cause serious and fatal adverse events should be considered a public health problem in view of the enormous consumption of drugs by population. Bringing together a growing and unquestionable body of evidence, the physician needs to have knowledge of the consequences of the rebound effect and how to minimize it, increasing safety in the management of modern drugs. On the other hand, this rebound can be used in a curative way, broadening the spectrum of the modern therapeutics. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

Cause and Prevention of Playground Injuries and Litigation; Case Studies.

ERIC Educational Resources Information Center

Frost, Joe L.; Sweeney, Theodora B.

This study examined 187 playground injuries and 13 fatalities that resulted in lawsuits between 1981 and 1995, taken from the files of two expert witnesses on playground safety who testified in the cases. The data are presented by geographic location, nature of injuries, cause of injuries/fatalities, playground equipment implicated, location of…

Risk of fatal industrial accidents and death from other external causes among asphalt workers

PubMed Central

Burstyn, I; Boffetta, P; Jarvholm, B; Partanen, T; Svane, O; Langard, S; Kauppinen, T; Stucker, I; Shaham, J; Heederik, D; Ahrens, W; Bergdahl, I; Cenee, S; Hooiveld, M; Randem, B; Johansen, C; Ferro, G; Kromhout, H

2004-01-01

Overall, no evidence was found supporting the hypothesis that asphalt workers are at increased risk of fatal industrial or road accidents. Mortality from other external causes did not increase in this population as a whole, but increased risks among short term workers deserve further attention. PMID:14691280

Fatal infection caused by a multiply resistant type 3 pneumococcus.

PubMed Central

Lawrenson, J B; Klugman, K P; Eidelman, J I; Wasas, A; Miller, S D; Lipman, J

1988-01-01

The most virulent pneumococcal serotype (type 3) has not to date been associated with multiple antimicrobial resistance. We report an unusual gastrointestinal presentation of fatal septicemia caused by a multiply resistant type 3 pneumococcus in a setting of increasing prevalence of multiple resistance, including resistance to erythromycin, clindamycin, and tetracycline. PMID:3170717

Detection of elephant endotheliotropic herpesvirus infection among healthy Asian elephants (Elephas maximus) in South India.

PubMed

Stanton, Jeffrey J; Nofs, Sally A; Zachariah, Arun; Kalaivannan, N; Ling, Paul D

2014-04-01

Elephant endotheliotropic herpesviruses (EEHVs) can cause fatal hemorrhagic disease in Asian (Elephas maximus) and African (Loxodonta africana) elephants. Of the seven known EEHV species, EEHV1 is recognized as the most common cause of hemorrhagic disease among Asian elephants in human care worldwide. Recent data collected from ex situ Asian elephants located in multiple North American and European institutions suggest that subclinical EEHV1 infection is common in this population of elephants. Although fatal EEHV1-associated hemorrhagic disease has been reported in range countries, data are lacking regarding the prevalence of subclinical EEHV infections among in situ Asian elephants. We used previously validated EEHV-specific quantitative real-time PCR assays to detect subclinical EEHV infection in three regionally distinct Asian elephant cohorts, totaling 46 in situ elephants in South India, during October and November 2011. Using DNA prepared from trunk washes, we detected EEHV1, EEHV3/4, and EEHV5 at frequencies of 7, 9, and 20% respectively. None of the trunk washes was positive for EEHV2 or 6. At least one EEHV species was detectable in 35% (16/46) of the samples that were screened. These data suggest that subclinical EEHV infection among in situ Asian elephants occurs and that Asian elephants may be natural hosts for EEHV1, EEHV3 or 4, and EEHV5, but not EEHV2 and EEHV6. The methodology described in this study provides a foundation for further studies to determine prevalences of EEHV infection in Asian elephants throughout the world.

JC Polyomavirus Attachment, Entry, and Trafficking: Unlocking the Keys to a Fatal Infection

PubMed Central

Maginnis, Melissa S.; Nelson, Christian D.S.; Atwood, Walter J.

2014-01-01

The human JC polyomavirus (JCPyV) causes a lifelong persistent infection in the reno-urinary tract in the majority of the adult population worldwide. In healthy individuals infection is asymptomatic, while in immunocompromised individuals the virus can spread to the central nervous system and cause a fatal demyelinating disease known as progressive multifocal leukoencephalopathy (PML). There are currently very few treatment options for this rapidly progressing and devastating disease. Understanding the basic biology of JCPyV-host cell interactions is critical for the development of therapeutic strategies to prevent or treat PML. Research in our laboratory has focused on gaining a detailed mechanistic understanding of the initial steps in the JCPyV life cycle in order to define how JCPyV selectively targets cells in the kidney and brain. JCPyV requires sialic acids to attach to host cells and initiate infection, and JCPyV demonstrates specificity for the oligosaccharide lactoseries tetrasaccharide c (LSTc) with an α2,6-linked sialic acid. Following viral attachment, JCPyV entry is facilitated by the 5-hydroxytryptamine (5-HT)2 family of serotonin receptors via clathrin-dependent endocytosis. JCPyV then undergoes retrograde transport to the endoplasmic reticulum (ER) where viral disassembly begins. A novel retrograde transport inhibitor termed Retro-2cycl prevents trafficking of JCPyV to the ER and inhibits both initial virus infection and infectious spread in cell culture. Understanding the molecular mechanisms by which JCPyV establishes infection will open up new avenues for the prevention or treatment of virus-induced disease. PMID:25078361

The Italian Register of Cardiovascular Diseases: Attack Rates and Case Fatality for Cerebrovascular Events

PubMed Central

Palmieri, L.; Barchielli, A.; Cesana, G.; de Campora, E.; Goldoni, C.A.; Spolaore, P.; Uguccioni, M.; Vancheri, F.; Vanuzzo, D.; Ciccarelli, P.; Giampaoli, S.

2007-01-01

Background The Italian register of cardiovascular diseases is a surveillance system of fatal and nonfatal cardiovascular events in the general population aged 35–74 years. It was launched in Italy at the end of the 1990s with the aim of estimating periodically the occurrence and case fatality rate of coronary and cerebrovascular events in the different geographical areas of the country. This paper presents data for cerebrovascular events. Methods Currentevents were assessed through record linkage between two sources of information: death certificates and hospital discharge diagnosis records. Events were identified through the ICD codes and duration. To calculate the number of estimated events, current events were multiplied by the positive predictive value of each specific mortality or discharge code derived from the validation of a sample of suspected events. Attack rates were calculated by dividing estimatedevents by resident population, and case fatality rate at 28 days was determined from the ratio of estimated fatal to total events. Results Attack rates were found to be higher in men than in women: mean age-standardized attack rate was 21.9/10,000 in men and 12.5/10,000 in women; age-standardized 28-day case fatality rate was higher in women (17.1%) than in men (14.5%). Significant geographical differences were found in attack rates of both men and women. Case fatality was significantly heterogeneous in both men and women. Conclusions Differences still exist in the geographical distribution of attack and case fatality rates of cerebrovascular events, regardless of the north-south gradient. These data show the feasibility of implementing a population-based register using a validated routine database, necessary for monitoring cardiovascular diseases. PMID:17971632

Prion 2005: Between Fundamentals and Society's Needs.

PubMed

Treiber, Carina

2006-01-25

Prion diseases for the most part affect individuals older than 60 years of age and share features with other diseases characterized by protein deposits in the brain, such as Alzheimer's disease and Parkinson's disease. The international conference "Prion 2005: Between Fundamentals and Society's Needs," organized by the German Transmissible Spongiform Encephalopathies Research Platform, aimed to integrate and coordinate the research efforts of participants to better achieve prevention, treatment, control, and management of prion diseases, including Creutzfeldt-Jakob disease and fatal familial insomnia in humans. Several main topics were discussed, such as the molecular characteristics of prion strains, the cell biology of cellular and pathogenic forms of the prion proteins, the pathogenesis of the diseases they cause, emerging problems, and promising approaches for therapy and new diagnostic tools. The presentations at the Prion 2005 conference provided new insights in both basic and applied research, which will have broad implications for society's needs.

Cytokine response signatures in disease progression and development of severe clinical outcomes for leptospirosis.

PubMed

Reis, Eliana A G; Hagan, José E; Ribeiro, Guilherme S; Teixeira-Carvalho, Andrea; Martins-Filho, Olindo A; Montgomery, Ruth R; Shaw, Albert C; Ko, Albert I; Reis, Mitermayer G

2013-01-01

The role of the immune response in influencing leptospirosis clinical outcomes is not yet well understood. We hypothesized that acute-phase serum cytokine responses may play a role in disease progression, risk for death, and severe pulmonary hemorrhage syndrome (SPHS). We performed a case-control study design to compare cytokine profiles in patients with mild and severe forms of leptospirosis. Among patients hospitalized with severe disease, we compared those with fatal and nonfatal outcomes. During active outpatient and hospital-based surveillance we prospectively enrolled 172 patients, 23 with mild disease (outpatient) and 149 with severe leptospirosis (hospitalized). Circulating concentrations of pro- and anti-inflammatory cytokines at the time of patient presentation were measured using a multiplex bead array assay. Concentrations of IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-17A, and TNF-α were significantly higher (P<0.05) in severe disease compared to mild disease. Among severe patients, levels of IL-6 (P<0.001), IL-8 (P = 0.0049) and IL-10 (P<0.001), were higher in fatal compared to non-fatal cases. High levels of IL-6 and IL-10 were independently associated (P<0.05) with case fatality after adjustment for age and days of symptoms. IL-6 levels were higher (P = 0.0519) among fatal cases who developed SPHS than among who did not. This study shows that severe cases of leptospirosis are differentiated from mild disease by a "cytokine storm" process, and that IL-6 and IL-10 may play an immunopathogenic role in the development of life-threatening outcomes in human leptospirosis.

Mucosal Herpes Immunity and Immunopathology to Ocular and Genital Herpes Simplex Virus Infections

PubMed Central

Chentoufi, Aziz Alami; BenMohamed, Lbachir

2012-01-01

Herpes simplex viruses type 1 and type 2 (HSV-1 and HSV-2) are amongst the most common human infectious viral pathogens capable of causing serious clinical diseases at every stage of life, from fatal disseminated disease in newborns to cold sores genital ulcerations and blinding eye disease. Primary mucocutaneous infection with HSV-1 & HSV-2 is followed by a lifelong viral latency in the sensory ganglia. In the majority of cases, herpes infections are clinically asymptomatic. However, in symptomatic individuals, the latent HSV can spontaneously and frequently reactivate, reinfecting the muco-cutaneous surfaces and causing painful recurrent diseases. The innate and adaptive mucosal immunities to herpes infections and disease remain to be fully characterized. The understanding of innate and adaptive immune mechanisms operating at muco-cutaneous surfaces is fundamental to the design of next-generation herpes vaccines. In this paper, the phenotypic and functional properties of innate and adaptive mucosal immune cells, their role in antiherpes immunity, and immunopathology are reviewed. The progress and limitations in developing a safe and efficient mucosal herpes vaccine are discussed. PMID:23320014

Spontaneous retrotransposon insertion into TNF 3'UTR causes heart valve disease and chronic polyarthritis.

PubMed

Lacey, Derek; Hickey, Peter; Arhatari, Benedicta D; O'Reilly, Lorraine A; Rohrbeck, Leona; Kiriazis, Helen; Du, Xiao-Jun; Bouillet, Philippe

2015-08-04

Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic inflammatory diseases that together affect 2-3% of the population. RA and AS predominantly involve joints, but heart disease is also a common feature in RA and AS patients. Here we have studied a new spontaneous mutation that causes severe polyarthritis in bone phenotype spontaneous mutation 1 (BPSM1) mice. In addition to joint destruction, mutant mice also develop aortic root aneurism and aorto-mitral valve disease that can be fatal depending on the genetic background. The cause of the disease is the spontaneous insertion of a retrotransposon into the 3' untranslated region (3'UTR) of the tumor necrosis factor (TNF), which triggers its strong overexpression in myeloid cells. We found that several members of a family of RNA-binding, CCCH-containing zinc-finger proteins control TNF expression through its 3'UTR, and we identified a previously unidentified regulatory element in the UTR. The disease in BPSM1 mice is independent of the adaptive immune system and does not appear to involve inflammatory cytokines other than TNF. To our knowledge, this is the first animal model showing both polyarthritis and heart disease as a direct result of TNF deregulation. These results emphasize the therapeutic potential of anti-TNF drugs for the treatment of heart valve disease and identify potential therapeutic targets to control TNF expression and inflammation.

Common Primary and Secondary Causes of Headache in the Elderly.

PubMed

Sharma, Tara L

2018-03-01

Headache in the elderly, defined as individuals aged 65 and older, although less prevalent than younger individuals, can present as a diagnostic challenge, given the increase in potentially fatal diseases within this population. These individuals require a complete history, neurological examination, and assessment of potential secondary causes of headaches. Secondary causes include temporal or giant cell arteritis, subdural hematomas, central nervous system (CNS) tumors, strokes, and CNS infections. Once secondary conditions are ruled out, then primary causes of headache are considered such as tension-type headache, migraine, cluster headache, or hypnic headache. This article reviews the distinguishing characteristics of the most common types of headache in patients over the age of 65 years old, along with potential diagnostic tests and treatment. © 2018 American Headache Society.

Clostridium perfringens Epsilon Toxin: A Malevolent Molecule for Animals and Man?

PubMed Central

Stiles, Bradley G.; Barth, Gillian; Barth, Holger; Popoff, Michel R.

2013-01-01

Clostridium perfringens is a prolific, toxin-producing anaerobe causing multiple diseases in humans and animals. One of these toxins is epsilon, a 33 kDa protein produced by Clostridium perfringens (types B and D) that induces fatal enteric disease of goats, sheep and cattle. Epsilon toxin (Etx) belongs to the aerolysin-like toxin family. It contains three distinct domains, is proteolytically-activated and forms oligomeric pores on cell surfaces via a lipid raft-associated protein(s). Vaccination controls Etx-induced disease in the field. However, therapeutic measures are currently lacking. This review initially introduces C. perfringens toxins, subsequently focusing upon the Etx and its biochemistry, disease characteristics in various animals that include laboratory models (in vitro and in vivo), and finally control mechanisms (vaccines and therapeutics). PMID:24284826

Clostridium perfringens epsilon toxin: a malevolent molecule for animals and man?

PubMed

Stiles, Bradley G; Barth, Gillian; Barth, Holger; Popoff, Michel R

2013-11-12

Clostridium perfringens is a prolific, toxin-producing anaerobe causing multiple diseases in humans and animals. One of these toxins is epsilon, a 33 kDa protein produced by Clostridium perfringens (types B and D) that induces fatal enteric disease of goats, sheep and cattle. Epsilon toxin (Etx) belongs to the aerolysin-like toxin family. It contains three distinct domains, is proteolytically-activated and forms oligomeric pores on cell surfaces via a lipid raft-associated protein(s). Vaccination controls Etx-induced disease in the field. However, therapeutic measures are currently lacking. This review initially introduces C. perfringens toxins, subsequently focusing upon the Etx and its biochemistry, disease characteristics in various animals that include laboratory models (in vitro and in vivo), and finally control mechanisms (vaccines and therapeutics).

Typhlitis Caused by Intestinal Serpulina-Like Bacteria in Domestic Guinea Pigs (Cavia porcellus)

PubMed Central

Vanrobaeys, Mia; De Herdt, Peter; Ducatelle, Richard; Devriese, Luc A.; Charlier, Gerard; Haesebrouck, Freddy

1998-01-01

Between January 1992 and December 1996, Serpulina-like bacteria were demonstrated in intestinal tract lesions from 37 of 88 guinea pigs submitted to the University of Ghent in Ghent, Belgium, for necropsy because of disease and death from different unknown causes. All infected animals had a history of sudden death with minimal introductory clinical signs. Occasionally, they produced yellow, slimy feces or showed nervous signs, but the condition always had a fatal outcome within 24 h. When larger colonies of guinea pigs were involved, the disease spread very rapidly unless treatment with ronidazole was initiated. Lesions consisted of a catarrhal or hemorrhagic inflammation of the colon and cecum (typhlitis). Electron microscopy demonstrated the presence of large numbers of Serpulina-like organisms adhering to the cecal mucosae of these animals. Attempts to isolate the agents failed. The organisms did not stain by an immunofluorescence technique for the detection of Serpulina hyodysenteriae. The present data provide evidence that intestinal Serpulina-like organisms can be important as a cause of disease in guinea pigs. PMID:9508297

Concomitant coronary and pulmonary embolism associated with patent foramen ovale: A case report.

PubMed

Chen, Zhongxiu; Li, Chen; Li, Yajiao; Tang, Hong; Rao, Li; Wang, Mian

2017-12-01

The differential diagnosis of acute chest pain is very important, and can sometimes be challenging. Related diseases share a number of risk factors, and occasionally, 1 condition causes another disease to develop. We described a 59-year-old man who presented to emergency department complaining of chest pain. He was suffered acute myocardial infarction (MI) and pulmonary embolism (PE) simultaneously. Dual antiplatelet therapy, statin, and low molecular weight heparin were administrated during his stay. The searches for cancers, autoimmune diseases, and hematologic diseases were unremarkable, ruling out a hypercoagulable state. Subsequent ultrasound scan revealed a thrombus in a vein of the lower left extremity. Thus, paradoxical embolism was highly suspected. Paradoxical embolism is a rare cause of acute MI, which may have occurred in our patient. This was evidenced by a previously unrecognized patent foramen ovale (PFO) with a right-to-left atrial shunt detected using contrast transesophageal echocardiography. Acute MI complicated with PE is not common in the clinical setting. The fatal condition is difficult to diagnose because of the similar symptoms and confusing causes. Paradoxical embolism can cause this phenomenon, and physicians should be highly vigilant in the search for a PFO in cases of paradoxical embolism. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Snake fungal disease: an emerging threat to wild snakes.

PubMed

Lorch, Jeffrey M; Knowles, Susan; Lankton, Julia S; Michell, Kathy; Edwards, Jaime L; Kapfer, Joshua M; Staffen, Richard A; Wild, Erik R; Schmidt, Katie Z; Ballmann, Anne E; Blodgett, Doug; Farrell, Terence M; Glorioso, Brad M; Last, Lisa A; Price, Steven J; Schuler, Krysten L; Smith, Christopher E; Wellehan, James F X; Blehert, David S

2016-12-05

Since 2006, there has been a marked increase in the number of reports of severe and often fatal fungal skin infections in wild snakes in the eastern USA. The emerging condition, referred to as snake fungal disease (SFD), was initially documented in rattlesnakes, where the infections were believed to pose a risk to the viability of affected populations. The disease is caused by Ophidiomyces ophiodiicola, a fungus recently split from a complex of fungi long referred to as the Chrysosporium anamorph of Nannizziopsis vriesii (CANV). Here we review the current state of knowledge about O. ophiodiicola and SFD. In addition, we provide original findings which demonstrate that O. ophiodiicola is widely distributed in eastern North America, has a broad host range, is the predominant cause of fungal skin infections in wild snakes and often causes mild infections in snakes emerging from hibernation. This new information, together with what is already available in the scientific literature, advances our knowledge of the cause, pathogenesis and ecology of SFD. However, additional research is necessary to elucidate the factors driving the emergence of this disease and develop strategies to mitigate its impacts.This article is part of the themed issue 'Tackling emerging fungal threats to animal health, food security and ecosystem resilience'. © 2016 The Author(s).

Snake fungal disease: an emerging threat to wild snakes

PubMed Central

Lorch, Jeffrey M.; Knowles, Susan; Lankton, Julia S.; Michell, Kathy; Edwards, Jaime L.; Kapfer, Joshua M.; Staffen, Richard A.; Wild, Erik R.; Schmidt, Katie Z.; Ballmann, Anne E.; Blodgett, Doug; Farrell, Terence M.; Glorioso, Brad M.; Last, Lisa A.; Price, Steven J.; Schuler, Krysten L.; Smith, Christopher E.; Wellehan, James F. X.; Blehert, David S.

2016-01-01

Since 2006, there has been a marked increase in the number of reports of severe and often fatal fungal skin infections in wild snakes in the eastern USA. The emerging condition, referred to as snake fungal disease (SFD), was initially documented in rattlesnakes, where the infections were believed to pose a risk to the viability of affected populations. The disease is caused by Ophidiomyces ophiodiicola, a fungus recently split from a complex of fungi long referred to as the Chrysosporium anamorph of Nannizziopsis vriesii (CANV). Here we review the current state of knowledge about O. ophiodiicola and SFD. In addition, we provide original findings which demonstrate that O. ophiodiicola is widely distributed in eastern North America, has a broad host range, is the predominant cause of fungal skin infections in wild snakes and often causes mild infections in snakes emerging from hibernation. This new information, together with what is already available in the scientific literature, advances our knowledge of the cause, pathogenesis and ecology of SFD. However, additional research is necessary to elucidate the factors driving the emergence of this disease and develop strategies to mitigate its impacts. This article is part of the themed issue ‘Tackling emerging fungal threats to animal health, food security and ecosystem resilience’. PMID:28080983

Differences in combinations and concentrations of drugs of abuse in fatal intoxication and driving under the influence cases.

PubMed

Edvardsen, Hilde Erøy; Tverborgvik, Torill; Frost, Joachim; Rogde, Sidsel; Morild, Inge; Waal, Helge; Clausen, Thomas; Slørdal, Lars; Vindenes, Vigdis

2017-12-01

In toxicology, international classification systems focus on single intoxicants as the cause of death. It is, however, well known that very few drug related deaths are caused by a single substance and that information concerning the drug concentrations as well as the combinations of drugs are essential in order to ascertain the cause of death. The aim of the study was to assess whether those prone to fatal intoxications differ significantly from chronic drug users - in terms of demographics and drug exposure patterns. Fatal psychoactive drug intoxications in Norway during 2012, where a forensic autopsy including toxicological analysis were performed, were included. Analytical findings in blood were compared with concentrations in blood from apprehended drivers under the influence of drugs and ethanol (DUID) during the same time period. The opioid and benzodiazepine concentrations were assessed as morphine and diazepam equivalents, respectively, in order to compare concentrations across the different groups. A total of 194 autopsy cases and 4811 DUID cases were included. Opioids were detected in around 90% of the drug intoxication cases, but in only 16% of the DUID cases. The number of substances detected in fatal intoxications was 4.9 compared to 2.6 in the DUID cases. The total opioid concentrations were significantly higher in the fatal intoxication cases compared to DUID cases (229ng/mL versus 56.9ng/mL morphine equivalents, respectively). Benzodiazepines were detected in 90% of the fatal cases. Only one fatal opioid mono-intoxication was found; a case with a very high methadone concentration (1238ng/mL). Mono-intoxication with heroin was not seen in any of the fatal intoxications in Norway, and single drug intoxications were rare (1.5%). Fatal intoxications were caused by a combination of drugs with significantly more substances as well as higher total drug concentrations among the fatal cases compared to the DUID cases. The combination of opioids and benzodiazepines seemed to represent an increased risk of death. The total load of drugs influence the degree of intoxication and the total concentration level must be considered, including the total number of substances. Our findings imply that international statistics regarding an opioid being the main intoxicant should have a shift in focus towards combinations of drugs (especially opioids and benzodiazepines) as a major risk factor for fatal drug overdoses. Copyright © 2017 Elsevier B.V. All rights reserved.

Candida lusitaniae causing fatal meningitis.

PubMed Central

Sarma, P. S.; Durairaj, P.; Padhye, A. A.

1993-01-01

Fatal meningitis due to Candida lusitaniae in a 35 year old previously healthy man is described. C. lusitaniae is an opportunistic fungal pathogen reported infrequently in the English literature. This is the third case report of meningitis and the first fatal infection in an adult from Central India due to C. lusitaniae known to the authors. PMID:8290437

Risk factors of fatal occupational accidents in Iran.

PubMed

Asady, Hadi; Yaseri, Mehdi; Hosseini, Mostafa; Zarif-Yeganeh, Morvarid; Yousefifard, Mahmoud; Haghshenas, Mahin; Hajizadeh-Moghadam, Parisa

2018-01-01

Occupational accidents are of most important consequences of globalization in developing countries. Therefore, investigating the causes of occupational accidents for improving the job situation and making operational policy is necessary. So the aim of this study was to investigate factors affecting the fatal occupational accidents and also calculate the years of life lost for dead workers. This cross-sectional study was conducted on data related to the 6052 injured workers that was registered in the 2013 registry system of the Ministry of Health and Medical Education of Iran. Variables including sex, education, age, job tenure, injury cause, referred location of injured workers, occupation, shift work, season, accident day, damaged part of the body were chosen as independent variables. The Chi-squared and Fisher exact tests were used for univariate analysis and then exact multiple logistic regression was carried out to identify independent risk factors of fatal occupational accidents. Finally, for dead workers, years of life lost, according to the injury causes was calculated. Among the 6052 accidents reported, 33 deaths were recorded. Chi-square and Fisher exact tests showed that factors including: current job tenure ( p  = 0.01), damaged parts of the body ( p  < 0.001) and injury cause ( p  < 0.001) are associated with the fatal accidents. Also exact multiple logistic regression analysis showed a significant association between electric shocks as a cause of injury (OR = 7.04; 95% CI: 1.01-43.74; p  = 0.02) and current job tenure more than 1 year (OR = 0.21; 95% CI: 0.05-0.70; p  = 0.005) with the fatal accidents. The total amount of years of life lost based on causes of injuries was estimated 1289.12 years. In Iran, fatal accident odds in workers with job tenure more than 1 year was less in comparing to the workers with job tenure less and equal to 1 year. Also odd of death for electrical shock was more than other causes of injuries. So it seems that employing of workers who have more than one-year work experience in a specific job and using of appropriate safeguards will be useful for the reducing of fatal occupational accidents.

Anorectal Complications During Neutropenic Period in Patients with Hematologic Diseases

PubMed Central

Solmaz, Soner; Korur, Aslı; Gereklioğlu, Çiğdem; Asma, Süheyl; Büyükkurt, Nurhilal; Kasar, Mutlu; Yeral, Mahmut; Kozanoğlu, İlknur; Boğa, Can; Ozdoğu, Hakan

2016-01-01

Background Neutropenic patients are susceptible to any anorectal disease, and symptomatic anorectal disease afflicts 2–32% of oncology patients. Perianal infections are the most feared complication, considering the lack of natural defense against infectious microorganisms. When septic complications develop, the anorectal disease is potentially fatal, especially in neutropenic patients in whom mortality rates range between 11–57%. Although anorectal diseases are a frequent complication with potentially fatal outcomes among patients with hematologic diseases, sufficient data are not available in the literature. In this study, we aimed to investigate the anorectal complications developing during the neutropenic period in patients with hematologic diseases. Methods A total of 79 patients whose neutropenic period (absolute neutrophil count <500/mcL) continued for 7 days, or longer were included in the study. Results A total of 34 patients out of 79 (43%) were detected to develop anorectal complications, of them 6 (7.6%) developed an anorectal infection. The patients were characterized according to the hematological disease and its status (active or not), the type of treatment and the presence of a history of an anorectal pathology before the onset of the hematologic disease. Nineteen (24.1%) patients had the history of anorectal disturbances before diagnosis of the hematologic disease, and recurrence of an anorectal pathology was found in 14 out of 19 patients(73.7%). In addition, the overall mortality rate was higher among the patients who developed anorectal complications compared to another group (41.2% vs. 22.2%, p=0.059). Conclusion Anorectal pathology is a common complication with high recurrence rate in neutropenic patients. Perianal infections are important as they can cause life-threatening outcomes although they are relatively rare among all anorectal complications. Therefore perianal signs and symptoms should be meticulously evaluated concerning early diagnosis and treatment. PMID:26977278

Molecular mechanisms of cryptococcal meningitis

PubMed Central

Liu, Tong-Bao; Perlin, David; Xue, Chaoyang

2012-01-01

Fungal meningitis is a serious disease caused by a fungal infection of the central nervous system (CNS) mostly in individuals with immune system deficiencies. Fungal meningitis is often fatal without proper treatment, and the mortality rate remains unacceptably high even with antifungal drug interventions. Currently, cryptococcal meningitis is the most common fungal meningitis in HIV-1/AIDS, and its disease mechanism has been extensively studied. The key steps for fungi to infect brain and cause meningitis after establishment of local infection are the dissemination of fungal cells to the bloodstream and invasion through the blood brain barrier to reach the CNS. In this review, we use cryptococcal CNS infection as an example to describe the current molecular understanding of fungal meningitis, including the establishment of the infection, dissemination, and brain invasion. Host and microbial factors that contribute to these infection steps are also discussed. PMID:22460646

Recent Advances in Understanding Enteric Pathogenic Escherichia coli

PubMed Central

Croxen, Matthew A.; Law, Robyn J.; Scholz, Roland; Keeney, Kristie M.; Wlodarska, Marta

2013-01-01

SUMMARY Although Escherichia coli can be an innocuous resident of the gastrointestinal tract, it also has the pathogenic capacity to cause significant diarrheal and extraintestinal diseases. Pathogenic variants of E. coli (pathovars or pathotypes) cause much morbidity and mortality worldwide. Consequently, pathogenic E. coli is widely studied in humans, animals, food, and the environment. While there are many common features that these pathotypes employ to colonize the intestinal mucosa and cause disease, the course, onset, and complications vary significantly. Outbreaks are common in developed and developing countries, and they sometimes have fatal consequences. Many of these pathotypes are a major public health concern as they have low infectious doses and are transmitted through ubiquitous mediums, including food and water. The seriousness of pathogenic E. coli is exemplified by dedicated national and international surveillance programs that monitor and track outbreaks; unfortunately, this surveillance is often lacking in developing countries. While not all pathotypes carry the same public health profile, they all carry an enormous potential to cause disease and continue to present challenges to human health. This comprehensive review highlights recent advances in our understanding of the intestinal pathotypes of E. coli. PMID:24092857

Emerging infections: a perpetual challenge

PubMed Central

Morens, David M; Folkers, Gregory K; Fauci, Anthony S

2008-01-01

Emerging and re-emerging infectious diseases, and their determinants, have recently attracted substantial scientific and popular attention. HIV/AIDS, severe acute respiratory syndrome, H5N1 avian influenza, and many other emerging diseases have either proved fatal or caused international alarm. Common and interactive co-determinants of disease emergence, including population growth, travel, and environmental disruption, have been increasingly documented and studied. Are emerging infections a new phenomenon related to modern life, or do more basic determinants, transcending time, place, and human progress, govern disease generation? By examining a number of historically notable epidemics, we suggest that emerging diseases, similar in their novelty, impact, and elicitation of control responses, have occurred throughout recorded history. Fundamental determinants, typically acting in concert, seem to underlie their emergence, and infections such as these are likely to continue to remain challenges to human survival. PMID:18992407

[Clinical features and prognostic factors of meningococcal disease: a case series study in Chile during the 2012-2013 outbreak].

PubMed

Matute, Isabel; Olea, Andrea; López, Darío; Loayza, Sergio; Nájera, Manuel; González, Claudia; Poffald, Lucy; Hirmas, Macarena; Delgado, Iris; Pedroni, Elena; Alfaro, Tania; Gormaz, Ana María; Sanhueza, Gabriel; Vial, Pablo; Dabanch, Jeannette; Gallegos, Doris; Aguilera, Ximena

2015-10-01

Meningococcal disease (MD) is a major global problem because of its case fatality rate and sequels. Since 2012 cases of serogroup W have increased in Chile, with nonspecific clinical presentation, high case fatality rate and serious consequences. To characterize the evolution and outcome of MD cases between January 2012 and March 2013 in Chile. Case series considering 149 MD cases of 7 regions. A questionnaire was applied and clinical records were reviewed, including individual, agent, clinical course and healthcare process variables. The analysis allowed to obtain estimates of the OR as likelihood of dying. 51.5% was meningococcemia, the case fatality rate reached 27%, prevailing serogroup W (46.6%). Factors that increased the probability of dying: > age, belonging to indigenous people, having lived a stressful event, having diarrhea, impaired consciousness, cardiovascular symptoms, low oxygen saturation and low Glasgow coma scale score. The case fatality rate exceeded normal levels and was higher in serogroup W. Increasing in this serogroup, associated to the increased presence of nonspecific symptoms or rapid progression to septicemia, hit a health system accustomed to more classic meningococcal disease presentation, which could partly explain the observed increased fatality rate.

Bacterial bloodstream infections in a tertiary infectious diseases hospital in Northern Vietnam: aetiology, drug resistance, and treatment outcome.

PubMed

Dat, Vu Quoc; Vu, Hieu Ngoc; Nguyen The, Hung; Nguyen, Hoa Thi; Hoang, Long Bao; Vu Tien Viet, Dung; Bui, Chi Linh; Van Nguyen, Kinh; Nguyen, Trung Vu; Trinh, Dao Tuyet; Torre, Alessandro; van Doorn, H Rogier; Nadjm, Behzad; Wertheim, Heiman F L

2017-07-12

Bloodstream infections (BSIs) are associated with high morbidity and mortality worldwide. However their aetiology, antimicrobial susceptibilities and associated outcomes differ between developed and developing countries. Systematic data from Vietnam are scarce. Here we present aetiologic data on BSI in adults admitted to a large tertiary referral hospital for infectious diseases in Hanoi, Vietnam. A retrospective study was conducted at the National Hospital for Tropical Diseases between January 2011 and December 2013. Cases of BSI were determined from records in the microbiology department. Case records were obtained where possible and clinical findings, treatment and outcome were recorded. BSI were classified as community acquired if the blood sample was drawn ≤48 h after hospitalization or hospital acquired if >48 h. A total of 738 patients with BSI were included for microbiological analysis. The predominant pathogens were: Klebsiella pneumoniae (17.5%), Escherichia coli (17.3%), Staphylococcus aureus (14.9%), Stenotrophomonas maltophilia (9.6%) and Streptococcus suis (7.6%). The overall proportion of extended spectrum beta-lactamase (ESBL) production among Enterobacteriaceae was 25.1% (67/267 isolates) and of methicillin-resistance in S. aureus (MRSA) 37% (40/108). Clinical data was retrieved for 477 (64.6%) patients; median age was 48 years (IQR 36-60) with 27.7% female. The overall case fatality rate was 28.9% and the highest case fatality was associated with Enterobacteriaceae BSI (34.7%) which accounted for 61.6% of all BSI fatalities. Enterobacteriaceae (predominantly K. pneumoniae and E. coli) are the most common cause of both community and hospital acquired bloodstream infections in a tertiary referral clinic in northern Vietnam.

Interacting roles of immune mechanisms and viral load in the pathogenesis of crimean-congo hemorrhagic fever.

PubMed

Saksida, Ana; Duh, Darja; Wraber, Branka; Dedushaj, Isuf; Ahmeti, Salih; Avsic-Zupanc, Tatjana

2010-07-01

Until now, the pathogenesis of Crimean-Congo hemorrhagic fever (CCHF) has not been well described. However, it has been hypothesized that it could be a result of the direct injury of virus-infected tissues in combination with the indirect effects of host immune responses, including cytokines. To shed more light on the role of viral load and cytokines, differential influences of CCHF virus (CCHFV) RNA load, antibody response, and cytokine production on severity and outcome of the disease were studied in sera of 46 patients with confirmed acute CCHF from Kosovo. In this study, viral load proved to be strongly related to the severity and outcome of the disease, with higher viral loads detected in patients with fatal outcomes than in surviving patients. Also, patients with fatal outcome had on average a weaker antibody response, if one was present at all. High levels of interleukin-10 (IL-10), gamma interferon (IFN-gamma), and tumor necrosis factor alpha (TNF-alpha) were associated with poor outcome, since detected concentrations were highest in patients with fatal outcome and lowest in patients with moderate disease course. Additionally, a positive linear dependence between viral load and these cytokines was observed. Interestingly, reduced levels of IL-12 were detected in all CCHF patients. Our study favors the hypothesis that CCHF could be a result of a delayed and downregulated immune response caused by IL-10, which leads to an increased replication and spread of CCHFV throughout the body. This consequently triggers increased production of IFN-gamma and TNF-alpha, cytokines mediating vascular dysfunction, disseminated intravascular coagulation, organ failure, and shock.

Patterns of ectopy leading to increased risk of fatal or near-fatal cardiac arrhythmia in patients with depressed left ventricular function after an acute myocardial infarction.

PubMed

Lerma, Claudia; Gorelick, Alexander; Ghanem, Raja N; Glass, Leon; Huikuri, Heikki V

2013-09-01

To identify potential new markers for assessing the risk of sudden arrhythmic events based on a method that captures features of premature ventricular complexes (PVCs) in relation to sinus RR intervals in Holter recordings (heartprint). Holter recordings obtained 6 weeks after acute myocardial infarction from 227 patients with reduced ventricular function (left ventricular ejection fraction ≤ 40%) were used to produce heartprints. Measured indices were: PVCs per hour, standard deviation of coupling interval (SDCI), and the number of occurrences of the most prevalent form of PVCs (SNIB). Predictive values, survival analysis, and Cox regression with adjustment for clinical variables were performed based on primary endpoint, defined as an electrocardiogram-documented fatal or near-fatal arrhythmic event, death from any cause, and cardiac death. High ectopy (PVCs per hour ≥10) was a predictor of all endpoints. Repeating forms of PVCs (SNIB ≥ 83) was a predictor of primary endpoint, hazard ratio = 3.5 (1.3-9.5), and all-cause death, hazard ratio = 2.8 (1.1-7.3), but not cardiac death. SDCI ≤ 80 ms was a predictor of all-cause death and cardiac death, but not of primary endpoint. High ectopy, prevalence of repeating forms of PVCs, and low coupling interval variability are potentially useful risk markers of fatal or near-fatal arrhythmias after myocardial infarction.

Extended investigation on road fatality in Brunei.

PubMed

Yusof, N B; Hoque, M A; Steele, M C; Yong, S Y

2018-06-08

Road fatality is one of the leading causes of death in Brunei with 79 deaths in 1993, the highest ever recorded. The Brunei government has been trying to reduce this by implementing new traffic measures and successfully reduced fatalities to 24 fatalities in 2014. Yearly road fatality has been fluctuating, but there has been a declining tendency overall. The aim of this study is to investigate road fatality in Brunei by extending the research. We developed a multiple regression model and carried out an analysis on road fatality in Brunei. Our analysis indicates that the road fatality appears to rise depending on the increase in the number of young drivers between 15 to 24 years and the number of unemployed people. Comparisons of Brunei road fatality rate per 10,000 vehicles are made with some other countries and we conclude that Brunei has approximately the same rate as Australia in 2014.

Machinery-related occupational fatalities in the United States, 1980 to 1989.

PubMed

Pratt, S G; Kisner, S M; Helmkamp, J C

1996-01-01

The National Traumatic Occupational Fatalities surveillance system identified machinery-related incidents as the second leading cause of traumatic occupational fatalities in the United States between 1980 and 1989. These incidents resulted in 8,505 civilian worker deaths and an average annual fatality rate of .80 per 100,000 workers. Workers aged 65 years and older had 5.8 times the fatality rate of workers aged 16 to 64 years (4.06 vs. 70). The highest industry-specific rate was noted in agriculture, forestry, and fishing (7.47). Tractors and other agricultural machinery were associated with nearly 9 of every 10 fatal machinery-related incidents involving workers aged 65 or older. Although numerous studies of agricultural machinery-related fatalities are found in the literature, detailed analyses of machinery-related fatalities in the construction industry as well as analyses of work situations and risk factors associated with fatal injuries are needed.

Construction fatality due to electrical contact in Ontario, Canada, 1997-2007.

PubMed

Kim, Hwan; Lewko, John; Garritano, Enzo; Sharma, Bhanu; Moody, Joel; Colantonio, Angela

2016-06-27

Electrical contact is a leading cause of occupational fatality in the construction industry. However, research on the factors that contribute to electricity-related fatality in construction is limited. To characterize, using an adapted Haddon's Matrix, the factors that contribute to electricity-related occupational fatalities in the construction industry in Ontario, Canada. Coroner's data on occupational electricity-related fatalities between 1997-2007 in the construction industry were acquired from the Ontario Ministry of Labour. Using an adapted Haddon's Matrix, we characterized worker, agent, and environmental characteristics of electricity-related occupational fatalities in the province through a narrative text analysis. Electrical contact was responsible for 15% of all occupational fatalities among construction workers in Ontario. Factors associated with said occupational fatalities included direct contact with electrical sources, lower voltage sources, and working outdoors. This study provides a profile of electricity-related occupational fatalities among construction workers in Ontario, and can be used to inform safety regulations.

Sex differences in case fatality before and after admission to hospital after acute cardiac events: analysis of community based coronary heart disease register.

PubMed Central

Sonke, G. S.; Beaglehole, R.; Stewart, A. W.; Jackson, R.; Stewart, F. M.

1996-01-01

OBJECTIVE: To determine whether the reported higher case fatality in hospital after an acute cardiac event in women can be explained by sex differences in mortality before admission and in baseline risk factors. DESIGN: Analyses of data from a community based coronary heart disease register. SETTING: Auckland region, New Zealand. SUBJECTS: 5106 patients aged 25-64 years with an acute cardiac event leading to coronary death or definite myocardial infarction within 28 days of onset, occurring between 1986 and 1992. MAIN OUTCOME MEASURES: Case fatality before admission, 28 day case fatality for patients in hospital, and total case fatality after an acute cardiac event. RESULTS: Despite a more unfavourable risk profile women tended to have lower case fatality before admission than men (crude odds ratio 0.88; 95% confidence interval 0.77 to 1.02). Adjustment for age, living arrangements, smoking, medical history, and treatment increased the effect of sex (0.72; 0.60 to 0.86). After admission to hospital, women had a higher case fatality than men (1.76; 1.43 to 2.17), but after adjustment for confounders this was reduced to 1.18 (0.89 to 1.58). Total case fatality 28 days after an acute cardiac event showed no significant difference between men and women (0.85; 0.70 to 1.02) CONCLUSIONS: The higher case fatality after an acute cardiac event in women admitted to hospital is largely explained by differences in living status, history, and medical treatment and is balanced by a lower case fatality before admission. PMID:8870571

Predictors of fatality in pandemic influenza A (H1N1) virus infection among adults

PubMed Central

2014-01-01

Background The fatality attributed to pandemic influenza A H1N1 was not clear in the literature. We described the predictors for fatality related to pandemic influenza A H1N1 infection among hospitalized adult patients. Methods This is a multicenter study performed during the pandemic influenza A H1N1 [A(H1N1)pdm09] outbreak which occurred in 2009 and 2010. Analysis was performed among laboratory confirmed patients. Multivariate analysis was performed for the predictors of fatality. Results In the second wave of the pandemic, 848 adult patients were hospitalized because of suspected influenza, 45 out of 848 (5.3%) died, with 75% of fatalities occurring within the first 2 weeks of hospitalization. Among the 241 laboratory confirmed A(H1N1)pdm09 patients, the case fatality rate was 9%. In a multivariate logistic regression model that was performed for the fatalities within 14 days after admission, early use of neuraminidase inhibitors was found to be protective (Odds ratio: 0.17, confidence interval: 0.03-0.77, p = 0.022), nosocomial infections (OR: 5.7, CI: 1.84-18, p = 0.013), presence of malignant disease (OR: 3.8, CI: 0.66-22.01, p = 0.133) significantly increased the likelihood of fatality. Conclusions Early detection of the infection, allowing opportunity for the early use of neuraminidase inhibitors, was found to be important for prevention of fatality. Nosocomial bacterial infections and underlying malignant diseases increased the rate of fatality. PMID:24916566

Heterogeneities in the case fatality ratio in the West African Ebola outbreak 2013–2016

PubMed Central

Ariyarajah, Archchun; Blake, Isobel M.; Dorigatti, Ilaria; Eckmanns, Tim; Fraser, Christophe; Hinsley, Wes; Jombart, Thibaut; Mills, Harriet L.; Newton, Emily; Nouvellet, Pierre; Perkins, Devin; Riley, Steven; Schumacher, Dirk; Shah, Anita; Van Kerkhove, Maria D.; Dye, Christopher; Ferguson, Neil M.

2017-01-01

The 2013–2016 Ebola outbreak in West Africa is the largest on record with 28 616 confirmed, probable and suspected cases and 11 310 deaths officially recorded by 10 June 2016, the true burden probably considerably higher. The case fatality ratio (CFR: proportion of cases that are fatal) is a key indicator of disease severity useful for gauging the appropriate public health response and for evaluating treatment benefits, if estimated accurately. We analysed individual-level clinical outcome data from Guinea, Liberia and Sierra Leone officially reported to the World Health Organization. The overall mean CFR was 62.9% (95% CI: 61.9% to 64.0%) among confirmed cases with recorded clinical outcomes. Age was the most important modifier of survival probabilities, but country, stage of the epidemic and whether patients were hospitalized also played roles. We developed a statistical analysis to detect outliers in CFR between districts of residence and treatment centres (TCs), adjusting for known factors influencing survival and identified eight districts and three TCs with a CFR significantly different from the average. From the current dataset, we cannot determine whether the observed variation in CFR seen by district or treatment centre reflects real differences in survival, related to the quality of care or other factors or was caused by differences in reporting practices or case ascertainment. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’. PMID:28396479

[Tetanus and Clostridium tetani--a brief review].

PubMed

Stock, Ingo

2015-02-01

Tetanus is an acute, often fatal, disease caused by an exotoxin (tetanospasmin) produced by the anaerobic, gram-positive spore-forming bacterium Clostridium tetani. It is characterized by generalized rigidity and convulsive spasms of skeletal muscles. In most industrialized countries, tetanus is a rare disease. However, in many tropical and subtropical countries with low vaccination coverage and poor medical care, it is still widely distributed. This applies in particular for neonatal tetanus. About 50 000 newborns and infants die each year from consequences from this severe illness. Management of tetanus involves neutralization of free circulating toxin, adequate antibacterial and symptomatic therapy as well as intensive care of the patient. For prophylaxis of the disease, active tetanus toxoid vaccination is the method of choice.

Association between Low to Moderate Arsenic Exposure and Incident Cardiovascular Disease. A Prospective Cohort Study

PubMed Central

Moon, Katherine A.; Guallar, Eliseo; Umans, Jason G.; Devereux, Richard B.; Best, Lyle G.; Francesconi, Kevin A.; Goessler, Walter; Pollak, Jonathan; Silbergeld, Ellen K.; Howard, Barbara V.; Navas-Acien, Ana

2014-01-01

Background Inorganic arsenic exposure in water and food is a global public health problem. Chronic exposure to high levels of arsenicis consistently associated with increased risk of cardiovascular disease, whereas prospective data on low to moderate chronic arsenic exposure (<100μg/L in drinking water) are lacking. Objective To evaluate the association between chronic low to moderate arsenic exposure and incident cardiovascular disease. Design Prospective cohort study. Setting The Strong Heart Study baseline visit in 1989-1991, with follow-up through 2008. Patients 3,575 American Indian men and women aged 45-74 years living in Arizona, Oklahoma, and North and South Dakota. Measurements The sum of inorganic and methylated arsenic species in urine at baseline was used as a biomarker of chronic arsenic exposure. Participants were followed for incident fatal and non-fatal cardiovascular disease, including coronary heart disease and stroke. Results 1,184 participants developed fatal and non-fatal cardiovascular disease and 439 participants developed fatal cardiovascular disease. Comparing the highest to lowest quartile arsenic concentrations (>15.7 vs. <5.8 μg/g creatinine), the hazard ratios (95% confidence interval) for cardiovascular disease, coronary heart disease, and stroke mortality after adjustment for socio-demographic factors, smoking, body mass index, and lipids were 1.65 (1.20, 2.27; p-trend<0.001), 1.71 (1.19, 2.44; p-trend<0.001) and 3.03 (1.08, 8.50; p-trend=0.061), respectively. The corresponding hazard ratios for incident cardiovascular disease, coronary heart disease, and stroke were 1.32 (1.09, 1.59; p-trend=0.002), 1.30 (1.04, 1.62; p-trend=0.006), and 1.47 (0.97, 2.21; p-trend=0.032), respectively. These associations varied by study region and were attenuated following further adjustment for diabetes, hypertension, and measures of kidney disease. Limitations Direct measurement of individual arsenic in drinking water was unavailable. Residual confounding and differences in potential confounders across study regions may exist. Conclusions Low to moderate chronic arsenic exposure, as measured in urine, was prospectively associated with cardiovascular disease incidence and mortality. PMID:24061511

Measles.

PubMed

Rota, Paul A; Moss, William J; Takeda, Makoto; de Swart, Rik L; Thompson, Kimberly M; Goodson, James L

2016-07-14

Measles is an infectious disease in humans caused by the measles virus (MeV). Before the introduction of an effective measles vaccine, virtually everyone experienced measles during childhood. Symptoms of measles include fever and maculopapular skin rash accompanied by cough, coryza and/or conjunctivitis. MeV causes immunosuppression, and severe sequelae of measles include pneumonia, gastroenteritis, blindness, measles inclusion body encephalitis and subacute sclerosing panencephalitis. Case confirmation depends on clinical presentation and results of laboratory tests, including the detection of anti-MeV IgM antibodies and/or viral RNA. All current measles vaccines contain a live attenuated strain of MeV, and great progress has been made to increase global vaccination coverage to drive down the incidence of measles. However, endemic transmission continues in many parts of the world. Measles remains a considerable cause of childhood mortality worldwide, with estimates that >100,000 fatal cases occur each year. Case fatality ratio estimates vary from <0.01% in industrialized countries to >5% in developing countries. All six WHO regions have set goals to eliminate endemic transmission of MeV by achieving and maintaining high levels of vaccination coverage accompanied by a sensitive surveillance system. Because of the availability of a highly effective and relatively inexpensive vaccine, the monotypic nature of the virus and the lack of an animal reservoir, measles is considered a candidate for eradication.

Defects of Lipid Synthesis Are Linked to the Age-Dependent Demyelination Caused by Lamin B1 Overexpression

PubMed Central

Rolyan, Harshvardhan; Tyurina, Yulia Y.; Hernandez, Marylens; Amoscato, Andrew A.; Sparvero, Louis J.; Nmezi, Bruce C.; Lu, Yue; Estécio, Marcos R. H.; Lin, Kevin; Chen, Junda; He, Rong-Rong; Gong, Pin; Rigatti, Lora H.; Dupree, Jeffrey; Bayır, Hülya; Kagan, Valerian E.; Casaccia, Patrizia

2015-01-01

Lamin B1 is a component of the nuclear lamina and plays a critical role in maintaining nuclear architecture, regulating gene expression and modulating chromatin positioning. We have previously shown that LMNB1 gene duplications cause autosomal dominant leukodystrophy (ADLD), a fatal adult onset demyelinating disease. The mechanisms by which increased LMNB1 levels cause ADLD are unclear. To address this, we used a transgenic mouse model where Lamin B1 overexpression is targeted to oligodendrocytes. These mice showed severe vacuolar degeneration of the spinal cord white matter together with marked astrogliosis, microglial infiltration, and secondary axonal damage. Oligodendrocytes in the transgenic mice revealed alterations in histone modifications favoring a transcriptionally repressed state. Chromatin changes were accompanied by reduced expression of genes involved in lipid synthesis pathways, many of which are known to play important roles in myelin regulation and are preferentially expressed in oligodendrocytes. Decreased lipogenic gene expression resulted in a significant reduction in multiple classes of lipids involved in myelin formation. Many of these gene expression changes and lipid alterations were observed even before the onset of the phenotype, suggesting a causal role. Our findings establish, for the first time, a link between LMNB1 and lipid synthesis in oligodendrocytes, and provide a mechanistic framework to explain the age dependence and white matter involvement of the disease phenotype. These results have implications for disease pathogenesis and may also shed light on the regulation of lipid synthesis pathways in myelin maintenance and turnover. SIGNIFICANCE STATEMENT Autosomal dominant leukodystrophy (ADLD) is fatal neurological disorder caused by increased levels of the nuclear protein, Lamin B1. The disease is characterized by an age-dependent loss of myelin, the fatty sheath that covers nerve fibers. We have studied a mouse model where Lamin B1 level are increased in oligodendrocytes, the cell type that produces myelin in the CNS. We demonstrate that destruction of myelin in the spinal cord is responsible for the degenerative phenotype in our mouse model. We show that this degeneration is mediated by reduced expression of lipid synthesis genes and the subsequent reduction in myelin enriched lipids. These findings provide a mechanistic framework to explain the age dependence and tissue specificity of the ADLD disease phenotype. PMID:26311780

Biallelic mutations in IRF8 impair human NK cell maturation and function

PubMed Central

Mace, Emily M.; Gunesch, Justin T.; Chinn, Ivan K.; Angelo, Laura S.; Maisuria, Sheetal; Keller, Michael D.; Togi, Sumihito; Watkin, Levi B.; LaRosa, David F.; Jhangiani, Shalini N.; Muzny, Donna M.; Stray-Pedersen, Asbjørg; Coban Akdemir, Zeynep; Smith, Jansen B.; Hernández-Sanabria, Mayra; Le, Duy T.; Hogg, Graham D.; Cao, Tram N.; Freud, Aharon G.; Szymanski, Eva P.; Collin, Matthew; Cant, Andrew J.; Gibbs, Richard A.; Holland, Steven M.; Caligiuri, Michael A.; Ozato, Keiko; Paust, Silke; Doody, Gina M.; Lupski, James R.; Orange, Jordan S.

2016-01-01

Human NK cell deficiencies are rare yet result in severe and often fatal disease, particularly as a result of viral susceptibility. NK cells develop from hematopoietic stem cells, and few monogenic errors that specifically interrupt NK cell development have been reported. Here we have described biallelic mutations in IRF8, which encodes an interferon regulatory factor, as a cause of familial NK cell deficiency that results in fatal and severe viral disease. Compound heterozygous or homozygous mutations in IRF8 in 3 unrelated families resulted in a paucity of mature CD56dim NK cells and an increase in the frequency of the immature CD56bright NK cells, and this impairment in terminal maturation was also observed in Irf8–/–, but not Irf8+/–, mice. We then determined that impaired maturation was NK cell intrinsic, and gene expression analysis of human NK cell developmental subsets showed that multiple genes were dysregulated by IRF8 mutation. The phenotype was accompanied by deficient NK cell function and was stable over time. Together, these data indicate that human NK cells require IRF8 for development and functional maturation and that dysregulation of this function results in severe human disease, thereby emphasizing a critical role for NK cells in human antiviral defense. PMID:27893462

Biallelic mutations in IRF8 impair human NK cell maturation and function.

PubMed

Mace, Emily M; Bigley, Venetia; Gunesch, Justin T; Chinn, Ivan K; Angelo, Laura S; Care, Matthew A; Maisuria, Sheetal; Keller, Michael D; Togi, Sumihito; Watkin, Levi B; LaRosa, David F; Jhangiani, Shalini N; Muzny, Donna M; Stray-Pedersen, Asbjørg; Coban Akdemir, Zeynep; Smith, Jansen B; Hernández-Sanabria, Mayra; Le, Duy T; Hogg, Graham D; Cao, Tram N; Freud, Aharon G; Szymanski, Eva P; Savic, Sinisa; Collin, Matthew; Cant, Andrew J; Gibbs, Richard A; Holland, Steven M; Caligiuri, Michael A; Ozato, Keiko; Paust, Silke; Doody, Gina M; Lupski, James R; Orange, Jordan S

2017-01-03

Human NK cell deficiencies are rare yet result in severe and often fatal disease, particularly as a result of viral susceptibility. NK cells develop from hematopoietic stem cells, and few monogenic errors that specifically interrupt NK cell development have been reported. Here we have described biallelic mutations in IRF8, which encodes an interferon regulatory factor, as a cause of familial NK cell deficiency that results in fatal and severe viral disease. Compound heterozygous or homozygous mutations in IRF8 in 3 unrelated families resulted in a paucity of mature CD56dim NK cells and an increase in the frequency of the immature CD56bright NK cells, and this impairment in terminal maturation was also observed in Irf8-/-, but not Irf8+/-, mice. We then determined that impaired maturation was NK cell intrinsic, and gene expression analysis of human NK cell developmental subsets showed that multiple genes were dysregulated by IRF8 mutation. The phenotype was accompanied by deficient NK cell function and was stable over time. Together, these data indicate that human NK cells require IRF8 for development and functional maturation and that dysregulation of this function results in severe human disease, thereby emphasizing a critical role for NK cells in human antiviral defense.

Duck plague

USGS Publications Warehouse

Friend, M.

1999-01-01

Duck plague is caused by a herpesvirus. Infection often results in an acute, contagious, and fatal disease. As with many other herpesviruses, duck plague virus can establish inapparent infections in birds that survive exposure to it, a state referred to as latency. During latency, the virus cannot be detected by standard methods for virus isolation. Studies of domestic species of waterfowl have detected multiple strains of the virus that vary in their ability to cause disease and death. Little is known about the response of wild waterfowl to strain differences.Duck plague outbreaks are thought to be caused when birds that carry the virus shed it through fecal or oral discharge, thus releasing the virus into food and water with which susceptible birds may have contact. Experimental studies have demonstrated spontaneous virus shedding by duck plague carriers during spring. Changes in the duration of daylight and onset of breeding are thought to be physiological stresses that stimulate virus shedding at this time of year. The carriers are immune to the disease, but the virus shed by them causes infection and disease among susceptible waterfowl. Bird-to-bird contact and contact with virus that has contaminated the environment perpetuate an outbreak. Scavenging and decomposition of carcasses of infected birds also contaminate the environment by releasing viruses from tissues and body fluids. Virus transmission through the egg has been reported, but the role of the egg in the disease cycle remains to be resolved.

Analysis of the Cochrane Review: Fibrates for secondary prevention of cardiovascular disease and stroke.

PubMed

Pires da Rosa, Gilberto; Libânio, Diogo; Filipe Azevedo, Luís

2017-01-01

The influence of fibrates on cardiovascular risk has been the focus of several clinical trials. This Cochrane Collaboration Systematic Review evaluated the efficacy of fibrates for secondary prevention of cardiovascular events and stroke, analyzing 13 randomized controlled trials, in a total of 16 112 participants with a history of cardiovascular disease. Fibrates showed a protective effect for the composite outcome of non-fatal stroke, non-fatal myocardial infarction (MI) and vascular death, mainly due to reduction in the risk of non-fatal or fatal MI. Nonetheless, these results largely relied on studies including clofibrate, a drug withdrawn from the market in 2002. No statistically significant differences regarding adverse events were found between fibrates and placebo. Although insufficient to support the routine prescription of fibrates in this setting, this evidence should be taken into account when deciding on lipid-modifying therapy in dyslipidemic patients with a history of cardiovascular disease. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Recurrent secondary spontaneous pneumothorax in silicosis: a case report.

PubMed

Amanda, Gina; Taufik, Feni Fitriani

2016-01-01

Silicosis is an occupational lung disease which is caused by inhalation and accumulation of crystalline silica particles in the lung. It commonly occurs in workers involved in quarrying, mining, sandblasting, tunneling, foundry work, and ceramics. Pneumothorax is one of the complications of silicosis with pleural involvement. The occurrence of pneumothorax in a patient with silicosis is a rare event, but it may be fatal. The rate of pneumothorax recurrence in silicosis is usually low. We report a case of recurrent secondary spontaneous pneumothorax in silicosis.

Neonatal thyrotoxicosis caused by maternal autoimmune hyperthyroidism.

PubMed

Correia, Miguel Fragata; Maria, Ana Teresa; Prado, Sara; Limbert, Catarina

2015-03-06

Neonatal immune hyperthyroidism is a rare but potentially fatal condition. It occurs in 1-5% of infants born to women with Graves' disease (GD). In most of the cases it is due to maternal antibodies transferred from the mother into the fetal compartment, stimulating the fetal thyroid by binding thyrotropin (thyroid-stimulating hormone, TSH) receptor. We present a case of neonatal thyrotoxicosis due to maternal GD detected at 25 days of age and discuss the potential pitfalls in the diagnosis. 2015 BMJ Publishing Group Ltd.

Neonatal thyrotoxicosis caused by maternal autoimmune hyperthyroidism

PubMed Central

Correia, Miguel Fragata; Maria, Ana Teresa; Prado, Sara; Limbert, Catarina

2015-01-01

Neonatal immune hyperthyroidism is a rare but potentially fatal condition. It occurs in 1–5% of infants born to women with Graves’ disease (GD). In most of the cases it is due to maternal antibodies transferred from the mother into the fetal compartment, stimulating the fetal thyroid by binding thyrotropin (thyroid-stimulating hormone, TSH) receptor. We present a case of neonatal thyrotoxicosis due to maternal GD detected at 25 days of age and discuss the potential pitfalls in the diagnosis. PMID:25750228

Acute pancreatitis: rare complication of chicken pox in an immunocompetent host.

PubMed

Kumar, Sunil; Jain, A P; Pandit, A K

2007-01-01

Chicken pox is a highly contagious infection, caused by the varicella zoster virus. Although generally a benign, self-limited disease, varicella may be associated with serious complications especially in adults. We present acute pancreatitis- a rare complication, in otherwise healthy patients suffering from chicken pox. The presence of pancreatitis in association with chickenpox in immunocompetent patients can influence the outcome of the latter. This interesting case will hopefully increase awareness about this complication and its fatality in chicken pox.

Population-based epidemiological study of infections caused by carbapenem-resistant Pseudomonas aeruginosa in the Calgary Health Region: importance of metallo-beta-lactamase (MBL)-producing strains.

PubMed

Laupland, Kevin B; Parkins, Michael D; Church, Deirdre L; Gregson, Daniel B; Louie, Thomas J; Conly, John M; Elsayed, Sameer; Pitout, Johann D D

2005-11-01

A study was conducted in the Calgary Health Region between May 2002 and April 2004 to define the population-based epidemiological characteristics of infections caused by imipenem-resistant Pseudomonas aeruginosa and to explore the clinical outcomes due to metallo- beta -lactamase (MBL)-producing and non-MBL-producing strains. Detailed clinical information was obtained by chart review, and phenotypic and molecular characterizations were performed using the MBL E-test, polymerase chain reaction with sequencing, and pulsed-field gel electrophoresis. A total of 228 patients with infections caused by imipenem-resistant P. aeruginosa were identified (annual incidence, 10.5 cases/100,000 population), with the highest incidence rate in those >or=75 years old. MBL-producing strains (98/228) were associated with higher rates of multidrug resistance and bacteremia. Ninety MBL-producing strains also produced VIM-2, 4 produced IMP-7, and 4 were unclassified. A cluster of VIM-2-producing strains was responsible for a nosocomial outbreak during 2003. The case-fatality rate was significantly higher for infections caused by MBL-producing strains than for those caused by non-MBL-producing strains (25% vs. 13%; relative risk, 1.98 [95% confidence interval, 1.00-3.90]; P=.05). MBL-producing P. aeruginosa strains were associated with a higher case-fatality rate and invasive disease. Our study highlights the potential importance of molecular laboratory techniques in infection control and patient care.

Clinical Sequencing Uncovers Origins and Evolution of Lassa Virus.

PubMed

Andersen, Kristian G; Shapiro, B Jesse; Matranga, Christian B; Sealfon, Rachel; Lin, Aaron E; Moses, Lina M; Folarin, Onikepe A; Goba, Augustine; Odia, Ikponmwonsa; Ehiane, Philomena E; Momoh, Mambu; England, Eleina M; Winnicki, Sarah; Branco, Luis M; Gire, Stephen K; Phelan, Eric; Tariyal, Ridhi; Tewhey, Ryan; Omoniwa, Omowunmi; Fullah, Mohammed; Fonnie, Richard; Fonnie, Mbalu; Kanneh, Lansana; Jalloh, Simbirie; Gbakie, Michael; Saffa, Sidiki; Karbo, Kandeh; Gladden, Adrianne D; Qu, James; Stremlau, Matthew; Nekoui, Mahan; Finucane, Hilary K; Tabrizi, Shervin; Vitti, Joseph J; Birren, Bruce; Fitzgerald, Michael; McCowan, Caryn; Ireland, Andrea; Berlin, Aaron M; Bochicchio, James; Tazon-Vega, Barbara; Lennon, Niall J; Ryan, Elizabeth M; Bjornson, Zach; Milner, Danny A; Lukens, Amanda K; Broodie, Nisha; Rowland, Megan; Heinrich, Megan; Akdag, Marjan; Schieffelin, John S; Levy, Danielle; Akpan, Henry; Bausch, Daniel G; Rubins, Kathleen; McCormick, Joseph B; Lander, Eric S; Günther, Stephan; Hensley, Lisa; Okogbenin, Sylvanus; Schaffner, Stephen F; Okokhere, Peter O; Khan, S Humarr; Grant, Donald S; Akpede, George O; Asogun, Danny A; Gnirke, Andreas; Levin, Joshua Z; Happi, Christian T; Garry, Robert F; Sabeti, Pardis C

2015-08-13

The 2013-2015 West African epidemic of Ebola virus disease (EVD) reminds us of how little is known about biosafety level 4 viruses. Like Ebola virus, Lassa virus (LASV) can cause hemorrhagic fever with high case fatality rates. We generated a genomic catalog of almost 200 LASV sequences from clinical and rodent reservoir samples. We show that whereas the 2013-2015 EVD epidemic is fueled by human-to-human transmissions, LASV infections mainly result from reservoir-to-human infections. We elucidated the spread of LASV across West Africa and show that this migration was accompanied by changes in LASV genome abundance, fatality rates, codon adaptation, and translational efficiency. By investigating intrahost evolution, we found that mutations accumulate in epitopes of viral surface proteins, suggesting selection for immune escape. This catalog will serve as a foundation for the development of vaccines and diagnostics. VIDEO ABSTRACT. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical sequencing uncovers origins and evolution of Lassa virus

PubMed Central

Andersen, Kristian G.; Shapiro, B. Jesse; Matranga, Christian B.; Sealfon, Rachel; Lin, Aaron E.; Moses, Lina M.; Folarin, Onikepe A.; Goba, Augustine; Odia, Ikponmwonsa; Ehiane, Philomena E.; Momoh, Mambu; England, Eleina M.; Winnicki, Sarah; Branco, Luis M.; Gire, Stephen K.; Phelan, Eric; Tariyal, Ridhi; Tewhey, Ryan; Omoniwa, Omowunmi; Fullah, Mohammed; Fonnie, Richard; Fonnie, Mbalu; Kanneh, Lansana; Jalloh, Simbirie; Gbakie, Michael; Saffa, Sidiki; Karbo, Kandeh; Gladden, Adrianne D.; Qu, James; Stremlau, Matthew; Nekoui, Mahan; Finucane, Hilary K.; Tabrizi, Shervin; Vitti, Joseph J.; Birren, Bruce; Fitzgerald, Michael; McCowan, Caryn; Ireland, Andrea; Berlin, Aaron M.; Bochicchio, James; Tazon-Vega, Barbara; Lennon, Niall J.; Ryan, Elizabeth M.; Bjornson, Zach; Milner, Danny A.; Lukens, Amanda K.; Broodie, Nisha; Rowland, Megan; Heinrich, Megan; Akdag, Marjan; Schieffelin, John S.; Levy, Danielle; Akpan, Henry; Bausch, Daniel G.; Rubins, Kathleen; McCormick, Joseph B.; Lander, Eric S.; Günther, Stephan; Hensley, Lisa; Okogbenin, Sylvanus; Schaffner, Stephen F.; Okokhere, Peter O.; Khan, S. Humarr; Grant, Donald S.; Akpede, George O.; Asogun, Danny A.; Gnirke, Andreas; Levin, Joshua Z.; Happi, Christian T.; Garry, Robert F.; Sabeti, Pardis C.

2015-01-01

Summary The 2013-2015 West African epidemic of Ebola virus disease (EVD) reminds us how little is known about biosafety level-4 viruses. Like Ebola virus, Lassa virus (LASV) can cause hemorrhagic fever with high case fatality rates. We generated a genomic catalog of almost 200 LASV sequences from clinical and rodent reservoir samples. We show that whereas the 2013-2015 EVD epidemic is fueled by human-to-human transmissions, LASV infections mainly result from reservoir-to-human infections. We elucidated the spread of LASV across West Africa and show that this migration was accompanied by changes in LASV genome abundance, fatality rates, codon adaptation, and translational efficiency. By investigating intrahost evolution, we found that mutations accumulate in epitopes of viral surface proteins, suggesting selection for immune escape. This catalog will serve as a foundation for the development of vaccines and diagnostics. PMID:26276630

Hemolysis in a patient with alkaptonuria and chronic kidney failure.

PubMed

Heng, Anne-Elisabeth; Courbebaisse, Marie; Kemeny, Jean Louis; Matesan, Raluca; Bonniol, Claude; Deteix, Patrice; Souweine, Bertrand

2010-07-01

In alkaptonuria, the absence of homogentisic acid oxidase results in the accumulation of homogentisic acid (HGA) in the body. Fatal disease cases are infrequent, and death often results from kidney or cardiac complications. We report a 24-year-old alkaptonuric man with severe decreased kidney function who developed fatal metabolic acidosis and intravascular hemolysis. Hemolysis may have been caused by rapid and extensive accumulation of HGA and subsequent accumulation of plasma soluble melanins. Toxic effects of plasma soluble melanins, their intermediates, and reactive oxygen side products are increased when antioxidant mechanisms are overwhelmed. A decrease in serum antioxidative activity has been reported in patients with chronic decreased kidney function. However, despite administration of large doses of an antioxidant agent and ascorbic acid and intensive kidney support, hemolysis and acidosis could not be brought under control and hemolysis led to the death of the patient.

Serology and cytokine profiles in patients infected with the newly discovered Bundibugyo ebolavirus.

PubMed

Gupta, Manisha; MacNeil, Adam; Reed, Zachary D; Rollin, Pierre E; Spiropoulou, Christina F

2012-02-20

A new species of Ebolavirus, Bundibugyo ebolavirus, was discovered in an outbreak in western Uganda in November 2007. To study the correlation between fatal infection and immune response in Bundibugyo ebolavirus infection, viral antigen, antibodies, and 17 soluble factors important for innate immunity were examined in 44 patient samples. Using Luminex assays, we found that fatal infection was associated with high levels of viral antigen, low levels of pro-inflammatory cytokines, such as IL-1α, IL-1β, IL-6, TNF-α, and high levels of immunosuppressor cytokines like IL-10. Also, acute infected patients died in spite of generating high levels of antibodies against the virus. Thus, our results imply that disease severity in these patients is not due to the multi-organ failure and septic shock caused by a flood of inflammatory cytokines, as seen in infections with other Ebolavirus species. Published by Elsevier Inc.

Seven cases of fatal aconite poisoning: forensic experience in China.

PubMed

Liu, Qian; Zhuo, Luo; Liu, Liang; Zhu, Shaohua; Sunnassee, Ananda; Liang, Man; Zhou, Lan; Liu, Yan

2011-10-10

This paper presents seven fatal cases of aconite poisoning encountered in the Tongji Center for Medicolegal Expertise in Hubei (TCMEH), China, from 1999 to 2008 retrospectively. In six of the cases, deaths occurred after drinking homemade medicated liquor containing aconite, and in one case death was due to ingestion of traditional Chinese medication containing aconite. Forensic autopsy and pathological examinations ruled out the presence of physical trauma or life-threatening diseases. Diagnosis of aconite poisoning was made after postmortem toxicological analysis. Animal experiment was performed in one case demonstrating that the medicated liquor could cause death rapidly. We present the autopsy and histopathological findings, toxicological analysis, and results of animal experiment done on samples from those seven cases. As an important herbal Chinese medicine, Aconitum species deserve special attention, especially because it contains poisonous alkaloids. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Firearm legislation and firearm-related fatalities in the United States.

PubMed

Fleegler, Eric W; Lee, Lois K; Monuteaux, Michael C; Hemenway, David; Mannix, Rebekah

2013-05-13

Over 30,000 people die annually in the United States from injuries caused by firearms. Although most firearm laws are enacted by states, whether the laws are associated with rates of firearm deaths is uncertain. To evaluate whether more firearm laws in a state are associated with fewer firearm fatalities. Using an ecological and cross-sectional method, we retrospectively analyzed all firearm-related deaths reported to the Centers for Disease Control and Prevention Web-based Injury Statistics Query and Reporting System from 2007 through 2010. We used state-level firearm legislation across 5 categories of laws to create a "legislative strength score," and measured the association of the score with state mortality rates using a clustered Poisson regression. States were divided into quartiles based on their score. Fifty US states. Populations of all US states. The outcome measures were state-level firearm-related fatalities per 100,000 individuals per year overall, for suicide, and for homicide. In various models, we controlled for age, sex, race/ethnicity, poverty, unemployment, college education, population density, nonfirearm violence-related deaths, and household firearm ownership. Over the 4-year study period, there were 121,084 firearm fatalities. The average state-based firearm fatality rates varied from a high of 17.9 (Louisiana) to a low of 2.9 (Hawaii) per 100,000 individuals per year. Annual firearm legislative strength scores ranged from 0 (Utah) to 24 (Massachusetts) of 28 possible points. States in the highest quartile of legislative strength (scores of ≥9) had a lower overall firearm fatality rate than those in the lowest quartile (scores of ≤2) (absolute rate difference, 6.64 deaths/100,000/y; age-adjusted incident rate ratio [IRR], 0.58; 95% CI, 0.37-0.92). Compared with the quartile of states with the fewest laws, the quartile with the most laws had a lower firearm suicide rate (absolute rate difference, 6.25 deaths/100,000/y; IRR, 0.63; 95% CI, 0.48-0.83) and a lower firearm homicide rate (absolute rate difference, 0.40 deaths/100,000/y; IRR, 0.60; 95% CI, 0.38-0.95). A higher number of firearm laws in a state are associated with a lower rate of firearm fatalities in the state, overall and for suicides and homicides individually. As our study could not determine cause-and-effect relationships, further studies are necessary to define the nature of this association.

Occupational Carbon Monoxide Fatalities in the US From Unintentional Non-Fire Related Exposures, 1992–2008

PubMed Central

Henn, Scott A.; Bell, Jennifer L.; Sussell, Aaron L.; Konda, Srinivas

2015-01-01

Objective To analyze characteristics of, and trends in, work-related carbon monoxide (CO) fatalities in the US. Methods Records of unintentional, non-fire related fatalities from CO exposure were extracted from the Bureau of Labor Statistics’ Census of Fatal Occupational Injuries and the Occupational Safety and Health Administration’s Integrated Management Information System for years 1992–2008 and analyzed separately. Results The average number of annual CO fatalities was 22 (standard deviation = 8). Fatality rates were highest among workers aged ≥65, males, Hispanics, winter months, the Midwest, and the Fishing, Hunting, and Trapping industry subsector. Self-employed workers accounted for 28% of all fatalities. Motor vehicles were the most frequent source of fatal CO exposure, followed by heating systems and generators. Conclusions CO has been the most frequent cause of occupational fatality due to acute inhalation, and has shown no significant decreasing trend since 1992. The high number of fatalities from motor vehicles warrants further investigation. PMID:23868822

Importance of Nonenteric Protozoan Infections in Immunocompromised People

PubMed Central

Barratt, J. L. N.; Harkness, J.; Marriott, D.; Ellis, J. T.; Stark, D.

2010-01-01

Summary: There are many neglected nonenteric protozoa able to cause serious morbidity and mortality in humans, particularly in the developing world. Diseases caused by certain protozoa are often more severe in the presence of HIV. While information regarding neglected tropical diseases caused by trypanosomatids and Plasmodium is abundant, these protozoa are often not a first consideration in Western countries where they are not endemic. As such, diagnostics may not be available in these regions. Due to global travel and immigration, this has become an increasing problem. Inversely, in certain parts of the world (particularly sub-Saharan Africa), the HIV problem is so severe that diseases like microsporidiosis and toxoplasmosis are common. In Western countries, due to the availability of highly active antiretroviral therapy (HAART), these diseases are infrequently encountered. While free-living amoebae are rarely encountered in a clinical setting, when infections do occur, they are often fatal. Rapid diagnosis and treatment are essential to the survival of patients infected with these organisms. This paper reviews information on the diagnosis and treatment of nonenteric protozoal diseases in immunocompromised people, with a focus on patients infected with HIV. The nonenteric microsporidia, some trypanosomatids, Toxoplasma spp., Neospora spp., some free-living amoebae, Plasmodium spp., and Babesia spp. are discussed. PMID:20930074

Pathogenesis of Lafora Disease: Transition of Soluble Glycogen to Insoluble Polyglucosan.

PubMed

Sullivan, Mitchell A; Nitschke, Silvia; Steup, Martin; Minassian, Berge A; Nitschke, Felix

2017-08-11

Lafora disease (LD, OMIM #254780) is a rare, recessively inherited neurodegenerative disease with adolescent onset, resulting in progressive myoclonus epilepsy which is fatal usually within ten years of symptom onset. The disease is caused by loss-of-function mutations in either of the two genes EPM2A (laforin) or EPM2B (malin). It characteristically involves the accumulation of insoluble glycogen-derived particles, named Lafora bodies (LBs), which are considered neurotoxic and causative of the disease. The pathogenesis of LD is therefore centred on the question of how insoluble LBs emerge from soluble glycogen. Recent data clearly show that an abnormal glycogen chain length distribution, but neither hyperphosphorylation nor impairment of general autophagy, strictly correlates with glycogen accumulation and the presence of LBs. This review summarizes results obtained with patients, mouse models, and cell lines and consolidates apparent paradoxes in the LD literature. Based on the growing body of evidence, it proposes that LD is predominantly caused by an impairment in chain-length regulation affecting only a small proportion of the cellular glycogen. A better grasp of LD pathogenesis will further develop our understanding of glycogen metabolism and structure. It will also facilitate the development of clinical interventions that appropriately target the underlying cause of LD.

Pathogenesis of Lafora Disease: Transition of Soluble Glycogen to Insoluble Polyglucosan

PubMed Central

Sullivan, Mitchell A.; Nitschke, Silvia; Steup, Martin; Minassian, Berge A.; Nitschke, Felix

2017-01-01

Lafora disease (LD, OMIM #254780) is a rare, recessively inherited neurodegenerative disease with adolescent onset, resulting in progressive myoclonus epilepsy which is fatal usually within ten years of symptom onset. The disease is caused by loss-of-function mutations in either of the two genes EPM2A (laforin) or EPM2B (malin). It characteristically involves the accumulation of insoluble glycogen-derived particles, named Lafora bodies (LBs), which are considered neurotoxic and causative of the disease. The pathogenesis of LD is therefore centred on the question of how insoluble LBs emerge from soluble glycogen. Recent data clearly show that an abnormal glycogen chain length distribution, but neither hyperphosphorylation nor impairment of general autophagy, strictly correlates with glycogen accumulation and the presence of LBs. This review summarizes results obtained with patients, mouse models, and cell lines and consolidates apparent paradoxes in the LD literature. Based on the growing body of evidence, it proposes that LD is predominantly caused by an impairment in chain-length regulation affecting only a small proportion of the cellular glycogen. A better grasp of LD pathogenesis will further develop our understanding of glycogen metabolism and structure. It will also facilitate the development of clinical interventions that appropriately target the underlying cause of LD. PMID:28800070

Sporadic Fatal Insomnia in an Adolescent

PubMed Central

Blase, Jennifer L.; Cracco, Laura; Schonberger, Lawrence B.; Maddox, Ryan A.; Cohen, Yvonne; Cali, Ignazio

2014-01-01

The occurrence of sporadic prion disease among adolescents is extremely rare. A prion disease was confirmed in an adolescent with disease onset at 13 years of age. Genetic, neuropathologic, and biochemical analyses of the patient’s autopsy brain tissue were consistent with sporadic fatal insomnia, a type of sporadic prion disease. There was no evidence of an environmental source of infection, and this patient represents the youngest documented case of sporadic prion disease. Although rare, a prion disease diagnosis should not be discounted in adolescents exhibiting neurologic signs. Brain tissue testing is necessary for disease confirmation and is particularly beneficial in cases with an unusual clinical presentation. PMID:24488737

Sarcocystis neurona schizonts-associated encephalitis, chorioretinitis, and myositis in a two-month-old dog simulating toxoplasmosis, and presence of mature sarcocysts in muscles.

PubMed

Dubey, J P; Black, S S; Verma, S K; Calero-Bernal, R; Morris, E; Hanson, M A; Cooley, A J

2014-05-28

Sarcocystis neurona is an unusual species of the genus Sarcocystis. Opossums (Didelphis virginianus, D. albiventris) are the definitive hosts and several other species, including dogs, cats, marine mammals, and horses are intermediate or aberrant hosts. Sarcocysts are not known to form in aberrant hosts. Sarcocystis neurona causes fatal disease in horses (Equine Protozoal Myeloencephalitis, EPM). There are numerous reports of fatal EPM-like infections in other species, usually with central nervous system signs and associated with the schizont stage of S. neurona. Here, we report fatal disseminated S. neurona infection in a nine-week-old golden retriever dog from Mississippi, USA. Protozoal merozoites were identified in smears of the cerebrospinal fluid. Microscopically, lesions and protozoa were identified in eyes, tongue, heart, liver, intestines, nasal turbinates, skeletal muscle and brain, which reacted intensely with S. neurona polyclonal antibodies. Mature sarcocysts were seen in sections of muscles. These sarcocysts were ultrastructurally similar to those of S. neurona from experimentally infected animals. These data suggest that the dog is another intermediate host for S. neurona. Data suggest that the dog was transplacentally infected. Copyright © 2014 Elsevier B.V. All rights reserved.

Intervention strategies to eliminate truck-related fatalities in surface coal mining in West Virginia.

PubMed

Zhang, Meng; Kecojevic, Vladislav

2016-01-01

The main objective of this review was to build upon a previous study on the root causes of truck-related fatalities in surface coal mining operations in West Virginia, and to develop intervention strategies to eliminate these fatalities. This review considers a two-pronged approach to accident prevention: one that is fundamental and traditional (safety regulations, training and education, and engineering of the work environment); and one that is innovative and creative (e.g., applying technological advances to better control and eliminate the root causes of accidents). Suggestions for improving current training and education system are proposed, and recommendations are provided on improving the safety of mine working conditions, specifically safety conditions on haul roads, dump sites, and loading areas. We also discuss various currently available technologies that can help prevent haul truck-related fatal accidents. The results of this review should be used by mine personnel to help create safer working conditions and decrease truck-related fatalities in surface coal mining.

Detection and quantification of virus DNA in plasma of patients with Epstein-Barr virus-associated diseases.

PubMed

Yamamoto, M; Kimura, H; Hironaka, T; Hirai, K; Hasegawa, S; Kuzushima, K; Shibata, M; Morishima, T

1995-07-01

Epstein-Barr virus (EBV) causes various diseases, such as infectious mononucleosis (IM), fatal IM, EBV-associated hemophagocytic syndrome (EBVAHS), and chronic active EBV infection (CAEBV). In the present study, cell-free EBV DNA was detected in the plasma of patients with EBV-associated diseases by PCR assay. The patients included 20 patients with IM, 2 patients with fatal IM, 4 patients with EBVAHS, 4 patients with CAEBV, and 38 healthy children (20 EBV seropositive and 18 EBV seronegative). In patients with IM, plasma samples were positive for EBV DNA in all patients (100%) in the acute phase and in 44% of the patients in the convalescent phase, but plasma samples from the 38 healthy control children were negative (0%) for EBV DNA. Quantitative PCR assay revealed that plasma from patients with IM contained the highest amount of virus DNA within 7 days following the onset of disease (mean, 6 x 10(4) copies per ml). The EBV DNA concentration decreased thereafter as the patients recovered. Plasma from patients with fatal IM contained more than 100 times more copies of EBV DNA (3 x 10(7) copies per ml) than plasma from patients with IM. Plasma from patients with the acute phase of EBVAHS contained 10 times more copies of EBV DNA (5 x 10(5) copies per ml) than plasma from IM, and then patients with the number of copies decreased similarly in both groups of patients in the convalescent phase (2 x 10(4) copies per ml). The amount of virus DNA in patients with CAEBV (6 x 10(4) copies per ml) was similar to that noted in patients with IM; however, it became higher (1 x 10(6) copies per ml) when the patients' clinical status deteriorated. These data suggest that the presence of cell-free EBV DNA in plasma is a common phenomenon in patients with EBV-associated diseases. The concentration of EBV DNA in plasma seems to be higher in patients with the more severe clinical categories of EBV diseases.

Induction of potential protective immunity against enterotoxemia in calves by single or multiple recombinant Clostridium perfringens toxoids.

PubMed

Jiang, Zhigang; De, Yanyan; Chang, Jitao; Wang, Fang; Yu, Li

2014-11-01

Cattle enterotoxemia caused by Clostridium perfringens toxins is a noncontagious, sporadic, and fatal disease characterized by sudden death. Strategies for controlling and preventing cattle enterotoxemia are based on systematic vaccination of herds with toxoids. Because the process of producing conventional clostridial vaccines is dangerous, expensive, and time-consuming, the prospect of recombinant toxoid vaccines against diseases caused by C. perfringens toxins is promising. In this study, nontoxic recombinant toxoids derived from α-, β- and ε-toxins of C. perfringens, namely, rCPA247-370 , rCPB and rEtxHP, respectively, were expressed in Escherichia coli. High levels of specific IgG antibodies and neutralizing antibodies against the toxins were detected in sera from calves vaccinated with either a single recombinant toxoid or a mixed cocktail of all three recombinant toxoids, indicating the potential of these recombinant toxoids to provide calves with protective immunity against enterotoxemia caused by C. perfringens. © 2014 The Societies and Wiley Publishing Asia Pty Ltd.

[Causes of death of German refugee children in 1945].

PubMed

Lylloff, K

2000-02-28

In the last months of the second World War, 250,000 German refugees landed in Denmark. A third of them were children under the age of 15. Seven thousand German refugee children under the age of five died in Denmark in 1945. Using birth certificates and death certificates from the Danish national archives and burial lists from the German refugee cemetaries I have collected data to reveal causes of death, age distributions and time of the deaths of the 7000 fatal cases among children under the age of five. Three thousand children under the age of one, 2000 children one year old and 2000 children 2-4 years old died. Most of them died just before and after the German surrender, but many died in the months following the German surrender. The infant mortality was extremely high all during 1945. The infants died from diseases due to malnutrition, but the older the children the more likely the causes of death were due to infectious diseases such as pneumonia, measles, diphtheria and gastroenteritis.

Severe Plasmodium knowlesi Malaria in a Tertiary Care Hospital, Sabah, Malaysia

PubMed Central

William, Timothy; Menon, Jayaram; Rajahram, Giri; Chan, Leslie; Ma, Gordon; Donaldson, Samantha; Khoo, Serena; Fredrick, Charlie; Jelip, Jenarun; Anstey, Nicholas M.

2011-01-01

The simian parasite Plasmodium knowlesi causes severe human malaria; the optimal treatment remains unknown. We describe the clinical features, disease spectrum, and response to antimalarial chemotherapy, including artemether-lumefantrine and artesunate, in patients with P. knowlesi malaria diagnosed by PCR during December 2007–November 2009 at a tertiary care hospital in Sabah, Malaysia. Fifty-six patients had PCR-confirmed P. knowlesi monoinfection and clinical records available for review. Twenty-two (39%) had severe malaria; of these, 6 (27%) died. Thirteen (59%) had respiratory distress; 12 (55%), acute renal failure; and 12, shock. None experienced coma. Patients with uncomplicated disease received chloroquine, quinine, or artemether-lumefantrine, and those with severe disease received intravenous quinine or artesunate. Parasite clearance times were 1–2 days shorter with either artemether-lumefantrine or artesunate treatment. P. knowlesi is a major cause of severe and fatal malaria in Sabah. Artemisinin derivatives rapidly clear parasitemia and are efficacious in treating uncomplicated and severe knowlesi malaria. PMID:21762579

Detection and Heterogeneity of Herpesviruses Causing Pacheco's Disease in Parrots

PubMed Central

Tomaszewski, Elizabeth; Wilson, Van G.; Wigle, William L.; Phalen, David N.

2001-01-01

Pacheco's disease (PD) is a common, often fatal, disease of parrots. We cloned a virus isolate from a parrot that had characteristic lesions of PD. Three viral clones were partially sequenced, demonstrating that this virus was an alphaherpesvirus most closely related to the gallid herpesvirus 1. Five primer sets were developed from these sequences. The primer sets were used with PCR to screen tissues or tissue culture media suspected to contain viruses from 54 outbreaks of PD. The primer sets amplified DNA from all but one sample. Ten amplification patterns were detected, indicating that PD is caused by a genetically heterogeneous population of viruses. A single genetic variant (psittacid herpesvirus variant 1) amplified with all primer sets and was the most common virus variant (62.7%). A single primer set (23F) amplified DNA from all of the positive samples, suggesting that PCR could be used as a rapid postmortem assay for these viruses. PCR was found to be significantly more sensitive than tissue culture for the detection of psittacid herpesviruses. PMID:11158102

Dengue viruses – an overview

PubMed Central

Bäck, Anne Tuiskunen; Lundkvist, Åke

2013-01-01

Dengue viruses (DENVs) cause the most common arthropod-borne viral disease in man with 50–100 million infections per year. Because of the lack of a vaccine and antiviral drugs, the sole measure of control is limiting the Aedes mosquito vectors. DENV infection can be asymptomatic or a self-limited, acute febrile disease ranging in severity. The classical form of dengue fever (DF) is characterized by high fever, headache, stomach ache, rash, myalgia, and arthralgia. Severe dengue, dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS) are accompanied by thrombocytopenia, vascular leakage, and hypotension. DSS, which can be fatal, is characterized by systemic shock. Despite intensive research, the underlying mechanisms causing severe dengue is still not well understood partly due to the lack of appropriate animal models of infection and disease. However, even though it is clear that both viral and host factors play important roles in the course of infection, a fundamental knowledge gap still remains to be filled regarding host cell tropism, crucial host immune response mechanisms, and viral markers for virulence. PMID:24003364

Lineage 2 west nile virus as cause of fatal neurologic disease in horses, South Africa.

PubMed

Venter, Marietjie; Human, Stacey; Zaayman, Dewald; Gerdes, Gertruida H; Williams, June; Steyl, Johan; Leman, Patricia A; Paweska, Janusz Tadeusz; Setzkorn, Hildegard; Rous, Gavin; Murray, Sue; Parker, Rissa; Donnellan, Cynthia; Swanepoel, Robert

2009-06-01

Serologic evidence suggests that West Nile virus (WNV) is widely distributed in horses in southern Africa. However, because few neurologic cases have been reported, endemic lineage 2 strains were postulated to be nonpathogenic in horses. Recent evidence suggests that highly neuroinvasive lineage 2 strains exist in humans and mice. To determine whether neurologic cases are being missed in South Africa, we tested 80 serum or brain specimens from horses with unexplained fever (n = 48) and/or neurologic signs (n = 32) for WNV. From March 2007 through June 2008, using reverse transcription-PCR (RT-PCR) and immunoglobulin (Ig) M ELISA, we found WNV RNA or IgM in 7/32 horses with acute neurologic disease; 5 horses died or were euthanized. In 5/7 horses, no other pathogen was detected. DNA sequencing for all 5 RT-PCR-positive cases showed the virus belonged to lineage 2. WNV lineage 2 may cause neurologic disease in horses in South Africa.

Genetic factors in human sleep disorders with special reference to Norrie disease, Prader-Willi syndrome and Moebius syndrome.

PubMed

Parkes, J D

1999-06-01

Sleep-wake problems are common in specific inborn errors of metabolism and structure of the central nervous system. Psychological factors, behavioural difficulties, metabolic disturbances, and widespread rather than focal damage to the nervous system are present in many of these diseases and all influence the sleep-wake cycle. However, a number of conditions cause relatively focal damage to the neuroanatomical substrate of sleeping and waking. These include fatal familial insomnia, with involvement of the prion protein gene on chromosome 20, Norrie disease, the Prader-Willi syndrome and the Moebius syndrome. The last three important conditions, although rare, are considered in detail in this review. They result in sensory deprivation, hypothalamic and mid-brain damage, and involve the X-chromosome, chromosome 15, and chromosome 13, respectively. These conditions cause a wide variety of sleep disturbance, including parasomnias, daytime sleepiness, and a condition like cataplexy. The place of the relevant gene products in normal sleep regulation needs further exploration.

Detection and quantification of virus DNA in plasma of patients with Epstein-Barr virus-associated diseases.

PubMed Central

Yamamoto, M; Kimura, H; Hironaka, T; Hirai, K; Hasegawa, S; Kuzushima, K; Shibata, M; Morishima, T

1995-01-01

Epstein-Barr virus (EBV) causes various diseases, such as infectious mononucleosis (IM), fatal IM, EBV-associated hemophagocytic syndrome (EBVAHS), and chronic active EBV infection (CAEBV). In the present study, cell-free EBV DNA was detected in the plasma of patients with EBV-associated diseases by PCR assay. The patients included 20 patients with IM, 2 patients with fatal IM, 4 patients with EBVAHS, 4 patients with CAEBV, and 38 healthy children (20 EBV seropositive and 18 EBV seronegative). In patients with IM, plasma samples were positive for EBV DNA in all patients (100%) in the acute phase and in 44% of the patients in the convalescent phase, but plasma samples from the 38 healthy control children were negative (0%) for EBV DNA. Quantitative PCR assay revealed that plasma from patients with IM contained the highest amount of virus DNA within 7 days following the onset of disease (mean, 6 x 10(4) copies per ml). The EBV DNA concentration decreased thereafter as the patients recovered. Plasma from patients with fatal IM contained more than 100 times more copies of EBV DNA (3 x 10(7) copies per ml) than plasma from patients with IM. Plasma from patients with the acute phase of EBVAHS contained 10 times more copies of EBV DNA (5 x 10(5) copies per ml) than plasma from IM, and then patients with the number of copies decreased similarly in both groups of patients in the convalescent phase (2 x 10(4) copies per ml). The amount of virus DNA in patients with CAEBV (6 x 10(4) copies per ml) was similar to that noted in patients with IM; however, it became higher (1 x 10(6) copies per ml) when the patients' clinical status deteriorated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7665644

Earthquakes, May-June 1981

USGS Publications Warehouse

Person, W.J.

1981-01-01

The months of May and June were somewhat quiet, seismically speaking. There was one major earthquake (7.0-7.9) off the west coast of South Island, New Zealand. The most destructive earthquake during this reporting period was in southern Iran on June 11 which caused fatalities and extensive damage. Peru also experienced a destructive earthquake on June 22 which caused fatalities and damage. In the United States, a number of earthquakes were experienced, but none caused significant damage. 

Anthrax: a continuing concern in the era of bioterrorism

PubMed Central

2005-01-01

Anthrax, a potentially fatal infection, is a virulent and highly contagious disease. It is caused by a gram-positive, toxigenic, spore-forming bacillus: Bacillus anthracis. For centuries, anthrax has caused disease in animals and, although uncommonly, in humans throughout the world. Descriptions of this naturally occurring disease begin in antiquity. Anthrax is primarily a disease of herbivores, which are infected by ingestion of spores from the soil. With the advent of modern microbiology, Pasteur developed the first successful anthrax vaccine in 1881. The incidence of the disease has continually decreased since the late 19th century, and animal vaccination programs drastically reduced the animal mortality from the disease. However, anthrax spores continue to be documented in soil samples from throughout the world. Research on anthrax as a biological weapon began more than 80 years ago, and today at least 17 nations are believed to have offensive biological weapons programs that include anthrax. Recent events in the USA have shown how society is affected by both hoax and real threats of anthrax bioweapons. This fourth article in the series on weapons of biowarfare/bioterrorism summarizes the historical background of anthrax as well as clinical and laboratory information useful for bioterrorism preparedness. PMID:16200179

18F-FDG PET imaging for identifying the dynamics of intestinal disease caused by SFTSV infection in a mouse model.

PubMed

Hayasaka, Daisuke; Nishi, Kodai; Fuchigami, Takeshi; Shiogama, Kazuya; Onouchi, Takanori; Shimada, Satoshi; Tsutsumi, Yutaka; Morita, Kouichi

2016-01-05

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease that causes fever, enteritis, thrombocytopenia, and leucopenia and can be fatal in up to 30% of cases. However, the mechanism of severe disease is not fully understood. Molecular imaging approaches, such as positron-emission tomography (PET), are functional in vivo imaging techniques that provide real-time dynamics of disease progression, assessments of pharmacokinetics, and diagnoses for disease progression. Molecular imaging also potentially provides useful approaches to explore the pathogenesis of viral infections. Thus, the purpose of this study was to image the pathological features of SFTSV infection in vivo by PET imaging. In a mouse model, we showed that 18F-FDG accumulations clearly identified the intestinal tract site as a pathological site. We also demonstrated that 18F-FDG PET imaging can assess disease progression and response to antiserum therapy within the same individual. This is the first report demonstrating a molecular imaging strategy for SFTSV infection. Our results provide potentially useful information for preclinical studies such as the elucidation of the mechanism of SFTSV infection in vivo and the assessment of drugs for SFTS treatment.

Individual and occupational factors related to fatal occupational injuries: a case-control study.

PubMed

Villanueva, Vicent; Garcia, Ana M

2011-01-01

This study has been designed in order to identify factors increasing the risk of a fatal outcome when occupational accidents occur. The aim is to provide further evidence for the design and implementation of preventive measures in occupational settings. The Spanish Ministry of Labour registry of occupational injuries causing absence from work includes information on individual and occupational characteristics of injured workers and events. Registered fatal occupational injuries in 2001 (n=539) were compared to a sample of non-fatal injuries in the same year (n=3493). Risks for a fatal result of occupational injuries, adjusted by individual and occupational factors significantly associated, were obtained through logistic regression models. Compared to non-fatal injuries, fatal occupational injuries were mostly produced by trapping or by natural causes, mostly related to elevation and transport devices and power generators, and injured parts of body more frequently affected were head, multiple parts or internal organs. Adjusted analyses showed increased risk of fatality after an occupational injury for males (adjusted odds ratio aOR=10.92; 95%CI 4.80-24.84) and temporary workers (aOR=5.18; 95%CI 2.63-10.18), and the risk increased with age and with advancing hour of the work shift (p for trends <0.01). Injuries taking place out of the usual occupational setting (aOR=2.85, 95%CI 2.27-3.59), or carrying out atypical tasks (aOR=2.08; 95%CI 1.27-3.39) showed increased risks of a fatal result too, as occupational accidents in agricultural or construction companies. These data can help to select and define priorities for programmes aimed to prevent fatal consequences of occupational injuries. Copyright © 2010 Elsevier Ltd. All rights reserved.

The injury mortality burden in Guinea

PubMed Central

2012-01-01

Background The injury mortality burden of Guinea has been rarely addressed. The paper aimed to report patterns of injury mortality burden in Guinea. Methods We retrieved the mortality data from the Guinean Annual Health Statistics Report 2007. The information about underlying cause of deaths was collected based on Guinean hospital discharge data, Hospital Mortuary and City Council Mortuary data. The causes of death are coded in the 9th International Classification of Diseases (ICD-9). Multivariate Poisson regression was used to test the impacts of sex and age on mortality rates. The statistical analyses were performed using Statatm 10.0. Results In 2007, 7066 persons were reported dying of injuries in Guinea (mortality: 72.8 per 100,000 population). Transportation, fire/burn, falls, homicide and drowning were the five leading causes of fatal injuries for the whole population, accounting for 37%, 22%, 12%, 10% and 6% of total deaths, respectively. In general, age-specific injury causes displayed similar patterns of the whole population except that poisoning replaced falls as a leading cause among children under five years old. Males were at 30-50% more risk of dying from six commonest causes than females and old age groups had higher injury mortality rates than younger age groups. Conclusion Transportation, fire/burn, falls, homicide, and drowning accounted for the majority of total injury mortality burden in Guinea. Males and old adults were high-risk population of fatal injuries and should be targeted by injury prevention. Lots of work is needed to improve weak capacities for injury control in order to reduce the injury mortality burden. PMID:22937768

A small nonhuman primate model for filovirus-induced disease.

PubMed

Carrion, Ricardo; Ro, Youngtae; Hoosien, Kareema; Ticer, Anysha; Brasky, Kathy; de la Garza, Melissa; Mansfield, Keith; Patterson, Jean L

2011-11-25

Ebolavirus and Marburgvirus are members of the filovirus family and induce a fatal hemorrhagic disease in humans and nonhuman primates with 90% case fatality. To develop a small nonhuman primate model for filovirus disease, common marmosets (Callithrix jacchus) were intramuscularly inoculated with wild type Marburgvirus Musoke or Ebolavirus Zaire. The infection resulted in a systemic fatal disease with clinical and morphological features closely resembling human infection. Animals experienced weight loss, fever, high virus titers in tissue, thrombocytopenia, neutrophilia, high liver transaminases and phosphatases and disseminated intravascular coagulation. Evidence of a severe disseminated viral infection characterized principally by multifocal to coalescing hepatic necrosis was seen in EBOV animals. MARV-infected animals displayed only moderate fibrin deposition in the spleen. Lymphoid necrosis and lymphocytic depletion observed in spleen. These findings provide support for the use of the common marmoset as a small nonhuman primate model for filovirus induced hemorrhagic fever. Copyright © 2011 Elsevier Inc. All rights reserved.

Mutant TDP-43 within motor neurons drives disease onset but not progression in amyotrophic lateral sclerosis.

PubMed

Ditsworth, Dara; Maldonado, Marcus; McAlonis-Downes, Melissa; Sun, Shuying; Seelman, Amanda; Drenner, Kevin; Arnold, Eveline; Ling, Shuo-Chien; Pizzo, Donald; Ravits, John; Cleveland, Don W; Da Cruz, Sandrine

2017-06-01

Mutations in TDP-43 cause amyotrophic lateral sclerosis (ALS), a fatal paralytic disease characterized by degeneration and premature death of motor neurons. The contribution of mutant TDP-43-mediated damage within motor neurons was evaluated using mice expressing a conditional allele of an ALS-causing TDP-43 mutant (Q331K) whose broad expression throughout the central nervous system mimics endogenous TDP-43. TDP-43 Q331K mice develop age- and mutant-dependent motor deficits from degeneration and death of motor neurons. Cre-recombinase-mediated excision of the TDP-43 Q331K gene from motor neurons is shown to delay onset of motor symptoms and appearance of TDP-43-mediated aberrant nuclear morphology, and abrogate subsequent death of motor neurons. However, reduction of mutant TDP-43 selectively in motor neurons did not prevent age-dependent degeneration of axons and neuromuscular junction loss, nor did it attenuate astrogliosis or microgliosis. Thus, disease mechanism is non-cell autonomous with mutant TDP-43 expressed in motor neurons determining disease onset but progression defined by mutant acting within other cell types.

Clinical implications and treatment of dengue.

PubMed

Chawla, Pooja; Yadav, Amrita; Chawla, Viney

2014-03-01

Dengue is a common pathogenic disease often proving fatal, more commonly affecting the tropics. Aedes mosquito is the vector for this disease, and outbreaks of dengue often cause mass damage to life. The current review is an effort to present an insight into the causes, etiology, symptoms, transmission, diagnosis, major organs affected, mitigation and line of treatment of this disease with special emphasis on drugs of natural origin. The disease has a potential to spread as an endemic, often claiming several lives and thus requires concerted efforts to work out better treatment options. Traditional medicine offers an alternative solution and could be explored as a safer treatment option. Development of a successful vaccine and immunization technique largely remains a challenge and a better antiviral approach needs to be worked out to complement the supportive therapy. No single synthetic molecule has found to be wholly effective enough to offer curative control and the line of treatment mostly utilizes a combination of fluid replacement and antipyretics-analgesics like molecules to provide symptomatic relief. Copyright © 2014 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

Everything You Always Wanted to Know About Rabies Virus (But Were Afraid to Ask).

PubMed

Davis, Benjamin M; Rall, Glenn F; Schnell, Matthias J

2015-11-01

The cultural impact of rabies, the fatal neurological disease caused by infection with rabies virus, registers throughout recorded history. Although rabies has been the subject of large-scale public health interventions, chiefly through vaccination efforts, the disease continues to take the lives of about 40,000-70,000 people per year, roughly 40% of whom are children. Most of these deaths occur in resource-poor countries, where lack of infrastructure prevents timely reporting and postexposure prophylaxis and the ubiquity of domestic and wild animal hosts makes eradication unlikely. Moreover, although the disease is rarer than other human infections such as influenza, the prognosis following a bite from a rabid animal is poor: There is currently no effective treatment that will save the life of a symptomatic rabies patient. This review focuses on the major unanswered research questions related to rabies virus pathogenesis, especially those connecting the disease progression of rabies with the complex dysfunction caused by the virus in infected cells. The recent applications of cutting-edge research strategies to this question are described in detail.

Obliterative bronchiolitis in fibreglass workers: a new occupational disease?

PubMed

Cullinan, Paul; McGavin, Clive R; Kreiss, Kathleen; Nicholson, Andrew G; Maher, Toby M; Howell, Tim; Banks, John; Newman Taylor, Anthony J; Chen, Chi-Hsien; Tsai, Perng-Jy; Shih, Tung-Sheng; Burge, P Sherwood

2013-05-01

Obliterative bronchiolitis (OB) is a rare disease with a small number of established occupational aetiologies. We describe a case series of severe OB in workers making glass-reinforced plastics. Workplace exposures were the likely cause after the independent diagnosis of OB in two workers laying up the fibreglass hulls of yachts; the second worker took over the job of the first after he left following a lung transplant. Presentation of these two cases at international meetings led to others identifying similar workers. We identified six workers with good evidence of OB. All were involved in preparing fibreglass with styrene resins, five as boat builders laying up fibreglass hulls and one during cooling-tower fabrication. The disease came on rapidly without unusual acute exposures. Two patients had lung transplants, while another died while waiting for one. Histology confirmed OB in the four with biopsies/post-mortem examinations or explanted lungs. A rare, potentially fatal disease occurring in six workers laying up fibreglass with styrene resins from five different worksites suggests that work exposures were the cause of their OB. The precise agent responsible awaits identification.

Effects of statins on stroke prevention in patients with and without coronary heart disease: a meta-analysis of randomized controlled trials.

PubMed

Briel, Matthias; Studer, Marco; Glass, Tracy R; Bucher, Heiner C

2004-10-15

To assess if lipid-lowering interventions (statins, fibrates, resins, n-3 fatty acids, diet) prevent nonfatal and fatal strokes in patients with and without coronary heart disease. We systematically searched the literature up to August 2002 to retrieve all randomized controlled trials of lipid-lowering interventions that reported nonfatal and fatal stroke and mortality data. The search yielded 65 trials with 200,607 patients for a meta-analysis to determine whether treatment effects differed between types of lipid-lowering interventions and between patient samples with and without coronary heart disease. The risk ratio for nonfatal and fatal stroke for statins as compared with control interventions was 0.82 (95% confidence interval [CI]: 0.76 to 0.90). The corresponding risk ratios for statins as compared with control were 0.75 (95% CI: 0.65 to 0.87) for patients with coronary heart disease and 0.77 (95% CI: 0.62 to 0.95) for those without coronary heart disease. The confidence intervals of risk ratios for nonfatal and fatal stroke associated with fibrates, resins, n-3 fatty acids, and diet all included 1, as did the confidence intervals for these interventions in patients with and without coronary heart disease. Weighted meta-regression analysis suggested a stronger association of stroke reduction with statin treatment than with the extent of cholesterol reduction. This meta-analysis suggests that statins reduce the incidence of stroke in patients with and without coronary heart disease.

Fatal toxoplasmosis associated with an atypical Toxoplasma gondii strain in a Bennett’s wallaby (Macropus rufogriseus) in Spain

USDA-ARS?s Scientific Manuscript database

Toxoplasmosis is often fatal in captive wallabies, but the causes of this high susceptibility are not well understood. Here, we report fatal toxoplasmosis in a Bennet´s wallaby (Macropus rufogriseus) due to an atypical T. gondii strain for the first time in Europe. The wallaby was one of a colony of...

Adult height and the risk of cause-specific death and vascular morbidity in 1 million people: individual participant meta-analysis.

PubMed

2012-10-01

The extent to which adult height, a biomarker of the interplay of genetic endowment and early-life experiences, is related to risk of chronic diseases in adulthood is uncertain. We calculated hazard ratios (HRs) for height, assessed in increments of 6.5 cm, using individual-participant data on 174374 deaths or major non-fatal vascular outcomes recorded among 1085949 people in 121 prospective studies. For people born between 1900 and 1960, mean adult height increased 0.5-1 cm with each successive decade of birth. After adjustment for age, sex, smoking and year of birth, HRs per 6.5 cm greater height were 0.97 (95% confidence interval: 0.96-0.99) for death from any cause, 0.94 (0.93-0.96) for death from vascular causes, 1.04 (1.03-1.06) for death from cancer and 0.92 (0.90-0.94) for death from other causes. Height was negatively associated with death from coronary disease, stroke subtypes, heart failure, stomach and oral cancers, chronic obstructive pulmonary disease, mental disorders, liver disease and external causes. In contrast, height was positively associated with death from ruptured aortic aneurysm, pulmonary embolism, melanoma and cancers of the pancreas, endocrine and nervous systems, ovary, breast, prostate, colorectum, blood and lung. HRs per 6.5 cm greater height ranged from 1.26 (1.12-1.42) for risk of melanoma death to 0.84 (0.80-0.89) for risk of death from chronic obstructive pulmonary disease. HRs were not appreciably altered after further adjustment for adiposity, blood pressure, lipids, inflammation biomarkers, diabetes mellitus, alcohol consumption or socio-economic indicators. Adult height has directionally opposing relationships with risk of death from several different major causes of chronic diseases.

Fall-related accidents among hikers in the Austrian Alps: a 9-year retrospective study

PubMed Central

Faulhaber, Martin; Pocecco, Elena; Ruedl, Gerhard; Walter, Dagmar; Sterr, Regina; Ebner, Hans; Schobersberger, Wolfgang; Burtscher, Martin

2017-01-01

Objective To analyse the circumstances of fatal and non-fatal mountain hiking accidents caused by falls. Methods The study was designed as a retrospective analysis. Mountain hiking accidents caused by falls were documented during a 9-year period (2006–2014). After screening of all data for potential exclusion criteria the final sample size of 5368 accidents and 5665 victims was included into the analyses. Main outcome measures were details about accidents, victims, type of trail and surface. Results The annual number of accidents showed a continuous increase from 467 in 2006 to 700 in 2014. In total, 5.8% of all victims died during the 9-year period. 75.3% of the hikers fell during descent and 80.9% of the victims had their accident on a marked hiking trail or small path. The sex ratio for non-fatal accidents was 55% female and 45% male; for fatal accidents the female-to-male ratio was 28%:72%. Mean age of all victims was 52.5±17.5 years and victims of fatalities were about 5 years older compared with victims of non-fatal accidents (57.5±16.5 vs 52.2±17.5 years, P<0.01). Conclusion Descent is the most risky part for accidents caused by falls during mountain hiking. Male hikers are at greater risk for fatalities independent of age and this is associated with accidents occurring in pathless terrain. The death rate from falls was 6%. We recommend a critical self-assessment of the individual capabilities and mountain hiking skills and adequate planning of the hiking tours for mountain hikers. PMID:29259815