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Russell J Brooke, Mirjam Ee Kretzschmar, Volker Hackert, Christian Jpa Hoebe, Peter Fm Teunis, Lance A Waller
We develop a novel approach to study an outbreak of Q fever in 2009 in the Netherlands by combining a human dose-response model with geostatistics prediction to relate probability of infection and associated probability of illness to an effective dose of Coxiella burnetii. The spatial distribution of the 220 notified cases in the at-risk population are translated into a smooth spatial field of dose. Based on these symptomatic cases, the dose-response model predicts a median of 611 asymptomatic infections (95% range 410 to 1,084) for the 220 reported symptomatic cases in the at-risk population; 2...
October 19, 2016: Epidemiology
Eunjoo Kim, Amy Garrett, Spencer Boucher, Min-Hyeon Park, Meghan Howe, Erica Sanders, Ryan G Kelley, Allan L Reiss, Kiki D Chang, Manpreet K Singh
BACKGROUND: Prior studies have suggested that inhibited temperament may be associated with an increased risk for developing anxiety or mood disorder, including bipolar disorder. However, the neurobiological basis for this increased risk is unknown. The aim of this study was to examine temperament in symptomatic and asymptomatic child offspring of parents with bipolar disorder (OBD) and to investigate whether inhibited temperament is associated with aberrant hippocampal volumes compared with healthy control (HC) youth...
October 21, 2016: Journal of Child and Adolescent Psychopharmacology
Valentina Talarico, Monica Aloe, Alice Monzani, Roberto Miniero, Gianni Bona
Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy defined by thrombocytopenia, non-immune microangiopathic hemolytic anemia and acute renal failure. HUS is typically classified into two primary types: 1) HUS due to infections, often associated with diarrhea (D+HUS, Shiga toxin-producing Escherichia Coli-HUS), with the rare exception of HUS due to a severe disseminated infection caused by Streptococcus; 2) HUS related to complement, such HUS is also known as "atypical HUS" and is not diarrhea associated (D-HUS, aHUS); but recent studies have shown other forms of HUS, that can occur in the course of systemic diseases or physiopathological conditions such as pregnancy, after transplantation or after drug assumption...
December 2016: Minerva Pediatrica
Vivian G Loo, Paul Brassard, Mark A Miller
OBJECTIVE To determine the risk of Clostridium difficile transmission from index cases with C. difficile infection (CDI) to their household contacts and domestic pets. DESIGN A prospective study from April 2011 to June 2013. SETTING Patients with CDI from Canadian tertiary care centers. PARTICIPANTS Patients with CDI, their household human contacts, and pets. METHODS Epidemiologic information and stool or rectal swabs were collected from participants at enrollment and monthly for up to 4 months. Pulsed-field gel electrophoresis (PFGE) was performed on C...
November 2016: Infection Control and Hospital Epidemiology
Vidya Ramachandraiah, Wilbert Aronow, Dipak Chandy
Sarcoidosis is a multisystem disease characterized by the presence of noncaseating granulomas, the exact etiology of which is yet to be determined. Pulmonary involvement occurs in the majority of patients and its severity ranges from asymptomatic involvement of mediastinal lymph nodes to progressive pulmonary fibrosis and chronic respiratory failure that is insensitive to treatment. Diagnosis of pulmonary sarcoidosis requires a compatible clinical picture supported by radiologic and pathologic data. A recent development in establishing the diagnosis of pulmonary sarcoidosis is endobronchial ultrasound that increases the yield of transbronchial needle aspiration of hilar and/or mediastinal lymph nodes...
October 21, 2016: Postgraduate Medicine
N Nand, A R Deshmukh, R Mathur, V Chauhan, Brijlal
Gitelman syndrome (GS) is a rare autosomal recessive salt-losing tubulopathy. The incidence of Gitelman syndrome is 25 cases in 1 million among western population. This patient presented with loose stool, vomiting and sudden onset quadriparesis. Investigations revealed hypokalaemia, metabolic acidosis, hypomagnesaemia, hypocalciuria, hypermagnesuria. Symptoms and hypokalemia improved after starting oral magnesium and potassium supplements. But the patient again presented with symptomatic hypokalemia and delivered a still born foetus with hydrocephalus...
October 2016: Journal of the Association of Physicians of India
Biswajyoti Borkakoty, Dipankar Biswas, Aniruddha Jakharia, Jagadish Mahanta
OBJECTIVE: Toxoplasma gondii infection is primarily asymptomatic and one third of world's population is estimated to be infected by this protozoan parasite. This study was carried out to determine the seroprevalence of T. gondii infection among pregnant women from north east India, where data on this important parasitic infection is scanty. METHODS: A total of 1141 serum archival samples collected from antenatal clinic attendees in 2007-09, were screened for T. gondii IgG by ELISA and analyzed with their socio demographic information...
October 2016: Journal of the Association of Physicians of India
Ajaratu Keshinro, Ioannis Hatzaras, Kenneth Rifkind, Shubhada Dhage, Kathie-Ann Joseph
INTRODUCTION: Cancer screening is a key component of primary care, and access to regular screening mammography (SMG) is highly dependent on recommendation and referral by a primary care provider (PCP). Women with no health insurance or who are underinsured often lack access to a regular PCP and thus access to routine screening. METHODS: We retrospectively reviewed the charts of 173 surgical patients diagnosed between January 2012 and December 2013. The main outcome variables were PCP status, method of cancer detection, and breast cancer stage at diagnosis...
October 20, 2016: Annals of Surgical Oncology
Ana Claudia Gomes Pereira Petisco, Jorge Eduardo Assef, Carlos Alberto de Jesus, Mohamed Hassan Saleh, Jose Eduardo Martins Barbosa, David Costa de Souza Le Bihan, Ibraim Masciarelli França Pinto, Simone Rolim Fernandes Fontes Pedra, Rodrigo Bellio de Mattos Barretto, Amanda Guerra de Moraes Rego Sousa
Cardiovascular diseases are the leading cause of mortality among women in several countries. Early detection of subclinical atherosclerosis (SA) could enable the adoption of preventive measures to avoid cardiovascular events. This study aimed to determine the prevalence of SA in Brazilian asymptomatic postmenopausal women in Framingham Risk Score (FRS) low and intermediate groups. Computed tomography (CT) and ultrasound (US) scans were performed in 138 asymptomatic postmenopausal women (56.1 ± 4.9 years of age) to survey for coronary artery and aortic calcification (CT scan) and assess carotid intima-media thickness (CIMT) and identify carotid plaques (US)...
October 20, 2016: International Journal of Cardiovascular Imaging
Linfang Lan, Xinyi Leng, Jill Abrigo, Vincent Ip, Yannie Oy Soo, Thomas Leung, Xiangyan Chen, Ka Sing Wong
No abstract text is available yet for this article.
October 20, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Rishabh Sehgal, Cherry X Cheung, Tristram Hills, Aqueel Waris, Donagh Healy, Tahir Khan
Jejunal pseudo-diverticulosis is a rare acquired herniation of the mucosa and submucosa through weakened areas of the muscularis mucosa of the mesenteric aspect of the bowel. They are asymptomatic in the majority of cases; however, they can present with a wide spectrum of non-specific symptoms such as chronic abdominal discomfort, postprandial flatulence, diarrhoea, malabsorption and steattorhoea. In up to 15% of cases, more serious acute complications may arise such as the development of intestinal obstruction, haemorrhage or as in our case, localized peritonitis secondary to perforation...
October 7, 2016: Journal of Surgical Case Reports
M Barburoglu, A Arat
BACKGROUND AND PURPOSE: There is very limited data concerning utilization of flow diverters in children. Our aim is to report results for the treatment of complex intracranial aneurysms and carotid cavernous fistulas by using flow diverters in children. MATERIALS AND METHODS: Retrospective review of children (17 years of age or younger) treated with flow diverters between May 2011 and July 2014 was performed. Clinical and laboratory data and angiographic findings were extracted...
October 20, 2016: AJNR. American Journal of Neuroradiology
S Sundaram, S Kannoth, B Thomas, P S Sarma, P N Sylaja
BACKGROUND AND PURPOSE: Cervical internal carotid artery occlusion can present with varied clinical manifestations such as transient ischemic attack, stroke, and chronic ocular ischemia, or can be asymptomatic. The outcome in these patients is considerably influenced by cerebral hemodynamic compensatory adaptation of the intracranial collateral pathways. Our aim was to study whether collateral circulation as assessed by CT angiography can predict 3-month outcome and initial stroke severity in patients with symptomatic cervical ICA occlusion...
October 20, 2016: AJNR. American Journal of Neuroradiology
Naoya Niwa, Takashi Ohigashi, Hideharu Bessho, Takashi Arakawa
A bifid ureter with a distal blind-ending branch is a rare congenital anomaly. Most patients are asymptomatic; only patients with complications, such as infection, vesicoureteral reflux, or stone formation, present symptoms. We describe the case of a patient with urinary stone located in the distal blind-ending branch of a bifid ureter diagnosed during transurethral lithotripsy. Preoperative noncontrast-enhanced computed tomography did not reveal a stone in the distal blind-ending branch of the bifid ureter, but a rigid ureteroscope did; however, it could not reach the stone...
October 17, 2016: Urology
Thomas Golabesk, Joan Palou, Oscar Rodriguez, Ruben Parada, Sergio Skrobot, José Antonio Peña, Humberto Villavicencio
OBJECTIVE: To evaluate the risk of long-term tumour recurrence and progression in patients with low- and intermediate-risk NMIBCs, which could facilitate optimisation in the follow-up schedules. PATIENTS AND METHODS: A single-institution, retrospective analysis of 704 patients with primary TaG1, TaG2, T1G1, and T1G2 urothelial carcinomas of the bladder (UBS) without concomitant carcinoma in situ (CIS), treated with transurethral resection (TUR) was performed. Response was determined and monitored by routine periodic urine cytology, cystoscopy, and upper tract imaging...
October 17, 2016: Urology
Ana Claudia Paradella, André Ferraz de Arruda Musegante, Carlos Roberto Brites
Intravesical botulinum toxin A (BoNTA) injection has been widely used for the treatment of detrusor overactivity in patients with neurogenic bladder due to spinal cord injury who do not respond to conventional treatment. There is no consensus about antibiotic prophylaxis for this procedure. We conducted a retrospective analysis of medical records of adult patients with spinal cord injury who underwent detrusor BoNTA injection between January of 2007 and December of 2013 in a rehabilitation hospital. Occurrence of symptomatic urinary tract infection (UTI) was assessed in 3 groups in accordance with their use of antibiotics (prophylactic dosage, 3 days, more than 3 days) for the treatment of asymptomatic bacteriuria...
October 17, 2016: Brazilian Journal of Infectious Diseases
Chao Jiang, Ni Leng, Changwei Liu, Congwei Jia, Xining Wu, Jianyi Wang, Bao Liu
Lipoma of the lower leg vein is rare, and the histopathological variant, fibrolipoma, is even rarer. Here, we report an intravascular fibrolipoma located at the junction of the deep femoral vein and the femoral vein in a 50-year-old male patient. Tumor resection and venous reconstruction with a prosthetic graft were performed. Eight months later, the patient was asymptomatic and did not exhibit swelling. To our knowledge, this is the first case report of an intravascular fibrolipoma in the literature. Lower vein venography, computed tomography venography, ultrasonography, and histologic images are presented, along with a description of the procedures employed for tumor resection and venous reconstruction...
October 17, 2016: Annals of Vascular Surgery
M Cascarino, Y Caron, C Butnaru, F Rongioletti, S Fraitag
BACKGROUND: Progressive mucinous histiocytosis is a very rare, benign, non-Langerhans' cell histiocytosis limited to the skin. This disorder has been observed solely in women, with the exception of three cases in male patients, and most cases are hereditary. The hereditary forms begin in childhood, with sporadic cases occurring later, and it is characterized by numerous papules of slow progression. The aetiology and mode of genetic transmission remain unclear. We report one sporadic case of progressive mucinous histiocytosis...
October 17, 2016: Annales de Dermatologie et de Vénéréologie
Marc P Bonaca, Mark A Creager, Jeffrey Olin, Benjamin M Scirica, Ian C Gilchrist, Sabina A Murphy, Erica L Goodrich, Eugene Braunwald, David A Morrow
OBJECTIVES: The aim of this study was to determine whether the reduction in peripheral revascularization with vorapaxar in patients with peripheral artery disease (PAD) is directionally consistent across indications, including acute limb ischemia, progressively disabling symptoms, or both. BACKGROUND: The protease-activated receptor-1 antagonist vorapaxar reduces peripheral revascularization in patients with PAD. METHODS: The TRA 2°P-TIMI 50 (Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events-Thrombolysis in Myocardial Infarction 50) trial randomized 26,449 patients with histories of myocardial infarction, stroke, or symptomatic PAD to vorapaxar or placebo on a background of standard therapy...
October 24, 2016: JACC. Cardiovascular Interventions
Kongkiat Chaikriangkrai, Ghanshyam Palamaner Subash Shantha, Hye Yeon Jhun, Patompong Ungprasert, Gardar Sigurdsson, Faisal Nabi, John J Mahmarian, Su Min Chang
STUDY OBJECTIVE: Coronary artery calcium score (CACS) is a well-established test for risk stratifying asymptomatic patients. Recent studies also indicate that CACS may accurately risk stratify stable patients presenting to the emergency department (ED) with acute chest pain; however, many were underpowered. The purpose of this systematic review and meta-analysis is to evaluate the prognostic value and accuracy of a zero (normal) CACS for identifying patients at acceptable low risk for future cardiovascular events who might be safely discharged home from the ED...
October 10, 2016: Annals of Emergency Medicine
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