Assessing Fever in Returning Travelers: Part II

  Zika continues to be the virus of the day for returning travelers, but there are several other diseases that we need to consider in these patients when they present to us in the emergency department. Chikungunya is epidemic in many of the same countries as Zika and can be even more devastating. And Avian and MERS-CoV is still present in many countries. Unlike patients infected with Zika virus, these patients do require isolation to protect our health care staff from infection. Chikungunya Chikungunya, which means “to walk bent over,” was likely endemic but unrecognized in the United States before the mosquito eradication programs initiated in the 1950s. While the presentation of chikungunya is similar to that of dengue, with fever, a petechial rash, and arthralgias, bleeding is usually less severe. However, the associated arthralgias are much more painful and can last from months to years. Chikungunya has a similar incubation period as dengue, 2-14 days, but most patients present by day four. Treatment is supportive and includes adequate pain control; there are no medications that specifically treat chikungunya. Immunity does develop after infection with chikungunya, but it is short-lived and not lifelong. Until outbreaks of recent years, chikungunya was a painful disease with a high morbidity but a very low mortality; however, changes in the virus have increased disease severity. Chikungunya is now being transmitted by Aedes albopictus, a temperate mosquit...
Source: EPMonthly.com - Category: Emergency Medicine Authors: Tags: Uncategorized Source Type: news

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Conclusion: H. pylori-induced follicular gastritis is considered as an additional risk factor for bleeding from gastric varices. PMID: 30881448 [PubMed]
Source: Gastroenterology Research and Practice - Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research
Unfortunately, the Acknowledgements section was not included in the original version of the article. The said section is given here.
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research
AbstractThe role of viral load in the outcome of patients requiring hospital admission due to influenza is not well established. We aim to assess if there is an association between the viral load and the outcome in hospitalized patients with a confirmed influenza virus infection. A retrospective observational study including all adult patients who were hospitalized in our center with a confirmed influenza virus infection from January to May 2016. Viral load was measured by real-time reverse-transcriptase –polymerase chain reaction (rRT-PCR) cycle threshold (Ct) value on upper respiratory tract samples. Its value was ...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research
AbstractDiagnosing a patient with Zika infection is not always straightforward. Here, we aim to describe our data collected from December 2015 to December 2017 and discuss the implemented algorithm and diagnostic challenges we encountered. At the National Reference Center for Arboviruses at the Institute of Tropical Medicine, Antwerp, Belgium (ITM), a commercial Zika virus (ZIKV) enzyme-linked immunosorbent assay (ELISA) detecting immunoglobulin (Ig) M and IgG, a commercial ZIKV immunofluorescence assay (IFA) detecting IgM, and an in-house Zika virus neutralization test (VNT) were implemented. For molecular detection of ZI...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research
In this study, we used silkworm pupae to develop a safer vaccine for Alzheimer’s disease (AD) patients. Aβ15 peptide was fused with the cholera toxin B subunit (CTB) and expressed in silkworm pupae. Then, we tested an oral vaccine with the peptide expressed by silkworm pupae in a transgenic mouse model of AD. The results show that anti-Aβ antibodies were induced, Aβ deposition in the brain decreased, the content of malondialdehyde was lower than in the other group, and memory and cognition of the mice improved. These results suggest that the high-nutrient CTB-Aβ15 silkworm pupa vaccine has ...
Source: Journal of Biotechnology - Category: Biotechnology Source Type: research
In this study, we report the morphology, biochemistry, and molecular characteristics of an A. mycotoxinivorans strain isolated from a pediatric patient with congenital ventricular septal defect and pneumonia. A female patient, 26 months old, presented with congenital ventricular septal defect. Pulmonary infection symptoms were observed after the patient received cardiac repair surgery. Sputum bacterial and fungal cultures were positive for Elizabethkingia anophelis and a fungus, which was not readily identifiable using biochemical identification, or MALDI-TOF MS analysis. The strain was finally identified as A. m...
Source: Journal of Medical Mycology - Category: Biology Source Type: research
Publication date: Available online 18 March 2019Source: BiologicalsAuthor(s): Shuyun Qin, Dmitriy Volokhov, Elvira Rodionova, Christoph Wirblich, Matthias J. Schnell, Vladimir Chizhikov, Alena DabrazhynetskayaAbstractThe Rapid Fluorescent Focus Inhibition Test (RFFIT) is a standard assay used to detect and assess the titers of rabies virus neutralizing antibodies (RVNA) in blood sera. To simplify the multistep RFFIT procedure by eliminating the immunostaining step, we generated a new recombinant RV expressing a green fluorescent protein (rRV-GFP) and assess its suitability for quantifying RVNA. We rescued the rRV-GFP virus...
Source: Biologicals - Category: Biology Source Type: research
Authors: Bai F, Ma Y, Guo H, Li Y, Xu F, Zhang M, Dong H, Deng J, Xiong L Abstract The concept of "acupoint sensitization" refers to the functional status of acupoint switches from silent to active under pathological conditions. In clinic, acupoint sensitization provides important guidance for acupoints selection in different diseases. However, the mechanism behind this phenomenon remains unclear. We generated a model of knee osteoarthritis (KOA) by intra-articular injection of monosodium iodoacetate (MIA) into the left knee of rats. The paw withdrawal mechanical threshold (PWMT) and the total number of m...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
Conclusion: LPR may be a risk factor for JORRP, contributing to its development by activating or reactivating a latent HPV infection. Results are in accordance with those from our previous study in adults. PMID: 30881982 [PubMed - in process]
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
i B Abstract The coracoacromial ligament (CAL), which restrains superior displacement of humeral head, connects the acromion and coracoid process. Due to the ligament's variations and its role in shoulder pain, CAL was investigated in this study. Sixty shoulders of 34 cadavers, from persons aged 61-98 (80.95 ± 8.81) years at death time, were dissected. The lengths of lateral (LBL) and medial borders (MBL), widths of acromial (AIW) and coracoid insertions (CIW), and thicknesses of lateral (LSTAI) and medial (MSTAI) sides of acromial insertions were measured by digital caliper. The data were subjected to stat...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
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