Human infection with Gongylonema pulchrum

A 43 year old woman developed a painful tumor at the left buccal mucosa. Following local anti-inflammatory treatment a 35 mm long, living female adult worm of Gongylonema pulchrum was extracted from the affected side. No further treatment was needed and recovery was complete 5 days after extraction. Infection had occurred possibly 6 weeks before in Hungary with ingestion of contaminated water from an open draw well. Although commonly occurring as parasitic infection of domestic cattle and other vertebrates, gongylonemiasis is very rare in humans. Only 48 cases have been described in the literature since 1864. Life cycle and pathology of G. pulchrum are discussed

Cutaneos larva migrans in travelers

The symptoms, medical history, and treatment of 98 patients with cutaneous larva migrans (creeping eruption) who attended a travel-related-disease clinic during a period of 4 years are reviewed. This condition is caused by skin-penetrating larvae of nematodes, mainly of the hookworm Ancylostoma braziliense and other nematodes of the family Ancylostomidae. Despite the ubiquitous distribution of these nematodes, in the investigated group only travelers to tropical and subtropical countries were affected; 28.9% of the patients had symptoms for > 1 month, and for 24.5% the probable incubation period was > 2 weeks. The efflorescences typically were on the lower extremities (73.4% of all locations). The buttocks and anogenital region were affected in 12.6% of all locations, and the trunk and upper extremities each were affected in 7.1%. Only a minority of patients presented with eosinophilia or an elevated serum level of IgE. No other laboratory data appeared to be related to the disease. Therapy with topical thiabendazole was successful for 98% of the patients. Systemic antihelmintic therapy was necessary in two cases because of disseminated, extensive infection

Malaria in Nonimmune Travelers

Background: With the current increase of international travel to tropical endemic areas, the incidence of malaria being imported into nonendemic countries has increased significantly. Disagreement concerning malaria chemoprophylaxis and inadequate knowledge of malarious areas, morbidity, and pretravel advise has led to confusion among both health professionals as well as travelers. Therefore, this study was conducted to investigate malaria imported into Germany by identifying the high-risk endemic areas, clinical presentations, and chemoprophylactic and therapeutic regimens related to reported cases. Methods: Between 1990 and 1993, the 160 nonimmune travelers, all German nationals or residents for more than 10 years, presenting to our travel clinic with microscopically confirmed malaria were investigated. For each, the travel history, chemoprophylaxis used during travel, symptoms, pathological diagnosis, and treatment efficacy were analyzed. Results: Africa (73%), Asia (21%), and Central South America (6%) were the endemic countries visited by our patients, of whom only 3% used the chemoprophylaxis recommended for their destination. Plasmodium falciparum was the most common pathogen, found in more than half of our patients, and P. vivax (29%), P. ova le (6%), P. malariae(6%), a mixed infection with P.falciparum and P vivax (3%) were also detected. All patients presented with fever and headaches, a majority with profuse night sweats, insomnia, arthralgias, and myalgias, and diarrhea and abdominal cramps were experienced in 13% and 8%, respectively. In falciparum malaria, a recrudescence was observed in all patients who received chloroquine only, whereas quinine, halofantrine, and mefloquine were highly effective. In vivax malaria, a relapse rate of 14% was noted in the patients treated with the currently recommended regimen of chloroquine and primaquine. Conclusions: Visitors to endemic countries, especially to Africa, are of significant risk. Given the low compliance rate of chemoprophylaxis, a high percentage of malaria in our patients could have been avoided by an appropriate prophylaxis regimen and optimal pretravel counseling

Gnathostomiasis nach Aufenthalt in Thailand.

During a 4-week holiday in Thailand a 13-year-old boy from Germany briefly fell ill with diarrhoea without blood-tinged stools and fever. 5 months later oedematous, reddish swellings occurred, at first on the right upper arm, later over the right side of the chest. Especially at night these swellings were associated with severe local and generalized itching. Bilaterally the axillary lymph-nodes were hard and slightly enlarged. There was a marked eosinophilia of 56%, the white count was 22,700/microliters and the serum level of IgE was raised to 1777 IU/ml. No worm eggs or larvae were found in the stool. Enzyme-linked immunosorbent assay, using larvae of Gnathostoma spinigerum as antigen, demonstrated antibodies against this nematode. Gnathostomiasis having been diagnosed treatment was started with albendazole (200 mg twice daily for 21 days), after which the boy was symptom free. After 2 months the eosinophilia had regressed to 10%, the white cell count was normal and the antibody titre had fallen

Epuraea imperialis (Reitter, 1877). New invasive species of Nitidulidae (Coleoptera) in Europe, with a checklist of sap beetles introduced to Europe and Mediterranean areas

Australian species Epuraea imperialis (Reitter, 1877), previously introduced to New Zealand, is recorded as a new invasive species from the Canary Islands, Continental Spain, Portugal, France, Belgium, and Italy. It is redescribed and figured, and its taxonomic position in the genus Epuraea Erichson, 1843 is discussed. A tentative checklist of sap beetles introduced to Europe and the Mediterranean areas is finally included

A Review of the External Validity of Clinical Trials with Beta-Blockers in Heart Failure

This is an open-access article distributed under the terms of the Creative Commons CC-BY-NC 3.0 License.Background: Beta-blockers (BBs) are the mainstay prognostic medication for all stages of chronic heart failure (CHF). There are many classes of BBs, each of which has varying levels of evidence to support its efficacy in CHF. However, most CHF patients have one or more comorbid conditions such as diabetes, renal impairment, and/or atrial fibrillation. Patient enrollment to randomized controlled trials (RCTs) often excludes those with certain comorbidities, particularly if the symptoms are severe. Consequently, the extent to which evidence drawn from RCTs is generalizable to CHF patients has not been well described. Clinical guidelines also underrepresent this point by providing generic advice for all patients. The aim of this review is to examine the evidence to support the use of BBs in CHF patients with common comorbid conditions. Methods: We searched MEDLINE, PubMed, and the reference lists of reviews for RCTs, post hoc analyses, systematic reviews, and meta-analyses that report on use of BBs in CHF along with patient demographics and comorbidities. Results: In total, 38 studies from 28 RCTs were identified, which provided data on six BBs against placebo or head to head with another BB agent in ischemic and nonischemic cardiomyopathies. Several studies explored BBs in older patients. Female patients and non-Caucasian race were underrepresented in trials. End points were cardiovascular hospitalization and mortality. Comorbid diabetes, renal impairment, or atrial fibrillation was detailed; however, no reference to disease spectrum or management goals as a focus could be seen in any of the studies. In this sense, enrollment may have limited more severe grades of these comorbidities. Conclusions: RCTs provide authoritative information for a spectrum of CHF presentations that support guidelines. RCTs may provide inadequate information for more heterogeneous CHF patient cohorts. Greater Phase IV research may be needed to fill this gap and inform guidelines for a more global patient population

Chiral metamaterials: retrieval of the effective parameters with and without substrate

After the prediction that strong enough optical activity may result in negative refraction and negative reflection, more and more artificial chiral metamaterials were designed and fabricated at difference frequency ranges from microwaves to optical waves. Therefore, a simple and robust method to retrieve the effective constitutive parameters for chiral metamaterials is urgently needed. Here, we analyze the wave propagation in chiral metamaterials and follow the regular retrieval procedure for ordinary metamaterials and apply it in chiral metamaterial slabs. Then based on the transfer matrix technique, the parameter retrieval is extended to treat samples with not only the substrate but also the top layers. After the parameter retrieval procedure, we take two examples to check our method and study how the substrate influences on the thin chiral metamaterials slabs. We find that the substrate may cause the homogeneous slab to be inhomogeneous, i.e. the reflections in forward and backward directions are different. However, the chiral metamaterial where the resonance element is embedded far away from the substrate is insensitive to the substrate.Comment: 15 pages, 6 figure

Detection and diversity of a putative novel heterogeneous polymorphic proline-glycine repeat (Pgr) protein in the footrot pathogen Dichelobacter nodosus

Dichelobacter nodosus, a Gram-negative anaerobic bacterium, is the essential causative agent of footrot in sheep. Currently, depending on the clinical presentation in the field, footrot is described as benign or virulent; D. nodosus strains have also been classified as benign or virulent, but this designation is not always consistent with clinical disease. The aim of this study was to determine the diversity of the pgr gene, which encodes a putative proline-glycine repeat protein (Pgr). The pgr gene was present in all 100 isolates of D. nodosus that were examined and, based on sequence analysis had two variants, pgrA and pgrB. In pgrA, there were two coding tandem repeat regions, R1 and R2: different strains had variable numbers of repeats within these regions. The R1 and R2 were absent from pgrB. Both variants were present in strains from Australia, Sweden and the UK, however, only pgrB was detected in isolates from Western Australia. The pgrA gene was detected in D. nodosus from tissue samples from two flocks in the UK with virulent footrot and only pgrB from a flock with no virulent or benign footrot for >10 years. Bioinformatic analysis of the putative PgrA protein indicated that it contained a collagen-like cell surface anchor motif. These results suggest that the pgr gene may be a useful molecular marker for epidemiological studies

Oligo-Miocene magnetostratigraphy and rock magnetism of the Xishuigou section, Subei (Gansu Province, western China) and implications for shallow inclinations in central Asia.

Magnetostratigraphy of 222 remanent directions together with late Oligocene to early Miocene mammal and charophyte paleontology suggest that 2179 m of the Xishuigou section (Subei, Gansu Province, China) were deposited from ~26 to ~19 Ma. Stratigraphic patterns of bulk susceptibility, anisotropy of magnetic susceptibility parameters, and natural and anhysteretic remanent magnetization intensities demonstrate that (1) faulting does not significantly affect the record, (2) sediment deposition was relatively continuous, (3) sediment source changed around 23 Ma, and (4) rapid uplift near Subei occurred at 21 Ma. Subei rotated 27° ± 5° counterclockwise with respect to the 20 Ma pole from the Eurasian synthetic apparent polar wander path. Folding and rotation of the section took place after 19 Ma. The paleolatitude of Subei is 14° less than at present and 19° ± 3° less than predicted from the reference pole. Both rock magnetic and paleomagnetic data sets suggest that the unusually low paleolatitude is the result of synsedimentary inclination shallowing, a phenomenon which has likely affected other paleomagnetic data from central Asia

A trio of gamma-ray burst supernovae: GRB 120729A, GRB 130215A/SN 2013ez, and GRB 130831A/SN 2013fu

We present optical and near-infrared (NIR) photometry for three gamma-ray burst supernovae (GRB-SNe): GRB 120729A, GRB 130215A/SN 2013ez, and GRB 130831A/SN 2013fu. For GRB 130215A/SN 2013ez, we also present optical spectroscopy at t − t0 = 16.1 d, which covers rest-frame 3000–6250 Å. Based on Fe ii λ5169 and Si ii λ6355, our spectrum indicates an unusually low expansion velocity of ~4000–6350 km s-1, the lowest ever measured for a GRB-SN. Additionally, we determined the brightness and shape of each accompanying SN relative to a template supernova (SN 1998bw), which were used to estimate the amount of nickel produced via nucleosynthesis during each explosion. We find that our derived nickel masses are typical of other GRB-SNe, and greater than those of SNe Ibc that are not associated with GRBs. For GRB 130831A/SN 2013fu, we used our well-sampled R-band light curve (LC) to estimate the amount of ejecta mass and the kinetic energy of the SN, finding that these too are similar to other GRB-SNe. For GRB 130215A, we took advantage of contemporaneous optical/NIR observations to construct an optical/NIR bolometric LC of the afterglow. We fit the bolometric LC with the millisecond magnetar model of Zhang & Mészáros (2001, ApJ, 552, L35), which considers dipole radiation as a source of energy injection to the forward shock powering the optical/NIR afterglow. Using this model we derive an initial spin period of P = 12 ms and a magnetic field of B = 1.1 × 1015 G, which are commensurate with those found for proposed magnetar central engines of other long-duration GRBs