Background information about Avian Infl uenza and hints for ornithologists

Wildvögel, v.a. Wassergeflügel, sind Reservoir für alle Influenzaviren. Von wirtschaftlicher Bedeutung sind die Subtypen H5 und H7, während H1, H2 und H3 Erreger der Humangrippe sind. Diese niedrig pathogenen Vogelgrippeviren verursachen normalerweise bei infi zierten Vögeln keine klinischen Symptome. Nach Transfer niedrig pathogener Vogelgrippeviren in Geflügelhaltungen mit den daraus resultierenden, rasch aufeinander folgenden Virenzyklen durch rasche Vogelpassagen und sofortige Neuinfektion kann sich ein solches niedrig pathogenes Virus jedoch in ein hoch pathogenes Vogelgrippevirus (HPAI-Virus) umwandeln. Diese hoch pathogenen Viren können dann sowohl wieder über Wildvögel, als auch über Transport kontaminierter Vögel, Gefl ügelprodukte und Materialien sowie über Wasser weiterverbreitet werden. Der aktuelle, große Ausbruch der Gefl ügelgrippe geht auf den HPAI-Virus H5N1 zurück, der vermutlich in den späten 1990er Jahren in Hausenten in Südchina entstanden ist. Im Jahr 2005 begann diese Krankheit, sich von Südostasien aus westwärts zu verbreiten und trat damit als direkte Bedrohung für europäische Geflügelbestände in Erscheinung. Außerdem wurden einige wenige menschliche Fälle einer HPAI H5N1-Erkrankung aus Südostasien gemeldet. Alle diese menschlichen Erkrankungen standen mit sehr engen Kontakten zu oder Verspeisen von infizierten Tieren (vor allem Hühner, Enten und Schweine) in Verbindung und eine mögliche Mensch-zu-Mensch-Übertragung wird noch kontrovers diskutiert. Obwohl die Vogelgrippe nach wie vor eine Geflügelkrankheit ist, besteht die Möglichkeit, dass sich das Virus in seiner genetischen Struktur – z.B. durch Vermischung mit einem Humangrippevirus – so verändern kann, dass es leicht zwischen Menschen übertragen werden kann und bei diesen auf ein weitgehend unvorbereitetes Immunsystem trifft. Obwohl sich die Wahrscheinlichkeit einer solchen Veränderung nicht abschätzen lässt, liefern drei Pandemien im 20 Jahrhundert, die alle auf mutierte Vogelgrippeviren zurückzuführen sind, genug Anlass zur sorgfältigen Beobachtung der momentanen Lage.Waterfowl are known to be the major reservoir for all 16 H- and 9 N- Subtypes of low pathogenic avian infl uenza viruses (LPAIV), including the subtypes H5 and H7 being a serious economic threat to the poultry industry as well as H1, H2, H3 that are the main source for human infl uenza. LPAI neither cause any signs of disease in the infected wild birds nor in poultry. However, low pathogenic avian infl uenza virus of the subtypes H5 and H7 can be introduced into poultry holdings. Especially in industrial holdings with large numbers of highly susceptible animals, the previously stable viruses of low pathogenicity begin to evolve rapidly and may mutate into highly pathogenic avian infl uenza (HPAI) (known as fowl plague and also called „bird flu“) causing up to 100% mortatlity in infected birds. Aft erwards, infections of HPAI are usually spread by movement of stock, infectious feces, contaminated water or bird products. Free fl ying birds are usually also blamed to spread the disease, but this could be never proven to have happened. Since 1959 none of the outbreaks of HPAI has approached the size of the ongoing epizootic in Southeast Asia, which most probably originated in the late 1990 ies presumbly in captured ducks in Southern China and is caused by a new HPAI virus of the subtype H5N1. In 2005 the disease started to spread westwards and appears to be a threat for European poultry. Th e asian H5N1 cause serious public health concern for at least three reasons. Th ese AIV isolates can cause heavy economic losses in the poultry industry and through loss of poultry may exaggerate to human food protein defi cits in the developing world. In addition, they have the potential to cross the species barriers and cause human disease and death though only when connected to very close contacts with infected animals or raw consumption of infected birds (chicken, ducks). Last but not least there is the potential of the virus to change it‘s genetic structure – most probably by mixing with a human infl uenza virus (H1, H2, H3) that may achieve human-to-human spread by meeting the unprepared immune system of men resulting in a new human pandemia. Th ree pandemias during the 20 th century – all originating from HPAI viruses- emphasise the danger of the probability of H5N1 becoming the next pandemia virus

Influenza A(H1N1) infection and severe cardiac dysfunction in adults: A case series

Zusammenfassung: HINTERGRUND: Während die virale Myokarditis und das Herzversagen anerkannte und gefürchtete Komplikationen einer saisonalen Influenza A Infektion sind, liegen bislang nur wenig Informationen über ein durch das 2009 Influenza A(H1N1) Virus induziertes Herzversagen vor. METHODEN UND HAUPTERGEBNISSE: Diese Fallsammlung fasst den Krankheitsverlauf von vier Patienten mit 2009 Influenza A(H1N1) Infektion zusammen, welche an unserer Klinik im Zeitraum von November 2009 bis September 2010 behandelt wurden. Alle Patienten präsentierten sich mit einer schweren kardialen Funktionsstörung (akutes Herzversagen, kardiogener Schock oder Herzkreislaufstillstand im Rahmen eines Kammerflimmerns) als das führende Symptom einer Influenza A(H1N1) Infektion. Zwei Patienten waren mit hoher Wahrscheinlichkeit kardial vorerkrankt, und drei benötigten eine Katecholamintherapie, um die hämodynamische Funktion zu stabilisieren. Mit Ausnahme eines Patienten der vor der Diagnosestellung der Influenza A(H1N1) Infektion verstarb, wurden alle Patienten mit einer antiviralen Therapie mit Oseltamivir und supportiver Intensivtherapie behandelt. Ein Acute Respiratory Distress Syndrom infolge der Influenza A(H1N1) Infektion trat bei einem Patienten auf. Die Herzfunktion normalisierte sich bei zwei Patienten und war bei einem Patienten noch bei Krankenhausentlassung eingeschränkt. SCHLUSSFOLGERUNG: Eine Influenza A(H1N1) Infektion kann mit einer schweren kardialen Funktionseinschränkung assoziiert sein. Diese kann sich sogar als führendes klinisches Symptom darstellen. Während einer Influenza Pandemie kann eine genaue Anamneseerhebung Grippeähnliche Symptome hervorbringen und sollte auch bei kritisch kranken Patienten mit akutem Herzversagen eine Diagnostik auf H1N1 Infektion veranlasse

53-jähriger Patient mit Fieber und Husten

Zusammenfassung: Wir beschreiben einen Patienten mit später HIV-Präsentation, Meningitis tuberculosa und offener Lungentuberkulose bei Miliartuberkulose unter schwerer HIV-assoziierter Immunsuppression. Im Verlauf tritt eine weitere opportunistische Infektion (Pneumocystis-jiroveci-Pneumonie) und im Rahmen der antiretroviralen Therapie ein Immunrekonstitutionssyndrom (IRIS) auf. Letzteres führt zu weiteren Organmanifestationen der Miliartuberkulose (urogenital, gastrointestinal). Mit der späten HIV-Präsentation assoziierte Probleme sind opportunistische Infektionen und das IRIS zu Beginn der antiretroviralen Therapie. Die Wahl des Behandlungszeitpunkts der HIV-Infektion bei gleichzeitiger opportunistischer Infektion ist entscheiden

Revision of reversed shoulder arthroplasty : is a reoperation possible?

Introduction. As the number of reversed shoulder arthroplasty (RSA) procedures increases, the revision rate will also increase. In case of severe bone insufficiency, instability or infection of the primary RSA, revision to another RSA is preferable but not always possible. Hemiarthroplasty (HA), spacers and resection arthroplasty (RA) have been described in this indication. Materials and methods. Between 2004 and 2016, 20 shoulders in 19 patientswere treated at Ghent University Hospital for failed revision of RSA. Nine received a megahead prosthesis, a spacerwas implanted in 6, and 5 underwent RA. Results. Indications for implantation of a megahead prosthesis were loosening RSA (n = 5), infection (n = 4), dislocation (n = 1) and nerve irritation (n = 1). Improvement of range ofmotionwas observed. Anterosuperior migration of the prosthesis was noted in 2 patients. Another 2 patients were ultimately revised to RSA. Seven permanent spacerswere implanted for infection, of which 2 remain in place till today. The other 5 were revised to RSA. Of the 5 patients treated with RA, 3 were revised further on to RSA, resulting in pain relief and regain of function. Discussion. Our study shows that amegahead prosthesis has better functional results than RA, but is inferior to RSA. Due to increasing surgical experience and improving technique, 9 patients could ultimately be reconverted to another RSA. A review of current literature is presented. In HA and RA, the functional results are poor, and pain relief is uncertain. Results of spacers are variable and can be satisfactory. Arthrodesis is a last resort. Conclusion. In our case series study, a hemiarthroplasty can be performed in case of failure of RSA. However, the results are inferior to another RSA

Nephropathia epidemica and Puumala virus occurrence in relation to bank vole (Clethrionomys glareolus) dynamics and environmental factors in northern Sweden

The objectives of the thesis were to investigate the spatio-temporal patterns of nephropathia epidemica (NE) in humans and Puumala virus (PUU) occurrence in relation to bank vole (Clethrionomys glareolus) dynamics and environmental factors in a region of high incidence of NE in northern Sweden. Nephropathia epidemica is a mild form of hemorrhagic fever with renal syndrome, and in northern Sweden the most prevailing serious febrile viral infection, second to influenza. All serologically confirmed NE cases during 1991-2001 in the four northernmost counties (n = 2,468) were used to establish spatio-temporal patterns of the occurrence of the human disease. Within the study region, the bank voles show marked population fluctuations with 3-4 yr cycles and the incidence of NE has a temporal component strongly correlated to annual numbers of bank voles in autumn. People living in rural dwellings near coastal areas were abundant among notified cases and middle-aged males were over-represented. The patients were often infected in autumn when engaged in activities such as handling of fire wood, gardening or hay-handling near man-made rodent refugia or cleaning/redecorating within one. A proportion of these patients, confident about site of PUU exposure, were used to establish field sites in two separate studies. Firstly a five year study (1995-1999) at six sites spanning a bank vole population cycle, and secondly a spatially extensive study at 32 sites was conducted in autumn 1998. Densities, fluctuations and demography of vole populations differ between sites of known occurrence of NE were compared to random forest sites. Five years of repeated biannual sampling revealed that case sites harbored more bank voles than random forest sites, in particular during population peaks. For the individual bank voles, the probability of PUU infection was significantly higher in population peak year, increased with age and was higher for males than for females. In the spatially extended study, it was found that in particular environmental characteristics associated with old-growth moist forests (i.e. Alectoria spp., Picea abies, fallen wood and Vaccinium myrtillus) were associated with high bank vole numbers and numbers of PUU infected bank voles. This implies that success in circulation and persistence of PUU within local bank vole populations is strongly influenced by the local environments. In future modeling of PUU transmission, influence of bank vole demography and environmental factors should be useful on establishing risk assessments and identifying areas of particular risk of PUU exposure

Infection and transmission of Nosema bombi in Bombus terrestris colonies and its effect on hibernation, mating and colony founding

The impact of the microsporidium Nosema bombi on Bombus terrestris was studied by recording mating, hibernation success, protein titre in haemolymph, weight change during hibernation, and colony founding of queens that were inoculated with N. bombi in the larval phase. Infection with N. bombi was diagnosed in 36% of B. terrestris queens exposed to N. bombi. Mating and hibernation of queens was not significantly affected by N. bombi infection but colony founding was reduced significantly. Haemolymph protein titre of N. bombi diseased queens was reduced, possibly indicating a disturbance of the metabolism. It was demonstrated that N. bombi infection was transmitted to the successive age cohorts in a colony and to the adults that were already in the colony prior to the introduction of the infection. The study showed a significant negative impact of N. bombi on B. terrestris colony development and indoor rearing

HUBUNGAN KADAR HEMOGLOBIN IBI HAMIL TRIMESTER III DENGAN LAMA PERSALINAN DI RB ANNISA KOTA SEMARANG

Kematian ibu di Indonesia yaitu 390 per 100000 kelahiran hidup merupakan tertinggi di ASEAN menurut SDKI 1994. Penyebab langsung kematian ibu antara lain perdarahan (28%), eklampsia (24 %), infeksi(11%), partus lama (5%), abortus (5%) dan lain-lain (11%). Penyebab tidak langsungnya antara lain anemia, kurang energi kronis (KEK) dan keadaan 4 terlalu (terlalu muda/tua, sering dan banyak). Penelitian ini bertujuan untuk mengetahui hubungan kadar Hb ibu trimester III dengan lama persalinan di RB Annisa Kota Semarang. Jenis penelitian ini adalah explanatory research dengan metode survei analitik dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah seluruh ibu hamil trimester III yang memeriksakan kemalilan dan bersalin di RB Annisa Kota Semarang sebanyak 52 orang ibu hamil. Pengambilan sampel dilakukan secara purposive. Pengol;ahan dan amalisa data dilakukan dengan menggunakan komputer SPSS 10.0 diuji dengan uji Chi-Square untuk keseluruhan responden kemudian dibagi atas primipara dan multipara dan masing-masing diuji lagi dengan korelasi Pearson Product Momen. Hasil penelitian ini menunjukkan bahwa sebagian besar responden adalah primipara (65,4%), kadar Hb normal (78,8%), lama persalinan normal (84,6%). Rata-rata kadar Hb 11,594 gram %, rata-rata lama persalinan responden 242,27 menit. Standar deviasi kadar Hb 0,909. Standar deviasi lama persalinan 133,11. Hasil uji statistik dengan Chi-Square pada keseluruhan responden menunjukkan probabilitas 0,218 artinya tidak ada hubungan antara kadar hb ibu hamil trimester III dengan lama persalinan di RB Annisa Kota Semarang. Pda primipara setelah diuji dengan korelasi Pearson Product Momen menunujukkan bahwa tidak ada hubungan antara kadar hb ibu hamil trimester III dengan lama persalinan di RB Annisa Kota Semarang (p=0,080; r=-0,304). Demikian juga pada multipara tidak ada hubungan antara kadar hb ibu hamil trimester III dengan lama persalinan di RB Annisa Kota Semarang (p=0,394; r=0,214). Disarankan bagi peneliti lain agar penelitian selanjutnya dapar meneliti variabel-variabel lain yang belum diteliti yang mungkin berhubungan dan mempengaruhi lama persalinan dengan jumlah sampel yang lebih besar. Kata Kunci: Kadar Hb, hamil, lama persalinan RELATION OF PREGNANT WOMAN HEMOGLOBIN RATE (HB) TRIMESTER III WITH LONG DURATION LABOUR IN RB ANNISA SEMARANG Mother mortality in Indonesia that is 390 per 100000 birth of life represent highest in ASEAN according to SDKI 1994. Direct cause of mother mortality for example bleeding (28%), eklampsia (24 %), infektion(11%), prolonged labour(5%), abortus (5%) others (11%). Indirect cause of mother mortality for example anemia, lack chronic energy (KEK) and situation 4 too (too young/old, often and many). This research aim to know thr relation of pregnan moman Hb rate thhird trimester with long duration labour in RB Annisa Semarang. This research type is explanatory research with analitic survey method with approach of cross sectional. Population in this research is entire pregnant woman third trimester checking pregnancy and labour in RB Annisa Semarang counted 52 pregnant woman in month of April until Mei 2005. Intake of sample done by purposive. Processing and data analysis done by using SPSS computer 10.0 tested with Chi-Square test to the overall of reponder then divided to the multipara and primipara and each tested again with Pearson Product Moment correlation. Result of this research indicate that most responder is primipara (65,4%), normal Hb rate (78,8%), normal long duration labour (84,6%). Rate Hb mean 11,594 gram %, responder duration labour mean 242,27 menutes. Deviasi Hb rate standard 0,909. Deviasi standard duration labour 133,11. Result of statistical test with Chi-Square at overall of responder show its 1,218 probability mean there is no relation between pregnant women hb rate of third trimester with long duration labour in RB Annisa Semarang. At primipara after tested with Pearson Product Moment correlation indicate that there is no relation between pregnant women hb rate of third trimester with long duration labour in RB Annisa Semarang (p=0,080; r=-0,304). And so do at multipara there is no relation between pregnant women hb rate of third trimester with long duration labour in RB Annisa Town Semarang (p=0,394; r=0,214). Suggested to other researcher so that furthermore research can check other variable like styles of eat some food in pregnant women which not yet been checed which possible correlate and influence long duration labour with amount of larger ones sampel. Keyword: Rate Hb, Pregnant, Long duration labou