Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy

BACKGROUND: Morgellons is a poorly characterized constellation of symptoms, with the primary manifestations involving the skin. We conducted an investigation of this unexplained dermopathy to characterize the clinical and epidemiologic features and explore potential etiologies. METHODS: A descriptive study was conducted among persons at least 13 years of age and enrolled in Kaiser Permanente Northern California (KPNC) during 2006-2008. A case was defined as the self-reported emergence of fibers or materials from the skin accompanied by skin lesions and/or disturbing skin sensations. We collected detailed epidemiologic data, performed clinical evaluations and geospatial analyses and analyzed materials collected from participants' skin. RESULTS: We identified 115 case-patients. The prevalence was 3.65 (95% CI = 2.98, 4.40) cases per 100,000 enrollees. There was no clustering of cases within the 13-county KPNC catchment area (p = .113). Case-patients had a median age of 52 years (range: 17-93) and were primarily female (77%) and Caucasian (77%). Multi-system complaints were common; 70% reported chronic fatigue and 54% rated their overall health as fair or poor with mean Physical Component Scores and Mental Component Scores of 36.63 (SD = 12.9) and 35.45 (SD = 12.89), respectively. Cognitive deficits were detected in 59% of case-patients and 63% had evidence of clinically significant somatic complaints; 50% had drugs detected in hair samples and 78% reported exposure to solvents. Solar elastosis was the most common histopathologic abnormality (51% of biopsies); skin lesions were most consistent with arthropod bites or chronic excoriations. No parasites or mycobacteria were detected. Most materials collected from participants' skin were composed of cellulose, likely of cotton origin. CONCLUSIONS: This unexplained dermopathy was rare among this population of Northern California residents, but associated with significantly reduced health-related quality of life. No common underlying medical condition or infectious source was identified, similar to more commonly recognized conditions such as delusional infestation

Free-living amoebae and their associated bacteria in Austrian cooling towers: a 1-year routine screening

Free-living amoebae (FLA) are widely spread in the environment and known to cause rare but often serious infections. Besides this, FLA may serve as vehicles for bacterial pathogens. In particular, Legionella pneumophila is known to replicate within FLA thereby also gaining enhanced infectivity. Cooling towers have been the source of outbreaks of Legionnaires' disease in the past and are thus usually screened for legionellae on a routine basis, not considering, however, FLA and their vehicle function. The aim of this study was to incorporate a screening system for host amoebae into a Legionella routine screening. A new real-time PCR-based screening system for various groups of FLA was established. Three cooling towers were screened every 2 weeks over the period of 1 year for FLA and Legionella spp., by culture and molecular methods in parallel. Altogether, 83.3 % of the cooling tower samples were positive for FLA, Acanthamoeba being the dominating genus. Interestingly, 69.7 % of the cooling tower samples were not suitable for the standard Legionella screening due to their high organic burden. In the remaining samples, positivity for Legionella spp. was 25 % by culture, but overall positivity was 50 % by molecular methods. Several amoebal isolates revealed intracellular bacteria.TRP 209-B20(VLID)308958

PRELIMINARY EXPERIMENTS ON TRANSPIRATION COOLING IN RAMJETS AND SCRAMJETS

Transpiration cooling systems are a promising approach to handle the high wall temperatures and heat loads generated in supersonic combustion ramjets (scramjets). The German Aerospace Center DLR has developed and set up a versatile test bench to investigate the applicability of transpiration cooling systems in scramjets and the phenomena resulting out of the interaction between such a cooling system, optional shock generators like wedge shaped struts and hot gas main flow. In the publication at hand, the developed test bench and its components are presented in detail, as well as a performance analysis for it based on preliminary experiments using gas sampling and optical Schlieren investigations. Further research and planned experiments are discussed and concretized

Communications for AnyPLACE: A smart metering platform with management and control functionalities

Recent developments under the term Smart Grid change how users consume electricity and interact with the power grid. Smart metering and energy management are developments that transform the yet passive energy consumer to a participant that is actively involved in the energy market by using variable energy tariffs or by demand-response services. But such functionality demands a platform that integrates all smart devices in the users property, connects to external services and electricity providers, and has interfaces that provide information and control to the user. AnyPLACE will develop such platform. Based on the latest legislation in the European member states, it will incorporate smart meters and create links to external service providers. Furthermore, it connects the devices in the property of the end-user in order to be able to fully monitor and control the energy consumption. This paper presents the AnyPLACE idea and the problems that are solved on the communications aspect. It provides an in-depth analysis of current European legislation in the context of smart metering and provides the requirements that need to be realized by the platform. Additionally, it proposes a strategy to create a solution that can be used in any place of Europe. The paper also incorporates the security and privacy requirements in different domains and sketches a solution and architecture to fulfill these by incorporating existing open source implementations as provided by the openHAB project

Drug safety related to agents used for opioid maintenance therapy

IntroductionThere is only little data regarding drug safety related to agents used for opioid maintenance therapy (OMT).Objectives/aimsTo study drug safety and the reporting behaviour of adverse drug reactions (ADR) related to OMT.MethodsA cross-sectional questionnaire-based telephone survey among physicians providing outpatient OMT in a federal state of Germany (n = 176; response rate = 55.7%) was conducted.ResultsMost of the respondents (n = 97/55.1%) reported that they observe ADR related to buprenorphine, [dihydro]codein and [levo]methdone rarely (n = 38/21.6%), very rarely (n = 39/22.2%) or never (n = 20/11.4%). Methadone was reported to be most frequently associated with the occurrence of ADR (n = 82/46.6%), followed by levomethadone (n = 33/18.8%), buprenorphine (n = 6/3.4%), and dihydrocodeine (n = 3/1.7%). Frequently observed ADR related to these agents were gastrointestinal, nervous system and psychiatric disorders, and hyperhidrosis. Methadone and levomethadone (not buprenorphine) were reported to be frequently associated with fatigue, weight gain, and sexual dysfunction. Only buprenorphine was reported to be frequently associated with withdrawal and rebound effects, and drug intolerance. Hundred twenty-nine participants (73.3%) stated that they never report ADR related to OMT, whereas n = 19 (10.8%) did so when referring to ADR related to their complete medical practice (Chi2 = 141.070; df = 1; P &lt; 0.001).ConclusionsOur data revealed similar patterns of ADR related to outpatient OMT as those reported in the product information or in pain therapy. Motivation to report ADR related to agents used for OMT may be reduced compared to ADR related to the general medical practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.</jats:sec