Akute Gefäßerkrankungen in der Gastroenterologie

Zusammenfassung: Vaskulär-gastroenterologische Notfälle zählen zu den häufigen Krankheitsbildern auf internistischen und chirurgischen Notfallstationen. Die klinischen Konsequenzen reichen von trivialen bis zu lebensbedrohlichen Situationen. Nur eine frühzeitige Erkennung der Symptomenkomplexe und die Anwendung der adäquaten diagnostischen Mittel führen zur korrekten Diagnosestellung mit nachfolgend - möglicherweise lebensrettender - Therapie. Um die hohen Mortalitätsraten der akuten Mesenterialischämien (50%), aortoenterischen Fisteln (30-40%), Aneurysmen viszeraler Arterien (10-100%) sowie des Budd-Chiari-Syndroms weiter senken zu können, gewinnen neue Strategien mit endovaskulärem Therapieansatz zunehmend an Bedeutung und ersetzen teilweise über viele Jahrzehnte etablierte Diagnose- und Therapiealgorithmen. Diese Übersichtsarbeit soll einen Überblick über aktuelle Diagnostik- und Therapiekonzepte häufiger vaskulär-gastroenterologischer Notfälle verschaffe

Population density, water supply, and the risk of dengue fever in Vietnam: cohort study and spatial analysis.

BACKGROUND: Aedes aegypti, the major vector of dengue viruses, often breeds in water storage containers used by households without tap water supply, and occurs in high numbers even in dense urban areas. We analysed the interaction between human population density and lack of tap water as a cause of dengue fever outbreaks with the aim of identifying geographic areas at highest risk. METHODS AND FINDINGS: We conducted an individual-level cohort study in a population of 75,000 geo-referenced households in Vietnam over the course of two epidemics, on the basis of dengue hospital admissions (n = 3,013). We applied space-time scan statistics and mathematical models to confirm the findings. We identified a surprisingly narrow range of critical human population densities between around 3,000 to 7,000 people/km² prone to dengue outbreaks. In the study area, this population density was typical of villages and some peri-urban areas. Scan statistics showed that areas with a high population density or adequate water supply did not experience severe outbreaks. The risk of dengue was higher in rural than in urban areas, largely explained by lack of piped water supply, and in human population densities more often falling within the critical range. Mathematical modeling suggests that simple assumptions regarding area-level vector/host ratios may explain the occurrence of outbreaks. CONCLUSIONS: Rural areas may contribute at least as much to the dissemination of dengue fever as cities. Improving water supply and vector control in areas with a human population density critical for dengue transmission could increase the efficiency of control efforts. Please see later in the article for the Editors' Summary

Epidemiology of Dengue Virus in Iquitos, Peru 1999 to 2005: Interepidemic and Epidemic Patterns of Transmission

To develop prevention (including vaccines) and control programs for dengue fever, a significant mosquito-borne disease in the tropics, there is an urgent need for comprehensive long term field epidemiological studies. We report results from a study that monitored ∼2,400 school children and some adult family members for dengue infection at 6 month intervals from 1999 to 2005, in the Amazonian city of Iquitos, Peru. At enrollment, ∼80% of the participants had a previous infection with DENV serotypes 1 and 2 or both. During the first 15 months, about 3 new infections for every 100 participants were observed among the study participants. In 2001, DENV-3, a serotype not previously observed in the region, invaded Iquitos in a process characterized by 3 distinct periods: amplification over at least a 5–6 month period, replacement of previously circulating serotypes, and epidemic transmission when incidence peaked. Incidence patterns of new infections were geographically distinct from baseline prevalence rates prior to arrival of DENV-3, but closely mirrored them during the invasion. DENV transmission varied geographically corresponding to elevated mosquito densities. The invasion of a novel serotype is often characterized by 5–6 months of silent transmission before traditional surveillance programs detect the virus. This article sets the stage for subsequent publications on dengue epidemiology

Barrier and internal wave contributions to the quantum probability density and flux in light heavy-ion elastic scattering

We investigate the properties of the optical model wave function for light heavy-ion systems where absorption is incomplete, such as $\alpha + ^{40}$Ca and $\alpha + ^{16}$O around 30 MeV incident energy. Strong focusing effects are predicted to occur well inside the nucleus, where the probability density can reach values much higher than that of the incident wave. This focusing is shown to be correlated with the presence at back angles of a strong enhancement in the elastic cross section, the so-called ALAS (anomalous large angle scattering) phenomenon; this is substantiated by calculations of the quantum probability flux and of classical trajectories. To clarify this mechanism, we decompose the scattering wave function and the associated probability flux into their barrier and internal wave contributions within a fully quantal calculation. Finally, a calculation of the divergence of the quantum flux shows that when absorption is incomplete, the focal region gives a sizeable contribution to nonelastic processes.Comment: 16 pages, 15 figures. RevTeX file. To appear in Phys. Rev. C. The figures are only available via anonynous FTP on ftp://umhsp02.umh.ac.be/pub/ftp_pnt/figscat

Expanding the Repertoire of Natural Product-Inspired Ring Pairs for Molecular Recognition of DNA

A furan amino acid, inspired by the recently discovered proximicin natural products, was incorporated into the scaffold of a DNA-binding hairpin polyamide. While unpaired oligomers of 2,4-disubstituted furan amino acids show poor DNA-binding activity, furan (Fn) carboxamides paired with N-methylpyrrole (Py) and N-methylimidazole (Im) rings demonstrate excellent stabilization of duplex DNA as well as discrimination of noncognate sequences, consistent with function as a Py mimic according to the Py/Im polyamide pairing rules

Analytic curves in algebraic varieties over number fields

We establish algebraicity criteria for formal germs of curves in algebraic varieties over number fields and apply them to derive a rationality criterion for formal germs of functions, which extends the classical rationality theorems of Borel-Dwork and P\'olya-Bertrandias valid over the projective line to arbitrary algebraic curves over a number field. The formulation and the proof of these criteria involve some basic notions in Arakelov geometry, combined with complex and rigid analytic geometry (notably, potential theory over complex and $p$-adic curves). We also discuss geometric analogues, pertaining to the algebraic geometry of projective surfaces, of these arithmetic criteria.Comment: 55 pages. To appear in "Algebra, Arithmetic, and Geometry: In Honor of Y.i. Manin", Y. Tschinkel & Yu. Manin editors, Birkh\"auser, 200

The Extinction of Dengue through Natural Vulnerability of Its Vectors

Dengue transmission has not always been confined to tropical areas. In some cases, this has been due to a reduced geographic range of the mosquitoes that are able to carry dengue viruses. In Australia, Aedes aegypti mosquitoes once occurred throughout temperate, drier parts of the country but are now restricted to the wet tropics. We used a computer modelling approach to determine whether these mosquitoes could inhabit their former range. This was done by simulating dengue mosquito populations in virtual environments that experienced 10 years of actual daily weather conditions (1998–2007) obtained for 13 locations inside and outside the current tropical range. We discovered that in areas outside the Australian wet tropics, Ae. aegypti often becomes extinct, particularly when conditions are too cool for year-round egg-laying activity, and/or too dry for eggs to hatch. Thus, despite being a global pest and disease vector, Ae. aegypti mosquitoes are naturally vulnerable to extinction in certain conditions. Such vulnerability should be exploited in vector control programs

Widespread West Nile virus activity, eastern United States, 2000.

In 1999, the U.S. West Nile (WN) virus epidemic was preceded by widespread reports of avian deaths. In 2000, ArboNET, a cooperative WN virus surveillance system, was implemented to monitor the sentinel epizootic that precedes human infection. This report summarizes 2000 surveillance data, documents widespread virus activity in 2000, and demonstrates the utility of monitoring virus activity in animals to identify human risk for infection

Dengue epidemics and human mobility

In this work we explore the effects of human mobility on the dispersion of a vector borne disease. We combine an already presented stochastic model for dengue with a simple representation of the daily motion of humans on a schematic city of 20x20 blocks with 100 inhabitants in each block. The pattern of motion of the individuals is described in terms of complex networks in which links connect different blocks and the link length distribution is in accordance with recent findings on human mobility. It is shown that human mobility can turn out to be the main driving force of the disease dispersal.Comment: 24 pages, 13 figure