Characteristics of clinical presentation of avian influenza in humans

Virusi influence A sa svojih 16 hemaglutinina (HA) i 9 neuraminidaza (NA) široko su rasprostranjeni među pticama selicama i močvaricama. Većina ptičjih sojeva ima malu patogenost, ali je nekoliko sojeva izrazito virulentno, poglavito tip H5N1. Do 1997. godine nije bilo podataka da H5N1 virus može inficirati i uzrokovati bolest u ljudi. U Hong Kongu se te godine pojavila epidemija uzrokovana virusom H5N1 u kojoj je oboljelo 18, a umrlo šest ljudi. U većine oboljelih registrirani su teži respiratorni simptomi s rendgenski utvrđenom pneumonijom. Akutni respiratorni distres sindrom i sindrom oštećenja više organa razvili su se u bolesnika sa smrtnim ishodom. Nakon 1997. godine virus je kontinuirano evoluirao, što je dovelo do promjena u antigenosti i pojačanoj virulenciji. Filogenetska analiza ukazuje da je genotip Z postao dominantan, te se počeo širiti na nepredviđen način u jugoistočnoj Aziji. Do sada je bolest zabilježena u više od 160 ljudi u jugoistočnoj Aziji, ali i u Turskoj i Iraku s 50 % mortalitetom. Većina bolesnika u početku bolesti ima vrućicu i simptome slične gripi. Gotovo svi bolesnici razvijaju i pneumoniju. Pored respiratornih simptoma, velik postotak bolesnika ima i gastrointestinalne tegobe, kao što su proljev, povraćanje i bolove u trbuhu. U težim slučajevima tijek bolesti je karakteriziran brzim razvojem difuznih plućnih infiltrata i znakovima akutnog respiratornog distres sindroma, te višestrukog zatajivanja organa. Osim toga, postoje izvještaji i o atipičnim prezentacijama i blažim oblicima bolesti. Najvažniji laboratorijski nalazi su leukopenija, poglavito limfopenija, trombocitopenija i blago povišenje vrijednosti aminotransferaza. Mehanička ventilacija i mjere intezivnog liječenja primjenjuju se u većine bolesnika, a liječenje antivirusnim lijekovima u pravilu je započinjalo sa zakašnjenjem.Influenza A viruses with their 16 hemagglutinins (HA) and 9 neuraminidases (NA) are widespread in migratory birds and water fowl. Most avian strains are of low pathogenicity, while few strains are highly pathogenic, especially subtype H5N1. Before 1997, there was no evidence indicating that H5N1 influenza virus could infect and cause disease in humans. The same year an outbreak caused by H5N1 occurred in Hong Kong resulting in six deaths among 18 people. Severe respiratory symptoms with radiological evidence of pneumonia were recorded in the majority of cases. Patients with lethal outcome developed acute respiratory distress syndrome and multiple organ dysfunction syndrome. Since 1997, H5N1 virus continued to evolve, with changes in antigenicity and enhanced pathogenicity. Phylogenetic analyses indicate that the Z genotype has become dominant, and has spread in an unprecedented fashion across Southeast Asia. So far, the desease was registered in 160 people, however in Turkey and Iraq with mortality rate of 50 %. Most patients have initial fever and an influenza- like symptoms. Amost all patients develop pneumonia. Besides respiratory symptoms, a large proportion of patients also complained of gastrointestinal symptoms such as diarrhea, vomiting, and abdominal pain. The course of the illness in severe cases was characterized by rapid development of diffuse infiltrates and manifestations of the acute respiratory distress syndrome, and multiorgan failure. Furthermore, atypical presentations, and milder cases have also been reported. Common laboratory findings have been leukopenia, particularly support as well as intensive care, while treatment with antiviral agents usually started with delay

Characteristics of clinical presentation of avian influenza in humans

Virusi influence A sa svojih 16 hemaglutinina (HA) i 9 neuraminidaza (NA) široko su rasprostranjeni među pticama selicama i močvaricama. Većina ptičjih sojeva ima malu patogenost, ali je nekoliko sojeva izrazito virulentno, poglavito tip H5N1. Do 1997. godine nije bilo podataka da H5N1 virus može inficirati i uzrokovati bolest u ljudi. U Hong Kongu se te godine pojavila epidemija uzrokovana virusom H5N1 u kojoj je oboljelo 18, a umrlo šest ljudi. U većine oboljelih registrirani su teži respiratorni simptomi s rendgenski utvrđenom pneumonijom. Akutni respiratorni distres sindrom i sindrom oštećenja više organa razvili su se u bolesnika sa smrtnim ishodom. Nakon 1997. godine virus je kontinuirano evoluirao, što je dovelo do promjena u antigenosti i pojačanoj virulenciji. Filogenetska analiza ukazuje da je genotip Z postao dominantan, te se počeo širiti na nepredviđen način u jugoistočnoj Aziji. Do sada je bolest zabilježena u više od 160 ljudi u jugoistočnoj Aziji, ali i u Turskoj i Iraku s 50 % mortalitetom. Većina bolesnika u početku bolesti ima vrućicu i simptome slične gripi. Gotovo svi bolesnici razvijaju i pneumoniju. Pored respiratornih simptoma, velik postotak bolesnika ima i gastrointestinalne tegobe, kao što su proljev, povraćanje i bolove u trbuhu. U težim slučajevima tijek bolesti je karakteriziran brzim razvojem difuznih plućnih infiltrata i znakovima akutnog respiratornog distres sindroma, te višestrukog zatajivanja organa. Osim toga, postoje izvještaji i o atipičnim prezentacijama i blažim oblicima bolesti. Najvažniji laboratorijski nalazi su leukopenija, poglavito limfopenija, trombocitopenija i blago povišenje vrijednosti aminotransferaza. Mehanička ventilacija i mjere intezivnog liječenja primjenjuju se u većine bolesnika, a liječenje antivirusnim lijekovima u pravilu je započinjalo sa zakašnjenjem.Influenza A viruses with their 16 hemagglutinins (HA) and 9 neuraminidases (NA) are widespread in migratory birds and water fowl. Most avian strains are of low pathogenicity, while few strains are highly pathogenic, especially subtype H5N1. Before 1997, there was no evidence indicating that H5N1 influenza virus could infect and cause disease in humans. The same year an outbreak caused by H5N1 occurred in Hong Kong resulting in six deaths among 18 people. Severe respiratory symptoms with radiological evidence of pneumonia were recorded in the majority of cases. Patients with lethal outcome developed acute respiratory distress syndrome and multiple organ dysfunction syndrome. Since 1997, H5N1 virus continued to evolve, with changes in antigenicity and enhanced pathogenicity. Phylogenetic analyses indicate that the Z genotype has become dominant, and has spread in an unprecedented fashion across Southeast Asia. So far, the desease was registered in 160 people, however in Turkey and Iraq with mortality rate of 50 %. Most patients have initial fever and an influenza- like symptoms. Amost all patients develop pneumonia. Besides respiratory symptoms, a large proportion of patients also complained of gastrointestinal symptoms such as diarrhea, vomiting, and abdominal pain. The course of the illness in severe cases was characterized by rapid development of diffuse infiltrates and manifestations of the acute respiratory distress syndrome, and multiorgan failure. Furthermore, atypical presentations, and milder cases have also been reported. Common laboratory findings have been leukopenia, particularly support as well as intensive care, while treatment with antiviral agents usually started with delay

Clinical and epidemiological characteristics of Q fever in hospitalized patients

Retrospektivno su analizirane kliničke i epidemiološke značajke Q-groznice u 25 bolesnika koji su hospitalizirani u Klinici za infektivne bolesti u Zagrebu od 1. siječnja do 31. prosinca 2004. godine. Dijagnoza Q-groznice postavljena je u svih bolesnika serološki, imunoenzimskim testom (ELISA). Bolest se pojavljivala od ožujka do srpnja. Svi bolesnici su se razboljeli sporadično, a stanovnici su grada Zagreba i njegove okolice. Trinaest (52, 0%) bolesnika s Q-groznicom inficirano je u mjestu stanovanja, 10 (40, 0%) u drugim dijelovima Hrvatske, dok su dva (8, 0%) bolesnika u inkubacijskom razdoblju boravila u Bosni i Hercegovini. Bilo je znatno više muškaraca, nego žena (22:3). Većina bolesnika (68, 0%) je bila u dobi od 21-40 godina. Vodeći simptomi bolesti bili su vrućica, glavobolja i kašalj, a najvažniji patološki laboratorijski nalazi ubrzana sedimentacija eritrocita i povišena vrijednost C-reaktivnog proteina. Rendgenskim slikanjem pluća u većine bolesnika otkriven je intersticijski infiltrat, smješten u jednom plućnom režnju (23 ili 92, 0%). Pleuralni izljev je registriran u dva (8, 0%) bolesnika. Bolesnici su liječeni azitromicinom, fluorokinolonima i doksiciklinom. Doksiciklin je pokazao najbolji klinički učinak. Svi bolesnici su izliječeni.We retrospectively analysed clinical and epidemiological characteristics of Q fever in 25 patients hospitalized at the University Hospital for Infectious Diseases in Zagreb from January 1 to December 31, 2004. The diagnosis of Q fever was confirmed by serology in all patients, by an enzyme-linked immunosorbent assay (ELISA). The disease occurred from March to July. All patients were sporadic cases, and they were inhabitants of Zagreb and its surrounding areas. Thirteen (52.0 %) patients with Q fever were infected in their place of living, 10 (40.0 %) in other parts of Croatia, while 2 (8.0 %) patients were in Bosnia and Hercegovina during the incubation period. There were significantly more males than females (22:3). Most of the patients (68.0 %) were aged 21–40 years. Main symptoms of disease were fever, headache, and cough, and most significant pathological laboratory findings were accelerated erythrocyte sedimentation rate and increased value of C- reactive protein. Chest X-ray revealed interstitial pulmonary infiltrates in the majority of patients, localized in a single pulmonary lobe (23 or 92.0 %). Pleural effusion was recorded in 2 (8.0 %) patients. The patients were treated with azithromycin, fluoroquinolone, and doxycycline. Doxycycline showed the best clinical efficacy. All patients were cured

Clinical and epidemiological characteristics of Q fever in hospitalized patients

Retrospektivno su analizirane kliničke i epidemiološke značajke Q-groznice u 25 bolesnika koji su hospitalizirani u Klinici za infektivne bolesti u Zagrebu od 1. siječnja do 31. prosinca 2004. godine. Dijagnoza Q-groznice postavljena je u svih bolesnika serološki, imunoenzimskim testom (ELISA). Bolest se pojavljivala od ožujka do srpnja. Svi bolesnici su se razboljeli sporadično, a stanovnici su grada Zagreba i njegove okolice. Trinaest (52, 0%) bolesnika s Q-groznicom inficirano je u mjestu stanovanja, 10 (40, 0%) u drugim dijelovima Hrvatske, dok su dva (8, 0%) bolesnika u inkubacijskom razdoblju boravila u Bosni i Hercegovini. Bilo je znatno više muškaraca, nego žena (22:3). Većina bolesnika (68, 0%) je bila u dobi od 21-40 godina. Vodeći simptomi bolesti bili su vrućica, glavobolja i kašalj, a najvažniji patološki laboratorijski nalazi ubrzana sedimentacija eritrocita i povišena vrijednost C-reaktivnog proteina. Rendgenskim slikanjem pluća u većine bolesnika otkriven je intersticijski infiltrat, smješten u jednom plućnom režnju (23 ili 92, 0%). Pleuralni izljev je registriran u dva (8, 0%) bolesnika. Bolesnici su liječeni azitromicinom, fluorokinolonima i doksiciklinom. Doksiciklin je pokazao najbolji klinički učinak. Svi bolesnici su izliječeni.We retrospectively analysed clinical and epidemiological characteristics of Q fever in 25 patients hospitalized at the University Hospital for Infectious Diseases in Zagreb from January 1 to December 31, 2004. The diagnosis of Q fever was confirmed by serology in all patients, by an enzyme-linked immunosorbent assay (ELISA). The disease occurred from March to July. All patients were sporadic cases, and they were inhabitants of Zagreb and its surrounding areas. Thirteen (52.0 %) patients with Q fever were infected in their place of living, 10 (40.0 %) in other parts of Croatia, while 2 (8.0 %) patients were in Bosnia and Hercegovina during the incubation period. There were significantly more males than females (22:3). Most of the patients (68.0 %) were aged 21–40 years. Main symptoms of disease were fever, headache, and cough, and most significant pathological laboratory findings were accelerated erythrocyte sedimentation rate and increased value of C- reactive protein. Chest X-ray revealed interstitial pulmonary infiltrates in the majority of patients, localized in a single pulmonary lobe (23 or 92.0 %). Pleural effusion was recorded in 2 (8.0 %) patients. The patients were treated with azithromycin, fluoroquinolone, and doxycycline. Doxycycline showed the best clinical efficacy. All patients were cured

Gender-dependent differences in plasma matrix metalloproteinase-8 elevated in pulmonary tuberculosis.

Tuberculosis (TB) remains a global health pandemic and greater understanding of underlying pathogenesis is required to develop novel therapeutic and diagnostic approaches. Matrix metalloproteinases (MMPs) are emerging as key effectors of tissue destruction in TB but have not been comprehensively studied in plasma, nor have gender differences been investigated. We measured the plasma concentrations of MMPs in a carefully characterised, prospectively recruited clinical cohort of 380 individuals. The collagenases, MMP-1 and MMP-8, were elevated in plasma of patients with pulmonary TB relative to healthy controls, and MMP-7 (matrilysin) and MMP-9 (gelatinase B) were also increased. MMP-8 was TB-specific (p<0.001), not being elevated in symptomatic controls (symptoms suspicious of TB but active disease excluded). Plasma MMP-8 concentrations inversely correlated with body mass index. Plasma MMP-8 concentration was 1.51-fold higher in males than females with TB (p<0.05) and this difference was not due to greater disease severity in men. Gender-specific analysis of MMPs demonstrated consistent increase in MMP-1 and -8 in TB, but MMP-8 was a better discriminator for TB in men. Plasma collagenases are elevated in pulmonary TB and differ between men and women. Gender must be considered in investigation of TB immunopathology and development of novel diagnostic markers

Chlamydia pneumoniae and Mycoplasma pneumoniae pneumonia: comparison of clinical, epidemiological characteristics and laboratory profiles

The purpose of our retrospective 3-year study was to analyse and compare clinical and epidemiological characteristics in hospitalized patients older than 6 years with community-acquired pneumonia (CAP) caused by Chlamydia pneumoniae (87 patients) and Mycoplasma pneumoniae (147 patients). C. pneumoniae and M. pneumoniae infection was confirmed by serology. C. pneumoniae patients were older (42·12 vs. 24·64 years), and were less likely to have a cough, rhinitis, and hoarseness (P<0·001). C. pneumoniae patients had higher levels of C-reactive protein (CRP), and aspartate aminotransferase (AST) than M. pneumoniae patients (P<0·001). Pleural effusion was recorded more frequently in patients with M. pneumoniae (8·84 vs. 3·37%). There were no characteristic epidemiological and clinical findings that would distinguish CAP caused by M. pneumoniae from C. pneumoniae. However, some factors are indicative for C. pneumoniae such as older age, lack of cough, rhinitis, hoarseness, and higher value of CRP, and AST

Report on the first season of German-Kurdish excavations at Muqable in 2015

In 2015, a new excavation project entitled “Kurdish-German Archaeological Mission in Dohuk” (KUGAMID) was launched. It is organized as a joint project between the University of Tübingen and the Department of Antiquities of Dohuk and is jointly directed by Peter Pfälzner (Tübingen) and Hassan Ahmad Qasim (Dohuk). Three sites were selected for excavation: Bassetki, Muqable I and Muqable III. The following report will summarize the results of the first season of excavations at the two neighbouring mounds of Muqable I and Muqable III, located approximately 5 km southeast of Bassetki and 23 km west of Dohuk in the Autonomous Region of Kurdistan in Iraq. The first season of excavations at Muqable took place from 11th August until October 1st, 2015. Funding has been supplied by the Fritz Thyssen Foundation, and we are deeply grateful for this financial support

Pottery of Phases 16-19” and "Pottery of Phases 20-23" in: Pfälzner, P. – Qasim, H. A. “Urban developments in North-Eastern Mesopotamia from the Ninevite V to the Neo-Assyrian periods. Excavations at Bassetki in 2017.

Pottery comes from various debris layers (mainly A16 to A18) and from floor layers of the domestic building of Phase A19