The changing pattern of human brucellosis: clinical manifestations, epidemiology, and treatment outcomes over three decades in Georgia

<p>Abstract</p> <p>Background</p> <p>Brucellosis is an endemic infection in Georgia. We conducted a review of patient records with a suspected or confirmed diagnosis of brucellosis over three decades at the central referral hospital for brucellosis cases, the Institute of Parasitology and Tropical Medicine (IPTM) in Tbilisi. The purpose was to describe the demographic profile and clinical characteristics as well as diagnostic and treatment strategies in patients with brucellosis.</p> <p>Methods</p> <p>Data were abstracted from randomly selected patient records at the IPTM. In total, 300 records were reviewed from three time periods: 1970-73, 1988-89, and 2004-2008.</p> <p>Results</p> <p>The age distribution of patients shifted from a median age of 40 years in the first time period to 20 years in the third time period. Azeri ethnicity was an increasing proportion of the total number of cases. The frequency of relapsed infection was 14.7% (44 cases). A total of 50 patients received vaccine therapy, and although the vaccine produced immune responses, demonstrated by an increase in agglutination titers, it was not associated with improved outcome.</p> <p>Conclusion</p> <p>The demographics of brucellosis in Georgia fit a profile of persons that tend sheep. Osteoarticular complications were commonly detected, especially in children. The changing pattern of brucellosis in Georgia suggests clinicians should be updated about different trends in brucellosis in their country.</p

Long term population dynamics - theory and reality in a peatland ecosystem

1. Population dynamics is a field rich in theory and poor in long‐term observational data. Finding sources of long‐term data is critical as ecosystems around the globe continue to change in ways that current theories and models have failed to predict. Here we show how long‐term ecological data can improve our understanding about palaeo‐population change in response to external environmental factors, antecedent conditions and community diversity. 2. We examined a radiometrically dated sediment core from the Didachara Mire in the mountains of south‐western Georgia (Caucasus) and analysed multiple biological proxies (pollen, fern spores, non‐pollen palynomorphs, charcoal, diatoms, chrysophyte cysts, midges, mites and testate amoebae). Numerical techniques, including multivariate ordination, rarefaction, independent splitting and trait analysis, were used to assess the major drivers of changes in community diversity and population stability. Integrated multi‐proxy analyses are very rare in the Caucasus, making this a unique record of long‐term ecological change in a global biodiversity hotspot. 3. Synthesis. Population changes in the terrestrial community coincided primarily with external environmental changes, while populations within the peatland community were affected by both internal and external drivers at different times. In general, our observations accord with theoretical predictions that population increases lead to greater stability and declines lead to instability. Random variation and interspecific competition explain population dynamics that diverged from predictions. Population change and diversity trends were positively correlated in all taxonomic groups, suggesting that population‐level instability is greater in more diverse communities, even though diverse communities are themselves more stable. There is a continuing need to confront population theory with long‐term data to test the predictive success of theoretical frameworks, thereby improving their ability to predict future change