Human African trypanosomiasis in endemic populations and travellers

Human African trypanosomiasis (HAT) or sleeping sickness is caused by the protozoan parasites Trypanosoma brucei (T.b.) gambiense (West African form) and T.b. rhodesiense (East African form) that are transmitted by the bite of the tsetse fly, Glossina spp.. Whereas most patients in endemic populations are infected with T.b. gambiense, most tourists are infected with T.b. rhodesiense. In endemic populations, T.b. gambiense HAT is characterized by chronic and intermittent fever, headache, pruritus, and lymphadenopathy in the first stage and by sleep disturbances and neuro-psychiatric disorders in the second stage. Recent descriptions of the clinical presentation of T.b. rhodesiense in endemic populations show a high variability in different foci. The symptomatology of travellers is markedly different from the usual textbook descriptions of African HAT patients. The onset of both infections is almost invariably an acute and febrile disease. Diagnosis and treatment are difficult and rely mostly on old methods and drugs. However, new molecular diagnostic technologies are under development. A promising new drug combination is currently evaluated in a phase 3 b study and further new drugs are under evaluatio

Multiple liver abscesses with isolation of streptococcus intermedius related to a pyogenic dental infection in an immuno-competent patient

<p>Abstract</p> <p>Introduction</p> <p><it>Streptococcus intermedius </it>- a member of the <it>Streptococcus anginosus </it>group - is part of the normal microbial flora of the oral cavity. Despite being regarded as a harmless apathogenic commensal, <it>Streptococcus intermedius </it>has been described to cause abscesses in various locations of the body.</p> <p>Case Presentation</p> <p>We report the clinical case and course of treatment of a 18-year-old male patient presenting with multiple hepatic abscesses associated with an untreated pyogenic dental infection.</p> <p>Conclusion</p> <p><it>Streptococcus intermedius </it>can cause liver abscesses emerging from dental infectious foci even in previously healthy patients without underlying innate or aquired immunodeficiency. The case illustrates the potential danger and underestimated risk associated with untreated dental infections.</p

Fermion loops, loop cancellation and density correlations in two dimensional Fermi systems

We derive explicit results for fermion loops with an arbitrary number of density vertices in two dimensions at zero temperature. The 3-loop is an elementary function of the three external momenta and frequencies, and the N-loop can be expressed as a linear combination of 3-loops with coefficients that are rational functions of momenta and frequencies. We show that the divergencies of single loops for low energy and small momenta cancel each other when loops with permuted external variables are summed. The symmetrized N-loop, i.e. the connected N-point density correlation function of the Fermi gas, does not diverge for low energies and small momenta. In the dynamical limit, where momenta scale to zero at fixed finite energy variables, the symmetrized N-loop vanishes as the (2N-2)-th power of the scale parameter.Comment: 24 pages (including 3 EPS figures), LaTeX2e; submitted to Phys. Rev.

Intestinal perforation due to adult tapeworm of Taenia: a case report and review of the literature

Taeniasis is an intestinal helminth infection due to adult tapeworms belonging to the genus Taenia. Taeniasis remains a major burden in low-income countries in Asia. We present a case of intestinal perforation caused by adult tapeworm of Taenia in a 50-year-old Nepali male. The patients presented to the hospital with severe abdominal pain and intermittent vomiting. Following clinical presentations and imaging features, gastrointestinal perforation was suspected. Surgical removal of adult tapeworm of Taenia, suspected to be T. saginata or T. asiatica, was carried out during exploratory laparotomy, which was followed by an uneventful postoperative period. In addition to case presentation, we systematically review published case reports on taeniasis-related intestinal perforation. A learning point from this case is clinician should maintain a clinical suspicion of taeniasis as a possible cause of intestinal perforation in endemic areas

Quasi-1D dynamics and nematic phases in the 2D Emery model

We consider the Emery model of a Cu-O plane of the high temperature superconductors. We show that in a strong-coupling limit, with strong Coulomb repulsions between electrons on nearest-neighbor O sites, the electron-dynamics is strictly one dimensional, and consequently a number of asymptotically exact results can be obtained concerning the electronic structure. In particular, we show that a nematic phase, which spontaneously breaks the point- group symmetry of the square lattice, is stable at low enough temperatures and strong enough coupling.Comment: 8 pages, 5 eps figures; revised manuscript with more detailed discussions; two new figures and three edited figuresedited figures; 14 references; new appendix with a detailed proof of the one-dimensional dynamics of the system in the strong coupling limi

Cutaneous leishmaniasis in Switzerland: first experience with species-specific treatment

Background: Different species of the genus Leishmania can cause cutaneous (CL) and mucosal leishmaniasis (ML). PCR-based tests allow a rapid diagnosis and determination of the species, thereby enabling species-oriented treatment. Such treatment procedures have not been evaluated to date. Methods: Patients presenting with CL and ML between 1999 and 2011 were analysed retrospectively. PCR technology was used to diagnose the disease and identify the protozoan to the species level. Results: A total of 61 cases were reviewed, including 58 patients with CL and three patients with ML. Treatment was effective in most patients. Treatment failure was reported in six patients with L. panamensis (one fluconazole, one ketoconazole), L. infantum (one excision, one fluconazole), L. tropica (one paromomycin/methylbenzethonium), L. braziliensis (1 paromomycin/methylbenzethonium). In 11 (18%) patients treatment had to be interrupted due to adverse events, and in eight patients (13 %) a second treatment had to be applied. Treatment with meglumine antimoniate had to be interrupted in six patients, with QTc prolongation the reason for the interruption in three patients. Conclusions: Species-related, targeted treatment resulted in good responses in CL and ML lesions. Treatment recommendations for L. panamensis were changed from ketoconazole to miltefosine because of new evidence of treatment failures. Meglumine antimoniate should be restricted to species with poor response to alternative medications and should be used with caution in patients older than 60years because of its toxicity. Treatment in immunosuppressed patients was successful, but relapses were observed when the immune system could not be restored. This is the first report on L. aethiopica from Egyp

Singular Structure and Enhanced Friedel Oscillations in the Two-Dimensional Electron Gas

We calculate the leading order corrections (in $r_s$) to the static polarization $\Pi^{*}(q,0,)$, with dynamically screened interactions, for the two-dimensional electron gas. The corresponding diagrams all exhibit singular logarithmic behavior in their derivatives at $q=2 k_F$ and provide significant enhancement to the proper polarization particularly at low densities. At a density of $r_s=3$, the contribution from the leading order {\em fluctuational} diagrams exceeds both the zeroth order (Lindhard) response and the self-energy and exchange contributions. We comment on the importance of these diagrams in two-dimensions and make comparisons to an equivalent three-dimensional electron gas; we also consider the impact these finding have on $\Pi^{*}(q,0)$ computed to all orders in perturbation theory

Van Hove singularity and spontaneous Fermi surface symmetry breaking in Sr3Ru2O7

The most salient features observed around a metamagnetic transition in Sr3Ru2O7 are well captured in a simple model for spontaneous Fermi surface symmetry breaking under a magnetic field, without invoking a putative quantum critical point. The Fermi surface symmetry breaking happens in both a majority and a minority spin band but with a different magnitude of the order parameter, when either band is tuned close to van Hove filling by the magnetic field. The transition is second order for high temperature T and changes into first order for low T. The first order transition is accompanied by a metamagnetic transition. The uniform magnetic susceptibility and the specific heat coefficient show strong T dependence, especially a log T divergence at van Hove filling. The Fermi surface instability then cuts off such non-Fermi liquid behavior and gives rise to a cusp in the susceptibility and a specific heat jump at the transition temperature.Comment: 11 pages, 4 figure