Forecasting Dengue, Chikungunya and Zika cases in Recife, Brazil: a spatio-temporal approach based on climate conditions, health notifications and machine learning

Dengue has become a challenge for many countries. Arboviruses transmitted by Aedes aegypti spread rapidly over the last decades. The emergence chikungunya fever and zika in South America poses new challenges to vector monitoring and control. This situation got worse from 2015 and 2016, with the rapid spread of chikungunya, causing fever and muscle weakness, and Zika virus, related to cases of microcephaly in newborns and the occurrence of Guillain-Barret syndrome, an autoimmune disease that affects the nervous system. The objective of this work was to construct a tool to forecast the distribution of arboviruses transmitted by the mosquito Aedes aegypti by implementing dengue, zika and chikungunya transmission predictors based on machine learning, focused on multilayer perceptrons neural networks, support vector machines and linear regression models. As a case study, we investigated forecasting models to predict the spatio-temporal distribution of cases from primary health notification data and climate variables (wind velocity, temperature and pluviometry) from Recife, Brazil, from 2013 to 2016, including 2015’s outbreak. The use of spatio-temporal analysis over multilayer perceptrons and support vector machines results proved to be very effective in predicting the distribution of arbovirus cases. The models indicate that the southern and western regions of Recife were very susceptible to outbreaks in the period under investigation. The proposed approach could be useful to support health managers and epidemiologists to prevent outbreaks of arboviruses transmitted by Aedes aegypti and promote public policies for health promotion and sanitation

A condition mimicking lung mass appearance in childhood: Round pneumonia [Çocukta akcigerde kitle görünümünü taklit eden bir durum: Yuvarlak pnömoni]

In childhood, pneumonia is one of the major infectious diseases responsible for significant morbidity and mortality. Clinical and radiographic features of round pneumonia simulate pulmonary masses. Streptococcus pneumoniae, Mycobacterium tuberculosis, and Klebsiella pneumoniae are the most frequent etiologic agents of Round pneumonia in children. A two-year-old boy presented with fever, cough, respiratory distress, tachypnea, suprasternal-intercostal retractions, rales and expiratory wheezes. In the laboratory findings white blood cell count was 17300/mm 3, neutrophils 56%, erythrocyte sedimentation rate 54 mm/hour, C-reactive protein 68.84 mg/L, and chest radiogram showed right perihilar 2.5 cm density. In the chest computed tomography scan a 24 mm size irregular contoured consolidation-atelectasis complex in the superior segment of the lower lobe of right lung, demineralization at the right side of T5 vertebra and enlargement at the neural foramina was present. Thorax-abdomen magnetic resonance imaging was performed to exclude neuroblastoma. The spinal cord and neural foramina were normal. The case was discussed at the Aegean University Medicine Faculty Pediatric Respiratory-Allergy Council and the round consolidation with air bronchogram was consistent with round pneumonia. Clinical and radiographic recovery was performed after third generation cephalosporin treatment. In this case we aim to mention the round pneumonia which mimics lung masses

Key stone plasty and asymmetric hump resection in crooked nose deformity

© 2022 Elsevier Inc.Objective: The aim of this study is to propose a new approach in crooked nose deformity with key-stone plasty and asymmetric hump resection. Method: Twelve patients with crooked nose deformities were operated using the open rhinoplasty technique. Our method, unlike other methods, has two different steps. Following asymmetric hump resection, cartilaginous and osseous septum were cut separated at the key stone area or more caudally and fix the septum with sutures again by allowing them to slide over each other in a way that directs the septum to the midline. If there is an inability to reveal the septum, we apply a longer spreader graft to the cartilage septum side. Results: The mean ages were 27.4 years. The mean follow-up time of the patients was 19.1 months. No complications were observed due to this technique. This technique was effective in the treatment of all our patients with crooked nose deformities. Conclusion: A novel surgical approach with key-stone plasty and asymmetric hump resection method was proposed in crooked nose deformity with a video animation

Successful desensitization of a case with desferrioxamine hypersensitivity

PubMed ID: 17093379Thalassaemia major is a severe chronic hemolytic disease, resulted with iron overload mainly due to regular blood transfusions. Iron overload may lead to serious organ toxicity and even fatal complications, if no iron excretion is achieved by a chelating agent. First introduced in 1976 as s.c. treatment for thalassaemia major, desferrioxamine (DFO) has substantially improved the life expectancy in the disease. While DFO can cause local allergic reactions including redness, itching, pain and lumps, on rare occasion anaphylactic reactions can occur. The mechanism of anaphylaxis like reactions is not well understood. In this case report, we presented a 10 years-old girl with thalassaemia major who had to stop DFO therapy after appearing of systemic allergic reactions with hypotension, tachycardia, pruritus and urticaria against this drug. Serum IgE level was normal, specific IgE and skin prick tests were negative. Intradermal test was resulted with positive reaction to DFO. The patient was hospitalized and desensitization protocol was initiated with rapid s.c. infusions per 15 min. The protocol was stopped at the 17th cycle because of local reaction reappeared. After that, DFO was further diluted and was restarted with lower dosage and longer infusion period. Then, DFO dosage was increased and the dilutions and infusion times were decreased gradually. By this desensitization programme, the patient would continue to use DFO chelation safely for 10 months