Imported Cutaneous Melioidosis in Traveler, Belgium

SCOPUS: le.jinfo:eu-repo/semantics/publishe

Buruli Ulcer in Long-Term Traveler to Senegal

A resource usage view consists of models that are important assets to analyze and control usage of hardware resources such as processors and memory elements. In this paper, we present the application of a top-down approach to construct a resource usage view using actual system runtime information. The models in this view help to address the concerns of a resource usage viewpoint providing information in terms of system-specific architecture and design execution elements such as execution scenarios, tasks, software components, processes, and threads. As part of our validation, constructing a resource usage view of an MRI system, a representative large software-intensive system, we observed that the constructed models for this view provide useful overviews and insights for practitioners to describe part of the system execution architecture and especially to analyze and evaluate the use of hardware resources in a top-down fashion.

34631 Do patients with vitiligo and health care professionals treating them recognize the burden in living with the disease in the United States? Findings from the VALIANT study

Vitiligo is a chronic autoimmune disease characterized by the destruction of melanocytes, resulting in pale or white patches of skin. The population-based Vitiligo and Life Impact Among International Communities (VALIANT) study sought to understand the impact and burden of vitiligo on quality of life (QoL) from the patient and physician perspective from around the world. The VALIANT study recruited adult participants (aged ≥18 years who self-reported a vitiligo diagnosis) via an online panel. Participants were asked questions regarding their mental health, psychosocial burden, and behavior in professional and social situations. Separately, health care professionals (HCPs; physicians, nurse practitioners, or physician assistants) who treat patients with vitiligo completed an online-based questionnaire. In the United States, 608 patients and 250 HCPs (166 dermatologists and 84 primary care providers) participated in the survey. Confidence in the ability to improve QoL and long-term psychological outcomes of their patients with vitiligo was noted in 67% and 58% of HCPs, respectively. HCPs and patients were asked the same questions regarding avoidance/impact behaviors; concordance was achieved on items such as wearing certain clothing to cover vitiligo lesions and avoiding going to beach/pool/social events. However, HCPs often underestimated the impact of vitiligo compared with the patient’s perspective in other areas, such as making career choices (33% vs 51%), managing other medical diseases (25% vs 49%), and obtaining other preventive care (20% vs 49%). In summary, increased understanding between HCPs and patients with vitiligo regarding a holistic understanding of the psychological burden and mental health of patients is needed

34612 Exploring the natural history of vitiligo in the United States: Findings from the VALIANT study

Vitiligo is a chronic autoimmune disease characterized by the destruction of melanocytes, resulting in depigmented skin lesions. Epidemiology studies in vitiligo are often limited to smaller sample sizes and rely on dermatology clinics as the source population. The population-based Vitiligo and Life Impact Among International Communities (VALIANT) study sought to understand the natural history of vitiligo among patients around the world. Here, data from US participants are presented. Participants were recruited via an online panel. Adults (aged ≥18 years) who self-reported a vitiligo diagnosis by a health care professional were eligible to participate. Of 608 US patients, 58% were male; median (range) age at the time of the survey was 36 (18–83) years. Mean disease duration was 11 years, with a mean 1.6 years between first noticing lesions and achieving a formal diagnosis. More than one-third of patients were previously misdiagnosed (37%), with higher rates among patients with darker skin types (67% for Fitzpatrick types IV–VI). Nearly two-thirds (62%) directly sought treatment for vitiligo; vitiligo was an incidental finding in the remaining 38%. Nearly two-thirds (64%) were diagnosed by a dermatologist, or a nurse practitioner or physician assistant in a dermatology-focused practice. Most patients (71%) noted a family history of vitiligo (comparable paternal vs maternal). Median body surface area affected by vitiligo was 4.23%, as measured by the self-assessed Vitiligo Extent Scale. In summary, these findings provide a new perspective on the diagnosis journey for patients with vitiligo and highlight the need for accurate, more timely diagnosis

Seroepidemiology of Dengue Virus in Mayotte, Indian Ocean, 2006

BACKGROUND: Although Dengue virus (DENV) circulation had been documented in neighbouring South-western Indian Ocean Islands, its presence in Mayotte is poorly characterised. To address this issue, we aimed to assess the seroprevalence of dengue IgG antibodies (DENV-IgG Ab) among the population and to investigate potential associations with individual and household characteristics. METHODS/PRINCIPAL FINDINGS: In November-December 2006 we conducted a cross-sectional serologic survey in Mayotte among 1,154 inhabitants aged≥2 years by using a multistage cluster random sampling method. The overall prevalence of DENV-specific IgG antibodies (ELISA) was 22.73% (95% CI, 18.16-27.31). The age-specific seroprevalence increased with age (χ2 for trend=11.86, P<0.0006), and was linked with previous known outbreaks in this region. In multivariate analysis, older age, being born in the Comoros and living in a household with a low socioeconomic index were positively associated with DENV IgG antibody positivity. CONCLUSIONS: These findings document substantial prior exposure of the population of Mayotte to DENV and highlight the risk of severe illness due to the possibility of sequential DENV infections. Further investigations characterizing current DENV circulation patterns and associated serotypes are needed

Outcomes of treatment of severe COVID-19 pneumonia with tocilizumab: a report of two cases from Tunisia

The SARS CoV-2 pandemic is a global health threat with high morbidity and mortality (1 to 4%) rates. COVID-19 is correlated with important immune disorders, including a “cytokine storm”. A new therapeutic approach using the immunomodulatory drug, Anti-IL6 (tocilizimub), has been proposed to regulate it. We report here the first Tunisian experience using tocilizimub in two severe cases of COVID-19 pneumonia. The diagnosis was confirmed by chest scan tomography. Biological parameters showed a high level of Interleukin-6 (IL-6) that increased significantly during hospitalization. The patients developed hypoxia, so they received intravenously 8 mg/kg body weight tocilizumab. There was a resultant decrease in the level of IL6, with clinically good evolution. Blocking the cytokine IL-6 axis is a promising therapy for patients developing COVID-19 pathology

Maintenance Therapy of Adult Vitiligo with 0.1% Tacrolimus Ointment: A Randomized, Double Blind, Placebo–Controlled Study

The risk of relapse after successful repigmentation in vitiligo is estimated to 40% within the first year. It has been shown in atopic dermatitis that continuous low-level use of topical corticosteroids and calcineurin inhibitors in previously affected skin can prevent new flares. We hypothesized that a twice-weekly application of 0.1% tacrolimus ointment might be effective for maintaining repigmentation in therapeutically repigmented lesions of vitiligo patients. After randomization, sixteen patients with 31 patches were assigned to the placebo group and 19 patients with 41 patches were assigned to the tacrolimus group. In the intention-to-treat analysis, 48.4% of lesions showed depigmentation in the placebo group, whereas 26.8% did in the tacrolimus group (P=0.059). The intention-to-treat results did not remain significant after adjustment for within-patient clustering, odds ratio (OR) 2.55; 95% confidence interval (CI; 0.65–9.97); P=0.1765. The per-protocol analysis (n=56) showed that 40% of lesions had some depigmentation in the placebo group, whereas only 9.7% did in the tacrolimus group (P=0.0075). The per-protocol results remained significant after adjustment for within-patient clustering: OR 6.22; 95% CI (1.48–26.12); P=0.0299. Our study shows that twice-weekly application of 0.1% tacrolimus ointment is effective in preventing the depigmentation of vitiligo patches that have been previously successfully repigmented

Buruli Ulcer in Long-Term Traveler to Senegal

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