Alveolar echinococcosis of the liver: Diffusion-weighted MRI findings and potential role in lesion characterisation

PURPOSE: To report the diffusion-weighted MRI findings in alveolar echinococcosis (AE) of the liver and evaluate the potential role of apparent diffusion coefficients (ADCs) in the characterisation of lesions. MATERIALS AND METHODS: We retrospectively included 22 patients with 63 AE liver lesions (≥1cm), examined with 3-T liver MRI, including a free-breathing diffusion-weighted single-shot echo-planar imaging sequence (b-values=50, 300 and 600s/mm(2)). Two radiologists jointly assessed the following lesion features: size, location, presence of cystic and/or solid components (according to Kodama's classification system), relative contrast enhancement, and calcifications (on CT). The ADCtotal, ADCmin and ADCmax were measured in each lesion and the surrounding liver parenchyma. RESULTS: Three type 1, 19 type 2, 17 type 3, three type 4 and 21 type 5 lesions were identified. The mean (±SD) ADCtotal, ADCmin and ADCmax for all lesions were 1.73±0.50, 0.76±0.38 and 2.63±0.76×10(-3)mm(2)/s, respectively. The mean ADCtotal for type 1, type 2, type 3, type 4 and type 5 lesions were 1.97±1.01, 1.76±0.53, 1.73±0.41, 1.15±0.42 and 1.76±0.44×10(-3)mm(2)/s, respectively. No significant differences were found between the five lesion types, except for type 4 (p=0.0363). There was a significant correlation between the presence of a solid component and low ADCmin (r=0.39, p=0.0016), whereas an inverse correlation was found between the relative contrast enhancement and ADCtotal (r=-0.34, p=0.0072). CONCLUSION: The ADCs of AE lesions are relatively low compared to other cystic liver lesions, which may help in the differential diagnosis. Although ADCs are of little use to distinguish between the five lesion types, their low value reflects the underlying solid component.

When nightclub security agents assault clients.

In 2006, a medico-legal consultation service devoted to adult victims of interpersonal violence was set up at the Lausanne University Hospital Centre, Switzerland: the Violence Medical Unit. Most patients are referred to the consultation by the Emergency Department. They are received by forensic nurses for support, forensic examination (in order to establish medical report) and community orientation. Between 2007 and 2009, among community violence, aggressions by security agents of nightclubs on clients have increased from 6% to 10%. Most of the victims are young men who had drunk alcohol before the assault. 25.7% presented one or several fractures, all of them in the head area. These findings raise questions about the ability of security agents of nightclubs to deal adequately with obviously risky situations and ensure client security.

Initiation of primary cell cultures from embryos of the mosquitoes Anopheles albimanus and Aedes taeniorhynchus (Diptera: Culicidae)

Primary cell cultures were obtained from eggs of Anopheles albimanus and Aedes taeniorhynchus mosquitoes, vectors of human malaria and of Venezuelan equine encephalitis virus, respectively. The cellular growth of the An. albimanus cells began four weeks after explanting the embryonic tissues in MK/VP12 medium, supplemented with 15% fetal bovine serum. The culture showed heterogeneous cellular morphology. With regard to the Ae. taeniorhynchus culture, growth occurred three weeks after initiating the culture in MM/VP12 medium. The majority of cells were small and round. Karyotypes were examined in the latter species.

Mosquito Frequency and Feeding Habits in an Enzootic Canine Dirofilariasis Area in Niterói, State of Rio de Janeiro, Brazil

Heartworm, a chronic fatal mosquito-borne canine disease, is frequently diagnosed in dogs from the State of Rio de Janeiro, where its prevalence is 29.7% in the city of Niterói. Nevertheless it is rarely detected in cats (0.8%) from the same state. Dogs are the primary source of infection to mosquitoes, because cats either do not demonstrate microfilaremia or it is too low and transient for transmission. A mosquito survey was conducted in Itacoatiara, Niterói, from March 1995 to February 1996, using canine, feline and human baits. A total of 21 mosquito species (3,888 females) was collected and biting frequency was highest at dusk. The four species collected most frequently (88.9%) were: Aedes taeniorhynchus (30% of the total catch; with the peak in May/June); Culex quinquefasciatus (22.5%; August/October); Aedes scapularis (19.4%; August, October/November and January) and Culex declarator (17%; November/January). Human baits were attractive to these species and dogs were significantly more attractive to them than cats. Ae. taeniorhynchus, Cx. quinquefasciatus, Ae. scapularis, Cx. declarator and Cx. nigripalpus are the most likely mosquito species to transmit Dirofilaria immitis parasites to dogs and may transmit the parasite to humans. It is also suggested that the vector to cats belongs to the genus Culex

Experimental Infection of Culex (Culex) quinquefasciatus and Aedes (Stegomyia) aegypti with Wuchereria bancrofti

A study was conducted to determine the susceptibility of local strains of Culex quinquefasciatus and Aedes aegypti to infection with the strain of Wuchereria bancrofti that occurs in Maceió, State of Alagoas, Brazil. Cx. quinquefasciatus blood fed simultaneously on the same microfilariae carrier ingested more blood and 2-3x more microfilariae than Ae. aegypti. Survival rates of both species of insects living for 21 days after blood feeding on microfilaraemic patients were not significantly different from the survival rates of mosquitoes that blood fed on amicrofilaraemic individuals. W. bancrofti parasites underwent normal development in Cx. quinquefasciatus, with third stage larvae first being recorded on the 11th day post infection, and their numbers increasing thereafter. Development of filariae in Ae. aegypti did not proceed beyond the first larval stage, and there was a progressively increasing number of non-viable larvae with the passage of time. It is concluded that Ae. aegypti is not involved in the transmission of W. bancrofti in Maceió.

Alveolar echinococcosis: from a deadly disease to a well-controlled infection. Relative survival and economic analysis in Switzerland over the last 35 years.

BACKGROUND/AIMS: Alveolar echinococcosis (AE) is a serious liver disease. The aim of this study was to explore the long-term prognosis of AE patients, the burden of this disease in Switzerland and the cost-effectiveness of treatment. METHODS: Relative survival analysis was undertaken using a national database with 329 patient records. 155 representative cases had sufficient details regarding treatment costs and patient outcome to estimate the financial implications and treatment costs of AE. RESULTS: For an average 54-year-old patient diagnosed with AE in 1970 the life expectancy was estimated to be reduced by 18.2 and 21.3 years for men and women, respectively. By 2005 this was reduced to approximately 3.5 and 2.6 years, respectively. Patients undergoing radical surgery had a better outcome, whereas the older patients had a poorer prognosis than the younger patients. Costs amount to approximately Euro108,762 per patient. Assuming the improved life expectancy of AE patients is due to modern treatment the cost per disability-adjusted life years (DALY) saved is approximately Euro6,032. CONCLUSIONS: Current treatments have substantially improved the prognosis of AE patients compared to the 1970s. The cost per DALY saved is low compared to the average national annual income. Hence, AE treatment is highly cost-effective in Switzerland.

Ecology of mosquitoes (Diptera: Culicidae) in areas of Serra do Mar State Park, State of São Paulo, Brazil. I - Monthly frequency and climatic factors

The ecology of mosquitoes were studied (Diptera: Culicidae) in areas of Serra do Mar State Park, State of São Paulo, Brazil. Systematized monthly human bait collections were made three times a day, for periods of 2 or 3 h each, in sylvatic and rural areas for 24 consecutive months (January 1991 to December 1992). A total of 24,943 specimens of adult mosquitoes belonging to 57 species were collected during 622 collective periods. Coquillettidia chrysonotum was the most frequent collected mosquito (45.8%) followed by Aedes serratus (6.8%), Cq. venezuelensis (6.5%), Psorophora ferox (5.2) and Ps. albipes (3.1%). The monthly averages of temperature and relative humidity were inserted in the ten-year average limits of maximum and minimum of the previous ten-years. Rainfall accompanied the curve of the ten-year averages. Those climatic factors were influential in the incidence of some species; temperature: Anopheles cruzii, An. mediopunctatus, Ae. scapularis, Ae. fulvus, Cq. chrysonotum, Cq. venezuelensis, Runchomyia reversa, Wyeomyia dyari, Wy. confusa, Wy. shannoni, Wy. theobaldi and Limatus flavisetosus; relative humidity: Ae. serratus, Ae. scapularis, Cq. venezuelensis and Ru. reversa; rainfall: An. cruzii, Ae. scapularis, Ae. fulvus, Cq. venezuelensis Ru. reversa, Wy. theobaldi and Li. flavisetosus.

Effects of flooding and temperature on Aedes albifasciatus development time and larval density in two rain pools at Buenos Aires University City

Aedes albifasciatus is a floodwater mosquito that breeds in temporary waters. This semi-domestic species, widely distributed in Argentina, is a competent vector of the western equine encephalitis. The present study was carried out in two rain pools of the city of Buenos Aires, from April 1998 through March 1999. Samples were taken twice a week during the cold season and daily during the warmer months, starting from October. Immature mosquitoes were collected with a dipper, being the number of dippers proportional to the flooded area. The estimated rainfall thresholds to initiate cohorts of Ae. albifasciatus were: 16-17 mm in the fall-winter period, 25 mm in the spring, and 30 mm in the summer. The development time of the different cohorts and the mean air temperature of their respective periods were estimated in all seasons, ranging from six days (at 24ºC) to 32 days (at 13ºC). The equation that best expresses the relationship between development time and mean air temperature is dt =166,27.e-0,1435.T (R²=0,92). Significantly shorter development times were recorded for larvae of the first three stages as compared to the fourth larval stage and pupae.

Environmental characteristics of the cemeteries of Buenos Aires City (Argentina) and infestation levels of Aedes aegypti (Diptera: Culicidae)

Cemeteries with many water-filled containers, flowers, sources of human blood, and shade are favorable urban habitats for the proliferation of Aedes aegypti, a vector of yellow fever and dengue. A total of 22,956 containers was examined in the five cemeteries of the city of Buenos Aires, Argentina. The vector was found in four cemeteries that showed an average infestation level of 5.5% (617 positive out of 11,196 water-filled containers). The four cemeteries positive for Ae. aegypti showed significantly different (p<0.01) infestation levels. Vegetation cover and percentage of infestation were significantly correlated (p<0.01), but neither cemetery area nor number of available containers were significantly related to the proportion of positive vases. Our results suggest that the cemeteries of Buenos Aires represent a gradient of habitat favorableness for this vector species, some of which may act as foci for its proliferation and dispersal.

Comparison between precipitin and ELISA tests in the bloodmeal detection of Aedes aegypti (Linnaeus) and Aedes fluviatilis (Lutz) mosquitoes experimentally fed on feline, canine and human hosts

The identification of arthropod bloodmeals is important in many epidemiological studies, as, the understanding of the life cycle of vectors and the patogens they transmit, as well as helping to define arthropods' control strategies. The precipitin test has been used for decades, but ELISA is slowly becoming more popular. To compare the two tests for sensitivity, specificity and accuracy to detect small insect bloodmeals, Aedes aegypti or Ae. fluviatilis mosquitoes were fed either on feline, canine or human hosts. Mosquitoes were frozen at 6, 12, 24, 48 or 72 h after feeding. Precipitin test showed better specificity and accuracy and ELISA test showed higher sensitivity. Better results with both tests were achieved when mosquitoes were frozen within 48 h from feeding.

Instruction of haematopoietic lineage choices, evolution of transcriptional landscapes and cancer stem cell hierarchies derived from an AML1-ETO mouse model.

The t(8;21) chromosomal translocation activates aberrant expression of the AML1-ETO (AE) fusion protein and is commonly associated with core binding factor acute myeloid leukaemia (CBF AML). Combining a conditional mouse model that closely resembles the slow evolution and the mosaic AE expression pattern of human t(8;21) CBF AML with global transcriptome sequencing, we find that disease progression was characterized by two principal pathogenic mechanisms. Initially, AE expression modified the lineage potential of haematopoietic stem cells (HSCs), resulting in the selective expansion of the myeloid compartment at the expense of normal erythro- and lymphopoiesis. This lineage skewing was followed by a second substantial rewiring of transcriptional networks occurring in the trajectory to manifest leukaemia. We also find that both HSC and lineage-restricted granulocyte macrophage progenitors (GMPs) acquired leukaemic stem cell (LSC) potential being capable of initiating and maintaining the disease. Finally, our data demonstrate that long-term expression of AE induces an indolent myeloproliferative disease (MPD)-like myeloid leukaemia phenotype with complete penetrance and that acute inactivation of AE function is a potential novel therapeutic option.

Women, Debt & Health; a Joint report of The Women’s Health Council and MABS

Women, Debt & Health; a Joint report of The Women’s Health Council and MABS The main aims of the â?~Women, Debt and Healthâ?T project were to:- explore whether women attending the MABS service commonly discuss health during their money advice and budgeting consultations;- investigate whether women attending MABS identifi ed links between their debt or financial difficulties and their health; and- document the types of health issues experienced by MABS clients.- A secondary aim of the research was to explore the need for, and nature of, further research in this area. Click here to download PDF 1.1mb

Text2Emotion: un gestor d'experiències SOA : extracció d'emocions per al suport a la gestió de relació amb clients

Customer Experience Management (CEM) se ha convertido en un factor clave para el éxito de las empresas. CEM gestiona todas las experiencias que un cliente tiene con un proveedor de servicios o productos. Es muy importante saber como se siente un cliente en cada contacto y entonces poder sugerir automáticamente la próxima tarea a realizar, simplificando tareas realizadas por personas. En este proyecto se desarrolla una solución para evaluar experiencias. Primero se crean servicios web que clasifican experiencias en estados emocionales dependiendo del nivel de satisfacción, interés, … Esto es realizado a través de minería de textos. Se procesa y clasifica información no estructurada (documentos de texto) que representan o describen las experiencias. Se utilizan métodos de aprendizaje supervisado. Esta parte es desarrollada con una arquitectura orientada a servicios (SOA) para asegurar el uso de estándares y que los servicios sean accesibles por cualquier aplicación. Estos servicios son desplegados en un servidor de aplicaciones. En la segunda parte se desarrolla dos aplicaciones basadas en casos reales. En esta fase Cloud computing es clave. Se utiliza una plataforma de desarrollo en línea para crear toda la aplicación incluyendo tablas, objetos, lógica de negocio e interfaces de usuario. Finalmente los servicios de clasificación son integrados a la plataforma asegurando que las experiencias son evaluadas y que las tareas de seguimiento son automáticamente creadas.

Dispersal of Aedes aegypti and Aedes albopictus (Diptera: Culicidae) in an urban endemic dengue area in the State of Rio de Janeiro, Brazil

Experimental releases of female Aedes (Stegomyia) aegypti and Aedes (Stegomyia) albopictus were performed in August and September 1999, in an urban area of Nova Iguaçu, State of Rio de Janeiro, Brazil, to estimate their flight range in a circular area of 1,600 m where 1,472 ovitraps were set. Releases of 3,055 Ae. aegypti and 2,225 Ae. albopictus females, fed with rubidium (Rb)-marked blood and surgically prevented from subsequent blood-feeding, were separated by 11 days. Rb was detected in ovitrap-collected eggs by atomic emission spectrophotometry. Rb-marked eggs of both species were detected up to 800 m from the release point. Eggs of Ae. albopictus were more numerous and more heterogeneously distributed in the area than those of Ae. aegypti. Eggs positively marked for Rb were found at all borders of the study area, suggesting that egg laying also occurred beyond these limits. Results from this study suggest that females can fly at least 800 m in 6 days and, if infected, potentially spread virus rapidly.