Severe Cutaneous Leishmaniasis in a Human Immunodeficiency Virus Patient Coinfected with Leishmania braziliensis and Its Endosymbiotic Virus.

Leishmaniaparasites cause a broad range of disease, with cutaneous afflictions being, by far, the most prevalent. Variations in disease severity and symptomatic spectrum are mostly associated to parasite species. One risk factor for the severity and emergence of leishmaniasis is immunosuppression, usually arising by coinfection of the patient with human immunodeficiency virus (HIV). Interestingly, several species ofLeishmaniahave been shown to bear an endogenous cytoplasmic dsRNA virus (LRV) of theTotiviridaefamily, and recently we correlated the presence of LRV1 withinLeishmaniaparasites to an exacerbation murine leishmaniasis and with an elevated frequency of drug treatment failures in humans. This raises the possibility of further exacerbation of leishmaniasis in the presence of both viruses, and here we report a case of cutaneous leishmaniasis caused byLeishmania braziliensisbearing LRV1 with aggressive pathogenesis in an HIV patient. LRV1 was isolated and partially sequenced from skin and nasal lesions. Genetic identity of both sequences reinforced the assumption that nasal parasites originate from primary skin lesions. Surprisingly, combined antiretroviral therapy did not impact the devolution ofLeishmaniainfection. TheLeishmaniainfection was successfully treated through administration of liposomal amphotericin B.

Coral communities exposed to differential large amplitude internal waves cooling and a severe heat stress in 2010 in the Andaman Sea

Tropical scleractinian corals are particularly vulnerable to global warming as elevated sea surface temperatures (SST) disrupt the delicate balance between the coral host and their algal endosymbionts, leading to symbiont expulsion, mass bleaching and mortality. While satellite sensing of SST has proven a good predictor of coral bleaching at the regional scale, there are large deviations in bleaching severity and mortality on the local scale, which are only poorly understood. Here, we show that internal waves play a major role in explaining local coral bleaching and mortality patterns in the Andaman Sea. In spite of a severe region-wide SST anomaly in May 2010, frequent upslope intrusions of cold sub-pycnocline waters due to breaking large amplitude internal waves (LAIW) alleviated heating and mitigated coral bleaching and mortality in shallow LAIW-exposed waters. In LAIW-sheltered waters, by contrast, bleaching susceptible species suffered severe bleaching and total mortality. These findings suggest that LAIW, which are ubiquitous in tropical stratified waters, benefit coral reefs during thermal stress and provide local refugia for bleaching susceptible corals. The swash zones of LAIW may thus be important, so far overlooked, conservation areas for the maintainance of coral diversity in a warming climate. The consideration of LAIW can significantly improve coral bleaching predictions and can provide a valuable tool for coral reef conservation and management.

A study of severe vehicular accidents. Phase 2.

National Highway Safety Bureau, Washington, D.C.

Caring for people with severe mental disorders : a national plan of research to improve services.

"Printed 1991"--P. [4] of cover.

Outcasts on Main Street : report of the Federal Task Force on Homelessness and Severe Mental Illness /

Includes bibliographical references (p. 75-78).

OMB proposal for severe cuts in the 1990 census [microform] : hearing before the Joint Economic Committee, Congress of the United States, One Hundredth Congress, first session, August 7, 1987.

CIS Microfiche Accession Numbers: CIS 88 J841-10

U.S. economic impact of the severe winter of 1982

Mode of access: Internet.

Severe storms [microform] : hearing before the Subcommittee on Natural Resources, Agriculture Research, and Environment of the Committee on Science and Technology, U.S. House of Representatives, Ninety-seventh Congress, first session, October 6, 1981.

"No. 177."

Severe weather preparedness.

"NOAA Weather Radio"--p. 10.

The identification of financial disincentives to educating childrern and youth with moderate to severe and multiple developmental disabilities in their home schools : final report : a summary /

"A summary."

Letters on the state of Christianity in India, in which the conversion of the Hindoos is considered as impracticable, to which is added, a vindication of the Hindoos, male and female, in answer to a severe attack made upon both by the Reverend ***

Bound with: James Hough. A reply to the letters of the Abbé Dubois on the state of Christianity in India. London, Seeley & Son, 1824.

A new history of the life and reign of the Czar Peter the Great, Emperor of all Russia, and father of his country : Giving an exact relation of I. His travels, studies, and personal fatigues, for the attaining of knowledge in civil and military affairs, and the improvement of his subjects. II. His introduction of arts and sciences, a naval force, and commerce with foreign nations; also his many reformations in church and state, the army, and the customs and manners of his people. III. His wars with the Swedes, Turks, Tartars and Persians; victories by sea and land; acquisitions of territory, and increase of power. IV. His regard to genius and merit, particularly in the instances of General Le Fort, Prince Menzikoff, and the Empress Catharine: and his severe justice on offenders, exemplified in the proceedings against the czarewitz, and others. /

By John Bancks.

Selection of traffic controls for severe weather conditons /

Final report, issued March 1977.

The effect of severe and prolonged muscular work on food consumption, digestion, and metabolism,

Mode of access: Internet.