Human filariasis in travelers and migrants: a retrospective 25-year analysis at the Institute of Tropical Medicine, Antwerp, Belgium

Author(s):  
Emmanuel Bottieau ◽  
Ralph Huits ◽  
Steven Van Den Broucke ◽  
Ula Maniewski ◽  
Steven Declercq ◽  
...  

Abstract Background Information on human filariasis in international travelers is scarce. We describe the epidemiology, clinical presentation and outcome of these infections in a reference travel clinic over the past decades. Methods We reviewed all cases of filariasis diagnosed at the Institute of Tropical Medicine, Antwerp, Belgium, from 1994 to 2018. Diagnosis was obtained by either parasitological methods (confirmed) or strict clinical case definitions (probable). We assessed the characteristics of cases at diagnosis and response to therapy within three to 12 months. Results A total of 320 patients (median age: 41 years; 71% males) were diagnosed with 327 filarial infections (Wuchereria bancrofti = 6; Onchocerca volvulus = 33, Loa loa = 150, Mansonella perstans = 130; unspecified species = 8). Diagnosis was confirmed in 213/320 (67%) patients. European long-term travelers accounted for 166 patients (52%) and visitors/migrants from tropical countries for another 110 (34%). Central Africa was the likely region of acquisition for 294 (92%) patients. The number of filariasis cases decreased from 21.5/year in average in the nineties to 6.3/year in the last decade, when loiasis became predominant. Cases reported symptoms in > 80% of all filarial infections but mansonellosis (45/123 single infections; 37%). Lymphatic filariasis and onchocerciasis cases responded well to conventional therapy. However, 30% of patients with loiasis and mansonellosis experienced treatment failure (with diethylcarbamazine and levamisole-mebendazole, respectively). Conclusions The burden and species distribution of filariasis in travelers evolved in the past decades. Most presentations were symptomatic. Case management would benefit from more effective therapies for loiasis and mansonellosis.

Neurosurgery ◽  
2012 ◽  
Vol 71 (4) ◽  
pp. E901-E904 ◽  
Author(s):  
Karen J. Fritchie ◽  
Mitchel D. Bauman ◽  
Quentin J. Durward

Abstract BACKGROUND AND IMPORTANCE: Myoepithelioma of bone is a rare osseous tumor thought to be related to myoepithelial lesions found at other anatomic sites such as the salivary gland and skin. These tumors are composed of varying proportions of epithelial and myoepithelial cells and exhibit a spectrum of biologic behavior ranging from benign to malignant. We present the first reported case of myoepithelioma of the skull. CLINICAL PRESENTATION: A 20-year-old white woman presented with a persistent right parieto-occipital skull nodule, relating its presence to a fall on the site 2 years previously. The nodule had become painful in the past 2 months. Her past medical history and workup were otherwise unremarkable. The initial biopsy was inconclusive for diagnosis. The lytic bone lesion was subsequently resected, and histopathological examination showed a proliferation of epithelioid cells in a myxochondroid background. Fluorescence in situ hybridization studies revealed a rearrangement of the EWSR1 locus. The morphologic and molecular findings were consistent with the diagnosis of myoepithelioma of bone. CONCLUSION: Six months after surgery, the patient is doing well with no evidence of recurrence. This case illustrates the clinical presentation, histopathology, and molecular findings of a myoepithelioma of the skull with successful surgical treatment. Because myoepitheliomas with benign morphological appearance may rarely act aggressively, long-term clinical follow-up is warranted.


2017 ◽  
Vol 50 (01) ◽  
pp. 068-073
Author(s):  
Venkat Arjunrao Gite ◽  
Hitesh Mahendra Jain ◽  
Sachin M. Bote ◽  
Jayant Vijay Nikose

ABSTRACTPurpose: We evaluate here our experience with modified Cantwell–Ransley technique described by Gearhart for correction of isolated continent epispadias in adults with respect to its long-term functional outcome and complications. Introduction: Isolated male epispadias is a rare anomaly with a reported incidence of 1 in 11,700 males. Many surgical techniques with various modifications described to correct epispadias as treatment are debatable and challenging. The majority of the cases are treated at childhood as clinical presentation is striking at birth; hence, presentation in adulthood is extremely rare. Materials and Methods: During the past 5 years, modified Cantwell–Ransley technique described by Gearhart was performed in five cases of isolated continent epispadias which includes two cases of proximal penile, two distal penile and one penopubic. All cases were fresh except one had prior failed repair. Corporal rotation was done by delayed absorbable sutures without incision and anastomosis and suprapubic diversions placed in all the cases. Results: All cases followed up ranging from 6 months to 5 years and were having horizontal and downwards angled penis. No case had urethrocutaneous fistula or stricture. One case had superficial skin infection which healed by secondary intention did not require any secondary procedure. All cases maintained erection post-operatively too. Catheterisation with soft tube revealed easily negotiable channel in all cases on follow-up. Conclusion: Modified Cantwell–Ransley repair described by Gearhart has excellent cosmetic, functional and anatomical results in isolated continent epispadias in the adult.


Author(s):  
Robert Klinck ◽  
Ben Bradshaw ◽  
Ruby Sandy ◽  
Silas Nabinacaboo ◽  
Mannie Mameanskum ◽  
...  

The Naskapi Nation of Kawawachikamach is an Aboriginal community located in northern Quebec near the Labrador Border. Given the region’s rich iron deposits, the Naskapi Nation has considerable experience with major mineral development, first in the 1950s to the 1980s, and again in the past decade as companies implement plans for further extraction. This has raised concerns regarding a range of environmental and socio-economic impacts that may be caused by renewed development. These concerns have led to an interest among the Naskapi to develop a means to track community well-being over time using indicators of their own design. Exemplifying community-engaged research, this paper describes the beginning development of such a tool in fall 2012—the creation of a baseline of community well-being against which mining-induced change can be identified. Its development owes much to the remarkable and sustained contribution of many key members of the Naskapi Nation. If on-going surveying is completed based on the chosen indicators, the Nation will be better positioned to recognize shifts in its well-being and to communicate these shifts to its partners. In addition, long-term monitoring will allow the Naskapi Nation to contribute to more universal understanding of the impacts of mining for Indigenous peoples.


Author(s):  
Lindsey C Bohl

This paper examines a few of the numerous factors that may have led to increased youth turnout in 2008 Election. First, theories of voter behavior and turnout are related to courting the youth vote. Several variables that are perceived to affect youth turnout such as party polarization, perceived candidate difference, voter registration, effective campaigning and mobilization, and use of the Internet, are examined. Over the past 40 years, presidential elections have failed to engage the majority of young citizens (ages 18-29) to the point that they became inclined to participate. This trend began to reverse starting in 2000 Election and the youth turnout reached its peak in 2008. While both short and long-term factors played a significant role in recent elections, high turnout among youth voters in 2008 can be largely attributed to the Obama candidacy and campaign, which mobilized young citizens in unprecedented ways.


2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.


2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Dr. Kamlesh Kumar Shukla

FIIs are companies registered outside India. In the past four years there has been more than $41 trillion worth of FII funds invested in India. This has been one of the major reasons on the bull market witnessing unprecedented growth with the BSE Sensex rising 221% in absolute terms in this span. The present downfall of the market too is influenced as these FIIs are taking out some of their invested money. Though there is a lot of value in this market and fundamentally there is a lot of upside in it. For long-term value investors, there’s little because for worry but short term traders are adversely getting affected by the role of FIIs are playing at the present. Investors should not panic and should remain invested in sectors where underlying earnings growth has little to do with financial markets or global economy.


2019 ◽  
Vol 20 (3) ◽  
pp. 251-264 ◽  
Author(s):  
Yinlu Feng ◽  
Zifei Yin ◽  
Daniel Zhang ◽  
Arun Srivastava ◽  
Chen Ling

The success of gene and cell therapy in clinic during the past two decades as well as our expanding ability to manipulate these biomaterials are leading to new therapeutic options for a wide range of inherited and acquired diseases. Combining conventional therapies with this emerging field is a promising strategy to treat those previously-thought untreatable diseases. Traditional Chinese medicine (TCM) has evolved for thousands of years in China and still plays an important role in human health. As part of the active ingredients of TCM, proteins and peptides have attracted long-term enthusiasm of researchers. More recently, they have been utilized in gene and cell therapy, resulting in promising novel strategies to treat both cancer and non-cancer diseases. This manuscript presents a critical review on this field, accompanied with perspectives on the challenges and new directions for future research in this emerging frontier.


Author(s):  
Nils Brunsson

This chapter argues that organizational reforms are driven by problems to be addressed, by solutions to be applied, and by forgetfulness. The greater the supply of any of these factors, the more likely it is that reforms will occur. Without problems, reforms are difficult to justify; without solutions they cannot be formulated; and without forgetfulness there is a risk that people will be discouraged by the fact that similar reforms have been tried and have failed in the past. In contemporary large organizations, problems tend to be easily found. Those interested in selling solutions often try to supply problems as well — problems that can be solved by their solutions. Forgetfulness can be promoted by the use of consultants with limited experience of the implementation and long-term effects of reforms. Reforms are also self-referential; they tend to cause new reforms. Thus, reforms can be considered as routines: they are likely to be repeated over and over again.


Author(s):  
Brad Partridge ◽  
Wayne Hall

Concussion management policies have become a major priority worldwide for sports that involve frequent collisions between participants because repeated head trauma has been associated with long-term cognitive impairments, mental health problems, and some forms of neurological degeneration. A number of concussion management policies have been developed by professional bodies and subsequently adopted by various sporting leagues. These have offered little guidance on how to navigate ethical issues in identifying and managing concussion. This chapter discusses ethical issues that arise in the diagnosis of concussion, debates about the longer-term consequences of repeated concussion injuries, and the design and implementation of policies that aim to prevent and manage concussion injuries in sporting matches.


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