Características de Oligoryzomys longicaudatus asociadas a la presencia del virus Andes (Hantavirus) / Oligoryzomys longicaudatus characteristics' associated with the presence of Andes virus (Hantavirus)

Oligoryzomys longicaudatus is the main reservoir of Andes virus (AND), which causes hantavirus pulmonary syndrome in Patagonia. The factors associated with the presence of antibodies against AND in this species are unknown. This study used a logistic regression model to analyze which characteristics of O. longicaudatus, captured in northern Argentinean Patagonia, led to an increased probability of an animal having antibodies against AND and to relate these characteristics to possible mechanisms of transmission of the virus within the population. Sex, age, body mass, and wounds were important predictors regarding the presence of antibodies against AND within O. longicaudatus populations. The probability of a wounded male O. longicaudatus adult having AND antibodies increased in parallel with the body mass. The probability of having antibodies was more than 80% in individuals with body masses above 44 gram. However, the possible transmission mechanism of AND within O. longicaudatus population is still uncertain and further studies involving a larger number of individuals and prolonged monitoring including the process of seroconversion are needed.

Oligoryzomys longicaudatus es el principal reservorio del virus Andes Sur (AND) causante del síndrome pulmonar por hantavirus en la Patagonia. Aún se desconoce qué características individuales están asociadas a una mayor presencia de anticuerpos contra AND en esta especie. En este estudio, mediante un modelo de regresión logística evaluamos qué características de O. longicaudatus, capturados en la Patagonia norte de Argentina, incrementan la probabilidad de un individuo de presentar anticuerpos contra AND para relacionarlos con posibles mecanismos de transmisión del virus dentro de la población. El sexo, la edad, la masa corporal y las heridas resultaron factores importantes para la circulación y persistencia del virus dentro de la población de O. longicaudatus. La probabilidad de que un O. longicaudatus, macho, adulto con heridas presente anticuerpos contra AND aumentó con el incremento de la masa corporal, siendo esta probabilidad mayor al 80% en individuos con masas corporales mayores a 44 g. Sin embargo, el posible mecanismo de transmisión de AND dentro de la población de O. longicaudatus queda aún incierto, por lo que son necesarios estudios futuros que involucren un mayor número de individuos y un tiempo prolongado de seguimiento en su proceso de seroconversión.

How can we improve the management of stroke in Nigeria; Africa?

Stroke is a significant economic; social and medical problem all over the world. This article discusses recent developments in stroke management worldwide. We reviewed and highlighted published clinical guidelines from several countries. The current thoughts on stroke care are discussed and summarized in concise and unambiguous terms. Limitation to optimal management in developing countries as well as areas requiring development and research are highlighted. It should be possible to utilize this in stimulating the development of management strategies for stroke; customized to the unique health structure in Nigeria. The management of stroke in Nigeria is suboptimal as there are significant deficiencies in the provision of diagnostic; treatment; rehabilitation and support services. The limited resources; manpower shortage; lack of organized stroke unit; neuro-imaging facilities; ambulance services; education of patients and general practitioners as well as impracticable use of thrombolytics are contributory. Training of stroke experts in collaboration with experts in the developed world with provision of neuro-imaging facilities would improve the outlook of stroke management in Nigeria. The focus in Nigeria must be on preventive strategies and ways to harness local resources in the acute treatment of stroke patients. Health education of the community with emphasis on control of the predisposing factors would reduce the burden of stroke in the country. Risk factor management should begin in childhood; with emphasis on exercise; nutrition; weight and blood sugar control; avoidance of tobacco and excessive alcohol; as well as effective treatment of hypertension and hyperlipidaemia

Henoch-Schonlein purpura: the Chandigarh experience.

OBJECTIVE: To determine the clinical profile of children with Henoch-Schonlein purpura (HSP). DESIGN: Hospital based descriptive follow-up study. SUBJECTS: 45 patients attending the Pediatric Rheumatology and Immunology clinic over the last 4 years. RESULTS: The patients were aged between 2.5-12 years with a male to female ratio of 2:1. All cases had palpable purpura. Gastrointestinal involvement was seen in 38 patients, with abdominal pain in 35 (78%) and lower GI bleed in 21 (47%). Large joint arthritis occurred in 60%. Renal involvement was seen in 14 subjects (31%). Major renal involvement occurred in 9 patients, with nephritic syndrome in 6 and nephrotic syndrome in 3 cases. Five patients had minor urinary abnormalities; 6 patients with major renal involvement and crescentic glomerulonephritis were treated with high dose pulse steroid therapy followed by oral prednisolone and azathioprine for 12-18 months. Normalization of urinary abnormalities occurred in these patients over 4-8 months and presently all are normotensive and off antihypertensive drugs. CONCLUSIONS: HSP in children is a common form of vasculitis. Though short term results in HSP nephritis have been good, long term prognosis in those with major renal involvement would remain guarded.

Disseminated mucormycosis in healthy adults.

Three patients of disseminated mucormycosis are described. None had predisposing factors. Two of them presented with nonspecific symptoms along with acute renal failure and peritonitis. Third patient had fulminating primary cutaneous mucormycosis which disseminated later. Development of acute renal failure with smooth enlargement of both kidneys in an apparently healthy individual or appearance of mould in a wound should raise the suspicion of mucormycosis. The hallmark of the infection was vascular invasion and thrombosis. Antemortem diagnosis could be made in one patient only. All patients had progressive downhill course despite supportive treatment, antibiotic and amphotericin in-B in one patient.