Anaphylaxis triggered by alpha-gal allergy. / Anafylaksi utløst av alfa-gal-allergi.

Background: Alpha-gal allergy or red meat allergy is a rare yet potentially severe allergy. Sensitisation usually occurs when alpha-gal present in the tick's saliva is transferred to humans during a tick bite, prompting the production of IgE antibodies to alpha-gal. Subsequent exposure to mammalian meat or other products containing alpha-gal can lead to allergic reactions. Case presentation: A previously healthy man in his sixties was admitted with acute anaphylaxis. A history of multiple tick bites and recent consumption of mammalian meat raised suspicion of anaphylaxis caused by alpha-gal syndrome. Interpretation: A diagnosis of alpha-gal syndrome was given based on elevated alpha-gal IgE antibodies, and further supported by medical history and clinical assessment. He was discharged with dietary instructions to eliminate food and products containing alpha-gal, and to manage allergy symptoms and anaphylaxis according to local guidelines.

Persistent Fever and Positive PCR 90 Days Post-SARS-CoV-2 Infection in a Rituximab-Treated Patient: A Case of Late Antiviral Treatment.

Background: Persistent fever after SARS-CoV-2 infection in rituximab-treated patients has been reported. Due to reduced sensitivity in conventional sampling methods and unspecific symptoms in these patients, distinguishing between low-grade viral replication or hyperinflammation is challenging. Antiviral treatment is recommended as prophylactic or early treatment in the at-risk population; however, no defined treatment approaches for protracted SARS-CoV-2 infection exist. Results: We present a case of 96 days of persistent fever and SARS-CoV-2 infection in a patient receiving B cell depletion therapy for multiple sclerosis. Migratory lung infiltrates and positive PCR tests from serum (day-58 post infection) and lower airways (day-90 post infection) confirmed continuous viral replication. The dominant symptoms were continuous high fever, dyspnea and mild to moderate hypoxemia, which never developed into severe respiratory failure. The patient was hospitalized three times, with transient improvement after late antiviral treatment and full recovery 6 months post-rituximab infusion. Conclusions: A strategy for securing samples from lower airways and serum should be a prioritization to strengthen diagnostic certainty in immunocompromised patients. B-cell-deprived patients could benefit from late treatment with SARS-CoV-2-specific monoclonal antibodies and antivirals. Importantly, increased intervals between immunosuppressive therapy should be considered where feasible.

Schistosomiasis in Norwegian students after travel to Africa. / Schistosomiasis hos norske studenter etter opphold i Afrika.

BACKGROUND: Schistosomiasis is a tropical infectious disease in which early diagnosis and treatment can prevent serious illness. This study examined the incidence and diagnosis of schistosomiasis in Norwegian exchange students who had been exposed to freshwater in Africa. MATERIAL AND METHOD: Students (n = 318) from Bergen and Oslo who had travelled to Africa as part of an exchange programme in the period 2003-18, were contacted and included in the study if they had been exposed to freshwater during their stay. A routine workup was performed comprising Schistosoma antibody testing, microscopy and/or PCR analysis of urine and faeces, dipstick urinalysis, and blood samples for analysis of eosinophilic granulocytes, creatinine and total IgE. Time, place and type of exposure were recorded in a questionnaire, along with symptoms. RESULTS: Schistosoma antibodies were detected in 46 (30 %) of the 151 students included in the study. None of the seropositive individuals had eggs detected in their urine or faeces, and none had eosinophilia. Two students reported cercarial dermatitis, while one had symptoms consistent with acute schistosomiasis. Rafting was the only form of freshwater exposure reported by 22 (55 %) of the 40 seropositive individuals. INTERPRETATION: A large proportion of the students who had been exposed to freshwater were diagnosed with schistosomiasis. The majority reported no symptoms. Rafting was the most common form of exposure. All were diagnosed by serologic tests, while other routine diagnostic tests for schistosomiasis proved less useful. Serological analysis should be the preferred form of testing for the diagnosis of schistosomiasis in travellers.

Renewable CO2 recycling and synthetic fuel production in a marine environment.

A massive reduction in CO2 emissions from fossil fuel burning is required to limit the extent of global warming. However, carbon-based liquid fuels will in the foreseeable future continue to be important energy storage media. We propose a combination of largely existing technologies to use solar energy to recycle atmospheric CO2 into a liquid fuel. Our concept is clusters of marine-based floating islands, on which photovoltaic cells convert sunlight into electrical energy to produce H2 and to extract CO2 from seawater, where it is in equilibrium with the atmosphere. These gases are then reacted to form the energy carrier methanol, which is conveniently shipped to the end consumer. The present work initiates the development of this concept and highlights relevant questions in physics, chemistry, and mechanics.

Wave-induced response of a floating two-dimensional body with a moonpool.

Regular wave-induced behaviour of a floating stationary two-dimensional body with a moonpool is studied. The focus is on resonant piston-mode motion in the moonpool and rigid-body motions. Dedicated two-dimensional experiments have been performed. Two numerical hybrid methods, which have previously been applied to related problems, are further developed. Both numerical methods couple potential and viscous flow. The semi-nonlinear hybrid method uses linear free-surface and body-boundary conditions. The other one uses fully nonlinear free-surface and body-boundary conditions. The harmonic polynomial cell method solves the Laplace equation in the potential flow domain, while the finite volume method solves the Navier-Stokes equations in the viscous flow domain near the body. Results from the two codes are compared with the experimental data. The nonlinear hybrid method compares well with the data, while certain discrepancies are observed for the semi-nonlinear method. In particular, the roll motion is over-predicted by the semi-nonlinear hybrid method. Error sources in the semi-nonlinear hybrid method are discussed. The moonpool strongly affects heave motions in a frequency range around the piston-mode resonance frequency of the moonpool. No resonant water motions occur in the moonpool at the piston-mode resonance frequency. Instead large moonpool motions occur at a heave natural frequency associated with small damping near the piston-mode resonance frequency.