Treatment with the Smallpox Antiviral Tecovirimat (ST-246) Alone or in Combination with ACAM2000 Vaccination Is Effective as a Postsymptomatic Therapy for Monkeypox Virus Infection

The therapeutic efficacies of smallpox vaccine ACAM2000 and antiviral tecovirimat given alone or in combination starting on day 3 postinfection were compared in a cynomolgus macaque model of lethal monkeypox virus infection. Postexposure administration of ACAM2000 alone did not provide any protection against severe monkeypox disease or mortality. In contrast, postexposure treatment with tecovirimat alone or in combination with ACAM2000 provided full protection. Additionally, tecovirimat treatment delayed until day 4, 5, or 6 postinfection was 83% (days 4 and 5) or 50% (day 6) effective.     

The effect of oral contraceptives on current wheezing in young women

BackgroundEmerging evidence suggests that sex steroid hormones may influence respiratory symptoms. The existing literature about the role of oral contraceptive pill (OCP) on respiratory disease is scarce and conflicting especially during the adolescent period. In this study, we aimed to investigate the effect of OCPs on current wheezing among adolescents and young adults.MethodsA questionnaire was administered face-to-face to adolescents and young women by a physician. The questionnaire included ISAAC survey-comprised questions on ever wheezing, current wheezing, allergic diseases, smoking history (active or passive), and family history of allergic diseases and questions on OCP usage status. The effect of OCPs on wheezing was evaluated by logistic regression analysis.ResultsA total of 487 subjects aged between 11.3 and 25.6 years participated in the study and 196 (40.2%) reported that they had used OCPs. 7.4% of the participants had physician-diagnosed asthma and 10.3% of them were active smokers. It was detected that OCPs were associated with increased risk for current wheezing (odds ratio, 2.36; 95% CI, 1.25–4.47 adjusted for asthma and current smoker) and this risk was related with the usage during the past year.ConclusionYoung women taking oral contraceptives had a higher rate of current wheezing, suggesting that sex steroids may be of importance for respiratory health.     

Association of ABO blood group and P. falciparum malaria related outcomes: a cross-sectional study in Ethiopia

Studies elucidate conflicting results about the relationships between ABO blood groups and Plasmodium infection outcomes in humans. This study examined association between ABO blood group and Plasmodium falciparum (P. falciparum) malaria related outcomes among 1065 malaria suspected febrile patients who attended Dore Baafano Health Center, southern Ethiopia, between December, 2010 and February, 2011. Blood specimens were collected and examined for malaria using Giemsa-staining, while stool specimens were examined for helminth infections using Kato-Katz method. Haemoglobin level and blood group were determined using hemocue machine and antisera hemagglutination test, respectively. Clinical data were also collected for the patients. Among the study participants, the proportion of O, A, B and AB blood groups were 40.1%, 30.1%, 29.0% and 14.3%, respectively, and P. falciparum malaria cases in the corresponding blood groups were 14.8%, 14.0%, 13.4% and 15.7%. The odds of non-severe P. falciparum malaria were not significantly different between individuals of blood group A versus O or B versus O or AB versus O. Mean haemoglobin concentration was significantly lower in P. falciparum infected blood type A individuals compared to P. falciparum infected blood type O (β=-1.25, 95% CI=-2.31 to -0.19) or non-A (β=-1.27, 95% CI=-2.23 to -0.32) individuals. The odds of P. falciparum malaria related anaemia was about three times higher in individuals with blood type A compared to those with blood type O (adjusted OR=2.82, 95% CI=1.05-7.56) or non-A individuals (adjusted OR=2.84, 95% CI=1.15-7.01). However, mean P. falciparum density did not significantly differ among patients according to their blood groups. In conclusion, individuals with blood group A had higher risk of anaemia compared to those with O and non-A phenotypes among P. falciparum malaria patients. However, there is a need to investigate the mechanism.     

Non-biting cyclorrhaphan flies (Diptera) as carriers of intestinal human parasites in slum areas of Addis Ababa, Ethiopia

A study was conducted to determine the role of non-biting cyclorrhaphan flies as carriers of intestinal parasites in slum areas of Addis Ababa from January 2004 to June 2004. A total of 9550 flies, comprising of at least seven species were collected from four selected sites and examined for human intestinal parasites using the formol-ether concentration method. The dominant fly species was Chrysomya rufifacies (34.9%) followed by Musca domestica (31%), Musca sorbens (20.5.%), Lucina cuprina (6.8%), Sarcophaga sp. (2.8%), Calliphora vicina (2.2%) and Wohlfahrtia sp. (1.8%). Six intestinal helminths (Ascaris lumbricoides, Trichuris trichiura, hookworms, Hymenolepis nana, Taenia spp. and Strongyloides stercoralis) and at least four protozoan parasites (Entamoeba histolytica/dispar, Entamoeba coli, Giardia lamblia and Cryptosporidium sp.) were isolated from both the external and gut contents of the flies. A. lumbricoides and T. trichiura among the helminths and E. histolytica/dispar and E. coli among the protozoans were the dominant parasites detected both on the external and in the gut contents of the flies, but occurring more in the latter. Among the flies, C. rufifacies and M. sorbens were the highest carriers of the helminth and protozoan parasites, respectively. The public health significance of these findings is highlighted.     

Variations in helminth faecal egg counts in Kato-Katz thick smears and their implications in assessing infection status with Schistosoma mansoni

Examination of stool specimens by Kato-Katz (K-K) thick smears is the standard method recommended by the WHO for field diagnosis of intestinal schistosomiasis. However, there is increasing concern that this technique has low diagnostic sensitivity. In 326 study subjects, we compared the diagnostic yield of examining one, three or five Kato-Katz thick smears prepared from one stool specimen using 41.7 mg templates. In a subset of 169 subjects who had no demonstrable Schistosoma mansoni eggs in their first three Kato-Katz thick smears, we assessed the comparative advantage of examining an additional three Kato-Katz thick smears from another stool specimen, taken four weeks later, to that of cumulative yield obtained by examining all five Kato-Katz thick smears derived from the first stool specimen. For all helminth infections, single Kato-Katz thick smear-based prevalence estimates were significantly lower than those obtained from triplet or quintet Kato-Katz thick smears. Prevalence of S. mansoni infection based on single, triplet and quintet Kato-Katz thick smears from one stool specimen were 31.3%, 45.7% and 52.1%, respectively. Prevalence estimate of S. mansoni based on quintet Kato-Katz thick smears from the first day stool specimens was not different from cumulative estimate obtained with two triplet Kato-Katz thick smears from two stool specimens, 52.1% and 52.8%, respectively. In conclusion, either examination of quintet Kato-Katz thick smears from one stool specimen using 41.7 mg template or initial triplet Kato-Katz thick smears from one stool specimen, and if these are negative, followed by examination of additional triplet Kato-Katz thick smears from subsequent day stool specimen can adequately assess individuals for infection status with S. mansoni.     

Wolff-Parkinson-White syndrome mimicking acute anterior myocardial infarction in a young male patient--a case report

A young male with Wolff-Parkinson-White syndrome whose electrocardiographic pattern was suggestive of acute anterior myocardial infarction is described. A 21-year-old male with a history of ventricular fibrillation after being successfully resuscitated was admitted to the coronary care unit. His electrocardiogram showed ST elevation in the precordial leads (V1-V6). This condition was erroneously interpreted as an acute myocardial infarction. At the fourth day, while ST elevations returned to baseline, short PR interval and delta waves were observed on the ECG. Myocardial infarction was excluded by biochemical tests, echocardiography, and coronary angiography. Electrophysiologic study confirmed Wolff-Parkinson-White syndrome with two accessory pathways.     

Late systolic wave on brachial artery blood flow velocity pattern in patients with coronary artery disease and its relation to vascular stiffness

Duplex-Doppler study typically exhibits triphasic brachial artery blood flow velocity pattern in subjects classified as normal without clinically evident atherosclerotic complications, heart disease, hypertension, or diabetes mellitus. In this study, the authors described the late systolic wave on the brachial artery blood flow velocity pattern in patients with coronary artery disease and investigated the relation between late systolic wave and vascular stiffness. Blood flow profile and velocity of the brachial artery were determined noninvasively by ultrasound pulsed-Doppler technique under the guidance of a B-mode ultrasound image in 96 patients with coronary artery disease (CAD). The control group consisted of 23 healthy subjects with no or maximally 2 risk factors (only among age, cigarette smoking, obesity, and gender) for vascular disease. None of the patients and controls had clinical evidence of arterial disorders at upper extremities. In 32 patients (33%) with CAD, a late systolic wave was observed in the brachial artery Doppler study. On the other hand, no late systolic wave was observed in the healthy subjects. In addition, multivessel disease, hypertension, advanced age, diabetes, and smoking were significantly more frequent in patients with the late systolic wave. In conclusion, peripheral arterial abnormalities induced by vascular stiffness may produce alterations in regional wave reflections, and the normal triphasic pattern of the brachial artery blood flow may change by the appearance of the late systolic wave.     

Right atrial appendage function in patients with chronic nonvalvular atrial fibrillation

To assess right atrial appendage (RAA) flow and its possible relationship to left atrial appendage (LAA) flow in chronic nonvalvular atrial fibrillation (AF), transesophageal echocardiography (TEE) was performed in 26 patients with chronic nonvalvular AF (group I). For the purpose of comparison, an additional group of 27 patients with chronic valvular AF due to mitral stenosis (group II) was analyzed. The clinically estimated duration of AF in group I was significantly longer than that of group II (8.7+/-3.4 versus 2.7+/-1.1 years). Although right atrial size and RAA maximal area were larger in group I than those in group II, left atrial size was larger in group II than that in group I. Group II had larger LAA maximal areas than group I, but this difference did not reach statistical significance. The two groups were not different with respect to the RAA or LAA emptying velocities. Significant correlations were observed between echocardiographic parameters of the two atria in patients with nonvalvular AF (r range, 0.4 to 0.7). In contrast, in patients with valvular AF, no correlation was observed between the echocardiographic parameters of the two atria (appendage emptying velocity, r = 0.38, p = 0.051; atrial size, r = -0.03, p = 0.89; maximal appendage area, r = 0.07, p = 0.75, respectively). There were no significant differences in the presence of right and left atrial spontaneous echo contrast and thrombus between the groups. All of the right and left atrial thrombi were confined to their respective appendages and were found in the atria with spontaneous echo contrast. Both RAA and LAA thrombi were present in one patient. In conclusion, our findings suggest that AF could affect both atria equally in nonvalvular AF, in contrast to valvular AF. Therefore, the assessment of RAA function as well as LAA may be important in patients with chronic nonvalvular AF.