Pathogenesis and management of a late manifestation of vivax malaria after deployment to Afghanistan: conclusions for NATO Armed Forces Medical Services

Because of the worldwide engagement of the German armed forces, tropical diseases may come to the attention of their medical services. In particular, acquired malarial infections, which sometimes become symptomatic only months or even years after soldiers return from military operations, need to be addressed. Other forces, such as the British, U.S., Australian, and Italian armed forces, reported cases of vivax malaria up to approximately 20 months after soldiers returned from military operations. The importance of a sound history and rapid diagnosis, leading to appropriate treatment, is emphasized in this case report of a 27-year-old German soldier who reported for sick call in his unit complaining of a flu-like illness, which later proved to be vivax malaria. The special parasitological features of Plasmodium vivax infection are discussed.     

Good interventions that few use: uptake of insect bite precautions in a group of Canadian Forces personnel deployed to Kabul, Afghanistan

We evaluated use of interventions to prevent insect bites in Canadian personnel deployed to Kabul, Afghanistan. Data were collected through a self-report written survey. The response rate was 92%, and intervention uptake was 11% applied repellent that day, 21% slept under a bednet their last sleep, and 78% wore insecticide-treated clothing. Two associations were usually evident in multivariate analyses: persons perceiving risk of exposure as high were more likely to use bednets and repellent, and individuals reminded to use an intervention had higher odds of doing so. However, even if perception of exposure risk was high and reminders were received, the use of bednets (60%) and repellent (40%) was relatively low. Hence, on the one hand, increased uptake of interventions through targeted messaging might be possible. On the other hand, effectiveness of these interventions might be substantially constrained because of nonuse, even in a motivated and informed population.     

Cardiovascular disease in a forward military hospital during operation iraqi freedom: a report from deployed cardiologists

BACKGROUND: No published data are available regarding cardiac evaluations in a forward military hospital setting. METHODS: Two cardiologists deployed in support of Operation Iraqi Freedom identified all of their cardiac evaluations. Patient demographic data, evaluations performed, outcomes, and return-to-duty rates were determined. RESULTS: Four hundred sixty-nine predominantly male patients were evaluated, with a mean age of 39 +/- 10 years. The most common reasons for referral were ischemic evaluation (n=283), arrhythmia/palpitations (n=83), and syncope (n=57). Of those referred with ischemia, the mean Framingham 10-year event risk calculated was low at 5.3 +/- 3.1%; 86% of military patient evaluations revealed no identifiable cardiovascular pathological condition, and patients were returned to duty. CONCLUSIONS: Cardiology support, with the availability of echocardiography and stress testing in the theater of operations, was able to provide cardiovascular consultative evaluations and management and to reduce rates of medical evacuations out of the theater of operations.     

Posterior fossa epidermoid in a member of a kindred with von Hippel-Lindau disease

The authors describe the case of a middle-aged member of a kindred with von Hippel-Lindau disease in whom a posterior fossa epidermoid developed. The epidermoid was initially thought to be a hemangioblastoma, a tumor to which those who have von Hippel-Lindau disease are predisposed. Radiologic investigations, especially magnetic resonance imaging, were useful in demonstrating the extra-axial nature of the tumor and also in characterizing it as an epidermoid.     

感染性海绵窦血栓形成长期影像学随访一例

患者女,51岁.无诱因发现视物模糊,右侧睁眼困难2周入院.入院诊断为右动眼神经麻痹.既往有高血压病史和颈椎病史,无糖尿病史.体检:神清,语言流利,右眼睑不完全性下垂,眼裂:左8 mm、右4 mm,右瞳孔直径0.4 cm,左瞳孔直径0.3 cm.右眼向内、上、下均受限,外展无露白,无其他异常体征.体温:36.5℃,血压:140/90 mmHg,心律:73次/min,律齐.实验室检查:白细胞10.4×109/L,中性粒细胞0.80,淋巴细胞0.15,中性粒细胞绝对值8.4×109L.脑脊液检查(-),血糖正常.1周后复查血常规正常.     

Infectious disease in Antarctica and its relation to aerospace medicine: a review

In many aspects, an Antarctic Station provides parallels to the environments encountered in space exploration, particularly with reference to infectious disease. In both instances, small groups of people live in isolation for long periods of time in a functionally sterile atmosphere. Therefore, studies of infectious disease in Antarctica should provide important insights into the experiences to be expected in spaceflight. This paper presents a summary of the information on the infectious and immunologic aspects of isolation derived over the years from research in Antarctica.     

脐尿管膀胱憩室合并感染1例

患者男性，15岁。因下腹部正中疼痛，寒战、高热3天人院。自述近1月来小便后下腹部即有疼痛感。无尿频、尿急、尿痛等尿刺激症状。外院曾诊断为腹腔肠问脓肿，经抗炎治疗包块缩小不明显。     

Infectious disease outbreaks in competitive sports: a review of the literature

Recent outbreaks of infectious diseases in athletes in competitive sports have stimulated considerable interest. The environments in which these athletes compete, practice, receive therapy for injuries, and travel, both domestically and internationally, provide varied opportunities for the transmission of infectious organisms. The purpose of this medical literature review is to identify the agents most commonly reported in the medical literature as responsible for infectious disease outbreaks in specific sports and their modes of transmission and to guide targeted prevention efforts. A literature review of English-language articles in medical publications that reported outbreaks of infectious diseases in competitive athletes was conducted in PubMed MEDLINE from 1966 through May 2005. Outbreaks that were solely food borne were excluded. Fifty-nine reports of infectious disease outbreaks in competitive sports were identified in the published medical literature. Herpes simplex virus infections appear to be common among wrestlers and rugby players, with no single strain responsible for the outbreaks. Methicillin-resistant Staphylococcus aureus was responsible for several recent outbreaks of soft tissue and skin infections among collegiate and professional athletes. The most common mode of transmission in outbreaks was direct, person-to-person (primarily skin-to-skin) contact. Blood-borne exposure was implicated in 2 confirmed outbreaks of hepatitis. Airborne and vector transmissions were rarely reported. This review provides an overview of infectious disease outbreaks thought to be either serious enough or unusual enough to report. Appropriate surveillance of the frequency of infections will allow sports medicine staff to identify outbreaks quickly and take necessary measures to contain further transmission and prevent future outbreaks.