Migrating subcutaneous swellings due to dirofilariasis after a visit to the South of France

In two women, aged 59 and 31 years, who suffered from an itching cutaneous nodule, subcutaneous dirofilariasis was diagnosed. The disease is characterised by recurrent migrating subcutaneous nodules and swellings. Both patients recently visited the South of France. Laboratory examination revealed a moderate eosinophilia. In both patients, filaria antibodies were demonstrated during the course of the disease and a nodule was eventually resected. Parasitological examination revealed Dirofilaria repens. After this the swellings did not recur. Dirofilariasis is a zoonosis common in dogs and cats, and is transmitted by mosquitoes. In humans, the most common clinical manifestation is a migrating subcutaneous nodule in the case of D. repens, and a pulmonary infiltrate (coin lesion on radiographs) in the case of Dirofilaria immitis. Filarial serology is often positive. The diagnosis is confirmed by parasitological examination of the excised nodule. Dirofilariasis is usually innocuous; it disappears after the worm has died but can cause patients to worry.     

A Case of Sparganosis mansoni in the Thigh: Serological Validation of Cure Following Surgery

Cases of Sparganum mansoni, caused by the plerocercoid larva of the tapeworm S. mansoni, occur throughout the world, particularly in Asian, Middle Eastern, and European countries. However, cases of infection with this parasite are rarely seen in Japan. Here, we present a case of a 61-year-old woman with a solitary subcutaneous nodule in left inner aspect of the thigh, from which a long, slender, whitish worm was surgically removed. The parasite was histopathologically identified as S. mansoni. Serological testing confirmed cure of the infection after surgical removal of the parasite. The authors advocate immunoserological examination in case of S. mansoni.     

Opisthorchis viverrini: the relationship between egg production,worm size and intensity of infection in the hamster

Worm recoveries, egg production and worm lengths were determined in golden Syrian hamsters given between five and 200 Opisthorchis viverrini metacercariae. Animals given five, 10 or 20 metacercariae showed similar worm recovery rates of 38%, 36% and 37%, respectively, whereas animals given 50, 100 or 200 metacercariae gave recoveries of 49%, 65% and 54%, respectively. The distribution of worms between right, left and middle liver lobes was similar for animals with between one and 43 worms but different for animals with between 64 and 154 worms.A curvilinear relationship between eggs found per gram of faeces per worm (epg/worm) and eggs/worm/24 hours and worm burden was observed at 60 days post-infection, with worm egg output decreasing as worm burden increased. Regression analysis of the logarithmically transformed data gave regression coefficients of r = 0·62 for log₁₀ epg/worm v. worm burden and r = 0·71 for log₁₀ eggs/worm/24 hours v. worm burden. When the same analyses were performed substituting worm density (worms/gram liver tissue) for worm burden, little or no difference was seen in the correlations obtained. A similar relationship was also observed between worm length and worm burden with mean worm length appearing to decrease with increase in worm burden.These results clearly show that worm crowding in the hamster host can have a profound effect on worm egg output and growth. The possible mechanisms underlying these phenomena are discussed and their potential relevance in human opisthorchiasis considered.     

^18F-FDG和^18F—FLT PET／CT诊断肺结节的影响因素研究

目的探讨^18F—FDG（^18F-脱氧葡萄糖）和^18F-FLT（^18F-胸腺嘧啶）双核素PET／CT显像诊断肺结节的影响因素，以提高PET／CT对肺结节的诊断价值。方法选择肺结节患者55例为研究对象，其中男性33例，女性22例，年龄17—82岁，28例为肺内孤立结节，其余为2～3个结节，结节大小0．6～11．0cm，所有患者均行肺部^18F-FDG和^18F—FLTPET／CT检查，分析^18F—FDG和^18F-FLT标准摄取值（SUV）与肺结节患者的性别、年龄、结节大小及病理类型等相互关系和意义。结果55例肺结节患者，^18F—FDG和^18F-FLT标准摄取值与患者的性别、年龄、结节大小等均无关（P〉0．05），^18F-FDG标准摄取值与患者的病理类型无关（P〉0.05），而^18F—FLT标准摄取值与患者的病理类型有关，恶性肿瘤的SUVFLT大于良性肿瘤（P〈0．05）。结论肺结节患者结节的病理类型是影响^18F—FLT标准摄取值的重要因素，^18F—FLTPET／CT鉴别诊断肺结节良恶性具有重要的价值和意义。     

2010-2013年北京市体检人群甲状腺结节检出情况分析

目的 探讨北京市体检人群甲状腺结节检出情况的变化趋势,预测北京市常住人口甲状腺结节患病情况.方法 采用现况研究的方法,对北京市2010-2013年参与体检人群的甲状腺结节检出情况进行分析,采用Excel2007建立数据库,应用SPSS16.0软件,采用x2和趋势x2检验对数据进行统计学分析,并根据2013年的北京市体检人群甲状腺结节的检出率和常住人口数,采用直接标准化法估算北京市常住人口甲状腺结节的患病概况.结果 2010-2013年,北京市体检中心共有92 725人接受甲状腺结节彩色多普勒超声检测,甲状腺结节整体检出率为36.7％(34 052例),其中男性检出率为30.4％,女性为43.5％,女性高于男性(x2=1.70×103,P＜0.01).2010-2013年间甲状腺结节检出率呈上升趋势(x2趋势=5.33×102,P＜0.01).以2010年的检出率为基数计算疾病增长速度显示,2012-2013年甲状腺结节检出率增长明显,女性明显高于男性,增速比分别为19.1％:9.9％和37.3％:14.5％.男女甲状腺结节检出率都随着年龄的增长呈上升趋势(总体x2趋势=5.74×103,P＜0.01),并以40～49岁和≥60岁组增长最为明显.根据2013年检出情况,估算获得北京市常住人口甲状腺结节预期检出率为38.2％,预测患病人数近790万.结论 北京市体检人群甲状腺结节检出率较高,发展速度较快,患病人群基数较大.     

The Provision of Potable Water in Eradication of Guinea Worm Infection in Ezza North,Southeastern, Nigeria

Guinea worm is a parasite found in unprotected drinking water sources, causes considerable morbidity and loss of agricultural production among rural people. The study was to determine the current status of Guinea worm infection in Ezza North and to evaluate the impact of control measures on guinea worm infection. A total of 200 individuals in Ezza North Southeastern, Nigeria were examined for guinea worm infection. A standardized questionnaire was used to determine the effect of potable water on guinea worm eradication/control, the source of drinking water, information on the knowledge, attitude, symptom management practices, availability of health facilities and boreholes installation status. The instrument for data collection was well constructed, validated and reliable tested questionnaire by an expert. Data obtained was analyzed using Epi-Info model 3.4 versions. Results of a study indicated majority of the respondents 195 (97.5 %) have access to safe drinking water supply which indicated no case of Guinea worm infection. The active use of potable water supply was found among the age group of 20–30 years 71 (35.5 %) and higher in male (57.5 %) than females (42.5 %). The drastic reduction of Guinea worm infection to zero (0) level in Ezza North were due to multiple factors as health education, availability of functional boreholes, presence of health centers for immediate treatment if any case discovered.     

基于肺结节分割的肺部体绘制传递函数自动设计方法

目的：研究一种体绘制传递函数设计方法,将胸腔体数据中重要的疑似结节区域高质量突出地显示出来以辅助肺癌的诊断.方法：不采用通常的高维函数交互设计方法,而是对肺部组织进行分类,通过肺实质分割以及肺结节分割方法得到胸腔数据场的类别标记矩阵,根据标记矩阵获得各类灰度分布,生成传递函数供用户在交互式设计界面上进行调整,并利用图形处理器（GPU）的体绘制方法实时绘制出图像.结果：该方法可有效绘出肺部的三维图像,并高亮出疑似肺结节.结论：该方法简化了用户操作,避免了复杂的高维传递函数设计,并且能够突出疑似结节,把胸部三维数据场高质量地绘制出来.     

Hookworm burdens and faecal egg counts: an analysis of the biological basis of variation

The relationships between various measures of faecal egg output and hookworm burdens were investigated in 84 villagers from West Bengal with mixed Necator americanus and Ancylostoma duodenale infections. The pattern of day to day variability in egg counts from individuals can be characterized by the linear relationship between the logarithms of the variances and means. Egg output is shown to be non-periodic in long runs of day-to-day records. The distribution of worm numbers per host is well described by the negative binomial probability model, and the relationship between per capita egg output and worm burden is non-linear where egg output declines as parasite burden rises. Density-dependent effects on fecundity are shown to act at comparatively low worm burdens in relation to the range of observed parasite loads. Egg output measures are shown to be qualitative as opposed to quantitative measures of worm burdens as a consequence of inherent sampling heterogeneity and variability induced by biological processes, such as density-dependent depression of parasite fecundity. The analyses suggest that it is possible, on the basis of egg counts, to discriminate between individuals with low and high hookworm burdens. The intrinsic per capita fecundities of the two species of hookworms are shown to be similar, but density-dependent constraints on egg production by N. americanus appear to be more severe than those acting on A. duodenale. This observation may help explain why A. duodenale appears to produce larger numbers of eggs per unit of time than N. americanus. The regulatory role of density-dependent fecundity and aggregated distributions of worm numbers per person are discussed in relation to the over-all transmission dynamics of hookworm parasites.     

组胺H2受体抑制剂西米替丁对大白鼠抵抗华支睾吸虫再感染拮抗作用的实验研究

目的观察组胺H2受体抑制剂西米替丁对大白鼠抵抗华支睾吸虫再感染的拮抗作用，探讨大白鼠抵抗华支睾吸虫再发生感染的可能机制。方法30只SD(Sprague—Dawley)系雄性大白鼠分成5个实验组，A、B组分别为初感染和再感染对照组；C组为再感染组，不给任何药物；D组为强的松龙处理再感染组，从再感染前1周起每周肌注强的松龙10mg／kg，共5次；E组为西米替丁处理再感染组，从再感染前1天起用西米替丁100mg/kg／d灌胃，共4周。初感染时每鼠接种囊蚴100个，感染后4周用吡喹酮100mg／kg连续灌胃治疗3天。再感染时每鼠接种囊蚴100个，每周采外周血进行嗜酸性粒细胞计数。4周后回收虫体计算回收率和保护率，并观察比较各组虫体发育情况。结果对照A、B组虫体回收率分别为60．7％和58．3％，虫体发育良好；C、D组和E组虫体回收率分别为4．3％，62．2％和33．7％；保护率分别为92．5％，-13．3％和45．8％；C组虫体小，虫体及生殖系统发育明显受阻；D组虫体比对照组大，发育良好；E虫体发育界于C组与D组之间。结论大白鼠抵抗华支睾吸虫再感染表现为降低虫体回收率和抑制虫体发育，与强的松龙能完全消除这一保护作用不同，组胺H2受体抑制剂西米替丁只表现为部分拮抗作用。     

合肥市某区人群甲状腺结节的患病状况及影响因素

目的 分析合肥市某区人群甲状腺结节患病影响因素,以期指导本地甲状腺结节防治工作。 方法 以整群抽样方法选取合肥市某区2 584例年龄>18岁的社区常住居民作为调查对象,对受试者完成实验室指标采集以及甲状腺B超检查,并由调查员完成问卷调查。应用Logistic回归分析模型分析探讨合肥地区甲状腺结节的相关影响因素。 结果 合肥市某区居民甲状腺结节超声检出率为11.20%,Logistic回归分析模型分析结果显示甲状腺结节患病与多种疾病具有相关性,女性、体重指数（body mass index,BMI）升高、糖基化血红蛋白（glycosylated hemoglobin A1c,HbA1c）、低密度脂蛋白胆固醇（low density lipoprotein cholesterol,LDL-C）、尿碘中位数（median urinary iodine,MUI）、甲状腺疾病家族史为甲状腺结节伴发因素（均有P < 0.05）。 结论 应加强合肥地区相应高风险人群甲状腺结节的早期筛查和干预。     

Rate of expulsion of Trichuris trichiura with multiple and single dose regimens of albendazole

The efficacy of multiple and single dose regimens of albendazole on Trichuris trichiura infection was evaluated by counting the number of worms expelled/day from two pair-matched groups of children, for nine days following therapy. The temporal patterns of worm expulsion were similar whether the children received a single 400 mg dose or two consecutive doses: no worms were passed before the second day, or after the sixth day, after intervention, and the maximum worm expulsion rate was attained on the fourth day. A second treatment six days after the first expelled no more worms. The results obtained here resemble those obtained previously with a three-day (600 mg) regimen of mebendazole in a study of heavily infected children. We conclude: that irrespective of dose, benzimidazole carbamates require the gut transit time plus 48 hours to immobilize T. trichiura; and that a single dose of albendazole is effective against light infections of T. trichiura but requires further evaluation with high intensity infections.     

The consequences of uncertainty for the prediction of the effects of schistosomiasis control programmes.

Progress in the development of schistosomiasis models for use in control programmes is limited by the considerable uncertainty in many of the biological parameters. In this paper, this problem is addressed by a comprehensive sensitivity analysis of a schistosomiasis model using the Latin Hypercube method. Fifty simulations with different parameter contributions are run for 50 years with treatment during the first 20 years and reinfection thereafter. The analysis shows only a relatively small divergence between simulations during the chemotherapy treatment programme but considerable divergence in reinfection levels after treatment is stopped. A skewed distribution of outcomes was seen with most simulations showing effective control and a few where control had less impact. The most important uncertainty source was due to the unknown levels of acquired immunity and also uncertainty in the true worm burden. In particular, the strength of the immune response was most important in determining whether control was effective with higher immunity leading to less effective control. Among those simulations in which control was not very effective, those in which the mean worm burden was high showed the least effective control. Since both these are areas of genuine uncertainty, it is proposed that uncertainty analysis should be an integral part of any projection of control programmes.     

舟山海岛地区甲状腺结节影响因素病例对照研究

目的分析浙江省舟山市海岛地区居民甲状腺结节患病的危险因素。方法按整群随机抽样法,对舟山市海岛居民进行流行病学问卷调查、甲状腺B超检查及尿碘检测;将甲状腺结节阳性者与B超下甲状腺无病变者按性别、年龄、城乡、职业以1:1配对各831人,进行病例对照研究;采用单因素及多因素Logistic回归模型分析相关的危险因素。结果年收入为甲状腺结节的保护因素(P=0.014,OR=0.875,95%CI=0.589～0.998),年收入在3～5万元者与其他收入者比较不易患甲状腺结节(P=0.042);吸烟者甲状腺结节患病率较高,尿碘值在100～199μg/L者甲状腺结节患病率较低(P<0.05)。结论海岛居民饮食生活习惯、碘营养水平等与甲状腺结节发生有一定关系,有关甲状腺结节发生的影响因素尚待进一步研究。     

Population distribution of Trichuris trichiura in a community of Jamaican children

The Trichuris trichiura worm burdens of 23 children living in a Place-of-Safety in Kingston, Jamaica, were assessed by stool collection for more than five days after treatment with mebendazole. This procedure was repeated after a seven-month period of natural re-infection. For both collections the maximum rate of worm expulsion was achieved on the fourth day after starting treatment. The worm population distributions were overdispersed and well described by the negative binomial probability model (k = 0.29) in each case. For any one individual, the number of worms passed on the first expulsion was unrelated, absolutely or relatively, to the number passed on the second. These data suggest that: knowledge of the time dependency of helminth expulsion is essential for the accurate estimation of worm burdens by this method; populations of Trichuris are more highly aggregated than those of Ascaris and may thus be more susceptible to control by selective rather than random chemotherapy; and the inherent predisposition of hosts to infection may be of minor importance in determining the distribution of worms in the population-heavily infected hosts appear no more or less likely to acquire large worm burdens on subsequent exposures.     

Learning from local knowledge to improve disease surveillance: perceptions of the guinea worm illness experience

Surveillance is an essential tool in any campaign to eradicate disease; guinea worm (dracunculiasis), which is targeted for eradication before the year 2000, is no exception. One criterion of an eradicable disease is that it be easy to recognize as the program advances. Few experts doubt that the experience of a meter-long subcutaneous worm protruding through a painful ulcer can be missed or confused with another disease, thus ensuring that guinea worm meets this criterion. Field experiences of anthropologists and health educators have shown that one should never assume that community perceptions of illness experience coincide fully with medical case definitions of disease. This paper describes efforts to learn how the Yoruba people of southwestern Nigeria perceive sobia, the local name for guinea worm. Qualitative methods including informal interview, village discussion and participant observation were used to discern a pattern of illness presentation and progression. Interestingly, local perceptions were found to include a variety of illness manifestations beyond the common clinical case definition of an emergent worm, thus creating the potential for a high level of false positive reports. Local knowledge was then used to design a pilot project that trained volunteers to become part of the surveillance network for the national eradication program. The volunteers, who were largely illiterate, were able to distinguish between cultural and clinical definitions, and submit quite accurate reports on the guinea worm status of their villages. Among the 164 volunteers, only two submitted false reports due to incorrect disease definition. In contrast local government health workers who were conducting village searches during the same period were significantly more likely to register false positive reports. The culturally sensitive training based on local knowledge received by the village volunteers is thought to have contributed to their superior performance.     

Rapid assessment method for prevalence and intensity of Loa loa infection

OBJECTIVE: To assess the validity of observations on eye worm and Calabar swellings for the rapid assessment of the prevalence and intensity of loiasis at the community level. METHOD: A total of 12895 individuals over the age of 15 years living in 102 communities in Cameroon and Nigeria took part in the study. A standardized questionnaire was administered to participants from whom finger-prick blood samples were collected and examined for Loa loa microfilariae. Rapid assessments of the prevalence and intensity of loiasis were made on the basis of a history of eye worm or Calabar swellings. FINDINGS: There was a strong correlation between the indices of the rapid assessment procedures and the parasitological indices of L. loa endemicity. The rapid assessment indices were effective in diagnosing high-risk communities (sensitivity 94-100%; specificity 66-92%). The highest sensitivity (100%) and specificity (92%) were obtained with a rapid assessment procedure based on a history of eye worm lasting 1-7 days together with confirmation by the guided recognition of a photograph of adult L. loa in the eye. CONCLUSION: Rapid assessment of the prevalence and intensity of loiasis at the community level can be achieved using a procedure based on the history of eye worm lasting 1-7 days together with confirmation by the guided recognition of a photograph of an adult L. loa in the eye.     

Toxic effects and bioaccumulation of cadmium in the aquatic oligochaete Tubifex tubifex

Although Tubifex tubifex (Oligochaeta, Tubificida) has been proposed as a test organism for ecotoxocological studies, very few data concerning sublethal toxicity and bioaccumulation are available on this worm. The aims of this work were to assess the toxicity of cadmium, one of the most toxic metals frequently encountered in polluted areas, on T. tubifex and the ability of the worm to accumulate this metal. Acute toxicity was analyzed by measurement of the 96-h LC(50) and daily survival rates. Results indicated that T. tubifex undergoes an adaptation period to Cd, the duration of which decreases with increasing Cd concentration. The various parameters affecting toxicity are discussed. Sublethal toxicity was studied by scanning electron microscopy. Observations revealed that Cd induced autotomy of the caudal region and mucus production. Autotomy is proposed as a criterion for sublethal toxicity. The results of bioaccumulation studies revealed that Cd is highly and rapidly taken up by the worm, suggesting involvement of efficient detoxification mechanisms. Consequently, the ability to accumulate large amounts of Cd may represent a potential toxicological risk to predators of the worm if Cd is accumulated in bioavailable forms.     

血吸虫卵计量变异的随机模型

目的 将随机模型引进到血吸虫卵计量变异的研究中。方法 随机模型将人群中虫卵计量变异分为两个来源（１）由于个体间配对成虫负荷的不同而导致的虫卵在个体间的变异和（２）对于某一具有特定成虫负荷的个体内虫卵计量的变异。结果 在综合考虑成虫，虫卵的分布特征，配对因素，宿主年龄等因素的基础上建立了数学方程，并介绍了模型的基本拟合方法和该模型的实际应用。结论 随机模型可以描述血吸虫卵计量变异的特征。     

A case of ectopic parasitism: Fasciola hepatica larvae burrow through a human brain and mimic cerebral aneurysm

An 8-year-old boy from Xuan-Han County, Sichuan Province, China presented with 6 months headache, nausea and vomiting. A computed tomography scan revealed multiple cerebral hemorrhages. Etiology of the cerebral hemorrhages was investigated by digital subtraction angiography, and cerebral aneurysm was entertained. Twenty-six days after his admission to the hospital, a flatworm emerged from the right eye of the patient. The worm was identified as Fasciola hepatica, based on the morphological characteristics of the worm.     

Worm plot: a simple diagnostic device for modelling growth reference curves

The worm plot visualizes differences between two distributions, conditional on the values of a covariate. Though the worm plot is a general diagnostic tool for the analysis of residuals, this paper focuses on an application in constructing growth reference curves, where the covariate of interest is age. The LMS model of Cole and Green is used to construct reference curves in the Fourth Dutch Growth Study 1997. If the model fits, the measurements in the reference sample follow a standard normal distribution on all ages after a suitably chosen Box-Cox transformation. The coefficients of this transformation are modelled as smooth age-dependent parameter curves for the median, variation and skewness, respectively. The major modelling task is to choose the appropriate amount of smoothness of each parameter curve. The worm plot assesses the age-conditional normality of the transformed data under a variety of LMS models. The fit of each parameter curve is closely related to particular features in the worm plot, namely its offset, slope and curvature. Application of the worm plot to the Dutch growth data resulted in satisfactory reference curves for a variety of anthropometric measures. It was found that the LMS method generally models the age-conditional mean and skewness better than the age-related deviation and kurtosis.