Primary dapsone-resistant leprosy in San Francisco

The dapsone sensitivity of strains of Mycobacterium leprae from 54 multibacilliferous untreated leprosy patients presenting to the United States Public Health Service Hospital in San Francisco, California, U.S.A., from 1978 to 1981 was studied by mouse foot pad inoculation. M. leprae from 53 patients were found fully sensitive to dapsone. M. leprae from one patient were resistant to only the lowest dietary level of dapsone, 0.0001%, since growth of the bacilli was inhibited by higher and clinically easily achievable levels. Mouse plasma dapsone levels confirmed the reliability of the drug-containing diets.     

Combined clofazimine- and dapsone-resistant leprosy. A case report

A preliminary report is presented on the finding in a patient with lepromatous leprosy relapsing after maintaining clinical inactivity and bacterial negativity with dapsone monotherapy for a period of 23 years. Interestingly, Mycobacterium leprae from the fresh skin lesions revealed resistance to both clofazimine and dapsone by standard mouse foot pad testing.     

一起恶性疟继发感染调查报告

四川省古蔺县确诊2例恶性疟病例,经追踪调查系输入恶性疟引起的继发感染。现将病人情况及调查结果报告如下。1病例情况病例1,女,6岁,四川省古蔺县金星乡人。于2004年1月10日开始出现不明原因畏寒、发热,最高体温41℃,伴恶心呕吐,偶伴腹痛,无皮下出血,无咳嗽流涕,按流感、传染性单核细胞增多症治疗无效。以进行性贫血和脾肿大考虑为黑热病,3月3日在四川省寄生虫病研究所采血检查,疑为恶性疟感染。次日再次血检,查见恶性疟配子体和小滋养体(以配子体为主),确认为恶性疟感染,复查2月28日骨髓片也查见恶性疟原虫大、小滋养体,仍以配子体为主。治…     

Second-Generation Anti-HCV Tests Predict Infectivity

Twenty-four blood donors found positive for the first-generation hepatitis C antibody (anti-HCV) test (Ortho EIA-I) and 88 of their recipients over the period from 1972 to 1990 were retrospectively investigated with different first- and second-generation anti-HCV tests. The aim of the study was to identify the infective donors and to evaluate the tests. Seven donors, who probably were infective carriers of HCV, were also second-generation test (EIA-II) positive, compared to only 3 out of 17 noninfective donors. Among the infected recipients, 14 out of 29 (48%) were positive for the second-generation test only. The second-generation test identified the infective donors in our study and was more sensitive than the first-generation test. We therefore recommend that blood donors are screened with EIA-II. Positive test results should be confirmed by the recombinant immunoblot assay (RIBA-II), and persons with positive or not conclusive RIBA-II should not be accepted as blood donors.     

Mortality among primary and secondary cases of measles in Bangladesh

Data were reviewed from an intensive 1975-1976 survey in two Bangladeshi villages that experienced a high incidence of measles. Mortality among secondary cases (four of 50, 8.0%) was significantly higher than that among primary cases (six of 290, 2.1%). In every case in which there was a death in a household with more than one case, it was the youngest patient who died. All children with secondary cases who died had a pre-illness weight-for-height status above the population mean. Measles mortality in Bangladesh appears to be determined by three factors: age, superinfections, and having a secondary case. The last two factors may be due to increased intrafamilial exposure to both the measles virus and the superinfecting pathogens.     

继发性嗜血细胞综合征15例临床分析

目的 探讨自身免疫病相关性与非自身免疫病相关性嗜血细胞综合征(HPS)两者的临床特征、治疗及预后.方法 回顾性收集15例2008年1月至2010年6月我院风湿科及血液科住院的继发性嗜血细胞综合征患者,分析临床及实验室特征、治疗以及预后的关系.并比较自身免疫病相关性嗜血细胞综合征(A组)与非自身免疫病相关性嗜血细胞综合征(B组)之间的异同点.采用Fisher精确概率法、t检验和秩和检验.结果 2组均表现出发热、出血、黄疸、肝脾肿大,A组特异性表现出关节痛、皮疹、自身抗体阳性,而B组中黄疸更常见(38%和100%,P=0.018).但比较2组实验室指标及预后差异均无统计学意义(P>0.05).激素联合免疫抑制剂和丙种球蛋白治疗预后更好(P<0.05).结论除黄疸外,自身免疫病相关性HPS与其他继发性HPS的临床表现及实验室指标无明显差异,激素联合免疫抑制剂及丙种球蛋白治疗有效.

Abstract：

Objecfive To investigate the clinical characteristics,treatment and prognosis of autoimmune diseases associated and non-autoimmune diseases associated hemophagocytic syndrome.Methotis Clinical records of 15 cases witll secondary hemophagocytic syndrome'were collected and the relations with treatment and prognosis was analyze.The similarities and differences between autoimmune disease associated bemophagocytic syndrome (group A)and non-autoimmune disease associated hemophagocytic syndrome (group B)were compared.Fisher exact test,t test and Willcoxen test were used for statistical analysis.Results Both groups had fever,bleeding,jaundice,hepatosplenomegaly,and arthralgia,skin rash and positive of autoantibodies in group A were discovered specifically.But in group B,the patients with icterus were mo common(38% vs 100%,p=0.018).There was no significant difference in their laboratory data and prognosis when compared between the two groups(P>0.05).The patients who received corticosteroids and IVIG and/or immunosuppressive agents had better prognosis(P<0.05).Conclusion Except for icterus there is no significant difference in clinical features and laboratory data among autoimmune disease associated hemophagocytic syndrome and other secondary hemophagocytic syndrome.And the therapy with corticosteroids combined with IVIG and/or immunosupprcssive agents is effective.     

Infectivity of medical staff for hepatitis B

Summary Prior to hepatitis B vaccination, 36,000 persons of the medical staff were tested for HBs antigen, HBc antibodies, and HBs antibodies. 210 sera were found positive for HBs antigen and HBc antibodies. Of these sera, 171 were available for testing for hepatitis B virus DNA as a marker of infectivity by spot hybridization. DNA was detected in only 15. One hundred and thirty-nine had HBe antibodies but no detectable HBe antigen, and only two of these were hepatitis B virus DNA positive. 12 had neither HBe antigen nor HBe antibodies and none had hepatitis B virus DNA. Hepatitis B virus DNA was, however, detected in 13 of 20 HBe antigen-positive but HBe antibody-negative sera. Our study confirms epidemiological observations that medical staff hardly plays any role as a source of HBV infection for patients.

---

Infektiosität von medizinischem Personal mit Hepatitis B

Zusammenfassung Vor der geplanten Hepatitis-B-Impfung wurden 36 000 Angehörige von medizinischen Berufen auf HBs-Antigen, HBc-Antikörper und HBs-Antikörper getestet. Dabei wurde in 210 Sera HBs-Antigen und HBc-Antikörper nachgewiesen. 171 dieser Sera konnten auch mittels Hybridisierungstechnik auf virale Hepatitis B-DNS als Marker der Infektiosität untersucht werden. Nur bei 15 war virale Nukleinsäure nachweisbar. Bei 139 fanden sich HBe-Antikörper, von denen aber nur zwei HBV-DNS-positiv waren. Zwölf Personen, die alle HBV-DNS-negativ waren, hatten weder HBe-Antigen noch HBe-Antikörper. Hingegen wurde virale Nukleinsäure bei 13 von 20 Sera gefunden, die HBe-Antigen, aber keine HBe-Antikörper enthielten. Unsere Untersuchung bestätigt die epidemiologische Beobachtung, daß dem medizinischen Personal kaum eine Rolle als Infektionsquelle für die Patienten zukommt.