Archive for December, 2010

Link: http://journals.lww.com/em-news/Fulltext/2005/11000/Lyme_Carditis__From_Asymptomatic_First_Degree.9.aspx

Excerpt:

A previously healthy 17-year-old girl was brought to our ED after a syncopal episode that occurred while she was standing in her kitchen earlier that evening. According to her mother, who was speaking to her at the time of the episode, she suddenly dropped to her knees and then lost consciousness for approximately 10 to 20 seconds. When she regained consciousness, she quickly returned to her baseline mental status, denying any confusion or lethargy. In fact, during our interview with the patient, she reported feeling great immediately after this event.

Her ECG showed an accelerated junctional rhythm with a rate of 120 beats per minute. Further history revealed that she had been seen by her pediatrician on the previous day for evaluation of a rash. She described the rash as it appeared that day as several erythematous patches approximately 5 cm to 6 cm in diameter that were located on her left forearm, abdomen, and thighs. She denied any previous skin conditions such as eczema or psoriasis, and could not recall any recent exposures to plants, ticks, new medications, or cleaning products. She was given a prescription for diphenhydramine, and aside from some general fatigue, was doing well up to the time of her syncopal event.

Link: http://arthritis-research.com/content/12/4/R134/abstract

Excerpt:

Compared with healthy controls, FM patients had significantly higher levels of glutamate+glutamine (Glx) (mean +/- SD: 10.71 +/- 0.50 arbitrary institutional units versus 9.89 +/- 1.04; P=0.049) and higher glutamate+glutamine/creatine (Glx/Cr) ratios (1.90 +/- 0.12 versus 1.72 +/- 0.23; P=0.034) in the posterior gyrus. Myo-inositol (Ins) levels of the right and left hippocampi were significantly lower in FM patients (4.49 +/- 0.74 versus 5.17 +/- 0.62; P=0.008 and 4.91 +/- 0.85 versus 6.09 +/- 0.78; P=0.004, respectively). In FM patients, there were also decreased myo-inositol/creatine (Ins/Cr) ratios in the left sensory-motor area (P=0.05) and the left hippocampus (P=0.002) and lower levels of choline (P=0.019) and N-acetyl aspartate + N-acetyl aspartyl glutamate (NAA+NAG) (P=0.034) in the left hippocampus. Significant correlations between depression, pain and global function and the posterior gyrus Glx levels and Glx/Cr ratios were observed.

Conclusions

Glx within the posterior gyrus could be a pathological factor in FM. Hippocampal dysfunction may be partially responsible for the depressive symptoms of FM. Additional studies with larger samples are required to confirm these preliminary data.

Link: http://www.ajtmh.org/cgi/content/full/79/6/971

Excerpt:

These findings suggest that deer tick-borne POWV may present a public health risk to human residents of and visitors to infested sites. 
Paradoxically, despite the apparent increase in the incidence of human infection, the proportion of ticks infected remained constant between the 1990s and the present. 
The increased geographic distribution of deer ticks and concomitant increases in their populations might produce a greater number of infected ticks overall, or might facilitate spillover from cryptic enzootic foci, which might produce additional human POWV infections. 

It may be that a proportion of the recent increase in the recognition of POWV encephalitis in North America is attributable to the emergence of DTV. 
Ongoing studies will therefore more completely characterize the transmission cycle and molecular epidemiology of DTV within this focus. 

Importantly, infection by viruses within the TBE serologic complex results in a wide range of clinical outcomes, ranging from asymptomatic to severe: DTV may be less pathogenic than prototypical POWV, as has been suggested previously. 

Experimental studies are required to evaluate this hypothesis. In the absence of this data, clinicians should consider tick-borne flavivirus infection in patients presenting 1) with neurologic symptoms and 2) residence or travel to tick-infested sites.

Linda’s comment:  A friend of mine on another group posted this valuable information….make a copy for your purse/wallet…IMPORTANT…

With all the food and pet products now coming from China, make sure to
scrutinize the labels. But no matter what the front of a box or package
says, turn it over and study the bar code. Many products no longer show
where they were made; they show only where the distributor is located. The
bar code will show the product’s origin.

Below are the first three digits of the barcode, and where the product is
made:

00 – 09 . . . . . . . . .     USA and/or Canada.
30 – 37 . . . . . . . . .     France
40 – 44 . . . . . . . . .     Germany
49 . . . . . . . . . . . . .      Japan
50 . . . . . . . . . . . . .      UK
471 . . . . . . . . . . . .     Taiwan
690 – 692 . . . . . . .    China

Also, if a product says “made in PROC,” this is People’s Republic of
China-China.

Link: http://www.fresnobee.com/2010/07/14/2006814/toxic-shower-threatens-valley.html

Excerpt:

A mysterious shower of microscopic chemicals near a Fresno
shopping center could be the first evidence of a broad,
undetected assault on the lungs of San Joaquin Valley residents.
If confirmed in other Valley cities, it means many thousands of
people are daily breathing these cocktails of chemicals — known
as ultra-fine particles — that corrode and damage lungs.
The plume in Fresno probably spreads over many square miles, not
just the Fashion Fair area where they were discovered, said UC
Davis atmospheric scientist Anthony Wexler, who detected the
pollution.

Excerpt:

A 71-year-old man was referred to our outpatient clinic because of arthralgia and swelling of his right hand. He also showed a subcutaneous nodule on his left knee. A second patient, a 57-year-old woman, was referred because of painful skin of her legs. Dermatologic examination revealed erythemateous livid discoloration on both feet and legs. There were reticular varices, corona flebectatia paraplantaris medialis and minimal pitting oedema. Serology tested positive in both patients for Borrelia and they both recalled tick bites. A third patient, a 73-year-old woman, was referred because of erythema and maculae located at her lower legs and positive Borrelia serology. Pathologic examination was typical for acrodermatitis chronica atrophicans, a late skin manifestation of Lyme borreliosis. In all patients, symptoms improved after treatment with doxycycline for four weeks. A lack of familiarity with this skin condition may lead to unnecessary vascular investigations and considerable delay in adequate treatment.

Link: http://www.plospathogens.org/article/info%3Adoi%2F10.1371%2Fjournal.ppat.1001144

Excerpt:

If insufficiently treated, Lyme borreliosis can evolve into an
inflammatory disorder affecting skin, joints, and the CNS. Early
innate immunity may determine host responses targeting infection.
Thus, we sought to characterize the immediate cytokine storm
associated with exposure of PBMC to moderate levels of live
Borrelia burgdorferi. Since
Th17 cytokines are connected to host defense against
extracellular bacteria, we focused on interleukin (IL)-17 and
IL-22. Here, we report that, despite induction of inflammatory
cytokines including IL-23, IL-17 remained barely detectable in
response to B. burgdorferi. In contrast, T cell-dependent
expression of IL-22 became evident within 10 h of exposure to the
spirochetes. This dichotomy was unrelated to interferon-? but to
a large part dependent on caspase-1 and IL-1 bioactivity derived
from monocytes. In fact, IL-1? as a single stimulus induced IL-22
but not IL-17. Neutrophils display antibacterial activity against
B. burgdorferi, particularly when opsonized by antibodies. Since
neutrophilic inflammation, indicative of IL-17 bioactivity, is
scarcely observed in Erythema migrans, a manifestation of skin
inflammation after infection, protective and antibacterial
properties of IL-22 may close this gap and serve essential
functions in the initial phase of spirochete infection.

Link: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20711724&retmode=ref&cmd=prlinks

Excerpt:

An increasing number of studies reveal that ticks and their hosts
are infected with multiple pathogens, suggesting that coinfection
might be frequent for both vectors and wild reservoir hosts.
Whereas the examination of associations between coinfecting
pathogen agents in natural host-vector-pathogen systems is a
prerequisite for a better understanding of disease maintenance
and transmission, the associations between pathogens within
vectors or hosts are seldom explicitly examined. We examined the
prevalence of pathogen agents and the patterns of associations
between them under natural conditions, using a previously
unexamined host-vector-pathogen system-green lizards Lacerta
viridis, hard ticks Ixodes ricinus, and Borrelia, Anaplasma, and
Rickettsia pathogens. We found that immature ticks infesting a
temperate lizard species in Central Europe were infected with
multiple pathogens. Considering I. ricinus nymphs and larvae, the
prevalence of Anaplasma, Borrelia, and Rickettsia was 13.1% and
8.7%, 12.8% and 1.3%, and 4.5% and 2.7%, respectively. The
patterns of pathogen prevalence and observed coinfection rates
suggest that the risk of tick infection with one pathogen is not
independent of other pathogens. Our results indicate that
Anaplasma can play a role in suppressing the transmission of
Borrelia to tick vectors. Overall, however, positive effects of
Borrelia on Anaplasma seem to prevail as judged by
higher-than-expected Borrelia-Anaplasma coinfection rates.

Link: http://www.vetscite.org/publish/items/006234/index.html

Excerpt:

An 11-year study of a population of wild sheep located on a
remote island off the coast of Scotland that gauged the animals’
susceptibility to infection may give new insight into why some
people get sicker than others when exposed to the same illness.
The answer to this medical puzzle may lie in deep-rooted
differences in how animals survive and reproduce in the wild,
according to the study, which was led by Princeton ecologist
Andrea Graham and published in the Oct. 29 issue of Science. The
research revealed that the sheep population over time has
maintained a balance of those with weaker and stronger levels of
immunity and fertility. “This is a groundbreaking study that to
my mind will change our whole understanding of the
immunoheterogenity in animal populations,” said Peter Hudson, the
Willaman Professor of Biology and director of life sciences at
Penn State University. “Graham and colleagues show beautifully
the tradeoffs in the immune system as a balance… that maximizes
reproductive output.”

Excerpt:

November 10, 2010 (Atlanta, Georgia) — West Nile virus (WNV) might persist for years after acute infection, resulting in long-term neurological consequences in more people than previously thought, a new study suggests.

Kristy Murray, DVM, PhD, from the University of Texas School of Public Health, in Houston, presented the findings here at the American Society of Tropical Medicine and Hygiene 59th Annual Meeting.

“West Nile virus is not just an acute disease,” Dr. Murray told Medscape Medical News. “Patients who have the neuroinvasive form of disease will more than likely have long-term symptoms and sequelae,” she said. “This is a major finding, considering that more than 1.7 million Americans have been exposed since this virus first came to the United States in 1999,” she added.

WNV infection is generally asymptomatic, but a neuroinvasive variant that can result in encephalitis, meningitis, and acute flaccid paralysis occurs in approximately 1 in 150 infected individuals, according to the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.

Dr. Murray and colleagues initially observed that a larger than expected number of patients who presented with WNV infections were experiencing progressive neurological disease or kidney failure. They subsequently investigated long-term outcome in 151 patients with WNV in Houston beginning in 2002.

Of patients who presented with encephalitis, 77% had abnormal neurological findings, and 23% exhibited renal disease (including 5 deaths from renal failure).

Previously, the researchers found that 5 of 25 subjects tested positive for WNV viral particles in the urine. The current analysis indicated that 34 of 81 subjects (42%) had persistent WNV viral shedding in the urine. Of those patients, 65% had proteinuria and 13% developed renal failure.