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First imported coccidioidomycosis in Turkey: A potential health risk for laboratory workers outside endemic areas.

ABSTRACT: Coccidioidomycosis caused by Coccidioides immitis or Coccidioides posadasii is endemic in arid climate zones in America, travel-related cases have been reported. We report the first documented case of coccidioidomycosis in Turkey, overviewing reported cases in Europe and underlying difficulties of differential diagnosis outside endemic regions. The patient was an otherwise healthy 41-year-old man who travelled endemic areas. Laboratory diagnosis was based on direct microscopy of two subsequent subcutaneous biopsy specimens and culture and confirmed molecularly. Laboratory personnel should become aware that BioSafety Level-3 organisms may become more frequent and widespread.

SUBMITTER: Kantarcioglu AS

PROVIDER: S-EPMC3930961 | biostudies-literature | 2014 Jan

REPOSITORIES: biostudies-literature

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First imported coccidioidomycosis in Turkey: A potential health risk for laboratory workers outside endemic areas.

Kantarcioglu A Serda AS Sandoval-Denis M M Aygun Gokhan G Kiraz Nuri N Akman Canan C Apaydin Hulya H Karaman Emin E Guarro Josep J de Hoog G Sybren GS Gurel M S MS

Medical mycology case reports 20140120

Coccidioidomycosis caused by Coccidioides immitis or Coccidioides posadasii is endemic in arid climate zones in America, travel-related cases have been reported. We report the first documented case of coccidioidomycosis in Turkey, overviewing reported cases in Europe and underlying difficulties of differential diagnosis outside endemic regions. The patient was an otherwise healthy 41-year-old man who travelled endemic areas. Laboratory diagnosis was based on direct microscopy of two subsequent s ...[more]

PMID: 24567896

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Project description:BACKGROUND:Infection with Schistosoma mansoni is a major cause of morbidity and mortality in endemic areas, and is increasingly diagnosed in migrants and travellers outside transmission areas. Markers for the assessment of morbidity and impact of control programs in endemic areas and for the clinical management of patients in the clinical setting are scant, especially for intestinal involvement. Ultrasonography is well established to evaluate hepatosplenic pathology; on the contrary, ultrasound evaluation of intestinal schistosomiasis is virtually unexplored. In this pilot study, we aimed to describe and evaluate the accuracy of unenhanced intestinal ultrasound for morbidity due to intestinal S. mansoni infection. METHODOLOGY/PRINCIPAL FINDINGS:We performed a blind case-control study of unenhanced intestinal ultrasound on 107 adults accessing the outpatient clinic of our Centre for Tropical Diseases between January-July 2018 as part of a screening for tropical diseases in migrants and travellers returning from endemic areas. Other clinical and laboratory data were obtained routine examination reports. We could not find any overtly pathological thickness of the gut wall in the sigma, proximal ascending colon, and terminal ileum, in patients with S. mansoni infection (n = 17), S. haematobium infection (n = 7), positive anti-Schistosoma serology (n = 31), and uninfected individuals (n = 52), with no difference among groups as assessed by ANOVA. No polyps or other intestinal abnormalities were visualized. There was no significant change in gut wall thickness one month after treatment with praziquantel in patients with S. mansoni infection (n = 11). CONCLUSIONS/SIGNIFICANCE:Our preliminary results suggest that intestinal ultrasound might not be a sensitive tool for detecting minor intestinal morbidity due to schistosomiasis. Further studies in a hospital setting comparing colonoscopy and ultrasonography may be envisaged; in endemic areas, further studies are needed to describe and assess the usefulness of intestinal ultrasound in patients stratified by infection intensity and compared with markers such as calprotectin and fecal occult blood.

Project description:BACKGROUND:China has achieved zero indigenous malaria case report in 2017. However, along with the increasing of international cooperation development, there is an increasing number of imported malaria cases from Chinese nationals returning from malaria-affected countries. Previous studies have focused on malaria endemic areas in China. There is thus limited information on non-endemic areas in China, especially on the performance of malaria surveillance and response in health facilities. METHODS:A comparative retrospective study was carried out based on routine malaria surveillance data collected from 2013 to 2017. All imported malaria cases reported within the mainland of China were included. Variables used in the comparative analysis between cases in former endemic and former non-endemic areas, included age, gender and occupation, destination of overseas travel, Plasmodium species and patient health outcome. Monthly aggregated data was used to compare seasonal and spatial characteristics. Geographical distribution and spatial-temporal aggregation analyses were conducted. Time to diagnosis and report, method of diagnosis, and level of reporting/diagnosing health facilities were used to assess performance of health facilities. RESULTS:A total of 16 733 malaria cases, out of which 90 were fatal, were recorded in 31 provinces. The majority of cases (96.2%) were reported from former malaria endemic areas while 3.8% were reported from former non-malaria endemic areas. Patients in the age class from 19 to 59 years and males made the highest proportion of cases in both areas. There were significant differences between occupational categories in the two areas (P < 0.001). In former endemic areas, the largest proportion of cases was among outdoor workers (80%). Two peaks (June, January) and three peaks (June, September and January) were found in former endemic and former non-endemic areas, respectively. Time between the onset of symptoms and diagnosis at clinics was significantly different between the two areas at different level of health facilities (P < 0.05). CONCLUSIONS:All the former non-endemic areas are now reporting imported malaria cases. However, the largest proportion of imported cases is still reported from former endemic areas. Health facilities in former endemic areas outperformed those in former non-endemic areas. Information, treatment, and surveillance must be provided for expatriates while capacity building and continuous training must be implemented at health facilities in China.

Project description:The use of noninvasive transcranial electrical stimulation (tES) has rapidly increased over the past two decades. Yet, tES continues to be largely implemented in laboratory and rehabilitation settings, thereby limiting accessibility to the broader population. We have previously demonstrated that transcranial alternating current stimulation (tACS) in the theta (4-7 Hz) band improves cognitive control, such as multitasking, in younger adults following a single tACS session, as well as in older adults following three tACS sessions. Here, the goal was to extend our in-lab results by (1) assessing the feasibility for at-home tACS and (2) evaluating whether five tACS sessions may yield continuing improvements in multitasking ability in young adults. Participants (aged 18 - 34 years) received bilateral prefrontal tACS while engaged in an adaptive multitasking training over five consecutive days in their home settings. Participants were randomly assigned to receive either 20-minutes of theta or delta tACS during daily multitasking training. Prior to and on the day immediately following five days of tACS, we assessed performance on single task, multitask, and sustained attention ability with analyses of variance statistics. 92.1% of participants were able to self-administer tACS at home without researcher assistance. However, we observed that both theta and delta tACS groups exhibited improvements in both single and multitask performance. Compared to previously collected data, five days of theta tACS was comparable to one day of theta tACS. However, theta tACS has continued benefits in older, but not younger adults as evidenced by previous research. Both groups similarly improved in sustained attention. These results demonstrate that laboratory paradigms utilizing neurostimulation can be effectively deployed in a home environment without direct support from research personnel. Moreover, these results suggest that while theta tACS may facilitate multitasking improvements over one session, multiple sessions of theta tACS results in diminishing returns in young adults. Additional research will be required to confirm if delta activity plays an important role in multitasking ability.

Dataset Information

First imported coccidioidomycosis in Turkey: A potential health risk for laboratory workers outside endemic areas.

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First imported coccidioidomycosis in Turkey: A potential health risk for laboratory workers outside endemic areas.

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