scholarly journals Case report of the patient source of the Babesia microti R1 reference strain and implications for travelers

2017 ◽  
Vol 25 (1) ◽  
Author(s):  
Philipp Stahl ◽  
Yves Poinsignon ◽  
Pascal Pouedras ◽  
Vasilica Ciubotaru ◽  
Laurence Berry ◽  
...  
Keyword(s):  
Cell Biology ◽  
Febrile Illness ◽  
Clinical Information ◽  
The United States ◽  
Babesia Microti ◽  
Cape Cod ◽  
Antibody Testing ◽  
Worldwide Distribution ◽  
The Usa ◽  
Endemic Areas

AbstractBackgroundIn 2002, a previously healthy 69-year-old man travelled to France from the United States and presented to our hospital with a febrile illness that subsequently was determined to be babesiosis. The blood isolated from this patient served as a source for propagation of the Babesia microti R1 strain with subsequent sequencing and annotation of the parasite genome.MethodsUpon admission, we obtained a medical history, performed a physical examination, and examined his blood for the presence of a blood borne pathogen by microscopy, PCR and indirect immunofluorescence antibody testing. Once the diagnosis of babesiosis was made, we reviewed the literature to assess the distribution of B. microti-associated babesiosis cases in immunocompetent patients from outside the USA.ResultsThe patient recalled a tick bite during the previous month on Cape Cod, Massachusetts. The diagnosis was confirmed by identification of Babesia-infected red blood cells on blood smears, amplification of B. microti DNA in blood by PCR and the presence of B. microti antibody in the serum. This strain was the first isolate of B. microti to be fully sequenced and its annotated genome serves as a reference for molecular and cell biology studies aimed at understanding B. microti pathophysiology and developing diagnostic tests and therapies. A review of babesiosis cases demonstrates a worldwide distribution of B. microti and identifies potential emerging endemic areas where travelers may be at risk of contracting B. microti infection.ConclusionThis case provides clinical information about the patient infected with the R1 isolate and a review of travel risk, diagnosis and treatment of babesiosis in endemic and non-endemic areas.

scholarly journals The Laboratory Diagnosis of HIV Infections

2005 ◽  
Vol 16 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Margaret Fearon
Keyword(s):  
Point Of Care ◽  
Diagnostic Testing ◽  
Clinical Information ◽  
Hiv Infections ◽  
Laboratory Diagnosis ◽  
The United States ◽  
Specific Information ◽  
Antibody Testing ◽  
Diagnostic Laboratory ◽  
Laboratory Results

HIV diagnostic testing has come a long way since its inception in the early 1980s. Current enzyme immunoassays are sensitive enough to detect antibody as early as one to two weeks after infection. A variety of other assays are essential to confirm positive antibody screens (Western blot, polymerase chain reaction [PCR]), provide an adjunct to antibody testing (p24 antigen, PCR), or provide additional information for the clinician treating HIV-positive patients (qualitative and quantitative PCR, and genotyping). Most diagnostic laboratories have complex testing algorithms to ensure accuracy of results and optimal use of laboratory resources. The choice of assays is guided by the initial screening results and the clinical information provided by the physician; both are integral to the laboratory's ability to provide an accurate laboratory diagnosis. Laboratories should also provide specific information on specimen collection, storage and transport so that specimen integrity is not compromised, thereby preserving the accuracy of laboratory results. Point of Care tests have become increasingly popular in the United States and some places in Canada over the past several years. These tests provide rapid, on-site HIV results in a format that is relatively easy for clinic staff to perform. However, the performance of these tests requires adherence to good laboratory quality control practices, as well as the backup of a licensed diagnostic laboratory to provide confirmation and resolution of positive or indeterminate results. Laboratory quality assurance programs and the participation in HIV proficiency testing programs are essential to ensure that diagnostic laboratories provide accurate, timely and clinically relevant laboratory results.

scholarly journals 2128. Murine Typhus and Pregnancy: Case Series and Literature Review

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S720-S721
Author(s):  
Melinda Tanabe ◽  
Lucas Blanton ◽  
Mauricio La Rosa de Los Rios ◽  
Camille Webb Camminati
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Febrile Illness ◽  
The United States ◽  
Murine Typhus ◽  
Worldwide Distribution ◽  
Hepatic Transaminases ◽  
Pubmed Database ◽  
Prolonged Duration ◽  
In Pregnancy

Abstract Background Murine typhus is an arthropod borne disease of worldwide distribution with recent reemergence in the United States of America. There is limited data about the presentation, treatment and outcomes in the pregnant population. We report two cases of murine typhus in pregnancy, as well as a case series based in literature published between 1990 and 2019. Methods A comprehensive search in Pubmed database using words murine typhus, pregnancy, R. typhi and endemic typhus was done. Exclusion criteria were asymptomatic murine typhus in pregnancy and undiagnosed febrile illness in pregnancy. Results Six articles met the criteria of symptomatic pregnant murine typhus infection. Four case reports plus our own 2 case reports, and 2 observational population studies. A total of 35 pregnancy patients were identified. Distribution was worldwide. Gestational age at presentation varied. Patients frequently presented with prolonged duration of fevers prior to presentation, headache, rash, thrombocytopenia and elevated hepatic transaminases. Diagnosis was mainly based on serology. Treatment varied and 8 cases did not receive any treatment at all. Overall pregnancy outcome was favorable, except in an Asian cohort reporting 6 patients with poor pregnancy outcomes. Conclusion The lack of data about murine typhus in pregnancy is of serious concern. Increase awareness of different presentations is needed in this population. Murine typhus infection can mimic other pregnancy-related pathologies that have very different treatments and outcomes. More data are needed about effective treatment and safety of doxycycline use during pregnancy. Disclosures All authors: No reported disclosures.

scholarly journals Estimation of Undetected Symptomatic and Asymptomatic cases of COVID-19 Infection and prediction of its spread in USA

2020 ◽  
Author(s):  
Ashutosh Mahajan ◽  
Ravi Solanki ◽  
Namitha Sivadas
Keyword(s):  
United States ◽  
Epidemic Model ◽  
Detection Rate ◽  
The United States ◽  
Disease Spread ◽  
Simulation Approach ◽  
Antibody Testing ◽  
Transmission Rates ◽  
The Usa ◽  
Second Wave

AbstractThe reported COVID-19 cases in the USA have crossed over 2 million, and a large number of infected cases are undetected whose estimation can be done if country-wide antibody testing is performed. In this work, we estimate this undetected fraction of the population by modeling and simulation approach. We propose a new epidemic model SIPHERD in which three categories of infection carriers Symptomatic, Purely Asymptomatic, and Exposed are considered with different transmission rates that are taken dependent on the lockdown conditions, and the detection rate of the infected carriers is taken dependent on the tests done per day. The model is first validated for Germany and South Korea and then applied for prediction of total number of confirmed, active and death, and daily new positive cases in the United States. Our study also demonstrates the possibility of a second wave of the infection if social distancing regulations are relaxed to a large extent. We estimate that around 12.7 million people are already infected, and in the absence of any vaccine, 17.7 million (range: 16.3-19.2) people, or 5.3% (range: 4.9–5.8) of the population will be infected by when the disease spread ends in the USA. We find the Infection to Fatality Ratio to be 0.93% (range: 0.85-1.01).

scholarly journals Performance Evaluation of a Prototype Architect Antibody Assay forBabesia microti

2018 ◽  
Vol 56 (8) ◽  
Author(s):  
Kevin Cheng ◽  
Kelly E. Coller ◽  
Christopher C. Marohnic ◽  
Zachary A. Pfeiffer ◽  
James R. Fino ◽  
...  
Keyword(s):  
Human Subjects ◽  
Fluorescent Antibody ◽  
Antibody Test ◽  
The United States ◽  
Babesia Microti ◽  
Antibody Testing ◽  
Specific Test ◽  
Content Type ◽  
Therapeutic Drugs ◽  
Prototype Test

ABSTRACTThe tick-borne protozoanBabesia microtiis responsible for more than 200 cases of transfusion-transmitted babesiosis (TTB) infection in the United States that have occurred over the last 30 years. Measures to mitigate the risk of TTB include nucleic acid testing (NAT) andB. microtiantibody testing. A fully automated prototypeB. microtiantibody test was developed on the Architect instrument. The specificity was determined to be 99.98% in volunteer blood donors (n= 28,740) from areas considered to have low endemicity forB. microti. The sensitivity of the prototype test was studied in experimentally infected macaques; a total of 128 samples were detected as positive whereas 125 were detected as positive with an indirect fluorescent antibody (IFA) test; additionally, 83 (89.2%) of the PCR-positive samples were detected in contrast to 81 (87.1%) using an IFA test. All PCR-positive samples that tested negative in the prototype antibody test were preseroconversion period samples. Following seroconversion, periods of intermittent parasitemia occurred; 17 PCR-negative samples drawn in between PCR-positive bleed dates tested positive both by the prototype test (robust reactivity) and IFA test (marginal reactivity) prior to the administration of therapeutic drugs, indicating that the PCR test failed to detect samples from persistently infected macaques. The prototype assay detected 56 of 58 (96.6%) human subjects diagnosed with clinical babesiosis by both PCR and IFA testing. Overall, the prototype anti-Babesiaassay provides a highly sensitive and specific test for the diagnosis ofB. microtiinfection. While PCR is preferred for detection of window-period parasitemia, antibody tests detect infected subjects during periods of low-level parasitemia.

Correlative microscopy in distrubuted (client/server) computing environments: tools for catalyzing the rapid dissemination of information about the cell biology of the human prostate

1995 ◽  
Vol 53 ◽  
pp. 682-683
Author(s):  
A. Hakam ◽  
J.T. Gau ◽  
M.L. Grove ◽  
B.A. Evans ◽  
M. Shuman ◽  
...  
Keyword(s):  
United States ◽  
Cell Biology ◽  
Tissue Bank ◽  
The United States ◽  
Prostate Adenocarcinoma ◽  
Correlative Microscopy ◽  
Client Server ◽  
Critical Elements ◽  
Transplant Organ

Prostate adenocarcinoma is the most common malignant tumor of men in the United States and is the third leading cause of death in men. Despite attempts at early detection, there will be 244,000 new cases and 44,000 deaths from the disease in the United States in 1995. Therapeutic progress against this disease is hindered by an incomplete understanding of prostate epithelial cell biology, the availability of human tissues for in vitro experimentation, slow dissemination of information between prostate cancer research teams and the increasing pressure to “ stretch” research dollars at the same time staff reductions are occurring.To meet these challenges, we have used the correlative microscopy (CM) and client/server (C/S) computing to increase productivity while decreasing costs. Critical elements of our program are as follows:1) Establishing the Western Pennsylvania Genitourinary (GU) Tissue Bank which includes >100 prostates from patients with prostate adenocarcinoma as well as >20 normal prostates from transplant organ donors.

Emigrant Psychoanalysts in the USA and the FBI Archives

2004 ◽  
Vol 6 (1) ◽  
pp. 75-92 ◽  
Author(s):  
James E. Goggin
Keyword(s):  
United States ◽  
Civil Rights ◽  
National Socialism ◽  
Cultural Context ◽  
Due Process ◽  
The United States ◽  
External Threats ◽  
The Usa ◽  
The Rich ◽  
New Nation

Interest in the fate of the German psychoanalysts who had to flee Hitler's Germany and find refuge in a new nation, such as the United States, has increased. The ‘émigré research’ shows that several themes recur: (1) the theme of ‘loss’ of one's culture, homeland, language, and family; and (2) the ambiva-lent welcome these émigrés received in their new country. We describe the political-social-cultural context that existed in the United States during the 1930s, 1940s and 1950s. Documentary evidence found in the FBI files of three émigré psychoanalysts, Clara Happel, Martin Grotjahn, and Otto Fenichel, are then presented in combination with other source material. This provides a provisional impression of how each of these three individuals experienced their emigration. As such, it gives us elements of a history. The FBI documents suggest that the American atmosphere of political insecurity and fear-based ethnocentric nationalism may have reinforced their old fears of National Socialism, and contributed to their inclination to inhibit or seal off parts of them-selves and their personal histories in order to adapt to their new home and become Americanized. They abandoned the rich social, cultural, political tradition that was part of European psychoanalysis. Finally, we look at these elements of a history in order to ask a larger question about the appropriate balance between a liberal democratic government's right to protect itself from internal and external threats on the one hand, or crossover into the blatant invasion of civil rights and due process on the other.

Sandra Ramos Revisited

2020 ◽  
Vol 2 (4) ◽  
pp. 32-54
Author(s):  
Silvia Spitta
Keyword(s):  
United States ◽  
The United States ◽  
Ancient Greek ◽  
Graphic Arts ◽  
Left Behind ◽  
The World ◽  
The Usa ◽  
Political Choices ◽  
The Rich

Sandra Ramos (b. 1969) is one of the few artists to reflect critically on both sides of the Cuban di-lemma, fully embodying the etymological origins of the word in ancient Greek: di-, meaning twice, and lemma, denoting a form of argument involving a choice between equally unfavorable alternatives. Throughout her works she shines a light on the dilemmas faced by Cubans whether in Cuba or the United States, underlining the bad personal and political choices people face in both countries. During the hard 1990s, while still in Havana, the artist focused on the traumatic one-way journey into exile by thousands, as well as the experience of profound abandonment experienced by those who were left behind on the island. Today she lives in Miami and operates a studio there as well as one in Havana. Her initial disorientation in the USA has morphed into an acerbic representation and critique of the current administration and a deep concern with the environmental collapse we face. A buffoonlike Trumpito has joined el Bobo de Abela and Liborio in her gallery of comic characters derived from the rich Cuban graphic arts tradition where she was formed. While Cuba is now represented as a rotten cake with menacing flies hovering over it ready to pounce, a bombastic Trumpito marches across the world stage, trampling everything underfoot, a dollar sign for a face.

Russian Federation and the United States of America: geostrategic directions to manage the Ukrainian crisis

2019 ◽  
pp. 123
Author(s):  
Attarid Awadh Abdulhameed
Keyword(s):  
United States ◽  
European Union ◽  
National Security ◽  
Russian Federation ◽  
United States Of America ◽  
The United States ◽  
The European Union ◽  
The Usa ◽  
Ukrainian Crisis ◽  
Zero Sum

Ukrainia Remains of huge importance to Russian Strategy because of its Strategic importance. For being a privileged Postion in new Eurasia, without its existence there would be no logical resons for eastward Expansion by European Powers.  As well as in Connection with the progress of Ukrainian is no less important for the USA (VSD, NDI, CIA, or pentagon) and the European Union with all organs, and this is announced by John Kerry. There has always ben Russian Fear and Fear of any move by NATO or USA in the area that it poses a threat to  Russians national Security and its independent role and in funence  on its forces especially the Navy Forces. There for, the Crisis manyement was not Zero sum game, there are gains and offset losses, but Russia does not accept this and want a Zero Sun game because the USA. And European exteance is a Foot hold in Regin Which Russian sees as a threat to its national security and want to monopolize control in the strategic Qirim.

Clinical Characteristics of Patients Diagnosed with Strongyloidiasis in a United States Urban Outpatient Dermatology Department: A Case Series

2017 ◽  
Vol 1 (3) ◽  
pp. 156-160
Author(s):  
Jacqueline Watchmaker ◽  
Sean Legler ◽  
Dianne De Leon ◽  
Vanessa Pascoe ◽  
Robert Stavert
Keyword(s):  
United States ◽  
Case Series ◽  
The United States ◽  
Screening Tools ◽  
Dermatology Department ◽  
Cutaneous Manifestations ◽  
Serologic Testing ◽  
Patient Reported ◽  
History Of ◽  
Endemic Areas

Background: Although considered a tropical disease, strongyloidiasis may be encountered in non-endemic regions, primarily amongst immigrants and travelers from endemic areas.  Chronic strongyloides infection may be under-detected owing to its non-specific cutaneous presentation and the low sensitivity of commonly used screening tools. Methods: 18 consecutive patients with serologic evidence of strongyloides infestation who presented to a single urban, academic dermatology clinic between September 2013 and October 2016 were retrospectively included.  Patient age, sex, country of origin, strongyloides serology titer, absolute eosinophil count, presenting cutaneous manifestations, and patient reported subjective outcome of pruritus after treatment were obtained via chart review.  Results: Of the 18 patients, all had non-specific pruritic dermatoses, 36% had documented eosinophila and none were originally from the United States. A majority reported subjective improvement in their symptoms after treatment. Conclusion:  Strongyloides infection and serologic testing should be considered in patients living in non-endemic regions presenting with pruritic dermatoses and with a history of exposure to an endemic area.Key Points:Chronic strongyloidiasis can be encountered in non-endemic areas and clinical manifestations are variableEosinophilia was not a reliable indicator of chronic infection in this case series Dermatologists should consider serologic testing for strongyloidiasis in patients with a history of exposure and unexplained pruritus

The United States as the Trade Partner of Poland in te Context of the Transatlantic Trade and Investment Partnership (TTIP)

2014 ◽  
Vol 9 (3) ◽  
pp. 201-213
Author(s):  
Renata Marks-Bielska ◽  
Wiesława Lizińska ◽  
Izabela Serocka
Keyword(s):  
Growth Rate ◽  
Foreign Trade ◽  
The United States ◽  
Average Growth ◽  
Transatlantic Trade ◽  
Central Statistical ◽  
The Usa ◽  
Central Statistical Office ◽  
Trade Partner ◽  
Structure Of Trade

Evaluation of the importance of the USA as the trade partner of Poland is the main objective of the paper, based on the changes in the value of trade during the years 2000-2012 and changes in the structure of trade during the years 2008-2012. The data from the Statistical Yearbooks of Foreign Trade published by the Central Statistical Office was used. The potential for foreign trade growth was illustrated using the simplified analysis based on the gravity model of foreign trade concept. Gradually increasing value of Polish trade with the USA (the average growth rate 9.8%, EU-15 countries 13.1%). Polish exports are characterised by a higher than imports growth rate (USA - exports growth by 12.5%, imports 9.2%, EU-15 - exports 15.1%, imports 11.6%). Trade is strongly dominated by position of one group of products (over 30% share in both exports and imports). The potential of trade is poorly exploited currently. Trade was focused mainly on the countries situated in the close neighbourhood (mainly the EU countries with the domination of Germany).

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