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In Lao People's Democratic Republic (PDR), we detected 7 patients infected with Centrocestus formosanus (1��122 adult specimens) after praziquantel treatment and purgation, together with several other trematode species including Opisthorchis viverrini and Haplorchis taichui. The patients were all men, 23��42 yr-of-age. Three subjects were from Vientiane Municipality and 1 each were from Khammouane, Saravane, Champassak, and Xiengkhouang Province. The patients had frequently eaten raw freshwater fish and were experiencing variable degrees of epigastric pain and indigestion accompanied by occasional diarrhea, although the relationship of these symptoms with C. formosanus infection was unclear. Centrocestus formosanus specimens were ovoid, 0.46 mm (0.41��0.52 mm) long, and 0.18 mm (0.16��0.20 mm) wide (n = 10) and were equipped with 32 circumoral spines on the oral sucker. The uterine eggs were 33.2 關m long (31.8��34.9 關m) and 18.5 關m wide (17.4��19.8 關m) (n = 20). Analysis of the nucleotide sequence of the 18S ribosomal RNA gene of our specimens (Laotian isolate) revealed 100% homology with that of an isolate from the United States reported in GenBank. Several species of freshwater fish collected from Xiengkhouang Province revealed a 17.0% prevalence (9 of 53 fish examined) for C. formosanus metacercariae. The results suggest that human C. formosanus infections have been masked by other trematode infections. ; open

Schistosomiasis and typhoid fever caused by blood flukes and Salmonella bacteria respectively are leading infectious diseases in most tropical parts of the world especially in sub-Saharan Africa. In countries where both are endemic, co-infection is a consistent reality. This study therefore investigated the incidence of dual Schistosoma mansoni and enteric Salmonella species infections in patients from Eldin Specialist and Plateau Specialist Hospitals, Jos, Plateau State, Nigeria. In this, a total of 250 each of blood and stool samples were collected from 250 patients who showed positive for widal tests and were receiving health care from the two hospitals. The samples were analyzed using standard methods which included culture, concentration and agglutination (Widal) techniques. Out of the 250 widal-positive patients used, only 34 (13.6%) were positive for typhoid fever by stool culture. The prevalence rates of the dual infections were observed to be 22 (8.8%) and 6 (2.4%) by Widal and stool culture techniques respectively. Co-infection was highest among females (28.6%) within the age bracket 40 - 49 years, followed by males (14.3%) within the age brackets 0 - 9 and 20 - 29 years. There was a stronger relationship between the two organisms by widal test (r = 0.858, P0.05). Although culture technique is reputed as a gold standard in the diagnosis of typhoid fever, widal test is suggested in the case of co-infection with Schistosoma parasite provided judicious interpretations of results are made against backgrounds of pertinent information. Since both diseases share social circumstances such as poverty and hygiene, governments' involvements in the improvement of the standard of living of individuals in areas of high endemicity is hereby recommended. Also, cases of the diseases should be detected and promptly treated to avoid further transmissions. Indiscriminate droppings of faeces should be discouraged as rain can wash them into water bodies for onward transmissions. When the organisms are detected from positive samples, treatment should be concurrent with both anti-schistosomal and anti-Salmonellal drugs.

Although mechanisms of modern military wounding may be distinct from those of ancient conflicts, the infectious sequelae of ballistic trauma and the evolving microbial flora of war wounds remain a considerable burden on both the injured combatant and their deployed medical systems. Battlefield surgeons of ancient times favoured suppuration in war wounding and as such Galenic encouragement of pus formation would hinder progress in wound care for centuries. Napoleonic surgeons eventually abandoned this mantra, embracing radical surgical intervention, primarily by amputation, to prevent infection. Later, microscopy enabled identification of microorganisms and characterization of wound flora. Concurrent advances in sanitation and evacuation enabled improved outcomes and establishment of modern military medical systems. Advances in medical doctrine and technology afford those injured in current conflicts with increasing survivability through rapid evacuation, sophisticated resuscitation and timely surgical intervention. Infectious complications in those that do survive, however, are a major concern. Addressing antibiotic use, nosocomial transmission and infectious sequelae are a current clinical management and research priority and will remain so in an era characterized by a massive burden of combat extremity injury. This paper provides a review of infection in combat wounding from a historical setting through to the modern evidence base.

By that decision of 12 October 2016, the First Civil Chamber of the Court of Cassation answers three questions relating to compensation for nosocomial infections: Can an independent radiology centre be regarded as an 'establishment' within the meaning of Article L. 1142-1 (I) of the Public Health Code? Is a practitioner obliged to inform the patient about the foreseeable but exceptional risks? Can Article L. 1142-1 (I) of the Public Health Code do. ; Par cette décision du 12 octobre 2016, la première chambre civile de la Cour de cassation répond à trois questions relatives à l'indemnisation des infections nosocomiales : Un centre de radiologie indépendant peut-il être considéré comme un « établissement » au sens de l'article L. 1142-1, I, du code de la santé publique ? Un praticien est-il tenu d'informer le patient sur les risques prévisibles encourus mais exceptionnels ? L'article L. 1142-1, I, du code de la santé publique peut-il faire l'o …

The European Food Safety Authority (EFSA) was required to support the European Commission in preparing the review of Regulation (EU) No 1152/2011. In Europe, red fox (Vulpes vulpes) is the main definitive host of the Echinococcus multilocularis (EM) lifecycle. There is no evidence that any other carnivore species can maintain the lifecycle in the absence of red fox, and this makes it to most relevant target species for surveillance. Movement of infected definitive hosts is an important introduction pathway. The knowledge on the geographical distribution of the environmental factors for the persistence of the lifecycle is scarce. In areas where no suitable autochthonous wild canid hosts and no highly suitable intermediate hosts are present, e.g. Malta, establishment of the EM cycle is considered close to impossible. Such countries do not need to carry out surveillance on domestic dogs to substantiate absence of EM in the relevant animal population. Reconsideration of some aspects of the current legislation regarding surveillance activities might be relevant; for example the identification of epidemiologically relevant units should be independent from political borders. Studies to improve the knowledge on epidemiological risk factors should be encouraged to enable risk-based sampling. Echinococcus notification should always be done at species level in order to discriminate between the more severe alveolar echinococcosis and the cystic echinococcosis. Praziquantel is the substance of choice for the treatment of dogs. However, the treatment window should be reconsidered to reduce the risk of re-infection: a general rule is to treat as close as possible to entry into a non-infected country. There is a lack of standardization of the diagnostic methods between laboratories. The diagnostic sensitivity of the tests should be established in accordance to the World Organisation for Animal Health (OIE) standards for validation. For the time being, the diagnostic sensitivity can be set conservatively to 78%.

Latent tuberculosis infection (LTBI) is defined as a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens without evidence of clinically manifested active tuberculosis (TB) disease. Individuals with LTBI represent a reservoir for active TB cases. The detection and management of LTBI is now a key component of the World Health Organization's End TB Strategy and the Government of Canada's federal framework for action on TB prevention and control. This is because people with LTBI can progress to active TB or undergo reactivation, a risk that is greatly increased in those with immunocompromising conditions. This overview provides a summary of LTBI and reactivation risk, as well as the recent advances in the diagnosis and treatment of LTBI.

The European Food Safety Authority (EFSA) was required to support the European Commission in preparing the review of Regulation (EU) No 1152/2011. In Europe, red fox (Vulpes vulpes) is the main definitive host of the Echinococcus multilocularis (EM) lifecycle. There is no evidence that any other carnivore species can maintain the lifecycle in the absence of red fox, and this makes it to most relevant target species for surveillance. Movement of infected definitive hosts is an important introduction pathway. The knowledge on the geographical distribution of the environmental factors for the persistence of the lifecycle is scarce. In areas where no suitable autochthonous wild canid hosts and no highly suitable intermediate hosts are present, e.g. Malta, establishment of the EM cycle is considered close to impossible. Such countries do not need to carry out surveillance on domestic dogs to substantiate absence of EM in the relevant animal population. Reconsideration of some aspects of the current legislation regarding surveillance activities might be relevant; for example the identification of epidemiologically relevant units should be independent from political borders. Studies to improve the knowledge on epidemiological risk factors should be encouraged to enable risk-based sampling. Echinococcus notification should always be done at species level in order to discriminate between the more severe alveolar echinococcosis and the cystic echinococcosis. Praziquantel is the substance of choice for the treatment of dogs. However, the treatment window should be reconsidered to reduce the risk of re-infection: a general rule is to treat as close as possible to entry into a non-infected country. There is a lack of standardization of the diagnostic methods between laboratories. The diagnostic sensitivity of the tests should be established in accordance to the World Organisation for Animal Health (OIE) standards for validation. For the time being, the diagnostic sensitivity can be set conservatively to 78%.

This project is an exploration of ideology in Dostoevsky's 1871 novel "Demons." In this work, Dostoevsky portrays the connection between utopianism and extremism. This project explores how romantic and political idealism becomes the foundation for violence and terrorism, through the relationship of the 1840's liberal Stepan Trofimovich Verhovensky and his nihilistic sons.

During the Korean war between 1951-1953, an epidemic occurred among United Nations sanctioned military troops, characterized by fever, haemorrhages, shock and renal failure with a case fatality rate of up to 15%. This disease became known as Korean haemorrhagic fever [Smadel, 1951; Earle, 1954]. Despite extensive investigations at that time no etiologic agent could be identified. In the far east the oldest suggestive description of a similar disease had been made as early as 1000 years ago in a Chinese medicine book [Lee, 1982a]. During the American Civil War between 1862-1866 epidemics of "general dropsy" with renal involvement were noted among northern army troops. This disease was later called "Bright's disease" [Brown, 1916]. In Europe the first descriptions of the disease appeared in the early 1900's, after outbreaks in Russia and Scandinavia [Mayer, 1952; Myhrman, 1934; Zetterholm, 1934]. The Russians called the disease haemorrhagic nephroso-nephritis and the Scandinavians named it nephropathia epidemica (NE).

Downy mildew (DM) of opium poppy (Papaver somniferum) caused by Peronospora somniferi is one of the most destructive diseases of this crop due to the systemic nature of infection as compared with local infections caused by Peronospora meconopsidis, the other downy mildew pathogen of this crop. We developed an inoculation method using Peronospora somniferi sporangia as inoculum and demonstrated for the first time that local infection of leaves by sporangia give rise to systemic infections in the plant as well as of seeds. Our results also showed that this inoculation protocol was very effective in reproducing disease symptoms and assessing the resistance response to DM in opium poppy genotypes under field conditions. More interestingly, results indicate that up to 100% of seed samples from some genotypes showing a complete (symptomless) resistant phenotype were infected by the pathogen when seeds were analyzed by a P. somniferi-specific nested-PCR protocol. This latter aspect deserves further attention while breeding opium poppy for resistance to P. somniferi. ; Regional Government of Andalusia (project P10-AGR-6497) to MMB; European Union through the European Regional Development Fund (ERDF). ; Peer reviewed

It was observed that small children and pregnant women were affected to only a small extent by the H1N1 influenza outbreak of winter 1978-79. This supports earlier findings from the epidemic season of 1977-78 and demonstrates that the evolutionary changes in the epidemic virus were not reflected in any appreciable way in this curious phenomenon. The frequency of elderly subjects possessing antibodies against the epidemic H1N1 virus was low, and virtually equal in the pre-epidemic and post-epidemic sampling. This low attack rate contrasts with observations on young military servicemen, in whom the re-infection rate was high, thus indicating that the infection with the winter 1977-78 virus had conferred only modest protection against the closely related virus which caused the winter 1978-79 outbreak.

Infection is a major complication of military chest injuries. In a series of 142 wounded, infectious complications occurred in 7 (4.9%). Factors influencing the incidence of infection are evaluated. In this group of injuries, 81 patients were admitted soon after wounding. The intrathoracic damage was severe, due to penetration of metallic fragment. The hemothorax was treated by immediate intercostal drainage. Immediate thoracotomy was performed in 10 patients and late thoractomy in 15. One patient developed a lung abscess and 5 patients had infection following thoracotomy (7.4%). Another 61 wounded patients had been first managed in a forward hospital, including three with thoractomy for massive bleeding. Two, not in a forward hospital, had a bullet removed from the lung. Upon admission to this hospital, intercostal drains were inserted when needed and four patients underwent thoracotomy. Larger wounds were debrided in 24 patients. Late thoracotomy was perfromed in seven. Chronic empyema developed in one patient after pneumonectomy performed at the field hospital, resulting in a resuscitation or infection rate of less than 2%. Factors contributing to a low infection rate were: early drainage of hemothoraces and wide debridement of larger wounds with delayed closure and avoidance of thoracotomy as primary treatment. Resection of lung tissue was avoided. Thoraco-abdominal injuries were treated separately. The clotted hemothorax was immediately evacuated. Prolonged antibiotic therapy was usually indicated.

An estimated 500,000 laboratory workers in the United States are at risk of exposure to infectious agents that cause disease ranging from inapparent to life-threatening infections, but the precise risk to a given worker unknown. The emergence of human immunodeficiency virus and hantavirus, the continuing problem of hepatitis B virus, and the reemergence of Mycobacterium tuberculosis have renewed interest in biosafety for the employees of laboratories and health care facilities. This review examines the history, the causes, and the methods for prevention of laboratory-associated infections. The initial step in a biosafety program is the assessment of risk to the employee. Risk assessment guidelines include the pathogenicity of the infectious agent, the method of transmission, worker-related risk factors, the source and route of infection, and the design of the laboratory facility. Strategies for the prevention and management of laboratory-associated infections are based on the containment of the infectious agent by physical separation from the laboratory worker and the environment, employee education about the occupational risks, and availability of an employee health program. Adherence to the biosafety guidelines mandated or proposed by various governmental and accrediting agencies reduces the risk of an occupational exposure to infectious agents handled in the workplace.

This licentiate thesis aims to understand how infection preventionists (IPs) continuously find problems and implement solutions related to health care-associated infections (HAIs) in hospital settings. HAIs are infections acquired by patients during the process of care and are among the main causes of deaths worldwide. Recently, practices for HAIs prevention and control have challenged IPs due to pandemics (e.g. COVID-19), antimicrobial resistance, population aging and limited resources in health care facilities. Such challenges demand actions to find, solve problems and implement solutions. However, IPs often fail to address these problems. The reasons stem from their inability to timely identify valuable problems and implement new solutions. Although the literature on infection prevention and control is well developed, previous studies have largely investigated how IPs implement preconceived practices to solve given problems as a single event, rather than on how to continuously find problems and implement solutions. This licentiate thesis comprises two empirical papers. Paper I investigates how infection prevention and control teams find problems with HAIs, and is based on a multiple case study of three infection prevention and control teams from one Swedish and two Brazilian hospitals. Paper II investigates how IPs continuously implement changes in infection prevention and control practices during pandemics, and is based on a qualitative descriptive study. The data in both papers were collected from 44 semi-structured interviews with health care professionals enrolled as IPs in Brazilian and Swedish hospitals. The key theories and literatures covered include Problem-Finding and Problem-Solving Perspective and Implementation research. This licentiate thesis contains three main contributions. First, it advances the Problem-Finding and Problem-Solving Perspective literature by providing empirical evidence on how to create valuable knowledge from ill-structured and complex problems. Second, this licentiate thesis ...

The Centers for Disease Control and Prevention estimates that 2 million patients suffer from hospital-acquired infections every year and nearly 100,000 of them die. Most of these medical errors are preventable. Hospital-acquired infections result in up to $4.5 billion in additional healthcare expenses annually. The U.S. government has responded to this financial loss by focusing on healthcare quality report cards and by taking strong action to curb healthcare spending. The Medicare Program has proposed changes to the Hospital Inpatient Prospective Payment System and Fiscal Year Rates: Proposed Rule CMS 1488-P-Healthcare-associated infection. Payment will be linked to performance. Under the new rule, payment will be withheld from hospitals for care associated with treating certain catheter-associated urinary tract infections, vascular catheter-associated infections, and mediastinitis after coronary artery bypass graft surgery. Infection-prevention strategies are essential. In the healthcare setting, the infection control department is categorized as non-revenue-producing. Funds dedicated to resources such as staff, educational programs, and prevention measures are vastly limited. Hospital leaders will need to balance the upfront cost needed to prevent hospital-related infections with the non-reimbursed expense accrued secondary to potentially preventable infections. The purpose of this paper is to present case studies and cost analysis of hospital-acquired infections and present strategies that reduce infections and cost.