Epidemiologic and Ecologic Features of Blastomycosis: A Review

Blastomycosis is a potentially fatal infection caused by Blastomyces dermatitidis, a fungus endemic to North America in areas surrounding the Ohio and Mississippi River valleys and the Great Lakes. The clinical manifestations, diagnostic techniques, and treatment strategies for blastomycosis are relatively well-described in the literature; however, the epidemiologic features of disease are not as clearly defined as those of other endemic mycoses, such as histoplasmosis and coccidioidomycosis. We review the ecologic and epidemiologic aspects of B. dermatitidis and blastomycosis, including geographic distribution, environmental niche, seasonality, and possible risk factors.     

Pain—Mechanisms and Management

In the past two decades there has been remarkable progress in understanding the neural mechanisms of pain. However, chronic pain is poorly understood and, by definition, poorly managed. In addition to hyperactivity of the sympathetic nervous system and damage to normal inhibitory mechanisms, social and psychological factors play a major role in producing the disability of chronic pain. New approaches to manage chronic pain include nonopiate drugs, transcutaneous electral nerve stimulation and psychological and behavioral methods. A nervous system network has recently been described that suppresses pain. This analgesic action is mediated by endogenous opioid peptides (endorphins) and by biogenic amines. The analgesia network can be activated either by electral stimulation or by opiates such as morphine or methadone.     

Pacific Islanders—Migration and Health

Native Hawaiians and peoples from American Samoa, Guam and the Trust Territories of the Pacific Islands are all recipients of US subsidized health care. Categorized as Pacific Islanders they are a heterogeneous group with differences in biology, cultural adaptation to varied ecological settings, historical influences resulting from colonialism and present-day political factionalism. Yet, westernization on home islands and migration to Hawaii and the western United States have created similarities in disease patterns among these culturally diverse peoples. They have high rates of the chronic diseases of civilization: cardiovascular disease, diabetes mellitus and hypertension. Obesity, associated with these ailments, has become a major health problem among Pacific Islanders and may be attributed to changes in local food production and consumption in conjunction with sedentarization. Culturally and linguistically distinct from the American mainstream, these people as migrants or residents are marginal within the US social structure and find if difficult to obtain adequate medical treatment.     

重症轮状病毒腹泻炎性标志物水平和心电图分析

目的:观察重症轮状病毒腹泻时炎性标志物水平和心电图变化.方法:回顾性分析64例重症轮状病毒腹泻患儿(rotavirus enteritis 组,RV组)和52例RV阴性单纯性腹泻患儿(对照组)的血清心肌酶谱与炎性因子水平,同时观察各组心电图变化.结果:RV组患儿治疗前高敏C反应蛋白(Hi-sensitive C-reactive protein,hs-CRP)与心肌酶谱水平显著高于对照组患儿(P＜0.01),且治疗后显著降低(P＜0.01).90.6%的RV组患儿出现心电图异常改变,明显高于对照组(P＜0.05).结论:重症轮状病毒感染易导致心肌功能损伤,应重视对重症轮状病毒腹泻患儿炎性标志物和心电图的监测.     

Enterovirus Infections: Etiologic,Epidemiologic and Clinical Aspects

The term enteroviruses was introduced in 1957 to bring together in one large family the polioviruses, Coxsackie A and B and echoviruses, all agents for which the human alimentary tract is the natural habitat. At present more than 60 distinct members are recognized: three polioviruses, 24 Coxsackie A, six Coxsackie B and 30 echoviruses. The list of new members, particularly in the echo-group, grows regularly. The viruses are frequently widely disseminated in the summer and fall of the year, circulating chiefly among young children, causing both apparent and inapparent infection. The enteroviruses are responsible for a wide spectrum of clinical manifestations, including non-specific febrile illness, sometimes with rash, aseptic meningitis, paralytic disease, respiratory infections, pericarditis and myocarditis. There is considerable overlap in biologic behavior, and the same syndrome can be induced by many different agents.In a few instances the clinical pattern is distinct enough to suggest the group of agents involved. Thus, herpangina is associated with the Coxsackie A viruses and epidemic myalgia (devil''s grip) with the Coxsackie B group. Paralytic disease is caused primarily by the polioviruses, but recently it has been found that other members, particularly the Coxsackie B viruses and Coxsackie A7 can also cause “paralytic poliomyelitis.”The ultimate potential of enteroviruses in terms of central nervous system disease and other manifestations is unpredictable. Great variety in terms of clinical and epidemiologic behavior of known and “new” viruses has been the pattern in the past, and is likely to continue.     

Resonance Raman Studies of Co—O2 and O—O Stretching Vibrations in Oxy-Cobalt Hemes

Strong evidence suggests that the stretching vibration of the bound oxygen can be perturbed by an accidentally degenerate porphyrin ring mode, resulting in two split frequencies. In the Co(II)(TpivPP) (pyridine) ¹⁸O₂ complex, we demonstrate that the ν(¹⁸O—¹⁸O) mode, after being shifted from its ν(¹⁶O—¹⁶O) value at 1,156 cm^-1, undergoes a resonance interaction with the 1,080 cm^-1 porphyrin mode, giving rise to two lines at 1,067 and 1,089 cm^-1. In the O₂ complex of Co(II) mesoporphyrin IX-substituted sperm whale myoglobin, we observed a dramatic intensity increase at 1,132 cm^-1 upon ¹⁶O₂ → ¹⁸O₂ substitution, which is due to the reappearance of the 1,132-cm^-1 porphyrin mode after the removal of resonance conditions. A decrease in O₂ binding affinity, caused by the proximal base tension, corresponds to an increase in the Co—O₂ stretching frequency. The ν(Co—O₂) at 527 cm^-1 for the low affinity Co(II)(TpivPP)(1,2-Me₂Im) O₂ complex is 11 cm^-1 higher than the 516-cm^-1 value for the high affinity complex (with N-MeIm replacing 1,2-Me₂Im). However, in the corresponding iron complexes the reverse behavior is observed, i.e., the ν(Fe—O₂) decreases for the (1,2-Me₂Im) complex. There is a 24-cm^-1 difference in the Co—O₂ stretching frequencies between Co(II)(TpivPP)(N-MeIm)O₂ (at 516 cm^-1) and oxy meso CoMb (at 540 cm^-1), suggesting a protein induced distortion of the Co—O—O linkage. However, the values for ν(Fe—O₂) are nearly identical between Fe(II)(TpivPP)(N-MeIm)O₂ (at 571 cm^-1) and oxy Mb (at 573 cm^-1), indicating that O₂ binds to myoglobin in the same manner as in the sterically unhindered “picket fence” complex. Evidence is presented that suggests the presence of two dioxygen stretching frequencies due to two different conformers in each of the N-MeIm and 1,2-Me₂Im complex of oxy Co(II)(TpivPP).