Background
Chikungunya fever is a globally spreading mosquito-borne disease that shows an unexpected neurovirulence. Even though the neurological complications have been a major cause of intensive ...care unit admission and death, to date, there is no systematic analysis of their spectrum available.
Objective
To review evidence of neurological manifestations in Chikungunya fever and map their epidemiology, clinical spectrum, pathomechanisms, diagnostics, therapies and outcomes.
Methods
Case report and systematic review of the literature followed established guidelines. All cases found were assessed using a 5-step clinical diagnostic algorithm assigning categories A–C, category A representing the highest level of quality. Only A and B cases were considered for further analysis. After general analysis, cases were clustered according to geospatial criteria for subgroup analysis.
Results
Thirty-six of 1196 studies were included, yielding 130 cases. Nine were ranked as category A (diagnosis of Neuro-Chikungunya probable), 55 as B (plausible), and 51 as C (disputable). In 15 cases, alternative diagnoses were more likely. Patient age distribution was bimodal with a mean of 49 years and a second peak in infants. Fifty percent of the cases occurred in patients <45 years with no reported comorbidity. Frequent diagnoses were encephalitis, optic neuropathy, neuroretinitis, and Guillain–Barré syndrome. Neurologic conditions showing characteristics of a direct viral pathomechanism showed a peak in infants and a second one in elder patients, and complications and neurologic sequelae were more frequent in these groups. Autoimmune-mediated conditions appeared mainly in patients over 20 years and tended to show longer latencies and better outcomes. Geospatial subgrouping of case reports from either India or Réunion revealed diverging phenotypic trends (Réunion: 88% direct viral vs. India: 81% autoimmune).
Conclusions
Direct viral forms of Neuro-Chikungunya seem to occur particularly in infants and elderly patients, while autoimmune forms have to be also considered in middle-aged, previously healthy patients, especially after an asymptomatic interval. This knowledge will help to identify future Neuro-Chikungunya cases and to improve outcome especially in autoimmune-mediated conditions. The genetics of Chikungunya virus might play a key role in determining the course of neuropathogenesis. With further research, this could prove diagnostically significant.
Objective
To evaluate pregnancy and neonatal outcomes, disease severity, and mother‐to‐child transmission of pregnant women with Chikungunya infection (CHIKV).
Design
Retrospective observational ...study.
Setting
Grenada.
Population
Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible.
Methods
This descriptive study investigated 731 mother‐infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA.
Main outcome measures
Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity.
Results
Of 416 mother‐infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (μ = 898 days, σ = 277 days) compared with infections outside of pregnancy (μ = 1064 days, σ = 244 days) (P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother‐to‐child transmission occurred in two (1.3%) mother‐infant pairs and two of eight intrapartum infections (25%).
Conclusion
CHIKV infection during pregnancy may be protective against long‐term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother‐to‐child transmission of CHIKV.
Tweetable
Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.
Tweetable
Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.
Objective Maternal obesity is a well‐known risk factor for caesarean delivery. The aim of this study is to determine whether all the spectrum of pre‐pregnancy maternal corpulence (body mass index ...BMI) is associated with the risk of caesarean delivery.
Design Observational study over 4.5 years (2001–05).
Setting Groupe Hospitalier Sud‐Réunion’s maternity (island of La Réunion, French overseas department, Indian Ocean).
Population All consecutive singleton live births having delivered at the maternity.
Methods Data have been analysed according to different risk factors. Maternal corpulence has been defined as the maternal pre‐pregnancy weight. BMIs have been studied by multiples of 5 kg/m2 from 10–14.9 kg/m2 to 40–44.9 kg/m2.
Main outcome measure Rate of caesarean section.
Results There were 17 462 singleton live births during the period, of which 16 952 (97.1% of the total) pre‐pregnancy BMIs have been determined. There is a linear association (χ2 for linear trend, P < 0.001) between maternal corpulence and risk of caesarean deliveries, the leanest mothers having the best rate of vaginal delivery. This linear association exists in a model controlling for diagnosis of gestational diabetes, term deliveries (≥37 weeks), very short maternal height (<1.50 m), primiparity and maternal age ≥ 35 years (adjusted χ2, P < 0.001).
Conclusion There is a significant linear association between pre‐pregnancy maternal corpulence and risk of caesarean deliveries in pregnancies at term. The authors discuss several interpretations including the adaptability of fetal birthweights to maternal corpulence and the concept of soft‐tissue dystocia.
The general objective of this work was to evaluate the quality of the little-known tropical woods of the Congo Basin, particularly
Coula edulis
, while looking for new biocidal products. The natural ...durability of the hazel tree of Gabon
Coula edulis
versus basidiomycete fungi was evaluated with native and extracted samples of heartwood against brown rot (
Rhodonia placenta
and
Coniophora puteana
) and white rot (
Trametes versicolor
and
Pycnoporus sanguineus
) fungi. The results showed that non-extracted samples were more durable. Fungal growth inhibition tests using different concentrations of extractives confirmed the fungicidal effects. Percentage of the different wood polymers and GC–MS analysis of wood extractives were carried out to examine correlations between durability and wood chemistry. Natural durability of
Coula edulis
could be explained by the unusually high lignin content and the presence of high amounts of polyphenols like gallic and ellagic acids and tannins.
Coula edulis
could therefore be a local alternative to help alleviate wood shortages in Gabon.
In this study, heat treatment was carried out in a relatively low temperature (230 degrees C). Mass loss kinetics was studied using equipment, specially conceived to measure sample's mass during the ...thermal treatment. Laboratory experiments were performed for heating rates of 1 degrees C min(-1). Mathematical model for kinetics of pyrolysis process was used and validated. During the pyrolysis of dry wood samples under inert atmosphere, measurements of temperature distribution and dynamic weight loss were performed. Five different wood species Fagus sylvatica (Beech), Populus nigra (Poplar), Fraxinus excelsior (Ash), Pinus sylvestris (Pine) and Abies pectinata (Silver Fir) were investigated. The unsteady-state mathematical model equations were solved numerically using the commercial package Femlab 2.0. A detailed discussion of the computational model and the solution algorithm is given. The validity of different model assumptions was analyzed. Experimental results were compared with those calculated by the model. Acceptable agreement was achieved.
Prolonged fatigue is increasingly reported among chikungunya virus (CHIKV)-infected populations. We investigated the relationships between CHIKV exposure, long-lasting rheumatic musculoskeletal pain ...(LRMSP) and chronic fatigue. 1094 participants (512 CHIKV seropositive and 582 seronegative) of the TELECHIK population-based cohort were analysed considering the duration of the manifestations throughout an average 2-year follow-up. Weighted prevalence rates and prevalence ratios for LRMSP, idiopathic chronic fatigue (ICF), and chronic fatigue syndrome (CFS)-like illness, both latter syndromes adapted from Centers for Disease Control (CDC)-1994/Fukuda criteria, were compared. Population attributable fractions (PAF) were estimated to assess the contribution of CHIKV infection to each of the three phenotypes. Among 362 adult subjects who had reported either rheumatic pain or fatigue at the onset of the infection, weighted prevalence rates of LRMSP, ICF and CFS-like illness were respectively of 32.9%, 38.7% and 23.9%, and of 8.7%, 8.5% and 7.4% among initially asymptomatic peers (P < 0.01, respectively). Each of the three outcomes was highly attributable to chikungunya (PAF of 43.2%, 36.2% and 41.0%, respectively). In the sub-cohort of CHIKV-infected subjects, LRMSP, ICF and CFS-like illness, which overlapped in 70%, accounted for 53% of the chronic manifestations. In addition to rheumatic disease, chronic fatigue could be considered in caring for patients with chronic chikungunya disease.
The purpose of the study was to weigh the community burden of chikungunya determinants on Reunion island. Risk factors were investigated within a subset of 2101 adult persons from a population-based ...cross-sectional serosurvey, using Poisson regression models for dichotomous outcomes. Design-based risk ratios and population attributable fractions (PAF) were generated distinguishing individual and contextual (i.e. that affect individuals collectively) determinants. The disease burden attributable to contextual determinants was twice that of individual determinants (overall PAF value 89.5% vs. 44.1%). In a model regrouping both categories of determinants, the independent risk factors were by decreasing PAF values: an interaction term between the reporting of a chikungunya history in the neighbourhood and individual house (PAF 45.9%), a maximal temperature of the month preceding the infection higher than 28.5 °C (PAF 25.7%), a socio-economically disadvantaged neighbourhood (PAF 19.0%), altitude of dwelling (PAF 13.1%), cumulated rainfalls of the month preceding the infection higher than 65 mm (PAF 12.6%), occupational inactivity (PAF 11.6%), poor knowledge on chikungunya transmission (PAF 7.3%) and obesity/overweight (PAF 5.2%). Taken together, these covariates and their underlying causative factors uncovered 80.8% of chikungunya at population level. Our findings lend support to a major role of contextual risk factors in chikungunya virus outbreaks.
Macassar ebony (Diospyros celebica) wood plantation is cultivated in Indonesia by the government as well as some communities. However the properties of the planted ebony are yet to be investigated. ...Thus, the purpose of this study was to investigate the proportion of juvenile and mature wood of ebony and to analyse its radial features from pith to bark, based on density, shrinkage, static bending in modulus of rupture and modulus of elasticity, fibre length, microfibril angle and natural durability. A segmented modeling approach was used to find the juvenile mature transition. Laboratory test was performed to characterise termite and decay fungi resistances from pith to bark of Macassar ebony. Maturation of Macassar ebony was estimated to start at radial increments of 9 cm from the pith, both by fibre length and microfibril angle. Projected figure of the proportion of juvenile wood in Macassar ebony was around 34%. The results also indicated that the Macassar ebony wood was 843.3 kg m−3 in density, 1.44 in coefficient of anisotropy (good stability), 10317.5 MPa in modulus of elasticity and 98.0 MPa in modulus of rupture. Natural durability of Macassar ebony against termite and decay fungi was rated to be class I (very durable). Toxic coumpounds analysed by gas chromatography-mass spectrometry (GCMS) and nuclear magnetic resonance (NMR) were dimethoxymethylnaphthol, dimethoxymetylnaphtol trimethylsilane and gallic acid trimethylsilane.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, FFLJ, IZUM, KILJ, NMLJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Last decades, wood was promoted as building material. Wood heat treatment by mild pyrolysis has been reported to improve biological durability and dimensional stability of the material and ...constitutes an attractive `` non biocidal `` alternative to classical preservation treatments. Previous studies have shown that conferred properties strongly depend on the heat treatment intensity. A quality control marker based on mass loss has been developed. For several years, the increased development of Tunisian wood industry provides a significant capacity of wood production and transformation. Forests in Tunisia consist essentially of coniferous species Aleppo pine (Pinus halepensis), Radiata pine (Pinus radiata), Maritime pine (Pinus pinaster), Stone pine (Pinus pinea), characterised by a weak natural durability. Improved durability and fungal resistance should allow the use of Tunisian species in the wood industry. Import limitation of European species and the use of local species allow the conservation of economic value added in the country and improve the economic balance. For this reason, several Tunisian softwood species (Aleppo pine, Radiata pine and Maritime pine) have been heat-treated under vacuum atmosphere at 230 degrees C to obtain a thermal degradation with mass losses of approximately 8, 10 and 12%. The oven device allows recording the dynamic Mass Loss (ML) during the treatment and following the thermodegradation kinetic. The chemical composition of the studied wood samples was determined before and after heat treatment. For each wood species and treatment intensity, wood chemical and mechanical analyses were performed by measuring O/C ratio, bending and hardness tests. Afterward, tests of decay resistance were performed according to the EN 113 Standard, with different fungal attacks (Poria Placenta, Coriolus Versicolor) at 22 degrees C and 70% of humidity for 16 weeks. Results were related to the mass loss. Furthermore, intensity of thermal degradation was evaluated by TD-GC-MS. Treated and untreated wood samples were maintained during 15 minutes at 230 degrees C under nitrogen in the thermodesorption tube in order to analyse and compare resulting from the wood thermodegradation volatile compounds.
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