We report molecular evidence for the presence of spotted fever group rickettsiae (SFGR) in ticks collected from roe deer, addax, red foxes, and wild boars in Israel. Rickettsia aeschlimannii was ...detected in Hyalomma marginatum and Hyalomma detritum while Rickettsia massiliae was present in Rhipicephalus turanicus ticks. Furthermore, a novel uncultured SFGR was detected in Haemaphysalis adleri and Haemaphysalis parva ticks from golden jackals. The pathogenicity of the novel SFGR for humans is unknown; however, the presence of multiple SFGR agents should be considered when serological surveillance data from Israel are interpreted because of significant antigenic cross-reactivity among Rickettsia. The epidemiology and ecology of SFGR in Israel appear to be more complicated than was previously believed.
A novel sapelovirus-like virus was isolated from a wild boar (Sus scrofa). In this study, partial viral genomic nucleotide sequences were determined using the rapid determination system of viral ...nucleic acid sequences (RDV) ver. 3.1, which we recently developed for discovering novel viruses. Phylogenetic analysis of VP1 and 3A proteins and their encoding nucleotide sequences of enteroviruses and sapeloviruses indicated that the isolated virus was closely related to porcine sapelovirus. RT-PCR detected viral sequences in six of 48 wild boar fecal samples.
The monument, worked in stone, consists of a differently sized three-step base (levels) and the actual body of the monument consisting of two steps (levels) also sized differently. In the upper part ...the monument ends with a cross whose arms, at the ends, are convex in shape. On the first step of the monument body, in a deep frame, rectangular in shape, are represented a sword and a weapon with bayonet as well as a cross painted with white. In the same framework are represented stylized floral elements. On the second step (upper) of the body are incised names of heroes, enclosed in a simple geometric frame (linear ornamentation). On the cross above the obelisk is incised another, in a medallion, to this is added floral and linear ornamentation. Height (h) monument: 3.90m.
Mentions about the monument: Good state of conservation.
Monumentul, lucrat în piatră, se compune dintr-o bază în trei trepte (nivele) diferit dimensionate și din corpul propriu-zis al monumentului alcătuit din două trepte (nivele) de asemenea dimensionate diferit. În partea superioară monumentul se încheie cu o cruce ale cărei brațe, la capete, au formă convexă. Pe prima treaptă a corpului monumentului, într-un cadru adâncit, de formă dreptunghiulară, sunt reprezentate o sabie și o armă cu baionetă precum și o cruce vopsită cu alb. În același cadru sunt reprezentate elemente florale stilizate. Pe cea de-a doua treaptă (cea superioară) a corpului sunt incizate nume de eroi, închise într-un cadru geometric simplu (ornamentație liniară). Pe crucea de deasupra obeliscului este incizată o alta, într-un medalion, la aceasta adăugându-se ornamentație florală și liniară. Înălțime (h) monument: 3,90m.
Mențiuni despre monument: Stare bună de conservare.
Monumentul, lucrat în piatră, se compune dintr-o bază în trei trepte (nivele) diferit dimensionate și din corpul propriu-zis al monumentului alcătuit din două trepte (nivele) de asemenea dimensionate diferit. În partea superioară monumentul se încheie cu o cruce ale cărei brațe, la capete, au formă convexă. Pe prima treaptă a corpului monumentului, într-un cadru adâncit, de formă dreptunghiulară, sunt reprezentate o sabie și o armă cu baionetă precum și o cruce vopsită cu alb. În același cadru sunt reprezentate elemente florale stilizate. Pe cea de-a doua treaptă (cea superioară) a corpului sunt incizate nume de eroi, închise într-un cadru geometric simplu (ornamentație liniară). Pe crucea de deasupra obeliscului este incizată o alta, într-un medalion, la aceasta adăugându-se ornamentație florală și liniară. Înălțime (h) monument: 3,90m.
Mențiuni despre monument: Stare bună de conservare.
Inscripții pe monument: „PENTRU PATRIE/ ÎN RĂZBOIUL/ 1914-1919” NUME DE EROI (42)
The population density of wild boar (
Sus scrofa) in Northern Switzerland has increased dramatically during the last three decades and the species has become a major threat to agriculture, causing ...severe damage to crops and grassland. Vulnerable fields have to be protected from wild boar incursion, which is in most cases achieved by using electric fences. Alternatively, deterrents basing on optical, acoustical or gustative effect are available. The effectiveness of most of these systems has not previously been scientifically tested in the field. In our study we investigated the effectiveness of solar blinkers at baited luring sites. We conducted field experiments at 4 different sites with free-ranging wild boars from January 2007 to January 2008. Data from 504 inspections of the luring sites indicate that solar blinkers reduced the probability of wild boar visits at the luring sites by 8.1% compared to the control sites. We therefore evaluate deterrence effect of solar blinkers to be insufficient for effective crop protection. Probability of wild boar visits at the luring sites changed throughout the study period, showing seasonal variation of the extent of wild boar activity in the fields.
► We investigated effectiveness of solar blinkers as a deterrent against wild boar. ► We found a non-significant 8.1% reduction of wild boar visits at luring sites. ► Solar blinkers are not recommendable for protection of crops against wild boar. ► Wild boar visits differed between months and massed in fall (Sept–Nov).
La pathologie cardiovasculaire de la femme est complexe, surtout dans la population la plus jeune. Les syndromes coronariens aigus ont une présentation clinique parfois trompeuse dans un contexte peu ...évocateur de pathologie cardiaque, car peu de facteurs de risques cardiovasculaires. Cette complexité entraîne un retard au diagnostic, qui assombrit le pronostic des infarctus du myocarde, et expose ces patientes à des complications liées à l’absence de reperfusion coronaire. Nous rapportons le cas d’une patiente qui a présenté un infarctus apical passé inaperçu, compliqué d’un volumineux thrombus intraventriculaire avec migration d’un embole dans la circulation cérébrale, responsable d’un accident ischémique. L’association des deux pathologies compliquant la prise en charge thérapeutique. Comme cela est déjà largement publié, le pronostic de l’infarctus du myocarde chez la femme est moins bon que chez l’homme, pour diverses raisons. Il est probable que dans la population la plus jeune, un autre mécanisme physiopathologique soit souvent en cause : l’hématome et la dissection coronaire spontanée. Le diagnostic est souvent complexe, y compris à l’angiographie coronaire. Comme nous le rapportons dans cette observation, une analyse trop rapide conclut fréquemment à un examen normal. Il est aussi fort probable que la physiopathologie différente, ne faisant pas intervenir la rupture de plaque mais un hématome ou dissection de paroi coronaire, influence défavorablement de pronostic du fait d’une mauvaise adaptation des traitements. En conclusion, en cas d’accident ischémique cérébral, un bilan cardiologique précis doit être réalisé, y compris chez les femmes jeunes sans facteur de risque cardiovasculaire car des pathologies comme l’hématome ou dissection coronaire peuvent survenir et par le biais de l’infarctus du myocarde contribuer la formation de thrombus muraux. L’IRM cardiaque semble être un élément de choix dans le diagnostic d’infarctus compliqué de thrombus intracavitaire.
Cardiovascular disease in women is a particularly complex pathology especially in the youngest population. The clinical presentation of acute coronary syndromes is sometimes misleading and does not necessarily point to the potential presence of cardiac disease given the frequent absence of cardiovascular risks. Such complexity results in delayed diagnosis, which worsens the outcome of myocardial infarction and generates complications related to the absence of coronary revascularization. We report the case of a patient who suffered an (undiagnosed) apical myocardial infarction that went undetected and was complicated by a voluminous intraventricular thrombus with embolus migration in the cerebral circulation resulting in an ischemic accident. The combination of these two pathologies make their therapeutic management particularly difficult. As widely reported in the literature, the outcome of myocardial infarction in women is poorer than in their male counterparts for a number of reasons. We can assume that in the youngest patients, another physiopathological mechanism is often involved, namely, the occurrence of hematoma and spontaneous coronary dissection. Diagnosis is often difficult even with coronary angiography diagnosis. As shown in the case reported here, initial examination results, if not thoroughly analyzed, may be erroneously interpreted as normal. It is also likely that the presence of hematoma or coronary wall dissection without any plaque rupture may negatively influence the outcome owing to the implementation of inappropriate treatments. In conclusion, in patients presenting with an ischemic cerebral accident, meticulous cardiac examination must be performed even in young women with no cardiovascular risk factors given that the occurrence of hematoma or coronary dissection may contribute to the formation of mural thrombi in the setting of myocardial infarction. Cardiac MRI seems to be particularly effective in the diagnosis of myocardial infarction complicated by the presence of intracavitary thrombi.
On dispose de peu de données françaises comparatives sur les caractéristiques, la prise en charge et le devenir des patients hospitalisés pour un infarctus avec sus-décalage de ST (STEMI). À partir ...du registre FAST-MI 2010, les données des patients admis pour STEMI ont été analysées en fonction de la région d’hospitalisation ; 6 grandes régions ont ainsi été constituées en les regroupant à partir des régions administratives en vigueur en 2010. On constate des variations régionales de la typologie des patients, reflétant pour une part les variations démographiques des différentes régions. La prise en charge aiguë varie, avec notamment, pour des raisons géographiques et d’organisation, une plus grande utilisation de l’angioplastie primaire en région parisienne. Dans l’ensemble, toutefois, et en dépit des variations statistiques, la prise en charge dans les différentes régions montre plus de similitudes que de différences importantes. Les complications, notamment la mortalité hospitalière, ne sont pas statistiquement différentes dans les différentes régions.
Data on regional variations in the characteristics, management and early outcome of patients admitted with ST-elevation myocardial infarction (STEMI) in France are limited. We used data from the FAST-MI 2010 registry to determine whether regional specificities existed, dividing the French territory into 6 larger geographical regions. Variations in the patients’ characteristics were found, partly related to regional variations in demography. Acute reperfusion strategy showed more use of primary percutaneous coronary intervention in the greater Paris area, compared to other regions, which would be expected owing to geography and local availability of catheterization laboratories. Overall, however, inhospital management showed more similarities than differences across regions. Complications, and in particular inhospital mortality, did not differ significantly among regions.
L’observation d’une patiente obèse, admise pour la prise en charge d’un syndrome coronaire aigu ST+ en angioplastie primaire, nous permet, à partir des résultats des publications récentes, études ...randomisées et registres, de rappeler les avantages de la voie radiale dans ce type d’indication en termes de réduction d’évènements majeurs, y compris de réduction de la mortalité. Nous discutons les éléments de réticence à l’utilisation de cette voie d’abord dont seule l’expérience et l’utilisation quotidienne permettront de placer cette voie d’abord comme celle devant s’imposer par défaut dans les SCA ST+.
This overweight woman's case, who underwent a primary coronary intervention for STEMI, reminds us how much the trans-radial angioplasty is interesting in this particular case leaning on the recent literature, randomized trials and registries, in terms of major adverse events reduction including mortality. We are going to debate about hesitation of using radial approach whose only everyday's practising could make this approach a STEMI one.
La prise en charge du syndrome coronaire aigu avec sus-décalage du segment ST n’a pas été récemment évaluée. L’objectif de l’étude est d’évaluer leur prise en charge en France en 2014 et de la ...comparer aux recommandations actuelles.
Cette étude multicentrique s’appuie sur un questionnaire envoyé par mail aux angioplasticiens français. Il évalue les données démographiques des coronarographistes, la prise en charge interventionnelle et médicamenteuse et le devenir des patients.
Cent soixante-seize réponses ont été analysées. La majorité des centres réalisaient plus de 600 angioplasties annuelles. En moyenne, 209 infarctus ont été admis par centre en 2014, plus fréquemment en centre hospitalo-universitaire qu’en centre régional ou privé (respectivement 51, 32 et 17 % des infarctus). La thromboaspiration – dont nous discutons l’apport – et les anti-GPIIbIIIa (34 % des cas) n’étaient pas systématiques mais adaptés à chaque patient, conformément aux recommandations. L’abord radial (85 % des cas) et les stents actifs (62 % des cas) étaient privilégiés. L’héparine non fractionnée et l’énoxaparine représentaient plus de 80 % des traitements anticoagulants. Les taux d’utilisation du clopidogrel, du prasugrel et du ticagrelor étaient comparables. La réadaptation cardiovasculaire était insuffisamment proposée à 50 % des patients.
Malgré une hétérogénéité de prise en charge du syndrome coronaire aigu avec sus-décalage du segment ST, l’ensemble des pratiques s’intègre dans les recommandations actuelles. Des efforts pourraient être faits sur l’utilisation des nouveaux inhibiteurs P2Y12.
Real life management of myocardial infarction has not recently been evaluated in France.
To describe ST-elevation myocardial infarction management in France in 2014 and to compare it with current guidelines.
A multicentre study was performed. An e-mail questionnaire was sent to French interventional cardiologists. Demographic data of interventional cardiologists, procedural aspects of percutaneous coronary intervention, antithrombotic treatments and patient rehabilitation have been investigated.
One hundred and seventy-six answers were analysed. Most of centres realized more than 600 annual angioplasties. An average of 209 myocardial infarctions were managed per centre in 2014, more often in academic than in general or private centres (respectively 51, 32 and 17% of infarctions). Anti-GPIIbIIIa (34% of the cases) and thromboaspiration were not systematic but depend on patient's characteristics, according to guidelines. Radial access was favoured in 85% of the cases and increased for the last decade. Drug eluting stents were used in 62% of cases. Unfractionated heparin and enoxaparine accounted for more than 80% of anticoagulants treatments. Overall, use of clopidogrel was as high as that of prasugrel or ticagrelor although clopidogrel is recommended in second-line. Cardiovascular rehabilitation was proposed to more than 50% of patients.
In spite of heterogeneity of ST-elevation myocardial infarction management in 2014, real-life practices generally comply with current guidelines.
Göreme National Park is located on about 12 km north of Nevşehir province, in Central Anatolia. The national park has 675 taxa at specific and infraspecific levels. A total number of 80 taxa (11.8 %) ...are endemic to Turkey. The plants in the park have showy flowers with various colors. Also, fruit and leaf shapes can be used effectively in landscape areas for a various designs purposes. In this paper, selected plants recommended for landscaping are given with their pictures, general information and aesthetic uses
Göreme Milli Parkı İç Anadolu Bölgesi’nde Nevşehir’in yaklaşık 12 km kuzeyinde bulunmaktadır. Milli park tür ve tür altı seviyelerinde bulunan toplam 675 taksonu barındırmaktadır. Toplam 80 takson (%11.8) Türkiye için endemiktir. Parktaki bitkiler farklı renklerde gösterişli yapraklara sahiptir. Ayrıca, meyve ve yaprak şekilleri peysaj alanlarında farklı tasarım amaçları için etkili olarak kullanılabilir. Bu çalışmada milli parkta bulunan endemik bitkiler, peysaj düzeni için önerilen bitkiler resimleri, genel bilgi ve estetik kullanımları ile birlikte verilmiştir
Durant les dernières décades, le pronostic de l’infarctus du myocarde n’a pas cessé de s’améliorer dans la population générale. Cependant, l’analyse précise de ces résultats montre toutefois que la ...réduction de mortalité est plus importante dans la population masculine que dans la population féminine. La surmortalité féminine dans cette pathologie est parfois discutée mais largement publiée dans la littérature. Ce moins bon pronostic des syndromes coronariens aigus avec sus-décalage du segment ST chez la femme est en grande partie expliqué par des facteurs cliniques aggravants comme un plus grand âge, une plus grande proportion de diabétiques, une plus grande fréquence de chocs cardiogéniques. D’autres facteurs, cette fois dans la prise en charge, semblent grever ce pronostic, avec notamment un moins grand recours aux stratégies de reperfusion, des délais plus longs dans la prise en charge, qui sont en grande partie liés aux doutes diagnostiques qui accompagnent cette pathologie réputée masculine. Ce doute déjà présent dans l’esprit de la patiente, chez son entourage, continu d’exister dans le monde médical pour se dissiper en salle de cathétérisme cardiaque. C’est ce que nous décrivons dans le premier cas clinique, avec des conséquences directes sur le pronostic. La reperfusion coronaire est la pierre angulaire du traitement de cette pathologie. Dans ce cadre, des complications hémorragiques liées au traitement peuvent aussi constituer une cause de surmortalité dans cette population réputée plus fragile. Lorsque l’on tient compte de tous ces facteurs cliniques, thérapeutiques, pouvant influencer le pronostic de cette pathologie, il semble persister une surmortalité féminine et en particulier dans les populations les plus jeunes. Il est possible, comme nous le décrivons dans le second cas clinique, qu’une entité physiopathologique différente, plus fréquente chez la femme, soit la cause de cette différence. En effet, la dissection coronaire spontanée et/ou hématome intrapariétal est de diagnostic parfois difficile échappant parfois aux thérapeutiques de reperfusion. De surcroît, ces thérapeutiques de reperfusion coronaire ne sont probablement pas adaptées à ce type de syndromes coronariens aigus. Il est donc très important de savoir les reconnaître à l’angiographie, compléter les investigations le cas échéant par une imagerie intra-coronaire et de continuer à faire des recherches pour adapter nos techniques d’angioplasties à cette pathologie.
The outcome of patients with ST elevation acute coronary syndrome (ACS) has been increasingly improving in the general population over the past few decades. However, detailed analysis of the results show that the reduction in mortality rates is higher in males compared to their female counterparts. The excess mortality rate observed in women, though sometimes questioned, has been widely reported in the literature. The higher mortality rate observed in women with ST elevation ACS can be explained by the presence of aggravating clinical factors such as older age, a higher percentage of diabetics, and a higher frequency of cardiogenic shock. Other factors pertaining to patient management seem to negatively impact the outcome. These factors include a lower use of reperfusion strategies, longer time to treatment mainly as a result of diagnostic uncertainty with respect to a disease, which is believed to affect principally the male gender. The doubts that female patients themselves and their families have about the nature of their symptoms are also present in the medical environment but cease to exist in the catheterization laboratory. This is illustrated in the first clinical case that we present here. Coronary reperfusion is the cornerstone of the therapeutic management of MI. In this context, bleeding complications associated with the implemented treatments can also result in an increased mortality rate in this more vulnerable population. When all the factors likely to influence the prognosis are taken into account, excess mortality seems to persist in women, especially in younger patients. As described in the second clinical case, a distinct physio-pathological factor, more frequent in women, could account for this higher mortality rate. Indeed, spontaneous coronary dissection and intramural hematoma are not always easy to diagnose and may not be adequately managed by reperfusion treatments. In addition, these coronary reperfusion strategies are probably not adapted to this type of ACS. It is, therefore, very important to identify them by angiography coupled with intra-coronary imaging examination when necessary and to carry out further research to adjust our PCI techniques to this pathology.
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