The mosquito-borne West Nile (WNV) and dengue 2 (DEN2V) viruses and tick-borne Langat (LGTV) and Omsk hemorrhagic fever (OHFV) viruses are arthropod-borne flaviviruses (family Flaviviridae, genus Flavivirus). These viruses are quite similar at both the nucleotide and amino acid level, yet they are very divergent in their biological properties and in the diseases they cause. The objective of this study was to examine the putative receptor-binding domains of the flaviviruses, the envelope (E) protein domain III (D3), which assume very similar structures either as part of the whole envelope protein or as individual entities, and to define the biophysical properties that distinguish among these viruses. Circular dichroism and Fourier transform infrared spectroscopy were employed to monitor the solution structure of these proteins. While the spectroscopic results found that the D3 from each of these viruses is composed of either beta-sheets or beta-turns, which is consistent with X-ray crystal data for tick-borne encephalitis and dengue viruses, these results reveal that recombinant D3s (rED3s) derived from tick-borne flaviviruses (LGT-rED3 and OHF-rED3) were similar to each other, while those from mosquito-borne flaviviruses (WN-rED3 and DEN-rED3) were similar to each other yet distinct from rED3 of the tick-borne viruses. Protein dynamic studies probed by fluorescence quenching and hydrogen/deuterium exchange found that the rED3s are dynamic entities. The tick-borne proteins again exhibit very similar dynamic properties, which are different from the mosquito-borne proteins. The WN-rED3 is significantly less stable than the other three rED3s. Overall, these differences in biophysical properties correlate with biological properties of these viruses that tick-borne flaviviruses are more stable than mosquito-borne flaviviruses.
As food allergies become increasingly prevalent and testing methods to identify "food allergy" increase in number, the importance of careful diagnosis has become even more critical. Misdiagnosis of food allergy and inappropriate use of unproven testing modalities may lead to a harmful food-elimination diet. This case is an example of an infant who was placed on an overly restrictive elimination diet at the recommendation of her health care providers, resulting in kwashiorkor and acquired acrodermatitis enteropathica. Pediatrics 2013;132:e229-e232 AUTHORS:
The development of effective vaccines has been an amazing public health achievement and has resulted in countless lives being saved. Dermatologic therapy has recently been greatly advanced by the licensure of an effective human papillomavirus vaccine and herpes zoster vaccine. Despite these successes, many infectious diseases do not currently have a preventive vaccine. We review potential vaccines against selected infectious agents, including viruses, bacteria, fungi, and protozoa that have cutaneous and mucocutaneous manifestations. The road to licensure of a new vaccine begins with exhaustive preclinical and clinical studies, and many of these will fail before a successful vaccine candidate is approved. This article focuses on vaccines that have yet to be approved for licensure.
Validation of a Questionnaire for Self-reporting of Hyperpigmentation Disorders in Chinese-Speaking Women of Chinese Descent D isorders of hyperpigmentation are more common in darker-skinned individuals 1 such as the Chinese. 2 A few studies have been performed in dermatology clinics attempting to determine the prevalence of lentigines, postinflammatory hyperpigmentation (PIH), and melasma. 3,4 However, the prevalence of these conditions in most populations is unknown. The goal of the present study was to develop and validate a questionnaire for self-reporting of hyperpigmentation disorders in Chinese women. Methods. A series of questions was first developed in English and then translated into Chinese. Some questions were reworded based on the rules of Chinese syntax. The resulting translations were reviewed by a panel of Chinese teachers for accuracy and comprehensibility. After approval was obtained from the institutional review board, an initial test with a focus group was carried out with a group of 6 Chinese women aged 18 to 55 years. They were sampled randomly from the waiting room of a Chinese-speaking primary care physician. Only women were chosen for this study because disorders of hyperpigmentation in Asians, such as melasma, are more common in women. 2 Furthermore, in our experience, women are more concerned about facial disorders of hyperpigmentation than men. After obtaining feedback from the focus group, we evaluated the questions and altered them to improve comprehension. These were then back-translated to English and then reviewed by one of us (A.G.P.), who confirmed that the meaning of the original English question was not lost (Figure 1). The questionnaire was then administered to women at the 2006 Chinese Health Fair in Houston, Texas. After they completed the questionnaire, the women were examined individually for the presence or absence of melasma, lentigines, and PIH by an examiner experienced in the diagnosis of these disorders. The examiner was blinded to the results of the questionnaire at the time of the examination. All patients in the focus group as well as those at the health fair gave written informed consent prior to participation.
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