Infectious mononucleosis is rarely associated with skin lesions. A 23-year-old woman with acute infectious mononucleosis who presented with moderately severe erythema multiforme is reported. The role of steroids in the management of this condition is briefly discussed.
The close relationship between Group A beta Hemolytic Streptococci (GABS) and rheumatic fever is a well established one. However, the concept of the streptococcus as the sole etiologic agent of the rheumatic heart disease (RHD) has been challenged over the past years. Since coxsackievirus group B (CVB) has long been proposed as a cause of acquired valvular disease simulating rheumatic fever, we attempted in this study to document infections with this group of viruses in patients with rheumatic fever. We obtained blood samples from 106 patients with old (quiescent) rheumatic fever/rheumatic heart disease [group I], 94 patients with acute rheumatic fever (ARF) [group II], and 74 normal matched controls. We tested for the presence of neutralizing antibodies to the 6 serotypes of CVB by a micro neutralization test. We have found that infection with CVB, especially types B2 and B4, was common in the studied population. Forty-two percent of normal individuals had evidence of infection with any of the 6 serotypes of CVB. Patients of group I had significantly more frequent infections with CVB 2. Patients in group II had significantly more frequent infections with CVB 2 and CVB 6. There was no clear correlation between such infections and the clinical course of rheumatic fever. There was no difference in the incidence of CVB infections between patients with definite ARF, and patients with suspected ARF. We set a low order association between rheumatic fever and infection with CVB types B2 and B6. We emphasize the importance of pursuing the investigation of the role of CVB in relation to RHD.
Aaron Wildavsky proposed in 1987 that cultural orientations such as egalitarianism and individualism frame public perceptions of technological risks, and since then a body of empirical research has grown to affirm the riskframing effects of personality and culture (Dake, 1991; Gastil et al., 2005; Kahan, 2008). Most of these studies, however, have focused on relatively mundane risks, such as handguns, nuclear power, genetically modified food, and cellphone radiation. In the contemplation of truly catastrophic risks – risks to the future of the species from technology or natural threats – a different and deeper set of cognitive biases come into play, the millennial, utopian, or apocalyptic psychocultural bundle, a characteristic dynamic of eschatological beliefs and behaviours. This essay is an attempt to outline the characteristic forms millennialism has taken, and how it biases assessment of catastrophic risks and the courses of action necessary to address them. Millennialism is the expectation that the world as it is will be destroyed and replaced with a perfect world, that a redeemer will come to cast down the evil and raise up the righteous (Barkun, 1974; Cohn, 1970). Millennialism is closely tied to other historical phenomena: utopianism, apocalypticism, messianism, and millenarian violence. Western historians of millenialism have focused the most attention on the emergence of Christianity out of the messianic expectations of subjugated Jewry and subsequent Christian movements based on exegesis of the Book of Revelations expecting the imminent return of Christ. But the millennial impulse is pancultural, found in many guises and with many common tropes from Europe to India to China, across the last several thousand years. When Chinese peasants followed religiopolitical revolutionaries claiming the mantle of the Coming Buddha, and when Mohammed birthed Islam preaching that the Last Judgement was imminent, they exhibited many similar features to medieval French peasants leaving their fields to follow would-be John the Baptists. Nor is the millennial impulse restricted to religious movements and beliefs in magical or supernatural agency. Revolutionary socialism and fascism embodied the same impulses and promises, although purporting to be based on science, das Volk, and the secular state instead of prophecy, the body of believers, and the Kingdom of Heaven (Rhodes, 1980; Rowley, 1983).
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