Dirofilaria repens, parasite of subcutaneous tissues of dogs and other carnivores, represents high infection risk for animals and humans in Europe. In men, infection usually presents as nodule in subcutaneous tissues or, less often, the lesions are localised around the eyes. The work presents first confirmed clinical case of human D. repens infection connected with cutaneous larva migrans syndrome. In patient, the migration of the worm caused true signs of creeping eruption, elevated sinuous track under the skin. It was connected with severe pain, burning and erythema of adjacent skin. Symptoms appeared at least three times, approximately once a month, always in the evening or night and lasted from several minutes to several days. In December 2014, during the scratching of residual pruritic lesion, patient removed 6-cm long, whitish worm from the wound. Morphological features (longitudinal ridges) and PCR amplification of cytochrome oxidase subunit 1 (CO1) confirmed Dirofilaria repens as etiological agent of infection. Herein, presented case confirmed that D. repens infection in humans can be associated with real creeping eruption, clinical sign of cutaneous larva migrans and should be included in its differential diagnosis.
SUMMARYObjectives: The aim of this study was to determine the prevalence of HBV infection among pregnant women in districts of Eastern Slovakia with a diverse prevalence of Roma population.Methods: Overall 59,279 serum samples from 9 regional departments of clinical microbiology from Eastern Slovakia were collected in the period from January 2008 till December 2009 and analysed.Results: The number of HBsAg positive samples overall and during pregnancy was 1.74% and 2.12%, respectively. Comparing districts with higher (>5%) and lower (<5%) Roma population, there was no significant difference in the prevalence of HBsAg positive samples overall (1.95% vs.1.62%). However, in the subgroup of pregnant women the prevalence of HBsAg positive samples (2.72% vs. 0.95%) differs significantly (p<0.01).Conclusions: The prevalence of HBV infection among pregnant women in Eastern Slovakia did not rapidly exceed the estimated nationwide prevalence. However, in districts with higher Roma population the expected higher prevalence of HBV infection was confirmed. This indicates the need to pay special attention to the prevention of hepatitis B in these districts.
Trichinellosis is a zoonosis caused by ingestion of undercooked raw meat from animals that harbour infectious larvae. In most of the Slovak regions there is ongoing life cycle of circulating trichinellosis in wild carnivores and wild boar population. The outbreak of trichinellosis occured in Rožňava district east Slovakia during spring in 2008. Ten members of farmer’s family and their relatives got ill while processing meat from home-made pig-slaughter for meals and meat products intended for wedding dinner. During the meat processing all of them tasted raw meat. Moreover, another 45 persons were exposed to this infection by eating heat-treated meat products. The most common predominant clinical signs were: myalgias, fever, fatigue, exanthema and periorbital oedema. On the 40th day after infection there were intermediate to high titres of trichinella IgG antibodies detected (10 patients), high levels of eosinophilia (10 patients) with maximum of 6.76 × 109/l (55 %) and profound changes in selected laboratory parameters: decreased levels of total proteins, increased levels of alpha 1-globulin and C reactive protein. Presence of IgG antibodies as well as aforementioned laboratory parameters was important markers of trichinellosis in our study, whereas other laboratory changes (leukocytosis, high levels of activity lactate dehydrogenase and creatine kinase) were detected only in few hospitalized patients.
This paper reviews the Case-based reasoning (CBR) approach and its usability in the medicine and presents a new concept on how to improve its adaptation phase. We use the CBR as a supporting method for decision support like diseases diagnostics or therapy identification. We investigated existing approaches, studies, and research works to solve one of the most critical problems in the CBR cycle -adaptation, which is often done manually by the experts in the relevant field. Based on the findings and our experiences with medical diagnostics through suitable data analytical methods, we proposed a new solution to solve this challenge. This approach is based on a comparison of the stored decision rules with the new one related to the current case. This comparison can result in three alternative states: (1) case base contains a similar case, and relevant rule can be applied. (2) The new case is very different from the stored ones, so the input from participated experts is needed, and a new rule will be stored. (3) The new case is partially similar satisfying adaptability conditions, in such a situation we adopt related decision rule to the new conditions under the supervision of the expert. We plan to experimentally test and verify this concept within available medical samples from our previous experiments.
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