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Leishmania and tularemia are infectious diseases that both can present with lymphadenopathy. Leishmania typically causes visceral or cutaneous forms, while tularemia can result in glandular tularemia characterized by lymphadenitis. We report a case of a patient presenting with localized cervical lymphadenopathy diagnosed with both leishmaniasis and tularemia. This case underscores the importance of considering both pathogenic agents in the differential diagnosis of localized lymphadenitis. Early treatment is crucial to prevent the dissemination of these infections.
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INTRODUCTION: Despite the reported cases of whooping cough in Armenia, there has been no formal evaluation of "who these cases are and their load on hospital wards". In a tertiary reference hospital, we determined the trend in hospitalized pertussis cases stratified by vaccination status and risk factors associated with apnea and hospital stay. METHODOLOGY: Retrospective cohort study of children (< 18 years) with confirmed pertussis hospitalized at the Republican Infectious Diseases Hospital between 2014 and 2018. Multivariate logistic regression was used to identify risk factors. RESULTS: The majority (62%) of 116 children (44% female, mean age 21 months) were from regions outside the capital city of Yerevan. Standardized pertussis admissions increased by almost fivefold, from 2.2/1,000 in 2014 to 10.6/1,000 in 2018. The cumulative average percentage (2014-2018) of children not vaccinated against pertussis was 33%, while 29% were completely vaccinated. Twenty-five children (21%) had apnea, two of whom died. Younger age (Odds Ratio (OR) = 1.04; P = 0.05), not having been vaccinated (OR = 3.57; P = 0.01) and having comorbidities (OR = 4.1; P = 0.09) were associated with apnea. After adjusting for age, the longer hospital stay (>8 days) was significantly associated with non-vaccination (OR = 5.0, P = 0.002). CONCLUSIONS: There is a progressive increase in rate of hospital admissions for pertussis meriting closer vigilance on a national scale. Unvaccinated children of younger age are predisposed to apnea and longer hospitalization and would benefit from early referral to specialized infectious units. This may improve clinical outcomes and reduce hospital burden.
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Tos Ferina/epidemiología , Adolescente , Armenia/epidemiología , Niño , Preescolar , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Vacuna contra la Tos Ferina/administración & dosificación , Estudios Retrospectivos , Factores de Riesgo , Centros de Atención Terciaria , Cobertura de Vacunación/estadística & datos numéricosRESUMEN
The use of water as a donor for hydrogen suitable for the reduction of several important classes of organic compounds is described. It is found that the reductive water splitting can be promoted by several metalloids among which silicon shows the best efficiency. The developed methodologies were applied for the reduction of nitro compounds, N-oxides, sulfoxides, alkenes, alkynes, hydrodehalogenation as well as for the gram-scale synthesis of several substrates of industrial importance.
RESUMEN
Pd- or Ni-catalyzed C-H arylation of 4-nitroimidazole derivatives directed by a manipulable nitro group was developed. The reaction tolerates a wide range of substituted aryl halides and 4-nitroimidazoles. The experiments indicated that the nitro group has influence on regioselectivity of the reaction. In addition, we have shown that the efficiency of the Suzuki-Miyaura cross-coupling reaction of nitroimidazoles is slightly lower in comparison to the direct C-H arylation. The exploration of the chemical potential of the nitro group and a putative reaction mechanism are discussed.