Anatomic Veterinary Usage: Discussion Around Technical Nomenclature Vs. Jargon.

This article discusses some examples of problems derived from the mix of technical jargon and anatomical veterinary words and makes recommendations regarding their use according to specific situations.

Pregnancy planning and outcomes in patients with multiple sclerosis after mitoxantrone therapy: a monocentre assessment.

BACKGROUND AND PURPOSE: Patients with multiple sclerosis (MS) have many pregnancy-related doubts and fears. Careful counselling is thus important. Mitoxantrone (MITO) is used in patients with aggressive MS and may affect reproductive capacity. The aim of this study was to investigate pregnancy planning and outcomes in patients with MS treated with MITO, both before and after the treatment. METHODS: Patients with MS previously treated with MITO were recruited. Clinical, demographic and treatment data were recorded. A questionnaire regarding the planning and outcomes of all pregnancies was administered. Parametric and non-parametric tests were performed using SPSS 22 software. RESULTS: A total of 238 patients (female/male, 158/80) were included; 106 subjects planned a pregnancy before MITO and 40 after MITO. Of these, respectively, 102 (97%) and 35 (85%) resulted in conception, 19 (19%) and 7 (18%) in miscarriage, 6 (6%) and 1 (3%) in abortion and 98 (96%) and 32 (91%) were full-term pregnancies. A total of 96 patients (40%) planned a pregnancy only before MITO (and not after), whereas 30 (13%) planned a pregnancy only after MITO (and not before) (P < 0.01). A total of 103 patients did not plan a pregnancy before MITO and 198 did not plan a pregnancy after MITO. The reasons included lack of interest or a partner, fear of MS and infertility. All of the babies born were healthy until the end of follow-up. CONCLUSIONS: Mitoxantrone does not affect the ability to conceive or pregnancy outcomes. We found no differences in pregnancies, abortions or miscarriages before and after MITO. The tendency to plan pregnancies decreased significantly after MITO. Our findings may be useful for improving the quality of life of patients and the approach taken by neurologists.

Elliptical Fourier descriptors of outline and morphological analysis in caudal view of foramen magnum of the tropical raccoon (Procyon cancrivorus) (Linnaeus, 1758).

OBJECTIVES: To evaluate sexual-size dimorphism and attempt at categorization of inter-individual shapes of foramen magnum outlines using Fourier descriptors which allow for shape outline evaluations with a resultant specimen character definition. MATERIALS AND METHODS: Individual characterization and quantification of foramen magnum shapes in direct caudal view based on elliptical Fourier technique was applied to 46 tropical raccoon skulls (26 females, 20 males). RESULTS: Incremental number of harmonics demonstrates morphological contributions of such descriptors with their relations to specific anatomical constructions established. The initial harmonics (1st to 3rd) described the general foramen shapes while the second (4th to 12th) demonstrated fine morphological details. Sexual-size dimorphism was observed in females (87.1%) and 91.7% in males, normalization of size produces 75% in females and 83% in males. With respect to foramen magnum dimorphism analysis, the result obtained through elliptic Fourier analysis was comparatively better in detail information of outline contours than earlier classical methods. The first four effective principal components defined 70.63% of its shape properties while the rest (22.51%) constituted fine details of morphology. CONCLUSION: Both size and shape seems important in sexual dimorphisms in this species, this investigation suggest clinical implications, taxonomic and anthropologic perspectives in foramen characterization magnum characterization and further postulates an increased possibility of volume reduction cerebellar protrusion, ontogenic magnum shape irregularities in the sample population with neurologic consequences especially among females.

The use of an antioxidant dressing on hard-to-heal wounds: a multicentre, prospective case series.

OBJECTIVE: Oxidative stress can contribute to impaired wound healing and chronic wounds. Our objective was to test the results of a new antioxidant dressing that could help stop the oxidative stress of cells in the wound bed. METHOD: A multicentre, prospective case study series was conducted in three Spanish hospitals. The RESVECH 2.0 index was used for healing assessment. Data from each patient was collected by the attending clinical researchers. Data analysis was performed using the statistical concept intention-to-treat (ITT). Descriptive results were presented as frequency and percentages for qualitative variables and mean, standard deviation (SD), range and median for quantitative variables. For analytical-inferential analyses, incidence of healing was calculated for chronic and acute wounds. Relative risk (RR) was used to establish the differences of healing between both types of wounds. Healing was represented by Kaplan-Meier survival curves, and these were compared using the log-rank test. RESULTS: A total of 31 patients with hard-to-heal wounds were recruited. During the 8-week follow-up period, nine wounds (29%) completely healed, of which seven (77.8%) were acute and two (22.2%) chronic. The remaining wounds (22) showed a significant improvement after treatment with the antioxidant dressing. RESVECH 2.0 scores decreased an average of 10.16 points over the 8-week period. CONCLUSION: The antioxidant dressing could represent an alternative in the dressing landscape for many types of acute and chronic wounds.

Classification of dependence-related skin lesions: a new proposal.

A new theoretical framework on the development of pressure ulcers and other dependence-related lesions requires continued in-depth analysis of their conceptual bases. This study reports the historical background, definitions, and production mechanisms of these lesions, describing the differential pathognomonic features of pressure and/or shear ulcers, moisture-associated skin damage, and lesions from rubbing or friction. It also discusses the combined/multifactorial lesions that can be found in the clinical setting. Finally, it presents the new classification of these lesions proposed by the Spanish Pressure Ulcers and Chronic Wounds Advisory Panel.

An analysis of sexual size dimorphism in goose.

1. Sexual size dimorphism (SSD) is a common phenomenon in animals. Rensch's rule states that larger species generally exhibit a higher male to female body size ratio than smaller ones. 2. Domesticated animals offer excellent opportunities for testing predictions of the functional explanations of Rensch's rule and this was tested in a meta-analysis of SSD in 38 breeds of domestic geese compared among themselves and with their wild relatives (subfamily Anserinae, 35 species). 3. Domestic geese and wild Anser species taken together supported Rench's rule but the wild species did not. 4. The non-targeted sex selection hypothesis seems to provide the best intuitive explanation for the lack of SSD in geese.

Activated Carbon Modifications for Heterogeneous Fenton-Like Catalysis.

The effective and efficient degradation of persistent, recalcitrant pollutants by advanced oxidation processes is vital to both reduce hazardous waste and remediate polluted waters. One such advanced oxidation process is the use of Fenton chemistry, which can be optimized using heterogeneous catalysts. However, to make this AOP viable over conventional treatment methods, the technology needs to be optimized from both a technical and economic standpoint. From a heterogeneous catalyst optimization perspective, varying the surface chemistry of activated carbon and impregnating or doping with Fenton-like catalytic nanomaterials removes precipitation complications associated with traditional iron species in Fenton chemistry while generating effective amounts of highly oxidative hydroxyl radicals. Utilizing various techniques to synthesize heterogeneous catalysts with activated carbon as a backbone, in the presence of H2O2 the formation of hydroxyl radicals and removal of benzoic acid is tested. Comparing various additives, raw activated carbon impregnated with 5% MnO2 in the presence of H2O2 realized a high concentration of hydroxyl radical formation while maintaining low cost and relative ease of synthesis. This AC-Mn5 catalyst performed effectively in varying concentrations of H2O2, utilizing various synthesis techniques, after simulated aging of the catalyst structure, and over a wide pH range with the highest radical formation at acidic pH values. Utilizing this catalytic material as a substitute for iron species associated with traditional Fenton technology, the goal of designing a full set of oxidation functions towards persistent, recalcitrant pollutant removal while maintaining cost-effectiveness and scalability is proposed. It is anticipated these catalytic materials are effective to eliminate analogous contaminants and mixtures.

Lesion-associated microglia and macrophages mediate corralling and react with massive phagocytosis for debris clearance and wound healing after LPS-induced dopaminergic depletion.

Neuroinflammation contributes to neuronal degeneration in Parkinson's disease (PD). However, how brain inflammatory factors mediate the progression of neurodegeneration is still poorly understood. Experimental models of PD have shed light on the understanding of this phenomenon, but the exploration of inflammation-driven models is necessary to better characterize this aspect of the disorder. The use of lipopolysaccharide (LPS) to induce a neuroinflammation-mediated neuronal loss is useful to induce reliable elimination of dopaminergic neurons. Nevertheless, how this model parallels the PD-like neuroinflammation is uncertain. In the present work, we used the direct LPS injection as a model inductor to eliminate dopaminergic neurons of the substantia nigra pars compacta (SNpc) in rats and reevaluated the inflammatory reaction. High-resolution 3D histological examination revealed that, although LPS induced a reliable elimination of SNpc dopaminergic neurons, it also generated a massive inflammatory response. This inflammation-mediated injury was characterized by corralling, a damaged parenchyma occupied by a vast population of lesion-associated microglia and macrophages (LAMMs) undertaking wound compaction and scar formation, surrounded by highly reactive astrocytes. LAMMs tiled the entire lesion and engaged in long-standing phagocytic activity to resolve the injury. Additionally, modeling LPS inflammation in a cell culture system helped to understand the role of phagocytosis and cytotoxicity in the initial phases of dopaminergic degeneration and indicated that LAMM-mediated toxicity and phagocytosis coexist during LPS-mediated dopaminergic elimination. However, this type of severe inflammatory-mediated injury, and subsequent resolution appear to be different from the ageing-related PD scenario where the architectural structure of the parenchyma is mostly preserved. Thus, the necessity to explore new experimental models to properly mimic the inflammatory compound observed in PD degeneration.

Effects of the cyclin-dependent kinase inhibitor R-roscovitine on eosinophil survival and clearance.

BACKGROUND: Eosinophils are pro-inflammatory cells implicated in the pathogenesis of asthma and atopy. Apoptosis has been proposed as a potential mechanism underlying the resolution of eosinophilic inflammation and studies have indicated the ability of interventions that induce human eosinophil apoptosis to promote the resolution of eosinophilic inflammation. Recently, the cyclin-dependent kinase (CDK) inhibitor R-roscovitine was shown to enhance neutrophil apoptosis and promote the resolution of neutrophilic inflammation. OBJECTIVE: The purpose of this study was to examine the expression of CDKs in human blood eosinophils, the effects of R-roscovitine on eosinophil survival in vitro and whether R-roscovitine could influence eosinophilic lung inflammation in vivo. METHODS: Eosinophils were isolated from human peripheral blood and the effects of R-roscovitine on apoptosis, degranulation and phagocytic uptake examined in vitro. The effects of R-roscovitine on eosinophilic lung inflammation in vivo were also assessed using an ovalbumin mouse model. RESULTS: Our data demonstrate that human eosinophils express five known targets for R-roscovitine: CDK1, -2, -5, -7 and -9. R-roscovitine induced eosinophil apoptosis in a time- and concentration-dependent manner but also accelerated transition to secondary necrosis as assessed by microscopy, flow cytometry and caspase activation. In addition, we show that R-roscovitine can override the anti-apoptotic signals of GM-CSF and IL-5. We report that the pro-apoptotic effect of R-roscovitine is associated with suppression of Mcl-1L expression and that this compound enhanced phagocytic clearance of eosinophils by macrophages. Finally, we show that R-roscovitine induces apoptosis in murine peripheral blood and spleen-derived eosinophils; despite this, R-roscovitine did not modulate the tissue and lumen eosinophilia characteristic of the ovalbumin mouse model of airway eosinophilia. CONCLUSION AND CLINICAL RELEVANCE: These data demonstrate that R-roscovitine is capable of inducing rapid apoptosis and secondary necrosis in eosinophils but does not affect the onset or improve the resolution of eosinophilic airway inflammation in vivo.

[Eclipse retinopathy: three case reports]. / Retinopatía por eclipse. A propósito de tres casos.

CASE REPORT: We present the evolution of eclipse retinopathy in 3 patients who came to our hospital after the eclipse of October 2005 and had foveal lesions and visual field alterations. DISCUSSION: Eclipse retinopathy is a maculopathy that occurs after exposure to intense solar radiation, such as occurs during an eclipse, and is produced by a photochemical mechanism. Although the macular changes and symptoms are usually reversible, residual defects at the level of the EPR and scotoma in visual fields can occur. For these reasons the most appropriate treatment is prevention by means of public awareness campaigns.

Elliptic Fourier Analysis in the Study of the Male Genitalia to Discriminate Three Macrolophus Species (Hemiptera: Miridae).

Within the genus Macrolophus (Heteroptera: Miridae), the species M. costalis (Fieber), M. melanotoma (Costa) and M. pygmaeus (Rambur) are present in the Mediterranean region on a wide variety of plant species. While M. costalis can easily be separated from the other two by the black tip at the scutellum, M. pygmaeus and M. melanotoma are cryptic species, extremely similar to one another in external traits, which has resulted in misidentifications. M. pygmaeus is an efficient biological control agent, both in greenhouse and field crops. The misidentification of these cryptic species could limit the effectiveness of biological control programs. Although the morphology of the left paramere of the male genitalia has been used as a character for identification of these two cryptic species, there is controversy surrounding the reliability of this character as a taxonomic tool for these species. Using geometric morphometric techniques, which are a powerful approach in detecting slight shape variations, the left parameres from these three Macrolophus species were compared. The paramere of M. costalis was larger and had a different shape to that of M. melanotoma and M. pygmaeus; however, no differences in size or shape were found between the left paramere of M. melanotoma and that of M. pygmaeus. Therefore, our results confirm that this character is too similar and it cannot be used to discriminate between these two cryptic species.

Diferente asimetría craneal según sexo en el conejo toy / Different skull asymmetry according to sex in toy rabbits

RESUMEN: Los conejos denominados toy son seleccionados por su apariencia pedomórfica ('infantilizada'). El objetivo principal de este estudio fue analizar las asimetrías craneales en este tipo de conejo. Para ello, se estudiaron un total de 46 cráneos adultos (9 machos y 37 hembras), recurriéndose a técnicas de morfométrica geométrica a partir 10 hitos anatómicos pareados y 3 en el plano sagital, en la cara dorsal del cráneo. Nuestra hipótesis es que a través de la selección artificial en los machos (objetivo principal para la obtención de nuevos fenotipos) las asimetrías se expresarán como valores de asimetría más altos. El tamaño de los cráneos resultó similar entre ambos sexos, pero presentaban la asimetría fluctuante fue mayor en machos. La asimetría fluctuante se considera un indicador negativo de la capacidad de resistir pequeñas anomalías en su desarrollo, anomalías que son generalmente el resultado de estrés genético o ambiental. En otras palabras, los machos estarían sujetos a una selección más fuerte y, en consecuencia, se verían más afectados por el manejo, en comparación con las hembras. Estos resultados pueden facilitar la comprensión de los patrones y procesos subyacentes al dimorfismo sexual en fenotipos extremos, como lo son los de los conejos toy.

SUMMARY: Toy rabbits are selected for their paedomorphic ('babyish') appearance. The main objective of this study is to analyse the skull asymmetries of toy rabbits. For this purpose, a total of 46 adult skulls (9 males and 37 females) were studied. Geometric morphometric technique with five pairs of anatomical landmarks and three on sagittal plane on dorsal aspect of skull was used. Our hypothesis is that through artificial selection on males (which are the main subject for obtaining new phenotypes among toys) asymmetries will be expressed as higher asymmetrical values. Skulls' size was similar between sexes, but males presented a higher level of fluctuating asymmetry. Fluctuating asymmetry indicates a negative ability to buffer subtle developmental anomalies, normally from genetic or environmental origin. In other words, males would be under stronger directed selection and consequently be more affected by management (including selective) factors compared to females. These results can allow a better understanding of the patterns and processes underlying sexual shape dimorphism, especially with extreme phenotypes, as toy rabbits are.

Horse choanae are directionally asymmetric / Las coanas de los caballos son direccionalmente asimétricas

SUMMARY: Studies related to the upper respiratory pathway asymmetries are still scarce in the veterinary literature. We present here a study of choanae asymmetries of a pure horses belonging to "Cavall Pirinenc Català" (Pyrenean Horse Breed). For this goal, the palates of 23 dry skulls with no apparent pathologies were photographed and evaluated using geometric morphometrics. On each photo, we identified and digitized a total of 26 points (subset of 2 mid-sagittal, 4 paired landmarks (discrete homologous points) and 10 semilandmarks (points on an outline determined by extrinsic criteria) per side on the choana. Both fluctuating and directional asymmetries appeared statistically significant, the latter accounting more than half of the total variation. The lateral bend observed in horse choanae may be due to the asymmetrically positioned nasal passages. So detected equine choana asymmetry must rather be considered functional, with no clinical implication and presents an important consideration when equine choanae shape.

RESUMEN: Los estudios relacionados con las asimetrías de las vías respiratorias superiores aún son escasos en la literatura veterinaria. Presentamos un estudio de coanas asimetrías de un caballo puro perteneciente al "Cavall Pirinenc Català" (Raza del Caballo de los Pirineos). Para ello, se fotografiaron y evaluaron los paladares de 23 cráneos secos sin patologías aparentes mediante morfometría geométrica. En cada foto, identificamos y digitalizamos un total de 26 puntos (subconjunto de 2 puntos medio sagitales, 4 puntos de referencia emparejados (puntos homólogos discretos) y 10 puntos semillanos (puntos en un contorno determinado por criterios extrínsecos) por lado de la coana. Ambos fluctúan Las asimetrías direccionales aparecieron estadísticamente significativas, representando estas últimas más de la mitad de la variación total. La curvatura lateral observada en las coanas de caballo puede deberse a los conductos nasales asimétricamente posicionados. Por lo tanto, la asimetría de coanas equinas detectada debería considerarse funcional, sin implicación clínica y presenta una importante consideración cuando se forman coanas equinas.

Inhibition of E. coli and S. aureus with selenium nanoparticles synthesized by pulsed laser ablation in deionized water.

Nosocomial diseases are mainly caused by two common pathogens, Escherichia coli and Staphylococcus aureus, which are becoming more and more resistant to conventional antibiotics. Therefore, it is becoming increasingly necessary to find other alternative treatments than commonly utilized drugs. A promising strategy is to use nanomaterials such as selenium nanoparticles. However, the ability to produce nanoparticles free of any contamination is very challenging, especially for nano-medical applications. This paper reports the successful synthesis of pure selenium nanoparticles by laser ablation in water and determines the minimal concentration required for ~50% inhibition of either E. coli or S. aureus after 24 hours to be at least ~50 ppm. Total inhibition of E. coli and S. aureus is expected to occur at 107±12 and 79±4 ppm, respectively. In this manner, this study reports for the first time an easy synthesis process for creating pure selenium to inhibit bacterial growth.

Sustained and complete hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) degradation in zero-valent iron simulated barriers under different microbial conditions.

Flow-through columns packed with "aged" zero-valent iron (ZVI) between layers of soil and sand were constructed to mimic a one-dimensional permeable reactive iron barrier (PRB). The columns were continuously fed RDX (hexahydro-1,3,5-trinitro-1,3,5-triazine, ca. 18 mg l(-1)) for over one year. Two columns were bioaugmented with dissimilatory iron reducing bacteria (DIRB) Shewanella algae BrY or Geobacter metallireducens GS-15 to investigate their potential to enhance the reactivity of aged iron by reductive dissolution of passivating iron oxides or via production of biogenic reactive minerals. A third column was not bioaugmented to evaluate colonization by indigenous soil microorganisms. [14C]-RDX was completely removed in all columns at the start of the iron layer, and concentration profiles showed rapid and sustainable RDX removal over one year; however, a phylogenetic profile conducted after one year using DGGE analysis of recovered DNA did not detect S. algae BrY or G. metallireducens in their respective columns. Bacterial DNA was recovered from within the ZVI. Several unidentified 14C-labeled byproducts were present in the effluent of all columns. Dissolved 14C removal and the detection of dissolved inorganic 14C in these columns (but not in the sterile control) suggest microbial-mediated mineralization of RDX and sorption/precipitation of degradation products. Enhanced RDX mineralization in bioaugmented columns was temporary relative to the indigenously colonized column. However, shorter acclimation periods associated with bioaugmented PRBs may be desirable for rapid RDX mineralization, thereby preventing breakthrough of potentially undesirable byproducts. Overall, these results show that high RDX removal efficiency by ZVI-PRBs is achievable and sustainable and that the efficacy and start-up of ZVI-PRBs might be enhanced by bioaugmentation.

Ultrastructural and enzyme histochemical study of ovarian hilar cells in women and their relationships with sympathetic nerves.

The ultrastructure of normal ovarian hilar cells, both during the reproductive era and after the menopause, shows evidence of steroid hormone synthesis. In this respect these cells are very similar to Leydig cells in that they contain mitochondria with a dense matrix, a highly developed smooth endoplasmic reticulum, Reinke crystals, and microcystalline inclusions. The latter are much more numerous than in the normal testis. Their enzymatic activities are quite similar to those of Leydig cells. Ovarian hilar cells seem to originate from progressive metamorphosis of fibroblastic cells under the induction of sympathetic nervous structures. Their relations with hilar nerves are of three types: simple direct membrane contact without a Schwann cell sheath, intimate intracytoplasmic relationships, and specialized contacts, which are comparable to a synapse.

Intraoperative ultrasonography in surgery for liver tumors.

Intraoperative ultrasonography was used in 37 patients during surgery for suspected liver tumors. The size, number, and site of the lesions were determined together with the relationship of the tumor to the intrahepatic vessel, as well as possible small daughter lesions within the liver. Final diagnosis in these patients was hepatocellular carcinoma in 19 cases, metastases from colorectal cancers in 15 cases, and benign lesions in three cases. Previously undetected small tumors were revealed in one patient with sigmoid cancer and in five patients with liver cell carcinoma who had cirrhosis. Vascular tumoral infiltrations were easily displayed and the surgical approach modified accordingly: a more extended resection was performed in two cases of huge central hepatic metastases. Intraoperative ultrasonography revealed seven cases of small (2 to 3 cm) hepatocellular carcinomas in cirrhotic livers that were not visible or palpable, thus allowing a subsegmentary resection. Finally, in three cases of atypical tumors, an intraoperative echo-guided biopsy specimen was required to establish the benign nature of lesions and resection was avoided. Intraoperative ultrasonography facilitates the diagnosis of small liver tumors and can also aid the surgeon in his choice of technique, especially in cases of cirrhosis of the liver. A resection can be avoided altogether when multiple lesions are involved, or echo-guided subsegmentary resections can be performed in cirrhotic livers when a less extended resection is required. This technique makes it possible to establish the relationship between the tumor and intrahepatic vessels, thus preventing vascular injury and making radical hepatic resection safer.

Ultrasonographic study of portal venous system in portal hypertension and after portosystemic shunt operations.

One hundred sixty patients with portal hypertension were examined by means of ultrasonography in order to evaluate the sensitivity of this technique in the diagnosis of intrahepatic portal hypertension and in the detection of portal vein thrombosis. Thirty-eight of these patients were selected for a portosystemic shunt and were reexamined after operation to assess the value of ultrasonography as a screening test for the patency of surgical portosystemic shunts. In patients with intrahepatic portal hypertension the main ultrasonographic findings observed were dilatation of the portal trunk of more than 1.3 cm (56.6% of cases), patency and dilatation of the umbilical vein (5.8%), presence of intra-abdominal collateral vessels (11.6%), splenomegaly with dilatation of splenic vein radicles at the hilus (91.3%), and disappearance of normal caliber variations during respiration in splenic or mesenteric veins (78.5% and 88.4%, respectively). The disappearance of normal caliber variations proved a highly specific and sensitive finding. Partial or total occlusion of the portal trunk was observed at ultrasonography in 19 of 21 (90.5%) patients with portal vein thrombosis. Surgical portosystemic shunts were displayed in 28 of 37 patients (75.7%). Ultrasonography seems to be the most important noninvasive tool in the diagnosis of portal hypertension. In patients selected for surgical portosystemic shunts ultrasonography supplies morphologic data regarding liver parenchyma and abdominal vascular anatomy, and it should be performed as a routine screening test for assessment of surgical shunt patency.

Mediterranean spotted fever: clinical, laboratory and epidemiological features of 199 cases.

Most previous studies of Mediterranean spotted fever (MSF) have included cases that either were not laboratory-confirmed or were confirmed by the Weil-Felix test. The authors report the detailed clinical, laboratory and epidemiological features of 199 serologically-confirmed cases of MSF (by microimmunofluorescence). This work demonstrates that the disease is difficult to diagnose, especially at the beginning; that it can be fatal (2.5% of cases); and that a rapid and specific diagnosis is necessary to identify atypical cases. Epidemiological features such as season (summer essentially), presence of a dog, and travel in an endemic area (the Mediterranean Basin) are important in the diagnosis. In such cases fever associated with rash have to be considered and treated as MSF.

Haemolysis with Mediterranean spotted fever and glucose-6-phosphate dehydrogenase deficiency.

Mediterranean spotted fever with haemolysis is reported in a glucose-6-phosphate dehydrogenase deficient Algerian man. The clinical course was unusually severe for a 27-year-old patient. The authors suspect G6PD deficiency to be a cause of enhanced severity in Mediterranean spotted fever as well as in other rickettsioses.