[Infrasound - implications for human medicine]. / Infraschall ­ humanmedizinische Implikationen.

Infrasound describes ubiquitous, low-frequency sound (< 20 Hz) in the environment with a long wavelength below the median hearing threshold, which can nevertheless be heard and tactilely perceived, depending on the sound pressure level and frequency spectrum. In nature, infrasound emissions usually occur only in the low-threshold range. Nevertheless, after strong and chronic exposure to usually artificially generated infrasound emissions, various effects on the ear and the body, sometimes questionably critical to health, can be observed. Correct measurement and assessment of infrasound sources is complex and controversial. Established guidelines are scarce. Innovative research areas include infrasound monitoring for evaluation of natural events and infrasound applications in medicine. In the future, it is hoped that new insights will be gained from infrasound research and that a more extensive classification in occupational medicine will be possible.

The potential impact of an implementation of microalgae-based wastewater treatment on the energy balance of a municipal wastewater treatment plant in Central europe.

Integration of a photobioreactor for WWT by microalgae is calculated as a future alternative for cost-efficient and environmentally-friendly nutrient removal for municipal WWTPs. High growth rates and higher biogas yields (compared to conventional sewage sludge) of algal biomass can significantly improve WWTP energy balances. This study focuses on temperate climate zones with changing seasons and discusses energy potential of microalgae-enhanced wastewater treatment for an existing WWTP (32,000 PE) in Central Germany. For WWTP-dimensioning and determination of energy-rich biomasses for anaerobic digestion and CHP, actual influent load data was used and calculation was carried out according to valid regulations. Algae growth figures are based on pilot-scale test series from Germany and correspond to the relevant climatic and local process conditions. Computed results show a shift in the energy balance from a current energy demand of 662,173kWh a-1 to an energy production of approx. 1,9MWhel. a-1 and 1 MWhth. a-1.

A fatal case of Lassa fever in London, January 2009.

In January 2009, the eleventh [corrected] case of Lassa fever imported to the United Kingdom was diagnosed in London. Risk assessment of 328 healthcare contacts with potential direct exposure to Lassa virus - through contact with the case or exposure to bodily fluids - was undertaken. No contacts were assessed to be at high risk of infection and no secondary clinical cases identified.

Investigations and control measures following a case of inhalation anthrax in East London in a drum maker and drummer, October 2008.

The patient is believed to have acquired the infection from making animal hide drums. Environmental investigations identified one drum and two pieces of animal skins contaminated with anthrax spores.

Leptospirosis pulmonary haemorrhage: a diagnostic challenge.

Leptospirosis is a re-emerging zoonosis with worldwide distribution. Antibiotic treatment is available, but leptospirosis is rarely suspected due to the non-specific clinical presentation, and is also underreported due to the difficulty in confirming the diagnosis. The syndrome of leptospirosis pulmonary haemorrhage is increasingly described; it is severe and can present without the classical manifestations of Weil's disease. We discuss two cases of leptospirosis with pulmonary haemorrhage; both our patients experienced a dramatic deterioration hours after their admission, and required emergency intubation and intensive therapy unit support. Massive haemoptysis is a life threatening complication of leptospirosis, even outside tropical areas.

Life-threatening necrotizing fasciitis of the neck: an unusual consequence of a sore throat.

BACKGROUND: Necrotizing fasciitis is life-threatening bacterial infection which spreads with frightening speed along the fascial planes resulting in extensive tissue necrosis and often death. The infection is caused by either Group A streptococci or a combination of aerobic and anaerobic bacteria. Necrotizing fasciitis of the neck is rare and commonly has a dental origin. CASE REPORT: Here we present a unique case of the condition that was preceded by a sore throat in a young immunocompetent woman. We also describe, for the first time, a successful outcome involving primary skin closure and daily irrigation of the wound with hydrogen peroxide.

Bloodstream infection due to Acinetobacter spp: epidemiology, risk factors and impact of multi-drug resistance.

Acinetobacter spp. are increasingly reported as important causes of human infection. Many isolates exhibit multi-drug resistance, raising concerns over our ability to treat serious infections with these organisms. The impact of infection on clinical outcome as well as the importance of multi-drug resistance is poorly defined. A descriptive retrospective observational study was undertaken of all episodes of Acinetobacter bacteremia occurring in a UK tertiary care centre from 1998-2006. Demographics of infected patients, characteristics and antimicrobial susceptibility of infecting strains were recorded and the impact of antimicrobial therapy on all causes of 30-day mortality assessed. Three hundred ninety-nine episodes of Acinetobacter bacteremia were identified, with A. baumannii being the most frequently isolated species. Most episodes occurred in critical care and were associated with multidrug resistance, with carbapenem resistance rising from 0% in 1998 to 55% in 2006. Although bacteremia due to carbapenem-resistant Acinetobacter and a requirement for critical care were associated with a higher mortality, mortality was not reduced by the administration of appropriate empirical antimicrobial therapy. A prospective study is required to identify both the most effective intervention and those most likely to benefit from treatment.