RESUMEN
We present a case of East-African trypanosomiasis (EAT) in a 56-year-old Dutch woman returning from holiday in Tanzania and Kenya. The diagnosis was delayed due to the lack of suspicion and secondly because of postponed analysis of blood microscopy after negative rapid malaria antigen testing. Second stage trypanosomiasis was ruled out with liquor analysis. She was treated first with pentamidine and shortly thereafter with suramin, after which she recovered. We emphasize the use of thin/thick smear diagnostics in travellers returning from endemic countries.
Asunto(s)
Diagnóstico Tardío , Viaje , Trypanosoma/aislamiento & purificación , Tripanosomiasis Africana/diagnóstico , Tripanosomiasis Africana/tratamiento farmacológico , Animales , Diagnóstico Diferencial , Femenino , Humanos , Kenia , Malaria , Persona de Mediana Edad , Países Bajos , Pentamidina/administración & dosificación , Suramina/administración & dosificación , Tanzanía , Trypanosoma/genéticaRESUMEN
Families predisposed to longevity show enhanced glucose tolerance and skeletal muscle insulin sensitivity compared with controls, independent of body composition and physical activity. Intramyocellular lipid (IMCL) accumulation in skeletal muscle has been associated with insulin resistance. Here, we assessed whether subjects enriched for familial longevity have lower IMCL levels. We determined IMCL levels in 48 subjects from the Leiden Longevity Study, comprising 24 offspring of nonagenarian siblings and 24 partners thereof as control subjects. IMCL levels were assessed noninvasively using short echo time proton magnetic resonance spectroscopy ((1)H-MRS) of the tibialis anterior muscle with a 7 Tesla human MR scanner. IMCL levels were calculated relative to the total creatine (tCr) CH3 signal. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). After correction for age, sex, BMI, and physical activity, offspring of long-lived nonagenarian siblings tended to show lower IMCL levels compared with controls (IMCL/tCr: 3.1 ± 0.5 vs. 4.5 ± 0.5, respectively, P = 0.051). In a pairwise comparison, this difference reached statistical significance (P = 0.038). We conclude that offspring of nonagenarian siblings predisposed to longevity show lower IMCL levels compared with environmentally matched control subjects. Future research should focus on assessing what mechanisms may explain the lower IMCL levels in familial longevity.
Asunto(s)
Salud de la Familia , Metabolismo de los Lípidos , Longevidad , Fibras Musculares Esqueléticas/metabolismo , Hijos Adultos , Anciano , Índice de Masa Corporal , Estudios de Cohortes , Femenino , Humanos , Resistencia a la Insulina , Pierna , Espectroscopía de Resonancia Magnética , Masculino , Análisis por Apareamiento , Persona de Mediana Edad , Actividad Motora , Países Bajos , Hermanos , Encuestas y CuestionariosRESUMEN
Haemophagocytic syndrome is a rare and life-threatening disease, which often goes unrecognised in adults, with high mortality as a consequence. Here we present two adult patients who were diagnosed with haemophagocytosis of distinct underlying causes which, despite treatment, led to fatal outcomes. Measuring ferritin is an easy and cheap resource in diagnosis.