Alveolar echinococcosis is one of the most important lethal zoonotic helminth infections in the northern hemisphere. Currently, the threat to public health is increasing, as evidenced by the rising prevalence rate of alveolar echinococcosis, as well as the invasion of urban areas by infected wild foxes. This threat is further increased due to the involvement of pet dogs, and probably cats, as emerging sources of infection. These increased threats to public health also have associated economic risks; therefore, there is a need for effective and sustainable methods of control. In this paper, initiatives to control alveolar echinococcosis by targeting its definitive hosts through anthelmintic baiting campaigns initiated by local residents who used local resources for bait production, distribution and collection of fecal samples for diagnosis are described. Further, when such distribution programs are coupled with the use of GIS-based maps, the optimum distribution of bait was obtained. These programs have also included the use of intravital diagnostic analyses of infection rates, which have been overseen by the Forum on Environment and Animals (FEA), and also allowed a nationwide monitoring of echinococcosis in difinitive hosts. In addition, a government initiative requiring mandatory reporting of echinococcosis in dogs to health authorities was recently initiated in Japan. Overall, the results of this study have shown that use of collaborative control initiatives targeting zoonotic agents of alveolar echinococcosis can be an effective method for reducing the threat of lethal echinococcosis in the northern hemisphere.
Animals ; Anthelmintics/economics/therapeutic use ; Echinococcosis, Hepatic/drug therapy/epidemiology/*parasitology/*prevention & control ; Echinococcus/*physiology ; Government Programs ; Humans ; Public Health/methods ; *Zoonoses/epidemiology/parasitology

STUDY DESIGN: Retrospective case series. PURPOSE: To elucidate the impact of postoperative occiput-C2 (O-C2) angle change on subaxial cervical alignment. OVERVIEW OF LITERATURE: In the case of occipito-upper cervical fixation surgery, it is recommended that the O-C2 angle should be set larger than the preoperative value postoperatively. METHODS: The present study included 17 patients who underwent occipito-upper cervical spine (above C4) posterior fixation surgery for atlantoaxial subluxation of various etiologies. Plain lateral cervical radiographs in a neutral position at standing were obtained and the O-C2 angle and subaxial lordosis angle (the angle between the endplates of the lowest instrumented vertebra (LIV) and C7 vertebrae) were measured preoperatively and postoperatively soon after surgery and ambulation and at the final follow-up visit. RESULTS: There was a significant negative correlation between the average postoperative alteration of O-C2 angle (DO-C2) and the average postoperative alteration of subaxial lordosis angle (Dsubaxial lordosis angle) (r=-0.47, p=0.03). CONCLUSIONS: There was a negative correlation between DO-C2 and Dsubaxial lordosis angles. This suggests that decrease of mid-to lower-cervical lordosis acts as a compensatory mechanism for lordotic correction between the occiput and C2. In occipito-cervical fusion surgery, care must be taken to avoid excessive O-C2 angle correction because it might induce mid-to-lower cervical compensatory decrease of lordosis.
Animals ; Follow-Up Studies ; Humans ; Lordosis* ; Occipital Bone ; Retrospective Studies ; Spinal Curvatures ; Spinal Fusion ; Spine ; Walking

OBJECTIVESThe aim of this study was to determine the prevalence of Echinococcus multilocularis environmental contamination in an urban fringe-the Nopporo forest park of Sapporo city, Hokkaido, Japan. A secondary aim was to determine possible transmission risks areas by associating percentage occurrence of E. multilocularis-positive faeces with the different land-use classes.

METHODSWild fox faeces collected from the environment were examined by intravital methods, such as the taeniid egg sucrose floatation technique, E. multilocularis coproantigen enzyme-linked immunosorbent analysis and DNA test of taeniid eggs by PCR. Geospatial maps produced by the Global Positioning System and Landsat data were analysed using geographic information system software to determine the association between percentage occurrences of E. multilocularis-positive fox faeces and land-use classes.

RESULTSOur findings showed high prevalence rates in both E. multilocularis egg and coproantigen-positive faeces (16 and 49%, respectively) in the investigated urban fringe forest park. Data revealed that percentage occurrence of E. multilocularis-positive fox faeces was associated with land-use classes, such as forest and open field (P < 0.05).

CONCLUSIONSWe conclude that Nopporo forest park in the urban fringe of Sapporo city, Hokkaido is a reservoir with a high prevalence of zoonotic infective agents for alveolar echinococcosis. Our findings suggest that interface habitats between forests or woodlands and open fields are indispensable for continued maintenance of the life-cycle of E. multilocularis and, as such, constitute high risk areas for echinococcosis transmission.

BACKGROUND: Exacerbation of asthma has a negative impact on quality of life and increases the risk of fatal asthma. One of the known risk factors for patients with a history of near-fatal asthma is reduced sensitivity to dyspnea. OBJECTIVE: We aimed to identify patients with such risk before they experienced severe exacerbation of asthma. METHODS: We analyzed asthma symptoms and peak expiratory flow rate (PEFR) values of 53 patients recorded daily in a diary over a mean period of 274 days. Patients matched their symptoms to one of eight categories ranging in severity from 'absent' to 'severe attack'. We then analyzed the relationship between PEFR and asthma symptoms by dividing the PEFR value by the values of clinical parameters, including asthma symptom level.
Asthma ; Dyspnea ; Forced Expiratory Volume ; Humans ; Peak Expiratory Flow Rate ; Quality of Life ; Risk Factors