Characterization of Hemorrhagic Fever with Renal Syndrome Caused by Hantaviruses, Estonia

Thirty cases of hemorrhagic fever with renal syndrome (HFRS) due to Puumala virus (PUUV), Saaremaa virus (SAAV), and Dobrava virus infection were confirmed in Estonia. Except for the levels of serum creatinine, no remarkable differences were found in the clinical course of HFRS caused by PUUV and SAAV

Overall survival of patients with metastatic prostate cancer starting androgen deprivation therapy with degarelix, a gonadotropin-releasing hormone antagonist.

198 Background: Morbidity and mortality amongst patients diagnosed with metastatic prostate cancer remains high and androgen deprivation therapy is the mainstay of hormonal treatments for these patients. The gonadotropin-releasing hormone (GnRH) antagonist, degarelix, has a fast and profound onset of action and compares favorably with GnRH agonists in terms of progression-free survival (PFS) and overall survival during the first year of treatment. It is of interest to assess longer term survival data in patients with very advanced disease. Methods: Data from several studies of patients treated with degarelix are available for descriptive analysis from a study repository. We analyzed data from patients with metastatic disease and prostate-specific antigen (PSA) &gt; 50 ng/mL treated with degarelix from 17 controlled and uncontrolled trials for overall survival and PFS. Possible selection bias over time was also estimated. Results: Overall, 519 patients with metastatic disease and PSA &gt; 50 ng/mL were included; median age was 71 (±6) years. Survival at 36 months was 83% for patients with baseline PSA &gt; 50 to &lt; 200 ng/mL and 72% for patients with baseline PSA &gt; 200 ng/mL. The corresponding numbers for PSA-PFS were 29% and 15%, respectively (Table). A delayed separation of Kaplan-Meier estimates was observed between the PSA &gt; 50 to &lt; 200 ng/mL and &gt; 200 ng/mL groups; 6 months for PSA-PFS and 12 months for survival. A Cox regression indicated no significant effect of age (p = 0.20) or BMI (p = 0.33). The data suggest some selection bias over time in the most advanced patients. Conclusions: The data indicate that 77% of patients with metastatic disease and PSA &gt; 50 ng/mL who start degarelix treatment are alive after an observation period of 36 months. This is an analysis of uncontrolled data and a comparative randomized approach is required to allow potential comparison with other treatments. [Table: see text] </jats:p

Surveillance of tick-borne encephalitis in emerging risk areas in southern Sweden : a retrospective case finding study

Tick-borne encephalitis (TBE) is an emerging infection causing CNS infection of various severity. Good knowledge of the incidence in the population and defined risk areas is important in risk communication and vaccination recommendations. The aim of this study was to investigate potential underreporting by retrospectively diagnose TBE among patients with viral CNS infections of unknown etiology in a region with emerging risk areas for TBE, and define variables associated with performed TBE serology at the time of infection. Epidemiological data and microbiological diagnostics of cases with viral CNS infection of unknown etiology treated at departments of infectious diseases and pediatrics in Skane County during 2000-2012 were investigated. Analyses to evaluate variables associated with performed TBE serology at the time of infection were performed. Retrospective TBE serology was performed on stored blood samples when available. TBE serology was already performed at the time of CNS infection in 193 out of 761 cases. Department, type of clinical manifestation, time period of illness, and whether Borrelia serology had been performed were independent variables associated with having had TBE serology performed or not at the time of illness. Only one of 137 cases, where samples could be retrospectively analyzed for TBE, turned out positive. This study shows a low frequency of TBE sampling among patients with meningoencephalitis in a region with emerging risk for TBE. A higher awareness of TBE as differential diagnosis could contribute to earlier detection of new risk areas and adequate preventive advice to the public.Funding Agencies|Linkoping University; European Union through the European Regional Development Fund; OSK Interreg Program ScandTick Innovation; Interreg North Sea Region Programme 2014-2020 as part of the NorthTick project [38-2-7-19]; Region Skane; Research and Development Committee at the Central Hospital Kristianstad</p