Search

Summary Background In 2018–19, Borna disease virus 1 (BoDV-1), the causative agent of Borna disease in horses, sheep, and other domestic mammals, was reported in five human patients with severe to fatal encephalitis in Germany. However, information on case frequencies, clinical courses, and detailed epidemiological analyses are still lacking. We report the occurrence of BoDV-1-associated encephalitis in cases submitted to the Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, Regensburg, Germany, and provide a detailed description of newly identified cases of BoDV-1-induced encephalitis. Methods All brain tissues from 56 encephalitis cases from Bavaria, Germany, of putative viral origin (1999–2019), which had been submitted for virological testing upon request of the attending clinician and stored for stepwise diagnostic procedure, were systematically screened for BoDV-1 RNA. Two additional BoDV-1-positive cases were contributed by other diagnostic centres. Positive results were confirmed by deep sequencing, antigen detection, and determination of BoDV-1-reactive antibodies in serum and cerebrospinal fluid. Clinical and epidemiological data from infected patients were collected and analysed. Findings BoDV-1 RNA and bornavirus-reactive antibodies were detected in eight newly analysed encephalitis cases and the first human BoDV-1 isolate was obtained from an unequivocally confirmed human BoDV-1 infection from the endemic area. Six of the eight BoDV-1-positive patients had no record of immunosuppression before the onset of fatal disease, whereas two were immunocompromised after solid organ transplantation. Typical initial symptoms were headache, fever, and confusion, followed by various neurological signs, deep coma, and severe brainstem involvement. Seven of nine patients with fatal encephalitis of unclear cause were BoDV-1 positive within one diagnostic centre. BoDV-1 sequence information and epidemiological analyses indicated independent spillover transmissions most likely from the local wild animal reservoir. Interpretation BoDV-1 infection has to be considered as a potentially lethal zoonosis in endemic regions with reported spillover infections in horses and sheep. BoDV-1 infection can result in fatal encephalitis in immunocompromised and apparently healthy people. Consequently, all severe encephalitis cases of unclear cause should be tested for bornaviruses especially in endemic regions. Funding German Federal Ministry of Education and Research.

After many years of controversy, there is now recent and solid evidence that classical Borna disease virus 1 (BoDV-1) can infect humans. On the basis of six brain autopsies, we provide the first systematic overview on BoDV-1 tissue distribution and the lesion pattern in fatal BoDV-1-induced encephalitis. All brains revealed a non-purulent, lymphocytic sclerosing panencephalomyelitis with detection of BoDV-1-typical eosinophilic, spherical intranuclear Joest–Degen inclusion bodies. While the composition of histopathological changes was constant, the inflammatory distribution pattern varied interindividually, affecting predominantly the basal nuclei in two patients, hippocampus in one patient, whereas two patients showed a more diffuse distribution. By immunohistochemistry and RNA in situ hybridization, BoDV-1 was detected in all examined brain tissue samples. Furthermore, infection of the peripheral nervous system was observed. This study aims at raising awareness to human bornavirus encephalitis as differential diagnosis in lymphocytic sclerosing panencephalomyelitis. A higher attention to human BoDV-1 infection by health professionals may likely increase the detection of more cases and foster a clearer picture of the disease.

Quality of life (QOL) tends to be lower among the homeless than the general population, and traumatic events experienced on the streets have a negative impact on QOL. Low-income countries face a high number of street youth, yet little research has been performed so far on QOL, trauma, and posttraumatic stress disorder (PTSD) among this group. This study aimed at examining the QOL of a sample of Ethiopian street youth within a rehabilitation program and at exploring whether the street youth have experienced traumatic events and show posttraumatic stress symptoms. We interviewed 84 street youths with the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) and the Diagnostic Interview for Children and Adolescents (DICA). Mean QOL scores differed significantly between the groups assessed at the beginning and at the end of the program (Cohen's d = 0.48). Eighty-three percent of the Ethiopian street youths had experienced traumatic events, and 25.0% met criteria for PTSD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. QOL did not differ between those with and without PTSD symptoms. These findings show the high rate of traumatic events among Ethiopian street youth and the importance for rehabilitation programs that focus on improving QOL. The results of the study may have cultural limitations.

Quality of life (QOL) tends to be lower among the homeless than the general population, and traumatic events experienced on the streets have a negative impact on QOL. Low-income countries face a high number of street youth, yet little research has been performed so far on QOL, trauma, and posttraumatic stress disorder (PTSD) among this group. This study aimed at examining the QOL of a sample of Ethiopian street youth within a rehabilitation program and at exploring whether the street youth have experienced traumatic events and show posttraumatic stress symptoms. We interviewed 84 street youths with the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) and the Diagnostic Interview for Children and Adolescents (DICA). Mean QOL scores differed significantly between the groups assessed at the beginning and at the end of the program (Cohen's d = 0.48). Eighty-three percent of the Ethiopian street youths had experienced traumatic events, and 25.0% met criteria for PTSD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. QOL did not differ between those with and without PTSD symptoms. These findings show the high rate of traumatic events among Ethiopian street youth and the importance for rehabilitation programs that focus on improving QOL. The results of the study may have cultural limitations.

Cervical injury is a serious and often fatal complication of ankylosing spondylitis in the setting of minor trauma. This case report describes a 51-year-old woman with ankylosing spondylitis and a minor trauma who developed severe bradycardia during positioning for x ray. Further diagnostic revealed a hyperextensive fracture of C4 with fragments compressing the cervical medulla. The woman subsequently died from hypoxic brain damage. Reviewing the literature, a high alertness in ankylosing spondylitis and minor trauma with neck immobilisation is emphasised, early diagnosis using cervical spine computed tomography is essential to a favourable outcome, and the mechanism of bradycardia in cervical trauma is discussed.

Das Verfahren von F. K. Ligtenberg wurde derart abgewandelt, das man es—nach kleinen Erganzungen— mit der ublichen Ausstattung eines spannungsoptischen Laboratoriums anwenden kann. Ferner wurden Auswertungsformeln fur krummlinige Koordinaten entwickelt, ein zeichnerisches Verfahren zum unmittelbaren Bestimmen der Hauptkrummungslinien aus den Moirelinien angegeben und das Auflosungsvermogen des Verfahrens uberschlagig berechnet. Das abgewandelte Verfahren ist an Beispielen erprobt worden.

Es gibt mehrere Wege, um eine Integralgleichung fur ein Randwertproblem der Elastizitatstheorie aufzustellen. Zu den wichtigsten gehort die Verwendung der Formeln von SOMIGLIANA, BETTI und MAXWELL; eine andere, speziell fur ebene Probleme geeignete Methode geht von der komplexen Darstellung elastischer Felder aus und benutzt Satze der Funktionentheorie. Die vom Gesichtspunkt der Mechanik einfachste und einleuchtendste Methode stand jedoch am Anfang dieser Entwicklung; bereits FREDHOLM und LAURICELLA haben 1906 die Spannungen in einem elastischen Korper durch Oberlagerung singularer Losungen fur den Halbraum dargestellt und sind so zu einer Formulierung der klassischen Randwertaufgaben in der Gestalt einer Integralgleichung gelangt.

Der gebotenen Raumbeschrankungen wegen ist dieser Bericht keineswegs vollstandig, nicht einmal was die im Rahmen dieses Forschungsvorhabens erzielten Ergebnisse betrifft. So wurde z.B. die Moglichkeit nicht erwahnt, die Integralgleichung fur das statische Problem auf eine Integralgleichung fur das geometrische Problem zuruckzufuhren, indem man vom Grundgedanken der Losungsmethode von KUPRADZE 1963, 1967, KUPRADZE und Mitarbeiter 1968 ausgeht und durch Grenzubergang (Heranrucken der geschlossenen Testkurve im Ausengebiet an die Berandung) zu einer Integralgleichung gelangt (RIEDER 1968). Diesem KUPRADZEschen Typ last sich insbesondere die Integralgleichung von KANDLER 1967 und WINDISCH 1967, 197o zuordnen (RIEDER 1969); eine verbesserte Behandlung der Ecken auf der Integrationsstufe der Kraftebelegungen und Schraubenversetzungen hat KERMANIDIS 1975 erprobt.

Die Kerne der bisher verwendeten Integralgleichungen enthalten — mit Ausnahme der GLAHNschen Integralgleichung fur die drehbar gelagerte Platte (vgl. Teil V dieses Berichts) — eine Singularitat der Ordnung \({{(s-\bar{s})}^{-1}}\), so das das Integral nur im Sinne des CAUCHYschen Hauptwerts existiert. Zwar zeigen die Rechenergebnisse, das die damit verbundenen numerischen Schwierigkeiten durch Abspaltung des CAUCHYschen Hauptwerts gut zu uberwinden sind; immerhin ist sorgfaltig auf eine genugend stetige bzw. glatte Annaherung der Randkurve und der darauf erklarten Funktionen zu achten. Gunstiger wurde jedoch eine FREDHOLMsche Integralgleichung mit einem wenigstens auf glatter Berandung stetigen Kern erscheinen, bei der die genannten Schwierigkeiten von vornherein gar nicht auftreten.