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      Infectious Diseases and the Kidney

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          Abstract

          The kidney is involved in a wide range of bacterial, viral, fungal, and parasitic diseases. In most systemic infections, renal involvement is a minor component of the illness, but in some, renal failure may be the presenting feature and the major problem in management. Although individual infectious processes may have a predilection to involve the renal vasculature, glomeruli, interstitium, or collecting systems, a purely anatomic approach to the classification of infectious diseases affecting the kidney is rarely helpful because most infections may involve several different aspects of renal function.

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          A newly discovered human pneumovirus isolated from young children with respiratory tract disease

          From 28 young children in the Netherlands, we isolated a paramyxovirus that was identified as a tentative new member of the Metapneumovirus genus based on virological data, sequence homology and gene constellation. Previously, avian pneumovirus was the sole member of this recently assigned genus, hence the provisional name for the newly discovered virus: human metapneumovirus. The clinical symptoms of the children from whom the virus was isolated were similar to those caused by human respiratory syncytial virus infection, ranging from upper respiratory tract disease to severe bronchiolitis and pneumonia. Serological studies showed that by the age of five years, virtually all children in the Netherlands have been exposed to human metapneumovirus and that the virus has been circulating in humans for at least 50 years.
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            Cloning of a human parvovirus by molecular screening of respiratory tract samples.

            The identification of new virus species is a key issue for the study of infectious disease but is technically very difficult. We developed a system for large-scale molecular virus screening of clinical samples based on host DNA depletion, random PCR amplification, large-scale sequencing, and bioinformatics. The technology was applied to pooled human respiratory tract samples. The first experiments detected seven human virus species without the use of any specific reagent. Among the detected viruses were one coronavirus and one parvovirus, both of which were at that time uncharacterized. The parvovirus, provisionally named human bocavirus, was in a retrospective clinical study detected in 17 additional patients and associated with lower respiratory tract infections in children. The molecular virus screening procedure provides a general culture-independent solution to the problem of detecting unknown virus species in single or pooled samples. We suggest that a systematic exploration of the viruses that infect humans, "the human virome," can be initiated.
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              The prevalence of hepatitis C virus infection in the United States, 1999 through 2002.

              Defining the primary characteristics of persons infected with hepatitis C virus (HCV) enables physicians to more easily identify persons who are most likely to benefit from testing for the disease. To describe the HCV-infected population in the United States. Nationally representative household survey. U.S. civilian, noninstitutionalized population. 15,079 participants in the National Health and Nutrition Examination Survey between 1999 and 2002. All participants provided medical histories, and those who were 20 to 59 years of age provided histories of drug use and sexual practices. Participants were tested for antibodies to HCV (anti-HCV) and HCV RNA, and their serum alanine aminotransferase (ALT) levels were measured. The prevalence of anti-HCV in the United States was 1.6% (95% CI, 1.3% to 1.9%), equating to an estimated 4.1 million (CI, 3.4 million to 4.9 million) anti-HCV-positive persons nationwide; 1.3% or 3.2 million (CI, 2.7 million to 3.9 million) persons had chronic HCV infection. Peak prevalence of anti-HCV (4.3%) was observed among persons 40 to 49 years of age. A total of 48.4% of anti-HCV-positive persons between 20 and 59 years of age reported a history of injection drug use, the strongest risk factor for HCV infection. Of all persons reporting such a history, 83.3% had not used injection drugs for at least 1 year before the survey. Other significant risk factors included 20 or more lifetime sex partners and blood transfusion before 1992. Abnormal serum ALT levels were found in 58.7% of HCV RNA-positive persons. Three characteristics (abnormal serum ALT level, any history of injection drug use, and history of blood transfusion before 1992) identified 85.1% of HCV RNA-positive participants between 20 and 59 years of age. Incarcerated and homeless persons were not included in the survey. Many Americans are infected with HCV. Most were born between 1945 and 1964 and can be identified with current screening criteria. History of injection drug use is the strongest risk factor for infection.
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                Author and article information

                Contributors
                eavner@mcw.edu
                william.harmon@childrens.harvard.edu
                patrick.niaudet@nck.aphp.fr
                nori@wakayama-med.ac.jp
                Journal
                978-3-540-76341-3
                10.1007/978-3-540-76341-3
                Pediatric Nephrology
                Pediatric Nephrology
                Sixth Completely Revised, Updated and Enlarged Edition
                978-3-540-76327-7
                978-3-540-76341-3
                2009
                : 1235-1273
                Affiliations
                [1 ]GRID grid.30760.32, ISNI 0000000121118460, Medical College of Wisconsin, ; Wisconsin, USA
                [2 ]GRID grid.2515.3, ISNI 0000000403788438, Harvard Medical School, , Children's Hospital Boston, ; 300 Longwood Avenue, Boston, Massachusetts 02115 USA
                [3 ]GRID grid.412134.1, ISNI 0000000405939113, Service de Néphrologie Pédiatrique Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), , Hôpital Necker‐Enfants Malades, ; 149, rue de Sèvres, 75743 Paris Cedex 15, France
                [4 ]GRID grid.412857.d, ISNI 0000000417631087, Department of Pediatrics Wakayama Medical University, , Wakayama Medical University Hospital, ; 641–8510811–1 Kimiidera Wakayama City, Japan
                Article
                52
                10.1007/978-3-540-76341-3_52
                7121468
                0edcec31-9858-4b6d-bf69-f5afac7151d2
                © Springer-Verlag Berlin Heidelberg 2009

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

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                © Springer-Verlag Berlin Heidelberg 2009

                nephrotic syndrome,severe acute respiratory syndrome,disseminate intravascular coagulation,hemolytic uremic syndrome,hemorrhagic fever

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