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1

Spatio-temporal risk factors for viral haemorrhagic septicaemia (VHS) in Danish aquaculture.  

PubMed

Viral haemorrhagic septicaemia (VHS) is an economically very important fish disease in the northern hemisphere. When the VHS virus was first isolated in Denmark 50 yr ago, more than 80% of the 800 Danish fish farms were considered to be infected, but vigilant surveillance and eradication programmes led to a drastic reduction in prevalence, and finally, to complete eradication of VHS. Denmark thus obtained official status as an approved VHS-free member state within the European Union in November 2013. Data on outbreaks within the country have been collected since 1970, and here we combined these data with the geographical coordinates of fish farms to identify clusters of high disease prevalence and other risk factors. Our analyses revealed a statistically significant cluster in the southwestern part of the country, which persisted throughout the study period. Being situated within such a cluster was a significant risk factor for VHS. For freshwater rainbow trout farms situated inland, the number of upstream farms was a determining risk factor for VHS, as was distance to the nearest VHS-infected farm and year. Whether the farm used fresh or marine water in production did not have any influence on the risk of VHS, when accounting for whether the farm was situated inside a cluster of high risk. This information can be used when implementing risk-based surveillance programmes. PMID:24991736

Bang Jensen, Britt; Ersbøll, Annette Kjær; Korsholm, Henrik; Skall, Helle Frank; Olesen, Niels Jørgen

2014-05-13

2

Eighteen years of vaccination against viral haemorrhagic septicaemia in France.  

PubMed

Viral haemorrhagic septicaemia (VHS) has been considered for many years to be a major cause of loss in the French trout industry. The high prevalence of VHS in certain geographic areas made a control strategy based on control policy unfeasible. This provided the impetus for immunoprophylaxis development that resulted in 3 successive types of vaccines: inactivated, live attenuated and recombinant vaccines. When delivered by intraperitoneal injection, the 2 propiolactone-inactivated VHS virus was immunogenic and/or protective for trout all of sizes, but it was not suitable for the practical immunization of alevin, the trout life stage that is the most sensitive to VHS. A carp cell-passed, attenuated variant of the VHS virus was effective after both immersion or injection delivery and met the practical requirements of juvenile vaccination. However, this vaccine was discarded because it retained some virulence that discouraged the launching of its commercialization. Then came the era of genetically engineered vaccines. The recombinant glycoprotein of VHSV produced in Escherichia coli or in Saccharomyces cerevisiae failed to protect fish whatever the route of delivery. A recombinant baculovirus vaccine was found to be immunogenic and protective against VHS, but only when delivered by injection. Due to its cost and route of delivery, the latter vaccine was not licensed. Simultaneously, the sudden occurrence of another rhabdovirosis, infectious haematopoietic necrosis (IHN), in France, rendered vaccination against VHS questionable. Indeed, no cross-protection between these 2 rhabdoviroses exists. If vaccination is still believed to be an effective control method for VHS, it should be based in the future upon an autoreplicative vaccine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8581010

de Kinkelin, P; Béarzotti, M; Castric, J; Nougayrède, P; Lecocq-Xhonneux, F; Thiry, M

1995-01-01

3

Selection of rainbow trout resistant to viral haemorrhagic septicaemia virus and transmission  

E-print Network

Selection of rainbow trout resistant to viral haemorrhagic septicaemia virus and transmission a programme of selection for resistance to viral haemorrhagic septicaemia virus (VHSV) in rainbow trout poorly as compared with the fins of susceptible fish. rainbow trout / selection / viral haemorrhagic

Paris-Sud XI, Université de

4

Septicaemia and adrenal haemorrhage in congenital asplenia  

Microsoft Academic Search

Five patients developed overwhelming infection as a result of congenital asplenia, which was previously unsuspected in all cases. Each illness followed a fulminant course resulting in death within 24 hours. They illustrate the respective roles of Haemophilus influenzae infection (n = 4) and adrenal haemorrhage (n = 4) in this condition. We suggest a management protocol for screening infants with

M P Dyke; R P Martin; P J Berry

1991-01-01

5

Global spread and evolution of viral haemorrhagic septicaemia virus.  

PubMed

Viral haemorrhagic septicaemia virus (VHSV) is a rhabdovirus that infects over 48 species of teleosts and is lethal in many. VHSV threatens marine and aquatic fisheries. VHSV was first discovered outside Europe in 1988 in fish from the Pacific coast of North America. In 1994, VHSV was discovered in Newfoundland. In 2003, VHSV was isolated from fish in Lake St. Clair (Michigan and Ontario). In this study, we used 46 nucleotide sequences for the glycoprotein gene from 12 studies and 150 nucleotide sequences for the nucleoprotein gene from nine studies. We combined phylogenetics and a geographic information system to visualize the transmission paths of VHSV lineages. We also reconstructed the spread of VHSV lineages through optimization of geographic data for viral isolates on phylogenetic trees. We demonstrate that VHSV was transmitted from the North Atlantic Ocean and/or Baltic Sea to the Atlantic coast of North America and Japan in independent events. From the Atlantic coast, the virus was transmitted independently to the Laurentian Great Lakes and the Pacific coast of Canada and the contiguous United States. From the Pacific Northwest, the virus was transmitted to Asia and Alaska in independent events. These results clarify the debate ongoing in the literature on the geographic spread of VHSV. PMID:21916899

Studer, J; Janies, D A

2011-10-01

6

Comparative susceptibility among three stocks of yellow perch, Perca flavescens (Mitchill), to viral haemorrhagic septicaemia virus strain IVb from the Great Lakes.  

PubMed

The Great Lakes strain of viral haemorrhagic septicaemia virus IVb (VHSV-IVb) is capable of infecting a wide number of naive species and has been associated with large fish kills in the Midwestern United States since its discovery in 2005. The yellow perch, Perca flavescens (Mitchill), a freshwater species commonly found throughout inland waters of the United States and prized for its high value in sport and commercial fisheries, is a species documented in several fish kills affiliated with VHS. In the present study, differences in survival after infection with VHSV IVb were observed among juvenile fish from three yellow perch broodstocks that were originally derived from distinct wild populations, suggesting innate differences in susceptibility due to genetic variance. While all three stocks were susceptible upon waterborne exposure to VHS virus infection, fish derived from the Midwest (Lake Winnebago, WI) showed significantly lower cumulative % survival compared with two perch stocks derived from the East Coast (Perquimans River, NC and Choptank River, MD) of the United States. However, despite differences in apparent susceptibility, clinical signs did not vary between stocks and included moderate-to-severe haemorrhages at the pelvic and pectoral fin bases and exophthalmia. After the 28-day challenge was complete, VHS virus was analysed in subsets of whole fish that had either survived or succumbed to the infection using both plaque assay and quantitative PCR methodologies. A direct correlation was identified between the two methods, suggesting the potential for both methods to be used to detect virus in a research setting. PMID:23305522

Olson, W; Emmenegger, E; Glenn, J; Winton, J; Goetz, F

2013-08-01

7

Viral haemorrhagic septicaemia virus induces vig -2, a new interferon-responsive gene in rainbow trout  

Microsoft Academic Search

An mRNA differential display methodology was used to study the rainbow trout response to viral infection. A new transcript (vig -2) induced by viral haemorrhagic septicaemia virus (VHSV) in rainbow trout leucocytes was identified from the head-kidney. vig -2 was also induced in vivo during experimental infection and following DNA immunisation with a plasmid containing a gene encoding the viral

Pierre Boudinot; Samia Salhi; Mar Blanco; Abdenour Benmansour

2001-01-01

8

Mortality among cattle and buffaloes in Sri Lanka due to haemorrhagic septicaemia  

Microsoft Academic Search

Data on the mortality of cattle and buffaloes in 62 epizootics of haemorrhagic septicaemia (HS) in the HS enzootic and non-enzootic regions of Sri Lanka was collected and subjected to statistical analysis. It was found that the overall mortality for buffaloes was higher than for cattle (45.2 and 15.8% respectively,P<0.001). For buffaloes in enzootic areas only the overall mortality was

M. C. L. Alwis

1981-01-01

9

Protective immunity to VHS in rainbow trout ( Oncorhynchus mykiss , Walbaum) following DNA vaccination  

Microsoft Academic Search

Rainbow trout fingerlings were immunized by intramuscular injection of a plasmid DNA vector encoding the viral haemorrhagic septicaemia virus (VHSV) glycoprotein (G) or nucleocapsid protein (N) genes under the control of a cytomegalovirus promoter. Challenge with VHSV 52 days later demonstrated that both viral genes, and the G gene in particular, were able to induce protective immunity against VHS. In

N. LORENZEN; E. LORENZEN; K. EINER-JENSEN; J. HEPPELL; T. WU; H. DAVIS

1998-01-01

10

Do imports of rainbow trout carcasses risk introducing viral haemorrhagic septicaemia virus into England and Wales?  

PubMed

A qualitative import risk assessment was undertaken to assess the likelihood of introduction and establishment of viral haemorrhagic septicaemia virus (VHSV) genotype 1a in England and Wales (E&W), via the processing of imported rainbow trout (Oncorhynchus mykiss) carcasses from continental Europe. The likelihood was estimated for one import from an infected farm. Four main routes by which susceptible populations could be exposed to VHSV via processing waste were considered: (i) run-off from solid waste to watercourses, (ii) contamination of birds or rodents with VHSV by scavenging solid waste, (iii) discharge of liquid waste to mains drainage, and (iv) discharge of liquid waste directly to watercourses. Data on the biophysical characteristics of VHSV, its epidemiology, fish processing practices and waste management were collected. Likelihoods for each step of the four pathways were estimated. Pathway 4 (discharge of liquid waste to a watercourse) was judged as the most likely to result in infection of susceptible individuals. Levels of virus entering the aquatic environment via pathways 1-3 were judged to be many times lower than pathway 4 due mainly to the treatment of solid waste (pathways 1 and 2) and high levels of dilution (pathways 1, 2 and 3). Thirty-four trout farms process fish, of which seven have imported carcasses for processing. Compared with other processing facilities, on-farm processing results in a higher likelihood of VHSV exposure and establishment via all four pathways. Data availability was an issue; the analysis was particularly constrained by a lack of data on the prevalence of VHSV in Europe, volume of trade of carcasses into the UK and processing practices in E&W. It was concluded that the threat of VHSV introduction into E&W could be reduced by treatment of liquid effluent from processing plants and by sourcing carcasses for on-farm processing only from approved VHSV free areas. PMID:23095349

Pearce, F M; Oidtmann, B C; Thrush, M A; Dixon, P F; Peeler, E J

2014-06-01

11

Survey of viral haemorrhagic septicaemia virus in wild fishes in the southeastern Black Sea.  

PubMed

Species diversity in the Black Sea ecosystem has been declining rapidly over the last 2 decades. To assess the occurrence and distribution of viral haemorrhagic septicaemia virus (VHSV) in various wild fish species, a wild marine fish survey was carried out in 2009, 2010, and 2011. The pooled or individual samples of kidney, liver, and spleen of 5025 specimens, belonging to 17 fish species, were examined virologically using cell culture. The cells showing cytopathic effects (CPE) were subjected to ELISA and multiplex reverse transcriptase polymerase chain reaction (RT-mPCR), for VHSV and infectious pancreatic necrosis virus (IPNV), after blind passaging to determine the virus species causing CPE. The virus species and possibility of co-infection with IPNV were verified by the RT-mPCR developed in this study. Twelve species of fish (pontic shad Alosa immaculata, red mullet Mullus barbatus, three-bearded rockling Gaidropsarus vulgaris, black scorpionfish Scorpaena porcus, Mediterranean horse mackerel Trachurus mediterraneus, whiting Merlangius merlangus euxinus, stargazer Uranoscopus scaber, pilchard Sardina pilchardus, garfish Belone belone, round goby Neogobius melanostomus, thornback ray Raja clavata, and anchovy Engraulis encrasicolus) tested positive for VHSV Genotype Ie (VHSV-Ie). Except whiting, pilchard, and round goby, the rest are new host records for VHSV. The extent and spread of VHSV-Ie was significantly higher among bottom fish than among pelagic fish. Sensitivity and specificity of the RT-mPCR developed was sufficiently high, suggesting that this assay may be used for both diagnostic and surveillance testing. According to the RT-mPCR results, IPNV was not present in wild fish. These results support the hypothesis that the VHSV-Ie genotype, highly prevalent among fish species in the Black Sea, may have a serious impact on the population dynamics of wild fish stocks. PMID:24991737

Ogut, H; Altuntas, C

2014-05-13

12

Isolation of viral haemorrhagic septicaemia virus from muskellunge, Esox masquinongy (Mitchill), in Lake St Clair, Michigan, USA reveals a new sublineage of the North American genotype  

Microsoft Academic Search

Viral haemorrhagic septicaemia virus (VHSV) was isolated from muskellunge, Esox masquinongy (Mitchill), caught from the NW portion of Lake St Clair, Michigan, USA in 2003. Affected fish exhibited congestion of internal organs; the inner wall of the swim bladder was thickened and con- tained numerous budding, fluid-filled vesicles. A virus was isolated using fish cell lines inoculated with a homogenate

E Elsayed; M Faisal; M Thomas; G Whelan; W Batts; J Winton

2006-01-01

13

Restriction endonuclease analysis using Hha Ia nd HpaII to discriminate among group B Pasteurella multocida associated with haemorrhagic septicaemia  

Microsoft Academic Search

The purpose of this study was to improve and standardise restriction endonuclease analysis (REA) for discriminating isolates of serogroup B Pasteurella multocida associated with haemorrhagic septicaemia in wild and domestic animals and to create a reference database that can be used for epidemiological studies. Two techniques for extraction and isolation of chromosomal DNA were compared, a DNAzol1 method and an

RICHARD B. RIMLER

14

Development of neutralizing antibody responses in muskellunge, Esox masquinongy (Mitchill), experimentally exposed to viral haemorrhagic septicaemia virus (genotype IVb).  

PubMed

A complement-dependent 50% plaque neutralization test was used to assess the neutralizing antibody response in sera of muskellunge, Esox masquinongy, experimentally infected with viral haemorrhagic septicaemia virus (VHSV, genotype IVb) by immersion. Groups of muskellunge were challenged with varying concentrations of VHSV: Group 1 with 10(2) plaque-forming units (pfu)?mL(-1) , Group 2 with 4?×?10(3) ?pfu?mL(-1) , Group 3 with 10(5) ?pfu?mL(-1) and Group 4 with 0?pfu?mL(-1) . The fish were held at a temperature of 11?±?1?°C and were sampled over a 20-week period. Neutralizing antibodies were not detected in sera of any of the negative control fish throughout the study. Low neutralizing titres were detected in Groups 1-3 by 6?days post-infection (p.i.). Neutralizing titres of ?80 [corrected]. were not detected again until 3, 4 and 7?weeks p.i. for Groups 2, 3 and 1, respectively, with peak titres for those groups occurring 16, 11 and 17?weeks p.i., respectively. VHSV was detected in serum for up to 11?weeks p.i. Results of this study show that survivors can be detected by a serological technique, despite being virus negative. This may benefit the investigation of VHSV IVb distribution in the Great Lakes and the study of host immune responses to this emerging sublineage. PMID:22091537

Millard, E V; Faisal, M

2012-01-01

15

Molecular epidemiology of viral haemorrhagic septicaemia virus (VHSV) in British Columbia, Canada, reveals transmission from wild to farmed fish.  

PubMed

Viral haemorrhagic septicaemia virus (VHSV) is a fish pathogen found throughout the Northern Hemisphere and is capable of infecting and causing mortality in numerous marine and freshwater hosts. In the coastal waters of British Columbia, Canada, the virus has been detected for 20 yr with many occurrences of mass mortalities among populations of Pacific herring Clupea pallasii (Valenciennes) and sardine Sardinops sagax as well as detections among cultured Atlantic Salmo salar and Chinook Oncorhynchus tshawytscha salmon. We compared nucleotide sequence of the full glycoprotein (G) gene coding region (1524 nt) of 63 VHSV isolates sampled during its recorded presence from 1993 to 2011 from 6 species and a total of 29 sites. Phylogenetic analysis showed that all isolates fell into sub-lineage IVa within the major VHSV genetic group IV. Of the 63 virus isolates, there were 42 unique sequences, each of which was ephemeral, being repeatedly detected at most only 1 yr after its initial detection. Multiple sequence types were revealed during single viral outbreak events, and genetic heterogeneity was observed within isolates from individual fish. Moreover, phylogenetic analysis revealed a close genetic linkage between VHSV isolates obtained from pelagic finfish species and farmed salmonids, providing evidence for virus transmission from wild to farmed fish. PMID:23709462

Garver, Kyle A; Traxler, Garth S; Hawley, Laura M; Richard, Jon; Ross, Jay P; Lovy, Jan

2013-05-27

16

Model for ranking freshwater fish farms according to their risk of infection and illustration for viral haemorrhagic septicaemia.  

PubMed

We developed a model to calculate a quantitative risk score for individual aquaculture sites. The score indicates the risk of the site being infected with a specific fish pathogen (viral haemorrhagic septicaemia virus (VHSV); infectious haematopoietic necrosis virus, Koi herpes virus), and is intended to be used for risk ranking sites to support surveillance for demonstration of zone or member state freedom from these pathogens. The inputs to the model include a range of quantitative and qualitative estimates of risk factors organised into five risk themes (1) Live fish and egg movements; (2) Exposure via water; (3) On-site processing; (4) Short-distance mechanical transmission; (5) Distance-independent mechanical transmission. The calculated risk score for an individual aquaculture site is a value between zero and one and is intended to indicate the risk of a site relative to the risk of other sites (thereby allowing ranking). The model was applied to evaluate 76 rainbow trout farms in 3 countries (42 from England, 32 from Italy and 2 from Switzerland) with the aim to establish their risk of being infected with VHSV. Risk scores for farms in England and Italy showed great variation, clearly enabling ranking. Scores ranged from 0.002 to 0.254 (mean score 0.080) in England and 0.011 to 0.778 (mean of 0.130) for Italy, reflecting the diversity of infection status of farms in these countries. Requirements for broader application of the model are discussed. Cost efficient farm data collection is important to realise the benefits from a risk-based approach. PMID:24815039

Oidtmann, Birgit C; Pearce, Fiona M; Thrush, Mark A; Peeler, Edmund J; Ceolin, Chiara; Stärk, Katharina D C; Dalla Pozza, Manuela; Afonso, Ana; Diserens, Nicolas; Reese, R Allan; Cameron, Angus

2014-08-01

17

Induction of rainbow trout MH class I and accessory proteins by viral haemorrhagic septicaemia virus.  

PubMed

Major histocompatibility (MH) class I receptors are glycoproteins which play a critical role during responses to intracellular pathogens by presenting endogenous peptides to cytotoxic T cell lymphocytes (CD8+). To date, little is known about MH class I regulation at the protein level during viral infections in fish. In this study, we characterised the MH class I pathway response to polyinosinic-polycytidylic acid (poly I:C) and upon infection with viral haemorrhagic septicemia virus (VHSV) genotype IVa using the rainbow trout monocyte/macrophage cell line RTS11. A 14-day challenge with VHSV IVa at 14°C demonstrated enhanced expression of the class I heavy chain, ?2 microglobulin (?2M) and tapasin, while the expression of other accessory molecules ERp57 and calreticulin remained unchanged. However, when infection occurred at 2°C no change in expression levels of any of these molecules was observed. ?2M accumulated in the media of RTS11 over time, however the ?2M concentrations were 2 fold higher in cultures infected with VHSV 14 days post infection. Strikingly, when cells were maintained at 2°C the secretion of ?2M was significantly reduced in both infected and non-infected cultures. These results indicate that VHSV infection alters the kinetics of ?2M release as well as the expression of MH class I and suggests that cellular immunity against VHSV can be compromised at low temperatures which may increase host susceptibility to this virus during the winter. PMID:24607971

Sever, Lital; Vo, Nguyen T K; Lumsden, John; Bols, Niels C; Dixon, Brian

2014-06-01

18

The Laurentian Great Lakes strain (MI03) of the viral haemorrhagic septicaemia virus is highly pathogenic for juvenile muskellunge, Esox masquinongy (Mitchill).  

PubMed

The Great Lakes strain of viral haemorrhagic septicaemia virus (VHSV) isolated from adult subclinical muskellunge, Esox masquinongy (Mitchill), in Lake St. Clair, MI, USA was shown to be highly pathogenic in juvenile muskellunge through intraperitoneal (i.p.) injection and waterborne challenge. Mortality began as early as 3 days after exposure in waterborne challenged fish, whereas fish infected by the i.p. route experienced the first mortality by 5 days post-infection (p.i.). The median lethal intraperitoneal injection dose (IP-LD(50)) was approximately 2.21 plaque forming units (PFU) as opposed to the median lethal immersion challenge dose (IM-LD(50)) of 1.7 x 10(4) PFU mL(-1). A high, medium and low dose of infection caused acute, subacute and chronic progression of the disease, respectively, as was evident by the cumulative mortality data. Clinical signs of disease observed in dead and moribund fish were very pale gills, dermal petechial haemorrhages along the flanks, severe nuchal haemorrhages, intramuscular haemorrhages at the fin-muscle junction and focal haemorrhaging on the caudal peduncle. Internal lesions included livers that were pale, discoloured and friable, and kidneys that were either congested or degenerative in appearance, and petechial to ecchymotic haemorrhages on the swim bladder wall. Histopathologic examination demonstrated massive haemorrhages in the swimbladder wall and muscle, severe vacuolation and multifocal necrosis of the liver, multifocal necrosis of the gills and depletion of lymphoid tissues within the spleen. Kidney tissues also exhibited a mixed pattern of degeneration that included tubular necrosis, interstitial oedema and congestion. Virus was recovered from kidney and spleen tissues through tissue culture and reverse transcriptase-polymerase chain reaction (RT-PCR). PMID:20367742

Kim, R K; Faisal, M

2010-06-01

19

Isolation of viral haemorrhagic septicaemia virus from muskellunge, Esox masquinongy (Mitchill), in Lake St Clair, Michigan, USA reveals a new sublineage of the North American genotype.  

PubMed

Viral haemorrhagic septicaemia virus (VHSV) was isolated from muskellunge, Esox masquinongy (Mitchill), caught from the NW portion of Lake St Clair, Michigan, USA in 2003. Affected fish exhibited congestion of internal organs; the inner wall of the swim bladder was thickened and contained numerous budding, fluid-filled vesicles. A virus was isolated using fish cell lines inoculated with a homogenate of kidney and spleen tissues from affected fish. Focal areas of cell rounding and granulation appeared as early as 24 h post-inoculation and expanded rapidly to destroy the entire cell sheet by 96 h. Electron microscopy revealed virions that were 170-180 nm in length by 60-70 nm in width having a bullet-shaped morphology typical of rhabdoviruses. The virus was confirmed as VHSV by reverse transcriptase-polymerase chain reaction. Sequence analysis of the entire nucleoprotein and glycoprotein genes revealed the virus was a member of the North American genotype of VHSV; however, the isolate was sufficiently distinct to be considered a separate sublineage, suggesting its origin may have been from marine species inhabiting the eastern coastal areas of the USA or Canada. PMID:17026670

Elsayed, E; Faisal, M; Thomas, M; Whelan, G; Batts, W; Winton, J

2006-10-01

20

Mutations in the glycoprotein of viral haemorrhagic septicaemia virus that affect virulence for fish and the pH threshold for membrane fusion.  

PubMed

To study the molecular basis of virulence of viral haemorrhagic septicaemia virus (VHSV), we used a cross-reactive neutralizing MAb to select MAb-resistant (MAR) mutants with reduced pathogenicity for fish. From sequence determination of the G gene of MAR mutants, attenuated laboratory variant and avirulent field strains, we identified two distant regions of the glycoprotein associated with virulence: region I (aa 135-161), homologous to the putative fusion peptide of both rabies virus (RV) and vesicular stomatitis virus (VSV), and region II (surrounding aa 431-433), homologous to RV and VSV domains controlling the conformational changes necessary for the fusion process to take place. Simultaneous mutations in both regions resulted in the most attenuated phenotype and we obtained genetic evidence that regions I and II may be structurally linked. As the MAR mutants had mutations in or near domains involved in fusion, the fusion properties of VHSV and its variants were analysed. This work allowed us to postulate that the fusion domain of VHSV is probably constituted of two distinct regions of the protein connected through a disulfide bridge between cysteines 110 and 152. Finally, we obtained evidence suggesting that the pH threshold for fusion is a determinant for virulence: restriction of fusion to a more acidic pH was associated with attenuation for the variant tr25 which had a shift of the threshold for maximal fusion from pH 6.30 (for the parental strain) to pH 6.00; conversely, two field strains which had maximal fusion at pH 6.60 were the most virulent. PMID:10355769

Gaudin, Y; de Kinkelin, P; Benmansour, A

1999-05-01

21

A retrospective study on the epidemiology of anthrax, foot and mouth disease, haemorrhagic septicaemia, peste des petits ruminants and rabies in Bangladesh, 2010-2012.  

PubMed

Anthrax, foot and mouth disease (FMD), haemorrhagic septicaemia (HS), peste des petits ruminants (PPR) and rabies are considered to be endemic in Bangladesh. This retrospective study was conducted to understand the geographic and seasonal distribution of these major infectious diseases in livestock based on data collected through passive surveillance from 1 January 2010 to 31 December 2012. Data analysis for this period revealed 5,937 cases of anthrax, 300,333 of FMD, 13,436 of HS, 247,783 of PPR and 14,085 cases of dog bite/rabies. While diseases were reported in almost every district of the country, the highest frequency of occurrence corresponded to the susceptible livestock population in the respective districts. There was no significant difference in the disease occurrences between districts bordering India/Myanmar and non-border districts (p>0.05). Significantly higher (p<0.01) numbers of anthrax (84.5%), FMD (88.3%), HS (84.9%) and dog bite/rabies (64.3%) cases were reported in cattle than any other species. PPR cases were reported mostly (94.8%) in goats with only isolated cases (5.2%) in sheep. The diseases occur throughout the year with peak numbers reported during June through September and lowest during December through April, with significant differences (p<0.01) between the months. The annual usages of vaccines for anthrax, FMD, HS and PPR were only 7.31%, 0.61%, 0.84% and 11.59% of the susceptible livestock population, respectively. Prophylactic vaccination against rabies was 21.16% of cases. There were significant differences (p<0.01) in the administration of anthrax, FMD and HS vaccines between border and non-border districts, but not PPR or rabies vaccines. We recommend that surveillance and reporting of these diseases need to be improved throughout the country. Furthermore, all suspected clinical cases should be confirmed by laboratory examination. The findings of this study can be used in the formulation of more effective disease management and control strategies, including appropriate vaccination policies in Bangladesh. PMID:25101836

Mondal, Shankar P; Yamage, Mat

2014-01-01

22

Common signs & symptoms of meningitis & septicaemia  

E-print Network

Common signs & symptoms of meningitis & septicaemia � Meningitis Trust July 2011 � Next review July rates may vary. The Meningitis Trust relies on voluntary donations to provide lifelong support for people affected by meningitis Meningitis Septicaemia Meningitis & Septicaemia Meningococcal Septicaemia

23

9 CFR 83.4 - VHS-regulated fish and VHS-regulated areas.  

Code of Federal Regulations, 2012 CFR

...2012-01-01 false VHS-regulated fish and VHS-regulated areas. 83.4 ...SEPTICEMIA § 83.4 VHS-regulated fish and VHS-regulated areas. (a)(1) APHIS will list as a VHS-regulated fish any fish species found in...

2012-01-01

24

9 CFR 83.4 - VHS-regulated fish and VHS-regulated areas.  

...2014-01-01 false VHS-regulated fish and VHS-regulated areas. 83.4 ...SEPTICEMIA § 83.4 VHS-regulated fish and VHS-regulated areas. (a)(1) APHIS will list as a VHS-regulated fish any fish species found in...

2014-01-01

25

9 CFR 83.4 - VHS-regulated fish and VHS-regulated areas.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 false VHS-regulated fish and VHS-regulated areas. 83.4 ...SEPTICEMIA § 83.4 VHS-regulated fish and VHS-regulated areas. (a)(1) APHIS will list as a VHS-regulated fish any fish species found in...

2010-01-01

26

9 CFR 83.4 - VHS-regulated fish and VHS-regulated areas.  

Code of Federal Regulations, 2013 CFR

...2013-01-01 false VHS-regulated fish and VHS-regulated areas. 83.4 ...SEPTICEMIA § 83.4 VHS-regulated fish and VHS-regulated areas. (a)(1) APHIS will list as a VHS-regulated fish any fish species found in...

2013-01-01

27

9 CFR 83.4 - VHS-regulated fish and VHS-regulated areas.  

Code of Federal Regulations, 2011 CFR

...2011-01-01 false VHS-regulated fish and VHS-regulated areas. 83.4 ...SEPTICEMIA § 83.4 VHS-regulated fish and VHS-regulated areas. (a)(1) APHIS will list as a VHS-regulated fish any fish species found in...

2011-01-01

28

9 CFR 83.3 - Interstate movement of live VHS-regulated fish species from VHS-regulated areas.  

Code of Federal Regulations, 2012 CFR

...Interstate movement of live VHS-regulated fish species from VHS-regulated areas. ...Interstate movement of live VHS-regulated fish species from VHS-regulated areas. ...of this section, live VHS-regulated fish, including fish moved to live fish...

2012-01-01

29

9 CFR 83.3 - Interstate movement of live VHS-regulated fish species from VHS-regulated areas.  

Code of Federal Regulations, 2010 CFR

...Interstate movement of live VHS-regulated fish species from VHS-regulated areas. ...Interstate movement of live VHS-regulated fish species from VHS-regulated areas. ...of this section, live VHS-regulated fish, including fish moved to live fish...

2010-01-01

30

9 CFR 83.3 - Interstate movement of live VHS-regulated fish species from VHS-regulated areas.  

...Interstate movement of live VHS-regulated fish species from VHS-regulated areas. ...Interstate movement of live VHS-regulated fish species from VHS-regulated areas. ...of this section, live VHS-regulated fish, including fish moved to live fish...

2014-01-01

31

9 CFR 83.3 - Interstate movement of live VHS-regulated fish species from VHS-regulated areas.  

Code of Federal Regulations, 2011 CFR

...Interstate movement of live VHS-regulated fish species from VHS-regulated areas. ...Interstate movement of live VHS-regulated fish species from VHS-regulated areas. ...of this section, live VHS-regulated fish, including fish moved to live fish...

2011-01-01

32

9 CFR 83.3 - Interstate movement of live VHS-regulated fish species from VHS-regulated areas.  

Code of Federal Regulations, 2013 CFR

...Interstate movement of live VHS-regulated fish species from VHS-regulated areas. ...Interstate movement of live VHS-regulated fish species from VHS-regulated areas. ...of this section, live VHS-regulated fish, including fish moved to live fish...

2013-01-01

33

Viral haemorrhagic fevers  

Microsoft Academic Search

Viral haemorrhagic fevers are viral infections that can cause shock, haemorrhage and multi-organ dysfunction. Their geographical distribution is limited by the ecology of their vectors, and many of them exist in tropical zones. The most common viral haemorrhagic fevers are not transmissible from person to person, and no viral haemorrhagic fevers are a threat to casual contacts. However, four viruses

Barbara Bannister

2005-01-01

34

VHS Surveillance in Dr. Greg Whitledge, Dr. Jesse Trushenski,  

E-print Network

be certified as disease- free #12;IL Aquaculture Industry 2005 2006 2007 2008 2009 SalesUS$ Production Year Total Food Fish Sales : 2005 - 2009 #12;Surveillance Objectives · VHS surveillance of wild and feral watershed · Known VHS-susceptible species only (28 species) · Whole fish or tissues (kidney, spleen, heart

35

Thalamic haemorrhage.  

PubMed

Thalamic haemorrhage is usually considered a single entity although the thalamus is composed of anatomically as well as functionally discrete subregions receiving blood from different arteries. The clinical features vary according to the intrathalamic location of the haematomas and the bleeding artery. We investigated the impact of haematoma location and vascular territory on the clinical symptoms and signs, neuro-imaging findings and clinical courses of patients with thalamic haemorrhages by a retrospective analysis of 175 consecutive patients with thalamic haemorrhage. Based on the neuro-imaging findings we classified thalamic haematomas into four regional types and one global type according to the primary bleeding sites: (i) anterior type occurring in the territory of the tuberothalamic arteries, (ii) posteromedial type occurring in the territory of the thalamic-subthalamic paramedian arteries, (iii) posterolateral type occurring in the territory of the thalamogeniculate arteries. (iv) dorsal type occurring in the territory of the posterior choroidal arteries and (v) global type occupying the entire area of the thalamus. We studied the clinical and neuroimaging characteristics of each type. Eleven patients (7%) had the anterior type: these were the smallest haematomas and often ruptured into the anterior horn of the lateral ventricle. The major clinical signs were acute behavioural abnormalities: the clinical course was usually benign. Twenty-four patients (14%) had the posteromedial type in which haematomas often ruptured into the third ventricle, causing marked hydrocephalus, and often extended mediocaudally, involving the mesencephalon. The prognoses of this type depended on the presence of mesencephalic involvement which was associated with the worst outcome among the types even if the size of the haematoma itself was not large. The posterolateral type was most frequent (77 patients, 44%) and was characterized by large haematomas, rupture into the posterior horn of the lateral ventricle and frequent extension into the posterior limb of the internal capsule. Clinical signs included marked sensory and motor signs, hemineglect in right-side haematomas and language abnormalities with left-side haematomas. The case fatality with this type was relatively high (35%) and permanent neurologic sequelae frequently resulted. In the dorsal type (32 patients, 18%) haematomas were best visualized at the level of the body of the lateral ventricle on CT scans. The size was moderate and haematomas often extended posterolaterally into the adjacent subcortical white matter. Sensory and motor signs were common and about one third of the patients were first misdiagnosed as having lacunar infarcts. The prognoses were excellent. The global type (31 patients, 18%) of thalamic haemorrhage was clinically and radiologically very similar to the posterolateral type except that the haematomas were too large to define the bleeding focus. Severe sensory and motor signs were almost always present. In this type 25 patients died (the case fatality was 81%). PMID:9009994

Chung, C S; Caplan, L R; Han, W; Pessin, M S; Lee, K H; Kim, J M

1996-12-01

36

[Viral haemorrhagic fever].  

PubMed

Viral haemorrhagic fever denotes various kinds of febrile illness caused by certain viruses which often presents with bleeding tendency and occasionally shock. Out of these, the four maladies, Lassa fever, Ebola haemorrhagic fever, Marburg haemorrhagic fever and Crimean-Congo haemorrhagic fever which are endemically present in Africa or eastern Europe, are known to be such diseases with high man-to-man communicability. These four haemorrhagic fevers are, therefore, designated as special conditions requiring isolation during the period when the infected patients are shedding the viruses, not only in Japan but also in many other countries. We have so far only one such case of Lassa fever who returned to Japan from Sierra Leone in 1987. Some haemorrhagic fevers including dengue (haemorrhagic) fever and hantavirus infections (e.g. haemorrhagic fever with renal syndrome) are not known to be man-to-man transmissible and requiring no isolation. We have a number of dengue and dengue haemorrhagic fevers here in Japan today among imported febrile cases from tropical or subtropical countries. Every physician should take viral haemorrhagic fevers into consideration as one of the possibilities in diagnosing patients returning from overseas travel. PMID:9283226

Masuda, G

1997-08-01

37

Haemorrhagic Fevers, Viral  

MedlinePLUS

... fever, dengue, Omsk haemorrhagic fever, Kyasanur forest disease). Ebola virus diseases All information on Ebola virus disease Technical information, publications, situation assessments, feature ...

38

Educational Products Videotapes (VHS format, other formats by  

E-print Network

Educational Products DVDs Videotapes (VHS format, other formats by special request) and DVDs (-R://sprott.physics.wisc.edu/wop.htm#videos The quality of the DVDs is much higher than what you see from the streamed version. Lecture Kit A kit = Adult M) For more information or to place an order for T-shirts, DVDs or Lecture Kits contact: (608) 262

Saffman, Mark

39

Spontaneous Intratesticular Haemorrhage  

Microsoft Academic Search

Spontaneous intratesticular haemorrhage is a rare disease. Four cases have been described, all diagnosed after orchidectomy. We present an additional patient with a spontaneously arisen intratesticular haematoma in whom orchidectomy could be avoided.

Per Ovesen; Søren Mommsen

1991-01-01

40

Omsk haemorrhagic fever.  

PubMed

Omsk haemorrhagic fever is an acute viral disease prevalent in some regions of western Siberia in Russia. The symptoms of this disease include fever, headache, nausea, severe muscle pain, cough, and moderately severe haemorrhagic manifestations. A third of patients develop pneumonia, nephrosis, meningitis, or a combination of these complications. The only treatments available are for control of symptoms. No specific vaccine has been developed, although the vaccine against tick-borne encephalitis might provide a degree of protection against Omsk haemorrhagic fever virus. The virus is transmitted mainly by Dermacentor reticulatus ticks, but people are mainly infected after contact with infected muskrats (Ondatra zibethicus). Muskrats are very sensitive to Omsk haemorrhagic fever virus. The introduction of this species to Siberia in the 1930s probably led to viral emergence in this area, which had previously seemed free from the disease. Omsk haemorrhagic fever is, therefore, an example of a human disease that emerged owing to human-mediated disturbance of an ecological niche. We review the biological properties of the virus, and the epidemiological and clinical characteristics of Omsk haemorrhagic fever. PMID:20850178

R?žek, Daniel; Yakimenko, Valeriy V; Karan, Lyudmila S; Tkachev, Sergey E

2010-12-18

41

Ebola haemorrhagic fever.  

PubMed

This article focuses on the management of a patient who was admitted to The Aga Khan Hospital in Dar es Salaam, Tanzania, with suspected Ebola haemorrhagic fever (Ebola HF). It defines the disease, symptoms and how it is spread, diagnosed, treated and prevented. Recommendations are made for management of Ebola HF in a hospital setting. PMID:12216182

Walker, L

42

Is this charred material from a VHS video cassette?  

NASA Astrophysics Data System (ADS)

At his residence, a victim in a double homicide had installed a home-built video surveillance system. The suspects either knew of or discovered this system and removed it. In a backyard at a location associated with the suspects was a barrel used for burning trash. Could charred debris recovered from a metal bowl found among the contents of the barrel be the remains of a VHS video cassette? A positive answer to the question was obtained through a combination of optical microscopy, Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), and Energy Dispersive Spectroscopy (EDS).

Fruchtenicht, Tara; Blackledge, Robert D.; Williams, Teresa R.

2010-06-01

43

Comparison of MPEG-1 digital videotape with digitized sVHS videotape for quantitative echocardiographic measurements  

NASA Technical Reports Server (NTRS)

Digital format is rapidly emerging as a preferred method for displaying and retrieving echocardiographic studies. The qualitative diagnostic accuracy of Moving Pictures Experts Group (MPEG-1) compressed digital echocardiographic studies has been previously reported. The goals of the present study were to compare quantitative measurements derived from MPEG-1 recordings with the super-VHS (sVHS) videotape clinical standard. Six reviewers performed blinded measurements from still-frame images selected from 20 echocardiographic studies that were simultaneously acquired in sVHS and MPEG-1 formats. Measurements were obtainable in 1401 (95%) of 1486 MPEG-1 variables compared with 1356 (91%) of 1486 sVHS variables (P <.001). Excellent agreement existed between MPEG-1 and sVHS 2-dimensional linear measurements (r = 0.97; MPEG-1 = 0.95[sVHS] + 1.1 mm; P <.001; Delta = 9% +/- 10%), 2-dimensional area measurements (r = 0.89), color jet areas (r = 0.87, p <.001), and Doppler velocities (r = 0.92, p <.001). Interobserver variability was similar for both sVHS and MPEG-1 readings. Our results indicate that quantitative off-line measurements from MPEG-1 digitized echocardiographic studies are feasible and comparable to those obtained from sVHS.

Garcia, M. J.; Thomas, J. D.; Greenberg, N.; Sandelski, J.; Herrera, C.; Mudd, C.; Wicks, J.; Spencer, K.; Neumann, A.; Sankpal, B.; Soble, J.

2001-01-01

44

9 CFR 93.911 - Ports designated for the importation of live VHS-regulated fish species.  

...the importation of live VHS-regulated fish species. 93.911 Section 93.911...IMPORTATION OF CERTAIN ANIMALS, BIRDS, FISH, AND POULTRY, AND CERTAIN ANIMAL, BIRD... General Provisions for Vhs-Regulated Fish Species § 93.911 Ports...

2014-01-01

45

9 CFR 93.911 - Ports designated for the importation of live VHS-regulated fish species.  

Code of Federal Regulations, 2013 CFR

...the importation of live VHS-regulated fish species. 93.911 Section 93.911...IMPORTATION OF CERTAIN ANIMALS, BIRDS, FISH, AND POULTRY, AND CERTAIN ANIMAL, BIRD... General Provisions for Vhs-Regulated Fish Species § 93.911 Ports...

2013-01-01

46

9 CFR 93.911 - Ports designated for the importation of live VHS-regulated fish species.  

Code of Federal Regulations, 2012 CFR

...the importation of live VHS-regulated fish species. 93.911 Section 93.911...IMPORTATION OF CERTAIN ANIMALS, BIRDS, FISH, AND POULTRY, AND CERTAIN ANIMAL, BIRD... General Provisions for Vhs-Regulated Fish Species § 93.911 Ports...

2012-01-01

47

9 CFR 93.911 - Ports designated for the importation of live VHS-regulated fish species.  

Code of Federal Regulations, 2011 CFR

...the importation of live VHS-regulated fish species. 93.911 Section 93.911...IMPORTATION OF CERTAIN ANIMALS, BIRDS, FISH, AND POULTRY, AND CERTAIN ANIMAL, BIRD... General Provisions for Vhs-Regulated Fish Species § 93.911 Ports...

2011-01-01

48

9 CFR 93.911 - Ports designated for the importation of live VHS-regulated fish species.  

Code of Federal Regulations, 2010 CFR

...the importation of live VHS-regulated fish species. 93.911 Section 93.911...IMPORTATION OF CERTAIN ANIMALS, BIRDS, FISH, AND POULTRY, AND CERTAIN ANIMAL, BIRD... General Provisions for Vhs-Regulated Fish Species § 93.911 Ports...

2010-01-01

49

Ebola haemorrhagic fever  

PubMed Central

Ebola viruses are the causative agents of a severe form of viral haemorrhagic fever in man, designated Ebola haemorrhagic fever, and are endemic in regions of central Africa. The exception is the species Reston Ebola virus, which has not been associated with human disease and is found in the Philippines. Ebola virus constitutes an important local public health threat in Africa, with a worldwide effect through imported infections and through the fear of misuse for biological terrorism. Ebola virus is thought to also have a detrimental effect on the great ape population in Africa. Case-fatality rates of the African species in man are as high as 90%, with no prophylaxis or treatment available. Ebola virus infections are characterised by immune suppression and a systemic inflammatory response that causes impairment of the vascular, coagulation, and immune systems, leading to multiorgan failure and shock, and thus, in some ways, resembling septic shock. PMID:21084112

Feldmann, Heinz; Geisbert, Thomas W

2012-01-01

50

Early onset neonatal septicaemia in a level II nursery.  

PubMed

A prospective study of 486 high risk neonates admitted to a level II nursery in a relatively poor and rural area of Malaysia was carried out to determine the incidence, the spectrum of micro-organisms and predisposing factors in relation to early onset septicaemia. The incidence of proven or probable septicaemia was 57.61 per 1000 high risk newborns over 1.5 kg. The case fatality was 10.71 per cent. Coagulase negative staphylococci, Streptococcus Group B and Klebsiella species were the most commonly isolated organisms. Meconium staining of liquor was the most common risk factor for admission to the nursery, and prematurity was the most significant risk factor for early neonatal infection (P < 0.005) followed by small for gestational age (P < 0.04). Although the incidence of septicaemia was quite high in the level II nursery, the mortality rate was comparable to established figures. PMID:8057985

Malik, A S; Pennie, R A

1994-03-01

51

Hereditary Haemorrhagic Telangiectasia  

Microsoft Academic Search

\\u000a Hereditary Haemorrhagic Telangiectasia (HHT, Osler–Weber–Rendu syndrome) exemplifies diseases which have catalysed advances\\u000a in the understanding of fundamental pathophysiological mechanisms. The hallmark of HHT is the development of abnormal blood\\u000a vessels, involving the lung in approximately 50% of cases. This chapter will focus on the molecular mechanisms that underlie\\u000a their generation. While not all clinical problems in HHT can be directly

Claire Shovlin; S. Paul Oh

52

Hereditary haemorrhagic telangiectasia  

Microsoft Academic Search

Summary. Hereditary haemorrhagic telangiectasia (also known as Osler-Weber-Rendu syndrome) is a relatively common, under-recognized autosomal- dominant disorder that results from multisystem vascular dysplasia. It is characterized by telangiecta- ses and arteriovenous malformations of skin, mucosa and viscera. This article summarizes the clinical manifestations and the management of this disorder and its management. This review underscores an urgent need to conduct

A. S HAPIRO

2008-01-01

53

Haemorrhagic Enteropathies in Red Deer (Cervus Elaphus)  

Microsoft Academic Search

Sir, — I would like to draw your readers’ attention to the occurrence of post-stress haemorrhagic enteropathies in red deer (Cervus elaphus). Haemorrhagic enteropathy has been observed in approximately 75 percent of red deer necropsied at the Invermay Animal Health Laboratory and has also been seen in wapiti (Cervus canadensis). Deer dying with post-stress haemorrhagic enteropathy commonly have splash haemorrhages

H. J. F. McAllum

1982-01-01

54

VHS domains of ESCRT-0 cooperate in high-avidity binding to polyubiquitinated cargo  

SciTech Connect

VHS (Vps27, Hrs, and STAM) domains occur in ESCRT-0 subunits Hrs and STAM, GGA adapters, and other trafficking proteins. The structure of the STAM VHS domain-ubiquitin complex was solved at 2.6 {angstrom} resolution, revealing that determinants for ubiquitin recognition are conserved in nearly all VHS domains. VHS domains from all classes of VHS-domain containing proteins in yeast and humans, including both subunits of ESCRT-0, bound ubiquitin in vitro. ESCRTs have been implicated in the sorting of Lys63-linked polyubiquitinated cargo. Intact human ESCRT-0 binds Lys63-linked tetraubiquitin 50-fold more tightly than monoubiquitin, though only 2-fold more tightly than Lys48-linked tetraubiquitin. The gain in affinity is attributed to the cooperation of flexibly connected VHS and UIM motifs of ESCRT-0 in avid binding to the polyubiquitin chain. Mutational analysis of all the five ubiquitin-binding sites in yeast ESCRT-0 shows that cooperation between them is required for the sorting of the Lys63-linked polyubiquitinated cargo Cps1 to the vacuole.

Ren, Xuefeng; Hurley, James H. (NIH)

2010-03-30

55

Comparison of MPEG digital video with super VHS tape for diagnostic echocardiographic readings  

NASA Technical Reports Server (NTRS)

BACKGROUND: Digital recording of echocardiographic studies is on the clinical horizon. However, full digital capture of complete echocardiographic studies in traditional video format is impractical, given current storage capacity and network bandwidth. To overcome these constraints, we evaluated the diagnostic image quality of digital video by using MPEG (Motion Picture Experts Group) compression. METHODS AND RESULTS: Fifty-eight complete, consecutive studies were recorded simultaneously with the use of MPEG-1 and sVHS videotape. Each matched MPEG and sVHS study pair was reviewed by two from a total of six readers, and findings were recorded with the use of a detailed, computerized reporting tool. Intrareader and interreader discrepancies were characterized as major or minor and analyzed in total and for specific subgroups of findings (left and right ventricular parameters, valvular insufficiency, and left ventricular regional wall motion). Intrareader discrepancies were reviewed by a consensus panel for agreement with either MPEG or sVHS findings. There was an exact concordance between MPEG and sVHS readings in 83% of findings. The majority of discrepancies were minor, with major discrepancies in only 2.7% of findings. There was no difference in the rate of consensus panel agreement with MPEG or sVHS for instances of intrareader discrepancy, either in total or for any subgroup of findings. Interreader discrepancy rates were nearly identical for both MPEG and sVHS. CONCLUSIONS: MPEG-1 digital video is equivalent to sVHS videotape for diagnostic echocardiography. MPEG increases the range of practical options for digital echocardiography and offers, for the first time, the advantages of digital recording in a familiar video format.

Soble, J. S.; Yurow, G.; Brar, R.; Stamos, T.; Neumann, A.; Garcia, M.; Stoddard, M. F.; Cherian, P. K.; Bhamb, B.; Thomas, J. D.

1998-01-01

56

Dengue/dengue haemorrhagic fever  

NSDL National Science Digital Library

A World Health Organization page devoted to the control of dengue. Many excellent informative PDF files are available from this page dealing with vector control, as well as recognition of symptoms, and treatment of dengue haemorrhagic fever. Estimated numbers of at risk people are staggering. A powerful resource for teaching the importance of vector borne diseases.

0002-11-30

57

Delirium in Acute Subarachnoid Haemorrhage  

Microsoft Academic Search

Background: Delirium may be a presenting feature in acute subarachnoid haemorrhage (SAH). The aim of this study was to investigate the risk factors for delirium in acute SAH and to analyse the relation between delirium and location and amount of haematic densities and hydrocephalus. Methods: We assessed delirium in a sample of 68 consecutive patients with acute (?4 days) SAH

Lara Caeiro; Coraline Menger; José M. Ferro; Rodolfo Albuquerque; M. Luísa Figueira

2005-01-01

58

EWI12/BOB:Lrk/0568/vhs TEACHING AND EXAMINATION REGULATIONS  

E-print Network

.59 Higher Education and Research Act) Master's programmes Computer Science and Telematics Faculty for the Computer Science and Telematics programmes #12;EWI12/BOB:Lrk/0568/vhs Remarks These Teaching and examination regulations for the Master's programmes Computer Science and Telematics are in the format used

59

Takotsubo cardiomyopathy following subarachnoid haemorrhage.  

PubMed

A 67-year-old woman was admitted with aneurysmal subarachnoid haemorrhage and a 12-lead ECG showed ST segment elevation. Transthoracic echocardiography confirmed akinesis of the left ventricular mid-apical segment, with an ejection fraction of 26%, features characteristic of takotsubo cardiomyopathy. Five days later, we identified thrombus in the apex of the left ventricle. Sixteen days after onset, the thrombus had disappeared and wall motion improved (ejection fraction 58%) without evidence of cardioembolism. Takotsubo cardiomyopathy is a cause of cardiac dysfunction after stroke, including SAH. It is characterised by transiently depressed contractile function of the left mid and apical ventricle, without obstructive coronary artery disease. Clinicians should suspect takotsubo cardiomyopathy in patients with subarachnoid haemorrhage who have an ECG abnormality. Echocardiography is needed to detect the distinctive regional wall motion abnormality. Despite its severity in the acute phase, takotsubo cardiomyopathy is self-limiting and its management is conservative. PMID:24101552

Maekawa, Hidetsugu; Hadeishi, Hiromu

2014-08-01

60

Postoperative intracranial haemorrhage: a review.  

PubMed

Postoperative haemorrhage (POH) is one of the most serious complications of any cranial neurosurgical procedure and is associated with significant morbidity and mortality. The relative paucity of work investigating this postoperative complication prompted us to undertake a review of the literature, focussing on demographic, clinical, and surgical risk factors. A literature search was undertaken using Ovid MEDLINE (1950-2009) using keywords including craniectomy, craniotomy, neurosurgery, intracranial, reoperation, repeat craniotomy, postoperative, haemorrhage, haematoma, and bleeding. The rates of POH following intracranial procedures reported in the literature vary greatly, and meaningful comparison is difficult. We defined postoperative haemorrhage as that following craniotomy, which is clinically significant and requires surgical evacuation. Risk factors include pre-existing medical comorbidities including hypertension, coagulopathies and haematological abnormalities, intraoperative hypertension and blood loss, certain lesion pathologies including tumours, chronic subdural haematomas, and deficiencies in haemostasis. We conclude by providing recommendations for clinical practice based on the literature reviewed to aid clinicians in the detection and avoidance of POH. PMID:21246389

Seifman, Marc A; Lewis, Phillip M; Rosenfeld, Jeffrey V; Hwang, Peter Y K

2011-10-01

61

[Meningitis can resemble subarachnoid haemorrhage].  

PubMed

A 70 year-old man was admitted under the diagnosis of subarachnoid haemorrhage and presented with a history of ear pain, followed by acute onset of severe headache, nausea, vomiting, impaired consciousness, and fever. However, a computed tomography (CT) showed an acute mastoiditis and pneumocephalus, and a lumbar puncture confirmed the diagnosis meningitis. The increased middle ear pressure relative to the intracranial pressure had caused air and bacteria to penetrate intracerebrally. This case illustrates the importance of a rapid diagnostic workup in acute onset headache including a careful anamnesis, CT and lumbar puncture. PMID:22579098

Elghoura, Nour Foad Diab

2012-05-14

62

Assessment and management of gastrointestinal (GI) haemorrhage  

Microsoft Academic Search

Acute gastrointestinal (GI) bleeding is both a common reason for hospital attendance and a common occurrence in hospitalized patients. Acute upper gastrointestinal haemorrhage (AUGH) is much more likely to be responsible for profuse or life-threatening bleeding than is lower GI haemorrhage. Despite advances in endoscopic and pharmacological treatments, AUGH still carries an overall mortality of around 10%. Prompt assessment and

Andrew R. Moore; Anthony I. Morris

2008-01-01

63

Predicting deterioration in patients with lobar haemorrhages  

Microsoft Academic Search

OBJECTIVETo study the clinical course and determine predictors of deterioration in patients with lobar haemorrhages).METHODSA comprehensive review of 61 consecutive patients with lobar haemorrhages was performed. Neurological deterioration was defined as (1) decrease in Glasgow coma sum score by 2 points, (2) new neurological deficit, or (3) clinical signs of brain herniation. A univariate logistic regression was performed and expressed

Kelly D Flemming; Eelco F M Wijdicks; Erik K St Louis; Hongzhi Li

1999-01-01

64

[Haemorrhagic shock after severe blunt shoulder trauma].  

PubMed

The management of severe injured patients requires life-threatening lesions research, especially potential haemorrhagic lesions. The haemorrhagic shock is a rare but serious complication of shoulder girdle traumas. We report in this study the clinical and paraclinical signs that lead us to take care from such evolution. PMID:15904739

Da Costa-Silva, S; Bessereau, J; Ricard-Hibon, A; Juvin, Ph; Marty, J

2005-05-01

65

Secondary Haemorrhagic Disease of the Newborn  

PubMed Central

Clinical, laboratory, and necropsy findings are presented in 5 newborn infants who died with a haemorrhagic diathesis developing within 24 hours after birth. 4 babies were born prematurely; 3 suffered birth asphyxia; and 3 became hypothermic. Laboratory studies showed fibrin degradation products, low platelet counts, and deficient coagulation factors. At necropsy extensive subarachnoid haemorrhages of a characteristic type were seen in all cases, and intravascular fibrin deposits in all but one. Haemorrhage in these babies is considered to be due to consumption of platelets and coagulation factors as a consequence of disseminated intravascular coagulation. Predisposing conditions and possible pathogenic mechanisms are discussed. Platelet counts aid early diagnosis of this form of haemorrhagic disease. Treatment by exchange transfusion using fresh heparinized blood is suggested. ImagesFIG. 1.FIG. 2. PMID:5506940

Chessells, Judith M.; Wigglesworth, J. S.

1970-01-01

66

An unusual cause of lower gastrointestinal haemorrhage.  

PubMed

A previously unreported cause of lower gastrointestinal haemorrhage in a 63-year-old female patient on clopidogrel for cardiac comorbidities is presented. Endoscopy suggested a small bowel or colonic aetiology but failed to accurately localise the source. The patient became haemodynamically unstable despite conservative management and temporary cessation of clopidogrel. CT angiography demonstrated a pseudoaneurysm arising from the superior rectal artery. Percutaneous embolisation using coils was performed to successfully occlude the pseudoaneurysm, prevent further haemorrhage and avoid emergency colonic resection. PMID:22669967

Janmohamed, Azara; Noronha, Lizanne; Saini, Ashish; Elton, Colin

2011-01-01

67

[Haemorrhagic fever viruses, possible bioterrorist use].  

PubMed

The majority of haemorrhagic fever viruses are responsible for various clinical manifestations, the mutual characteristics of which are fever and haemorrhage in 5 to 70% of cases. All degrees of severity can be observed, ranging from isolated fever to multi-organ failure and death. These viruses belong to one of the following families: filoviridae, arenaviridae, bunyaviridae, and flaviviridae. They must be considered as dangerous biological weapons that could potentially be used. Most of the viruses responsible for haemorrhagic fever can be transmitted to humans through the air in spray form, except the dengue virus and the agents of haemorrhagic fever from the Congo Crimea and the haemorrhagic fever with renal syndrome that are difficult to handle in cell culture. In the event of a bioterrorist act, the management of persons infected or suspected of being so will be made by the referent departments of infectious diseases, defined by the French Biotox plan. Management includes isolation, confirmation or invalidation of the diagnosis and rapid initiation of treatment with ribavirin. Ribavirin is recommended for the treatment and prophylaxis of arenavirus and bunyavirus infections; it is not effective for the other families of virus. Except for yellow fever, there is no vaccination for the other forms of viral haemorrhagic fever. PMID:15687968

Rigaudeau, Sophie; Bricaire, François; Bossi, Philippe

2005-01-29

68

Anticoagulation-related intracranial extracerebral haemorrhage.  

PubMed Central

From January 1981 to June 1986 116 patients with anticoagulation-related intracranial haemorrhage were referred to hospital. Seventy six of these haemorrhages were extracerebral, 69 were in the subdural and seven in the subarachnoid space. No epidural haemorrhages were identified. Compared with non-anticoagulation-related haematomas, the risk of haemorrhage was calculated to be increased fourfold in men and thirteenfold in women. An acute subdural haematoma, mostly due to contusion, was more frequently accompanied by an additional intracerebral haematoma than a chronic subdural haematoma. Trauma was a more important factor in acute subdural haematomas than in chronic. Almost half of the patients (48%) had a history of hypertension, more than a third (35%) had heart disease and about one fifth (18%) were diabetic. Headache was the most frequent initial symptom. Later decreased level of consciousness and focal neurological signs exceeded the frequency of headache. Three patients with subarachnoid haemorrhage and nine patients with acute subdural haematomas died, while those with chronic subdural haematomas all survived and had at the most mild, non-disabling sequelae. Myocardial infarction (22%), pulmonary embolism (20%), and arterial disease (20%) were the most frequent reasons for anticoagulant treatment. Critical review based on established criteria for anticoagulation treatment suggests there was no medical reason to treat a third of these patients. The single most useful measure that could be taken to reduce the risk of anticoagulation-induced intracranial haemorrhage would be to identify patients who are being unnecessarily treated and to discontinue anticoagulants. PMID:2769275

Mattle, H; Kohler, S; Huber, P; Rohner, M; Steinsiepe, K F

1989-01-01

69

An unusual outbreak of Streptococcus bovis septicaemia in racing pigeons (Columba livia)  

Microsoft Academic Search

In December 1991, an outbreak of Streptococcus bovis septicaemia occurred in a Belgian pigeon loft where 25 male and 25 female racing pigeons were housed. The main clinical signs included inability to fly and poor breeding results. None of the female pigeons and only one male pigeon was able to fly. Nine affected pigeons were necropsied. Histologically a tenosynovitis of

P De Herdt; R Ducatelle; F Haesebrouck; LA Devriese; B De Groote; S Roels

1994-01-01

70

Post transfusion septicaemia 1980-1989: importance of donor arm cleansing  

Microsoft Academic Search

AIMS: To determine the prevalence of Pseudomonas fluorescens on the arms of blood donors, and to elucidate one possible cause for its predominance (60% of cases during 1980-89) in exogenous post transfusion septicaemia (PTS). METHODS: Skin swabs were taken from the arms of 782 blood donors and cultured on to heated blood agar. After incubation, Oxidase reagent and the Gram

A Puckett; G Davison; C C Entwistle; J A Barbara

1992-01-01

71

Effects of subarachnoid haemorrhage on intracranial prostaglandins.  

PubMed Central

Prostaglandins E2, F2 alpha, 6 oxo F1 alpha and thromboxane B2 increased in cisternal CSF following mock subarachnoid haemorrhage in dogs, particularly PGE2 (X25.5). Concentrations were increased also in lumbar CSF of five patients some 8 days after subarachnoid haemorrhage. Subarachnoid haemorrhage did not alter the production of prostaglandins by dog whole cortex or choroid plexuses in vitro, but production by pooled dissected cerebral arteries of PGE2 was increased and of 6 oxo F1 alpha was decreased. Intravenous indomethacin decreased prostaglandin production by cerebral tissues, and caused a marked decrease in the prostacyclin metabolite in CSF. The implications of our findings for the aetiology of cerebral vasospasm are discussed. PMID:6573437

Walker, V; Pickard, J D; Smythe, P; Eastwood, S; Perry, S

1983-01-01

72

Fatal Clostridium sordellii ischio-rectal abscess with septicaemia complicating ultrasound-guided transrectal prostate biopsy  

Microsoft Academic Search

Clostridium sordellii is a Gram-positive spore-forming anaerobic bacillus rarely encountered in human infection. A case of C. sordellii ischio-rectal abscess with rapidly fatal septicaemia is described which complicated ultrasound-guided transrectal biopsy of the prostate, despite ciprofloxacin prophylaxis. Neither C. sordellii ischio-rectal abscess nor ischio-rectal abscess complicating transrectal biopsy have been reported previously. Judging from our experience and the reviewed literature,

A. Borer; J. Gilad; E. Sikuler; K. Riesenberg; F. Schlaeffer; D. Buskila

1999-01-01

73

Sequential epidemic outbreaks of septicaemias by Serratia and Klebsiella species on a medical Intensive Care Unit  

Microsoft Academic Search

The high rate of septicaemias (20%, 19% and 14%) observed in our Intensive Care Unit (ICU) during the first 3 years was due to an epidemic incidence of Serratia sp. (S) (26% during the first year) and Klebsiella sp. (K) (25% during the third) and decreased significantly in the following 6 years (mean incidence of 11%) (ppppp2=3.78, p=0.052). The large

J. L. Cortés; E. Domínguez Villota; A. Algora-Weber; C. Chamorro; M. C. Torrecilla; J. M. Mosquera

1988-01-01

74

Vibrio parahemolyticus septicaemia in a liver transplant patient: a case report  

Microsoft Academic Search

Introduction  \\u000a Vibrio parahemolyticus is the leading cause of vibrio-associated gastroenteritis in the United States of America, usually related to poor food handling;\\u000a only rarely has it been reported to cause serious infections including sepsis and soft tissue infections. In contrast, Vibrio vulnificus is a well-known cause of septicaemia, especially in patients with cirrhosis. We present a patient with V. parahemolyticus

Rajeev R Fernando; Sujatha Krishnan; Morgan G Fairweather; Charles D Ericsson

2011-01-01

75

The Herpes Simplex Virus Type 1 vhs-UL41 Gene Secures Viral Replication by Temporarily Evading Apoptotic Cellular Response to Infection: Vhs-UL41 Activity Might Require Interactions with Elements of Cellular mRNA Degradation Machinery  

Microsoft Academic Search

We have previously shown that herpes simplex virus type 1 (HSV-1) infection is associated with early destabilization\\/degradation of infected cell mRNAs and consequent shutoff of host protein synthesis by the activity of the virion-associated host shutoff (vhs) UL41 protein. Wild-type (wt) virus destabilized\\/degraded the housekeeping -actin and -tubulin mRNAs as well host stress functions, like the heat shock 70 protein

Ari Barzilai; Ifaat Zivony-Elbom; Ronit Sarid; Eran Noah; Niza Frenkel

2006-01-01

76

Haemorrhage control in extremity stab injury  

PubMed Central

The Foley catheter is described in the emergency treatment of penetrating cardiac injuries, and its intra-operative use to control bleeding while definitive measures for intravascular embolization are being made. We present the first reported case of the use of a urinary catheter to control haemorrhage in an extremity stab injury to obtain haemodynamic stability while awaiting definitive surgical treatment. This quick, easy and useful technique can be used for junctional vascular injuries and wounds with a narrow neck, and can be easily removed once in the operating theatre. This life-saving, simple and cost-effective technique ‘internalises’ the externally applied pressure to control massive haemorrhage while awaiting definitive operative intervention. The catheter can be sutured in place if the patient is to be transferred to another department or hospital. PMID:24968429

Singh, R. A.; Asprou, F.; Patel, Amit; Trickett, R. W.

2013-01-01

77

Lessons from nosocomial viral haemorrhagic fever outbreaks.  

PubMed

The outbreak of Marburg haemorrhagic fever in Angola in 2004-2005 shows once again the devastating and rapid spread of viral haemorrhagic fevers in medical settings where hygiene practices are poorly applied or ignored. The legacy of years of war and poverty in Angola has resulted in very poor medical education and services. The initial high rate of infection among infants in Angola may have been related to poor hospital practices, possibly administration of vaccines. Though the outbreak in Angola was in a part of Africa not previously known to have filovirus infection, prior ecological modelling had predicted this location and many others. Prevention of future outbreaks will not be easy. The urgent need is dissemination of knowledge and the training, discipline and resources for good clinical practice. Educating the public to demand higher standards could be a powerful tool. Good practices are difficult to establish and maintain on the scale needed. PMID:16373655

Fisher-Hoch, Susan P

2005-01-01

78

Fatal jejunal haemorrhage syndrome in cows.  

PubMed

Jejunal haemorrhage syndrome in a four-year-old Holstein Friesian cow Umbilical cord accident in a stillborn calf Cerebellar abiotrophy/dysgenesis in a three-day-old calf Congenital swayback in a three-week-old lamb Louping ill in a two-week-old lamb These are among matters discussed in the disease surveillance report for June from SAC Consulting: Veterinary Services (SAC C VS). PMID:25344042

2014-10-25

79

Uterine artery embolization: an effective treatment for intractable obstetric haemorrhage  

Microsoft Academic Search

AIM: To present the findings of uterine artery embolization (UAE) in the management of obstetric haemorrhage.MATERIALS AND METHODS: From October 1999 to February 2003, 10 women with postpartum haemorrhage (n=7) and post-abortion haemorrhage with placenta accreta (n=3), were referred to our department for pelvic angiography and possible arterial embolization.RESULTS: Angiography revealed engorged and tortuous uterine arteries in all patients; and

T.-M Hong; H.-S Tseng; R.-C Lee; J.-H Wang; C.-Y Chang

2004-01-01

80

An unusual outbreak of Streptococcus bovis septicaemia in racing pigeons (Columba livia).  

PubMed

In December 1991, an outbreak of Streptococcus bovis septicaemia occurred in a Belgian pigeon loft where 25 male and 25 female racing pigeons were housed. The main clinical signs included inability to fly and poor breeding results. None of the female pigeons and only one male pigeon was able to fly. Nine affected pigeons were necropsied. Histologically a tenosynovitis of the tendon of the deep pectoral muscle was observed in most of them and S bovis was isolated from the canalis triosseus or the shoulder joints of five of the nine pigeons. The pigeons were successfully treated with ampicillin administered in the drinking water for seven days. PMID:8135007

De Herdt, P; Ducatelle, R; Haesebrouck, F; Devriese, L A; De Groote, B; Roels, S

1994-01-01

81

Pyogranulomatous myocarditis due to Staphylococcus aureus septicaemia in two harbour porpoises (Phocoena phocoena).  

PubMed

Staphylococcus aureus septicaemia was diagnosed in a dead, stranded harbour porpoise from the German Baltic Sea and in a live harbour porpoise by-caught in inner Danish waters and taken into captivity. Lesions included pyogranulomatous myocarditis, necrotising suppurative bronchopneumonia, pyelonephritis, osteomyelitis and leptomeningitis, and abscesses in lymph nodes and skeletal muscles. The captive animal had fibrinous suppurative epicarditis and pyogranulomatous myocarditis with abscesses. In both animals the organism was suspected to have entered through skin lesions or via the respiratory tract. PMID:11918049

Siebert, U; Müller, G; Desportes, G; Weiss, R; Hansen, K; Baumgärtner, W

2002-03-01

82

Outcome following subdural haemorrhages in infancy  

PubMed Central

Subdural haemorrhages (SDH) are associated with significant neurodisability in affected individuals. The incidence of SDH in infants is between 12 and 25 cases per 100?000 children and most detected SDH are due to physical abuse. In the infant brain, SDH are caused by tearing of the bridging veins in the subdural space and may result in significant brain injury. The challenge of assessing outcome in infants with SDH is evaluating whether SDH or other accompanying brain insults are instrumental in the neurodevelopmental outcome. PMID:17376941

Jayawant, Sandeep; Parr, Jeremy

2007-01-01

83

AN AUDIT OF PRIMARY POST PARTUM HAEMORRHAGE  

Microsoft Academic Search

(20.9%), prolonged labour 21 (21.9%), retained placental tissues, 11 (12.5%), retained placenta, 11 (11.4%) Couvelliar uterus, 10 (10.4%), placenta preavia, 8 (8.3%), placenta increta, 7 (7.3%), chorioamnionitis 5 (5.2%), and multiple pregnancy, 2 (2.1%). Risk factors, grand multiparity 70 (51.5%), antepartum haemorrhage 12 (8.9%), instrumental delivery 10(7.3%), previous PPH, 6 (4.5%), choreoamnionitis, 5 (3.6%), multiple pregnancy, 2 (1.5%), no risk

Shamshad Bibi; Nargis Danish; Anisa Fawad; Muhammad Jamil

84

Listeria septicaemia following insertion of a dynamic hip screw: A case report and literature review  

PubMed Central

INTRODUCTION Listeria monocytogenes is a food borne bacterial pathogen which is rarely encountered in the United Kingdom. This rare and potentially life threatening infection has a high mortality rate and therefore requires early antimicrobial intervention. PRESENTATION OF CASE A case report of a patient who developed Listeria septicaemia following insertion of a dynamic hip screw is described. This 84 year old immunocompromised lady had a mechanical fall at home, from which she sustained a left neck of femur fracture. She had a background of rheumatoid arthritis, and for the last 10 years had been taking 5 mg prednisolone daily. After early surgical intervention with a dynamic hip screw, she developed Listeria septicaemia, following which she was treated successfully with ampicillin and gentamicin. DISCUSSION Infection with unusual pathogens is not uncommon amongst immunocompromised patients. Regardless of the cause, this cohort of patients’ requires increased post operative surveillance to ensure that such a complication does not go unnoticed. CONCLUSION This case report demonstrates the importance of having a low threshold for investigation in immunocompromised patients whilst also stressing the significance of early diagnosis and intervention. PMID:22706298

Shahban, Shafiq Arif; Manjula, Natarajan; Siddiqui, Shabih

2012-01-01

85

Targeted obstetric haemorrhage programme improves incoming resident confidence and knowledge.  

PubMed

Postpartum haemorrhage is an infrequent but potentially life-threatening obstetrical emergency amenable to simulation. An educational programme consisting of a lecture and high-fidelity simulation exercise was given to incoming obstetrics and gynaecology (OB) and family medicine (FM) residents. Residents reported pre- and post-intervention confidence scores on a 1-5 Likert scale and a subset completed a postpartum haemorrhage knowledge assessment. Residents reported significant improvements in confidence in parameters involved in diagnosis and management of postpartum haemorrhage. The postpartum haemorrhage test mean scores significantly increased (57.4 ± 9.6% vs 77.1 ± 7.9%, p < 0.01) and were significantly correlated to confidence scores (Spearman's coefficient of 0.651, p < 0.001). In conclusion, an education programme that incorporates high-fidelity simulation of postpartum haemorrhage improves the confidence and knowledge of incoming residents and appears to be an effective educational approach. PMID:24219716

Straub, H L; Morgan, G; Ochoa, P; Grable, I; Wang, E; Kharasch, M; Plunkett, B A

2013-11-01

86

Application of screening tools to detect risk of hospital readmission in elderly patients in Valencian Healthcare System (VHS) (Spain).  

PubMed

The Sustainable Social and Healthcare Model (SSHM) is aimed to establish new care pathways in primary care systems contributing to the decrease of health services use and costs and improve the integration and efficiency of social and health care for elderly people with long-term care (LTC) needs. One of these strategies is the segmentation of population in risk groups through standardized tools. This paper is a retrospective study aimed to determine the viability of the implementation of the screening tools Probability of Repeated Admission - Pra - and The Community Assessment Risk Screen - CARS - to detect patients at risk of hospital readmission in a sample of 500 elderly people (65+) from the VHS in Spain. Patients were recruited from three Health Departments. Data from selected tools and predictive variables were collected through the healthcare database from the VHS. The most important results indicate that both instruments predict with high efficacy the proportion of patients not readmitted (negative predictive value between 91% and 92%). Moreover, the tools performed with a moderate efficiency being the Pra less sensitive (54%) and more specific (81%) than CARS (with a sensitivity and specificity of 64%). Results from this study suggest that the application of instruments as Pra and CARS are of interest to the Valencian Health Administration as they can be a good strategy to improve the management of elderly patients at risk with comorbidities and guiding clinical decision. PMID:25022713

Doñate-Martínez, Ascensión; Garcés Ferrer, Jorge; Ródenas Rigla, Francisco

2014-01-01

87

Evolutionary analysis of the ENTH/ANTH/VHS protein superfamily reveals a coevolution between membrane trafficking and metabolism  

PubMed Central

Background Membrane trafficking involves the complex regulation of proteins and lipids intracellular localization and is required for metabolic uptake, cell growth and development. Different trafficking pathways passing through the endosomes are coordinated by the ENTH/ANTH/VHS adaptor protein superfamily. The endosomes are crucial for eukaryotes since the acquisition of the endomembrane system was a central process in eukaryogenesis. Results Our in silico analysis of this ENTH/ANTH/VHS superfamily, consisting of proteins gathered from 84 complete genomes representative of the different eukaryotic taxa, revealed that genomic distribution of this superfamily allows to discriminate Fungi and Metazoa from Plantae and Protists. Next, in a four way genome wide comparison, we showed that this discriminative feature is observed not only for other membrane trafficking effectors, but also for proteins involved in metabolism and in cytokinesis, suggesting that metabolism, cytokinesis and intracellular trafficking pathways co-evolved. Moreover, some of the proteins identified were implicated in multiple functions, in either trafficking and metabolism or trafficking and cytokinesis, suggesting that membrane trafficking is central to this co-evolution process. Conclusions Our study suggests that membrane trafficking and compartmentalization were not only key features for the emergence of eukaryotic cells but also drove the separation of the eukaryotes in the different taxa. PMID:22748146

2012-01-01

88

Bichat guidelines for the clinical management of haemorrhagic fever viruses and bioterrorism-related haemorrhagic fever viruses.  

PubMed

Haemorrhagic fever viruses (HFVs) are a diverse group of viruses that cause a clinical disease associated with fever and bleeding disorder. HFVs that are associated with a potential biological threat are Ebola and Marburg viruses (Filoviridae), Lassa fever and New World arenaviruses (Machupo, Junin, Guanarito and Sabia viruses) (Arenaviridae), Rift Valley fever (Bunyaviridae) and yellow fever, Omsk haemorrhagic fever, and Kyanasur Forest disease (Flaviviridae). In terms of biological warfare concerning dengue, Crimean-Congo haemorrhagic fever and Hantaviruses, there is not sufficient knowledge to include them as a major biological threat. Dengue virus is the only one of these that cannot be transmitted via aerosol. Crimean-Congo haemorrhagic fever and the agents of haemorrhagic fever with renal syndrome appear difficult to weaponise. Ribavirin is recommended for the treatment and the prophylaxis of the arenaviruses and the bunyaviruses, but is not effective for the other families. All patients must be isolated and receive intensive supportive therapy. PMID:15677844

Bossi, Philippe; Tegnell, Anders; Baka, Agoritsa; Van Loock, Frank; Hendriks, Jan; Werner, Albrecht; Maidhof, Heinrich; Gouvras, Georgios

2004-12-01

89

Bilateral adrenal gland haemorrhage: an unusual cause  

PubMed Central

Summary Our patient had drainage of a large amoebic liver abscess. This got complicated by a severe degree of hypotension, which required aggressive fluid resuscitation and hydrocortisone support. Computerised tomography (CT) of the abdomen revealed bilateral adrenal gland haemorrhage (BAH) resulting in primary adrenal gland failure, which was the cause for hypotension. Patient was on long-term warfarin for provoked deep vein thrombosis of lower limb, which was discontinued before the procedure. Thrombophilia profile indicated the presence of lupus anticoagulant factor with prolonged activated partial thromboplastin time (aPTT). Patient was discharged on lifelong warfarin. This case emphasises the need for strong clinical suspicion for diagnosing BAH, rare but life-threatening condition, and its association with amoebic liver abscess and anti-phospholipid antibody syndrome (APLS). Learning points Recognition of BAH as a rare complication of sepsis.APLS can rarely cause BAH. PMID:25276353

Shenoy, Vasant; Malabu, Usman; Cameron, Donald; Sangla, Kunwarjit

2014-01-01

90

Viral haemorrhagic fever and vascular alterations.  

PubMed

Pathogenesis of viral haemorrhagic fever (VHF) is closely associated with alterations of the vascular system. Among the virus families causing VHF, filoviruses (Marburg and Ebola) are the most fatal, and will be focused on here. After entering the body, Ebola primarily targets monocytes/macrophages and dendritic cells. Infected dendritic cells are largely impaired in their activation potency, likely contributing to the immune suppression that occurs during filovirus infection. Monocytes/macrophages, however, immediately activate after viral contact and release reasonable amounts of cytokines that target the vascular system, particularly the endothelial cells. Some underlying molecular mechanisms such as alteration of the vascular endothelial cadherin/catenin complex, tyrosine phosphorylation, expression of cell adhesion molecules, tissue factor and the effect of soluble viral proteins released from infected cells to the blood stream will be discussed. PMID:18278167

Aleksandrowicz, P; Wolf, K; Falzarano, D; Feldmann, H; Seebach, J; Schnittler, H

2008-02-01

91

Sporadic Lateral Ventricular Hemangioblastoma presenting with Intraventricular and Subarachnoid Haemorrhage.  

PubMed

Intraventricular hemangioblastoma (HB) is very rare; few cases of intraventricular HB have been reported in the literature, either sporadically or in association with von Hippel-Lindau disease. Furthermore, the incidence of ventricular haemorrhage from HB seems to be uncommon. We report a unique case of sporadic HB of the right lateral ventricle presenting with intratumoural and intraventricular haemorrhage in addition to multifocal intracranial superficial siderosis, indicating the presence of a subarachnoid haemorrhage (SAH) as well. Such a combination has not been reported before. In the future, the detection of an intraventricular mass in association with ventricular haemorrhage, with or without SAH, should include HB as a differential diagnosis, particularly when the imaging appearances are not typical of the more common intraventricular tumours. PMID:24273675

Al-Najar, Mahasen; Al-Hadidy, Azmy; Saleh, Alaa; Al-Tamimi, Ahmad; Al-Darawish, Asaad; Obeidat, Fatima

2013-11-01

92

Spontaneous iliopsoas haemorrhage--an unusual complication of streptokinase therapy.  

PubMed Central

We report a case of spontaneous iliopsoas haemorrhage following intravenous streptokinase which serves to remind physicians of the potential dangers of this form of therapy. Images Figure 1 PMID:2099433

Gillanders, I. A.; Nakielny, R.; Channer, K. S.

1990-01-01

93

[Retinal haemorrhages in non-accidental head injury in childhood].  

PubMed

Retinal haemorrhages are one of the three cardinal manifestations of the "shaken baby syndrome" or "non-accidental head injury" in childhood. The role of an ophthalmologist in suspected non-accidental head injury has not only medical but also legal aspects and has been discussed controversially in the literature. The differential diagnosis and the specificity of retinal haemorrhages in childhood for an abusive head trauma will be pointed out in this paper. PMID:25181505

Oberacher-Velten, I M; Helbig, H

2014-09-01

94

An Unusual Case of Bilateral Vitreous Haemorrhage following Snake Bite  

PubMed Central

A-45-year-old man presented to us with diminution of vision in both eye following snake bite. On examination vision in the right eye (RE) was 6/36 and vision in left eye (LE) was hand movement positive and fundus examination revealed a subhyloid haemorrhage, left eye showed vitreous haemorrhage. Patient was advised bed rest, vitamin C tablets and oral steroids. PMID:24454404

Bhandari, Vipul; Lohia, Meenal

2013-01-01

95

[A new viral infectious disease: Ebola haemorrhagic fever (author's transl)].  

PubMed

All references about a new viral infection, which was seen in Sudan and Zaire at 1976 called "Ebola Haemorrhagic Fever" with high fever, diarrhoea, vomiting and great systemic haemorrhagic manifestations were reviewed. We discussed the history, etiology, epidemiology, source of infections, mode of transmission, period of communicability, clinical and laboratory findings and control measures of the disease. Some comments were made about what could be done, if a new disease of unknown etiology is seen in any part of our country. PMID:7453587

Tuncer, A

1980-01-01

96

Rabbit haemorrhagic disease (RHD) and rabbit haemorrhagic disease virus (RHDV): a review  

PubMed Central

Rabbit haemorrhagic disease virus (RHDV) is a calicivirus of the genus Lagovirus that causes rabbit haemorrhagic disease (RHD) in adult European rabbits (Oryctolagus cuniculus). First described in China in 1984, the virus rapidly spread worldwide and is nowadays considered as endemic in several countries. In Australia and New Zealand where rabbits are pests, RHDV was purposely introduced for rabbit biocontrol. Factors that may have precipitated RHD emergence remain unclear, but non-pathogenic strains seem to pre-date the appearance of the pathogenic strains suggesting a key role for the comprehension of the virus origins. All pathogenic strains are classified within one single serotype, but two subtypes are recognised, RHDV and RHDVa. RHD causes high mortality in both domestic and wild adult animals, with individuals succumbing between 48-72 h post-infection. No other species has been reported to be fatally susceptible to RHD. The disease is characterised by acute necrotising hepatitis, but haemorrhages may also be found in other organs, in particular the lungs, heart, and kidneys due to disseminated intravascular coagulation. Resistance to the disease might be explained in part by genetically determined absence or weak expression of attachment factors, but humoral immunity is also important. Disease control in rabbitries relies mainly on vaccination and biosecurity measures. Such measures are difficult to be implemented in wild populations. More recent research has indicated that RHDV might be used as a molecular tool for therapeutic applications. Although the study of RHDV and RHD has been hampered by the lack of an appropriate cell culture system for the virus, several aspects of the replication, epizootology, epidemiology and evolution have been disclosed. This review provides a broad coverage and description of the current knowledge on the disease and the virus. PMID:22325049

2012-01-01

97

The rabbit shunt model of subarachnoid haemorrhage.  

PubMed

Aneurysmal subarachnoid haemorrhage (SAH) is a disease with devastating complications that leads to stroke, permanent neurological deficits and death. Clinical and ex-perimental work has demonstrated the importance of the contribution of delayed cerebral vasospasm (DCVS) indepen-dent early events to mortality, morbidity and functional out-come after SAH. In order to elucidate processes involved in early brain injury (EBI), animal models that reflect acute events of aneurysmal bleeding, such as increase in intracranial pressure (ICP) and decrease in cerebral perfusion pressure, are needed. In the presented arterial shunt model, bleeding is initially driven by the pressure gradient between mean arterial blood pressure and ICP. SAH dynamics (flow rate, volume and duration) depend on physiological reactions and local anatomical intrathecal (cistern) conditions. During SAH, ICP reaches a plateau close to diastolic arterial blood pressure and the blood flow stops. Historical background, anaesthesia, perioperative care and monitoring, SAH induction, technical considerations and advantages and limitations of the rabbit blood shunt SAH model are discussed in detail. Awareness of technical details, physiological characteristics and appropriate monitoring methods guarantees successful implementation of the rabbit blood shunt model and allows the study of both EBI and DCVS after SAH. PMID:25326333

Marbacher, Serge; Nevzati, Edin; Croci, Davide; Erhardt, Salome; Muroi, Carl; Jakob, Stephan M; Fandino, Javier

2014-12-01

98

Characterization of a VHS virus genotype III isolated from rainbow trout (Oncorhychus mykiss) at a marine site on the west coast of Norway  

PubMed Central

Background Norwegian production of rainbow trout (Oncorhynchus mykiss) has been without any outbreaks of VHS for many years until the disease emerged in a farm in western Norway in November 2007. The fish were, in addition to VHS virus, positive for gill chlamydia-like bacteria, Flavobacterium psychrophilum, and a microsporidian. A new VHS virus genotype III was isolated from the fish in RTgill-W1 cells and the complete coding region (11,065 nucleotides) was sequenced. This virus was also used in a challenge experiment to see if it could cause any mortality in rainbow trout in sea water. Results This is the first time a nearly complete sequence of a genotype III virus isolate has been presented. The organization of the genes is the same as in the other VHS virus genotypes studied (GI and GIV). Between the ORFs are nontranslated regions that contain highly conserved sequences encompassing the polyadenylation signal for one gene, and the putative transcription initiation site of the next gene. The intergenic regions vary in length from 74 nt to 128 nt. The nucleotide sequence is more similar to genotype I isolates compared to isolates from genotype II and IV. Analyses of the sequences of the N and G protein genes show that this new isolate is distinct from other VHS virus isolates and groups closely together with isolates from genotype III. In a challenge experiment, using intraperitoneal (ip) injection of the isolate, co-habitation with infected fish, and bath challenge, mortalities slightly above 40% were obtained. There was no significant difference in mortality between the bath challenged group and the ip injected group, while the mortality in the co-habitation group was as low as 30%. Conclusions All VHS virus isolates in genotype III are from marine fish in the North East Atlantic. Unlike the other known genotype III isolates, which are of low virulence, this new isolate is moderately virulent. It was not possible to detect any changes in the virus genome that could explain the higher virulence. A major problem for the study of virulence factors is the lack of information about other genotype III isolates. PMID:20102597

2010-01-01

99

[Fatal alveolar haemorrhage following a "bang" of cannabis].  

PubMed

The new methods of cannabis consumption (home made water pipe or "bang") may be responsible for fatal respiratory complications. We present a case, with fatal outcome, of a man of 19 years with no previous history other than an addiction to cannabis using "bang". He was admitted to intensive care with acute dyspnoea. A CT scan showed bilateral, diffuse alveolar shadowing. He was anaemic with an Hb of 9.3g/l. Bronchoalveolar lavage revealed massive alveolar haemorrhage. Investigations for infection and immunological disorder were negative and toxicology was negative except for cannabis. Antibiotic treatment was given and favourable progress allowed early discharge. Death occurred 15 days later due to alveolar haemorrhage following a further "bang" of cannabis. Autopsy showed toxic alveolar haemorrhage. The probable mechanism is pulmonary damage due to acid anhydrides released by the incomplete combustion of cannabis in contact with plastic. These acids have a double effect on the lungs: a direct toxicity with severe inflammation of the mucosa leading to alveolar haemorrhage and subsequently the acid anhydrides may lead to the syndrome of intra-alveolar haemorrhage and anaemia described in occupational lung diseases by Herbert in Oxford in 1979. It manifests itself by haemoptysis and intravascular haemolysis. We draw attention to the extremely serious potential consequences of new methods of using cannabis, particularly the use of "bang" in homemade plastic materials. PMID:21943539

Grassin, F; André, M; Rallec, B; Combes, E; Vinsonneau, U; Paleiron, N

2011-09-01

100

Ebola haemorrhagic fever in Zaire, 1976.  

PubMed

Between 1 September and 24 October 1976, 318 cases of acute viral haemorrhagic fever occurred in northern Zaire. The outbreak was centred in the Bumba Zone of the Equateur Region and most of the cases were recorded within a radius of 70 km of Yambuku, although a few patients sought medical attention in Bumba, Abumombazi, and the capital city of Kinshasa, where individual secondary and tertiary cases occurred. There were 280 deaths, and only 38 serologically confirmed survivors.The index case in this outbreak had onset of symptoms on 1 September 1976, five days after receiving an injection of chloroquine for presumptive malaria at the outpatient clinic at Yambuku Mission Hospital (YMH). He had a clinical remission of his malaria symptoms. Within one week several other persons who had received injections at YMH also suffered from Ebola haemorrhagic fever, and almost all subsequent cases had either received injections at the hospital or had had close contact with another case. Most of these occurred during the first four weeks of the epidemic, after which time the hospital was closed, 11 of the 17 staff members having died of the disease. All ages and both sexes were affected, but women 15-29 years of age had the highest incidence of disease, a phenomenon strongly related to attendance at prenatal and outpatient clinics at the hospital where they received injections. The overall secondary attack rate was about 5%, although it ranged to 20% among close relatives such as spouses, parent or child, and brother or sister.Active surveillance disclosed that cases occurred in 55 of some 550 villages which were examined house-by-house. The disease was hitherto unknown to the people of the affected region. Intensive search for cases in the area of north-eastern Zaire between the Bumba Zone and the Sudan frontier near Nzara and Maridi failed to detect definite evidence of a link between an epidemic of the disease in that country and the outbreak near Bumba. Nevertheless it was established that people can and do make the trip between Nzara and Bumba in not more than four days: thus it was regarded as quite possible that an infected person had travelled from Sudan to Yambuku and transferred the virus to a needle of the hospital while receiving an injection at the outpatient clinic.Both the incubation period, and the duration of the clinical disease averaged about one week. After 3-4 days of non-specific symptoms and signs, patients typically experienced progressively severe sore throat, developed a maculopapular rash, had intractable abdominal pain, and began to bleed from multiple sites, principally the gastrointestinal tract. Although laboratory determinations were limited and not conclusive, it was concluded that pathogenesis of the disease included non-icteric hepatitis and possibly acute pancreatitis as well as disseminated intravascular coagulation.This syndrome was caused by a virus morphologically similar to Marburg virus, but immunologically distinct. It was named Ebola virus. The agent was isolated from the blood of 8 of 10 suspected cases using Vero cell cultures. Titrations of serial specimens obtained from one patient disclosed persistent viraemia of 10(6.5)-10(4.5) infectious units from the third day of illness until death on the eighth day. Ebola virus particles were found in formalin- PMID:307456

1978-01-01

101

Ebola haemorrhagic fever in Zaire, 1976  

PubMed Central

Between 1 September and 24 October 1976, 318 cases of acute viral haemorrhagic fever occurred in northern Zaire. The outbreak was centred in the Bumba Zone of the Equateur Region and most of the cases were recorded within a radius of 70 km of Yambuku, although a few patients sought medical attention in Bumba, Abumombazi, and the capital city of Kinshasa, where individual secondary and tertiary cases occurred. There were 280 deaths, and only 38 serologically confirmed survivors. The index case in this outbreak had onset of symptoms on 1 September 1976, five days after receiving an injection of chloroquine for presumptive malaria at the outpatient clinic at Yambuku Mission Hospital (YMH). He had a clinical remission of his malaria symptoms. Within one week several other persons who had received injections at YMH also suffered from Ebola haemorrhagic fever, and almost all subsequent cases had either received injections at the hospital or had had close contact with another case. Most of these occurred during the first four weeks of the epidemic, after which time the hospital was closed, 11 of the 17 staff members having died of the disease. All ages and both sexes were affected, but women 15-29 years of age had the highest incidence of disease, a phenomenon strongly related to attendance at prenatal and outpatient clinics at the hospital where they received injections. The overall secondary attack rate was about 5%, although it ranged to 20% among close relatives such as spouses, parent or child, and brother or sister. Active surveillance disclosed that cases occurred in 55 of some 550 villages which were examined house-by-house. The disease was hitherto unknown to the people of the affected region. Intensive search for cases in the area of north-eastern Zaire between the Bumba Zone and the Sudan frontier near Nzara and Maridi failed to detect definite evidence of a link between an epidemic of the disease in that country and the outbreak near Bumba. Nevertheless it was established that people can and do make the trip between Nzara and Bumba in not more than four days: thus it was regarded as quite possible that an infected person had travelled from Sudan to Yambuku and transferred the virus to a needle of the hospital while receiving an injection at the outpatient clinic. Both the incubation period, and the duration of the clinical disease averaged about one week. After 3-4 days of non-specific symptoms and signs, patients typically experienced progressively severe sore throat, developed a maculopapular rash, had intractable abdominal pain, and began to bleed from multiple sites, principally the gastrointestinal tract. Although laboratory determinations were limited and not conclusive, it was concluded that pathogenesis of the disease included non-icteric hepatitis and possibly acute pancreatitis as well as disseminated intravascular coagulation. This syndrome was caused by a virus morphologically similar to Marburg virus, but immunologically distinct. It was named Ebola virus. The agent was isolated from the blood of 8 of 10 suspected cases using Vero cell cultures. Titrations of serial specimens obtained from one patient disclosed persistent viraemia of 106.5-104.5 infectious units from the third day of illness until death on the eighth day. Ebola virus particles were found in formalin- PMID:307456

1978-01-01

102

Value of integron detection for predicting antibiotic resistance in patients with Gram-negative septicaemia.  

PubMed

Multidrug-resistant Enterobacteriaceae are a major public health threat and complicate the choice of drugs for empirical antibiotic therapy, especially in sepsis patients who require rapid, appropriate treatment. The objective of this study was to examine the value of integrons as a global predictive marker of acquired antibiotic resistance in septicaemia-causing Enterobacteriaceae by direct detection in positive blood cultures. The integron genetic marker can be detected in a single test, whereas multiple PCRs are needed to detect the hundreds of known antibiotic resistance genes. A total of 166 positive blood cultures were included in the study, and integrons were detected with a quantitative PCR method both in positive blood cultures and isolated Enterobacteriaceae. The results of integron detection directly on positive blood cultures were consistent in 98.8% of cases with integron detection in isolated Enterobacteriaceae. Negative predictive values (NPVs) were >90% for resistance to third-generation cephalosporins, aminoglycosides, ciprofloxacin and trimethoprim/sulfamethoxazole. In the current context of antibiotic stewardship, these good NPVs indicate that this method might be useful for preserving broad-spectrum antibiotics. The results of this proof-of-concept study must be confirmed in order to demonstrate the clinical relevance of integron detection, not only in positive blood cultures but also, to gain time, in raw biological samples. PMID:25130099

Barraud, Olivier; François, Bruno; Chainier, Delphine; Vignaud, Julie; Ploy, Marie-Cécile

2014-10-01

103

Antibodies to haemorrhagic fever viruses in Madagascar populations.  

PubMed

Sera of 381 adult people from 5 areas in Madagascar were tested by the indirect immunofluorescence method for antibodies against Congo-Crimean haemorrhagic fever and Rift Valley fever viruses (Bunyaviridae), Ebola (strains Zaire and Sudan) and Marburg viruses (Filoviridae), and Lassa virus (Arenaviridae). The highest prevalence rate was that of Ebola virus (4.5%). As no haemorrhagic syndrome has been found associated with this virus, the possible presence of a less pathogenic, antigenically related, strain is discussed. The prevalences of Congo-Crimean haemorrhagic fever and Rift Valley viruses were very low, despite previous viral isolations from potential vectors. No serum reacted against Lassa or Marburg antigens. The results are analysed in the light of the geographical and bioecological characteristics of Madagascar, which is a true 'microcontinent' very different from the African mainland. PMID:2515626

Mathiot, C C; Fontenille, D; Georges, A J; Coulanges, P

1989-01-01

104

Risk factors associated with optic disc haemorrhage in patients with normal tension glaucoma  

Microsoft Academic Search

PurposeTo evaluate the risk factors associated with optic disc haemorrhage in patients with normal tension glaucoma (NTG).Patients and methodsTwo hundred and eighty-one eyes of 281 patients with NTG (113 eyes with optic disc haemorrhage and 168 eyes without haemorrhage) were included in this study. Associations between optic disc haemorrhage and various patient-related variables (diabetes; hypertension; hypotension; cardiac disease; stroke; cold

Y-d Kim; S B Han; K H Park; S H Kim; S J Kim; M Seong; T W Kim; D M Kim

2010-01-01

105

Acute neck pain, an atypical presentation of subarachnoid haemorrhage  

PubMed Central

Subarachnoid haemorrhage can be a massively debilitating condition with long?term repercussions. The “classic” presentation of sudden?onset severe headache normally raises suspicions. However, if the presentation is atypical, the diagnosis may be missed. We report on a 52?year?old man who presented with a 1?day history of progressively worsening right?sided neck pain spreading to the chest with associated symptoms of autonomic dysfunction. After initial stabilisation, the patient's Glasgow Coma Scale (GCS) score declined, with subsequent CT scan showing an extensive subarachnoid haemorrhage. PMID:17384369

Ahmed, Julian; Blakeley, Chris; Sakar, Ramy; Aktar, Khalida; Hashemi, Kambiz

2007-01-01

106

Acute neck pain, an atypical presentation of subarachnoid haemorrhage.  

PubMed

Subarachnoid haemorrhage can be a massively debilitating condition with long-term repercussions. The "classic" presentation of sudden-onset severe headache normally raises suspicions. However, if the presentation is atypical, the diagnosis may be missed. We report on a 52-year-old man who presented with a 1-day history of progressively worsening right-sided neck pain spreading to the chest with associated symptoms of autonomic dysfunction. After initial stabilisation, the patient's Glasgow Coma Scale (GCS) score declined, with subsequent CT scan showing an extensive subarachnoid haemorrhage. PMID:17384369

Ahmed, Julian; Blakeley, Chris; Sakar, Ramy; Aktar, Khalida; Hashemi, Kambiz

2007-04-01

107

Effects of apolipoprotein E genotype on outcome after ischaemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage  

PubMed Central

Background Rodent models of acute ischaemic stroke and head injury suggest that apolipoprotein E (APOE) genotype influences neuronal repair, regeneration and survival after brain injury. Possession of an APOE ?4 allele is associated with poor outcome after head injury in clinical studies. APOE might therefore influence outcome after acute stroke in humans. Objective and methods To comprehensively search, identify, assess and carry out meta?analyses of studies reporting on the association between APOE and the combined outcome of death or dependency, or death alone, several months after ischaemic stroke, intracerebral haemorrhage (ICH) or subarachnoid haemorrhage (SAH). Results Main analyses included data from nine studies on 2262 patients (1453 with ischaemic stroke, 199 with ICH and 610 with SAH). Overall, ?4+ genotypes were not significantly associated with risk of death or dependency several months after stroke. However, there was significant heterogeneity between studies, and between the three pathological types of stroke. ?4+ genotypes were associated with increased death or dependency after SAH (relative risk (RR) 1.40, 95% confidence interval (CI) 1.06 to 1.84), with a trend towards a similar association with ICH (RR 1.38, 95% CI 0.99 to 1.92), but not with ischaemic stroke (RR 0.98, 95% CI 0.85 to 1.12). Results were similar for death alone. Conclusions APOE may differentially affect outcome after the three main pathological types of stroke. Further, large studies are needed to confirm or refute these findings, and to assess the possibility of an interaction between the effects of APOE and age. PMID:16926234

Martinez-Gonzalez, N A; Sudlow, C L M

2006-01-01

108

Ventriculostomy associated haemorrhage: A complication of anti-platelet therapy during coiling.  

PubMed

Abstract A young man with Fisher grade IV subarachnoid haemorrhage (SAH) underwent aneurysm coiling following external ventriculostomy. Coiling was complicated by thrombus formation and parent vessel occlusion necessitating anti-platelet therapy. Several hours after anti-platelet therapy, catastrophic haemorrhage associated with the ventriculostomy tract occurred. Timing and location of haemorrhage suggest combined anti-platelet therapy and ventriculostomy may have been causal. The literature on ventriculostomy haemorrhage rates and risks with concomitant anti-platelet therapy are reviewed. Where endovascular coiling is being considered, the possibility of ventriculostomy-related haemorrhage should be considered and should influence subsequent treatment decisions. PMID:24810986

Sims-Williams, Hugh P; Weinberg, Daniel; Jadun, Changez K; Brydon, Howard L

2014-12-01

109

Diffuse alveolar haemorrhage associated with aerosol propellant use.  

PubMed

Diffuse alveolar haemorrhage (DAH) is a clinical syndrome resulting from injury to the alveolar microcirculation, most commonly associated with not only autoimmune disorders or connective tissue disease, but also a variety of infections, neoplasms and toxins. We report here a case of an otherwise healthy young man with DAH attributable to an inhalation injury resulting from use of aerosol spray paint. PMID:23955981

Kelchen, Phillip; Jamous, Fady; Huntington, Mark K

2013-01-01

110

Haemorrhages in head tissues during the asphyxiation process  

Microsoft Academic Search

Two rates of carbon dioxide flow into the termination chamber were applied for the euthanasia of rats. The classical phases of asphyxia were observed in both groups of animals although their course was prolonged in rats exposed to the lower gas flow. The haemorrhages were assessed histologically in the following structures: the pericranium, compact bone and diploë of the skull,

Roman Hauser; Zbigniew Jankowski; Tomasz Gos; Maciej Krzy?anowski

2001-01-01

111

Subdural haemorrhage in infants: when are they non-accidental?  

Microsoft Academic Search

Subdural haemorrhage is relatively common in children under the age of 2 years. The most common cause is shaken baby syndrome. Paediatricians are often challenged to make this diagnosis with confidence. A clinician must approach this problem from a thorough understanding of the epidemiological, clinical, pathological features of the condition. He\\/she must work with a team of specialists in the

A. Kemp

2001-01-01

112

Rare retinal haemorrhages in translational accidental head trauma in children  

Microsoft Academic Search

Purpose The characteristic findings in accidental head injury consist of linear skull fracture, epidural haematoma, localized subdural haematoma, or cortical contusion because of a linear or translational impact force. Retinal haemorrhages have been found, although uncommon, in accidental head trauma.Methods We performed a retrospective study of 24 consecutive cases of children with severe head injuries caused by falls. Inclusion criteria

V Sturm; P B Knecht; K Landau; M N Menke

2009-01-01

113

Optimal treatment determination on the basis of haematoma volume and intra-cerebral haemorrhage score in patients with hypertensive putaminal haemorrhages: a retrospective analysis of 310 patients  

PubMed Central

Background Hypertensive putaminal haemorrhage comprises major part of intra-cerebral haemorrhages, with particularly high morbidity and mortality. However, the optimal treatments for these individuals remain controversial. Methods From June 2010 to August 2013, patients with hypertensive putaminal haemorrhages were treated in the Department of Neurosurgery, West China Hospital. Information regarding the age, signs of cerebral herniation, haematoma volume, intra-ventricular haemorrhage, intra-cerebral haemorrhage score and the treatments of each patient were analyzed retrospectively. The outcome was evaluated by the 30-day mortality rate. Results The 30-day mortality rate of the patients with haematomas volume greater than or equal to 30 ml and intra-cerebral haemorrhage scores of 1 or 2 was decreased in the surgical group compared with those in the conservative group (1.92% VS. 21.40%, OR?=?0.072, p?=?0.028; 15.40% VS. 33.3%, OR?=?0.365, p?=?0.248, respectively). The mortality rate of the patients with signs of cerebral herniation was not significantly different between the surgical and conservative groups (83.30% VS. 100%; p?=?0.529). The intra-cerebral haemorrhage score was significantly associated with the 30-day mortality rate of patients with intra-cerebral haemorrhages (r?=?-0.798, p?haemorrhage scores of 1 or 2 could benefit from the surgical removal of haematomas. The intra-cerebral haemorrhage score can accurately predict the 30-day mortality rate of patients with hypertensive putaminal haemorrhages. PMID:24996971

2014-01-01

114

Bilateral adrenal haemorrhagic infarction in a patient with antiphospholipid syndrome.  

PubMed

A 68-year-old woman with antiphospholipid syndrome presented with a 3-day history of bilateral loin pain, vomiting, fever and confusion. On examination she was febrile, hypotensive and tachycardic. Investigations revealed raised inflammatory markers, renal impairment and hyponatraemia. Abdominal ultrasound revealed two well-defined heterogeneous areas bilaterally in the region of the adrenal glands. This prompted serum cortisol measurement and a CT of the abdomen. Cortisol was low in the context of sepsis at 48?nmol/L, and CT confirmed bilateral heterogeneous adrenal pathology. The patient was managed for septic shock and adrenal insufficiency. She was recognised to have several risk factors for haemorrhagic infarction of the adrenals: antiphospholipid syndrome, sepsis, postoperative state and anticoagulant therapy. She was discharged well on glucocorticoid and mineralocorticoid therapy and a repeat CT at 4?weeks confirmed the diagnosis of bilateral adrenal infarct and haemorrhage. PMID:25410037

Godfrey, Rebecca Louise; Clark, James; Field, Benjamin

2014-01-01

115

Endometriosis: a rare and interesting cause of recurrent haemorrhagic ascites.  

PubMed

Recurrent haemorrhagic ascites as a cause of endometriosis is rare. We report the case of a 36-year-old woman presenting acutely with abdominal distension, ascites and an elevated CA-125 raising the suspicion of ovarian malignancy. Tissue biopsies retrieved during laparoscopy confirmed the diagnosis of endometriosis associated with haemorrhagic ascites. Gonadotropin-releasing hormone (GnRH) analogues were started to manage symptoms, with good effect. Subsequently, in vitro fertilisation resulted in a successful singleton pregnancy and by the second trimester, there was full resolution in symptoms. During the early puerperal period, the development of massive ascites recurred, requiring symptomatic relief through repeated ascitic drainage and GnRH analogues. Long-term follow-up is planned with the hope of continuing with medical management at least until the patient's family is complete when the surgical option of bilateral salpingo-oophorectomy with or without hysterectomy will be discussed. PMID:25355738

Bignall, Jenine; Arambage, Kirana; Vimplis, Sotirios

2014-01-01

116

Detection and localization of internal haemorrhaging using electrical bioimpedance  

NASA Astrophysics Data System (ADS)

Electrical bioimpedance is an effective measuring tool to provide quick, non-invasive, real-time results which will be applied to the detection of internal haemorrhaging. Experiments were performed on female Fancy Rats weighing 333±44g, and 10mL of porcine blood was injected abdominally over 3 minutes. Data was collected using an 8×8 needle electrode array at 5 kHz, and 95 kHz and sent to the BioParHom Z-Flow. A strong correlation was found between the electrode paths crossing directly through the blood injection site, showing a decrease of about -0.17±0.1?/mL for the 5 kHz frequency. This correlation allows us to quickly detect internal haemorrhaging and also localize it with the current path set-up in the electrode array.

Morse, J.; Fenech, M.

2013-04-01

117

Do retinal haemorrhages occur in infants with convulsions?  

Microsoft Academic Search

Aim:To determine the prevalence of retinal haemorrhages in infants presenting with convulsions and admitted to hospital, and to consider whether this finding indicates shaken baby syndrome.Methods:Prospective study of children aged 15 days to 2 years admitted with a diagnosis of first convulsion over a 2-year period (May 2004–May 2006). All infants were examined by an experienced ophthalmologist using indirect ophthalmoscopy

A I Curcoy; V Trenchs; M Morales; A Serra; M Pineda; J Pou

2009-01-01

118

Neurovascular phenotypes in hereditary haemorrhagic telangiectasia patients according to age  

Microsoft Academic Search

Hereditary haemorrhagic telangiectasia (HHT) is inherited as an autosomal dominant trait with varying penetrance and expressivity. Some of the most devastating consequences of this disease result from cerebral vascular malformations that manifest themselves in either arteriovenous fistulae (AVF), small nidus-type arteriovenous malformations (AVM) or micro-AVMs with a nidus less than 1 cm in size. The purpose of this study was to

T. Krings; A. Ozanne; S. M. Chng; H. Alvarez; G. Rodesch; P. L. Lasjaunias

2005-01-01

119

Haemorrhage into juxta-facet cysts causing bilateral foot drop  

PubMed Central

An 89 year old gentleman awaiting surgery for carcinoma of caecum presented with sudden back pain and developed foot drop two weeks later. MRI revealed multiple spinal metastases with a cyst in the canal at L4/5 causing spinal canal stenosis. Surgery revealed a juxta articular synovial cyst with haemorrhage in it. We discuss the presentation and management of juxtarticular cysts with a review of the literature. PMID:24960793

George, KJ; Roy, D; Shad, A

2012-01-01

120

Auditory laterality and attentional deficits after thalamic haemorrhage  

Microsoft Academic Search

Thalamic lesions have been shown to produce severe cognitive deficits involving language and memory. A majority of the studies\\u000a have reported cognitive deficits after lesions in the anterior and dorsomedial thalamic nuclei. We report five case studies\\u000a of effects on language processing after postero-dorsal thalamic haemorrhages. Four of the patients had lesions on the right\\u000a side, and one patient had

Knut Wester; Dexter R. F. Irvine; Kenneth Hugdahl

2001-01-01

121

Prevention of upper gastrointestinal haemorrhage: current controversies and clinical guidance  

PubMed Central

Acute upper gastrointestinal (GI) bleeding is a common medical emergency and associated with significant morbidly and mortality. The risk of bleeding from peptic ulceration and oesophagogastric varices can be reduced by appropriate primary and secondary preventative strategies. Helicobacter pylori eradication and risk stratification with appropriate gastroprotection strategies when used with antiplatelet drugs and nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in preventing peptic ulcer bleeding, whilst endoscopic screening and either nonselective beta blockade or endoscopic variceal ligation are effective at reducing the risk of variceal haemorrhage. For secondary prevention of variceal haemorrhage, the combination of beta blockade and endoscopic variceal ligation is more effective. Recent data on the possible interactions of aspirin and NSAIDs, clopidogrel and proton pump inhibitors (PPIs), and the increased risk of cardiovascular adverse events associated with all nonaspirin cyclo-oxygenase (COX) inhibitors have increased the complexity of choices for preventing peptic ulcer bleeding. Such choices should consider both the GI and cardiovascular risk profiles. In patients with a moderately increased risk of GI bleeding, a NSAID plus a PPI or a COX-2 selective agent alone appear equivalent but for those at highest risk of bleeding (especially those with previous ulcer or haemorrhage) the COX-2 inhibitor plus PPI combination is superior. However naproxen seems the safest NSAID for those at increased cardiovascular risk. Clopidogrel is associated with a significant risk of GI haemorrhage and the most recent data concerning the potential clinical interaction of clopidogrel and PPIs are reassuring. In clopidogrel-treated patients at highest risk of GI bleeding, some form of GI prevention is indicated. PMID:23997925

Brooks, Johanne; Warburton, Richard

2013-01-01

122

Spontaneous subdural haemorrhage in a patient with scleroderma renal crisis.  

PubMed

A 52-year-old woman with a history of systemic sclerosis presented with new onset seizures and renal failure. The patient's history, laboratory data and pathology supported the diagnosis of scleroderma renal crisis. The patient was also noted to have a subdural haemorrhage (SDH) in the absence of trauma. This is the first report of scleroderma renal crisis associated with a spontaneous SDH. PMID:25193814

Bhangoo, Munveer Singh; Hein, Paul; Nicholson, Laura; Carter, Caitlin

2014-01-01

123

Liver Enzymes and Ultrastructure in Rabbit Haemorrhagic Disease (RHD)  

Microsoft Academic Search

Rabbit haemorrhagic disease (RHD) is caused by a calicivirus infection that kills most adult rabbits 24–72 h after viral inoculation.\\u000a Two liver enzymes (AST, aspartate aminotransferase, and ALT, alanine aminotransferase) were monitored in blood samples of\\u000a calicivirus-infected rabbits during the short course of RHD. Values of AST were used to differentiate three stages of hepatocellular\\u000a degeneration in RHD: mild (up

P. G. Ferreira; A. Costa-e-Silva; E. Monteiro; M. J. R. Oliveira; A. P. Águas

2006-01-01

124

Damage control resuscitation from major haemorrhage in polytrauma.  

PubMed

Trauma is a global disease that affects patients across the socio-economic spectrum. Uncontrolled major haemorrhage occurs from both blunt and penetrating trauma which may lead to hypovolaemic shock and ultimately death. In polytrauma patients that require urgent resuscitation secondary to major haemorrhage, high volume fluid infusions followed by definitive surgical care have been superseded by damage control resuscitation. DCR is a systematic approach to major trauma that integrates the principles of haemostatic resuscitation, permissive hypotension and damage control surgery (DCS). The aim of DCR is to aggressively minimise hypovolaemic shock and limit the development of coagulopathy, hypothermia and acidosis known as the lethal triad. Besides increased volumes of scientific knowledge to underpin modern trauma resuscitation techniques upon, patient survival is also dependent upon effective teamwork and leadership. In conclusion, successful resuscitation from major haemorrhage depends upon a variety of factors distilled into a trauma team with effective leadership, excellent technical and non-technical team skills as well as the early initiation of DCR. PMID:23412314

Carlino, William

2014-02-01

125

Managing Major Postpartum Haemorrhage following Acute Uterine Inversion with Rusch Balloon Catheter  

PubMed Central

Acute postpartum uterine inversion is a relatively rare complication. The uterus inverts and the uterine fundus prolapses to or through the dilated cervix. It is associated with major postpartum haemorrhage with or without shock. Shock is sometimes out of proportion to the haemorrhage. Minimal maternal morbidity and mortality can be achieved when uterine inversion is promptly and aggressively managed. We present this report of three cases of acute uterine inversion complicated with major postpartum haemorrhage and managed with Rusch balloon. The paper highlights the importance of early recognition and the safety of the use of intrauterine balloon to manage major postpartum haemorrhage in these cases. PMID:24826322

Keriakos, Remon; Chaudhuri, Smriti Ray

2011-01-01

126

Quantification of exercise-induced pulmonary haemorrhage with bronchoalveolar lavage.  

PubMed

Exercise-induced pulmonary haemorrhage (EIPH) causes serious economic losses in the horse racing industry. Endoscopic examination indicates that 40-90% of horses exhibit EIPH following sprint exercise, but the limitations of the endoscope prevent diagnosis in many horses. Bronchoalveolar lavage (BAL) was utilised to detect red blood cells (RBCs) in the terminal airways in 6 horses. Two lavages were performed at weekly intervals prior to exercise, one within 90 min after exercise, and 5 at weekly intervals after exercise. The horses were exercised strenuously at 12.5-14.6 m/s on a treadmill (3 degree incline). Heart rates ranged from 192-207 beats/min, and mean pulmonary arterial pressures (mPAP) ranged from 80-102 mmHg. Neither epistaxis nor endoscopic evidence of EIPH was seen in any of the 6 horses following exercise. However, the number of RBCs in the lavage fluid increased significantly over control values immediately after exercise in all horses but returned to control values by one week after exercise. Haemosiderophages in the BAL fluid did not increase until one week after exercise and remained elevated for 3 weeks after exercise. Twenty per cent of the total population of alveolar macrophages contained haemosiderin. A positive relationship occurred between the number of RBCs in the lavage fluid and mPAP; the amount of haemorrhage increased as the mPAP exceeded 80 to 90 mmHg. The results with BAL used as the diagnostic tool, suggest that all strenuously exercised horses may exhibit EIPH; the amount of haemorrhage appears to be associated with the magnitude of the high pulmonary arterial pressure. PMID:9705109

Meyer, T S; Fedde, M R; Gaughan, E M; Langsetmo, I; Erickson, H H

1998-07-01

127

A review of the pathophysiology of exercise-induced pulmonary haemorrhage in the equine athlete  

Microsoft Academic Search

In the United States, more than 75% of equine athletes are reported to suffer from exercise-related haemorrhage of the respiratory tract (Voynick and Sweeney, 1986; Sweeney et al., 1990). Fiberoptic endoscopy has traced the source of blood to beyond the bifurcation of the trachea. In 1981, the term exercise-induced pulmonary haemorrhage (EIPH) was introduced (Pascoe et al., 1981). Racehorses of

L. L. Donaldson

1991-01-01

128

Aetiological examination of an outbreak of haemorrhagic syndrome in a broiler flock in Japan  

Microsoft Academic Search

The aetiology of an outbreak of haemorrhagic syndrome (HS) in a commercial broiler flock was examined. At a rearing farm, 596 of 6376 chicks (9.3%) in a flock were culled with depression and increased mortality from 12 to 26 days of age, with a peak at 16 to 19 days of age. Most of the affected chicks examined had haemorrhagic

N. Yuasa; K. Imai; K. Watanabe; F. Saito; M. Abe; K. Komi

1987-01-01

129

Classification of Non-Aneurysmal Subarachnoid Haemorrhage: CT Correlation to the Clinical Outcome.  

PubMed

To propose a new computed tomography (CT)-based classification system for nonaneurysmal subarachnoid haemorrhage (SAH), which predicts patients' discharge clinical outcome and helps to prioritize appropriate patient management. A 5-year, retrospective, two-centre study was carried out involving 1486 patients presenting with SAH. One hundred and ninety patients with nonaneurysmal SAH were included in the study. Initial cranial CT findings at admission were correlated with the patients' discharge outcomes measured using the Modified Rankin Scale (MRS). A CT-based classification system (type 1 e 4) was devised based on the topography of the initial haemorrhage pattern. Seventy-five percent of the patients had type 1 haemorrhage and all these patients had a good clinical outcome with a discharge MRS of 1. Eight percent of the patients presented with type 2 haemorrhage, 62% of which were discharged with MRS of 1 and 12% of patients had MRS 3 or 4. Type 3 haemorrhage was found in 10%, of which 16% had good clinical outcome, but 53% had moderate to severe disability (MRS 3 and 4) and 5% were discharged with severe disability (MRS 5). Six percent of patients presented with type 4 haemorrhage of which 42% of the patients had moderate to severe disability (MRS 3 and 4), 42% had severe disability and one-sixth of the patients died. Highly significant differences were found between type 1 (1a and 1b) and type 2 (p¼ 0.003); type 2 and type 3 (p ¼ 0.002); type 3 and type 4 (p ¼ 0.001). Haemorrhages of the type 1 category are usually benign and do not warrant an extensive battery of clinical and radiological investigations. Type 2 haemorrhages have a varying prognosis and need to be investigated and managed along similar lines as that of an aneurysmal haemorrhage with emphasis towards radiological investigation. Type 3 and type 4 haemorrhages need to be extensively investigated to find an underlying cause. PMID:24059766

Nayak, S; Kunz, A B; Kieslinger, K; Ladurner, G; Killer, M

2011-10-31

130

Diffuse alveolar haemorrhage due to 5-nitroimidazole treatment.  

PubMed

Diffuse alveolar haemorrhage (DAH) is indicated by the presence of red blood cells, fibrin and haemosiderin deposits in the lung parenchyma. We present a case of DAH in a 25-year-old male following 5-nitroimidazole treatment. The first episode of haemoptysis occurred following metronidazole treatment 10 months previously. The second episode of haemoptysis occurred following ornidazole treatment 10 days before admission. During his first admission, the patients haemoglobin concentration decreased to 40 g/L. The CXR was normal, whereas high resolution CT of the lungs revealed a diffuse acinonodular pattern. Serological tests for connective tissue diseases were negative. The haemorrhagic appearance of the BAL fluid obtained during fibreoptic bronchoscopy was consistent with DAH. Microbiological analysis of the BAL fluid showed no evidence for bacterial or mycobacterial infection. Haemosiderin laden macrophages were detected in BAL fluid and lung biopsy specimens. DAH due to use of 5-nitroimidazole was diagnosed on the basis of the patient's previous history and complete recovery following treatment with corticosteroid. This is the first reported case of DAH due to use of 5-nitroimidazole. Physicians should be aware of this side-effect when prescribing this group of drugs to patients. PMID:19645871

Uyar, Meral; Elbek, Osman; Bayram, Nazan; Ekiz, Sule; Bakir, Kemal; Dikensoy, Oner

2009-05-01

131

Octreotide infusion or emergency sclerotherapy for variceal haemorrhage.  

PubMed

To compare octreotide with injection sclerotherapy in the treatment of acute variceal haemorrhage, patients admitted with gastrointestinal bleeding and oesophageal varices confirmed by endoscopy were randomised to receive either emergency sclerotherapy with 3% sodium tetradecyl sulphate or octreotide (50 micrograms intravenous bolus plus 50 micrograms per h intravenous infusion for 48 h). At the end of the study period (48 h), the octreotide group also had sclerotherapy to obliterate the varices. 100 patients were recruited. Demographic features including the aetiology of portal hypertension and the Child-Pugh's grading of the two groups were similar. Bleeding was initially controlled in 90% of patients by emergency sclerotherapy and in 84% by octreotide infusion (95% confidence interval 0-19.5, p = 0.55). There were no significant differences between the two groups in early (within 48 h of randomisation) rebleeding (16% vs 14%), blood transfusion (3 units vs 3.5), hospital stay (5 days vs 6 days), or hospital mortality (27% vs 20%). No notable side-effects were associated with octreotide. We conclude that octreotide infusion and emergency sclerotherapy are equally effective in controlling variceal haemorrhage. PMID:8103145

Sung, J J; Chung, S C; Lai, C W; Chan, F K; Leung, J W; Yung, M Y; Kassianides, C; Li, A K

1993-09-11

132

Bioinformatics analysis of rabbit haemorrhagic disease virus genome  

PubMed Central

Background Rabbit haemorrhagic disease virus (RHDV), as the pathogeny of Rabbit haemorrhagic disease, can cause a highly infectious and often fatal disease only affecting wild and domestic rabbits. Recent researches revealed that it, as one number of the Caliciviridae, has some specialties in its genome, its reproduction and so on. Results In this report, we firstly analyzed its genome and two open reading frameworks (ORFs) from this aspect of codon usage bias. Our researches indicated that mutation pressure rather than natural is the most important determinant in RHDV with high codon bias, and the codon usage bias is nearly contrary between ORF1 and ORF2, which is maybe one of factors regulating the expression of VP60 (encoding by ORF1) and VP10 (encoding by ORF2). Furthermore, negative selective constraints on the RHDV whole genome implied that VP10 played an important role in RHDV lifecycle. Conclusions We conjectured that VP10 might be beneficial for the replication, release or both of virus by inducing infected cell apoptosis initiate by RHDV. According to the results of the principal component analysis for ORF2 of RSCU, we firstly separated 30 RHDV into two genotypes, and the ENC values indicated ORF1 and ORF2 were independent among the evolution of RHDV. PMID:22044910

2011-01-01

133

How to manage peroperative haemorrhage when vaginally treating genital prolapse.  

PubMed

Surgery of genital prolapse causes haemorrhagic complications in about 1% of cases. The pelvis is highly vascular and accessing the usual landmarks of vaginal surgery, in particular the sciatic spine, is delicate work. Meticulous dissection of closed spaces is often difficult, and exposure and haemostatic procedures will be challenging in the event of any bleeding complication. When fixing prosthesis to the sacrospinous ligament, the inferior gluteal artery and its coccygeal branch are at risk. Fixation to the sacrospinous ligament must be performed more than 25mm away from the sciatic spine and, if possible, must not transfixiate it. Safe insertion of prosthesis requires sufficient experience, and an adequate learning curve. Being aware of vascular anatomy allows one to understand and treat haemorrhagic incidents. Packing or selective embolization seem to be the two methods to adopt, depending on the severity of bleeding and the conditions of exposure on the one hand, and on the technical resources available for embolization, on the other. Hypogastric ligature appears to be ineffective in this context. PMID:24813082

Azaïs, H; Bassil, A; Giraudet, G; Rubod, C; Lucot, J-P; Cosson, M

2014-07-01

134

w RAPID RISK ASSESSMENT Outbreak of Ebola haemorrhagic  

E-print Network

Main conclusions and recommendations An outbreak of Ebola haemorrhagic fever is currently ongoing in Uganda with 38 cases reported, including 16 deaths. Two similar outbreaks have been seen in the past in Uganda. Through these, Uganda has developed a solid experience in dealing with such outbreaks, with the support currently of the World Health Organization, the US Centers for Disease Control and Prevention, and specialised non-governmental organisations. As the incubation period can be up to three weeks, it is likely that additional cases will be identified in the coming weeks. However, control measures currently implemented in Uganda with the support of international partners, such as isolation of cases and active monitoring of contacts, should prevent further spread of the disease. It is unlikely, but not impossible, that travellers infected in Uganda could arrive in the EU while incubating the disease and develop symptoms while in the EU. However, such cases should seek medical attention and be isolated, therefore preventing further transmission. EU citizens in Uganda are not at risk of becoming infected unless they are in direct contact with bodily fluids of dead or living infected persons or animals. Avoiding such contact would effectively mitigate this risk. Public health issue To assess the risk at EU level associated with the current Ebola haemorrhagic fever outbreak in Uganda. Source and date of request ECDC internal decision on 1 August 2012. Consulted experts ECDC experts.

unknown authors

2012-01-01

135

A huge cystic hygroma of the neck associated with intraventricular haemorrhage in a term neonate.  

PubMed

We report on a female term neonate who presented with a huge cystic hygroma of the right neck associated with intraventricular haemorrhage as demonstrated by computerized tomography and magnetic resonance imaging studies. She underwent extraventricular drainage and excision of the neck mass with stable postoperative condition. Psychomotor retardation was found thereafter. To our knowledge, the association of a large cystic hygroma of the neck with intracranial haemorrhage has not been reported previously. The possible mechanism of the occurrence of the haemorrhage is discussed. PMID:10229051

Yang, A D; Chang, Y L; Chaou, W T

1999-03-01

136

Critical care in emergency department: massive haemorrhage in trauma.  

PubMed

Inadequate resuscitation of major haemorrhage is an important cause of avoidable death in severely injured patients. Early recognition of blood loss, control of bleeding and restoration of circulating volume are critical to the management of trauma shock, and transfusion of blood components is a key intervention. Vital signs may be inadequate to determine the need for transfusion, and resuscitation regimens targeting vital signs may be harmful in the context of uncontrolled bleeding. This article addresses current concepts in haemostatic resuscitation. Recent guidelines on the diagnosis and treatment of coagulopathy in major trauma, and the role of component and adjuvant therapies, are considered. Finally, the potential role of thromboelastography and rotational thromboelastometry are discussed. PMID:22328635

Mahambrey, Tushar; Pendry, Katherine; Nee, Alexandra; Bonney, Samantha; Nee, Patrick A

2013-01-01

137

Haemorrhage after home birth: audit of decision making and referral.  

PubMed

In the Netherlands, 20 per cent of women give birth at home. In 0.7 per cent, referral to secondary care because of postpartum haemorrhage (PPH) is indicated. Midwives are regularly trained in managing obstetric emergencies. A postgraduate training programme developed for Dutch community-based midwives called 'CAVE' (pre-hospital obstetric emergency course) focuses on the identification and management of obstetric emergencies, including timely and adequate referral to hospital. This descriptive study aims to identify substandard care (SSC) in PPH after home birth in the Netherlands. Sixty seven cases of PPH reported by community-based midwives were collected. After applying selection criteria, seven cases were submitted to audit. The audit panel consisted of 12 midwives (of which seven contributed a case), 10 obstetricians, an educational expert and an ambulance paramedic. First, an individual assessment was performed by all members. Subsequently, at a plenary audit meeting, SSC factors were determined and assigned incidental, minor and major substandard care. PMID:24371910

Smit, Marrit; Dijkman, Anneke; Rijnders, Marlies; Bustraan, Jacqueline; van Dillen, Jeroen; Middeldorp, Johanna; Havenith, Barbara; van Roosmalen, Jos

2013-11-01

138

A rare case of Weil's disease with alveolar haemorrhage  

PubMed Central

Leptospirosis, a disease of protean manifestations occurs sporadically throughout the year with a peak seasonal incidence during the rainy season mimicking other febrile viral illness. In the rare case, the disease leads to renal and hepatic involvement with hemorrhage which may be associated with multisystem organ dysfunction in form of pulmonary, cardiac and central nervous system, when it is known as Weil's disease. Rarely haemorrhagic manifestations are assosciated. Early diagnosis is important as sometimes the disease may be life threatening. Proper antibiotics results in dramatic improvement. We hereby presented a case that had clinical features of Weil's disease with cough, dyspnoea and haemoptysis. Leptospirosis was detected on ELISA testing. Patient was cured rapidly with antibiotics. PMID:25183149

Chakrabarti, Abhiram; Nandy, Manab; Pal, Dipankar; Mallik, Sudesna

2014-01-01

139

Aneurysmal subarachnoid haemorrhage in Parry-Rhomberg syndrome  

PubMed Central

Parry–Romberg syndrome (PRS) or progressive hemi facial atrophy syndrome is a rare condition of unknown aetiology that is characterised by progressive unilateral facial and cranial atrophic changes of skin, subcutaneous tissues and bone. The authors describe a 37-year-old female with a history of PRS, who presented with a subarachnoid haemorrhage secondary to rupture of a 9 mm fusiform aneurysm of the posterior cerebral artery. There was an associated external carotid arterio-venous fistula noted with this aneurysm. The aneurysm was treated by endovascular route and was successfully coiled. Follow-up angiogram revealed spontaneous resolution of the fistula with good occlusion of the aneurysm. The aetio-pathogenesis of this rare occurrence, literature review and its management is discussed. PMID:22674607

Kuechler, Derek; Kaliaperumal, Chandrasekaran; Hassan, Alfrazdaq; Fanning, Noel; Wyse, Gerry; O'Sullivan, Michael

2011-01-01

140

Umbilical cord ulceration causing foetal haemorrhage and stillbirth.  

PubMed

We report a case of umbilical cord ulceration associated with obstruction of the duodeno-jejunal junction by a peritoneal band. Umbilical cord ulceration is a rare condition; a literature review identified a total of 17 cases only. In all cases, the ulceration was associated with congenital intestinal obstruction. Cord ulceration usually presents as sudden foetal deterioration due to foetal haemorrhage. This condition is associated with high perinatal mortality and morbidity. The causes of this condition are still unknown, and prenatal diagnosis is difficult. Awareness of the possible association between umbilical cord ulceration and intestinal obstruction, and of the need to deliver such pregnancies immediately when an abnormal foetal heart rate pattern develops might be the only means of preventing intrauterine death and improving neonatal outcomes. PMID:18382024

Chan, Symphorosa S C; Lau, Amy P K; To, K F; Leung, T Y; Lau, T K; Leung, T N

2008-04-01

141

Viewpoint: filovirus haemorrhagic fever outbreaks: much ado about nothing?  

PubMed

The recent outbreak of Marburg haemorrhagic fever in the Democratic Republic of Congo has put the filovirus threat back on the international health agenda. This paper gives an overview of Marburg and Ebola outbreaks so far observed and puts them in a public health perspective. Damage on the local level has been devastating at times, but was marginal on the international level despite the considerable media attention these outbreaks received. The potential hazard of outbreaks, however, after export of filovirus from its natural environment into metropolitan areas, is argued to be considerable. Some avenues for future research and intervention are explored. Beyond the obvious need to find the reservoir and study the natural history, public health strategies for a more timely and efficient response are urgently needed. PMID:10886793

Borchert, M; Boelaert, M; Sleurs, H; Muyembe-Tamfum, J J; Pirard, P; Colebunders, R; Van der Stuyft, P; van der Groen, G

2000-05-01

142

Threat of Marburg and Ebola viral haemorrhagic fevers in Africa.  

PubMed

Marburg and Ebola viruses are members of the filovirus family that can be regarded as recently emerged. These viruses have caused sporadic outbreaks of fatal haemorrhagic disease in Africa, Europe and recently in the USA. The case fatality rates rank among the highest ranging from 33-80%. The mode of transmission of these viruses are clearly through close contact with blood and body fluids. Disease outbreaks have been amplified in hospital situations with poor blood precautions. In villages disease has been amplified through contamination with blood and fluids during nursing the sick and burial rituals. The source of the viruses has eluded discovery and new theories regarding the nature of these viruses are being entertained. The threat of new outbreaks in Africa is real since serological evidence of the presence of the virus has been documented in Kenya, Sudan, Zaire, Zimbabwe, Gabon, Cote-d'Ivoire and Gabon. PMID:8625857

Tukei, P M

1996-01-01

143

[Fruit of the emergence of an enterovirus: acute haemorrhagic conjunctivitis].  

PubMed

First seen in Ghana and Indonesia in the early 70's, acute haemorrhagic conjunctivitis or "Apollo 11" disease is an eye infection caused by Enterovirus type 70 (EV70). The disease appeared to be a highly contagious conjunctivitis which spread rapidly all over the world. EV70 has been considered as an emerging virus and was classified as a new Enterovirus. No human or animal virus genetically similar to EV70 was known before the sudden outcome of the disease in Ghana, West Africa. EV70 appeared as a pretty demonstrative example of virus emergence and virus spreading. Studies of virus genetic mutations emphasized the variations of RNA virus within a short time period. The current review presents the EV70 infection and the genetic profile of the virus from its emergence to nowadays. PMID:18957336

Sane, F; Sauter, P; Fronval, S; Goffard, A; Dewilde, A; Hober, D

2008-01-01

144

Subarachnoid haemorrhage and cerebral vasculopathy in a child with sickle cell anaemia.  

PubMed

Stroke in sickle cell anaemia (SCA) is either infarctive or haemorrhagic in nature. In childhood, over 75% of strokes in SCA are infarctive. We present an adolescent with SCA who developed hypertension at the age of 13, and was treated with lisinopril. Sixteen months later she was found in cardiorespiratory arrest and died on arrival in hospital. The last transcranial Doppler scan performed 6?months before her death and a brain MRI were reported normal. The autopsy discovered massive subarachnoid haemorrhage in association with vascular damage in the circle of Willis arteries. The case highlights a cause of haemorrhagic stroke, the first reported association between hypertension, SCA and a histopathologically proven cerebral vasculopathy. The difficulties in the management of haemorrhagic stroke and the poor outcome in SCA are discussed. PMID:25336550

Inusa, Baba; Casale, Maddalena; Booth, Caroline; Lucas, Sebastian

2014-01-01

145

Recurrent vitreous haemorrhage and epidural haematoma in a child with hypofibrinogenaemia.  

PubMed

A 14-month-old male infant was brought by parents for redness of the right eye of 18 days duration. Exam and B-scan ultrasonography revealed total hyphema, dense vitreous haemorrhage and lens subluxation in the right eye while CT disclosed right small epidural haematoma. The left eye had neither retinal haemorrhage nor disc oedema. There was no sign of shaken baby syndrome. Fibrinogen level in the blood was very low. The parents are first-degree cousins with two family members having hypofibrinogenaemia. Vitreous haemorrhage recurred after surgical intervention resulting in phthisis and loss of vision. Hypofibrinogenaemia needs to be included in the differential diagnosis of ocular haemorrhage and vision loss. PMID:22778479

Mansour, Ahmad M; Jaroudi, Mahmoud O

2012-01-01

146

Fatal haemorrhage from varicose veins: is the correct advice being given?  

PubMed Central

Summary A case report is presented illustrating the occasional sinister nature of varicose veins, revealing the need for assessment of haemorrhage risk of the patient and appropriate advice. PMID:18840868

Cocker, DM; Nyamekye, IK

2008-01-01

147

Contralateral haemorrhagic pulmonary metastases (“choriocarcinoma syndrome”) after pneumonectomy for primary pulmonary choriocarcinoma  

PubMed Central

The case history is presented of a patient which illustrates both the diagnostic difficulties of an extremely rare tumour (choriocarcinoma of the lung) and its associated haemorrhagic metastases (“choriocarcinoma syndrome”). Images PMID:7517072

Durieu, I; Berger, N; Loire, R; Gamondes, J P; Guillaud, P H; Cordier, J F

1994-01-01

148

Genetic heterogeneity in hereditary haemorrhagic telangiectasia: possible correlation with clinical phenotype  

Microsoft Academic Search

Hereditary haemorrhagic telangiectasia (HHT) or Osler-Weber-Rendu syndrome is an autosomal dominant vascular dysplasia characterised by recurrent haemorrhage. Our initial linkage studies found an HHT gene to be localised to 9q3 in two large kindreds. In the present study, we examine an additional five unrelated HHT families. Linkage analysis in this region resulted in a peak multipoint location score of 13.03,

K A McAllister; F. Lennon; B Bowles-Biesecker; W C McKinnon; E A Helmbold; D S Markel; C E Jackson; A E Guttmacher; M A Pericak-Vance; D A Marchuk

1994-01-01

149

Contrecoup haemorrhage in a patient with left pubic fracture but right obturator artery bleeding.  

PubMed

Contrecoup injury following head trauma is well known. It is caused by the acceleration-deceleration mechanism that can be fully explained by Newton's first law of motion. We report on a victim of a motor vehicle accident with non-displacement left pubis fracture but haemorrhage from the right obturator artery. Contrecoup haemorrhage should be excluded first in unstable patients without evidence of significant trauma but with a minor pelvic fracture. PMID:17652697

Huang, Ying C; Liu, Peter; Su, Jenn-Shyan; Lin, Yi-Lii

2007-08-01

150

Unusual case of subarachnoid haemorrhage in patient with Fabry's disease: case report and literature review  

PubMed Central

Fabry’s disease is a rare, X linked recessive disease affecting 1 in 40 000 persons. The symptoms result from a lack of or a non-functioning enzyme ? galactosidase, which leads to globotriaosylceramide accumulation in the walls of blood vessels. Mortality is generally from cardiac or renal complications and death from subarachnoid haemorrhage is distinctly rare. The authors report a man with Fabry’s disease who died after subarachnoid haemorrhage from a progressively enlarging fusiform basilar aneurysm. PMID:22761201

Cormican, Michael T; Paschalis, Thanasis; Viers, Angela; Alleyne, Cargill H

2012-01-01

151

Paediatric pulmonary haemorrhage: Independent lung ventilation as effective strategy in management  

PubMed Central

Pulmonary haemorrhage is an uncommon symptom in paediatrics with the etiology varying among the series by age, location, and the diagnostic tests employed. Once airway protection and volume resuscitation are ensured, localization of the anatomic site of bleeding, isolation of the involved airway, control of haemorrhage and treatment of the underlying cause of becomes essential. In localized persistent bleeding, airway control may be achieved by lung isolation with double lumen endotracheal tube and synchronous independent lung ventilation PMID:25316981

Murkute, Amol; Angadi, Ullas; Jain, Pawan; Sharique, Tanzila; Hegde, Rajesh

2014-01-01

152

Historical overview and review of current day treatment in the management of acute variceal haemorrhage  

PubMed Central

Variceal haemorrhage is one of the most devastating consequences of portal hypertension, with a 1-year mortality of 40%. With the passage of time, acute management strategies have developed with improved survival. The major historical treatment landmarks in the management of variceal haemorrhage can be divided into surgical, medical, endoscopic and radiological breakthroughs. We sought to provide a historical overview of the management of variceal haemorrhage and how treatment modalities over time have impacted on clinical outcomes. A PubMed search of the following terms: portal hypertension, variceal haemorrhage, gastric varices, oesophageal varices, transjugular intrahepatic portosystemic shunt was performed. To complement this, Google™ was searched with the aforementioned terms. Other relevant references were identified after review of the reference lists of articles. The review of therapeutic advances was conducted divided into pre-1970s, 1970/80s, 1990s, 2000-2010 and post-2010. Also, a summary and review on the pathophysiology of portal hypertension and clinical outcomes in variceal haemorrhage was performed. Aided by the development of endoscopic therapies, medication and improved radiological interventions; the management of variceal haemorrhage has changed over recent decades with improved survival from an often-terminating event in recent past. PMID:24914369

Rajoriya, Neil; Tripathi, Dhiraj

2014-01-01

153

Quality of care in the management of major obstetric haemorrhage.  

PubMed

Substandard care is reported to occur in a large number of cases of major obstetric haemorrhage (MOH). A prospective audit was carried out by a multidisciplinary team at our hospital over a one year period to assess the quality of care (QOC) delivered to women experiencing MOH. MOH was defined according to criteria outlined in the Scottish Audit of Maternal Morbidity (SAMM). 31 cases were identified yielding an incidence of 3.5/1000 deliveries. The predominant causes were uterine atony 11 (35.4%), retained products of conception 6 (19.3%) and placenta praevia/accreta 6 (19.3%). Excellent initial resuscitation and monitoring was noted with a high level of senior staff input. Indicators of QOC compared favourably with the SAMM. Areas for improvement were identified. This pilot study demonstrates the feasibility of detailed prospective data collection in MOH in a busy Dublin obstetric unit with a view to developing a national audit. Standardization of definitions allows for international comparisons. PMID:21675096

Johnson, S N; Khalid, S; Varadkar, S; Fleming, J; Fanning, R; Flynn, C M; Byrne, B

2011-04-01

154

Magnesium protection against in vitro cerebral vasospasm after subarachnoid haemorrhage.  

PubMed

Mg2+ has recently been proposed for the treatment of cerebral vasospasm and is known to dilate vessels. In this study, we examine the effects of Mg2+ on in vitro vasospasm using CSF from vasospastic subarachnoid haemorrhage patients with vasospasm (CSFv). Oxygen consumption and isometric force measurements in the porcine carotid artery were used to assess the contractile and metabolic status of the vessels' responses to CSFv and the effect of Mg2+. Mg2+ caused a dose dependant decrease in tension following contraction by CSFv. Mg2+ (12 mM) caused a normalization of relaxation rate in tissue exposed to CSFv, caused a significant decrease in basal oxygen consumption, as well as significantly decreasing the rate of oxygen consumption of the porcine carotid artery when stimulated by CSF (0.70 +/- 0.12 versus. 0.46 +/- 0.1 micromol O2 min(-1) g(-1)). Acute Mg2+ addition demonstrated the most effective protection using an assay based on CSFv contraction. These results suggest that Mg2+ can protect vascular smooth muscle exposed to CSFv by benefiting contractile behaviour and metabolism of the arteries. PMID:11708544

Pyne, G J; Cadoux-Hudson, T A; Clark, J F

2001-10-01

155

[Ebola and Marburg fever--outbreaks of viral haemorrhagic fever].  

PubMed

With an increasing frequency of traveling and tourism to exotic countries, a new threat-import of rare, very dangerous infections-emerges in humane medicine. Ebola fever and Marburg fever, whose agents come from the same group of Filoviridae family, belong among these diseases. The natural reservoir of these viruses has not yet been precisely determined. The pathogenesis of the diseases is not absolutely clear, there is neither a possibility of vaccination, nor an effective treatment. Fever and haemorrhagic diathesis belong to the basic symptoms of the diseases. Most of the infected persons die, the death rate is 70-88 %. The history of Ebola fever is relatively short-30 years, Marburg fever is known almost 40 years. Hundreds of people have died of these diseases so far. The study involves epidemics recorded in the world and their epidemiological relations. Not a single case has been recorded in the Czech Republic, nevertheless a sick traveler or infected animals are the highest risk of import these diseases. In our conditions, the medical staff belong to a highly endangered group of people because of stringent isolation of patients, strict rules of barrier treatment regime and high infectivity of the diseases. For this reason, the public should be prepared for possible contact with these highly virulent infections. PMID:17230375

Chlíbek, R; Smetana, J; Vacková, M

2006-12-01

156

Clinical and epidemiological patterns of Argentine haemorrhagic fever  

PubMed Central

The epidemiology of Argentine haemorrhagic fever (AHF) is closely related to cricetine rodents acting as natural hosts of Junin virus. The endemo-epidemic area, which has increased 5 times since the disease was first recognized 15-20 years ago, is located in a densely populated region of Argentina. It has been shown that the virus of LCM is active in humans and rodents of the AHF endemic area; this demonstrates the simultaneous presence of two arenaviruses pathogenic for man in a given geographic location. The disease is characterized by haematological, renal, neurological and cardiovascular changes. Electron microscopy and immunohistochemical studies have shown cytopathic changes, characteristic intracellular virus-like particles, and antigenic determinants of Junin virus in different organs from 9 cases of AHF. No deposits of immunoglobulins or C3 were found in the kidneys; in addition, an absence of fibrinogen and C3 in the hepatocytes and of immunoglobulins in the spleen was observed. These findings suggest a direct viral pathogenic action in the human disease. Ultrastructural and immunofluorescence studies in tissues of guinea-pigs inoculated with two strains of Junin virus revealed the presence of the same types of virus-like particles and antigenic determinants of Junin virus as were encountered in the human subjects with AHF. ImagesFig. 2Fig. 3 PMID:1085212

Maiztegui, J. I.

1975-01-01

157

Intra-alveolar haemorrhage in sudden infant death syndrome: a cause for concern?  

PubMed Central

BACKGROUND: The "Back to Sleep" campaign in 1991 resulted in a dramatic decrease in the incidence of sudden infant death syndrome (SIDS). The proportion of presumed SIDS deaths being actually suspicious deaths from airway obstruction is likely to have become relatively greater. There is usually little pathological evidence to suggest smothering, but intra-alveolar haemorrhage appears to be more prominent in cases where interference with the airway is suspected. AIM: To attempt to quantify intra-alveolar haemorrhage to see whether it could be used as a marker to distinguish between smothering/overlaying and SIDS. METHODS: Intra-alveolar haemorrhage was quantified using digital image analysis on haematoxylin/eosin stained sections taken from the lungs of 62 consecutive infants who had died suddenly and unexpectedly. Cases were initially classified according to the original cause of death. After quantitation, the case histories were critically reviewed. Three pathologists independently made microscopic assessments of the degree of intra-alveolar haemorrhage in the first 24 cases to see whether these accurately reflected the quantitative results. RESULTS: 73% of those infants with a history suggesting possible involuntary overlaying and 45% of those with a history suspicious of smothering had significant intra-alveolar haemorrhage (> 5% of total lung surface area assessed). From the history, the cause of death in 11 cases initially classified as SIDS would better have been given as "Unascertained." Simple microscopic assessments underestimated the true extent of the haemorrhage in 33% (8/24). CONCLUSIONS: If a moderate degree (at least 5%) of pulmonary parenchymal haemorrhage is observed, this may be an indicator of airway obstruction for a significant period, either from overlaying or possibly smothering. The diagnosis of SIDS may be being used inappropriately in such cases. Images PMID:10645227

Yukawa, N; Carter, N; Rutty, G; Green, M A

1999-01-01

158

Comparison effect of intravenous tranexamic acid and misoprostol for postpartum haemorrhage  

PubMed Central

Background: Postpartum haemorrhage (PPH) is the third-most common cause of maternal death in the United States and it is still the first prevalent cause of maternal death in developing countries. Active prevention of haemorrhage with an uterotonic or other new drugs leads to a decrease in postpartum vaginal haemorrhage. The aim of this study was to compare anti-haemorrhagic effect of Tranexamic acid (TXA) and Misoprostol for PPH. Patients and Methods: In a double-blinded randomised control clinical trial, 200 women were included after Caesarean or natural vaginal delivery with abnormal PPH. They were divided into two equal intervention and control groups. Effect of intravenous TXA and Misoprostol for postpartum haemorrhage was examined. Results: The mean age of patients was 26.7 ± 6.5 years which ranged from 14 to 43 years. The sonographic gestational age in the group treated with TXA was 37.7 ± 3.4 weeks and it was 37.4 ± 3.3 weeks for the other group (P = 0.44). The haemorrhage in the TXA and Misoprostol groups was 1.2 ± 0.33 litres and 1.18 ± 0.47 litres, respectively (P = 0.79). The haemoglobin levels after 6-12 hours of labour, in TXA group was more than that of the Misoprostol group, but this difference was not statistically significant (P = 0.22 and P = 0.21, respectively). Conclusion: Regarding to the superior results in Misoprostol group in one hand and lack of significant differences between two groups in haemorrhage during labour, post-partum haemoglobin level and discharge haemoglobin level, we can state that Misoprostol has no specific preferences to TXA, but more studies with greater population are needed. PMID:25114373

Sahhaf, Farnaz; Abbasalizadeh, Shamsi; Ghojazadeh, Morteza; Velayati, Atefeh; Khandanloo, Roya; Saleh, Parviz; Piri, Reza; Naghavi-Behzad, Mohammad

2014-01-01

159

Thermal probes alone or with epinephrine for the endoscopic haemostasis of ulcer haemorrhage.  

PubMed

In the last two decades, significant progress has been made in the diagnosis, prognostication and treatment of patients with severe peptic ulcer haemorrhage. Patients can now be risk stratified by clinical presentation and endoscopic stigmata of ulcer haemorrhage. The purposes of this chapter are to discuss: (1) the techniques of thermal probe with or without epinephrine for haemostasis of ulcers with major stigmata of haemorrhage and (2) the outcomes of treatment of patients with ulcer haemorrhage treated with endoscopic thermal probes or other therapies, medical therapy and/or surgery. Compared to medical therapy alone, patients with major stigmata actively bleeding ulcers, non-bleeding visible vessels and non-bleeding adherent clots have been shown to benefit from endoscopic haemostasis with bipolar probe, heater probe, lasers or epinephrine injection. Outcomes showing significant improvement include blood transfusions, emergency surgery rates and length of hospital stay. Meta-analyses have also reported improvements in mortality for endoscopic compared with medical therapy of patients with severe ulcer haemorrhage and major stigmata. Patients with minor stigmata of ulcer haemorrhage (such as flat spots) or no stigmata (clean-based ulcers) do not benefit from endoscopic haemostasis. Thermal probes have the advantages of good coaptive coagulation, target irrigation, portability and relative inexpense. Recently, patients with active arterial bleeding, non-bleeding adherent clots or non-bleeding visible vessels have been reported to have better results with combination epinephrine injection and thermal probe compared to monotherapy alone (such as injection, bipolar or heater probe). In addition, repeat endoscopic combination therapy has been reported to be as effective but safer than emergency surgery for management of recurrent ulcer haemorrhage. PMID:10952807

Machicado, G A; Jensen, D M

2000-06-01

160

Neonatal septicaemia caused by diverse clones of Klebsiella pneumoniae & Escherichia coli harbouring blaCTX-M-15  

PubMed Central

Background & objectives: Information about the genetic diversity of the extended-spectrum ?-lactamases (ESBLs) and the clonal relationship of the organisms causing neonatal infections is limited, particularly from India where neonatal mortality is high. This study was undertaken to investigate the molecular epidemiology and risk factors associated with neonatal septicaemia caused by ESBL-producing Klebsiella pneumoniae and Escherichia coli. Methods: Bloodstream isolates (n=26) of K. pneumoniae (n=10) and E. coli (n=16) from the neonates admitted in a tertiary care hospital in New Delhi during January to May 2008 were characterized. Antimicrobial susceptibility tests were carried out and ESBL production was assessed phenotypically. PCR was carried out for ESBL and ampC genes. Genotyping was performed by pulsed-field gel electrophoresis (PFGE). Conjugation experiments were done to determine the mobility of ESBL genes. Risk factors associated with ESBL-producing K. pneumoniae and E. coli infections were analysed. Results: Resistance rates to most of the antibiotics tested were high, except for imipenem. Among the isolates tested, 60 per cent of K. pneumoniae and 75 per cent of E. coli were ESBL producers. PFGE of the isolates demonstrated a vast diversity of genotypes with no epidemic clones. Despite the clonal diversity, blaCTX-M-15 was detected in 100 per cent of ESBL-positive isolates. The other genes present in ESBL-positive isolates were blaTEM-1, blaSHV-1, blaSHV-28, blaSHV-11, and blaSHV-12. Class 1 integrons were detected in 7 of 18 ESBL-positive isolates. Moreover, the plasmid carrying blaCTX-M-15, in E. coli and K. pneumoniae were self transferable. Feeding through an enteral tube was identified as the only risk factor for sepsis by ESBL-producing organisms. Interpretation & conclusions: The study emphasises the presence of blaCTX-M-15 in clonally diverse isolates indicating probable horizontal transfer of this gene. The widespread dissemination of CTX-M-15 is of great concern as it further confines the limited therapeutic interventions available for neonates. PMID:23703349

Roy, Subhasree; Gaind, Rajni; Chellani, Harish; Mohanty, Srujana; Datta, Saswati; Singh, Arun K.; Basu, Sulagna

2013-01-01

161

A Five-Year Experience of Carbapenem Resistance in Enterobacteriaceae Causing Neonatal Septicaemia: Predominance of NDM-1  

PubMed Central

Treatment of neonatal sepsis has become a challenge with the emergence of carbapenemase-producing bacteria. This study documents the trend of carbapenem susceptibility in Enterobacteriaceae that caused septicaemia in neonates over a five year period (2007–2011) and the molecular characterisation of Enterobacteriaceae resistant to carbapenems and cephalosporins. Hundred and five Enterobacteriaceae including Escherichia coli (n?=?27), Klebsiella pneumoniae (n?=?68) and Enterobacter spp. (n?=?10) were isolated from blood of septicaemic neonates followed by antibiotic susceptibility tests, determination of MIC values, phenotypic and genotypic detection of ?-lactamases. Carbapenem was the most active antimicrobial tested after tigecycline. CTX-M type was the most prevalent ESBL throughout the period (82%). New Delhi Metallo-?-lactamase-1 (NDM-1), which is a recent addition to the carbapenemase list, was the only carbapenemase identified in our setting. Fourteen percent of the isolates possessed blaNDM-1. Carbapenem non-susceptibility was first observed in 2007 and it was due to loss of Omp F/Ompk36 in combination with the presence of ESBLs/AmpCs. NDM-1 first emerged in E. coli during 2008; later in 2010, the resistance was detected in K. pneumoniae and E. cloacae isolates. NDM-1-producing isolates were resistant to other broad-spectrum antibiotics and possessed ESBLs, AmpCs, 16S-rRNA methylases, AAC(6?)-Ib-cr, bleomycin resistant gene and class 1 integron. Pulsed field gel electrophoresis of the NDM-1-producing isolates indicated that the isolates were clonally diverse. The study also showed that there was a significantly higher incidence of sepsis caused by NDM-1-harbouring isolates in the male sex, in neonates with low birth weight and neonates born at an extramural centre. However, sepsis with NDM-1-harbouring isolates did not result in a higher mortality rate. The study is the first to review the carbapenem resistance patterns in neonatal sepsis over an extended period of time. The study highlights the persistence of ESBLs (CTX-Ms) and the emergence of NDM-1 in Enterobacteriaceae in the unit. PMID:25406074

Datta, Saswati; Roy, Subhasree; Chatterjee, Somdatta; Saha, Anindya; Sen, Barsha; Pal, Titir; Som, Tapas; Basu, Sulagna

2014-01-01

162

[Perforation and haemorrhage duodenal bulbar ulcers in a child: a case report].  

PubMed

A perforation rarely reveals a primary duodenal ulcer. The occurring of digestive haemorrhage in post operative followings evokes spontaneously a stress ulcer. We report an observation of a child who presented on fourth day delay after operation an ulcer of the anterior duodenal bulbar face and a haemorrhage of the posterior bulbar face. A 7-year-old girl with no particular pathological antecedent was admitted for abdominal pain, bile vomiting and constipation evolving since 6 days. Clinical examination revealed a general state thickening, an infectious syndrome, a meteoric and general abdominal sensitivity. The abdominal radiography without preparation showed a pneumoperitoneum. The surgical exploration discovered a perforated ulcer on the bulbar anterior face. A simple closure associated with omental patch was performed. Four days after operation, she presented an abundant digestive haemorrhage with shock. The resuscitation did not improve the patient's general state. The upper digestive endoscopy revealed a haemorrhage of the posterior bulbar face. An adrenalin injection stopped the bleeding. The treatment by neutron pump inhibitors and an eradicating treatment of Helicobacter pylori permitted the healing of the ulcers. The occurring of digestive haemorrhage in the followings of surgical intervention for perforated ulcer involves an upper digestive endoscopy. This examination can reveal misdiagnosed ulcer during the surgical exploration and permits to perform a haemostatic act. PMID:19102114

Ngom, G; Diouf, M L; Fall, M; Konaté, I; Sankalé, A A; Diop, M; Fall, I; Ndoye, M

2008-01-01

163

Safety of withholding anticoagulation in patients with mechanical prosthetic valves and intracranial haemorrhage.  

PubMed

Patients with prosthetic heart valves require lifelong anticoagulation to prevent thromboembolism. When they have intracranial haemorrhage, anticoagulation has to be withheld. This study was aimed to identify safety duration and complications of anticoagulation withholding in patients with prosthetic heart valves and intracranial haemorrhage. This was a retrospective descriptive study in 26 prosthetic heart valve patients hospitalised in Srinagarind Hospital, Khon Kaen University because of intracranial haemorrhage from 2003 to 2008. Range of anticoagulation withholding was 1 to 26 days with mean 8.5 ± 7.7 days. Most patients (84.6%) were withheld anticoagulation for less than 14 days. There were five in-hospital deaths mostly within 3 days of admission from severe intracranial haemorrhage. No data of reintroduction of anticoagulation was found in three patients because they were lost to follow up. One patient had right basal ganglia infarction after 7 days of anticoagulation withholding. Prosthetic heart valve dysfunction was suspected in one patient who withheld anticoagulant for 76 days. Discontinuation of anticoagulation in patients with prosthetic heart valves and intracranial haemorrhage for less than 7 days was associated with low thromboembolic risk and there was no clinical evidence of prosthetic heart valve dysfunction when anticoagulation was withheld for less than 14 days. PMID:22435901

Krittalak, K; Sawanyawisuth, K; Tiamkao, S

2011-10-01

164

Acute intracerebral haemorrhage: grounds for optimism in management.  

PubMed

Spontaneous intracerebral haemorrhage (ICH) is one of the most devastating types of stroke, which has considerable disease burden in "non-white" ethnic groups where the population-attributable risks of elevated blood pressure are very high. Since the treatment of ICH remains largely supportive and expectant, nihilism and the early withdrawal of active therapy influence management decisions in clinical practice. However, approaches to management are now better defined on the basis of evidence that both survival and speed (and degree) of recovery are critically dependent on the location, size, and degree of expansion and extension into the intraventricular system of the haematoma of the ICH. Although no medical treatment has been shown to improve outcome in ICH, several promising avenues have emerged that include haemostatic therapy and intensive control of elevated blood pressure. Conversely, there is continued controversy over the role of evacuation of the haematoma of ICH via open craniotomy. Despite being an established practice for several decades, and having undergone evaluation in multiple randomised trials, there is uncertainty over which patients have the most to gain from an intervention with clear procedural risk. Minimally invasive surgery via local anaesthetic applied drill-puncture of the cranium and infusion of a thrombolytic agent is an attractive option for patients requiring critical management of the haematoma, not just in low resource settings but arguably also in specialist centres of western countries. With several ongoing clinical trials nearing completion, these treatments could enter routine practice within the next few years, further justifying the urgency of "time is brain" and that active management within well-organized, comprehensive acute stroke care units includes patients with ICH. PMID:23088860

Delcourt, Candice; Anderson, Craig

2012-12-01

165

Skeletal muscle PO2: indicator of peripheral tissue perfusion in haemorrhagic shock.  

PubMed

The following conclusions can be made on the basis of this work: 1) Measurements of skeletal muscle oxygen tension provide an excellent index of tissue perfusion in haemorrhagic shock. 2) Correction of cardiac output and arterial blood oxygen tension in haemorrhagic shock does not necessarily ensure normal tissue oxygenation. 3) In haemorrhagic shock adequate replacement of blood loss using a balanced salt solution in addition to blood replacement is an integral part of the fluid management. 4) Correction of hypovolemia with an equivalent volume of a plasma expander and subsequent reinfusion of shed blood also returns tissue perfusion to normal. However, this treatment results in marked haemodilution and correction of extracellular fluid loss remains inadequate. PMID:26185

Niinikoski, J; Halkola, L

166

Mosquito-borne haemorrhagic fevers of South and South-East Asia*  

PubMed Central

During the past decade outbreaks of a severe haemorrhagic disease caused by dengue viruses of multiple types have been reported in the Philippines, Thailand, Malaysia, Viet-Nam and eastern India. In many of these outbreaks chikungunya virus, a group A arbovirus, was simultaneously the cause of similar but probably milder disease. Both these viruses appear to be able to be able to produce classical dengue fever in some individuals and disease with haemorrhagic manifestations in others. Because of the growing public health importance and the progressive spread of this disease a unified review of its clinical and epidemiological features has been needed. This paper presents the history and salient clinical features of mosquito-borne haemorrhagic fever and summarizes recent epidemiological studies and current diagnostic and control methods. ImagesFIG. 4 PMID:5297536

Halstead, Scott B.

1966-01-01

167

Sudden headache, third nerve palsy and visual deficit: thinking outside the subarachnoid haemorrhage box.  

PubMed

A 75-year-old lady presented with sudden severe headache and vomiting. Examination was normal, and CT and lumbar puncture not convincing for subarachnoid haemorrhage. Shortly thereafter, she developed painless diplopia. Examination confirmed right third cranial nerve palsy plus homonymous left inferior quadrantanopia. Urgent cerebral MRI with angiography was requested to assess for a possible posterior communicating artery aneurysm, but revealed an unsuspected pituitary mass. Pituitary adenoma with pituitary apoplexy was diagnosed. Pituitary apopolexy is a syndrome comprising sudden headache, meningism, visual and/or oculomotor deficits, with an intrasellar mass. It is commonly due to haemorrhage or infarction within a pituitary adenoma. Treatment includes prompt steroid administration, and potentially surgical decompression. While subarachnoid haemorrhage is an important, well-recognised cause of sudden severe headache, other aetiologies, including pituitary apoplexy, should be considered and sought. PMID:23913476

Ní Chróinín, Danielle; Lambert, John

2013-11-01

168

Superselective Embolisation in Acute Lower Gastrointestinal Haemorrhage: A Single Institution Experience  

PubMed Central

Background: Superselective embolisation has been recognised as integral in the management of lower gastrointestinal haemorrhage. It has also reduced the need for emergency surgery. The objective of this case series was to describe the lower gastrointestinal haemorrhage cases seen in our centre, its diagnosis and the role of superselective embolisation in patient management. Methods: All patients who underwent superselective embolisation from January 2008 until April 2009 in our centre were analysed. Data were collected from the hospital electronic medical records. Results: Four patients (three males) with a mean age of 81 years were analysed. Multidetector computerised tomography and digital subtraction angiography were positive in all patients. Superselective embolisation with platinum microcoils was performed in all patients (n = 4). Technical success was achieved in all patients (100%). Conclusion: Superselective embolisation in the treatment of lower gastrointestinal haemorrhage is safe and effective with a very high technical success rate. PMID:22135510

Md Ralib, Ahmad Razali; Zakaria, Rozman; Mohamad, Zahiah; Muda, Ahmad Sobri

2009-01-01

169

Association between circulating angiotensin-converting enzyme and exercise-induced pulmonary haemorrhage in Thoroughbred racehorses.  

PubMed

Exercise-induced pulmonary haemorrhage has an impact on racehorse performance. Although endoscopic diagnosis (with or without the aid of bronchoalveolar lavage) is considered to be the standard diagnostic method for this condition, the use of biomarkers that could aid in quantifying risk and severity of the condition would represent an advance in equine sport medicine. This preliminary research investigated the use of angiotensin-converting enzyme (ACE) activity in plasma of racehorses and demonstrated that ACE activity is increased in horses with higher degrees of haemorrhage and is a promising biomarker for EIPH in racehorses. PMID:22196974

Costa, M F M; Ronchi, F A; Ivanow, A; Carmona, A K; Casarini, D; Slocombe, R F

2012-10-01

170

Magnesium for aneurysmal subarachnoid haemorrhage (MASH-2): a randomised placebo-controlled trial  

PubMed Central

Summary Background Magnesium sulphate is a neuroprotective agent that might improve outcome after aneurysmal subarachnoid haemorrhage by reducing the occurrence or improving the outcome of delayed cerebral ischaemia. We did a trial to test whether magnesium therapy improves outcome after aneurysmal subarachnoid haemorrhage. Methods We did this phase 3 randomised, placebo-controlled trial in eight centres in Europe and South America. We randomly assigned (with computer-generated random numbers, with permuted blocks of four, stratified by centre) patients aged 18 years or older with an aneurysmal pattern of subarachnoid haemorrhage on brain imaging who were admitted to hospital within 4 days of haemorrhage, to receive intravenous magnesium sulphate, 64 mmol/day, or placebo. We excluded patients with renal failure or bodyweight lower than 50 kg. Patients, treating physicians, and investigators assessing outcomes and analysing data were masked to the allocation. The primary outcome was poor outcome—defined as a score of 4–5 on the modified Rankin Scale—3 months after subarachnoid haemorrhage, or death. We analysed results by intention to treat. We also updated a previous meta-analysis of trials of magnesium treatment for aneurysmal subarachnoid haemorrhage. This study is registered with controlled-trials.com (ISRCTN 68742385) and the EU Clinical Trials Register (EudraCT 2006-003523-36). Findings 1204 patients were enrolled, one of whom had his treatment allocation lost. 606 patients were assigned to the magnesium group (two lost to follow-up), 597 to the placebo (one lost to follow-up). 158 patients (26·2%) had poor outcome in the magnesium group compared with 151 (25·3%) in the placebo group (risk ratio [RR] 1·03, 95% CI 0·85–1·25). Our updated meta-analysis of seven randomised trials involving 2047 patients shows that magnesium is not superior to placebo for reduction of poor outcome after aneurysmal subarachnoid haemorrhage (RR 0·96, 95% CI 0·86–1·08). Interpretation Intravenous magnesium sulphate does not improve clinical outcome after aneurysmal subarachnoid haemorrhage, therefore routine administration of magnesium cannot be recommended. Funding Netherlands Heart Foundation, UK Medical Research Council. PMID:22633825

Mees, Sanne M Dorhout; Algra, Ale; Vandertop, W Peter; van Kooten, Fop; Kuijsten, Hans AJM; Boiten, Jelis; van Oostenbrugge, Robert J; Salman, Rustam Al-Shahi; Lavados, Pablo M; Rinkel, Gabriel JE; van den Bergh, Walter M

2012-01-01

171

Direct binding of the Kex2p cytosolic tail to the VHS domain of yeast Gga2p facilitates TGN to prevacuolar compartment transport and is regulated by phosphorylation  

PubMed Central

Human Golgi-localized, ?-ear–containing, ADP-ribosylation factor–binding proteins (Ggas) bind directly to acidic dileucine sorting motifs in the cytosolic tails (C-tails) of intracellular receptors. Despite evidence for a role in recruiting ubiquitinated cargo, it remains unclear whether yeast Ggas also function by binding peptide-sorting signals directly. Two-hybrid analysis shows that the Gga1p and Gga2p Vps27, Hrs, Stam (VHS) domains both bind a site in the Kex2p C-tail and that the Gga2p VHS domain binds a site in the Vps10p C-tail. Binding requires deletion of an apparently autoinhibitory sequence in the Gga2p hinge. Ser780 in the Kex2p C-tail is crucial for binding: an Ala substitution blocks but an Asp substitution permits binding. Biochemical assays using purified Gga2p VHS–GGA and TOM1 (GAT) and glutathione S-transferase–Kex2p C-tail fusions show that Gga2p binds directly to the Kex2p C-tail, with relative affinities Asp780 > Ser780 > Ala780. Affinity-purified antibody against a peptide containing phospho-Ser­780 recognizes wild-type Kex2p but not S780A Kex2p, showing that Ser780 is phosphorylated in vivo; phosphorylation of Ser780 is up-regulated by cell wall–damaging drugs. Finally, mutation of Ser780 alters trafficking of Kex2p both in vivo and in cell-free trans-Golgi network (TGN)–prevacuolar compartment (PVC) transport. Thus yeast Gga adaptors facilitate TGN–PVC transport by direct binding of noncanonical phosphoregulated Gga-binding sites in cargo molecules. PMID:23408788

De, Mithu; Abazeed, Mohamed E.; Fuller, Robert S.

2013-01-01

172

Successful treatment of right-sided native valve methicillin-resistant Staphylococcus aureus endocarditis and septicaemia with teicoplanin and rifampicin: a case report.  

PubMed

Vancomycin is the drug of choice in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infection. However, the presence of certain clinical complications like renal failure alters vancomycin pharmacokinetics, leading to drug accumulation and toxicity. This highlights the need to identify an effective substitute for treating MRSA infections when vancomycin cannot be used. We report the case of a 57-y-old Indian male diagnosed with tricuspid valve endocarditis with septicaemia and a right upper lobe cavity caused by MRSA. The patient also presented with renal failure, which precluded the use of vancomycin for treatment. A 6-week regimen of teicoplanin and rifampicin was used instead, and the infection was successfully treated. This case report provides evidence of the effectiveness of teicoplanin and rifampicin in the treatment of MRSA bacteraemia in situations where the use of vancomycin is contraindicated. PMID:22385220

Saravu, Kavitha; Mukhopadhyay, Chiranjay; Satyanarayanan, Vishwanath; Pai, Ananth; Komaranchath, Ashok Sebastian; Munim, Frenil; Shastry, Barkur Ananthakrishna; Tom, Devasia

2012-07-01

173

Screening for Systemic Manifestations of Vascular Malformations in Patients With Hereditary Haemorrhagic Telangiectasia (Osler Disease)  

Microsoft Academic Search

Hereditary haemorrhagic telangiectasia (Rendu-Osler-Weber syndrome) is a disease characterized by systemic vascular malformations. Typical clinical manifestations are recurrent epistaxis and telangiectases of the skin and the mucous membranes. The syndrome is furthermore characterized by its hereditary aspect. The disease seems to be much more complicated than previously thought, mainly because of the accompanying vascular malformations in vital organs, like the

Ana Cerra Pohl; Jochen Alfred Werner; Benedikt Josef Folz

174

Impact of rabbit haemorrhagic disease on introduced predators in the Flinders Ranges, South Australia  

Microsoft Academic Search

The impact of rabbit haemorrhagic disease (RHD) on the population dynamics and diet of foxes and feral cats was studied in the Flinders Ranges, South Australia. Populations of both foxes and cats decreased substantially some 6-10 months after the advent of RHD, when rabbit numbers were reduced by 85%. The diet of foxes changed as a result of reduced rabbit

C. HoldenA; G. MutzeB

175

Intracranial haemorrhage in idiopathic thrombocytopenic purpura. Paediatric Haematology Forum of the British Society for Haematology  

Microsoft Academic Search

A UK survey was carried out to discover the frequency, circumstances, and outcome of intracranial haemorrhage (ICH) complicating idiopathic thrombocytopenic purpura (ITP) of childhood. A questionnaire was circulated through the membership of the UK Paediatric Haematology Forum, and thence to local paediatricians and haematologists. It sought information on any child with ITP who had had an ICH during the 20

J S Lilleyman

1994-01-01

176

Feasibility of electrical impedance tomography in haemorrhagic stroke treatment using adaptive mesh  

NASA Astrophysics Data System (ADS)

EIT has been proposed for acute stroke differentiation, specifically to determine the type of stroke, either ischaemia (clot) or haemorrhage (bleed) to allow the rapid use of clot-busting drugs in the former (Romsauerova et al 2006) . This addresses an important medical need, although there is little treatment offered in the case of haemorrhage. Also the demands on EIT are high with usually no availability to take a 'before' measurement, ruling out time difference imaging. Recently a new treatment option for haemorrhage has been proposed and is being studied in international randomised controlled trial: the early reduction of elevated blood pressure to attenuate the haematoma. This has been shown via CT to reduce bleeds by up to 1mL by Anderson et al 2008. The use of EIT as a continuous measure is desirable here to monitor the effect of blood pressure reduction. A 1mL increase of haemorrhagic lesion located near scalp on the right side of head caused a boundary voltage change of less than 0.05% at 50 kHz. This could be visually observed in a time difference 3D reconstruction with no change in electrode positions, mesh, background conductivity or drift when baseline noise was less than 0.005% but not when noise was increased to 0.01%. This useful result informs us that the EIT system must have noise of less than 0.005% at 50 kHz including instrumentation, physiological and other biases.

Nasehi Tehrani, J.; Anderson, C.; Jin, C.; van Schaik, A.; Holder, D.; McEwan, A.

2010-04-01

177

Computational Intelligence Method for Early Diagnosis Dengue Haemorrhagic Fever Using Fuzzy on Mobile Device  

NASA Astrophysics Data System (ADS)

Mortality from Dengue Haemorrhagic Fever (DHF) is still increasing in Indonesia particularly in Jakarta. Diagnosis of the dengue shall be made as early as possible so that first aid can be given in expectation of decreasing death risk. The Study will be conducted by developing expert system based on Computational Intelligence Method. On the first year, study will use the Fuzzy Inference System (FIS) Method to diagnose Dengue Haemorrhagic Fever particularly in Mobile Device consist of smart phone. Expert system application which particularly using fuzzy system can be applied in mobile device and it is useful to make early diagnosis of Dengue Haemorrhagic Fever that produce outcome faster than laboratory test. The evaluation of this application is conducted by performing accuracy test before and after validation using data of patient who has the Dengue Haemorrhagic Fever. This expert system application is easy, convenient, and practical to use, also capable of making the early diagnosis of Dengue Haemorraghic to avoid mortality in the first stage.

Salman, Afan; Lina, Yen; Simon, Christian

2014-03-01

178

PATHOGENESIS OF THE GRAFT-VERSUS-HOST REACTION IN CHICKEN EMBRYOS. THE DEVELOPMENT OF HAEMORRHAGIC LESIONS  

Microsoft Academic Search

Adult, allogeneic lymphoid tissue was introduced into chicken embryos on day 4 or clay 6 by inoculation on the chorio-allantoic membrane, intravenous injection or intracoelomic grafting. Severe haemorrhagic lesions appeared on the body surface and in the chorio-allantoic membrane within 6 days after the inoculation of donor cells. However, there was no spleen enlargement in these embryos. The development of

Karen Z Walker; Gutta I Schoefl; KJ Lafferty; EP Adams

1973-01-01

179

A limited outbreak of Ebola haemorrhagic fever in Etoumbi, Republic of Congo, 2005  

Microsoft Academic Search

Ebolavirus has caused highly lethal outbreaks of haemorrhagic fever in the Congo basin. The 2005 outbreak in the Republic of Congo occurred in the Etoumbi district of Cuvette Ouest Department between April and May. The two index cases were infected while poaching. The sanitary response consisted of active surveillance and contact tracing, public awareness campaigns and community mobilization, case management

Dieudonné Nkoghe; Mamadou Lamine Kone; Adamou Yada; Eric Leroy

2011-01-01

180

Mountain sickness, retinal haemorrhages, and acclimatisation on Mount Everest in 1975  

Microsoft Academic Search

During the 1975 British Everest Expedition, which made the first ascent of the south-west face, observations were made in relation to mountain sickness and the appearance of retinal changes. Two Sherpas with cerebral oedema and one Briton with pulmonary oedema were treated. Retinal haemorrhages occurred in four out of six Britons who were newcomers to altitudes over 6000 m (19

C Clarke; J Duff

1976-01-01

181

Effect of bedding on the incidence of exercise induced pulmonary haemorrhage in racehorses in Hong Kong  

Microsoft Academic Search

An investigation into the incidence of exercise induced pulmonary haemorrhage (EIPH) in thoroughbreds in Hong Kong was carried out between the 1981 and 1983 racing seasons. A total of 1039 post race endoscopic examinations were performed in 1982-1983 and the results indicated that 46.8 per cent of runners had EIPH. This was not statistically different from the percentage of horses

DK Mason; EA Collins; KL Watkins

1984-01-01

182

Women's breastfeeding experiences following a significant primary postpartum haemorrhage: A multicentre cohort study  

Microsoft Academic Search

BACKGROUND: Postpartum haemorrhage (PPH) is a significant and increasing contributor to maternal mortality and morbidity. Following a PPH, women may have difficulties initiating and sustaining breastfeeding, although little has been published on this issue. The aim of this study was to describe breastfeeding experiences in a cohort of women following a significant PPH. METHODS: This is a descriptive study based

Jane F Thompson; Laura J Heal; Christine L Roberts; David A Ellwood

2010-01-01

183

Nosocomial infection of Crimean-Congo haemorrhagic fever in eastern Iran: case report.  

PubMed

An outbreak of Crimean-Congo haemorrhagic fever occurred in the county of Birjand in eastern Iran in November 2011. Four cases were involved in this outbreak. Two patients died after admission to hospital, one of whom was a nurse who acquired the infection nosocomially, and the others were treated successfully. PMID:23266037

Chinikar, Sadegh; Shayesteh, Majid; Khakifirouz, Sahar; Jalali, Tahmineh; Rasi Varaie, Fereshteh Sadat; Rafigh, Mahboubeh; Mostafavi, Ehsan; Shah-Hosseini, Nariman

2013-01-01

184

The role of angiography in the management of haemorrhage from major fractures of the pelvis  

Microsoft Academic Search

n a series of 150 consecutive patients with unstable fractures of the pelvis, angiography was performed in 23 (15%) who had uncontrolled hypotension. There were three anteroposterior compression (APC), eight lateral compression (LC) and 12 vertical shear (VS) injuries. Arterial sources of haemorrhage were identified in 18 (78%) patients and embolisation was performed. Angiography was required in 28% of VS

R. E. Cook; J. F. Keating; I. Gillespie

2002-01-01

185

Initial enlargement of the opposite pupil as a false localising sign in intraparenchymal frontal haemorrhage  

Microsoft Academic Search

Ipsilateral third nerve palsy with early pupillary enlargement is an important sign of transtentorial herniation from a supratentorial mass lesion. A case of frontal, intraparenchymal haemorrhage is reported in which the first ocular manifestation of transtentorial herniation was enlargement of the contralateral pupil. The ipsilateral pupil dilated only after complete oculomotor palsy of the contralateral eye. After partial frontal lobectomy

R Chen; R Sahjpaul; R F Del Maestro; L Assis; G B Young

1994-01-01

186

Experimental respiratory Marburg virus haemorrhagic fever infection in the common marmoset (Callithrix jacchus)  

PubMed Central

Marburg virus causes a highly infectious and lethal haemorrhagic fever in primates and may be exploited as a potential biothreat pathogen. To combat the infection and threat of Marburg haemorrhagic fever, there is a need to develop and license appropriate medical countermeasures. To determine whether the common marmoset (Callithrix jacchus) would be an appropriate model to assess therapies against Marburg haemorrhagic fever, initial susceptibility, lethality and pathogenesis studies were performed. Low doses of virus, between 4 and 28 TCID50, were sufficient to cause a lethal, reproducible infection. Animals became febrile between days 5 and 6, maintaining a high fever before succumbing to disease between 8 and 11 days postchallenge. Typical signs of Marburg virus infection were observed including haemorrhaging and a transient rash. In pathogenesis studies, virus was isolated from the animals’ lungs from day 3 postchallenge and from the liver, spleen and blood from day 5 postchallenge. Early signs of histopathology were apparent in the kidney and liver from day 3. The most striking features were observed in animals exhibiting severe clinical signs, which included high viral titres in all organs, with the highest levels in the blood, increased levels in liver function enzymes and blood clotting times, decreased levels in platelets, multifocal moderate-to-severe hepatitis and perivascular oedema. PMID:23441639

Smither, Sophie J; Nelson, Michelle; Eastaugh, Lin; Laws, Thomas R; Taylor, Christopher; Smith, Simon A; Salguero, Francisco J; Lever, Mark S

2013-01-01

187

Ebola haemorrhagic fever among hospitalised children and adolescents in nothern Uganda : Epidemiologic and clinical observations  

Microsoft Academic Search

Background A unique feature of previous Ebola outbreaks has been the relative sparing of children. For the first time, an out break of an unusual illness-Ebola haemorrhagic fever occurred in Northern Uganda - Gulu district. Objectives To describe the epidemiologic and clinical aspects of hospitalised children and adolescents on the isolation wards. Methods A retrospective descriptive survey of hospital records

Kaducu O. F

2001-01-01

188

Genetic background and risk of postpartum haemorrhage: results from an Italian cohort of 3219 women.  

PubMed

Postpartum haemorrhage (PPH) is a leading cause of maternal mortality, particularly in the developing countries, and of severe maternal morbidity worldwide. To investigate the impact of genetic influences on postpartum haemorrhage, in association with maternal and intrapartum risk factors, using a candidate gene approach. All women (n = 6694) who underwent a vaginal delivery at the Obstetric Unit of a large University hospital in Milan (Italy) between July 2007 and September 2009 were enrolled. The first consecutive 3219 women entered the genetic study. Postpartum haemorrhage was defined as ?500 mL blood loss. Eight functional polymorphisms in seven candidate genes were chosen because of their potential role in predisposing to or protecting from haemorrhagic conditions: tissue factor (F3), factor V (F5), tissue factor pathway inhibitor (TFPI), platelet glycoprotein Ia/IIa (ITGA2), prothrombin (F2), platelet glycoproteins Ib? (GP1BA) and angiotensin-converting enzyme (ACE). After correction for the already known PPH risk factors, only the promoter polymorphism of the tissue factor gene (F3 -603A>G) showed a significant association with PPH, the G allele exerting a protective effect (P = 0.00053; OR = 0.79, 95% CI = 0.69-0.90). The protective effect against PPH of the TF -603A>G polymorphism is biologically plausible since the G allele is associated with an increased protein expression and Tissue Factor is strongly represented in the placenta at term, particularly in decidual cells of maternal origin. PMID:25333208

Biguzzi, E; Franchi, F; Acaia, B; Ossola, W; Nava, U; Paraboschi, E M; Asselta, R; Peyvandi, F

2014-11-01

189

Comparative Study of Processing of Haemorrhagic Body Fluids by Using Different Techniques  

PubMed Central

Background: Haemorrhagic fluids are samples which are commonly received for cytological examination. The diagnostic efficacy suffers when large numbers of red blood cells are present in the sample. Haemorrhagic fluids are processed by a variety of techniques and the common goal of each technique is selection and concentration of an adequate number of tumour cells with intact cell morphologies, without losing them during processing. Aim: Present study was undertaken to improve the quality of haemorrhagic fluid by using three different haemolysing agents, namely Carnoy’s Fixative (CF), saline in Normal Saline Rehydration Technique (NSRT) and Glacial Acetic Acid (GAA) for haemolysis and to find out the most effective processing technique for better cytomorphological assessment. Material and Methods: This study was carried out on 51 haemorrhagic fluids. Processing of haemorrhagic fluid was done by using haemolysing agents, namely CF, GAA and NSRT. After processing fluids with these three techniques, three smears were prepared from each of them, out of which one was air dried and two were wet fixed. Fourth type of smear made without application of haemolysing agent was used as control.The smears were stained with Leishman’s stain and wet fixed smears were stained with Hematoxylin and Eosin (H and E) , and Papanicolou’s stain (Pap) respectively. Results: NSRT showed lysis of red blood cells (RBCs) in 72.5% of cases, followed by that of CF in 60.8% cases and that of GAA in only 3.9% of cases. Retention of epithelial/mesothelial cells was seen in 70.5% cases with NSRT, followed by that of CF in 57.8% of cases and then by that of GAA in 50.9% of cases. Cytomorphological details were best preserved in CF in 60.6% of cases, followed by GAA in 58.8% of cases and NSRT in 52.9% of cases. Conclusion: The most effective method for RBC lysis in smear background and cell retention is NSRT and cytomorphological details are best preserved with CF. But, considering the overall results and procedural simplicity, it was concluded that NSRT was a better technique for processing of haemorrhagic fluid. PMID:24298471

Shabnam, Mirza; Sharma, Sangeeta; Upreti, Sanjay; Bansal, Rani; Saluja, Mahip; Khare, Anjali; Tripathi, Meenakshi; Khanna, Shrey

2013-01-01

190

[Actiopathogenic study of per and postoperative haemorrhage in adenotonsillectomy in the child (author's transl)].  

PubMed

This study involved 4 201 records between July 1st 1969 and February 28th 1979. Various parameters represented by specific patient data (age, sex, ENT infections), laboratory examinations, operative findings and weather conditions were studied. Adenoidectomy was found to be more haemorrhagic than adenotonsillectomy, in particular in the presence of a large clump of adenoids and in autumn or winter. Use of a halothane-nitrous oxide-oxygen mixture decreased the number of haemorrhages which by contrast were increased by an operative position in a dorsal horizontal position. Finally, any deviation from standard meterological conditions would appear to be a pejorative factor. The authors conclude by stating that no serious complications were seen and that it is important to undertake a precise and complete preoperative laboratory assessment. Finally, mutual confidence between surgeon and anaesthetist is an additional factor in decreasing risk. PMID:7103335

Moreau, M C; Morelle-Lafon, E; Bonhomme, F

1982-01-01

191

Osteogenesis imperfecta presenting as aneurysmal subarachnoid haemorrhage in a 53-year-old man  

PubMed Central

The authors describe a case of aneurysmal subarachnoid haemorrhage in a 53-year-old man with background of osteogenesis imperfecta (OI). CT brain revealed diffuse subarachnoid haemorrhage (SAH) and cerebral angiogram subsequently confirmed vertebral artery aneurysm rupture leading to SAH. To the authors knowledge this is the first case of vertebral artery aneurysmal SAH described in OI. A previously undiagnosed OI was confirmed by genetic analysis (COL1A1 gene mutation). This aneurysm was successfully treated by endovascular route. Post interventional treatment patient developed stroke secondary to vasospasm. Communicating hydrocephalus, which developed in the process of management, was successfully treated with ventriculo-peritoneal shunt. The aetio-pathogenesis and management of this condition is described. The authors have reviewed the literature and genetic basis of this disease. PMID:22674700

Kaliaperumal, Chandrasekaran; Walsh, Tom; Balasubramanian, Chandramouli; Wyse, Gerry; Fanning, Noel; Kaar, George

2011-01-01

192

Skin rash, headache and abnormal behaviour: unusual presentation of intracranial haemorrhage in dengue fever  

PubMed Central

Dengue viral infections are one of the most important mosquito borne diseases in the world. The dengue virus is a single stranded RNA virus belonging to the Flaviviridae family. There are four serotypes (DEN 1–4) classified according to biological and immunological criteria. Patients may be asymptomatic or their condition may give rise to undifferentiated fever, dengue fever, dengue haemorrhagic fever (DHF), or dengue shock syndrome. Annually, 100 million cases of dengue fever and half a million cases of DHF occur worldwide and 2.5 billion people are at risk. At present, dengue is endemic in 112 countries. Early recognition and prompt initiation of appropriate treatment are vital if disease related morbidity and mortality are to be limited. We present an interesting case of dengue fever with headache, skin rash and abnormal behaviour who had a massive intracranial haemorrhage with fatal outcome. PMID:22242067

Wani, Abdul Majid; Mejally, Mousa Ali Al; Hussain, Waleed Mohd; Maimani, Wail Al; Hanif, Sadia; Khoujah, Amer Mohd; Siddiqi, Ahmad; Akhtar, Mubeena; Bafaraj, Mazen G; Fareed, Khurram

2010-01-01

193

A new locus for hereditary haemorrhagic telangiectasia (HHT3) maps to chromosome 5  

Microsoft Academic Search

Patients with hereditary haemorrhagic telangiectasia (HHT, or Osler-Weber-Rendu syndrome) have variable presentation patterns and a high risk of preventable complications. Diagnostic tests for mutations in endoglin (HHT type 1) and ALK-1 (HHT type 2) are available. Some HHT patients are now known to have HHT-juvenile polyposis overlap syndrome due to Smad4 mutations. Families were ascertained following the presentation of probands

S G Cole; M E Begbie; G M F Wallace; C L Shovlin

2005-01-01

194

Hereditary haemorrhagic telangiectasia with pulmonary arteriovenous malformations: a treatable cause of thromboembolic cerebral events  

Microsoft Academic Search

Hereditary haemorrhagic telangiectasia (HHT) or Osler-Weber-Rendu syndrome is associated with mucocutaneous telangiectases and iron deficiency anaemia caused by epistaxis or blood loss from the gastrointestinal tract. We describe a 41-year-old Chinese man who presented with amaurosis fugax secondary to emboli from pulmonary arteriovenous malformations associated with HHT. He was diagnosed with the disorder in adolescence but follow-up in the outpatient

J K C Yoong; M M Htoo; V Jeyaseelan

195

Crimean-Congo Haemorrhagic Fever in Kosova : a fatal case report  

Microsoft Academic Search

Crimean-Congo haemorrhagic fever (CCHF) is an often fatal viral infection described in about 30 countries around the world. The authors report a fatal case of Crimean-Congo hemorrhagic fever (CCHF) observed in a patient from Kosova. The diagnosis of CCHF was confirmed by reverse transcription-PCR. Late diagnosis decreased the efficacy of treatment and patient died due to severe complications of infection.

Salih Ahmeti; Lul Raka

2006-01-01

196

Risk Factors for Neonatal Intraventricular Haemorrhage in Spontaneous Prematurity at 32 Weeks Gestation or Less  

Microsoft Academic Search

In this study we aimed to establish which clinical and histopathological factors are associated with early-onset neonatal intraventricular haemorrhage (IVH) in non-iatrogenic preterm delivery before 32 weeks of gestation.We retrospectively reviewed all singleton pregnancies delivered before 32 weeks of gestation after spontaneous onset of preterm labour or preterm membrane rupture during the period January 1993 to June 1997. Clinical and

P. Vergani; L. Patanè; P. Doria; C. Borroni; A. Cappellini; J. C. Pezzullo; A. Ghidini

2000-01-01

197

Primary Supratentorial Haemorrhage – Surgery or no Surgery in an Indian Setup  

PubMed Central

Introduction: Rise of hypertension among younger age group has increased the prevalence of intracranial haemorrhage. Conflicting reviews regarding the mode of treatment has been a concern to the treating physicians especially in a developing country like India. This study was undertaken to underline the importance of management and propose a local protocol for primary supra-tentorial haemorrhage. Materials and Methods: Patients presenting with primary supratentorial (ST) haemorrhage fulfilling inclusion criteria are included in the study. Decompression craniotomy done in all the patients and the patient particulars noted. The primary outcome of death is correlated with various particulars and statistical analysis done with SPSS version 16. Results: Mean age of presentation was 54.2 years, ranging from 38-71years. Male comprised 82.1% (23 patients). Seven out of eight patients with Glasgow coma scale (GCS) ?7 (87.5%) expired whereas only 3 out of 20 (15%) patients with GCS >7 expired. 50% of the patients with intracranial haemorrhage (ICH) in temporo-pari et al., (2/4) or in basal ganglia with cortical extension (5/10) expired whereas the mortality in cases of ICH in parietal lobe and frontal lobes were 25% (1/4) and 20% (2/10) respectively. Clot volume ?100ml had a mortality of 19% (4/21) whereas the mortality was as high as 85.7% (6/7) with clot volume >100ml. Conclusion: Emergency Craniotomy and Evacuation of the Hematoma could be a feasible option in between 40 ml to 100ml of Primary ST ICH without intra-ventricular extension. In cases of intra-ventricular extension of haematoma surgery is less helpful. Midline shift of 5 mm or more might be a poor prognostic factor. PMID:25386479

Singh, Th Gojendra; Ghalige, Hemanth S; S, Abhilash; Singh, Motilal; Berma, Subrata Kishore Deb; N, Prasanna Kumar

2014-01-01

198

Haemorrhagic infarction after autologous cranioplasty in a patient with sinking flap syndrome  

Microsoft Academic Search

Summary  Sinking flap syndrome is a potential complication of large decompressive craniectomies that usually resolves completely after\\u000a cranioplasty. We report a 77 year-old female who underwent an autologous cranioplasty to treat a sinking flap syndrome. In\\u000a the first post-operative day she developed a large hemispheric haemorrhagic infarction. In this report we discuss the possible\\u000a pathogenic mechanism of such a complication.

P. C. Cecchi; P. Rizzo; M. Campello; A. Schwarz

2008-01-01

199

Relationship of pulmonary arterial pressure to pulmonary haemorrhage in exercising horses.  

PubMed

Exercise-induced pulmonary haemorrhage (EIPH) is characterised by blood in the airways after strenuous exercise and results from stress failure of the pulmonary capillaries. The purpose of this experiment was to establish a threshold value of transmural pulmonary arterial pressure at which haemorrhage occurs in the exercising horse. Five geldings, age 4-14 years, were run in random order once every 2 weeks at 1 of 4 speeds (9, 11, 13, 15 m/s); one day with no run was used as a control. Heart rate, pulmonary arterial pressure and oesophageal pressure were recorded for the duration of the run. Transmural pulmonary arterial pressure was estimated by electronic subtraction of the oesophageal pressure from the intravascular pulmonary arterial pressure. Within 1 h of the run, bronchoalveolar lavage was performed and the red and white blood cells in the fluid were quantified. Red cell counts in the lavage fluid from horses running at 9, 11 and 13 m/s were not significantly different from the control value, but after runs at 15 m/s, red cell counts were significantly (P<0.05) higher. White cell counts were not different from control values at any speed. Analysis of red cell count vs. transmural pulmonary arterial pressure indicated that haemorrhage occurs at approximately 95 mmHg. Red cell lysis in the lavage fluid was also apparent at transmural pulmonary arterial pressures above 90 mmHg. We conclude that, in the exercising horse, a pulmonary arterial pressure threshold exists above which haemorrhage occurs, and that pressure is often exceeded during high speed sprint exercise. PMID:11037258

Langsetmo, I; Meyer, M R; Erickson, H H

2000-09-01

200

[Carotid dissection during angioplasty for vasospasm induced by subarachnoid haemorrhage. The use of multimodal cerebral monitoring].  

PubMed

We report the case of a 54-year-old woman presenting subarachnoid haemorrhage. She experienced multiple vasospasms and treatment included triple-H (hypervolaemia, hypertension, and haemodilution) and endovascular therapies. Right internal carotid dissection complicated angioplasty of the right middle cerebral artery. Combined brain tissue partial pressure of oxygen monitoring and transcranial echo-Doppler could have facilitated early diagnosis. Despite successful revascularization of right internal carotid by stenting, this complication caused acute stroke with refractory intracranial hypertension. PMID:19945247

Bordes, J; Boret, H; Prunet, B; Montcriol, A; Goutorbe, P

2009-12-01

201

Distal enlargement of the optic nerve sheath in the hyperacute stage of intracerebral haemorrhage  

Microsoft Academic Search

AimsOptic nerve sheath diameter (ONSD) enlargement is detectable in patients with increased intracranial pressure. The aim was to detect an enlargement of the ONSD using optic nerve sonography in patients with acute intracerebral haemorrhage (ICH) within 6 h of the onset of symptoms.MethodsThirty-one acute ICH patients, 15 age-matched acute ischaemic stroke patients and 16 age-matched healthy volunteers were enrolled consecutively

David Školoudík; Roman Herzig; Tá?a Fadrná; Michal Bar; Pavel Hradílek; Martin Roubec; Monika Jelínková; Daniel Ša?ák; Michal Král; Jana Chmelová; Miroslav He?man; Kate?ina Langová; Petr Ka?ovský

2010-01-01

202

A Brain Parenchyma Model-Based Segmentation of Intraventricular and Intracerebral Haemorrhage in CT Scans.  

PubMed

Accurate quantification of haemorrhage volume in a computed tomography (CT) scan is critical in the management and treatment planning of intraventricular (IVH) and intracerebral haemorrhage (ICH). Manual and semi-automatic methods are laborious and time-consuming limiting their applicability to small data sets. In clinical trials measurements are done at different locations and on a large number of data; an accurate, consistent and automatic method is preferred. A fast and efficient method based on texture energy for identification and segmentation of hemorrhagic regions in the CT scans is proposed. The data set for the study was obtained from CLEAR-IVH clinical trial phase III (41 patients' 201 sequential CT scans from ten different hospitals, slice thickness 2.5-10 mm and from different scanners). The DICOM data were windowed, skull stripped, convolved with textural energy masks and segmented using a hybrid method (a combination of thresholding and fuzzy c-means). Artifacts were removed by statistical analysis and morphological processing. Segmentation results were compared with the ground truth. Descriptive statistics, Dice statistical index (DSI), Bland-Altman and mean difference analysis were carried out. The median sensitivity, specificity and DSI for slice identification and haemorrhage segmentation were 86.25%, 100%, 0.9254 and 84.90%, 99.94%, 0.8710, respectively. The algorithm takes about one minute to process a scan in MATLAB(®). A hybrid method-based volumetry of haemorrhage in CT is reliable, observer independent, efficient, reduces the time and labour. It also generates quantitative data that is important for precise therapeutic decision-making. PMID:24028979

Bhanu Prakash, K N; Morgan, T C; Hanley, D M; Nowinski, W L

2012-07-01

203

Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid haemorrhage: British aneurysm nimodipine trial  

Microsoft Academic Search

OBJECTIVE--To determine the efficacy of oral nimodipine in reducing cerebral infarction and poor outcomes (death and severe disability) after subarachnoid haemorrhage. DESIGN--Double blind, placebo controlled, randomised trial with three months of follow up and intention to treat analysis. To have an 80% chance with a significance level of 0.05 of detecting a 50% reduction in an incidence of cerebral infarction

J. D. Pickard; G. D. Murray; R. Illingworth; M. D. Shaw; G. M. Teasdale; P. M. Foy; P. R. Humphrey; D. A. Lang; R. Nelson; P. Richards

1989-01-01

204

Haemorrhage in intracerebral arteriovenous malformations: detection with MRI and comparison with clinical history  

Microsoft Academic Search

Fifty-one patients with 59 angiographically proven cerebral arteriovenous malformations (AVMs) were examinded by high-field MRI to detect blood breakdown products. Results were correlated with the history of intracranial bleeding. Evidence of previous episodes of haemorrhage was seen in 10 of 12 patients (83.3%) with verified bleeding, in 4 of 9 patients (44.4%) with symptoms which could suggest bleeding and in

L. Prayer; D. Wimberger; R. Stiglbauer; J. Kramer; B. Richling; G. Bavinzski; T. Czech; H. Imhof

1993-01-01

205

A quantitative study of lung dysfunction following haemorrhagic shock in rats  

PubMed Central

Haemorrhagic shock occasionally causes an episode of lung dysfunction, the severity of which appears to correlate with fatal outcome. Our previous study indicated that proinflammatory cytokines, such as tumour necrosis factor (TNF)-? and interleukin (IL)-1?, played a key role in the development of lung dysfunction through recruitment of activated neutrophils by causing pulmonary endothelial cell damage. Here, we examined this issue quantitatively by grading four groups of severity of bleeding in rats. As the amount of bleeding increased, the expression of mRNA for TNF-? and IL-1? in the lung tissue and the pulmonary serum levels of both cytokines increased progressively up to 5 h, and the frequency of activated neutrophils increased likewise. The lung dysfunction indices serum lactic dehydrogenase-3 isozyme (LDH-3), partial pressure of arterial oxygen (PaO2) and alveolar-arterial oxygen tension difference (AaDO2) in blood deteriorated as the amount of bleeding increased. The frequency of activated neutrophils in the lung correlated well with the LDH-3 level 5 h after haemorrhagic shock. The present results demonstrate that the increase of proinflammatory cytokines and the recruitment of activated neutrophils into the lung following haemorrhagic shock are quantitatively related to progression of lung dysfunction as the amount of bleeding increases. PMID:20041965

Sato, Hiroaki; Tanaka, Toshiko; Kita, Toshiro; Tanaka, Noriyuki

2010-01-01

206

Ranitidine and oxygen derived free radical scavengers in haemorrhagic shock induced gastric lesions.  

PubMed Central

The role of oxygen derived free radicals in gastric lesions induced by haemorrhagic shock and the protective effect of oxygen radical scavengers, allopurinol and ranitidine, were investigated. Forty five rabbits underwent haemorrhagic shock for 30 minutes and reinfusion of shed blood. They were killed 30 minutes later. The animals were divided in five groups: A (n = 10): Control, B (n = 10): intravenous ranitidine pretreatment, C (n = 10): oral allopurinol, 24 and 2 h before surgery; D (n = 10): intravenous pretreatment with superoxide Dismutase plus catalase, E (n = 5): 60 minute haemorrhagic shock without reinfusion and treatment. Erosions and/or petechiae in all animals in Group A were observed. Three animals in group B and C and 2 in group D (p less than 0.005, p less than 0.001) had gastric lesions. The lesions in the pretreatment groups were significantly smaller than in controls. Oxygen radicals plus HCl play an important role in shock induced gastric lesions. Oxygen radical antagonists show a significant protective role. PMID:3384367

Tsimoyiannis, E C; Sarros, C J; Tsimoyiannis, J C; Moutesidou, K; Akalestos, G; Kotoulas, O B

1988-01-01

207

Ranitidine and oxygen derived free radical scavengers in haemorrhagic shock induced gastric lesions.  

PubMed

The role of oxygen derived free radicals in gastric lesions induced by haemorrhagic shock and the protective effect of oxygen radical scavengers, allopurinol and ranitidine, were investigated. Forty five rabbits underwent haemorrhagic shock for 30 minutes and reinfusion of shed blood. They were killed 30 minutes later. The animals were divided in five groups: A (n = 10): Control, B (n = 10): intravenous ranitidine pretreatment, C (n = 10): oral allopurinol, 24 and 2 h before surgery; D (n = 10): intravenous pretreatment with superoxide Dismutase plus catalase, E (n = 5): 60 minute haemorrhagic shock without reinfusion and treatment. Erosions and/or petechiae in all animals in Group A were observed. Three animals in group B and C and 2 in group D (p less than 0.005, p less than 0.001) had gastric lesions. The lesions in the pretreatment groups were significantly smaller than in controls. Oxygen radicals plus HCl play an important role in shock induced gastric lesions. Oxygen radical antagonists show a significant protective role. PMID:3384367

Tsimoyiannis, E C; Sarros, C J; Tsimoyiannis, J C; Moutesidou, K; Akalestos, G; Kotoulas, O B

1988-06-01

208

N-Butyl Cyanoacrylate Is Very Effective for Massive Haemorrhage during the Perinatal Period  

PubMed Central

Objective The liquid embolic agent n-butyl cyanoacrylate (NBCA) is a tissue adhesive used as an immediate and permanent embolic agent when mixed with oil-based contrast medium. In this study, the preservation of fertility with TAE using NBCA for massive haemorrhage during pregnancy or the peripartum period and the utility of this therapy were investigated. Methods Cases from January 2005 to October 2010 in which TAE was performed for massive haemorrhage in pregnant women, particularly during the peripartum period, were investigated. Results TAE was performed in 27 pregnant women. The embolic agent used was GS only in five cases, NBCA only in 19 cases, and additional embolization with NBCA when the effect with GS was insufficient in three cases, one each of abruptio placentae, cervical pregnancy, and uterine atony.A comparison of mean blood loss when each embolic agent was used for haemostasis showed a significant difference between cases in which GS only was used and cases in which NBCA only was used. In a comparison of mean transfusion volume, a significant difference was seen between cases in which both GS and NBCA were used and cases in which NBCA only was used. In a postoperative follow-up survey, menses resumed in eight patients, including four patients who later became pregnant and three who delivered. Conclusions TAE with NBCA, which has an embolic effect unrelated to clotting dysfunction for massive haemorrhage during the peripartum period, is a minimally invasive and very effective treatment method for patients with severe DIC. PMID:24223099

Igarashi, Suguru; Izuchi, Shinichirou; Ogawa, Yukihisa; Yoshimathu, Misako; Takizawa, Kenji; Nakajima, Yasuo; Tanaka, Mamoru; Ishizuka, Bunpei; Suzuki, Nao

2013-01-01

209

Update on the Surgical Trial in Lobar Intracerebral Haemorrhage (STICH II): statistical analysis plan  

PubMed Central

Background Previous studies had suggested that the outcome for patients with spontaneous lobar intracerebral haemorrhage (ICH) and no intraventricular haemorrhage (IVH) might be improved with early evacuation of the haematoma. The Surgical Trial in Lobar Intracerebral Haemorrhage (STICH II) set out to establish whether a policy of earlier surgical evacuation of the haematoma in selected patients with spontaneous lobar ICH would improve outcome compared to a policy of initial conservative treatment. It is an international, multi-centre, prospective randomised parallel group trial of early surgery in patients with spontaneous lobar ICH. Outcome is measured at six months via a postal questionnaire. Results Recruitment to the study began on 27 November 2006 and closed on 15 August 2012 by which time 601 patients had been recruited. The protocol was published in Trials (http://www.trialsjournal.com/content/12/1/124/). This update presents the analysis plan for the study without reference to the unblinded data. The trial data will not be unblinded until after follow-up is completed in early 2013. The main trial results will be presented in spring 2013 with the aim to publish in a peer-reviewed journal at the same time. Conclusion The data from the trial will provide evidence on the benefits and risks of early surgery in patients with lobar ICH. Trial registration ISRCTN: ISRCTN22153967 PMID:23171588

2012-01-01

210

Skull fracture and haemorrhage pattern among fatal and nonfatal head injury assault victims – a critical analysis  

PubMed Central

Abstract: Background: The global incidence of fatal head injuries as the result of assault is greater than the number of non-fatal cases. The important factors that determine the outcome in terms of survival of such head injury cases include the type of weapon used, type and site of skull fracture, intra cranial haemorrhage and the brain injury. The present study aims to highlight the role of skull fractures as an indirect indicator of force of impact and the intra cranial haemorrhage by a comparative study of assault victims with fatal and nonfatal head injuries. Methods: 91 head injury cases resulting from assault were studied in the Department of Forensic Medicine, IMS, BHU Varanasi over a period of 2 years from which 18 patients survived and 73 cases had a lethal outcome. Details of the fatal cases were obtained from the police inquest and an autopsy while examination of the surviving patients was done after obtaining an informed consent. The data so obtained were analyzed and presented in the study. Results: Assault with firearms often led to fatality whereas with assault involving blunt weapons the survival rate was higher. Multiple cranial bones were involved in 69.3% cases while comminuted fracture of the skull was common among the fatal cases. Fracture of the base of the skull was noted only in the fatal cases and a combination of subdural and subarachnoid haemorrhage was found in the majority of the fatal cases. Conclusions: The present study shows skull fractures to be an important indicator of severity of trauma in attacks to the head. Multiple bone fracture, comminuted fracture and base fractures may be considered as high risk factors in attempted homicide cases. PMID:21483205

Chattopadhyay, Saurabh; Tripathi, Chandrabhal

2010-01-01

211

A Late Haemorrhagic Complication in an ArterioVenous Malformation Cured with Radiosurgery  

PubMed Central

Summary Radiosurgery is a recognized safe form of treating and usually curing arteriovenous malformations (AVMs). Complications related to radiosurgery, especially late sequelae, are rare. Such sequelae may be secondary to incomplete treatment of the original lesion such as haemorrhage, or secondary to the radiation damage to the tissue, or both. Sometimes treatment may induce new lesions. We report a patient who had an AVM cured with radiosurgery, but developed hemisensory loss acutely and had changes on MRI in keeping with a haematoma. We discuss the possible differential diagnosis that should be considered. PMID:22681728

Le Feuvre, D.E.J.; Parkes, J.D.; Mukheiber, P.; James, R.; Taylor, A.G.

2012-01-01

212

Enteropathy associated T-cell lymphoma presenting with multiple episodes of small bowel haemorrhage and perforation  

PubMed Central

Enteropathy-associated T cell lymphoma (EATCL) is an intestinal neoplasm of intra-epithelial T lymphocytes associated with coeliac disease. Although the incidence is rare, EATCL runs an aggressive disease course and produces multi-focal ulcerative lesions most commonly in the proximal small bowel. As such, patients may present with intestinal perforation, obstruction or haemorrhage. Management of EATCL requires a combination of early diagnosis and treatment by surgical resection followed by chemotherapy to achieve treatment success. Overall however, the treatment completion rate remains at 50% and EATCL carries a poor prognosis with a 5-year survival rate of <20%. PMID:24876396

Pun, Amy H.; Kasmeridis, Harry; Rieger, Nicholas; Loganathan, Arun

2014-01-01

213

[Three consecutive operations for chronic subdural haemorrhage in an 87-year-old man].  

PubMed

We describe a man aged 87 with a subdural haemorrhage which needed to be evacuated three times over an eight-week period. After the third operation the patient's physical and cognitive performance increased markedly, even though his performance had been assessed as "normal for his age" during his illness. The case illustrates the impressive regenerative capacity of the aged brain, the challenge in differentiating between disease symptoms and age-associated functional decline, the difficulties in deciding when to operate on an old patient, and the importance of functional assessments in health care for the elderly. PMID:15559927

Møinichen, Einar; Wyller, Torgeir Bruun; Gjølberg, Tor

2004-11-01

214

Partial Recovery of Audiological, Vestibular, and Radiological Findings following Spontaneous Intralabyrinthine Haemorrhage  

PubMed Central

The diagnosis, work-up, and treatment of sudden sensorineural hearing loss and sudden vestibular loss vary widely between units. With the increasing access to both magnetic resonance imaging and objective vestibular testing, our understanding of the various aetiologies at hand is increasing. Despite this, the therapeutic options are limited and without a particularly strong evidence base. We present a rare, yet increasingly diagnosed, case of intralabyrinthine haemorrhage (ILH) together with radiological, audiological, and vestibular test results. Of note, this occurred spontaneously and has shown partial recovery in all the mentioned modalities. PMID:24455375

Pezier, Thomas; Hegemann, Stefan

2013-01-01

215

Spontaneous acute subdural haemorrhage, cerebral and pulmonary metastases in a complete mole.  

PubMed

Complete and partial moles remit spontaneously in most cases, following evacuation of the uterine cavity. However, either persistent trophoblastic disease or a frank trophoblastic tumour can follow a complete hydatidiform mole. To our knowledge, acute subdural haematoma, as a complication of cerebral metastases, following treatment for hydatidiform mole has not been reported. We describe a 29-year-old woman who presented with spontaneous acute subdural haemorrhage and pulmonary metastases, eight months after evacuation of a complete hydatidiform mole, with a fatal outcome. PMID:17609811

Agrawal, A; Agrawal, C S; Kumar, A; Kumar, M; Yadav, R

2007-07-01

216

Deep vein thrombosis induced by thalidomide to control epistaxis secondary to hereditary haemorrhagic telangiectasia.  

PubMed

Thalidomide was recently reported to reduce the severity and frequency of epistaxes in patients with hereditary haemorrhagic telangiectasia (HHT). We here describe the case of a patient with HHT and severe epistaxes refractory to medical and local surgical treatments who developed an extensive deep vein thrombosis shortly after initiation of treatment with thalidomide. This is the first report of venous thromboembolic complication induced by thalidomide prescribed in this setting. Although thalidomide was recently found to provide an alternative therapeutic strategy in patients with HHT and refractory epistaxes, this agent should be used with great caution in this indication, given its thrombogenicity and difficulties to manage systemic anticoagulation in patients with HHT. PMID:21885956

Penaloza, Andrea; Vekemans, Marie-Christiane; Lambert, Catherine; Hermans, Cedric

2011-10-01

217

Endoscopic resection of giant lipoma mimicking colonic neoplasm initially presenting with massive haemorrhage: a case report  

PubMed Central

Lipomas of the colon are benign tumors that rarely occur. Their size ranges from 2 mm to several cm. They are usually asymptomatic but occasionally they present with clinical manifestations depending on tumor size, localization and complications, which often lead to diagnostic difficulty. A 40-year-old man presented with massive rectal haemorrhage. During colonoscopy a giant polyp of over 50 mm in its bigger diameter, with a thick stalk of 2 cm, located in the transverse colon, was revealed. Endoscopic resection was performed with success. Histologic examination demonstrated a giant lipoma. In this report discussion over endoscopic resection of colonic lipomas mimicking neoplasms is also performed. PMID:20181161

2009-01-01

218

Ebola haemorrhagic fever in Sudan, 1976. Report of a WHO/International Study Team.  

PubMed

A large outbreak of haemorrhagic fever (subsequently named Ebola haemorrhagic fever) occurred in southern Sudan between June and November 1976. There was a total of 284 cases; 67 in the source town of Nzara, 213 in Maridi, 3 in Tembura, and 1 in Juba. The outbreak in Nzara appears to have originated in the workers of a cotton factory. The disease in Maridi was amplified by transmission in a large, active hospital. Transmission of the disease required close contact with an acute case and was usually associated with the act of nursing a patient. The incubation period was between 7 and 14 days. Although the link was not well established, it appears that Nzara could have been the source of infection for a similar outbreak in the Bumba Zone of Zaire.In this outbreak Ebola haemorrhagic fever was a unique clinical disease with a high mortality rate (53% overall) and a prolonged recovery period in those who survived. Beginning with an influenza-like syndrome, including fever, headache, and joint and muscle pains, the disease soon caused diarrhoea (81%), vomiting (59%), chest pain (83%), pain and dryness of the throat (63%), and rash (52%). Haemorrhagic manifestations were common (71%), being present in half of the recovered cases and in almost all the fatal cases.Two post mortems were carried out on patients in November 1976. The histopathological findings resembled those of an acute viral infection and although the features were characteristic they were not exclusively diagnostic. They closely resembled the features described in Marburg virus infection, with focal eosinophilic necrosis in the liver and destruction of lymphocytes and their replacement by plasma cells. One case had evidence of renal tubular necrosis.Two strains of Ebola virus were isolated from acute phase sera collected from acutely ill patients in Maridi hospital during the investigation in November 1976. Antibodies to Ebola virus were detected by immunofluorescence in 42 of 48 patients in Maridi who had been diagnosed clinically, but in only 6 of 31 patients in Nzara. The possibility of the indirect immunofluorescent test not being sufficiently sensitive is discussed.Of Maridi case contacts, in hospital and in the local community, 19% had antibodies. Very few of them gave any history of illness, indicating that Ebola virus can cause mild or even subclinical infections. Of the cloth room workers in the Nzara cotton factory, 37% appeared to have been infected, suggesting that the factory may have been the prime source of infection. PMID:307455

1978-01-01

219

Life threatening intracerebral haemorrhage following saw- scaled viper (Echis carinatus) envenoming-authenticated case report from Sri Lanka  

PubMed Central

Background Echis carinatus (Saw scaled viper {SSV}) is a venomous snake found in the parts of Middle East and Central Asia. SSV envenoming is characterized by local swelling and coagulopathy. Various bleeding manifestations are commonly seen with SSV envenoming. In contrast to other part of Asia, saw scale viper envenoming has not been reported to cause life threatening haemorrhagic manifestations in Sri Lanka. Case presentation We report a 19 years old healthy boy who developed massive left temporo-parietal intra cerebral haemorrhage following Echis carinatus (Saw scaled viper) bite in Sri Lanka. Conclusion Although subspecies of SSV in Sri Lanka is regarded as a ‘non lethal venomous snake’, the occurrence of rare potentially fatal complications such as intracerebral haemorrhage should be considered in their management. This case report is intended to bring the awareness of this fatal complication of SSV envenoming in Sri Lanka. PMID:23565979

2013-01-01

220

A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project1981-86. 2. Incidence, case fatality rates and overall outcome at one year of cerebral infarction, primary intracerebral and subarachnoid haemorrhage  

Microsoft Academic Search

The age and sex specific incidence rates for cerebral infarction, primary intracerebral haemorrhage and subarachnoid haemorrhage in a population of approximately 105,000 are presented. Over four years 675 patients with a first-ever stroke were registered with the Oxfordshire Community Stroke Project. The pathological diagnosis was confirmed by computerised tomography (CT) scan, necropsy or lumbar puncture (cases of subarachnoid haemorrhage only)

J Bamford; P Sandercock; M Dennis; J Burn; C Warlow

1990-01-01

221

[Acute headache: limitations of cerebral computed tomography and analysis of cerebrospinal fluid in the diagnosis of subarachnoid haemorrhage].  

PubMed

Subarachnoid haemorrhage constitutes a neurological emergency. In most cases the diagnosis is easy to establish by cerebral computed tomography or cerebrospinal fluid tap. However, in rare cases verification of the diagnosis is more difficult and a residual uncertainty remains. We describe three patients supposed to have a subarachnoid haemorrhage without pathological findings in both cerebral computed tomography and cerebrospinal fluid. In these cases vasospasm or cerebral aneurysm were detected by means of transcranial Doppler sonography and/or conventional angiography. We comment on the special features of this rare presentation of a severe acute neurological emergency, and we discuss diagnostic work-up and differential diagnoses. PMID:21128197

Burghaus, L; Liu, W; Fink, G R; Eggers, C

2011-01-01

222

Protective effects of PARP inhibition on liver microcirculation and function after haemorrhagic shock and resuscitation in male rats  

Microsoft Academic Search

Objective  The aim of this study was to investigate the impact of the water-soluble poly-(ADP)-ribose-polymerase (PARP) inhibitor 5-aminoisoquinolinone (5-AIQ) on liver microcirculation and function after haemorrhagic shock and resuscitation.Design  Controlled, randomized animal study.Setting  University animal care facility and research laboratory.Subject  Male Sprague–Dawley rats were subjected to haemorrhagic shock for 1?h, followed by resuscitation with shed blood and crystalloid solution for a total of 5 h.Interventions  The

J. P. Roesner; D. A. Vagts; T. Iber; C. Eipel; B. Vollmar; G. F. E. Nöldge-Schomburg

2006-01-01

223

New hope: community-based misoprostol use to prevent postpartum haemorrhage.  

PubMed

The wide gap in maternal mortality ratios worldwide indicates major inequities in the levels of risk women face during pregnancy. Two priority strategies have emerged among safe motherhood advocates: increasing the quality of emergency obstetric care facilities and deploying skilled birth attendants. The training of traditional birth attendants, a strategy employed in the 1970s and 1980s, is no longer considered a best practice. However, inadequate access to emergency obstetric care and skilled birth attendants means women living in remote areas continue to die in large numbers from preventable maternal causes. This paper outlines an intervention to address the leading direct cause of maternal mortality, postpartum haemorrhage. The potential for saving maternal lives might increase if community-based birth attendants, women themselves, or other community members could be trained to use misoprostol to prevent postpartum haemorrhage. The growing body of evidence regarding the safety and efficacy of misoprostol for this indication raises the question: if achievement of the fifth Millennium Development Goal is truly a priority, why can policy makers and women's health advocates not see that misoprostol distribution at the community level might have life-saving benefits that outweigh risks? PMID:22879523

Prata, Ndola; Passano, Paige; Bell, Suzanne; Rowen, Tami; Potts, Malcolm

2013-07-01

224

Case definition for Ebola and Marburg haemorrhagic fevers: a complex challenge for epidemiologists and clinicians.  

PubMed

Viral haemorrhagic fevers (VHFs) represent a challenge for public health because of their epidemic potential, and their possible use as bioterrorism agents poses particular concern. In 1999 the World Health Organization (WHO) proposed a case definition for VHFs, subsequently adopted by other international institutions with the aim of early detection of initial cases/outbreaks in western countries. We applied this case definition to reports of Ebola and Marburg virus infections to estimate its sensitivity to detect cases of the disease. We analyzed clinical descriptions of 795 reported cases of Ebola haemorrhagic fever: only 58.5% of patients met the proposed case definition. A similar figure was obtained reviewing 169 cases of Marburg diseases, of which only 64.5% were in accordance with the case definition. In conclusion, the WHO case definition for hemorrhagic fevers is too specific and has poor sensitivity both for case finding during Ebola or Marburg outbreaks, and for early detection of suspected cases in western countries. It can lead to a hazardous number of false negatives and its use should be discouraged for early detection of cases. PMID:20128442

Pittalis, Silvia; Fusco, Francesco Maria; Lanini, Simone; Nisii, Carla; Puro, Vincenzo; Lauria, Francesco Nicola; Ippolito, Giuseppe

2009-10-01

225

Ischaemic and haemorrhagic brain lesions in newborns with seizures and normal Apgar scores.  

PubMed Central

Serial ultrasound scans and conventional and diffusion weighted magnetic resonance imaging (MRI) were performed on 16 neonates who presented with seizures. The Apgar scores were normal and subsequently no metabolic or infective cause could be found. The aim of the study was to evaluate the extent to which early sequential imaging can elucidate the cause of seizures in apparently neurologically normal infants. Fourteen of the infants had haemorrhagic or ischaemic lesions on MRI and these were detected by ultrasound scanning in 11. Early ultrasound scanning detected the haemorrhagic lesions but the ischaemic lesions were often not seen until the end of the first week of life. Early MRI, however, was able to detect all the ischaemic lesions. The evolution of the insult could be timed by using serial ultrasound scans and a combination of diffusion weighted and conventional MRI during the first week of life, confirming a perinatal insult even in the absence of fetal distress. Although the aetiology of these lesions remains obscure, serial ultrasound scans will detect the presence of cerebral lesions in neonates presenting with isolated seizures but additional MRI sequences will give better definition on type, site, and extent of the pathology. Images Figures 5 and 6 Figure 2 Figures 3 and 4 Figure 1 PMID:7583609

Mercuri, E.; Cowan, F.; Rutherford, M.; Acolet, D.; Pennock, J.; Dubowitz, L.

1995-01-01

226

Epistaxis related to exercise-induced pulmonary haemorrhage in south African Thoroughbreds.  

PubMed

This study investigated if environmental factors had an effect on the incidence of epistaxis related to exercise-induced pulmonary haemorrhage (EIPH) among racehorses in southern Africa. Data covering the period 1986-2001 and involving 778 532 race runs were analysed. This included the following information: date of race, age, sex, name of breeder, trainer, distance, jockey, state of going, weight carried, racing centre and altitude. Veterinarians employed by the Jockey Club suspended officially entered horses that presented with epistaxis (frank bleeding from the nostrils) after racing. On-course endoscopy is not performed as a standard practice at any southern African racetrack. Epistaxis was identified in 1287 horses (0.165%). More horses presented with EIPH-related epistaxis (a) at sea level, (b) from May to October, (c) when older (> 3 years), (d) after 1995, (e) on Fridays and Sundays, and (f) more in geldings than in mares or entire males. No association could be established between epistaxis and breeder, trainer, distance run, jockey, state of going and weight carried. It is concluded that the frequency of EIPH-related epistaxis is associated with altitude, winter and spring, sex and age. It is suggested that racing at lower altitudes may increase the probability of exercise-induced pulmonary haemorrhage. PMID:15038426

Weideman, H; Schoeman, S J; Jordaan, G F; Kidd, M

2003-12-01

227

First dengue haemorrhagic fever epidemic in the Americas, 1981: insights into the causative agent.  

PubMed

Historical records describe a disease in North America that clinically resembled dengue haemorrhagic fever during the latter part of the slave-trading period. However, the dengue epidemic that occurred in Cuba in 1981 was the first laboratory-confirmed and clinically diagnosed outbreak of dengue haemorrhagic fever in the Americas. At that time, the presumed source of the dengue type 2 strain isolated during this epidemic was considered controversial, partly because of the limited sequence data and partly because the origin of the virus appeared to be southern Asia. Here, we present a molecular characterisation at the whole-genome level of the original strains isolated at different time points during the epidemic. Phylogenetic trees constructed using Bayesian methods indicated that 1981 Cuban strains group within the Asian 2 genotype. In addition, the study revealed that viral evolution occurred during the epidemic - a fact that could be related to the increasing severity from month to month. Moreover, the Cuban strains exhibited particular amino acid substitutions that differentiate them from the New Guinea C prototype strain as well as from dengue type 2 strains isolated globally. PMID:25091743

Rodriguez-Roche, Rosmari; Hinojosa, Yoandri; Guzman, Maria G

2014-12-01

228

Viral haemorrhagic fevers in Europe--effective control requires a co-ordinated response.  

PubMed

Viral haemorrhagic fevers (VHF) have attracted the attention of the medical world and general public for many reasons, some based in reality and more on misinformation. They are amongst the highest profile infections in the public mind, because they are thought to be highly infectious and to kill most of their victims in a dramatic way (1,2). To add to the intrigue, mysteries remain about the source of some of the viruses involved. They emerge and re-emerge in many countries, most recently Ebola in Uganda in 2000 (3) and Gabon in 2001/02 (4), and Congo Crimean Haemorrhagic Fever (CCHF) in Kosovo (5) and Pakistan in 2001 (6). Large outbreaks have affected populations in endemic areas, living mainly in inaccessible areas or refugee camps where living conditions are very difficult. Poorly resourced medical facilities have played a role in amplifying transmission and infection control measures have been difficult or virtually impossible to establish. These viruses are likely to remain a threat until the reservoir is identified and as long as endemic areas are afflicted with ecological change, poverty and social instability. Recent events since September 11 2001 remind us of their potential to be used as weapons, and that fear can present a risk to public health. PMID:12631941

Crowcroft, N S; Morgan, D; Brown, D

2002-03-01

229

Blood, sweat and tears: androgenic-anabolic steroid misuse and recurrent primary post-tonsillectomy haemorrhage.  

PubMed

A 30-year-old male body builder and androgenic-anabolic steroid and insulin abuser was admitted for day case elective tonsillectomy (bipolar). He returned with primary post-tonsillectomy haemorrhage 18?h after the operation and required bipolar cautery to the multiple small bleeding points in the right and left tonsillar fossa. Thorough coagulation screen was normal. Recurrent primary haemorrhage occurred 3?h post-operatively requiring immediate surgical intervention, removal of the inferior poles, precautionary throat packs, intubation and observation on the intensive treatment unit (ITU). Re-examination in theatre revealed a bleeding left superior pole that was under-run to achieve haemostasis and the patient returned to ITU. Hypertensive episodes were noted in the emergency department and intraoperatively including one recording >200?mm?Hg. Haemostasis was eventually achieved once the blood pressure was adequately controlled. A slow wean of steroids was also instigated and the patient was managed on a surgical ward for 2?weeks post-tonsillectomy. PMID:25398921

Fox, Richard; Varadharajan, Kiran; Patel, Bhavesh; Beegun, Issa

2014-01-01

230

RAPID RISK ASSESSMENT Outbreak of Ebola haemorrhagic fever in the Democratic Republic of Congo  

E-print Network

An outbreak of Ebola haemorrhagic fever is ongoing in the Democratic Republic of Congo (DRC) with 15 cases reported, including nine deaths in Orientale province. It is the first time that the Ebola species Bundibugyo has been laboratory confirmed as the cause of an Ebola outbreak in DRC. This finding indicates that the current outbreak in DRC is not related to the recently ended outbreak in Uganda, which was caused by the Ebola species Sudan. The epidemiological features of this outbreak are consistent with previous outbreaks of Ebola haemorrhagic fever, although the currently observed case fatality rate is significantly higher than the one observed in the first outbreak of Bundingbuyo virus in 2007 in Uganda. However, it is premature to draw final conclusions about the pathogenicity of this Bundingbuyo viral strain. As the incubation period can last up to three weeks, it is likely that additional cases will be identified in the coming weeks. However, control measures currently implemented in DRC with the support of international partners, e.g. isolation of cases and active monitoring of contacts, should prevent further spread of the disease. It is unlikely, but not impossible, that travellers infected in DRC could arrive in the EU while incubating the disease and develop symptoms while in the EU. These cases would seek medical attention and be isolated, preventing further transmission.

Main Conclusions

2012-01-01

231

Crimean-Congo haemorrhagic fever virus infection in the western province of Saudi Arabia.  

PubMed

In 1990, an outbreak of suspected viral haemorrhagic fever involving 7 individuals occurred in Mecca in the Western Province of Saudi Arabia. Congo-Crimean haemorrhagic fever (CCHF), not previously known to be present in Saudi Arabia, was incriminated. A study of the epidemiology of this virus was therefore carried out in Mecca, and in nearby Jeddah and Taif in 1991-1993; 13 species of ixodid ticks (5 Hyalomma spp., 5 Rhipicephalus spp., 2 Amblyomma spp., 1 Boophilus sp.) were collected from livestock (camels, cattle, sheep, goats), and of these 10 were capable of transmitting CCHF. Camels had the highest rate of tick infestation (97%), and H. dromedarii was the commonest tick (70%). Attempts to isolate virus from pools of H. dromedarii and H. anatolicum anatolicum were unsuccessful. The source of infection in 3 confirmed cases of CCHF was contact with fresh mutton and, in a suspected case, slaughtering sheep. An investigation in Mecca, which included a serological survey of abattoir workers, identified 40 human cases of confirmed or suspected CCHF between 1989 and 1990, with 12 fatalities. Significant risk factors included exposure to animal blood or tissue in abattoirs, but not tick bites. It is suspected that the CCHF virus may have been introduced to Saudi Arabia by infected ticks on imported sheep arriving at Jeddah seaport, and that it is now endemic in the Western Province. PMID:9231193

el-Azazy, O M; Scrimgeour, E M

1997-01-01

232

Evolutionary history and molecular epidemiology of rabbit haemorrhagic disease virus in the Iberian Peninsula and Western Europe  

Microsoft Academic Search

BACKGROUND: Rabbit haemorrhagic disease virus (RHDV) is a highly virulent calicivirus, first described in domestic rabbits in China in 1984. RHDV appears to be a mutant form of a benign virus that existed in Europe long before the first outbreak. In the Iberian Peninsula, the first epidemic in 1988 severely reduced the populations of autochthonous European wild rabbit. To examine

Fernando Alda; Tania Gaitero; Mónica Suárez; Tomás Merchán; Gregorio Rocha; Ignacio Doadrio

2010-01-01

233

An information value based analysis of physical and climatic factors affecting dengue fever and dengue haemorrhagic fever incidence  

Microsoft Academic Search

BACKGROUND: Vector-borne diseases are the most dreaded worldwide health problems. Although many campaigns against it have been conducted, Dengue Fever (DF) and Dengue Haemorrhagic Fever (DHF) are still the major health problems of Thailand. The reported number of dengue incidences in 1998 for the Thailand was 129,954, of which Sukhothai province alone reported alarming number of 682. It was the

Kanchana Nakhapakorn; Nitin Kumar Tripathi

2005-01-01

234

EFFECTS OF THE SYMPATHETIC NERVOUS SYSTEM AND THE ADRENAL MEDULLARY HORMONES ON DOG HIND LIMB BLOOD FLOW AFTER HAEMORRHAGE  

Microsoft Academic Search

The contributions of the sympathetic nervous system and the adrenal medullary catecholamines to the response of dog hind limb resistance vessels to haemorrhage were examined. Anaesthetized dogs were bled either 30% or 45% of blood volume. There was little difference between the vascular conductance response in untreated hind limbs and sympathectomized limbs. Conductance in limbs that had been both sympathectomized

WP Anderson; J Ludbrook

1976-01-01

235

Antenatal onset of haemorrhagic and\\/or ischaemic lesions in preterm infants: prevalence and associated obstetric variables  

Microsoft Academic Search

AIMTo assess the prevalence of an antenatal onset of haemorrhagic and\\/or ischaemic lesions in preterm infants; to identify possibly related obstetric risk factors.METHODSA prospective cohort study was made of 1332 infants born at less than 34 completed weeks, using cranial ultrasound, for the presence of antenatal brain lesions (group A) involving the periventricular white matter (PVWM) or central grey matter.

L S de Vries; P Eken; F Groenendaal; K J Rademaker; B Hoogervorst; H W Bruinse

1998-01-01

236

Reliability of the ECASS Radiological Classification of Postthrombolysis Brain Haemorrhage: A Comparison of CT and Three MRI Sequences  

Microsoft Academic Search

Background: Postthrombolysis brain haemorrhagic transformations (HT) are often categorized with the CT-based classification of the European Cooperative Acute Stroke Study (ECASS). However, little is known about the reliability of this classification and its extension to MRI. Our objective was to compare the inter- and intraobserver reliability of this classification on CT and 3 MRI sequences. Methods: Forty-three patients with postthrombolysis

P. Renou; I. Sibon; T. Tourdias; F. Rouanet; C. Rosso; D. Galanaud; A. Drier; M. Coudert; S. Deltour; S. Crozier; D. Dormont; Y. Samson

2010-01-01

237

Detection and differentiation of epizootic haemorrhagic disease of deer and bluetongue viruses by serogroup-specific sandwich ELISA  

Microsoft Academic Search

A serogroup specific sandwich ELISA was developed for the detection of epizootic haemorrhagic disease of deer viruses (EHDV) in infected insects and tissue culture preparations. Polyclonal rabbit antiserum against purified EHDV core particles was used to capture viral antigen and specific binding detected using guinea pig antisera against EHDV core particles followed by anti-guinea pig immunoglobulin enzyme-labelled conjugate. The assay

J. A. Thevasagayam; M. P. Wellby; P. P. C. Mertens; J. N. Burroughs; J. Anderson

1996-01-01

238

Leukocyte–hepatocyte interaction in calicivirus infection: differences between rabbits that are resistant or susceptible to rabbit haemorrhagic disease (RHD)  

Microsoft Academic Search

Calicivirus infection is lethal for adult rabbits, whereas young rabbits (less than 8-weeks-old) are resistant to the same infectious agent. The virus replicates in the liver and causes a fulminant hepatitis in adult rabbits leading to rabbit haemorrhagic disease (RHD); this is in contrast with the mild and transient hepatitis observed in infected young rabbits. We have used electron microscopy

P. G. Ferreira; A. Costa-E-Silva; M. J. R. Oliveira; E. Monteiro; A. P. Águas

2005-01-01

239

A comparison of different cloned genome segments of Epizootic haemorrhagic disease virus as serogroup-specific probes  

Microsoft Academic Search

Summary The eight largest double-stranded (ds) RNA genome segments of Epizootic haemorrhagic disease virus (EHDV) serotype 2 (Alberta strain) have been cloned. Of these, segments 4, 5, 6, 7, and 8 are represented by clones that correspond in size to those predicted for full-length clones. The different clones were used as nucleic acid probes to study the nucleic acid homology

L. H. Nel; H. Huismans

1990-01-01

240

Study of the effector mechanism involved in the production of haemorrhagic necrosis of the small intestine in rat passive anaphylaxis.  

PubMed Central

1. The effector mechanism of intestinal necrosis in rat anaphylaxis was studied following several complementary approaches: (i) the use of monoclonal antibodies (mAb) belonging to different classes (IgG1, IgG2b and IgE anti-DNP), (ii) the assay of mediators, and (iii) the use of pharmacological tools. 2. Lethality and haemorrhagic necrosis of the small intestine were observed in IgE-sensitized rats, whereas IgG mAb produced milder physiological disturbances. 3. Inhibition of leukotriene biosynthesis reduced the drop of systemic blood pressure (BP) and the extent of protein-rich plasma exudation but it did not influence the haemorrhagic component of intestinal necrosis. 4. The antihistamine, pyrilamine, partially diminished the haemorrhagic component of the intestinal necrosis. 5. The involvement of mediators related to platelet-activating factor (PAF) was studied by examining the pharmacological effects of these autacoids and of PAF-receptor antagonists (PCA4248, UR12460 and BB823). PAF induced intestinal lesions similar to those observed in IgE-sensitized rats and PAF-receptor antagonists markedly decreased haemorrhage in IgE-sensitized rats. 6. PAF levels were transiently increased after dinitrophenol (DNP)- bovine serum albumin (BSA) challenge in the small intestine of IgE-sensitized rats. 7. These data stress differences in the outcome of anaphylaxis related to the type of receptors for the Fc portion of immunoglobulins that are involved. IgE is the antibody class that elicits the most severe response due to the activation of mast cells via Fc epsilon RI (surface receptors that bind IgE antibodies with high affinity), and the only one able to produce intestinal haemorrhagic necrosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7952870

Pellon, M. I.; Steil, A. A.; Furio, V.; Sanchez Crespo, M.

1994-01-01

241

Haemorrhage from a radiosurgically treated arteriovenous malformation after its angiographically proven obliteration: a case report.  

PubMed

Small lower-grade Spetzler-Martin arteriovenous malformations (AVMs) are mainly treated by microsurgical resection or stereotactic radiosurgery. The choice of treatment largely depends on the referring centre's preference and the patient's decision. We present here a patient with an AVM repeatedly treated at our Leksell Gamma Knife unit with radiographically confirmed obliteration of the AVM which subsequently began bleeding. This case demonstrates the possibility of late complications in radiosurgically treated AVMs even after their demonstrable obliteration. Meticulous histological examination was performed, proving patency of the AVM nidus. The risk of haemorrhagic complications of radiosurgically removed AVMs despite angiographic proof of their obliteration is, in our view, a cogent argument for preferring surgical resection if the AVM is accessible and for prolonged follow-up after radiosurgical treatment of an AVM. PMID:20464791

Bradác, O; Mayeroá, K; Hrabal, P; Benes, V

2010-05-01

242

Myocardial dysfunction after subarachnoid haemorrhage and tako-tsubo cardiomyopathy: a differential diagnosis?  

PubMed

The frequent occurrence of a reversible left ventricular dysfunction complicating subarachnoid haemorrhage raises a number of issues about the clinical and pathophysiological similarities with the transient left ventricular apical ballooning syndrome (TLVABS) or tako-tsubo cardiomyopathy (TTC). Given the latest clinical and pathophysiological evidence about neurogenic cardiomyopathies, the diagnosis of TTC should not be ruled out in patients experiencing acute brain injury and cerebrovascular events. Each type of reversible left ventricular dysfunction mediated by the central nervous system and initiated by acute brain injury, both physical, such as intracranial bleeding or head traumas, and psychological, such as sudden emotional stress, could be encompassed in a single definition with larger inclusion criteria, such as 'acute ballooning cardiomyopathy' (ABC), that is likely to be more representative of the real needs in the clinical setting. PMID:20124311

Trio, Olimpia; de Gregorio, Cesare; Andò, Giuseppe

2010-04-01

243

European survey on laboratory preparedness, response and diagnostic capacity for Crimean-Congo haemorrhagic fever, 2012.  

PubMed

Crimean-Congo haemorrhagic fever (CCHF) is an infectious viral disease that has (re-)emerged in the last decade in south-eastern Europe, and there is a risk for further geographical expansion to western Europe. Here we report the results of a survey covering 28 countries, conducted in 2012 among the member laboratories of the European Network for Diagnostics of 'Imported' Viral Diseases (ENIVD) to assess laboratory preparedness and response capacities for CCHF. The answers of 31 laboratories of the European region regarding CCHF case definition, training necessity, biosafety, quality assurance and diagnostic tests are presented. In addition, we identified the lack of a Regional Reference Expert Laboratory in or near endemic areas. Moreover, a comprehensive review of the biosafety level suitable to the reality of endemic areas is needed. These issues are challenges that should be addressed by European public health authorities. However, all respondent laboratories have suitable diagnostic capacities for the current situation. PMID:25011064

Fernandez-Garcia, M D; Negredo, A; Papa, A; Donoso-Mantke, O; Niedrig, M; Zeller, H; Tenorio, A; Franco, L

2014-01-01

244

Deafness due to haemorrhagic labyrinthitis and a review of relapses in Streptococcus suis meningitis.  

PubMed

Deafness is a common and often permanent neurological sequel of Streptococcus (S.) suis meningitis. Suppurative labyrinthitis, rather than direct auditory nerve infection, has been found to be the site responsible for deafness. Neuroimaging is important to localise the site involved in hearing loss and to assess the feasibility of a cochlear implantation. S. suis is very sensitive to penicillin. Although a relapse of S. suis meningitis is uncommon, it can occur despite an adequate duration of appropriate antibiotic therapy. We describe a patient with S. suis meningitis, who developed permanent deafness from haemorrhagic labyrinthitis, as shown on magnetic resonance imaging. She suffered a relapse despite a seven-week course of intravenous antibiotics. A review on six cases of relapse reported in the literature shows that relapses occurred despite two to four weeks of antibiotics being administered to the patients. The clinical implications and treatment of relapse are discussed. PMID:20358139

Tan, J H; Yeh, B I; Seet, C S R

2010-02-01

245

Immunosuppression abrogates resistance of young rabbits to Rabbit Haemorrhagic Disease (RHD)  

PubMed Central

Rabbit Haemorrhagic Disease (RHD) is caused by a calicivirus (RHDV) that kills 90% of infected adult European rabbits within 3 days. Remarkably, young rabbits are resistant to RHD. We induced immunosuppression in young rabbits by treatment with methylprednisolone acetate (MPA) and challenged the animals with RHDV by intramuscular injection. All of these young rabbits died within 3 days of infection due to fulminant hepatitis, presenting a large number of RHDV-positive dead or apoptotic hepatocytes, and a significant seric increase in cytokines, features that are similar to those of naïve adult rabbits infected by RHDV. We conclude that MPA-induced immunosuppression abrogates the resistance of young rabbits to RHD, indicating that there are differences in the innate immune system between young and adult rabbits that contribute to their distinct resistance/susceptibility to RHDV infection. PMID:24490832

2014-01-01

246

Risk factors and surgical interventions associated with primary postpartum haemorrhage unresponsive to first-line therapies.  

PubMed

Abstract The aim of this study was to investigate risk factors and surgical interventions associated with primary postpartum haemorrhage (PPH) unresponsive to first-line therapies. A retrospective analysis was performed of 212 women who experienced primary PPH (blood loss ? 500 ml). Logistic regression analysis identified that caesarean section (odds ratio [OR] 2.745; 95% confidence interval [CI], 1.063-7.085; p = 0.037) and abnormal placental adhesion (OR 3.823; 95% CI, 1.333-10.963; p = 0.013) were risk factors for PPH unresponsive to first-line therapies. There was no significant difference in blood loss, blood transfusion and success rate among intrauterine tamponade, B-Lynch suture and uterine artery ligation. Intrauterine tamponade is the least invasive and most rapid approach, so it should be taken as the first choice for surgical management after unresponsiveness to first-line therapies. PMID:24911676

Yan, J-Y; Zhou, Z-M; Xu, X; Huang, X-Y; Xu, R-L; Lin, S-H

2014-10-01

247

A chronic grey matter penumbra, lateral microvascular intussusception and venous peduncular avulsion underlie diabetic vitreous haemorrhage  

PubMed Central

The landmark publications that gave such impetus to our understanding of proliferative diabetic retinopathy are reviewed in the light of more recent reports. Briefly, confluence of small areas of capillary closure in the midperipheral and peripheral retina results in arteriovenous shunting and abnormal oxygen partial pressure gradients. These gradients embrace a chronic ischaemic penumbra that stimulates neuroglial secretion of angiogenic growth factors and upregulation of their receptors in the retinal venous endothelium and adventitia. The blood shunting produces biomechanical stresses within the veins and induces microvascular intussusception near arteriovenous crossings, giving way to neovascular outgrowths and/or segmental venous lesions (such as omega loops and coils) that penetrate the inner limiting lamina. The lamellar collagenous matrix of the vitreous cortex is then exploited for integrin?dependent rete expansion along chemotactic gradients. During posterior vitreous detachment, haemorrhaging takes place from the arterialised veins as venous neovascular peduncles are avulsed. PMID:17446507

McLeod, David

2007-01-01

248

The illegal introduction of rabbit haemorrhagic disease virus in New Zealand.  

PubMed

In 1997, a group of pastoral farmers, frustrated by governmental and official responses to their problems of rabbit control, introduced and spread the rabbit haemorrhagic disease virus in a clandestine operation that succeeded in distributing infection over a large area of the South Island before the disease was detected by government officials. The government concluded that eradication was not technically or economically feasible and the disease was accepted as being endemic. The episode highlighted the inadequate decision-making environment that existed at the time, now improved by the passage of the Hazardous Substances and New Organisms Act. It also highlights the importance of having a comprehensive biosecurity detection and response capability, including the ability to conduct prompt risk assessments, since preventing entry of biological agents may be difficult to achieve in the face of a determined adversary. PMID:16796041

O'Hara, P

2006-04-01

249

Haemorrhage in the course of subcardial gastrointestinal stromal tumor - a case description.  

PubMed

This paper is a discussion of the case of a 51-year-old female patient admitted urgently for haemorrhage from the upper gastrointestinal tract and increased dysphagia. After preliminary treatment, the patient was qualified for surgery, during which a large lesion was discovered in the shape of a stromal tumor closely connected with the oesophago-gastric junction. A resection of the tumor and part of the oesophagus was carried out, and a cervical fistula was formed. After a 4-month period, the continuity of the gastrointestinal tract was restored by forming a substitute organ out of the ascending colon and the end of the small intestine, anastomosed on the cervix. The patient was discharged in good overall condition. PMID:24868300

Pedowski, Tomasz; Pedowska, Marlena; Masiak, Wioletta; Ciecha?ski, Aleksander; Cwik, Grzegorz; D?browski, Andrzej; Wallner, Grzegorz

2014-01-01

250

Haemorrhage in the course of subcardial gastrointestinal stromal tumor - a case description  

PubMed Central

This paper is a discussion of the case of a 51-year-old female patient admitted urgently for haemorrhage from the upper gastrointestinal tract and increased dysphagia. After preliminary treatment, the patient was qualified for surgery, during which a large lesion was discovered in the shape of a stromal tumor closely connected with the oesophago-gastric junction. A resection of the tumor and part of the oesophagus was carried out, and a cervical fistula was formed. After a 4-month period, the continuity of the gastrointestinal tract was restored by forming a substitute organ out of the ascending colon and the end of the small intestine, anastomosed on the cervix. The patient was discharged in good overall condition. PMID:24868300

Pedowska, Marlena; Masiak, Wioletta; Ciechanski, Aleksander; Cwik, Grzegorz; Dabrowski, Andrzej; Wallner, Grzegorz

2014-01-01

251

Feasibility of scintigraphy in exercise-induced pulmonary haemorrhage detection and quantification: preliminary studies.  

PubMed

We hypothesised that scintigraphic imaging of the lungs following injection of 99mTc labelled red blood cells (99mTc-RBC) in the exercising horse might enable exercise-induced pulmonary haemorrhage (EIPH) quantification. Ideally, to favour detection of bleeding, circulating 99mTc-RBC not involved in the haemorrhage should be removed from the circulation quickly. Altering RBC during labelling to stimulate splenic uptake of 99mTc-RBC may encourage this. In order to investigate this hypothesis, 99mTc-RBC distribution was followed for 1 h in 2 groups of horses. Group 1 was injected i.v., at rest, with radioactive nondenatured RBC (99mTc-NDRBC); Group 2 received labelled RBC partly denatured by heating (99mTc-HDRBC). In Group 2, splenic uptake was higher at all times and radioactivity in the lung was proportionally higher and decreased less quickly than in Group 1. Hence, the time-consuming 99mTc-HDRBC labelling technique did not demonstrate any advantage over the easier 99mTc-NDRBC labelling procedure. Additionally, the feasibility of scintigraphic visualisation of a small amount of pulmonary bleeding was confirmed with the following trial: using an endoscope, a radioactive solution mimicking 50 ml of bleeding was deposited at the usual site of EIPH in a live horse. The radioactivity recorded in that area was compared to the one obtained in the same region in Group 1 and 2. The activity measured 20 min post endoscopy corresponded to 33% of the activity obtained in Group 1 vs. 8% in Group 2 at that timing. Once again, there was no advantage of using 99mTc-HDRBC vs. 99mTc-NDRBC. These results demonstrated that small amounts of bleeding might potentially be detected with scintigraphy; they also suggest that the limiting factor for detecting small amounts of bleeding may be the level of lung background radioactivity. PMID:10659238

Votion, D M; Roberts, C A; Marlin, D J; Lekeux, P M

1999-07-01

252

The acute management of haemorrhage, surgery and overdose in patients receiving dabigatran.  

PubMed

Dabigatran is an oral direct thrombin inhibitor (DTI) licensed for stroke prevention in atrial fibrillation and likely to be soon approved in Europe for treatment of venous thrombosis. Predictable pharmacokinetics and a reduced risk of intracranial haemorrhage do not negate the potential risk of haemorrhage. Unlike warfarin, there is no reversal agent and measurement of the anticoagulant effect is not 'routine'. The prothrombin time/international normalised ratio response to dabigatran is inconsistent and should not be measured when assessing a patient who is bleeding or needs emergency surgery. The activated partial thromboplastin time (APTT) provides a qualitative measurement of the anticoagulant effect of dabigatran. Knowledge of the time of last dose is important for interpretation of the APTT. Commercially available DTI assays provide a quantitative measurement of active dabigatran concentration in the plasma. If a patient receiving dabigatran presents with bleeding: omit/delay next dose of dabigatran; measure APTT and thrombin time (consider DTI assay if available); administer activated charcoal, with sorbitol, if within 2 h of dabigatran ingestion; give tranexamic acid (1 g intravenously if significant bleeding); maintain renal perfusion and urine output to aid dabigatran excretion. Dabigatran exhibits low protein binding and may be removed by dialysis. Supportive care should form the mainstay of treatment. If bleeding is life/limb threatening, consider an additional haemostatic agent. There is currently no evidence to support the choice of one haemostatic agent (FEIBA, recombinant factor VIIa, prothrombin complex concentrates) over another. Choice will depend on access to and experience with available haemostatic agent(s). PMID:23435652

Alikhan, Raza; Rayment, Rachel; Keeling, David; Baglin, Trevor; Benson, Gary; Green, Laura; Marshall, Scott; Patel, Raj; Pavord, Sue; Rose, Peter; Tait, Campbell

2014-02-01

253

Innate immune responses of salmonid fish to viral infections.  

PubMed

Viruses are the most serious pathogenic threat to the production of the main aquacultured salmonid species the rainbow trout Oncorhynchus mykiss and the Atlantic salmon Salmo salar. The viral diseases Infectious Pancreatic Necrosis (IPN), Pancreatic Disease (PD), Infectious Haemorrhagic Necrosis (IHN), Viral Haemorrhagic Septicaemia (VHS), and Infectious Salmon Anaemia (ISA) cause massive economic losses to the global salmonid aquaculture industry every year. To date, no solution exists to treat livestock affected by a viral disease and only a small number of efficient vaccines are available to prevent infection. As a consequence, understanding the host immune response against viruses in these fish species is critical to develop prophylactic and preventive control measures. The innate immune response represents an important part of the host defence mechanism preventing viral replication after infection. It is a fast acting response designed to inhibit virus propagation immediately within the host, allowing for the adaptive specific immunity to develop. It has cellular and humoral components which act in synergy. This review will cover inflammation responses, the cell types involved, apoptosis, antimicrobial peptides. Particular attention will be given to the type I interferon system as the major player in the innate antiviral defence mechanism of salmonids. Viral evasion strategies will also be discussed. PMID:23981327

Collet, Bertrand

2014-04-01

254

The seroprevalance of Crimean-Congo haemorrhagic fever in people living in the same environment with Crimean-Congo haemorrhagic fever patients in an endemic region in Turkey.  

PubMed

Crimean-Congo haemorrhagic fever (CCHF) is endemic in Turkey, and since 2004 many cases have been reported from different regions of Turkey. There are limited data about the seroprevalence of the disease in household members of patients or persons sharing the same environment. We evaluated seroprevalence of CCHF in the immediate neighbourhood and in household members of patients living in the same environment as confirmed cases of CCHF in an endemic area of Turkey. A total of 625 healthy subjects [mean (s.d.) age: 42·3 (18·4) years, 58·7% females] without a past history of CCHF infection included in this case-control, retrospective study were evaluated in terms of sociodemographic characteristics, risk factors for CCHF via a study questionnaire, while serum analysis for CCHF virus (CCHFV) IgG antibodies was performed by ELISA. Anti-CCHFV IgG antibodies were positive in 85 (13·6%) participants. None of the seropositive individuals had a history of symptomatic infection. Regression analysis revealed that animal husbandry [odds ratio (OR) 1·84, 95% confidence interval (CI) 1·09-3·11], contact with animals (OR 2·31, 95% CI 1·08-5·10), contact with ticks (OR 3·45, 95% CI 1·87-6·46), removing ticks from animals by hand (OR 2·48, 95% CI 1·48-4·18) and living in a rural area (OR 4·05, 95% CI 1·65-10·56) were associated with increased odds of having IgG seropositivity, while being a household member of a patient with prior CCHF infection had no influence on seropositivity rates. This result also supports the idea that CCHF is not transmitted person-to-person by the airborne route. PMID:23688370

Koksal, I; Yilmaz, G; Aksoy, F; Erensoy, S; Aydin, H

2014-02-01

255

Cerebral atrophy and subdural haemorrhage after cerebellar and cerebral infarcts in an 8-month-old child after having been stung by a scorpion.  

PubMed

A scorpion sting causing cerebellar and cerebral infarctions with corpus callosum involvement and bilateral cerebral atrophy with subdural haemorrhage in an 8-month-old girl, has not been previously described to the best of our knowledge. PMID:24962491

S???rc?, Ahmet; Öztürk, Mehmet; Yak?nc?, Cengiz

2014-01-01

256

Retinal haemorrhage as a complication of gas encephalography and gas myelography. Prospective study using oxgen gas with a discussion of pathogenetic mechanisms.  

PubMed Central

Seventy patients, submitted to oxygen encephalography and oxygen myelography, were examined by retinal funduscopy to establish the incidence of intraocular haemorrhages, a complication reported to be frequent by other investigators. We did not discover any retinal haemorrhages. Pathogenetic factors influencing intracranial or intraocular venous pressure or both are discussed, particularly the effect due to different technical procedures during the examination, and the type of anaesthesia used. PMID:599352

Slagsvold, J E; Larsen, J L

1977-01-01

257

An infant with methylmalonic aciduria and homocystinuria (cblC) presenting with retinal haemorrhages and subdural haematoma mimicking non-accidental injury  

Microsoft Academic Search

In this article, we report an infant with methylmalonic aciduria and homocystinuria in whom retinal haemorrhages together with subdural and intraventricular cerebral haemorrhage were the prominent initial presenting features. A 5-week-old Oriental girl, born at 34 weeks gestation to non-consanguineous parents following an otherwise uneventful pregnancy, presented with a 3-day history of increasing lethargy, and reduced urine output in the

Peter J. Francis; David M. Calver; Peter Barnfield; Charles Turner; R. Neil Dalton; Mike P. Champion

2004-01-01

258

Holistic physiological care compared with active management of the third stage labour compared with holistic physiological care for women at low risk of postpartum haemorrhage: a cohort study  

Microsoft Academic Search

Question\\u000aIs ‘holistic psychophysiological care’ in the third stage of labour safe for women at low risk of postpartum haemorrhage?. Background\\u000aAlthough there have been four randomised trials and a Cochrane Review on the safety and effectiveness of care during the third stage labour, no previous study has focussed only on women at low risk of postpartum haemorrhage and no

Kathleen Fahy; Carolyn Hastie; Andrew Bisits; Christine Marsh; Lurena Smith; Anne Saxton

2010-01-01

259

Neutralisation of Local Haemorrhage Induced by the Saw-Scaled Viper Echis carinatus sochureki Venom Using Ethanolic Extract of Hibiscus aethiopicus L.  

PubMed Central

The objective of the study is to investigate the anti-snake venom activities of a local plant, Hibiscus aethiopicus L. The H. aethiopicus was dried and extracted with ethanol. Different assays were performed according to standard techniques, to evaluate the plant's acute toxicity and its antivenom activities. The results of evaluating the systemic acute toxicity of the H. aethiopicus extract using “oral and intra-peritoneal” route were normal even at the highest dose (24?g/kg) tested. All guinea pigs (n = 3) when treated with venoms E. c. sochureki (75??g) alone induced acute skin haemorrhage. In contrast, all guinea pigs (n = 18) treated with both venom and the plant extract at a concentration between 500 and 1000?mg/kg showed no signs of haemorrhage. Moreover, all guinea pigs (n = 18) treated with venom and the plant extract below 400?mg/kg showed acute skin haemorrhage. All guinea pigs treated with venom E. c. sochureki (75??g) alone induced acute skin haemorrhage after both 24 and 32 hours. In contrast, all guinea pigs treated with both venom and the plant extract (administered independently) at concentrations between 500 and 1000?mg/kg showed no signs of haemorrhage after 32 hours. However, after 24 hours all tested guinea pigs showed less inhibition (<60%) compared to that obtained after 32 hours. The outcome of this study reflects that the extract of H. aethiopicus plant may contain an endogenous inhibitor of venom induced local haemorrhage. PMID:22666294

Hasson, S. S.; Al-Balushi, M. S.; Said, E. A.; Habbal, O.; Idris, M. A.; Mothana, R. A. A.; Sallam, T. A.; Al-Jabri, A. A.

2012-01-01

260

Imported viral haemorrhagic fever with a potential for person-to-person transmission: review and recommendations for initial management of a suspected case in Belgium.  

PubMed

Viral haemorrhagic fevers are caused by a wide range of viruses. There are 4 types of viruses well known to spread from person to person and able to cause nosocomial outbreaks with a high case fatality rate: an arenavirus (Lassa fever and more exceptionally the Junin and Machupo virus), a bunyavirus (Crimean-Congo haemorrhagic fever) and the Filoviridae (Ebola and Marburg viruses). So far there have been only a limited number of imported cases of viral haemorrhagic fever in industrialized countries. In recent years an increasing number of outbreaks of filovirus infections have occurred in Africa and in 2000 5 cases of Lassa fever were brought from Sierra Leone to Europe. Therefore European physicians should consider the possibility of a viral haemorrhagic fever in an acutely ill patient just returning from Africa or South-America with fever for which there is no obvious cause. Such patients should be questioned for risk factors for viral haemorrhagic fever. Using universal precautions for handling blood and body fluids and barrier nursing techniques there is little risk that if a patient with viral haemorrhagic fever arrives in Belgium there will be secondary cases. PMID:12534129

Colebunders, R; Van Esbroeck, M; Moreau, M; Borchert, M

2002-01-01

261

Delayed onset pulmonary glue emboli in a ventilated patient: a rare complication following endoscopic cyanoacrylate injection for gastric variceal haemorrhage.  

PubMed

Cyanoacrylate injection is a recognised endoscopic treatment option for variceal haemorrhage. We describe a 34-year old man with hepatitis B cirrhosis who presented to the hospital with upper gastrointestinal haemorrhage from gastric and oesophageal varices. Haemostasis was achieved via cyanoacrylate injection sclerotherapy and banding. Ten days later, the patient developed acute hypoxia and fever. His chest radiograph showed wide-spread pulmonary shadowing. A non-contrast CT scan confirmed multiple emboli of injected glue material from the varix with parenchymal changes either suggesting acute lung injury or pulmonary oedema. He gradually recovered with supportive treatment and was discharged home. On follow-up, he remained asymptomatic from a chest perspective. This case report discusses the rare complication of pulmonary embolisation of cyanoacrylate glue from variceal injection sites and the diagnostic dilemmas involved. Emphasis is placed on the importance of maintaining high index of clinical suspicion when assessing patients with possible procedure related complications. PMID:25320260

Chew, Joyce Ruo Yi; Balan, Anu; Griffiths, William; Herre, Jurgen

2014-01-01

262

Haematological, serum electrolyte and blood gas effects of small volume hypertonic saline in experimentally induced haemorrhagic shock.  

PubMed

The effects of treatment with small volume hypertonic (2400 mOsm/litre) and isotonic (300 mOsm/litre) saline on serum electrolyte and biochemical concentrations, haemograms and blood gases were evaluated in 12 horses using a haemorrhagic shock model. Intravascular catheters were placed surgically for sample collection prior to anaesthesia. Controlled haemorrhage was initiated and continued until mean systemic pressure reached 50 to 60 mmHg. Hypertonic or isotonic saline (2 litres) was administered by intravenous infusion and data collected for 2 h. Following haemorrhage, packed cell volume (PCV), haemoglobin, blood glucose concentrations and erythrocyte numbers increased whereas plasma total protein and albumin concentrations decreased. Infusion of hypertonic saline resulted in a further decrease in total protein and albumin concentrations. Glucose concentrations and other haematological variables were unaffected. Isotonic saline administration did not affect electrolyte, total protein or albumin concentrations. Concentrations of sodium and chloride were unaffected by hypotension but increased significantly following hypertonic saline treatment, exceeding normal values during the immediate post treatment period. Serum osmolality increased concurrently. No significant changes in arterial and venous blood gas values were observed with haemorrhage or isotonic saline treatment. A transient decrease in arterial and venous blood pH and a sustained decrease in venous bicarbonate and base excess concentrations occurred following hypertonic saline administration. No significant increases in any serum biochemical concentrations occurred during hypotension or following infusion of either isotonic or hypertonic saline. These results demonstrate that small volume hypertonic saline can be administered safely to horses without producing extreme changes in electrolyte concentrations, blood gases or haematological parameters. PMID:2120034

Schmall, L M; Muir, W W; Robertson, J T

1990-07-01

263

Exercise-induced Haemorrhagic Lesions in the Dorsocaudal Extremities of the Caudal Lobes of the Lungs of Young Thoroughbred Horses  

Microsoft Academic Search

The dorsocaudal extremities of the caudal lobes of the lungs of racehorses are vulnerable to exercise-induced pulmonary haemorrhage (EIPH). The morphology of the lungs at these sites was studied in 13 Thoroughbred horses aged 18 to 22 months. These animals, which had been performing low-intensity exercise on a track at maximum running speeds of approximately 5–8·5 metres\\/second (m\\/s), were withdrawn

M. Oikawa

1999-01-01

264

Non-fatal case of Crimean-Congo haemorrhagic fever imported into the United Kingdom (ex Bulgaria), June 2014.  

PubMed

Crimean-Congo haemorrhagic fever (CCHF) was diagnosed in a United Kingdom traveller who returned from Bulgaria in June 2014. The patient developed a moderately severe disease including fever, headaches and petechial rash. CCHF was diagnosed following identification of CCHF virus (CCHFV) RNA in a serum sample taken five days after symptom onset. Sequence analysis of the CCHFV genome showed that the virus clusters within the Europe 1 clade, which includes viruses from eastern Europe. PMID:25108534

Lumley, S; Atkinson, B; Dowall, Sd; Pitman, Jk; Staplehurst, S; Busuttil, J; Simpson, Aj; Aarons, Ej; Petridou, C; Nijjar, M; Glover, S; Brooks, Tj; Hewson, R

2014-01-01

265

Field-deployable real-time polymerase chain reaction detection of bluetongue and epizootic haemorrhagic disease viral ribonucleic acid  

Microsoft Academic Search

Summary Nucleic acid sequence information from molecular evolution studies of bluetongue virus (BTV) and related epizootic haemorrhagic disease virus (EHDV) strains has resulted in a large database of genomic information. Published sequence data and sequence data from our laboratory were used to design real-time field-deployable reverse transcriptase-polymerase chain reaction assays for the detection of BTV or EHDV viral RNA. The

W. C. Wilson; D. E. Stallknecht; J. O. Mecham

266

Involvement of the cholinergic system in the central histamine-induced reversal of critical haemorrhagic hypotension in rats.  

PubMed

Histamine, acting centrally as a neurotransmitter, evokes a reversal of haemorrhagic shock in rats due to the activation of the sympathetic and the renin-angiotensin systems as well as the release of arginine vasopressin and proopiomelanocortin-derived peptides. In the present study, we demonstrate influences of cholinergic receptor antagonists on the central histamine-induced resuscitating action. Experiments were carried out in male anaesthetised Wistar rats subjected to a haemorrhagic hypotension of 20-25 mmHg, resulting in the death of all control animals within 30 min. Histamine (100 nmol) administered intracerebroventricularly (icv) at 5 min of critical hypotension produced a long-lasting pressor effect with increases in heart rate and peripheral blood flows, and a 100% survival at 2 h. Mean arterial pressure and blood flow changes were almost completely blocked by nicotinic receptor antagonist mecamylamine (246.3 nmol; icv) and partially inhibited by muscarinic receptor blocker atropine sulphate (14.8 nmol; icv). Cholinergic receptor antagonists given alone in the control saline-treated groups did not affect cardiovascular parameters in the post-bleeding period. In conclusion, there are interactions between the histaminergic and cholinergic systems, with an involvement of both nicotinic and muscarinic receptors, in the central cardiovascular regulation in haemorrhagic hypotension in rats. PMID:19617656

Yalcin, M; Savci, V; Jochem, J

2009-06-01

267

Ambient temperature and spontaneous intracerebral haemorrhage: a cross-sectional analysis in Tainan, Taiwan  

PubMed Central

Objectives Ambient temperature has been reported to play a role in the occurrence of spontaneous intracerebral haemorrhage (ICH). This study aimed to investigate the relation between ambient temperature of onset time and ICH and the effect of hourly temperature within 72?h before ICH. Design This is a cross-sectional case-only study and a retrospective analysis of a prospective database. Setting Two medical centres in Southern Taiwan participating a prospective stroke registry. Participants A total of 933 patients with ICH registered from August 2006 to July 2008. Primary and secondary outcome measures The hourly temperature was collected, and patients were grouped according to the deciles of hourly temperature at onset. Primary outcome was the association between the number of ICH cases and mean temperature (or temperature variation). Secondary outcome was the difference of onset temperature and hourly temperature before onset in patients with known onset time. Results Winter (n=282) had significant higher ICH cases than other seasons (n=651; p=0.002). Of those patients with an exact time of onset, the results showed 13% patients occurred at the lowest decile temperature group (<17.4°C) and 8% patients occurred at the highest decile temperature group (>30.8°C). It showed a significant temperature change before onset for these patients (p<0.005). Conclusions This study showed that lower ambient temperature and variation of temperatures precipitated ICH in southern Taiwan. Better protecting vulnerable people from cold temperatures may prevent the occurrences of ICH. PMID:22685220

Fang, Chen-Wen; Ma, Mi-Chia; Lin, Huey-Juan

2012-01-01

268

Diode laser in the treatment of epistaxis in patients with hereditary haemorrhagic telangiectasia.  

PubMed

Periodic and spontaneous nosebleed is the most common clinical manifestation of hereditary haemorrhagic telangiectasia (HHT), present in 95% of patients suffering from this syndrome. The purpose of this retrospective study was to evaluate the effectiveness and safety of diathermocoagulation of telangiectasia on the nasal mucosa with a diode laser in the treatment of epistaxis in patients with HHT. From 2005 to 2010, 24 patients diagnosed with HHT and with mild-severe nosebleed were treated in our hospital with diode laser. Patients were given a pre- and post-operation evaluation questionnaire to determine the frequency and severity of nosebleed, the recurrence-free period of time after treatment and quality of life. We compared the pre- and post-operation haemoglobin values three months after the last treatment. After treatment, a decrease in the weekly frequency and entity of nosebleed was observed, together with substantial improvement in the quality of life and an increase in haematic haemoglobin. Diode laser treatment of telangiectasia on nasal mucosa represents a valuable, safe, effective and repeatable therapeutic option in treating mild and severe nosebleed, and it is associated with improvement in quality of life from psychological, social and clinical points of view. PMID:22767981

Fiorella, M L; Lillo, L; Fiorella, R

2012-06-01

269

Mouse and human strategies identify PTPN14 as a modifier of angiogenesis and hereditary haemorrhagic telangiectasia.  

PubMed

Hereditary haemorrhagic telangiectasia (HHT) [corrected] is a vascular dysplasia syndrome caused by mutations in transforming growth factor-?/bone morphogenetic protein pathway genes, ENG and ACVRL1. HHT [corrected] shows considerable variation in clinical manifestations, suggesting environmental and/or genetic modifier effects. Strain-specific penetrance of the vascular phenotypes of Eng(+/-) and Tgfb1(-/-) mice provides further support for genetic modification of transforming growth factor-? pathway deficits. We previously identified variant genomic loci, including Tgfbm2, which suppress prenatal vascular lethality of Tgfb1(-/-) mice. Here we show that human polymorphic variants of PTPN14 within the orthologous TGFBM2 locus influence clinical severity of HHT, [corrected] as assessed by development of pulmonary arteriovenous malformation. We also show that PTPN14, ACVRL1 and EFNB2, encoding EphrinB2, show interdependent expression in primary arterial endothelial cells in vitro. This suggests an involvement of PTPN14 in angiogenesis and/or arteriovenous fate, acting via EphrinB2 and ACVRL1/activin receptor-like kinase 1. These findings contribute to a deeper understanding of the molecular pathology of HHT [corrected] in particular and to angiogenesis in general. PMID:22233626

Benzinou, Michael; Clermont, Frederic F; Letteboer, Tom G W; Kim, Jai-Hyun; Espejel, Silvia; Harradine, Kelly A; Arbelaez, Juan; Luu, Minh Thu; Roy, Ritu; Quigley, David; Higgins, Mamie Nakayama; Zaid, Musa; Aouizerat, Bradley E; van Amstel, Johannes Kristian Ploos; Giraud, Sophie; Dupuis-Girod, Sophie; Lesca, Gaetan; Plauchu, Henri; Hughes, Christopher C W; Westermann, Cornelius J J; Akhurst, Rosemary J

2012-01-01

270

Travelling waves in the occurrence of dengue haemorrhagic fever in Thailand  

NASA Astrophysics Data System (ADS)

Dengue fever is a mosquito-borne virus that infects 50-100 million people each year. Of these infections, 200,000-500,000 occur as the severe, life-threatening form of the disease, dengue haemorrhagic fever (DHF). Large, unanticipated epidemics of DHF often overwhelm health systems. An understanding of the spatial-temporal pattern of DHF incidence would aid the allocation of resources to combat these epidemics. Here we examine the spatial-temporal dynamics of DHF incidence in a data set describing 850,000 infections occurring in 72 provinces of Thailand during the period 1983 to 1997. We use the method of empirical mode decomposition to show the existence of a spatial-temporal travelling wave in the incidence of DHF. We observe this wave in a three-year periodic component of variance, which is thought to reflect host-pathogen population dynamics. The wave emanates from Bangkok, the largest city in Thailand, moving radially at a speed of 148km per month. This finding provides an important starting point for detecting and characterizing the key processes that contribute to the spatial-temporal dynamics of DHF in Thailand.

Cummings, Derek A. T.; Irizarry, Rafael A.; Huang, Norden E.; Endy, Timothy P.; Nisalak, Ananda; Ungchusak, Kumnuan; Burke, Donald S.

2004-01-01

271

Arterial embolisation for persistent primary postpartum haemorrhage: before or after hysterectomy?  

PubMed

Arterial embolisation is a recognised treatment for postpartum haemorrhage (PPH). In this retrospective study, we evaluate its use in the management of persistent PPH. Records of all births during a 54 month period at a university hospital were analysed. Two sub-groups were identified. Group I (n= 5), underwent embolisation after hysterectomy and Group II (n= 4), had embolisation as a first-line theraphy without hysterectomy. Of 20,215 births, there were 636 cases of PPH (3.1%). Nine required embolisation to control bleeding (1.4%). Group I needed multiple surgical procedures, had a larger pre- and post-operative blood requirement (12-100, median 22 units, vs. 6-12, median 8.5 units), longer embolisation (33-93, median 54 minutes, vs 20-66, 47 minutes) with a larger radiation exposure (5194-9067, median 6301 dGy, vs. 269-3862, median 950 dGy), a longer intensive care stay (3-7, median four days vs. 0-1.5, median one day), and more complications, when compared with Group II. Three of four women from Group II resumed menstrual function. Embolisation prior to hysterectomy may be preferable to embolisation after hysterectomy for the control of PPH. PMID:15270943

Bloom, Allan I; Verstandig, Anthony; Gielchinsky, Yuval; Nadiari, Michel; Elchalal, Uri

2004-08-01

272

Is oestrogen therapy justified in the treatment of hereditary haemorrhagic telangiectasia: a biochemical evaluation  

PubMed

INTRODUCTION: Systemic and topical oestrogen can provoke squamous metaplasia of epithelium. In Hereditary Haemorrhagic Telangiectasia (HTT) the underlying telangiectasia may be protected from trauma and epistaxis reduced. Oestrogens have been advocated but their efficacy is unclear.1 Recent advances have now identified two oestrogen and one progesterone receptors. The aim of this study is to analyse the sex receptor status of HHT nasal mucosa to determine if oestrogen therapy is biochemically justified. METHOD: Five HHT patients (three men, two women) and eight controls (four men, four women) underwent nasal mucosa biopsy. Samples were fixed in formalin and paraffin embedded. Alpha oestrogen (ERalpha ), beta oestrogen (Erbeta) and progesterone receptors (PgR) receptors wre identified using mouse monoclonal antibodies by the Streptavidin-biotin peroxidase method. RESULTS: Erbeta was detected in two HHT patients (one man, one woman) and two control patients. ERalpha and PgR was absent in HHT patients. CONCLUSION: This pilot study demonstrated that a subgroup of HHT patients is Erbeta positive. Oestrogen theraphy therefore has a potential therapeutic role on a biochemical basis in these patients. Erbeta status should be determined before considering oestrogen therapy. PMID:11123171

Pau; Carney; Walker; Murty

2000-12-01

273

Relationship between Watershed Infarcts and Recent Intra Plaque Haemorrhage in Carotid Atherosclerotic Plaque  

PubMed Central

Objective Watershed infarcts (WSI) are thought to result from hemodynamic mechanism, but studies have suggested that microemboli from unstable carotid plaques may distribute preferentially in watershed areas, i.e., between two cerebral arterial territories. Intraplaque haemorrhage (IPH) is an emerging marker of plaque instability and microembolic activity. We assessed the association between WSI and IPH in patients with recently symptomatic moderate carotid stenosis. Methods and Results We selected 65 patients with symptomatic moderate (median NASCET degree of stenosis?=?31%) carotid stenosis and brain infarct on Diffusion-Weighted Imaging (DWI) on Magnetic Resonance Imaging (MRI) from a multicentre prospective study. Fourteen (22%) had WSI (cortical, n?=?8; internal, n?=?4; cortical and internal, n?=?2). Patients with WSI were more likely to have IPH than those without WSI although the difference was not significant (50% vs. 31%, OR?=?2.19; 95% CI, 0.66–7.29; P?=?0.20). After adjustment for degree of stenosis, age and gender, the results remained unchanged. Conclusion About one in fifth of brain infarcts occurring in patients with moderate carotid stenosis were distributed in watershed areas. Albeit not significant, an association between IPH - more generally plaque component - and WSI, still remains possible. PMID:25272160

Isabel, Clothilde; Lecler, Augustin; Turc, Guillaume; Naggara, Olivier; Schmitt, Emmanuelle; Belkacem, Samia; Oppenheim, Catherine; Touze, Emmanuel

2014-01-01

274

Pulmonary inflammation due to exercise-induced pulmonary haemorrhage in Thoroughbred colts during race training.  

PubMed

This study investigated the putative roles of inflammation and platelet-activating factor (PAF) in exercise-induced pulmonary haemorrhage (EIPH). Two-year-old Thoroughbred colts (n=37) were exercised on a racetrack for 5months before commencement of the study. Each colt was then exercised at 15-16m/s over 800-1000m and broncho-alveolar lavage fluid (BALF) was collected 24h later. The colts were subsequently divided into two groups on the basis of BALF analysis; an EIPH-positive group (presence of haemosiderophages, n=23) and an EIPH-negative group (absence of haemosiderophages, n=14). BALF from the EIPH-positive group had a significantly higher protein concentration (0.39±0.28 vs. 0.19±0.12mg/mL, P=0.031), higher PAF bioactivity (0.18±0.12 vs. 0.043±0.05 340:380nm ratio, P=0.042) and a higher lipid hydroperoxide concentration compared to the EIPH-negative group. There was also a lower nitrite concentration and reduced production of superoxide anion and hydrogen peroxide by alveolar macrophages in the EIPH-positive group. There was evidence of pulmonary inflammation and a decreased innate immune response of alveolar macrophages in EIPH-positive colts compared with the EIPH-negative group. PMID:22108190

Michelotto, Pedro V; Muehlmann, Luis A; Zanatta, Ana L; Bieberbach, Eloyse W R; Kryczyk, Marcelo; Fernandes, Luis C; Nishiyama, Anita

2011-11-01

275

A case of Crimean-Congo haemorrhagic fever with normal laboratory findings.  

PubMed

Crimean-Congo haemorrhagic fever (CCHF) is a tick-borne disease caused by Nairovirus, of the family Bunyaviridae. This is the first case report of a confirmed CCHF case without laboratory abnormality. A 36-year-old woman was admitted to our clinic with the complaints of fever, chills, myalgia and vomiting. She was living in a CCHF-endemic region and had received a tick bite ten days previously. Her complaints had started five days after the tick bite, and bleeding of the nose and vagen followed. Under laboratory analysis, serum white blood cell (WBC) was 7300/mm3, haemoglobin (Hb)11.9 gr/dL, platelet (Plt) count 293000/mm3, aspartate transaminase (AST) was 23 U/L, alanine transaminase (ALT) 14 U/L, lactate dehydrogenase (LDH) 139 U/L, creatinine phosphokinase (CPK) 39 U/L, INR 0.8 and APTT 26.2 seconds. Based on these clinical and epidemiological findings, a diagnosis of CCHF infection was suspected, and the diagnosis of CCHF was confirmed with a blood sample tested by TaqMan-based one-step RT-PCR positivity and IgM antibody positivity. We suggest that patients from an endemic region who have typical epidemiological and clinical findings should be evaluated as a possible case for CCHF even if the laboratory findings are not compatible. PMID:25269965

Sari, Tugba; Hatipoglu, Cigdem Ataman

2014-09-01

276

Environmental correlates of crimean-congo haemorrhagic fever incidence in Bulgaria  

PubMed Central

Background Crimean-Congo Haemorrhagic Fever (CCHF) is a zoonotic viral disease transmitted by ixodid tick bites, mainly of Hyalomma spp., or through contact with blood/tissues from infected people or animals. CCHF is endemic in the Balkan area, including Bulgaria, where it causes both sporadic cases and community outbreaks. Methods We described trends of CCHF in Bulgaria between 1997 and 2009 and investigated the associations between CCHF incidence and a selection of environmental factors using a zero-inflated modelling approach. Results A total of 159 CCHF cases (38 women and 121 men) were identified between 1997 and 2009. The incidence was 0.13 cases per 100,000 population/year with a fatality rate of 26%. An epidemic peak was detected close to the Turkish border in the summer of 2002. Most cases were reported between April and September. Increasing mean temperature, Normalized Difference Vegetation Index (NDVI), savannah-type land coverage or habitat fragmentation increased significantly the incidence of CCHF in the CCHF-affected areas. Similar to that observed in Turkey, we found that areas with warmer temperatures in the autumn prior to the case-reporting year had an increased probability of reporting zero CCHF cases. Conclusions We identified environmental correlates of CCHF incidence in Bulgaria that may support the prospective implementation of public health interventions. PMID:23270399

2012-01-01

277

Survey of ticks (Acarina: Ixodidae) for Crimean haemorrhagic fever virus activity in Jammu & Kashmir state, India.  

PubMed

A survey of ixodid ticks was carried on in 1977 to determine the crimean haemorrhagic fever (CHF) virus activity in Jammu & Kashmir state, India. In all, 412 immatures and 3258 adults belonging to 7 genera and 16 species of ticks were collected as ectoparasites of small and large mammals. These included one species each of the genera Boophilus, Dermacentor and Nosomma, 2 species of Rhipicephalus, 3 species of Ixodes and 4 species each of Haemaphysalis and Hyalomma. Haem. bispinosa was the predominant species followed by B. microplus, Haem. montgomeryi, R. haemaphysaloides and Hyal. m. isaaci. The four Hyalomma species viz., Hyal. a. anatolicum (incriminated as the vector of CHF virus), Hyal. detritum, Hyal. dromedarii and Hyal. m. isaaci were found parasitizing goat, sheep, camel and cattle and were collected in the districts of Jammu, Rajouri, Poonch and Udhampur. Four species viz., Haem. intermedia, Hyal. detritum, Hyal. dromedarii and Hyal. m. isaaci are new records for the state. A total of 138 pools comprising eight species under six genera of ticks were processed for isolating the virus. CHF virus was not isolated. The role of ixodid ticks, particularly those of the genus Hyalomma in the dissemination of CHF virus is highlighted. PMID:2111801

Kaul, H N; Shetty, P S; Ghalsasi, G R; Dhanda, V

1990-01-01

278

Long Non-Coding RNA Expression Profiles in Hereditary Haemorrhagic Telangiectasia  

PubMed Central

Hereditary Haemorrhagic Telangiectasia (HHT) is an autosomal dominantly inherited vascular disease characterized by the presence of mucocutaneous telangiectasia and arteriovenous malformations in visceral organs. HHT is predominantly caused by mutations in ENG and ACVRL1, which both belong to the TGF-? signalling pathway. The exact mechanism of how haploinsufficiency of ENG and ACVRL1 leads to HHT manifestations remains to be identified. As long non-coding RNAs (lncRNAs) are increasingly recognized as key regulators of gene expression and constitute a sizable fraction of the human transcriptome, we wanted to assess whether lncRNAs play a role in the molecular pathogenesis of HHT manifestations. By microarray technology, we profiled lncRNA transcripts from HHT nasal telangiectasial and non-telangiectasial tissue using a paired design. The microarray probes were annotated using the GENCODE v.16 dataset, identifying 4,810 probes mapping to 2,811 lncRNAs. Comparing HHT telangiectasial tissue with HHT non-telangiectasial tissue, we identified 42 lncRNAs that are differentially expressed (q<0.001). Using GREAT, a tool that assumes cis-regulation, we showed that differently expressed lncRNAs are enriched for genomic loci involved in key pathways concerning HHT. Our study identified lncRNAs that are aberrantly expressed in HHT telangiectasia and indicates that lncRNAs may contribute to regulate protein-coding loci in HHT. These results suggest that the lncRNA component of the transcriptome deserves more attention in HHT. A deeper understanding of lncRNAs and their role in telangiectasia formation possesses potential for discovering therapeutic targets in HHT. PMID:24603890

T?rring, Pernille M.; Larsen, Martin Jakob; Kjeldsen, Anette D.; Ousager, Lilian Bomme; Tan, Qihua; Brusgaard, Klaus

2014-01-01

279

Electrode configurations for detection of intraventricular haemorrhage in the premature neonate.  

PubMed

Intraventricular haemorrhage is a common cause of death in premature human infants. As preventative measures and treatments become available, a method for monitoring and detection is required. Electrical impedance tomography (EIT) is a viable monitoring method compared to modalities such as ultrasound, MRI or CT because of its low cost and contrast sensitivity to blood. However, its sensitivity to blood may be obscured by the low conductivity skull, high conductivity cerebrospinal fluid (CSF) and shape changes in the head and body. We estimated the sensitivity of three 16-electrode and impedance measurement configurations to bleeding using both idealized spherical and realistic geometry three-dimensional finite element models of the neonatal head. Sensitivity distribution responses to alterations in skull composition as well as introduction of conductivity anomalies were determined. Of the three patterns tested, a measurement scheme that employed electrodes at locations based on the 10-20 EEG layout, and impedance measurements involving current return over the anterior fontanelle produced superior distinguishabilities in regions near the lateral ventricles. This configuration also showed strongly improved sensitivities and selectivities when skull composition was varied to include the anterior fontanelle. A pattern using electrodes placed in a ring about the equator of the model had similar sensitivities but performed worse than the EEG layout in terms of selectivity. The third pattern performed worse than either the Ring or EEG-based patterns in terms of sensitivity. The overall performance of the EEG-based pattern on a spherical homogeneous model was maintained in a sensitivity matrix calculated using a homogeneous realistic geometry model. PMID:19075369

Sadleir, R J; Tang, Te

2009-01-01

280

Leukocyte count and incidence of subarachnoid haemorrhage: a prospective cohort study  

PubMed Central

Background Subarachnoid haemorrhage (SAH) is a devastating disease, in the majority of cases caused by a rupture of an arterial intracranial aneurysm. The effect of systemic low-grade inflammation on incidence of SAH is not known. The purpose of this study was to evaluate the relationship between leukocyte count, a marker of systemic inflammation, and incidence of SAH in a large cohort study. Methods Leukocyte count and other cardiovascular risk factors were measured in 19,794 individuals (17,083 men and 2,711 women, mean age 44 years) participating in a health screening program between 1974 and 1981. Incidence of SAH in relation to baseline leukocyte concentration was studied during a mean follow-up of 27 years in participants free from previous stroke. Results Ninety-five participants had a SAH, corresponding to an incidence of 22 per 100,000 in women and 17 per 100,000 in men. The hazard ratio for SAH per one standard deviation (2.01?×?109 cells/L) increase of leukocyte concentration was 1.26 (95% CI 1.05-1.53, p?=?0.014) after adjustment for several potential confounding factors including smoking. In sensitivity analysis, there was a significant association in smokers but not in non-smokers. Conclusions High leukocyte count at baseline was associated with increased incidence of SAH, although this relationship might be restricted to smokers. The results support the view that low-grade systemic inflammation could be involved in the pathogenesis of SAH, or constitute an early risk marker for the disease. PMID:24708536

2014-01-01

281

[Multiple Ebola virus haemorrhagic fever outbreaks in Gabon, from October 2001 to April 2002].  

PubMed

Outbreaks of Ebola virus haemorrhagic fever have been reported from 1994 to 1996 in the province of Ogooué Ivindo, a forest zone situated in the Northeast of Gabon. Each time, the great primates had been identified as the initial source of human infection. End of November 2001 a new alert came from this province, rapidly confirmed as a EVHV outbreak. The response was given by the Ministry of Health with the help of an international team under the aegis of WHO. An active monitoring system was implemented in the three districts hit by the epidemic (Zadié, Ivindo and Mpassa) to organize the detection of cases and their follow-up. A case definition has been set up, the suspected cases were isolated at hospital, at home or in lazarets and serological tests were performed. These tests consisted of the detection of antigen or specific IgG and the RT-PCR. A classification of cases was made according to the results of biological tests, clinical and epidemiological data. The contact subjects were kept watch over for 21 days. 65 cases were recorded among which 53 deaths. The first human case, a hunter died on the 28th of October 2001. The epidemic spreads over through family transmission and nosocomial contamination. Four distinct primary foci have been identified together with an isolated case situated in the South East of Gabon, 580 km away from the epicenter. Deaths happened within a delay of 6 days. The last death has been recorded on the 22nd of March 2002 and the end of the outbreak was declared on the 6th of May 2002. The epidemic spreads over the Gabon just next. Unexplained deaths of animals had been mentionned in the nearby forests as soon as August 2001: great primates and cephalophus. Samples taken from their carcasses confirmed a concomitant animal epidemic. PMID:16267965

Nkoghe, D; Formenty, P; Leroy, E M; Nnegue, S; Edou, S Y Obame; Ba, J Iba; Allarangar, Y; Cabore, J; Bachy, C; Andraghetti, R; de Benoist, A C; Galanis, E; Rose, A; Bausch, D; Reynolds, M; Rollin, P; Choueibou, C; Shongo, R; Gergonne, B; Koné, L M; Yada, A; Roth, C; Mve, M Toung

2005-09-01

282

Diagnosis of Ebola haemorrhagic fever by RT-PCR in an epidemic setting.  

PubMed

This study reports the first field evaluation of a new diagnostic technique for Ebola virus disease with sensitivity and specificity. Ebola virus causes rare but fulminating outbreaks in Equatorial Africa. Rapid differentiation from other infections is critical for timely implementation of public health measures. Patients usually die before developing antibodies, necessitating rapid virus detection. A reverse transcriptase-polymerase chain reaction (RT-PCR) assay was developed, implemented and evaluated at Centre International de Recherches Médicales de Franceville (CIRMF) in Gabon, to detect Ebola viral RNA in peripheral blood mononuclear cells (PBMC). Twenty-six laboratory-confirmed patients during and 5 after the acute phase of Ebola haemorrhagic fever, 15 healthy controls and 20 febrile patients not infected with Ebola virus were studied. RT-PCR results were compared with ELISA antigen capture, and Ebola specific IgM and IgG antibody detection. Ebola virus RNA was amplified from 26/26 specimens from the acute phase, 3/5 during recovery, 0/20 febrile patients and 1/15 negative controls. Sensitivity of RT-PCR in identifying acute infection and early convalescence compared with antigen or IgM detection was 100% and 91% respectively, and specificity compared with antigen detection and IgM assay combined was 97%. Antigen capture detected only 83% of those identified by PCR, and IgM only 67%. Ebola virus RNA was detected in all 13 fatalities, only 5 of whom had IgM and none IgG. RT-PCR detected Ebola RNA in PBMC one to three weeks after disappearance of symptoms when antigen was undetectable. RT-PCR was the most sensitive method and able to detect virus from early acute disease throughout early recovery. PMID:10686031

Leroy, E M; Baize, S; Lu, C Y; McCormick, J B; Georges, A J; Georges-Courbot, M C; Lansoud-Soukate, J; Fisher-Hoch, S P

2000-04-01

283

A survey of exercise-induced pulmonary haemorrhage in Quebec standardbred racehorses.  

PubMed

Sixty Standardbred horses, aged 3 to 10 years, were examined endoscopically for exercise-induced pulmonary haemorrhage (EIPH) 1 h after racing, on at least 3 occasions. Racing time, finishing position and post exercise venous lactate concentrations were also recorded. Horses positive for tracheal blood on endoscopy were classified as having either grade 1 EIPH (one or a few spots of blood in the trachea), or grade 2 (stream of blood). Air temperature, relative humidity and air pollutant levels were recorded on each examination day. Of the 60 horses, 52 (87%) were EIPH-positive on at least one evaluation out of 3 and 40 of the 52 (77%) showed grade 2 EIPH on at least one occasion. Of the 52 EIPH-positive horses, 52% bled 3 times out of 3, 21% 2 out of 3 and 27% once. When only the first examination was considered, 37 of the 60 horses (62%) were EIPH-positive. There was no significant relation detected between either presence or frequency of EIPH and age, sex, or gait. Horses that showed grade 2 EIPH bled significantly (P = < 0.001) more frequently (mean: 83% of examinations) than horses having shown no more than grade 1 EIPH (47% of examinations). No significant differences could be detected between EIPH-positive and EIPH-negative races in the average racing times, finishing positions and blood lactate concentrations of the 29 horses which showed intermittent EIPH. The proportion of horses showing EIPH on each day where at least 5 horses were examined was correlated with air temperature, relative humidity, and the levels of several air pollutants on those days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7889923

Lapointe, J M; Vrins, A; McCarvill, E

1994-11-01

284

Pulmonary haemodynamics in the exercising horse and their relationship to exercise-induced pulmonary haemorrhage.  

PubMed

Exercise-induced pulmonary haemorrhage (EIPH) is a common occurrence in race horses. Although blood in cases of EIPH has been suspected to originate from the bronchial circulation, which receives approximately 1% of the left ventricular output, physiological evidence has recently emerged to indicate that the pulmonary circulation, which receives the entire output of the right ventricle, is a more likely source. High transmural pulmonary capillary pressures have been shown to cause breaks in the capillary endothelium, basement membrane as well as in the alveolar epithelium. Blood constituents escape into the interstitium and alveoli through such breaks in the blood-gas barrier--a phenomenon referred to as stress failure of pulmonary capillaries. Concomitant measurement of pulmonary arterial and venous pressures in strenuously exercising horses have revealed that both of these variables increased dramatically such that the intravascular pulmonary capillary pressure during exertion at 14 m/s (heart rate of 214 beats/min) approached 105 cm H2O (79 mmHg). Alveolar pressure during peak inhalation is likely to be negative; therefore, it is probable that transmural (intravascular minus perivascular) pulmonary capillary pressure of maximally exercising horses may be greater than 105 cm of water. Thus, the pulmonary blood-gas barrier, which has to be thin to provide for adequate diffusion of O2, is exposed to very high transmural forces associated with high cardiac output during exercise. Recent evidence suggests that the alveolar-capillary membrane may not be able to withstand the high transmural forces during maximal exertion, and that stress failure of pulmonary capillaries occurs, leading to EIPH. Intravenous furosemide premedication 4 h before exercise attenuates the exercise-induced rise in pulmonary arterial, capillary and venous pressures and, therefore, may be efficacious in reducing or limiting the extent of EIPH in race horses. PMID:8298955

Manohar, M; Hutchens, E; Coney, E

1993-01-01

285

Stress failure of pulmonary capillaries as a mechanism for exercise induced pulmonary haemorrhage in the horse.  

PubMed

Exercise induced pulmonary haemorrhage (EIPH) is a serious problem in the Thoroughbred industry. The condition apparently occurs essentially in all Thoroughbreds in training but the mechanism has proved elusive. There is now strong evidence that the condition is caused by mechanical failure of the walls of the pulmonary capillaries when the pressure inside them rises to very high levels. It is well known that pulmonary capillaries have extremely thin walls to allow rapid exchange of respiratory gases across them. Recently we have shown that the wall stresses are very large when the capillary transmural pressure is raised, and in anesthetised rabbits, ultrastructural damage to the walls is seen at pressures of 40 mmHg and above. The incidence of stress failure is greatly increased at high lung volumes; and many of the ultrastructural changes are rapidly reversible when the capillary pressure is reduced. The principal forces acting on the capillary have been analysed. The strength of the thin part of the capillary wall can be attributed to the Type IV collagen in the extracellular matrix. The pulmonary vascular pressures of galloping Thoroughbreds reach very high levels. Mean pulmonary artery and left atrial pressures of up to 120 and 70 mmHg respectively have been directly measured with indwelling catheters. The reason for the high pulmonary vascular pressures is that these animals have been selectively bred over hundreds of years to run at great speeds over short distances and their maximal oxygen consumptions are very high. As a consequence, cardiac outputs are substantial, and the left ventricle needs very high filling pressures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7889916

West, J B; Mathieu-Costello, O

1994-11-01

286

Gauze packing as damage control for uncontrollable haemorrhage in severe thoracic trauma  

PubMed Central

Introduction The usefulness of thoracic damage control (DC) for trauma requiring a thoracotomy is not established. The aim of this study was to clarify the usefulness of thoracic packing as DC surgery. Methods This was a retrospective case series study of 12 patients with thoracic trauma suffering uncontrollable intrathoracic haemorrhage and shock who underwent intrathoracic packing. Our thoracic DC technique consisted of ligation and packing over the bleeding point or filling gauze in the bleeding spaces as well as packing for the thoracotomy wound. The success rates of intrathoracic haemostasis, changes in the circulation and the volume of discharge from the thoracic tubes were evaluated. Results Packing was undertaken for the thoracic wall in five patients, for the lung in four patients, for the vertebrae in two patients and for the descending thoracic aorta in one patient. Haemostasis was achieved successfully in seven cases. Of these, the volume of discharge from the thoracic tube exceeded 400ml/hr within three hours after packing in three patients, decreased to less than 200ml/hr within seven hours in six patients and decreased to 100ml/hr within eight hours in six patients. Systolic pressure could be maintained over 70mmHg by seven hours after packing. Conclusions Intrathoracic packing is useful for some patients, particularly in the space around the vertebrae, at the lung apex, and between the diaphragm and the thoracic wall. After packing, it is advisable to wait for three hours to see whether vital signs can be maintained and then to wait further to see if the discharge from the thoracic tube decreases to less than 200ml/hr within five hours. PMID:23317720

Toyoda, H; Harunari, N; Iwashita, M; Kosuge, T; Arata, S; Suzuki, N

2013-01-01

287

Self-perceived health status following aneurysmal subarachnoid haemorrhage: a cohort study  

PubMed Central

Objective The objective of the study was to assess the long-term self-reported health status and quality of life (QoL) of patients following an aneurysmal subarachnoid haemorrhage (ASAH) using a self-completed questionnaire booklet. Design A two-cohort study. Setting A regional tertiary neurosurgical centre. Participants 2 cohorts of patients with ASAH treated between 1998 and 2008 and followed up at approximately 1?year. Interventions Routine care. Primary and secondary outcomes A range of standardised scales included: AKC Short Sentences Test, the Barthel Index, the Self-Report Dysexecutive Questionnaire, the Everyday Memory Questionnaire, Stroke Symptom Checklist, Wimbledon Self-Report Scale, Modified Rankin Score (MRS) and a new Stroke-QoL. The data from summated scales were fit to the Rasch measurement model to validate the summed score. Results 214 patients (48%) returned the questionnaires; the majority (76%) had a World Federation of Neurosurgeons grade of 1 or 2. The most frequent aneurysm type was that of the anterior communicating artery (28%) with approximately 90% of aneurysms of the anterior circulation. Of those previously in full or part-time employment, 48.9% were unemployed at follow-up. All summated scales satisfied the Rasch measurement model requirements, such that their summed scores were a sufficient statistic. Given this, one-third of patients were noted to have a significant mood disorder and 25% had significant dysexecutive function. Patients with an MRS of 3, 4 or 5 had significantly worse scores on most outcome measures, but a significant minority of those with a score of zero had failed to return to work and displayed significant mood disorder. Conclusions A range of self-reported cognitive and physical deficits have been highlighted in a cohort of patients with ASAH. While the MRS has been shown to provide a reasonable indication of outcome, in routine clinical follow-up it requires supplementation by instruments assessing dysexecutive function, memory and mood. PMID:24699459

Quinn, Audrey C; Bhargava, Deepti; Al-Tamimi, Yahia Z; Clark, Matthew J; Ross, Stuart A; Tennant, Alan

2014-01-01

288

Idiopathic pulmonary calcification and ossification in an elderly woman with a missed diagnosis of subarachnoid haemorrhage.  

PubMed

This is a case of idiopathic pulmonary calcification and ossification in a 70 year old with long-standing diabetes and hypertension. Thirteen years prior to her demise, she was first noticed to have multiple calcific deposits in her lungs on a chest X-ray film. She had no risk factors for soft tissue calcification and ossification. Histology of tissue from autopsy showed intraparenchymal pulmonary calcification and ossification with marrow elements. Idiopathic pulmonary calcification and ossification is rare. At autopsy, she was also found to have had bilateral subarachnoid haemorrhage (SAH), a diagnosis missed during clinical evaluation. We highlight the pertinent details in our patient's management that could have helped to prevent a missed diagnosis of SAH. Even though SAH occurs most commonly following head trauma, the more familiar medical use of SAH is for non-traumatic SAH occurring following a ruptured cerebral aneurysm. This patient had notable risk factors for cerebral aneurysm formation but an aneurysm was not identified at autopsy. The location of the blood high on the cerebral convexities further suggests a traumatic origin rather than a ruptured aneurysm. Heterotopic calcification and ossification (HO) is known to occur in the setting of severe neurologic disorders such as traumatic brain injury but the fact that the lung calcification in our patient predated the brain injury by over 10 years makes it unlikely for the HO to have been due to the brain trauma. Other organ pathologies found at autopsy include chromophobe renal cell carcinoma, renal papillary necrosis, lymphocytic thyroiditis, and seborrheic keratosis. PMID:24391231

Odubanjo, M O; Abdulkareem, F B; Banjo, A; Ekwere, T E; Awelimobor, D I

2013-09-01

289

Studies on dengue and dengue haemorrhagic fever (DHF) in West Bengal State, India.  

PubMed

A large outbreak of dengue and dengue haemorrhagic fever (DHF) occurred from August to November 2005 involving all districts of West Bengal. Altogether 6293 persons were serologically diagnosed to be suffering from dengue through detection of IgM antibodies, with 27 (0.42%) seropositive deaths. In Kolkata alone 3967 persons were affected with 14 deaths. A total of 874 sera samples from febrile patients were quantitatively analysed for IgG and IgM antibodies using the IVD microwell ELISA dengue fever test kit. In 21.6%, no antibody was detected and 52.6% had only IgG antibodies. In 8.9% only IgM antibodies and in 16.8% both IgG, IgM antibodies were present, suggesting primary and secondary dengue respectively. About 10% of secondary dengue would develop DHF. As in this outbreak secondary dengue was 65.3% of total dengue cases, so of the 6293 dengue victims presumably, 3998 had secondary dengue, thus having risk of DHF in about 400 persons. Case fatality rate amongst DHF patients was 8.5%. This study also indicated that DHF would be a nagging problem in coming days. Age-group analysis of primary and secondary dengue cases revealed that although secondary cases occurred in all ages, more of primary cases belonged to younger ages (1-10) years and more of secondary cases in middle to older ages. Prevailing type during this outbreak was DEN3. This epidemiological study of an outbreak categorized prevalence of primary and secondary dengue, calculated risk factors for precipitation of DHF, model of which could be utilized to compare and evaluate future epidemiological pattern, where-ever and whenever applicable. PMID:17370674

Hati, A K

2006-03-01

290

Chemical- and radiation-induced haemorrhagic cystitis: current treatments and challenges  

PubMed Central

To review the published data on predisposing risk factors for cancer treatment-induced haemorrhagic cystitis (HC) and the evidence for the different preventive and therapeutic measures that have been used in order to help clinicians optimally define and manage this potentially serious condition. Despite recognition that HC can be a significant complication of cancer treatment, there is currently a lack of UK-led guidelines available on how it should optimally be defined and managed. A systematic literature review was undertaken to evaluate the evidence for preventative measures and treatment options in the management of cancer treatment-induced HC. There is a wide range of reported incidence due to several factors including variability in study design and quality, the type of causal agent, the grading of bleeding, and discrepancies in definition criteria. The most frequently reported causal factors are radiotherapy to the pelvic area, where HC has been reported in up to 20% of patients, and treatment with cyclophosphamide and bacillus Calmette-Guérin, where the incidence has been reported as up to 30%. Mesna (2-mercaptoethane sodium sulphonate), hyperhydration and bladder irrigation have been the most frequently used prophylactic measures to prevent treatment-related cystitis, but are not always effective. Cranberry juice is widely cited as a preventative measure and sodium pentosanpolysulphate as a treatment, although the evidence for both is very limited. The best evidence exists for intravesical hyaluronic acid as an effective preventative and active treatment, and for hyperbaric oxygen as an equally effective treatment option. The lack of robust data and variability in treatment strategies used highlights the need for further research, as well as best practice guidance and consensus on the management of HC. PMID:24000900

Payne, Heather; Adamson, Andrew; Bahl, Amit; Borwell, Jonathan; Dodds, David; Heath, Catherine; Huddart, Robert; McMenemin, Rhona; Patel, Prashant; Peters, John L; Thompson, Andrew

2013-01-01

291

froide (11 14 C) et nulle en eau rchauffe (20 C); elle est, d'autre part, proportionnelle  

E-print Network

-en-Josas, 78352 Jouy-en-Josas, Cedex, France) C'est le couple truite Arc-en-ciel (Oncorhynchus mykiss) et virus d (1980) Occurrence of viral haemorrhagic septicaemia in rainbow trout Salmo gairdneri Richardson reared

Boyer, Edmond

292

Heat probe thermocoagulation and pure alcohol injection in massive peptic ulcer haemorrhage: a prospective, randomised controlled trial.  

PubMed Central

We conducted a prospective randomised controlled trial of 137 patients with massive peptic ulcer haemorrhage over a period of 12 months to compare the haemostatic effects of endoscopic heat probe thermocoagulation and pure alcohol injection. Seventy eight patients (56.9%) were in shock at the time of randomisation to the trial. The age, sex, number of patients in shock, haemoglobin value at the time of entry to the trial, number of patients with severe medical illness, location of bleeders, and stigmata of recent haemorrhage were comparable among the heat probe, pure alcohol, and control groups. The initial haemostatic effect of the heat probe was better than that of the pure alcohol injection (44 of 45 v 31 of 46, p = 0.0004). The ultimate haemostasis achieved by the heat probe group (41 of 45) was better than that of the pure alcohol group (31 of 46, p = 0.012) and of controls (24 of 46, p = 0.0001). The duration of hospital stay was shorter for patients in the heat probe group than for the control group (6.2 days v 13.8 days, p less than 0.05). The incidence of emergency surgery was less for the heat probe than the control group (three of 45 v 12 of 46, p = 0.027). The mortality rate was less in the heat probe than in the control group (one of 45 v seven of 46, p = 0.031). We suggest that heat probe thermocoagulation should be the first treatment of choice for arrest of massive peptic ulcer haemorrhage. PMID:2196207

Lin, H J; Lee, F Y; Kang, W M; Tsai, Y T; Lee, S D; Lee, C H

1990-01-01

293

Detection of cerebral aneurysms in nontraumatic subarachnoid haemorrhage: role of multislice CT angiography in 130 consecutive patients  

Microsoft Academic Search

Purpose.  The leading cause of a nontraumatic subarachnoid haemorrhage is rupture of an intracranial aneurysm. The aim of this study\\u000a was to assess the usefulness of multislice computed tomography angiography (CTA) in identifying and evaluating cerebral aneurysms\\u000a by comparing it with intra-arterial digital subtraction angiography (DSA) and intraoperative findings.\\u000a \\u000a \\u000a \\u000a Materials and methods.  During a 20-month period (June 2004 and February 2006), 130

M. El Khaldi; P. Pernter; F. Ferro; A. Alfieri; N. Decaminada; L. Naibo; G. Bonatti

2007-01-01

294

Maternal Mortality Review: A Case of Pulmonary Haemorrhage Due to Ruptured Lung Haemangioma Secondary to Ghon's Focus Invasion.  

PubMed

Haemangioma can be present in the lung but rarely causes complications unless there is a bleed. Ghon's focus is a result of post primary tuberculosis. It is a caseating granuloma which invades the surrounding tissue. It is usually benign and may resolve spontaneously without causing complications or active tuberculosis. This case illustrates an unfortunate patient who had a pre-existing haemangioma in the lung which was in close proximity of a Ghon's focus that had invaded on to the haemangioma leading to haemorrhage causing death. This study seeks to highlight the importance of conducting a full post mortem in cases of maternal mortality. PMID:24814628

Paranthaman, V; Subashini, A

2014-02-01

295

Comparative clinical trial of epsilon amino-caproic acid and tranexamic acid in the prevention of early recurrence of subarachnoid haemorrhage.  

PubMed Central

A comparative controlled clinical trial of epsilon aminocaproic acid (EACA), 36 g/day and tranexamic acid (TEA), 6 g/day, was undertaken to assess their effectiveness in reducing early recurrence of subarachnoid haemorrhage (SAH). Of 90 patients treated with EACA recurrent haemorrhage was seen in 8% of these patients and 7% of the patients developed delayed ischaemic deficit. The total pre-operative mortality in EACA-group was 11%. Of 61 patients treated with TEA, 10% had recurrent haemorrhage and delayed ischaemic deficit occurred in 5% of the patients. The total pre-operative mortality in TEA-group was 11%. No difference was found between the effectiveness and side-effects of these drugs. PMID:7031186

Chowdhary, U M; Sayed, K

1981-01-01

296

Specific cancer rates may differ in patients with hereditary haemorrhagic telangiectasia compared to controls  

PubMed Central

Background Hereditary haemorrhagic telangiectasia (HHT) is inherited as an autosomal dominant trait, affects ~1 in 5,000, and causes multi-systemic vascular lesions and life-limiting complications. Life expectancy is surprisingly good, particularly for patients over 60ys. We hypothesised that individuals with HHT may be protected against life-limiting cancers. Methods To compare specific cancer rates in HHT patients and controls, we developed a questionnaire capturing data on multiple relatives per respondent, powered to detect differences in the four most common solid non skin cancers (breast, colorectal, lung and prostate), each associated with significant mortality. Blinded to cancer responses, reports of HHT-specific features allowed assignment of participants and relatives as HHT-subjects, unknowns, or controls. Logistic and quadratic regressions were used to compare rates of specific cancer types between HHT subjects and controls. Results 1,307 participants completed the questionnaire including 1,007 HHT-subjects and 142 controls. The rigorous HHT diagnostic algorithm meant that 158 (12%) completed datasets were not assignable either to HHT or control status. For cancers predominantly recognised as primary cancers, the rates in the controls generally matched age-standardised rates for the general population. HHT subjects recruited through the survey had similar demographics to controls, although the HHT group reported a significantly greater smoking habit. Combining data of participants and uniquely-reported relatives resulted in an HHT-arm of 2,161 (58% female), and control-arm of 2,817 (52% female), with median ages of 66ys [IQR 53–77] and 77ys [IQR 65–82] respectively. In both crude and age-adjusted regression, lung cancers were significantly less frequent in the HHT arm than controls (age-adjusted odds ratio 0.48 [0.30, 0.70], p?=?0.0012). Breast cancer prevalence was higher in HHT than controls (age-adjusted OR 1.52 [1.07, 2.14], p?=?0.018). Overall, prostate and colorectal cancer rates were equivalent, but the pattern of colorectal cancer was modified, with a higher prevalence in younger HHT patients than controls. Conclusions These preliminary survey data suggest clinically significant differences in the rates of lung, breast and colorectal cancer in HHT patients compared to controls. For rare diseases in which longitudinal studies take decades to recruit equivalent datasets, this type of methodology provides a good first-step method for data collection. PMID:24354965

2013-01-01

297

Prevention of Kidney Haemorrhagic Necrosis of Choline-Deficient Rats by ?-Methyldopa Treatment  

PubMed Central

In a previous report from our laboratory we have shown a marked increase in the levels of renal catecholamines in choline-deficient rats in comparison to choline-supplemented animals, while the content of acetylcholine remained unchanged. Since the changes in tissue catecholamines occurred before kidney lesions developed, we have suggested that an imbalance between sympathetic and parasympathetic systems plays an important role in the pathogenesis of renal injury in choline-deficient rates, this imbalance being the result of an excess of catecholamines in the kidneys. A series of experiments was then planned to explore this theory further by administering adrenergic blocking agents in an attempt to prevent the development of the renal injury in choline deficiency. We report here our results on the administration of ?-methyldopa, a drug that depletes the tissue stores of catecholamines, to choline-deficient and choline-supplemented rats. Young male Wistar rats were divided at random into 4 groups: Group CS, fed a choline-supplemented diet; Group CS + D, fed a choline-supplemented diet and treated with ?-methyldopa; Group CD, fed a choline-deficient diet; and Group CD + D, fed a cholinedeficient diet and treated with ?-methyldopa. The appropriate groups received daily i.p. injections of ?-methyldopa (300 mg/kg body wt). The kidneys of all surviving rats were studied grossly and histologically, and the levels of noradrenaline and adrenaline determined. All animals from Control Groups CS and CS + D showed essentially normal kidneys on gross and light microscopic examination. On the other hand, CD rats showed marked renal injury, while the kidneys lesions of CD + D animals were significantly less pronounced than those of rats from Group CD. The total content of noradrenaline and adrenaline in the kidneys of CD + D and CD rats were not statistically different, although the CD + D animals tended to have lower levels of catecholamines. The content of noradrenaline and adrenaline of rats from Group CD was significantly higher than the corresponding values in CS rats. Also, the total content of renal noradrenaline of CD + D animals was found to be unaltered when compared to that of CS rats, while their content of adrenaline was found to be higher than the corresponding value in CS group. The noradrenaline levels of CS and CS + D rats were similar, but the latter group had a higher renal adrenaline content than the former. These findings, besides confirming our previous observations, clearly show that ?-methyldopa afforded a protective effect against the renal injury of choline deficiency, thus giving strong additional support to the theory that the kidney haemorrhagic necrosis of choline deficiency in young rats is probably due to an autonomic imbalance. PMID:7326217

Rossi, M. A.; Costa, R. S.

1981-01-01

298

Anaesthesia in a patient with subarachanoidal haemorrhage and high oxygen affinity haemoglobinopathy (HB york): case report  

PubMed Central

Background Approximately 90 haemoglobinopathies have been identified that result in abnormally high oxygen affinity. One of these is haemoglobinopathy York (HbY), first described in 1976. HbY causes an extreme leftward shift of the oxygen dissociation curve with the P50 value changing to 12.5 - 15.5 mmHg (normal value 26.7 mmHg), indicating that approximately half of the haemoglobin is not available as oxygen carrier. Patients with haemoglobinopathies with increased oxygen affinity could suffer from the risk developing ischaemic complications due to a lack of functional oxygen carriers. This is, to best of our knowledge, the first case report on a patient with HbY published in connection with anesthesia. Case Presentation A 42-year-old female with a severe headache and Glasgow coma scale (GCS) of 15 was admitted to the neurosurgical intensive care unit with a ruptured, right sided ICA aneurysm with consecutive subarachnoid haemorrhage [Fisher III, World Federation of Neurosurgical Societies (WFNS) I)]. The medical history of the patient included an erythrocytosis (Hb 17.5?g/dl) on the base of a high-oxygen-affinity haemoglobinopathy, called Hb York (HbY). With no time available to take special preoperative precautions, rapid blood loss occurred during the first attempt to clip the aneurysm. General transfusion procedures, according to the guidelines based on haemoglobin and haematocrit values, could not be applied due to the uncertainty in the oxygen carrier reduction. To maintain tissue oxygen supply, clinical indicators of ischaemia were instead utilized to gauge the appropriate required blood products, crystalloids and colloids replacements. Despite this, the patient survived the neurosurgical intervention without any neurological deficit. Conclusions Family members of patients with HbY (and other haemoglobinopathies with increased oxygen affinity) should undergo clinical assessment, particularly if they are polycythaemic. If the diagnosis of HbY is confirmed, they should carry an "emergency anaesthesiology card" in order to avert perioperative risks arising from their "hidden" anemia. PMID:22870883

2012-01-01

299

Use of portal pressure studies in the management of variceal haemorrhage.  

PubMed

Portal hypertension occurs as a complication of liver cirrhosis and complications such as variceal bleeding lead to significant demands on resources. Endoscopy is the gold standard method for screening cirrhotic patients however universal endoscopic screening may mean a lot of unnecessary procedures as the presence of oesophageal varices is variable hence a large time and cost burden on endoscopy units to carry out both screening and subsequent follow up of variceal bleeds. A less invasive method to identify those at high risk of bleeding would allow earlier prophylactic measures to be applied. Hepatic venous pressure gradient (HVPG) is an acceptable indirect measurement of portal hypertension and predictor of the complications of portal hypertension in adult cirrhotics. Varices develop at a HVPG of 10-12 mmHg with the appearance of other complications with HPVG > 12 mmHg. Variceal bleeding does not occur in pressures under 12 mmHg. HPVG > 20 mmHg measured early after admission is a significant prognostic indicator of failure to control bleeding varices, indeed early transjugular intrahepatic portosystemic shunt (TIPS) in such circumstances reduces mortality significantly. HVPG can be used to identify responders to medical therapy. Patients who do not achieve the suggested reduction targets in HVPG have a high risk of rebleeding despite endoscopic ligation and may not derive significant overall mortality benefit from endoscopic intervention alone, ultimately requiring TIPS or liver transplantation. Early HVPG measurements following a variceal bleed can help to identify those at risk of treatment failure who may benefit from early intervention with TIPS. Therefore, we suggest using HVPG measurement as the investigation of choice in those with confirmed cirrhosis in place of endoscopy for intitial variceal screening and, where indicated, a trial of B-blockade, either intravenously during the initial pressure study with assessment of response or oral therapy with repeat HVPG six weeks later. In those with elevated pressures, primary medical prophylaxis could be commenced with subsequent close monitoring of HVPG thus negating the need for endoscopy at this point. All patients presenting with variceal haemorrhage should undergo HVPG measurement and those with a gradient greater than 20 mmHg should be considered for early TIPS. By introducing portal pressure studies into a management algorithm for variceal bleeding, the number of endoscopies required for further intervention and follow up can be reduced leading to significant savings in terms of cost and demand on resources. PMID:22816007

Addley, Jennifer; Tham, Tony Ck; Cash, William Jonathan

2012-07-16

300

Oral misoprostol for preventing postpartum haemorrhage in home births in rural Bangladesh: how effective is it?  

PubMed Central

Aims Evidence exists about prevention of postpartum haemorrhage (PPH) by oral administration of misoprostol in low-income countries, but effectiveness of prevention by lay community health workers (CHW) is not sufficient. This study aimed to investigate whether a single dose (400 µg) of oral misoprostol could prevent PPH in a community home-birth setting and to assess its acceptability and feasibility among rural Bangladeshi women. Methods This quasi-experimental trial was conducted among 2,017 rural women who had home deliveries between November 2009 and February 2010 in two rural districts of northern Bangladesh. In the intervention district 1,009 women received 400 µg of misoprostol immediately after giving birth by the lay CHWs, and in the control district 1,008 women were followed after giving birth with no specific intervention against PPH. Primary PPH (within 24 hours) was measured by women's self-reported subjective measures of the normality of blood loss using the ‘cultural consensus model.’ Baseline data provided socio-economic, reproductive, obstetric, and bleeding disorder information. Findings The incidence of primary PPH was found to be lower in the intervention group (1.6%) than the control group (6.2%) (p<0.001). Misoprostol provided 81% protection (RR: 0.19; 95% CI: 0.08–0.48) against developing primary PPH. The proportion of retained and manually removed placentae was found to be higher in the control group compared to the intervention group. Women in the control group were more likely to need an emergency referral to a higher level facility and blood transfusion than the intervention group. Unexpectedly few women experienced transient side effects of misoprostol. Eighty-seven percent of the women were willing to use the drug in future pregnancy and would recommend to other pregnant women. Conclusion Community-based distribution of oral misoprostol (400 µg) by CHW appeared to be effective, safe, acceptable, and feasible in reducing the incidence of PPH in rural areas of Bangladesh. This strategy should be scaled up across the country where access to skilled attendance is limited. PMID:21845143

Nasreen, Hashima-E-; Nahar, Shamsun; Al Mamun, Mahfuz; Afsana, Kaosar; Byass, Peter

2011-01-01

301

Impact of Pulmonary Arteriovenous Malformations on Respiratory-Related Quality of Life in Patients with Hereditary Haemorrhagic Telangiectasia  

PubMed Central

Fifteen to fifty percent of patients with hereditary haemorrhagic telangiectasia have pulmonary arteriovenous malformations. The objective of this study was to measure the effect of the presence of pulmonary arteriovenous malformations and of their embolisation on respiratory-related quality of life (QoL). We prospectively recruited patients with a diagnosis of hereditary haemorrhagic telangiectasia based on the Curaçao criteria and/or the identification of a pathogenic mutation. Respiratory-related quality of life was measured using the Saint George’s Respiratory Questionnaire (SGRQ). Patients who underwent embolisation of pulmonary arteriovenous malformations completed the questionnaire before and 6–12 mo after the procedure. The 56 participants were divided into three groups: no pulmonary arteriovenous malformation (group A, n?=?10), small pulmonary arteriovenous malformations not accessible to embolotherapy (group B, n?=?19), and large pulmonary arteriovenous malformations accessible to embolotherapy (group C, n?=?27). The SGRQ score was significantly higher in group C compared to the other groups, indicating a worse respiratory-specific QoL. There was no significant difference between groups A and B. Among the 17 patients who underwent an embolisation, the SGRQ score decreased significantly after the procedure, to a value similar to that in patients without pulmonary arteriovenous malformation. Our results indicate that the presence of large but not small pulmonary arteriovenous malformations negatively affects the respiratory-related quality of life and that embolisation of pulmonary arteriovenous malformations normalizes the respiratory-related quality of life. PMID:24603803

Blivet, Sandra; Cobarzan, Daniel; Beauchet, Alain; El Hajjam, Mostafa; Lacombe, Pascal; Chinet, Thierry

2014-01-01

302

Evaluation of a vector-control strategy of haemorrhagic thelohanellosis in carp, caused by Thelohanellus hovorkai (Myxozoa).  

PubMed

The life cycle of Thelohanellus hovorkai (Myxozoa), the causative agent of haemorrhagic thelohanellosis of carp Cyprinus carpio, involves the alternate oligochaete host Branchiura sowerbyi, which plays the role of vector in the parasite's transmission. Field investigations in carp farms suggested that oligochaete fauna were closely associated with the substrate type of the pond. The pond bottom in the enzootic farm consisted of clay soil and soft sediments comprised of organic mud, in which B. sowerbyi dominated in high densities, with a maximum of 5.6 ind. kg(-1) soil. In another case, in a carp farm with no previous history of the disease, the pond bottom was sandy soil, in which small-sized oligochaetes, composed mainly of Limnodrilus socialis, dominated. Laboratory studies on the substrate preference of oligochaetes proved that B. sowerbyi prefers mud to sand, whereas L. socialis has no tendency to substrate tropism. The delicate body surface of B. sowerbyi was subject to damage by rugged-edged sand particles, which inflicted severe injuries to the worms. Transmission experiments showed that L. socialis, which are non-susceptible to T. hovorkai, suppressed the production of T. hovorkai actinospores in B. sowerbyi in a mixed assemblage of oligochaetes. Field and experimental evidence in this study imply that substrate replacement in culture ponds might regulate the benthic oligochaete communities, resulting in minimization of the impact of haemorrhagic thelohanellosis. We propose that ecological control of oligochaete fauna by environmental management is a promising strategy against myxozoan diseases. PMID:12887252

Liyanage, Yasoja S; Yokoyama, Hiroshi; Wakabayashi, Hisatsugu

2003-06-20

303

The model of response to viral haemorrhagic fevers of the National Institute for Infectious Diseases "Lazzaro Spallanzani".  

PubMed

Viral haemorrhagic fevers (VHF) are severe and life-threatening diseases caused by a range of viruses. However, only four agents of VHF are known to be readily capable of person-to-person spread: Lassa virus, Crimean/Congo haemorrhagic fever virus, Ebola and Marburg viruses. Diseases caused by these viruses are endemic only in few areas in the world, most notably Africa and some rural parts of the Middle East and Eastern Europe. Nonetheless, the increasing volume of international travel presents a greater likelihood for the importation of these infections or of suspected cases in non endemic countries. Four conditions can lead to the importation and to the subsequent recognition of VHF within Europe: 1) patients arriving as a result of a planned medical evacuation; 2) persons who became sick on route to their destination; 3) persons discovered ill when entering a country, for example during routine clinical examination at the airport; 4) persons becoming sick after their arrival. Public health implications and the risk of secondary spread of pathogens in the above reported circumstances are very different. Similarly, preparedness and response should vary. This paper summarizes the present knowledge on the four VHF capable of person-to-person spread, describes the high isolation area constructed at the Italian National Institute for Infectious Diseases Lazzaro Spallanzani in Rome to respond to the occurrence of VHF. A brief overview of procedures and equipment adopted is provided. PMID:11693443

Armignacco, O; Lauria, F N; Puro, V; Macrì, G; Petrecchia, A; Ippolito, G

2001-01-01

304

Haemorrhages of the sole horn of dairy cows as a retrospective indicator of laminitis: an epidemiological study.  

PubMed

Eleven herds with clinical laminitis problems and 11 control herds were studied for 2 consecutive years. All the claws were trimmed and photographically recorded once each year, 2 to 6 months after the cows had calved. The haemorrhages of the sole horn were evaluated and scored for each digit, and data relevant to the factors associated with an increased risk of laminitis for each herd were collected and related to these scores for sole haemorrhages. It was found that the laminitic herds were more prone to the sole lesions than the control herds, the hind claws were more prone than the front claws, the primiparous cows were more prone than the multiparous cows and the Swedish Friesian cows were more prone than the Swedish Red and White cows. High scores were also correlated with hard floors (ie concrete) in the cow stalls, with fewer than 4 daily feedings of concentrates, with a short time allocated for the cows to eat concentrates, with feeding concentrates only at the first meal in the morning and in the afternoon and with the interaction between these last 2 variables. PMID:8209821

Bergsten, C

1994-01-01

305

The development of quality indicators for the prevention and management of postpartum haemorrhage in primary midwifery care in the Netherlands  

PubMed Central

Background At present, there are no guidelines on prevention and management of postpartum haemorrhage in primary midwifery care in the Netherlands. The first step towards implementing guidelines is the development of a set of quality indicators for prevention and management of postpartum haemorrhage for primary midwifery supervised (home) birth in the Netherlands. Methods A RAND modified Delphi procedure was applied. This method consists of five steps: (1) composing an expert panel (2) literature research and collection of possible quality indicators, (3) digital questionnaire, (4) consensus meeting and (5) critical evaluation. A multidisciplinary expert panel consisting of five midwives, seven obstetricians and an ambulance paramedic was assembled after applying pre-specified criteria concerning expertise in various domains relating to primary midwifery care, secondary obstetric care, emergency transportation, maternal morbidity or mortality audit, quality indicator development or clinical guidelines development and representatives of professional organisations. Results After literature review, 79 recommendations were selected for assessment by the expert panel. After a digital questionnaire to the expert panel seven indicators were added, resulting in 86 possible indicators. After excluding 41 indicators that panel members unanimously found invalid, 45 possible indicators were assessed at the consensus meeting. During critical evaluation 18 potential indicators were found to be overlapping and two were discarded due to lack of measurability. Conclusions A set of 25 quality indicators was considered valid for testing in practice. PMID:24139411

2013-01-01

306

Transient decrease in blood heterophils and sustained liver damage caused by calicivirus infection of young rabbits that are naturally resistant to rabbit haemorrhagic disease  

Microsoft Academic Search

Young rabbits are naturally resistant to rabbit haemorrhagic disease (RHD) caused by the same calicivirus that kills, within 3 days, nearly all adult animals. We have investigated changes in blood leukocytes, and in the morphology and biochemistry of the liver (the organ where caliciviruses replicate) of young rabbits undergoing benign infection by the RHD virus. Four-week-old rabbits were infected with

P. G. Ferreira; A. Costa-e-Silva; E. Monteiro; M. J. R. Oliveira; A. P. Águas

2004-01-01

307

Serum procalcitonin and C-reactive protein as markers of sepsis and outcome in patients with neurotrauma and subarachnoid haemorrhage.  

PubMed

This prospective study evaluated serum procalcitonin (PCT) and C-reactive protein (CRP) as markers for systemic inflammatory response syndrome (SIRS)/sepsis and mortality in patients with traumatic brain injury and subarachnoid haemorrhage. Sixty-two patients were followed for 7 days. Serum PCT and CRP were measured on days 0, 1, 4, 5, 6 and 7. Seventy-seven per cent of patients with traumatic brain injury and 83% with subarachnoid haemorrhage developed SIRS or sepsis (P=0.75). Baseline PCT and CRP were elevated in 35% and 55% of patients respectively (P=0.03). There was a statistically non-significant step-wise increase in serum PCT levels from no SIRS (0.4+/-0.6 ng/ml) to SIRS (3.05+/-9.3 ng/ml) to sepsis (5.5+/-12.5 ng/ml). A similar trend was noted in baseline PCT in patients with mild (0.06+/-0.9 ng/ml), moderate (0.8+/-0.7 ng/ml) and severe head injury (1.2+/-1.9 ng/ml). Such a gradation was not observed with serum CRP There was a non-significant trend towards baseline PCT being a better marker of hospital mortality compared with baseline CRP (ROC-AUC 0.56 vs 0.31 respectively). This is the first prospective study to document the high incidence of SIRS in neurosurgical patients. In our study, serum PCT appeared to correlate with severity of traumatic brain injury and mortality. However, it could not reliably distinguish between SIRS and sepsis in this cohort. This is in part because baseline PCT elevation seemed to correlate with severity of injury. Only a small proportion of patients developed sepsis, thus necessitating a larger sample size to demonstrate the diagnostic usefulness of serum PCT as a marker of sepsis. Further clinical trials with larger sample sizes are required to confirm any potential role of PCT as a sepsis and outcome indicator in patients with head injuries or subarachnoid haemorrhage. PMID:15675205

Oconnor, E; Venkatesh, B; Mashongonyika, C; Lipman, J; Hall, J; Thomas, P

2004-08-01

308

Effects of an external nasal strip and frusemide on pulmonary haemorrhage in Thoroughbreds following high-intensity exercise.  

PubMed

The purpose of this study was to examine the effects of an external nasal strip (NS), frusemide (FR) and a combination of the 2 treatments (NS + FR) on exercise-induced pulmonary haemorrhage (EIPH) in Thoroughbred horses. It was hypothesised that both the NS and FR would attenuate EIPH as assessed by red blood cell count in bronchoalveolar lavage fluid. In random order, 8 horses completed each of 4 sprint exercise tests on a treadmill: 1) NS; 2) FR (0.5 mg/kg bwt i.v., 4 h pre-exercise); 3) NS + FR; and 4) control (C; no treatment). After a 5 min warm-up (4.5 m/s), horses completed 2 min running at 120% maximum oxygen consumption (VO2max) with the treadmill set at 3 degrees incline. Mean +/- s.d. running speed was 14.2+/-0.2 m/s. In the FR and NS + FR trials, horses carried weight equal to that lost as a result of frusemide administration. During exercise at 120% Vo2max, oxygen consumption (Vo2) and carbon dioxide production (Vco2) were measured at 15 s intervals. Plasma lactate concentration was measured in samples collected before exercise, at the end of the sprint and after 5 min cool-down at the trot. Thirty minutes after the run, bronchoalveolar lavage (BAL) was performed and the red cell count in the fluid quantified. Vo2 and Vco2 were significantly lower in NS and NS + FR trials than in the C and FR trials at the end of the sprint exercise protocol. However, plasma lactate concentrations did not differ among treatments. Compared with the C trial (61.1+/-30.5 x 10(6) red blood cells/ml BAL fluid), pulmonary haemorrhage was significantly (P<0.05) decreased in both the NS (15.9+/-4.0 x 106 RBC/ml) and FR (12.2+/-5.8 x 10(6) RBC/ml) trials. EIPH in the NS + FR trial (7.9+/-1.0 x 10(6) RBC/ml) was further diminished (P<0.05) compared to the NS trial, but not different from the FR trial. We conclude that both the external nasal strip and frusemide attenuate pulmonary haemorrhage in Thoroughbred horses during high-speed sprint exercise. The external nasal strip appears to lower the metabolic cost of supramaximal exertion in horses. Given the purported ergogenic effects of frusemide, the external nasal strip is a valuable alternative for the attenuation of EIPH. PMID:11720029

Geor, R J; Ommundson, L; Fenton, G; Pagan, J D

2001-11-01

309

Exercise-induced pulmonary haemorrhage (EIPH) in horses results from locomotory impact induced trauma--a novel, unifying concept.  

PubMed

Exercise-induced pulmonary haemorrhage (EIPH) in horses, although of major welfare and economic importance worldwide, is of uncertain cause. It is accepted that the dorsocaudal region of the lung is particularly prone to the condition, but present theories of causation cannot satisfactorily explain the mechanism or pattern of occurrence. We propose that EIPH results from locomotory impact induced trauma; the mechanism being similar to that producing lung tissue damage following thoracic impact injury. In impact injury, the localised impulsive load on the chest wall is transmitted by pressure waves through the lung at a slower speed than in the chest wall. The waves are subsequently reflected from the distal chest wall and other structures, producing a complex pattern of wave motion; waves travelling from regions of large cross-section to narrower ones are amplified in magnitude, consequently these regions can experience very high local stresses. Compression/dilation and shear waves are produced within the parenchyma and the latter particularly have been implicated as the cause of parenchymal damage and rupture with oedema and haemorrhage. This form of soft tissue damage has been shown to occur at remarkably low loads with an impact velocity greater than about 11 m/s and pressure exceeding approximately 14 kPa. In the horse, the lung is subjected to comparable levels of locomotory derived impulsive force during moderate to high speed exercise and this is the basis of the mechanism causing EIPH. During locomotion, the force following ground-strike of the front legs is transmitted, with some attenuation, through the forelimbs to the scapulae. The anatomical arrangement of the scapula, coupled with the direction of the force at the shoulder (scapulo humeral joint) produces an impulsive force on the rib cage, approximately just below mid height of the frontal aspect of the chest approximately over the fourth rib. As a result, pressure waves are transmitted through the lung parenchyma towards the dorsal and caudal regions; these waves are subsequently reflected at the distal chest wall, spine and diaphragm causing a complex pattern of wave interaction. The observed locations of EIPH are at the sites where wave intensity is expected to be greatest due to changes in cross section and reflection. Based on available information, it is estimated that impulsive forces of more than 100 kPa, lasting approximately 10 ms, would be applied to the chest wall by each scapula in a 500 kg horse when galloping; this level of force would be sufficient to cause oedema and haemorrhage as observed in impact induced injury. PMID:9622318

Schroter, R C; Marlin, D J; Denny, E

1998-05-01

310

Expert consultation on risk factors for introduction of infectious pathogens into fish farms.  

PubMed

An expert consultation was conducted to provide quantitative parameters required to inform risk-based surveillance of aquaculture holdings for selected infectious hazards. The hazards were four fish diseases endemic in some or several European countries: infectious salmon anaemia (ISA), viral haemorrhagic septicaemia (VHS), infectious haematopoietic necrosis (IHN), and koi herpes virus disease (KHD). Experts were asked to provide estimates for the relative importance of 5 risk themes for the hazard to be introduced into and infect susceptible fish at the destination. The 5 risk themes were: (1) live fish and egg movements; (2) exposure via water; (3) on-site processing; (4) short distance mechanical transmission and (5) distance independent mechanical transmission. The experts also provided parameter estimates for hazard transmission pathways within the themes. The expert consultation was undertaken in a 2 step approach: an online survey followed by an expert consultation meeting. The expert opinion indicated that live fish movements and exposure via water were the major relevant risk themes. Experts were recruited from several European countries and thus covered a range of farming systems. Therefore, the outputs from the expert consultation have relevance for the European context. PMID:24780587

Oidtmann, Birgit C; Peeler, Edmund J; Thrush, Mark A; Cameron, Angus R; Reese, R Allan; Pearce, Fiona M; Dunn, Peter; Lyngstad, Trude M; Tavornpanich, Saraya; Brun, Edgar; Stärk, Katharina D C

2014-08-01

311

Standard anticoagulation for mesenteric vein thrombosis, revealing a 'zebra' diagnosis: hereditary haemorrhagic telangiectasia--the dripping truth!  

PubMed

A 60-year-old man was treated in the hospital for mesenteric vein thrombosis and discharged home on anticoagulation. On warfarin the patient started to bleed profusely from the nose and tongue. He was evaluated by ENT (ears, nose and throat); a nasal endoscopy revealed several vascular ectasias. Subsequent detailed history and general physical examination established the diagnosis of hereditary haemorrhagic telangiectasia also known as Osler-Weber-Rendu syndrome. On further evaluation, pulmonary arteriovenous malformations were diagnosed on imaging and treated by intervention radiology. In hindsight, the diagnosis could have been made in the general practitioner's office with just a routine thorough history and a physical examination at a new patient visit. We report this case to stress upon the importance of vigilant clinical, medical and family history and a thorough examination to establish an early diagnosis of this not-so-rare entity. PMID:24165501

Aggarwal, Aakash; Kahlon, Arundeep Singh; Rane, Meghan; Banas, Emerald

2013-01-01

312

A novel vaccine against Crimean-Congo Haemorrhagic Fever protects 100% of animals against lethal challenge in a mouse model.  

PubMed

Crimean-Congo Haemorrhagic Fever (CCHF) is a severe tick-borne disease, endemic in many countries in Africa, the Middle East, Eastern Europe and Asia. Between 15-70% of reported cases are fatal. There is no approved vaccine available, and preclinical protection in vivo by an experimental vaccine has not been demonstrated previously. In the present study, the attenuated poxvirus vector, Modified Vaccinia virus Ankara, was used to develop a recombinant candidate vaccine expressing the CCHF virus glycoproteins. Cellular and humoral immunogenicity was confirmed in two mouse strains, including type I interferon receptor knockout mice, which are susceptible to CCHF disease. This vaccine protected all recipient animals from lethal disease in a challenge model adapted to represent infection via a tick bite. Histopathology and viral load analysis of protected animals confirmed that they had been exposed to challenge virus, even though they did not exhibit clinical signs. This is the first demonstration of efficacy of a CCHF vaccine. PMID:24621656

Buttigieg, Karen R; Dowall, Stuart D; Findlay-Wilson, Stephen; Miloszewska, Aleksandra; Rayner, Emma; Hewson, Roger; Carroll, Miles W

2014-01-01

313

Risk factors for development of sterile haemorrhagic cystitis in canine lymphoma patients receiving oral cyclophosphamide: a case-control study.  

PubMed

Sterile haemorrhagic cystitis (SHC) is a known risk of cyclophosphamide treatment; however, most canine reports are case series. This case-control study examined risk factors for SHC in dogs with lymphoma receiving oral cyclophosphamide. Twenty-two dogs with SHC and 66 control dogs were identified. On univariate analysis, SHC risk factors included age (P?=?0.041), induction protocol (P?=?0.021) and cumulative cyclophosphamide dose (P?=?0.002). On multivariate analysis, increasing cumulative cyclophosphamide dose was associated with increased risk of SHC and the 'short' induction protocol (protocol 1) was associated with decreased risk. Controlling for age and induction protocol, odds of SHC increased by 2.21 per 750?mg?m(-2) increase in cyclophosphamide dose (P?=?0.001). SHC from oral cyclophosphamide is a predominately delayed toxicity resulting from high cumulative doses. PMID:23078083

Gaeta, R; Brown, D; Cohen, R; Sorenmo, K

2014-12-01

314

High virulence differences among phylogenetically distinct isolates of the fish rhabdovirus viral hemorrhagic septicaemia virus are not explained by variability of the surface glycoprotein G or the non-virion protein Nv.  

PubMed

Viral hemorrhagic septicaemia virus (VHSV) is an important viral pathogen in European rainbow trout farming. Isolates from wild marine fish and freshwater trout farms show highly different virulence profiles: isolates from marine fish species cause little or no mortality in rainbow trout following experimental waterborne challenge, whilst challenge with rainbow trout isolates results in high levels of mortality. Phylogenetic analyses have revealed that the highly virulent trout-derived isolates from freshwater farms have evolved from VHSV isolates from marine fish host species over the past 60 years. Recent isolates from rainbow trout reared in marine zones show intermediate virulence. The present study aimed to identify molecular virulence markers that could be used to classify VHSV isolates according to their ability to cause disease in rainbow trout. By a reverse genetics approach using a VHSV-related novirhabdovirus [infectious hematopoietic necrosis virus (IHNV)], four chimaeric IHNV-VHSV recombinant viruses were generated. These chimaeric viruses included substitution of the IHNV glyco- (G) or non-structural (Nv) protein with their counterparts from either a trout-derived or a marine VHSV strain. Comparative challenge experiments in rainbow trout fingerlings revealed similar levels of survival induced by the recombinant (r)IHNV-VHSV chimaeric viruses regardless of whether the G or Nv genes originated from VHSV isolated from a marine fish species or from rainbow trout. Interestingly, recombinant IHNV gained higher virulence following substitution of the G gene with those of the VHSV strains, whilst the opposite was the case following substitution of the Nv genes. PMID:24189623

Einer-Jensen, Katja; Harmache, Abdallah; Biacchesi, Stéphane; Bremont, Michel; Stegmann, Anders; Lorenzen, Niels

2014-02-01

315

Pulmonary Delivery of an Ultra-Fine Oxytocin Dry Powder Formulation: Potential for Treatment of Postpartum Haemorrhage in Developing Countries  

PubMed Central

Oxytocin is recommended by the World Health Organisation as the most effective uterotonic for the prevention and treatment of postpartum haemorrhage. The requirement for parenteral administration by trained healthcare providers and the need for the drug solution to be maintained under cold-chain storage limit the use of oxytocin in the developing world. In this study, a spray-dried ultrafine formulation of oxytocin was developed with an optimal particle size diameter (1-5 µm) to facilitate aerosolised delivery via the lungs. A powder formulation of oxytocin, using mannitol, glycine and leucine as carriers, was prepared with a volume-based median particle diameter of 1.9 µm. Oxytocin content in the formulation was assayed using high-performance liquid chromatography-mass spectroscopy and was found to be unchanged after spray-drying. Ex vivo contractility studies utilising human and ovine uterine tissue indicated no difference in the bioactivity of oxytocin before and after spray-drying. Uterine electromyographic (EMG) activity in postpartum ewes following pulmonary (in vivo) administration of oxytocin closely mimicked that observed immediately postpartum (0-12 h following normal vaginal delivery of the lamb). In comparison to the intramuscular injection, pulmonary administration of an oxytocin dry powder formulation to postpartum ewes resulted in generally similar EMG responses, however a more rapid onset of uterine EMG activity was observed following pulmonary administration (129 ± 18 s) than intramuscular injection (275 ± 22 s). This is the first study to demonstrate the potential for oxytocin to elicit uterine activity after systemic absorption as an aerosolised powder from the lungs. Aerosolised oxytocin has the potential to provide a stable and easy to administer delivery system for effective prevention and treatment of postpartum haemorrhage in resource-poor settings in the developing world. PMID:24376618

Ibrahim, Jibriil P.; Bischof, Robert J.; Nassta, Gemma C.; Olerile, Livesey D.; Russell, Adrian S.; Meiser, Felix; Parkington, Helena C.; Coleman, Harold A.; Morton, David A. V.; McIntosh, Michelle P.

2013-01-01

316

Pulmonary delivery of an ultra-fine oxytocin dry powder formulation: potential for treatment of postpartum haemorrhage in developing countries.  

PubMed

Oxytocin is recommended by the World Health Organisation as the most effective uterotonic for the prevention and treatment of postpartum haemorrhage. The requirement for parenteral administration by trained healthcare providers and the need for the drug solution to be maintained under cold-chain storage limit the use of oxytocin in the developing world. In this study, a spray-dried ultrafine formulation of oxytocin was developed with an optimal particle size diameter (1-5 µm) to facilitate aerosolised delivery via the lungs. A powder formulation of oxytocin, using mannitol, glycine and leucine as carriers, was prepared with a volume-based median particle diameter of 1.9 µm. Oxytocin content in the formulation was assayed using high-performance liquid chromatography-mass spectroscopy and was found to be unchanged after spray-drying. Ex vivo contractility studies utilising human and ovine uterine tissue indicated no difference in the bioactivity of oxytocin before and after spray-drying. Uterine electromyographic (EMG) activity in postpartum ewes following pulmonary (in vivo) administration of oxytocin closely mimicked that observed immediately postpartum (0-12 h following normal vaginal delivery of the lamb). In comparison to the intramuscular injection, pulmonary administration of an oxytocin dry powder formulation to postpartum ewes resulted in generally similar EMG responses, however a more rapid onset of uterine EMG activity was observed following pulmonary administration (129 ± 18 s) than intramuscular injection (275 ± 22 s). This is the first study to demonstrate the potential for oxytocin to elicit uterine activity after systemic absorption as an aerosolised powder from the lungs. Aerosolised oxytocin has the potential to provide a stable and easy to administer delivery system for effective prevention and treatment of postpartum haemorrhage in resource-poor settings in the developing world. PMID:24376618

Prankerd, Richard J; Nguyen, Tri-Hung; Ibrahim, Jibriil P; Bischof, Robert J; Nassta, Gemma C; Olerile, Livesey D; Russell, Adrian S; Meiser, Felix; Parkington, Helena C; Coleman, Harold A; Morton, David A V; McIntosh, Michelle P

2013-01-01

317

Global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990-2010: findings from the Global Burden of Disease Study 2010  

PubMed Central

Summary Background The burden of ischaemic and haemorrhagic stroke varies between regions and over time. With differences in prognosis, prevalence of risk factors, and treatment strategies, knowledge of stroke pathological type is important for targeted region-specific health-care planning for stroke and could inform priorities for type-specific prevention strategies. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) to estimate the global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990–2010. Methods We searched Medline, Embase, LILACS, Scopus, PubMed, Science Direct, Global Health Database, the WHO library, and regional databases from 1990 to 2012 to identify relevant studies published between 1990 and 2010. We applied the GBD 2010 analytical technique (DisMod-MR) to calculate regional and country-specific estimates for ischaemic and haemorrhagic stroke incidence, mortality, mortality-to-incidence ratio, and disability-adjusted life-years (DALYs) lost, by age group (aged <75 years, ?75 years, and in total) and country income level (high-income and low-income and middle-income) for 1990, 2005, and 2010. Findings We included 119 studies (58 from high-income countries and 61 from low-income and middle-income countries). Worldwide, the burden of ischaemic and haemorrhagic stroke increased significantly between 1990 and 2010 in terms of the absolute number of people with incident ischaemic and haemorrhagic stroke (37% and 47% increase, respectively), number of deaths (21% and 20% increase), and DALYs lost (18% and 14% increase). In the past two decades in high-income countries, incidence of ischaemic stroke reduced significantly by 13% (95% CI 6–18), mortality by 37% (19–39), DALYs lost by 34% (16–36), and mortality-to-incidence ratios by 21% (10–27). For haemorrhagic stroke, incidence reduced significantly by 19% (1–15), mortality by 38% (32–43), DALYs lost by 39% (32–44), and mortality-to-incidence ratios by 27% (19–35). By contrast, in low-income and middle-income countries, we noted a significant increase of 22% (5–30) in incidence of haemorrhagic stroke and a 6% (–7 to 18) non-significant increase in the incidence of ischaemic stroke. Mortality rates for ischaemic stroke fell by 14% (9–19), DALYs lost by 17% (–11 to 21%), and mortality-to-incidence ratios by 16% (–12 to 22). For haemorrhagic stroke in low-income and middle-income countries, mortality rates reduced by 23% (–18 to 25%), DALYs lost by 25% (–21 to 28), and mortality-to-incidence ratios by 36% (–34 to 28). Interpretation Although age-standardised mortality rates for ischaemic and haemorrhagic stroke have decreased in the past two decades, the absolute number of people who have these stroke types annually, and the number with related deaths and DALYs lost, is increasing, with most of the burden in low-income and middle-income countries. Further study is needed in these countries to identify which subgroups of the population are at greatest risk and who could be targeted for preventive efforts. PMID:25104492

Krishnamurthi, Rita V; Feigin, Valery L; Forouzanfar, Mohammad H; Mensah, George A; Connor, Myles; Bennett, Derrick A; Moran, Andrew E; Sacco, Ralph L; Anderson, Laurie M; Truelsen, Thomas; O'Donnell, Martin; Venketasubramanian, Narayanaswamy; Barker-Collo, Suzanne; Lawes, Carlene M M; Wang, Wenzhi; Shinohara, Yukito; Witt, Emma; Ezzati, Majid; Naghavi, Mohsen; Murray, Christopher

2014-01-01

318

Clinical Manifestations and Case Management of Ebola Haemorrhagic Fever Caused by a Newly Identified Virus Strain, Bundibugyo, Uganda, 2007-2008  

PubMed Central

A confirmed Ebola haemorrhagic fever (EHF) outbreak in Bundibugyo, Uganda, November 2007–February 2008, was caused by a putative new species (Bundibugyo ebolavirus). It included 93 putative cases, 56 laboratory-confirmed cases, and 37 deaths (CFR?=?25%). Study objectives are to describe clinical manifestations and case management for 26 hospitalised laboratory-confirmed EHF patients. Clinical findings are congruous with previously reported EHF infections. The most frequently experienced symptoms were non-bloody diarrhoea (81%), severe headache (81%), and asthenia (77%). Seven patients reported or were observed with haemorrhagic symptoms, six of whom died. Ebola care remains difficult due to the resource-poor setting of outbreaks and the infection-control procedures required. However, quality data collection is essential to evaluate case definitions and therapeutic interventions, and needs improvement in future epidemics. Organizations usually involved in EHF case management have a particular responsibility in this respect. PMID:23285243

Roddy, Paul; Howard, Natasha; Van Kerkhove, Maria D.; Lutwama, Julius; Wamala, Joseph; Yoti, Zabulon; Colebunders, Robert; Palma, Pedro Pablo; Sterk, Esther; Jeffs, Benjamin; Van Herp, Michel; Borchert, Matthias

2012-01-01

319

Acute post-stroke blood pressure relative to premorbid levels in intracerebral haemorrhage versus major ischaemic stroke: a population-based study  

PubMed Central

Summary Background It is often assumed that blood pressure increases acutely after major stroke, resulting in so-called post-stroke hypertension. In view of evidence that the risks and benefits of blood pressure-lowering treatment in acute stroke might differ between patients with major ischaemic stroke and those with primary intracerebral haemorrhage, we compared acute-phase and premorbid blood pressure levels in these two disorders. Methods In a population-based study in Oxfordshire, UK, we recruited all patients presenting with stroke between April 1, 2002, and March 31, 2012. We compared all acute-phase post-event blood pressure readings with premorbid readings from 10-year primary care records in all patients with acute major ischaemic stroke (National Institutes of Health Stroke Scale >3) versus those with acute intracerebral haemorrhage. Findings Of 653 consecutive eligible patients, premorbid and acute-phase blood pressure readings were available for 636 (97%) individuals. Premorbid blood pressure (total readings 13?244) had been measured on a median of 17 separate occasions per patient (IQR 8–31). In patients with ischaemic stroke, the first acute-phase systolic blood pressure was much lower than after intracerebral haemorrhage (158·5 mm Hg [SD 30·1] vs 189·8 mm Hg [38·5], p<0·0001; for patients not on antihypertensive treatment 159·2 mm Hg [27·8] vs 193·4 mm Hg [37·4], p<0·0001), was little higher than premorbid levels (increase of 10·6 mm Hg vs 10-year mean premorbid level), and decreased only slightly during the first 24 h (mean decrease from <90 min to 24 h 13·6 mm Hg). By contrast with findings in ischaemic stroke, the mean first systolic blood pressure after intracerebral haemorrhage was substantially higher than premorbid levels (mean increase of 40·7 mm Hg, p<0·0001) and fell substantially in the first 24 h (mean decrease of 41·1 mm Hg; p=0·0007 for difference from decrease in ischaemic stroke). Mean systolic blood pressure also increased steeply in the days and weeks before intracerebral haemorrhage (regression p<0·0001) but not before ischaemic stroke. Consequently, the first acute-phase blood pressure reading after primary intracerebral haemorrhage was more likely than after ischaemic stroke to be the highest ever recorded (OR 3·4, 95% CI 2·3–5·2, p<0·0001). In patients with intracerebral haemorrhage seen within 90 min, the highest systolic blood pressure within 3 h of onset was 50 mm Hg higher, on average, than the maximum premorbid level whereas that after ischaemic stroke was 5·2 mm Hg lower (p<0·0001). Interpretation Our findings suggest that systolic blood pressure is substantially raised compared with usual premorbid levels after intracerebral haemorrhage, whereas acute-phase systolic blood pressure after major ischaemic stroke is much closer to the accustomed long-term premorbid level, providing a potential explanation for why the risks and benefits of lowering blood pressure acutely after stroke might be expected to differ. Funding Wellcome Trust, Wolfson Foundation, UK Medical Research Council, Stroke Association, British Heart Foundation, National Institute for Health Research. PMID:24582530

Fischer, Urs; Cooney, Marie Therese; Bull, Linda M; Silver, Louise E; Chalmers, John; Anderson, Craig S; Mehta, Ziyah; Rothwell, Peter M

2014-01-01

320

Use of the non-pneumatic anti-shock garment (NASG) to reduce blood loss and time to recovery from shock for women with obstetric haemorrhage in Egypt  

Microsoft Academic Search

Obstetric haemorrhage is one of the leading causes of maternal mortality. In many low-resource settings, delays in transport to referral facilities and in obtaining lifesaving treatment, contribute to maternal deaths. The non-pneumatic anti-shock garment (NASG) is a low-technology pressure device that decreases blood loss, restores vital signs, and has the potential to improve adverse outcomes by helping women survive delays

S. Miller; J. M. Turan; K. Dau; M. Fathalla; M. Mourad; T. Sutherland; S. Hamza; F. Lester; E. B. Gibson; R. Gipson; K. Nada; P. Hensleigh

2007-01-01

321

Protein kinase C inhibition prevents upregulation of vascular ETB and 5HT1B receptors and reverses cerebral blood flow reduction after subarachnoid haemorrhage in rats  

Microsoft Academic Search

The pathogenesis of cerebral ischaemia after subarachnoid haemorrhage (SAH) still remains elusive. The purpose of the present study was to examine whether specific protein kinas C (PKC) inhibition in rats could alter the transcriptional SAH induced Endothelin (ET) type B and 5-hydroxytryptamine type 1B (5-HT1B) receptor upregulation and prevent the associated cerebral blood flow (CBF) reduction. The PKC inhibitor RO-31-7549

Saema S Beg; Jacob A Hansen-Schwartz; Petter J Vikman; Cang-Bao Xu; Lars I Edvinsson

2007-01-01

322

The role of the sympathetic nervous system in the resuscitative effect of stimulating the central serotonin 1A receptors in haemorrhagic shock in rats.  

PubMed

Haemorrhagic shock is a life threatening condition, and, as such, it is important to understand the mechanisms taking part in its reversal. In the 1990s, it was shown that activation of serotonin 1A receptors is responsible for the circulatory decompensation and development of the sympathoinhibitory phase. In previous reports, it was demonstrated that activation of serotonin 1A receptors induces resuscitative effects in haemorrhaged rats. However, the effectory mechanisms still require further investigation. The aim of the present study was to determine whether the sympathetic nervous system participates in the effects of serotonin through central serotonin 1A receptors in haemorrhagic shock in rats. In order to determine the role of the sympathetic nervous system alpha-1-, alpha-2-, and beta-adrenergic receptor agonists - prazosin, yohimbine and propranolol, respectively, were used. We found that stimulation of the central serotonin 1A receptors by the administration of a selective agonist - 8-hydroxy-2-(di-n-propylamino)tetralin, 1-(2,5-dimethoxy-4-iodophenyl)-aminopropane (8-OH-DPAT) into the lateral brain ventricle is connected with the activation of compensation mechanisms leading to the increase in the heart rate and blood pressure. The current results demonstrate that the stimulation of peripheral alpha-1-, alpha-2- and beta-adrenergic receptors plays an essential role in the resuscitative effect triggered by the stimulation of central serotonin 1A receptors. PMID:24681056

Sowa, Pawel; Adamczyk-Sowa, Monika; Zwirska-Korczala, Krystyna; Misiolek, Maciej; Pierzchala, Krystyna

2014-06-01

323

Molecular diagnostic and genetic characterization of highly pathogenic viruses: application during Crimean-Congo haemorrhagic fever virus outbreaks in Eastern Europe and the Middle East  

PubMed Central

Several haemorrhagic fevers are caused by highly pathogenic viruses that must be handled in Biosafety level 4 (BSL–4) containment. These zoonotic infections have an important impact on public health and the development of a rapid and differential diagnosis in case of outbreak in risk areas represents a critical priority. We have demonstrated the potential of a DNA resequencing microarray (PathogenID v2.0) for this purpose. The microarray was first validated in vitro using supernatants of cells infected with prototype strains from five different families of BSL-4 viruses (e.g. families Arenaviridae, Bunyaviridae, Filoviridae, Flaviviridae and Paramyxoviridae). RNA was amplified based on isothermal amplification by Phi29 polymerase before hybridization. We were able to detect and characterize Nipah virus and Crimean–Congo haemorrhagic fever virus (CCHFV) in the brains of experimentally infected animals. CCHFV was finally used as a paradigm for epidemics because of recent outbreaks in Turkey, Kosovo and Iran. Viral variants present in human sera were characterized by BLASTN analysis. Sensitivity was estimated to be 105–106 PFU/mL of hybridized cDNA. Detection specificity was limited to viral sequences having ?13–14% of global divergence with the tiled sequence, or stretches of ?20 identical nucleotides. These results highlight the benefits of using the PathogenID v2.0 resequencing microarray to characterize geographical variants in the follow-up of haemorrhagic fever epidemics; to manage patients and protect communities; and in cases of bioterrorism. PMID:23240764

Filippone, C; Marianneau, P; Murri, S; Mollard, N; Avsic-Zupanc, T; Chinikar, S; Despres, P; Caro, V; Gessain, A; Berthet, N; Tordo, N

2013-01-01

324

Pressor effects of the alpha 2-adrenoceptor agonist B-HT 933 in anaesthetized and haemorrhagic rats: comparison with the haemodynamic effects of amidephrine.  

PubMed Central

1. Blood pressure responses to single and multiple bolus doses of the alpha 2-adrenoceptor agonist B-HT 933 were analysed in intact anaesthetized rats which were either normotensive or hypotensive as a result of haemorrhage. Single bolus doses of B-HT 933 in normotensive rats induced a fall in blood pressure, whilst further doses induced dose-dependent pressor responses which were inhibited by the alpha 2-adrenoceptor antagonist yohimbine and unaffected by the alpha 1-adrenoceptor agonist prazosin. In the haemorrhagic, hypotensive animals, single bolus doses of B-HT 933 induced immediate dose-dependent pressor responses; the maximum pressor responses to the bolus of B-HT 933 and its ED50 values were the same in both the normotensive and hypotensive, haemorrhagic animals. 2. Cardiac output, its distribution and tissue blood flows were determined with tracer microspheres in intact anaesthetized normotensive and haemorrhagic, hypotensive rats during depressor (normotensive) and pressor (normotensive and hypotensive) responses to B-HT 933. Haemodynamics were also determined during pressor responses to the alpha 1-adrenoceptor agonist amidephrine. 3. In control normotensive rats, a single dose of B-HT 933 (1 mg kg-1) reduced blood pressure by reducing cardiac output (through a decrease in heart rate). It increased the fractional distribution of cardiac output to the spleen and stomach, reduced it to the heart and liver and reduced cardiac and hepatic blood flow. A further dose of B-HT 933 (1 mg kg-1 bolus followed by 100 micrograms min-1 infusion) increased blood pressure by increasing total peripheral resistance, which was accompanied by decreased proportions of cardiac output passing to the heart, liver and testes. There was also increased fractional distribution of cardiac output to the lungs, spleen, kidneys and stomach but blood flows through the liver and testes were reduced. Amidephrine (6 micrograms kg-1 bolus followed by 0.5 micrograms min-1 infusion) increased blood pressure by increasing cardiac output through an increased stroke volume. It increased cardiac output distribution to the kidneys and brain, increasing blood flow through the heart, lungs, brain, testes, epididimides, skin and large intestine. 4. Haemorrhage caused a fall in blood pressure which resulted from decreased total peripheral resistance and cardiac output (the latter due to decreases in both heart rate and stroke volume). It reduced the proportion of cardiac output distributed to the lungs, spleen, kidneys, testes and pancreas/mesentery and decreased blood flow through these organs as well as through the heart, liver, brain, epididimides, skin and the gastrointestinal tract.4 PMID:2569342

MacLean, M. R.; Thomson, M.; Hiley, C. R.

1989-01-01

325

Effect of routine controlled cord traction as part of the active management of the third stage of labour on postpartum haemorrhage: multicentre randomised controlled trial (TRACOR)  

PubMed Central

Objective To assess the impact of controlled cord traction on the incidence of postpartum haemorrhage and other characteristics of the third stage of labour in a high resource setting. Design Randomised controlled trial. Setting Five university hospital maternity units in France. Participants Women aged 18 or more with a singleton fetus at 35 or more weeks’ gestation and planned vaginal delivery. Interventions Women were randomly assigned to management of the third stage of labour by controlled cord traction or standard placenta expulsion (awaiting spontaneous placental separation before facilitating expulsion). Women in both arms received prophylactic oxytocin just after birth. Main outcome measure Incidence of postpartum haemorrhage ?500 mL as measured in a collector bag. Results The incidence of postpartum haemorrhage did not differ between the controlled cord traction arm (9.8%, 196/2005) and standard placenta expulsion arm (10.3%, 206/2008): relative risk 0.95 (95% confidence interval 0.79 to 1.15). The need for manual removal of the placenta was significantly less frequent in the controlled cord traction arm (4.2%, 85/2033) compared with the standard placenta expulsion arm (6.1%, 123/2024): relative risk 0.69, 0.53 to 0.90); as was third stage of labour of more than 15 minutes (4.5%, 91/2030 and 14.3%, 289/2020, respectively): relative risk 0.31, 0.25 to 0.39. Women in the controlled cord traction arm reported a significantly lower intensity of pain and discomfort during the third stage than those in the standard placenta expulsion arm. No uterine inversion occurred in either arm. Conclusions In a high resource setting, the use of controlled cord traction for the management of placenta expulsion had no significant effect on the incidence of postpartum haemorrhage and other markers of postpartum blood loss. Evidence to recommend routine controlled cord traction for the management of placenta expulsion to prevent postpartum haemorrhage is therefore lacking. Trial registration ClinicalTrials.gov NCT01044082. PMID:23538918

2013-01-01

326

Epizootic haemorrhagic disease virus in Reunion Island: evidence for the circulation of a new serotype and associated risk factors.  

PubMed

Bluetongue virus (BTV) and epizootic haemorrhagic disease virus (EHDV) are members of the Orbivirus genus of the Reoviridae family transmitted between ruminants by the bites of Culicoides midges. BTV went undetected in Reunion Island between its first documented emergence in 1979 and two other serious outbreaks with both BTV-3 and EHDV-6 in 2003, and both EHDV-6 and BTV-2 in 2009. In these outbreaks, infected animals developed symptoms including hyperthermia, anorexia, congestion, prostration and nasal discharge. Samples were collected in 2011 to assess the prevalence of BT and EHD in ruminants native to Reunion Island by serological analysis. A cross-sectional study was undertaken on 67 farms, including a total of 276 cattle, 142 sheep and 71 goats. The prevalence rates of BT and EHD were 58% (95% CI [54.03-62.94]) and 38% (95% CI [33.85-42.63], respectively. Two further suspected outbreaks were confirmed to involve EHDV and BTV/EHDV. A new circulating EHDV serotype 1 of unknown origin was isolated. Our results confirm that the prevalence of both BT and EHD is high and that both are likely currently circulating. A high risk of BTV and EHDV infections was associated with the introduction of ruminants from neighbouring farms without quarantine, the presence of organic and other waste on the farm, and treatment against ectoparasites and insects. PMID:24636165

Cêtre-Sossah, Catherine; Roger, Matthieu; Sailleau, Corinne; Rieau, Lorène; Zientara, Stephan; Bréard, Emmanuel; Viarouge, Cyril; Beral, Marina; Esnault, Olivier; Cardinale, Eric

2014-06-01

327

Intrapulmonary administration of recombinant activated factor VII in diffuse alveolar haemorrhage: a report of two case stories  

PubMed Central

Background Diffuse alveolar haemorrhage (DAH) is a serious pulmonary complication characterised by a high mortality rate and the absence of specific treatment. The intrapulmonary administration of activated recombinant factor VII (rFVIIa) in DAH was recently published in six patients by Heslet et al with an efficient hemostatic effect. We describe two cases of DAH treated with intrapulmonary rFVIIa. Methods Two cases of DAH were admitted to the ICU after presenting abrupt desaturation, tachypnea, cough and haemoptysis, requiring orotracheal intubation and mechanical ventilation. The diagnosis was achieved by the bloody return during the bronchoalveolar lavage, during the procedure rFVIIa (50 ?g/Kg in 50 ml of isotonic saline) was administered via the bronchoscope. Results Immediate cessation of bleeding was observed. Prior to intrapulmonary administration of rFVIIa, the FiO2 was 1, which was reduced to 0.4 24 hours later. Following the procedure, the haemostatic effect made blood transfusion superfluous. No thrombotic complications associated with administration of the drug were observed. After the intervention both cases progressed fast and was discharged from the ICU with no further episodes of bleeding. Conclusion 1. Local intrabronchial deposition of DAH with rFVIIa has been shown to be effective in controlling life-threatening DAH. 2. In the case described above, no thrombotic complications were observed following the intrapulmonary administration of rFVIIa. PMID:18789132

Estella, Ángel; Jareño, Antonio; Perez-Bello Fontaiña, Luis

2008-01-01

328

The impact of postpartum haemorrhage management guidelines implemented in clinical practice: a systematic review of the literature.  

PubMed

Postpartum haemorrhage (PPH) is an urgent obstetric condition requiring an immediate response and a multidisciplinary approach. The aim of this study was to review PPH management guidelines implemented in clinical practice, to evaluate their impact regarding prevention, diagnosis and treatment, and to analyze how the numbers of PPH cases changed in the post-intervention period. A systematic search in the PubMed database was performed. The references of all included articles were examined. Studies evaluating the management of PPH and the impact on the numbers of cases of this pathology after the implementation of new or updated guidelines were involved in the analysis. Two reviewers independently examined the titles and abstracts of all identified citations, selected potentially eligible studies, and evaluated their full-text versions. Methodological quality was assessed using a checklist based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. We analyzed seven articles that evaluated the impact of new or updated guidelines for PPH management implemented in clinical practice. In four trials, the numbers of PPH cases declined after the intervention. Guidelines for PPH management can have a positive impact on the reduction of the number of PPH cases. PMID:24792537

Nadisauskiene, Ruta J; Kliucinskas, Mindaugas; Dobozinskas, Paulius; Kacerauskiene, Justina

2014-07-01

329

Brain abscess developing in a non-operated spontaneous intracerebral haemorrhage: a case report and literature review.  

PubMed

Brain abscesses are a rare but potentially lethal neurological lesions, generally occurring after septic episodes in immunodeficient patients or complicating neurosurgical procedures. Even though they are known complications of surgically treated intracerebral haemorrhages (ICH), the presence of a brain abscess at the site of an untreated ICH is a rare event. Such cases may result from haematogenous spread from distant foci or contiguous sites and are often preceded by episodes of sepsis and local infection. Immunodeficiency, AIDS, age, diabetes mellitus and vitamin-K deficiency are predisposing factors. Abscess formation should be considered in case of clinical deterioration, headache, and any neurological deficit after febrile episodes. Early diagnosis with neuroradiological imaging, infection blood markers and microbiological identification of the causative pathogen is crucial for treatment with surgical drainage or excision and specific antibiotic therapy, which guarantee good outcome and long-term survival. In fact, while prompt diagnosis and treatment guarantee good outcome and long-term survival, morbidity and mortality are very high in case of misdiagnosis. We report a case of a 49-year old man presenting with a brain abscess 13 weeks after a spontaneous ICH, without previous episodes of sepsis and with a suspected septic arthritis 2 weeks after abscess drainage. PMID:24310475

Rigante, Luigi; Tufo, Tommaso; Scoppettuolo, Giancarlo; Donato, Concetta; Mangiola, Annunziato

2013-01-01

330

Organisation of health care during an outbreak of Marburg haemorrhagic fever in the Democratic Republic of Congo, 1999.  

PubMed

Organising health care was one of the tasks of the International Scientific and Technical Committee during the 1998-1999 outbreak in Durba/Watsa, in the north-eastern province (Province Orientale), Democratic Republic of Congo. With the logistical support of Médecins sans Frontières (MSF), two isolation units were created: one at the Durba Reference Health Centre and the other at the Okimo Hospital in Watsa. Between May 6th, the day the isolation unit was installed and May 19th, 15 patients were admitted to the Durba Health Centre. In only four of them were the diagnosis of Marburg haemorrhagic fever (MHF) confirmed by laboratory examination. Protective equipment was distributed to health care workers and family members caring for patients. Information about MHF, modes of transmission and the use of barrier nursing techniques was provided to health care workers and sterilisation procedures were reviewed. In contrast to Ebola outbreaks, there was little panic among health care workers and the general public in Durba and all health services remained operational. PMID:15066337

Colebunders, Robert; Sleurs, Hilde; Pirard, Patricia; Borchert, Matthias; Libande, Modeste; Mustin, Jean Pierre; Tshomba, Antoine; Kinuani, Léon; Olinda, Loku Abisa; Tshioko, Florimond; Muyembe-Tamfum, Jean-Jacques

2004-05-01

331

Zebrafish fin immune responses during high mortality infections with viral haemorrhagic septicemia rhabdovirus. A proteomic and transcriptomic approach  

PubMed Central

Background Despite rhabdoviral infections being one of the best known fish diseases, the gene expression changes induced at the surface tissues after the natural route of infection (infection-by-immersion) have not been described yet. This work describes the differential infected versus non-infected expression of proteins and immune-related transcripts in fins and organs of zebrafish Danio rerio shortly after infection-by-immersion with viral haemorrhagic septicemia virus (VHSV). Results Two-dimensional differential gel electrophoresis detected variations on the protein levels of the enzymes of the glycolytic pathway and cytoskeleton components but it detected very few immune-related proteins. Differential expression of immune-related gene transcripts estimated by quantitative polymerase chain reaction arrays and hybridization to oligo microarrays showed that while more transcripts increased in fins than in organs (spleen, head kidney and liver), more transcripts decreased in organs than in fins. Increased differential transcript levels in fins detected by both arrays corresponded to previously described infection-related genes such as complement components (c3b, c8 and c9) or class I histocompatibility antigens (mhc1) and to newly described genes such as secreted immunoglobulin domain (sid4), macrophage stimulating factor (mst1) and a cluster differentiation antigen (cd36). Conclusions The genes described would contribute to the knowledge of the earliest molecular events occurring in the fish surfaces at the beginning of natural rhabdoviral infections and/or might be new candidates to be tested as adjuvants for fish vaccines. PMID:20875106

2010-01-01

332

Modelling impact-initiated wave transmission through lung parenchyma in relation to the aetiology of exercise-induced pulmonary haemorrhage.  

PubMed

Recently we proposed that exercise-induced pulmonary haemorrhage (EIPH) results from locomotory-impact-induced trauma by impact of the scapula on the chest wall during footfall and the consequent transmission of waves through the lung. A computational model has been developed to demonstrate that wave amplification and focusing occur in the dorsocaudal tip of the lung for waves originating on the anterior subscapular surface. The propagation of an acoustic wave was investigated in a simplified 2-dimensional representation of a vertical anterio-dorsal section of horse lung. It was demonstrated that a complicated pattern of waves is transmitted from the scapula to the dorsal region. Wave motion was characterised using the instantaneous rate of change of pressure with time (dp/dt) which is associated with lung injury. Due to wave reflection and focusing, dp/dt is transiently very high on the spinal and diaphragmatic lung walls, particularly in the vicinity of the dorsal tip. The model therefore predicts that lung injury may occur in the region in which EIPH is reported to originate. PMID:10659218

Schroter, R C; Leeming, A; Denny, E; Bharath, A; Marlin, D J

1999-07-01

333

Exercise-induced haemorrhagic lesions in the dorsocaudal extremities of the caudal lobes of the lungs of young thoroughbred horses.  

PubMed

The dorsocaudal extremities of the caudal lobes of the lungs of racehorses are vulnerable to exercise-induced pulmonary haemorrhage (EIPH). The morphology of the lungs at these sites was studied in 13 Thoroughbred horses aged 18 to 22 months. These animals, which had been performing low-intensity exercise on a track at maximum running speeds of approximately 5-8.5 metres/second (m/s), were withdrawn from the racehorse training programme for reasons of unsuitability. Lung lesions observed in the dorsocaudal lung extremities in 10 of the 13 horses were not found in the craniodorsal or cranioventral portions of the lungs. The lesions, which resembled those previously found in Thoroughbred racehorses aged 5 to 11 years with a history of EIPH, were of two main types, namely, multifocal bronchiolar distortion and alveolar epithelialization. EIPH lesions were found only in horses that had been trained at maximum speeds greater than approximately 7.0 m/s. It would seem, therefore, that exercise intensity is an important factor in the pathogenesis of EIPH and that running speeds greater than approximately 7.0 m/s may be sufficient to generate the pulmonary vascular pressures necessary to cause EIPH lesions in young Thoroughbreds. PMID:10542123

Oikawa, M

1999-11-01

334

Detection and differentiation of epizootic haemorrhagic disease of deer and bluetongue viruses by serogroup-specific sandwich ELISA.  

PubMed

A serogroup specific sandwich ELISA was developed for the detection of epizootic haemorrhagic disease of deer viruses (EHDV) in infected insects and tissue culture preparations. Polyclonal rabbit antiserum against purified EHDV core particles was used to capture viral antigen and specific binding detected using guinea pig antisera against EHDV core particles followed by anti-guinea pig immunoglobulin enzyme-labelled conjugate. The assay is EHDV specific and detects all 8 serotypes. No cross-reactions were found with related viruses such as bluetongue (BTV), Palyam, Tilligery or African horse sickness virus (AHSV). A similar serogroup specific sandwich ELISA was also developed for BTV. The assays showed a similar sensitivity in detecting the respective EHDV or BTV antigens in a pool of 500 midges where only 2 were infected. These assays allow a simple and rapid means of detecting and differentiating members of these closely related serogroups. The sensitivity of the tests will allow more extensive studies on vector competence and virus/vector distribution. PMID:8690767

Thevasagayam, J A; Wellby, M P; Mertens, P P; Burroughs, J N; Anderson, J

1996-01-01

335

Molecular characterisation of a coxsackievirus A24 that caused an outbreak of acute haemorrhagic conjunctivitis, Tunisia 2003.  

PubMed

This study reports the genetic characteristics of coxsackievirus A24 isolates from Tunisia, including a coxsackievirus A24 variant (CVA24v) that caused an outbreak of acute haemorrhagic conjunctivitis (AHC) between September and November 2003. The virus genome was detected by PCR from conjunctival swabs obtained from patients with AHC. Four virus isolates were obtained from PCR-positive samples and were serotyped by sequence analysis of the VP1 and VP4 genomic region and by seroneutralisation. Phylogenetic analysis of the VP1, VP4 and 3C genomic regions was performed. Other Tunisian CVA24 isolates from paralytic cases and healthy individuals were also amplified, sequenced and included in the phylogenetic analysis. The epidemic strain belonged to the CVA24 serotype. Phylogenetic analysis of the 3C region of the genome revealed a strong relationship between the Tunisian epidemic strain and strains that caused outbreaks in Korea (2002) and Guadeloupe and French Guiana (2003). Phylogenetic analysis of the VP1 and VP4 regions showed a clear distinction between serotype CVA24 isolates from conjunctivitis and non-conjunctivitis cases. This is the first study to report an outbreak of AHC caused by CVA24v in the North African region. PMID:17328730

Triki, H; Rezig, D; Bahri, O; Ben Ayed, N; Ben Yahia, A; Sadraoui, A; Ayed, S

2007-02-01

336

Evolutionary history and molecular epidemiology of rabbit haemorrhagic disease virus in the Iberian Peninsula and Western Europe  

PubMed Central

Background Rabbit haemorrhagic disease virus (RHDV) is a highly virulent calicivirus, first described in domestic rabbits in China in 1984. RHDV appears to be a mutant form of a benign virus that existed in Europe long before the first outbreak. In the Iberian Peninsula, the first epidemic in 1988 severely reduced the populations of autochthonous European wild rabbit. To examine the evolutionary history of RHDV in the Iberian Peninsula, we collected virus samples from wild rabbits and sequenced a fragment of the capsid protein gene VP60. These data together with available sequences from other Western European countries, were analyzed following Bayesian Markov chain Monte Carlo methods to infer their phylogenetic relationships, evolutionary rates and demographic history. Results Evolutionary relationships of RHDV revealed three main lineages with significant phylogeographic structure. All lineages seem to have emerged at a common period of time, between ~1875 and ~1976. The Iberian Peninsula showed evidences of genetic isolation, probably due to geographic barriers to gene flow, and was also the region with the youngest MRCA. Overall, demographic analyses showed an initial increase and stabilization of the relative genetic diversity of RHDV, and a subsequent reduction in genetic diversity after the first epidemic breakout in 1984, which is compatible with a decline in effective population size. Conclusions Results were consistent with the hypothesis that the current Iberian RHDV arose from a single infection between 1869 and 1955 (95% HPD), and rendered a temporal pattern of appearance and extinction of lineages. We propose that the rising positive selection pressure observed throughout the history of RHDV is likely mediated by the host immune system as a consequence of the genetic changes that rendered the virus virulent. Consequently, this relationship is suggested to condition RHDV demographic history. PMID:21067589

2010-01-01

337

Retention in the endoplasmic reticulum is the underlying mechanism of some hereditary haemorrhagic telangiectasia type 2 ALK1 missense mutations.  

PubMed

Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant disease characterised by vascular dysplasia and increased bleeding that affect 1 in 5,000 people world-wide. Pathology is linked to mutations in genes encoding components of the heteromeric transforming growth factor-beta receptor (TGF-beta) and SMAD signalling pathway. Indeed HHT1 and HHT2 result from mutations in the genes encoding endoglin and activin-like kinase 1 (ALK1), TGF-beta receptor components. However, the fundamental cellular defects underlying HHT is poorly understood. Previously using confocal microscopy and N-glycosylation analysis, we found evidence that defective trafficking of endoglin from the endoplasmic reticulum (ER) to the plasma membrane is a mechanism underlying HHT1 in some patients. In this study, we used confocal microscopy to investigate whether a similar mechanism contributes to HHT2 pathology. To do this we expressed wild-type ALK1 and a number of HHT2 patient mutant variants as C-terminally tagged EGFP fusion proteins and tested their localisation in HeLa cells. We found that wild-type ALK1-EGFP was targeted predominantly to the plasma membrane, as evidenced by its colocalisation with the co-expressed HA-tagged endoglin. However, we found that in the majority of cases analysed the HHT2 patient mutant protein was retained within the ER as indicated by their colocalisation with the ER resident marker (calnexin) and lack of colocalisation with cell surface associated HA-endoglin. We conclude that defective trafficking and retention in the ER of mutant ALK1 protein is a possible mechanism of HHT2 in some patients. PMID:23124896

Hume, Alistair N; John, Anne; Akawi, Nadia A; Al-Awadhi, Aydah M; Al-Suwaidi, Sarah S; Al-Gazali, Lihadh; Ali, Bassam R

2013-01-01

338

Comparison of Montreal Cognitive Assessment and Mini-Mental State Examination in Evaluating Cognitive Domain Deficit Following Aneurysmal Subarachnoid Haemorrhage  

PubMed Central

Objective Cognitive deficits are common after aneurysmal subarachnoid haemorrhage (aSAH), and clinical evaluation is important for their management. Our hypothesis was that the Montreal Cognitive Assessment (MoCa) is superior to the Mini-Mental State Examination (MMSE) in screening for cognitive domain deficit in aSAH patients. Methods We carried out a prospective observational and diagnostic accuracy study on Hong Kong aSAH patients aged 21 to 75 years who had been admitted within 96 hours of ictus. The domain-specific neuropsychological assessment battery, the MoCA and MMSE were administered 2–4 weeks and 1 year after ictus. A cognitive domain deficit was defined as a cognitive domain z score

Wong, George Kwok Chu; Lam, Sandy Wai; Wong, Adrian; Ngai, Karine; Poon, Wai Sang; Mok, Vincent

2013-01-01

339

Mortality event in freshwater drum Aplodinotus grunniens from Lake Ontario, Canada, associated with viral haemorrhagic septicemia virus, type IV.  

PubMed

A mortality event primarily affecting freshwater drum Aplodinotus grunniens was noted during April and May 2005 in the Bay of Quinte, Lake Ontario, Canada. A conservative estimate of the number of dead drum was approximately 100 metric tonnes. Large numbers of dead round goby Neogobius melanostomus were also seen, as well as a few muskellunge Esox masquinongy. In the drum, there was a consistent histological pattern of variably severe panvasculitis, a necrotising myocarditis, meningoencephalitis and a segmental enteritis. Moderate numbers of bullet-shaped viral particles consistent with a rhabdovirus were identified by transmission electron microscopy (TEM) in affected heart tissue. Following primary isolation from pooled tissues on fathead minnow (FHM) cells, a morphologically similar virus, approximately 165 x 60 nm in size, was visualised. Identification of the isolate as viral haemorrhagic septicemia virus (VHSV) was confirmed by enzyme immunoassay and by polymerase chain reaction. An appropriately sized product (468 bp) of the G-glycoprotein gene (nucleotides [nt] 340 to 807) was generated with RNA extracted from FHM cell supernatant. Analysis of a 360 nt partial glycoprotein gene sequence (nt 360 to 720) indicated a 96.4 to 97.2% nucleotide identity with known strains of North American (NA) VHSV. Analysis using Neighbour-joining distance methods assigned the isolate to the same lineage as the NA and Japanese isolates (Genogroup IV). However, there was sufficient sequence divergence from known NA VHSV isolates to suggest that this isolate may represent a distinct subgroup. The effects of ongoing mortality in freshwater drum and in multiple species during spring 2006 suggest that this newly recognised virus in the Great Lakes will have continued impact in the near future. PMID:17760383

Lumsden, J S; Morrison, B; Yason, C; Russell, S; Young, K; Yazdanpanah, A; Huber, P; Al-Hussinee, L; Stone, D; Way, K

2007-06-29

340

Prediction of two month modified Rankin Scale with an ordinal prediction model in patients with aneurysmal subarachnoid haemorrhage  

PubMed Central

Background Aneurysmal subarachnoid haemorrhage (aSAH) is a devastating event with a frequently disabling outcome. Our aim was to develop a prognostic model to predict an ordinal clinical outcome at two months in patients with aSAH. Methods We studied patients enrolled in the International Subarachnoid Aneurysm Trial (ISAT), a randomized multicentre trial to compare coiling and clipping in aSAH patients. Several models were explored to estimate a patient's outcome according to the modified Rankin Scale (mRS) at two months after aSAH. Our final model was validated internally with bootstrapping techniques. Results The study population comprised of 2,128 patients of whom 159 patients died within 2 months (8%). Multivariable proportional odds analysis identified World Federation of Neurosurgical Societies (WFNS) grade as the most important predictor, followed by age, sex, lumen size of the aneurysm, Fisher grade, vasospasm on angiography, and treatment modality. The model discriminated moderately between those with poor and good mRS scores (c statistic = 0.65), with minor optimism according to bootstrap re-sampling (optimism corrected c statistic = 0.64). Conclusion We presented a calibrated and internally validated ordinal prognostic model to predict two month mRS in aSAH patients who survived the early stage up till a treatment decision. Although generalizability of the model is limited due to the selected population in which it was developed, this model could eventually be used to support clinical decision making after external validation. Trial Registration International Standard Randomised Controlled Trial, Number ISRCTN49866681 PMID:20920243

2010-01-01

341

Protocol for a systematic review of the clinical effectiveness of pre-hospital blood components compared to other resuscitative fluids in patients with major traumatic haemorrhage  

PubMed Central

Background There is growing interest in the use of blood components for pre-hospital resuscitation of patients with major traumatic haemorrhage. It has been speculated that early resuscitation with blood components may have benefits in terms of treating trauma-induced coagulopathy, which in turn may influence survival. The proposed systematic review will evaluate the evidence on the clinical effectiveness of pre-hospital blood components (red blood cells and/or plasma or whole blood), in both civilian and military settings, compared with other resuscitation strategies in patients with major traumatic haemorrhage. Methods/design Standard systematic review methods aimed at minimising bias will be employed for study identification, selection and data extraction. General medical and specialist databases will be searched; the search strategy will combine terms for the population, intervention and setting. Studies will be selected for review if the population includes adult patients with major traumatic haemorrhage who receive blood components in a pre-hospital setting (civilian or military). Systematic reviews, randomised and non-randomised controlled trials and controlled observational studies will be included. Uncontrolled studies will be considered depending on the volume of controlled evidence. Quality assessment will be tailored to different study designs. Both patient related and surrogate outcomes will be considered. Synthesis is likely to be primarily narrative, but meta-analyses and subgroup analyses will be undertaken where clinical and methodological homogeneity exists. Discussion Given the increasing use by emergency services of blood components for pre-hospital resuscitation, this is a timely systematic review, which will attempt to clarify the evidence base for this practice. As far as the authors are aware, the proposed systematic review will be the first to address this topic. Systematic review registration PROSPERO CRD42014013794 PMID:25344301

2014-01-01

342

Chemical chaperone treatment reduces intracellular accumulation of mutant collagen IV and ameliorates the cellular phenotype of a COL4A2 mutation that causes haemorrhagic stroke.  

PubMed

Haemorrhagic stroke accounts for ?20% of stroke cases and porencephaly is a clinical consequence of perinatal cerebral haemorrhaging. Here, we report the identification of a novel dominant G702D mutation in the collagen domain of COL4A2 (collagen IV alpha chain 2) in a family displaying porencephaly with reduced penetrance. COL4A2 is the obligatory protein partner of COL4A1 but in contrast to most COL4A1 mutations, the COL4A2 mutation does not lead to eye or kidney disease. Analysis of dermal biopsies from a patient and his unaffected father, who also carries the mutation, revealed that both display basement membrane (BM) defects. Intriguingly, defective collagen IV incorporation into the dermal BM was observed in the patient only and was associated with endoplasmic reticulum (ER) retention of COL4A2 in primary dermal fibroblasts. This intracellular accumulation led to ER stress, unfolded protein response activation, reduced cell proliferation and increased apoptosis. Interestingly, the absence of ER retention of COL4A2 and ER stress in cells from the unaffected father indicate that accumulation and/or clearance of mutant COL4A2 from the ER may be a critical modifier for disease development. Our analysis also revealed that mutant collagen IV is degraded via the proteasome. Importantly, treatment of patient cells with a chemical chaperone decreased intracellular COL4A2 levels, ER stress and apoptosis, demonstrating that reducing intracellular collagen accumulation can ameliorate the cellular phenotype of COL4A2 mutations. Importantly, these data highlight that manipulation of chaperone levels, intracellular collagen accumulation and ER stress are potential therapeutic options for collagen IV diseases including haemorrhagic stroke. PMID:24001601

Murray, Lydia S; Lu, Yinhui; Taggart, Aislynn; Van Regemorter, Nicole; Vilain, Catheline; Abramowicz, Marc; Kadler, Karl E; Van Agtmael, Tom

2014-01-15

343

Use of hospitalisation history (lookback) to determine prevalence of chronic diseases: impact on modelling of risk factors for haemorrhage in pregnancy  

Microsoft Academic Search

Background  Concern about the completeness of comorbidity information in hospital records has been raised as a limitation of using hospital\\u000a discharge data for research. The aim of this study is to assess the impact of additional comorbidity information from prior\\u000a hospital admissions on estimation of prevalence and modelling of risk factors for obstetric haemorrhage.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A range of chronic disease prevalence for

Jian Sheng Chen; Christine L Roberts; Judy M Simpson; Jane B Ford

2011-01-01

344

Hidden threat of tortoise ticks: high prevalence of Crimean-Congo haemorrhagic fever virus in ticks Hyalomma aegyptium in the Middle East  

PubMed Central

It is the first time that Crimean-Congo haemorrhagic fever virus (CCHFV), causing potentially lethal disease of humans, has been reported from the Middle East region and from the tortoise tick Hyalomma aegyptium from a tortoise host, whose epidemiological significance may have remained almost completely overlooked so far. We used RT-PCR to screen for 245 ticks collected from 38 Testudo graeca tortoise individuals. Results of our genetic screening provide unambiguous evidence of occurrence of CCHFV in this region and host, suggesting a potentially important role of H. aegyptium in CCHF epidemiology. PMID:24618184

2014-01-01

345

Hidden threat of tortoise ticks: high prevalence of Crimean-Congo haemorrhagic fever virus in ticks Hyalomma aegyptium in the Middle East.  

PubMed

It is the first time that Crimean-Congo haemorrhagic fever virus (CCHFV), causing potentially lethal disease of humans, has been reported from the Middle East region and from the tortoise tick Hyalomma aegyptium from a tortoise host, whose epidemiological significance may have remained almost completely overlooked so far. We used RT-PCR to screen for 245 ticks collected from 38 Testudo graeca tortoise individuals. Results of our genetic screening provide unambiguous evidence of occurrence of CCHFV in this region and host, suggesting a potentially important role of H. aegyptium in CCHF epidemiology. PMID:24618184

Široký, Pavel; B?lohlávek, Tomáš; Papoušek, Ivo; Jandzik, David; Mikulí?ek, Peter; Kubelová, Michaela; Zdražilová-Dubská, Lenka

2014-01-01

346

Influence of ACTH-(1-24) on free radical levels in the blood of haemorrhage-shocked rats: direct ex vivo detection by electron spin resonance spectrometry.  

PubMed Central

1. The influence of ACTH-(1-24) on the blood levels of highly reactive free radicals in haemorrhagic shock was studied in rats. 2. Volume-controlled haemorrhagic shock was produced in adult rats under general anaesthesia (urethane, 1.25 g kg-1 intraperitoneally) by stepwise bleeding until mean arterial pressure stabilized at 20-23 mmHg. Rats were intravenously (i.v.) treated with either ACTH-(1-24) (160 micrograms kg-1 in a volume of 1 ml kg-1) or equivolume saline. Free radicals were measured in arterial blood by electron spin resonance spectrometry using an ex vivo method that avoids injection of the spin-trapping agent (alpha-phenyl-N-tert-butylnitrone). 3. Blood levels of free radicals were 6490 +/- 273 [arbitrary units (a.u.) ml-1 whole blood, before starting bleeding, and 30762 +/- 2650 after bleeding termination (means +/- s.e. mean of the values obtained in all experimental groups). All rats treated with saline died within 30 min, their blood levels of free radicals being 35450 +/- 5450 a.u. ml-1 blood, 15 min after treatment. Treatment with ACTH-(1-24) produced a rapid and sustained restoration of arterial pressure, pulse pressure, heart rate and respiratory function, with 100% survival at the end of the observation period (2 h); this was associated with an impressive reduction in the blood levels of free radicals, that were 12807 +/- 2995, 10462 +/- 2850, 12294 +/- 4120, and 10360 +/- 2080 a.u. ml-1 blood, 15, 30, 60 and 120 min after ACTH-(1-24) administration, respectively. 4. These results provide a direct demonstration that (i) in haemorrhagic shock there is a rapid and massive production of highly reactive free radicals, and that (ii) the sustained restoration of cardiovascular and respiratory functions induced by the i.v. injection of ACTH-(1-24) is associated with a substantial reduction of free radical blood levels. It is suggested that ACTH-(1-24) prevents the burst of free radical generation during blood mobilisation and subsequent tissue reperfusion, and this may be an important component of its mechanism of action in effectively preventing death for haemorrhagic shock. PMID:8872353

Guarini, S.; Bazzani, C.; Ricigliano, G. M.; Bini, A.; Tomasi, A.; Bertolini, A.

1996-01-01

347

Psychosocial outcomes at three and nine months after good neurological recovery from aneurysmal subarachnoid haemorrhage: predictors and prognosis  

PubMed Central

Objectives: To investigate (1) the prevalence of various aspects of cognitive and psychosocial dysfunction, including post-traumatic stress symptoms, over nine months after subarachnoid haemorrhage (SAH); (2) whether SAH is preceded by increased life stress; (3) to what extent adverse outcomes may be predicted from preillness life stress, early neurological impairment, age, and sex; and (4) relations between emotional and functional outcomes. Methods: 52 patients with good neurological recovery after surgery for SAH were each matched for age, sex, and occupation with a healthy control participant. SAH patients were assessed three and nine months postdischarge on measures of cognitive functioning, mood, and social functioning. Objective stressors and subjective life change during the preceding year were rated retrospectively. Controls completed measures of mood and social functioning once only. Results: Compared with controls, SAH patients showed increased mood disturbance, subtle cognitive impairment, and abnormally low independence and participation on measures of social functioning. 60% showed clinically significant post-traumatic stress symptomatology (intrusive thoughts or avoidance of reminders) at three months and 30% at nine months. Independence in activities of daily living was greatly reduced in half to a third of the sample at both three and nine months. Productive employment was below the 10th percentile of the control group for 75% of patients at three months and for 56% at nine months; this outcome could not be predicted from selected demographic, premorbid, or clinical variables but dependence on others for organisational activities was predicted by impaired prose recall. Mood at nine months was strongly predicted by prior mental health problems, poor physical health, dysphasia, and impaired prose recall at three months. There was no evidence of an abnormally high level of stressful life events in the year before SAH, although patients rated their subjective level of stress in this period slightly more highly than did the control participants. Conclusions: These findings highlight the need for structured support and treatment after surgery for SAH to reduce persisting mood disturbance and increase independence and participation. PMID:12023423

Powell, J; Kitchen, N; Heslin, J; Greenwood, R

2002-01-01

348

Left atrial appendage occlusion with the Watchman device in a patient with paroxysmal atrial fibrillation and intolerance of all forms of anticoagulation due to hereditary haemorrhagic telangiectasia.  

PubMed

An elderly woman presented to our attention because of paroxysmal atrial fibrillation and cerebrovascular events requiring systemic anticoagulation and a concomitant, serious bleeding diathesis (the Osler-Weber-Rendu syndrome, or hereditary haemorrhagic telangiectasia). Her risk of suffering a major stroke was significant given a CHA(2)DS(2)VASc score of 6. However, she was unable to tolerate any form of anticoagulation because of torrential epistaxis and previous gastrointestinal haemorrhage on antiplatelet therapy. We proceeded with percutaneous occlusion of the left atrial appendage with a Watchman device. Ten months post-procedure she is well, without recurrence of neurological symptoms, and off all forms of anticoagulation. The current internationally accepted practice post-deployment of the Watchman device mandates warfarin transition for 6 months to allow for endothelialisation of the device. However, there is no evidence in the literature to support left atrial appendage occlusion without any peri-procedural antiplatelet and anticoagulation therapy and therefore our case represents novel and important anecdotal evidence that secondary stroke prevention with left atrial appendage occlusion may be effective and safe even in patients who cannot tolerate any form of anticoagulation at all. PMID:24621286

Spina, R; Gunalingam, B

2014-03-01

349

An asymmetrical fenestration of the basilar artery coexisting with two aneurysms in a patient with subarachnoid haemorrhage: case report and review of the literature.  

PubMed

The vertebrobasilar system is a part of the cerebral arterial circle (circle of Willis), which forms the collateral circulation of the brain. A 75-year-old Caucasian female was admitted to hospital because of a strong headache radiating to the neck. On the basis of a neurological examination, the patient was classified into group III of the Hunt and Hess scale. Subarachnoid haemorrhage and 2 aneurysms of the cerebral arteries were diagnosed during multidetector 64-row computed tomography and angiography. An asymmetrical fenestration of the proximal part of the basilar artery was also observed. The bleeding aneurysm locating at anterior communicating artery was diagnosed and clipped surgically by right fronto-parietal craniotomy. The second aneurysm was located just after the junction of the vertebral arteries on the wall of the basilar artery. The presented case firstly illustrates the asymmetric fenestration of the proximal part of the basilar artery coexisting with subarachnoid haemorrhage and 2 aneurysms of brain arteries. Such observation should increase diagnostic attention in the detection of possible associated aneurysms and can help in preventing complications during all endovascular treatment procedures. PMID:24902104

Polguj, M; Majos, M; Topol, M; Majos, A

2014-05-01

350

RT-PCR Assays for Seven Serotypes of Epizootic Haemorrhagic Disease Virus & Their Use to Type Strains from the Mediterranean Region and North America  

PubMed Central

Epizootic haemorrhagic disease virus (EHDV) infects wild ruminants, causing a frequently fatal haemorrhagic disease. However, it can also cause bluetongue-like disease in cattle, involving significant levels of morbidity and mortality, highlighting a need for more rapid and reliable diagnostic assays. EHDV outer-capsid protein VP2 (encoded by genome-segment 2 [Seg-2]) is highly variable and represents the primary target for neutralising antibodies generated by the mammalian host. Consequently VP2 is also the primary determinant of virus “serotype”, as identified in virus neutralisation tests (VNT). Although previous reports have indicated eight to ten EHDV serotypes, recent serological comparisons and molecular analyses of Seg-2 indicate only seven EHDV “types”. Oligonucleotide primers were developed targeting Seg-2, for use in conventional RT-PCR assays to detect and identify these seven types. These assays, which are more rapid and sensitive, still show complete agreement with VNT and were used to identify recent EHDV isolates from the Mediterranean region and North America. PMID:20862243

Maan, Narender S.; Maan, Sushila; Nomikou, Kyriaki; Johnson, Donna J.; El Harrak, Mehdi; Madani, Hafsa; Yadin, Hagai; Incoglu, Serife; Yesilbag, Kadir; Allison, Andrew B.; Stallknecht, David E.; Batten, Carrie; Anthony, Simon J.; Mertens, Peter P. C.

2010-01-01

351

[Ebola--haemorrhagic fever].  

PubMed

This review presents the latest findings on ebola. Ebola presents one of the highest case-fatality rates of all infectious diseases, and in 2007 outbreaks were observed first in the Democratic Republic of Congo and later in Uganda with a new subtype. Accumulating evidence suggests that fruit bats are a likely reservoir for the ebola virus. The frequency of filovirus outbreaks in Central Africa is increasing and the potential for introduction and patient care in Denmark is evaluated. PMID:19087734

Fabiansen, Christian; Kronborg, Gitte; Thybo, Søren; Nielsen, Jens Ole

2008-11-24

352

Topical timolol for treatment of epistaxis in hereditary haemorrhagic telangiectasia associated with bradycardia: a look at CYP2D6 metabolising variants.  

PubMed

A 59-year-old man presented to the emergency department with lightheadedness. He had started intranasal administration of ophthalmic timolol for the prevention of epistaxis associated with hereditary haemorrhagic telangiectasia approximately 3 weeks earlier with excellent response. His heart rate was about half its normal rate, an ECG revealed sinus bradycardia, and it was determined he had significant cardiac issues in his family history. Essentially all other tests were normal. The discontinuation of the intranasal use of timolol resolved any further episodes of lightheadedness and bradycardia. It was determined through genetic testing that he is an intermediate metaboliser of CYP2D6, the main enzyme contributing to the metabolism of timolol. This explains the development of the bradycardia after intranasal timolol use. The metabolising variants of CYP2D6 need to be considered when prescribing medications metabolised by this enzyme, so possible adverse effects can be avoided. PMID:24518395

Epperla, Narendranath; Brilliant, Murray H; Vidaillet, Humberto

2014-01-01

353

Enzyme immuno assay for the detection of virus specific IgG and IgM antibody in patients with haemorrhagic fever with renal syndrome.  

PubMed

Consecutive serum samples collected from 235 patients with Haemorrhagic Fever with Renal Syndrome (HFRS), between two days and two years after onset of disease, have been analysed for the presence of IgG and IgM type of antibodies specific for Hanta-viruses. The sera were screened in parallel by a newly developed indirect Immuno Enzyme Assay (EIA) in parallel with Indirect Immunofluorescent Antibody Assay (IFA). In both tests the Hantaan virus strain 76-118 was used as the antigen. The EIA was much more sensitive than the IFA test for the detection of IgM type antibodies. With the indirect EIA IgM type antibodies against Hantaan virus 76-118 have been detected in HFRS patient's sera from the second day of illness indicating the usefulness of this test for the early serological diagnosis of this disease. PMID:2898929

Ivanov, A P; Tkachenko, E A; Petrov, V A; Pashkov, A J; Dzagurova, T K; Vladimirova, T P; Voronkova, G M; van der Groen, G

1988-01-01

354

Combine intravitreal bevacizumab with Nd: YAG laser hyaloidotomy for valsalva pre-macular haemorrhage and observe the internal limiting membrane changes: a spectralis study  

PubMed Central

Valsalva retinopathy was described as a particular form of retinopathy, pre-retinal and subinternal limiting membrane haemorrhages in nature that rarely may break through and become subhyloid or intravitreal, secondary to a sudden increase in intrathoracic pressure. We reported a new way that Nd:YAG laser for ILM hyaloidotomy in order to drain the sub-ILM blood into vitreous cavity combined with intravitreal bevacizumab to improve the absorption of blood. Therapeutic alliance make significant outcome, protecting vision in time. We used spectralis OCT to observe sub-ILM mix cells and special ILM structure in this lesion for the first time, as the spectralis OCT can reach histology level imagination. PMID:23638430

Hua, Rui; Liu, Li-Min; Hu, Yue-Dong; Zhou, Yun; Chen, Lei

2013-01-01

355

Scientific foundation and possible implications for practice of the Minimizing Adverse Haemorrhagic Events by Transradial Access Site andSystemic Implementation of AngioX (MATRIX) trial.  

PubMed

Early invasive management and the use of combined antithrombotic therapies have decreased the risk of recurrent ischaemia in patients with acute coronary syndrome (ACS) but have also increased the bleeding risk. Transradial intervention (TRI) and bivalirudin infusion compared to transfemoral intervention (TFI) or unfractionated heparin (UFH) plus glycoprotein IIb/IIIa inhibitors (GPI) decrease bleeding complications in patients with ACS. To what extent, a bleeding preventive strategy incorporating at least one of these two treatment options translates into improved outcomes is a matter of debate. The Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX study is a large-scale, multicenter, prospective, open-label trial, conducted at approximately 100 sites in Europe aiming to primarily assess whether TRI and bivalirudin infusion, as compared to TFI and UFH plus provisional GPI, decrease the 30-day incidence of death, myocardial infarction or stroke across the whole spectrum of ACS patients. PMID:24395497

Valgimigli, Marco; Calabrò, Paolo; Cortese, Bernardo; Frigoli, Enrico; Garducci, Stefano; Rubartelli, Paolo; Andò, Giuseppe; Santarelli, Andrea; Galli, Mario; Garbo, Roberto; Repetto, Alessandra; Ierna, Salvatore; Briguori, Carlo; Limbruno, Ugo; Violini, Roberto; Gagnor, Andrea

2014-02-01

356

Emergency cholecystectomy and hepatic arterial repair in a patient presenting with haemobilia and massive gastrointestinal haemorrhage due to a spontaneous cystic artery gallbladder fistula masquerading as a pseudoaneurysm  

PubMed Central

Background Haemobilia usually occurs secondary to accidental or iatrogenic hepatobiliary trauma. It can occasionally present with cataclysmal upper gastrointestinal haemorrhage posing as a life threatening emergency. Haemobilia can very rarely be a complication of acute cholecystitis. Here we report a case of haemobilia manifesting as massive gastrointestinal haemorrhage in a patient without any prior history of biliary surgery or intervention and present a brief review of literature. Case presentation A 22 year old male admitted with history suggestive of acute cholecystitis subsequently developed waxing waning jaundice and recurrent episodes of upper gastrointestinal bleed. Endoscopy showed an ulcer in the first part of duodenum with a clot, no active bleed was visible. Angiography was suggestive of a ruptured pseudoaneurysm in the vicinity of the right hepatic artery probably originating from the cystic artery. Coil embolization was tried but the coil dislodged into the right branch of hepatic artery distal to the site of pseudoaneurysm. Review of angiographic video in light of operative findings demonstrated a fistulous communication between cystic artery and gallbladder as the cause, a simultaneous cholecystoduodenal fistula was also noted. Retrograde cholecystectomy, closure of cholecystoduodenal fistula and right hepatic arteriotomy with retrieval of the endo-coil and hepatic arterial repair was performed. Conclusion Fistula between the cystic artery and gallbladder has been commonly reported to occur after laparoscopic cholecystectomy. Spontaneous fistulous communication, i.e. in the absence of any prior trauma or intervention, between cystic artery and gallbladder is rare with very few reports in literature. Aetiopathogenesis of the disease, in the context of current literature is reviewed. The diagnostic dilemma posed by the confounding finding of an ulcer in the duodenum, the iconic video angiographic depiction as also the therapeutic challenge of a failed embolization with consequent microcoil migration and primary hepatic arterial repair in the emergency situation is discussed. PMID:23452779

2013-01-01

357

The histopathology of non-steroidal anti-inflammatory drug induced gastroduodenal damage: correlation with Helicobacter pylori, ulcers, and haemorrhagic events  

PubMed Central

Aims—The spectrum of microscopic lesions resulting from the chronic use of non-steroidal anti-inflammatory drugs (NSAIDs), known as chemical gastritis, remains unclear, and the variable prevalence reported in different studies makes this issue a matter of lively debate. The aim of this study was to evaluate the prevalence and importance of chemical gastritis in patients regularly taking NSAIDs. Owing to the high prevalence of Helicobacter pylori infection, particularly in subjects over 60 years of age, and in view of a possible association with damage, the presence of H pylori infection in the same tissue sample was also determined in all patients. Methods—One hundred and ninety seven subjects were enrolled, 118 of whom were receiving chronic treatment with NSAIDs and 79 of whom were controls, pair matched for age, sex, and clinical symptoms (ulcer-like dyspepsia or upper digestive tract haemorrhage). Antral biopsies taken during upper gastroduodenal endoscopy were assessed for chemical gastritis according to a modified version of Dixon's score, and for helicobacter correlated chronic active gastritis, according to the updated Sydney system. Results—Chemical gastritis was identified in 11 patients taking NSAIDs (9%) and in four controls (5%) (p < 0.05). Helicobacter pylori was detected in 53 patients taking NSAIDs (45%) and in 34 controls (43%). Patients taking NSAIDs had a significantly higher number of erosions and ulcers and worse endoscores than controls. The presence of H pylori did not appear to increase histological damage, ulcer prevalence, or haemorrhagic events. Conclusions—Chemical gastritis is present in a limited number of patients regularly taking NSAIDs, and is not strongly correlated with NSAID induced damage. In many cases of peptic ulcer or upper gastrointestinal bleeding in patients taking NSAIDs, the presence of chemical gastritis or H pylori infection cannot solely account for the development of mucosal damage. Key Words: chemical gastritis • non-steroidal anti-inflammatory drugs • Helicobacter pylori PMID:11429423

Frezza, M; Gorji, N; Melato, M

2001-01-01

358

Jan Matzeliger (VHS 3/4 inch) (Video).  

National Technical Information Service (NTIS)

This is a story about a man who revolutionized the shoe industry. Jan E. Matzeliger was the inventor of a machine that could duplicate the movement of the human hand in making shoes. Matzeliger's hand process lasting machine has stood the test of time and...

1989-01-01

359

Jan Matzeliger (VHS 1/2 inch) (Video).  

National Technical Information Service (NTIS)

This is a story about a man who revolutionized the shoe industry. Jan E. Matzeliger was the inventor of a machine that could duplicate the movement of the human hand in making shoes. Matzeliger's hand process lasting machine has stood the test of time and...

1989-01-01

360

Santa Fe (VHS 1/2 inch) (Video).  

National Technical Information Service (NTIS)

The program offers a lyrical interpretation of the culture of Santa Fe, New Mexico, with its Indian, Spanish, and Mexican heritages. Glimpses of the past are mixed with scenes of today to show the richness of the southwestern tradition and heritage.

1974-01-01

361

Santa Fe (VHS 3/4 inch) (Video).  

National Technical Information Service (NTIS)

The film offers a lyrical interpretation of the culture of Santa Fe, NM, with its Indian, Spanish, and Mexican heritage. Glimpses of the past are mixed with scenes of today to show the richness of the southwestern tradition and heritage.

1974-01-01

362

Waiting for Godot (VHS 1/2 inch) (Video).  

National Technical Information Service (NTIS)

Featuring original staging by Nobel-Prize winning playwright Samuel Beckett, the video is the story of two clownish nomads whose search for a Mr. Godot ultimately is realized as a penetrating introspective universally recognized by anyone seeking truth of...

1990-01-01

363

Krapp's Last Tape (VHS 1/2 inch) (Video).  

National Technical Information Service (NTIS)

Featuring original staging by Nobel Prize winning playwright, Samuel Beckett, the video tells the story of Krapp, an impassioned, eccentric, recluse whose existence consists chiefly of recalling both pleasant and unpleasant memories with the assistance of...

1990-01-01

364

pH-Dependent Solution Structure and Activity of a Reduced Form of the Host-Defense Peptide Myticin C (Myt C) from the Mussel Mytilus galloprovincialis  

PubMed Central

Myticin C (Myt C) is a highly variable host-defense peptide (HDP) associated to the immune response in the mediterranean mussel (Mytilus galloprovincialis), which has shown to be active across species due to its strong antiviral activity against a fish rhabdovirus found in fish cells overexpressing this HDP. However, the potential antimicrobial properties of any synthetic analogue of Myt C has not yet been analysed. Thus, in this work we have synthesised the sequence of the mature peptide of Myt C variant c and analysed the structure activity relationships of its reduced (non-oxidized) form (red-MytCc). In contrast to results previously reported for oxidized isoforms of mussel myticins, red-MytCc was not active against bacteria at physiological pH and showed a moderate antiviral activity against the viral haemorrhagic septicaemia (VHS) rhabdovirus. However, its chemotactic properties remained active. Structure/function studies in neutral and acid environments by means of infrared spectroscopy indicated that the structure of red-MytCc is pH dependent, with acid media increasing its alpha-helical content. Furthermore, red-MytCc was able to efficiently aggregate artificial phospholipid membranes at low pH, as well as to inhibit the Escherichia coli growth, suggesting that this activity is attributable to its more structured form in an acidic environment. All together, these results highlight the dynamic and environmentally sensitive behavior of red-Myt C in solution, and provide important insights into Myt C structure/activity relationships and the requirements to exert its antimicrobial/immunomodulatory activities. On the other hand, the pH-dependent direct antimicrobial activity of Myt C suggests that this HDP may be a suitable template for the development of antimicrobial agents that would function selectively in specific pH environments, which are sorely needed in this “antibiotic-resistance era”. PMID:23880927

Martinez-Lopez, Alicia; Encinar, Jose Antonio; Medina-Gali, Regla Maria; Balseiro, Pablo; Garcia-Valtanen, Pablo; Figueras, Antonio; Novoa, Beatriz; Estepa, Amparo

2013-01-01

365

A survey of viral diseases in farmed and feral salmonids in Switzerland.  

PubMed

A field survey was carried out to study the occurrence and distribution of viruses causing diseases of major impact in fish farming, namely viral haemorrhagic septicaemia (VHS), infectious haematopoietic necrosis (IHN) and infectious pancreatic necrosis (IPN) in farmed and wild fish in Switzerland. The presence of VHS virus (VHSV), IHN virus (IHNV) and IPN virus (IPNV) in the tissue samples was tested by virus isolation in cell cultures, and subsequent virus identification by immunofluorescence. The sera were screened for anti-VHSV antibodies (VHSV-AB) using a serum plaque neutralization test with complement addition. These data were then compared with results of a similar survey performed in 1984/85, and with data from routine diagnostic work completed at the Centre for Fish and Wildlife Health (FIWI) of the University of Bern from 1978 to 2001. Sampling sites included private and government fish farms as well as natural habitats from all major river catchments in Switzerland. In 2000/01, 522 tissue samples and 1910 sera were collected from 3400 fish. In 1984/85 1239 tissue samples and 694 sera were collected from 1628 fish. During the last 24 years of routine diagnostics at the FIWI, 1776 tissue samples were examined for presence of viruses. The results of the tissue analysis from the surveys in 1984/85 and 2000/01 showed low numbers of sites with virus-positive fish (five VHSV, three IPNV and three VHSV, one IPNV, respectively) in Swiss fish farms and rivers. The sites with virus-positive fish were located throughout the country. The decline in virus-positive cases observed between the two surveys agrees with data from the routine diagnostic work of the FIWI which show a decrease in total virus isolations from approximately 35 cases per year in the late 1970s, to approximately 10 cases per year during the last 10 years. However, in 1984/85 8.3% (58 of 694 serum samples) and in 2000/01 6.3% (121 of 1910 serum samples) proved to be positive for VHSV-AB. The 58 positive samples in 1984/85 originated from 40 of 175 sites (23%) and the 121 positive samples in 2000/01 were from 84 of 217 (29%) sites. These results are indicative of a wider distribution of VHSV than expected from the results of the virus isolations. PMID:12962226

Knuesel, R; Segner, H; Wahli, T

2003-03-01

366

Exercise-induced pulmonary haemorrhage in the horse: results of a detailed clinical, post mortem and imaging study. IV. Changes in the bronchial circulation demonstrated by C.T. scanning and microradiography.  

PubMed

The purpose of this study was to use radiographic contrast techniques and special imaging methods to identify and high-light bronchial arterial involvement in lung lesions associated with exercise-induced pulmonary haemorrhage (EIPH) in horses. The lungs from four horses with histories of EIPH were prepared for computerised tomographic scanning and microradiography by perfusing the broncho-oesophageal artery with a mixture of red latex and either barium or iodine contrast materials while the pulmonary supply received only blue latex. Computerised tomographic scan slices of the prepared inflated lungs were obtained from the caudal tip of the lung to the hilus. Microradiography of selected lung slices was also performed on a Faxitron. Diffuse areas of increased density, with preferential bronchial arterial supply noted on the computerised tomographic scans were confirmed by microradiography. Dense focal and diffuse plexuses of markedly hypertrophied and highly branched bronchial arterial networks were identified, centred around certain small airways. The vascular supply to these plexuses was recruited predominantly from neighbouring bronchial vessels, and in some cases, from the enlarged vasa vasorum of pulmonary arteries sending anastomoses to the affected areas. The authors conclude that bronchial vascular lesions in EIPH cases are the likely origin of haemorrhage; that small airway disease is the probable initiating stimulus for bronchial vascular proliferation in these lesions; and that the morphology and nature of the neovascular tissue in these lesions provides the conditions leading to haemorrhage in the lungs of horses with EIPH. PMID:3678182

O'Callaghan, M W; Pascoe, J R; Tyler, W S; Mason, D K

1987-09-01

367

Guidance for contact tracing of cases of Lassa fever, Ebola or Marburg haemorrhagic fever on an airplane: results of a European expert consultation  

PubMed Central

Background Travel from countries where viral haemorrhagic fevers (VHF) are endemic has increased significantly over the past decades. In several reported VHF events on airplanes, passenger trace back was initiated but the scale of the trace back differed considerably. The absence of guidance documents to help the decision on necessity and scale of the trace back contributed to this variation. This article outlines the recommendations of an expert panel on Lassa fever, Ebola and Marburg haemorrhagic fever to the wider scientific community in order to advise the relevant stakeholders in the decision and scale of a possible passenger trace back. Method The evidence was collected through review of published literature and through the views of an expert panel. The guidance was agreed by consensus. Results Only a few events of VHF cases during air travel are reported in literature, with no documented infection in followed up contacts, so that no evidence of transmission of VHF during air travel exists to date. Based on this and the expert opinion, it was recommended that passenger trace back was undertaken only if: the index case had symptoms during the flight; the flight was within 21 days after detection of the event; and for Lassa fever if exposure of body fluid has been reported. The trace back should only be done after confirmation of the index case. Passengers and crew with direct contact, seat neighbours (+/? 1 seat), crew and cleaning personal of the section of the index case should be included in the trace back. Conclusion No evidence has been found for the transmission of VHF in airplanes. This information should be taken into account, when a trace back decision has to be taken, because such a measure produces an enormous work load. The procedure suggested by the expert group can guide decisions made in future events, where a patient with suspected VHF infection travelled on a plane. However, the actual decision on start and scale of a trace back always lies in the hands of the responsible people taking all relevant information into account. PMID:23170851

2012-01-01

368

A critical review of anaesthetised animal models and alternatives for military research, testing and training, with a focus on blast damage, haemorrhage and resuscitation.  

PubMed

Military research, testing, and surgical and resuscitation training, are aimed at mitigating the consequences of warfare and terrorism to armed forces and civilians. Traumatisation and tissue damage due to explosions, and acute loss of blood due to haemorrhage, remain crucial, potentially preventable, causes of battlefield casualties and mortalities. There is also the additional threat from inhalation of chemical and aerosolised biological weapons. The use of anaesthetised animal models, and their respective replacement alternatives, for military purposes -- particularly for blast injury, haemorrhaging and resuscitation training -- is critically reviewed. Scientific problems with the animal models include the use of crude, uncontrolled and non-standardised methods for traumatisation, an inability to model all key trauma mechanisms, and complex modulating effects of general anaesthesia on target organ physiology. Such effects depend on the anaesthetic and influence the cardiovascular system, respiration, breathing, cerebral haemodynamics, neuroprotection, and the integrity of the blood-brain barrier. Some anaesthetics also bind to the NMDA brain receptor with possible differential consequences in control and anaesthetised animals. There is also some evidence for gender-specific effects. Despite the fact that these issues are widely known, there is little published information on their potential, at best, to complicate data interpretation and, at worst, to invalidate animal models. There is also a paucity of detail on the anaesthesiology used in studies, and this can hinder correct data evaluation. Welfare issues relate mainly to the possibility of acute pain as a side-effect of traumatisation in recovered animals. Moreover, there is the increased potential for animals to suffer when anaesthesia is temporary, and the procedures invasive. These dilemmas can be addressed, however, as a diverse range of replacement approaches exist, including computer and mathematical dynamic modelling of the human body, cadavers, interactive human patient simulators for training, in vitro techniques involving organotypic cultures of target organs, and epidemiological and clinical studies. While the first four of these have long proven useful for developing protective measures and predicting the consequences of trauma, and although many phenomena and their sequelae arising from different forms of trauma in vivo can be induced and reproduced in vitro, non-animal approaches require further development, and their validation and use need to be coordinated and harmonised. Recommendations to these ends are proposed, and the scientific and welfare problems associated with animal models are addressed, with the future focus being on the use of batteries of complementary replacement methods deployed in integrated strategies, and on greater transparency and scientific cooperation. PMID:24329746

Combes, Robert D

2013-11-01

369

Extra-cerebral severe infections associated with haemorrhagic hereditary telangiectasia (Rendu-Osler-Weber Disease): five cases and a review of the literature.  

PubMed

Hereditary haemorrhagic telangiectasia (HHT) is one of the most common autosomal dominant disorders and is characterized by genetically determined abnormalities of vascular structure. People affected by HHT are predisposed to severe infections such as cerebral abscesses, typical of patients with pulmonary arteriovenous malformations, and extra-cerebral infections such as bacteraemia, septic arthritis, osteomyelitis, hepatic abscesses, skin infections and infective endocarditis. We present a retrospective series of severe bacterial extra-cerebral infections in five patients affected by HHT, admitted to our Institute from January 2007 to June 2013. We also reviewed the literature of the last five years concerning infectious complications in people affected by HHT. Our study shows that HHT patients with infectious complications exclusively localized in extra-cerebral sites are usually fragile, old and affected by comorbidities. Moreover, we recognized a trend of Staphylococcus aureus (SA) severe infection recurrence in such patients, both in our series and in the literature. In our opinion these results suggest the need to evaluate the possible benefits of SA nasal colonization screening and decolonization in such patients. PMID:24651092

Musso, Maria; Capone, Alessandro; Chinello, Pierangelo; Di Bella, Stefano; Galati, Vincenzo; Noto, Pasquale; Taglietti, Fabrizio; Topino, Simone; Petrosillo, Nicola

2014-03-01

370

Enzyme-linked immunosorbent assays for the detection of antibody to Crimean-Congo haemorrhagic fever virus in the sera of livestock and wild vertebrates.  

PubMed Central

IgM antibody response to Crimean-Congo haemorrhagic fever (CCHF) virus was monitored in experimentally infected sheep and cattle by an IgM capture enzyme-linked immunoassay (ELISA). Specific binding of antigen was detected by a rabbit anti-CCHF horseradish peroxidase conjugate or a sandwich technique with hyperimmune mouse anti-CCHF ascitic fluid and commercially available anti-mouse immunoglobulin peroxidase conjugate. The persistence of IgM antibody activity was found to be of shorter duration than in humans, and this may be a function of the relative lack of susceptibility of these animals to infection with CCHF virus. IgG antibody responses in the sheep could be monitored by sandwich ELISA using commercially available anti-sheep immunoglobulin peroxidase conjugates. Total antibody activity in the sera of experimentally infected sheep, cattle and small mammals could be monitored in a competitive ELISA (CELISA) using rabbit anti-CCHF peroxidase conjugate. The CELISA was applied to the sera of 960 wild vertebrates from a nature reserve in South Africa, and the prevalence of antibody was found to be greatest in large mammals such as rhinoceros, giraffe and buffalo, which are known to be the preferred hosts of the adult tick (Hyalomma) vectors of the virus. PMID:8270014

Burt, F. J.; Swanepoel, R.; Braack, L. E.

1993-01-01

371

The prevalence of maternal F cells in a pregnant population and potential overestimation of foeto-maternal haemorrhage as a consequence  

PubMed Central

Background Acid elution (AE) is used to estimate foeto-maternal haemorrhage (FMH). However AE cannot differentiate between cells containing foetal or adult haemoglobin F (F cells), potentially leading to false positive results or an overestimate of the amount of FMH. The prevalence of F cells in pregnant populations remains poorly characterised. The purpose of this study was to ascertain the incidence of HbF-containing red cells in our pregnant population using anti-HbF-fluorescein isothiocyanate flow cytometry (anti-HbF FC) and to assess whether its presence leads to a significant overestimate of FMH. Material and methods Eighty-eight pregnant patients were assessed for the presence of F cells and foetal red cells by AE and anti-HbF FC. The “FMH equivalent”, estimated by AE and anti-HbF FC, was calculated. Results Thirty-six percent of the pregnant population had F-cell populations detectable by anti-HbF FC while AE detected F cells in 48% of the population. The mean estimated FMH equivalent determined by AE and anti-HbF FC was 0.59 mL (0–23.93 mL) and 0.41 (0 to 2.19 mL), respectively (p=0.012). In 3% of our population, AE overestimated the FMH by >3 mL due to the presence of an F-cell population of at least 16%. Discussion Thirty-six percent of a prospectively evaluated group of consecutive pregnant women were found to have F-cell populations. In some patients, these findings were clinically significant as AE overestimated the degree of FMH as a consequence. PMID:24960639

Corcoran, Deirdre; Murphy, Deirdre; Donnelly, Jennifer C.; Ainle, Fionnuala Ni

2014-01-01

372

Training Traditional Birth Attendants on the Use of Misoprostol and a Blood Measurement Tool to Prevent Postpartum Haemorrhage: Lessons Learnt from Bangladesh  

PubMed Central

A consensus emerged in the late 1990s among leaders in global maternal health that traditional birth attendants (TBAs) should no longer be trained in delivery skills and should instead be trained as promoters of facility-based care. Many TBAs continue to be trained in places where home deliveries are the norm and the potential impacts of this training are important to understand. The primary objective of this study was to gain a more nuanced understanding of the full impact of training TBAs to use misoprostol and a blood measurement tool (mat) for the prevention of postpartum haemorrhage (PPH) at home deliveries through the perspective of those involved in the project. This qualitative study, conducted between July 2009 and July 2010 in Bangladesh, was nested within larger operations research, testing the feasibility and acceptability of scaling up community-based provision of misoprostol and a blood measurement tool for prevention of PPH. A total of 87 in-depth interviews (IDIs) were conducted with TBAs, community health workers (CHWs), managers, and government-employed family welfare visitors (FWVs) at three time points during the study. Computer-assisted thematic data analysis was conducted using ATLAS.ti (version 5.2). Four primary themes emerged during the data analysis, which all highlight changes that occurred following the training. The first theme describes the perceived direct changes linked to the two new interventions. The following three themes describe the indirect changes that interviewees perceived: strengthened linkages between TBAs and the formal healthcare system; strengthened linkages between TBAs and the communities they serve; and improved quality of services/service utilization. The data indicate that training TBAs and CHW supervisors resulted in perceived broader and more nuanced changes than simply improvements in TBAs’ knowledge, attitudes, and practices. Acknowledgeing TBAs’ important role in the community and in home deliveries and integrating them into the formal healthcare system has the potential to result in changes similar to those seen in this study. PMID:24847601

Passano, Paige; Bohl, Daniel D.; Islam, Arshadul; Prata, Ndola

2014-01-01

373

Haemorrhagic cystitis in haematopoietic stem cell transplantation (HSCT): a prospective observational study of incidence and management in HSCT centres within the GITMO network (Gruppo Italiano Trapianto Midollo Osseo)  

PubMed Central

Haemorrhagic cystitis (HC) is a recognised complication in patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT). This study evaluates the incidence and severity of HC in patients undergoing allogeneic HSCT during hospitalisation and within the first 100 days following transplant, looking at the use of prophylaxis, management of HC, outcomes at 100 days post transplant, and to identify any correlations between development of HC and the different conditioning regimens for transplant or HC prevention methods used. Results Four hundred and fifty patients (412 adult and 38 paediatric) were enrolled in this prospective, multicentre, and observational study. HC was observed in 55 patients (12.2%) of which 8/38 were paediatric (21% of total paediatric sample) and 47/412 adults (11.4% of total adult sample). HC was observed primarily in the non-related HSCT group (45/55; 81.8%, p= 0.001) compared to sibling and myeloablative transplant protocols (48/55; 87.3%; p= 0.008) and with respect to reduced intensity conditioning regimens (7/55;12.7%). In 33 patients with HC (60%), BK virus was isolated in urine samples, a potential co-factor in the pathogenesis of HC. The median day of HC presentation was 23 days post HSCT infusion, with a mean duration of 20 days. The most frequent therapeutic treatments were placement of a bladder catheter (31/55; 56%) and continuous bladder irrigation (40/55; 73%). The range of variables in terms of conditioning regimens and so on, makes analysis difficult. Conclusions This multi-centre national study reported similar incidence rates of HC to those in the literature. Evidence-based guidelines for prophylaxis and management are required in transplant centres. Further research is required to look at both prophylactic and therapeutic interventions, which also consider toxicity of newer conditioning regimens. PMID:24834115

Gargiulo, G; Orlando, L; Alberani, F; Crabu, G; Di Maio, A; Duranti, L; Errico, A; Liptrott, S; Pitrone, R; Santarone, S; Soliman, C; Trunfio, A; Selleri, C; Bruno, B; Mammoliti, S; Pane, F

2014-01-01

374

Does cryotherapy before drainage increase the risk of intraocular haemorrhage and affect outcome?. A prospective, randomised, controlled study using a needle drainage technique and sustained ocular compression  

PubMed Central

AIMS/BACKGROUND—A prospective, randomised, controlled clinical trial was conducted to investigate the effect of performing cryotherapy before drainage of subretinal fluid (SRF) on the incidence of intraocular haemorrhage (IOH) in the management of retinal detachment.?METHODS—Eighty eyes of 80 patients with rhegmatogenous retinal detachment requiring SRF drainage were recruited. Thirty four cases were randomised to receive drainage before cryotherapy (drainage, air injection, cryotherapy, and explant = DACE group) while 46 cases had drainage after cryotherapy (cryotherapy, drainage, air injection, and explant = CDAE group). All cases had trans-scleral drainage of SRF using a 27 gauge hypodermic needle combined with prolonged, intraocular hypertension.?RESULTS—There was a low incidence of IOH associated with drainage in both groups with no statistically significant difference between the groups (DACE group = 2.9%; CDAE group = 4.3%; p = 0.43). There was no significant difference between the groups in the rate of anatomical success with a single operation (DACE group = 82.4%; CDAE group = 86.9%; p = 0.38). There was no significant difference between the groups in the visual outcome. An improvement of two Snellen lines or more occurred in 52.9% of the DACE group and in 56.5% of the CDAE group (p = 0.93).?CONCLUSION—It was concluded that the surgical sequence of applying cryotherapy before drainage of SRF can be safely and effectively performed. The sequences CDAE and CDE, when air injection is not required, along with DACE should all be part of the surgical repertoire for the management of retinal detachments.?? PMID:9290370

Pearce, I; Wong, D; McGalliard, J; Groenewald, C

1997-01-01

375

A higher body temperature is associated with haemorrhagic transformation in patients with acute stroke untreated with recombinant tissue-type plasminogen activator (rtPA).  

PubMed

Higher body temperature is a prognostic factor of poor outcome in acute stroke. Our aim was to study the relationship between body temperature, HT (haemorrhagic transformation) and biomarkers of BBB (blood-brain barrier) damage in patients with acute ischaemic stroke untreated with rtPA (recombinant tissue-type plasminogen activator). We studied 229 patients with ischaemic stroke <12 h from symptom onset. Body temperature was determined at admission and every 6 h during the first 3 days. HT was evaluated according to ECASS II (second European Co-operative Acute Stroke Study) criteria in a multimodal MRI (magnetic resonance imaging) at 72 h. We found that 55 patients (34.1%) showed HT. HT was associated with cardioembolic stroke (64.2% against 23.0%; P<0.0001), higher body temperature during the first 24 h (36.9°C compared with 36.5°C; P<0.0001), more severe stroke [NIHSS (National Institutes of Health Stroke Scale) score, 14 (9-20) against 10 (7-15); P=0.002], and greater DWI (diffusion-weighted imaging) lesion volume at admission (23.2 cc compared with 13.2 cc; P<0.0001). Plasma MMP-9 (matrix metalloproteinase 9) (187.3 ng/ml compared with 44.2 ng/ml; P<0.0001) and cFn (cellular fibronectin) levels (16.3 ?g/ml compared with 7.1 ?g/ml; P=0.001) were higher in patients with HT. Body temperature within the first 24 h was independently associated with HT {OR (odds ratio), 7.3 [95% CI (confidence interval), 2.4-22.6]; P<0.0001} after adjustment for cardioembolic stroke subtype, baseline NIHSS score and DWI lesion volume. This effect remained unchanged after controlling for MMP-9 and cFn. In conclusion, high body temperature within the first 24 h after ischaemic stroke is a risk factor for HT in patients untreated with rtPA. This effect is independent of some biological signatures of BBB damage. PMID:21861843

Leira, Rogelio; Sobrino, Tomás; Blanco, Miguel; Campos, Francisco; Rodríguez-Yáñez, Manuel; Castellanos, Mar; Moldes, Octavio; Millán, Mónica; Dávalos, Antoni; Castillo, José

2012-02-01

376

Neutralisation of venom-induced haemorrhage by IgG from camels and llamas immunised with viper venom and also by endogenous, non-IgG components in camelid sera.  

PubMed

Envenoming by snakes results in severe systemic and local pathology. Intravenous administration of antivenom, prepared from IgG of venom immunised horses or sheep, is the only effective treatment of systemic envenoming. Conventional antivenoms, formulated as intact IgG, papain-cleaved (Fab) or pepsin-cleaved F(ab')2 fragments, are however ineffective against the local venom effects because of their inability to penetrate the blood/tissue barrier. We have embarked on a new research program to examine (i) whether the unusually small (15 kDa) antigen-binding fragment of camelid heavy chain IgG (V(H)H) can be exploited to neutralise the local effects of envenoming and (ii) whether a novel antivenom to treat both the systemic and local effects of envenoming can be formulated by combining anti-snake venom V(H)H and conventional F(ab')2. In this preliminary study, we demonstrate that camels and llamas respond to immunisation with Echis ocellatus venom with high antibody titres and broad antigen specificity. These encouraging immunological results were matched by the successful elimination of venom-induced haemorrhage by IgG from the venom-immunised camels and llamas. Unexpectedly, we report for the first time that camelid serum contains a non-IgG, highly potent inhibitor of venom-induced haemorrhage. PMID:16359717

Harrison, R A; Hasson, S S; Harmsen, M; Laing, G D; Conrath, K; Theakston, R D G

2006-03-01

377

Bacterial septicaemia in prerecruit edible crabs, Cancer pagurus L.  

PubMed

Juvenile edible crabs, Cancer pagurus L., were surveyed from Mumbles Head and Oxwich Bay in South Wales, UK, and the number of heterotrophic bacteria and vibrios in the hemolymph was determined. The percentage of crabs with hemolymph containing bacteria was variable over the survey with higher numbers of animals affected in summer than in winter. Post-moult crabs contained significantly higher numbers of heterotrophic bacteria in the hemolymph than pre- and intermoult animals. Crabs with cuticular damage to the gills also had significantly higher numbers of bacteria in the hemolymph. Crabs were found to have a high prevalence of infection by the dinoflagellate, Hematodinium. Such animals had significantly fewer bacteria in the blood in comparison with Hematodinium-free animals. Of the 463 crabs surveyed, only 3 individuals had hemolymph containing 2000 + CFU mL(-1). Based on 16S rRNA gene sequences, two of these crabs contained a Vibrio pectenicida-like isolate, while the other had a mixed assemblage of vibrios. Although 59% of the crabs surveyed had culturable bacteria in the hemolymph, the majority only had small numbers (<2000 CFU mL(-1) ), suggesting that such infections may be of limited importance to the sustainability of the crab fishery in this region. PMID:23962351

Smith, A L; Whitten, M M A; Hirschle, L; Pope, E C; Wootton, E C; Vogan, C L; Rowley, A F

2014-08-01

378

Aetiology of Neonatal Septicaemia in Qatif, Saudi Arabia.  

ERIC Educational Resources Information Center

Of the 1,797 babies admitted to a hospital in Saudi Arabia over a 3-year period, 8% were documented as having NNS. Identified several gram-positive bacteria, several gram-negative bacteria, and candida albicans as etiological agents in the cases of NNS. Determined the antibiotic susceptibility of the bacteria. (BC)

Elbashier, Ali M.; And Others

1994-01-01

379

Childhood Septicaemia Due To Salmonella Species in Ibadan, Nigeria  

Microsoft Academic Search

A cross sectional study to assess the incidence and antibiotic sensitivity patterns of Salmonella isolates in septicaemic children who were presented at the children's emergency unit and children out -patient clinic, University College Hospital, Ibadan was undertaken. A total of 442 samples from children (6 months and 11 years) with the history of fever were investigated, using blood culture method.

380

Development of an indirect ELISA method for the parallel measurement of IgG and IgM antibodies against Crimean-Congo haemorrhagic fever (CCHF) virus using recombinant nucleoprotein as antigen.  

PubMed

Recombinant nucleoprotein from Crimean-Congo Haemorrhagic Fever (CCHF) virus was successfully derived from a baculovirus expression system and purified for use in a novel enzyme-linked immunosorbent assay (ELISA) diagnostic test. Comparable tests were used for detection of IgG and IgM antibodies, thus allowing efficient detection of both antibodies in parallel. The major benefits of the assay also included removing any requirement for polyclonal sera, thus eliminating variation in preparations and allowing standardisation between laboratories. The assay was successfully tested using a panel of positive sera supplied from samples identified as being positive in Turkey, Tajikistan and Kosovo and shown to be sensitive and specific. It is envisaged that this simple diagnostic ELISA for CCHF virus infection which removes the reliance on polyclonal antibody preparations, will be accessible to a wider range of laboratories enabling them to carry out routine diagnosis. This will improve the efficiency of diagnosis and subsequent management of infected patients. PMID:22155577

Dowall, S D; Richards, K S; Graham, V A; Chamberlain, J; Hewson, R

2012-02-01

381

Complete Genome Sequence and Comparative Analysis of the Fish Pathogen Lactococcus garvieae  

Microsoft Academic Search

Lactococcus garvieae causes fatal haemorrhagic septicaemia in fish such as yellowtail. The comparative analysis of genomes of a virulent strain Lg2 and a non-virulent strain ATCC 49156 of L. garvieae revealed that the two strains shared a high degree of sequence identity, but Lg2 had a 16.5-kb capsule gene cluster that is absent in ATCC 49156. The capsule gene cluster

Hidetoshi Morita; Hidehiro Toh; Kenshiro Oshima; Mariko Yoshizaki; Michiko Kawanishi; Kohei Nakaya; Takehito Suzuki; Eiji Miyauchi; Yasuo Ishii; Soichi Tanabe; Masaru Murakami; Masahira Hattori

2011-01-01

382

And We Were Sad, Remember (Open-Captioned) (VHS 1/2 inch and text) (Video).  

National Technical Information Service (NTIS)

Shows how our attempts to conceal death from children are not only ineffective, but harmful to children. Shows why children need to know about death, and how parents can help children deal with death when it happens.

1978-01-01

383

An integrated system: virtual reality, haptics and modern sensing technique (VHS) for post-stroke rehabilitation  

Microsoft Academic Search

In this paper, we introduce an interdisciplinary project, involving researchers from the fields of Physical Therapy, Computer Science, Psychology, Communication and Cell Neurobiology, to develop an integrated virtual reality, haptics and modern sensing technique system for post-stroke rehabilitation. The methodology to develop the system includes identification of movement pattern, development of simulated task and diagnostics. Each part of the methodology

Shih-Ching Yeh; Albert A. Rizzo; Weirong Zhu; Jill Stewart; Margaret McLaughlin; Isaac Cohen; Younbo Jung; Wei Peng

2005-01-01

384

Turkey Operation - Year Round Production (VHS 3/4 inch) (Video).  

National Technical Information Service (NTIS)

Turkey operations are at greater risk since turkeys are more sensitive to disease than other commercial poultry. Turkeys also require longer to mature and need more contact with people. Range turkeys require different biosecurity procedures since it is ha...

1989-01-01

385

Benjamin O. Davis, Jr - American (VHS 1/2 inch) (Video).  

National Technical Information Service (NTIS)

The video is about Benjamin O. Davis, Jr., the first black to graduate from West Point in the 20th century. Davis led the all black Tuskegee Airmen into aerial combat during World War II. In a lecture given at the Smithsonian Institution National Air and ...

1991-01-01

386

Van Hove excitons and high-Tc superconductivity VIIIB. vHs - Jahn-Teller effect  

Microsoft Academic Search

This paper considers the structurak phase transitions of La2-xBaxCuO4 in a detailed model describing the tilting of the O octahedra (optical modes), strains (acoustic modes), and electrons near the two saddle points (X, Y) of the Brillouin zone. The model contains nonlinear terms in the tilting part, strain-tilting coupling, and electron-tilting coupling, which is new and important in discussing the

R. S. Markiewicz

1992-01-01

387

AZT Therapy for Early HIV Infection (VHS 1/2 inch and text) (Video).  

National Technical Information Service (NTIS)

The video presents highlights from a state-of-the-art meeting on early intervention in HIV infection, convened by the National Institute of Allergy and Infectious Diseases in 1990. It will provide health professionals with guidelines for the treatment of ...

1990-01-01

388

Low cholesterol, statin therapy, and intracerebral haemorrhage  

Microsoft Academic Search

To the Editor—It is well known that cholesterol is essential for normal membrane fluidity, and adequate cholesterol levels seem to be important for maintaining the integrity of small cerebral vessels and their resistance to rupture. Although epidemiological studies have failed to associate cerebral infarction and cholesterol, they have found an inverse relation between cholesterol levels and the incidence of intracerebral

Luca Mascitelli; Francesca Pezzetta

2009-01-01

389

Recovery of Hafnia alvei from diseased brown trout, Salmo trutta L., and healthy noble crayfish, Astacus astacus (L.), in Bulgaria.  

PubMed

Hafnia alvei was isolated in Bulgaria from healthy noble crayfish, Astacus astacus (L.), and then from farmed diseased brown trout, Salmo trutta L., with signs of haemorrhagic septicaemia. The isolates were identified initially with conventional phenotyping and commercial Merlin Micronaut and API 20E rapid identification systems, followed by sequencing of the 16S rRNA gene. Hafnia alvei Bt1, Bt2 and Aa4 were of low virulence to rainbow trout and brown trout, although cytotoxicity was demonstrated by Bt1 and Bt2, but not by Aa4. PMID:24422558

Orozova, P; Sirakov, I; Chikova, V; Popova, R; Al-Harbi, A H; Crumlish, M; Austin, B

2014-10-01

390

Managing Meningococcal Disease (Septicaemia or Meningitis) in Higher Education Institutions. Guidelines  

ERIC Educational Resources Information Center

Students face many pressures today--pressure to be successful, financial worries and uncertainty about future career prospects. Good health is often taken for granted. It has taken publicity about recurring cases on meningococcal disease at university to bring home to students, universities and their associated doctors that students are at risk.…

Universities UK, 2004

2004-01-01

391

Sourced from EVERYBODY.co.nz About meningitis and meningococcal septicaemia  

E-print Network

. Escherichia coli (E. coli) and group B streptococcal bacteria can also cause meningitis in newborn babies, weeks or months without becoming ill and carrying the bacteria can help to make you more immune. The bacteria which can cause meningitis in newborn babies are commonly found in the intestine and vagina. Signs

Hickman, Mark

392

Septicaemia models using Streptococcus pneumoniae and Listeria monocytogenes: understanding the role of complement properdin.  

PubMed

Streptococcus pneumoniae and Listeria monocytogenes, pathogens which can cause severe infectious disease in human, were used to infect properdin-deficient and wildtype mice. The aim was to deduce a role for properdin, positive regulator of the alternative pathway of complement activation, by comparing and contrasting the immune response of the two genotypes in vivo. We show that properdin-deficient and wildtype mice mounted antipneumococcal serotype-specific IgM antibodies, which were protective. Properdin-deficient mice, however, had increased survival in the model of streptococcal pneumonia and sepsis. Low activity of the classical pathway of complement and modulation of Fc?R2b expression appear to be pathogenically involved. In listeriosis, however, properdin-deficient mice had reduced survival and a dendritic cell population that was impaired in maturation and activity. In vitro analyses of splenocytes and bone marrow-derived myeloid cells support the view that the opposing outcomes of properdin-deficient and wildtype mice in these two infection models is likely to be due to a skewing of macrophage activity to an M2 phenotype in the properdin-deficient mice. The phenotypes observed thus appear to reflect the extent to which M2- or M1-polarised macrophages are involved in the immune responses to S. pneumoniae and L. monocytogenes. We conclude that properdin controls the strength of immune responses by affecting humoral as well as cellular phenotypes during acute bacterial infection and ensuing inflammation. PMID:24728387

Dupont, Aline; Mohamed, Fatima; Salehen, Nur'Ain; Glenn, Sarah; Francescut, Lorenza; Adib, Rozita; Byrne, Simon; Brewin, Hannah; Elliott, Irina; Richards, Luke; Dimitrova, Petya; Schwaeble, Wilhelm; Ivanovska, Nina; Kadioglu, Aras; Machado, Lee R; Andrew, Peter W; Stover, Cordula

2014-08-01

393

Profile of Neonatal Septicaemia at a District-level Sick Newborn Care Unit  

PubMed Central

Although sepsis is a major cause of morbidity and mortality among newborns in resource-poor countries, little data are available from rural areas on culture-proven sepsis. The aim of the present study was to provide information in this regard. The study reports results on the incidence and aetiology of neonatal sepsis cases admitted to a facility in a rural area in eastern India. Blood culture was done for all babies, with suspected clinical sepsis, who were admitted to the sick newborn care unit at Suri where the study was conducted during March 2009–August 2010. A standard form was used for collecting clinical and demographic data. In total, 216 neonatal blood culture samples were processed, of which 100 (46.3%) grew potential pathogens. Gram-negative infection was predominant (58/100 cases) mainly caused by enteric Gram-negative bacteria. Klebsiella pneumoniae was the most common Gram-negative isolate. The emergence of fungal infection was observed, with 40% of the infection caused by yeast. Gram-negative organisms exhibited 100% resistance to ampicillin, cefotaxime, and gentamicin. Amikacin and co-trimoxazole showed 95% (n=57) resistance, and ciprofloxacin showed 83.3% (n=50) resistance among the Gram-negative bacteria. Carbapenem showed emerging resistance (n=4; 6.6%). Results of analysis of risk factors showed an extremely significant association between gestation and sepsis and gender and sepsis. Gastrointestinal symptoms were highly specific for fungal infections. One-third of babies (n=29), who developed culture-positive sepsis, died. Blood culture is an investigation which is frequently unavailable in rural India. As a result, empirical antibiotic therapy is commonly used. The present study attempted to provide data for evidence-based antibiotic therapy given to sick newborns in such rural units. The results suggest that there is a high rate of antibiotic resistance in rural India. Urgent steps need to be taken to combat this resistance. PMID:22524118

Singh, Arun K.; Ghosh, Chiranjib; Dasgupta, Sudipta; Mukherjee, Suchandra; Basu, Sulagna

2012-01-01

394

Changing patterns in sensitivity of causative organisms of septicaemia in children: the need for quinolones.  

PubMed

A review of the pattern, and antibiotic sensitivities of blood culture isolates over a 3 year period in children presenting to the Paediatric Unit of Ahmadu Bello University Teaching Hospital, Kaduna is reported. Positive blood culture isolates were obtained in 26.9% of 1,982 children. The most prevalent isolates were Staphylococcus aureus (59.9%), Escherichia coli (16.9%) and Klebsiella (16.3%). There was a striking paucity of isolation of Salmonella typhi (1.3%) and Streptococcus. Sensitivity to commonly used drugs like ampicillin/cloxacillin, genticin, ceftazidime and chloramphenicol was low (8.0-50.0%), with a corresponding delayed fever resolution and prolonged hospital stay. 31.0-83.3% of the isolates were highly sensitive to pefloxacin, norfloxacin and ofloxacin, which were not generally recommended for use in paediatric patients. In two patients with no response to commonly used antibiotics, use of quinolones lysed their fever within 48 hours. This change of antibiotic sensitivity patterns calls for a thorough investigation into the potential role of these quinolones in paediatric chemotherapeutics either singly or in appropriate combinations with existing antibiotics. PMID:15490798

Orogade, A A; Akuse, R M

2004-03-01

395

Trends in Mortality from Septicaemia and Pneumonia with Economic Development: An Age-Period-Cohort Analysis  

Microsoft Academic Search

BackgroundHong Kong population has experienced drastic changes in its economic development in the 1940s. Taking advantage of Hong Kong’s unique demographic and socioeconomic history, characterized by massive, punctuated migration waves from Southern China, and recent, rapid transition from a pre-industrialized society to the first ethnic Chinese community reaching “first world” status over the last 60 years (i.e., in two or

Irene O. L. Wong; Benjamin J. Cowling; Gabriel M. Leung; C. Mary Schooling

2012-01-01

396

Repetitive episodes of cryptogenic septicaemia in a patient with cirrhosis: a case of "heavy metal".  

PubMed

Endotipsitis or primary infection of a TIPS-stent, is an uncommon but possible life- threatening condition by its potential evolution to sepsis and death. Diagnosis should be suspected in patients with a TIPS-stent presenting with stent-dysfunction associated with fever or relapsing episodes of bacteremia/sepsis without any other alternative focus. A certain diagnosis is made by post-factum histopathological and/or microbiological examination of the TIPS-stent which is only possible after liver transplantation or at autopsy, whereas it can be highly suspected in case of repetitive positive blood-cultures without any other focus in a patient with a TIPS-stent. The microorganisms responsible for endotipsitis are most frequently of Gram-negative enteric origin. The regimen and duration of the treatment should be individualized and depends on multiple factors like the antibiotic sensitivity of the organism and the patients condition. In case of a fungal infection, longer treatment is recommended. PMID:21563658

Mortier, L; Stockmans, G; Maleux, G; Heye, S; Aerts, R; Monbaliu, D; Darius, T; Pirenne, J; Meersseman, P; George, C; Van Steenbergen, W; Cassiman, D; Verslype, C; Nevens, F; Laleman, W

2011-03-01

397

Spontaneous septicaemia with multi-organ dysfunction--a new face for Pantoe agglomerans?  

PubMed

Pantoe agglomerans (P. agglomerans) is an unusual cause for sepsis in immunocompetent individuals, especially in the absence of characteristic risk factors. We report one such case occurring in a farmer, manifesting with severe illness. The severe nature of illness and the apparently spontaneous origin of septicemia underline the pathogenic potential of this organism. When coupled with the ubiquity of the organism, there is a definite possibility that this disease may become increasingly frequent in the near future, especially in agronomic countries like India. Further studies on the epidemiology and natural history of this disease are required. PMID:22182651

Naha, Kushal; Ramamoorthi; Prabhu, Mukhyaprana

2012-01-01

398

Fractured Patterns - A History of BLM: Part 1 and 2 (VHS 1/2 and text) (Video).  

National Technical Information Service (NTIS)

The training package consists of a two-part video program and a printed chronology of major milestones in the management of the public lands. Part 1, 'The Public Disposal Era', provides a general overview of public land policies and their effects on land ...

1987-01-01

399

Mehr Mut zur Intensivierung des VHS-Sprachunterrichts (An Encouragement to Intensify Language Instruction in the People's Universities)  

ERIC Educational Resources Information Center

Discusses aspects of the intensified foreign language program at the People's Universities, on the basis of a summer program in Mainz. This course drew more men than women. There was a higher percentage of students finishing than in regular courses. Occupational and educational motives predominated. (Text is in German.) (IFS/WGA)

Reiske, Renate

1977-01-01

400

Olympic Spirit: Building Resiliency in Youth (Closed Captioned) (VHS 1/2 inch, activity guide and other printed material) (Video).  

National Technical Information Service (NTIS)

This video and accompanying activity guide are designed to provide teachers with a creative and engaging approach to supplementing classroom drug and violence prevention lessons. Themes for this project are drawn from the Olympic Games, as well as the Par...

1995-01-01

401

Myron Kebus, M.S., DVM Wisconsin Department of Agriculture, Trade & Consumer  

E-print Network

requirements AFS Bluebook Standards VHS testing and surveillance result Epidemiology Fish farm record farms 70 fish per group 560 fish total All VHS negative VHS testing has greatly increased VHS has not been found on fish farms Compliance with VHS testing requirements is good Demand for funds for VHS

Kane, Andrew S.

402

Fatal intracerebral haemorrhage secondary to Aspergillus arteritis following aneurysm clipping.  

PubMed

Abstract Cerebral aspergillosis is rare and presents a high mortality. We report a case of cerebral aspergillosis following elective clipping of an intracerebral aneurysm and review the literature surrounding the topic. Early diagnosis and aggressive treatment maximizes survival rates. PMID:25076112

Halliday, Jane; Joseph, Jacob A; Gurusinghe, Nihal T

2014-12-01

403

Organising pneumonia presenting as acute life threatening pulmonary haemorrhage  

PubMed Central

Organising pneumonia, previously called bronchiolitis obliterans organising pneumonia is a clinicopathological entity of unknown aetiology, which has been reported with increasing frequency. Various modes of presentation have been described such as cough, fever, weight loss and alveolar opacities on chest radiograph. Haemoptysis as primary presenting symptom has only rarely been reported. The authors report a case in which massive life-threatening haemoptysis was the major presenting symptom. No aetiology was identified for the haemoptysis and the diagnosis was confirmed on postmortem histology. This case highlights the importance of considering organising pneumonia in the differential diagnosis of acute severe haemoptysis. PMID:22674096

Narasimhaiah, Damodhara Honnavally; Chakravorty, Indranil; Swamy, Rajiv; Prakash, Doraiswamy

2011-01-01

404

Severe rectal haemorrhage after treatment for faecal incontinence  

PubMed Central

Bulking agent injected submucosally is an alternative effective treatment for faecal incontinence in elderly patients who fail conservative measures. Since most elderly patients are on antiplatelet therapy and are sometimes unaware of their medication, this can lead to serious complications. PMID:25180215

Taggarshe, Deepa; Visco, Jeffrey J.

2014-01-01

405

Leukocytoclastic vasculitis presenting with acute haemorrhagic oedema of the scrotum  

PubMed Central

Fournier’s gangrene is a form of rapidly progressive necrotising fasciitis involving the soft tissues of the male genitalia. The treatment for this urologic emergency is immediate surgical debridement. Misdiagnosis of Fournier’s may lead to unnecessary surgical interventions, making careful recognition of systemic signs of illness crucial. The authors present a case of a 48-year-old patient who presented emergently with massive scrotal oedema, erythema and pain suspicious for Fournier’s gangrene and systemic signs of illness, including palpable purpura and leukocytoclastic vasculitis on biopsy. PMID:22679273

Reyner, Karina; Dahm, Philipp

2011-01-01

406

Traumatic intraperitoneal haemorrhage. Diagnosis by paracentesis and lavage.  

PubMed Central

A method is described for detecting blood in the peritoneal cavity in cases of blunt abdominal trauma. It involves introducing a peritoneal dialysis catheter through a single puncture site in the anterior abdominal wall and in some cases performing lavage. Fifty cases have been investigated by this method and the results are presented. PMID:1147533

Tucker, J. K.; Hurlow, R. A.; Mahajan, K. K.

1975-01-01

407

Clinical audit: a useful tool for reducing severe postpartum haemorrhages?1 Running title: Audit of postpartum haemorrhage2  

E-print Network

criteria-based audits on the prevalence of severe PPH.10 Design. Quasi-experimental before-and-after survey the performance17 rate for each recommended procedure. Differences in these variables between 2005 and 2008 were18

408

9 CFR 93.916 - Special provisions.  

...IMPORTATION OF CERTAIN ANIMALS, BIRDS, FISH, AND POULTRY, AND CERTAIN ANIMAL... General Provisions for Vhs-Regulated Fish Species § 93.916 Special provisions. (a) Slaughter. Live VHS-regulated fish from VHS-regulated regions may be...

2014-01-01

409

9 CFR 93.912 - Import permits.  

...IMPORTATION OF CERTAIN ANIMALS, BIRDS, FISH, AND POULTRY, AND CERTAIN ANIMAL...General Provisions for Vhs-Regulated Fish Species § 93.912 Import permits. (a) Live VHS-regulated fish imported from VHS-regulated...

2014-01-01

410

The Media and Reserve Library, located in the lower level of the west wing, has over 13,000 videotapes, DVDs and audiobooks covering a multitude of subjects. Below is a listing of titles currently available on the topic of Art. For more information on the  

E-print Network

-4502 Age of Anxiety VHS-4359 Age of Consent (Michael Powell) DVD-4779 Age of Reason: Age of Passion VHS-5255 Agony and the Ecstasy DVD-3308 American Splendor DVD-4828 Ancient Africans VHS-1538 Andrei Rublev

Saldin, Dilano

411

Spill prevention control and countermeasure training series, parts 1-4: The law, drilling for oil (vhs 1/2 inch) (video). Audiovisual  

SciTech Connect

This video gives: an overview of the SPCC regulations, regulated community, and SPCC plan requirements; an overview of OPA `90 FRP requirements; a general description of where oil is found; an explanation of drilling operations and equipment; a description of well completion process, well fluid flow, and complete well configurations; and inspection and SPCC requirements as drilling and well sites.

NONE

1994-12-31

412

Detection of VHSV IVb within the gonads of Great Lakes fish using in situ hybridization.  

PubMed

Viral haemorrhagic septicaemia virus (VHSV) genotype IVb was recently detected as the cause of numerous mortality events in Great Lakes fish. In situ hybridization was used to examine the gonads from 13 fish, including freshwater drum Aplodinotus grunniens and muskellunge Esox masquinongy that were infected naturally, as well as rainbow trout Oncorhynchus mykiss and fathead minnows Pimphales promelas, which were experimentally infected. Although the ovaries and testes of fish infected by VHSV IVb had few lesions, viral RNA was present in the ovaries of the rainbow trout and fathead minnow and was abundant in the gonads of muskellunge and in the ovaries of freshwater drum. Viral RNA was present mainly surrounding yolk vacuoles/granules or adjacent to the germinal vesicle, with lesser amounts found within the germinal vesicle, in the mesovarium and/or tunica albuginea and blood vessels of the ovary. Viral RNA was also found in and surrounding primary and secondary spermatocytes of the muskellunge. PMID:21797039

Al-Hussinee, L; Lumsden, J S

2011-05-24

413

Overview of recent DNA vaccine development for fish  

USGS Publications Warehouse

Since the first description of DNA vaccines for fish in 1996, numerous studies of genetic immunisation against the rhabdovirus pathogens infectious haematopoietic necrosis virus (IHNV) and viral haemorrhagic septicaemia virus (VHSV) have established their potential as both highly efficacious biologicals and useful basic research tools. Single small doses of rhabdovirus DNA constructs provide extremely strong protection against severe viral challenge under a variety of conditions. DNA vaccines for several other important fish viruses, bacteria, and parasites are under investigation, but they have not yet shown high efficacy. Therefore, current research is focussed on mechanistic studies to understand the basis of protection, and on improvement of the nucleic acid vaccine applications against a wider range of fish pathogens.

Kurath, G.

2005-01-01

414

Causes of death in calves with experimentally induced bovine neonatal pancytopenia (BNP).  

PubMed

The objective of this study was to identify the different causes of death in calves affected with bovine neonatal pancytopenia (BNP). A total of 51 precolostral calves were fed with colostrum from cows which had lost at least one calf after parturition due to BNP in previous lactations. Clinical BNP could be induced in 71% (36/51) and subclinical BNP in 20% (10/51) of the calves. 9% (5/51) of the calves stayed BNP-unaffected despite challenging with the same mixed colostrum and approved passive transfer of colostral antibodies. The case fatality rate in BNP-affected cases was 83% (38/46). In the 38 lethal BNP-cases gross-pathological and histopathological examinations were performed. BNP-induced haemorrhagic anaemia was the cause of death in 18 calves (47%). 19 of these lethal cases (50%) died due to infectious diseases, especially due to pneumonia, enteritis and septicaemia. One calf died due to severe enteritis and exsiccosis without any signs of BNP (3%). In conclusion, anaemia as the consequence of haemorrhages was the most prevalent cause of death in BNP-affected calves, however, BNP has been approved to increase the lethality of common infectious neonatal diseases. PMID:24490345

Henniger, Pauline; Henniger, Thomas; Seehusen, Frauke; Distl, Ottmar; Ganter, Martin

2014-01-01

415

Variation in the agr-dependent expression of ?-toxin and protein A among clinical isolates of Staphylococcus aureus from patients with septicaemia  

Microsoft Academic Search

In Staphylococcus aureus synthesis of many virulence factors is regulated by the agr locus. The regulatory molecule RNAIII, induced by agr, activates transcription of the ?-toxin gene, hla, while it acts as a repressor of the protein A gene, spa. Forty clinical strains of S. aureus from human blood cultures were analysed for ?-toxin and protein A production. An inverse

S Li; S Arvidson; R Möllby

1997-01-01

416

Selective Ablation of Virion Host Shutoff Protein RNase Activity Attenuates Herpes Simplex Virus 2 in Mice?  

PubMed Central

The virion host shutoff (vhs) protein of herpes simplex virus (HSV) has endoribonuclease activity and rapidly reduces protein synthesis in infected cells through mRNA degradation. Herpes simplex virus 1 (HSV-1) and HSV-2 vhs mutants are highly attenuated in vivo, but replication and virulence are largely restored to HSV-2 vhs mutants in the absence of a type I interferon (IFN) response. The role of vhs in pathogenesis and the hindrance of the type I IFN response have classically been examined with viruses that completely lack vhs or express a truncated vhs protein. To determine whether RNase activity is the principal mechanism of vhs-mediated type I IFN resistance and virulence, we constructed a HSV-2 point mutant that synthesizes full-length vhs protein lacking RNase activity (RNase? virus). Wild-type and mutant HSV-2 vhs proteins coimmunoprecipitated with VP16 and VP22. vhs protein bearing the point mutation was packaged into the virion as efficiently as the wild-type vhs protein. Like a mutant encoding truncated vhs, the RNase? virus showed IFN-dependent replication that was restricted compared with that of the wild-type virus. The RNase? virus was highly attenuated in wild-type mice infected intravaginally, with reduced mucosal replication, disease severity, and spread to the nervous system comparable to those of the vhs truncation mutant. Surprisingly, in alpha/beta interferon (IFN-?/?) receptor knockout mice, the vhs RNase mutant was more attenuated than the vhs truncation mutant in terms of disease severity and virus titer in vaginal swabs and central nervous system samples, suggesting that non-enzymatically active vhs protein interferes with efficient virus replication. Our results indicate that vhs enzymatic activity plays a complex role in vhs-mediated type I IFN resistance during HSV-2 infection. PMID:18234805

Korom, Maria; Wylie, Kristine M.; Morrison, Lynda A.

2008-01-01

417

Hereditary haemorrhagic telangiectasia in a patient taking anticoagulant drugs who has sustained facial trauma.  

PubMed

The authors present the case of a 41-year-old patient with hereditary hemorrhagic telangiectasia (HHT), who in the past had an aortic valve replacement surgery, currently takes anticoagulant drugs and has sustained an extensive trauma to the nose as a result of a dog bite. The HHT is diagnosed basing on the presence of at least three out of four symptoms or signs: spontaneous epistaxis, vascular lesions in the internal organs, skin telangiectasias and a family history of the disease. The presented patient showed hepatic angioma, history of recurrent bleeding from the tongue and spontaneous epistaxis as well as numerous skin telangiectasias. In his case, HHT coincided with chronic treatment with coagulants implemented after an implantation of the artificial aortic replacement valve, what substantially modified the clinical picture and course of treatment. PMID:24278075

Kami?ski, Bart?omiej; B?ochowiak, Katarzyna; Olek-Hrab, Karolina; Sokalski, Jerzy; Witmanowski, Henryk

2013-06-01

418

Hereditary haemorrhagic telangiectasia in a patient taking anticoagulant drugs who has sustained facial trauma  

PubMed Central

The authors present the case of a 41-year-old patient with hereditary hemorrhagic telangiectasia (HHT), who in the past had an aortic valve replacement surgery, currently takes anticoagulant drugs and has sustained an extensive trauma to the nose as a result of a dog bite. The HHT is diagnosed basing on the presence of at least three out of four symptoms or signs: spontaneous epistaxis, vascular lesions in the internal organs, skin telangiectasias and a family history of the disease. The presented patient showed hepatic angioma, history of recurrent bleeding from the tongue and spontaneous epistaxis as well as numerous skin telangiectasias. In his case, HHT coincided with chronic treatment with coagulants implemented after an implantation of the artificial aortic replacement valve, what substantially modified the clinical picture and course of treatment. PMID:24278075

Kaminski, Bartlomiej; Olek-Hrab, Karolina; Sokalski, Jerzy; Witmanowski, Henryk

2013-01-01

419

Emergency Liver Resection with Staplers for Spontaneous Liver Haemorrhage in a Patient Receiving Anticoagulant Therapy  

PubMed Central

Introduction. Emergency liver resection during active bleeding in a patient who takes anticoagulant therapy is a complicated and high-risk surgery. Aim. We described a technique that is combination of staplers, total hepatic vascular occlusion, and hemostatic agent (TachoSil) application for safe and quick hepatectomy. Patient and Method. A 72-year-old woman who uses warfarin regularly due to valvuloplasty admitted emergency unit with abdominal pain and shock. At admission, her hemoglobin, hematocrit, and INR values were 5.2?g/dL, 14.9%, and 6.7, respectively. Radiologic evaluation revealed abdominal free fluid and a liver lesion on segments V, VI, and VII. Emergency laparotomy was required. There was an active bleeding from a liver hematoma that could not be controlled by packing, and an urgent hepatic resection was required. Under total hepatic vascular occlusion, segments V, VI, and VII were resected with endoscopic nonvascular staplers. Cut surface of the liver was coagulated with bipolar cautery and covered with a hemostatic material. Results. Hepatectomy took six minutes, and the duration of surgery was 80 minutes. There was no complication and no transfusion required after surgery, and the patient was discharged on 8th day, uneventfully. Conclusion. Emergency hepatectomy with staplers, under vascular control with hemostatic agents, provided a rapid and safe surgery. PMID:23935634

Kutlutürk, Koray; Soyer, Vural; Dirican, Abuzer; Unal, Bulent; Aydin, Cemalettin; Kayaalp, Cuneyt; Yilmaz, Sezai

2013-01-01

420

Emergency liver resection with staplers for spontaneous liver haemorrhage in a patient receiving anticoagulant therapy.  

PubMed

Introduction. Emergency liver resection during active bleeding in a patient who takes anticoagulant therapy is a complicated and high-risk surgery. Aim. We described a technique that is combination of staplers, total hepatic vascular occlusion, and hemostatic agent (TachoSil) application for safe and quick hepatectomy. Patient and Method. A 72-year-old woman who uses warfarin regularly due to valvuloplasty admitted emergency unit with abdominal pain and shock. At admission, her hemoglobin, hematocrit, and INR values were 5.2?g/dL, 14.9%, and 6.7, respectively. Radiologic evaluation revealed abdominal free fluid and a liver lesion on segments V, VI, and VII. Emergency laparotomy was required. There was an active bleeding from a liver hematoma that could not be controlled by packing, and an urgent hepatic resection was required. Under total hepatic vascular occlusion, segments V, VI, and VII were resected with endoscopic nonvascular staplers. Cut surface of the liver was coagulated with bipolar cautery and covered with a hemostatic material. Results. Hepatectomy took six minutes, and the duration of surgery was 80 minutes. There was no complication and no transfusion required after surgery, and the patient was discharged on 8th day, uneventfully. Conclusion. Emergency hepatectomy with staplers, under vascular control with hemostatic agents, provided a rapid and safe surgery. PMID:23935634

Kutlutürk, Koray; Soyer, Vural; Dirican, Abuzer; Unal, Bulent; Aydin, Cemalettin; Kayaalp, Cuneyt; Yilmaz, Sezai

2013-01-01